CN107518954B - Distraction osteogenesis device - Google Patents
Distraction osteogenesis device Download PDFInfo
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- CN107518954B CN107518954B CN201710832779.7A CN201710832779A CN107518954B CN 107518954 B CN107518954 B CN 107518954B CN 201710832779 A CN201710832779 A CN 201710832779A CN 107518954 B CN107518954 B CN 107518954B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
Abstract
The invention relates to the technical field of oral medical treatment, and discloses a distraction osteogenesis device, which comprises: at least two belt rings which are respectively sleeved on the teeth on the left side and the right side of the patient; at least one anchorage pin fixed to the patient's maxilla; the anchorage rod is arranged corresponding to the anchorage nail, and an anchorage part is arranged on the anchorage rod and is used for abutting against the anchorage nail; the arch expander is used for providing traction force for stretching the osteogenesis device; the connecting rods are connected with the belt rings in a one-to-one correspondence manner, and the connecting rods connect the belt rings to the bow expander; the expander applies force to the band ring and the anchorage bar and forms traction to the jaw bone of the patient. The invention is easy to process, simple in clinical operation and has good traction effect.
Description
Technical Field
The invention relates to the technical field of oral medical treatment, in particular to a distraction osteogenesis device.
Background
Stretch bone formation is an endogenous bone tissue engineering technology based on the principle that under the action of stable and slow stretch force, the differentiation and proliferation functions of undifferentiated mesenchymal cells in a stress area are activated. The bone section cut by the operation is gradually drawn by the external force generated by the distraction osteogenesis device to form new bone deposition between the bone fracture ends, and meanwhile, the bone section and the bone tissue synchronously grow through the adaptability change of peripheral tissues including skin, blood vessels, nerves, cartilage and periosteum caused by the distraction force.
At present, the distraction osteogenesis technology is more and more widely applied to craniomaxillofacial clinic. Stretch osteogenesis is widely used for treating maxillofacial dysplasia, such as hemifacial dysplasia, maxillary dysplasia due to severe cleft lip and palate, jaw defects due to tumor or trauma, sunken deformity in the middle of face, and hypoplasia and asymmetry of face, and is also used for treating obstructive sleep apnea syndrome and other related symptoms.
When the stretching osteogenesis aiming at the upper jaw front section is applied to the treatment of a patient with serious insufficient development of the upper jaw bone or cleft lip and palate with insufficient development of the upper jaw bone, the horizontal osteotomy is usually performed on the upper jaw front section through a maxillofacial surgery, and the vertical osteotomy is performed between a first molar and a second molar in the upper jaw, between the upper jaw front molar or between the upper jaw first molar and a cuspid. And then, stretching and bone formation are carried out by adopting a stretching and bone formation device suitable for the anterior segment of the upper jaw, the amount of the anterior segment of the upper jaw bone is increased to obtain the space required for relieving the crowding of the dentition, the coverage of the anterior teeth is improved, and the lateral appearance of soft tissues is improved to a certain extent.
The existing distraction osteogenesis devices suitable for the anterior maxillary segment are mainly classified into an extracranial fixed support type External distraction osteogenesis device (RED) and an Intraoral distraction osteogenesis device (IA).
For the extracranial fixed bracket type external distraction osteogenesis device, the distraction osteogenesis device needs to be fixed by placing titanium plates on the skull and the maxilla, the generated wound is large, and the operation needs to be performed again when the distraction osteogenesis device is removed. In addition, the components of the distraction osteogenesis device are large, easily causing loosening or causing trauma, and the distraction osteogenesis device is not detachable for as long as half a year of distraction treatment, greatly affecting the daily life of the patient, and thus having low psychological acceptance by the patient.
Compared with the extracranial distraction osteogenesis device, the distraction osteogenesis device arranged in the mouth has the advantages that the size of the components is small, the components are positioned in the mouth, the appearance is not influenced, the disassembly operation is easier, the wound is small, the accidental occurrence rate of the wound is low, the influence on the life of a patient is small, and the distraction osteogenesis device is gradually favored by orthodontists and patients and becomes the mainstream scheme of the current treatment.
The intraoral distraction osteogenesis devices of the prior art are primarily dental support distraction osteogenesis devices. It is usually fixed to the maxillary teeth by an adhesive and applies traction to the teeth, conducted to the jaw, to push the anterior segment of the jaw forward. However, with such distraction osteogenesis devices, the jaw bone moves and the teeth shift, and subsequently the shifted teeth need to be realigned.
Disclosure of Invention
The invention aims to provide a distraction osteogenesis device. The invention is easy to process, simple in clinical operation and has good traction effect.
In order to solve the above problems, the present invention provides a distraction osteogenesis apparatus for being placed on the upper jaw of a patient, comprising: at least two belt rings which are respectively sleeved on the teeth on the left side and the right side of the patient;
at least one anchorage pin fixed to the patient's maxilla;
the anchorage rod is arranged corresponding to the anchorage nail, and an anchorage part is arranged on the anchorage rod and is used for abutting against the anchorage nail;
the arch expander is used for providing traction force for stretching the osteogenesis device;
the connecting rods are connected with the belt rings in a one-to-one correspondence manner, and the connecting rods connect the belt rings to the bow expander;
the expander applies force to the band ring and the anchorage bar and forms traction to the jaw bone of the patient.
As a distraction osteogenesis device is arranged in the mouth, the invention has small volume, does not need to be provided with an external part of the mouth and has small influence on the appearance and life of a patient.
In the invention, traction force is directly applied to the maxilla through the anchorage nails by the anchorage nails, and the front section of the maxilla is pushed to move forwards, so that the displacement of teeth is avoided while the front section of the maxilla moves, and the traction effect is better than that of the prior art tooth-supported traction apparatus.
In addition, in the distraction osteogenesis device of the present invention, since the traction force is transmitted by means of the band and the anchorage pin at the same time, the influence on the position of the teeth is small and the difficulty in clinical operation is low compared to the dental support type distraction osteogenesis device depending only on the band, and the effective distraction osteogenesis amount of the maxilla is increased while the dental reaction is reduced to the maximum extent.
Preferably, the anchorage part is a concave part formed by sinking the anchorage rod in the direction departing from the anchorage nail, and the anchorage nail is abutted against the concave part;
alternatively, the anchorage portion is an annular washer provided on the anchorage rod, through which the anchorage pin is driven into the maxilla of the patient.
Compared with an annular anchorage part, the concave part is simple in shape and has better freedom degree and flexibility.
The annular washer can increase the retention of the device and has good stability.
In addition, it is preferable that the anchorage bar is formed in an arc shape protruding in the direction of the anchorage nail. The arc-shaped anchorage rod can be prevented from deforming along with the output of traction force, and better support strength is achieved on the premise of the same thickness.
Preferably, the number of the anchorage units is at least two, and the two anchorage units are respectively distributed on both sides of the upper jaw of the patient. The traction force of the upper jaw part can be balanced by arranging the two anchorage parts, and a better traction effect is achieved.
Preferably, the anchorage bar is connected directly to the expander at both ends. The structure formed by direct connection is simple, and the processing difficulty is very low.
Or, preferably, the number of the belt rings is at least four, and two belt rings are respectively sleeved on the first molar or the second molar on the left side and the right side of the patient. Because first molar and second molar are strong, difficult removal utilizes the band ring of cup jointing on first molar or second molar, can provide good support and supplementary traction.
The other two belt rings are respectively sleeved on the premolars or the canines on the left and the right sides of the patient, and two ends of the anchorage rod are respectively connected with two connecting rods correspondingly connected with the two belt rings.
The four belt rings can increase the reinforcement sites, so that the distractor is not easy to loosen or fall off, and the traction movement of the maxilla is smoother.
Connect anchorage bar on the connecting rod, borrow the connecting rod to convey traction force, compare in with anchorage bar lug connection on expanding the bow ware, reduced the occupation of the play interface of expanding the bow ware to can adjust the ratio of the traction force that anchorage nail received and the traction force size of belt ring according to the angle of connecting rod and anchorage bar, it is very convenient. Further, the anchorage bar is connected to the connection bar connected to the premolars or the cuspids of the patient, and the shape and strength of the anchorage bar can be used to better prevent the displacement of the premolars or the cuspids while providing stable support to the anchorage bar.
In addition, as the optimization, the distraction osteogenesis device also comprises a connecting piece connected with the arch expander, and the connecting piece is provided with a blind hole with a certain depth; the connecting rod is inserted into the blind hole and is connected with the bow expander.
The anchorage bar can be replaced according to the treatment process by the aid of the arranged blind holes, so that more personalized customized treatment can be provided.
Further, preferably, the distraction osteogenesis apparatus further comprises a spacer installed in the blind hole for adjusting the depth of the anchorage bar into the blind hole. The length of the anchorage rod extending out can be adjusted by arranging the spacing piece, so that the requirement for replacing the anchorage rod can be reduced or eliminated, and the cost is greatly reduced.
Also, preferably, when both ends of the anchorage bar are directly connected to the pantograph expander, the anchorage bar may be divided into a rear section directly connected to the pantograph expander and a front section provided with the anchorage portion;
the distraction osteogenesis device also comprises a connecting piece arranged on the rear section, and a blind hole with certain depth is arranged on the connecting piece;
both ends of the front section are inserted into the blind holes and fixed on the rear section;
the distraction osteogenesis device further comprises a spacer which is arranged in the blind hole and used for adjusting the depth of the front section penetrating into the blind hole.
The length of the front section of the anchorage bar projecting out can likewise be adjusted by means of blind holes and spacers.
Preferably, the two belt loops which are sleeved on the premolars or the cuspids on the left and right sides of the patient are also provided with a traction hook which is used for being connected with an extraoral traction mask. The traction hook can be matched with a detachable extraoral traction mask, so that the traction direction of the front part of the maxilla can be better controlled.
Drawings
Fig. 1 is a schematic view of a patient's upper jaw without a distraction osteogenesis device in accordance with a first embodiment of the present invention;
FIG. 2 is a schematic illustration of the patient's upper jaw with a distraction osteogenesis device attached to the first embodiment of the present invention;
FIG. 3 is a schematic illustration of a second embodiment of the present invention showing a patient's maxilla after installation of a distraction osteogenesis device;
FIG. 4 is a schematic view of a connecting rod according to the second and eighth embodiments of the present invention inserted into a blind hole;
FIG. 5a is a schematic view of the connecting rod inserted into the blind hole and the spacer is a gasket according to the third and ninth embodiments of the present invention;
FIG. 5b is a schematic view of the connecting rod inserted into the blind hole and the spacer is a spring according to the third and ninth embodiments of the present invention;
FIG. 6 is a schematic illustration of a patient's upper jaw with a distraction osteogenesis apparatus attached to a fourth embodiment of the present invention;
FIG. 7 is a schematic representation of a fifth embodiment of the present invention showing a patient's maxilla after installation of a distraction osteogenesis device;
FIG. 8 is a schematic illustration of a patient's upper jaw with a stretch osteogenesis apparatus attached to a sixth embodiment of the present invention;
FIG. 9 is a schematic illustration of the upper jaw of a patient after installation of a distraction osteogenesis device according to a seventh embodiment of the present invention;
FIG. 10 is a schematic view of the upper jaw of a patient with an eighth embodiment of the present invention installed with a distraction osteogenesis device;
figure 11 is a schematic view of the upper jaw of a patient with a stretch bone formation device attached thereto according to a tenth embodiment of the present invention.
Description of reference numerals:
1-a belt ring; 2-anchorage nail; 3-maxilla; 4-anchorage bar; 4 a-anchorage portion; 4 b-anterior segment; 4 c-rear section; 5-expanding the bow; 6-connecting rod; 7-a connector; 7 a-blind hole; 8-a spacer; 9-a towing hook.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings.
Implementation mode one
Referring to fig. 1, for patients with malformed maxilla, the dentition is often severely misaligned because the smaller jaw is not enough to provide enough space to sprout the teeth, and the face may also exhibit varying degrees of malformation, requiring targeted treatment.
A first embodiment of the invention provides a distraction osteogenesis device, for placement in the patient's oral maxilla as shown in figure 2 during treatment. It includes: at least two belt rings 1, the two belt rings 1 are respectively sleeved on the teeth on the left and the right sides of the patient.
It will be clear to one skilled in the art that in this embodiment, the teeth to which the band 1 is secured may be selected as desired. For example, referring to fig. 2, the band 1 may be secured to the first molars on the left and right of the patient. Of course, the band ring 1 may be fitted to the second molars on both left and right sides of the patient, or may be additionally provided to the first molars and the second molars. Obviously, the band 1 can be snap-fitted to the teeth by physical means and further secured by means of an adhesive.
Because the first molar and the second molar are strong in branch resistance and relatively difficult to move, the belt ring 1 sleeved on the first molar or the second molar can provide good support and auxiliary traction.
The distraction osteogenesis device further comprises:
at least one anchorage pin 2 fixed to the maxilla 3 of the patient;
the anchorage device comprises an anchorage rod 4 arranged corresponding to the anchorage nail 2, wherein an anchorage part 4a is arranged on the anchorage rod 4, and the anchorage part 4a is used for abutting against the anchorage nail 2.
The arch expander 5 is used for providing traction force for stretching the osteogenesis device;
the connecting rods 6 are connected with the belt rings 1 in a one-to-one correspondence manner, and each belt ring 1 is connected to the bow expander 5 through the connecting rods 6;
the expander 5 applies force to the band 1 and the anchorage bar 4 and forms traction to the jaw bone of the patient. The arch expander 5 adopted by the invention can be a spiral arch expander, and of course, other types of arch expanders 5 can be selected according to the situation, such as a four-ring arch expander. Both ends of the anchorage bar 4 may be directly connected to the expander 5 so that the expander 5 may directly apply force to the anchorage bar 4.
In the present embodiment, the maxilla 3 may be an anterior part of the maxilla 3, and it is needless to say that the requirements of the present patent application can be basically satisfied when the anchorage pins 2 are implanted in other parts of the maxilla 3. The two ends of the anchorage rod 4 are directly connected to the arch expander 5, so that the structure is simple and the processing difficulty is low.
Wherein, the anchorage part 4a is a ring-shaped gasket arranged on the anchorage rod 4, and the anchorage nail 2 is nailed into the maxillary bone 3 of the patient through the ring-shaped gasket. The annular washer can increase the retention of the device and has good stability. The transmission and expression of the traction force can be realized well by the rod-shaped anchorage rod 4.
In the present embodiment, as shown in fig. 2, two tie bars 6 are provided, and the two tie bars 6 are connected to the two strap rings 1, respectively. Of course, the number of the connecting rods 6 can be increased according to actual requirements, but preferably is not more than four, so that the processing difficulty of the anchorage rod 4 is avoided, and the cost is increased.
Further, it is to be noted that, in the present embodiment, as shown in fig. 2, the distraction osteogenesis apparatus and the anterior teeth are not provided with a connection. Therefore, after the distraction osteogenesis device is used, the distraction osteogenesis device can be temporarily disassembled and the subsequent fixing and correcting stage can be carried out. In this case, the distraction osteogenesis device can also act to strengthen the anchorage of the posterior teeth, preventing the posterior teeth from advancing when aligning the anterior teeth.
An implantation and treatment procedure of the present invention may be as follows:
1. given a treatment plan and the construction of the distraction osteogenesis device based on the patient's condition, it is possible to simply verify that the shapes match using a plaster model. The distraction osteogenesis device can be made according to the plaster model of the patient, and the device is tried on before the operation to confirm whether the device is in place.
2. The patient is osteotomized using maxillofacial surgery.
3. The distraction osteogenesis device is installed in the mouth of a patient, the belt ring 1 can be installed on the corresponding tooth, and then the anchorage nail 2 can be implanted in the anchorage part 4a, namely the through hole of the annular gasket. During installation, the band 1 can be coated with adhesive and fixed with the teeth.
4. The bow expander 5 is forced by the key. The elastic potential energy obtained by the expander 5 will be applied to the teeth and anchorage pins 2 via the connection 7 and the anchorage bar 4, so that the maxilla 3 of the patient is continuously subjected to traction.
As a distraction osteogenesis device is arranged in the mouth, the invention has small volume, does not need to be provided with an external part of the mouth and has small influence on the appearance and life of a patient.
In the present invention, by applying traction force directly to the maxilla 3 through the anchorage pins 2 by means of the anchorage pins 2 and pushing the anterior segment of the maxilla 3 to be displaced forward, the displacement of teeth is prevented while the anterior segment of the maxilla 3 is moved, and the traction effect is superior to that of the prior art dental-supported distractors.
In the distraction osteogenesis device of the present invention, since the traction force is transmitted by means of the band 1 and the anchorage pin 2 at the same time, the influence on the position of the teeth is small and the difficulty in clinical operation is low compared to the dental support type distraction osteogenesis device relying only on the band 1, and the effective distraction osteogenesis amount of the maxilla is increased while the dental reaction is reduced to the maximum extent.
Second embodiment
A second embodiment of the present invention provides a distraction osteogenesis apparatus, which is a further improvement of the first embodiment, and is mainly improved in that, in the second embodiment of the present invention, as shown in fig. 3, the anchorage bar 4 is divided into a rear section 4c directly connected to the arch expander 5 and a front section 4b provided with an anchorage portion 4 a;
referring to fig. 3 and 4, the distraction osteogenesis device further comprises a connecting piece 7 arranged on the rear section 4c, and the connecting piece 7 is provided with a blind hole 7a with a certain depth; wherein the connecting piece 7 can be fixed on the rear section 4c by welding or integral molding.
The front section 4b is inserted into the blind holes 7a at both ends and fixed to the rear section 4 c.
Because the anchorage bar 4 and the connecting bar 6 have certain mechanical fatigue. As the course of treatment progresses, mechanical fatigue may increase, causing slight deformation of the anchorage bar 4 and the connecting bar 6, which may also result in a greater distance of the anchorage pin 2 from the arch expander 5.
Therefore, in the present embodiment, this increase in distance can be accommodated by replacing the anchorage bar 4 or increasing the length of the front section 4b, so that the pantograph 5 can always operate with maximum mechanical output.
In summary, the front section 4b of the anchorage bar 4 can be replaced according to the course of treatment by means of the blind hole 7a provided, so that a more personalized and customized treatment can be provided. Meanwhile, the material performance requirements of the anchorage rod 4 and the connecting rod 6 can be reduced, and the material cost of the distraction osteogenesis device is reduced.
Third embodiment
The third embodiment of the present invention provides a distraction osteogenesis device, and the third embodiment is a further improvement of the second embodiment, and is mainly characterized in that in the third embodiment of the present invention, referring to fig. 5a, the distraction osteogenesis device further comprises a spacer 8, and the spacer 8 is installed in the blind hole 7a for adjusting the depth of the front section 4b into the blind hole 7 a.
When the supporting length of the anchorage rod 4 needs to be replaced and adjusted, the protruding length of the front section 4b of the anchorage rod 4 can be adjusted by plugging the spacer 8 into the blind hole 7a, so that the need for replacing the anchorage rod 4 can be reduced or eliminated, and the cost can be greatly reduced.
In this embodiment, the spacer 8 may be in the form of a shim as shown in fig. 5 a. The material of the spacer 8 can be determined according to actual requirements, and particularly, the spacer can be made of rubber so as to be more easily plugged into the blind hole 7 a.
As a further development of this embodiment, the spacer 8 may also be in the form of a spring as described in fig. 5 b. When the spacer 8 has elasticity, the distraction osteogenesis apparatus can be also temporarily removed after the completion of the distraction osteogenesis session. At this point, in the subsequent fixed orthodontic phase, the distraction osteogenesis device can be used to push the molars backward, providing more clearance for the anterior dental area to improve and relieve crowding of the dentition.
Obviously, resilient pads may also be used to achieve similar technical effects.
Embodiment IV
A fourth embodiment of the present invention provides a distraction osteogenesis device, which is different from the first to third embodiments, mainly in that in the first three embodiments of the present invention, the number of the belt loops 1 is at least two; in the fourth embodiment of the present invention, however, the number of belt loops 1 is at least four.
Specifically, referring to fig. 6, two belt loops 1 are respectively fitted to the first molar or the second molar on the left and right sides of the patient.
Because the first molar and the second molar are strong in branch resistance and relatively difficult to move, the belt ring 1 sleeved on the first molar or the second molar can provide good support and auxiliary traction.
The other two belt rings 1 are respectively sleeved on the premolars or the canines on the left and the right sides of the patient, and two ends of the anchorage bar 4 are respectively connected with two connecting rods 6 correspondingly connected with the two belt rings 1.
The four belt rings 1 can increase the reinforcement sites, so that the distractor is not easy to loosen or fall off, and the traction movement of the maxilla 3 is smoother.
It is worth mentioning that when the anchorage nail is planted at the rear part of the maxilla 3, the clinical operation difficulty is very high, and the damage is easy to occur due to abundant nerve vessels at the rear part of the maxilla. And in this embodiment, cup joint belt ring 1 respectively on the first molar or the second molar of patient's the left and right sides to utilize first molar and second molar to provide the support in upper jaw rear portion, greatly reduced clinical operation complexity, and avoided the neural blood vessel rich region in upper jaw 3's rear portion, reduced clinical unexpected emergence.
Further, by connecting the anchorage bar 4 to the connection bar 6 connected to the premolars or the cuspids of the patient, the anchorage bar 4 is stably supported and the displacement of the premolars or the cuspids can be more effectively prevented by the shape and strength of the anchorage bar 4.
It should be noted that, in the present embodiment, as shown in fig. 6, both ends of the anchorage bar 4 are respectively connected to two connection bars 6 correspondingly connected to the belt rings 1 sleeved on the anterior molars or the cuspids on both left and right sides of the patient. The ring belt 1 that cup joints on the premolar or the cuspid of the left and right sides of the patient can also be provided with rotation axis and hasp for the ring belt can be opened and closed, so that the dismantlement of ring belt self, and with anchorage bar 4 and the relevant dismantlement of connecting rod matched with.
Fifth embodiment
The fifth embodiment of the present invention provides a distraction osteogenesis device, which is a further improvement of the fourth embodiment, and is mainly improved in that in the fifth embodiment of the present invention, as shown in fig. 7, the anchorage bar 4 is formed in an arc shape protruding toward the anchorage nail 2.
Form curved anchorage pole 4 and possess better compressive capacity, can prevent that it from taking place deformation along with traction force's output, possess better support strength under the prerequisite of same thickness.
Sixth embodiment
A sixth embodiment of the present invention provides a distraction osteogenesis device, which is a further improvement of the fourth or fifth embodiment, and is mainly improved in that, in the sixth embodiment of the present invention, as shown in fig. 8, the anchorage portion 4a is a concave portion formed by recessing the anchorage bar 4 in a direction away from the anchorage nail 2, and the anchorage nail 2 abuts against the concave portion;
since different patients are likely to develop different disease progression during the course of treatment. Temporary removal of the distraction osteogenesis apparatus may be required. When the anchorage part 4a is formed into a concave part, the anchorage nail 2 does not need to be taken down when the main body of the distraction osteogenesis device is detached, and the main body of the distraction osteogenesis device can be installed back at any time, so that the device is very convenient. Therefore, the method has better degree of freedom and flexibility.
Seventh embodiment
A seventh embodiment of the present invention provides a distraction osteogenesis device, which is a further improvement of the fourth, fifth or sixth embodiment, and the main improvement is that in the seventh embodiment of the present invention, referring to fig. 9, at least two anchorage parts 4a are provided and the two anchorage parts 4a are respectively distributed on both sides of the upper jaw of the patient.
When only one anchorage portion 4a is provided, the anchorage portion 4a is generally provided at the midline position of the front portion of the maxilla 3. Clinically, the site of most patients at this location usually coincides with the incisor aperture. Since the incisor cavity contains abundant vascular nerves, severe pain and bleeding are caused after the anchorage nail 2 is implanted.
Therefore, the arrangement of the two anchorage portions 4a not only can balance the traction force of the maxilla portion, but also can avoid the risk that the anchorage nail 2 is implanted into the incisor hole, thereby relieving the pain of the patient.
Embodiment eight
An eighth embodiment of the present invention provides a distraction osteogenesis device, which is a further improvement of any one of the fourth to seventh embodiments, and the main improvement is that, in the eighth embodiment of the present invention, referring to fig. 10 and 4, the distraction osteogenesis device further comprises a connecting member 7 connected with the arch expander 5, wherein the connecting member 7 is provided with a blind hole 7a with a certain depth;
the connecting rod 6 is inserted into the blind hole 7a and connected with the bow expander 5.
Because the anchorage bar 4 and the connecting bar 6 have certain mechanical fatigue. As the course of treatment progresses, mechanical fatigue may increase, causing slight deformation of the anchorage bar 4 and the connecting bar 6, which may also result in a greater distance of the anchorage pin 2 from the arch expander 5.
When the two ends of the anchorage bar 4 are respectively connected with the two connecting rods 6 correspondingly connected with the belt rings 1 sleeved on the premolars or the canines on the left and right sides of the patient, the distance can be increased by simultaneously replacing the connecting rods 6 and the anchorage bar 4 connected with the connecting rods 6, so that the arch expander 5 can always keep the maximum mechanical output and work.
In summary, the anchorage bar 4 and the connecting bar 6 can be replaced according to the course of treatment by means of the blind holes 7a provided, so that a more personalized customized treatment can be provided. Meanwhile, the material performance requirements of the anchorage rod 4 and the connecting rod 6 can be reduced, and the material cost of the distraction osteogenesis device is reduced.
Example nine
A ninth embodiment of the present invention provides a distraction osteogenesis device, which is a further improvement of the eighth embodiment, and is mainly improved in that, in the ninth embodiment of the present invention, referring to fig. 5a, the distraction osteogenesis device further comprises a spacer 8, and the spacer 8 is installed in the blind hole 7a for adjusting the depth of the anchorage bar 4 penetrating into the blind hole 7 a. The length of the connecting rod 6 extending can be adjusted by providing the spacer 8, so that the need for replacing the anchorage rod 4 and the connecting rod 6 can be reduced or eliminated, and the cost can be greatly reduced.
When the supporting length of the anchorage rod 4 needs to be replaced and adjusted, the protruding length of the front section 4b of the anchorage rod 4 can be adjusted by plugging the spacer 8 into the blind hole 7a, so that the requirement for replacing the anchorage rod 4 can be reduced or eliminated, and the cost is greatly reduced.
In this embodiment, the spacer 8 may be in the form of a shim as shown in fig. 5 a. The material of the spacer 8 can be determined according to actual requirements, and particularly, the spacer can be made of rubber so as to be more easily plugged into the blind hole 7 a.
As a further development of this embodiment, the spacer 8 may also be in the form of a spring as described in fig. 5 b. When the spacer 8 has elasticity, the distraction osteogenesis apparatus can be also temporarily removed after the completion of the distraction osteogenesis session. In the subsequent fixed correction stage, the distraction osteogenesis device can be used for pushing the molar to move backwards, so that more gaps are provided for the anterior tooth area, and the crowding of the dentition is improved and removed. Of course, in order to prevent the distraction osteogenesis from affecting the anterior teeth in the process of pushing the molars to move backwards, the ring belt 1 can be sleeved on the anterior molars or the cuspids on the left and right sides of the patient.
Obviously, resilient pads may also be used to achieve similar technical effects.
Detailed description of the preferred embodiment
The tenth embodiment of the invention provides a distraction osteogenesis device, and the tenth embodiment is a further improvement of any one of the fourth to ninth embodiments, and the main improvement is that in the tenth embodiment of the invention, as shown in fig. 11, two belt loops 1 sleeved on the anterior molars or the cuspids on the left and right sides of the patient are further provided with a towing hook 9, and the towing hook 9 is used for connecting with an extraoral traction mask.
By means of the towing hook 9, it is possible to cooperate with a detachable extraoral towing mask, better controlling the direction of towing of the front part of the maxilla 3.
The extraoral traction mask can be installed or removed as needed. The outside-mouth traction mask is installed in the private space, so that the traction direction can be adjusted, the traction efficiency is improved, and the outside-mouth traction mask is taken down before entering a public place, so that the influence on the body and mind of a patient can be avoided.
It will be appreciated by those of ordinary skill in the art that in the embodiments described above, numerous technical details are set forth in order to provide a better understanding of the present application. However, the technical solutions claimed in the claims of the present application can be basically implemented without these technical details and various changes and modifications based on the above embodiments. Accordingly, in actual practice, various changes in form and detail may be made to the above-described embodiments without departing from the spirit and scope of the invention.
Claims (6)
1. A distraction osteogenesis device for placement on the upper jaw of a patient, comprising:
at least two belt rings (1), wherein the two belt rings (1) are respectively sleeved on the teeth on the left side and the right side of a patient;
at least one anchorage pin (2) fixed to the maxilla (3) of the patient;
the anchorage device comprises an anchorage rod (4) which is arranged corresponding to the anchorage nail (2), wherein an anchorage part (4 a) is arranged on the anchorage rod (4), and the anchorage part (4 a) is used for abutting against the anchorage nail (2);
an expander (5) for providing traction for the distraction osteogenesis device;
the connecting rods (6) are connected with the belt rings (1) in a one-to-one correspondence manner, and the connecting rods (6) connect the belt rings (1) to the bow expander (5);
the expander (5) applies force to the belt ring (1) and the anchorage bar (4) and forms traction to the jaw bone of the patient;
two ends of the anchorage rod (4) are directly connected to the arch expander (5);
the anchorage bar (4) is divided into a rear section (4 c) directly connected with the arch expander (5) and a front section (4 b) provided with the anchorage part (4 a);
the distraction osteogenesis device also comprises a connecting piece (7) arranged on the rear section (4 c), and a blind hole (7 a) with a certain depth is arranged on the connecting piece (7);
both ends of the front section (4 b) are inserted into the blind holes (7 a) and fixed on the rear section (4 c);
the distraction osteogenesis device further comprises a spacer (8), wherein the spacer (8) is installed in the blind hole (7 a) and is used for adjusting the depth of the front section (4 b) penetrating into the blind hole (7 a);
the number of the belt rings (1) is at least four,
two belt rings (1) are respectively sleeved on the first molar or the second molar on the left side and the right side of a patient;
the other two belt rings (1) are respectively sleeved on the anterior molars or the cuspids on the left and the right sides of the patient, and two ends of the anchorage bar (4) are respectively connected with two connecting rods (6) correspondingly connected with the belt rings (1) sleeved on the anterior molars or the cuspids on the left and the right sides of the patient;
the distraction osteogenesis device also comprises a connecting piece (7) connected with the arch expander (5), and a blind hole (7 a) with a certain depth is arranged on the connecting piece (7);
the connecting rod (6) is inserted into the blind hole (7 a) and connected with the arch expander (5).
2. The distraction osteogenesis device according to claim 1, wherein the anchorage portion (4 a) is a recess formed by the anchorage bar (4) being recessed in a direction away from the anchorage nail (2), the anchorage nail (2) resting on the recess;
or the anchorage part (4 a) is an annular gasket arranged on the anchorage rod (4), and the anchorage nail (2) penetrates through the annular gasket and is nailed into the maxilla (3) of the patient.
3. The distraction osteogenesis device according to claim 1, wherein the anchorage bar (4) is convex in an arc shape towards the direction of the anchorage nail (2).
4. Distraction osteogenesis device according to claim 1, wherein the anchorage portion (4 a) is at least two and the two anchorage portions (4 a) are distributed on either side of the patient's upper jaw.
5. The distraction osteogenesis apparatus according to claim 1, further comprising a spacer (8), said spacer (8) being mounted within said blind hole (7 a) for adjusting the depth of penetration of said anchorage bar (4) into said blind hole (7 a).
6. The distraction osteogenesis apparatus according to claim 1, wherein a traction hook (9) is further arranged on the two belt rings (1) sleeved on the anterior molar or cuspid on the left and right sides of the patient, and the traction hook (9) is used for connecting with an extraoral traction mask.
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| CN201710832779.7A CN107518954B (en) | 2017-09-15 | 2017-09-15 | Distraction osteogenesis device |
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| CN201710832779.7A CN107518954B (en) | 2017-09-15 | 2017-09-15 | Distraction osteogenesis device |
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| CN107518954B true CN107518954B (en) | 2023-03-24 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN108324355A (en) * | 2018-02-06 | 2018-07-27 | 南京医科大学附属口腔医院 | A kind of built-in arch distraction device |
| CN108742895A (en) * | 2018-06-25 | 2018-11-06 | 上海交通大学医学院附属第九人民医院 | A kind of built-in sagittal distraction osteogenesis device of the upper jaw |
| CN109044542A (en) * | 2018-08-06 | 2018-12-21 | 上海精功齿科技术有限公司 | One kind being used for the insufficient sagittal of maxillary development to expansion begg appliance device and manufacturing method |
| CN109199612A (en) * | 2018-09-29 | 2019-01-15 | 杭州西湖生物材料有限公司 | A kind of bone anchorage expands bow device and its application method |
| CN110151338B (en) * | 2019-04-26 | 2021-11-05 | 南京医科大学附属口腔医院 | Direction-adjustable maxillary anterior distractor and clinical application thereof |
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| CN201572200U (en) * | 2010-01-11 | 2010-09-08 | 西安交通大学口腔医院 | Modified intraoral frame premaxillary tractor |
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| US6334771B1 (en) * | 2000-09-15 | 2002-01-01 | Eric Jein-Wein Liou | Rapid palatal expander |
| CN201572200U (en) * | 2010-01-11 | 2010-09-08 | 西安交通大学口腔医院 | Modified intraoral frame premaxillary tractor |
| EP3064167A1 (en) * | 2015-03-05 | 2016-09-07 | Medicon Eg Chirurgiemechaniker-Genossenschaft | Distraction set, comprising a device for distraction or elongation of bone segments |
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