METHOD FOR SURGICAL ACCESS TO AN UPPER JAW BONE OF A PATIENT WHEN PERFORMING AN ORTHOGNATIC INTERVENTION Russian patent published in 2019 - IPC A61B6/00 A61B17/24 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgical dentistry and maxillofacial surgery, and can be used for surgical access to upper jaw bone when performing orthognatic intervention. In the preoperative period, the volume and dimensions of upper jaw bone deformations subject to surgical treatment are determined by spiral computed tomography. 64 cuts are made in one turn of gantry with cut-off thickness of 0.625 mm, without inclination of gantry with voltage of 120 kV, current intensity of 175 mA, during 2.2 seconds at pitch of 0.516:1. Using an overview transcript, multi-plane reconstructions of the patient's upper jaw image are performed in three planes – coronary, frontal and sagittal. After performing endotracheal narcosis and antiseptic treatment of the operating area, conductive and infiltration anesthesia is performed in the upper jaw region using a solution of ropivacaine with epinephrine in concentration 1:200,000. Patient's upper lip is pulled back with application of Langenbeck hooks. Mucous membrane is incised, the line of which is placed parallel to the transitional fold of the upper vestibule of the oral cavity and in the middle between the red rim of the upper lip and attachment of the frenulum of the upper lip of the patient. Mucosal incision length is selected according to mesio-distal dimensions of the central and lateral incisors of the upper jaw and anomalies of the tooth-jaw system. Mucosa after the incision is retained and brought down using Langenbeck hooks. Tissues are dissected parallel to the mucous membrane above the circular muscle of the mouth in the submucous layer and the upper jawbone bone is exposed. Lowering muscle of the nose, the wing and transverse parts of the nasal muscle, the buccal muscle, the circular muscle of the mouth and the nasal muscle are separated with the help of a raspator. That way, the upper jaw bone of the patient is accessed and visualized before the planned orthognatic intervention.

EFFECT: method provides surgical access to a patient's upper jaw bone when performing orthognatic intervention, sufficient and necessary imaging of the upper jaw bone, minimization of circulatory disorders in soft tissues of perioral, infraorbital and buccal areas, absence of scalp wound of muscular fibers, as well as reduced time of patient's rehabilitation ensured by optimal preoperative and operating procedures.

1 cl, 3 ex