CN102920535B

CN102920535B - Jawbone restoration

Info

Publication number: CN102920535B
Application number: CN201210488763.6A
Authority: CN
Inventors: 张卫平
Original assignee: Beijing AK Medical Co Ltd
Current assignee: Beijing AK Medical Co Ltd
Priority date: 2012-11-26
Filing date: 2012-11-26
Publication date: 2014-07-23
Anticipated expiration: 2032-11-26
Also published as: WO2014079178A1; CN102920535A

Abstract

The invention provides a jawbone restoration which is arranged at a physiological jawbone lacking position of a patient to replace a physiological jawbone and comprises a jawbone restoration main body and an osseous fusion surface, wherein the jawbone restoration main body is in the same shape as the physiological jawbone; the osseous fusion surface is arranged on the joint surface of the jawbone restoration main body and the adjacent physiological jawbone; and the osseous fusion surface has a micropore structure into whcih bone cells are grown. By using the technical scheme, the jawbone restoration is highly similar to the lacking physiological bone of the patient in form, the closed lacking position is fully filled, and the position fixation is good; and by setting the osseous fusion surface facilitating growth of bone cells, long-term bone fusion of the restoration and the physiological bone is facilitated.

Description

Jawbone dummy

Technical field

The present invention relates to medical science prosthesis field, in particular to a kind of jawbone dummy.

Background technology

On cranium jaw face, mandibular defect is comparatively common in clinical case.Jaw facial cyst and tumor, acute and chronic osteomyelitis of jaws, osteoradionecrosis, the serious diseases such as wound, infection and congenital hereditary can cause mandibular bone partly or entirely excision or forfeiture, bone structure seriality is interrupted, and damaged with adjacent soft tissue how.Jaw defect have a strong impact on patient language, breathe, chew, swallow and the physiological function such as face appearance, make patient's quality of life degradation.

At present, clinical conventional jaw defect Therapeutic Method comprises autologous bone transplanting, homogeneous allogenic bone transplantation, distraction osteogenesis and bone tissue engineer technology etc., but still exist defect location to fill the problems such as sealing is undesirable, and maintenance is poor, and moulding and appearance is recovered to be difficult to reach Perfect Reconstruction with mating.Recently also there is the metal of employing Rapid Manufacturing Technology to set up the three-dimensional skeleton model of defect and the method to the direct machine-shaping prosthesis of metal material by CNC Machine Tools such as machining centers by CT scan data, solved to a certain extent initial stage fixation problem, but sclerous tissues at a specified future date combination and muscle ligament group soft tissue adhesion effect are still undesirable.

Summary of the invention

The present invention aims to provide a kind of jawbone dummy, to solve jawbone recovery technique of the prior art, be difficult to the jawbone prosthese that Perfect Reconstruction shape and physiology bone meet, exist defect location to fill sealing undesirable, the sclerous tissues at a specified future date of the problem that maintenance is poor and the prosthesis directly processed with metal is in conjunction with the undesirable problem of effect.

To achieve these goals, the invention provides a kind of jawbone dummy, be arranged on the alternative physiology jawbone in position that patient lacks physiology jawbone,, comprising: jawbone is repaired main body, identical with physiology jawbone shape; Bony fusion face, is arranged on jawbone and repairs on synestotic of main body and adjacent physiology; Bony fusion mask has microcellular structure to grow into for osteocyte.

Further, jawbone reparation main body comprises that upper jaw bone is repaired main body and/or mandibular bone is repaired main body.

Further, upper jaw bone repair main body comprise one or more structures in physiology upper tooth jaw district, anterior nasal spine, eye socket lower edge, zygomatic process structure partly or entirely.

Further, mandibular bone repair main body comprise physiology lower tooth jaw district, lower jaw member, angle of mandible, mandibular ramus, coronoid process, condyle prominent in one or more structures partly or entirely.

Further, it is one-body molded that jawbone is repaired main body.

Further, also comprise, tendon or soft tissue attachment region, be arranged on jawbone and repair on the face joining with physiology ligament starting point and stop in main body, and tendon or soft tissue attachment region have microcellular structure and grow into for physiology tendon or soft tissue cells.

Further, the inside of tendon or soft tissue attachment region and/or periphery are provided with tendon locking holes.

Further, jawbone is repaired in main body and is provided with the connection projection with overhanging screw hole, for being connected with the physiology bone of adjacency by mounting screw.

Further, also comprise fixation steel plate; Jawbone is repaired in main body and is provided with fixation steel plate screw hole, and one end of fixation steel plate is connected with fixation steel plate screw hole by mounting screw, and the other end of fixation steel plate is the link being connected with the physiology bone of adjacency.

Further, also comprise for the Dental Implant base station fixing hole of Dental Implant is installed, be arranged on the position that jawbone is repaired corresponding alveolar ridge in main body.

Further, jawbone is repaired in main body and is provided with in order to the through hole through nerve or vascular bundle.

Apply technical scheme of the present invention, the physiology bone that jawbone dummy lacks to patient is highly similar in form, fully fills sealing defect location, and position is fixed well; And, being provided with and being convenient to the bony fusion face that osteocyte is grown into, the long-term bone that is conducive to dummy and physiology bone merges.

Accompanying drawing explanation

The Figure of description that forms the application's a part is used to provide a further understanding of the present invention, and schematic description and description of the present invention is used for explaining the present invention, does not form inappropriate limitation of the present invention.In the accompanying drawings:

Fig. 1 shows the schematic diagram of jawbone dummy of the present invention.

The upper jaw bone that Fig. 2 shows in jawbone dummy of the present invention is repaired the schematic diagram of main body.

Fig. 3 shows the schematic diagram of the first direction of the mandibular bone reparation main body in jawbone dummy of the present invention.

The mandibular bone that Fig. 4 shows in jawbone dummy of the present invention is repaired the schematic diagram of the second direction of main body.

Fig. 5 shows the combination schematic diagram that mandibular bone in jawbone dummy of the present invention is repaired main body and physiology bone.

Fig. 6 shows the schematic diagram that overhanging screw hole is set in jawbone dummy of the present invention.

Fig. 7 shows the scheme of installation that fixation steel plate is set in jawbone dummy of the present invention.

Fig. 8 shows first embodiment that comprises part upper jaw bone of jawbone dummy of the present invention.And

Fig. 9 shows second embodiment that comprises part mandibular bone of jawbone dummy of the present invention.

The specific embodiment

It should be noted that, in the situation that not conflicting, embodiment and the feature in embodiment in the application can combine mutually.Describe below with reference to the accompanying drawings and in conjunction with the embodiments the present invention in detail.

Shown in Figure 1, the invention provides a kind of jawbone dummy, comprise that upper jaw bone is repaired main body 10 and mandibular bone is repaired main body 20; Jawbone is repaired in main body has bony fusion face 30, Dental Implant base station fixing hole 40, tendon or soft tissue attachment region 50, tendon locking holes 60, through hole 70, overhanging screw hole 80.

It is the position to be repaired that need fill up according to patient and the CT of perienchyma thereof that jawbone is repaired main body, the scan-datas such as MRI, by the reverse reconstruction of three-dimensional model of computer software, also design according to this and meet the jawbone dummy that individual dissection is learned form completely, applied metal rapid shaping technique is electron beam melting forming technique (Electron Beam Melting for example, EBM) or Selective Laser Sintering (Selected Laser Sintering, SLS) under computer control, rapid processing becomes the point-device jawbone dummy of physical dimension blank, through necessary following process, for example hole again, tapping, surface treatment, assembling etc., become the directly product of implant into body.

Jawbone of the present invention is repaired main body and is adopted medical metal, comprises that the materials such as medical stainless steel, titanium and titanium-base alloy, cobalt-base alloys make, and this class medical metal material has all confirmed through clinical practice for many years the biology performance that it is good.

Shown in Figure 2, the covering scope that upper jaw bone is repaired main body 10 can comprise upper tooth jaw district, expands to anterior nasal spine, eye socket lower edge, zygomatic process if desired isostructural partly or entirely by the damaged situation of bone.

Shown in Figure 3, the covering scope that mandibular bone is repaired main body 20 can comprise lower tooth jaw district, lower jaw member, angle of mandible, mandibular ramus, coronoid process, condyle prominent isostructural partly or entirely.

Preferably, it is one-body molded that upper jaw bone is repaired the structures such as main body 10 its upper tooth jaw districts, anterior nasal spine, eye socket lower edge, zygomatic process.It is one-body molded that mandibular bone is repaired the structures such as main body 20 its lower tooth jaw districts, lower jaw member, angle of mandible, mandibular ramus, coronoid process, condyle are prominent.

The synestotic interface of physiology that upper jaw bone reparation main body 10, mandibular bone reparation main body 20 are connected with adjacent wish is called bony fusion face 30, and this bony fusion mask has microcellular structure.This microcellular structure is a kind of porous surface gap, the multidirectional micro hole structure that inside is interconnected, and this hole is conducive to osteocyte creeps and grows into, and the bony fusion face 30 on postoperative artificial dummy will merge to reach steady in a long-term with physiology bone structure generation bone.

Shown in Figure 2, preferably, upper jaw bone is repaired main body 10 and is being provided with tendon or soft tissue attachment region 50 corresponding to each upper jaw physiology ligament starting point and stop, tendon or soft tissue attachment region 50 hold and grow into provide reliable impetus to the motion freely of following jawbone muscle group for physiology tendon and soft tissue cells for a porous region, and its aperture, porous region is 0.25mm to 3mm; These tendons or soft tissue attachment region comprise: the masseter attachment region 54 that is positioned at zygomatic process and zygomatic arch lower edge; Be positioned at the medial pterygoid attachment region 55 of the prominent and maxillary tuberosity of vertebra; Be positioned at the genioglossus attachment region 510 of mental spine; Be positioned at the zygomaticus major attachment region 51 in cheekbone sutura zygomaticotemporalis the place ahead; Be positioned at the levator labii superioris attachment region of infraorbital margin of maxilla; Be positioned at the levator labii superioris alaeque nasi attachment region 52 of frontal process of the maxilla; Be positioned at the levator anguli oris attachment region 53 of upper jaw bone canine fossa.

Referring to shown in Fig. 3 to Fig. 5, preferably, mandibular bone is repaired main body 20 and is being provided with tendon or soft tissue attachment region 50 corresponding to each lower jaw physiology ligament starting point and stop, tendon or soft tissue attachment region 50 are grown into for a porous region with three-dimensional communication hole supplies physiology tendon and soft tissue cells to hold to following jaw face muscle group, motion freely provides reliable impetus, and its aperture, porous region of three-dimensional communication hole is 0.25mm to 3mm; These tendons or soft tissue attachment region comprise: be positioned at the prominent back bevel of condyle and lateral surface meniscus and hgamentum temporomandibulare attachment region; Be positioned at the stylomandibular ligament attachment region of angle of mandible and ramus of mandible trailing edge; Be positioned at the depressor labii inferioris depressor anguli oris attachment region 59 of mandibular bone external obilque line; Be positioned at the mentalis attachment region 58 of mandibular bone lateral incisor tip of a root place surface of bone; Be positioned at the masseter attachment region 54 of mandibular bone masseteric tuberosity; Be positioned at the temporalis attachment region 57 of ramus of mandible processus coracoideus leading edge; Be positioned at the medial pterygoid attachment region 55 of trberositas pterygoidea mandibulae; Be positioned at the lateral pterygoid attachment region 56 of mandibular bone lamina lateralis processus pterygoidei lateral surface.

Shown in Figure 6, preferably, upper jaw bone is repaired main body 10, mandibular bone is repaired main body 20 and be provided with overhanging screw hole 80 near the synestotic bony fusion face 30 of the adjacent physiology being connected with wish, and overhanging screw hole 80 covers adjacent physiology bone surface.Postoperative initial stage upper jaw bone is repaired main body 10 and is fixed by the screw through in overhanging screw hole 80 and adjacent physiology synosteosis with mandibular bone reparation main body 20, and being beneficial to creeps to the micropore inside of bony fusion face 30 to grow into form at the physiology bone osteocyte of the bony fusion face binding site with upper jaw bone reparation main body 10, mandibular bone reparation main body 20 in the future is firmly connected.

Shown in Figure 7, preferably, upper jaw bone is repaired main body 10, mandibular bone is repaired main body 20 and be provided with fixation steel plate screw hole 91 near the synestotic bony fusion face 30 of the adjacent physiology being connected with wish.Postoperative initial stage upper jaw bone is repaired main body 10, mandibular bone is repaired main body 20 and fixed with adjacent physiology synosteosis by the fixation steel plate 90 of general type, is beneficial in the future physiology bone and at bony fusion face binding site osteocyte, to the micropore inside of bony fusion face 30, creeps to grow into form firmly and connect.

Referring to shown in Fig. 5 to Fig. 8, preferably, upper jaw bone is repaired main body 10, the mandibular bone reparation corresponding alveolar ridge of main body 20 position arranges respectively Dental Implant base station fixing hole 40(and for example arranges 1, a plurality of until 16).Dental Implant base station fixing hole 40 is interior can implant Dental Implant base station 41 for this, Dental Implant corona 42 is installed on Dental Implant base station 41, for realize the function of physiology tooth by Dental Implant.

Preferably, upper jaw bone repair main body 10 near corresponding physiology upper jaw bone infraorbital foramen position by left and right be respectively equipped with through hole 70 when needing in order to through nervus infraorbitalis and vascular bundle, through hole 70 is one or more.

Preferably, mandibular bone repair main body 20 near corresponding physiology mandibular bone mental foramen position by left and right be respectively equipped with through hole 70 when needing in order to through nervus mandibularis and vascular bundle, through hole 70 is one or more.

Preferably, jawbone is repaired in main body tendon or soft tissue attachment region and periphery to be provided with tendon locking holes 60 temporary fixed in order to use stitching thread to carry out tendon or soft tissue in operation, be beneficial in the future tendon and to the micropore inside of tendon or soft tissue attachment region 50, creep to grow into form firmly and connect.

Preferably, jawbone reparation main body other regions except tendon or soft tissue attachment region 50 are smooth surface.

Shown in Figure 8, there is shown the jawbone dummy of the first embodiment of the present invention, comprise that the upper jaw bone of repairing a upper jaw bone part repairs main body 10.

Shown in Figure 9, there is shown the jawbone dummy of the second embodiment of the present invention, comprise that the mandibular bone of repairing a mandibular bone part repairs main body 20.

A kind of design, making and the operation process of jawbone dummy of the present invention are:

1. preoperatively patient's jaw face is carried out to CT, MRI check to obtain affected part data and set up threedimensional model, when a side shortage of data, can use mirror method to copy side seam Data flipping, by computer aided design software, design the jawbone dummy that can recover the desirable appearance form of patient, at jawbone dummy corresponding site, design bony fusion face, Dental Implant base station fixing hole, tendon or soft tissue attachment region, tendon locking holes, through hole, fixation steel plate screw hole, the overhanging screw hole of being combined with the adjacent physiology osseous tissue of wish linking.

2. applied metal rapid shaping technique is as electron beam melting forming technique (Electron Beam Melting, EBM) or Selective Laser Sintering (Selected Laser Sintering, SLS) under computer control, rapid processing becomes the point-device jawbone dummy of physical dimension blank, then becomes the directly product of implant into body through necessary following process such as boring, tapping, surface treatment, assembling etc.

3. row jawbone dummy implant surgery, upper jaw bone is repaired to main body, mandibular bone to be repaired main body and implants corresponding precalculated position according to prior surgery planning, the adjacent physiology osseous tissue faying face that bony fusion face is connected with wish is fitted tightly, by overhanging screw hole, use bone screw that jawbone dummy and adjacent physiology bone are fixed, also can use conventional jaw face fixation steel plate that jawbone dummy and adjacent physiology bone are fixed.

4. by being exclusively used in to plug into, from disconnected neural collagen protein nerve sheath pipe, through upper jaw bone, repair the through hole in main body and mandibular bone reparation main body respectively; and pegged graft and sew up with suture ligature into corresponding collagen protein nerve sheath pipe port from the jaw face nerve broken ends of fractured bone of both sides that breaks inside and outside jawbone impaired, injured nerve will likely not be subject to the interference of its hetero-organization of periphery and will repair along the pipeline growth of collagen protein nerve sheath pipe inside under collagen protein nerve sheath protection of pipe.

5. need are adhered to the soft tissues such as fixing tendon ligament solid at corresponding tendon or soft tissue attachment region with sewing up linear slit.

6. close wound, conventional post surgery treatment and nursing.

The microcellular structure of this jawbone dummy bony fusion face and the laminating of adjacent host's physiology bone sclerotin close contact after jawbone dummy is implanted, following osteocyte forms the microcellular structure on the jawbone dummy surface of growing in good bone and merges; In addition being sewn the soft tissues such as physiology tendon ligament that are fixed on each tendon or soft tissue attachment region also grows into tendon or soft tissue attachment region to form the motion impetus of jawbone muscle group holding.

The machining path of jawbone dummy is for utilizing the rapid shaping technique melt moldings such as laser sintered or high-power electron beam melting, and concrete grammar is as follows:

A) by CT or MRI scanning, obtain the tomoscan data of patient's jaw face, and according to tomoscan data inverse to the threedimensional model of setting up jawbone dummy;

B) use professional software to carry out layering to the jawbone dummy parts three-dimensional data model of design-build in computer, to obtain the outline data of a series of monolayer slices;

C) to laser or the above-mentioned serial synusia data of high-power electron beam rapid forming equipment input;

The medical metal powder of floor height respective thickness while d) laying with aforementioned three-dimensional data model layering in laser or high-power electron beam rapid forming equipment processing cabin;

E) by computer controlled controlling laser beam or high-power electron beam, medical metal powder is scanned and selectively fusing;

F) repeat aforementioned laying powder, scanning fusing step so that the mutual clinkering of the material of each layer of selected fusing becomes whole;

G) complete the jawbone dummy parts that the powder of removing not melting after the melting process of whole aspects can obtain required shape and structure;

H), owing to needed entity, hole, micropore etc. structure having been designed in the lump in data file when building jawbone dummy parts three-dimensional data model, therefore above-mentioned various structures complete manufacture by disposable in laser sintered or high-power electron beam melting process.

The foregoing is only the preferred embodiments of the present invention, be not limited to the present invention, for a person skilled in the art, the present invention can have various modifications and variations.Within the spirit and principles in the present invention all, any modification of doing, be equal to replacement, improvement etc., within all should being included in protection scope of the present invention.

Claims

1. a jawbone dummy, is arranged on the alternative described physiology jawbone in position that patient lacks physiology jawbone, it is characterized in that, comprising:

Jawbone is repaired main body, identical with described physiology jawbone shape;

Bony fusion face (30), is arranged on described jawbone and repairs on synestotic of main body and adjacent physiology; Described bony fusion face (30) has microcellular structure and grows into for osteocyte;

Tendon or soft tissue attachment region (50), be arranged on described jawbone and repair on the face joining with physiology ligament starting point and stop in main body, described tendon or soft tissue attachment region (50) have the microcellular structure of three-dimensional communication hole and grow into for physiology tendon or soft tissue cells.

2. jawbone dummy according to claim 1, is characterized in that, described jawbone is repaired main body and comprised that upper jaw bone is repaired main body (10) and/or mandibular bone is repaired main body (20).

3. jawbone dummy according to claim 2, is characterized in that, described upper jaw bone repair main body (10) comprise one or more structures in physiology upper tooth jaw district, anterior nasal spine, eye socket lower edge, zygomatic process structure partly or entirely.

4. jawbone dummy according to claim 2, is characterized in that, described mandibular bone repair main body (20) comprise physiology lower tooth jaw district, lower jaw member, angle of mandible, mandibular ramus, coronoid process, condyle prominent in one or more structures partly or entirely.

5. according to the jawbone dummy described in any one in claim 1 to 4, it is characterized in that, it is one-body molded that described jawbone is repaired main body.

6. jawbone dummy according to claim 1, is characterized in that, inside and/or the periphery of described tendon or soft tissue attachment region (50) are provided with tendon locking holes (60).

7. jawbone dummy according to claim 1, is characterized in that, described jawbone is repaired in main body and is provided with the connection projection with overhanging screw hole (80), for being connected with the physiology bone of adjacency by mounting screw.

8. jawbone dummy according to claim 1, is characterized in that, also comprises fixation steel plate (90); Described jawbone is repaired in main body and is provided with fixation steel plate screw hole (91), one end of described fixation steel plate (90) is connected with described fixation steel plate screw hole (91) by mounting screw, and the other end of described fixation steel plate (90) is the link being connected with the physiology bone of adjacency.

9. jawbone dummy according to claim 1, is characterized in that, also comprises for the Dental Implant base station fixing hole (40) of Dental Implant is installed, and is arranged on the position that described jawbone is repaired corresponding alveolar ridge in main body.

10. jawbone dummy according to claim 1, is characterized in that, described jawbone is repaired in main body and is provided with in order to the through hole (70) through nerve or vascular bundle.