APPLICATION OF 3D MODELING IN 3D PRINTING FOR THE LOWER JAW RECONSTRUCTION

Aim of study: improvement of functional and aesthetic results of microsurgery reconstructions of the lower jaw due to the use of the methodology of 3D modeling and 3D printing. Application of this methodology has been demonstrated on the example of treatment of 4 patients with locally distributed tumors of the mouth cavity, who underwent excision of the tumor with simultaneous reconstruction of the lower jaw with revascularized fibular graft.Before, one patient has already undergo segmental resection of the lower jaw with the defect replacement with the avascular ileac graft and a reconstruction plate. Then, a relapse of the disease and lysis of the graft has developed with him. Modeling of the graft according to the shape of the lower jaw was performed by making osteotomies of the bone part of the graft using three-dimensional virtual models created by computed tomography data. Then these 3D models were printed with a 3D printer of plastic with the scale of 1:1 with the fused deposition modeling (FDM) technology and were used during the surgery in the course of modeling of the graft. Sterilizing of the plastic model was performed in the formalin chamber.This methodology allowed more specific reconstruction of the resected fragment of the lower jaw and get better functional and aesthetic results and prepare patients to further dental rehabilitation. Advantages of this methodology are the possibility of simultaneous performance of stages of reconstruction and resection and shortening of the time of surgery

ANALYSIS OF FACTORS OF IDENTIFICATION PROCEDURES OF THE FUNCTIONING OF THE STATE BORDER OFFICE OF UKRAINE IN THE CONDITIONS OF THE SPECIAL PERIOD

У статті визначено сукупність факторів, які визначають порядок функціонування Державної прикордонної служби України в умовах особливого періоду, проведено їх аналіз, систематизацію та ранжування. Зазначене дозволяє сформувати узагальнений інформаційний потенціал для побудови моделей функціонування в умовах особливого періоду, прийняття ефективних рішень щодо застосування сил та засобів прикордонного відомства для забезпечення безпеки державного кордону.В статье определена совокупность факторов, определяющих порядок функционирования Государственной пограничной службы Украины в условиях особого периода, проведена их систематизация, анализ и ранжирование. Отмеченное позволяет сформировать обобщенный информационный потенциал для построения моделей функционирования в условиях особого периода, принятия эффективных решений по применению сил и средств пограничного ведомства для обеспечения безопасности государственной границы.Outlining the group of factors which affect functioning of the State Border Guard Service during the special period and the results of their rankings enable creation of generalized information capacity in order to build the models of the State Border Guard Service’s functioning during the special period, making effective decisions regarding the use of forces and means of the border agency for providing border security

Mucoepidermoid carcinoma of the hard palate in a 9-year-old girl (clinical case)

The objective of the work is to demonstrate the signs of mucoepidermoid carcinoma of the minor salivary glands in pediatric patients on a clinical example.Clinical case. In August 2017, a girl of 9 years old appeared in the area of the right half of the hard palate. The dentist at the place of residence diagnosed an abscess in the area of the hard palate, performed the lancing and drainage of the “abscess”, prescribed antibiotic therapy. After 3.5 months (in December 2017), hyperemia and an increase in the volume of the mucous membrane reappeared in the same zone. Reapplied to the dentist. The girl was sent to the Oral and Maxillofacial Surgery Department, where the hard palate formation was removed on 23.01.2018; according to histological examination a highly differentiated tumor of the hard palate was diagnosed. The girl was sent for a consultation to the N. N. Blokhin National Medical Research Center of Oncology, where histological preparations were reviewed: a fragment of the mucous membrane of the hard palate covered with squamous epithelium, with the growth of low-grade mucoepidermoid cancer (from the minor salivary glands of the hard palate). A biopsy of the postoperative scar 3 mm long and of the formation of a hard palate 1 mm in diameter was performed; during histological examination of the biopsy material tumor cells were not detected (the material was represented by fibrous tissue). Despite the biopsy results, taking into account the medical history, the results of a review of histological preparations, the rarity and high aggressiveness of the tumor, poor prognosis for relapse, lack of data for regional and distant metastases, at the concilium it was accepted the decision to conduct repeated surgery. In the Surgical Department No. 1 of the Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology on 13.03.2018 a resection of the hard palate was performed with plastic surgery of the defect with a mixed skin-muscle flap on the vascular pedicle.Conclusion. Mucoepidermoid cancer of the minor salivary glands of the hard palate in children and adolescents can be manifested by the presence of a slowly growing, painless, pale blue tumor. For a correct clinical and morphological diagnosis, a biopsy of the tumor is necessary, further the removal of the tumor is recommended with resection of the hard palate, in view of the high risk of tumor spreading in the thickness of the bone

The results of using free osteomyofascial flaps in the simultaneous reconstruction of combined post-resection facial defects with an intraoral component

The study objective is to analyze the results of the use of free osteomyofascial flaps in the reconstruction of combined post-resection facial defects with an intraoral component. Materials and methods. Fifty-three patients were operated by the proposed method. The muscle portions which were used with free flaps were: m. flexor hallucis longus with the free fibula flap (n = 27), m. vastus lateralis with anterolateral thigh flap (n = 11), m. subscapularis with the scapula free flap (n = 15). An analysis of postoperative complications was performed, as well as an analysis of the timing of dental implantation. Results. The average hospital stay was 15 days. The main complications from the recipient area were: local inflammation in the reconstruction area – 2 (3.8 %) cases, hematoma on the neck – 2 (3.8 %), fistula formation – 1 (1.9 %), full flap necrosis was noted in 1 (3.7 %) case, hypertrophic growths of granulation tissue on the muscle portions of the flaps in 3 (5.7 %). The main complications from the donor zone: hematomas – 0 cases. In 2 (13.3 %) patients after using a chimeric scapular flap, lymphorrea up to 50–70 ml was noted. Dental implantation was performed in 4 (9.5 %) cases. There were no complications or difficulties in performing dental implantation. The average time taken to form the soft tissue contour in the area of implants after installing the gingiva formers in our study was 2.5 weeks, which is 2 weeks faster than using flaps that include a skin paddle. Conclusion. This reconstruction method could be used as a main for the plastic elimination of combined facial defects with an intraoral component