METHOD FOR ELIMINATION OF DEFECTS OF LOWER JAW BODY Russian patent published in 2024 - IPC A61B17/24 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to maxillofacial surgery. Mucous membrane and periosteum are incised within the oral vestibule at 4–5 mm below the mucogingival line within the preserved fragments of the lower jaw and along the transitional fold within the defect. Incision is continued in the retromolar regions and further upwards, in a projection of the anterior edges of the mandibular branches. Vestibular mucoperiosteal flap is folded back within the body, external and internal mucoperiosteal flaps within the mandibular branches. Osteotomies of preserved fragments of lower jaw are performed with formation of bone fragments. Outer surface of the preserved fragments of the lower jaw body and their base are skeletonised with preserving the integrity of the mental neurovascular bundle on a large fragment of the lower jaw. External and internal surfaces of mandibular branches are skeletonized with visualization of lower jaw uvula and preservation of lower, alveolar neurovascular bundles at the entrance to mandibular foramen. Attachments of the mucous membrane, periosteum and floor muscles of the oral cavity to the inner surface of the preserved fragments of the lower jaw body are preserved. Horizontal osteotomies are performed on inner surfaces of mandibular branches at 5–6 mm from the uvula. Osteotomies are continued from front edges of branches in lower direction, along external surface of mandible body, in projection of external oblique lines. At the level of the first lower molars, the osteotomies are continued vertically downwards, reaching the base of the lower jaw body. Additional vertical osteotomy of the mandible body is performed in a projection between the second premolar and the first molar on a large preserved fragment of the mandible body. Five bone fragments are formed: two fragments of branches and three movable tooth-containing fragments of lower jaw body – one posterior and one anterior fragments of large preserved fragment and one fragment of small preserved fragment of lower jaw. Moving forward and towards the centre of the posterior fragment of the large preserved fragment and the fragment of the small preserved fragment of the lower jaw body with maintaining contact of bone surfaces along the osteotomy line. Large preserved fragment of the lower jaw is advanced and rotated to the centre of the anterior fragment. Displaced tooth-containing fragments of the lower jaw are fixed in a new position between each other and to the fragments of the branches of the lower jaw with plates and screws. Mucoperiosteal flaps are closed in the oral cavity.

EFFECT: method enables reducing the number of surgical injuries accompanying the elimination of the mandibular body defects, avoiding the inconveniences caused to the patients, as well as reducing the length of rehabilitation.

1 cl, 2 ex, 6 dwg