METHOD FOR POSTERIOR FLEXION OSTEOTOMY OF A TOOTH-CONTAINING FRAGMENT OF THE LOWER JAW DURING AN ORTHOGNATHIC OPERATION Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery, and is intended for use in orthognathic surgery. After infiltration and mandibular anaesthesia, the mucous membrane of the lower fornix of the oral vestibule is incised on both sides, at distance of 0.5 cm from the edge of the attached gum, from the projection of tooth 3.5 to the middle one-third of the pterygomandibular fold on the left and from the projection of tooth 4.5 to the middle one-third of the pterygomandibular fold on the right. Then skeletonization of external and internal surfaces of body and branches of lower jaw is performed, on the inner surface of the right branch of the lower jaw, a "uvula" is visualized, and using a bur, an osteotomy of the cortical plate of the inner surface of the lower jaw is performed on the right, at 0.5 cm from the "uvula", osteotomy is continued downwards on the lower jaw body on the right parallel to its oblique line, cortical plate of outer surface of mandible body is cut in projection of teeth 4.6–4.7. Then, the lower jaw body and ramus are split on the right along the osteotomy lines, and the right lower alveolar nerve is visualized. A similar osteotomy is performed on the left. Then, lower jaw tooth-containing fragment is mobilized. An individual stereolithographic template is placed on the occlusal surface of the teeth of the upper and lower jaws. A wire ligature intermaxillary fixation is performed, and a tooth-containing fragment is placed in a planned position. Further, the joint-containing fragments are positioned and the presence of interfragmental bone interferences is assessed, in the presence of interosseous interference, an additional vertical line of the osteotomy of the tooth-containing fragment of the lower jaw is performed anteriorly from the excess bone contact to the lingual cortical plate with the using of piezosurgical equipment, subperiosteal fracture is formed by manual pressure in the lingual direction. Then the osteotomy fragment is matched with the surface of the joint-forming fragment and fixed using a plate and screws through the existing surgical approach; the surgical wounds are closed in layers.

EFFECT: due to elimination of interfragmental bone interferences, method allows to eliminate dislocations of joint-forming fragments of lower jaw, preventing their torsion and rotation.

1 cl, 4 dwg, 1 ex