METHOD FOR MANDIBULAR FRACTURE OSTEOSYNTHESIS WITH SIMULTANEOUS ELIMINATION OF ADENTIA Russian patent published in 2019 - IPC A61B17/56 A61B17/68 

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Method for mandibular fracture osteosynthesis with simultaneous elimination of adentia involves using a simulated titanium plate of rectangular shape, in the plane of which there are through holes for bone screws, and in upper rib area there are vertical elements containing neck and support head for installation of solid cast metal teeth crowns. Titanium plate and the neck form a single cast flat structure, and the support head is permanent. Before the surgical intervention, 3D computer tomography is performed, the results of which are used to assess the position of the maxillary nerve. Depending on anatomical features and position of the mandibular nerve, the vertical size, length of the titanium plate and the required number of vertical elements are calculated. Titanium plate is simulated. 3D stereolithography model of the lower jaw is produced by 3D tomography results. On this model, titanium plate is placed in bone. Then template with marking is made to create holes on patient's lower jaw bone. After pre-medication under endonasotracheal anesthesia, an incision is made along a ridge of an alveolar process. Ridge of the alveolar process and an external surface of the lower jaw are skeletonized at the level of the segment of the lower jaw that grasps the area of the fracture and absent teeth. Bone fragments are repositioned to a correct anatomical position. Bone bed in the jaw is made congruent to the size of the titanium plate in the area of secondary adentia. Titanium plate is installed in formed bone bed in jaw to neck of vertical elements. Further, the manufactured template is applied on the vertical elements to the neck and to the external surface of the lower jaw. Perforation holes are inserted through the holes in the template on the bone fragments. Pattern is removed and, by matching perforated holes with through holes for bone screws of titanium plate, screw is inserted into perforation holes, which fix titanium plate to fragments of jaw along edges from fracture slot, wound is covered with flap, and sutures are applied.

EFFECT: method enables stable fixation of lower jaw fragments with simultaneous elimination of denture defect, possibility of implantation, without waiting for consolidation of fracture, which reduces rehabilitation period, accelerates treatment time, recovery chewing and aesthetic function; intraosseous apparatus enables to obtain a good cosmetic effect, increases support area and more uniform load distribution, eliminates additional formation of channels for implant installation.

1 cl, 2 dwg