CN112137769A - 一种颞下颌关节假体 - Google Patents

一种颞下颌关节假体 Download PDF

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CN112137769A
CN112137769A CN202011001811.5A CN202011001811A CN112137769A CN 112137769 A CN112137769 A CN 112137769A CN 202011001811 A CN202011001811 A CN 202011001811A CN 112137769 A CN112137769 A CN 112137769A
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prosthesis
mandible
glenoid
fixing plate
joint
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孙增辉
初建宇
代瑞
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Beijing Zhong An Tai Hua Science & Technology Co ltd
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Beijing Zhong An Tai Hua Science & Technology Co ltd
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    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30934—Special articulating surfaces
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

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Abstract

本申请涉及植入假体的领域，尤其是涉及一种颞下颌关节假体。一种颞下颌关节假体，包括下颌骨假体、下颌骨固定板、由超高分子量聚乙烯/陶瓷制成的关节窝假体、关节窝固定板以及由钴铬钼合金机械加工而成/陶瓷制成的髁突假体，下颌骨假体与髁突假体配合的一端成型有定位凸台，所述髁突假体上成型有与定位凸台配合的定位凹槽。将下颌骨假体上的髁突设计成分离的单独一个髁突假体，将髁突假体设置成由钴铬钼合金或陶瓷制成，与高分子聚乙烯材料或陶瓷制成的关节窝假体配合形成活动关节部分的结构。因此下颌骨关节、下颌骨固定板的部分均可以由钛合金材料3D打印以适合每个患者独特的脸部形状，同时也解决了长期使用导致骨溶解的问题。

Description

一种颞下颌关节假体
技术领域
本申请涉及植入假体的领域，尤其是涉及一种颞下颌关节假体。
背景技术
颞下颌关节常由于创伤、肿瘤、炎症、强直或先天性疾病致其解剖结构部分或完全丧失，从而使其功能部分或完全丧失。理想的方法是重建一个形态、组织成分和功能都类同于原颞下颌关节的新关节，恢复关节的功能，但是目前尚无法实现，人工关节是可选方法之一。
颞下颌关节假体为了适应每个人独特的人体结构，以及出于加工方便、强度足够、无人体排斥反应等方面考虑，我司原先的颞下颌关节关节假体采用高分子聚乙烯和钛合金3D打印形成。钛合金3D打印形成的假体和聚乙烯在活动关节假体的位置长期配合使用时会导致高分子聚乙烯磨损后掉落碎屑导致骨溶解。
发明内容
为了克服假体长期使用导致骨溶解的问题，本申请提供一种颞下颌关节假体。
本申请提供的一种颞下颌关节假体，采用如下的技术方案：
一种颞下颌关节假体，包括下颌骨假体、下颌骨固定板、由超高分子量聚乙烯/陶瓷制成的关节窝假体、关节窝固定板以及由钴铬钼合金机械加工而成/陶瓷制成的髁突假体，下颌骨假体与髁突假体配合的一端成型有定位凸台，所述髁突假体上成型有与定位凸台配合的定位凹槽。
通过采用上述技术方案，将下颌骨假体上的髁突设计成分离的单独一个髁突假体，将髁突假体设置成由钴铬钼合金或陶瓷制成，与高分子聚乙烯材料或陶瓷制成的关节窝假体配合形成活动关节部分的结构。因此下颌骨关节、下颌骨固定板的部分均可以由钛合金材料3D打印以适合每个患者独特的脸部形状。定位凸台和定位凹槽配合将髁突假体配合在下颌骨假体上，同时陶瓷相互之间具有良好的耐磨性能，因此能够解决长期使用导致骨溶解的问题。机械加工成型的钴铬钼合金也具有良好的强度和光滑度，不会像3D打印的钛合金材料那样即使经过打磨也会有细纹导致高分子聚乙烯材料磨损产品碎屑。因此也解决了长期使用导致骨溶解的问题。
优选的，所述定位凸台为圆台状。
通过采用上述技术方案，将定位凸台设计成圆台状，使得定位凸台和定位凹槽配合时更易插入，且能够做到配合插接后两者紧密配合不留缝隙。
优选的，所述下颌骨健体和下颌骨固定板一体成型，所述下颌骨固定板上成型有多个第一固定孔。
通过采用上述技术方案，在下颌骨固定板上成型第一固定孔来使得紧固件可以穿过第一固定孔将下颌骨固定板与下颌骨相连接，使得下颌骨假体被定位。
优选的，所述下颌骨假体的表面成型有网孔。
通过采用上述技术方案，在下颌骨假体的表面成型网孔结构，使得附近的肌肉能够较好地附着在下颌骨假体上。
优选的，所述下颌骨假体的内部为仿金刚石晶胞支撑结构。
通过采用上述技术方案，将下颌骨假体的内部设置成仿金刚石晶胞的结构，使得下颌骨假体具有强度较好的内部支撑的同时还不会过重。
优选的，所述关节窝假体和关节窝固定板相连接，所述关节窝固定板由钛合金材料3D打印形成，所述关节窝固定板的表面成型有多个第二固定孔。
通过采用上述技术方案，将关节窝假体和关节窝固定板分离设置，同时关节窝固定板有钛合金材料3D打印形成，使得关节窝固定板适应患者面部形状。钛合金材料能够在较薄的情况下具有良好的结构强度，由于关节窝固定板有部分是要贴合在上颌骨的侧面，因此可以在结构强度足够的情况下减少对脸型的影响。
优选的，所述关节窝假体面向上颌骨的一侧成型有连接凸块，所述连接凸块的两侧靠近上端的位置均成型有滑块，所述关节窝固定板面向关节窝假体的一侧成型有连接凹槽，连接凹槽的其中一侧贯穿关节窝固定板，且连接凹槽与贯穿关节窝固定板位置相邻的两侧均成型有滑槽。
通过采用上述技术方案，在关节窝假体上设置连接凸块和连接凹槽的结构来配合，两者配合插连时滑块卡入滑槽内，使得两者仅能够沿着滑块滑槽的配合方向运动，而无法在其他方向上自由活动。
优选的，所述连接凸块面向上颌骨一侧成型有止退块，连接凹槽的底面成型有与止退块配合的止退槽，所述止退槽朝向连接凹槽贯穿关节窝固定板一侧深度逐渐增大。
通过采用上述技术方案，通过止退块和止退槽的结构，使得连接凸块和连接凹槽插连后到达止退块和止退槽配合的位置时，关节窝假体和关节窝固定板的相对位置被完全锁死，在不破坏物理结构的情况下无法使两者分离。
综上所述，本申请包括以下至少一种有益技术效果：
1.将下颌骨假体上的髁突设计成分离的单独一个髁突假体，将髁突假体设置成由钴铬钼合金或陶瓷制成，与高分子聚乙烯材料或陶瓷制成的关节窝假体配合形成活动关节部分的结构；下颌骨关节、下颌骨固定板的部分均可以由钛合金材料3D打印以适合每个患者独特的脸部形状，同时能够解决长期使用导致骨溶解的问题。
2.将关节窝假体和关节窝固定板分离设置，同时关节窝固定板有钛合金材料3D打印形成，使得关节窝固定板适应患者面部形状，钛合金材料能够在较薄的情况下具有良好的结构强度，因此可以在结构强度足够的情况下减少对脸型的影响。
附图说明
图1是颞下颌关节假体和上颌骨、下颌骨配合时的结构示意图；
图2是颞下颌关节假体的结构示意图；
图3是下颌骨假体、下颌骨固定板和髁突假体的结构示意图；
图4是关节窝假体、关节窝固定板的结构示意图；
图5是关节窝固定板的结构示意图。
附图标记说明：1、下颌骨假体；2、下颌骨固定板；3、髁突假体；4、关节窝假体；5、关节窝固定板；6、第一固定孔；7、定位凸台；8、定位凹槽；9、连接凸块；10、滑块；11、止退块；12、第二固定孔；13、连接凹槽；14、止退槽；15、滑槽。
具体实施方式
以下结合附图1-5对本申请作进一步详细说明。
本申请实施例公开一种颞下颌关节假体。
如图1和图2所示，颞下颌关节假体包括下颌骨假体1、用于连接下颌骨的下颌骨固定板2、连接在下颌骨假体1上的髁突假体3、关节窝假体4以及用于连接上颌骨的关节窝固定板5。
如图2和图3所示，下颌骨假体1为人体下颌骨仿生结构，下颌骨假体1的表面成型有网孔来使得附近的肌肉能够更好地附着在下颌骨假体1上，同时下颌骨假体1内部为仿金刚石晶胞结构作为内部支撑。下颌骨固定板2一体成型于下颌骨假体1靠近下颌骨一端的外侧面，下颌骨固定板2的表面成型有多个第一固定孔6，通过紧固件穿过第一固定孔6使得下颌骨固定板2与下颌骨连接固定。下颌骨假体1靠近上颌骨的一端成型有圆台状的定位凸台7。下颌骨假体1和下颌骨固定板2均由钛合金3D打印形成。
如图3所示，髁突假体3为人体髁突仿生结构，髁突假体3面向下颌骨假体1的一端成型有与定位凸台7相适配的定位凹槽8。髁突假体3由钴铬钼合金机械加工而成。
如图4所示，关节窝假体4为人体仿关节窝结构，关节窝假体4面向上颌骨的一侧一体成型有连接凸块9。连接凸块9的两侧靠近上端的位置均成型有滑块10，连接凸块9面向上颌骨一侧成型有止退块11，止退块11沿滑块10的长度方向厚度逐渐增大或减小。关节窝假体4由超高分子量聚乙烯/陶瓷制成。
如图4和图5所示，关节窝固定板5的内侧壁贴合人体上颌骨，且关节窝固定板5的表面成型有多个第二固定孔12，通过紧固件穿过第二固定孔12后将关节窝固定板5和上颌骨相连接。关节窝固定板5面向关节窝假体4的一侧成型有连接凹槽13，连接凹槽13的底面成型有与止退块11配合的止退槽14。连接凹槽13的其中一侧贯穿关节窝固定板5，且连接凹槽13与贯穿关节窝固定板5位置相邻的两侧均成型有滑槽15。连接关节窝假体4和关节窝固定板5时，从关节窝假体4以止退块11较薄的一侧开始将连接凸块9插入连接凹槽13内，滑块10与滑槽15配合使得两者不会脱开。止退块11滑移至与止退槽14配合的位置后，在不破坏物理结构的情况下连接凸块9无法从连接凹槽13内脱出。
具体使用过程：
按照患者原先咬合关系拍摄领面部螺旋CT，将数据导入医疗软件中，重建三维模型。切除
CT设备扫描后获得病人的三维骨骼模型信息，根据三维骨骼模型信息打印颞下颌关节假体的各个配件。
先将关节窝假体4和关节窝固定板5配合连接，将髁突假体3配合放置在下颌骨假体1的定位凸台7。将下颌骨假体1定位后通过紧固件穿过下颌骨固定板2将下颌骨假体1和下颌骨固定。将关节窝假体4、关节窝固定板5定位后，通过紧固件穿过关节窝固定板5将关节窝假体4、关节窝固定板5和上颌骨固定。
以上均为本申请的较佳实施例，并非依此限制本申请的保护范围，故：凡依本申请的结构、形状、原理所做的等效变化，均应涵盖于本申请的保护范围之内。

Claims (8)

1.一种颞下颌关节假体，其特征是：包括下颌骨假体(1)、下颌骨固定板(2)、由超高分子量聚乙烯/陶瓷制成的关节窝假体(4)、关节窝固定板(5)以及由钴铬钼合金机械加工而成/陶瓷制成的髁突假体(3)，下颌骨假体(1)与髁突假体(3)配合的一端成型有定位凸台(7)，所述髁突假体(3)上成型有与定位凸台(7)配合的定位凹槽(8)。
2.根据权利要求1所述的颞下颌关节假体，其特征是：所述定位凸台(7)为圆台状。
3.根据权利要求1所述的颞下颌关节假体，其特征是：所述下颌骨健体和下颌骨固定板(2)一体成型，所述下颌骨固定板(2)上成型有多个第一固定孔(6)。
4.根据权利要求1-3任一项所述的颞下颌关节假体，其特征是：所述下颌骨假体(1)的表面成型有网孔。
5.根据权利要求4所述的颞下颌关节假体，其特征是：所述下颌骨假体(1)的内部为仿金刚石晶胞支撑结构。
6.根据权利要求1所述的颞下颌关节假体，其特征是：所述关节窝假体(4)和关节窝固定板(5)相连接，所述关节窝固定板(5)由钛合金材料3D打印形成，所述关节窝固定板(5)的表面成型有多个第二固定孔(12)。
7.根据权利要求6所述的颞下颌关节假体，其特征是：所述关节窝假体(4)面向上颌骨的一侧成型有连接凸块(9)，所述连接凸块(9)的两侧靠近上端的位置均成型有滑块(10)，所述关节窝固定板(5)面向关节窝假体(4)的一侧成型有连接凹槽(13)，连接凹槽(13)的其中一侧贯穿关节窝固定板(5)，且连接凹槽(13)与贯穿关节窝固定板(5)位置相邻的两侧均成型有滑槽(15)。
8.根据权利要求7所述的颞下颌关节假体，其特征是：所述连接凸块(9)面向上颌骨一侧成型有止退块(11)，连接凹槽(13)的底面成型有与止退块(11)配合的止退槽(14)，所述止退槽(14)朝向连接凹槽(13)贯穿关节窝固定板(5)一侧深度逐渐增大。
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