ANATOMICAL AND ANTHROPOLOGICAL VIEW OF TARGET POINTS AND LANDMARKS OF LOCAL ANESTHESIA IN THE MAXILLOFACIAL REGION:A NARRATIVE REVIEW
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Abstract
Background:The anatomical-anthropological approach to local anesthesia target sites utilizes knowledge of
individual anatomical variations in elderly patients to optimize conduction anesthesia efficacy while minimizing
complication risks.
Aim:The aim of this study is to study the correlation of changes in anatomical and anthropological landmarks with
the age of patients, finding constant points for successful anesthesia in dental practice.
Materials and Methods: The review is based on a retrospective analysis of articles on the anatomical and
anthropological features of the structure of the maxillofacial region of the age group of patients, studied the
location of the exit of the infraorbital, greater palatine, mental, and inferior alveolar nerves, taking into account the
spatial relationships of bone structures and soft tissues in elderly patients. A systematic search was conducted in
the PubMed, Wiley, Springer, eLibrary, Cyberleninka, Journals.lww.com, ResearchGate databases. The search
period was from 1953 to 2024 for the following keywords: geriatric dentistry, age-related changes, infraorbital
foramen, mandibular foramen, greater palatine foramen, mental foramen, trigeminal nerve, local anesthesia in
Russian, English, German. More than 200 articles were reviewed, found 65 papers for the primary review, after a
qualitative 38 publications were selected on age-related features inherent in patients of different age groups as the
most relevant to the goals and objectives of the review. Review was conducted according to the PRISMA
guidelines.
Results:A review of publications has revealed variability in anatomical-topographic parameters and the
positioning of major foramina on the facial skull among elderly individuals across different geographic and
chronological populations, as well as a close correlation between age-related changes in the maxillofacial region,
tooth loss, and sexual dimorphism.
Conclusion:To successfully achieve targeted anesthesia points and prevent complications during and after
injection in elderly patients, it is essential to personalize the process of local conduction anesthesia and conduct
preliminary radiographic and digital diagnostic methods.