METHOD FOR SURGICAL RECONSTRUCTION IN THE ELIMINATION OF DEFECTS IN THE MAXILLARY SINUS MUCOSA LARGER THAN 10 MM AND TOTAL MUCOSAL DEFECTS WHEN PERFORMING SINUS LIFTING WITH IMPLANTATION Russian patent published in 2021 - IPC A61B17/00 A61B17/24 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dental surgery. An incision of the mucous membrane to the bone is performed along the alveolar ridge of the upper jaw in the area in the projection of the bottom of the maxillary sinus. The vestibular and oral muco-periosteal flaps are peeled off. From the vestibular side, the bone wall is thinned with a bone scraper to a thickness of 0.5 to 0.3 mm. Then, using a diamond bur or an ultrasonic surgical apparatus, an osteotomy is performed in the anterolateral wall of the maxillary sinus for its entire remaining thickness to the mucous membrane of the maxillary sinus. Next, the mucous membrane of the maxillary sinus is peeled upwards. If it breaks by more than 10 mm or if there is a total rupture with the absence of clear edges for the forthcoming comparison, the remnants of the mucous membrane in the area of ​​the maxillary sinus bottom are removed with a curettage spoon. Next, a microdrill with a diameter of 0.9-1.2 mm drills two through canals in the palatal bone wall at a distance of 8-10 mm from each other. Further, a collagen membrane is introduced into the sinus and the defect of the sinus mucosa is isolated with a restriction of the reconstruction zone. From the side of the oral cavity through the mucous membrane or through the subperiosteal access, a needle with resorbable suture material is inserted into the formed canal, sutured membrane. Then the needle is brought out into the oral cavity through the second canal in the palatine wall of the maxillary sinus. Tied at least 4 knots with rigid fixation of the insulating membrane to the inner palatal wall of the maxillary sinus. The membrane is placed in the form of a dome 8-12 mm above the bottom of the maxillary sinus. The edges of the membrane are taken out through the trepanation hole, sutured along its edges with resorbable suture material, and an airtight cavity is created using an insulating membrane. At the same time, when the size of the initial height from the edge of the alveolar process to the bottom of the maxillary sinus is 3 mm or more, a bed for dental implants is formed. Further, the formed space under the membrane is filled with osteoplastic material and bone chips and implants are placed. When the size of the initial height from the edge of the alveolar process to the bottom of the maxillary sinus is less than 3 mm, the formed space under the membrane is filled with osteoplastic material and bone chips, and implants are placed 6 months after surgical reconstruction. The wound is closed first with internal mattress sutures made of resorbable suture material. Then the wound is sutured with two-row interrupted monofilament non-resorbable sutures.

EFFECT: method makes it possible to provide a reliable clinical effect of dental implantation with anatomical restoration of the reconstructed zone in the area of ​​the maxillary sinus floor, to provide a sufficient bone height for simultaneous installation of dental implants in the reconstruction area, to reduce the patient's treatment time, and to improve the patient's quality of life.

1 cl, 3 ex