RU202269U1 - LOWER JAW RECONSTRUCTIVE PLATE - Google Patents

Abstract

The utility model relates to medicine. The reconstructive plate of the lower jaw has holes for fixation and consists of the upper vestibular mesh, the upper lingual mesh and the basal part. The vestibular and lingual mesh has holes in the area with a diameter of 2 mm. The inner surface of the upper vestibular and lingual mesh is intended for the placement of bone autograft. The utility model ensures the optimization of the integration of an autograft by improving its revascularization. 2 ill.

Description

The utility model relates to medicine, namely to maxillofacial surgery and dental surgery.

Known reconstructive plate of the lower jaw, which has holes for fixation to the lower jaw with screws, the proximal and distal parts of the plate are fixed to the lower jaw from the vestibular side, the intermediate part of the plate is located above the proximal and distal parts of the plate by ½ their height in the vertical plane; the intermediate part of the plate has 2 holes for fixing the reconstructive autograft to the bone tissue, which are located at the same level with each other; the intermediate part of the plate is connected to the proximal and distal ends of the plate using transition arms at an angle of 45 degrees [1].

The disadvantages of this reconstructive plate of the lower jaw are insufficient stability of fixation of the reconstructive autograft to the plate, insufficient stability of the osteosynthesis of fragments, a high risk of developing inflammatory complications in the reconstructive autograft and fragments around the plate, insufficient adaptation of the autograft to bone fragments of the post-resection plate and the difficulty of integration in the soft tissues. autograft through its revascularization.

Known reconstructive plate of the lower jaw, which has holes for fixation to the lower jaw with screws, the proximal and distal parts of the plate are fixed to the lower jaw from the vestibular side, the intermediate part of the plate is made in the form of monolithically connected four links; the angle formed at the junction of the links with each other is 92 °; the angle formed at the transition of the distal and proximal parts of the plate to the intermediate one along the lower edges is 46 °; in the area of connection of the links of the intermediate part of the plate with each other there are holes for fixing intraosseous screws [2].

The disadvantages of this reconstructive plate of the lower jaw are the low stability of fixation of the reconstructive autograft to the plate, insufficient stability of the osteosynthesis of fragments, a high risk of developing inflammatory complications in the reconstructive autograft and fragments around the plate, insufficient adaptation of the autograft to bone fragments of the post-resection defect and the difficulty of integration in the area of the plate. autograft through its revascularization.

Known reconstructive plate of the lower jaw, consisting of the proximal and distal parts, the proximal part of which is fixed to the lower jaw and has two processes covering the lower jaw from the vestibular and lingual sides, the processes have from 2 to 3 holes for fixation, the processes are located at different levels in the vertical jaw plane [3].

The disadvantages of this reconstructive plate of the lower jaw are the low stability of fixation of the reconstructive autograft to the plate, insufficient stability of the osteosynthesis of fragments, a high risk of developing inflammatory complications in the reconstructive autograft and fragments around the plate, insufficient adaptation of the autograft to bone fragments of the post-resection defect and the difficulty of integration in the area of the plate. autograft through its revascularization. This reconstruction plate for the lower jaw is taken as a prototype.

The purpose of creating a useful model is to optimize the integration of an autograft by improving its revascularization.

This goal is achieved by the fact that the reconstructive plate of the lower jaw consists of the upper vestibular mesh, the upper lingual mesh and the basal part. The vestibular and lingual meshes have holes in an area with a diameter of 2 mm, and the inner surface of the upper vestibular and lingual meshes is intended to accommodate bone autograft.

Comparison of the proposed device with others known in the field of medicine has shown that it meets the criteria of a utility model.

A useful device is illustrated by graphic material. In Figures 1 and 2, a reconstructive plate of the lower jaw is shown consisting of an upper vestibular mesh (1), an upper lingual mesh (2) and a basal part (3). The vestibular and lingual mesh has holes (4) in an area with a diameter of 2 mm, and the inner the surface of the upper vestibular and lingual meshes is intended for the placement of bone autograft.

The device is used as follows. The surgical field is processed. Under general anesthesia, the lower jaw is resected, and the fragments are repositioned. Then, the upper vestibular mesh, the upper lingual mesh and the basal part are compared and fixed with screws to the jaw distally and medially relative to the defect. Bone autograft is placed on the inner surface of the upper vestibular and lingual mesh. The wound is sutured in layers. 2-4 months after the operation, the patient undergoes removal of the upper vestibular and upper lingual mesh while preserving the basal part and orthopedic treatment.

The positive effect of using the proposed device is expressed in the fact that it allows you to optimize the integration of the autograft by improving its revascularization.

Optimization of the integration of the autograft is ensured by the fact that the vestibular and lingual meshes have holes in the area with a diameter of 2 mm, which improves revascularization.

Achievements of the technical result are confirmed by clinical examples of the installation of the proposed device in the Department of Maxillofacial Surgery of the S. Seredavina.

Clinical example 1. Patient C, 39 years old. Diagnosis - Ameloblastoma of the lower jaw on the right. The patient underwent surgical intervention - fragmentary resection of the lower jaw body on the left with one-stage reconstruction of the lower jaw with a reconstructive plate with an autograft. Under general anesthesia, at a distance of 1.5-2 cm from the edge of the lower jaw, an incision was made bordering the corner of the lower jaw and continued to the body. The skin is dissected, the superficial fascia with the saphenous muscle, the facial vein and artery are ligated and transected. The submandibular gland is bluntly retracted from top to bottom. The chewing and medial pterygoid muscles were cut off from the bone with a scalpel, and the raspatory together with the periosteum were separated upward. The mucous membrane was dissected along the marginal gingiva from the vestibular and lingual sides; the alveolar part of the lower jaw was skeletonized with the help of a raspator. With the help of the Jigli saw, a fragmentary resection of the lower jaw was performed, and the reposition of the fragments was carried out. A reconstructive plate of the lower jaw was used: the upper vestibular mesh, the upper lingual mesh and the basal part were juxtaposed and fixed with screws to the jaw distally and medially relative to the defect. Bone autograft was placed on the inner surface of the upper vestibular and lingual meshes. The wound was sutured in layers. 4 months after surgery, the patient underwent removal of the upper vestibular and upper lingual mesh while preserving the basal part and orthopedic treatment. The stability of the fragments is clinically determined.

Clinical example 2. Patient N., 69 years old. Diagnosis - Osteoblastoclastoma of the lower jaw on the right. The patient underwent surgery - resection of the lower jaw on the right with one-stage reconstruction of the lower jaw with a reconstructive plate. Under general anesthesia, 1.5-2 cm away from the edge of the lower jaw, a skin incision was made, bordering the corner and edge of the lower jaw. The skin is dissected, the superficial fascia with the saphenous muscle, the facial vein and artery are ligated and transected. The submandibular gland is bluntly retracted from top to bottom. The chewing and medial pterygoid muscles are cut off from the bone with a scalpel, and the raspatory together with the periosteum are separated upward along with the parotid gland. Using the Jigli saw, a fragmentary resection of the lower jaw was performed. A reconstructive plate of the lower jaw was used: the upper vestibular mesh, the upper lingual mesh and the basal part were juxtaposed and fixed with screws to the jaw distally and medially relative to the defect. Bone autograft was placed on the inner surface of the upper vestibular and lingual meshes. The wound was sutured in layers. 4 months after surgery, the patient underwent removal of the upper vestibular and upper lingual mesh while preserving the basal part and orthopedic treatment. The stability of the fragments is clinically determined.

The proposed model can be used in the departments of maxillofacial surgery, surgical dentistry.

SOURCES OF INFORMATION

1. RF patent for utility model No. 194058 dated 05/29/2019;

2. RF patent for utility model No. 194186 dated 05/29/2019;

3. RF patent for utility model No. 131596 dated 03/14/2013.

Claims (1)

The reconstructive plate of the lower jaw has holes for fixation, characterized in that it consists of an upper vestibular mesh, an upper lingual mesh and a basal part, the vestibular and lingual mesh has holes in an area with a diameter of 2 mm, and the inner surface of the upper vestibular and lingual mesh is intended for placement bone autograft.

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