DE9115341U1 - Support grid for receiving particulate bone replacement materials - Google Patents
Support grid for receiving particulate bone replacement materialsInfo
- Publication number
- DE9115341U1 DE9115341U1 DE9115341U DE9115341U DE9115341U1 DE 9115341 U1 DE9115341 U1 DE 9115341U1 DE 9115341 U DE9115341 U DE 9115341U DE 9115341 U DE9115341 U DE 9115341U DE 9115341 U1 DE9115341 U1 DE 9115341U1
- Authority
- DE
- Germany
- Prior art keywords
- support grid
- plastic
- grid according
- bone
- support
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 239000000316 bone substitute Substances 0.000 title claims description 11
- 239000004033 plastic Substances 0.000 claims description 18
- 229920003023 plastic Polymers 0.000 claims description 18
- 229920000642 polymer Polymers 0.000 claims description 10
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical class CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 claims description 9
- 238000001356 surgical procedure Methods 0.000 claims description 9
- 230000001815 facial effect Effects 0.000 claims description 6
- 230000009477 glass transition Effects 0.000 claims description 6
- 239000003814 drug Substances 0.000 claims description 5
- 229940079593 drug Drugs 0.000 claims description 5
- 229920006125 amorphous polymer Polymers 0.000 claims description 4
- JJTUDXZGHPGLLC-IMJSIDKUSA-N 4511-42-6 Chemical compound C[C@@H]1OC(=O)[C@H](C)OC1=O JJTUDXZGHPGLLC-IMJSIDKUSA-N 0.000 claims description 3
- 239000003242 anti bacterial agent Substances 0.000 claims description 3
- 229940088710 antibiotic agent Drugs 0.000 claims description 3
- 230000015556 catabolic process Effects 0.000 claims description 3
- 239000000824 cytostatic agent Substances 0.000 claims description 3
- 230000001085 cytostatic effect Effects 0.000 claims description 3
- 238000006731 degradation reaction Methods 0.000 claims description 3
- 229920000704 biodegradable plastic Polymers 0.000 claims description 2
- 238000010521 absorption reaction Methods 0.000 claims 1
- 229920001169 thermoplastic Polymers 0.000 claims 1
- 239000004416 thermosoftening plastic Substances 0.000 claims 1
- 210000000988 bone and bone Anatomy 0.000 description 18
- 238000002271 resection Methods 0.000 description 11
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 5
- WSFSSNUMVMOOMR-UHFFFAOYSA-N Formaldehyde Chemical compound O=C WSFSSNUMVMOOMR-UHFFFAOYSA-N 0.000 description 3
- 230000015572 biosynthetic process Effects 0.000 description 3
- 239000004310 lactic acid Substances 0.000 description 3
- 235000014655 lactic acid Nutrition 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 229910001220 stainless steel Inorganic materials 0.000 description 3
- 239000010935 stainless steel Substances 0.000 description 3
- 230000006978 adaptation Effects 0.000 description 2
- 229920002988 biodegradable polymer Polymers 0.000 description 2
- 239000004621 biodegradable polymer Substances 0.000 description 2
- 230000036760 body temperature Effects 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 230000002349 favourable effect Effects 0.000 description 2
- 239000007943 implant Substances 0.000 description 2
- 238000011065 in-situ storage Methods 0.000 description 2
- 229920004934 Dacron® Polymers 0.000 description 1
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Chemical class OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 239000004677 Nylon Substances 0.000 description 1
- 238000009825 accumulation Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 239000004202 carbamide Substances 0.000 description 1
- 238000002512 chemotherapy Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000006735 deficit Effects 0.000 description 1
- 238000002405 diagnostic procedure Methods 0.000 description 1
- 239000003937 drug carrier Substances 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 239000000806 elastomer Substances 0.000 description 1
- 210000003054 facial bone Anatomy 0.000 description 1
- 210000002454 frontal bone Anatomy 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- JJTUDXZGHPGLLC-UHFFFAOYSA-N lactide Chemical compound CC1OC(=O)C(C)OC1=O JJTUDXZGHPGLLC-UHFFFAOYSA-N 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000004060 metabolic process Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 229920001778 nylon Polymers 0.000 description 1
- 230000011164 ossification Effects 0.000 description 1
- 229920000747 poly(lactic acid) Polymers 0.000 description 1
- 239000005020 polyethylene terephthalate Substances 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 230000001681 protective effect Effects 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 210000000216 zygoma Anatomy 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/148—Materials at least partially resorbable by the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2/2803—Bones for mandibular reconstruction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2/2846—Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
- A61B17/8071—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30065—Properties of materials and coating materials thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/30677—Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
- A61F2002/30909—Nets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0071—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof thermoplastic
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Epidemiology (AREA)
- Biomedical Technology (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Neurology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Chemical & Material Sciences (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Plastic & Reconstructive Surgery (AREA)
- Materials For Medical Uses (AREA)
- Surgical Instruments (AREA)
Description
1. Dr. med. dent. Dipl.-Chem. Alfred Patyk, Nonnenstieg 20, 3400 Göttingen1.Dr. med. dent. Dipl.-Chem. Alfred Patyk, Nonnenstieg 20, 3400 Göttingen
2. Dr. med. Dr. med. dent. Hans Albert Merten, Robert-Koch-Str. 40, 3400 Göttingen2. Dr. med. Dr. med. dent. Hans Albert Merten, Robert-Koch-Str. 40, 3400 Göttingen
Stützgitter zur Aufnahme von partikulären KnochenersatzmaterialienSupport grid for receiving particulate bone replacement materials
Die Erfindung bezieht sich auf ein Stützgitter zur Aufnahme von partikulären Knochenersatzmaterialien insbesondere bei der osteoplastischen Mund-, Kiefer- und Gesichtschirurgie, wobei das Stützgitter aus einem physiologisch verträglichen Kunststoff besteht. Gerade bei der Mund-, Kiefer- und Gesichtschirurgie ergibt sich häufig die Notwendigkeit, zerstörte oder entfernte Knochenbereiche neu aufzubauen. Dies gilt beispielsweise nach der Entfernung eines Tumors im Kieferbereich. Als besonders effektiv hat sich hierbei der Einsatz von partikulären KnochenersatzmaterialienThe invention relates to a support grid for receiving particulate bone replacement materials, particularly in osteoplastic oral, maxillofacial and facial surgery, whereby the support grid consists of a physiologically compatible plastic. Especially in oral, maxillofacial and facial surgery, there is often a need to rebuild destroyed or removed bone areas. This applies, for example, after the removal of a tumor in the jaw area. The use of particulate bone replacement materials has proven to be particularly effective in this regard.
herausgestellt. Diese werden in der Regel der Beckenkammregion (Spongiosachips) des Patienten selbst entnommen. Bis zur Bildung eines Ersatzknochens aus den partikulären Knochenersatzmaterialien müssen diese mechanisch abgestützt werden. Bei vollständiger Durchtrennung beispielsweise des Unterkiefers sind zusätzlich die beiden Resektionsstümpfe gegeneinander zu fixieren.These are usually taken from the patient's iliac crest region (spongiosa chips). Until replacement bone is formed from the particulate bone replacement materials, they must be mechanically supported. If the lower jaw is completely severed, for example, the two resection stumps must also be fixed against each other.
Ein Schutzgitter der eingangs beschriebenen Art ist bekannt. Hierbei ist der Kunststoff Dacron oder Nylon und mit einem Polyäther-Harnstoff-Elastomer imprägniert. Das Stützgitter weist die Form einer Halbschale auf, die einen menschlichen Unterkiefer aufnimmt. Bei der Anwendung ist mit einer Schere der benötigte Teil des Kunststoffgitters aus der Halbschale herauszutrennen. Anschließend ist das Stützgitter an den festen Knochenbestandteilen des zu behandelnden Unterkiefers zu fixieren. Hierzu werden in der Regel Drähte aus rostfreiem Stahl verwendet. Beim Fixieren wird das Stützgitter, welches als halbstarr zu bezeichnen ist, an die Konturen des zu behandelnden Kiefers angepaßt. Das am Kiefer fixierte Stützgitter kann dann mit den partikulären Knochenersatzmaterialien gefüllt werden. Als nachteilig stellt sich bei dem bekannten Stützgitter heraus, daß es in einer zweiten Operation wieder vom Kieferknochen abgenommen werden muß. Andernfalls treten mit relativ großer Häufigkeit Komplikationen auf. Außerdem kann das bekannte Stützgitter nur mit sehr großem Aufwand präzise an die Resektionsstümpfe eines zu behandelnden Unterkieferknochens angepaßt werden. Hierzu ist ein Modell der Resektionsstümpfe anzufertigen. An den zu behandelnden Kiefer selbst kann das Stützgitter nur durch die Befestigungsmaterialien angedrückt werden.A protective grille of the type described above is known. The plastic is Dacron or nylon and impregnated with a polyether-urea elastomer. The support grille has the shape of a half-shell that accommodates a human lower jaw. When using it, the required part of the plastic grille is to be cut out of the half-shell using scissors. The support grille is then fixed to the solid bone components of the lower jaw to be treated. Stainless steel wires are usually used for this. When fixing, the support grille, which can be described as semi-rigid, is adapted to the contours of the jaw to be treated. The support grille fixed to the jaw can then be filled with the particulate bone replacement materials. A disadvantage of the known support grille is that it has to be removed from the jawbone again in a second operation. Otherwise, complications occur with relatively high frequency. In addition, the known support grid can only be precisely adapted to the resection stumps of a mandibular bone to be treated with great effort. For this purpose, a model of the resection stumps must be made. The support grid can only be pressed onto the jaw to be treated using the fastening materials.
Es sind biologisch abbaubare Polymere bekannt, die beispielsweise auf Derivaten der Milchsäure, wie L-Lactid, DL-Lactid und Polylactiden basieren. Aus diesen Kunststoffen lassen sich Schienen, Platten, Schrauben und DrähteBiodegradable polymers are known that are based on, for example, lactic acid derivatives such as L-lactide, DL-lactide and polylactides. These plastics can be used to make splints, plates, screws and wires.
ausbilden, die bei der Knochenchirurgie vorteilhaft einsetzbar sind. Sie ersetzen hier Metallteile, die nach der Heilung des behandelten Knochens in einer zweiten Operation wieder zu entfernen wären.which can be used advantageously in bone surgery. They replace metal parts that would have to be removed again in a second operation after the treated bone has healed.
Der Erfindung liegt die Aufgabe zugrunde, ein Stützgitter der eingangs beschriebenen Art aufzuzeigen, das nach dem Aufbau des Ersatzknochens nicht wieder entfernt werden muß und eine präzise Anpassung an die zu behandelnden Mund-, Kiefer- oder Gesichtsknochen erlaubt.The invention is based on the object of providing a support grid of the type described above which does not have to be removed again after the construction of the replacement bone and which allows a precise adaptation to the oral, jaw or facial bones to be treated.
Erfindungsgemäß wird dies dadurch erreicht, daß der Kunststoff ein biologisch abbaubares und thermoplastisch verformbares Polymer ist. Ein Stützgitter aus biologisch abbaubarem Kunststoff zersetzt sich bei geeignet gewählter Abbauzeit im Anschluß an die Bildung des Ersatzknochens und ruft so keine Störungen hervor, wie sie von dauerhaften Implantaten bekannt sind. Werden zur Befestigung des Stützgitters an Resektionsstümpfen Schrauben aus Edelstahl verwandt, so sollten diese jedoch nach der Bildung des Ersatzknochens und dem biologischen Abbau des Stützgitters wieder explantiert werden. Dies ist jedoch mit äußerst geringem Aufwand möglich. Schrauben sind diesbezüglich gegenüber Draht als Befestigungsmittel zu bevorzugen. Es ist jedoch auch möglich, Schrauben zur Befestigung des Stützgitters zu verwenden, die ebenfalls aus resorbierbarem Material hergestellt sind. Die thermische Plastizität des Stützgitters erlaubt dessen Verformung nach Erwärmung beispielsweise in einem Wasserbad. Dennoch kann im erkalteten Zustand bei Körpertemperatur eine sehr gute Stabilität erreicht werden. Diese Stabilität ist so groß, daß in vielen Fällen auf eine zusätzliche gegenseitige Versteifung der Resektionsstümpfe verzichtet werden kann. Vorteilhaft läßt sich das thermoplastisch verformbare Stützgitter bei der Operation in situ nachmodellieren. Dies kann beispielsweise unter Verwendung eines in einem Wasserbad erwärmten TupfersAccording to the invention, this is achieved by the plastic being a biodegradable and thermoplastically deformable polymer. A support grid made of biodegradable plastic decomposes after the replacement bone has formed if the degradation time is chosen appropriately and thus does not cause any problems such as those known from permanent implants. If stainless steel screws are used to attach the support grid to resection stumps, these should be explanted again after the replacement bone has formed and the support grid has biologically decomposed. However, this can be done with very little effort. In this respect, screws are preferred over wire as a fastening means. However, it is also possible to use screws to attach the support grid, which are also made of resorbable material. The thermal plasticity of the support grid allows it to be deformed after heating, for example in a water bath. Nevertheless, very good stability can be achieved when cooled at body temperature. This stability is so great that in many cases additional mutual stiffening of the resection stumps is not necessary. The thermoplastically deformable support grid can be advantageously remodeled in situ during the operation. This can be done, for example, using a swab warmed in a water bath.
erfolgen. So ist eine exakte Anpassung des Stützgitters an die gewünschte Form des Ersatzknochens und die behandelnden Resektionsstümpfe möglich. Diese Möglichkeit ist beiden bekannten Elementen aus biologisch abbaubaren Polymeren aufgrund deren massiver Formgebung nicht gegeben. Erst die lokal geringen Querschnitte der Gitterform erlauben die individuelle Anpassung des Stützgitters in situ.This allows the support grid to be precisely adapted to the desired shape of the replacement bone and the resection stumps being treated. This option is not available for the two known elements made of biodegradable polymers due to their massive shape. Only the locally small cross-sections of the grid shape allow the individual adaptation of the support grid in situ.
Die Abbauzeit des Kunststoffs in humanen Organismen kann von der Größenordnung Monate sein. Unter normalen Umständen wird aus den partikulären Knochenersatzmaterialien binnen sechs bis zwölf Wochen der Ersatzknochen gebildet. Hieran anschließend sollte sich das Stützgitter im Organismus zersetzen. Auf diese Weise wird bei minimaler Beeinträchtigung die Stützfunktion durch das Stützgitter voll gewährleistet.The degradation time of the plastic in human organisms can be of the order of months. Under normal circumstances, the replacement bone is formed from the particulate bone replacement materials within six to twelve weeks. After this, the support grid should decompose in the organism. In this way, the support function is fully guaranteed by the support grid with minimal impairment.
Der Kunststoff kann ein amorphes Polymer mit einem Glasübergang zwischen 45 und 80°C sein. Amorphe Polymere sind weitgehend rontgentransluzent, so daß postoperative bildgebende diagnostische Verfahren nicht behindert werden. Ein Glasübergang zwischen 45 und 80°C stellt sicher, daß das Stützgitter als Implantat im humanen Organismus seine maximale Stabilität aufweist, während es problemlos in einem Wasserbad auf Temperaturen erwärmt werden kann, bei denen es verformbar ist. Zudem ermöglicht ein Glasübergang bei verhältnismäßig geringen Temperaturen eine besonders leichte und schonende intraoperative Nachmodulation des Stützgitters.The plastic can be an amorphous polymer with a glass transition between 45 and 80°C. Amorphous polymers are largely X-ray translucent, so that postoperative imaging diagnostic procedures are not hindered. A glass transition between 45 and 80°C ensures that the support grid has its maximum stability as an implant in the human organism, while it can easily be heated in a water bath to temperatures at which it is deformable. In addition, a glass transition at relatively low temperatures enables a particularly easy and gentle intraoperative post-modulation of the support grid.
Das Polymer kann auf Bausteinen basieren, die Derivate der Milchsäure sind. Derartige Polymere werden mit einer Abbauzeit von einigen Monaten im menschlichen Organismus zu Milchsäure abgebaut. Die Milchsäure fällt auch bei in humanen Organismus natürlich ablaufenden Prozessen an. Der humane Organismus wird daher durch den Anfall der Milchsäure nicht geschädigt. Grundsätzlich wäre auch an die Verwendung vonThe polymer can be based on building blocks that are derivatives of lactic acid. Such polymers are broken down into lactic acid in the human organism over a period of several months. Lactic acid is also produced in processes that occur naturally in the human organism. The human organism is therefore not harmed by the accumulation of lactic acid. In principle, the use of
Polymeren zu denken, die auf Derivaten der Glycolsäure basieren. In der Praxis hat sich jedoch das Polymer "RESOMER R" (Boehringer, Ingelheim), das aus racemischen D,L-Lactid hergestellt wird, als besonders vorteilhaft erwiesen. "RESOMER R" ist ein amorphes Polymer mit einem Glasübergang zwischen 50 und 65"C.Polymers based on derivatives of glycolic acid should be considered. In practice, however, the polymer "RESOMER R" (Boehringer, Ingelheim), which is made from racemic D,L-lactide, has proven to be particularly advantageous. "RESOMER R" is an amorphous polymer with a glass transition between 50 and 65°C.
Dem Kunststoff können Arzneimittel, insbesondere Antibiotika oder Zytostatika zugesetzt sein. Bei Verwendung des Stützgitters als Wirkstoffträger können die Arzneimittel vorteilhaft genau in das gewünschte Gebiet eingebracht werden. So lassen sich lokale Infektionen bekämpfen bzw. lokale Chemotherapien durchführen. Das Stützgitter wirkt als dabei als Langzeitdepot und gibt die dem Kunststoff zugesetzten Arzneimittel mit seinem Abbau frei.Medicines, especially antibiotics or cytostatics, can be added to the plastic. When the support grid is used as a drug carrier, the medicines can be advantageously introduced into the desired area. This makes it possible to fight local infections or carry out local chemotherapy. The support grid acts as a long-term depot and releases the medicines added to the plastic as it breaks down.
Das Stützgitter kann eine Maschenweite von ca. 4 &khgr; 4 mm aufweisen, wobei zwischen den Maschen ca. 2 mm breite Stege angeordnet sind. Eine Maschenweite von 4 &khgr; 4 mm erlaubt die Manipulation der partikulären Knochenersatzmaterialien durch die Maschinen. Dennoch werden die Knochenersatzmaterialien sicher gehalten. Eine Stegbreite von 2 mm resultiert in eine hinreichende Stabilität des Stützgitters. Als vorteilhaft hat sich hierbei eine Stärke des Stützgitters von ca. 1 mm erwiesen, die hier angegebenen Größen beziehen sich auf eine Verwendung des Stützgitters bei der Mund-, Kiefer- und Gesichtschirurgie. Bei anderen Anwendungen, z. B. der Extremitätenchirurgie, mögen andere Abmessungen vorzuziehen sein.The support grid can have a mesh size of approx. 4 x 4 mm, with approx. 2 mm wide bars arranged between the meshes. A mesh size of 4 x 4 mm allows the particulate bone replacement materials to be manipulated by the machines. Nevertheless, the bone replacement materials are held securely. A bar width of 2 mm results in sufficient stability of the support grid. A thickness of approx. 1 mm for the support grid has proven to be advantageous; the sizes given here refer to the use of the support grid in oral, maxillofacial and facial surgery. For other applications, e.g. extremity surgery, other dimensions may be preferable.
Die Erfindung wird im Folgenden anhand eines Ausführungsbeispiels erläutert und beschrieben. Es zeigen:The invention is explained and described below using an exemplary embodiment. Shown are:
Figur 1 das unverformte Stützgitter nach seiner Herstellung,Figure 1 the undeformed support grid after its manufacture,
Figur 2 das Stützgitter in einer ersten Anwendungsmöglichkeit undFigure 2 the support grid in a first application and
Figur 3 das Stützgitter in einer zweiten Anwendungsmöglichkeit.Figure 3 shows the support grid in a second possible application.
Das in Figur 1 dargestellte Stützgitter 1 weist Stege 2 auf, zwischen denen Maschen 3 verbleiben. Die Stege 2 sind 2 mm
breit und die Maschenweite beträgt 4 &khgr; 4 mm. Die Stärke des Stützgitters liegt bei 1 mm. Diese Abmessung erweist sich
zumindest bei der Mund-, Kiefer- und Gesichtschirurgie als vorteilhaft. Das Stützgitter 1 besteht aus einem einerseits
physiologisch verträglichen und andererseits biologisch abbaubaren Kunststoff. Dieser Kunststoff ist ein
thermoplastisch verformbares Polymer. Hergestellt wird das Stützgitter 1 unter Einwirkung von Druck und Temperatur in
einer Preßform. Bei Verwendung des Polymers 11RESOMER R 207"
haben sich eine Temperatur von 140°C und ein Druck von 7,5
MPa, also 75 bar, bei einer Einwirkungsdauer von 30 sec als günstig herausgestellt. Nach dem Ausformen des Stützgitter
aus der Preßform kann es notwendig sein, die Kanten des Stützgitters mit langsam rotierenden, schneidenden Werkzeugen
nachzuarbeiten. Im Anschluß daran wird das Stützgitter mit Formaldehyd gassterilisiert und vor der Operation eine Woche
gelagert. Bei der Herstellung des Stützgitters ist es möglich, der Kunststoffrohmasse Arzneimittel, beispielsweise
Antibiotika oder Zytostatika, beizumischen. Eine günstige Größe für das Stützgitter ist
10 &khgr; 6 cm. Mit dieser Größe sind nahezu alle Anwendungsmöglichkeiten bei der Mund-, Kiefer- und
Gesichtschirurgie abzudecken. Es ist aber auch problemlos möglich, mehrere einzelne Stützgitter zu einer größeren
zusammenhängenden Einheit zu verschweißen.The support grid 1 shown in Figure 1 has webs 2 between which meshes 3 remain. The webs 2 are 2 mm wide and the mesh size is 4 x 4 mm. The thickness of the support grid is 1 mm. This dimension has proven to be advantageous at least in oral, maxillofacial and facial surgery. The support grid 1 consists of a plastic that is both physiologically compatible and biodegradable. This plastic is a thermoplastically deformable polymer. The support grid 1 is manufactured under the influence of pressure and temperature in a press mold. When using the polymer 11 RESOMER R 207", a temperature of 140°C and a pressure of 7.5 MPa, i.e. 75 bar, with an exposure time of 30 seconds have proven to be favorable. After the support grid has been removed from the mold, it may be necessary to rework the edges of the support grid with slowly rotating, cutting tools. The support grid is then sterilized with formaldehyde gas and stored for a week before the operation. When producing the support grid, it is possible to add drugs, such as antibiotics or cytostatics, to the raw plastic mass. A favorable size for the support grid is
10 x 6 cm. This size covers almost all possible applications in oral, maxillofacial and facial surgery. However, it is also possible to weld several individual support grids together to form a larger, connected unit.
Vor der Implantation wird das Stützgitter 1 in einem Wasserbad bis über den Bereich seines Glasübergangs erwärmtBefore implantation, the support grid 1 is heated in a water bath to above the range of its glass transition
und dann im verformbaren Zustand in die gewünschte Form gebracht. Hierzu kann es auch sinnvoll sein, Teile des Stützgitters abzutrennen.and then brought into the desired shape in a malleable state. For this purpose, it may also be useful to cut off parts of the support grid.
Figur 2 zeigt die Verwendung eines vorgeformten StützgittersFigure 2 shows the use of a preformed support grid
1 bei einem Unterkiefer 4, aus dem Knochenmaterial entfernt wurde. Der Kiefer wurde hierbei jedoch nicht vollständig durchtrennt. Vielmehr verblieb unter der Entnahmestelle ein Steg 5. Das Stützgitter 1 formt zusammen mit dem Steg 5 einen Aufnahmeraum 6 für partikuläre Knochenersatzmaterialien, die beispielsweise der Beckenkammregion des Patienten entnommen sind. Der Aufnahmeraum kann im Gegensatz zu der dargestellten Ausführungsform auch allseitig geschlossen ausgebildet werden, wobei der Verschluß natürlich erst nach Einfüllen der Knochenersatzmaterialien erfolgt. Zur genauen Anpassung des Stützgiters 1 an den Unterkiefer 4 kann dieses durch einen in einem Wasserbad erhitzten Tupfer lokal soweit erwärmt werden, daß es erneut verformbar ist. Bei Körpertemperatur ist das Stützgitter 1 jedoch starr. Im vorliegenden Fall gemäß Figur1 in a lower jaw 4 from which bone material was removed. However, the jaw was not completely severed. Rather, a bar 5 remained under the removal site. The support grid 1 together with the bar 5 forms a receiving space 6 for particulate bone replacement materials, which are taken, for example, from the patient's iliac crest region. In contrast to the embodiment shown, the receiving space can also be closed on all sides, whereby the closure naturally only takes place after the bone replacement materials have been filled in. In order to precisely adapt the support grid 1 to the lower jaw 4, it can be locally heated using a swab heated in a water bath to such an extent that it can be deformed again. At body temperature, however, the support grid 1 is rigid. In the present case according to Figure
2 nimmt das Stützgitter 1 keine nennenswerten mechanischen Kräfte auf. Es ist daher nicht unbedingt notwendig, das Stützgitter 1 fest am Unterkiefer 4 zu befestigen. Einem Verrutschen des Stützgitters 1 sollte jedoch vorgebeugt werden.2, the support grid 1 does not absorb any significant mechanical forces. It is therefore not absolutely necessary to attach the support grid 1 firmly to the lower jaw 4. However, slipping of the support grid 1 should be prevented.
Der in Figur 3 dargestellte Unterkiefer 4 ist vollständig durchtrennt. Zwei Resektionsstümpfe 7, 8 liegen sich ohne knöchernde Verbindung miteinander gegenüber. Das Stützgitter 1 bildet hier nicht nur den Aufnahmeraum 6, sondern dient auch zur starren Verbindung der Resektionsstümpfe 7, 8 miteinander. Hierzu sind Schrauben 9 vorgesehen, mit denen das Stützgitter 1 starr an den Resektionsstümpfen 7, 8 befestigt ist. Zusätzlich kann eine Überbrückungsplatte 10 vorgesehen sein, die in der Anfangsphase der Bildung eines Ersatzknochens die zwischen den Resektionsstümpfen 7, 8 auftretende Kräfte abfängt. Die Überbrückungsplatte 10 istThe lower jaw 4 shown in Figure 3 is completely severed. Two resection stumps 7, 8 lie opposite each other without a bony connection. The support grid 1 not only forms the receiving space 6, but also serves to rigidly connect the resection stumps 7, 8 to each other. For this purpose, screws 9 are provided with which the support grid 1 is rigidly attached to the resection stumps 7, 8. In addition, a bridging plate 10 can be provided, which absorbs the forces occurring between the resection stumps 7, 8 in the initial phase of the formation of a replacement bone. The bridging plate 10 is
mit Schrauben 11 an den Resektionsstümpfen 7,8 befestigt. Üblicherweise werden die Überbrückungsplatte 10 sowie die Schrauben 9 und 11 aus Edelstahl ausgebildet sein. Sie sind mit geringem Aufwand wieder zu explantieren. Ein Explantieren des Stützgitters 1, welches sich aufwendig und schwierig gestalten würde, entfällt hingegen, da es biologisch abgebaut wird.with screws 11 attached to the resection stumps 7,8. The bridging plate 10 and the screws 9 and 11 are usually made of stainless steel. They can be explanted again with little effort. Explanting the support grid 1, which would be time-consuming and difficult, is not necessary, however, as it is biologically degraded.
Vorteilhaft läßt sich das neue Stützgitter 1 auch für sog. Auflagerungsplastiken, z. B. bei der Erhöhung der Jochbeinprominenz, der Modulierung der Kinnprominenz und dem Niveauausgleich der Kalottenregion nutzen. Hierzu wird das Stützgitter im erwärmten, plastischen Zustand individuell verformt und anschließend mit den partikulären Knochenersatzmaterialien gefüllt.The new support grid 1 can also be used advantageously for so-called overlay plastics, e.g. for increasing the prominence of the cheekbone, modulating the prominence of the chin and leveling the calvarial region. For this purpose, the support grid is individually deformed in the heated, plastic state and then filled with the particulate bone replacement materials.
Weiterhin ist es möglich, das Stützgitter als sog. Platzhalter zu verwenden. Zur Erhöhung der Kieferkammregion ist es bekannt, die Kieferkammregion längs vom Kiefer abzutrennen und unter Zwischenfügung eines sog. Platzhalters erhöht wieder anzubringen. Der Platzhalter sollte hierbei die Ausbildung einer knöchernen Verbindung zwischen den beiden Teilen des Kiefers ermöglichen. Diese Eigenschaft ist dem Stützgitter zu eigen.It is also possible to use the support grid as a so-called placeholder. To raise the jaw ridge region, it is known to separate the jaw ridge region lengthways from the jaw and reattach it at a higher level with a so-called placeholder in between. The placeholder should enable the formation of a bony connection between the two parts of the jaw. This is an inherent property of the support grid.
Es versteht sich, daß es auch außerhalb des Gebiets der Mund-, Kiefer- und Gesichtschirurgie mannigfaltige Anwendungsmöglichkeiten für das Stützgitter gibt. So ist beispielsweise an einen Einsatz beim Spongiosaplastiken im Bereich der Röhrenknochen zu denken. Weiterhin kommt seine Verwendung bei der Orbitalchirurgie zur Überbrückung von Orbitalranddefekten und damit auch für die Rekonstruktion von Stirnbein- und Kalottendefekten in Frage. Die günstige Wirkungsweise des Stützgitters beruht in allen Fällen auf einer Doppelfunktion bei der Knochenneubildung. Zum einen kommt dem Stützgitter eine Richtfunktion für die neuIt goes without saying that there are also a variety of possible uses for the support grid outside the field of oral, maxillofacial and facial surgery. For example, it could be used in cancellous bone grafting in the area of long bones. It can also be used in orbital surgery to bridge defects in the orbital rim and thus also for the reconstruction of defects in the frontal bone and the skull. The beneficial effect of the support grid is based in all cases on a dual function in the formation of new bone. On the one hand, the support grid has a directing function for the new
gebildeten Knochen zu. Damit ist den Chirurgen auch die Möglichkeit gegeben, die Form des neu gebildeten Knochensn über die Ausformung des Stützgitters zu manipulieren. Zum anderen erlaubt das Stützgitter einen weitestgehend ungehinderten Stoffwechsel in den Bereichen, in denen die Knochenneubildung stattfindet. Die Maschen des Stützgitters stellen die Durchblutung dieser Bereiche sicher. Sobald das Stützgitter seine Aufgabe erfüllt hat, wird es vom betrachteten Organismus rückstandsfrei resorbiert.formed bone. This also gives surgeons the opportunity to manipulate the shape of the newly formed bone by shaping the support grid. On the other hand, the support grid allows for a largely unhindered metabolism in the areas where new bone formation takes place. The mesh of the support grid ensures blood flow to these areas. As soon as the support grid has fulfilled its task, it is reabsorbed by the organism in question without leaving any residue.
Claims (8)
Knochenersatzmaterialien insbesondere bei der
osteoplastischen Mund-, Kiefer- und Gesichtschirurgie, wobei das Stützgitter aus einem physiologisch verträglichen
Kunststoff besteht, dadurch gekennzeichnet, daß der
Kunststoff ein biologisch abbaubares und thermoplastisch
verformbares Polymer ist.1. Support grid for the absorption of particulate
Bone replacement materials, especially in
osteoplastic oral, maxillofacial and facial surgery, whereby the support grid is made of a physiologically compatible
Plastic, characterized in that the
Plastic is a biodegradable and thermoplastic
deformable polymer.
zwischen 45 und 80°C ist.3. Support grid according to claim 1, characterized in that the plastic is an amorphous polymer with a glass transition
between 45 and 80°C.
gekennzeichnet, daß das Polymer auf Bausteinen basiert, die Derivate der Milchsäure sind.4. Support grid according to claim 1 or 3, characterized
characterized in that the polymer is based on building blocks which are derivatives of lactic acid.
Zytostatika, zugesetzt sind.6. Support grid according to claim 1, characterized in that the plastic contains drugs, in particular antibiotics or
Cytostatics are added.
aufweist, wobei zwischen den Maschen (3) ca. 2 mm breite
Stege (2) angeordnet sind.7. Support grid according to claim 1, characterized in that the support grid (1) has a machine width of approximately 4 x 4 mm
between the meshes (3) there is a gap of approx. 2 mm
webs (2) are arranged.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE9115341U DE9115341U1 (en) | 1991-12-11 | 1991-12-11 | Support grid for receiving particulate bone replacement materials |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE9115341U DE9115341U1 (en) | 1991-12-11 | 1991-12-11 | Support grid for receiving particulate bone replacement materials |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| DE9115341U1 true DE9115341U1 (en) | 1992-02-20 |
Family
ID=6874094
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| DE9115341U Expired - Lifetime DE9115341U1 (en) | 1991-12-11 | 1991-12-11 | Support grid for receiving particulate bone replacement materials |
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| Country | Link |
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| DE (1) | DE9115341U1 (en) |
Cited By (23)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE4302709C1 (en) * | 1993-02-01 | 1994-07-28 | Kirsch Axel | Cover device with cover membrane |
| EP0625340A2 (en) * | 1993-04-22 | 1994-11-23 | Axel Dr. Kirsch | Sleeve for healing promotion of bone defects |
| DE4418159C1 (en) * | 1994-05-25 | 1995-09-14 | Eberle Medizintech Elemente | Mechanical supporting lattice for deflective bone filled with replacement material |
| DE4414675C1 (en) * | 1994-04-27 | 1995-09-28 | Kirsch Axel | Covering device for bone defects and method for their production |
| EP0713685A1 (en) * | 1994-11-22 | 1996-05-29 | Lucio Martinotti | Mesh for orthopaedic traumatological surgery |
| EP0741551A1 (en) * | 1994-01-28 | 1996-11-13 | American Medical Electronics, Inc. | Cranio-maxillofacial bone defect repair |
| WO1996041586A1 (en) * | 1995-06-08 | 1996-12-27 | Axel Kirsch | Device for treating a bone recess |
| DE19725788A1 (en) * | 1997-06-18 | 1998-01-29 | Strobl Walter | Support for membranes for the controlled regeneration of parodontal tissue |
| WO1998007384A1 (en) * | 1996-08-19 | 1998-02-26 | Macropore, Inc. | Resorbable, macro-porous, non-collapsing and flexible membrane barrier for skeletal repair and regeneration |
| US5741257A (en) * | 1993-02-01 | 1998-04-21 | Kirsch; Axel | Membrane for temporarily covering a bone surgery site |
| DE19741273C1 (en) * | 1997-09-19 | 1999-03-11 | Johann Flaum | Aids to stimulate tooth growth and jaw regeneration |
| WO2000059409A1 (en) * | 1999-04-06 | 2000-10-12 | Guetlbauer Franz | Bone implant device for generating tissue using bone replacement materials and method for producing said bone implant device |
| EP1069874A1 (en) * | 1998-04-07 | 2001-01-24 | Macropore, Inc. | Membrane with tissue-guiding surface corrugations |
| US6328765B1 (en) | 1998-12-03 | 2001-12-11 | Gore Enterprise Holdings, Inc. | Methods and articles for regenerating living tissue |
| FR2819715A1 (en) * | 2001-01-25 | 2002-07-26 | Cousin Biotech | BONE REPAIR DEVICE |
| WO2011136898A1 (en) * | 2010-04-29 | 2011-11-03 | Synthes Usa, Llc | Orthognathic implant |
| ITRM20110168A1 (en) * | 2011-03-31 | 2012-10-01 | Alma Mater Studiorum Uni D I Bologna | SURGICAL DEVICE FOR THE RECONSTRUCTION OF BONE STRUCTURES. |
| EP2760354A4 (en) * | 2011-09-30 | 2015-12-09 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
| US9277948B2 (en) | 2010-04-29 | 2016-03-08 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| CN107072786A (en) * | 2014-09-30 | 2017-08-18 | 尼欧斯有限公司 | Surgical membrane |
| US9924986B2 (en) | 2009-12-18 | 2018-03-27 | Charles River Engineering Solutions And Technologies, Llc | Articulating tool and methods of using |
| CN108601659A (en) * | 2016-01-28 | 2018-09-28 | 德普伊新特斯产品公司 | The division attachment of retainer is accommodated for graft |
| IT201800006534A1 (en) * | 2018-06-21 | 2019-12-21 | Improved prosthesis. |
-
1991
- 1991-12-11 DE DE9115341U patent/DE9115341U1/en not_active Expired - Lifetime
Cited By (51)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5591234A (en) * | 1993-02-01 | 1997-01-07 | Axel Kirsch | Post-surgery orthopedic covering |
| US5741257A (en) * | 1993-02-01 | 1998-04-21 | Kirsch; Axel | Membrane for temporarily covering a bone surgery site |
| DE4302709C1 (en) * | 1993-02-01 | 1994-07-28 | Kirsch Axel | Cover device with cover membrane |
| EP0625340A2 (en) * | 1993-04-22 | 1994-11-23 | Axel Dr. Kirsch | Sleeve for healing promotion of bone defects |
| EP0625340A3 (en) * | 1993-04-22 | 1995-03-29 | Kirsch Axel | Sleeve for healing promotion of bone defects. |
| EP0741551A4 (en) * | 1994-01-28 | 1998-01-07 | American Med Electronics | Cranio-maxillofacial bone defect repair |
| EP0741551A1 (en) * | 1994-01-28 | 1996-11-13 | American Medical Electronics, Inc. | Cranio-maxillofacial bone defect repair |
| US5824088A (en) * | 1994-04-27 | 1998-10-20 | Kirsch; Axel | Cover device for bone voids and method for the manufacture thereof |
| DE4414675C1 (en) * | 1994-04-27 | 1995-09-28 | Kirsch Axel | Covering device for bone defects and method for their production |
| WO1995031940A3 (en) * | 1994-05-25 | 1995-12-21 | Eberle Medizintech Elemente | Supporting grid |
| DE4418159C1 (en) * | 1994-05-25 | 1995-09-14 | Eberle Medizintech Elemente | Mechanical supporting lattice for deflective bone filled with replacement material |
| US5730743A (en) * | 1994-05-25 | 1998-03-24 | Eberle Medizintech Elemente | Supporting grid |
| WO1995031940A2 (en) * | 1994-05-25 | 1995-11-30 | Eberle Medizintechnische Elemente Gmbh | Supporting grid |
| US5766175A (en) * | 1994-11-22 | 1998-06-16 | Martinotti; Lucio | Retinaculum for orthopedic traumatology |
| EP0713685A1 (en) * | 1994-11-22 | 1996-05-29 | Lucio Martinotti | Mesh for orthopaedic traumatological surgery |
| WO1996041586A1 (en) * | 1995-06-08 | 1996-12-27 | Axel Kirsch | Device for treating a bone recess |
| WO1998007384A1 (en) * | 1996-08-19 | 1998-02-26 | Macropore, Inc. | Resorbable, macro-porous, non-collapsing and flexible membrane barrier for skeletal repair and regeneration |
| US5919234A (en) * | 1996-08-19 | 1999-07-06 | Macropore, Inc. | Resorbable, macro-porous, non-collapsing and flexible membrane barrier for skeletal repair and regeneration |
| DE19725788C2 (en) * | 1997-06-18 | 1998-07-23 | Strobl Walter | Support structure for membranes for the controlled regeneration of periodontal tissue |
| DE19725788A1 (en) * | 1997-06-18 | 1998-01-29 | Strobl Walter | Support for membranes for the controlled regeneration of parodontal tissue |
| DE19741273C1 (en) * | 1997-09-19 | 1999-03-11 | Johann Flaum | Aids to stimulate tooth growth and jaw regeneration |
| EP0903124A2 (en) | 1997-09-19 | 1999-03-24 | Johann Flaum | Aid for stimulating dental growth and regenerating jaw |
| EP1069874A4 (en) * | 1998-04-07 | 2003-03-19 | Macropore Inc | Membrane with tissue-guiding surface corrugations |
| EP1069874A1 (en) * | 1998-04-07 | 2001-01-24 | Macropore, Inc. | Membrane with tissue-guiding surface corrugations |
| US6328765B1 (en) | 1998-12-03 | 2001-12-11 | Gore Enterprise Holdings, Inc. | Methods and articles for regenerating living tissue |
| WO2000059409A1 (en) * | 1999-04-06 | 2000-10-12 | Guetlbauer Franz | Bone implant device for generating tissue using bone replacement materials and method for producing said bone implant device |
| WO2002058529A2 (en) * | 2001-01-25 | 2002-08-01 | Cousin Biotech | Bone repair device |
| WO2002058529A3 (en) * | 2001-01-25 | 2003-09-25 | Cousin Biotech | Bone repair device |
| US7208015B2 (en) | 2001-01-25 | 2007-04-24 | Cousin Biotech | Bone repair device |
| US7335232B2 (en) | 2001-01-25 | 2008-02-26 | Cousin Biotech | Method for repairing bone |
| FR2819715A1 (en) * | 2001-01-25 | 2002-07-26 | Cousin Biotech | BONE REPAIR DEVICE |
| US9808297B2 (en) | 2008-10-10 | 2017-11-07 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
| US11911083B2 (en) | 2008-10-10 | 2024-02-27 | Acumed Llc | Bone fixation system with opposed mounting portions |
| US11033306B2 (en) | 2009-12-18 | 2021-06-15 | Charles River Engineering Solutions And Technologies, Llc | Articulating tool and methods of using |
| US9924986B2 (en) | 2009-12-18 | 2018-03-27 | Charles River Engineering Solutions And Technologies, Llc | Articulating tool and methods of using |
| US10080567B2 (en) | 2010-04-29 | 2018-09-25 | DePuy Synthes Products, Inc. | Orthognathic implant and method of use |
| WO2011136898A1 (en) * | 2010-04-29 | 2011-11-03 | Synthes Usa, Llc | Orthognathic implant |
| US11357514B2 (en) | 2010-04-29 | 2022-06-14 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| US9277948B2 (en) | 2010-04-29 | 2016-03-08 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| US9855056B2 (en) | 2010-04-29 | 2018-01-02 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| EP3263050A1 (en) * | 2010-04-29 | 2018-01-03 | Synthes GmbH | Orthognathic implant |
| US9381072B2 (en) | 2010-04-29 | 2016-07-05 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| US9066733B2 (en) | 2010-04-29 | 2015-06-30 | DePuy Synthes Products, Inc. | Orthognathic implant and methods of use |
| ITRM20110168A1 (en) * | 2011-03-31 | 2012-10-01 | Alma Mater Studiorum Uni D I Bologna | SURGICAL DEVICE FOR THE RECONSTRUCTION OF BONE STRUCTURES. |
| EP2760354A4 (en) * | 2011-09-30 | 2015-12-09 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
| US9775657B2 (en) | 2011-09-30 | 2017-10-03 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
| CN107072786A (en) * | 2014-09-30 | 2017-08-18 | 尼欧斯有限公司 | Surgical membrane |
| CN108601659A (en) * | 2016-01-28 | 2018-09-28 | 德普伊新特斯产品公司 | The division attachment of retainer is accommodated for graft |
| US11207185B2 (en) | 2016-01-28 | 2021-12-28 | DePuy Synthes Products, Inc. | Splitting attachment for graft containment cage |
| IT201800006534A1 (en) * | 2018-06-21 | 2019-12-21 | Improved prosthesis. | |
| EP3586799A1 (en) * | 2018-06-21 | 2020-01-01 | Adler Ortho S.p.a. | Bone prosthesis |
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