[Alveolar distraction osteogenesis: possible complications and methods of their treatment]. / Al'veolyarnyi distraktsionnyi osteogenez: vozmozhnye oslozhneniya i sposoby ikh ustraneniya.

OBJECTIVE: The aim of the study. Analysis of emerging complications during the method of alveolar distraction osteogenesis in patients with jaw defects. A retrospective analysis of foreign and domestic literature was carried out. A systematic literary search was carried out in the electronic bibliographic databases Web of Science (for foreign articles) and Elibrary and Dissercat (for domestic). MATERIAL AND METHODS: In the period from 2005 to 2019 in the clinic of the Department of Maxillofacial and Plastic Surgery of the Moscow State Medical University. Evdokimov conducted an examination and comprehensive treatment of 490 patients with primary and secondary adentia of the upper and lower jaws, accompanied by a significant deficiency of bone tissue of the alveolar ridge vertically. A comprehensive dental rehabilitation of patients with jaw defects by the method of distraction osteogenesis was carried out. RESULTS: The most common complications are: exposure of the fixation modules of the distraction apparatus - 24% of cases, failure of bone regenerate - 13%, inflammatory phenomena - 13%, displacement of the distraction vector - 43%, paresthesia - 7%. CONCLUSION: Based on our analysis of the identified complications during the distraction osteogenesis method, it was found that these complications are not critical in the treatment of patients with jaw bone deficiency and do not jeopardize the success of rehabilitation. With diagnosis and timely approach to treatment, complications are avoidable.

SURGICALLY ASSISTED RAPID MAXILLARY EXPANSION: RETROSPECTIVE ANALYSIS OF COMPLICATIONS 2012-2017.

Surgically assisted rapid maxillary expansion (SARME) is a common technique developed to treat skeletally mature patients with transverse maxillary deficiency. Although SARME is supposed to be a relatively safe procedure, it is not completely free of complications. The purpose of this study was to reveal the most typical postoperative SARME complications. Retrospective evaluation of the clinical cases of 665 patients (247 males and 418 females, mean age 25,3 years) with the diagnosis of maxillary transverse deficiency, who underwent SARME in period between 2012 and 2017 at the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry, Moscow. According to the results of the research, the most typical complications of SARME are paresthesia of the infraorbital nerve branches and nasopalatine nerve (198/665), distraction device dislocation (61/665), inflammation in the distraction device area (57/665), insufficient expansion of the maxilla (42/665), asymmetric expansion (27/665). The number of complications revealed indicates that SARME is an operation associated with the risks of postoperative complications. Careful treatment planning, following the operation protocol and performing the minimally invasive access can help to avoid the majority of complications.