CN203749647U - Bone repairing guide plate component for artificial temporomandibular joint replacement - Google Patents

Bone repairing guide plate component for artificial temporomandibular joint replacement Download PDF

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Publication number
CN203749647U
CN203749647U CN 201420141523 CN201420141523U CN203749647U CN 203749647 U CN203749647 U CN 203749647U CN 201420141523 CN201420141523 CN 201420141523 CN 201420141523 U CN201420141523 U CN 201420141523U CN 203749647 U CN203749647 U CN 203749647U
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CN
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Prior art keywords
guide plate
guide
ramus
zygomatic arch
condylar
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CN 201420141523
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Chinese (zh)
Inventor
白果
杨驰
何冬梅
陆川
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上海交通大学医学院附属第九人民医院
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30988Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof

Abstract

The utility model discloses a bone repairing guide plate component for artificial temporomandibular joint replacement. An articular tubercle guide plate is attached to the outer lateral surface of a zygomatic arch, and the lower edge of the articular tubercle guide plate is blade-shaped or provided with a shoulder; a zygomatic arch guide plate is attached to the outer lateral surface of the zygomatic arch, the zygomatic arch guide plate is U-shaped, and the opening part of the U shape is blade-shaped; a condyle process guide plate is attached to the outer lateral surface of a condyle process, and the upper edge of the condyle process guide plate is blade-shaped or provided with a shoulder; a ramus guide plate is attached to the outer lateral surface of a mandibular ramus, the upper part of the ramus guide plate is hollow, and the hollow part is blade-shaped. The bone repairing guide plate component for the artificial temporomandibular joint replacement precisely guides maxillary articular tubercle bottom osteotomy, mandibular condyle amputation, outer lateral surface grinding for the zygomatic arch, and outer lateral surface grinding for the ramus, and unnecessary bone loss is reduced.

Description

一种人工颞下颌关节置换骨修整导板组件 An artificial bone temporomandibular joint replacement trim guide plate assembly

技术领域 FIELD

[0001] 本实用新型涉及一种医疗辅助装置,尤其涉及的是一种人工颞下颌关节置换骨修整导板组件。 [0001] The present invention relates to a medical instrument, in particular, it relates to an artificial bone temporomandibular joint replacement trim guide plate assembly.

背景技术 Background technique

[0002] 标准型人工颞下颌关节无法与患者颌骨形态完全匹配,所以必须对每个患者进行适应假体外形的颌骨修整,主要为上颌骨颧弓、关节结节、下颌骨髁突及升支外侧面。 [0002] Standard artificial temporomandibular joint can not exactly match the patient jaw morphology, it must be trimmed to adapt mandibular prosthesis shape of each patient, mainly maxillary zygomatic arch, articular nodules, and mandibular condyle ramus outer surface. 而对于颌骨修整,国内尚无应用于临床指导骨修整的工具,因此,骨修整具有一定盲目性,会造成不必要的骨量损失。 As for the mandible dressing, there is no national clinical guidelines used in bone repair tools, therefore, bone trim with a certain blindness, cause unnecessary loss of bone mass. 其次,由于骨修整磨削骨质均为皮质骨,为颌骨最坚硬部分,盲目磨削会极大减低颌骨强度,且颧弓自身厚度较薄,盲目磨削可能导致上部假体即人工关节窝,无法行螺钉固位;再次,由于上颌骨颧弓骨修整位置近颅底,风险大,若磨削过多有损伤颅底、造成脑脊液漏可能;且下颌骨髁突内侧为颌内动静脉血管束走行,骨修整时易损伤造成大出血,所以需要导板辅助精确截骨,降低神经、血管损伤风险。 Second, since the dressing of the grinding bone cortical bone are, for the most part the hard maxilla, mandible blind grinding will greatly reduce the strength, and the zygomatic arch itself is thin, the upper portion of the blind may cause grinding of artificial prostheses i.e. glenoid fossa, the line can not screw retention; again, because the maxillary bone zygomatic arch trim position near the skull base, risk, if there is too much damage to the grinding base of the skull, causing leakage of cerebrospinal fluid may be; and mandibular condyle within the inside of the jaw traveling arterial and venous blood tubes, easy to damage caused by bleeding bone repair, it is necessary to guide the auxiliary precise osteotomy, reduce nerve, vascular injury risk.

实用新型内容 SUMMARY

[0003] 本实用新型的目的在于克服现有技术的不足,提供了一种人工颞下颌关节置换骨修整导板组件,能够方便术中使用、精确显示上下颌骨磨削部位及截骨方向。 [0003] The object of the present invention is to overcome the disadvantages of the prior art, there is provided an artificial bone temporomandibular joint replacement trim guide plate assembly can be conveniently used in surgery to precisely display the upper and lower jaw portions and grinding osteotomy direction.

[0004] 本实用新型是通过以下技术方案实现的,本实用新型包括关节结节导板、颧弓导板、髁突导板、升支导板; [0004] The present invention is achieved by the following technical solutions, the present invention comprises a guide plate articular eminence, zygomatic arch guide plate, guide plate condyle, ramus guide plate;

[0005] 所述关节结节导板贴附于颧弓外侧面,关节结节导板的下部边缘为刃状或带有肩台,关节结节导板的表面设有与关节窝假体匹配的螺钉孔及辅助定位孔; [0005] The guide plate is attached to the articular eminence zygomatic arch outer side surface, the lower edge of guide plate articular tubercle into an edge with a shoulder or a surface joint nodules guide plate is provided with screw holes match glenoid prosthesis and the auxiliary positioning hole;

[0006] 所述颧弓导板贴附于颧弓外侧面,颧弓导板为U型,U型的开口部位为刃状,边缘开设多个辅助定位孔; [0006] The guide plate is attached to the zygomatic arch zygomatic arch outer side, zygomatic arch U-shaped guide plate, the U-shaped opening into an edge portion, the edge defines a plurality of auxiliary positioning hole;

[0007] 所述髁突导板贴附于髁突外侧面,髁突导板上开设多个螺钉孔,髁突导板的上部边缘为刃状或设有肩台; [0007] The guide plate is attached to the condyle condylar side condylar guide plate defines a plurality of screw holes, the upper edge of the condylar guide plate into an edge or shoulder is provided;

[0008] 所述升支导板贴附于下颌骨升支外侧面,所述升支导板的上部镂空,所述镂空部位为刃状,升支导板上设有与髁突假体相匹配的螺钉孔。 [0008] The lift supporting plate attached to an outer side surface of the guide ramus of the mandible, the ramus hollow upper guide plate, said hollow portion into an edge, the ascending branch of the guide plate is provided with condylar prosthesis to match the screw hole.

[0009] 作为本实用新型的优选方式之一,所述关节结节导板的刃状部或肩台的宽度为 [0009] As one preferred embodiment of the present invention, the width of the articular tubercle guide plate or blade-like shoulder portions is

2.5mmο 2.5mmο

[0010] 作为本实用新型的优选方式之一,所述髁突导板的刃状部或肩台的宽度为2.5mm。 [0010] As one preferred embodiment of the present invention, the width of the blade-shaped portion or the shoulder of the condylar guide plate is 2.5mm.

[0011] 作为本实用新型的优选方式之一,所述关节结节导板、颧弓导板、髁突导板、升支导板的导板主体厚度为1.5_。 [0011] As one preferred embodiment of the present invention, the articular tubercle guide plate guides the zygomatic arch, the guide plate condyle, ramus guide plate main body guide plate having a thickness of 1.5_.

[0012] 术中采用改良耳前切口+下颌下切口充分暴露颧弓、髁突及下颌骨升支,分别按手术设计次序将经由等离子或环氧乙烷消毒的导板戴入并使之与骨面紧密贴合,牢固固位;再按颧弓导板及髁突导板中间镂空范围和边缘指示截骨方向或实施骨修整,而后安放关节结节导板及升支导板引导关节结节下截骨、升支外侧面骨修整及假体打孔定位,最后安放假体并以钛螺钉固位。 [0012] + mandibular incision surgery incision using fully exposed before the zygomatic arch improved ear, and the mandible condyle ramus, respectively guide the design order operation via plasma or ethylene oxide sterilization and allowed to wear into the bone close contact with the surface, retaining solid; press the middle of the zygomatic arch and condyle guide plate guides the scope and hollow edge direction indicated osteotomy or bone trimming embodiment, the guide plate then placed articular tubercle and ramus osteotomy guide plate guiding the articular eminence, ramus and the outer side surface of the bone prosthesis trimming punch is positioned, and finally leave the body security retention screw and titanium. 由于关节结节导板及髁突导板边缘准确显示截骨方向,颧弓导板及升支导板镂空部分准确显示骨磨削范围及深度,关节结节导板及升支导板则精确匹配假体孔洞,由此可确保假体按术前设计进行植入,实现了术前设计到术中应用的过渡,保证了手术的精确性,最大程度减少了骨量损失,确保标准型颞下颌关节的应用效果。 Since the articular tubercle guide plate and the condylar guide edge accurately show the osteotomy direction, zygomatic arch guide plate and the ascending branch of the guide hollow part accurately displays the bone grinding range and depth of the articular tubercle guide plate and the ascending branch of the guide plate is an exact match prosthesis bore by this ensures that the prosthesis for implantation by preoperative designed to achieve the transition to the preoperative intraoperative application of design to ensure the accuracy of surgery, to minimize the loss of bone mass, the effect of the application to ensure the standard of the temporomandibular joint.

[0013] 本实用新型相比现有技术具有以下优点:本实用新型可以使标准型人工关节置换手术骨修整更容易进行,便于术者操作,极大缩短手术时间;准确指导上颌骨关节结节底部截骨、下颌骨髁突截除及颧弓外侧面、升支外侧面磨削,同时保护颅底及髁突内侧面走行重要神经血管束,经导板指导下骨修整更精确,减少不必要骨量损失;经导板指导下骨修整可良好保护周围解剖结构,避免了骨修整区域的神经血管损伤;导板应用实现了术前设计到术中操作的转化,确保人工关节在最理想位置植入,保证了人工关节的应用效果,最大限度减少骨修整量,增加人工关节假体与颌骨贴合程度,减少术中术后并发症的发生,提高标准型人工关节假体的使用效果。 [0013] The present invention has the following advantages over the prior art: The present invention enables standard arthroplasty bone repair easier, facilitates the surgeon to operate, greatly shorten the operation time; accurate guidance temporomandibular joint tubercle bottom osteotomy, mandibular condylar cut away and the zygomatic arch outer side surface, an outer side surface of the grinding ascending branch, while protecting the base of the skull and the inner side surface of the traveling condylar important neurovascular bundles, by trimming the lower guide plate to guide the bone more precisely, to reduce unnecessary loss of bone mass; by the surrounding bone repair can be well protected lower guide plate guiding anatomy avoid neurovascular injury bone repair region; guide application implements preoperative design to conversion surgery operations, ensuring artificial joint implant in optimal position to ensure that the effect of the application of artificial joints, minimizing the amount of bone repair, increase artificial joint prostheses and maxilla fit together extent, reduce the incidence of intraoperative and postoperative complications and improve the effect of the use of standard artificial joint prosthesis.

附图说明 BRIEF DESCRIPTION

[0014] 图1是本实用新型关节结节导板的结构示意图, [0014] FIG. 1 is a schematic view of the present invention, the articular eminence guide plate,

[0015] 图2是本实用新型颧弓导板的结构示意图; [0015] FIG. 2 is a schematic view of the present invention zygomatic arch guide plate;

[0016] 图3是本实用新型髁突导板的结构示意图; [0016] FIG. 3 is a schematic view of the present invention condylar guide plate;

[0017] 图4是本实用新型升支导板的结构示意图。 [0017] FIG. 4 is a schematic view of the present invention ramus guide plate.

具体实施方式 Detailed ways

[0018] 下面对本实用新型的实施例作详细说明,本实施例在以本实用新型技术方案为前提下进行实施,给出了详细的实施方式和具体的操作过程,但本实用新型的保护范围不限于下述的实施例。 [0018] Hereinafter, the present invention embodiments described in detail, the present embodiments are implemented in the present invention, the technical solution of the premise, gives a detailed embodiment and the specific operation, but the scope of the present invention is protected It is not limited to the following examples.

[0019] 本实施例主要应用于颞下颌关节强直、髁突骨关节炎晚期及各种髁突退行性变晚期病例的全关节置换治疗中。 [0019] This embodiment is mainly applied temporomandibular joint, bone condylar total joint advanced arthritis and various degenerative condylar replacement therapy in advanced cases. 术前基于患者CT数据,运用三维重建技术,精确还原患者颌骨模型,并导入匹配的假体数据,在数字化颌骨模型上进行假体的模拟植入,从而确定颌骨磨削位置、范围、方向及深度;再利用CAD/CAM技术设计截骨导板,并通过三维打印技术将数字化设计转化为术中导板。 Based on CT data of the patient before surgery, the use of three-dimensional reconstruction, accurately reproduce mandibular model of the patient, and import data matching the prosthesis, for implantation of the prosthesis is simulated on a digital model of the maxilla, mandible to determine the grinding position, range , and the direction of depth; reuse of CAD / CAM technology osteotomy guide plate design, by three dimensional printing techniques and digital design guides into surgery.

[0020] 本实施例包括关节结节导板1、颧弓导板2、髁突导板3、升支导板4。 [0020] This embodiment includes a guide plate articular eminence, zygomatic arch guide plate 2, condyle guide plate 3, the guide plate 4 ramus.

[0021] 如图1所示,所述关节结节导板I贴附于颧弓外侧面,关节结节导板I的下部边缘为刃状;所述关节结节导板I的刃状部的宽度为2.5_,指导关节结节下部截骨方向,并根据术前测量数据确定截骨深度,修整关节结节为一平面,以适应标准型关节窝假体上部平整外形。 [0021] As shown in FIG. 1, the guide plate articular tubercle I attached to the zygomatic arch outer side surface, the lower edge of the articular tubercle guide plate into an edge I; the width of the blade-shaped portion of the articular eminence of the guide plate I 2.5_, a lower articular tubercle osteotomy guide direction, and the measurement data determined osteotomy depth preoperative trimming joint nodules a plane to accommodate the upper portion of the standard glenoid prosthesis flat shape. 在关节结节导板I表面的设有多个与关节窝假体匹配的螺钉孔6与辅助定位孔5,用以标记关节窝假体放置位置。 I articular tubercle guide surface is provided with a plurality of screw holes match with the prosthesis socket 6 and the auxiliary positioning hole 5 to mark glenoid prosthesis placement.

[0022] 如图2所示,所述颧弓导板2贴附于颧弓外侧面,颧弓导板2为U型,U型的开口部位为刃状,刃状边缘指示骨修整内外向深度,指导颧弓外侧面骨磨削,颧弓导板2上设有多个螺钉孔6,用钛螺钉进行定位。 [0022] 2, the zygomatic arch guide plate 2 is attached to the zygomatic arch outer side, zygomatic arch U-shaped guide plate 2, the opening portion of the U-shaped blade-shaped, blade-shaped inner and outer edges trimmed bone indicating the depth, zygomatic arch guide outer side surface grinding bone, the zygomatic arch is provided with a plurality of screw holes on the guide plate 26, positioned with titanium screws.

[0023] 患者颧弓及关节结节经过上述两导板修整后,可与关节窝假体顶部及固定板内侧面紧密贴合,并按照关节结节导板I上的螺钉孔6,直接安放假体并与对应孔洞匹配,即可直接行螺钉固位。 [0023] Patients zygomatic arch and the articular eminence after the above-mentioned two guides dressing may glenoid endoprosthesis top and fastening plate in close contact, and in accordance with the screw holes in the articular eminence guides I 6, installed directly leave the body and matched with the corresponding holes, to direct the line-retaining screw.

[0024] 如图3所示,所述髁突导板3贴附于髁突外侧面,髁突导板3上开设多个螺钉孔6用于固定位置,髁突导板3的上部边缘设有肩台,所述髁突导板3的肩台的宽度为2.5_,通过下颌下切口截除髁突,并保护髁突内侧走行的神经血管束。 [0024] As shown in FIG. 3, the condylar guide plate 3 is attached to an outer side surface of the condylar condylar guide plate defines a plurality of screw holes 36 for fixing the position of the condylar guide plate 3 is provided with an upper edge shoulder the condylar guide shoulder width 2.5_ 3, mandibular condyle incision amputated, medial condyle and down the protective neurovascular bundle row.

[0025] 如图4所示,所述升支导板4贴附于下颌骨升支外侧面,所述升支导板4的上部镂空,所述镂空部位为刃状,升支需骨修整部分镂空,镂空边缘指示骨修整内外向深度,指导升支外侧面骨磨削,升支导板4上设有用于固定髁突假体的螺钉孔6,指导手术医生利用打孔钻确定髁突假体摆放位置,打2〜3孔后将髁突假体打孔导板撤下,直接安放假体并与对应孔洞匹配,即可直接行螺钉固位。 [0025] As shown in FIG. 4, the ascending branch of the guide plate 4 is attached to the outer side surface ramus of the mandible, the upper hollow support liter of the guide plate 4, a hollow portion into an edge, ramus bone need to trim the hollow portion , hollow inner and outer edges trimmed bone indicating the depth guide ramus bone grinding the outer surface, is provided for fixing the condylar ramus projecting guide plate 4 screw holes 6 of the prosthesis, the surgeon guide the drill hole is determined using condylar prosthesis pendulum playback position, beat 2 ~ condylar prosthesis after projection hole perforated guide plate removed, installed directly body and leave a corresponding matching holes, to direct the line-retaining screw.

[0026] 本实施例的关节结节导板1、颧弓导板2、髁突导板3、升支导板4的导板主体厚度为1.5mmο [0026] The present articular eminence guide plate 1 of the embodiment, the zygomatic arch guide plate 2, the guide plate 3 condyle, ramus guide plate body 4 has a thickness of 1.5mmο

Claims (4)

1.一种人工颞下颌关节置换骨修整导板组件,其特征在于,包括关节结节导板、颧弓导板、髁突导板、升支导板; 所述关节结节导板贴附于颧弓外侧面,关节结节导板的下部边缘为刃状或带有肩台,关节结节导板的表面设有与关节窝假体匹配的螺钉孔及辅助定位孔; 所述颧弓导板贴附于颧弓外侧面,颧弓导板为U型,U型的开口部位为刃状,边缘开设多个辅助定位孔; 所述髁突导板贴附于髁突外侧面,髁突导板上开设多个螺钉孔,髁突导板的上部边缘为刃状或设有肩台; 所述升支导板贴附于下颌骨升支外侧面,所述升支导板的上部镂空,所述镂空部位为刃状,升支导板上设有与髁突假体相匹配的螺钉孔。 1. An artificial temporomandibular joint replacement bone trim guide assembly comprising articular tubercle guides zygomatic arch guide condylar guides ramus guide plate; the articular eminence guiding plate attached to the zygomatic outer arch side, the lower edge of guide plate articular tubercle into an edge with a shoulder or a surface provided with articular tubercle guide plate screw hole and the auxiliary positioning hole matching the prosthesis socket; zygomatic arch of the guiding plate is attached to the outer side surface of the zygomatic arch zygomatic arch U-shaped guide plate, the U-shaped opening into an edge portion, the edge defines a plurality of secondary positioning apertures; the condylar guide plate attached to an outer side surface of the condylar condylar guide plate defines a plurality of screw holes, condylar the upper edge of the guide plate is provided with blade-like or shoulder; the ascending branch of the guide plate is attached to the outer side surface ramus of the mandible, the upper hollow support liter guide plate, said hollow portion into an edge, provided on the guide ramus a screw hole matched prosthesis condyle.
2.根据权利要求1所述的一种人工颞下颌关节置换骨修整导板组件,其特征在于,所述关节结节导板的刃状部或肩台的宽度为2.5mm。 2. An artificial temporomandibular joint replacement according to claim 1 trimmed bone plate assembly guide, characterized in that the width of the blade-shaped portion of the shoulder or the articular eminence guide plate is 2.5mm.
3.根据权利要求1所述的一种人工颞下颌关节置换骨修整导板组件,其特征在于,所述髁突导板的刃状部或肩台的宽度为2.5mm。 An artificial temporomandibular joint according to claim 1, said bone replacement trim guide plate assembly, characterized in that the width of the blade-shaped projecting portion or shoulder of the condyle guide plate is 2.5mm.
4.根据权利要求1所述的一种人工颞下颌关节置换骨修整导板组件,其特征在于,所述关节结节导板、颧弓导板、髁突导板、升支导板的导板主体厚度为1.5mm。 4. An artificial temporomandibular joint according to claim 1 replacing bone trim guide plate assembly, characterized in that the articular tubercle guide plate, zygomatic arch guide condylar guides ramus guide plate guide plate main body having a thickness of 1.5mm .
CN 201420141523 2014-03-26 2014-03-26 Bone repairing guide plate component for artificial temporomandibular joint replacement CN203749647U (en)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104939951A (en) * 2014-03-26 2015-09-30 上海交通大学医学院附属第九人民医院 Artificial temporal-mandibular joint replacement bone trimming guide plate assembly
CN105266874A (en) * 2014-09-19 2016-01-27 北京大学口腔医学院 Upper jaw Le Fort I type osteotomy operation guide plate and design method thereof
CN105726087A (en) * 2016-04-26 2016-07-06 中山大学孙逸仙纪念医院 Fibula cutting shaping positioner through 3D printing
WO2017195022A1 (en) * 2016-05-12 2017-11-16 Cadskills Bvba Prosthesis for a temporomandibular joint

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104939951A (en) * 2014-03-26 2015-09-30 上海交通大学医学院附属第九人民医院 Artificial temporal-mandibular joint replacement bone trimming guide plate assembly
CN104939951B (en) * 2014-03-26 2017-06-13 上海交通大学医学院附属第九人民医院 An artificial bone temporomandibular joint replacement trim guide plate assembly
CN105266874A (en) * 2014-09-19 2016-01-27 北京大学口腔医学院 Upper jaw Le Fort I type osteotomy operation guide plate and design method thereof
CN105266874B (en) * 2014-09-19 2017-12-01 北京大学口腔医学院 Le FortⅠ one kind maxillary osteotomy with a type and design method surgical guide
CN105726087A (en) * 2016-04-26 2016-07-06 中山大学孙逸仙纪念医院 Fibula cutting shaping positioner through 3D printing
WO2017195022A1 (en) * 2016-05-12 2017-11-16 Cadskills Bvba Prosthesis for a temporomandibular joint

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