Introduction. Surgical interventions are accompanied by acute stress reactions, which are staged and cause functional changes, primarily in the nervous, cardiovascular, endocrine systems. The study of biochemical stress markers in blood provides valuable information about the state of patient’s state under conditions of surgical aggression. Aim: To investigate the biochemical manifestations of stress reactions in blood of dental patients with different
individual psychological characteristics during planned surgical treatments in the maxillofacial department. Materials and methods. The level of neuroticism was determined in 64 patients at the Department of Maxillofacial Surgery of Lviv Regional Clinical Hospital, by testing according to the well-known Eysenck method. The level of reactive anxiety and depressive manifestations in patients was determined using the Hospital Anxiety and Depression Scale (HADS). Before the surgery (before premedication) and fve hours after its completion, the content of cortisol, prolactin and interleukin-1β was examined in the peripheral venous blood of the patients. Results and discussion. Before premedication, the highest levels of cortisol and prolactin in the peripheral venous blood of patients with high neuroticism and anxiety, which could not be eliminated by antistress therapy in the stage of preoperative preparation, were found. In the pre-surgery period, all patients, regardless of their level of neuroticism, had a low level of interleukin 1-β in blood - 8.5 ± 3.6 pg/ml (p = 0.2547). Despite the satisfactory anaesthetic support of the surgical interventions, all patients had increased cortisol in blood, due to the development of an acute inflammatory reaction induced by surgical trauma. In the postsurgical period, there was also a statistically signifcant increase of interleukin 1-β in the blood in all patients - up to 19.7 ± 4.6 pg/ml. There is a close relationship (χ2 = 17.89, p < 0.01) between the anxious state of the patients and the increase in the concentration of prolactin in their blood. Conclusions. Under conditions of surgical stress in dental patients before analgesia, similar changes occur at biochemical level - the blood cortisol and prolactin levels increase, the intensity of this process being more pronounced in emotionally labile patients (with a high level of neuroticism). There is a close relationship between the psycho-emotional state of patients (their level of anxiety)
and the dynamics of prolactin concentration in blood, while the concentration of cortisol in blood is affected by phlogogenic factors caused by surgical trauma.
Manifestation of traumatic disorders is often chracterised by reorganization or ossifcation of the TMJ hematoma, while the use of conservative therapy after TMJ traumatic injuries is often ineffective. The purpose of the preswent work was to study the effectiveness of arthrocentesis in the complex treatment of post-traumatic temporomandibular disorders. 24 patients with a history of mandibular condylar fractures underwent CT, ultrasound and MRI. TMJ arthrocentesis was performed under local anesthesia. After osteosynthesis, the number of patients with stage III according to Wilkes was up to 58.33% while, after splinting- 33.33%. The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 84.61% of patients with intra-articular disorders of the second degree, and also in 72.72% of patients with internal disorders of the third degree, the position and function of the articular disc being restored. Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has proven useful in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible.