CN107115163B - Personalized temporomandibular joint socket prosthesis - Google Patents

Personalized temporomandibular joint socket prosthesis Download PDF

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Publication number
CN107115163B
CN107115163B CN201610105007.9A CN201610105007A CN107115163B CN 107115163 B CN107115163 B CN 107115163B CN 201610105007 A CN201610105007 A CN 201610105007A CN 107115163 B CN107115163 B CN 107115163B
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China
Prior art keywords
patient
wing plate
zygomatic arch
temporomandibular joint
joint socket
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CN201610105007.9A
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Chinese (zh)
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CN107115163A (en
Inventor
杨驰
张善勇
何冬梅
陈敏洁
白果
滕晓梅
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Shenzhen Putianyang Medical Technology Co ltd
Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Shenzhen Putianyang Medical Technology Co ltd
Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Priority to CN201610105007.9A priority Critical patent/CN107115163B/en
Publication of CN107115163A publication Critical patent/CN107115163A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30326—The prosthesis having different structural features at different locations within the same prosthesis differing in height or in length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A61F2002/30654—Details of the concave socket
    • A61F2002/30655—Non-spherical concave inner surface

Abstract

The invention discloses an individualized temporomandibular joint socket prosthesis, which comprises an outer side fixing wing plate and a condyle supporting surface, wherein the inner side surface of the outer side fixing wing plate is jointed and fixed with the outer side surface of a zygomatic arch of a patient, the lower edge of the outer side fixing wing plate is connected with the condyle supporting surface into a whole, a top bulge is arranged on the top surface of the condyle supporting surface and positioned in the direction of the inner side surface of the outer side fixing wing plate, the top surface of the condyle supporting surface with the top bulge is jointed with the temporomandibular joint socket of the patient, the bottom surface of the condyle supporting surface is jointed with a lower condyle in a wrapping mode, and at least one of the length, the height and the concave-convex shape of the inner side surface of the outer side fixing wing plate is matched according to the. The invention can reduce the bone grinding amount of the zygomatic arch of a patient in the implantation operation of the temporomandibular joint fossa prosthesis, reduce the trauma and interference of the implantation of the temporomandibular joint fossa prosthesis on the tissues around the zygomatic arch of the patient and ensure that the joint fossa prosthesis has better stability.

Description

Personalized temporomandibular joint socket prosthesis
Technical Field
The invention relates to the technical field of medical treatment, in particular to an individualized temporomandibular joint fossa prosthesis.
Background
Temporomandibular joint replacement is an important means of treating severe osteoarthritis, ankylosis, condylar tumor, and paroxysmal absorption of the condylar process. The temporomandibular joint prosthesis replacement surgery has the advantages of stability, no absorption, no need to open up a second surgical area, and reduced surgical trauma, and has been widely used abroad. The foreign standard temporomandibular joint socket prosthesis is designed according to the anatomical structure of caucasian people, has a certain difference with the anatomical structure of Chinese people, needs bone grinding to match the prosthesis shape during the operation, has high operation difficulty and has the risk of injury of cranial base and lower alveolar neurovascular bundle.
At present, there is a domestic scholars disclosing a standard type artificial temporomandibular joint socket prosthesis adapted to the anatomical configuration of Chinese, the socket prosthesis comprising a retention wing plate in contact with and secured to the zygomatic arch, the retention wing plate having a standard length, height and thickness. Due to the individual difference of human zygomatic arch structures, particularly the length and height of the zygomatic arches of different individuals are inconsistent, and the fact that the lateral sides of the zygomatic arches of patients are usually in a fluctuant form is found in the clinical application process, the standard temporomandibular fossa prosthesis is used for replacement surgery aiming at different patients, the problems that the size of a fixing wing plate is not matched with the size of the zygomatic arches of the patients, the fixing effect of a wing plate is poor, the wing plate is not tightly attached to the lateral sides of the zygomatic arches of the patients, bone grinding needs to be carried out on the zygomatic arches of the patients, or the whole temporomandibular fossa is unstable due to the existence of attachment gaps are. The stability of the temporomandibular joint fossa is not good, which easily causes the rotation center of the whole temporomandibular joint to slightly move forwards, raise or descend, thereby causing the problems of masticatory muscle fatigue, mouth opening restriction and the like.
Disclosure of Invention
The invention aims to provide a temporomandibular joint socket prosthesis with an individualized matching design, so as to solve the problem of unstable retention of the temporomandibular joint socket prosthesis in the clinical application process.
In order to achieve the above object, the present invention provides a temporomandibular joint socket prosthesis, which comprises two parts, namely an outer retention wing plate and a condyle supporting surface, wherein the inner side surface of the outer retention wing plate is attached to the outer side surface of the zygomatic arch of a patient for retention, the lower edge of the outer retention wing plate is connected with the condyle supporting surface into a whole, the top surface of the condyle supporting surface is provided with a top protrusion, the top protrusion is positioned in the direction of the inner side surface of the outer retention wing plate, the top surface of the condyle supporting surface with the top protrusion is attached to the inner side surface of the skull base of the patient, the bottom surface of the condyle supporting surface is attached to the lower protruding head in a wrapping manner, and at least one of the length, the height and the concave-convex shape of the inner side surface of the retention wing plate is individually matched according to.
At least one of the length, the height and the concave-convex shape of the inner side surface of the outer retention wing plate is matched according to the zygomatic arch structure of the patient in an individualized way, and the personalized match comprises the following steps: acquiring zygomatic arch structure data of a patient through measurement of the zygomatic arch of the patient, comprising: at least one of a length of the zygomatic arch, a height of the zygomatic arch, and a relief form of a lateral surface of the zygomatic arch of the patient.
As an alternative, the temporomandibular joint socket prosthesis is integrally formed from a high molecular polyethylene material.
As an alternative, the length of the outer fixing wing plate is matched according to the length of the zygomatic arch of the patient in an individualized way, and the range is 20-30 mm.
As an alternative, the height of the lateral retention wing plate is matched according to the individual zygomatic arch height of the patient, and the upper edge of the wing plate does not exceed the upper edge of the bony region of the zygomatic arch of the patient and ranges from 5mm to 8 mm.
As an alternative, the concave-convex shape of the inner side surface of the lateral retention wing plate is individually matched according to the zygomatic arch structure of the patient, and comprises: the concave-convex shape of the inner side surface of the outer retention wing plate is matched with the concave-convex shape of the surface of the outer side surface of the zygomatic arch of the patient, and the thickness value of the outer retention wing plate is the minimum at the most protruded part of the surface of the outer side surface of the zygomatic arch of the patient; the most sunken part of the surface of the lateral side of the zygomatic arch of the patient has the largest thickness value of the lateral retention wing plate; the thickness value of the outer fixing wing plate varies according to the sunken degree of the lateral surface of the zygomatic arch of the patient, and ranges from 1.5mm to 3.5 mm.
As an alternative, the outer side retention wing plate is provided with a plurality of screw holes, the screw holes are arranged in a single-row or multi-row staggered mode, the diameter range of the screw holes is 1.5-2.0 mm, and screws with the same diameter as the screw holes are used for penetrating through the screw holes to connect and fix the wing plate and the zygomatic arch of a patient.
As an alternative, the shape and size of the top protrusion on the top surface of the condyle supporting surface are individually matched according to the concave shape of the temporomandibular fossa of the patient, and the top surface of the condyle supporting surface with the top protrusion can be tightly attached to the fossa surface of the temporomandibular fossa of the patient.
As an alternative, the bottom surface of the condyle supporting surface is in an inwards-concave oval sphere shape, the thickness of the condyle supporting surface is more than or equal to 4mm, and the condyle supporting surface is connected with the lower condyle head downwards in a wrapping mode.
As an alternative, the width of the top plane of the condyle supporting surface is matched with the width of the temporomandibular joint fossa of the patient in an individualized way, and the range is 12-15 mm.
As an alternative, the width of the bottom plane of the condyle supporting surface is matched with the size of the condyle head wrapped at the lower part in a personalized way, and the range is 14-20 mm.
As an alternative, the front and back directions of the bottom of the condylar supporting surface are respectively provided with a baffle plate which extends downwards along the bottom of the supporting surface, the height of the baffle plate is 5mm, and the thickness of the baffle plate is 3mm, so that the dislocation which can occur in the process of the motion of the condylar head in the glenoid prosthesis can be prevented.
The invention has the advantages that: the outer side fixing wing plate is matched with the length and the height of the patient's zygomatic arch in an individualized way, so that the area of the patient's zygomatic arch for fixing the glenoid prosthesis is effectively utilized, the wound and the interference on the tissues around the patient's zygomatic arch caused by the overlong and overhigh side fixing wing plate of the standard glenoid prosthesis are avoided, and the adverse effect on the postoperative muscle growth healing of the patient is eliminated; the outer side fixing wing plate with the concave-convex shape on the inner side surface is designed in an individualized way according to the concave-convex shape on the outer side surface of the zygomatic arch of a patient, so that the problems that when the side fixing wing plate with fixed thickness is jointed and fixed with the zygomatic arch of the patient in the prior art, the joint is poor and a gap exists after the joint due to the uneven concave-convex shape on the outer side surface of the zygomatic arch of the patient are solved, the stability of the outer side fixing wing plate and the zygomatic arch after the fixing is effectively improved, and the strength of the wing plate is ensured, so that the dislocation of the prosthesis caused by prying and the like in the operation can not be generated, wherein the minimum thickness value is set to be 1.5mm, the requirements on the strength and the rigidity of the fixing wing plate are ensured, and the maximum value of 3; the diameter range of the screw hole on the retention wing plate is 1.5-2.0 mm, so that the retention strength of the screw can be ensured, the good retention effect on the glenoid prosthesis can be realized, and the self strength of the side retention wing plate can not be obviously reduced; the shape and the size of a top bulge on the top surface of the condyle supporting surface are matched with the concave shape of the temporomandibular joint fossa of the patient, so that the top surface of the condyle supporting surface and the temporomandibular joint fossa surface of the patient realize a good fitting effect, and the problems that when the standard type joint fossa prosthesis is implanted, the top bulge is unmatched in shape and too large or too small in size, wound damage is caused to the temporomandibular joint fossa surface area of the patient when the standard type joint fossa prosthesis is fitted with the temporomandibular joint fossa of the patient, or fitting is not tight, and a large gap exists are solved; the design that the thickness of the condylar bearing surface is more than or equal to 4mm ensures the strength and rigidity of the glenoid fossa body of the prosthesis; the width of the top plane of the condylar supporting surface is matched with the width of a temporomandibular joint socket of a patient, the variable range is 12-15 mm, and the personalized width design avoids the change of stress points of the lower condylar head caused by the over-small width of the top plane and the possible damage to blood vessels and nerves of the skull base of the patient caused by the over-wide top plane; the width of the bottom plane of the condyle supporting surface is matched with the size of the condyle head wrapped at the lower part, the personalized width design avoids the situation that the size of the condyle head is not matched with the size of the lower part to cause that the movable area of the condyle head is too small or too large, and meanwhile, the variable range is 14-20 mm and is obtained based on anatomical data statistics; due to the design of the baffle plates in the front-back direction at the bottom of the bearing surface, the height of the baffle plate of 5mm is enough to prevent the condyle extrusive head from dislocation during movement, and the thickness of the baffle plate of 3mm can meet the requirements of the strength and the rigidity of the baffle plate.
Drawings
FIG. 1 is a schematic front view of a personalized temporomandibular joint socket prosthesis provided by an embodiment of the present invention;
FIG. 2 is a schematic view of the back of a personalized temporomandibular joint socket prosthesis provided by an embodiment of the present invention;
FIG. 3 is a schematic top view of a personalized temporomandibular joint socket prosthesis provided in accordance with an embodiment of the present invention;
fig. 4 is a schematic side view of a personalized temporomandibular joint socket prosthesis provided by an embodiment of the present invention.
Detailed Description
The invention is described in further detail below with reference to specific embodiments and with reference to the accompanying drawings.
Referring to the attached drawings, the temporomandibular joint socket prosthesis comprises an outer retention wing plate 1 and a condyle supporting surface 2, the inner side surface of the outer retention wing plate 1 is attached to the outer side surface of the zygomatic arch of a patient for retention, the lower edge of the outer retention wing plate is connected with the condyle supporting surface 2 into a whole, a top protrusion 3 is arranged on the top surface of the condyle supporting surface, the top protrusion 3 is positioned in the direction of the inner side surface of the outer retention wing plate 1, the top surface of the condyle supporting surface 2 with the top protrusion 3 is attached to the temporomandibular joint socket of the patient, and the bottom surface of the condyle supporting surface 2 is attached to the lower condyle head in a wrapping manner.
More specifically, the inner side surface of the outer retention wing plate 1 is attached to the outer side surface of the zygomatic arch of the patient, and is fixed on the outer side of the zygomatic arch of the patient in a mode that a screw passes through a plurality of screw holes 4 on the retention wing plate, so that the whole glenoid fossa prosthesis is retained, the upper edge of the outer retention wing plate 1 does not exceed the upper edge of the zygomatic arch bony region of the patient, the lower edge is connected with the condylar bearing surface 2 into a whole, and the outer retention wing plate 1 is integrally erected on the edge of the top surface of the condylar bearing surface 2; the top surface of the condyle supporting surface 2 is provided with a top bulge 3 protruding upwards, the top bulge 3 is positioned in the direction of the inner side surface of the outer side fixing wing plate 1 and is used for matching with the sunken shape of the temporomandibular fossa of the patient, and the top surface of the condyle supporting surface 2 with the top bulge 3 can be tightly attached to the temporomandibular fossa surface of the patient; the bottom surface of the condyle supporting surface 2 is designed into an inwards concave oval sphere, and the bottom surface is downwards connected with the condyle head in a wrapping mode; the front end and the rear end of the bottom surface of the condylar supporting surface 2 along the direction of the lateral fixing wing plate 1 are respectively provided with a baffle 5 extending downwards, so as to prevent the possibility of dislocation when the condylar head moves in the condylar supporting surface.
At least one of the length, height, and concave-convex shape of the medial side of the lateral retention flap is matched according to the zygomatic arch structure of the patient, including: acquiring zygomatic arch structure data of a patient through measurement of the zygomatic arch of the patient, comprising: at least one of a length of the zygomatic arch, a height of the zygomatic arch, and a relief form of a lateral surface of the zygomatic arch of the patient. The method can be used for measuring according to a CT (Computed Tomography) mode and acquiring the zygomatic arch structure data of a patient, so that the personalized glenoid prosthesis with the outer side fixing wing plate matched with the zygomatic arch length, height or concave-convex shape of the outer side surface of the patient can be personalized according to the zygomatic arch structure data of the patient.
As an alternative, the temporomandibular joint socket prosthesis in embodiments of the invention is integrally formed from a high molecular weight polyethylene material. The high molecular polyethylene material ensures the requirements of the strength and the rigidity of the prosthesis, and the integral molding eliminates unstable factors such as relative movement and the like possibly occurring among all functional parts of the prosthesis.
Optionally, the length of the outer retention wing plate is designed according to the measured zygomatic arch length of the patient, and the length of the retention wing plate can be selected within the range of 20-30 mm according to anatomical data statistics, the number of screw holes for fixation on the wing plate and the diameter requirements of the screws. The retention wing plate matched with the length of the zygomatic arch of the patient can achieve good retention effect, avoid the damage to the tissues around the zygomatic arch of the patient caused by the overlong length of the wing plate and be more beneficial to the growth and healing of the muscles of the tissues at the front side and the rear side of the zygomatic arch of the patient after the operation.
Optionally, the height of the outer side fixing wing plate is designed according to the measured zygomatic arch height of the patient in a matching mode, the upper edge of the wing plate does not exceed the upper edge of the bony region of the zygomatic arch of the patient, the average height of the narrowest part of the zygomatic arch of the Chinese is 6mm according to anatomical data statistics, and the zygomatic arch height data is mostly distributed in a range of 5-8 mm, so that the fixing wing plate with the personalized matching design has the zygomatic arch height of 5-8 mm, can obtain a good fixing effect, avoids the compression and damage to muscle tissues above the zygomatic arch of the patient due to the fact that the upper edge of the wing plate exceeds the upper edge of the bony region of the zygomatic arch of the patient, and is more beneficial to the growth and healing of the tissues above the zygomatic arch of the patient.
Optionally, the concave-convex shape of the inner side surface of the outer retention wing plate is matched according to the measured concave-convex structure of the outer surface of the zygomatic arch of the patient, and the thickness value of the outer retention wing plate is the smallest at the most protruded part of the outer surface of the zygomatic arch of the patient; the most sunken part of the outer surface of the zygomatic arch of the patient has the largest thickness value of the outer fixing wing plate; the thickness value of the wing plate varies according to the sunken degree of the lateral surface of the zygomatic arch of the patient, and ranges from 1.5mm to 3.5 mm. The minimum value of the thickness of the wing plate is set to be 1.5mm, so that the requirements on the strength and the rigidity of the wing plate are met, the maximum value of the thickness is 3.5mm, so that the situation that the muscle growth of a patient is influenced due to the excessive thickness of the wing plate and the facial protrusion of the patient is not influenced is avoided, the beauty is not influenced due to the fact that the maximum value of the thickness is 3.5mm, the problems that the side fixing wing plate with the fixed thickness is not well attached and gaps exist after attachment due to the fact that the surface of the outer side of the zygomatic arch of the patient is in an uneven and concave-convex shape in the prior art are solved, the stability after the outer side fixing wing plate is fixed with the zygomatic arch is effectively improved, the strength of the wing plate is guaranteed, the prosthesis dislocation caused by the problems of prying and the like in the operation is avoided.
Those skilled in the art will appreciate that the lateral retention wings of the temporomandibular fossa prosthesis of embodiments of the present invention may be adapted to match the patient's zygomatic arch structure in any one, two or three of the three ways described above.
Optionally, the outer side retention wing plate is provided with a plurality of screw holes, the screw holes are arranged in a single-row or multi-row staggered mode, the diameter range of the screw holes is 1.5-2.0 mm, the retention wing plate penetrates through the screw holes to be connected and fixed with the zygomatic arch of a patient through screws, the diameter of the screw holes is 1.5-2.0 mm, the retention strength of the screws can be guaranteed, the good retention effect on the glenoid prosthesis can be achieved, and the obvious reduction of the strength of the side retention wing plate can not be caused.
Optionally, the shape and size of the top protrusion on the top surface of the condyle supporting surface are matched according to the concave shape of the temporomandibular fossa of the patient, so that the top surface of the condyle supporting surface and the temporomandibular fossa surface of the patient can achieve a good and tight fitting effect, and the problems that when a standard type fossa prosthesis is implanted, the shape of the top protrusion is not matched, and the size is too large or too small, wound damage or poor fitting is caused to the fossa area of the patient when the standard type fossa prosthesis is fitted with the temporomandibular fossa surface of the patient, and a large gap exists after fitting are solved.
Optionally, the bottom surface of the condylar process bearing surface is in an inwards concave oval sphere shape, the thickness of the bearing surface is more than or equal to 4mm, and the bearing surface is downwards connected with the condylar process head at the lower part in a wrapping mode. When an ordinary adult bites, the force borne by the temporomandibular fossa area can reach 200-300N, and the thickness of the bearing surface is larger than or equal to 4mm, so that the fossa glenoid prosthesis is not easy to break when bearing the biting force.
Optionally, the width of the top plane of the condylar supporting surface is matched with the width of the temporomandibular fossa of the patient, the variable range is 12-15 mm, and the personalized width design avoids the change of the stress point of the lower condylar head caused by the excessively small width of the top plane and the possible damage to the blood vessels and nerves in the temporomandibular fossa region of the patient caused by the excessively wide top plane.
Optionally, the width of the bottom plane of the condyle supporting surface is matched with the size of the condyle head wrapped at the lower part, the personalized width design avoids the situation that the size of the condyle head is not matched with the size of the condyle head at the lower part to cause the activity area of the condyle head to be too small or too large, and meanwhile, the variable range is 14-20 mm and is obtained based on anatomical data statistics.
Optionally, the condyle process bearing surface bottom anteroposterior direction respectively sets up a baffle along bearing surface bottom downwardly extending for prevent that the condyle process head from producing the dislocation when the bearing surface moves, the high design of baffle is 5mm, and the thickness design is 3mm, and 5 mm's baffle height is enough to prevent that the condyle process head from producing the dislocation when the bearing surface moves, and 3 mm's baffle thickness then can guarantee the intensity and the rigidity demand of baffle.
The above optional technical solutions can be implemented together with the technical solution of the lateral retention wing plate matching the patient's zygomatic arch structure, or a plurality of the above optional technical solutions can be implemented together with the technical solution of the lateral retention wing plate matching the patient's zygomatic arch structure, so as to achieve the best implementation effect of the present invention.
The following examples are actual cases in clinical procedures. The data measured for the patient's zygomatic arch were: the length of the zygomatic arch is 28mm, the height of the zygomatic arch region is 6mm, and the surface shape of the lateral surface of the zygomatic arch of the patient is that the difference between the most sunken part and the most protruded part is 1 mm. In this embodiment, the personalized temporomandibular joint socket prosthesis has an outer side flap of 28mm in length, 6mm in height and 2-3 mm in thickness, wherein the most protruded part of the patient's zygomatic arch surface, the wing panel has a minimum thickness of 2mm, the most depressed part of the patient's zygomatic arch surface has a maximum thickness of 3mm, the wing panel has 5 single rows of screw holes with a diameter of 2mm, the screw passes through the screw hole to connect and retain the wing panel with the patient's zygomatic arch, the shape and size of the top protrusion on the top surface of the condylar supporting surface match the depressed shape of the patient's temporomandibular joint socket, the thinnest thickness of the condylar supporting surface is designed to be 4.5mm, the width of the top surface of the condylar supporting surface matches the width of the temporomandibular joint socket of the patient and is 13mm, the width of the bottom surface of the condylar supporting surface matches the size of the condylar head of the patient and is 19mm, and the supporting surface has two downwardly extending baffles in, height 5mm, thickness 3 mm.
According to the temporomandibular fossa prosthesis provided by the embodiment of the invention, due to the personalized matching of the outer retention wing plate and the zygomatic arch of the patient, the bone grinding to the zygomatic arch of the patient in the operation process is greatly reduced, the trauma and the disturbance to the zygomatic arch and surrounding tissues of the patient caused by the size problem of the retention wing plate of the standard prosthesis are avoided, and meanwhile, the retention stability of the temporomandibular fossa prosthesis is superior to that of the standard fossa prosthesis; the functional part of the temporomandibular joint socket prosthesis and the width of the top surface and the width of the bottom surface of the condylar process bearing surface are matched according to the position where the patient is jointed with the prosthesis, so that the damage of the top surface and the bottom surface of the condylar process bearing surface to the upper and lower jointed parts and tissues of the joint socket prosthesis of the patient is avoided; the top bulge on the top surface of the condylar process bearing surface is matched according to the sunken shape of the temporomandibular fossa of the patient, so that the top surface of the condylar process bearing surface and the temporomandibular fossa surface of the patient can realize good and tight fitting effect, and the problems that the wound damage to the temporomandibular fossa area of the patient is caused when the top bulge is not matched in shape, too large in size or too small in size to fit the temporomandibular fossa surface of the patient when a standard type fossa glenoid prosthesis is implanted, or the fitting is not tight, and a large gap exists after the fitting are caused are solved.
The temporomandibular joint socket prosthesis provided by the embodiment of the invention improves the stability of the joint socket prosthesis, prolongs the service life of the temporomandibular joint socket prosthesis and improves the life experience of the patient using the temporomandibular joint socket prosthesis while reducing the damage of the implanted joint socket prosthesis to the tissues around the joint socket of the patient.
The above description is only a preferred embodiment of the present invention and does not limit the technical solution of the present invention.

Claims (10)

1. A personalized temporomandibular joint socket prosthesis is characterized in that the temporomandibular joint socket prosthesis comprises an outer retention wing plate and a condyle supporting surface, the inner side surface of the outer retention wing plate is attached to the outer side surface of a zygomatic arch of a patient for retention, the lower edge of the outer retention wing plate is connected with the condyle supporting surface into a whole, a top bulge is arranged on the top surface of the condyle supporting surface and is positioned in the direction of the inner side surface of the outer retention wing plate, the top surface of the condyle supporting surface with the top bulge is attached to the temporomandibular joint socket of the patient, the bottom surface of the condyle supporting surface is attached to a lower condyle head in a wrapping mode, at least one of the length, the height and the concave-convex shape of the inner side surface of the outer retention wing plate is matched according to the zygomatic arch structure of the patient, the bottom surface of the condyle supporting surface is in the shape of an inwards-concave oval sphere, the thickness value of the outer fixing wing plate is the minimum at the most protruded part of the surface of the lateral side of the zygomatic arch of the patient; the most sunken part of the surface of the lateral side of the zygomatic arch of the patient has the largest thickness value of the lateral retention wing plate; the thickness value of the outside fixing wing plate changes according to the sunken degree of the outer side surface of the zygomatic arch of the patient so as to be completely attached to the zygomatic arch shape, the thickness range is 1.5-3.5 mm, the concave-convex shape of the inner side surface of the outside fixing wing plate is matched according to the zygomatic arch structure of the patient, and the outside fixing wing plate comprises: the concave-convex shape of the inner side surface of the outer fixing wing plate is matched with the concave-convex shape of the outer side surface of the zygomatic arch of the patient.
2. The personalized temporomandibular joint socket prosthesis of claim 1, wherein at least one of the length, height and concave-convex shape of the medial side of the lateral retention flap being matched according to the patient's zygomatic arch structure comprises: acquiring zygomatic arch structure data of a patient through measurement of the zygomatic arch of the patient, comprising: at least one of a length of the zygomatic arch, a height of the zygomatic arch, and a relief form of a lateral surface of the zygomatic arch of the patient.
3. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the temporomandibular joint socket prosthesis is integrally formed of a high molecular polyethylene material.
4. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the length of the lateral retention flap is matched to the patient's zygomatic arch length in the range of 20-30 mm.
5. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the height of the lateral retention flap matches the patient's zygomatic arch height in the range of 5-8 mm.
6. The personalized temporomandibular joint socket prosthesis of claim 1 wherein the lateral retention wing plate has a plurality of screw holes arranged in a single row or multiple rows staggered and ranging in diameter from 1.5 to 2.0mm and is secured to the zygomatic arch of the patient by screws passing through the screw holes.
7. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the shape and size of the top protrusion on the top surface of the condylar bearing surface matches the concave shape of the temporomandibular joint socket of the patient.
8. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the width of the top plane of the condylar bearing surface matches the width of the temporomandibular joint socket of the patient in the range of 12-15 mm.
9. The personalized temporomandibular joint socket prosthesis of claim 1, wherein the width of the bottom plane of the condylar bearing surface matches the size of the inferior condylar head in the range of 14-20 mm.
10. The personalized temporomandibular joint socket prosthesis of claim 1, wherein a downwardly extending baffle is provided anteroposteriorly of the bottom of the condylar bearing surface, the baffle having a height of 5mm and a thickness of 3 mm.
CN201610105007.9A 2016-02-25 2016-02-25 Personalized temporomandibular joint socket prosthesis Active CN107115163B (en)

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CN116492114A (en) * 2022-03-18 2023-07-28 上海交通大学医学院附属第九人民医院 Skull base joint fossa prosthesis, construction method thereof and preparation method thereof

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