CN105852931B - The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing - Google Patents
The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing Download PDFInfo
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- CN105852931B CN105852931B CN201610288256.6A CN201610288256A CN105852931B CN 105852931 B CN105852931 B CN 105852931B CN 201610288256 A CN201610288256 A CN 201610288256A CN 105852931 B CN105852931 B CN 105852931B
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- jawbone
- osteotomy
- plate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/176—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
- A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
Abstract
The present invention provides the guiding positioning components for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing, include that the first guiding locator, the second guiding locator and third guide locator, the first guiding locator to be fixed on fibula and assist fibula osteotomy moulding successively according to Jaw neoplasm excision and reconstruction operations process；Second guiding locator is fixed on the sclerotin position of Jaw neoplasm front and rear sides and Jaw neoplasm is assisted to cut off；Third guides the osteotomy part of locator and fibula to connect, and third guiding locator is connected between the sclerotin position of the front and rear sides after excision Jaw neoplasm and is assisted reconstruction of jaw using the osteotomy part of fibula as bone graft.Using the present invention, can guide the operations such as fibula osteotomy, Jaw neoplasm excision and reconstruction of jaw that can accurately implement, it is easy to operate, it is low to the skill requirement of operator, can prevent operator with feel operation and caused by surgical procedure error problem.
Description
Technical field
The present invention relates to medical instruments field more particularly to the guiding for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing
Positioning component.
Background technology
Tumor invading, inflammation, wound and radiotherapy are the main reason for causing jawbone to destroy, and operative treatment usually needs
Bulk jawbone is cut off, patient facial region's external defects are necessarily caused and is engaged the forfeiture of masticatory function, this just needs superior reparation
Reconstruction technique intercepts one section of fibula of self shank non-bearing, and it is most currently used to fashion into the shape similarity metric jawbone of jawbone
Means.However, generally there are following defects in Jaw neoplasm excision both at home and abroad and reconstruction operations at present：
(1) since the shape of shank fibula is straight type, and jawbone is L-type, bowed multi-C stereo mixture, so operation
Middle to need doctor repeatedly to block fibula and bend the form for fashioning into approximate jawbone, difficulty is well imagined, time-consuming and laborious in art,
Operator's skill requirement is high, this is also to often result in rebuild the main reason for effect is undesirable.
(2) Jaw neoplasm resection operation regards lower progress in half-blindness, and operating space is small, and technology requires height, and operating difficulty is big, by
Cause resection error excessive in lacking experience, cause fibula to be matched with jaw defect position bad, and is easy Residual Disease
Become tissue, there are the risks of postoperative recurrence.
(3) colleague both at home and abroad at present is primarily focused in the form of reconstruction of jaw, i.e. the appearance recovery side of patient
Face but ignores the recovery of the occlusion masticatory function of patient, is engaged the bad Quality of Life to patient of masticatory function in fact
Bigger.A large amount of reconstruction of jaw cases that we complete in early days, have smoothly restored patient's appearance, but the most of patients later stage have a denture made it is tired
Difficulty affects the recovery of occlusion masticatory function.The reparation of removable denture is carried out on the fibula of transplanting, often maintenance is poor, nozzle
Inefficiency is chewed, and tooth-implanting maintenance is good, is the most ideal style for restoring meshing functionss, is conducive to have a denture made, it is particularly advantageous to
The reconstruction of jaw scheme of tooth-implanting is pursuing a goal for Oral and Maxillofacial Surgery and Prosthodontics doctor, but often because of jawbone weight
Build position deficient accuracy and deficient reasonability or planting body implant angle or depth it is not good enough, cause Most patients to lose plantation
Tooth chance.
Invention content
Technical problem to be solved by the present invention lies in provide a kind of cutting off and rebuilding for Jaw neoplasm for increasing material manufacturing
Guiding positioning component, can guide fibula osteotomy, Jaw neoplasm excision and the operations such as reconstruction of jaw that can accurately implement, grasp
Make it is easy, it is low to the skill requirement of operator, can prevent operator with feel operation and caused by surgical procedure error problem.
In order to solve the above technical problem, the present invention provides being cut off for Jaw neoplasm for increasing material manufacturing and drawing for reconstruction
Positioning component is led, is positioned successively including the first guiding locator, the second guiding according to Jaw neoplasm excision and reconstruction operations process
Device and third guide locator, and the first guiding locator is fixed on fibula, and assists fibula osteotomy moulding；Described
Two guiding locators are fixed on the sclerotin position of Jaw neoplasm front and rear sides, and Jaw neoplasm is assisted to cut off；The third guiding
The osteotomy part of locator and fibula connects, and the third guiding locator is connected to the front and rear sides after excision Jaw neoplasm
Between sclerotin position, and reconstruction of jaw is assisted using the osteotomy part of fibula as bone graft；The first guiding locator, second
It guides locator and third guiding locator is all made of resin or plastics are molded by 3D printing.
As a preferred option, the first guiding locator including the first osteotomy guide plate and positions latch closure, and described first
Osteotomy guide plate is equipped with the long trough curve-surface cavity closed with the osteotomy part bone face paste of fibula, and the positioning latch closure is equipped with two, point
It is not buckled in the position being connected with the osteotomy part both ends of fibula and is connect with the both ends of the first osteotomy guide plate, the positioning
Latch closure is equipped with the annular surface cavity that the position being connected with the osteotomy part both ends of fibula fastens, and the annular of the positioning latch closure is bent
The long trough curve-surface cavity abrupt transition of face cavity and the first osteotomy guide plate, the first osteotomy guide plate are equipped with multiple use
Threaded hole is opened up on fibula in guiding operator and is oriented to installation for the first osteotomy guide plate is connect with fibula first
Hole.
As a preferred option, the end of the positioning latch closure is extended with tenon, the both ends point of the first osteotomy guide plate
The tongue-and-groove that She You not be connected with the tenon.
As a preferred option, the both ends of the first osteotomy guide plate are respectively equipped with from the end face of the first osteotomy guide plate
Outwardly directed first section leads side；The first osteotomy guide plate is equipped with bending and is oriented to fracture, and the bending is oriented to fracture
For V-shaped.
As a preferred option, the second guiding locator includes two pieces of sclerotin for being set to Jaw neoplasm front and rear sides
The second osteotomy guide plate at position, the second osteotomy guide plate be equipped with outside jawbone side seam face paste close medial surface, described second section
Bone conduction plate is equipped with for guiding operator to open up threaded hole on jawbone and connect for the second osteotomy guide plate and jawbone
Second connect is oriented to mounting hole.
As a preferred option, the second osteotomy guide plate is equipped with outside from the end face close to the end face of Jaw neoplasm side
The the second section leads side stretched out；The lateral surface of the second osteotomy guide plate is equipped with boss, and the guiding mounting hole is opened in
The boss center；The second osteotomy guide plate extends the buckling parts of oriented jawbone edge wrapping.
As a preferred option, the third guiding locator includes bone graft directing plate, Dental implantion guiding hole seat, front
Jawbone fixed plate and rear portion jawbone fixed plate, the guide tracks of the bone graft directing plate and the extension track of reconstruction of jaw coordinate
Unanimously, several bone graft mounting holes, the bone graft mounting hole and the screw thread on fibula are offered on the bone graft directing plate
Hole is corresponding, and the Dental implantion guiding hole seat is set on the bone graft directing plate and its aperture is opposite with bone graft, described
Front jawbone fixed plate and rear portion jawbone fixed plate be connected to the both ends of the bone graft directing plate and equipped with it is corresponding
The medial surface that jaw bones face paste is closed is equipped with several jawbones in the front jawbone fixed plate and rear portion jawbone fixed plate and fixes
Hole, the jawbone mounting hole are corresponding with the threaded hole on jawbone.
As a preferred option, the bone graft directing plate extends the first of the wrapping of on the upside of oriented bone graft or downside and fastens
Portion, the Dental implantion guiding hole seat are set on first buckling parts；The side of the front jawbone fixed plate extends oriented
Second buckling parts of jawbone edge wrapping, the other side of the front jawbone fixed plate are equipped with the third fastened with tooth or teeth space
Buckling parts；The rear portion jawbone fixed plate extends the 4th buckling parts of oriented jawbone edge wrapping.
As a preferred option, the central axis in the hole of the Dental implantion guiding hole seat is in bone graft bone face, the tooth
Cooperation is plugged with the guide post passed through for different-diameter drill bit in plantation guiding hole seat, and the guide post includes cylinder-shaped body, institute
It states cylinder-shaped body and is equipped with the stepped hole communicated with the hole of Dental implantion guiding hole seat, the top of the stepped hole is big straight
Diameter, lower part are minor diameter；The periphery of the cylinder-shaped body is equipped with lug boss, the lower surface of the lug boss and the Dental implantion
Guide the upper surface cooperation of hole seat.
As a preferred option, the bone graft directing plate is equipped with the titanium plate locating slot extended along bone graft track, institute
It states to offer on titanium plate locating slot and several passes through the through-hole that titanium plate and bone graft link together for whole screw.
The guiding positioning component for cutting off and rebuilding for Jaw neoplasm for implementing the increasing material manufacturing of the present invention, with the prior art
It compares, has the advantages that：
(1) according to Jaw neoplasm excision and reconstruction operations process, first, fibula osteotomy is assisted using the first guiding locator
It is moulding；Secondly, it is cut off using the second guiding locator auxiliary Jaw neoplasm；Finally, jawbone is assisted using third guiding locator
It rebuilds；As it can be seen that in entire surgical procedure, by guiding locator, guiding fibula osteotomy, Jaw neoplasm excision and jawbone accordingly
The operations such as reconstruction can accurately be implemented, easy to operate, low to the skill requirement of operator, can prevent operator and be operated with feeling
Surgical procedure error problem caused by and；Also, 3 guiding locators are all made of resin or plastics are molded by 3D printing, energy
Enough ensure that completing complicated accurate per-sonalization structures makes.
(2) the first guiding locator of the invention keeps the first osteotomy guide plate and fibula in place by the design of positioning latch closure
Accurately, prevent the first osteotomy guide plate from twisting or sliding on fibula, it is ensured that fibula is moulding by predetermined design scheme osteotomy, hand
Art effect is accurate；Meanwhile also by the setting of the first guiding mounting hole, for the titanium plate in the operation of follow-up reconstruction of jaw, bone graft
Connection between third guiding locator provides unified threaded hole, avoids titanium plate, bone graft and third guiding locator
Bone injury is transplanted caused by fixed secondary drilling, also ensures that titanium plate, bone graft and third guiding locator at jaw defect just
The accuracy of position.
(3) setting that the second guiding locator of the invention is oriented to mounting hole by second, can make the second osteotomy guide plate
It is held in a predetermined position and firm stable, is slid when avoiding excision Jaw neoplasm, Jaw neoplasm resection operation is made more to hold
It easily carries out, is operated convenient for patient；Jawbone Pathoses region is cut off along boundary precise and safety under being guided through the second osteotomy guide plate, is avoided
Residual, effectively reduce postoperative recurrence risk, while for follow-up reconstruction of jaw operation in titanium plate and third guide locator it
Between connection unified threaded hole is provided, avoid titanium plate and jawbone damage caused by third guiding locator fixes secondary drilling
Wound also ensures that the accuracy that titanium plate and third guide locator in place at jaw defect.
(4) third of the invention guiding locator, which uses, collects Dental implantion and reconstruction of jaw in integral structure, by moving
Dental implantion is designed on bone grafting directing plate and guides hole seat, can make bone graft directing plate while guiding reconstruction of jaw operation, it is auxiliary
Dental implantion part operation is helped, if implantation hole preparation, planting body are implanted into, greatly improves operation precision and success rate.
Description of the drawings
In order to illustrate the technical solution of the embodiments of the present invention more clearly, will simply be situated between to the attached drawing of embodiment below
It continues.
Fig. 1 is the decomposition chart of the first guiding locator；
Fig. 2 is structural schematic diagram when the first guiding locator is connect with fibula；
Fig. 3 is structural schematic diagram when the second guiding locator is connect with mandibular；
Fig. 4 is outer side view when third guiding locator is connect with mandibular；
Fig. 5 is the inner side view of third guiding locator；
Fig. 6 is the sectional view of guide post.
Specific implementation mode
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, complete
Site preparation describes, it is clear that described embodiments are only a part of the embodiments of the present invention, instead of all the embodiments.It is based on
Embodiment in the present invention, those of ordinary skill in the art are obtained every other without creative efforts
Embodiment shall fall within the protection scope of the present invention.
In conjunction with referring to Fig. 1 to Fig. 6, the preferred embodiment of the present invention, a kind of increasing material manufacturing for Jaw neoplasm excision and
The guiding positioning component of reconstruction includes the first guiding locator 1, second successively according to Jaw neoplasm excision and reconstruction operations process
Locator 2 and third is guided to guide locator 3, the first guiding locator 1 is fixed on fibula 4, and fibula is assisted to cut
Bone is moulding；The second guiding locator 2 is fixed on sclerotin position (i.e. front jawbone and the rear portion of 51 front and rear sides of Jaw neoplasm
Jawbone), and Jaw neoplasm is assisted to cut off；The third guiding locator 3 is connect with the osteotomy part of fibula 4, and the third is drawn
Between the sclerotin position (i.e. front jawbone and rear portion jawbone) for leading the front and rear sides that locator 3 is connected to after excision Jaw neoplasm,
And reconstruction of jaw is assisted using the osteotomy part of fibula 4 as bone graft 41.As it can be seen that Jaw neoplasm excision and reconstruction operations process
It is：First, assist fibula osteotomy moulding using the first guiding locator 1；Secondly, jawbone is assisted using the second guiding locator 2
Tumor resection；Finally, reconstruction of jaw is assisted using third guiding locator 3.It is fixed by guiding accordingly in entire surgical procedure
Position device, the operations such as guiding fibula osteotomy, Jaw neoplasm excision and reconstruction of jaw can accurately be implemented, easy to operate, to operation
The skill requirement of person is low, can prevent operator with feel operation and caused by surgical procedure error problem.It should be noted that institute
It states the first guiding locator 1, second guiding locator 2 and third guiding locator 3 is all made of resin or plastics pass through 3D printing
Molding, it can be ensured that complete complicated accurate per-sonalization structures and make.
As depicted in figs. 1 and 2, the specific setting form of the first guiding locator 1 is as follows：
The first guiding locator 1 includes the first osteotomy guide plate 11 and positioning latch closure 12, the first osteotomy guide plate 11
Equipped with the long trough curve-surface cavity closed with the osteotomy part bone face paste of fibula 4, there are two the positioning latch closure 12 is set, snapping is distinguished
It connect in the position being connected with the osteotomy part both ends of fibula 4 and with the both ends of the first osteotomy guide plate 11, the locating ring
Button 12 is equipped with the annular surface cavity that the position being connected with the osteotomy part both ends of fibula 4 fastens, the ring of the positioning latch closure 12
The long trough curve-surface cavity abrupt transition of shape curve-surface cavity and the first osteotomy guide plate 11 is set on the first osteotomy guide plate 11
Have multiple for guiding operator to open up threaded hole on fibula 4 and connect with fibula 4 for the first osteotomy guide plate 11
First is oriented to mounting hole 13.
In the present embodiment, the head mathematical model of patient is obtained with CBCT or CT scan, passes through software three-dimensional reconstruction
Establish Three-dimensional model.Operation plan is formulated on 3-dimensional digital skull model and draw fibula osteotomy with computer software
Boundary line and threaded hole draw the first osteotomy guide plate 11 and locating ring according to the range of osteotomy boundary line and the position of threaded hole
The profile of button 12, and the first osteotomy for using the non-toxic materials such as resin, plastics to be fabricated to entity by 3D printing forming technique is led
Plate 11 and positioning latch closure 12.In the range of the long trough curve-surface cavity of the first osteotomy guide plate 11 is according to fibula osteotomy boundary line
Outer side seam face form generating, closed with the outer side seam face paste of the osteotomy part of fibula 4；There are two the positioning latch closure 12 is set,
Annular surface cavity is according to the outer side seam face form generating except the range of fibula osteotomy boundary line, the osteotomy part with fibula 4
The connected position in both ends fastens, and the end of the positioning latch closure 12 is extended with tenon 14, the both ends of the first osteotomy guide plate 11
It is respectively equipped with the tongue-and-groove 15 being connected with the tenon 14, from there through the cooperation of tenon 14 and tongue-and-groove 15, makes positioning latch closure
12 link together with the first osteotomy guide plate 11, to effectivelying prevent the first osteotomy guide plate 11 to twist or slide on fibula
It is dynamic, it is ensured that fibula is moulding by predetermined design scheme osteotomy, and surgical effect is accurate.The first osteotomy guide plate 11 is equipped with multiple the
One is oriented to mounting hole 13, and the position for being oriented to mounting hole 13 according to first when fibula bone-culting operation, can guide operator in fibula
Threaded hole is opened up on 4, and the first osteotomy guide plate 11 is connected and fixed with fibula 4 by screw, makes the first osteotomy guide plate
11 are held in a predetermined position, and more firm stable, are slid when avoiding osteotomy operation, reduce osteotomy operation and predetermined hand
Art scheme error, makes fibula bone-culting operation be easier to make for, and is operated convenient for patient；The osteotomy part of fibula 4 is as bone graft 41
It performs the operation for subsequent reconstruction of jaw, when reconstruction of jaw, the threaded hole on fibula 4 (namely bone graft 41) corresponds to first and is oriented to peace
Dress hole 13 also is provided with multiple, wherein at least two threaded holes are corresponding with the connecting hole in titanium plate, at least two threaded holes and the
Bone graft mounting hole on three guiding locators 3 is corresponding.The setting for being oriented to mounting hole 13 by first as a result, while after being
Connection between titanium plate, bone graft 41 in continuous reconstruction of jaw operation and third guiding locator 3 provides unified threaded hole, keeps away
Exempt to transplant bone injury caused by titanium plate, bone graft 41 and third guiding locator 3 fix secondary drilling, has also ensured that titanium plate, moves
The accuracy that bone grafting 41 and third guide locator 3 in place at jaw defect.
More preferably, the both ends of the first osteotomy guide plate 11 are respectively arranged with the first section leads side 16, first section
Guide edge 16 is the leader of fibula osteotomy boundary line, is used for the position and direction of fibula osteotomy boundary line in guided operation,
Under being instructed through the first osteotomy guide plate 11 fibula 4 is cut down to precise and safety along fibula osteotomy boundary line (i.e. the first section leads side 16)
Plan osteotomy part.Further, first section leads side 16 is protruding from the end face of the first osteotomy guide plate 11,
Thus osteotomy operation is facilitated to be carried out under sight direct-view, it is moulding more controllable to complicated osteotomy, it is ensured that osteotomy surface is more accurate.
More preferably, the first osteotomy guide plate 11 is equipped with bending and is oriented to fracture 17, and it is V words that the bending, which is oriented to fracture 17,
Shape.Jawbone is complicated L-type, arch mixture, and fibula 4 is used as strip long bone, need repeatedly to block, fracture it is moulding to match jaw
Bone defect shape.And bend be oriented to fracture 17 it is bootable primary complete fibula block it is moulding, it is easy to operate, and accurate matching
The bending structure of jaw defect.Moreover, because being that the first osteotomy guide plate is disconnected two parts in view of bending is oriented to fracture 17, it is
It is conveniently operated, the first osteotomy guide plate 11 is equipped with handle 18, and the both ends of the handle 18 are connected to the bending and are oriented to fracture
On the first osteotomy guide plate 11 of 17 both sides, two parts to will be switched off by the handle 18 are connected.
First guiding locator 1 use process is as follows：
(1) positioning latch closure 12 is fastened on the position being connected with the osteotomy part both ends of fibula 4, at this point, positioning latch closure 12
It is fixed；
(2) after the tenon 14 on the alignment positioning latch closure 12 of tongue-and-groove 15 on the first osteotomy guide plate 11 being closed, the first osteotomy
Guide plate 11 is connected and fixed with positioning latch closure 12；
(3) the first guiding mounting hole 13 on the first osteotomy guide plate 11 is passed through to be tightened in 4 corresponding spiral shell of fibula using screw
In pit, the first osteotomy guide plate 11 is made to be connected and fixed with fibula 4；
(4) positioning latch closure 12 is removed, being oriented to fracture 17 along the bending of the first section leads side 16 and V-shaped carries out osteotomy
Moulding operation.
As shown in figure 3, the specific setting form of the second guiding locator 2 is as follows：
The second guiding locator 2 includes second section of two pieces of sclerotin positions for being set to 51 front and rear sides of Jaw neoplasm
Bone conduction plate 21, the second osteotomy guide plate 21 are equipped with the medial surface closed with side seam face paste outside jawbone, the second osteotomy guide plate 21
It is equipped with for guiding operator to open up threaded hole on jawbone 5 and connect with jawbone 5 for the second osteotomy guide plate 21
Second is oriented to mounting hole 22.
In the present embodiment, the head mathematical model of patient is obtained with CBCT or CT scan, passes through software three-dimensional reconstruction
Establish Three-dimensional model.Operation plan is formulated on 3-dimensional digital skull model and draw excision boundary with computer software
Line and threaded hole draw the profile of two piece of second osteotomy guide plate 21 according to the range of excision boundary line and the position of threaded hole,
And the second osteotomy guide plate 21 of entity is fabricated to by 3D printing forming technique using non-toxic materials such as resin, plastics.Second section
The medial surface of bone conduction plate 21 is affixed according to 5 outer side seam face form generating of jawbone with 5 outer side seam face of jawbone completely；Second is oriented to peace
Hole 22 is filled at least provided with 2, the position for being oriented to mounting hole 22 according to second when Jaw neoplasm resection operation, can guide operation
Person opens up threaded hole on jawbone 5, and the second osteotomy guide plate 21 is linked together with jawbone 5 by screw, makes the second osteotomy
Guide plate 21 is held in a predetermined position and firm stable, avoid excision Jaw neoplasm when slide, reduce osteotomy operation in advance
Determine operation plan error, Jaw neoplasm resection operation is made to be easier to make for, is operated convenient for patient.When reconstruction of jaw, on jawbone 5
Threaded hole corresponds to second and is oriented to mounting hole 22 at least provided with two, wherein and it is at least one corresponding with connecting hole in titanium plate, until
Few one corresponding with the jawbone mounting hole on third guiding locator 3.The setting for being oriented to mounting hole 22 by second as a result,
Titanium plate and third in performing the operation for follow-up reconstruction of jaw guide the connection between locator 3 to provide unified threaded hole, avoid
Titanium plate and third guiding locator 3 fix secondary drilling caused by jawbone damage, also ensure that titanium plate and third guiding locator 3 in
Accuracy in place at jaw defect.
More preferably, the second osteotomy guide plate 21 is equipped with the second section leads side 23 close to 51 side of Jaw neoplasm, this
Two section leads sides 23 are the leader for cutting off boundary line, the position and direction for cutting off boundary line in guided operation, warp
Second osteotomy guide plate 21 guiding lower edge excision boundary line (i.e. the second section leads side 23) cuts off to precise and safety Jawbone Pathoses area
Domain avoids remaining, and effectively reduces the risk of postoperative recurrence.Further, second section leads side 23 is from second osteotomy
The end face of guide plate 21 is protruding, thus facilitates excision operation to be carried out under sight direct-view, it is ensured that Jaw neoplasm is precisely cut off.
More preferably, the lateral surface of the second osteotomy guide plate 21 is equipped with boss 24, and the second guiding mounting hole 22 is opened
It is located at 24 center of the boss.The height of the boss 24 is about 3mm, and guiding function is played in auger shell pit or during tightening up a screw,
Ensure that threaded hole or screw direction are consistent with anticipated orientation and can make the second osteotomy guide plate 21 tight perpendicular to bone face, after tightening the screw
Paste bone face.
More preferably, the second osteotomy guide plate 21 extends the buckling parts 25 of 5 edge of oriented jawbone wrapping, to ensure second section
Bone conduction plate 21 is accurate in place, reduces surgical procedure error.By taking Submandibular neoplasms are cut off as an example, the bone on front side of Submandibular neoplasms
The second osteotomy guide plate at matter position extends the buckling parts of oriented chin subordinate edge wrapping, is located at the sclerotin position on rear side of Submandibular neoplasms
The second osteotomy guide plate be extended with the buckling parts wrapped to lower border of the mandible.
It is described second guiding locator 2 use process is as follows：
(1) the second guiding mounting hole 22 on the second osteotomy guide plate 21 is passed through to be tightened in 5 corresponding spiral shell of jawbone using screw
In pit, the second osteotomy guide plate 21 is made to be connected and fixed with jawbone 5；
(2) Jaw neoplasm excision operation is carried out along the second section leads side 23；
(3) after Jaw neoplasm excision, the second guiding locator 2 is removed.
As shown in Figures 4 to 6, the specific setting form of the third guiding locator 3 is as follows：
The third guiding locator 3 includes bone graft directing plate 31, Dental implantion guiding hole seat 32, front jawbone fixed plate
33 and rear portion jawbone fixed plate 34, the extension track that the guide tracks of the bone graft directing plate 31 are rebuild with jawbone 5 is with unification
It causes, offers several bone graft mounting holes 35 on the bone graft directing plate 31, the bone graft mounting hole 35 and fibula 4 (
That is bone graft 41) on threaded hole it is corresponding, Dental implantion guiding hole seat 32 be set on the bone graft directing plate 31 and
Its aperture is opposite with bone graft 41, and the front jawbone fixed plate 33 and rear portion jawbone fixed plate 34 are connected to the transplanting
The both ends of bone guided plate 31 are simultaneously equipped with the medial surface closed with 5 bone face paste of corresponding jawbone, and the front jawbone fixed plate 33 is with after
Several jawbone mounting holes 36 are equipped in portion's jawbone fixed plate 34, the jawbone mounting hole 36 is opposite with the threaded hole on jawbone 5
It answers.
In the present embodiment, the head mathematical model of patient is obtained with CBCT or CT scan, passes through software three-dimensional reconstruction
Establish Three-dimensional model.Operation plan is formulated on 3-dimensional digital skull model with computer software and draws bone graft draws
The profile of guide plate 31, Dental implantion guiding hole seat 32, front jawbone fixed plate 33 and rear portion jawbone fixed plate 34, and use resin,
The non-toxic materials such as plastics make integral bone graft directing plate 31 by 3D printing forming technique, Dental implantion guides hole seat 32,
Front jawbone fixed plate 33 and rear portion jawbone fixed plate 34.Bone graft directing plate 31 extends the life of track form according to virtual bone graft
At the bone graft mounting hole 35 on bone graft directing plate 31 is corresponding with the threaded hole on bone graft 41 (i.e. fibula 4), bone graft
41 are screwed on bone graft directing plate 31, thus so that bone graft 41 is prolonged using the guide tracks of bone graft directing plate 31
It is matched consistent to stretch track, it is ensured that bone graft is accurately positioned and fixes.The Dental implantion guides hole seat 32 according to reconstruction of jaw
Position and select the region of setting, when such as mandible reconstruction, Dental implantion guiding hole seat 32 is then set to the bone graft
The upside of directing plate 31 and its aperture is opposite with the top bone face of bone graft 41, when such as maxillary reconstruction, the Dental implantion guiding
Hole seat 32 is then set to the downside of the bone graft directing plate 31 and its aperture is opposite with the bottom bone face of bone graft 41, to really
The optimum position of conservation implant implantable graft bone center of top.The front jawbone fixed plate 33 and rear portion jawbone fixed plate 34
Medial surface according to 5 outer side seam face form generating of corresponding jawbone, is affixed completely with 5 outer side seam face of jawbone；The jawbone is fixed
Hole 36 is corresponding with the threaded hole on jawbone 5, and front jawbone fixed plate 33 and rear portion jawbone fixed plate 34 are solid by screw respectively
It is scheduled on the sclerotin of jaw defect position front and rear sides, so that it is guaranteed that bone graft directing plate 31 is accurate in place and is fixed on expected position
It sets.As it can be seen that the present invention, which uses, collects Dental implantion and mandible reconstruction in integral structure, by being designed on bone graft directing plate 31
Dental implantion guides hole seat 32, can make bone graft directing plate 31 while guiding reconstruction of jaw operation, assist Dental implantion part
Operation greatly improves operation precision and success rate if implantation hole preparation, planting body are implanted into.
More preferably, the bone graft directing plate 31 extends the first buckling parts of 41 upside of oriented bone graft or downside wrapping
311, the Dental implantion guiding hole seat 32 is set on first buckling parts 311；The side of the front jawbone fixed plate 33
Extend the second buckling parts 331 of 5 edge of oriented jawbone wrapping, the other side of the front jawbone fixed plate 33 be equipped with tooth or
The third buckling parts 332 that teeth space fastens；The rear portion jawbone fixed plate 34 extends the 4th buckling parts of 5 edge of oriented jawbone wrapping
341.By taking mandible reconstruction as an example, the upside of bone graft directing plate 31 extends the first buckling parts that 41 upside of oriented bone graft wraps
311, Dental implantion guiding hole seat 32 is set on the first buckling parts 311, which can guide hole seat 32 by Dental implantion
41 upside of bone graft is led to, keeps the aperture of Dental implantion guiding hole seat 32 opposite with the top bone face of bone graft 41；Front jawbone is solid
The downside of fixed board 33 extends the second buckling parts 331 of oriented chin subordinate edge wrapping, the upside of front jawbone fixed plate 33 be equipped with
The third buckling parts 332 that tooth and teeth space fasten, to make front jawbone fixed plate 33 fitting patient's chin portion's sclerotin and tooth completely
Teeth portion position makes bone graft directing plate 31 be good for side mandibular accurate match with front；The downside of rear portion jawbone fixed plate 34 is extended with
The 4th buckling parts 341 wrapped to angle of mandible, to make the fitting patient's lower jaw angular position sclerotin completely of rear portion jawbone fixed plate 34,
Bone graft directing plate 31 is set to be good for side Mandibular Rumas accurate match with rear portion.Thereby, it is possible to ensure that bone graft directing plate 31 is accurate
In place, reduce surgical procedure error.
More preferably, the central axis in the hole of the Dental implantion guiding hole seat 32 is in 41 bone face of bone graft, to make plantation
The snap-in force of body is transmitted along plantation long axis of body, and good fixed foundation is provided for kind of a tooth.
More preferably, cooperation is plugged with the guide post 37 passed through for different-diameter drill bit in the Dental implantion guiding hole seat 32,
The guide post 37 includes cylinder-shaped body 371, and the cylinder-shaped body 371 is equipped with the hole phase that hole seat 32 is guided with the Dental implantion
The top of logical stepped hole 372, the stepped hole 372 is that major diameter matches reamer brake, deeply right in the process in drill bit
Reamer plays direction guiding function, and when drill bit reaches predetermined depth, 372 top baseplane of stepped hole connects with drill bit brake
It touches, so that drill bit is stopped deeply, to ensure that the depth for planting nest is consistent；The lower part of stepped hole 372 is that minor diameter matches reamer brill
Head plays guiding function during drill bit gos deep into standby hole direction.It needs to replace leading for different pore size step by step in surgical procedure
Column 37 can replace corresponding reamer to match guide post 37, to effectively prevent a bore diameter is excessive to cause bone graft simultaneously
Major injury.
More preferably, the periphery of the cylinder-shaped body 371 is equipped with lug boss 373, the lower surface of the lug boss 373 and institute
The upper surface for stating Dental implantion guiding hole seat 32 coordinates, and in surgical procedure, needs guide post 37 being inserted into Dental implantion guiding hole seat 32
Kong Zhong shows that guide post 37 is completed in place when lug boss 373, which is in close contact Dental implantion, guides the upper surface of hole seat 32.
Third guiding locator 3 use process is as follows：
(1) the bone graft mounting hole 35 on bone graft directing plate 31 is passed through to be tightened in 41 (i.e. fibula of bone graft using screw
4) in corresponding threaded hole, bone graft 41 is made to be fixed on bone graft directing plate 31, moulding positioning is carried out to bone graft 41；
(2) the jawbone mounting hole 36 in front jawbone fixed plate 33 and rear portion jawbone fixed plate 34 is passed through to tighten using screw
In 5 corresponding threaded hole of jawbone, so that the bone graft directing plate 31 for being fixed with bone graft 41 is connected at jaw defect, make transplanting
The both ends end face of bone 41 is engaged with front and back strong 5 osteotomy surface of side jawbone；
(3) it utilizes screw that the connecting hole on titanium framework (i.e. titanium plate) is passed through to be tightened in 5 corresponding threaded hole of jawbone, makes titanium
Holder is fixed at jaw defect, passes through the connecting hole on titanium framework (titanium plate) to be tightened in 41 (i.e. fibula of bone graft using screw
4) in corresponding threaded hole, titanium plate and bone graft 41 is made to be fixed together；
(4) screw on bone graft mounting hole 35 and jawbone mounting hole 36 is unclamped, third is removed and guides locator 3, complete
Bone graft fixed operation.
It should also be noted that, when mandible reconstruction, one can also be arranged along bone graft on the bone graft directing plate 31
The titanium plate locating slot that 41 tracks extend, makes interior fixed titanium framework (i.e. titanium plate) be located in desired location, and be bonded bone graft completely
41 bone faces, it is ensured that bone collection is accurately implemented.Further, several passed through for whole screw is offered on the titanium plate locating slot will
The through-hole that titanium plate links together with bone graft 41.When removing third guiding locator 3, retain the spiral shell on the lead to the hole site
Silk, to keep the connection between titanium plate and bone graft, and unclamps on 36 position of bone graft mounting hole 35 and mandibular mounting hole
Screw, that is, removable third guides locator 3.
Above disclosed is only presently preferred embodiments of the present invention, cannot limit the right of the present invention with this certainly
Range, therefore according to equivalent variations made by scope of the present invention patent, be still within the scope of the present invention.
Claims (10)
1. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing, which is characterized in that according to Jaw neoplasm
Excision and reconstruction operations process include that the first guiding locator, the second guiding locator and third guide locator, institute successively
It states the first guiding locator to be fixed on fibula, and assists fibula osteotomy moulding；The second guiding locator is fixed on jawbone
The sclerotin position of tumour front and rear sides, and Jaw neoplasm is assisted to cut off；The osteotomy part of third the guiding locator and fibula
Connection, the third guiding locator are connected between the sclerotin position of the front and rear sides after excision Jaw neoplasm, and with fibula
Osteotomy part as bone graft assist reconstruction of jaw；The first guiding locator, the second guiding locator and third guiding
Locator is all made of resin or plastics are molded by 3D printing.
2. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as described in claim 1, feature
It is, the first guiding locator includes the first osteotomy guide plate and positioning latch closure, and the first osteotomy guide plate is equipped with and fibula
The long trough curve-surface cavity that closes of osteotomy part bone face paste, the positioning latch closure is equipped with two, is buckled in section with fibula respectively
The connected position in bone parts both ends is simultaneously connect with the both ends of the first osteotomy guide plate, and the positioning latch closure is equipped with section with fibula
The annular surface cavity that the connected position in bone parts both ends fastens, the annular surface cavity of the positioning latch closure with described first section
The long trough curve-surface cavity abrupt transition of bone conduction plate, the first osteotomy guide plate are equipped with multiple for guiding operator in fibula
On open up threaded hole and for the first osteotomy guide plate connect with fibula first be oriented to mounting hole.
3. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 2, feature
It is, the end of the positioning latch closure is extended with tenon, and the both ends of the first osteotomy guide plate are respectively equipped with matches with the tenon
Close the tongue-and-groove of connection.
4. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 2, feature
It is, the both ends of the first osteotomy guide plate are respectively equipped with from outwardly directed first section in the end face of the first osteotomy guide plate
Guide edge；The first osteotomy guide plate is equipped with bending and is oriented to fracture, and it is V-shaped that the bending, which is oriented to fracture,.
5. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 2, feature
It is, the second guiding locator includes that second osteotomy at two pieces of sclerotin positions for being set to Jaw neoplasm front and rear sides is led
Plate, the second osteotomy guide plate are equipped with the medial surface closed with side seam face paste outside jawbone, and the second osteotomy guide plate is equipped with and is used for
Guiding operator opens up threaded hole on jawbone and is oriented to peace for the second osteotomy guide plate is connect with jawbone second
Fill hole.
6. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 5, feature
It is, the second osteotomy guide plate is equipped with close to the end face of Jaw neoplasm side from outwardly directed second section leads in the end face
Side；The lateral surface of the second osteotomy guide plate is equipped with boss, and the guiding mounting hole is opened in the boss center；Described
Two osteotomy guide plates extend the buckling parts of oriented jawbone edge wrapping.
7. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 5, feature
It is, the third guiding locator includes bone graft directing plate, Dental implantion guiding hole seat, front jawbone fixed plate and rear portion jaw
The extension track cooperation of bone fixation plate, the guide tracks and reconstruction of jaw of the bone graft directing plate is consistent, and the bone graft draws
Several bone graft mounting holes are offered on guide plate, the bone graft mounting hole is corresponding with the threaded hole on fibula, the tooth kind
Plant guiding hole seat is set on the bone graft directing plate and its aperture is opposite with bone graft, and the front jawbone fixed plate is with after
Portion's jawbone fixed plate is connected to the both ends of the bone graft directing plate and equipped with the inside closed with corresponding jaw bones face paste
Be equipped with several jawbone mounting holes in face, the front jawbone fixed plate and rear portion jawbone fixed plate, the jawbone mounting hole with
Threaded hole on jawbone is corresponding.
8. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 7, feature
It is, the bone graft directing plate extends the first buckling parts of on the upside of oriented bone graft or downside wrapping, the Dental implantion guiding
Hole seat is set on first buckling parts；The side of the front jawbone fixed plate extends the second of oriented jawbone edge wrapping
Buckling parts, the other side of the front jawbone fixed plate are equipped with the third buckling parts fastened with tooth or teeth space；The rear portion jaw
Bone fixation plate extends the 4th buckling parts of oriented jawbone edge wrapping.
9. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 7, feature
It is, the central axis in the hole of the Dental implantion guiding hole seat coordinates on bone graft bone face, the Dental implantion guiding hole seat
Be plugged with the guide post passed through for different-diameter drill bit, the guide post includes cylinder-shaped body, the cylinder-shaped body be equipped with
The stepped hole that the hole of the Dental implantion guiding hole seat communicates, the top of the stepped hole is major diameter, and lower part is minor diameter；It is described
The periphery of cylinder-shaped body is equipped with lug boss, and the lower surface of the lug boss guides the upper surface of hole seat to match with the Dental implantion
It closes.
10. the guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing as claimed in claim 7, feature
It is, the bone graft directing plate is equipped with the titanium plate locating slot extended along bone graft track, is opened up on the titanium plate locating slot
Have and several passes through the through-hole that titanium plate and bone graft link together for whole screw.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201610288256.6A CN105852931B (en) | 2016-05-03 | 2016-05-03 | The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing |
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| CN201610288256.6A CN105852931B (en) | 2016-05-03 | 2016-05-03 | The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing |
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| CN105852931B true CN105852931B (en) | 2018-09-07 |
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| CN106109021B (en) * | 2016-08-31 | 2022-06-24 | 复旦大学附属华山医院 | Adjustable arc forehead portion mode baffle |
| CN108606823A (en) * | 2016-12-09 | 2018-10-02 | 深圳市普天阳医疗科技股份有限公司 | A kind of mandibular resetting apparatus and production method |
| CN107320155A (en) * | 2017-06-30 | 2017-11-07 | 深圳市倍康美医疗电子商务有限公司 | A kind of digitlization forming method of intraoral tumor resection and repairing accessory |
| CN109662770B (en) * | 2019-01-15 | 2024-03-22 | 上海交通大学医学院附属第九人民医院 | Titanium alloy Sandwich bone grafting and fixing titanium plate generated by three-dimensional printing technology |
| CN110313994B (en) * | 2019-03-18 | 2022-07-05 | 江苏时间环三维科技有限公司 | Be applied to two guide boards of taking one's place that rebuild mandible of folding of multistage fibula |
| US11819382B2 (en) * | 2019-05-09 | 2023-11-21 | DDS Company, Inc. | Tissue borne fixation system, device, and methods of making and using same |
| CN111481281B (en) * | 2020-04-21 | 2022-12-27 | 上海交通大学医学院附属第九人民医院 | Preparation method of internal fixing device for fibula reconstruction mandible |
| CN112076002B (en) * | 2020-10-13 | 2021-06-15 | 四川大学 | GBR middle periosteum nail position and direction positioning guide plate and manufacturing method thereof |
| CN114569260A (en) * | 2020-11-18 | 2022-06-03 | 中山大学附属口腔医院 | Guiding plate for positioning after maxillary osteotomy |
| IT202100002270A1 (en) | 2021-02-03 | 2022-08-03 | Univ Degli Studi Di Torino | MANDIBLE CUT GUIDE |
| CN113017765B (en) * | 2021-02-22 | 2022-07-12 | 上海交通大学医学院附属第九人民医院 | Integrated external mandible osteotomy fixing device and using method |
| USD1006225S1 (en) | 2022-03-17 | 2023-11-28 | DDS Company, Inc. | Foundation guide seating site |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US8083746B2 (en) * | 2004-05-07 | 2011-12-27 | Arthrex, Inc. | Open wedge osteotomy system and surgical method |
| US9155548B2 (en) * | 2013-03-12 | 2015-10-13 | Hsieh-Hsing Lin | Positioning device for bone drilling |
| CN105266874B (en) * | 2014-09-19 | 2017-12-01 | 北京大学口腔医学院 | A kind of type osteotomy surgical guides of upper jaw Le Fort I and its design method |
| CN104825235A (en) * | 2015-05-22 | 2015-08-12 | 杭州六维齿科医疗技术有限公司 | Fibular flap repairing mandible defect operation guiding template and manufacturing method |
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