JP2006341067A - Guide material for medical application - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a guide material for medical applications to guide an operation apparatus to a drilling target position when the drilling operation is done for a defect part of a human body as a surgical target. <P>SOLUTION: The guide material 110 is equipped with at least one or more crown parts 112 for covering and attaching the defect part of the human body, and at least one or more support parts 114 which is fixed by covering the human body part next to the defect part and connected together with the crown part. Each crown part has a guide hole penetrating to the upper and lower directions for guiding the operation apparatus to each drilling target position, and slits of the upper and lower directions which are opened in the side direction from the guide hole to recognize the whole part of the upper and lower directions of the guide hole with eyes from outside. Also, the guide hole forms rough half-tubular shape opened to the slit side, and at least the width of the slit is wider than the diameter of the rough half-tubular shaped guide hole. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

The present invention relates to a guide member that properly guides a drilling device when performing a drilling operation on a part of a human body part, and in particular, a drill device for implanting an implant (artificial root) into a jawbone or the like in an implant treatment by a dentist. It is related with the guide member which guides.

  In the so-called implant treatment, an artificial dental fossa is formed by drilling a submucosal jaw bone with a drilling device in a defective portion of a dentition, and an implant is placed in the artificial dental root and an artificial dental crown (denture) is placed in the implanted artificial root. This is a treatment method that compensates for the missing part of the dentition by applying a step.

Of the implant treatment steps, it is important for the dentist to place the implant at an appropriate position in the artificial tooth placement step, and the suitability of the drilling state by the drill device is a major factor in determining the success or failure of the implant treatment. For this reason, the guide member for guiding a drill apparatus appropriately conventionally has been provided. As will be described in detail later, the guide member includes a crown portion that guides the drill over the dentition defect portion and a support portion that is fixed to the tooth adjacent to the dentition defect portion in order to fix the crown portion. The crown part is provided with a guide hole penetrating vertically to guide the drill to the artificial cavity.

However, in the case of the conventional guide member, since it is necessary to make the dentist imagine the crown state during treatment, many of the crown portions are formed in a pseudo tooth shape, and the molding process is complicated. Further, since the support portion is also fitted and fixed to adjacent teeth, fine molding corresponding to the individual teeth of the patient is necessary, and the molding process is complicated also in this respect. Therefore, it is difficult to produce guide members by molding methods such as so-called milling such as NC molding suitable for mass production, and it is necessary to carry out by a method that relies on manual operation by a dentist or an expensive molding method such as optical forging molding. As a result, the cost of the guide molding was increased, which in turn prevented the implant treatment itself from becoming popular. In the case of a conventional guide member, since the crown portion has a pseudo tooth shape as described above, at least the upper end portion (ceiling portion) is closed, so a drill device is inserted into the guide hole. Even if it is guided to the artificial cavity position, it is difficult to visually recognize the actual drilling state from the outside, and it is impossible for the dentist who primarily avoids damage to important parts of the human body such as nerves to wipe away the anxiety during treatment There was a problem. Furthermore, in order to avoid this, it has been proposed to open the crown part on the buccal side (viewing side of the dentist). Contrary to this, there is a problem that the guide device is formed to be opened to the side and the guide of the drill device, which is the original purpose of the guide member, is incomplete, and the drill cuts the crown itself and the amount of cutting waste is a predetermined amount. Including the risk of adversely affecting the human body.

  In addition, the guide member needs a support portion that covers one or more adjacent teeth in a state where it is connected to the crown portion in order to support the crown portion that covers the dentition defect. In order to achieve perfection, it is necessary to fit the inner wall to the outer surface (outer wall) of the adjacent tooth, but conversely, if it tries to fit most of the outer surface of the adjacent tooth, a molding method such as milling Makes mass production difficult. Further, when the inner wall of the support portion is mainly focused only on fitting to adjacent teeth, there is a problem that it is necessary to use a soft material that bends when being covered, and is not suitable for milling. Furthermore, since the conventional guide member has a pseudo tooth shape, there is a problem in that a sufficient drill drilling work space cannot be secured when positioned in the dentition missing portion existing in the back of the mouth.

JP 2003-245289 A European Patent No. 1043960

  The present invention has been provided in view of the above circumstances, and an object of the present invention is to provide a medical guide member having a shape in which a drilling state of a drill device can be sufficiently visually recognized and can be easily molded.

The present invention provides a medical guide member that guides a working device to a drilling target position when performing a drilling operation on a surgical target portion (for example, a missing part of a human body part). Specifically, it is formed with at least one or more coronal members that are mounted on the surgical target portion. In addition, when there is a human body part adjacent to the surgical target part, it is preferable to include at least one support member that is fixed on the adjacent human body part and is integrally connected to the coronal member. Each coronal member is provided with a guide hole penetrating in the vertical direction to guide the work device to the respective target drilling position, and laterally from the guide hole so that the entire vertical direction of the guide hole can be visually recognized from the outside. It has a slit in the up and down direction that is open. Moreover, it is preferable that a coronal member approximates the shape of the human body part corresponding to the operation target part.

The guide hole is formed in a substantially half-cylinder shape opened to the slit side, and the width of the slit is preferably at least larger than the diameter of the guide hole having a substantially half-cylinder shape, and an outer wall is formed on the inner wall of the guide hole. A substantially half-cylinder-shaped guide member formed so as to match is fixed, and the guide member is preferably formed of a curable material having biocompatibility and higher visibility than the crown-shaped member.

  Moreover, the upper end surface of each coronal member can be made substantially parallel to the medical human body reference. In addition, each support member is configured in a substantially cylindrical shape having an opening penetrating in the vertical direction, and the inner wall of each support member and the outer wall of the human body part are fitted when covered with an adjacent human body part. It is preferable that the upper end portion of the adjacent human body part is fixed upward. Furthermore, it is preferable that the upper end surfaces of the coronal member and the support member have a substantially planar shape as a whole.

  The present invention as described above is typically for dental use in guiding a drilling device to a desired artificial cavity position when drilling an artificial cavity for embedding an artificial tooth root in a defective part of a dentition as a surgical target part. It is provided as a guide member. Specifically explaining the individual elements, the coronary member is at least one or more crown members to be mounted on the missing part of the dentition regardless of edentulous jaws or toothed jaws, A guide hole penetrating in the vertical direction to guide the drill device to the target artificial cavity position, and the vertical direction opened to the side from the guide hole so that the entire vertical direction of the guide hole can be seen from the outside It has a slit. As for the support member, it can be fitted and fixed on the tooth adjacent to the missing portion of the dentition and integrally molded with the crown member.

  Moreover, it is preferable that the upper end surface of the crown member is substantially parallel to the occlusal plane. Each support member has a substantially cylindrical shape having an opening penetrating in the vertical direction, and is fixed by fitting the inner wall of each support member with the outer wall of each adjacent tooth. The upper end of each tooth is preferably free upward.

  Furthermore, it is also mentioned that at least the crown member is preferably disposed at a height close to the top of the cusp when it is put on the missing part of the dentition.

Another aspect of the present invention is a medical guide member that guides the working device to a drilling target position when performing a drilling operation on the surgical target portion, and is at least one coronal shape that is mounted on the surgical target portion. It is formed with a member and at least one or more support members that are fixedly placed over a human body part adjacent to the surgical target part and integrally connected to the coronal member. Each support member is configured in a substantially cylindrical shape having an opening penetrating in the vertical direction. When the support member is placed on an adjacent human body part, the upper part of the inner wall of the support member is the upper part of the outer wall of the human body part. By providing a slit that engages and opens to the side, the human body part can be sandwiched from the side by two members. One of these two members has high flexibility in the lateral direction of the human body part, and the other has low flexibility. Further, the upper end surface of each coronal member and the support member is substantially parallel to the medical human body reference surface, and the height of the upper end surface of the coronal member is lower than the height of the upper end surface of the support member. preferable. The upper end surface of the coronal member may be formed in a step-like shape with a lower height as the corresponding perforation target position when it is placed on the surgical target portion becomes distal.

Specifically, as a dental guide member for guiding a drill device to a desired artificial cavity position when drilling an artificial cavity for implanting an artificial tooth root with respect to a defective part of a dentition as a surgical target part The provided coronal member is at least one or more crown members to be mounted over the missing part of the dentition, each having a guide hole penetrating in the vertical direction to guide the drill device to the target artificial cavity location ing. In addition, each support member is arranged so as to be able to cover each of at least one or more teeth adjacent to the missing portion of the dentition, and when each adjacent member is covered, An upper portion of the inner wall engages with an upper portion of the outer wall of each adjacent tooth, and a slit is provided that opens at a position on the cheek side and facing the connecting position of each support member. The support part is composed of a cheek side part formed by a slit and an inner side part of the mouth, both of which can sandwich adjacent teeth from the side when the support member is put on each tooth, and the cheek side The portion is tapered so that the portion becomes thinner toward the slit. In addition, the taper shape on the cheek side is narrower toward the slit in both the vertical and lateral directions, and the inner wall of the cheek side is coated with a low human invasive adhesive. Is preferred. When used as a dental guide member, an occlusal plane is used as a medical human body reference plane. Furthermore, it is preferable that each crown member is formed so as to be stepped downward toward the inner side of the mouth.

  According to the guide member of the present invention, since there is a slit that opens the guide hole of the coronal member that covers the surgical target part, typically the defect part of the human body part, the drilling state is maintained during the drilling operation. Fully visible. For example, the dentist can fully visually recognize the drilling state of the drill device from the outside of the buccal side during implant treatment. Further, since the slit is only opened to the outside, the molding becomes easy, and it can be produced by so-called milling such as NC. The guide hole is provided with a guide member (also referred to as “toyu”) formed of a curable material having biocompatibility. Since the guide hole is an open shape having a semi-cylindrical shape, for example, in implant treatment, the drill is brought into contact with the inner peripheral wall of the guide hole instead of being guided by surrounding the side of the drill device (particularly the drill). Therefore, a drilling operation is performed. Therefore, for example, depending on the skill of the dentist, the possibility of causing a certain degree of deviation from the proper perforation state is allowed. In such a case, in the guide device of the present invention, the crown member (crown-shaped member) is not cut due to the presence of the guide member, and the guide member having biocompatibility is cut in a minute amount even if it is not cut or cut. Therefore, it is possible to provide a guide member with less adverse effects on the human body.

  In addition, since the upper end surface of the coronal member is substantially parallel to the medical human body reference, for example, the upper end surface of the crown member is substantially parallel to the occlusal plane, this guide member is a reference for dentists during implant treatment. It can be used as a reference, and treatment can be performed with the final prosthetic image. In addition, the support member has a hollow cylindrical shape and is fitted to adjacent teeth etc. on the side, but has an opening on the upper side, so that the guide member can be fixed to the adjacent teeth etc. The possibility of being installed can be avoided and molding is also facilitated. In addition, since the height of the support member can be lowered, the patient does not need to open a large mouth, and treatment by the dentist is facilitated.

  Further, in another guide member of the present invention, a slit is provided in a support member for adjacent teeth, and a so-called crab claw shape is formed toward the front of the dentition by the slit. In addition, the cheek side (one of the crab claws) is less flexible than the mouth inner side (the other crab claws), so the cheek side can be easily bent when covered on the adjacent teeth from above. Can be put on. On the other hand, since only the cheek side portion bends, if the adhesive is applied only to the side portion, sufficient fixing between the support member and the adjacent teeth can be ensured. Further, in the other guide members, the coronal member (dental crown member) is formed in a staircase shape, and the upper end surface of each staircase is substantially parallel to a medical reference surface such as an occlusal plane. Even when positioned in the row defect portion, a sufficient space can be secured for the drilling operation or the like, and the drilling operation can be executed without feeling uneasy for the dentist.

First, as a premise for explaining the guide member of the present invention, the shape of a conventional guide member and implant treatment using the guide member will be described. FIG. 1 is a schematic view showing an example of a conventional guide member, and reference numeral 10 indicates a guide member. The guide member 10 covers the crown portion 12 formed in the shape of a crown that compensates for the missing portion of the dentition and the adjacent teeth 24a, 24b, and 24c adjacent to the missing portion, and supports the crown portion 12. Support portions 14a, 14b, and 14c are provided, and a guide hole 16 is formed in the crown portion 12.

As shown by an arrow A in FIG. 1, the guide member 10 can fix the crown portion 12 by covering the support portions 14a, 14b, and 14c on the adjacent teeth 24a, 24b, and 24c, respectively. In such a guide member 10, the artificial periodontal cavity 22, 22 at the target implantation position can be drilled by drilling under the mucosa 20 along the guide holes 16, 16 with a drill device. This process can also be understood from referring to the state of inserting the drill 40a of the drill device 40 into the guide hole 16 with the guide member 10 as shown in FIG. Let's be done.

However, there are various problems when the artificial dental fossa 22 and 22 are perforated using the conventional guide member 10. First, in the case of the guide member 10, since the crown portion 16 has a shape that simulates the shape of each tooth, the drill 40 a inside the crown portion 12 is used when the dentist performs a drilling operation. It is impossible to visually recognize the appearance, particularly the depth of insertion of the drill 40a. This is because even if the crown 12 is made of a transparent body, the visibility is greatly reduced compared to a completely open state, even if the visibility is improved. The solution cannot be found because it is difficult to grasp the drill position. In addition, it is advantageous for the dentist to perform the drilling operation while having an image at the time of the crown which is the final state of the implant treatment, but it is complicated at the time of molding. There is no problem when the dentist creates manual guide members corresponding to individual patients because it is necessary to create a unique shape, but many patient guide members are produced by mechanical processes, especially in reducing costs. It is difficult to produce by a contributing milling process. This is the same in the molding of the support portion 14, and particularly when the upper portion (ceiling portion) of the support portion 14 is closed so as to cover the adjacent teeth 24, 24 like the guide member 10. It has been found that Further, in the case of such a shape that the upper part of the support part 14 is closed and covered with the adjacent teeth 24, 24, when the guide member 10 is covered, it protrudes larger in the height direction than the occlusal surface at the support part 14 position. As a result, the burden on the patient undergoing treatment increases, and the workability of the dentist performing the treatment also decreases.

In contrast, the first guide member of the present invention ensures the visibility and workability of the dentist when drilling the artificial cavity, and has the same effect as when the dentist molds manually. However, it offers a simple shape that can be milled. Referring to FIG. 3, an example of the guide member 110 of the present invention is schematically shown in a state where the guide member 110 is put on the dentition missing part, and the element has the same function as the conventional guide member 10. Are given the same reference numbers (for example, reference numbers 110 and 112 correspond to reference numbers 10 and 12, respectively). First, the guide member 110 is covered with a crown portion 112 formed in the shape of a crown that compensates for a missing portion of the dentition, and adjacent teeth 124a, 124b, and 124c adjacent to the missing portion. Supporting portions 114a, 114b, and 114c are provided.

Next, the guide hole of the crown part 112 will be described with reference to FIGS. 3 and 4. FIG. 4 is a plan view of the guide member 110 as viewed from above. Unlike the conventional case, the guide hole 116 of the tooth crown portion 112 has a half-cylinder shape opened toward the cheek side (see reference numeral 116 in FIG. 3). Further, the crown portion 112 has a width wider than the semi-cylindrical guide hole 116 and is opened to the outside on the cheek side (see the opening 132). Therefore, the dentist can easily approach the drilling operation. Specifically, the drill is guided to the proper artificial cavity position by bringing the outer peripheral surface of the drill 40a into contact with the inner peripheral surface of the guide hole 116. The state can be visually recognized from the outside. Further, the width a of the opening 132 may be enlarged from the guide hole 116 toward the outside of the cheek side, but may be formed with substantially the same width in consideration of the convenience of milling molding. This is because the guide member 110 of the present invention is based on the premise of development that it can be molded by milling. In the case of handmade or optical forging molding, etc., by providing an effective guide member even by milling. Compared to the above, the molding cost can be reduced.

  Further, a semi-cylindrical guide half cylinder (hereinafter also referred to as “tou”) 130 is engaged and fixed to the guide hole 116 along the inner peripheral surface thereof. The tou 130 is formed of a hardened material that has little influence on the human body, and has a color that is easily visible when placed on the guide member 110 that is a transparent body. For example, titanium is typically used. If such a tou 130 is disposed so as to cover the inner surface of the guide hole 116, the drill 40 a is guided by the toe 130 during the drilling operation to form an artificial cavity, and the dentist defines the guide hole 116. Even if the drill 40a cuts the inner hole of the guide hole during drilling, the toe 130 is cut as an alternative, and since it is a hardened material, it is difficult to produce cutting waste and the cutting waste is left on the human body. It is effective because it has no adverse effects.

Furthermore, the upper end surface of the crown portion 112 has a substantially planar shape (see the one-point difference line X in the schematic cross-sectional view 5 showing each crown portion 112 corresponding to an arbitrary tooth). In the case of the conventional crown 12, since it has a pseudo tooth shape, it is necessary to form a complicated end face shape that is different for each tooth of the patient, but the crown 112 of the guide member 110 of the present invention is required. Since the upper end surface X is also substantially flat, it is easy to mold and can be easily handled by milling. On the other hand, the reason why the upper end surface shape of the crown portion 112 of the conventional guide member 10 is selected as the crown shape is to give the dentist an image of the crowned shape, and in this respect, the embodiment of the present embodiment. It may be considered inconvenient for the dentist to make the upper end surface of the crown portion 112 like the guide member 110 into a substantially planar shape. However, what a dentist desires during drilling is not a crown shape, but a medical reference plane, in particular an occlusal plane, which is recognized by viewing the crown shape. In view of this point, in the crown portion 112 of the present embodiment, the upper end surface is made substantially parallel to the occlusal surface (virtual) (preferably the upper end surface is close to the height of the occlusal surface). In this way, while the molding is simple (can be easily milled), it is possible to avoid reducing the workability even for the dentist who performs the drilling operation, and rather a clear occlusal surface is provided. Therefore, it is possible to perform drilling work while imagining the occlusal surface.

Next, support portions 114a, 114b, and 114c (hereinafter, may be simply referred to as a reference number 114 as a generic name) that are respectively covered on the adjacent teeth 124a, 124b, and 124c to support the crown portion 112. explain. As can be understood with reference to FIGS. 3 and 4, each support portion 114 is formed integrally with the aforementioned crown portion 112 and has an opening 134 penetrating in the vertical direction. The openings 134 are fitted in the circumferential direction with respect to the adjacent teeth 124 when the support portion 114 is put on the adjacent teeth 124. Therefore, when the support portion 114 is put on the adjacent tooth 124, the support portion 114 is fitted and fixed to the adjacent tooth 124. As a result, the crown portion 112 can be fixed to the mucous membrane (or the jawbone surface) 120. Further, when the support portion 114 is placed on the adjacent teeth 124, the opening 134 is provided so that the upper end portion of the support portion 114 is free upward. Accordingly, when the adjacent teeth 24 are put on the adjacent teeth 24 like the support portion 14 of the conventional guide member 10, the molding accuracy of the plane inside the ceiling portion of the support portion 14 (the plane that fits the shape of the upper end of the adjacent teeth) is poor It is possible to avoid the risk of violating the fear that the fixed state of the entire guide member may be damaged by being lifted and covered.

Furthermore, if the configuration in which the opening 134 penetrating in the vertical direction is provided and the upper portion of the adjacent tooth 124 in the state of being covered with the support portion 114 is adopted is adopted, the opening 134 penetrating in the vertical direction in milling is formed. Since it is possible to allow the upper end of the support portion 114 to be molded into a substantially planar shape, the upper end can be easily molded in the milling process.

Next, the second guide member 210 of the present invention is a modified example of the first guide member 110, FIG. 6 shows a perspective view of the second guide member 210 itself, and FIG. 7 shows the guide. FIG. 8 is a plan view in which the guide member 212 is viewed from above, with the member 210 placed on the dentition. The crown portion 212 and the support portion 214 shown here correspond to the crown portion 112 and the support portion 114 of the first guide member 110, respectively. Specifically, the guide member 210 is covered with a crown portion 212 formed in the shape of a crown that compensates for a missing portion of the dentition, and adjacent teeth 224a, 224b, and 224c adjacent to the missing portion, and the crown portion. And support portions 214a, 214b, and 214c that support 212.

First, the crown part 212 will be described. The crown portions 212a and 212b are formed in a stepped shape that becomes lower toward the back side of the mouth so that a dentist can easily approach during drilling. Referring to FIG. 9, a cross-sectional shape of the crown portion 212 is schematically shown. As is apparent from this figure, guide holes 216a and 216b for guiding the drill to an appropriate artificial cavity position are provided in the respective crown portions 212a and 212b so as to penetrate in the vertical direction. Further, as indicated by alternate long and short dash lines Y1, Y2, and Y3, the upper surface of the support portion 214 and the upper surfaces of the crown portions 212a and 212b are parallel to the occlusal plane X, and the distance from the occlusal plane X is increased in order. . This is in consideration of workability and visibility when the dentist puts the drill 40a in the back of the mouth. Specifically, by making such a staircase shape, the intraoral space becomes narrower as it goes to the inner side of the mouth, but the drilling work space of the drill 40a can be secured and maintained, and the implant can be embedded with reference to the occlusal plane X. It is easy for the dentist who predicts the entry position to understand the progress of the drilling operation, and the anxiety about the operation can be reduced. Furthermore, milling can be easily performed with such a shape. In addition, in the 2nd guide member 210 of this invention in FIGS. 6-9, the two crown parts 212 are provided 212a, 212b, and the structure where a staircase becomes low for each crown part 212a, 212b is illustrated. However, this is only an example, and when the guide hole 216 is further added, the crown portion 212 may be further provided according to this, and the steps may be increased at the same time (for example, three guide holes 216 are provided). In such a case, a crown portion is further provided on the inner side of the mouth, and this is used as an upper surface lower than the crown portion 212b). 6 to 9, the top surface of the crown portion 212b is lower than the top surface of the crown portion 212a, but the top surfaces of the crown portions 212a and 212b may be on the same plane. Good. Specifically, referring to FIG. 9, the occlusal planes Y2 and Y3 are substantially the same, however. Further, unlike the above-described first guide member 110 of the present invention, the second guide member 210 in FIG. 6 and the like illustrates a form in which the guide hole 216 is closed inside the crown portion 212. However, the tooth crown portion 212 is provided with an opening (see reference numeral 132 in FIG. 4) as in the tooth crown portion 112 of the first guide member 110, and the guide holes 216a and 216b each have a semi-cylindrical shape (see FIG. 4). (See reference number 130).

Next, the support part 214 will be described. In the support portion 114 of the first guide member 110 of the present invention described above, each of the adjacent teeth 124a, 124b, 124c is covered with an opening 134 penetrating in the vertical direction. The support portions 214a, 214b, and 214c are integrally connected, but at the same time, slit-like openings 234 are provided in the respective cheek side portions 220a, 220b, and 220c (see FIG. 8). In FIG. 10, the figure which looked at the support part 214a located in the front-end | tip from the cheek side (arrow B direction in FIG. 6, FIG. 7) is shown. As is apparent from this figure, the cheek side portion 220a has a tapered shape that becomes thinner in the dentition direction (the direction opposite to the arrow A in FIGS. 6 and 7). FIG. 11 is a view of the buccal side portion 220a as viewed from the front (viewed in the direction of arrow A in FIG. 6 and FIG. 7), and the buccal side portion 220a is formed in a tapered shape that narrows inward. ing. That is, the support portion 214a is first formed into an annular shape in the milling molding process, and then the slit-like opening 234 is cut out, and the cheek side portion 220a formed thereby is shaved toward the tip direction (slit direction). It is formed with. Therefore, the cheek side portion 220a of the support portion 214a is significantly more flexible than the mouth inner side portion 220d. Further, as shown in FIG. 11, an adhesive 222 having a low human invasiveness such as a resin is applied to the inside of the cheek side portion 220a (not applied to the mouth inner side portion 220d).

Further, the inner wall of the support portion 214a has a shape that engages with the upper surface of the adjacent tooth 224a when it is supported by the adjacent tooth 224a. In detail, it demonstrates with the process of supporting the support part 214a to the adjacent tooth | gear 224a, referring FIG. FIG. 12 is a cross-sectional view seen from the front dentition direction (the aforementioned A direction) showing a state in which the support portion 214a is supported on the adjacent teeth 224a from above by the adjacent teeth 224a of the lower dentition. First, as shown to Fig.12 (a), the support part 214a (In FIG. 12, only a cheek side part 220a and a mouth inner side part 220d are displayed) is covered on the adjacent tooth | gear 224a from upper direction. The inner wall of the support portion 214a engages with the outer surface of the upper portion of the adjacent tooth 224a from the most widened periphery (shown as reference numbers 226d and 226a as one point on the left and right in FIG. 12 as a cross-sectional view). Has been milled. The reason why the inner wall of the support portion 214a is milled so as to engage only with the upper portion of the adjacent teeth 224a is that the ease of milling by mechanical means is taken into consideration.

The support portion 214a covered with the adjacent teeth 224a is pressed downward as it is, and after each inner wall abuts against the adjacent teeth 224a, a force (hereinafter referred to as normal force) is applied to the surface of the adjacent teeth 224a at the corresponding contacts 226a and 226d. , Referred to as “acting force”). At this time, as described above, the cheek side portion 220a is thinner than the mouth inner side portion 220d and is formed in a tapered shape, so that the flexibility is high. Therefore, when the downward pressing of the support portion 214a is continued, the highly flexible cheek side portion 220a is bent in the cheek direction by the above-described action force (see three arrows in FIG. 12A), The inner side portion 220d having low flexibility is in contact with the adjacent tooth 224a while maintaining its shape.

Further, if the support portion 214a is pressed downward, the support portion 214a moves downward relative to the adjacent teeth 224a until the inner wall surface of the support portion 214a engages with the outer surface of the corresponding adjacent teeth 224a. After that, it becomes impossible to proceed. The advancement becomes impossible, and both the cheek side portion 220a and the mouth inner side portion 220d abut on the upper portion of the adjacent tooth 224a. However, as shown in FIG. 12B, the lower part of the inner wall of the support portion 214a is not in contact with the outer surface of the adjacent tooth 224a, and most of the gap has a gap. However, an adhesive (resin or the like) is filled in the gap between the lower portion of the inner wall of the cheek side portion 220a and the lower portion of the outer surface of the adjacent tooth 224a. This is because the adhesive is applied in advance to the inner wall of the cheek side portion 220a as described above.
In this state, a dentist or the like presses the lower portion of the cheek side portion 220a toward the adjacent tooth 224a (see FIG. 12C). The buccal side portion 220a is inherently flexible and easily bent in the buccal direction by the adhesive, and is fixed. Further, since the inner side portion 220d has low flexibility, the contact force with the adjacent tooth 224a is maintained as it is. It will be different. Therefore, the support part 214a can ensure sufficient fixation only by pressing the lower part of the cheek side part 220a in the direction of the adjacent tooth 224a from the cheek side after covering while pressing from above the adjacent tooth 224a.

  As described above, the first and second embodiments of the guide member of the present invention have been described with reference to FIGS. 3 to 12, but the guide member of the present invention is not limited to this, and claims. It includes other embodiments without departing from the spirit and spirit of the invention described in the above. For example, although the above embodiment has been exemplified as the guide member corresponding to the lower tooth row, it is also possible to correspond to the upper tooth row. In addition, the number of each crown portion and support portion varies depending on the number of implants to be implanted and the number of adjacent teeth that bear the support. Furthermore, although it has been described as a guide member in dental implant treatment in the above description, it can be used as a medical guide member used when performing a drilling operation on a human body part widely.

It is a perspective view of the conventional guide member and the missing tooth row | line | column corresponding to this. It is the perspective view which showed the mode of the drilling operation | work in the state which put the conventional guide member on the dentition defect | deletion part. It is a perspective view of the state where the guide member of the present invention was put on the dentition missing part. It is a top view of the guide member of FIG. It is the figure which looked at the crown member of the guide member of FIG. 3 from the cheek side. It is a perspective view of the other guide member of this invention. It is a perspective view of the state which covered the guide member of Drawing 6 on the dentition missing part. It is a top view of the guide member of FIG. It is the schematic seen from the cheek side of the guide member of FIG. It is the schematic which looked at the support part of the front-end | tip of the guide member of FIG. 6 from the cheek side. It is the schematic which looked at the support part of FIG. 10 from the front tooth row side. It is the figure which showed the process of supporting the support part of FIG.

Explanation of symbols

110: Guide member 112 ... Crown member (crown member)
114 ... support member 116 ... guide member (Toyu)
130 ... Guide hole 132 ... Opening (slit)
134 ... opening 210 ... guide member 212 ... crown member (crown member)
214 ... support members 220a, b, c ... cheek side 220d ... mouth inner side

Claims (21)

A medical guide member that guides the working device to a drilling target position when performing a drilling operation on a surgical target part,
Formed with at least one or more coronal members to be worn over the surgical target,
Each crown member is provided with a guide hole penetrating in the vertical direction in order to guide the working device to the target drilling position, and from the guide hole to the side so that the entire vertical direction of the guide hole can be visually recognized from the outside. And has a vertical slit opened
Further, the guide hole is formed in a substantially semi-cylindrical shape opened to the slit side, and the width of the slit is at least larger than the diameter of the substantially semi-cylindrical guide hole. . The medical guide member according to claim 1, wherein the coronal member approximates a shape of a human body part corresponding to a surgical target part. 3. The apparatus according to claim 1, further comprising at least one support member that is fixed over a human body part adjacent to the surgical target portion and is integrally connected to the coronal member. Medical guide member. A substantially half-cylinder-shaped guide member formed so that the outer wall is matched is fixed to the inner wall of the guide hole, and the guide member has a biocompatibility and is more visible than the crown-shaped member. The medical guide member according to any one of claims 1 to 3, wherein the medical guide member is formed of a highly curable material. The guide member according to any one of claims 2 to 4, wherein an upper end surface of each of the coronal members is substantially parallel to a medical human body reference. Each of the support members is formed in a substantially cylindrical shape having an opening penetrating in the vertical direction, and when covering the adjacent human body part, at least a part of the inner wall of each of the support members and the outer wall of the human body part The upper end part of the said adjacent human body part is free upwards, when it fixes, and at least one part of them fits, The any one of Claims 3-4 characterized by the above-mentioned. Medical guide member. The medical guide member according to any one of claims 3 to 6, wherein upper ends of the coronal member and the support member have a substantially planar shape. It is given as a dental guide member that guides the drilling device to a desired artificial cavity position when drilling an artificial cavity for implanting an artificial dental root to the missing part of the dentition as a surgical target part,
The coronal member is at least one or more crown members to be mounted over the missing portion of the dentition, each having a guide hole penetrating in the vertical direction to guide the drill device to the target artificial cavity position; and 8. A slit in the vertical direction opened from the guide hole to the side so that the entire vertical direction of the guide hole can be visually recognized from the outside. The medical guide member according to 1. It is given as a dental guide member that guides the drilling device to a desired artificial cavity position when drilling an artificial cavity for implanting an artificial dental root to the missing part of the dentition as a surgical target part,
The coronal member is at least one or more crown members to be mounted over the missing portion of the dentition, each having a guide hole penetrating in the vertical direction to guide the drill device to the target artificial cavity position; and In order to be able to visually recognize the entire vertical direction of the guide hole from the outside, it has a vertical slit opened from the guide hole to the side,
The medical device according to any one of claims 3 to 7, wherein the support member is fitted and fixed on a tooth adjacent to the defect and integrally formed with the crown member. Guide member. The medical guide member according to claim 8, wherein an upper end surface of the crown member is substantially parallel to the occlusal plane. Each of the support members has a substantially cylindrical shape having an opening penetrating in the vertical direction, and at least a part of the inner wall of each of the support members and at least a part of the outer wall of each of the adjacent teeth are fitted. 11. The medical guide member according to claim 9, wherein each of the adjacent teeth is fixed upward, and an upper end portion of each adjacent tooth is freely upward. The at least top part of the crown member is disposed at a height close to the top of the cusp when it is put on the missing part of the dentition. Medical guide member. A medical guide member that guides the working device to a drilling target position when performing a drilling operation on a surgical target part,
At least one or more coronal members to be worn over the surgical target part;
It is formed with at least one support member that is fixed over the human body part adjacent to the surgical target part and is integrally connected to the coronal member,
Each support member is formed in a substantially cylindrical shape having an opening penetrating in the vertical direction. When the support member is put on the adjacent human body part, the upper part of the inner wall of the support member is the upper part of the outer wall of the human part. Is formed so that the human body part can be sandwiched from the side by two members by providing a slit that opens further toward the side,
One of the two members is highly flexible in the lateral direction of the human body part, and the other is low in flexibility,
A medical guide member.   The guide member according to claim 13, wherein upper ends of the coronal members and the support members are substantially parallel to a medical human body reference plane. The medical guide member according to claim 13 or 14, wherein a height of an upper end surface of the coronal member is lower than a height of an upper end surface of the support member. 16. The upper end surface of the coronal member is formed to have a stepped lower height as the corresponding perforation target position when it is put on the surgical target portion becomes distal. The medical guide member according to any one of the above. It is given as a dental guide member that guides the drilling device to a desired artificial cavity position when drilling an artificial cavity for implanting an artificial dental root to the missing part of the dentition as a surgical target part,
The coronal member is at least one or more crown members to be mounted over the missing part of the dentition, each provided with a guide hole penetrating in the vertical direction to guide the drill device to the target artificial cavity position,
Each of the support members is arranged so as to be covered on each of at least one or more teeth adjacent to the missing portion of the dentition, and each of the support members is placed on the adjacent teeth. The upper part of the inner wall of the teeth is engaged with the upper part of the outer wall of each tooth, and further, a slit is provided that opens at a position on the cheek and facing the connecting position of each support member,
When the support member is put on each tooth by the cheek side portion and the mouth inner side portion formed by the slit, the tooth can be sandwiched from the side, and the cheek side portion faces the slit. The medical guide member according to any one of claims 13 to 16, wherein the medical guide member is tapered so as to be thin. 18. The medical guide member according to claim 17, wherein the buccal side portion has a tapered shape that narrows toward the slit in both the vertical direction and the lateral direction. The medical guide member according to claim 17 or 18, wherein an adhesive having low human invasiveness is applied to an inner wall of the cheek side portion. The medical guide member according to any one of claims 17 to 19, wherein the medical human body reference plane is an occlusal plane. The medical guide according to any one of claims 17 to 20, characterized in that each of the crown members is formed in a stepwise manner toward the back side of the mouth. Element.

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