METHOD FOR COMBINED EXTENSION OF UPPER JAW IN ADULT PATIENTS WITH NARROWING OF UPPER JAW DUE TO CLEFT LIP AND PALATE Russian patent published in 2025 - IPC A61C7/00 A61B17/60 A61B17/68 A61B17/80 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to dentistry, orthodontics and maxillofacial surgery. It involves clinical photographing of the patient, anthropometry of the teeth, dental arches, cone-beam computed tomography of the skull with cephalometry and measurement of the width of apical bases in accordance with the Penn-analysis. After establishing the diagnosis, the clinical-laboratory stages of making the distraction apparatus supported by orthodontic implants are performed using analogue technologies. Orthodontic implants are installed in the area of hard palate, impressions with transfers are made with subsequent production of gypsum working models with analogues of orthodontic implants. Distraction apparatus is made and placed in the patient's mouth. Surgical stage of treatment is carried out in an operating room under combined endotracheal anaesthesia. Two 2-cm-long incisions of the mucous membrane of the upper lip are made on the sides of the cleft of the alveolar process of the upper jaw at distance of 0.5 cm from the upper arch of the vestibule. Mucoperiosteal flap is detached, an anterior surface of the upper jaw is skeletonised, the nasal mucosa is mobilized from the bottom and walls of the piriform opening. Upper jaw osteotomy is performed along Le Fort I lines. The chisel is used to separate maxillary cusps and pterygoid plates on both sides. Screw of the distraction apparatus is unscrewed in order to check the fixation stability and functionality. Edges of the incisional wound are matched and sutured. On 5th postoperative day, the distraction apparatus is activated. After activation, the activation screw is retentioned for 3 months. Further, orthodontic treatment is started. Patient is dynamically observed by an orthodontist and a maxillofacial surgeon. 6 and 12 months after completion of activation of the distraction apparatus, a control cone-beam computed tomography is carried out in order to determine the state of bone tissue after the performed surgical intervention.

EFFECT: method enables higher effectiveness of diagnosis, planning and treatment of adult patients with narrowing of the upper jaw due to cleft lip and palate by creating a single interdisciplinary algorithm of treatment, minimizing the risk of recurrences.

2 cl, 16 dwg, 2 tbl, 2 ex