CN112245074B - Jaw bone grafting guide board that takes one's place - Google Patents

Jaw bone grafting guide board that takes one's place Download PDF

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Publication number
CN112245074B
CN112245074B CN202010948755.XA CN202010948755A CN112245074B CN 112245074 B CN112245074 B CN 112245074B CN 202010948755 A CN202010948755 A CN 202010948755A CN 112245074 B CN112245074 B CN 112245074B
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China
Prior art keywords
bone
guide plate
place
guiding plate
plate
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CN202010948755.XA
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Chinese (zh)
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CN112245074A (en
Inventor
王磊
解东平
史敬存
王旭东
吴梓谦
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Chuangyan Digital Technology Nantong Jiangsu Co ltd
Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
Original Assignee
Chuangyan Digital Technology Nantong Jiangsu Co ltd
Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Priority to CN202010948755.XA priority Critical patent/CN112245074B/en
Publication of CN112245074A publication Critical patent/CN112245074A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B33ADDITIVE MANUFACTURING TECHNOLOGY
    • B33YADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00Products made by additive manufacturing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4616Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of temporo-mandibular joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4687Mechanical guides for implantation instruments
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02PCLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
    • Y02P10/00Technologies related to metal processing
    • Y02P10/25Process efficiency

Abstract

The application relates to a jaw bone transplanting in-place guide plate, which comprises a guide plate body, wherein the guide plate body comprises a main plate and a plurality of positioning parts positioned on the inner side of the main plate, the positioning parts are respectively fixed on a mandibular bone stump and a transplanted bone, the main plate between two adjacent positioning parts forms an arch structure, and a gap for accommodating soft tissues is reserved between the arch structure and the mandibular bone stump or the transplanted bone. The application has the advantages of ensuring the guiding and positioning of the transplanted bone, fully preserving the soft tissues such as the muscles brought by the bone flap, ensuring the functional recovery and the plumpness of the face of the reconstruction operation, and avoiding the influence on the functional recovery after the soft tissues such as the muscles brought by the bone flap are fully peeled off.

Description

Jaw bone grafting guide board that takes one's place
Technical Field
The application relates to the technical field of oral and maxillofacial surgical medical instruments, in particular to a jaw bone transplanting in-situ guide plate.
Background
Currently, digital surgical techniques are rapidly developing and widely cited in surgical clinics. Among the techniques that can accurately translate preoperative designs into intraoperative procedures are surgical navigation and guides. The operation navigation needs to register information such as CT, MRI and the like before or during operation with a patient entity through a large-scale and high-cost navigator, so that the operation is complex, and the navigation is likely to fail. The surgical guide plate technology has certain application in orthopaedics, plastic surgery and maxillofacial surgery, the data used are mostly derived from CT or three-dimensional scanning, the requirements on equipment are high, the process of designing the guide plate is complex, and special engineering technicians are required to operate to finish the forming of the guide plate.
There are many methods for repairing and reconstructing mandible, but the most commonly used and best effect is autologous bone grafting, and after some osteotomy is performed on a human body, bone is usually taken from ilium, and then the bone is shaped and then implanted into the resected part.
In order to achieve the purpose of accurately repairing the damage of the mandible and reconstructing the normal form of the mandible, the surgical guide plate technology is widely applied to auxiliary operation processes. In general, the guiding plate in the jaw bone grafting operation is tightly attached to the bone surface, and a small gap is reserved between the guiding plate and the bone surface, so that guiding of the bone graft in place is facilitated, however, the inventor finds that the thickness of soft tissues such as muscles and the like in the bone flap is difficult to fully strip in the actual operation process, and the soft tissues such as the muscles and the like in the bone flap have important significance for functional recovery and facial fullness after the bone grafting, and the muscles can also reduce the absorption of the bone graft. Clinical studies prove that the muscle tissue in bone grafting can not only reconstruct blood circulation of bone tissue, but also bring osteoblasts and osteoinductive multiple growth factors into the bone tissue, promote new bone formation, accelerate bone tissue repair, reduce compression and torsion of muscle pedicles in the bone grafting process, also protect good blood circulation of bone flaps, and lay a solid foundation for healing of the bone flaps after operation. How to ensure the guiding and positioning of the transplanted bone and make full use of the benefits of soft tissues such as muscles and the like brought by bone flaps to the human body is not disclosed at present.
Disclosure of Invention
Therefore, the application aims to solve the technical problems of ensuring the guiding and positioning of the transplanted bone and fully utilizing the benefits of soft tissues such as muscles and the like brought by bone flaps on human bodies and avoiding the influence on functional recovery after the soft tissues such as muscles and the like brought by the bone flaps are fully peeled, thereby providing the jaw bone transplanting and positioning guiding plate.
A jaw bone graft in-place guide plate comprising a guide plate body, the guide plate body comprising: a main board and a plurality of positioning parts positioned on the inner side of the main board, wherein,
the positioning parts are respectively fixed on the mandible stump bone and the transplanted bone, and the main board between the two adjacent positioning parts forms an arch structure, and a gap for accommodating soft tissues is arranged between the arch structure and the mandible stump bone or the transplanted bone.
Further, an arc-shaped surface closely attached to the surfaces of the mandibular residual bone and the transplanted bone is formed on the inner side of the positioning part.
Further, a plurality of positioning parts are provided with fixing holes, and the fixing holes are consistent with the positions of reserved nail holes on the bone of the mandible stump and the bone grafting.
Further, at least two fixing holes are formed in each positioning portion.
Further, each fixing hole is set to be a nail hole of 1.80mm-4.50 mm.
Further, the main board is provided with a kidney-shaped hole along the length direction, a plurality of reinforcing ribs are arranged in the kidney-shaped hole, and two ends of each reinforcing rib are integrally formed with the inner wall of the kidney-shaped hole.
Further, a partition plate is arranged between two adjacent reinforcing ribs, and the partition plate is tightly attached to the reinforcing ribs and the inner walls of the kidney-shaped holes.
Further, the guide plate body is made of photosensitive resin.
Further, the guide plate body is of an integrally formed structure for 3D printing.
The technical scheme of the application has the following advantages:
1. the jaw bone transplanting in-place guide plate provided by the application can accurately guide the transplanted bone to be in place in a bone transplanting operation through the guide plate, and can keep stable reconstruction of the transplanted bone and the damaged bone of the mandible, at the moment, soft tissues such as muscles on the transplanted bone are accommodated in through gaps on the guide plate body, so that soft tissues such as muscles carried in bone flaps of the transplanted bone are not required to be peeled cleanly, soft tissues of bone injuries at the positioning part are only required to be peeled off, the positioning part is convenient to position, and therefore, the functional recovery and facial plumpness after bone transplanting are effectively improved, meanwhile, in clinical research, the absorption of the transplanted bone can be reduced by the muscles, the muscle tissues in bone transplanting can not only reconstruct blood circulation of the transplanted bone tissues, but also can be brought into osteoblasts and various growth factors induced by bones, the formation of new bone is promoted, the repair of the bone tissues is accelerated, the compression and torsion of muscle pedicles can be reduced in the bone transplanting process, the blood circulation of the bone flaps can be protected well, and a solid foundation is laid for the healing of the bone flaps after operation.
2. The jaw bone transplanting in-place guide plate and the fixing holes can be used for fixing the guide plate body and the transplanted bone, so that slippage is avoided when the mandible is reconstructed, errors of operation and a preset operation scheme are reduced, the positions of the fixing holes are consistent with those of nail holes on the transplanted bone and the two mandible stump bones, damage to patients is effectively reduced, and bone is prevented from being damaged when the nail holes are fixed.
3. The guiding plate for the jaw bone grafting in-place, provided by the application, has the advantages that the fixing effect of the guiding plate body and the transplanted bone is better and more stable due to the arrangement of the plurality of fixing holes of each group, so that the stability of the transplanted bone during the reconstruction of the mandible is further improved.
4. According to the jaw bone transplanting guide plate in-place, the reinforcing ribs and the partition plates are arranged in the main plate, so that the structural strength of the guide plate body is effectively enhanced, the guide plate is firm and durable in the operation process, meanwhile, the 3D printed product is not easy to deform, the accuracy of the guide plate is guaranteed, deviation cannot occur, repeated trimming is not needed, the operation time is short, the positioning is accurate, the effect is good, printing materials can be effectively saved, and the production cost is reduced.
5. The jaw bone transplanting in-place guide plate provided by the application has the advantages that the guide plate body is of a 3D printing integrated structure, and the 3D printing technology is utilized, so that the operation is more accurate and reliable.
Drawings
In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present application, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic view showing the installation structure of a jaw bone graft in-place guide plate and a bone graft and a jaw bone stump according to an embodiment of the present application;
FIG. 2 is a schematic view showing the overall structure of a jaw bone graft in-place guide plate according to an embodiment of the present application;
fig. 3 is a schematic inside view of a jaw bone graft in-place guide plate in one embodiment of the present application.
Reference numerals illustrate:
1. transplanting bone; 2. mandibular bone stump; 3. a guide plate body; 31. a main board; 32. a positioning part; 4. a fixing hole; 5. waist-shaped holes; 6. reinforcing ribs; 7. a partition board.
Detailed Description
The following description of the embodiments of the present application will be made apparent and fully in view of the accompanying drawings, in which some, but not all embodiments of the application are shown. All other embodiments, which can be made by those skilled in the art based on the embodiments of the application without making any inventive effort, are intended to be within the scope of the application.
In the description of the present application, it should be noted that the directions or positional relationships indicated by the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. are based on the directions or positional relationships shown in the drawings, are merely for convenience of describing the present application and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present application. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present application, it should be noted that, unless explicitly specified and limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be either fixedly connected, detachably connected, or integrally connected, for example; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present application will be understood in specific cases by those of ordinary skill in the art.
In addition, the technical features of the different embodiments of the present application described below may be combined with each other as long as they do not collide with each other.
Examples
The application is described in further detail below with reference to fig. 1-3.
The utility model provides a guiding plate is taken one's place in jaw grafting, mainly be applied to mandibular repair operation, before processing the guiding plate, scan the defective part of patient's jaw first, utilize medical software to carry out three-dimensional reconstruction to jaw and ilium model, move the three-dimensional model of ilium to jaw bone position and replace original pathological change jaw, find out the ilium section of intercepting that best matches through adjustment ilium model position, angle, length and become bone 1, design ideal operation scheme, carry out three-dimensional modeling to the guiding plate promptly, and guide plate that required is processed out to leading-in 3D printer.
As shown in fig. 1 and 2, the jaw bone graft in-place guide plate in the present embodiment includes a guide plate body 3, the guide plate body 3 includes a main plate 31 and three positioning portions 32 located inside the main plate 31, the main plate 31 is provided along the arrangement direction of the mandibular residual bone 2 and the graft bone 1, the positioning portions 32 and the main plate 31 are integrally formed, wherein two positioning portions 32 are provided on both ends of the main plate 31 in the length direction, respectively, and are fixed on the mandibular residual bone 2, and the other positioning portion 32 is located between the two positioning portions 32 and is fixed on the graft bone 1, thereby guiding the graft bone 1 to be in place accurately in the bone graft operation and maintaining stable reconstruction of the graft bone 1 and the mandibular residual bone 2. And the main board 31 between two adjacent positioning parts 32 forms an arch structure, and a gap for accommodating soft tissues such as muscles is formed between the arch structure and the bone 2 at the stump of the mandible or the bone 1, so that the distance between the main board 31 and the bone 1 is 5mm, and therefore, in the actual operation process, soft tissues such as muscles carried in the bone flap of the bone 1 are not required to be fully stripped, soft tissues such as muscles on other bone 1 are only required to be fully stripped, and soft tissues such as muscles on other bone 1 are accommodated in the gap, thereby effectively avoiding soft tissues such as muscles in the bone flap of the bone 1, reducing damage to the muscles, improving functional recovery and facial fullness after bone grafting, and simultaneously, the absorption of the bone 1 by the muscles can be reduced. Clinically, the muscle tissue in the bone grafting can reconstruct blood circulation of the bone 1 tissue, can bring into osteoblasts and various osteoinductive growth factors, promote new bone formation, accelerate bone tissue repair, reduce compression and torsion of muscle pedicles in the bone grafting process, ensure good blood circulation of bone flaps, and lay a solid foundation for healing of the bone flaps after operation.
As shown in fig. 1 and 3, the positioning portion 32 is formed at an inner side thereof with an arc surface closely adhered to the surfaces of the mandibular bone stump 2 and the bone graft 1, thereby ensuring accurate positioning during the operation, facilitating the fixation of the guide plate body 3 to the bone graft 1 and the mandibular bone stump 2. Two fixing holes 4 are formed in the three positioning portions 32 and used for fixing the guide plate body 3 and the bone grafting 1, so that the bone grafting 1 is prevented from sliding during the operation of reconstructing the mandible, and errors of operation and a preset operation scheme are reduced. The two fixing holes 4 are consistent with the reserved nail holes on the mandibular stump bone 2 and the transplanted bone 1 in position, so that the damage of a patient is effectively reduced, and the bone is prevented from being damaged when the nail holes are fixed. Each fixing hole 4 is a nail hole with the diameter ranging from 1.80mm to 4.50mm, and the guide plate body 3 can be firmly fixed on the bone grafting 1 and the mandible stump 2 through the cooperation of the titanium nails and the fixing holes 4, so that the guide plate body 3 can accurately reconstruct the bone grafting 1 and the mandible stump 2 in operation.
As shown in fig. 1 and 3, the main board 31 is provided with the kidney-shaped hole 5 along its length direction, be equipped with a plurality of strengthening ribs 6 in the kidney-shaped hole 5, the strengthening rib 6 is arranged along main board 31 length direction and is set up, strengthening rib 6 and main board 31 integrated into one piece, be equipped with baffle 7 between two adjacent strengthening ribs 6 simultaneously, baffle 7 is tightly pasted with strengthening rib 6 and kidney-shaped hole 5 inner wall, effectively strengthen the structural strength of leading board body 3, it is more durable in the operation in-process, guarantee the difficult deformation of the product that 3D printed out simultaneously, guarantee the precision of leading board, can not appear the deviation, need not repair repeatedly, the operation time is short, the location is accurate, and is effectual, and can effectively save printing material, reduce manufacturing cost.
As shown in fig. 2, the guide plate body 3 is an integrally formed structure for 3D printing, and the operation can be more accurate and reliable by using the 3D printing technology. In addition, in this embodiment of the application, the guide plate body 3 is made of photosensitive resin material, which has the characteristics of rapid solidification, high molding precision, good surface effect, high mechanical strength, low odor, storage resistance and strong universality, and improves the processing precision degree of the guide plate.
It is apparent that the above examples are given by way of illustration only and are not limiting of the embodiments. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. While still being apparent from variations or modifications that may be made by those skilled in the art are within the scope of the application.

Claims (9)

1. A guiding plate for jaw bone grafting in-place, comprising a guiding plate body (3), characterized in that the guiding plate body (3) comprises: a main plate (31) and a plurality of positioning parts (32) positioned on the inner side of the main plate (31), wherein the positioning parts (32) are respectively fixed on the mandibular residual bone (2) and the transplanted bone (1), and the main plate (31) between two adjacent positioning parts (32) forms an arch structure, and a gap for accommodating soft tissues is arranged between the arch structure and the transplanted bone (1); the gap reduces damage to muscles and improves functional recovery and facial fullness.
2. The jawbone graft in-place guide plate according to claim 1, wherein an arc surface closely fitting the surfaces of the mandibular stump bone (2) and the graft bone (1) is formed inside the positioning part (32).
3. The guiding plate for the jawbone transplanting in place according to claim 1, wherein a plurality of positioning parts (32) are respectively provided with a fixing hole (4), and the fixing holes (4) are consistent with the positions of reserved nail holes on the jawbone stump bone (2) and the transplanting bone (1).
4. A jaw bone graft in-place guide plate according to claim 3, characterized in that the fixation holes (4) on each of the positioning portions (32) are provided with at least two.
5. A jaw bone graft in-place guide plate according to claim 3, characterized in that each of the fixation holes (4) is provided as a nail hole of 1.80-4.50 mm.
6. The guiding plate for the jawbone grafting in-place according to claim 1, wherein the main plate (31) is provided with a kidney-shaped hole (5) along the length direction, a plurality of reinforcing ribs (6) are arranged in the kidney-shaped hole (5), and two ends of each reinforcing rib (6) are integrally formed with the inner wall of the kidney-shaped hole (5).
7. The guiding plate for the jawbone grafting in-place according to claim 6, wherein a partition plate (7) is arranged between two adjacent reinforcing ribs (6), and the partition plate (7) is tightly attached to the reinforcing ribs (6) and the inner wall of the kidney-shaped hole (5).
8. The guiding plate for jaw bone grafting in-place according to claim 1, wherein the guiding plate body (3) is made of photosensitive resin material.
9. The jaw bone graft in-situ guiding plate according to claim 1, wherein: the guide plate book (3) is of an integrated structure for 3D printing.
CN202010948755.XA 2020-09-10 2020-09-10 Jaw bone grafting guide board that takes one's place Active CN112245074B (en)

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CN112245074B true CN112245074B (en) 2023-09-22

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