Lyubchenko O. Endoprosthesis and Rehabilitation of Patients with Temporomandibular Joint Pathology

The thesis is dedicated to solving the scientific problem of a new direction in the treatment of patients with bone-destructive pathology of the temporomandibular joint by developing and implementing into practical health care the bipolar total TMJ endoprosthesis with a distraction device which enables to lengthen the branch of the mandible on the affected side adaptively to the growth of the healthy side. Before clinical application of the engineered endoprosthesis a biomechanical study of the reliability of the proposed design and capabilities of the mandible and zygomatic arch bone tissues to retain the endoprosthesis elements was conducted. The biomechanical estimations prove the reliability of the proposed design and the capabilities of the angle of mandible and zygomatic arch to be a bearing for fixing the endoprosthesis.In order to control quality of the treatment and to assess the patients' general condition both before and after TMJ arthroplasty by means of the bipolar total endoprosthesis with the distraction device we have studied: exchange of connective tissue, leukogram acute-phase indicators of peripheral blood, immune status, nutritional status of patients, and electromyography of facial muscles. The investigated parameters enable to assess the quality of the treatment provided. An algorithm for complex treatment of patients with the bone-destructive pathology of TMJ that includes total joint replacement surgery by means of the bipolar total endoprosthesis with the distraction device has been worked out. Application of the given endoprosthesis will enable to accelerate patients' medical and social rehabilitation.