RESULTS OF BLOOD FLOW’S INVESTIGATION IN THE MICROVASCULAR PULP AT PATIENTS WITH CARIES AND PULPITIS REQUIRING TREATMENT WITH ANESTHESIA

  • V.N. Kulygina N. I. Pirogov Vinnitsya National Medical University
  • O.V. Muntian N. I. Pirogov Vinnitsya National Medical University
Keywords: local anesthesia, caries of the teeth, pulpitis, laser Doppler fluometry.

Abstract

Recently in dentistry for determination of microcirculation in different tissues of the maxillofacial area became widespread using functional method of laser Doppler fluometry (LDF). Certain importance of this method has a microcirculation’s character for diagnosis and choice of treatment of pulpitis. However, only in single researches the study of dental pulp’s microcirculation before and during the local anesthesia at pulpitis using non-invasive and most informative method of LDF has been conducted.

The aim to determine the state of blood flow in the microvasculature pulp in patients with caries and pulpitis that require treatment with local anesthesia  using LDF.

Materials and methods. To achieve study of capillary blood flow using LDF research of 109 patients with acute deep caries, 18 – acute traumatic pulpitis and pulp hyperemia, 25 – acute and chronic forms of pulpitis requiring dental treatment with local anesthesia aged from 20 to 49 years old. 30 healthy individuals with absence of carious lesions and pulpitis of similar teeth’s groups and identical age period served as control.

Results of research. The use of non-invasive, safe and highly sensitive method of LDF with spectral analysis fluctuations of blood flow can adequately assess the degree of microcirculatory disturbances in dental pulp in acute deep caries and different forms of pulpitis.

At acute deep caries established significant changes in microcirculatory blood flow in the pulp of the tooth compared with the control group, characterized by an increase in capillary blood flow indicator in 2.9 times (p <0.001) and decrease in the value of variability of red blood cells flow in 1.5 times (p <0 , 05) and microvascular vasomotor activity in 4.5 times (p <0.001). According to Wavelet analysis violation in the system of pulp’s blood supply accompanied by a significant decrease of active flaxmotion components (epithelial, neurogenic, myogenic) at the same time unreliable - passive (respiratory and cardiac), myogenic and neurogenic components of microvessel’s tone and value of shunt and nutritional blood flow. It’s indicates on possibility of blood flow’s recovering in the microcirculation of the pulp and its function at choosing appropriate local anesthesia and treatment.

Disorders in microcirculation system of the pulp at patients with acute traumatic pulpitis and pulp hyperemia that manifest of all indicators increasing of general hemomicrocirculation state (blood perfusion of tissue, the size and variability of activation of vasomotor nerve fibers) and Wavelet transformation (active and passive factors of regulation of microcirculation ) combined with a decrease in vascular tone and increase of shunt’s blood flow indicate on preserve the viability of the pulp. Probable due to compensatory mechanisms of regulating microvascular blood flow and sufficient reserve possibilities its restoration using rational choice of local anesthesia and treatment, which can not deepen capillary blood flow.

At patients with acute and chronic pulpitis established significant disorders of all parts of pulp’s microcirculation and a significant increase in blood supply vessels on the background of an identical reduction rhythmic structure of flaxmotions that regulated epithelial vasodilators, neurogenic and myogenic genesis, and an increase in blood volume and microvessels in venular part suspicion decrease of vascular tone and decreasing quality of arteriolo-venular anastomoses. These changes indicate on profound violation of nutritional blood flow in microcirculation system of the pulp, which indicates the inability to its restoration, and, therefore, necessity of using local anesthetics with a prolonged period of action on the vascular bed to prevent bleeding during treatment.

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References

1. Ермольев С.Н. Оптические методы функциональных исследований в стоматологии / Ермольев С.Н. // Материлы XXIII и XXIV Всерос. науч. – практ. конф. – М., 2010. – С. 216-219.

2. Ермольев С.Н. Способ диагностики витальности пульпы зуба/ Ермольев С.Н. - Патент №2355292; опубл. 20.05.09, Бюл. №14. – 7 с.

3. Козлов В.И. Лазерная допплеровская флоуметрия в оценке состояния и расстройств микроциркуляции крови: метод. пособ. для врачей / Козлов В.И., Азизов Г.А., Гурова О.А - М.: РУДН ГНЦ лазерной медицины, 2012. – 32 с.

4. Крупаткин А.И. Лазерная допплеровская флоуметрия микроциркуляции крови / Крупаткин А.И.- М.: Изд-во «Медицина», 2005. — 256 с.

5. Лобова А.С. Гемодинамика в пульпе зуба при биологическом методе лечения пульпита: автореф. дис. на соискание науч. степени канд. мед. наук: спец. 14.01.14 «Стоматология» / Лобова А.С. – М., 2011. – 24 с.

6. Логинова Н.К. Лазерная допплеровская флоуметрия микроциркуляции крови / Логинова Н.К. – М., 2008.- 17 с.

7. Реброва О. Ю. Статистический анализ медицинских данных. Применение пакета программ Statistica / О. Ю. Реброва. – М.: Медиа Сфера, 2002. – 312 с.

8. Тюльпин Ю.С. Исследование возможностей метода лазерной одонтодиагностики : автореф. дис. на соискание науч. степени канд. мед. наук: спец. 14.01.14 «Стоматология» / Тюльпин Ю.С. – М., 2010. –24 с.

Файзуллаева Н. Н. Лабораторно-клиническое обоснование использования современных адгезивных систем при лечении глубокого кариозного процесса и случайно вскрытой пульпы зуба: автореф. дис. на соискание науч. степени канд. мед. наук: спец. 14.01.14 «Стоматология» / Файзуллаева Н. Н. – М., 2009.- 26 с.
Published
2018-03-21
How to Cite
Kulygina, V., & Muntian, O. (2018). RESULTS OF BLOOD FLOW’S INVESTIGATION IN THE MICROVASCULAR PULP AT PATIENTS WITH CARIES AND PULPITIS REQUIRING TREATMENT WITH ANESTHESIA. Ukrainian Dental Almanac, (2), 31-37. Retrieved from https://dental-almanac.org/index.php/journal/article/view/23
Section
THERAPEUTIC DENTISTRY