EP1853175A1 - Outil medical de decoupe d'une paroi en un materiau dur, et procede de decoupe correspondant - Google Patents

Outil medical de decoupe d'une paroi en un materiau dur, et procede de decoupe correspondant

Info

Publication number
EP1853175A1
EP1853175A1 EP06707406A EP06707406A EP1853175A1 EP 1853175 A1 EP1853175 A1 EP 1853175A1 EP 06707406 A EP06707406 A EP 06707406A EP 06707406 A EP06707406 A EP 06707406A EP 1853175 A1 EP1853175 A1 EP 1853175A1
Authority
EP
European Patent Office
Prior art keywords
tool
handpiece
hard material
material wall
working area
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.)
Withdrawn
Application number
EP06707406A
Other languages
German (de)
English (en)
Inventor
Walter Mössle
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Kaltenbach and Voigt GmbH
Original Assignee
Kaltenbach and Voigt GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Kaltenbach and Voigt GmbH filed Critical Kaltenbach and Voigt GmbH
Publication of EP1853175A1 publication Critical patent/EP1853175A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1695—Trepans or craniotomes, i.e. specially adapted for drilling thin bones such as the skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C3/00—Dental tools or instruments
    • A61C3/02—Tooth drilling or cutting instruments; Instruments acting like a sandblast machine
    • A61C3/03—Instruments operated by vibration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1688—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the sinus or nose
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320074—Working tips with special features, e.g. extending parts blade
    • A61B2017/320077—Working tips with special features, e.g. extending parts blade double edge blade, e.g. reciprocating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/0061—Air and water supply systems; Valves specially adapted therefor

Definitions

  • the invention relates to a medical tool or handpiece for cutting a hard material wall and a method for cutting a material wall using a medical handpiece with tool according to the preamble of claim 1, 2 or 15.
  • clamping tools have already been proposed in each case in a handpiece whose cutting work movement is a rotational movement or a vibratory movement.
  • a medical or dental instrument and a tool for such an instrument are described, wherein a front longitudinal portion of the instrument is formed by a rod-shaped handpiece with a forwardly projecting handpiece shaft, arranged in the free end region of a holding device for the tool is and can be brought by a vibration drive in the handpiece in vibration.
  • the tool is formed by a so-called rose drill whose shaft is abrasive in a longitudinal section adjoining the working head. Through this abrasive longitudinal section of Shank it is possible to machine the edge of an access opening of a cavity.
  • the tool or the handpiece according to DE 198 25 261 A1 is set up to work out a cutout in a fabric on the basis of the tubular shape of a saw blade-shaped tool, the tool being simultaneously abrasive on the entire circumference of its sleeve-shaped form.
  • the tool described in DE 298 10 114 U1 is set up to machine a cavity in the body tissue at the edge, wherein the depth of the cavity is less than the depth of the body tissue.
  • the tool is able to machine an annular edge of a cavity, however, the tool is not adapted to work out a cut or cutout in the body tissue.
  • the invention has the object of developing a tool or a handpiece or a method of the type described above so that a handling-friendly, especially continuous, cutting the hard material wall is achieved.
  • a guide slide element protruding laterally from it is arranged, which is smooth on its upper side.
  • the hole in the hard material wall, through which the guide sliding element can be placed and placed behind the hard material wall, can be machined by the working section, or a slot or a cutout in the hard material wall can be machined with the working section starting from the hole incorporated.
  • the invention thus further comprises the use of the medical tool for the preparation of a cut or cutout in a cranial bone wall.
  • the incorporation of only a single exit hole in the hard material wall is required, whereby the incorporation of at least two further exit holes can be avoided and saved in comparison with the prior art.
  • a curved cut can be incorporated and therefore any desired shape of the cut or cut can be realized. It is only a single exit hole required, in which the tool can be introduced so that the guide slide with its smooth top engages behind at least one of the two inner cut edges. When cutting a curve, the tool should be guided so that the guide sliding element remains behind the inner cutting edge.
  • the tool when cutting a curve, therefore, the tool is to be continuously rotated so slightly that the guide slide is always directed across the cutting line.
  • the thereby required attention of the user can be reduced if the guide slide is formed by a flange projecting on all sides, which is preferably arranged circular and coaxial with the shaft.
  • the engagement of the hard material wall is ensured in each rotational position of the tool, without the user must pay special attention.
  • the tool with the guide slide element is rotationally symmetrical with respect to its longitudinal central axis
  • the tool is also suitable for a rotating working movement.
  • the handpiece has a rotary drive for the tool.
  • the tool, handpiece and / or method according to the invention are suitable or suitable not only for the human or animal body but also for models or prostheses thereof or for artificial bodies or body parts for practicing cutting or operating.
  • a preferred embodiment of the guide slide is a flat leg or a flat disc, the free peripheral wall is preferably rounded convex.
  • Such a guide sliding element allows a gentle investment inside the hard material wall, whereby injuries are avoided.
  • the embodiments according to the invention are particularly suitable for cutting and separating a bone wall, on the inside of which a periosteum or membrane (dura) is arranged, as is the case with the human or animal cranial bone.
  • the guide slide is moved when cutting or separating between the inner edge of the cutting edge and the membrane, wherein the Membrane is lifted from the inside of the bone wall.
  • the membrane is also treated gently, the anchor and guiding effect of the anchor element can be exploited.
  • the membrane is not perforated and if possible not injured.
  • their detachment from the bone wall is already initiated by the lifting of the membrane, so that the membrane can be easily removed or peeled off.
  • the method according to the invention makes it possible to cut the hard material wall and, in particular, to cut out a cutout with simple and handling-friendly handling. In this case, the aforementioned advantages of the invention can also be achieved.
  • features are included which further simplify the medical tool or handpiece or method and form a quick cut of selective cut lines or allow cutouts.
  • FIG. 1 shows a medical instrument according to the invention with a handpiece and a tool attached thereto for cutting a hard material wall by cutting, in particular for cutting one
  • Bone wall in side view; 2 shows the treatment instrument in an operative position in perspective view; 3 shows the front end region of a tool according to the invention in an enlarged view; 4 shows the section IV - IV in Fig. 3; Fig. 5 shows an operation site in a schematic representation.
  • the instrument designated in its entirety by 1 in FIG. 1 is particularly suitable for cutting and separating a hard material wall, in particular a bone wall.
  • the main parts of the instrument 1 are an elongated handpiece 2 with a rod-shaped and preferably straight-grip part 2a and a handpiece shaft 3, which is mounted in the handle part 2a, is accessible from the front end and protrudes, for example, and in the front end region of a holding device 4 is arranged for a tool 5.
  • the tool 5 is a straight or angled or curved extending component that in its rear End region has a connecting shaft 5 a for connecting to the handpiece shaft 3, in its central region a support shaft 5 b, in its front end region in which it preferably extends straight, a work area 5 c and at its front end a laterally projecting from the working area 5 c sliding element 5 d , which performs an armature and support function to be described in operation operation.
  • the working area 5c is designed to be abrasive at least on a side directed transversely to the projecting guide sliding element 5d, preferably over the entire circumference.
  • a vibratory drive 6 arranged in the instrument 1 or handpiece 2
  • the working area 5c by a lateral feed movement 10 of the same a section through a hard material wall, in particular a bone wall 7, incorporated, wherein the working area 5 c passes through the hard material wall.
  • the hard material wall is a bone wall 7, e.g. a skull bone, on the inside of which a periosteum is arranged, which is referred to below as membrane 8.
  • the guide sliding element 5d is smooth, in particular on its upper side 5e, preferably on all sides, so that it slides well in a lateral movement relative to the hard material wall and membrane 8 and causes only a slight sliding stress.
  • the upper side 5e encloses with the lateral surface of the working region 5c or its longitudinal central axis 5f an approximately right angle Wl, which may also be slightly larger, and e.g. about 90 ° to 110 °, in particular about 95 ° to 100 °.
  • the axial thickness a of the anchor element 5d may be approximately the same size as the cross-sectional size dl of the working region 5c or smaller. In the exemplary embodiment, the thickness a is about 0.1 mm to 1 mm, in particular about 0.3 mm.
  • the cross-sectional dimension d1 may be about 0.5 mm to 3 mm or more, e.g. about 1 mm up
  • the work area 5c may be convergent with respect to its cross-sectional size d1 in the direction of the guide slide 5d.
  • the underside 5g preferably extends at right angles to the working area 5c or its longitudinal central axis 5f.
  • the free end of the anchor element 5d is preferably convergent radially outwardly, in particular rounded at its flange edge 5h, for example rounded in a semicircular shape, as shown in particular in FIG.
  • the bottom 5g and / or the top 5e may be planar surfaces. In the context of the invention, however, the guide sliding element 5d is also advantageous useful if the top 5e and / or the bottom 5g is slightly curved or are, for example, in the sense of curvature of a discus.
  • the upper side 5e and / or the lower side 5g can thus form support surfaces which are shaped convergent with respect to a center plane extending at right angles to the longitudinal center plane of the working region 5c towards the free end or edge of the guide sliding element.
  • the lateral projection b, with which the guide slide element 5d projects laterally from the working region 5c, can be e.g. about 1 mm to 5 mm or more, in particular about 2 mm.
  • the supernatant b is greater than the cross-sectional dimension dl of the working area 5c.
  • the flat guide slide element 5d can protrude to one or both opposite sides.
  • the guide sliding element 5d is formed by a disk which protrudes on all sides and is preferably of circular design and is arranged concentrically to the longitudinal central axis 5f, its diameter d2 being approximately 5 mm.
  • the tool 5 may have a channel 9 extending longitudinally in its shaft 5i, which emerges from the shaft 5i at such a point with a mouth opening 9a that a treatment agent supplied through the channel 9, e.g. a cooling and / or disinfecting liquid, is directed to the working area 5 c and / or on the guide slide 5d.
  • a treatment agent supplied through the channel 9 e.g. a cooling and / or disinfecting liquid
  • the channel 9 extends through the tool 5 to its free end, wherein the channel 9 exits at the bottom 5g approximately centrally from the guide slide 5d with a beam.
  • a treatment gas e.g. Air or a mixture to be supplied.
  • the abrasiveness of the working area 5c can be realized in different ways.
  • the lateral surface of the working area 5c can be occupied eg with small hard particles, eg diamond-coated.
  • the working area 5c has approximately longitudinally, in particular straight, extending cutting edges 11, which may be formed, for example, by a polygonal, for example triangular to square, cross-section.
  • FIG. 4 shows a quadrangular cross-section, wherein the cutting edges 11 formed by the corners can have the same spacing from one another in the circumferential direction.
  • the working area 5 c may have longitudinal grooves 12, which preferably terminate in the cutting edges 11 and may be rounded, for example, in cross-section.
  • the handle part 2a of the handpiece 2 projecting or with its front end approximately final rod-shaped handpiece shaft 3 is elastically pivotally mounted on all sides in the grip part 2a.
  • elastically yielding or compressible bearing parts 13, 14, for example, bearing rings serve, which are arranged at an axial distance from each other. Due to the elastically yielding mounting of the handpiece shaft 3, it is center-centered at rest in a vibration center position.
  • the vibration generator or vibration drive 6 generates high-frequency short-stroke oscillations in the sense of a vibration with a preferably in the sound or
  • Ultrasonic frequency range the oscillations or amplitudes being e.g. transversely and / or along the handle shaft 3 may be linear or may be elliptical or circular circumferential and in each case in a plane or their direction may vary spatially. Spatial vibrations have proven to be particularly advantageous. Due to the radial and axial resilient mounting of the handpiece shaft 3 are in the
  • Directions is abrasive effective.
  • the respective direction of action of the tool 5, in which the latter sinks into the material to be processed, is directed transversely, preferably at right angles to the abrasive working area 5 c.
  • the vibration drive has a frequency of about 4 kHz to 8 kHz, preferably about 6 kHz, wherein in the region of the tool 5, an amplitude of the preferably spatial oscillations of about 0.05 mm to 0.2 mm, in particular about 0.1 mm, results.
  • a control device be assigned so that it allows adjustment of the vibration power in the aforementioned range or a setting beyond this range, so that possibly also considerably larger amplitudes can be adjusted.
  • the handpiece 2 is preferably connected by a quick-release coupling 15, in particular a threaded coupling or a plug-in coupling, releasably connected to a connecting piece 16, from which extends a supply line 17 to a supply unit, not shown.
  • a quick-release coupling 15 in particular a threaded coupling or a plug-in coupling
  • the plug-in coupling is preferably one which, in the coupled state, ensures rotation of the handpiece 2 about its longitudinal central axis 2b and thereby ensures passage of the at least one treatment or cooling medium in a medium line 9a extending forwards through the handpiece 2 to to the Tool 5 extends where it is connected to the channel 9.
  • Such designated with plug / rotary coupling coupling is formed with a cylindrical or stepped cylindrical coupling pin 15a and a rotatably receiving coupling recess 15b, wherein in the present embodiment, the coupling pin 15a protrudes from the connector 16 to the front and the coupling recess 15b opens to the rear of the handpiece 2 ,
  • a known detachable, in particular manually überdrückbare elastic securing device 18 unintentional release of the plug / rotary coupling is prevented in the coupled state.
  • the securing device 18, which is effective with an elastically prestressed securing element can be over-pressed and locked or released in a way that is easy to handle.
  • a hard material wall can be machined on a narrow side in a simple, advantageous and easy-to-handle manner or separated by cutting or cut out a cutout 21 in the hard material wall.
  • the tool 5 is attached to the hard material wall on the narrow side so that the guide sliding element 5d engages under the hard material wall. Then the tool with its working area 5c is moved laterally against the hard material wall 7 when the drive 6 is switched on so that the working area 5c is abrasive or machined and mills or incorporates a slot 22 in the material wall.
  • the working area 5c extends obliquely to a connecting shaft 5a of the tool 5 or to the longitudinal central axis 2b of the handpiece 2, the angle W2 included therebetween being obtuse, and preferably about 105 ° to 135 °, in particular 120 ° is.
  • the working section 5c and a section of the shaft 5i facing it may be formed in an angular or arcuate manner to the side facing away from the guide sliding element 5d.
  • the guide sliding element 5d is formed by a flat disc which preferably projects from the working area 5c on all sides.
  • the guide slide 5d may be formed by a laterally projecting flat leg. Even with such an embodiment of the anchor member 5d this is able to ensure the desired operation and operation guidance and support function, in which the guide slide 5d is guided on the underside of the bone wall. The operator does not need it to watch that the tool 5 slips out of the slot 22, since this is prevented by the guide slide member 5d by placing it on the underside.
  • the feed movement 10 is to be performed transversely to this leg in order to ensure the aforementioned guiding and supporting function.
  • a flat leg which forms the guide sliding element 5d can also protrude on both sides, so that both slit edges are grasped under.
  • a hole 23 is made in the hard material wall in the edge area of the desired cutout 21, e.g. is drilled so large that the front end of the tool 5 is introduced with the laterally projecting guide sliding member 5 d therein in a starting position described above, in which the cutting operation can begin.
  • the embodiment according to the invention and the method according to the invention are particularly advantageous for cutting a hard material wall, in particular a bone wall 7, on the inside of which a membrane rests which is formed by a bone skin in a bone wall 7.
  • a skull bone is the dura.
  • Sinus lift in the maxillary sinus is e.g. around the Schneidersche membrane.
  • Such a type of membrane protects the underlying tissue and must not be perforated, on the contrary, a gentle treatment is desired.
  • a bone wall 7, which is occupied on the underside by a membrane 8, can also be machined, cut or cut on the narrow side with the tool 5 or handpiece 2 according to the invention, as has already been described, without the membrane 8 being perforated or damaged. It is essential that in this case the tool 5 is set so that the guide sliding element 5d passes between the membrane 8 and the bone wall 7 and is guided there. This can be achieved in a simple manner by moving and pressing the tool 5 narrowly against the bone wall 7 while maintaining a slight pressure of the anchor element 5d against the underside of the bone wall 7, see feed direction 10.
  • the thus formed bone portion 24 can be detached from the membrane 8 and removed. After that stands the surgical site a surgical intervention below the bone wall 7 available.
  • the handpiece 2 has a rotary drive for the tool 5.

Abstract

L'invention concerne un outil médical (5) servant à la découpe d'une paroi en un matériau dur (7), comprenant une tige (5i) présentant une zone de travail (5c) au moins sur une partie de sa longueur, laquelle exerce, par vibration ou rotation, une action abrasive. L'invention vise à obtenir, par manipulation facile, une découpe continue de ladite paroi en un matériau dur et, à cet effet, est caractérisée en ce qu'il est prévu à l'extrémité avant de la tige (5i), un élément coulissant de guidage plat (5d), latéralement à distance de celle-ci, venant en prise au-dessous de ladite paroi en un matériau dur, et qui est configuré lisse sur sa face supérieure (5e).
EP06707406A 2005-03-03 2006-03-03 Outil medical de decoupe d'une paroi en un materiau dur, et procede de decoupe correspondant Withdrawn EP1853175A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102005009802A DE102005009802A1 (de) 2005-03-03 2005-03-03 Medizinisches Werkzeug oder Handstück zum Schneiden einer Hartmaterialwand und Verfahren zum Schneiden einer Materialwand unter Verwendung eines medizinischen Handstücks mit Werkzeug
PCT/EP2006/001976 WO2006092327A1 (fr) 2005-03-03 2006-03-03 Outil medical de decoupe d'une paroi en un materiau dur, et procede de decoupe correspondant

Publications (1)

Publication Number Publication Date
EP1853175A1 true EP1853175A1 (fr) 2007-11-14

Family

ID=36353307

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06707406A Withdrawn EP1853175A1 (fr) 2005-03-03 2006-03-03 Outil medical de decoupe d'une paroi en un materiau dur, et procede de decoupe correspondant

Country Status (4)

Country Link
US (1) US20080161844A1 (fr)
EP (1) EP1853175A1 (fr)
DE (1) DE102005009802A1 (fr)
WO (1) WO2006092327A1 (fr)

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GB0618366D0 (en) * 2006-09-19 2006-10-25 Sra Dev Ltd Improved ultrasonic surgical tool
ES2346909T3 (es) * 2006-09-25 2010-10-21 Piezosurgery S.R.L. Pieza manual con herramienta quirurgica para realizar orificios en tejidos oseos.
US8029523B2 (en) * 2007-03-30 2011-10-04 Innovative Implant Technology, Llc Maxillary bone cutting system, kit, and method of using the same
FR2915671A1 (fr) * 2007-05-04 2008-11-07 Satelec Sa Insert ultrasonique de soulevement de membrane sinusienne
US9271751B2 (en) * 2007-05-29 2016-03-01 Ethicon Endo-Surgery, Llc Ultrasonic surgical system
CN101828975B (zh) * 2009-03-09 2013-01-02 温世政 齿槽骨切削装置
EP2745796B1 (fr) * 2012-12-21 2018-03-21 W & H Dentalwerk Bürmoos GmbH Instrument sonique destiné à séparer deux tissus différents
US20170333169A1 (en) * 2016-05-19 2017-11-23 Tram Quynh Hoang Scaler Tips and Implant Cleaning Inserts

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Also Published As

Publication number Publication date
WO2006092327A1 (fr) 2006-09-08
US20080161844A1 (en) 2008-07-03
DE102005009802A1 (de) 2006-09-07

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