CN112790826A

CN112790826A - Intraoral access condyloid process osteotomy guide plate based on three-dimensional printing

Info

Publication number: CN112790826A
Application number: CN202110105706.4A
Authority: CN
Inventors: 司家文; 张雷; 王旭东; 沈国芳
Original assignee: Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
Current assignee: Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
Priority date: 2021-01-26
Filing date: 2021-01-26
Publication date: 2021-05-14

Abstract

The invention relates to the technical field of medical instruments, in particular to an intraoral access condyloid apophysis osteotomy guide plate based on three-dimensional printing, which comprises an integrally formed osteotomy guide plate body, wherein the shape of the osteotomy guide plate body is matched with a preset fit area on the surface of a mandible, and the inner side surface of the osteotomy guide plate body is completely fit with the surface of the mandible when in use; the osteotomy guide plate body is provided with an osteotomy guide part which is attached to the root of the part to be osteotomy of the mandible, a guide surface is arranged on the osteotomy guide part, and the guide surface is set as a reference standard of an osteotomy tangent plane. Because the osteotomy guide part with the guide surface is arranged, the direction of osteotomy operation can be accurately guided, the bone removing position is more accurate, the operation time is reduced, and the problems of increased bleeding, accidental injury, increased postoperative swelling infection risk and the like caused by navigation and excessive bone removal in the operation are avoided.

Description

Intraoral access condyloid process osteotomy guide plate based on three-dimensional printing

Technical Field

The invention relates to the technical field of medical instruments, in particular to an intraoral access condyloid process osteotomy guide plate.

Background

Various benign hyperplastic lesions can occur in the condyles of the mandible, such as excessive condylar hyperplasia, chondromas of the condyles, osteomas of the condyles and the like, so that the elevation of the mandible is high, the occlusion is disordered, and the surface form is deviated.

Currently, for benign proliferative lesions of the condyles, the basic treatment strategies of surgical resection of the condyles of the lesions, restoration of occlusion relation and facial appearance are clinically used, and orthognathic surgery and condylar resection surgery are used as main surgical methods. The traditional condylar resection mainly adopts extraoral approach, opens tissues such as parotid gland, condylar joint capsule and the like through the incision in front of the tragus to expose the diseased condylar and then resects the condylar. In the prior art, personal experience and judgment of an operator are used as guidance to perform the condylar resection operation, so that the operation exposure is insufficient, the resection area is inaccurate, and severe complications such as facial scars, facial nerve injury (traumatic facial paralysis), parotid fistula, temporomandibular joint rigidity and the like can be caused. With the development of the digital oral surgery technology and the progress of the surgical technology, an endoscopic auxiliary external condylar resection surgical technology for intraoral access is created in practice, the digital surgical design and intraoperative navigation guide intraoperative osteotomy position are utilized, the reliability of the technology is verified, the surgical technology can be used for performing personalized accurate osteotomy design according to the specific form and range of lesion of each patient, and various complications of extraoral access are avoided.

However, secondary damage exists because other incisions are needed for placing the surgical navigation registration support; the design position and the actual position have errors due to the looseness of the navigation positioning support; the navigation operation is longer in whole time, and the problems of postoperative swelling, infection, increased bleeding during the operation and the like are caused.

Disclosure of Invention

The invention aims to provide an intraoral access condyloid process osteotomy guide plate based on three-dimensional printing, which can accurately apply a preoperative osteotomy design scheme to an operation without intraoperative navigation so as to guide the condyloid process osteotomy operation and has the advantages of simplicity, effectiveness and low risk.

The purpose of the invention is realized as follows: an intraoral access condyloid process osteotomy guide plate based on three-dimensional printing comprises an integrally formed osteotomy guide plate body, wherein the shape of the osteotomy guide plate body is matched with a preset fit area of the surface of a mandible, and the inner side surface of the osteotomy guide plate body is completely fit with the surface of the mandible when the intraoral access condyloid process osteotomy guide plate is used; cut bone baffle body has the osteotomy guide portion of the root of the part of waiting to cut bone of laminating mandible, cut and be equipped with the spigot surface on the bone guide portion, the spigot surface sets up the reference basis into the osteotomy tangent plane.

The invention has the beneficial effects that:

1. the osteotomy guide part with the guide surface can accurately guide the direction of the osteotomy operation, so that the bone removing position is more accurate, the operation time is reduced, and the problems of increased bleeding, accidental injury, increased postoperative swelling infection risk and the like caused by intraoperative navigation and excessive bone removal are avoided;

2. the preoperative osteotomy design scheme can be accurately applied to the operation without intraoperative navigation so as to guide the condylar osteotomy operation, and the method has the advantages of simplicity, effectiveness and low risk.

Drawings

FIG. 1 is a schematic perspective view of an osteotomy version of the beak projections.

FIG. 2 is another perspective view of an osteotomy version of the beak projection.

FIG. 3 is a perspective view of an osteotomy version of the condylar projection.

In the figure, 1 cuts the bone guide body, 2 cuts the bone guide, 2a guiding surface, 3 coracoid osteotomy locating hole, 4 mandible, 5 coracoid, 6 condylar process, 7 condylar osteotomy locating hole.

Detailed Description

The invention will be further described with reference to the accompanying figures 1-3 and specific examples.

In this embodiment, the beak projections 5 are cut first, followed by the condylar projections 6.

With reference to fig. 1-3, the present embodiment provides a three-dimensional printing-based intraoral access condyloid process bone cutting guide, which structurally includes an integrally formed bone cutting guide body 1, wherein the shape of the bone cutting guide body 1 matches with a predetermined fit area on the surface of the mandible 4, and the inner side surface of the bone cutting guide body 1 completely fits the surface of the mandible 4 during use.

Above-mentioned cut bone baffle body 1 has the osteotomy guide portion 2 of the root of the part of waiting to cut the bone of laminating mandible 4, cut and be equipped with spigot surface 2a on the bone guide portion 2, spigot surface 2a sets up the reference benchmark into the osteotomy tangent plane, spigot surface 2a can align with the osteotomy tangent plane, the direction that can accurately guide the operation of cutting the bone, it is more accurate to make the position of going the bone, reduce operation time, avoid the art in the navigation and too much go the bleeding increase that the bone leads to, accidental damage, postoperative swelling infects the risk and increases the scheduling problem.

In order to enhance the structural strength and ensure the osteotomy positioning accuracy, the osteotomy guide 2 is provided to protrude with respect to the outer lateral surface of the osteotomy guide body 1, the osteotomy guide 2 extends in a flange configuration along the contour line of the osteotomy cut surface, and the guide surface 2a extends along the contour line of the osteotomy cut surface.

In this embodiment, the whole bone cutting guide body 1 is integrally formed by a 3D printing method, when the bone cutting guide body 1 is manufactured, the patient's mandible 4 is scanned and reconstructed by ct, the coracoid portion 5 and the condylar portion 6 which need to be cut are positioned, the bone cutting range and the bone cutting guide body 1 are designed, then the bone cutting guide body 1 is manufactured based on a three-dimensional printing technology, the optimal material of the bone cutting guide body 1 is titanium and titanium alloy materials, and better printing materials are not excluded in the future, that is, the bone cutting guide body is not limited to the materials listed in this embodiment.

When an operation is performed, the bone cutting guide plate body 1 is located on the surface of the mandible 4, the inner side face of the bone cutting guide plate body 1 is tightly attached to the surface of the mandible 4 after being in place, due to the fact that the surface of the mandible 4 is irregular, the unique in-place position consistent with the design can be determined through hand feeling during clamping, the bone cutting guide plate body 1 is temporarily fixed in an ideal position through a mode of drilling a fixed titanium nail into the positioning hole 3, the bone cutting operation of the beak protruding part 5 is performed, the titanium nail is removed after bone removal, and therefore the bone cutting guide plate body 1 is removed.

Since the coracoid portion 5 and the condylar portion 6 are considered to be close to each other, in order to smoothly perform the operation, the coracoid portion 5 relatively forward is cut first and then the condylar portion 6 behind the coracoid portion 5 is cut in the osteotomy.

As shown in fig. 1 and 2, when cutting the beak projection 5, the osteotomy guide body 1 is fitted to the surface close to the beak projection 5 close to the mandible 4, then the root of the beak projection 5 is fitted with the osteotomy guide portion 2 and aligned with the osteotomy cut surface, the osteotomy guide body 1 is provided with two coracoid osteotomy positioning holes 3, one of the coracoid osteotomy positioning holes 3 is close to the osteotomy cut surface of the beak projection 5, two titanium nails are respectively passed through the two coracoid osteotomy positioning holes 3, the osteotomy guide body 1 is fixed to the mandible 4, and two titanium nail positioning points are left on the surface close to the beak projection 5 of the mandible 4 to perform the next operation of cutting the condylar projection 6, thereby locking the osteotomy guide body 1, and then the operation of cutting the beak projection 5 is performed with reference to the guide surface 2 a.

As shown in FIG. 3, after the operation of cutting the beak-like projections 5 is completed, the new osteotomy guide body 1 is replaced to perform the osteotomy operation of the condylar-like projections 6, the osteotomy guide body 1 is provided with two coracoid osteotomy positioning holes 3 and one condylar osteotomy positioning hole 7, the osteotomy guiding portion 2 of the osteotomy guide body 1 is attached to the root of the condylar-like projections 6, the two coracoid osteotomy positioning holes 3 of the osteotomy guide body 1 are exactly corresponding to the two titanium nail positioning points left in the operation of cutting the beak-like projections 5 one by one, the condylar osteotomy positioning hole 7 is close to the osteotomy section of the condylar projections 6, the two coracoid osteotomy positioning holes 3 and the one condylar osteotomy positioning hole 7 both penetrate the titanium nails to perform the position locking of the osteotomy guide body 1, so that the osteotomy guide body 1 can be very stably and accurately locked at the preset position to avoid the dislocation phenomenon of the osteotomy guide body 1 during the osteotomy operation, finally, the operation of cutting the condylar protuberance 6 is performed with reference to the guide surface 2 a.

As can be seen from fig. 1 to 3, both the coracoid osteotomy positioning hole 3 and one of the condylar osteotomy positioning holes 7 have a convex structure protruding from the outer lateral surface of the osteotomy guide body 1, and the positioning hole 3 penetrates through the corresponding convex structure, so that the structure of the titanium nail fixing point is reinforced.

While the preferred embodiments of the present invention have been described, those skilled in the art will appreciate that various changes and modifications can be made therein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims

1. The utility model provides an intraoral access condyloid process cuts bone conduction board based on three-dimensional printing which characterized in that: the bone cutting guide plate comprises an integrally formed bone cutting guide plate body (1), wherein the shape of the bone cutting guide plate body (1) is matched with a preset fit area on the surface of a mandible (4), and the inner side surface of the bone cutting guide plate body (1) is completely fit with the surface of the mandible (4) in use;

cut bone baffle body (1) and have the root of the part of waiting to cut bone of laminating mandible (4) cut bone guide portion (2), cut and be equipped with spigot surface (2a) on bone guide portion (2), spigot surface (2a) set up the reference benchmark for cutting the bone tangent plane.

2. The three-dimensional printing-based intraoral access condyloid process osteotomy guide of claim 1, wherein: cut and be equipped with two at least confession titanium nails on the bone conduction board body (1) and pass in order to cut the locating hole that bone conduction board body (1) was fixed on mandible (4).

3. The three-dimensional printing-based intraoral access condyloid process osteotomy guide of claim 2, wherein: each positioning hole of the osteotomy guide plate body (1) is provided with a boss structure protruding relative to the outer side surface of the osteotomy guide plate body (1), and the positioning hole penetrates through the corresponding boss structure.

4. The three-dimensional printing-based intraoral access condyloid process osteotomy guide of claim 2 or 3, wherein: at least one locating hole is located proximate the osteotomy cut plane.

5. The three-dimensional printing-based intraoral access condyloid process osteotomy guide of claim 1, wherein: the osteotomy guide part (2) is arranged in a protruding way relative to the outer side surface of the osteotomy guide plate body (1).

6. The three-dimensional printing-based intraoral access condyloid process osteotomy guide of claim 5, wherein: the osteotomy guide (2) extends as a flange structure along the contour of the osteotomy cut plane, and the guide surface (2a) extends along the contour of the osteotomy cut plane.