FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to plastic reconstructive surgery, and is intended for use in maxillofacial surgery for restoration of bone tissue of the alveolar crest in the distal portion of the upper jaw in bone defects of the alveolar crest, leading to through bone defects of the bottom of the maxillary sinus. Infiltration anaesthesia is performed. Thereafter, an incision is made in the area of the alveolar crest reconstruction to the bone along the border of the bone defect of the alveolar crest. Then, from the vestibular side of the alveolar process, a trapezoidal incision of the mucous membrane is made to the bone, wherein the greater base of the trapezium coincides with the incision made along the border of the bone defect of the alveolar crest, and the bone defect of the bottom of the maxillary sinus is located within the boundaries of the trapezoidal incision of the mucous membrane. Then, mucoperiosteal flaps are formed from the palatal side and from the vestibular side of the alveolar process; the mucous membrane of the alveolar process is detached from the vestibular side to the bone to the lower border of the bone defect of the bottom of the maxillary sinus. Thereafter, the mucous membrane is stratified to the upper border of the bone defect of the sinus floor. Formed mucoperiosteal flap is folded back from the vestibular side of the alveolar process. Mucous membrane of the alveolar process remained after the dissection within the bone defect of the sinus floor is detached to the bone along the perimeter of the bone defect. Thereafter, the first resorbable membrane is inserted under the mucous membrane along the perimeter of the bone defect of the sinus floor. Then, to the exposed bone of the palatal side of the alveolar process along the greater base of the trapezoidal incision, the edge of the second resorbable membrane is attached with non-resorbable pins, on the second membrane the bone material is laid in an amount sufficient to restore the bone tissue of the sinus floor and the reconstructed portion of the alveolar crest in width and height. After that, the opposite edge of the second membrane is fixed with non-resorbable pins on the exposed bone of the vestibular side of the alveolar process so that the second membrane with bone material completely overlaps the first membrane. Then, in the area of the alveolar crest reconstruction, the second membrane with the bone material is shaped close to the initial anatomical shape of the patient’s alveolar crest, after which the folded mucoperiosteal flap of the alveolar process is mobilized, pulled on the second membrane with bone material and sutured without tension with the mucoperiosteal flap of the palatine side.
EFFECT: by recovering bone tissues of the alveolar crest in bone defects leading to through bone defects of the bottom of the maxillary sinus, the method enables recovering the functions of chewing, speech, respiration, and salivation control.
1 cl, 4 dwg, 1 ex
