CN114711888A - Special osteotome for accurately separating connection of wing upper jaw and upper jaw in orthognathic surgery and using method - Google Patents
Special osteotome for accurately separating connection of wing upper jaw and upper jaw in orthognathic surgery and using method Download PDFInfo
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- 238000001356 surgical procedure Methods 0.000 title claims abstract description 26
- 238000000034 method Methods 0.000 title claims abstract description 22
- 210000002050 maxilla Anatomy 0.000 claims abstract description 12
- 210000004513 dentition Anatomy 0.000 claims description 27
- 230000036346 tooth eruption Effects 0.000 claims description 27
- 210000000988 bone and bone Anatomy 0.000 claims description 16
- 210000001847 jaw Anatomy 0.000 claims description 15
- 238000000926 separation method Methods 0.000 claims description 6
- 238000010146 3D printing Methods 0.000 claims description 5
- 238000005516 engineering process Methods 0.000 claims description 4
- 239000011347 resin Substances 0.000 claims description 4
- 210000003484 anatomy Anatomy 0.000 claims description 3
- 229920005989 resin Polymers 0.000 claims description 3
- 229910001220 stainless steel Inorganic materials 0.000 claims description 3
- 239000010935 stainless steel Substances 0.000 claims description 3
- 206010023149 Jaw fracture Diseases 0.000 claims 1
- 230000000399 orthopedic effect Effects 0.000 claims 1
- 239000003814 drug Substances 0.000 abstract description 2
- 238000010586 diagram Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000011160 research Methods 0.000 description 2
- 241000251730 Chondrichthyes Species 0.000 description 1
- 239000002390 adhesive tape Substances 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 239000010839 body fluid Substances 0.000 description 1
- 230000007797 corrosion Effects 0.000 description 1
- 238000005260 corrosion Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 239000004053 dental implant Substances 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000001681 protective effect Effects 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/06—Implements for therapeutic treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C3/00—Dental tools or instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C3/00—Dental tools or instruments
- A61C3/02—Tooth drilling or cutting instruments; Instruments acting like a sandblast machine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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Abstract
The invention discloses a special osteotome for accurate connection and disconnection of wing upper jaw and upper jaw in orthognathic surgery and a using method thereof, belonging to the technical field of clinical medicine
A plate; the curved-edge osteotome consists of a chisel handle and a curved chisel edge positioned at the tip of the chisel handle, and an osteotome slide rail is arranged in the middle of the chisel handle; the angle adjusting rod is composed of a U-shaped
The angle indicator is characterized by comprising a plate fixing clamp and an angle indicator plate which are fixedly connected, wherein an angle adjusting hole is formed in the angle indicator plate; the osteotome slide rail and the angle adjusting hole are arranged in a crossed manner and are connected in a sliding manner through a sliding assembly; u shape
The inner two ends of the plate fixing clamp are fixed with individuality
The plate is used for being fixed on a maxillary dental column, ensuring that the relative position of the angle adjusting rod and a maxilla is fixed, and separating the connection of the maxilla and the wing by using the bent blade osteotome with the well determined direction; in the process of orthognathic surgery, the osteotome carries out connection and disconnection of the wing upper jaw in an accurate direction, solves the problem that the direction of the wing upper jaw connection seam cannot be determined in the operation, and can reduce the risk of pterygoid process fracture at the wing upper jaw connection position.
Description
Technical Field
The invention belongs to the technical field of clinical medicine, and particularly relates to a special osteotome for accurately separating a wing upper jaw from a wing upper jaw in orthognathic surgery and a using method thereof.
Background
Orthognathic surgery is to correct the dentognathic face deformity by using a surgical method so as to obtain good maxillofacial form and occlusion function. In the operation, the maxillary deformity needs to be separated before being corrected. The posterior inferior part of the maxilla is connected to the pterygoid process, a region known as the winged maxillary junction. Because of the special anatomical position of the wing, the operation can not be performed under direct vision in the operation, so the separation and the disconnection of the wing-upper jaw connection need extra care, otherwise, the wing process fracture of the sphenoids can be caused, and the risk of the great bleeding of the internal jaw artery is further brought. Research shows that the osteotome can be separated along the seam of the wing-upper jaw connection part during operation, so that the risk of the pterygoid process fracture can be obviously reduced.
At present, a common appliance for connection and disconnection of a wing and an upper jaw in orthognathic surgery is an osteotome with a bend, and although the connection and disconnection of the wing and the upper jaw can be realized, the pterygoid process fracture is often caused inevitably. Aiming at the problem of connection and disconnection of the upper wing and the upper jaw, scholars at home and abroad have related researches and design and invent various special osteotomes for connection of the upper wing and the upper jaw, such as a swan neck osteotome or a shark fin osteotome. However, the operation is carried out on the premise that the direction of the seam at the connection part of the wing and the upper jaw cannot be determined in the operation, and the defect of blind operation exists.
Therefore, how to determine the direction of the alar-maxillary joint seam in the operation and disconnect the alar-maxillary joint along the direction is a difficult problem which is troubled for the clinician at present.
Disclosure of Invention
The invention aims to provide a special osteotome for accurately separating wing upper jaw connection in orthognathic surgery and a using method thereof.
The invention is realized by the following technical scheme:
the utility model relates to a special osteotome for accurate separation of upper wing and upper jaw in orthognathic surgery, which comprises a curved edge osteotome 1, an angle adjusting rod 2 and an individualized osteotome
A plate 3; the curved-edge osteotome 1 is composed of a chisel handle 6 as a main body structure and a curved chisel edge 4 positioned at the tip of the chisel handle 6, and an osteotome slide rail 5 is arranged in the middle of the chisel handle 6; the angle adjusting rod 2 is formed by a U-shaped
The plate fixing clamp 10 is fixedly connected with an angle indicating plate 18, and an angle is arranged on the angle indicating plate 18A degree-adjusting hole 19; the osteotome slide rail 5 of the curved-edge osteotome 1 and the angle adjusting hole 19 of the angle adjusting rod 2 are arranged in a crossed manner and are connected together in a sliding manner through a sliding component; the U shape
The two ends of the inner side of the plate fixing clamp 10 are fixedly connected with individuality
Plate 3, said personalization
The plate 3 is intended to be fixed to the maxillary dentition of a patient.
Furthermore, the bent chisel edge 4 and the axis of the chisel handle 6 form an obtuse angle to adapt to the anatomical structure of the wing maxillofacial cleft, so that the wing maxillofacial cleft can be more conveniently contacted with the wing maxillofacial cleft for connection; the end of the chisel handle 6 is provided with a rough finger grip 7 for increased friction and comfort.
Further, the sliding assembly is composed of an angle fixing nut 15, an angle fixing sliding block 16 and an angle fixing screw 17, the angle fixing sliding block 16 is located in the osteotome sliding rail 5 and can slide back and forth in the osteotome sliding rail 5, the angle adjusting rod 2 is connected with the curved-edge osteotome 1 through the angle fixing nut 15 and the angle fixing screw 17 by adjusting the position of the angle fixing sliding block 16 corresponding to the angle adjusting hole 19 when the angle is adjusted to a proper angle.
Further, the surface of the angle indicating plate 18 is marked with scales of 100 to 120 degrees, and after the seam direction at the front wing upper jaw joint is determined, the angle fixing slider 16 can be moved to a corresponding angle, and the direction of the bent blade osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17.
Further, the U shape
The outer side of one side end part of the plate fixing clamp 10 is connected with the end part of an angle indicating plate 18 through a direction adjusting screw 13 and a direction adjusting nut 14; can be adjusted by the direction adjusting screw 13Nut 14 adjusting U shape
The positional relationship of the plate retaining clip 10 and the angle indicator plate 18 ensures that the angle indicator plate 18 is parallel to the coronal plane during use.
Further, the U shape
An opening degree adjusting rod 9 is arranged inside the plate fixing clamp 10, and one end of the opening degree adjusting rod 9 penetrates through the U-shaped part
The other side of the plate fixing clamp 10 is locked and fixed through a butterfly nut 8; the U shape can be adjusted according to the lip-tongue/cheek-tongue diameter of different patients' teeth in operation
The degree of opening of the plate fixing clip 10 ensures individualization
The plate 3 is fixed on the maxillary dentition of the patient, so that the relative position of the angle adjusting rod 2 and the maxilla can be ensured to be fixed.
Further, the U shape
The inner ends of the plate fixing clips 10 are passed through
Plate fixing nut 11 and
plate fixing screw 12 and personalization
The plates 3 are connected.
Further, the personalization
The inner side surface of the plate 3 is provided with a personalized groove 20, the shape of the personalized groove 20 is matched with the maxillo-mandibular dentition labial-lingual/buccal-lingual surface of a patient, and the personalized groove is ensured
The plate 3 is fixed on the maxillary dentition of the patient; the personalization
The middle of the plate 3 is provided with a connection hole 21 for passing through
Plate fixing screw 12 and U-shape
The board fixing clips 10 are connected.
Furthermore, the curved edge osteotome 1 and the angle adjusting rod 2 are both made of medical stainless steel and are personalized
The board 3 is made of a photo-curable resin.
The invention also aims to provide a use method of the special osteotome for connecting and disconnecting the upper wing and the upper jaw in orthognathic surgery, which comprises the following steps:
the method comprises the following steps: firstly, according to the maxillary dentition model of a patient, four personalized teeth are manufactured by using a 3D printing technology
Plate 3, four personalized
The plates 3 are paired pairwise to ensure that the personalized grooves 20 on the inner sides of the plates are respectively matched with the labial/buccal-lingual surfaces of the maxillary dentition on the left and right sides, so that the requirement of personalization during the operation is met
The plate 3 can be connected withStable and accurate contact of maxillary dentition;
step two: performing virtual skull reconstruction through CT data of a patient before an operation, and measuring an angle formed by a bone seam at the wing-upper jaw connection part of the patient and a median sagittal plane;
step three: in operation, when the maxilla is fully exposed, the individual can be used
Plate 3 and U-shape
The plate fixing clips 10 are connected and fixed, and the U shape is adjusted by rotating the butterfly nuts 8
The tightness of the plate fixing clip 10 ensures individualization
The plate 3 is fixed on the maxillary dentition of the patient; at the same time, the angle-adjusting indicator plate 18 is U-shaped
The positional relationship of the plate retaining clip 10 ensures that the angle indicator plate 18 is parallel to the coronal plane; the direction adjusting screw 13 and the direction adjusting nut 14 are screwed down to fix the angle indicating plate 18 and the U shape
A board fixing clip 10;
step four: according to the angle between the seam of the wing upper jaw connection part and the median sagittal plane measured before the operation, the corresponding position of the angle fixing slide block 16 in the angle adjusting hole 19 is adjusted; the direction of the curved-edge osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17;
step five: holding the rough finger-holding area 7 of the chisel handle 6 of the curved osteotome 1 by hand, holding the bone hammer by the other hand, chiseling the curved chisel edge 4 of the osteotome 1 along the bone seam connected with the wing upper jaw, and separating the wing upper jaw connection; the other side is the same, and the accurate separation of the double-side wing upper jaw connection is finally completed.
Compared with the prior art, the invention has the following advantages:
the special osteotome for accurately separating the wing upper jaw connection in the orthognathic operation and the use method solve the technical problems of determining the direction of the wing upper jaw connection bone seam in the operation and accurately separating the wing upper jaw connection along the direction of the osteotome; firstly, the wing upper jaw connection bone seam angle of a patient is measured and recorded before operation, and then individuation is made by using a 3D printing technology
The plate is fixed on the maxillary dentition, so that the relative position of the angle adjusting rod and the maxilla can be ensured to be fixed, and then the angle of the bent blade osteotome is accurately adjusted according to the angle of the wing maxilla connection bone seam measured before the operation; from this, can with the accurate transfer of the angle of measurement before the art to the art in, when carrying out wing upper jaw connection in the art and break off, the crooked chisel edge can be accurate get into along wing upper jaw connection bone seam, and final accurate completion double flank upper jaw connection breaks off to reduce wing upper jaw junction pterygoid process fracture's risk.
Drawings
In order to more clearly illustrate the detailed description of the invention or the technical solutions in the prior art, the drawings used in the detailed description or the prior art description will be briefly described below. Throughout the drawings, like elements or portions are generally identified by like reference numerals. In the drawings, elements or portions are not necessarily drawn to scale.
FIG. 1: the invention discloses a three-dimensional structure schematic diagram of a special osteotome for a wing upper jaw connection accurate separation special osteotome in orthognathic surgery, which is disclosed by embodiment 1;
FIG. 2: the invention discloses a three-dimensional structure schematic diagram of a bent-edge osteotome of a special osteotome for accurately separating winged upper jaw in orthognathic surgery, which is disclosed by embodiment 1;
FIG. 3: the angle adjusting rod and the individuation of the special osteotome for accurately separating the upper wing and the upper jaw in orthognathic surgery in the embodiment 1 of the invention
A schematic connection of the plates;
FIG. 4: individuation of special osteotome for accurately separating wing upper jaw connection in orthognathic surgery in embodiment 1 of the invention
A schematic structural view of the panel;
FIG. 5: the invention relates to a plan view of a special osteotome for accurately separating wing upper jaw in orthognathic surgery, which is disclosed by embodiment 1;
FIG. 6: the side view of the special osteotome for precisely separating the wing upper jaw in orthognathic operation, which is disclosed by the embodiment 1 of the invention;
the names of the parts in the figure are: curved edge osteotome 1, angle adjusting rod 2, individuation
Plate 3, bent chisel edge 4, osteotome slide rail 5, chisel handle 6, rough finger holding area 7, butterfly nut 8, opening degree adjusting rod 9, U-shaped
A plate fixing clip 10,
A plate fixing nut 11,
The angle adjusting device comprises a plate fixing screw 12, a direction adjusting screw 13, a direction adjusting nut 14, an angle fixing nut 15, an angle fixing slide block 16, an angle fixing screw 17, an angle indicating plate 18, an angle adjusting hole 19, a personalized groove 20 and a connecting hole 21.
Detailed Description
For clearly and completely describing the technical scheme and the specific working process thereof, the specific implementation mode of the invention is as follows by combining the attached drawings of the specification:
in the present invention, unless otherwise expressly stated or limited, the terms "mounted," "connected," "secured," and the like are to be construed broadly and can, for example, be fixedly connected, detachably connected, or integrally formed; can be mechanically or electrically connected; they may be directly connected or indirectly connected through intervening media, or they may be interconnected within two elements or in a relationship where two elements interact with each other unless otherwise specifically limited. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
In the present invention, unless otherwise expressly stated or limited, the first feature "on" or "under" the second feature may be directly contacting the first and second features or indirectly contacting the first and second features through an intermediate. Also, a first feature "on," "over," and "above" a second feature may be directly or diagonally above the second feature, or may simply indicate that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature may be directly under or obliquely under the first feature, or may simply mean that the first feature is at a lesser elevation than the second feature.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Example 1
As shown in fig. 1, the special osteotome for accurate connection and disconnection of upper and lower jaws in orthognathic surgery comprises a curved-edge osteotome 1, an angle adjusting rod 2 and a personalized osteotome
The bone chisel with the bent edge comprises a plate 3, wherein the bone chisel with the bent edge 1 consists of a chisel handle 6 serving as a main body structure and a bent chisel edge 4 positioned at the tip of the chisel handle 6, and an bone chisel slide rail 5 is arranged in the middle of the chisel handle 6; the angle adjusting rod 2 is formed by a U-shaped
The angle indicator is characterized by comprising a plate fixing clamp 10 and an angle indicator plate 18 which are fixedly connected, wherein an angle adjusting hole 19 is formed in the angle indicator plate 18; the osteotome slide rail 5 of the curved-edge osteotome 1 and the angle adjusting hole 19 of the angle adjusting rod 2 are arranged in a crossed manner and are connected together in a sliding manner through a sliding component; the U shape
The two ends of the inner side of the plate fixing clamp 10 are fixedly connected with individuality
Plate 3, said personalization
The plate 3 is intended to be fixed to the maxillary dentition of a patient.
As shown in fig. 2, in the present embodiment, the bent chisel edge 4 and the axis of the chisel handle 6 form an obtuse angle to adapt to the anatomy of the maxillofacial cleft wing, so that the maxillofacial cleft wing can be more conveniently contacted for connection; the end of the chisel handle 6 is provided with a rough finger grip 7 for increased friction and comfort.
As shown in fig. 3, in the present embodiment, the sliding assembly is composed of an angle fixing nut 15, an angle fixing slider 16 and an angle fixing screw 17, the angle fixing slider 16 is located in the osteotome slide rail 5 and can slide back and forth in the osteotome slide rail 5, and the angle adjusting rod 2 is connected to the curved-edge osteotome 1 by adjusting the corresponding position of the angle fixing slider 16 in the angle adjusting hole 19 and by adjusting the angle fixing nut 15 and the angle fixing screw 17 when the angle is adjusted to a proper angle.
In this embodiment, the surface of the angle indicating plate 18 is marked with scales of 100 to 120 degrees, and after the seam direction at the front wing upper jaw joint is determined, the angle fixing slider 16 can be moved to a corresponding angle, and the direction of the bent blade osteotome 1 can be fixed by screwing the angle fixing nut 15 and the angle fixing screw 17.
In this embodiment, the U-shape
The outer side of one side end part of the plate fixing clamp 10 is connected with the end part of an angle indicating plate 18 through a direction adjusting screw 13 and a direction adjusting nut 14; the U-shape can be adjusted by a direction adjusting screw 13 and a direction adjusting nut 14
The positional relationship of the plate retaining clip 10 to the angle indicator plate 18 ensures that the angle indicator plate 18 is parallel to the coronal plane when in use.
In this embodiment, the U-shape
An opening degree adjusting rod 9 is arranged inside the plate fixing clamp 10, and one end of the opening degree adjusting rod 9 penetrates through the U-shaped part
The other side of the plate fixing clamp 10 is locked and fixed through a butterfly nut 8; the U shape can be adjusted according to the lip-tongue/cheek-tongue diameter of different patients' teeth in operation
The degree of opening of the plate fixing clip 10 ensures individualization
The plate 3 is fixed on the maxillary dentition of the patient, so that the relative position of the angle adjusting rod and the maxillary bone can be ensured to be fixed. The U shape
The inner ends of the plate fixing clips 10 are passed through
Plate fixing nut 11 and
plate fixing screw 12 and personalization
The plates 3 are connected.
In the present embodiment, the personalization is performed as shown in fig. 4
The inner side surface of the plate 3 is provided with a personalized groove 20, the shape of the personalized groove 20 is matched with the maxillo-mandibular dentition labial-lingual/buccal-lingual surface of a patient, and the personalized groove is ensured
The plate 3 is fixed on the maxillary dentition of the patient; the personalization
The middle of the plate 3 is provided with a connection hole 21 for passing through
Plate fixing screw 12 and U-shape
The board fixing clips 10 are connected.
In the embodiment, the curved-edge osteotome 1 and the angle adjusting rod 2 are both made of medical stainless steel, so that the strength is high, the deformation is not easy to occur, the corrosion resistance is high, and the body fluid is not easy to corrode; personalization
The plate 3 is made of a light-curable resin, personalised by 3D printing techniques using light-curable resins
The plate 3 exactly matches the patient's denticleotis/bucco-lingual morphology. After the manufacture is successful, the adhesive tape is manufactured,the hardness, the strength and the precision are high, and the stable and accurate contact with dentition can be ensured when the dental implant is used in the operation. After the connection of the upper jaw with the double side wings is accurately broken, the device is dismantled. The main body part curved edge osteotome 1 and the angle adjusting rod 2 can be repeatedly used after being cleaned, disinfected and autoclaved, and are personalized
The plate 3 is made specific to each patient for each use and therefore must be disposable.
Example 2
The size parameters of the special osteotome for connection and disconnection of the upper wing and the upper jaw in the orthognathic surgery of the embodiment are as follows:
the total length of curved sword osteotome 1 is 167mm, and the cross section is the rectangle, and is long for 16mm, and wide for 10mm, osteotome slide rail 5 length is 35mm, and the width is 5mm, and the coarse finger grip 7 length is 67mm, and the crooked chisel edge 4 is 100 with the contained angle that chisel handle 6 was formed.
The integral length of the angle adjusting rod 2 is 54mm, the width of the angle indicating plate is 8mm, the length of the angle adjusting hole 19 is 10mm, and individuation is realized
The plate 3 being secured to the U-shape
The distance is 10mm and U-shaped after the plate fixing clip 10
The plate retaining clip 10 is 27mm in height and the wing nut 8 is 20mm in width.
Personalization
The overall length of the plate 3 is 20mm, the width is 10mm, the thickness is 5mm, the width and the length of the personalized groove 20 are designed according to dentition, and the depth is 3 mm.
Example 3
The use method of the special osteotome for accurately separating the upper wing jaw in the orthognathic operation specifically comprises the following steps:
the method comprises the following steps: firstly, according to the maxillary dentition model of a patient, four personalized teeth are manufactured by using a 3D printing technology
Plate 3, four personalized
The plates 3 are paired pairwise to ensure that the personalized grooves 20 on the inner sides of the plates are respectively matched with the labial/buccal-lingual surfaces of the maxillary dentition on the left and right sides, so that the requirement of personalization during the operation is met
The plate 3 can be stably and accurately contacted with the maxillary dentition;
step two: performing virtual skull reconstruction through CT data of a patient before an operation, and measuring an angle formed by a bone seam at the connection part of the wing upper jaw and the median sagittal plane of the patient;
step three: in operation, when the maxilla is fully exposed, the individual can be used
Plate 3 and U-shape
The plate fixing clamps 10 are connected and fixed, and the U shape is adjusted by rotating the butterfly nuts 8
The tightness of the plate fixing clip 10 ensures individualization
The plate 3 is fixed on the maxillary dentition of the patient; at the same time, the angle-adjusting indicator plate 18 is U-shaped
The positional relationship of the plate retaining clip 10 ensures that the angle indicating plate 18 is parallel to the coronal plane; the direction adjusting screw 13 and the direction adjusting nut 14 are screwed down to fix the angle indicating plate 18 and the U shape
A board fixing clip 10;
step four: according to the angle between the seam of the wing upper jaw connection part and the median sagittal plane measured before the operation, the corresponding position of the angle fixing slide block 16 in the angle adjusting hole 19 is adjusted; the direction of the curved-edge osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17;
step five: holding the rough finger-gripping area 7 of the chisel handle 6 of the curved osteotome 1 by hand, holding the bone hammer by the other hand, chiseling the curved chisel edge 4 of the osteotome 1 along the bone seam of the wing upper jaw connection, and separating the wing upper jaw connection; the other side is the same, and the accurate separation of the double-side wing upper jaw connection is finally completed.
The preferred embodiments of the present invention have been described in detail with reference to the accompanying drawings, however, the present invention is not limited to the specific details of the above embodiments, and various simple modifications can be made to the technical solution of the present invention within the technical idea of the present invention, and these simple modifications are within the protective scope of the present invention.
It should be noted that the various technical features described in the above embodiments can be combined in any suitable manner without contradiction, and the invention is not described in any way for the possible combinations in order to avoid unnecessary repetition.
In addition, any combination of the various embodiments of the present invention can be made, and the same should be considered as the disclosure of the present invention as long as the idea of the present invention is not violated.
Claims (10)
1. The utility model discloses a special osteotome that wing upper jaw connects accurate disconnection in orthognathic art, which is characterized in that, including curved edge osteotome (1), angle adjusting rod (2) and individualized osteotome
A plate (3); the curved-edge osteotome (1) consists of a chisel handle (6) as a main body structure and a curved chisel edge (4) positioned at the tip of the chisel handle (6),an osteotome slide rail (5) is arranged in the middle of the chisel handle (6); the angle adjusting rod (2) is formed by a U-shaped rod
The angle indicator is characterized by comprising a plate fixing clamp (10) and an angle indicator plate (18) which are fixedly connected, wherein an angle adjusting hole (19) is formed in the angle indicator plate (18); an osteotome slide rail (5) of the curved-edge osteotome (1) and an angle adjusting hole (19) of the angle adjusting rod (2) are arranged in a crossed manner and are connected together in a sliding manner through a sliding component; the U shape
The two ends of the inner side of the plate fixing clamp (10) are fixedly connected with individuality
A plate (3), said personalization
The plate (3) is used for being fixed on the maxillary dentition of a patient.
2. The special osteotome for accurately separating the upper wing jaw from the upper wing jaw in orthognathic surgery as claimed in claim 1, wherein the bent chisel edge (4) and the axis of the chisel handle (6) form an obtuse angle to adapt to the anatomy structure of the upper wing jaw fracture and can be more conveniently contacted with the upper wing jaw for connection; the end part of the chisel handle (6) is a rough finger grip area (7) for increasing the friction force and the use comfort.
3. The special osteotome for precise connection and disconnection of upper and lower jaws of orthopedics wing and jaw in claim 2, wherein the sliding component comprises an angle fixing nut (15), an angle fixing slider (16) and an angle fixing screw (17), the angle fixing slider (16) is positioned in the osteotome slide rail (5) and can slide back and forth in the osteotome slide rail (5), and the angle adjusting rod (2) is connected with the curved-edge osteotome (1) by adjusting the corresponding position of the angle fixing slider (16) in the angle adjusting hole (19) and the angle fixing screw (17) when the angle is adjusted to a proper angle.
4. The special osteotome for precise connection and disconnection of upper and lower wing jaw in orthognathic surgery as claimed in claim 3, wherein the surface of said angle indicator plate (18) is marked with scales of 100 ° -120 °, when the seam direction at the connection of upper and lower wing jaw before surgery is determined, the angle fixing slider (16) can be moved to the corresponding angle, and the direction of the curved blade osteotome (1) can be fixed by screwing the angle fixing nut (15) and the angle fixing screw (17).
5. The special osteotome for accurate connection and disconnection of winged upper jaw in orthognathic surgery as claimed in claim 4, wherein said U-shape
The outer side of one side end part of the plate fixing clamp (10) is connected with the end part of an angle indicating plate (18) through a direction adjusting screw (13) and a direction adjusting nut (14); the U shape can be adjusted by a direction adjusting screw (13) and a direction adjusting nut (14)
The position relationship between the plate fixing clamp (10) and the angle indicating plate (18) ensures that the angle indicating plate (18) is parallel to the coronal plane when in use.
6. The special osteotome for accurate connection and disconnection of winged upper jaw in orthognathic surgery as claimed in claim 5, wherein said U-shape
An opening degree adjusting rod (9) is arranged in the plate fixing clamp (10), and one end of the opening degree adjusting rod (9) penetrates through the U-shaped part
The other side of the plate fixing clamp (10) is locked and fixed through a butterfly nut (8); the U shape can be adjusted according to the lip-tongue/cheek-tongue diameter of different patients' teeth in operation
The opening degree of the plate fixing clip (10) ensures individualization
The plate (3) is fixed on the maxillary dentition of the patient, thereby ensuring that the relative position of the angle adjusting rod (2) and the maxilla is fixed.
7. The special osteotome for accurate connection and disconnection of winged upper jaw in orthognathic surgery as claimed in claim 6, wherein said U-shape
The two ends of the inner side of the plate fixing clamp (10) pass through
Plate fixing nut (11) and
plate set screw (12) and personalization
The plates (3) are connected.
8. The special osteotome for accurate connection and disconnection of winged maxilla in orthognathic surgery of claim 7, wherein said individualization comprises
The inner side surface of the plate (3) is provided with a personalized groove (20), the shape of the personalized groove (20) is matched with the maxillary dentition labial lingual/buccal lingual surface of a patient, and the personalized groove is ensured
The plate (3) is fixed on the maxillary dentition of the patient; the personalization
The middle of the plate (3) is provided with a connecting hole (21) for passing through
Plate fixing screw (12) and U-shape
The board fixing clips (10) are connected.
9. The special osteotome for accurate connection and disconnection of upper and lower jaws in orthognathic surgery as claimed in claim 8, wherein said curved blade osteotome (1) and angle adjusting rod (2) are made of medical stainless steel and are personalized
The plate (3) is made of a photocurable resin.
10. The method for using the special osteotome for connection and disconnection of upper and lower jaws in orthognathic surgery according to claim 1, comprising the following steps:
the method comprises the following steps: firstly, according to the maxillary dentition model of a patient, four personalized teeth are manufactured by using a 3D printing technology
Plate (3), four personalized
The plates (3) are paired pairwise to ensure that the personalized grooves (20) on the inner sides of the plates are respectively matched with the labial/buccal lingual surfaces of the maxillary dentition on the left and right sides, so that the requirement of personalized use in operation is met
The plate (3) can be stably and accurately contacted with the maxillary dentition;
step two: performing virtual skull reconstruction through CT data of a patient before an operation, and measuring an angle formed by a bone seam at the connection part of the wing upper jaw and the median sagittal plane of the patient;
step three: in operation, when the maxilla is fully exposed, the individual can be used
Plate (3) and U-shape
The plate fixing clamps (10) are connected and fixed, and the U shape is adjusted by rotating the butterfly nuts (8)
The tightness of the plate fixing clip (10) ensures individuality
The plate (3) is fixed on the maxillary dentition of the patient; at the same time, the angle adjusting indicator board (18) and the U-shape
The position relation of the plate fixing clamp (10) ensures that the angle indicating plate (18) is parallel to the coronal plane; a direction adjusting screw (13) and a direction adjusting nut (14) are screwed down, and an angle indicating plate (18) and a U-shaped are fixed
A plate fixing clip (10);
step four: according to the angle formed by the seam of the wing upper jaw connection part and the median sagittal plane measured before the operation, the corresponding position of the angle fixing slide block (16) in the angle adjusting hole (19) is adjusted; the direction of the curved-edge osteotome (1) is fixed by screwing the angle fixing nut (15) and the angle fixing screw (17);
step five: holding the rough finger holding area (7) of the chisel handle (6) of the bent osteotome (1) by a hand, holding the bone hammer by the other hand, chiseling the bent chisel edge (4) of the osteotome (1) along the bone seam connected with the wing upper jaw, and separating the wing upper jaw connection; the other side is the same, and the accurate separation of the double-side wing upper jaw connection is finally completed.
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| CN202210451839.1A CN114711888B (en) | 2022-04-26 | 2022-04-26 | Special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery and use method |
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| CN202210451839.1A CN114711888B (en) | 2022-04-26 | 2022-04-26 | Special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery and use method |
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Also Published As
| Publication number | Publication date |
|---|---|
| CN114711888B (en) | 2024-03-08 |
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