DE102021110531B4 - Oral surgical bone block holder - Google Patents

Abstract

Oral surgical bone block holder (1), designed for holding a bone block (9) and for attaching a bone block (9) to a jaw section of a human jaw (10), the bone block holder (1) comprises a first gripping lever (21a) and a second gripping lever (21b ), wherein the gripping levers (21) are rotatably connected to one another via a joint (23), a first holding surface (33a) being attached to the first gripping lever (21a) and a second holding surface (33b) being attached to the second gripping lever (21b) and/ or can be attached, the bone block holder being set up in such a way that the two holding surfaces (33a, 33b) are aligned with one another in the attached state and the bone block (9) can be clamped between the two holding surfaces (33a, 33b), characterized in that a first holding surface (33a) is attached to a first holding area (24a) of the first gripping lever (21a), and that a second holding surface (33b) is attached to a second holding area (24b) of the second gripping lever (21b), the first holding area (24a) and/or the second holding area has a template bore (41) across the associated first or second holding surface (33a, 33b), wherein the second holding area (24b) and/or the first holding area has an outlet opening (42) across the respective second or first holding surface (33b, 33a).

Description

The invention relates to an oral surgical bone block holder.

When an implant is inserted into a jawbone, a drill is used to create a drill hole in the jaw in which the implant is attached. A minimum bone width is required for stable attachment of the implant, although this is not the case in some patients. The jawbone can then be artificially widened using an autologous bone transplant.

To do this, a bone block from the patient is taken from another part of the jaw or another bone and placed on the side of the jawbone, thereby artificially widening it. The transplanted bone grows together with the original jawbone, creating a sufficiently wide jawbone section into which the implant can be inserted.

The removed bone block must be processed after removal and before insertion into the jawbone. In particular, the surrounding edges of the jaw block must be processed. In particular, a circumferential predetermined breaking point can be introduced there, at which the bone block is subsequently divided into two bone disks. There is currently no suitable tool available for this processing.

The US 2014 / 0 012 338 A1 discloses a surgical implant inserter for inserting a surgical implant, comprising: a first clamp, the first clamp having a first handle; a second clamp having a second handle pivotally connected to the first handle at a pivot point, at least one of the first clamp and the second clamp holding at least a portion of the surgical implant; and a coupling for coupling the first and second handles to the first and second clamps to enable the first and second clamps to move toward and away from one another along a generally linear common axis of motion and for the first and second ones to move Clamps can rotate when the first and second clamps press the at least a portion of the surgical implant against at least one bone.

The DE 33 11 347 C2 discloses a manually operable pulling tool for surgical staples that, when implanted in the skin of a patient, have an exposed web and opposing L-shaped legs engaging the skin. The pulling tool has an upper handle and a lower handle, each with a front and a rear end. The handles are hinged together near their front ends and are manually pivotable between open and closed positions.

The invention is based on the object of providing a suitable tool for the processing and subsequent insertion of a bone block into the oral cavity, which can be used in particular in the context of an autologous bone transplant.

The object on which the invention is based is achieved by an oral surgical bone block holder according to claim 1; Refinements are the subject of the subclaims and the description.

The bone block holder is set up to hold a bone block of the type mentioned at the outset. The bone block holder comprises a first gripping lever and a second gripping lever, the gripping levers being rotatably connected to one another via a joint. A first holding surface is attached to the first gripping lever and a second holding surface is attached and/or attachable to the second gripping lever. The two holding surfaces are aligned with each other when attached. The bone block can be clamped between the two holding surfaces.

When designing the bone block holder, additional requirements must be taken into account in particular, which require its use on the bone to be transplanted. It is therefore necessary that the bone block holder can be sterilized and that the material does not interact with cooking. The material that can be considered, at least for the holding surfaces, is titanium or a suitable stainless steel alloy.

In one embodiment, the holding surfaces are detachably attached to the associated gripping lever. In this case, the holding surfaces or the holding jaws carrying the holding surfaces can, if necessary, be selected from a large number of units available. The geometry of the bone block holder can be selected as required to suit the requirements. A single bone block holder thus becomes more flexible in its range of applications.

In one embodiment, the holding surface, in particular together with the holding jaw, is secured to the holding area via a securing mechanism. This can prevent the holding surface from coming loose during use. In particular, the security mechanism can be inserted enable the holding jaw along an insertion direction and prevent removal against the insertion direction while the bone block is being held as intended.

In one embodiment, the securing mechanism comprises a predetermined breaking point, wherein the securing mechanism is set up in such a way that a targeted break of the predetermined breaking point enables the holding surfaces to be removed from the holding area. The broken predetermined breaking point can also represent an indicator that the holding surface or holding jaw has already been used once. Accordingly, a holding surface that has already been removed can no longer be attached to the holding area.

In one embodiment, the holding surfaces are permanently attached to the associated gripping lever, in particular formed integrally with the associated gripping lever. The setup time is shortened in this embodiment because the bone block holder is immediately ready for use.

In one embodiment, a circumferential edge of the bone block held between the holding surfaces is accessible to a processing tool, which serves in particular to create a circumferential predetermined breaking point.

In particular, a free space zone is provided which extends from the holding surface in the direction of the joint. The free space zone represents in particular an access area for the processing tool. The free space zone can represent a projection of a gap between the two holding surfaces in the direction of the joint. The free space zone can extend from the holding surface at least 5mm towards the joint.

The previously described free space zone in particular also extends completely around the entire holding area. This allows full accessibility of the edge.

In one embodiment, at least one holding mandrel, in particular a plurality of holding mandrels, is attached to the first holding surface and projects in the direction of the second holding surface. Alternatively or in combination, at least one holding mandrel is attached to the second holding surface and projects in the direction of the first holding surface. The holding pins can penetrate the bone block and hold the bone block more reliably. At least the static friction between the holding area and the bone block can be increased.

In one embodiment, two stops are provided. In a stop state, the two stops rest against one another and the holding surfaces are arranged at a distance from one another. This ensures that the holding surfaces always have a predetermined minimum distance from one another and, in particular, that the compression effect on the bone block is limited. The stops are in particular arranged on one of the two gripping levers.

In one embodiment, the holding surfaces are trapezoidal. In particular, a long side length of the holding surface is a maximum of 25mm, in particular a maximum of 20mm, and/or a short side length of the holding surface is shorter than the long side length, in particular the short side length is a maximum of 15mm. In particular, the height of the holding surface is a maximum of 15mm.

The invention relates to an arrangement comprising a bone block holder of the type described above. The arrangement comprises a first set with a plurality of first, in particular releasable, holding jaws, the first holding jaws being accommodated in at least one sterile packaging. The set includes in particular two first holding jaws. The first holding jaws can be contained in a common sterile packaging.

The arrangement according to the invention particularly provides for the gripping levers and the holding jaws to be kept separately. The holding jaws can be made available as a sterile disposable item, whereby the set of holding jaws can be selected from a range as required. The gripping levers can be intended for multiple use.

In addition to the first set, a second set can be provided with a plurality of second holding jaws, the second holding jaws being accommodated separately from the first holding jaws in at least one sterile packaging. If necessary, the holding jaws of the first or second set can be selected.

In one embodiment, the holding jaws of the first set and the holding jaws of the second set have a different nominal distance from one another. The nominal distance refers to the distance between the two holding surfaces of the respective holding jaws when these are attached to the gripping lever and the bone block holder is in the stop position.

• der Knochenblockhalter umfasst Anschläge und ist derart eingerichtet, dass
  • - in einem Anschlagzustand die Anschläge miteinander in Anlage sind,
  • - im Anschlagzustand weisen die an den Greifhebeln angebrachten Haltebacken einen geringstmöglichen Abstand zueinander auf,
  • - die Haltebacken sind derart ausgebildet, dass im Anschlagzustand die Halteflächen einen Abstand zueinander aufweisen, welcher dem Nennabstand entspricht.

The nominal distance of a set of holding jaws is defined in particular as follows:

• the bone block holder includes stops and is set up in such a way that
  • - in a stop state the stops are in contact with one another,
  • - in the stop state, the holding jaws attached to the gripping levers are at the smallest possible distance from one another,
  • - The holding jaws are designed in such a way that in the stop state the holding surfaces are at a distance from one another which corresponds to the nominal distance.

To prepare the bone block holder, the depth of the bone block can first be determined. Based on this, a set of holding jaws is then selected from a plurality of sets of holding jaws. The holding jaws selected in this way are now attached to the gripping levers of the bone block holder.

In one embodiment, the first holding surface is permanently attached to the first gripping lever, while the second holding surface is detachably attached to the second gripping lever. The setup time is therefore reduced, while at the same time there is flexibility with regard to the nominal distance.

In one embodiment, the bone block holder is set up in such a way that a peripheral edge of the bone block held between the holding surfaces is accessible to a processing tool.

In one embodiment, a free space zone is provided which extends from the holding surface towards the joint. The free space zone can in particular represent a projection of a gap between the two holding surfaces in the direction of the joint. The free space zone can alternatively or in combination extend from the holding surface at least 5mm towards the joint.

• - beträgt eine lange Seitenlänge der Haltefläche max. 40 mm, insbesondere etwa 35 mm, und/oder
• - ist eine kurze Seitenlänge der Haltefläche kürzer als die lange Seitenlänge und beträgt insbesondere max. 35 mm, und/oder
• - beträgt eine Höhe der Haltefläche max. 15 mm.

In one embodiment, the holding surfaces are trapezoidal. In particular

• - a long side length of the holding surface is a maximum of 40 mm, in particular approximately 35 mm, and/or
• - a short side length of the holding surface is shorter than the long side length and is in particular a maximum of 35 mm, and/or
• - the height of the holding surface is max. 15 mm.

By rotating the gripping levers along an axis of rotation defined by the joint, the holding surfaces can be moved toward or away from each other.

In one embodiment, the arrangement comprises a first set with a plurality of first holding jaws, the first holding jaws being accommodated in at least one sterile packaging. The first holding jaws can be accommodated in a common sterile packaging. In particular, a set comprises two first holding jaws.

In one embodiment, the arrangement comprises a second set with a plurality of second holding jaws, the second holding jaws being accommodated separately from the first holding jaws in at least one sterile packaging.

In one embodiment, the first set and the second set have a different nominal distance from one another.

According to the invention, a first holding surface is attached to a first holding area of the first gripping lever, and a second holding surface is attached to a second holding area of the second gripping lever.
The first holding area and/or the second holding area has a template hole across the respective first or second holding surface, wherein the second holding area has an outlet opening across the respective second or first holding surface. The template hole can be used to guide a drilling tool, which can be used to create a hole for screwing the bone block into the jawbone. The drilling tool can be passed through the outlet hole on the other holding area on the other side.

The template hole can have a cross section of max. 2mm and a length of at least 2mm. This can ensure adequate guidance of the drilling tool required for this purpose.

The outlet opening can have a larger cross section than the template hole. It should be taken into account here that the outlet opening should serve less to guide the drilling tool, but in different situations an exact alignment of the two holding areas will not be possible. The larger outlet opening provides the tolerance for the inexact, in particular not parallel, alignment of the two holding areas when creating the bore.

In one embodiment, the template hole of one holding area is in such a way receiving opening of the other holding area is arranged so that in a closed position of the bone block holder a straight drilling tool can be guided both through the template hole and through the receiving opening, in particular even if the holding areas are not aligned parallel to one another.

In one embodiment, the gripping lever has a handle. The handle has a bulbous course starting from the joint up to a distal end. The bulbous shape allows for easy handling and good power transmission from the user's hand to the bone block holder. The handle can have a first handle section, an adjoining second handle section, and an adjoining third handle section, the second handle section having a diameter of at least 1.5 times the first handle section and the third handle section.

In one embodiment, the gripping lever has a handle, the handle having a main grip direction starting from the joint up to a distal end, which is aligned at an acute angle, in particular of max. 45° or max. 20°, to a main holding direction of the holding section. In this way, good handling of the bone block holder can be ensured even if the bone block is introduced into the mouth area of a patient and is to be connected to the jawbone there.

In particular, the main holding direction is defined by a direction of the longest extent of the holding surface.

In particular, the main grip direction is defined by a straight line through the joint and a distal end of the grip section.

• Ermitteln einer Tiefe des Knochenblocks,
• Auswählen eines Satzes von Haltebacken aus einer Mehrzahl von Sätzen von Haltebacken basierend auf der ermittelten Tiefe;
• Anbringen der Haltebacken des ausgewählten Satzes an die Greifhebel des Knochenblockhalters.

In one embodiment, the invention comprises a method for preparing a bone block holder or an arrangement of the aforementioned type. The method comprises the following method steps:

• Determining a depth of the bone block,
• selecting a set of jaws from a plurality of sets of jaws based on the determined depth;
• Attach the holding jaws of the selected set to the gripping levers of the bone block holder.

The advantages and refinements mentioned with regard to the method and the device are also applicable to the device or the method.

• 1 einen erfindungsgemäßen Knochenblockhalter
  1. a) in Seitenansicht,
  2. b) in Draufsicht;
• 2 einen zu haltenden Knochenblock in perspektivischer Ansicht;
• 3 der Knochenblock nach 2 in zwei Teile geteilt;
• 4 die Halteanordnung des Knochenblockhalters nach 1 in schematischer Seitenansicht in einer ersten Ausgestaltung;
• 5 die Halteanordnung des Knochenblockhalters nach 1 in schematischer Seitenansicht in einer zweiten Ausgestaltung;
• 6 zwei Sätze Haltebacken des Knochenblockhalters jeweils in einer Sterilverpackung;
• 7 die Halteanordnung des Knochenblockhalters nach 1 in schematischer Seitenansicht in einer dritten Ausgestaltung;
• 8 einen Sicherungsmechanismus in der Ausgestaltung nach den 4 und 5;
• 9 eine Abwandlung des Sicherungsmechanismus nach 8;
• 10 ausschnittsweise zwei schematische Ansichten des Knochenblockhalters während einer bestimmungsgemäßen Verwendung.

The invention is explained in more detail below with reference to the figures; herein shows:

• 1 a bone block holder according to the invention
  1. a) in side view,
  2. b) in plan view;
• 2 a perspective view of a bone block to be held;
• 3 the bone block 2 divided in two parts;
• 4 the holding arrangement of the bone block holder 1 in a schematic side view in a first embodiment;
• 5 the holding arrangement of the bone block holder 1 in a schematic side view in a second embodiment;
• 6 two sets of bone block holder holding jaws, each in sterile packaging;
• 7 the holding arrangement of the bone block holder 1 in a schematic side view in a third embodiment;
• 8th a security mechanism designed according to the 4 and 5 ;
• 9 a modification of the security mechanism 8th ;
• 10 Partially two schematic views of the bone block holder during intended use.

The bone block holder 1 according to the invention has a gripping arrangement 2 and a holding arrangement 3. The gripping arrangement 2 is set up so that the user can grip the bone block holder 1 and can provide a gripping force B by gripping. The holding arrangement 3 is designed to hold a bone block 9 with a holding force H. By providing the gripping force B, the holding force H can be generated, which holds the bone block 9 securely on the holding arrangement 3.

2 shows a bone block 9, which is to be held by the bone block holder. The bone block 9 essentially has a prismatic shape based on a trapezoid as a base surface. The trapezoid has two parallel sides, each with a short side length I2 and a long side length I1 and a height h. The bone block 9 has a depth t, which geometrically represents the extent of the parallel displacement of the trapezoid base. It goes without saying that the above geometric data represents only a rough description of the real bone block and should not be understood as exact in the geometric sense.

The depth t of the bone block 9 is in particular a maximum of 10 mm, in particular 5 - 8 mm.

The long side length I1 of the bone block 9 is in particular a maximum of 40 mm, in particular approximately 35 mm.

The short side length I2 of the bone block 9 is in particular shorter than the long side length I1.

The height of the bone block 9 is in particular a maximum of 15 mm.

The peripheral edge K of the bone block 9 is processed for further use. In particular, if necessary, a predetermined breaking point 91, in particular a circumferential one, is introduced into the edge K. The predetermined breaking point 91 can be formed by a notch. At this predetermined breaking point, the bone block 9 is divided into two bone block disks 92 of approximately the same size ( 3 ). During the processing of the peripheral edge K, the bone block 9 is held by means of the bone block holder 1. The circumferential edge K is accessible to a processing tool, in particular a milling tool, while the bone block is held in the bone block holder.

The gripping arrangement 2 has two gripping levers 21a, 21b, which are connected to one another via a joint 23 so that they can rotate about an axis of rotation A. The gripping levers 21 are designed essentially identically and are described together below.

A gripping lever 21 has a handle 22 for gripping by the user and a holding area 24. The joint 23 is arranged between the handle 22 and the holding area 24. The two gripping levers 21a, 21b overlap at the joint 23, so that the two gripping levers 21 form an x-shaped arrangement. If the handles 22 of the two gripping levers 21a, 21b are moved towards one another, this also produces a movement of the holding areas 24 of the two gripping levers 21a, 21b towards one another.

A jaw receptacle 25 is arranged on the holding area 24 for receiving one holding jaw 31 ( 4 and 5 ). The holding jaw 31 has a second jaw attachment 36, which cooperates with a first jaw attachment 26 of the holding area 24. Together, the two jaw fasteners 26, 36 hold the holding jaw 31 on the holding area 24. In the present example, the jaw fasteners are designed as a snap-in connection. One of the jaw fastenings is designed as a locking projection, the other jaw fastening is designed as a locking receptacle for the locking projection.

The holding jaws 31 each have a holding surface 33a, 33b. In the assembled state, the two holding surfaces 33a, 33b of the two holding jaws 31 face each other. The bone block 9 is clamped in a space Z between the holding surfaces 33a, 33b when a sufficient holding force H is generated. For improved fixation of the bone block 9, at least one holding mandrel 34 can be provided on the holding surface 33 of at least one of the holding jaws, in particular on the holding surfaces on both holding jaws, which protrudes in the direction of the other holding surface. The holding pins 34 ensure that even if the holding force decreases for a short time, the bone block 9 is still held reliably and does not fall down.

The movement of the holding surfaces towards one another is limited by a pair of stops 27, in particular one stop 27 being attached to each of the holding areas 24. The holding surfaces are therefore at a minimum distance X1 ( 4 ) or X2 ( 5 ) held to each other. The 4 and 5 each show the bone block holder in the stop state, ie the stops 27 lie against one another and the holding jaws 31 have the smallest possible distance X1, X2 from one another.

The 4 and 5 each show holding jaws 31 in the same gripping arrangement 2. The holding jaws 31 are designed differently in the respective embodiments with regard to the arrangement of the holding surfaces 31 relative to the jaw fastenings 36. This has the result that the holding surfaces 31 in the 5 have a minimum distance X2 that is less than the minimum distance X1 in the embodiment 4 .

In the present embodiment, the smallest distance X1, X2 is determined by the shape of the holding jaws, since the holding areas 24 are held at a fixed minimum distance from one another by the stops. The specific minimum distances X1, X2 of the respective holding jaws 31x, 31y is therefore referred to as the nominal distance that is inherent in the holding jaws.

The holding jaws 31 are preferably selected such that the nominal distance X1, The stops also prevent the bone block from being compressed too much.

A free space zone F adjoins the holding surface 33 in the direction of the joint 23. This free space zone F makes it possible to make the circumferential edge K accessible from the side of the joint 23 using a machining tool. The free space zone has a distance D in the direction of the joint 23 of at least 5 mm from the holding surface 33. The joint 23, the stop 27 and other parts, if any, are arranged outside this free space zone F.

The free space zone F is in particular a projection of the space Z between the two holding surfaces in the direction of the joint 23.

The user can now select a suitable set of holding jaws 31 depending on the depth t of the bone block and insert them into the holding areas 24. The holding jaws of a set S1, S2 are packaged sterile and intended for a single use. 6 shows two different sets S1, S2 with holding jaws from the 4 and 5 , each contained in a sterile packaging 32. It is irrelevant whether the holding jaws of a set are accommodated in a common sterile packaging 32 or whether the holding jaws of a set are each accommodated separately from one another in two sterile packaging 32 (both variants are in 6 shown). It is relevant that the holding jaws from different sets are not contained in the same sterile packaging.

In 6 The shape of the holding surface 33 can also be seen. The holding surface is trapezoidal, although a geometrically exact trapezoidal shape is not important here either. The holding surface 33 has two parallel sides, each with a short side length L2 and a long side length L1 and a height H.

The geometric description of the holding surface applies generally, in particular regardless of further configurations, in particular regardless of whether the holding surfaces are detachably or firmly attached to the gripping levers.

The holding surface is trapezoidal, with the holding surface having a long side length I1, a short side length L2 and a height H. An exact trapezoidal shape is also not important for the holding surface.

The long side length L1 of the holding surface 33 is in particular a maximum of 25 mm, in particular a maximum of 20 mm.

The long side length L1 of the holding surface 33 is in particular at least 10mm, in particular at least 15mm.

The short side length L2 of the holding surface 33 is in particular shorter than the long side length L1.

The height H of the holding surface 33 is in particular a maximum of 15 mm, in particular a maximum of 10 mm.

The height H of the holding surface 33 is in particular at least 5 mm.

7 shows parts of an embodiment of the bone block holder, in which the holding surfaces 33 are each firmly attached to the respectively assigned gripping lever 21, in particular are formed integrally with the respective assigned gripping lever 21. Furthermore, the features of the previously presented bone block holders are based on the design 7 applicable.

8th shows details of an embodiment with releasable holding jaws 31. Shown are parts of a holding jaw 31 and a holding area 24 of the gripping lever 21, to which the holding jaw 31 is attached.

To connect the holding jaw 31 to the holding area 24, the holding jaw 31 is displaced in an insertion direction E relative to the holding area 24. The insertion direction E is, for example, in 6 marked on the top holding jaw 31. In 4 shows the insertion direction into the image plane and is aligned parallel to the z-axis. The holding jaw 31 is consequently inserted into the holding area 24 parallel to the height H of the trapezoidal shape. The holding area 24 itself tapers: the taper thus provides a natural stop for the holding jaw 31.

To secure the holding jaw 31 on the holding area 24, a securing mechanism 38, 28 is provided. The securing mechanism includes a securing latch 38 with a projection 382 on the holding jaw 31. The securing mechanism includes a securing receptacle 28 on the holding area 24. In a securing state ( 8b) the projection 382 protrudes into the securing receptacle 28 in such a way that the projection is prevented from shifting against the insertion direction E during the intended use of the bone block holder.

The projection 382 is arranged on a deformable lever 381. During the insertion of the holding jaw 31 along the insertion direction E, the lever 231 ( 8a) bend in such a way that insertion is possible. The lever is put under pretension. The bolt 832 prestressed in this way then snaps into the safety receptacle 28. The latch 382 latched in this way then prevents the holding jaw 31 from moving against the insertion direction E during intended use.

A predetermined breaking point 383 is provided on the safety latch 38, in this example between the lever 381 and the projection 382. The predetermined breaking point 383 is formed by a specifically weakened point with a reduced cross section. To remove the holding jaw 31 from the holding area 24, the holding jaw is subjected to high force against the insertion direction E. This leads to a break in the predetermined breaking point 383 ( 8c ). The projection can therefore no longer provide any holding force.

In this example, the predetermined breaking point 383 is preferably designed in such a way that the projection 382 is merely bent when the predetermined breaking point breaks, but remains on the safety latch 38. This prevents material parts from entering the treatment room in an uncontrolled manner.

9 shows details of a modification of the design 8th in the backup state analog 8b . Also shown is a security mechanism 38, 28, which essentially provides an identical function to the security mechanism 8th . Only the shape of the components has changed slightly. In particular, the latch 28 and the securing receptacle 38 have a cylindrical or spherical securing surface.

10a shows the bone block holder 2 during possible use, with at least one bone block 9 (one or two bone blocks 9) being attached to an exposed portion of a jawbone 10. The bone block 9 is held on the holding pins.

The bone block 9 should be screwed to the jawbone 10. For this purpose, coaxial drillings must be made through the bone block or both bone blocks and the jawbone 10, along a first drilling direction S1 or a second drilling direction S2. The bone block holder 2 serves as a drilling template.

For this purpose, the holding area 24 or the holding jaw 31 has a template hole 41, which forms a guide for a drilling tool (not shown). The drilling tool is intended to carry out mutually aligned bores through the at least one bone block and the jawbone.

The template hole 41 has a diameter D41 of max. 2mm and a length L41 of at least 2mm, so that a drilling tool can be guided through the template hole 41. An outlet opening 42 is arranged on the opposite holding area 24 or holding jaw 31, which is coaxially aligned with the template bore 41 of the other holding area 24 or holding jaw 31.

10b shows a slightly modified use in which the two holding areas 24 or holding jaws 31 are not aligned exactly parallel to one another. Such a relatively imprecise alignment of the two holding areas is likely to be the standard case when used as intended, since the jawbone usually also has an irregular shape. In order to still be able to set the hole with the drilling tool, the outlet opening 42 is designed with a larger diameter. The drilling tool can thus protrude through the outlet opening even if the holding areas 24 or holding jaws 31 are aligned differently to one another.

Each holding area 24 or each holding jaw 31 has a template hole 41 and an outlet opening 42 in order to be able to place the hole through the bone block and the jaw section from both sides. The hole is placed in particular from the oral cavity towards the cheek side, so that the template hole is arranged on the side of the oral cavity. The handle points towards the mouth opening. A drilling in the first drilling direction S1 is used, for example, if the section of the jawbone 10 is a left lower jaw section. A drilling in the second drilling direction S2 is used, for example, if the section of the jawbone 10 is a right lower jaw section. The previous directional information refers to the direction in which the patient is facing.

The handle has a bulbous course starting from the joint 23 to a distal end 22d ( 1 ). In particular, the handle 22 has a first handle section 22a, an adjoining second handle section 22b, and an adjoining third handle section 22c. The second handle section 22b has a diameter of at least 1.2 times the first handle section 22a and the third handle section 22c. The bulbous shape essentially replicates the internal shape of a fist and thus enables force to be transferred from the hand to the handle, which promotes optimal gripping of the bone block.

Starting from the joint 23 to the distal end 22d, the handle has a main grip direction gr, which is aligned at an acute angle gh of approximately 15° to a main holding direction hr of the holding arrangement 3. This increases ergonomics when attaching the bone block to the patient's jawbone. If the handle is guided through the mouth opening, the holding surface must be arranged parallel to the jaw plane.

Reference symbol list

1

Bone block holder

2

Gripping arrangement

21a,b

Gripping lever

22

Handle

22a-c

Handle section

22d

distal end

23

joint

24

Holding area

25

Jaw recording

26

first jaw attachment

27

attack

28

Backup recording

3

Holding arrangement

31

holding jaw

32

Sterile packaging

33

holding surface

34

retaining mandrel

36

second jaw attachment

38

safety latch

381

lever

382

head Start

383

Predetermined breaking point

41

Template drilling

42

Exhaust opening

9

Bone block

10

Jawbone

t

Depth of bone block

I1

first length of the bone block

I2

second length of bone block

H

Height of the bone block

L1

first length of the holding surface

L2

second length of the holding surface

gr

Main grip direction

Mr

Main holding direction

gh

Angle between main grip direction and main holding direction

H

Height of the holding surface

F

Open space zone

D

Distance of the free space zone around the holding area

A

Axis of rotation

G

Gripping strength

H

Holding power

K

surrounding edge

E

Insertion direction

Z

Space between the holding surfaces

S1

first drilling direction

S2

second drilling direction

X1, X2

Nominal distance between the holding surfaces of a set

Claims (10)

Oral surgical bone block holder (1), designed for holding a bone block (9) and for attaching a bone block (9) to a jaw section of a human jaw (10), the bone block holder (1) comprises a first gripping lever (21a) and a second gripping lever (21b ), wherein the gripping levers (21) are rotatably connected to one another via a joint (23), a first holding surface (33a) being attached to the first gripping lever (21a) and a second holding surface (33b) being attached to the second gripping lever (21b) and/ or can be attached, the bone block holder being set up in such a way that the two holding surfaces (33a, 33b) are aligned with one another in the attached state and the bone block (9) can be clamped between the two holding surfaces (33a, 33b), characterized in that a first holding surface (33a) is attached to a first holding area (24a) of the first gripping lever (21a), and that a second holding surface (33b) is attached to a second holding area (24b) of the second gripping lever (21b), the first holding area (24a) and/or the second holding area has a template bore (41) across the associated first or second holding surface (33a, 33b), wherein the second holding area (24b) and/or the first holding area has an outlet opening (42) across the respective second or first holding surface (33b, 33a). Bone block holder (1). Claim 1 , characterized in that the holding surfaces (33a, 33b) are permanently attached to the associated gripping lever (21a, 21b); or that the holding surfaces (33a, 33b) are detachably attached to the associated gripping lever (21a, 21b), in particular wherein the holding surfaces (33a, 33b) are attached via a securing mechanism (28, 38). are secured in the holding area, in particular wherein the securing mechanism (28, 38) comprises a predetermined breaking point (383), the securing mechanism (28, 38) being set up in such a way that the holding surfaces (33a) can be removed by a targeted break of the predetermined breaking point (383). 33b) is made possible by the holding area. Bone block holder (1) according to one of the preceding claims, characterized by at least one holding mandrel (34), in particular a plurality of holding mandrels (34), wherein the at least one holding mandrel (34) is attached to the first holding surface (33a) and in the direction of second holding surface (33b), and/or wherein the at least one holding mandrel (34) is attached to the second holding surface (33b) and projects in the direction of the first holding surface (33a). Bone block holder (1) according to one of the preceding claims, characterized by two stops (27, 27) which are set up in such a way that in a stop state - the two stops rest against one another, - the holding surfaces (33a, 33b) are arranged at a distance from one another, wherein in particular a distance (X1, Bone block holder (1) according to one of the preceding claims, characterized in that the outlet opening (42) is aligned with the template bore in a closed state. Bone block holder (1) according to the previous claim, characterized in that the template bore (41) has a cross section of max. 2mm and a length of at least 2mm and/or, and that the outlet opening (42) has a larger cross section than the template bore (41). Bone block holder (1) according to one of the preceding claims, characterized in that the template bore (41) of one holding area (24a) is arranged in relation to the receiving opening of the other holding area (24b) such that in a closed position of the bone block holder (1) a straight Drilling tool can be guided through both the template hole (41) and the outlet opening (42). Bone block holder (1) according to one of the preceding claims, characterized in that the gripping lever (21a) has a handle (22), the handle (22) having a bulbous course starting from the joint (23) to a distal end (22d). , in particular, the handle (22) has a first handle section (22a), an adjoining second handle section (22b), and an adjoining third handle section (22c), the second handle section (22b) having at least 1.5 times the diameter of the first handle section (22a) and the third handle section (22c). Bone block holder (1) according to one of the preceding claims, characterized in that the gripping lever (21a) has a handle (22), the handle (22) having a main grip direction (gr.) starting from the joint (23) to a distal end (22d). ) which is aligned at an acute angle (gh), in particular max. 45° or max. 20°, to a main holding direction (hr) of the holding section. Arrangement (1) comprising a bone block holder (1) according to one of the preceding claims.

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