METHOD OF PERFORMING THE SINUS LIFTING OPERATION WITH SIMULTANEOUS REMOVAL OF THE RETENTION CYST OF THE MAXILLARY SINUS Russian patent published in 2023 - IPC A61B17/00 A61C9/00 A61C3/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, and in particular to surgical dentistry. The patient in the preoperative period is subjected to computed tomography of the head and scanning of the upper dentition. The resulting images are combined in a computer program and a navigation template is modeled in the form of a mouthguard covering the teeth of the upper jaw from the oral surface to the level of clinical equators, and from the vestibular surface reaching the zygomatic bone. At the same time, in the navigation template, in the zone the lower third of the maxillary sinus, in the projection of the planned dental implantation, an oval hole is formed, and in the projection of the retention cyst, determined according to computed tomography, another hole is modeled in the template. After that, the virtual model of the template is converted into a physical one using an additive computer method for producing 3D printing from a biocompatible dental polymer. The template is then post-printed and sterilized. Anesthesia is performed in the operation area, the template is fixed on teeth of the upper jaw, along the lower border of the oval hole in the template form a semilunar horizontal incision to the bone. The template is removed and the incision is extended in the distal directions, the mucoperiosteal flap is exfoliated with a raspator and the lateral wall of the maxillary sinus is skeletonized. A template is put on and an anthrotomic window is formed along the boundaries of the oval hole without damaging the Schneiderian membrane, so that the bone “island” formed as a result of the manipulation remains on the Schneiderian membrane. Further through the second hole in the template, modeled in the projection of the cyst, a second anthrotomic bone window is created without damaging the Schneiderian membrane. After that, the Schneider's membrane is pierced with a needle through the window in the projection of the cyst, the contents of the cyst are punctured, followed by removal of its membrane, while the patient sits upright in the chair. Next, using curettes for sinus lifting, the Schneider's membrane is peeled off through the bone window in the area of the lower third of the maxillary sinus from the palatine and lateral walls, not reaching the edge of the window in the projection of the cyst, and the Schneider's membrane is lifted up, the space between the bone tissue and the elevated Schneider's membrane is filled with autologous material. Then both trepanation bone windows are covered with a resorbable membrane and fixed, the mucoperiosteal flap is returned to its place and sutured with interrupted sutures.

EFFECT: method allows to carry out a minimally invasive intervention, including simultaneous sinus lifting and removal of the retention cyst of the maxillary sinus, which ensures the prevention of inflammation in the maxillary sinus, prevents the development of edema and contributes to the successful subsequent dental implantation of patients with partial or complete absence of teeth, complicated by bone deficiency.

1 cl, 1 ex