METHOD FOR MANDIBULAR DEFECTS REPLACEMENT AND MILLING CUTTER FOR ITS IMPLEMENTATION Russian patent published in 2020 - IPC A61B17/00 A61B17/24 A61F2/08 G16H30/20 A61K35/28 

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine, namely to maxillofacial surgery, and is applicable for bone grafting jaws. Prior to the surgical reconstructive intervention, computed tomography is performed with bone reconstruction of the facial skeleton, then the model of the facial skeleton is printed on 3D printer, where the reconstructive intervention is to be performed, after which the obtained model is scanned with Medit i 500 dental scanner, and in the ExoCad program, a lost portion or a portion to be resected is simulated 0.5 cm less than the original, the obtained fragment of the face skeleton is printed on 3D-D printer with wall thickness of model 0.2 cm, then printed the fragment with non-woven titanium material in 3-4 layers, then by cold pressing is shaped to non-woven titanium material in accordance with printed workpiece, located inside material, during pressing, under pressure, printed workpiece is destructed, its remains are extracted by dissecting non-woven titanium material, followed by surgical treatment, wherein at the first stage of the surgical management, the bioengineering composition is started, for this purpose, a surgical approach to the iliac bone flap is performed: incision is made in accordance with the course of the iliac crest with length of 10 cm and in layers are accessed to the iliac crest, then the cutter is used to obtain a spiral-shaped bone chips, filling the non-woven titanium material through its incision at a preliminary stage, filling the inner walls of the mold with collagen membranes, then placing the FRP-membrane obtained from the patient's blood, after which the obtained spiral-shaped bone chips are mixed in ratio of 1:1 with artificial bone material BioOss and filling the inner space of the form of non-woven titanium material, mold dissection area from non-woven titanium material is sutured with resorbable suture, then through previously made access in the region of iliac bone end subcutaneous tunnel is formed in an anterior abdominal wall area, dissected fascia of rectus abdominis muscle, muscular tissue of abdominal rectus muscle is stratified to volume corresponding to volume of formed structure of non-woven titanium material, and placing said bioengineered structure in thickness of rectus abdominis muscle, then fascia is closed with resorbable suture, after aging of bioengineering composition in abdominal rectus muscle thickness proceeds to second stage of surgical treatment, wherein two surgical brigades are involved: one performs access to a mature bioengineered composition, a second surgical team prepares a recipient zone to receive a bioengineered composition, for which prepares bone wound edges, after which bioengineering composition is fixed to edges of bone wound with titanium mini-plates on titanium mini screws.

EFFECT: inventions allow reducing intraoperative injures due to low-traumatic sampling of spiral bone chips, allowing to take into account all anatomical features of the patient and recovering the most physiological lower jaw for each specific patient.

4 cl, 1 dwg, 2 ex