METHOD FOR REPLACING BONE DEFECTS IN THE JAWS WITH THE POSSIBILITY OF TEMPORARY DENTAL PROSTHETICS FOR THE PERIOD OF DENTAL IMPLANTS INTEGRATION Russian patent published in 2023 - IPC A61C13/107 A61C8/00 A61C5/40 

FIELD: medicine; surgical dentistry.

SUBSTANCE: in the preoperative period, the patient undergoes a CT scan of the jaws, then the dicom format is converted to the stl format and exported to the dental CAD program. Virtual planning of dental implantation and modeling of the shape of the alveolar bone in the area of the planned operation is carried out. The restored optical model of the jaw is superimposed on the original unmodified model, a closed contour curve is constructed along the intersection of the two models, which is then attached to the restored model, followed by the creation of a surface delimited by this curve, displaying the desired shape of the base of the future titanium plate design. After that, this surface is extruded to a given thickness along the normal to each point, forming a solid model of the plate. The edges of the plate are adjusted to the specified value of curvature with a virtual modeling tool — smoothing, and a visual check of the edge fit of the plate to the original model is carried out. Further, along the lower border of the plate, 2 mm away from the edge, the holes for screws are modeled, fixing the future titanium plate to the bone, the holes are modeled in the areas of the thickest cortical bone from the lingual and outer surfaces equidistantly at a distance of not more than 5 mm from each other and with a diameter of 1.2 mm, so that the total amount of holes is not less than 10 on each side of the jaw. At the top of the plate in the projection of the missing canines and first molars, abutments are modeled in the form of truncated cones with circular retentions, while the abutment is made integral with the plate. After that, a temporary bridge-like non-removable denture is modeled based on abutments, with the possibility of its separation from the plate model. After that, the digital model of the plate is converted into a cellular structure in the form of a plate, which is exported to the 3D printer software, in which the structure is 3D printed by direct laser sintering or electron beam melting of fine titanium powder or its alloys. The resulting design is subjected to mechanical and sterilization treatment. A virtual model of a fixed bridge-like temporary denture is converted into a physical one by volumetric printing from a dental polymer, ground and polished. Then the patient is given local anesthesia in the planned operating area, a mucoperiosteal flap is formed and the bone is skeletonized. In the area of dental implants, perforations are made with a dental drill in the atrophic part of the bone to a depth equal to the thickness of the cortical bone plate. A bone-replacing mass is placed on top represented by a xenograft mixed with a bone autograft, saturated with the patient's capillary blood in a ratio of one to one, and the mass of the previously made titanium structure is fixed by means of screws through the holes to the patient's bone. The mucoperiosteal flap is laid back and sutured with resorbable threads, which are removed on the tenth day after the operation, a temporary bridge-like non-removable denture is fixed on the abutments with temporary cement.

EFFECT: method makes it possible to temporarily restore chewing efficiency during the period of restoration of jaw defects and integration of dental implants in patients with complete absence of teeth.

3 cl, 3 dwg, 1 ex