METHOD FOR ELIMINATION OF LOWER JAW BODY ATROPHY Russian patent published in 2021 - IPC A61B17/00 A61C8/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to maxillofacial surgery. A receiving bed is prepared with an incision of the mucous membrane and periosteum along the entire length of the atrophied body of the lower jaw. The vestibular and lingual muco-periosteal flaps are thrown back and the entire surface of the lower jaw body is skeletonized along its entire length with detachment of the facial muscles and muscles of the floor of the oral cavity, with the exception of the chin-lingual and chin-hypoglossal muscles attached to the chin spine. A tunnel is formed in soft tissues between the vestibular surface of the lower jaw body at the anterior edge of the masticatory muscle and recipient vessels - the facial artery and vein in the submandibular region. The peroneal autograft is collected on the vascular pedicle - the peroneal artery and veins while maintaining the muscle cuff 2-3 mm thick on the lateral and medial surfaces of the fibula without including the skin area from the lateral surface of the leg. An autograft is simulated on the bloodstream with a wedge-shaped osteotomy with an angle of 70-80 degrees and two bone fragments 4-6 cm long are obtained. The frontal part of the mandible is formed by osteotomy of the formed acute angle at the junction. Grooves with a length of 10-15 mm and a width of 5-7 mm are formed in the end sections of the peroneal autograft. Next, the vascular pedicle is cut off from the donor bed. The modeled peroneal autograft is fixed with the posterior surface of the fibula to the occlusal surface of the mandible body. Then the peroneal autograft is fixed with two screws to the anterior part of the lower jaw body and two screws to the anterior edges of the branches of the lower jaw. The grooves located in the end sections of the peroneal autograft are contacted and supported on the anterior edges of the branches of the lower jaw. A diastasis of 3-4 mm is provided between the lower surface of the peroneal autograft and the occlusal surface of the lateral parts of the body of the lower jaw. The vascular pedicle of the peroneal autograft is passed through the tunnel formed in the soft tissues to the recipient vessels. The peroneal autograft is revascularized by anastomoses between the artery and veins of its vascular pedicle and the facial artery, facial and submental veins. Next, the edges of the vestibular and lingual muco-periosteal flaps are compared and sutured together after their mobilization.

EFFECT: method allows to reduce trauma, damage from the donor and recipient areas, to minimize the patient's discomfort, and to shorten the rehabilitation period.

1 cl, 2 ex, 5 dwg