[«Surgery First¼ or two-stage protocol for the comprehensive rehabilitation of patients with combined deformities of the jaws]. / «Surgery First¼ ili dvukhetapnyi protokol kompleksnoi reabilitatsii patsientov s sochetannymi deformatsiyami chelyustei.

The review article examines the methodology for the complex treatment of patients with occlusion anomalies without prior orthodontic treatment, the problems of treating patients with combined jaw deformities, the history of the development and appearance of orthognathic surgery, the prerequisites for the emergence of a two-stage treatment method. Differences between two-step and classic treatment protocols. The authors described the problems associated with the use of the two-stage treatment method, the advantages of the two-stage treatment method in comparison with the classic three-stage approach, examined the goals, objectives and differences of orthodontic treatment, identified the problems associated with the implementation of this treatment method.

[Sensory disorders in inferior alveolar nerve after sagittal split osteotomy of the mandible].

Methodology of the sagittal split osteotomy of the mandible improved from year to year. However, there is still the problem of neurosensory disorders of inferior alveolar nerve in the early and late postoperative period is widely covered in the foreign literature. The incidence of these disorders ranges from 40 to 55%. During 2009-2013 years in Central Research Institute of Stomatology and Maxillofacial Surgery were operated 127 patients with associated deformities of the jaws: 102 according to traditional methods, 25 - by improved methods. Assessment of lower alveolar nerve conducted by electric teeth pulp test methods, blink reflex, computed tomography in 3D mode and the questionnaire. The results showed that the improved method of the sagittal split osteotomy of the mandible by using piezoelectric bone surgery saw during cutting of the cortical bone of the mandible and special splitters with replacing of damaging factors makes it possible to reduce the incidence of neurosensory disorders of inferior alveolar nerve and reduce the time of rehabilitation.

[Stability assessment after orthognathic procedures with multisegmental maxilla osteotomy].

Results stability of orthognathic procedures with multisegmental Le Fort I maxilla osteotomy in patients with II and III class malocclusion was assessed in the study. Multisegmental Le Fort I maxilla osteotomy allows receiving stable functional bite and reducing preoperative orthodontic treatment period.

[Diagnostics and treatment of patients with mandible salient angles].

Problem of diagnostics and treatment of patients with disproportion of lower face zone was discussed which was expressed in the form of mandible salient angles and produced aesthetic problem to many people especially to womanhood. Complex of diagnostic methods was offered that gave the possibility to differentiate types of pathology into groups for easing method of treatment chose. Methods of treatment were listed allowing to receive high aesthetic and functional results.

[Comprehensive approach to treatment of patients with teeth-jaws anomalies accompanied by nose functional disturbances and esthetic deformations].

Problem of medical rehabilitation of patients with teeth-jaws anomalies accompanied by nose functional disturbances and esthetic deformations was viewed. Method of comprehensive reconstructive intervention on facial cranium was presented allowing to restore correct jaws relationship to cranium base. Correction of nasal and endonasal structures was performed, functions of nasal breathing and esthetic face parameters as a whole were restored. Comprehensive approach to planning and carrying out surgical treatment let to receive high esthetic and functional results.

[Bioresorbable plates and screws use in treatment of patients in maxillo-facial surgery].

In department of reconstructive-regenerative surgery and microsurgery of the face and neck of CRIS in the period 2001-2004 operations on 15 patients with various diseases of maxillofacial area treatment of which demanded application of various types of clamps were made. For treatment of the patients there were used bioresorbable plates and screws from materials LactoSorb and BioSorb. In all patients optimum aesthetic and functional results were achieved.

[Experimental-morphologic study of bone tissue reaction to carbon-containing material implantation with initiated X-ray contrast property].

In experimental study on 15 rabbits (chinchilla) influence of titanium plates implanted lapped on adjacent tissues in the region of the lower jaw body (comparison group) and carbon material with added boron in the concentrations of 8 and 15% (the study group) was studied. Results of the experimental-morphological investigation show that carbon-based materials with boron addition (with its content 8 and 15%) did not impede adaptive rebuilding of bone tissues and in particular bone structure regeneration in the process of reactive rebuilding of the "maternal" bone. Moreover, as the result of reactive processes developing in osseous tissues after implantation of the tested materials their successful integration in surrounding tissue structures was detected.

[Efficacy of use of X-ray contrast carbon material in maxillo-facial surgery].

The possibilities of the use of carbon implants in cases of any defects of any part of facial skeleton and soft tissues of both inherent and acquired nature were studied. Taking into account X-ray transparency of carbon implants the experiment was carried out to make the material X-ray contrast when using the addition of powdered metallic boron in the range of concentrations 8-12%. It was successful and the samples were visualized. In these cases spiral computed tomography is the optimal tool to make all deformation volume clear, to plan operative interventions and to observe the treatment results.

[Procedure for visualization of carbonic materials in maxillofacial surgery by spiral computed tomography]. / Metodika vizualizatsii uglerodnykh materialov v cheliustno-litsevoi kirurgii s pomoshch'iu spiral'noi komp'iuternoi tomografii.

The paper considers whether carbonic materials whose contrasting is achieved when they contain 8-12% of metallic boron power may be applied to restore bone defects of the facial skull. Implants of this composition were employed to operate on 4 patients with different defects of the facial skull. A three-projection of SCT image obtained in the "SOFT" mode was used as a way of registration. The results of the studies have indicated that the materials under study have X-ray contrast, a complete biological compatibility, and non-toxicity when they are used in clinical practice.

[Anesthesia in cranio-facial surgery]. / Anesteziia v kraniofatsial'noi khirurgii.

Reconstructive operations on the facial skeleton and on the skull have been widely introduced in surgery. Increment of indications and augmentation of traumaticity from surgical interventions pose to anesthesiologist a set of such problems, as tracheal intubation, antinociceptive protection, prevention of hepatocerebral encephalopathy. The peculiarities of cerebral and hepatic circulation and metabolism as well as approaches in anesthesia and craniofacial surgery are discussed.

[Maxillonasal dysostosis: Binder's syndrome]. / Verkhnecheliustno-nosovoi dizostoz--sindrom Bindera.

It is known that the septum of the nose participates in sagittal growth of medial face. Teratogenic deficiency of vitamin K promotes premature ossification of the septum cartilage. It results in hypoplasia of maxillonasal complex, development of characteristic concave profile with the impressed and short nose with half the moon naries, infringement of an occlusion. The orthodontic treatment should be carried out from younger children's age. The surgical treatment is directed on elimination of bone-skeletal infringements of an occlusion, reconstruction of normal contours of middle face and lengthening of a nose. In our clinic for the last 13 years 11 patients with Binder's syndrome were examined and operated.

[The characteristics of the contact area of an endoprosthesis made from Ostek graphite-based material and of the mandibular bone fragment]. / Kharakteristika zony kontakta éndoproteza iz materiala na osnove grafita "Ostek" i kostnogo fragmenta nizhnei cheliusti.

Interactions between endoprostheses made of carbonic composition "Ostec" and bone tissue were studied after plastic repair of experimental vast defects in the mandible in 22 rabbits and 10 dogs over the course of 2 years. Histologic findings showed the formation of a layer of fibrous connective tissue 3 months after the operation and later; at some places the implant directly joins the rabbit bone, which frequently undergoes chondroid transformation. Microscopically, the structure of "Ostec" represents carbonic threads forming large bundles. By the 6th and 12th months of experiment connective tissue elements penetrate the fissures between the bundles and the perforation gaps of the endoprosthesis, forming bone-like and bone structures in them.

[A modified method for the surgical treatment of patients with maxillary retro- and micrognathism]. / Modifitsirovannyi metod khirurgicheskogo lecheniia bol'nykh s verkhnei retro- i mikrognatiei.

A method of surgical treatment of patients with upper retro- and micrognathia is proposed, consisting in improving the fixation of osteotomied maxillary complex. Implantation of carbonic ceramics behind the maxillary tubercles and osteosynthesis of bone fragments with titanium miniplates helps do without prolonged intermaxillary fixation and permits exercise in the early postoperative period, thus cutting down the invalidity period. Analysis of the results attained in 14 patients showed no relapses of maxillary deformation and a stable functional and esthetic effect.

[Diagnostic and treatment planning errors in patients with combined jaw deformities and the means for their prevention]. / Oshibki diagnostiki i planirovaniia lecheniia bol'nykh s sochetannymi deformatsiiami cheliustei i puti ikh profilaktiki.

The authors analyze errors in the treatment of 18 patients with combined deformations of the jaws. Errors in the diagnosis, surgical treatment and the postoperative care are discussed, as are irrational orthodontic measures. Principles of the prevention of combined therapy complications are presented.