Method for making plastic repair in frontal part of the oral cavity

FIELD: medicine.

SUBSTANCE: method involves making cut along mucogingival boundary of the maxilla down to periosteum. The mucous membrane is detached in transition fold area. It is moved towards deeper oral cavity atrium fornix and sutured to periosteum. Wound surface is covered with bound flap taken from buccal area behind lip commissure. To form the flap, the first incision is made on the maxillary transition fold area behind lip commissure. The incision is continued downwards over the cheek 2-3 mm far from the commissure towards mandibular transition fold. The second incision is done in maxillary transition fold area 1 cm distal from the previous one. The incision is continued downwards over the cheek and connected to the first incision end. Mucosubmucous flap is detached beginning from the lower end. The formed flap width in the central region is to be equal to 1 cm. The flap is turned on the feeding pedicle at an angle of 90°, laid over the wound surface on vestibular side of maxillary alveolar process and fixed with sutures on mucous membrane edge. Another version of the method involves making incision along mucogingival boundary of the mandible down to periosteum. The mucous membrane is detached in transition fold area. It is moved towards deeper oral cavity atrium fornix and sutured to periosteum. Wound surface is covered with bound flap taken from buccal area behind lip commissure. To form the flap, the first incision is made on the maxillary transition fold area along projection immediately behind lip commissure. The incision is continued downwards over the cheek towards mandibular transition fold. The second incision is done in maxillary transition fold area from the beginning of the first incision. The incision is continued downwards over the cheek towards mandibular transition fold. Mucosubmucous flap is detached beginning from the upper end. The formed flap width in the central region is to be equal to 1 cm. The flap is turned on the feeding pedicle at an angle of 90°, laid over the wound surface on vestibular side of mandibular alveolar process and fixed with sutures on mucous membrane edge.

EFFECT: improved esthetic and functional results.

2 cl

 

The method relates to medicine, in particular to oral and maxillofacial surgery, and may be applicable to deepen the vestibule of the mouth.

The known method of the plastic of the vestibule of the oral cavity [1], which consists in forming a flap of mucous membrane of the lips with the base on the alveolar ridge (part). After ofseparate mucous from the periosteum flap is placed on the alveolar ridge (part) and is stitched to the periosteum in the deepest place of the vault of the vestibule of the mouth.

The disadvantages of this method are:

- formation of an open wound and healing it by second intention;

- the possibility of significant scarring of the lip;

- the possibility of compromising the function of the lips.

Also known the way of the plastic of the vestibule of the oral cavity [1], which consists in carrying out section to the periosteum on the Muco-gingival border within the lower anterior teeth. Mucous membrane from the region of the transition folds usepreview, move into the area over the deep vault of the vestibule of the oral cavity and is stitched to the periosteum.

The disadvantages of this method are:

- healing by second intention formed on the wound surface;

- the possibility of significant scarring of the vestibule of the oral cavity with subsequent flattening;

the lack of sufficient growth in the depth of p is addware the mouth.

The closest analogue is the way the plastic of the vestibule of the oral cavity [2], which includes the above-described methods using a free graft, taken on a solid sky in the molar region. After preparation of the wound surface of the alveolar ridge (part) in accordance with the above methods it was covered free autograft, fixed joints and protective bandage.

The disadvantages of this method are:

- invasiveness donor area at the donor site;

- the possibility of rejection autograft.

The purpose of the invention is to achieve optimal functional and aesthetic results for plastic vestibule of the oral cavity in the anterior.

To achieve this goal when the plastic of the vestibule of the oral cavity in the anterior, according to the invention, for the first time are encouraged to use non-free flap from the cheek for commissural lips.

The unsatisfactory results obtained when using the nearest analogues led to this work.

The way the plastic of the vestibule of the oral cavity in the anterior as follows.

For the plastic threshold in the anterior maxilla, the incision is performed on the Muco-gingival border of the upper jaw to the periosteum. The mucous membrane at the site of the transition folds of USEPA byvaut, move into the area over the deep vault of the vestibule of the oral cavity and is stitched to the periosteum. For the formation of the first flap incision is made on the plot of the transition folds of the upper jaw projection for comissures. The incision continues down the cheek, reached 2-3 mm from comissary, transition to the crease of the lower jaw. A second incision is made at the site of the transition folds of the upper jaw distal to the previous 1 see the incision continue on the cheek down and connect with the end of the first incision. From the bottom end, usepreview Muco-submucosal flap. The width of the flap formed in the Central division should be 1 see Then the flap on the supply leg turn at an angle of 90°, is placed on the wound surface vestibular side of the alveolar ridge of the upper jaw and fixed with sutures to the edges of the mucous membrane.

For the plastic threshold in the anterior mandibular incision is performed on the Muco-gingival border of the mandible to the periosteum. The mucous membrane at the site of the transition folds usepreview, move into the area over the deep vault of the vestibule of the oral cavity and is stitched to the periosteum. The first section for forming flap are doing on the site of the transition folds of the upper jaw projection just behind commissural lips. The incision continues down the cheek to transition the crease bottom the second jaw. A second incision is made at the site of the transition folds of the upper jaw from the beginning of the first section, continuing on the cheek to transition the crease of the mandible, distal to the previous 1 see since the top end usepreview Muco-submucosal flap. The width of the flap formed in the Central division should be 1 see Then the flap on the supply leg turn at an angle of 90°, is placed on the wound surface vestibular side of the alveolar part of the mandible and fixed with sutures to the edges of the mucous membrane.

The proposed method takes proprietary flap for plastic vestibule of the oral cavity in the anterior improves the manufacturability of surgical intervention and allows you to achieve optimal functional and aesthetic results. Clinical examples.

Patient Y., 9 years old. Diagnosis: the small vestibule of the mouth, the high attachment of the frenulum of the lower lip, atrophic gingivitis. Produced plastic surgery vestibule of the oral cavity by the given method, with the closure of the wound surface proprietary flap from the cheek for commissural lips, according to the method specified. Viewed through 6 months. No complaints, functional and aesthetic result is good, the engraftment of the graft.

Patient T., 10 years. Diagnosis: the small vestibule of the oral cavity, atrophic gingivitis. Made of plastic arches on the spine of the mouth by the present method, section Muco-gingival border of the upper jaw, the separation and movement of the mucous membrane in the region deeper vault of the vestibule of the oral cavity, closing the wound surface proprietary flap from the cheek for commissural lips. Viewed through 8 months. Functional and aesthetic results are good.

Literature:

1. Middleton R.A. Preprosthetic surgery. In: R.E. McDonald, Hurt W.C., H.W. Gilmore, Middleton R. A. Current therapy in dentistry, V.7, St. Louis, C.V. Mosby company, 1980, p.267-272.

2. Artukovic A.S., Kristinka PS Comparative characteristics of methods vestibuloplasty. Dentistry, 1990, No. 6, p.54-56.

1. The way the plastic of the vestibule of the oral cavity in the front section, including the section on Muco-gingival border of the upper jaw to the periosteum, the separation of the mucosa at the site of the transition folds with moving it into a deeper vault of the vestibule of the oral cavity and podlivaniem to the periosteum, closing the wound, wherein the wound closed proprietary flap from the cheek for commissural lips to form a first flap incision is made on the plot of the transition folds of the upper jaw projection for commissural lips, continue to cut down on the cheek, reached 2-3 mm from comissary, transition to the crease of the lower jaw, make a second incision at the site of the transition folds of the upper jaw is estaline previous 1 cm, continue the cut on my cheek down and connect with the end of the first incision, usepreview Muco-submucosal flap from the bottom end, the width of the flap formed in the Central division should be 1 cm, then turn the flap on the supply leg at an angle of 90°, is placed on the wound surface vestibular side of the alveolar ridge of the upper jaw and fixed with sutures to the edges of the mucous membrane.

2. The way the plastic of the vestibule of the oral cavity in the front section, including the section on Muco-gingival border of the mandible to the periosteum, the separation of the mucosa at the site of the transition folds with moving it into a deeper vault of the vestibule of the oral cavity and podlivaniem to the periosteum, closing the wound surface, characterized in that closed the wound surface proprietary flap from the cheek for commissural lips to form a first flap incision is made on the plot of the transition folds of the upper jaw projection just behind commissural lips, continue to cut down the cheek to transition the crease of the lower jaw, a second incision is made at the site transition the folds of the upper jaw from the beginning of the first section, continue the incision on the cheek to transition the crease of the lower jaw, since the top end, usepreview Muco-submucosal flap, when this width is formed on the flap in the Central division should be 1 cm, then the flap on the supply leg turn at an angle of 90°, is placed on the wound surface vestibular side of the alveolar part of the mandible and fixed with sutures to the edges of the mucous membrane.



 

Same patents:

FIELD: medicine.

SUBSTANCE: method involves making two incisions on atrophied region of alveolar process or alveolar portion on the same side with mouth vestibule directed from one tooth to the other one in parallel to each other 2-4 mm far from each other. Each incision has beginning and end 1-1.5 mm far from dental cervix. Trapezoid incision is done on alveolar process or alveolar portion on the side close to oral cavity and a flap is built with its base turned towards the alveolar edge. Periosteum and mucous membrane are separated from bone via the produced incisions from the vestibular side and oral cavity side, forming tunnel in this way. Cortical plate of alveolar process or alveolar portion is perforated with spherical bore form vestibular side, from alveolar edge side and from oral cavity side. Resorbable membrane strip containing hydroxyapatite is introduced into the built tunnel from the oral cavity side. Some quantity of paste, containing hydroxyapatite grains, required for filling defect, is introduced into space between bone and membrane by means of syringe.

EFFECT: improved cosmetic results.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out dental prosthetics in lateral maxillary region when bone tissue height from alveolar process to the maxillary sinus is equal to 0.5-0.7 cm by increasing bone tissue height. Incision is made along alveolar process crest, mucoperiosteal flap is separated, rectangular fragment is formed in the lateral region and mucous membrane is lifted in the vicinity of maxillary sinus fundus. The newly created space is filled with osteoplastic material, intraosseous dental implants are set, the mucoperiosteal flap is laid, the wound is sutured and prosthetic repair follows. A rectangular bone fragment is formed separable. Its lower boundary is an area located at the level of maxillary sinus fundus or 1 mm higher and its upper boundary is an area planned for building new maxillary sinus fundus. When formed, the boundaries are joined with vertical saw cuts. The fragment is placed into physiologic saline. 2-3 mm thick fragment is cut out with a saw from the maxillary sinus fundus exposing a part of compact plate. After having filled the newly created space with osteoplastic material, the lateral rectangular opening is covered with the fragment taken out from the physiologic saline and fixed.

EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications; enforced osteogenesis process.

18 dwg

FIELD: medicine.

SUBSTANCE: method involves cutting mucous membrane and periosteum in the area of lateral hard palate portions. Cuts are done in anterior and middle hard palate part. Mucoperiosteal flaps are produced. The flaps are separated from nasal mucosa and bone part of the hard palate. Mucous and submucous layer are cut in retromolar zones beginning from Langenbeck incision back edge and finishing in glossal surface projection of mandibular alveolar process with pterygoid processes hamulus of the main bone being exposed. Soft tissues are detached from the processes in interfacial space layer located between musculus levator veli palatini and the hamulus to the pharyngopalatine muscle insertion site. Upper pole of musculus levator veli palatini tendons is cut in the cases of lacking mobility. Reticular implant manufactured from 40-60 mm thick titanium nickelide thread and cell size of 3x3-4x4 mm is sutured to mucoperiosteal flaps surfaces turned towards nasal cavity or to each other after moving them. The implants are attached to each other. The mucoperiosteal flaps are fixed by means of removable protection plate.

EFFECT: enhanced effectiveness of treatment; prevented flap divergence; forming solid connective tissue regenerate.

FIELD: medical engineering.

SUBSTANCE: device has casing formed by head and handle parts. External part of the casing has facial part, back part, transition parts, scraper part having sharp edge for cleaning tongue and bristle toothbrush. Bristle fibers are fixed on facial head part surface. Device casing is manufactured as a whole with the scraper part. Sharp scraper edge is formed by line of intersection of one of transition parts and back part of the external part of the casing and is directed mainly along the casing.

EFFECT: enhanced effectiveness of hygienic treatment; simplified design; low material consumption.

13 cl, 8 dwg

FIELD: medicine, oral surgery.

SUBSTANCE: one should cut the stump for several osseous fragments, replace the fragment with the help of compression-distraction apparatus till complete substitution of the defect, stabilize the fragment being the nearest one against the stump after development of the regenerate when submental area is reached, stabilize another fragment on reaching the area of mandibular angle, replace the last fragment before the contact with opposite stump is available, and in case of its absence - to cranial bottom. In peculiar case, one should cut fragments of 2 cm length. The innovation suggested enables to develop protuberance of submental area and accelerate defect's restoration.

EFFECT: higher efficiency for defects' substitution.

1 cl, 3 dwg, 1 ex

FIELD: medical engineering.

SUBSTANCE: device has two parts having symmetrical handles. The parts are joined. One of parts ends in branch having cylindrical contact tongue member. The second one ends in branch having contact frame elongated in longitudinal direction. The tongue member has polygonal cross-section hole. Hole cross-section area is greater than cylindrical tongue contour area by 15-20%.

EFFECT: improved fixation conditions; excluded slipping of curved septum part between the branches.

2 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves forming larynx lumen using stent. Silicon stent is set into larynx lumen in a way that upper end of the stent is 0.3-0.5 cm higher than the vocal cords and the lower one is 0.5 cm below stenosis area. The stent is sutured with a through U-shaped suture using long-term resorption material through larynx walls. External diameter of the stent is 1-2 mm greater than age lumen of the larynx. Tracheostomic cannula is arranged below the stent without its fixation being done.

EFFECT: enhanced effectiveness in repairing larynx lumen.

3 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves making surgical operation with defect cavity being filled with transplant modified with allofibrobalsts. Non-modified transplant is concurrently used. The modified transplant is introduced portion-by-portion, rubbing along peripheral part and waiting for previous portion to be saturated with blood. Next to it, the non-modified transplant is placed in the cavity center. The number of implants to be used is as follows in % by volume. Modified transplant makes up 70-90%, non-modified transplant 10-30%.

EFFECT: enhanced effectiveness in filling defect cavity with transplant; enhanced therapeutic effectiveness of treatment.

1 tbl

FIELD: medicine, oral surgery.

SUBSTANCE: one should perform an incision along mucous-gingival border of patient's jaw up to periosteum, separate mucosa at the section of transitional fold, replace separated mucosa into area of deeper vestibular arch to be sutured to periosteum, cover wound surface with a not free fragment out of the section of alar-mandibular fold. One should perform the first incision to form a fragment at the part of mucous-gingival maxillary border behind the tuber, continue this incision downwards along anterior edge of medial alar muscle towards mandibular transitional fold behind the 8th tooth. Then it is necessary to perform the 2nd incision at the part of maxillary transitional fold behind the 8th tooth by leaving 1 cm against the 1st one. One should continue the incision along the cheek at projection of anterior edge of mandibular branch, connect the second incision with the onset of the first one, separate mucous-submucous fragment beginning from inferior end, moreover, the width of developed fragment in central department should correspond to 1 cm. One should rotate the fragment upon nutritive pedicle at the angle of 90 deg., apply the fragment onto wound surface of vestibular side of maxillary alveolar process, fix the fragment with sutures to mucous edges. In another variant, the first incision for developing a fragment should be performed at the part of transitional maxillary fold behind the 8th tooth. One should continue this incision downwards along anterior edge of medial alar muscle to mandibular mucous-gingival border the 8th tooth. Then one should perform the second incision at the part of maxillary transitional fold behind the 8th tooth from the onset of the first incision by continuing this incision along the cheek at projection of anterior edge of mandibular branch towards transitional fold. Then one should separate mucous-submucous fragment by starting from superior edge, moreover, the width of formed fragment in central department should correspond to 1 cm. Then one should rotate the fragment upon nutritive pedicle at the angle of 90 deg. and apply it onto wound surface of vestibular side of mandibular alveolar part. The innovation suggested enables to improve functional and esthetic results of vestibular plasty of mouth cavity.

EFFECT: higher efficiency of vestibular plasty.

2 cl, 2 ex

FIELD: medicine.

SUBSTANCE: method involves shaping bone portion of alveolar process using bores and separation disks after cutting out mucoperiosteal flap having greater size then defect has, throwing out flap from exposed bone and making mobilization. Alveolar process bone plates are bluntly broken. Transplant is placed on the alveolar process, surrounded with bone plates in sandwich manner, strengthened with mucoperiosteal flap and sutured with interrupted sutures.

EFFECT: high reliability in repairing anatomical shape.

FIELD: medicine, phthisiology.

SUBSTANCE: one should create pulmonary atelectasis from inside due to applying bronchial valve in tuberculosis-affected lung in case of bronchoscopy depending upon localization of tubercular process. The method enables to avoid course anatomical alterations and functional disorders, avoid the development of reactive exudative pleuritis and rigid pneumothorax.

EFFECT: higher efficiency of therapy.

3 dwg, 1 ex

FIELD: medicine, surgical stomatology.

SUBSTANCE: in case of patient's average-severe or severe state before surgical interference or at satisfactory state - after surgical interference one should intravenously once introduce perfluorane at the dosage of 1-3 ml/kg body weight followed by daily treatment of the wound with perfluorane, washing and introducing perfluorane-impregnated gauze tampons till the end of exudation phase. The method enables to widen the number of preparations to treat odontogenic phlegmons of oral area, simplify therapeutic technique due to excluding the work with patient's blood, accelerate the process of purification and regeneration of soft tissues in the region of inflammation and shorten therapy terms.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medical engineering.

SUBSTANCE: device has supporting member and mechanism for applying pressure. The supporting member is designed as dentogingival cup fixable on maxillary teeth. Pressure mechanism is composed of springs connected to the dentogingival cup center on one end and to pelots on the other end for producing pressure in the nose deformity area.

EFFECT: simplified design; improved operation features.

2 dwg

FIELD: medicine, stomatology.

SUBSTANCE: for radical treatment of pulpitis one should lance pulpal cavity, remove pathogenic pulp and fill it with bioinert material after antiseptic treatment by applying granulated porous titanium nickelide at granules' size being 1-100 mcm and predominant pores' size being 0.5-50 mcm. The method enables to achieve reparation of trophic, protective and plastic functions of the pulp removed.

EFFECT: higher efficiency of therapy.

2 cl, 2 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: method involves shaping bone portion of alveolar process using bores and separation disks after cutting out mucoperiosteal flap having greater size then defect has, throwing out flap from exposed bone and making mobilization. Alveolar process bone plates are bluntly broken. Transplant is placed on the alveolar process, surrounded with bone plates in sandwich manner, strengthened with mucoperiosteal flap and sutured with interrupted sutures.

EFFECT: high reliability in repairing anatomical shape.

FIELD: medicine, oral surgery.

SUBSTANCE: one should perform an incision along mucous-gingival border of patient's jaw up to periosteum, separate mucosa at the section of transitional fold, replace separated mucosa into area of deeper vestibular arch to be sutured to periosteum, cover wound surface with a not free fragment out of the section of alar-mandibular fold. One should perform the first incision to form a fragment at the part of mucous-gingival maxillary border behind the tuber, continue this incision downwards along anterior edge of medial alar muscle towards mandibular transitional fold behind the 8th tooth. Then it is necessary to perform the 2nd incision at the part of maxillary transitional fold behind the 8th tooth by leaving 1 cm against the 1st one. One should continue the incision along the cheek at projection of anterior edge of mandibular branch, connect the second incision with the onset of the first one, separate mucous-submucous fragment beginning from inferior end, moreover, the width of developed fragment in central department should correspond to 1 cm. One should rotate the fragment upon nutritive pedicle at the angle of 90 deg., apply the fragment onto wound surface of vestibular side of maxillary alveolar process, fix the fragment with sutures to mucous edges. In another variant, the first incision for developing a fragment should be performed at the part of transitional maxillary fold behind the 8th tooth. One should continue this incision downwards along anterior edge of medial alar muscle to mandibular mucous-gingival border the 8th tooth. Then one should perform the second incision at the part of maxillary transitional fold behind the 8th tooth from the onset of the first incision by continuing this incision along the cheek at projection of anterior edge of mandibular branch towards transitional fold. Then one should separate mucous-submucous fragment by starting from superior edge, moreover, the width of formed fragment in central department should correspond to 1 cm. Then one should rotate the fragment upon nutritive pedicle at the angle of 90 deg. and apply it onto wound surface of vestibular side of mandibular alveolar part. The innovation suggested enables to improve functional and esthetic results of vestibular plasty of mouth cavity.

EFFECT: higher efficiency of vestibular plasty.

2 cl, 2 ex

FIELD: medicine.

SUBSTANCE: method involves making surgical operation with defect cavity being filled with transplant modified with allofibrobalsts. Non-modified transplant is concurrently used. The modified transplant is introduced portion-by-portion, rubbing along peripheral part and waiting for previous portion to be saturated with blood. Next to it, the non-modified transplant is placed in the cavity center. The number of implants to be used is as follows in % by volume. Modified transplant makes up 70-90%, non-modified transplant 10-30%.

EFFECT: enhanced effectiveness in filling defect cavity with transplant; enhanced therapeutic effectiveness of treatment.

1 tbl

FIELD: medicine.

SUBSTANCE: method involves forming larynx lumen using stent. Silicon stent is set into larynx lumen in a way that upper end of the stent is 0.3-0.5 cm higher than the vocal cords and the lower one is 0.5 cm below stenosis area. The stent is sutured with a through U-shaped suture using long-term resorption material through larynx walls. External diameter of the stent is 1-2 mm greater than age lumen of the larynx. Tracheostomic cannula is arranged below the stent without its fixation being done.

EFFECT: enhanced effectiveness in repairing larynx lumen.

3 dwg, 1 tbl

FIELD: medical engineering.

SUBSTANCE: device has two parts having symmetrical handles. The parts are joined. One of parts ends in branch having cylindrical contact tongue member. The second one ends in branch having contact frame elongated in longitudinal direction. The tongue member has polygonal cross-section hole. Hole cross-section area is greater than cylindrical tongue contour area by 15-20%.

EFFECT: improved fixation conditions; excluded slipping of curved septum part between the branches.

2 cl, 3 dwg

FIELD: medicine, oral surgery.

SUBSTANCE: one should cut the stump for several osseous fragments, replace the fragment with the help of compression-distraction apparatus till complete substitution of the defect, stabilize the fragment being the nearest one against the stump after development of the regenerate when submental area is reached, stabilize another fragment on reaching the area of mandibular angle, replace the last fragment before the contact with opposite stump is available, and in case of its absence - to cranial bottom. In peculiar case, one should cut fragments of 2 cm length. The innovation suggested enables to develop protuberance of submental area and accelerate defect's restoration.

EFFECT: higher efficiency for defects' substitution.

1 cl, 3 dwg, 1 ex

Up!