METHOD FOR PREVENTION OF UNCONTROLLED CHANGE IN VOLUME OF OSTEOGENIC GRAFT IN POSTOPERATIVE PERIOD AFTER ELIMINATION OF CONGENITAL AND ACQUIRED DEFECTS OF JAW BONE Russian patent published in 2022 - IPC A61K35/12 A61B17/56 A61C8/00 A61P1/02 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely maxillofacial surgery; it can be used for the prevention of uncontrolled change in a volume of an osteogenic graft in the postoperative period after a transplant operation for elimination of congenital and acquired defects of the jaw bone. A multicomponent osteogenic graft is used, including: dental implant – 10%, autologous cell pool of a stromal vascular fraction – 10%, platelet mass – 5%, fibrinogen of autologous blood plasma of a patient – 20%, granular osteoconductive bone plastic material of animal origin – 55%. A number of graft components is determined based on a 3D volume of a defect. To do this, the bone defect is segmented into geometrically simple hollow and outer segments. A volume of each segment is calculated, multiplied by a coefficient of natural compaction of granular bone plastic material, which is 1.15 for hollow segments; 1.25 for outer segments, calculated volumes are added, and the total amount of granular osteoconductive bone plastic material of animal origin is determined. Volumes of the dental implant, autologous cell pool of the stromal vascular fraction, platelet mass, and fibrinogen of autologous blood plasma of the patient are determined by the above-mentioned proportions. Autologous cell pool of the stromal vascular fraction is prepared by a tumescent lipoaspiration method. To do this, 200 ml of adipose tissue is taken from the area of the anterior abdominal wall. Adipose tissue is washed with a phosphate-salt solution, subjected to enzymatic treatment with a type 1 collagenase solution. After that, cells of the stromal-vascular fraction are isolated, which are placed in sterile culture Petri dishes with a growth medium, and then placed in a CO₂ gas incubator for cultivation at a temperature of +37°C and a CO₂ content of 5% for 14 days until reaching a monolayer. Then, cells are passed three times until reaching 50 million cells. On the day of the transplant operation, the patient has a puncture of the cubital vein, peripheral blood is taken in a volume of 40 ml into 4 tubes with K2 EDTA for the preparation of platelet mass and fibrinogen of autologous blood plasma. Tubes are centrifuged twice: initially, to settle erythrocytes and leukocytes, then, blood plasma is taken from 4 tubes to obtain fibrinogen of autologous blood plasma, then, after repeated centrifugation, 6 ml of platelet mass is obtained. On the day of the operation, granular osteoconductive bone plastic material of animal origin is added to 2 ml of fibrinogen of autologous blood plasma. Then, autologous cell pool of the stromal vascular fraction in the volume of 15 million cells is introduced, then, platelet mass is introduced, 200 mcl of a sterile calcium gluconate solution is added, after which the resulting mixture is incubated at a temperature of +37°C for 15 min, until a fibrin clot is formed, with further packaging in a sterile vial, labeling, and transportation to an operating room in a thermal container at a room temperature. In the operating room, 40 min before the transplant operation, the dental implant is inserted into the vial with the above-mentioned mixture containing autologous cell pool of the stromal vascular fraction, platelet mass, fibrinogen of autologous blood plasma of the patient, granular osteoconductive bone plastic material of animal origin. Then, the dental implant is installed in the bone defect, after which the mixture containing autologous cell pool of the stromal vascular fraction, platelet mass, fibrinogen of autologous blood plasma of the patient, granular osteoconductive bone plastic material of animal origin is placed around and on top of the dental implant, the wound is sutured.

EFFECT: method provides for the prevention of uncontrolled change in a shape and volume of a graft, full-fledged biotransformation of bone plastic material, and a predictable clinical result, reduction of material costs and psycho-emotional discomfort of a patient due to the optimization of a composition and properties of a multicomponent osteogenic graft.

1 cl, 8 dwg, 1 ex