METHOD FOR PERFORMING PLASTY OF MAXILLARY SINUS PERFORATION USING AUTOTRANSPLANTATION OF THE THIRD MOLAR Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to dental surgery and maxillofacial surgery, and can be used for plasty of oroantral communication caused by removing the maxillary first or second molar. Radiology diagnostics of the area of the proposed surgical intervention is performed, determining the location of the maxillary third, first or second molar subject to removal due to the chronic odontogenous process spreading to the maxillary sinus. The patient's venous blood is taken in order to obtain platelet- and fibrin-rich plasma in a non-vibratory centrifuge — the PRF or APRF technique. Non-invasive removal of the first or second molar to be removed is then performed under infiltration anaesthesia, separating the roots and separating the muco-periosteal flap. The area of the subantral-alveolar communication is treated, wherefor non-viable fragments of bone tissue in the alveolus of the removed tooth and inflammatory granulations are removed, the third molar is extracted and placed in a Petri dish with sterile saline solution mixed with a PRF or APRF gel in order to prevent death of the neurovascular bundle and periodontal ligament fibres and drying of hard tissues of the tooth. The third molar — the wisdom tooth — is then placed in the alveolus, buried 1.5 to 2 mm below the occlusal surface of the neighbouring teeth — the tooth is located beyond occlusal contacts, followed by applying simple interrupted and crossed seams to the edges of the alveolus of the removed teeth. The autografted third molar is splinted, i.e., stabilised using an orthodontic wire and a photopolymeric fluid composite by being fixed to the neighbouring teeth. Antibacterial and anti-inflammatory therapy is conducted in the postoperative period. Herewith, the degree of eruption and the root architecture of the maxillary third molar are determined prior to the operation. A previously non-functioning underdeveloped third molar is autografted by pre-placing the created PRF or APRF automembrane at the bottom of the alveolus of the removed maxillary first or second molar and correcting the interalveolar (interradicular) septa in the grafting zone in accordance with the structure of the autografted third molar.

EFFECT: due to the closure of perforation of oroantral communication using autografting of the third molar, method provides a possibility of preventing and treating odontogenous perforated maxillary sinusitis, restoring the continuity of the dentition and the chewing efficiency.

1 cl, 7 dwg, 2 ex