The important point in the implementation of bone grafting is a reliable fixation of fragments of the lower jaw in the last operational period. The choice of method of fixation depends on the clinical situation (the presence of teeth on the fragments, scar contraction and the degree of displacement of fragments).
Accordingly, the fixation can be carried out application tires, razoblacheniyami, periosteal metal plates and plate apparatus with external devices for fixation.
We used bone grafting of the mandible when using the outside of the ribs 108 of the patients, during the replacement paleopathology resection defects — 58, during the replacement of gunshot defects — 30, in the treatment of microgenia — 17 and during the replacement of defects of the mandible at the completion of an extensive sequestration — in 3 patients.
In previous articles we stated the point of view of the advantage of primary bone grafting with replacement paleopathology defects after removal of benign tumors.
In all cases, the use of primary bone grafting in the removal of benign tumors (39 patients) and malignant (2 patients) without prior radiation treatment of the tumor bone grafts had. Of 15 patients with malignant tumors who underwent primary autoplastic bone grafting after radiotherapy, 3 patients occurred graft rejection.
We are firmly convinced that the question of primary bone grafting of the mandible for the treatment of malignant tumors should be treated individually depending on the distribution of tumors in the surrounding soft tissue.
In 3 cases, when after removal of the tumor revealed a significant deficit in the surrounding soft tissues, we limited the holding of local plastic operations aimed at sealing the oral cavity, improving the functions of eating, speech, breathing.
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