METHOD FOR SINGLE-STAGE SURGICAL AND ORTHOPEDIC COMPLEX TREATMENT OF PATIENTS WITH FACIAL BONE TUMOR Russian patent published in 2024 - IPC A61B17/24 A61B6/03 A61C8/00 A61C7/00 A61C9/00 A61C13/107 A61C13/225 

FIELD: medicine.

SUBSTANCE: invention relates to maxillofacial, plastic, reconstructive surgery, oncology and orthopedic dentistry. At the first stage in the preoperative period, cone-beam computed tomography of the facial skeleton, intraoral scanning of teeth and oral mucosa are performed. Data of both studies are combined using software. 3D models of bone, teeth and maxillary mucosa are created. Templates for upper jaw resection and directed dental implantation, and upper jaw prosthesis are created. Limits of upper jaw resection are determined. Dental implants are planned to be installed in the area of buttresses, length and width of implants are determined. At the second stage, after three-time treatment of the surgical site with a skin antiseptic solution and treatment of the oral cavity with a water antiseptic solution, mucous membrane is incised along a transitional fold to a periosteum of an upper jaw, continuing along the border of a hard and soft palate, bordering a tubercle of the upper jaw, connecting along a median line of the palate. Subperiosteal, subperichondrial mobilization of mucoperiosteal and mucoperichondrial flaps, including a nasal mucosa. Tumor is visualized. Screws are used to fix 3D models of templates in the area of planned osteotomy lines. Upper jaw osteotomy is performed according to templates. Upper jaw with the tumor is mobilized from the retaining soft tissues; the mobilized tissues are removed, and hemostasis is performed. Mucous membrane covers the exposed areas of the bone tissue and wound surfaces. Defect is closed with interrupted sutures with absorbable suture material. Dental implants are installed along osteotomy lines according to 3D models of templates, and then—ball abutments. Two-phase one-stage impression with a corrective mass is taken from the level of the abutments. Face bow is applied. Axiography is performed. Individual functional prosthesis is made. Temporary prosthesis is checked for compliance with the defect size. Temporary prosthesis is fixed in the oral cavity on abutments. Occlusion is controlled. At the third stage, 1 month after the completion of the surgical treatment, the whole complex of chemotherapeutic and radiotherapeutic interventions is performed. Temporary prosthesis is replaced with permanent one 6 months later.

EFFECT: method makes it possible to carry out complex surgical and orthopedic treatment of patients with facial bone tumors, providing immediate chewing load and restoration of initial contours of soft tissues after surgery, improving patient’s quality of life in early postoperative period and at remote stage of rehabilitation.

1 cl, 1 ex