CN114711888B - Special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery and use method - Google Patents
Special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery and use method Download PDFInfo
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- 238000001356 surgical procedure Methods 0.000 title claims abstract description 34
- 238000000034 method Methods 0.000 title abstract description 19
- 210000004513 dentition Anatomy 0.000 claims abstract description 25
- 230000036346 tooth eruption Effects 0.000 claims abstract description 25
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 10
- 210000002050 maxilla Anatomy 0.000 claims abstract description 9
- 239000011347 resin Substances 0.000 claims description 4
- 229920005989 resin Polymers 0.000 claims description 4
- 210000003484 anatomy Anatomy 0.000 claims description 3
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- 239000010935 stainless steel Substances 0.000 claims description 3
- 239000003814 drug Substances 0.000 abstract description 2
- 208000010392 Bone Fractures Diseases 0.000 description 10
- 206010017076 Fracture Diseases 0.000 description 5
- 238000010146 3D printing Methods 0.000 description 4
- 238000005516 engineering process Methods 0.000 description 3
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- 206010060964 Arterial haemorrhage Diseases 0.000 description 1
- 241000251730 Chondrichthyes Species 0.000 description 1
- 208000004872 Maxillary Fractures Diseases 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 239000010839 body fluid Substances 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
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- 230000007547 defect Effects 0.000 description 1
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- 230000003993 interaction Effects 0.000 description 1
- 210000001847 jaw Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 210000002474 sphenoid bone Anatomy 0.000 description 1
- 230000001954 sterilising 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 disconnection of winged maxillary connection in orthognathic surgery and a use method thereof, belonging to the technical field of clinical medicine and comprising a bent blade osteotome, an angle adjusting rod and individuationA plate; the curved blade osteotome consists of a chisel handle and a curved chisel blade positioned at the tip of the chisel handle, and an osteotome sliding rail is arranged in the middle of the chisel handle; the angle adjusting rod is U-shapedThe angle indicating plate is provided with an angle adjusting hole; the osteotome sliding rails are arranged in a crossing way with the angle adjusting holes and are connected in a sliding way through the sliding component; u-shapeThe two ends of the inner side of the plate fixing clamp are fixed with individuationThe plate is used for being fixed on the maxillary dentition, guaranteeing the relative position fixation of the angle adjusting rod and the maxillary bone, and utilizing the curved blade osteotome with a determined direction to conduct the disconnection of the wing maxillary connection; in the orthognathic surgery process, the osteotome disclosed by the invention is used for performing pterygoid-maxillary connection and disconnection in a precise direction, so that the problem that the direction of a pterygoid-maxillary connection bone seam cannot be determined in the operation is solved, and the risk of pterygoid-pterygoid fracture at the pterygoid-maxillary connection position can be reduced.
Description
Technical Field
The invention belongs to the technical field of clinical medicine, and particularly relates to a special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery and a use method thereof.
Background
Orthognathic surgery is to correct the maxillofacial deformity by using a surgical method to obtain good maxillofacial morphology and occlusion function. In surgery, the maxillary deformity needs to be dissociated before correction. The lower part of the back of the maxilla is connected to the pterygoid process, a site called the ptero-maxillary connection. Because of the special anatomical position of the device, the operation cannot be performed under direct vision, so that the separation and breaking of the pteromaxillary connection needs to be carefully performed, otherwise, the pterygoid process fracture can be caused, and the risk of the intramaxillary arterial hemorrhage is further brought. Research shows that if the intraoperative osteotome can be separated along the bone seam at the connection part of the pterygoid and maxillary, the risk of pterygoid fracture can be obviously reduced.
A common instrument for the disconnection of the pterygoid-maxillary connection in orthognathic surgery is a curved osteotome, and although the pterygoid-maxillary connection can be disconnected, the pterygoid process fracture is often inevitably caused. Aiming at the problem of disconnection of the connection of the upper jaw of the wing, students at home and abroad have related researches and design and invent a plurality of special osteotomes for the connection of the upper jaw of the wing, such as a velvet osteotome or a shark fin osteotome. But the operation is performed on the premise that the direction of the bone seam at the joint of the upper jaw of the wing cannot be determined in the operation, and the defect of blind operation exists.
Thus, how to intraoperatively orient the winged maxillary connection suture and to disconnect the winged maxillary connection of the osteotome in this direction is a current challenge for clinicians.
Disclosure of Invention
The invention aims to provide a special osteotome for precise disconnection of a winged maxillary connection in orthognathic surgery and a use method thereof, wherein the winged maxillary connection is disconnected in a precise direction by using the osteotome in the surgery on the premise of defining the direction of a winged maxillary connection bone fracture before the surgery, so that the problem that the direction of the winged maxillary connection bone fracture cannot be determined in the surgery is solved, and the risk of pterygoid process fracture at the winged maxillary connection is reduced.
The invention is realized by the following technical scheme:
special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery comprises a curved blade osteotome 1, an angle adjusting rod 2 and individuationA plate 3; the curved edge osteotome 1 consists of a chisel handle 6 serving as a main body structure and a curved chisel edge 4 positioned at the tip end of the chisel handle 6, wherein an osteotome sliding rail 5 is arranged in the middle of the chisel handle 6; the angle adjusting lever 2 is formed by U-shaped +.>The plate fixing clamp 10 and the angle indicating plate 18 are fixedly connected, and the angle indicating plate 18 is provided with an angle adjusting hole 19; the osteotome sliding rail 5 of the bent blade 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; said U-shape->The inside two ends of the board fixing clip 10 are fixedly connected with personalized +.>Plate 3, said individualization->The plate 3 is intended to be fixed to the maxillary dentition of a patient.
Further, the bent chisel edge 4 forms an obtuse angle with the axis of the chisel handle 6 so as to adapt to the anatomical structure of the wing maxillary fracture, and the wing maxillary connection can be more conveniently contacted; the chisel handle 6 is terminated with a rough finger grip area 7 for increasing friction and comfort of use.
Further, the sliding assembly is composed of an angle fixing nut 15, an angle fixing sliding block 16 and an angle fixing screw 17, wherein 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, and when the angle is adjusted to a proper angle, the angle adjusting rod 2 is connected with the bent blade osteotome 1 through the angle fixing nut 15 and the angle fixing screw 17 by adjusting the position corresponding to the angle fixing sliding block 16 in the angle adjusting hole 19.
Further, the surface of the angle indicating plate 18 is marked with a scale of 100 ° -120 °, after the direction of the bone fracture at the upper jaw junction of the preoperative wing is determined, the angle fixing slider 16 can be moved to a 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.
Further, the U-shapeThe 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 the direction adjusting screw 13 and the direction adjusting nut 14The positional relationship of the plate retaining clip 10 and the angle indicating plate 18 ensures that the angle indicating plate 18 is parallel to the coronal plane in use.
Further, the U-shapeAn 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 +.>The other side of the plate fixing clamp 10 is locked and fixed through a butterfly nut 8; according to the lips and tongue/cheek tongue of different teeth of patients in operationDiameter, adjusting U-shape->The opening degree of the plate holder 10 ensures individualization +.>The plate 3 is fixed on the maxillary dentition of the patient, thereby ensuring the relative position fixation of the angle adjusting rod 2 and the maxillary bone.
Further, the U-shapeThe inner side both ends of the plate fixing clip 10 are passed +.>Plate fixing nut 11->Plate fixing screw 12 and individualization->The plates 3 are connected.
Further, the personalizingThe 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 lip tongue/cheek tongue surface of the maxillary dentition of the patient, and the personalization is ensured>The plate 3 is fixed on the maxillary dentition of the patient; said personalisation->The middle of the plate 3 is provided with a connecting hole 21 for passing +.>Plate fixing screw 12 and U-shape->The plate fixing clip 10 is attached.
Further, the curved blade osteotome 1 and the angle adjusting rod 2 are both made of medical stainless steel, and are personalizedThe plate 3 is made of a photocurable resin.
Another object of the present invention is to provide a method for using a special osteotome for severed pterygoid-maxillary connection in orthognathic surgery, comprising the steps of:
step one: firstly, according to the maxillary dentition model of a patient, four personalized models are manufactured by utilizing a 3D printing technologyBoard 3, four individuation->The plates 3 are matched in pairs, so that the personalized grooves 20 on the inner sides of the plates are matched with the labial lingual/buccal lingual surfaces of the maxillary dentition on the left side and the maxillary lingual/buccal lingual surfaces on the right side respectively, and the individuation ++ ∈is satisfied when the plates are used in operation>The plate 3 can be in stable and accurate contact with the maxillary dentition;
step two: performing virtual skull reconstruction through CT data of a patient before operation, and measuring an angle between a bone seam at a patient's wing upper jaw joint and a median sagittal plane;
step three: during operation, when the maxilla is fully exposed, the maxilla is personalizedPlate 3 and U-shape->The plate fixing clamp 10 is fixedly connected, and the U-shaped part is adjusted by rotating the butterfly nut 8>The tightness of the plate holder 10 ensures individualization +.>The plate 3 is fixed on the maxillary dentition of the patient; at the same time, the angle indication plate 18 is adjusted to be 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, and the angle indicating plate 18 and the U-shaped +.>A board fixing clip 10;
step four: according to the angle between the bone seam and the median sagittal plane of the wing-maxillary junction measured before operation, the position of the angle fixing slide block 16 corresponding to the angle adjusting hole 19 is adjusted; the direction of the curved blade osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17;
step five: the rough finger holding area 7 of the chisel handle 6 of the curved chisel 1 is held by the hand, the other hand holds the hammer, the curved chisel edge 4 of the chisel 1 is chisel along the seam of the wing upper jaw connection, and the wing upper jaw connection is broken; and the other side is the same, and finally the double-flank upper jaw connection is accurately disconnected.
Compared with the prior art, the invention has the following advantages:
the special osteotome for accurate disconnection of the winged maxillary connection in orthognathic surgery and the use method of the special osteotome solve the technical problems that the direction of the winged maxillary connection bone seam is determined in the surgery and the osteotome is used for accurate disconnection of the winged maxillary connection along the direction; first by measuring and recording the angle of the patient's pterygoid-maxillary joint seam prior to surgery, then personalizing with 3D printing technologyThe plate is fixed on the maxillary dentition, thereby ensuring the relative position fixation of the angle adjusting rod and the maxillary, and then according to the preoperative conditionThe measured angle of the wing upper jaw connecting bone fracture is accurately adjusted to the angle of the bent blade osteotome; from here, can be with the accurate transfer of preoperative measuring angle in the art, when the art carries out wing upper jaw connection and breaks, crooked chisel sword can be accurate along wing upper jaw connection bone seam entering, and the final accurate completion pair flank upper jaw connection breaks to reduce the risk of wing upper jaw junction sphenoid bone wing process fracture.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. Like elements or portions are generally identified by like reference numerals throughout the several figures. In the drawings, elements or portions thereof are not necessarily drawn to scale.
Fig. 1: the embodiment 1 of the invention relates to a three-dimensional structure schematic diagram of a special osteotome with accurate and separated connection of a winged upper jaw in orthognathic surgery;
fig. 2: the embodiment 1 of the invention relates to a three-dimensional structure schematic diagram of a curved edge osteotome of a special osteotome for accurate and discrete connection of a winged upper jaw in orthognathic surgery;
fig. 3: the embodiment 1 of the invention relates to an angle adjusting rod and individuation of a special osteotome for accurate and discrete connection of a winged upper jaw in orthognathic surgerySchematic connection of the plates;
fig. 4: the embodiment 1 of the invention relates to individuation of a special osteotome for accurate and discrete connection of a winged upper jaw in orthognathic surgerySchematic structural view of the plate;
fig. 5: the embodiment 1 of the invention relates to a top view of a special osteotome for accurate and discrete connection of a winged upper jaw in orthognathic surgery;
fig. 6: the side view of the special osteotome for accurate and discrete connection of the winged upper jaw in orthognathic surgery, 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 lever 2 and individuationPlate 3, curved chisel edge 4, osteotome slide rail 5, chisel handle 6, rough finger grip area 7, butterfly nut 8, opening degree adjusting lever 9, U-shaped ∈ ->Plate holder 10>Plate fixing nut 11>Plate set screw 12, direction adjustment screw 13, direction adjustment nut 14, angle fixation nut 15, angle fixation slide 16, angle fixation screw 17, angle indicator plate 18, angle adjustment hole 19, personalized groove 20, connecting hole 21.
Detailed Description
For a clear and complete description of the technical scheme and the specific working process thereof, the following specific embodiments of the invention are provided with reference to the accompanying drawings in the specification:
in the present invention, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally formed; can be mechanically or electrically connected; either directly or indirectly, through intermediaries, or both, may be in communication with each other or in interaction with each other, unless expressly defined otherwise. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances.
In the present invention, unless expressly stated or limited otherwise, a first feature "up" or "down" a second feature may be the first and second features in direct contact, or the first and second features in indirect contact via an intervening medium. Moreover, a first feature being "above," "over" and "on" a second feature may be a first feature being directly above or obliquely above the second feature, or simply indicating that the first feature is level higher than the second feature. The first feature being "under", "below" and "beneath" the second feature may be the first feature being directly under or obliquely below the second feature, or simply indicating that the first feature is less level than the second feature.
In the description of the present specification, a description referring to terms "one embodiment," "some embodiments," "examples," "specific examples," or "some examples," etc., means 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 present invention. In this specification, schematic representations of the above terms are not necessarily directed 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, the different embodiments or examples described in this specification and the features of the different embodiments or examples may be combined and combined by those skilled in the art without contradiction.
Example 1
As shown in FIG. 1, the special osteotome for accurate and discrete connection of the winged maxillary in orthognathic surgery according to the embodiment comprises a curved blade osteotome 1, an angle adjusting lever 2 and individuationThe plate 3, the said curved blade osteotome 1 is made up of chisel handle 6 as the main body structure and curved chisel blade 4 located in tip of chisel handle 6, the middle part of chisel handle 6 has osteotome slide rail 5; the angle adjusting lever 2 is formed by U-shaped +.>The plate fixing clamp 10 and the angle indicating plate 18 are fixedly connected, and the angle indicating plate 18 is provided with an angle adjusting hole 19; the osteotome sliding rail 5 of the bent blade 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; said U-shape->The inside two ends of the board fixing clip 10 are fixedly connected with personalized +.>Plate 3, said individualization->The plate 3 is intended to be fixed to the maxillary dentition of a patient.
In this embodiment, as shown in fig. 2, the curved chisel edge 4 forms an obtuse angle with the axis of the chisel handle 6 to adapt to the anatomical structure of the pterygoid process, so that the pterygoid process can be more conveniently contacted; the chisel handle 6 is terminated with a rough finger grip area 7 for increasing friction and comfort of use.
As shown in fig. 3, in this embodiment, the sliding assembly is composed of an angle fixing nut 15, an angle fixing slider 16 and an angle fixing screw 17, wherein the angle fixing slider 16 is located in the osteotome sliding rail 5 and can slide back and forth in the osteotome sliding rail 5, and when the angle is adjusted to a proper angle, the angle adjusting rod 2 is connected with the curved blade osteotome 1 through the angle fixing nut 15 and the angle fixing screw 17 by adjusting the position corresponding to the angle fixing slider 16 in the angle adjusting hole 19.
In this embodiment, the surface of the angle indicating plate 18 is marked with a scale of 100 ° -120 °, and after the direction of the bone fracture at the upper jaw junction of the preoperative wing is determined, the angle fixing slider 16 is moved to a corresponding angle, and the direction of the curved blade osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17.
In this embodiment, the U-shapeThe 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 means of a direction adjusting screw 13 and a direction adjusting nut 14>The positional relationship of the plate retaining clip 10 and the angle indicating plate 18 ensures that the angle indicating plate 18 is parallel to the coronal plane in use.
In this embodiment, the U-shapeAn 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 +.>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 teeth of patients during operation>The opening degree of the plate holder 10 ensures individualization +.>The plate 3 is fixed on the maxillary dentition of the patient, thereby ensuring the relative position fixation of the angle adjusting rod and the maxilla. Said U-shape->The inner side both ends of the plate fixing clip 10 are passed +.>Plate fixing nut 11->Plate fixing screw 12 and individualization->The plates 3 are connected.
As shown in fig. 4, in the present embodiment, the personalizingThe inner side surface of the plate 3 is provided with personalisationThe shape of the personalized groove 20 is matched with the maxillary dentition labial lingual/buccal lingual surfaces of the patient, so as to ensure the individuation +.>The plate 3 is fixed on the maxillary dentition of the patient; said personalisation->The middle of the plate 3 is provided with a connecting hole 21 for passing +.>Plate fixing screw 12 and U-shape->The plate fixing clip 10 is attached.
In the embodiment, the bent blade 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, the corrosion resistance is strong, and the corrosion is not easy to be corroded by body fluid; personalisationThe plate 3 is made of a photo-curable resin, personalized +_ prepared by 3D printing technique using photo-curable resin>The plate 3 is perfectly matched to the dentition labial lingual/buccal facial morphology of the patient. After successful manufacture, the hardness, the strength and the precision are high, and the stable and accurate contact with dentition during the operation is ensured. After the connection of the upper jaws of the double side wings is accurately separated, the device is disassembled. The main body part bending edge osteotome 1 and the angle adjusting rod 2 can be repeatedly used after cleaning, disinfection and high-pressure sterilization, and individuation +.>Each use of the plate 3 is made specifically for a different patient and must therefore be disposable.
Example 2
The size parameters of the special osteotome for the separation of the pterygoid-maxillary connection in orthognathic surgery of this embodiment are as follows:
the total length of the curved edge osteotome 1 is 167mm, the cross section is rectangular, the length is 16mm, the width is 10mm, the length of the osteotome sliding rail 5 is 35mm, the width is 5mm, the length of the rough finger holding area 7 is 67mm, and the included angle between the curved chisel edge 4 and the chisel handle 6 is 100 degrees.
The whole 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 the angle adjusting rod is personalizedThe plate 3 is fixed to the U-shape +.>After the plate fixing clip 10, the distance is 10mm, U-shaped +.>The plate fixing clip 10 has a height of 27mm and the wing nut 8 has a width of 20mm.
PersonalisationThe overall length of the plate 3 is 20mm, the width is 10mm, the thickness is 5mm, and the personalized groove 20 is 3mm in depth according to the dentition design width and length.
Example 3
The application method of the special osteotome for accurate and disconnection of the winged maxillary connection in orthognathic surgery specifically comprises the following steps:
step one: firstly, according to the maxillary dentition model of a patient, four personalized models are manufactured by utilizing a 3D printing technologyBoard 3, four individuation->The plates 3 are matched in pairs, so that the personalized grooves 20 on the inner sides of the plates are matched with the labial lingual/buccal lingual surfaces of the maxillary dentition on the left side and the maxillary lingual/buccal lingual surfaces on the right side respectively, and the individuation ++ ∈is satisfied when the plates are used in operation>The plate 3 can be in stable and accurate contact with the maxillary dentition;
step two: performing virtual skull reconstruction through CT data of a patient before operation, and measuring an angle between a bone seam at a patient's wing upper jaw joint and a median sagittal plane;
step three: during operation, when the maxilla is fully exposed, the maxilla is personalizedPlate 3 and U-shape->The plate fixing clamp 10 is fixedly connected, and the U-shaped part is adjusted by rotating the butterfly nut 8>The tightness of the plate holder 10 ensures individualization +.>The plate 3 is fixed on the maxillary dentition of the patient; at the same time, the angle indication plate 18 is adjusted to be 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, and the angle indicating plate 18 and the U-shaped +.>A board fixing clip 10;
step four: according to the angle between the bone seam and the median sagittal plane of the wing-maxillary junction measured before operation, the position of the angle fixing slide block 16 corresponding to the angle adjusting hole 19 is adjusted; the direction of the curved blade osteotome 1 is fixed by screwing the angle fixing nut 15 and the angle fixing screw 17;
step five: the rough finger holding area 7 of the chisel handle 6 of the curved chisel 1 is held by the hand, the other hand holds the hammer, the curved chisel edge 4 of the chisel 1 is chisel along the seam of the wing upper jaw connection, and the wing upper jaw connection is broken; and the other side is the same, and finally the double-flank upper jaw connection is accurately disconnected.
The preferred embodiments of the present invention have been described in detail above with reference to the accompanying drawings, but 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 scope of the technical concept of the present invention, and all the simple modifications belong to the protection scope of the present invention.
In addition, the specific features described in the above embodiments may be combined in any suitable manner, and in order to avoid unnecessary repetition, various possible combinations are not described further.
Moreover, any combination of the various embodiments of the invention can be made without departing from the spirit of the invention, which should also be considered as disclosed herein.
Claims (9)
1. Special osteotome for accurate disconnection of winged maxillary connection in orthognathic surgery, which is characterized by comprising a bent blade osteotome (1), an angle adjusting rod (2) and individuationA plate (3); the curved edge osteotome (1) consists of a chisel handle (6) serving as a main body structure and a curved chisel edge (4) positioned at the tip of the chisel handle (6), and an osteotome sliding rail (5) is arranged in the middle of the chisel handle (6); the angle adjusting rod (2) is U-shaped +.>The angle indicating plate comprises a plate fixing clamp (10) and an angle indicating plate (18) which are fixedly connected, wherein an angle adjusting hole (19) is formed in the angle indicating plate (18); the osteotome sliding rail (5) of the curved blade osteotome (1) and the angle adjusting hole (19) of the angle adjusting rod (2) are arranged in a crossing way and are connected together in a sliding way through a sliding component; said U-shape->The two ends of the inner side of the plate fixing clamp (10) are fixedly connected with individuation +>-a board (3), said individualization->The plate (3) is intended to be fixed to the maxillary dentition of a patient.
2. The special osteotome for accurate and discrete connection of the winged upper jaw in orthognathic surgery according to claim 1, wherein the bent chisel edge (4) forms an obtuse angle with the axis of the chisel handle (6) so as to adapt to the anatomical structure of the winged upper jaw, and the winged upper jaw connection can be contacted more conveniently; the end of the chisel handle (6) is provided with a rough finger holding area (7) for increasing friction and comfort level.
3. The special osteotome for precisely disconnecting the wing maxillary connection in orthognathic surgery according to claim 2, wherein the sliding component consists of an angle fixing nut (15), an angle fixing sliding block (16) and an angle fixing screw (17), wherein the angle fixing sliding block (16) is positioned in the osteotome sliding rail (5) and can slide back and forth in the osteotome sliding rail (5), the angle fixing sliding block (16) is adjusted to correspond to the position in the angle adjusting hole (19), and when the angle is adjusted to a proper angle, the angle adjusting rod (2) is connected with the curved blade osteotome (1) through the angle fixing nut (15) and the angle fixing screw (17).
4. A special osteotome for accurate separation of a winged maxillary connection in orthognathic surgery according to claim 3, characterized in that the surface of the angle indication plate (18) is marked with a scale of 100 ° -120 °, and when the direction of the bone gap at the preoperative winged maxillary connection is determined, the angle fixing slider (16) can be moved to a corresponding angle, and the direction of the curved blade osteotome (1) is fixed by screwing the angle fixing nut (15) and the angle fixing screw (17).
5. The special osteotome for accurate and discrete connection of the winged maxillary in orthognathic surgery according to claim 4, wherein the U-shapeThe outer side of one side end part of the plate fixing clamp (10) is connected with the end part of the angle indicating plate (18) through a direction adjusting screw (13) and a direction adjusting nut (14); u-shape can be adjusted by means of a direction adjusting screw (13) and a direction adjusting nut (14)>The positional relationship of the plate retaining clip (10) and the angle indicating plate (18) ensures that the angle indicating plate (18) is parallel to the coronal plane in use.
6. The special osteotome for accurate and discrete connection of the winged maxillary in orthognathic surgery according to claim 5, wherein the U-shapeAn 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 partThe 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 teeth of patients during operation>The opening degree of the plate fixing clip (10) ensures individuality->The plate (3) is fixed on the maxillary dentition of a patient, so that the relative position of the angle adjusting rod (2) and the maxillary bone can be ensured to be fixed.
7. The orthognathic intraoperative pterygoid maxillary connection of claim 6A special osteotome for breaking, characterized in that the U-shaped part is provided withThe two ends of the inner side of the plate fixing clamp (10) are respectively provided with a +.>Plate fixing nut (11)>Plate fixing screw (12) and individuation->The plates (3) are connected.
8. The special osteotome for precise and discrete connection of the winged maxillary in orthognathic surgery of claim 7, wherein the personalizingThe 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 surfaces of the patient, and individuation is guaranteed>The plate (3) is fixed on the maxillary dentition of the patient; said personalisation->The middle of the plate (3) is provided with a connecting hole (21) for passing through +.>Plate fixing screw (12) and U-shape +.>The plate fixing clips (10) are connected.
9. The special osteotome for accurate and discrete connection of the winged maxillary in orthognathic surgery according to claim 8, wherein the bent edge osteotome (1) and the angle adjusting rod (2) are made of medical stainless steel and are personalizedThe plate (3) is made of a photocurable resin.
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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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Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2476255Y (en) * | 2001-04-28 | 2002-02-13 | 中国人民解放军第二军医大学 | Double-edge iliac osteoclasts |
| WO2009128861A1 (en) * | 2008-04-15 | 2009-10-22 | Lonnie Paulos | Surgical chisel assembly and method of use |
| CN203001045U (en) * | 2012-11-15 | 2013-06-19 | 中国人民解放军北京军区总医院 | Mandibular angle osteotome |
| CN203789985U (en) * | 2014-04-17 | 2014-08-27 | 青岛市中心医院 | Adjustable osteotome |
| CN104055555A (en) * | 2014-06-25 | 2014-09-24 | 南京医科大学附属口腔医院 | Osteotome special for sagittal split ramus osteotomy |
| CN208942437U (en) * | 2017-08-07 | 2019-06-07 | 北京大学深圳医院 | The dedicated osteotome of dentistry implant operation |
| CN211583348U (en) * | 2019-12-23 | 2020-09-29 | 中国医学科学院整形外科医院 | Bone dissociation device |
| CN212234734U (en) * | 2020-03-02 | 2020-12-29 | 李璐杰 | Dental osteotome for department of stomatology |
| CN214434565U (en) * | 2020-12-25 | 2021-10-22 | 黄立勋 | Root cutting chisel for tooth root |
| CN114366358A (en) * | 2022-02-10 | 2022-04-19 | 魏晓静 | Inclined plane osteotome tool for lifting maxillary sinus for oral implantation |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104605915A (en) * | 2015-02-10 | 2015-05-13 | 楚德国 | Bone chisel for interior lifting of maxillary sinus |
-
2022
- 2022-04-26 CN CN202210451839.1A patent/CN114711888B/en active Active
Patent Citations (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2476255Y (en) * | 2001-04-28 | 2002-02-13 | 中国人民解放军第二军医大学 | Double-edge iliac osteoclasts |
| WO2009128861A1 (en) * | 2008-04-15 | 2009-10-22 | Lonnie Paulos | Surgical chisel assembly and method of use |
| CN203001045U (en) * | 2012-11-15 | 2013-06-19 | 中国人民解放军北京军区总医院 | Mandibular angle osteotome |
| CN203789985U (en) * | 2014-04-17 | 2014-08-27 | 青岛市中心医院 | Adjustable osteotome |
| CN104055555A (en) * | 2014-06-25 | 2014-09-24 | 南京医科大学附属口腔医院 | Osteotome special for sagittal split ramus osteotomy |
| CN208942437U (en) * | 2017-08-07 | 2019-06-07 | 北京大学深圳医院 | The dedicated osteotome of dentistry implant operation |
| CN211583348U (en) * | 2019-12-23 | 2020-09-29 | 中国医学科学院整形外科医院 | Bone dissociation device |
| CN212234734U (en) * | 2020-03-02 | 2020-12-29 | 李璐杰 | Dental osteotome for department of stomatology |
| CN214434565U (en) * | 2020-12-25 | 2021-10-22 | 黄立勋 | Root cutting chisel for tooth root |
| CN114366358A (en) * | 2022-02-10 | 2022-04-19 | 魏晓静 | Inclined plane osteotome tool for lifting maxillary sinus for oral implantation |
Also Published As
| Publication number | Publication date |
|---|---|
| CN114711888A (en) | 2022-07-08 |
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