Titanium Miniplates Research Articles

Combined Implant Prosthetic Rehabilitation and Orthognatic Treatment of a Patient With a Teeth Loss and Class III skeletal Malocclusion

Objective: The objective of the study is to assess treatment success of teeth loss patients with class III skeletal malocclusion through a multidisciplinary approach, including orthognathic surgery and implant prosthetic rehabilitation. Materials and Methods: The present retrospective study aimed at investigating the 5-year clinical treatments outcomes 16 patients with class III malocclusion and teeth loss. Clinical, laboratory, radiological methods were used in the examination of patients. Surgical stage included sagittal bilateral osteotomy of the lower jaw and reposition it back, Le Fort I osteotomy, 7-8 months after the orthognathic surgery 132 implants were inserted. After 2 to 4 months of submerged healing period patients had received implant-fixed prostheses. Results: No serious intraoperative or immediate postoperative complications were noted. At the control examination after 6 months after surgery, an X-ray examination we did not observe any clinical or radiological signs of inflammation in the area of osteotomy sites and titanium mini plates. Success rate of implants 5 years after was 96.2%. Conclusion:After orthognathic surgery and dental implant prosthetic rehabilitation, the masticatory function, esthetics of the facial profile and occlusion was improved. Patients expressed satisfaction with the result of treatment and improved quality of life.

A prospective study to evaluate the functional outcome of metacarpal shaft fracture treated with mini plates

Background: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. However, if significant shortening, rotational deformity and angulation occur, surgical treatment is required. Recent studies have shown good functional results with surgical treatment of metacarpal fractures using miniplates and screws as compared to the conservative treatment or K –wire fixation. Hence the study aims to assess the functional outcomes of patients with metacarpal fractures, who will be undergoing open reduction and fixation with low profile titanium plates in our department.Materials and Methods: Patients coming to the Department of Orthopaedic, at Sri Siddhartha MedicalCollege, Tumakuru with metacarpal shaft fractures who are treated with open reduction and internal fixation with mini-plate. All patients are operated in supine position and under infraclavicular block or general anesthesia. After the tourniquet is inflated, the forearm is placed in pronation, a dorsal longitudinal incision is made and the fracture is exposed with adequate soft tissue dissection. A low profile 2.0 mm titanium miniplate is applied with four screws, two on each side of the fracture. In oblique or spiral type of fractures, initially fixed with inter fragmentary screws and then by plate. Metacarpal alignment and angulation will be confirmed with fluoroscopy. The plate and screws was covered with periosteum and soft tissues.Results: The maximum subjects had injury on the right side (58.3%) and commones tbone to be involved was fracture of shaft of 5th metacarpal (37.5%). Transverse type (39.6%) was the commonest fracture pattern. Our study showed excellent functional outcome (54.2%) with lower complication rates and bone union was seen in minimum 6 weeks. Mean DASH score at 1 month (18.56), 3 month (11.56),6 months(3.02) with p value = 0.001.Conclusion: Plate and screw fixation is a good option for treating closed unstable metacarpal fractures, where other modalities of fixation are less effective. The rigid stable fixation provided by plating which withstands load without failure allowed early mobilization and achieved good functional results. Detailed clinical and radiological assessment of fracture, careful preoperative planning, meticulous dissection, precision in surgical technique (coverage of plate with soft tissue) and choosing the correct implant (low profile plate) are critical in achieving good results and minimizing the complication.

Biomechanical Evaluation of Chinese Customized Three-Dimensional Printed Titanium Miniplate in the Lefort I Osteotomy: A Finite Element Analysis

Biomechanical Evaluation of Chinese Customized Three-Dimensional Printed Titanium Miniplate in the Lefort I Osteotomy: A Finite Element Analysis

Safety and bone fusion achieved with mini-titanium plates for en-bloc cervical laminoplasty using a hydroxyapatite spacer: A preliminary report

Safety and bone fusion achieved with mini-titanium plates for <i>en-bloc</i> cervical laminoplasty using a hydroxyapatite spacer: A preliminary report

Kondil Kırıklarında Ortotropik Mandibula Modeli ile Sonlu Eleman Analizleri Kullanılarak Titanyum ve Rezorbe Olabilen Miniplak Sistemlerinin Karşılaştırılması

ABSTRACT&#x0D; Background: Mandibular fractures comprise a large portion of facial injuries. According to comprehensive series published, 17.5 - 52% of mandibular fractures are condyle fractures. With the development of plate and screw systems, open reduction and internal rigid fixation have also become methods that are accepted. Titanium miniplate and screw systems or resorbable plate and screw systems are used for this purpose. The purpose of this study is to compare the superiorities of titanium plate and screw systems to the superiorities of resorbable plate and screw systems on an orthotropic mandibular model using the finite element analysis (FEA) method.&#x0D; Method: With finite element analysis, stress values in bone, plate, and callus and the amount of displacement in plates and fragments with Von Mises forces were examined.&#x0D; Result: It was observed that solitary resorbable plates do not generate adequate stability.&#x0D; Conclusion: It was observed that titanium plate and screw systems were mechanically superior to resorbable plate and screw systems in the open treatment of mandibular condyle fractures. However, to fully support this opinion, studies with different designs using new resorbable plates are required.

Le Fort I İlerletme Osteotomisi Sonrası Farklı Fiksasyon Sistemlerinin Biyomekanik Olarak Karşılaştırması: İn Vitro Çalışma

Background: The aim of this study is to explore the effect of five different plate-screw systems on the stability after LeFort I osteotomy in polyurethane skull models. Also, we aimed secondarily to evaluate the efficiency of the use of micro and bioabsorbable fixation systems especially in the regions where the muscularity is relatively thin, in providing enough stability.&#x0D; Methods: Standard titanium miniplates, titanium microplates and bioabsorbable plates were applied for the internal fixation of artificially created LeFort I osteotomy on polyurethane skulls. Load applied in inferior-superior direction to simulate bite forces. The load-displacement values were recorded.&#x0D; Results: Significant differences were observed among the displacement values of five fixation systems at 120, 150, 180 and 200 N of loading (p&lt; 0.05). The highest displacement values were observed in the 4RLt-Micro group with the increasing load. The 4RLt-Mini and 4LLt-Mini groups showed the least displacement values, and the 4LLt-Mini group showed less displacement than the 4RLt-Mini group. The 2Lt/2It- Mini and 2Lt/2Ir-Mini groups showed proximate displacement values with the 4RLt-Mini and 4LLt-Mini groups.&#x0D; Conclusions: The results of this study show that the left sided L miniplates provide more stable results than the right sided ones. Also, it may be said that while sufficient stability can be obtained, the problem of palpability is also eliminated with the use of bioabsorbable plates in the regions with thin muscularity in combination with standard titanium miniplates. However, further in vitro and in vivo studies with wider advancement values needs to be conducted to confirm these results.

Surgical outcome of laminoplasty for cervical spondylotic myelopathy: a single-institution experience

Cervical spondylotic myelopathy (CSM) develops as a result of compression of the spinal cord in the cervical region. Early diagnosis and surgical treatment can limit the progression of symptoms. Various surgical approaches and strategies have been described in the literature. This study aims to evaluate the clinical and radiological results of open-door laminoplasty for the treatment of CSM. In this study, we retrospectively analyzed the patients who underwent expansive open-door laminoplasty secured with titanium miniplates. Thirty-four patients with CSM who were followed up postoperatively for more than 12 months were included in the study. The modified Japanese Orthopaedic Association (mJOA) score was used to assess the degree of myelopathy. We evaluated cervical sagittal alignment with C2–C7 Cobb angle, the ambulatory status with the Nurick grade, and measured postoperative neck pain with the visual analogue scale (VAS). Themeanm JOA score was 11 (range 6–15) preoperatively, and 13.5 (range 9–16) postoperatively with an average 55% recovery rate (range 0–75) (p < 0.001). Themean–Nurick grade was 2 (range 1–3) preoperatively and 1 (range 0–3) postoperatively (p < 0.001). The median cervical lordotic angle increased from 7.5 ° preoperatively to 12.5 ° postoperatively (p = 0.044). K-line (+) patients› mean mJOA scores significantly increased from 10.8 ± 1.7 to 13.3 ± 1.7 postoperatively (p < 0.001). The mean preoperative VAS reduced from 2.66 ± 1.4 to 1.59 ± 1.4 postoperatively (p < 0.001). Open-door laminoplasty technique is an effective surgical procedure that can be used safely to treat cervical spondylotic myelopathy. Our findings suggest that it can limit the progression of symptoms and alter the poor prognosis in CSM.

Surgical Accuracy of Positioning the Maxilla in Patients With Skeletal Class II Malocclusion Using Computer-Aided Design and Computer-Aided Manufacturing-Assisted Orthognathic Surgery.

To evaluate the surgical accuracy of positioning the maxilla in patients with skeletal class II malocclusion using computer-aided design and computer-aided manufacturing (CAD/ CAM)-assisted orthognathic surgery. The samples consisted of 10 patients with skeletal class II malocclusion, whose cone-beam computed tomographys taken before and immediately after surgery were available and who underwent bimaxillary orthognathic surgery by a single surgeon using Le Fort I osteotomy and bilateral sagittal split ramus osteotomy at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, South Korea between January 2018 and December 2019. After virtual surgical planning was performed using the FACEGIDE system (Korea), surgical cutting guides, intermediate splints, and custom-made titanium mini-plates were fabricated using CAD/CAM technique. Using 8 landmarks (anterior nasal spine, point A, #16, #13, contact point between #11 and #21, #23, #26, posterior nasal spine), the mean differences between the virtually planned (Virtual) and actual postsurgical position of the maxilla (Actual) in the three-dimensional coordinates (ΔActual-Virtual) and their mean absolute deviations were investigated. The mean differences of 8 landmarks were 0.42 mm left side movement in the transverse coordinate, 0.15 mm forward movement in the sagittal coordinate and 0.10 mm downward movement in the vertical coordinate. Their mean absolute deviations were 0.98, 0.67, and 0.62 mm in the sagittal, vertical, and transverse coordinates, respectively. Since the mean difference was less than 0.5 mm and the range of error was less than 1.0 mm, CAD/CAM-assisted orthognathic surgery might have a high degree of surgical accuracy and clinical relevance in the positioning of the maxilla.

Surgical Guides and Prebent Titanium Improve the Planning for the Treatment of Dentofacial Deformities Secondary to Condylar Osteochondroma.

To investigate current Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technologies applied in the treatment of dentofacial deformities secondary to condylar osteochondroma and introduce a modified method with additional pre-bent titanium miniplates to improve the accuracy of operation. Literature review about the application of CAD/CAM in the treatment of condylar osteochondroma and secondary dentofacial deformities was conducted. And 8 patients with condylar osteochondroma and secondary dentofacial deformities were treated by the CAD/CAM cutting and drilling surgical guides as well as pre-bent titanium miniplates. Pre- and post-operative 3D-cephalometric measurement were recorded and the difference between virtual simulation and postoperative modeling images was measured. Follow-up and radiographic examinations were performed. A total of 17 studies (including 216 patients) about the application of CAD/CAM in the treatment of dentofacial deformities secondary to condylar osteochondroma have been reported since 2010, including the 8 present patients. In our study, all patients were satisfied with the surgical outcome, without obvious relapse or evidence of temporomandibular joint disorder or other complications during follow-up; all patients avoided condylar reconstruction and sagittal split of ramus osteotomy on the ipsilateral mandible side. Comparison between simulated plans and actual postoperative outcomes showed surgical simulation plan was accurately transferred to the actual surgery. The application of CAD/CAM cutting and drilling guides as well as pre-bent titanium plates could achieve more accurate and favorable outcomes, improving the clinical planning and surgical execution for patients with condylar osteochondroma and secondary dentofacial deformities.

Surgical outcome of laminoplasty for cervical spondylotic myelopathy: a single-institution experience.

Cervical spondylotic myelopathy (CSM) develops as a result of compression of the spinal cord in the cervical region. Early diagnosis and surgical treatment can limit the progression of symptoms. Various surgical approaches and strategies have been described in the literature. This study aims to evaluate the clinical and radiological results of open-door laminoplasty for the treatment of CSM. In this study, we retrospectively analyzed the patients who underwent expansive open-door laminoplasty secured with titanium miniplates. Thirty-four patients with CSM who were followed up postoperatively for more than 12 months were included in the study. The modified Japanese Orthopaedic Association (mJOA) score was used to assess the degree of myelopathy. We evaluated cervical sagittal alignment with C2-C7 Cobb angle, the ambulatory status with the Nurick grade, and measured postoperative neck pain with the visual analogue scale (VAS). Themeanm JOA score was 11 (range 6-15) preoperatively, and 13.5 (range 9-16) postoperatively with an average 55% recovery rate (range 0-75) (p < 0.001). Themean-Nurick grade was 2 (range 1-3) preoperatively and 1 (range 0-3) postoperatively (p < 0.001). The median cervical lordotic angle increased from 7.5 ° preoperatively to 12.5 ° postoperatively (p = 0.044). K-line (+) patients› mean mJOA scores significantly increased from 10.8 ± 1.7 to 13.3 ± 1.7 postoperatively (p < 0.001). The mean preoperative VAS reduced from 2.66 ± 1.4 to 1.59 ± 1.4 postoperatively (p < 0.001). Open-door laminoplasty technique is an effective surgical procedure that can be used safely to treat cervical spondylotic myelopathy. Our findings suggest that it can limit the progression of symptoms and alter the poor prognosis in CSM.

FACTORS RELATED TO THE RESULTS OF SURGICAL TREATMENT OF ZYGOMATIC FRACTURES WITH MINIPLATES

Background: Fracture of the zygomatic complex is one of the most common facial injuries in maxillofacial trauma and mainly caused by traffic accidents. The objective of this study was to investigate the factors related to the results of surgical treatment of zygomatic fractures with miniplates. Subjects and Methods: 46 patients (average age 34.24 ± 15.16) were diagnosed with zygomatic fractures. All of patients were operated and treated with titanium miniplates. This study assessed the general treatment results of: anatomy, aesthetics and function at the time of discharge, 3 months, 6 months postoperatively. This study also investigated the factors related to the results of surgical treatment of zygomatic fractures with miniplates. Results: Factors associated with post-operative results include: Clinical manifestations: restricted mouth opening, maxillary sinus fracture (p&lt;0.05) X-ray: number of fracture lines (≥ 4 lines) and type IV fracture (p&lt;0.01); overlapping fracture; comminuted fracture; depressed fracture (p&lt;0.05); number of miniplates used: ≥ 2 (p&lt;0.05). Conclusions: Evaluating factors related to surgical results helps clinicians evaluate and make prognosis in order to develop treatment plan in time and minimize complications after surgery. Key words: Fracture of the zygomatic complex; Affecting factors; Internal fixation with miniplates

PSI-Guided Mandible-First Orthognathic Surgery: Maxillo-Mandibular Position Accuracy and Vertical Dimension Adjustability.

In orthognathic surgery, patient-specific osteosynthesis implants (PSIs) represent a novel approach for the reproduction of the virtual surgical planning on the patient. The aim of this study is to analyse the quality of maxillo-mandibular positioning using a hybrid mandible-first mandibular-PSI-guided procedure on twenty-two patients while the upper maxilla was fixed using manually bent stock titanium miniplates. The virtual surgical plan was used to design PSIs and positioning guides, which were then 3D printed using biocompatible materials. A Cone Beam Computed Tomography (CBCT) scan was performed one month after surgery and postoperative facial skeletal models were segmented for comparison against the surgical plan. A three-dimensional cephalometric analysis was carried out on both planned and obtained anatomies. A Spearman correlation matrix was computed on the calculated discrepancies in order to achieve a more comprehensive description of maxillo-mandibular displacement. Intraoperatively, all PSIs were successfully applied. The procedure was found to be accurate in planned maxillo-mandibular positioning reproduction, while maintaining a degree of flexibility to allow for aesthetics-based verticality correction in a pitch range between −5.31 and +1.79 mm. Such a correction did not significantly affect the achievement of planned frontal symmetry.

Protein Adsorbate Biohybrids and Sequential Hystallosteric Protein Adsorption

Abstract Protein adsorption on solid surfaces is characterized by multivalence, binding-unit overlap, sequential adsorption, surface allosterics, lateral interactions and pronounced adsorption-desorption hysteresis, giving rise to the sequential, hystallosteric, adsorption model ("SHA model"). Adsorption isotherms of fibrinogen on a titanium miniplates and of the growth factors rhBMP-2 and rhVEGF165 on PDLLA nanofiber fleeces are presented. Controversial Langmuir type isotherms of fibrinogen and rhVEGF165 can be understood on the basis of singular long-lived metastable states central to the SHA-model.

A simple method with a sterilized surgical glove for removal of stripped screw

In oral and maxillofacial surgery such as orthognathic surgery and open treatment of maxillofacial fracture, plate fixation is commonly performed. Although the removal of titanium miniplates is controversial, the plates are removed routinely or symptomatically. By excessive torque during the screw removal, stripping or breaking of screw heads may occur. Although miniplates and screws are used with angled screwdrivers for osteosynthesis in bilateral sagittal split osteotomy (BSSO) or open treatment of mandibular angle or subcondylar fracture, the removal of a damaged screw, especially with the angled screwdriver, is very difficult. Therefore, we report a simple method with a sterilized surgical glove for removal of the stripped screw.

Comparison between Treatment Outcomes of Titanium Miniplates and Titanium Lag Screws in Fixation of Mandibular Symphysis and Parasymphysis Fractures

Comparison between Treatment Outcomes of Titanium Miniplates and Titanium Lag Screws in Fixation of Mandibular Symphysis and Parasymphysis Fractures

Assessment of the Success of Oral Rehabilitation of Patients with with Teeth Loss and Class III Skeletal Malocclusion

Abstract Objective: The objective of the study is to assess treatment success of teeth loss patients with class III skeletal malocclusion through a multidisciplinary approach, including orthognathic surgery and implant prosthetic rehabilitation. Materials and methods: The present retrospective study aimed at investigating the 5-year clinical treatments outcomes 16 patients with class III malocclusion and teeth loss. Clinical, laboratory, radiological methods were used in the examination of patients. Surgical stage included sagittal bilateral osteotomy of the lower jaw and reposition it back. Le Fort I osteotomy, 7-8 months after the orthognathic surgery 132 implants were inserted. After 2 to 4 months of submerged healing period patients had received implant-fixed prostheses. Results: No serious intraoperative or immediate postoperative complications were noted. At the control examination after 6 months after surgery, an X-ray examination we did not observe any clinical or radiological signs of inflammation in the area of osteotomy sites and titanium mini plates. Success rate of implants 5 years after was 96.2%. Conclusion: After orthognathic surgery and dental implant prosthetic rehabilitation, the masticatory function, esthetics of the facial profile and occlusion was improved. Patients expressed satisfaction with the result of treatment and improved quality of life.

Results of treatment of patients with midfacial fractures

Background. Fractures of the bones of the facial skeleton, in particular the midface area, are one of the most frequent reasons for patients to apply to maxillofacial inpatient care, not only in Ukraine but also abroad. Along with more modern treatment technologies (osteosynthesis using titanium miniplates and minigrid for fixation bone fragments), methods of repositioning of fragments with subsequent tamponade of the maxillary sinus with iodoform tampon and without tamponade and fixation of fragments are used. A certain group of patients is treated conservatively, which is associated with their reluctance to undergo surgery, minimal displacement of fragments or minimal cosmetic and functional impairments. The purpose of the study. Comparative evaluation of the results of treatment of patients with fractures of the midface area by repositioning the fragments of the zygomatic-orbital complex without fixating the fragments and their subsequent fixation by tamponade of the maxillary sinus with iodoform tampon. Object and methods of research. The comparison was made of the results of treatment of 70 patients with fractures of the midface area, among which 13 patients were treated by the method of repositioning fragments of the zygomatic-orbital complex (ZOC) without fixation and without maxillary sinus tamponade, 29 patients underwent repositioning of ZOC fragments with subsequent fixation of fragments with iodoform tampon – the tamponade of the maxillary sinus was performed on the affected side. For comparison, the results of conservative treatment of 28 patients with fractures of the midface area were used. Results. It was found that the reliable (χ2=11.43; p&lt;0.05) majority of patients (64%) sought treatment within 0-3 days after injury. 83-89% of patients who underwent repositioning of the fragments had fresh small-fragment fractures. The reliable (χ2=11.43; p&lt;0.05) majority of them simultaneously had 3-4 sites of bone fractures of the midfacearea, hemosinus of varying degrees and paresthesia in the infraorbital area. In the majority of patients who underwent repositioning of bone fragments with and without tamponade (85% and 93%, respectively), the final displacements ranged from 3.1 to 6 mm. In patients treated conservatively, in most cases (93%) the displacements were greater than 3.1 mm, which remained after treatment. Conclusion. In the majority of patients treated with the studied methods, in the long term, the displacement of bone fragments remained, which had functional and cosmetic consequences. In all studied groups, a certain cosmetic effect was achieved over time, as evidenced by a reliable (χ2=160.9; p=0.00000) decrease in the indicator by the visual analogue scale .

Finite element analysis of different titanium miniplates: Evaluation of three-dimensional designs applied on condylar neck fractures

IntroductionThe fixation of condylar neck fractures is raising difficulties and for this reason, many plate designs have been developed. The current study compares the performance of four miniplates used in the condylar neck. Material and MethodsA virtual condylar neck fracture in a mandible obtained from a CT scan was fixed with four miniplates (two straight miniplates, lambda, strut, and trapezoidal). Using finite element analysis, we examined the fragments' displacements and stress distribution in the titanium material and bone. The models were analyzed under two loading conditions: a reduced bite force of 135 N and a force of 500 N. ResultsNo risk of material failure was observed. For a load of 135 N, all four plates offer an adequate fixation. For 500 N of applied loading, the lambda and strut plates showed the best rigidity and lowest bone strains. The two parallel plates showed the lowest rigidity and the trapezoidal plate the highest bone strains around all screws. DiscussionThese findings imply that three-dimensional miniplates (lambda, strut) perform better when higher loads are applied. On the other hand, the trapezoidal plate has an increased risk of screw loosening and the two straight plates higher mobility of the fragments.

Hardware Removal in Maxillofacial Trauma: A Retrospective Study.

Background Miniplates are commonly used for the fixation of maxillofacial fracture segments. Removal of the hardware is controversial. A retrospective study of medical records was performed to observe the reasons for plate removal. Materials and Methods A 10-year retrospective study of medical records was performed. Demographics, type of fracture, location, type of miniplate used, the time gap between the insertion and removal, and causes of hardware removal were assessed. Results About 1472 patients had undergone internal fixation for the facial fractures. Stainless steel miniplate was used in 489 patients, and titanium was used in 983 patients. Out of the 42 cases, 22 cases involved the removal of titanium hardware and 20 patients involved the removal of stainless steel hardware. Infection/osteomyelitis was the main cause of hardware removal. The maximum amount of hardware failure was in the mandible. 78.6% of hardware removal was performed in males. Conclusion Based on our study, routine removal of titanium miniplates can be performed in children to avoid growth disturbances, not indicated in adult patients unless symptomatic.

Radical removal of advanced cancer of the oral cavity and oropharynx

Surgery for advanced cancer of the oral cavity and oropharynx are among the most difficult. This is due to the topographical and anatomical features that limit the operating field and the proximity of the internal carotid artery, which penetrates into the skull without branches. Her injury and bandaging are fraught with lethality. In the postoperative period, due to a violation of the function of swallowing, there is a stagnation of oral fluid in the oral cavity, which pro[1]motes healing by secondary tension. The functions of the oropharynx are impaired: swallowing, chewing, breathing and speech.Purpose of the study. To develop an operation in patients with advanced cancer of the oral cavity and oropharynx, allowing to visualize the area of the tumor with it’s radical removal and postoperative healing without suppuration.Patients and methods. We’ve operated a patient with advanced cancer of the oral cavity and oropharynx with me[1]tastases to the cervical lymph nodes (T4 N1 M0 – IV st.). Cervical lymphodessection and removal of the tumor from the oral cavity and oropharynx was performed according to the method developed at the National Medical Research Centre for Oncology of the Ministry of Health of Russia: the tumor was removed after a preliminary modified mandib-ulotomy. Good visualization allowed for a radical operation, after which a urostoma was formed, which promotes the free flow of oral fluid from the oral cavity, without its stagnation and without suppuration of the tissues. The jaw was restored with two titanium mini-plates.Results. The healing was carried out by primary tension. On the 7th day after the operation, breathing was restored[1]decanulated. On day 20, epithelialization of the wound surface of the oral cavity and oropharynx occurred. The nasoesophageal probe was removed. Plastic orostoma was produced. By this time, the functions of the oropharyngeal region were partially restored: chewing, swallowing, and speech. Discharged home. Remission for more than 2 years.Conclusions. Previously performed modifi ed mandibulotomy in patients with advanced cancer of the oral cavity and oropharynx, allows you to expand the view of the operating field and provide a radical operation. The formed orostoma, preventing suppuration in the oral cavity, accelerates healing with the restoration of functions: chewing, swallowing, breathing and speech.