METHOD FOR RECONSTRUCTION OF COMPLEX DEFECTS OF MAXILLOFACIAL AREA Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery, and is intended for use in reconstruction of complex defects of the maxillofacial region. Bone tissue defect is replaced with endoprosthesis made from reconstructive material, based on spiral computed tomography of the patient's skeleton with subsequent fixation and covering the defect with a complex of patient's tissues. Reconstructible material is a ceramic material based on a ZrO₂-Al₂O₃ composite. Endoprosthesis is created individually for each patient using 3-D printing methods in stages using slip casting and gradient sintering, sterilized and installed in the defect area, for this purpose, preparation of bone edges of the defect, to which a ceramic endoprosthesis will be attached, including removal of soft tissues around the bone edges and alignment of the bone edge of the defect by milling treatment of the bone edges of the wound. After verifying the accuracy of contact of all attachment points of the endoprosthesis, holes are formed in the bone edges of the defect and the endoprosthesis is fixed in them with the help of mini screws made of titanium, and in the absence of floatation of the endoprosthesis under load, its cover is provided with rotated or free revascularized soft-tissue flaps with good blood supply. Ceramic material with a bimodal porous structure represented by micropores with pore volume of 50–80 %, a shape close to a spherical shape, diameter of 2–20 mcm, a wall thickness of 1–2 mcm and macropores and porous channels of irregular shape with size of 30–200 mcm, compression strength of ceramics is 20–200 MPa, and after verifying accuracy of contact of all attachment points of endoprosthesis, holes are formed with drill with diameter of 1.5–1.7 mm in bone edges of defect and fixing in them endoprosthesis using mini screws made of titanium with diameter 2.0–2.5 mm. Besides, the endoprosthesis cover is made with a rotated or free revascularized bone-skin fibular flap.

EFFECT: method, due to increased integration ability and adequacy of recovery of frame function of resected fragment of skull, enables improving quality of life of patients, expand the field of application of the method for patients with complex combined defects of the maxillofacial region, reduce complications caused by excessive traumatization and infection of tissues and toxicity of the reconstructive material.

1 cl, 7 dwg, 2 ex