Dentistry

doi: 10.25005/2074-0581-2018-20-2-3-170-175
ELIMINATION OF MANDIBULAR DEFECTS BY ENDOPROSTHESIS CREATED BY TECHNOLOGY OF ADDITIVE STEREOLITHOGRAPHY

M.Sh. Mirzoev1, M.N. Shakirov2, D.I. Khushvakhtov1, R.N. Dzhonibekova3, E.G. Grigoryev4

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.

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Authors informations:

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

E-mail: mirzoev_1965@bk.ru

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