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Rehabilitation of Patients with Malignant Neoplasms of the Maxillary Sinus after Combined Treatment

Реабилитация пациентов со злокачественными новообразованиями верхнечелюстной пазухи после комбинированного лечения

Rehabilitation of Patients with Malignant Neoplasms of the Maxillary Sinus after Combined Treatment

Abstract

Цель. Обосновать метод медицинской реабилитации пациентов с ороназальным сообщением путем разработки разобщающей каппы на этапе протезирования. Материалы и методы. На базе ГУ «Университетская стоматологическая клиника» проведен клинический осмотр 15 пациентов со злокачественными новообразованиями верхнечелюстной пазухи после комбинированного лечения. Клинически у пациентов определялся послеоперационный дефект твердых и мягких тканей челюстно-лицевой области: твердого и мягкого нёба, альвеолярного отростка верхней челюсти, передней и нижней стенки верхнечелюстной пазухи. Данной группе пациентов протезирование проводилось после лучевой терапии в отдаленные сроки наблюдения (6 месяцев). У пациентов с послеоперационным дефектом тканей получали оттиск при помощи стандартной оттискной ложки и альгинатного оттискного материала. Изготавливали гипсовую модель с нанесением границ пластинки. С помощью вакуумного формирователя и полимерной заготовки Cristal (твердые) и Soft (мягкие) с размерами 125×125 мм и толщиной 2 мм изготавливали разобщающую обтурирующую пластинку, проводили фиксацию каппы в полости рта с заглаживанием края каппы для предотвращения травматизации слизистой оболочки полости рта. Результаты. Разработанная технология изготовления разобщающей обтурирующей каппы методом термовакуумного прессования позволяет улучшить функциональные и эстетические результаты ортопедического лечения, сократить сроки лечения (изготовление каппы проводится в одно посещение). За счет эластичных свойств полимерного материала для изготовления каппы и способа изготовления процесс адаптации пациентов занимал короткий промежуток времени. Максимальное количество коррекций составило 3 посещения (для 1 пациента). Одна коррекция каппы понадобилась для 73,3% (11 пациентов), две – 20% (3 пациента). Заключение. Медицинская реабилитация пациентов с ороназальным сообщением может включать ортопедический этап лечения с изготовлением в короткие сроки за одно посещение изолирующей обтурирующей каппы с учетом индивидуальных анатомических особенностей послеоперационного дефекта твердых и мягких тканей. Purpose. To develop a medical rehabilitation method of patients with oronasal communication by manufacturing a separating mouth guard. Materials and methods. A clinical examination of 15 patients with malignant neoplasms of the maxillary sinus after combined treatment was carried out on the basis of the State Institution "The University Dental Clinic". Clinically, patients had a postoperative defect of hard and soft tissues of the maxillofacial region: hard and soft palate, alveolar process of the upper jaw, anterior and lower walls of the maxillary sinus. Prosthetics were performed after radiation therapy in the long-term period for this group of patients (6 months). An impression was taken by a standard impression tray and alginate impression material in patients with a postoperative tissue defect. A plaster cast was made with defect border marking. A separating obturating mouth guard was made by thermovacuum forming process using a crystal (hard) and soft polymer plates with dimensions of 125×125 mm and a thickness of 2 mm. The edge of the mouth guard was smoothed to prevent trauma to the oral mucosa and was fixed in the oral cavity. Results. Elaborating technology for manufacturing the separating obturating mouth guard by thermovacuum forming process allows improving functional and aesthetic results of prosthetics and reducing the treatment time (the mouth guard being made in one visit). Due to elastic properties of polymeric material used for the mouth guard manufacturing, and manufacturing method applied, the process of patients’ adaptation took a short period of time. The maximum number of corrections was 3 visits (for 1 patient). A single mouth guard correction was required for 73.3% (11 patients), and two corrections for 20% (3 patients). Conclusion. Medical rehabilitation of patients with oronasal communication may include prosthetics with manufacturing a separating obturating mouth guard in a short time in one visit according to individual anatomical features of a postoperative defect of hard and soft tissues.

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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