[The use of autogenous free vascularized fibula transplant for the correction of severe mandibular atrophy]. / Primenenie revaskuliarizirovannogo malobertsovogo autotransplantata dlia ustraneniia vyrazhennoi atrofii nizhnei cheliusti.

The purpose of the study was to increase the effectiveness of surgical treatment and rehabilitation of patients with severe mandibular atrophy by means of autogenous free vascularized fibula transplant use with subsequent dental implants placement in the reconstructed mandible and implant-retained fixed dentures. In 2017 5 female patients underwent surgical treatment of severe mandibular atrophy with autogenous free vascularized fibula transplant in Maxillofacial Surgery department of CRID with additional nonvascularized iliac bone grafts and functional rehabilitation with implant-supported constructions in two of the cases. Due to its form, length and vascularization fibular bone represents a good plastic material for full length mandibular alveolar part reconstruction. The inclusion of the skin paddle in the autogenous free vascularized fibula transplant promotes secure primary closure of the surgical wound in the oral cavity. The use autogenous free vascularized fibula transplant in patients with severe mandibular atrophy with demands a thorough presurgical planning and intraoperative modeling.

[Evolution of the mandibular defects reconstruction with free fibula flapx]. / Évoliutsiia v planirovanii i modelirovanii revaskuliarizuemogo malobertsovogo autotransplantata pri ustranenii defektov nizhnei cheliusti.

One of the most important steps in achieving aesthetical and functional result in mandible reconstruction with fibula free flap is positioning of the bony part relative to the basis of the native mandible. Positioning fibular bony part continuing inferior mandible border may produce a high discrepancy between the residual mandible and fibula bone that results in difficulty in denture rehabilitation. Positioning fibular bony part continuing alveolar mandible border creates asymmetric jowls and changed shape of jawline in border-line zone. The double-barrel technique solves this problem, but needs a meticulous preoperative planning and precision free fibula flap modelling.

[A new method of evaluation of split renal function based on contrast-enhanced multislice spiral computed tomography].

INTRODUCTION: Traditionally, evaluation of the split renal function is performed using nephroscintigraphy. However, as shown in several studies, there might be quite significant inaccuracy in the interpretation of dynamic nephroscintigraphy results. But due to the lack of alternative methods for evaluation of split renal function, nephroscintigraphy remains the method of choice. AIM: To investigate the feasibility of digital analysis of contrast-enhanced MSCT imaging for evaluation of the split renal function. MATERIALS AND METHODS: This is a prospective study conducted at the R.M. Fronshteyn Clinic of Urology from November 2015 to February 2017. The study comprised 31 patients with urolithiasis (n=7), hydronephrosis (n=9), kidney cancer (n=14) and urinary bladder tumor (n=1). During the preoperative period, the patients underwent contrast-enhanced MSCT, 3D-reconstruction, and digital analysis. The obtained data were compared with the results of dynamic nephroscintigraphy. RESULTS: Contrast-enhanced MSCT findings were not inferior to data obtained with dynamic nephroscintigraphy regarding information content (p<0.004). CONCLUSIONS: The new method of digital processing of three-dimensional contrast-enhanced MSCT allows for concomitant assessment of both the anatomical features of the kidney and renal function that may help to improve the accuracy of surgical planning to choose the optimal extension of the intervention.

[Potentials of 3D-modeling in reconstructive orbital surgery].

A technique of bone reconstructive surgery of orbitofrontonasomalar region using 3D-modeling based on multispiral computer tomography data is presented. The efficacy of intraoperative templates created using 3D-modeling was showed for harvesting and modeling of bone calvarial autografts. The steps of reconstructive procedure are explained in details for repair of medial and inferior orbital fractures.

[Planning and performing surgical stage of dental implantation in difficult clinical cases based on computer modeling].

Clinical experience of preoperative computer modeling of dental implant intervention is described. By studying the ergonomics and the accuracy a proper stereolithography guide is selected. This method allows performing a complex preoperative virtual study of dental implants placement depending on future prosthodontics restoration in difficult clinical cases. Requires collaboration at the planning stage of prosthodontist, surgeon, radiologist, 3D-modeling specialists.

[Clinical opportunities of 3D-modeling for implant treatment planning for the patients with full or partly adentia in difficult anatomo-topographic conditions].

The message is about dental rehabilitation in difficult anatomo-topographic conditions of full adentia and high-grade atrophy of alveolar processes. The more high quality level decision of this problem using the methods of 3D-computer modeling during the diagnostic examination and planning of dental implantation is proposed.