RU2246275C1 - Surgical method for repairing anatomical shape of alveolar process of a jaw - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves shaping bone portion of alveolar process using bores and separation disks after cutting out mucoperiosteal flap having greater size then defect has, throwing out flap from exposed bone and making mobilization. Alveolar process bone plates are bluntly broken. Transplant is placed on the alveolar process, surrounded with bone plates in sandwich manner, strengthened with mucoperiosteal flap and sutured with interrupted sutures.

EFFECT: high reliability in repairing anatomical shape.

Description

The invention relates to medicine, namely to dentistry. The proposed method can be used to correct defects of the alveolar process in the vestibular-oral direction for fixed prosthetics, for cosmetic correction of defects of the alveolar process, for implantation, for correction of the alveolar process in a limited area for removable prosthetics.

Known methods for restoring the anatomical form of the alveolar process of the jaw by filling the bone crest with a synthetic bone graft (see, for example, Arthur Ashman Implantation of implants in the jaw processes after filling the bone crest with a synthetic bone graft BIOPLANT-HTR, Clinical Dentistry, No. 4, 2001, pg. 56-59). In this analogue, after folding the mucoperiosteal flap of tissue exfoliation, holes are made in the bones every 3-4 mm. To stimulate bleeding with a syringe with a filter nozzle, blood is drawn through the filter nozzle at the end. Synthetic bone alloplast mixed with blood from a syringe is placed on a bleeding jaw comb. Close the wound and suture the flap.

The main disadvantage of this method is the placement on the crest of the alveolar bone of the jaw of synthetic bone alloplast. In this case, there may be cases of rejection of alloplast and, as a consequence, non-restoration of the alveolar process of the jaw due to the lack of stimulation of the development of its own bone.

Another analogue of the proposed method is a method of restoring the anatomical form of the alveolar process of the jaw by bone transplantation (see, for example, V.I. Zausaev, P. Naumov and others. Surgical dentistry, M .: Medicine, 1981, pp. 530-531 ), which consists in preparing a bed for a bone graft, taking a bone graft, laying a bone graft in a prepared bed and suturing soft tissues. The disadvantages of this analogue include a rather complicated operation, due to the need to take the graft from the rib or crest of the patient's ilium. Additional injury. Risk of complications. Graft fixation on the alveolar process of the jaw is also insufficient.

The closest analogue of the proposed method is a method of plasty of the alveolar ridge of the jaw (see, for example, RF patent No. 2181568, IPC A 61 B 17/34, published 04/27/2002), which consists in the fact that after antiseptic treatment, the bottom and walls of the hole of the extracted tooth are sprinkled with powdered crushed allogeneic demineralized lyophilized spongy or brefocost, the remaining space is rammed with blocks of the same graft, and the mucoperiosteal flap cut and mobilized from the vestibular surface of the alveolar o cane, before suturing, overlap on the de-epithelialized oral gingival margin. The disadvantage of this method is the need to use powder and graft blocks.

The objective of the invention is to increase the reliability of restoration of the anatomical form of the alveolar process of the jaw.

The technical result is achieved by the fact that in the present invention, the bone part of the alveolar bone is cut using burs or separation discs, the bone plates of the alveolar bone are stupidly broken, the graft is placed on the alveolar bone, surrounded by autologous bone plates in the form of a sandwich, and the mucosal-periosteal fold is strengthened by the mucocutaneous knotted seams.

The proposed method is as follows.

Cut out the mucosal-periosteal flap in excess of the size of the defect, fold the flap from the exposed bone, mobilize taking into account the future increase in bone volume. By means of burs or separation disks with water cooling at a speed of 130-150 rpm, the bone part of the alveolar bone is cut. The bone plates of the alveolar ridge, vestibular and / or oral, are stupidly broken, depending on the indications. The lyophilized graft block is cut out according to the size of the defect and soaked in isotonic sodium chloride solution. The graft is placed on the alveolar bone and is surrounded by autologous bone plates in the form of a sandwich, previously cut, from the vestibular and oral sides. Strengthen with a mucosal-periosteal flap, or with weakness of the mucous-periosteal flap, previously strengthen one of the varieties of biomembranes. The wound is sutured with knotted sutures. If necessary, cover with a removable protective plate, pre-made according to the plaster model of acrylic plastic.

As the graft, for example, a lyophilized bone graft or synthetic material can be used.

This sequence of operations and the presence of new operations in the method provides a more reliable fixation of the graft on the surface of the alveolar process of the jaw, faster restoration of the anatomical form of the process and stimulation of the development of own bone tissue.

Claims (1)

A method for surgical restoration of the anatomical form of the alveolar process of the jaw, including cutting out the mucosal-periosteal flap with an excess of the size of the defect, folding the flap from the exposed bone, mobilization, characterized in that the bone part of the alveolar process is cut using burs or separation discs, the bone plates from the alveolar bone are bluntly broken , lay the graft on the alveolar bone, surround autologous bone plates in the form of a sandwich, strengthen the mucous membrane periosteal flap, sutured the wound with knotted sutures.