Assessment of the quality of life of patients with total jaw defects

Cancer of the lower jaw is one of the most common causes of the development of total defects. There are many indices and indicators to assess the quality of life of patients with this pathology, but they do not fully describe the features of their postoperative rehabilitation. The question of developing an evaluation criterion for the introduction of a special device in patients with subtotal defects of the lower jaw remains open.Material and methods. In the period from 2010 to 2021, 100 patients with subtotal defects of the lower jaw, aged 30 to 65 years old, who are being treated in the Department of Maxillofacial Surgery at the Department of Maxillofacial Surgery of the GBUZ SKKKB, were interviewed. All patients were divided into 2 groups of 50 people each. In the main rehabilitation was carried out using a special device to optimize the biomechanics of the lower jaw, in the control group, rehabilitation was carried out without one. The article presents the results of assessing the quality of life, which were carried out using a special questionnaire.Conclusions. This questionnaire makes it possible to assess the standard of living of patients using a special device at the stages of rehabilitation.

Intraoral Bone Regeneration Using Stem Cells - What a Clinician Needs to Know: Based on a 15-Year MEDLINE Search

The choice of an appropriate autogenous source of stem cells has not been adequately addressed especially for intraoral bone regeneration. The current review aims to assess the clinical success of various human stem cells in oral bone regeneration. Articles studying the potential of various stem cells utilized for reconstruction of intraoral bone defects in humans were included in this review. Relevant articles were electronically searched in MEDLINE-PubMed database using keywords with different combinations. Only the articles published in English between 2006 and 2020 were included in this review. It was concluded that intra and extraoral stem cells can be successfully used for bone regeneration of various jaw defects. Depending on the origin, quantity, and quality, each cell type has its own advantages and disadvantages. Also, it brings to the fore the need for more clinical studies to validate and adopt the use of stem cells in regular clinical practice.

New way of closure of upper jaw defects

Article describes new original way of one-stage closure of upper jaw defects by using cutaneous-adiposal flap. The method is patented (patent of the Russian Federation for invention No. 2489096). We propose to use cutaneous-adiposal flap, mobilized in nasolabial furrow area, with axial pattern blood supply from angular artery and vein, by rotating to defect through buccal tonnel. This method allows to reliably eliminate upper jaw defect, improve functional and aesthetic results of treatment with minimal injuries caused by operation.Objective is to introduce new way of closure of upper jaw defects.

PRESERVED ALLOPLASTIC MATERIAL IN TREATMENT OF TUMORS AND ODONTOGENIC CYSTS IN CHILDREN

Long-term clinical observations on the treatment and rehabilitation of 117 children with tumors and tumor-like formations of the maxillofacial region are presented. To replace jaw defects, we used transplants preserved in various ways: frozen — in 48 patients, preserved in 0,5% formalin — in 7 patients, Kostma — in 7 pati¬ents, Deprotex — in 28 patients, Orgamax — in 27 patients. In the postoperative period, orthopedic and orthodontic rehabilitation of patients was carried out using removable and non-removable orthodontic appliances and dental implant systems. In the near term, no complications were revealed in 108 patients; consolidation of the graft with the bone bed occurred. 9 patients developed a purulent inflammatory process with allograft sequestration. The follow-ups of the patients showed that after transplantation, the allograft was gradually resorbed and replaced with a full-fledged organotypic regenerate within a period of 1,0 to 3 years. During the long-term up to 10 years follow-up, 92 patients (89,3 %) obtained good anatomical, functional and aesthetic results of rehabilitation, characterized by full restoration of the function of the dentition and facial aesthetics. In 11 patients (10,7 %), the results were satisfactory.

Fibula Graft Cutting Devices: Are 3D-Printed Cutting Guides More Precise than a Universal, Reusable Osteotomy Jig?

Individual cutting guides for the reconstruction of lower jaw defects with fibular grafts are often used. However, the application of these osteotomy tools is costly and time intensive. The aim of this study was to compare the precision of osteotomies using a 3D-printed guide with those using a universal, reusable, and more cost-efficient Multi-Use Cutting Jig (MUC-Jig). In this non-blinded experimental study, 10 cranio-maxillofacial surgeons performed four graft removals each in a randomized order using the same osteotomy angle, both proximally (sagittal cut) and distally (coronal cut), of a graft (45°, 30°, 15°, or 0°), first with the MUC-Jig then with the 3D-printed cutting guide. The 40 fibula transplants (Tx) of each method (n = 80) were then analyzed concerning their Tx length and osteotomy angles and compared to the original planning data. Furthermore, the surgeons’ subjective perception and the duration of the two procedures were analyzed. The mean relative length and mean relative angle deviation between the MUC-Jig (−0.08 ± 1.12 mm; −0.69° ± 3.15°) and the template (0.22 ± 0.90 mm; 0.36° ± 2.56°) group differed significantly (p = 0.002; p = < 0.001), but the absolute deviations did not (p = 0.206; p = 0.980). Consequently, clinically comparable osteotomy results can be achieved with both methods, but from an economic point of view the MUC-Jig is a more cost-efficient solution.