Method for surgical approach to lower jaw experimentally in rabbit

FIELD: medicine.

SUBSTANCE: method involves general anaesthesia, tissue dissection, lower jaw skeletisation, defect creation, and wound closure. The skin is incised in a projection of a lower edge of the lower jaw within the vascular segment at 5 mm from the edge of the lower jaw. The incision extends by blunt dissection towards the lower edge of the lower jaw with the facial vein and artery towards the mandibular angle; the lower edge of the lower jaw is skeletonised within the vascular segment. A blind vascular bed is formed within the vascular segment or at 1-5 mm anteriad from the vascular segment at an angle of 40-75° to the lower edge of the lower jaw in parallel with the mandibular canal; an implant made of the investigated material is placed into the bone bed until primarily stabilised.

EFFECT: method provides the minimum injuries accompanying creating the wound, reduces the risk of the incision wound damage by animals, enables performing the operation on both sides of the skeleton simultaneously, provides an adequate amount and quality of the bone tissue in the surgical area, reduces a risk of involving vital anatomical regions, and preserves the functional and anatomical integrity of the mastication muscles.

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The invention relates to medicine, namely to experimental surgery, pathological anatomy and pathological physiology. Various methods of surgical access in the experiment on rabbits to evaluate the osseointegration of materials.

The known method of surgical access to the lower jaw in the experiment on rabbits to evaluate the osseointegration of materials, which consists in the following steps. Under General anesthesia the animal is removed right lower Central incisor and create a bone defect of the wall of the alveoli, breaking off a fragment of her vestibular surface at 1/3 height. This was cut and otlivali trapezoidal mucoperiosteal flap in the extracted tooth on the vestibular surface of the alveolar process of the jaw. Within the alveoli cutters of increasing diameter is formed perceiving the implant, delving below the bottom of the hole about 1/3 of its length [1].

The disadvantage of this method is to create trauma the wound, the risk of possible damage by animals of the postoperative wound, the risk of infection of the wound microflora of the oral cavity, insufficient volume and quality of bone tissue in the operated area.

The known method of surgical access in the experiment on rabbits to evaluate the osseointegration of materials, which consists in the implantation of materials � the bodies of the lumbar vertebrae [2].

The disadvantage of this method is to create trauma the wound, the risk of possible damage by animals of the postoperative wound, insufficient volume and quality of bone tissue in the operated area, the risk of damage to vital organs.

The known method of surgical access to the lower jaw in the experiment on rabbits to evaluate the osseointegration of materials, which consists in the following steps. Under General anesthesia, an incision of tissues, stellerovaya angle and Ramus from masticatory muscles, draw the angle and the branch of the jaw, using a cutter to create round defect. The defect is closed with an implant overlap, strengthening it in the corners in the bone with titanium screws, sutured the wound [3].

The disadvantage of this method is to create trauma the wound by skeletonname actually chewing muscles, insufficient volume and quality of bone tissue in the operated area, the risk of inferior alveolar nerve damage, impaired functional and anatomical integrity of the masticatory muscles.

This method is taken as a prototype.

The aim of the invention is to ensure the minimal trauma of the creation of the wound, reducing the risk of damage of the animals of the postoperative wound, creating opportunities to operate simultaneously on opposite sides of the skeleton, providing�ions of sufficient volume and quality of bone tissue in the operated area adequate fixation of the implant, reducing the risk of damage to vital anatomical structures, the preservation of functional and anatomical integrity of the masticatory muscles.

This object is achieved in that an incision of the skin in the projection of the lower edge of the lower jaw, in the field of vascular clippings, some distance of 5 mm from the edge of the lower jaw; stupidly held in the region of the lower edge of the lower jaw, averting facial vein and artery in the direction of the angle of the mandible; produces stellerovaya the lower edge of the mandible in the field of vascular clippings; forming blind bone bed in the field of vascular clipping or some distance of 1-5 mm anterior to the vascular notch, angle of 40-75° with respect to the lower edge of the mandible parallel to the mandibular canal; in a bone bed set bicortical the implant material to the primary stability.

Method is used as follows. Under General anesthesia, make a removal of hair in the submandibular region of the rabbit. Produce antiseptic treatment of the surgical field. Make a skin incision in the projection of the lower edge of the lower jaw, in the field of vascular clippings, some distance of 5 mm from the edge of the lower jaw. Stupidly held in the region of the lower edge of the lower jaw, averting facial vein and artery in the direction of the angle of the mandible; producing� stellerovaya the lower edge of the mandible in the field of vascular clippings; form blind bone bed in the field of vascular clipping or some distance of 1-5 mm anterior to the vascular notch, angle of 40-75° with respect to the lower edge of the mandible parallel to the mandibular canal in a bone bed set bicortical the implant material to the primary stability. The wound is sutured in layers. At the stages of osseointegration excreted from the animal experiment. We study the osseointegration of the material with a spongy and compact bone tissue.

The method is illustrated graphic material. Figure 1 shows the skin incision in the projection of the lower edge of the lower jaw, in the field of vascular clippings, some distance of 5 mm from the edge of the lower jaw. Figure 2 shows stellerovaya the lower edge of the mandible in the field of vascular clippings. Figure 3 shows the formation of the blind of the bone bed in the field of vascular clippings at an angle of 40° with respect to the lower edge of the mandible parallel to the mandibular canal. Figure 4 shows the installation in a bone bed bicortical of the implant material to the primary stability.

Figure 5 schematically illustrates the formation of the blind of the bone bed in the field of vascular clippings under an angle of 75° with respect to the lower edge of the mandible parallel to the mandibular canal.

Figure 6 schematically shows the f�armirovanie blind bone bed some distance 1-5 mm anterior to the vascular clipping angle of 75° with respect to the lower edge of the lower jaw, parallel to the mandibular canal.

The proposed method allows you to enter the implant bicortical in spongy substance, which allows to study the processes of osseointegration with cortical and cancellous bone tissue. The formation of the bone bed at the angle of 40-75° with respect to the lower edge of the lower jaw, parallel to the canal of the lower jaw allows not to damage the neurovascular bundle, as well as the roots of the teeth, which are directed distally, in the direction of corner and border the bone cavity. Bone insertion area of the studied implant free of vital anatomical structures. When the proposed method of scilliroside the lower edge of the mandible in the field of vascular clippings preserved anatomical and functional integrity of the masticatory muscles.

Achieve the result of the new method is confirmed by examples, produced on the basis of the Institute of experimental medicine and biotechnology, Samara state medical University.

The method presents the following examples.

Example 1. From the vivarium taken rabbit-male, weighing 2500 g. Under General anesthesia (Zoletil-Rometer) removes hairline in the submandibular region of the rabbit. Produced antiseptic treatment of the surgical field. Produced skin incision in the projection of the lower edge of the lower jaw, in the area of SOS�destoy clippings, some distance of 5 mm from the edge of the lower jaw. Stupidly passed into the region of the lower edge of the mandible. Allotted facial vein and artery in the direction of the angle of the mandible. Produced by stellerovaya the lower edge of the mandible in the field of vascular clippings. Formed blind bone bed in the field of vascular clippings at an angle of 40° with respect to the lower edge of the mandible parallel to the mandibular canal. In a bone bed set bicortical the implant material to the primary stability. The wound is sutured in layers. The animal alive and transferred to the vivarium. On the 6th month after the operation the animal is derived from the experiment. Produced by fixation of the drug in 12% neutral formalin for 2 days. After fixation, the material is washed in running water for 24 hours. The drug decalcified in a solution of Trilon-B for 4 weeks Degreasing and dehydration of the material carried out in ethanol solutions (C2N5OH) of increasing concentration (70°, 80°, 96°, and absolute alcohol for 2-3 h in each solution), with further casting in paraffin. Slices with a thickness of 5 μm is made on a rotary microtome Sakura with subsequent staining with hematoxylin and eosin and pikrofuksin by van gieson. Investigated the osseointegration of the material with a spongy and compact bone tissue.

Example 2. From the vivarium taken rabbit-male mA�Soi 2500 G. Under General anesthesia (Zoletil-Rometer) removes hairline in the submandibular region of the rabbit. Produced antiseptic treatment of the surgical field. Produced skin incision in the projection of the lower edge of the lower jaw, in the field of vascular clippings, some distance of 5 mm from the edge of the lower jaw. Stupidly passed into the region of the lower edge of the mandible. Allotted facial vein and artery in the direction of the angle of the mandible. Produced by stellerovaya the lower edge of the mandible in the field of vascular clippings. Formed blind bone bed some distance by 5 mm. anterior to the vascular clipping angle of 75° with respect to the lower edge of the mandible parallel to the mandibular canal. In a bone bed set bicortical the implant material to the primary stability. The wound is sutured in layers. The animal alive and transferred to the vivarium. At 10 months after surgery, the animal is derived from the experiment. Produced by fixation of the drug in 12% neutral formalin for 2 days. After fixation, the material is washed in running water for 24 hours. The drug decalcified in a solution of Trilon-B for 4 weeks Degreasing and dehydration of the material carried out in ethanol solutions (C2H5OH) of increasing concentration (70°, 80°, 96°, and absolute alcohol for 2-3 h in each solution) further �Levkoy in paraffin. Slices with a thickness of 5 μm is made on a rotary microtome Sakura with subsequent staining with hematoxylin and eosin and pikrofuksin but van gieson. Investigated the osseointegration of the material with a spongy and compact bone tissue.

The positive effect of the proposed method is expressed in the fact that it provides minimal trauma when creating the wound, reduces the risk of damage by animals of the postoperative wound, creates opportunities to operate simultaneously on opposite sides of the skeleton, provides sufficient volume and quality of bone tissue in the operated area, reduces the risk of damage to vital anatomic areas, the preservation of functional and anatomical integrity of the masticatory muscles.

The method can be applied and widely used in experimental medicine to study the effects of new composite materials on the process of osseointegration.

Sources of information

1. Nikolsky, V. Y. Morphological analysis of reparative osteogenesis by direct dental implantation in the experiment on rabbits. Dentistry No. 3, 2005.

2. Korshunov V. A. Comparative analysis of the osseointegration properties of various implants in the experiment http://spinet.ru/news/?id=721

3. Malginov N. N. Improving the efficiency of osseointegration of titanium dental implants �UTEM optimization of their shape, the structure of the surface and application of cellular technologies in the experiment: Diss. Dr. med. Sciences. - Moscow. - 2011.

Method of surgical access to the lower jaw in the experiment on rabbits to evaluate the osseointegration of the material, including General anesthesia, an incision of tissues, stellerovaya lower jaw, the creation of the defect, wound closure, characterized in that an incision of the skin in the projection of the lower edge of the mandible in the field of vascular clippings, some distance of 5 mm from the edge of the lower jaw; stupidly held in the region of the lower edge of the lower jaw, averting facial vein and artery in the direction of the angle of the mandible; produces stellerovaya the lower edge of the mandible in the field of vascular clippings; form blind bone bed in the field of vascular clipping or some distance of 1-5 mm anterior to the vascular notch, angle of 40-75° with respect to the lower edge of the mandible parallel to the mandibular canal in a bone bed set bicortical the implant material to the primary stability.



 

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