CN114948288B

CN114948288B - Navigation device for assisting implantation of maxillary bone arch expander implantation anchorage nail

Info

Publication number: CN114948288B
Application number: CN202210541441.7A
Authority: CN
Inventors: 郭玖思; 韩向龙; 杨兴强; 尹一佳
Original assignee: Sichuan University
Current assignee: Sichuan University
Priority date: 2022-05-17
Filing date: 2022-05-17
Publication date: 2023-02-03
Anticipated expiration: 2042-05-17
Also published as: CN114948288A

Abstract

The invention provides a navigation device for assisting in implanting an anchorage nail of a maxillary bone arch expander, which comprises a guide hole, an annular elastic clamping device and a cross mortise and tenon structural connecting piece, wherein the annular elastic clamping device is arranged on the guide hole; the position of the guide hole is matched with the position of an implanting opening of the implant nail of the MSE spiral expander, the inclination angle and the hole height of the guide hole are matched with the planned implanting angle and depth of the implant nail, and the inner diameter of the guide hole is matched with a special screwdriver for implanting the implant nail; the turning part of the outer edge of the guide hole is provided with an annular recess. The invention has the advantages of nesting and fixing, accurate positioning, stable fixing, universal device, low cost, small and exquisite structure, nesting on a spiral expander of the MSE, positioning the MSE through a belt ring, then mounting the MSE, implanting an anchorage nail under the assistance of a guide plate, and then taking out the anchorage nail, thereby facilitating clinical operation.

Description

Navigation device for assisting implantation of maxillary bone arch expander implantation anchorage nail

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a navigation device for assisting implantation of an implantation anchorage nail of a maxillary bone arch expander.

Background

Transverse maxillary dysplasia (MTD) is a clinically common malocclusion deformity with the main clinical manifestations: inconsistent width of upper and lower dental arches, retroocclusal occlusion, crowding of dentition, inclination of incisor lips, widening of buccal vestibular sulcus space, and the like. The spontaneous correction rate of MTD is very low, and if the MTD is corrected improperly and properly, the MTD may cause the adverse consequences of periodontal tissue damage, functional shift of mandible, functional disorder of joint muscles, sleep apnea syndrome and the like, and may cause adverse effects on the functions of the oral and jaw systems and the beauty of the face of a patient.

A Maxillary bone Expander (MSE) is an orthodontic treatment device for solving the transverse Maxillary hypoplasia (fig. 1). MSE consists of 3 parts: 1) A spiral expander with 4 micro-planting nail positioning holes (the inner diameter is 1.8mm, and the thickness is 2 mm); 2) 4 extendable support arms; 3) The bilateral maxillary first molar cast band ring. The screw expander is placed near the junction of the soft palate and the hard palate at the rear part of the palate, and the positioning holes at the four corners of the screw expander can guide the micro-implant nail to be implanted into the correct position and prevent the implant nail from inclining. The support arms and molar cast band loop guide the appliance close to the palatal mucosa and increase stability during expansion of the arch.

Four planting anchorage nails of MSE are implanted into the maxillary cortex of bone for fixing the position of the arch expander and transmitting the expansion force generated by the device to the maxilla, thereby achieving the purpose of bony arch expansion (figure 2). The position and direction of the anchorage pin play a crucial role in the correct positioning and functioning of the MSE. In clinical use, the clinician needs to manually implant 4 micro-implants (1.8 mm diameter, 9, 11, 13mm length) into the seating hole, and remain parallel to each other in the lateral direction. The anterior 2 pieces are slightly anteverted to implant the thicker near palatal curvature area of the bone and the posterior 2 pieces are implanted in the thinner area of the bone to penetrate the double cortical bone. However, the operation difficulty is high, the technical level of clinicians is not uniform, the problems of improper implantation position, poor parallelism and the like of the implantation nail often occur in the treatment process, and the MSE is influenced to play the role.

At present, an implantation guide plate device (figure 3) is commonly adopted in the operations of implantation of implants planted in the oral cavity and the like, and parameters such as the implantation direction, position, depth and the like of the implants are limited through a guide plate limiting hole, so that the implantation accuracy of an implantation nail is greatly improved, the technical threshold of doctor operation is reduced, the implantation treatment effect is improved, and the technical popularization and the clinical application are facilitated. The invention aims to apply the idea of the implant guide plate to MSE planting anchorage nail implantation operation, and manufactures the navigation device for assisting the planting anchorage nail implantation of the maxillary bone arch expander.

The invention patent CN202021994748.5 provides an arch expander, a guide plate for assisting the arch expander to wear and a bone anchorage arch expanding device, and a 3D model of soft and hard tissues of the upper jaw of a patient is obtained; the arch expander and the guide plate are designed according to the upper jaw model of the patient, the shape of the arch expander is matched with the palate part of the patient, the guide plate is attached to the palate part and part of the tooth surface of the patient, the arch expander is provided with a position fixing hole for implanting an anchorage nail, and the guide plate is provided with a position fixing groove for accommodating the arch expander, a gap between the arch expander and the palate part and a position hole channel corresponding to the position fixing hole. When the arch expander is applied, the arch expander and the guide plate are positioned together to be in position with the upper jaw of a patient, the side wall of the tooth surface generates a fixing force, and the position and the direction of implantation of the implant nail are limited by the guide plate positioning hole, so that the aim of guiding the implantation of the implant nail is fulfilled.

This technique has the following disadvantages:

1. poor retention. The technology adopts a guide plate attached to the maxillary posterior dentition to achieve retention, namely, the guide plate is attached to 1/3 tooth surfaces of at least four teeth of first premolar, second premolar and first molar on two sides of a patient, so that stable support is obtained, and operation precision is maintained. However, the above-mentioned tooth surfaces are all non-undercut areas of the tooth body, and the guide plate is only "covered" on the tooth surface rather than "fixed" on the tooth surface, and the guide plate is very easy to dislocate due to the self-gravity of the guide plate and the movement of the cheek muscles when the patient opens the mouth. In practical clinical application, the MSE comprises a first maxillary bilateral molar belt ring, and accurate positioning and stable retention of the MSE are realized through the belt ring.

2. The customization cost is high. The arch expander and the guide plate of the technology are both manufactured by casting or printing according to the upper jaw model of the patient, and the manufacturing cost is very high. In practical clinical application, because the dentition and the dental arch form of each patient are different, the belt ring and the stretching support arm part of the MSE device need to be personalized and customized after the upper jaw model of the patient is obtained. However, the shape of the spiral expander with 4 micro-implant nail locating holes in the center of MSE and the positions of the locating holes are fixed, so that the implant guide plate only needs to solve the problem of guiding and positioning of the central part, can be made into a general navigation device, and does not need to be customized.

3. The guide plate is large in size and inconvenient to use. This navigation head wraps up whole arch expanding device and the soft or hard tissue in upper jaw back tooth district, occupies a large amount of intraoral space, and the intersection of bullport opening part forms the contained angle, leads to the doctor to operate very difficultly in narrow and small oral cavity environment.

Disclosure of Invention

Aiming at the technical problems, the invention provides a navigation device for assisting the implantation of an implantation anchorage nail of a maxillary bone arch expander, which achieves the following technical effects:

1. the embedded positioning is accurate, and the positioning is stable. The invention does not relate to a new MSE device, but only relates to an MSE implanting nail implanting navigation device. MSE devices conventionally employ a first maxillary bilateral molar band for retention and positioning. The device is fixed on the spiral expander at the center of the MSE through the clamping and holding structure with certain elasticity, and is tightly combined with the MSE spiral expander after being in place, so that the device cannot fall off.

2. The universal device reduces the cost. The invention relates to a universal MSE implanting nail implanting navigation device system, which can be used for mass production after single design aiming at each MSE device and does not need to be customized aiming at different patients.

3. Is small and exquisite and is convenient to use. The navigation device related by the invention has small volume, is nested on the spiral expander of MSE, the MSE is positioned by the belt ring and then is installed, and the implanting anchorage nail is implanted under the assistance of the guide plate and then is taken out, thereby being convenient for clinical operation.

The specific technical scheme is as follows:

the navigation device for assisting the implantation of the maxillary bone arch expander implantation anchorage nail comprises a guide hole, an annular elastic clamping device and a cross mortise-tenon structural connecting piece;

the position of the guide hole is matched with the position of an implanting opening of the implant nail of the MSE spiral expander, the inclination angle and the hole height of the guide hole are matched with the planned implanting angle and depth of the implant nail, and the inner diameter of the guide hole is matched with a special screwdriver for implanting the implant nail;

the turning part of the outer edge of the guide hole is provided with an annular recess.

Six annular elastic clamping devices are arranged at the lower edge of the guide hole, and the distribution positions of the annular elastic clamping devices are matched with the exposure positions of the circular rods on the side wall of the MSE spiral expander. The inner diameter of the annular elastic clamping device is matched with the outer diameter of a circular rod on the side wall of the MSE spiral expander, and the lower edge of the annular elastic clamping device is cut into a horizontal shape, so that the bottom surface of the annular elastic clamping device is flush with the bottom surface of the MSE spiral expander when the annular elastic clamping device is assembled on the MSE spiral expander.

And the guide holes are in a group and are respectively positioned at the left side and the right side of the MSE spiral expander. And the two groups of guide holes are connected by two groups of cross mortise and tenon structure connecting pieces. The cross mortise-tenon joint structural connecting pieces on the two sides are plug-in pieces, and can be tightly plugged.

Drawings

FIG. 1 is a typical maxillary bony expander MSE configuration;

FIG. 2 is a three-dimensional image reconstructed image of a patient after implantation of a maxillary bony arch expander MSE;

FIG. 3 is a prior art planting guide configuration;

FIG. 4 is an electronic model of MSE obtained by scanning in an embodiment;

FIG. 5 is a schematic view of the overall structure of the present invention;

FIG. 6 is a schematic illustration of a split structure of the present invention;

fig. 7 is a schematic diagram of the present invention in use after connecting with an MSE spiral expander.

The labels in the figure are: 1 is the bullport, 2 is annular elasticity card embraces the device, 3 is cross tenon fourth of the twelve earthly branches structure connecting piece, 4 is the MSE screw amplifier, 11 is annular sunken, 41 is MSE screw amplifier lateral wall round bar.

Detailed Description

The specific technical scheme of the invention is described by combining the embodiment.

As shown in fig. 5 and 6, the navigation device for assisting the implantation of the maxillary bone arch expander implantation anchorage nail comprises a guide hole 1, an annular elastic clamping device 2 and a cross mortise-tenon structural connecting piece 3;

the device comprises four guide holes 1, wherein the positions of the guide holes 1 are matched with the positions of implant openings of the implant nails of the MSE spiral expander 4, the inclination angles and the hole heights of the guide holes are matched with the planned implant angles and the planned implant depths of the implant nails, and the inner diameters of the guide holes 1 are matched with a special screwdriver for implanting the implant nails;

the guide hole 1 is provided with an annular recess 11 with the height of 1.5mm and the depth of 1mm at the turning part of the outer edge.

Six annular elastic clamping devices 2 are arranged on the lower edge of the guide hole 1, and the distribution positions of the annular elastic clamping devices 2 are matched with the exposure positions of the side wall round rods 41 of the MSE spiral expander. The inner diameter of the annular elastic clamping device 2 is matched with the outer diameter of a circular rod 41 on the side wall of the MSE spiral expander, and the lower edge of the annular elastic clamping device 2 is cut into a horizontal shape, so that the bottom surface of the annular elastic clamping device is flush with the bottom surface of the MSE spiral expander 4 when the annular elastic clamping device is assembled on the MSE spiral expander 4.

And the guide holes 1 are arranged in a group of two and are respectively positioned at the left side and the right side of the MSE spiral expander 4. And the two groups of guide holes are connected by two groups of cross mortise and tenon structure connecting pieces 3. The cross tenon-and-mortise structure connecting pieces 3 at two sides can be tightly inserted.

The preparation and use processes of the navigation device for assisting the implantation of the maxillary bone arch expander anchorage nail are as follows:

1. an electronic model of the MSE for which the flipper is to be made is obtained by scanning, as shown in fig. 4.

2. And designing a navigation device according to the position, the angle and the implantation depth of the implanted anchorage nail required by the MSE spiral expander 4, as shown in figure 5. The four columns above the navigation device are guide holes 1, and the inner diameter of each guide hole is equal to or slightly larger than the diameter of the implant nail planned to be implanted. The lower opening of the cylinder is butted with an MSE spiral expander 4 planting nail implantation opening. The central part of the cylinder is a cross tenon-and-mortise structure connecting piece 3. The lower edges of the two side cylinders are respectively provided with 3 annular elastic clamping devices 2 with inward openings, and the annular elastic clamping devices can be clamped on the side wall round rod 41 of the MSE spiral expander, so that the navigation device can be positioned on the MSE spiral expander 4.

3. In order to facilitate the assembly and disassembly of the navigation device, the navigation device is divided. The divided two side guide holes 1 are connected by the cross mortise-tenon structure connecting piece 3 in an inserting way, as shown in figure 6.

4. When the navigation device is used clinically, the MSE spiral expander 4 is fixed on the upper jaw of a patient through a belt ring, then the navigation device provided by the invention is respectively fixed on two sides of the MSE spiral expander 4 through the annular elastic clamping device 2, the guide holes 1 on two sides are connected through the cross mortise-tenon joint structural connecting piece 3, and the MSE spiral expander is fixed by sleeving orthodontic rubber bands of 3/8 inch and 14oz on the annular recess 11 of each guide hole 1, as shown in fig. 7. After the doctor finishes implanting the anchorage nail under the guide of the navigation device, the doctor can remove the rubber band and then disassemble the cross mortise-tenon structural connecting piece 3, and then separate the annular elastic clamping device 2 from the circular rod 41 on the side wall of the MSE spiral expander, so that the MSE implantation nail under the guide of the navigation device can be implanted.

Claims

1. The navigation device for assisting implantation of the maxillary bone arch expander planting anchorage nail is characterized by comprising a guide hole (1), an annular elastic clamping device (2) and a cross mortise and tenon structure connecting piece (3);

the device comprises four guide holes (1), wherein the positions of the guide holes (1) are matched with the positions of implant nail implanting openings of an MSE spiral expander (4), the inclination angle and the hole height of the guide holes are matched with the planned implanting angle and depth of the implant nails, and the inner diameters of the guide holes (1) are matched with a special screwdriver for implanting the implant nails;

the lower edge of the guide hole (1) is provided with six annular elastic clamping devices (2), and the distribution positions of the annular elastic clamping devices (2) are matched with the exposure positions of the side wall circular rods (41) of the MSE spiral expander; the inner diameter of the annular elastic clamping device (2) is matched with the outer diameter of a circular rod (41) on the side wall of the MSE spiral expander;

the two guide holes (1) are in a group and are respectively positioned at the left side and the right side of the MSE spiral expander (4); the two groups of guide holes (1) are connected by two groups of cross tenon-and-mortise structure connecting pieces (3).

2. The navigation device for assisting the implantation of the maxillary bone arch expander implantation anchorage nail according to claim 1, wherein the outer edge of the guide hole (1) is provided with an annular recess (11).

3. The navigation device for assisting the implantation of the maxillary bone arch expander implant anchorage nail according to claim 1, wherein the lower edge of the annular elastic clamping device (2) is cut into a horizontal shape, and the bottom surface of the annular elastic clamping device is flush with the bottom surface of the MSE spiral expander (4) when the annular elastic clamping device is assembled on the MSE spiral expander (4).

4. The navigation device for assisting the implantation of the maxillary bone arch expander implantation anchorage nail according to claim 1, wherein the two-side cross mortise-tenon structural connecting piece (3) is a plug-in piece.