RU-2861638-C1 - METHOD FOR ALVEOLAR BONE AUGMENTATION USING AUTOGENOUS TOOTH TISSUES

RU2861638C1RU 2861638 C1RU2861638 C1RU 2861638C1RU-2861638-C1

Abstract

FIELD: surgical dentistry. SUBSTANCE: invention is intended for use in increasing the volume of alveolar bone. Removal of the periodontal ligament, cementum, pulp tissue, separation of a dentin fragment into plates with a thickness of 1 mm to 1.5 mm is carried out. An incision of the mucous membrane down to the bone is made in the area of the defect, a mucoperiosteal flap is cut out and reflected, decortication of the bone area in the area of the bone defect is carried out. The obtained dentin plate is fixed with screws in the area of the bone tissue deficiency of the alveolar process of the upper jaw or the alveolar part of the lower jaw. The mucoperiosteal flap is placed back in place, the wounds are hermetically sutured. Wherein during decortication of the bone area in the area of the bone defect, autogenous bone chips are collected, and the obtained plate is fixed from the vestibular side of the alveolar process with complete overlap of the defect along its perimeter. The fixation is carried out with the plates installed at a distance of 0.5-2 mm from the physiological vestibular bone contour, after which the fixed plate is thinned to a thickness of 0.5-0.9 mm with rotating tools with diamond coating. Then, a screw for osteosynthesis is fixed in the centre of the lower edge of the plate into the alveolar process, with the outer side of the plate resting on the screw head, after which autogenous chips are placed in the area of the defect, first filling the cavity above the lower screw in the lower third of the plate, and then until the space between the plate and the alveolar process is completely filled. Depending on the size of the defect, one or two plates are used. EFFECT: creating a contour for bone tissue formation, placing implants at an earlier date, reducing rehabilitation time, avoiding postoperative complications in the form of oedema, haematoma, changes in facial configuration, severe postoperative pain due to the use of autogenous thin plates from extracted teeth. 1 cl, 6 dwg, 2 ex

Inventors

Amkhadova Malkan Abdrashidovna
Mityushin Artem Anatolevich
Abdurakhmanova Mesedo Shekhakhmedovna
Gergieva Tamara Feliksovna
Amkhadov Islam Sultanovich
Dzhabrailova Maryam Abuevna

Dates

Publication Date: 20260506
Application Date: 20251023

Claims (2)

1. A method of alveolar bone grafting using dental autotissues, which includes removing an autogenous tooth and preparing it, including: removing the periodontal ligament, cement, pulp tissue, separating the dentinal fragment into plates 1 mm to 1.5 mm thick, making an incision in the mucous membrane down to the bone in the area of the defect, cutting out and peeling off the mucoperiosteal flap, decorticating the bone area in the area of the bone defect, fixing the resulting dentinal plate with screws in the area of bone tissue deficiency in the alveolar process of the upper jaw or the alveolar part of the lower jaw, placing the mucoperiosteal flap in place, hermetically suturing the wound, characterized in that when decorticating the bone area in the area of the bone defect, autogenous bone chips are collected, the resulting plate is fixed with the vestibular sides of the alveolar process with complete coverage of the defect along its perimeter, while the fastening is carried out with the installation of plates at a distance of 0.5-2 mm from the physiological vestibular bone contour, after which the fixed plate is thinned to a thickness of 0.5-0.9 mm with rotating instruments with a diamond coating, then a screw for osteosynthesis is fixed in the center of the lower edge of the plate into the alveolar process with the support of the outer side of the plate on the screw head, then auto-chips are placed in the area of the defect, and first the cavity above the lower screw in the lower third of the plate is filled, and then until the space between the plate and the alveolar process is completely filled.
2. The method according to paragraph 1, characterized in that, depending on the size of the defect, one or two plates are used.

Description

The invention relates to the field of medicine, namely to surgical dentistry, and can be used to increase the volume of alveolar bone. Currently, dental implantation procedures are becoming increasingly common in outpatient dentistry, as they often involve cases of insufficient jaw bone volume in the proposed area of intervention. Bone reconstruction surgery to increase horizontal and vertical bone volume in the third quadrant is known. The surgery was performed using bone plate grafting with augmentation of crushed autogenous bone. (Journal of Clinical Dentistry. Smbatyan E.S. et al. "On the clinical application of a new method of bone tissue restoration in dental implantology. The Fuad Curie method." 2010/4 Oct-Dec. p. 43). The disadvantages of this method are its high traumatic nature, since an autogenous bone block is taken, which entails pronounced, negative postoperative phenomena, namely, swelling, hematoma, and severe pain. A method for lateral augmentation of the alveolar ridge of the jaw is known. An incision is made along the apex of the alveolar ridge in the area of the planned bone grafting. A mucoperiosteal flap is raised. The tooth is extracted. The socket is examined. An autogenous dentin block (ADB) is formed from the extracted tooth, matching the shape and size of the bone defect to be replaced. Through-and-through perforations are made over the entire area in a staggered pattern. The fabricated ADB is placed in a 2% chlorhexidine solution for 15 minutes. The receptacle is perforated, and a bevel is formed around its perimeter at an obtuse angle of 145-120°, congruent with the previously formed bevel of the ADB. After antiseptic treatment, the resulting material is placed in the defect area and secured with two mini-screws. Next, the mucoperiosteal flap is placed in place and secured with synthetic braided suture material. (RU Patent 2804989, IPC A61B 17/24, published 2023). The closest method is alveolar bone grafting with dental autotissues in the form of plates during osteoplastic surgeries, which includes extraction of teeth with vital pulp, preparation of extracted teeth, including: removal of the coronal portion, root apices, periodontal ligament, cementum, pulp tissues, separation of the dentinal fragment into rectangular plates with a thickness of 1 mm to 3 mm, making an incision of the mucous membrane down to the bone in the defect area, cutting out and peeling off the mucoperiosteal flap, decortication of the bone area in the bone defect area, adaptation and fixation of the dentinal plates with screws, placing the mucoperiosteal flap in place and hermetically suturing the wound. (RU Patent 2768970, IPC A61B 17/00, published 2022). When transplanting solid dentin fragments tightly adjacent to the alveolar ridge, only cortical jaw bone tissue forms, with pronounced sclerosis. This conglomerate creates an unpredictable situation for the long-term durability of dental implant-supported orthopedic structures. Postoperatively, any augmentation carries a risk of primary exposure. If solid dentin fragments become exposed, they will be completely lysed. Another disadvantage is the risk of primary graft exposure in the postoperative period, which, in the case of solid DBA, can lead to complete or significant lysis. Furthermore, the recovery period is at least six months. The objective of the proposed invention is to eliminate the above-mentioned shortcomings, to create an effective method for augmenting alveolar bone defects by reducing the regeneration time, by being atraumatic (tooth extraction is more atraumatic than bone block harvesting), and by providing enamel fragments to achieve a lasting osteoconductive effect. To solve the problem of alveolar bone grafting with autogenous dental tissue, the procedure involves removing the autogenous tooth and preparing it. Specifically, it involves removing the periodontal ligament, cementum, and pulp tissue, and separating the dentin fragment into 1 mm to 1.5 mm thick plates. An incision is made through the mucosa to the bone in the defect area, a mucoperiosteal flap is dissected and elevated, and the bone in the defect area is decorticated. The resulting dentin plate is fixed with screws in the area of bone deficiency in the alveolar process of the maxilla or the alveolar portion of the mandible. The mucoperiosteal flap is then repositioned, and the wounds are hermetically sutured. What's new is that during decortication of the bone defect, autogenous bone chips are harvested from the area, and the resulting plate is secured to the vestibular aspect of the alveolar process, completely covering the defect along its perimeter. The plates are positioned 0.5-2 mm from the physiological vestibular bone contour. The secured plate is then thinned to a thickness of 0.5-0.9 mm using rotating diamond-coated instruments. An osteosynthesis screw is then fixed into the alveolar process along the center of the lower edge of the plate, resting the outer surf