DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY

Scientific work

SRW report

According to the results of the final report, SRW of the Department in 2017 took the first place at the university. SRW performers were awarded.

Topics of SRW of the Department in 2018-2020: STUDY AND SUBSTANTIATE THE METHODS OF DIAGNOSIS AND COMPLEX TREATMENT OF TRAUMATIC INJURIES OF THE FACIAL BONES BY STUDYING THE BIOLOGICAL PROPERTIES OF DAMAGED TISSUES AND COMPUTER TECHNOLOGY.

Among the main scientific achievements in recent years

• development of methods of maxillofacial anesthesia, treatment of inflammatory processes, congenital and acquired defects and deformities, introduction of modern diagnostic methods, computed tomography with three-dimensional reconstruction and subsequent production of plastic models (since 12.2001);
• study of the properties of osteogenic progenitor cells by cloning (since 1986);
• the phenomenon of heterogeneity of human bone marrow fibroblasts, new reparative properties of bone cells were discovered;
• cranio-maxillofacial operations for trauma (since 1987), tumors of the maxillofacial area with spread to the cranial cavity (since 1995, at the Institute of Neurosurgery) were initiated in Ukraine;
• new biologically substantiated methods of treatment of facial skull fractures, mental complex, lower and upper jaws, fronto-facial injuries, diseases of the temporomandibular joint;
• restoration of the temporomandibular joint with an auto-joint from the patient’s foot (since 1986), distraction (increase in size) of the upper and lower jaws (since 1985);
• study of reparative osteogenesis and biomechanics of facial bones in normal and fractures, other diseases;
• microvascular reconstructive operations (since 1985, at the ShalimovNational Institute of Surgery and Implantology).

RESEARCH WORK OF THE DEPARTMENT FOR 2008-2010

Topic: Clinical-biological and anatomical-physiological substantiation of maxillofacial reconstructive and restorative operations and dental implantation

Purpose: to improve the results of treatment of patients with diseases of the maxillofacial area by developing biologically sound methods of surgery and methods to optimize the reparative osteogenesis.

Object of study: patients with anomalies, deformities, traumatic injuries of the maxillofacial area and difficult eruption of the lower third molars.

Research methods: clinical, radiological, anthropometric, three-dimensional reconstruction of the facial skull according to computed tomography, research of stereolithographic models, pathomorphological, cytological, immunological, microbiological, biochemical, functional (electromyography, electroodontodiagnostics), statistical.

RESEARCH RESULTS

On the basis of clinical, radiological and anthropometric researches the classification of micrognathia of the mandible is developed and biomechanically substantiated methods of surgical treatment of patients with this pathology are offered. At the same time, the creation of bone resistances on the outer cortical plate creates a reliable resistance to the force of contraction of stretched muscles and directs the bone fragments to the original position. Muscle distraction creates the conditions for compression of bone fragments with improved contact of osteotomy surfaces and ensures the preservation of the biomechanical ratios of the restored mandible and the main masticatory muscles.

The application of the developed methods of surgical correction of mandibular micrognathia allows not only to achieve elongation of the body and branches but also helps to normalize the functional state of the masticatory muscles and their electrical activity according to electromyography, which confirms the effectiveness and feasibility of these methods.

Patient with mandibular micrognathia before and after surgery

Electromyograms of the patient before and after surgery

A new method of treating tearing disorders has been developed.

Plastics of the tear ducts with their total damage: creation of a window into the nasal cavity, collection of an autograft from the cheek, formed a tunnel from a free flap of the cheek mucosa, diversion of a tear from the conjunctival sac to the nasal cavity in the created way.

A method of complex treatment of toxic osteomyelitis of the jaws in drug-addicted patients was developed, which compared to the traditional method, in addition to reducing mortality by 5 times, increased treatment efficiency by reducing the recurrence rate in the postoperative period from 82.5% to 33.33% and purulent-septic complications from 25% to 6.66%.

Developed and pathogenetically substantiated method of surgical treatment of difficult eruption of the lower third molars by creating the necessary space for their eruption by resection of the anterior edge of the jaw, which takes into account the individual characteristics of the patient, provides a radical solution to the problem of location for these teeth,allows to achieve a positive clinical result and save the tooth in 97% of cases.

Methods of correction of conditions of reparative bone regeneration with the use of the medication “Enoant” (containing grape polyphenols) and its combination with ozone and the medication “Siliks” depending on the risk of purulent-inflammatory complications in patients of this category and their effect on immune system and the structural and functional state of bone tissue.

Scheme of action of “Enoant”, ozone and “Siliks” in the treatment of open fractures of the mandible

Algorithms for planning surgical interventions using computer 3-D models and stereo-lithographic models of facial skull bones, methods of creating individual simulation models of the stress-strain state of facial bones have been developed.

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Metal osteosynthesis planning on a computer 3D model of the mandible

Distribution of equivalent stresses according to Mises on computer simulated finite element models of jaws
Model of bones of the middle zone of the face of a patient with micrognathia and narrowing of the dentition in the lateral areas	Model of the mandible after osteosynthesis with bone titanium miniplate and microscrews

The value of the results that were obtained

The introduction of the developed methods of diagnosis and treatment has significantly improved aesthetic and functional results, reduced temporary disability and reduced the incidence of postoperative complications in patients with deformities, traumatic injuries and difficult teething, which determines their social and economic importance.

According to the researchresults, 6 monographs, textbooks and manuals were published:

• Malanchuk V.O.Mammadov E.A. Immediate dental implantation.- K., 2008.- 154 p.
• Fundamentals of dentistry: a textbook / V.O Malanchuk, A.V. Borysenko, L.V. Kharkov and others, edited by V.O. Malanchuk. – К .: Medicina, 2009.- 592 p.
• Emergency medicine / ed. I.S. Zozuli.- K .: Medicine, 2008.- 696 p. (co-author Assoc. Prof. K.Ya. Peredkov)
• Malanchuk V.A.Kopchak A.V. Benign tumors and tumor-like lesions of the maxillofacial region and neck. – K., 2008.-271 p.
• Malanchuk V.O., Kopchak A.V. Benign tumors and tumor-like lesions of the maxillofacial area and neck. – K: Publishing House “Askania”., 2008.-320 p.
• «Oral and Maxillofacial Surgery. Part I. »English textbook on surgical dentistry for students of III-IV courses of the Faculty of Dentistry.

According to the researchresults, 24 articles were published, including in foreign publications of the CIS countries 3:

• Malanchuk V.O., Grigorovsky V.V., Dobriy-VechirT.V.Pathomorphological changes of periodontal tissues, frequency of their development and significance for organ-preserving interventions in persons with difficult eruption of the lower third molars. “Dentistry News” №3 2009, p.9-15.
• S. Chekman, V.O. Malanchuk, M.A. Gordiychuk Nanotechnologies and nanomaterials: application in dentistry and maxillofacial surgery // Ukr.med.chasopis, 6 (74) – XI / XII – 2009. – P.95-97.
• Malanchuk V.O., Volovar O.S., Timoshchenko N.M., Kostyuk T.M. Modern methods of diagnosis and treatment of hypertrophy of the masticatory muscles Bulletin of dentistry. – 2010. – №3. – 35-39.
• Malanchuk VO, Kopchak AV, Krishchuk MG Study of mandibular biomechanics on three-dimensional computer models by the finite element method Bulletin of Dentistry – 2009, №3, P.56-62
• Malanchuk V.A., GrigorovskyV.V., Brodetsky I.S. The incidence of pathological changes in the tissues of the jaws and the correlation of morphological parameters of the lesion in odontogenic osteomyelitis in persons with drug dependence. Dental South. – 2010.- №3.- P. 44-49.

According to the researchresults, 28 Patents of Ukraine for inventions were received, among which the most important are:

• Method of treating traumatic fractures of jaws. Declaratory patent for utility model 46678 Ukraine, dated 25.12.2009, Bull. № 24. Malanchuk V.O., Chekman I.S., Tsilenko O.L., Gordiychuk M.A.
• A method of restoring tearing in traumatic injuries of the middle zone of the face № 44342, 2009 Malanchuk V.O., Logvinenko I.P., ChepurnyYu.V.
• A method of treating fractures of the zygomatic bone Declarative patent for a utility model №33872 from 10.07.2008 Malanchuk V.O., Timoshchenko N.M., Volovar O.S.
• Method of surgical treatment of odontogenic sinusitis with oroantral connection Patent for utility model № 49926 dated 11.05.2010. Malanchuk V.O., Garlyauskaite I.Y., Keyan D.M., Yatsenko D.V.

According to the research results, 154 theses were published, including 16 abroad:

• Malanchuk V., Logvinenko I. The new method of coronal approach // Abstracts from the XXth Congress of the European Association for Cranio-Maxillofacial  Bruges (Belgium), September 14-18th, 2010.-2010.
• Malanchuk V., Коpchak A., Shidlovskiy N. Elastic And Visco-Elastic Properties Of The Cortical And Spongious Bone In Patients With Mandible Fractures //Abstracts from the XXth Congress of the European Association for Cranio-Maxillofacial Bruges (Belgium), September 14-18th, 2010.-2010.- Р.675-676
• Y., MalanchukV.A. Lacrimal disorders caused by fractures to the medial facial zone Text-book of abstracts of XX – th congress of the European Association for Cranio-Maxillofacial Surgery, 14-17 September 2010, Bruges,Belgium
• , Skvirtsova I. Electromyography as investigation method of masticatory muscles by surgical treatment of micrognathia of lower jaw. Stomatologija, Baltic Dental and Maxillofacial Journal, 2009. Suppl.6
• Malanchuk V., Dobriy-Vechir T. Surgery of challenging dentition of third mandibular molars Stomatologija, Baltic Dental and Maxillofacial Journal, 2009. Suppl.6

Performers of SRW stages:

• Volovar O.S. “Diagnosis and treatment of TMJ diseases on the background of somatic diseases”
• Astapenko O.O. “The use of bioresorptive plates in reconstructive surgery of the maxillofacial area”
• Kopchak A.V. “Biomechanical substantiation of methods of osteosynthesis of the mandible”
• Chumachenko O.V. “Correction of conditions of reparative osteogenesis in dental implantation”
• Logvinenko I.P. “Reconstruction of the nasoethmoidal complex in patients with fractures of the middle zone of the face”
• Brodetsky I.S. “Diagnosis and treatment of osteomyelitis of the jaws in drug addicts”
• V. “Treatment of lacrimal disorders in patients with fractures of the middle face.”
• Yefisko VM “Methods of surgical treatment of odontogenic sinusitis”
• Pererva V.V. “Diagnosis and treatment of inflammatory diseases of the salivary glands”
• Grabovetsky V.V. “Clinical and biological substantiation of dental implantation methods”
• Farshad I. “The use of Miramistin in the complex treatment of odontogenic sinusitis”
• Keyan D.M. “Surgical methods of removing oro-antral connections”
• Shvydchenko V.S. “Biopolymer nano-containing composites for use in Oral and Maxillofacial Surgery”
• M. ”Study of neuromuscular disorders in patients with traumatic injuries and facial deformities”
• Mamonov R.O. “The use of proteolysis inhibitors in the complex treatment of mandibular fractures”
• Korotkoruchko A.A. “Study of the biomechanics of the upper jaw using the finite element method”

Research work of students

The number of publications with the participation of students in 2008-2010 are 73.

Speeches of students of the department at Ukrainian and international students conferences were repeatedly awarded prizes.

Twice in 2008 and 2009 the students of the group won prizes at the All-Ukrainian Olympiad in Dentistry.

With the participation of the Department in 2009 and 2010 a conference of students and young scientists “Special issues of diagnosis and treatment of diseases of the ENT organs, craniofacial area and the visual organ” was held.

Topics of research work of the department(2011-2013)

“Substantiation of reconstructive and restorative operations on the maxillofacial area and methods of dental implantation on the basis of etio-pathogenetic, clinical-biological and structural-functional parameters”

Topics of research work of the department (2015-2017)

“Improvement of methods of reconstructive and restorative facial surgery and dental implantation taking into account etio-pathogenetic, clinical and anatomical-physiological factors”