CN213217733U - Orthognathic surgery plywood for lifting and positioning lower jaw - Google Patents
Orthognathic surgery plywood for lifting and positioning lower jaw Download PDFInfo
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- CN213217733U CN213217733U CN202020765928.XU CN202020765928U CN213217733U CN 213217733 U CN213217733 U CN 213217733U CN 202020765928 U CN202020765928 U CN 202020765928U CN 213217733 U CN213217733 U CN 213217733U
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Abstract
The utility model discloses a orthognathic surgery plywood for mandibular lifting and positioning, which comprises an occlusal plate and positioning wings connected with the mandibular lifting and supporting, wherein the occlusal plate is of an arc structure, the upper surface and the lower surface of the occlusal plate are respectively provided with a tooth impression matched with the shapes of the upper jaw dentition and the lower jaw dentition of a patient, and a plurality of ligation holes which are arranged along the length direction of the occlusal plate at intervals and are used for inter-jaw ligation; the two positioning wings are respectively connected to two ends of the bite plate through connecting pieces; the positioning wing is an arc-shaped plate, the inner side of the arc-shaped plate is attached to the lower jaw ascending limb of the patient, and a cortical screw fixing hole used for being connected with the lower jaw ascending limb of the patient is formed in the arc-shaped plate. The utility model has the advantages that: the bite plate for positioning the mandible distal end bone segment and the positioning wing for positioning the mandible proximal end bone segment (including the mandible lifting) are integrally designed, so that the manufacturing process of the positioning device is simplified, and fine errors in the processes of manufacturing and assembling in batches are avoided.
Description
Technical Field
The utility model relates to the field of auxiliary medical equipment, especially, relate to a orthognathic surgery plywood for lower jaw rises a location.
Background
The malformation of maxillofacial region refers to the abnormal size and shape of the jaw bone, the abnormal relationship between the upper and lower jaw bones and other craniofacial bones, and the accompanying abnormal function of the jaw, dentition and orofacial system and facial morphology caused by abnormal development of the jaw bone. Orthognathic surgery is the primary method of correcting dento-maxillofacial deformity. One of the most commonly used orthognathic surgical procedures is the bilateral mandibular discrete surgery (BSSRO), in which the positional relationship between the distal bone segment containing the dentition and the proximal bone segment containing the mandibular advancement is adjusted by the procedure to change the form and spatial position of the mandible and achieve the purpose of correcting the dentofacial deformity. Accurate positioning of proximal and distal bone segments in BSSRO surgery is helpful to obtain stable postoperative effect, reduce negative influence on temporomandibular joint, improve chewing function, etc.
However, during the performance of BSSRO surgery, the proximal and distal bone segments may shift, rotate and shift from the preoperatively planned position, and the condyles on the proximal bone segments may also shift from the preoperatively planned position. Although the positioning of the distal bone segment can be determined by the plate, the existing methods often cannot perform accurate rotation and positioning, especially for the cases requiring rotating mandibular advancement, and only depend on the manipulation and experience of the operator. The displacement and the inaccurate position of the mandibular ascending branch are important reasons for poor effect and relapse after orthognathic surgery, and the condylar process displacement can cause temporal mandibular dysfunction, even serious postoperative complications such as condylar pain, condylar absorption, restricted opening and the like, so how to accurately position the mandibular ascending branch of the bone segment at the near-heart end according to the surgical design in the orthognathic surgery process is an important link for ensuring the effect and the stability after orthognathic surgery.
Although many scholars at home and abroad design various mandibular lifting and positioning devices, most of the devices have complicated structures, are difficult to wear, are difficult to position in limited surgical fields, need to remove more soft tissues, need to spend more manpower and time in manufacturing and using, and currently, no simple, convenient and accurate mandibular lifting and positioning device is available clinically.
Disclosure of Invention
An object of the utility model is to provide a but the not enough of accurate positioning's orthognathic surgery plywood that is used for the lower jaw to rise a location to the position that rises a location is confirmed and is stabilized according to design before the art to accurate ground in orthognathic surgery art fast, guarantees the operation effect, reduces the incidence of relapse and complication behind the orthognathic surgery.
The utility model adopts the technical proposal that: a orthognathic surgery plywood used for mandibular lifting and positioning comprises an occlusal plate and positioning wings used for being connected with the mandibular lifting and supporting, wherein the occlusal plate is of an arc structure, the upper surface and the lower surface of the occlusal plate are respectively provided with a tooth impression matched with the shapes of upper and lower jaw dentitions of a patient, and a plurality of ligation holes are arranged at intervals along the length direction of the occlusal plate and are used for ligaturing between the jaws; the two positioning wings are respectively connected to two ends of the bite plate through connecting pieces; the positioning wing is an arc-shaped plate, the inner side of the arc-shaped plate is attached to the lower jaw ascending limb of the patient, and a cortical screw fixing hole used for being connected with the lower jaw ascending limb of the patient is formed in the arc-shaped plate.
According to the scheme, the upper surface and the lower surface of the inner edge of the occlusal plate are respectively provided with the guide inclined planes which incline towards the lingual side direction of the tooth impression, and the guide inclined planes are intersected with the lingual side part of the tooth impression, so that the occlusal plate can be conveniently guided to be in place in an operation.
According to the scheme, the included angle alpha between the guide inclined plane and the upper and lower surfaces of the occlusal plate is 30-60 degrees.
According to the scheme, the distance between the intersection of the guide inclined plane and the lingual side of the dental impression and the inner bottom of the dental impression is 1/4-1/3 of the depth of the dental impression.
According to the scheme, the connecting piece is of a V-shaped structure and comprises two connecting rods, and one ends of the two connecting rods are intersected and connected with the end part of the bite plate; the other ends of the two connecting rods are respectively connected with the outer side surface of the positioning wing, and the two connecting rods and the positioning wing form a triangular structure.
According to the scheme, the connecting rod is cylindrical, and the diameter of the connecting rod is 1-4 mm.
According to the scheme, the outer side face of the positioning wing is connected with the connecting rod, the inner side of the positioning wing is a tissue face which is attached to the anatomical appearance of the lower jaw ascending support front edge and the inner side and the outer side corresponding to a patient, and the thickness between the outer side face of the positioning wing and the tissue face is 1-4 mm.
According to the scheme, the positioning wing is provided with cortical screw fixing holes at the positions corresponding to the front edge of the mandibular ascending branch and/or the inner side and the outer side of the mandibular ascending branch, and the cortical screw fixing holes are used for fixing the mandibular ascending branch by cortical screws.
According to the scheme, the length, the width and the height of the positioning wing are not more than 3cm, 3cm and not less than 1cm, 1cm and 1 cm.
The utility model has the advantages that:
1. the utility model integrates the bite plate for positioning the far-end bone segment of the lower jaw and the positioning wing for positioning the near-end bone segment (including the lower jaw lifting support), thereby simplifying the manufacturing process of the positioning device and avoiding fine errors in the processes of manufacturing and assembling by times;
2. the design of the guide inclined plane is convenient for guiding the bite plate to be in place in an operation and is convenient for wearing and mounting the plywood;
3. the positioning wings are small and accurate, can be positioned on the front edge and the inner and outer sides of the mandibular ascending limb without excessively separating soft tissues, and can accurately and rapidly position the mandibular ascending limb according to preoperative design in a limited surgical field; the cortical screw fixing hole on the positioning wing can be used for fixing the position of the mandible lifting support in the operation and can also be used as a marking guide hole to ensure that the positioning wing is accurately attached to the same position of the mandible lifting support before and after the mandible is osteotomy;
4. the utility model has the advantages of simple structure, convenient to use has guaranteed the accuracy and the stability of lower jaw lift branch and intraoperative condylar process position, is worth the application and popularization.
Drawings
Fig. 1 is a schematic perspective view of an embodiment of the present invention.
Fig. 2 is a front view of the present embodiment.
Fig. 3 is a left side view of the present embodiment.
Fig. 4 is a top view of the present embodiment.
Fig. 5 is a schematic view of the guide ramp and dental impression position.
Fig. 6 is a schematic perspective view of the opening on the inner side of the positioning wing corresponding to the mandibular protrusion.
Fig. 7 is a schematic perspective view of the opening at the front edge of the mandibular ascension bracket corresponding to the positioning wing.
Wherein: 1-a bite plate; 2-a connecting rod; 3-positioning wings; 4-a guide ramp; 5-impression of teeth; 6-binding holes; 7-cortical bone screw fixation hole.
Detailed Description
For a better understanding of the present invention, reference is made to the following detailed description taken in conjunction with the accompanying drawings.
As shown in fig. 1 to 4, the orthognathic surgical plate for positioning a mandibular ascending and descending includes an occlusal plate 1 and positioning wings 3 for connecting to the mandibular ascending and descending, wherein the occlusal plate 1 is of an arc structure, and upper and lower surfaces of the occlusal plate 1 are respectively provided with a dental impression 5 matching the shape of the upper and lower jaw dentitions of a patient, and a plurality of ligation holes 6 arranged at intervals along the length direction of the occlusal plate 1 for inter-jaw ligation; two positioning wings 3 are respectively connected to two ends of the occlusal plate 1 through connecting pieces; the positioning wing 3 is an arc-shaped plate with the inner side attached to the mandible ascending ramus of a patient, and a cortical screw fixing hole 7 (usually a round hole) for fixing the mandible ascending ramus by a cortical screw is arranged on the arc-shaped plate. The utility model discloses in, bite-block 1 and positioning wing 3 integrated design.
In order to facilitate the patient to sleeve the dentition of the patient into the upper and lower dental impressions 5 during the operation, guide inclined planes 4 inclined towards the lingual side direction (i.e. the inner side direction, as shown in fig. 1) of the dental impressions 5 are respectively additionally arranged along the upper and lower surfaces in the dental articulator 1, and the guide inclined planes 4 are intersected with the lingual side portions of the dental impressions 5 so as to facilitate guiding the dental articulator 1 to be in place during the operation; the distance H between the intersection of the guide inclined plane 4 and the lingual side part of the dental impression 5 and the inner bottom of the dental impression 5 is 1/4-1/3 of the depth H of the dental impression 5; the included angle alpha between the guiding inclined plane 4 and the upper and lower surfaces of the bite plate 1 is 30-60 degrees as shown in fig. 5.
In this embodiment, the upper surface of the occlusal plate 1 is provided with an upper dental impression, the inner edge of the upper surface of the occlusal plate 1 is provided with an upper guiding inclined plane, the upper guiding inclined plane inclines downwards from the inner side of the occlusal plate 1 to the upper dental impression direction, and the upper guiding inclined plane intersects with the lingual side of the upper dental impression. The lower surface of the occlusal plate 1 is provided with a lower tooth impression, the inner edge of the lower surface of the occlusal plate 1 is provided with a lower guide inclined plane, the lower guide inclined plane inclines upwards from the inner side of the occlusal plate 1 to the upper tooth impression direction, and the lower guide inclined plane is intersected with the lingual side of the lower tooth impression.
In the embodiment, the occlusal plate 1 is provided with a tooth impression 5 matched with the dentition of the upper jaw and the lower jaw of a patient, and the occlusion relation of the surgical design is recorded; the occlusal plate 1 also has a plurality of ligature holes 6 for ligature between the jaws.
In this embodiment, the connecting member is a V-shaped structure, and includes two connecting rods 2, one end of each connecting rod 2 intersects with and is connected to an end portion of the bite plate 1 (as shown in fig. 4, the end portion is an outer edge of the bite plate 1 after the molar region is ground); the other ends of the two connecting rods 2 are respectively connected with the outer side surfaces of the positioning wings 3, and the two connecting rods 2 and the positioning wings 3 form a triangular structure. The connecting rod 2 is cylindrical, and the diameter of the connecting rod is 1-4 mm.
The utility model discloses in, the lateral surface of location wing 3 links to each other with connecting rod 2, and the inboard of location wing 3 is for the tissue face of laminating mutually with the dissection appearance that corresponds lower jaw lift front edge and inside and outside with the patient, and the thickness between 3 lateral surfaces of location wing and the tissue face is 1 ~ 4 mm.
The positioning wing 3 is provided with cortical screw fixing holes 7 (as shown in fig. 6 and 7) at the positions corresponding to the front edge of the mandibular ascending ramus and/or the inner side and the outer side of the mandibular ascending ramus for fixing the mandibular ascending ramus by cortical screws; the positioning wing 3 can extend to a certain extent in the directions of the front edge and the inner and outer side surfaces of the mandible ascending support of a corresponding patient according to the position of the cortical screw fixing hole 7 of the bone so as to ensure that the positioning wing 3 is accurately attached to the mandible ascending support; the positioning wing 3 can cover the front edge and the inner and outer side surfaces of the lower jaw ascending limb of a patient, the area of the tissue surface of the positioning wing 3 is determined according to the size of the jaw bone of the patient and the design of an operation incision, but the positioning wing 3 cannot be too large because the operation visual field is originally narrow; the positioning wing 3 is too small to easily find the anatomical shape of the corresponding mandible, which affects fixation. Therefore, the length, width and height of the positioning wing 3 are required to be not more than 3cm, 3cm and not less than 1cm, 1 cm.
The following is a detailed description of the making and using of the present invention.
1. Pre-operative data acquisition
After the preoperative orthodontics is finished, the upper and lower jaw plaster models of the patient are taken for standby; CT data of the hard tissues of the jaw face of the patient are obtained through CT scanning; and scanning the upper and lower jaw plaster models by using a three-dimensional scanner, and obtaining a three-dimensional scanning file of the plaster models through corresponding software.
2. Surgical design and the manufacture of said plywood
The software with the function of digitally reconstructing the CT data in three dimensions is used for obtaining a three-dimensional reconstruction image of the hard tissue of the jaw face of the patient, and the three-dimensional scanning file of the plaster model is imported to replace the dentition so as to obtain clearer dentition and occlusion relation. The surgical plan is designed according to the data of the patient's face shape, occlusion and cephalogram measurement, and the movement of the osteotomy and bone segments is simulated on the three-dimensional reconstructed image. And designing a bone pre-osteotomy plywood and a bone post-osteotomy plywood according to the operation scheme, and a connecting rod 2 and a positioning wing 3 which are connected with the bone pre-osteotomy plywood and the bone post-osteotomy plywood to obtain modeling data of the orthognathic surgery plywood. It should be noted that the shape of the mandibular ascension positioning wing 3 and the position of engagement with the mandibular ascension, as well as the shape of the cortical screw fixation hole 7 in the positioning wing 3 and the position of engagement with the mandibular ascension, should be identical before and after osteotomy. And (3) importing modeling data into a three-dimensional printer after the orthognathic surgery plywood is designed before and after osteotomy, and printing and manufacturing the orthognathic surgery plywood by using the three-dimensional printer. And after the plywood is printed, polishing and disinfecting for later use.
3. Used in surgery
Before the lower jaw BSSRO is carried out, the orthognathic surgical plate before osteotomy is arranged on the lower jaw, and holes are punched at the corresponding lower jaw ascending and supporting part according to the cortical screw fixing holes 7 designed on the positioning wings 3 for marking. After the orthognathic surgical plate is removed before osteotomy, mandibular BSSRO is performed. And after the mandible is cut into a proximal bone section and a distal bone section, the mandible is firstly cut according to the shape of the maxillary dental arch, the orthognathic surgical plywood is arranged on the upper jaw, the distal bone section of the lower jaw is adjusted and moved, and the distal bone section is positioned under the guidance of the plywood. After the positions of the upper jaw and the lower jaw are confirmed and the orthognathic surgical plywood is stably positioned, the intermaxillary ligation is performed temporarily. Adjusting and moving the proximal end bone segment until the lifting supports on the left side and the right side are respectively attached to the positioning wings 3, and determining that the cortical screw fixing hole 7 on the orthognathic surgery plywood is matched with the mark hole before the mandible osteotomy, namely, the lifting support of the mandible is positioned at the designed position. After the two side lifting supports and the positioning wings 3 are temporarily fixed by using cortical screws through cortical screw fixing holes 7 of the orthognathic surgical plywood, firm internal fixation is respectively carried out between the two side mandible osteotomy sections. After the firm internal fixation is completed, the cortical bone screw at the positioning wing 3 is removed, the maxilla is ligated and the orthognathic surgical plate is removed. If the occlusal plate 1 is worn after operation, the connecting pieces and the positioning wings 3 can be abraded at the connecting part with the occlusal plate 1.
It should be noted that the above is only a preferred embodiment of the present invention, and the present invention is not limited thereto, and although the present invention has been described in detail with reference to the embodiments, it will be apparent to those skilled in the art that the technical solutions described in the foregoing embodiments can be modified or some technical features can be replaced with equivalents, but any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention should be included in the scope of the present invention.
Claims (9)
1. An orthognathic surgery plywood used for positioning a lower jaw ascending and descending is characterized by comprising an occlusal plate and positioning wings used for being connected with the lower jaw ascending and descending, wherein the occlusal plate is of an arc structure, the upper surface and the lower surface of the occlusal plate are respectively provided with a tooth impression matched with the shapes of upper and lower jaw dentitions of a patient, and a plurality of ligation holes which are arranged at intervals along the length direction of the occlusal plate are used for inter-jaw ligation; the two positioning wings are respectively connected to two ends of the bite plate through connecting pieces; the positioning wing is an arc-shaped plate, the inner side of the arc-shaped plate is attached to the lower jaw ascending limb of the patient, and a cortical screw fixing hole used for being connected with the lower jaw ascending limb of the patient is formed in the arc-shaped plate.
2. An orthognathic surgical plate according to claim 1 wherein guide ramps are provided in the occlusal plate along the upper and lower surfaces thereof which are inclined in the lingual direction of the dental impression, the guide ramps meeting the lingual side of the dental impression to facilitate guiding the plate into position during surgery.
3. An orthognathic surgical plate for mandibular advancement positioning according to claim 2, wherein the angle α between the inclined guide surface and the upper and lower surfaces of the bite plate is between 30 ° and 60 °.
4. The orthognathic surgical template for mandibular advancement positioning according to claim 2, wherein the intersection of the guide ramp with the lingual side of the dental impression is a distance H from 1/4 to 1/3 of the depth H of the dental impression from the inner bottom of the dental impression.
5. The orthognathic surgical plate for mandibular advancement positioning according to claim 1, wherein the connecting member is a V-shaped structure comprising two links having one end intersecting and connected to the end of the bite plate; the other ends of the two connecting rods are respectively connected with the outer side surface of the positioning wing, and the two connecting rods and the positioning wing form a triangular structure.
6. The orthognathic surgical plate for mandibular advancement positioning according to claim 5, wherein the connecting rod is cylindrical and has a diameter of 1-4 mm.
7. The orthognathic surgical plate for mandibular ascension positioning according to claim 5, wherein the outer side of the positioning wings is connected to the connecting rods, the inner side of the positioning wings is a tissue surface that conforms to the anatomical contours of the patient's corresponding mandibular ascension front edge and inner and outer sides, and the thickness between the outer side of the positioning wings and the tissue surface is 1 to 4 mm.
8. The orthognathic surgical plate for mandibular advancement positioning according to claim 1, wherein the positioning wings have cortical screw fixation holes for cortical screws to fix the mandibular advancement at locations corresponding to the anterior edge of the mandibular advancement and/or the medial and lateral sides of the mandibular advancement.
9. An orthognathic surgical plate for mandibular advancement positioning according to claim 1, wherein the positioning wings have a length by width by height of no more than 3cm by 3cm and no less than 1cm by 1 cm.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202020765928.XU CN213217733U (en) | 2020-05-11 | 2020-05-11 | Orthognathic surgery plywood for lifting and positioning lower jaw |
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| CN202020765928.XU CN213217733U (en) | 2020-05-11 | 2020-05-11 | Orthognathic surgery plywood for lifting and positioning lower jaw |
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| CN213217733U true CN213217733U (en) | 2021-05-18 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114224514A (en) * | 2021-12-09 | 2022-03-25 | 四川大学 | Orthognathic operation locator based on intelligent control |
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2020
- 2020-05-11 CN CN202020765928.XU patent/CN213217733U/en active Active
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114224514A (en) * | 2021-12-09 | 2022-03-25 | 四川大学 | Orthognathic operation locator based on intelligent control |
| CN114224514B (en) * | 2021-12-09 | 2023-04-21 | 四川大学 | Positioner for orthognathic surgery based on intelligent control |
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