ELIMINATION OF MANDIBULAR DEFECTS BY ENDOPROSTHESIS CREATED BY TECHNOLOGY OF ADDITIVE STEREOLITHOGRAPHY
1Department of Maxillofacial Surgery with Pediatric Dentistry, Institute of Postgraduate Education in Healthсare of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
2Department of Maxillofacial Surgery and Dentistry of the Siberian State Medical University, Tomsk, Russian Federation
3Department of Maxillofacial Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4Division of Radiation Diagnostics, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation
Objective: Improving the technology of creating and manufacturing individual implantation designs in maxillofacial surgery based on stereolithographic stimulation.
Methods: The study is based on the analysis of the results of treatment of 12 patients aged 17-40 years with different pathologies of the mandibular bone structures: adamantinoma – 5 (41.7%), posttraumatic deformities – 2 (16.6%) and bisphosphonate-related and radiation-related necrosis of the lower jaw – 5 (41,7%). Both clinical and laboratory methods of examination of all patients were carried out according to the traditional scheme, and as a radiologic study, we chose CT in the 3D printer mode. Its indices allowed creating an additive technology of reproduction and manufacturing of a stereolithographic model of the maxillofacial bones. On these models, taking into account the volume, size of the defect and its individual characteristics, a wax composite was prepared, and then prepared a design of an endoprosthesis made of nickel-titanium alloy.
Results: The results of surgical interventions in 12 patients who underwent substitution of mandible defects were performed using implant structures based on CT data in a 3D printer mode using stereolithographic models, showed their high efficiency. All the operated patients had a primary wound healing in the postoperative period, earlier restoration of the volume of the lower jaw movement, which is confirmed by clinical and electromyographic studies of the function of the masticatory muscles of the operated zone.
Conclusions: The use of individual implant structures to replace bone defects of the lower jaw, created in the 3D printer mode on stereolithographic models, allows to shorten the operation time and fully restore the lost anatomical and aesthetic disorders of the maxillofacial area.
Keywords: Adamantinoma, implantation structure, nickel-titanium alloy, endoprostheses, stereolithography, 3D printer.
- Verbo EV, Ordzhonikidze MZ, Filippov IK. Optimizatsiya etapnogo lech-eniya patsientov s obshirnymi kombinirovannymy defektami litsa [Opti-mization of stage treatment of patients with extensive combined facial defects]. Stomatologiya. 2015;3:25-32.
- Gyunter VE. Materialy i implantaty s pamyat’yu formy v meditsine [The materials and implants with shape memory in medicine]. Tomsk, RF: MITS; 2014. 342 р
- Kokarev OV, Khodorenko VN, Radkevich AA, Gyunter VE, Chekalkin TL. Razvitie i diferentsirovka mezenkhimal’nykh kletok kostnogo mozga v poristo-pronitsaemykh implantatakh iz nikelida titana in vitro i in vivo [Development and differentiation of bone marrow-derived mesenchymal cells in porous implants from nickel-titanium alloy in vitro and in vivo]. Kletochnye tekhnologii v biologii v meditsine. 2016;2:108-15.
- Radkevich AA, Gantimurov AA, Galonsky VG, Khodorenko VN, Che-kalkin TL, Gyunter VE. Endoprotezirovanie vetvi i tela nizhney chelyusti s ispol‘zovaniem implantatov iz nikelida titana [Endoprosthetics of the man-dibular branch and body using implants of nickel-titanium alloy]. Tomsk, RF: Izd-vo OOO “NPP”; 2009. 16 p.
- Paches AI. Opukholi golovy i shei. 5-e isd., dop. i pererab. [The tumors of the head and neck]. Moscow, RF: Prakticheskaya meditsina; 2013. 478 p.
- Tairov UT, Yusupov ZYu, Dzhumaev ShM. Ispol’zovanie rekostruktivnykh titanovykh plastin i implantatov myshchelkovogo ot-rostka pry khirurgicheskom lechenii novoobrazovaniy nizhney chelyusti [Use of reconstructive titanium plates and the implants of condylar pro-cess under surgical treatment the neoplasms of mandible]. Vestnik Avitsen-ny [Avicenna Bulletin]. 2015;2:64-8.
- Khushvakhtov DI, Shakirov MN, Rizoev RR, Dzhonibekova RN. Tsistektomiya s zapolneniem kostnoy polosti poristo-pronitsaemym nikelid-titanom, obogashchyonnym trombotsitarnoy massoy [Cystektomy with filling the bone cavity by porous-permeable nikelid of titanium, en-riched with thrombocytic mass]. Vestnik poslediplomnogo obrazovaniya v sfere zdravookhraneniya. 2015;4:46-9.
- Shakirov MN, Gafarov KhO, Mirzoev MSh. K voprosu endoproteziro-vaniya myshchelkovykh otrostkov v khirurgicheskom lechenii stoykikh dvustoronnikh privychnykh vyvikhov nizhney chelyusti (sluchay iz prak-tiki) [To the issue of endoprosthetics of condylar processes in the surgical treatment of persistent bilateral jaw putbursts of the lower jaw (a case re-port)]. Nauchno-prakticheskiy zhurnal TIPPMK. 2011;4:48-51.
- Baulin IM, Badalyan VA, Ryakhovskiy AN. Eksperimental’noe issledo-vanie kollagenovoy matritsy dlya uvelicheniya ob’yoma desny s ispol’zovaniem 3D-modelirovaniya [The experimental study collagen ma-trices for increase the volume of the gums with use 3D-modeling]. Stomatologiya. 2015;5:8-10.
- Andonović V, Vrtanoski G. Growing rapid prototyping as a technology in dental medicine. Mech Eng Sci J. 2010;29:31-9.
- Yun PY. The application of three-dimensional printing techniques in the field of oral and maxillofacial surgery. J Korean Assoc Oral Maxillofac Surg. 2015;41:169-70.
- Dikova T, Dzhendov D, Simov M. Modern trends in the development of the technologies for production of dental constructions. Journal of IMAB – eAnnual Proceeding. 2015;21(4):974-81
- Hussein MO, Hussein LA. Novel 3D modeling technique of removable partial denture framework manufactured by 3D printing technology. Int J Adv Res. 2014;9:686-94.
- Katreva I, Dikova T, Abadzhiev M. 3D-printing in contemporary pros-thodontic treatment. Scripta Scientifica Medicinae Dentalis. 2016;2(1):16-20.
Mirzoev Mansurdzhon Shomilovich, Candidate of Medical Sciences, Head of the Department of Maxillofacial Surgery with Pediatric Dentistry, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Shakirov Mukhamedzhan Nigmatovich, Doctor of Medical Sciences, Professor of the Department of Maxillofacial Surgery and Dentistry of the Siberian State Medical University
Khushvakhtov Dodardzhon Izzatovich, Candidate of Medical Sciences, Assistant of the Department of Maxillofacial Surgery with Pediatric Dentistry, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Dzhonibekova Roziya Nadzhmuddinovna, Candidate of Medical Sciences, Head of the Department of Maxillofacial Surgery, Avicenna Tajik State Medical University
Grigoryev Evgeniy Gennadievich, Candidate of Medical Sciences, Senior Researcher, Division of Radiation Diagnostics, Tomsk National Research Medical Center, Russian Academy of Sciences
Address for correspondence:
Mirzoev Mansurdzhon Shomilovich
Candidate of Medical Sciences, Head of the Department of Maxillofacial Surgery with Pediatric Dentistry, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
734026, Republic of Tajikistan, Dushanbe, Somoni Ave., 59
Tel.: (+992) 919 172701
Materials on the topic:
- EFFICIENCY OF THE APPLICATION OF «STIMUL-OSS» OSTEOPLASTIC MATERIAL IN COMBINATION WITH PLATELET-RICH PLASMA FOR THE EXTRACTION OF THE RETAINED AND DYSTOPIC MANDIBULAR THIRD MOLAR
- APPLICATION OF SORPTION TECHNOLOGIES IN COMPLEX TREATMENT OF PURULENT-INFLAMMATORY DISEASES OF THE MAXILLOFACIAL AREA
- THE STUDY OF THE DEFECTS OF THE DENTITION PREVALENCE IN THE PLANNING OF ORTHOPEDIC DENTAL HEALTH SERVICE