METHOD FOR BONE GRAFTING OF LOWER JAW Russian patent published in 2021 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to maxillofacial surgery, and can be used for reconstructive surgery for tumors of the lower jaw. A MSCT study of the facial skeleton is performed. The obtained MSCT data are transferred using a 3D printer to a stereolithographic model of the facial skeleton. On the obtained stereolithographic model of the lower jaw, a reconstructive titanium plate is modeled on the outer surface, which is fixed within the healthy bone with screws, the reconstructive titanium plate is removed and the tumor is resected on the stereolithographic model. The resulting defect on the stereolithographic plastic model of the lower jaw is filled with base wax in such a way that it repeats the dimensions of the lower jaw. The wax model is transferred to a plastic template and sterilized. The iliac crest is accessed, a plastic template is applied and the graft is taken. The lower jaw is accessed, the soft tissues to the base of the lower jaw are dissected layer by layer. A sterile reconstructive titanium plate is applied on the outer surface of the lower jaw. The places of fixation of the plate to the jaw outside the tumor are marked according to pre-made measurements on the stereolithographic model and two holes at a distance of 7 mm from each other on each side of the lower jaw are made. The length of the stump of the lower jaw is determined on the stereolithographic plastic model of the lower jaw after resection. The zone of resection of the mandibular bone is determined. The modified section of bone tissue is resected according to pre-calculated lines. The reconstructive titanium plate is installed and the original position of the fragments of the lower jaw and its heads in the articular cavities is preserved. The resulting graft is separated in such a way as to give it elasticity and not break the continuity. The autogenic graft is modeled according to the size and shape of the manufactured plastic template. The graft is fixed with screws to the titanium reconstructive plate in such a way that the graft closes the defect of the lower jaw, and its edges come into contact with the stumps of the lower jaw. The muscles of the bottom of the oral cavity are fixed with suture material to the graft and the reconstructive titanium plate, the wound is sutured in layers, leaving rubber tube drainages, X-ray control of the lower jaw is carried out 5 months after the operation.

EFFECT: method provides the necessary conditions for preserving the original orthopedic position of the fragments of the lower jaw after resection of the tumor, preserving the previous occlusion, reducing the duration of the operation and the time of bone graft collection, restoring the function of chewing, the maximum possible aesthetic result of the operation both from the face configuration and from the oral cavity by modeling an autogenic graft according to a pre-made plastic template that repeats part of the lost bone of the lower jaw.

1 cl, 17 dwg, 3 ex