JP2005305150A - Jaw orthopedic force applying apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an apparatus performing orthopedics of the jaws which has little invasion to the body and composes an anchorage which can be easily treated. <P>SOLUTION: The apparatus, which performs the orthopedics of the jaws by promoting or holding formation of a bone in a suturing section 2 by giving a force in an orientation of expanding or holding the suturing section 2 to two sections between which the suturing section 2 of the ossa cranii is sandwiched, comprises the first anchorage 8 which is buried in a bone, a guide 10 connected to the first anchorage 8, the second anchorage 9 formed in a way able to slide along the guide 10, and a spring 11 arranged between the first anchorage 8 and the second anchorage 9, and the jaw orthopedic force applying apparatus performing the orthopedics of the jaws by promoting or holding formation of a bone in the suturing section 2 by applying a force to two sections , between which the suturing section 2 of the ossa cranii is sandwiched, is composed. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a device for performing jaw shaping and orthodontic treatment, and more particularly to a device for applying jaw shaping force to perform jaw movement or dental correction.

  Cleft lip and palate, 1st and 2nd bow arch syndrome, clavicular cranial dystrophy, Crouzon syndrome, Treacher-Collins syndrome, Pierre Robin syndrome, Down syndrome and jaw deformities Due to its high frequency, insurance is currently applied to orthodontic treatment and surgery. Regarding the treatment, osteotomy of the maxilla and mandible has been performed after the completion of the growth. However, the size of the surgical invasion, the subsequent onset, and the return are problems. However, recently, bone extension has been performed in the maxillofacial region for growing patients.

  As a method for shaping the upper jaw, a method for rapidly expanding the maxilla developed by Haas is also known (see Non-Patent Document 1). In this method, the medial palatal suture of the constricted maxilla is separated left and right with a strong force using an enlargement screw. In this device, the device is mounted using the premolars and molars as a fixed source, and the midline palatal suture is enlarged by this device.

  In the jaw extension method, the bone itself is increased by the callus extension method. The callus lengthening method is a method developed by Ilizarov of Russia, and is a method for solving a deficiency in bone quantity or a defect by mechanically pulling and extending a callus formed after osteotomy. This method has achieved remarkable results in the field of orthopedic surgery in correcting limb bone shortening and repairing acquired bone defects.

In the maxillofacial region, extension using an external fixation device or intraoral extension device has been reported for unilateral or bilateral mandibular dysplasia.
The basic schedule for maxillary bone extension consists of osteotomy, bone extension, callus formation and fixation. Osteotomy provides mobility to the bone by artificially breaking the cortical bone and then cutting the entire bone. And callus formation waits for healing of a periosteum and formation of a callus in an osteotomy part for the healing period of one week-two weeks. In the bone extension, the callus is extended at a speed of 0.5 to 1.0 mm per day by an external fixation device having a traction mechanism. Finally, fixation is performed using an extension device until bone maturation of the extension is obtained while observing with time by X-ray examination. Many are expected to remove the device in 8-12 weeks.

  In the maxillary forward movement by the callus extension method, after cutting the maxilla, a callus is formed at the cut portion, and the maxilla is moved forward while extending the callus. Then, the maxilla is fixed until the extension bone is formed.

  However, osteoarthritis of the maxilla and mandible remains the same as the surgical invasion, and in addition to the possibility of subsequent onset, it is difficult to set the target because it is performed during the growth period. The problem is that reoperation is often performed after completion. In addition, for patients who do not need surgery, treatment to add jaw shaping power, that is, treatment to change the maxillofacial form with the maxillary anterior traction device etc. has been carried out so far, but cooperation of patients is indispensable Therefore, if the apparatus is worn for a short time, the therapeutic effect is hardly obtained. Furthermore, since there are cases where surgery is required afterwards, this is also a big problem.

In addition to this, a band is attached to the maxillary dentition, it is fixed to the moving rail, an arm is fixed to the cheekbone, and each of the maxilla is extended in the anterior and downward direction by an angle adjusting screw and an anterior extension screw in the body. A technique has been devised (see Patent Document 1).
In these methods, a target site is moved to a predetermined position, and a bone is formed therebetween, and the bone itself is greatly deformed.

  A headgear is known as one that suppresses the growth of the jawbone. This is often used to suppress the growth of the upper jaw by the force of a spring (rubber) coming out of a belt or hat wound around the head. The headgear is a device that has a large contact area and can be removed.

JP 2002-263128 A Haas AJ: Rapid expansion of the maximized denarch and nasal cavity by opening the midpalatal structure. Angle Orthodist, 31: 73-90, 1961.

As described above, the conventional surgical correction treatment and bone extension are disadvantageous in that they involve surgical invasion, so that the time and cost required for the operation are required, and there is a possibility that sequelae may occur.
Furthermore, the cooperation of skilled plastic surgeons or oral surgeons is essential for these operations. In addition to the fact that the device that applies the jaw shaping force currently used depends on the patient's cooperation level, it can apply a continuous and long-term weak force that is the most suitable correction force. There wasn't. Furthermore, there is currently no simple and minimally invasive device that promotes alveolar bone growth in the vertical direction.
Moreover, since it is possible to remove the known headgear for suppressing bone growth, the cooperation of the patient is required. Furthermore, there is a drawback that the headgear itself stands out greatly.
In these techniques, the bone fixing device is a large-scale device, and a screw is passed through the cheekbone or the like to fix the fixing device to the skull or the like. For this reason, it is difficult for an infant whose bone is not sufficiently formed, and it is necessary to wait for a certain degree of growth.
At present, the appearance of a minimally invasive jaw shaping power imparting device that overcomes all of these drawbacks is desired. Therefore, we decided to create a device for imparting jaw shaping power that can be safely and easily attached and detached by a dentist with minimal surgical invasion.

  That is, in the conventional correction, the correction force is intermittently applied, and a large correction force is required. For this reason, a large force is applied at the time of wearing, and a large burden is imposed on the wearer, and the apparatus becomes large.

Therefore, the inventor has invented a method that has a low therapeutic effect by giving a small forming force continuously, can increase the amount of enlargement, can be reliably controlled, and has a large therapeutic effect. .
That is, jaw formation and skull formation are performed by continuously applying a small forming force beyond the periodontal ligament or suture.
Specifically, implant a minimally invasive implant anchor before and after zygomatic maxillary suture, right and left of midline palatal suture, and alveolar bone for minimally invasive, low cost, safe and reliable weak continuous It adds a lot of power.
Bone growth at the sutured portion is achieved by placing an anchor across the stitched portion and applying a weak, continuous force with a spring made of Ni-Ti wire, for example, between the anchors placed over the stitched portion. Is to promote. By applying force to the stitched portion without moving the bone, the target portion is moved along with the formation of the bone.
Then, anchors are arranged on the teeth and the jawbone through the periodontal ligament, and the teeth are pushed out in the vertical direction, whereby the formation of bone in the periodontal ligament is promoted and the jawbone can be extended vertically.

The human skull is composed of a brain skull and a facial skull.
Both the brain skull and the facial skull are composed of a mixture of membranous bone and cartilage bone. Each component has its own growth and function, and each component bone is connected by fiber bonding or cartilage bonding.
There are three bone growth patterns in the skull. Endothelial growth and membranous growth.
Endochondral growth, which is bone growth by replacement of cartilage with bone, will be described in the skull base and mandible. Major cartilage connections at the skull base include butterfly occipital cartilage connection, intersphenoid cartilage connection, sphenoid bone cartilage connection, and occipital cartilage connection. The butterfly occipital cartilage bond persists from 12 to 16 years of age, the sphenoid bone cartilage bond is present until around 7 years old, and the occipital endochondral cartilage bond exists until around 6 years old. The major cartilage joints in the mandible are the mandibular condylar cartilage, which is the growth site until adulthood, and the mandibular joint up to one year after birth.
Then, suture growth, which is bone growth by suture, will be described. The fibrous bond found between the membranous bones that make up the brain skull and the facial cranium is called a suture, and about 3 years after birth is the most active period of growth in each suture. When the growth in the suture is finished, the tissue layer that has been clearly recognized disappears and becomes an osteosynthesis.
Periosteal growth is bone growth due to surface bone addition.

The growth and development of the brain skull will be explained.
Oizumi-mon, the skull fountain, was closed about 18 months after birth, and the skull crown was mainly grown with sutures until around age 4. Bone growth by suturing is the most active period in 2 to 3 years after birth, and the suturing growth ends around puberty. When further ossification progresses, the suturing becomes an osteosynthesis. The closure of the suture begins on the inner surface of the calvaria around 25-30 years old. At the base of the skull, butterfly occipital cartilage connections persist to adulthood and are the main growth site of the skull base. About 12 to 13 years old for girls and about 2 years later for boys, ossification starts from the inner surface, and bone bonding on the outer surface is completed around 20 years old.
Next, the growth and development of the facial skull will be described.
The facial skeleton is composed of membranous bone that appears in close association with the nose and jaw. The maxilla constituting the upper face and the facial bones (nasal bone, lacrimal bone, ethmoid bone, palatal bone, cheekbone and ribs) adjacent to the maxilla are joined together by stitching, and are collectively called the maxillary complex. The growth of the nasal maxillary complex at the sutured part is the most active period from the embryonic period to 3 years after birth. The nasal septal cartilage continues to grow until about 10 years old, and along with the growth of the nasal septal cartilage, vertical growth occurs in frontal maxillary suture, frontal nasal bone suture and frontal zygomatic suture.

  As described above, at the bone joint such as the cranial suture part, bone is formed during the growth process, and by applying a weak and continuous force through the bone connection part such as the suture part, It can be shaped.

  Next, the periodontal ligament will be described. The periodontal ligament is a tissue between the tooth and the alveolar bone, and the tooth is supported by the alveolar bone via the periodontal ligament. When the periodontal ligament fibers are stretched strongly, the width of the periodontal ligament increases. This makes the fibers thinner and wider between cells. The periodontal ligament has the property of always trying to make its width constant, and the periodontal ligament that has grown too much tends to shrink to its original width. Then, osteoblasts that make bones appear between the fibers, and make bones on the surface of the alveolar bone. Blood vessels are also created to carry oxygen and nutrients there. Bone made by osteoblasts gradually calcifies and hardens.

  As described above, it is possible to grow bone using the periodontal ligament, and it is possible to extend the jawbone in the vertical direction by applying a force that expands perpendicularly to the periodontal ligament. It is.

  In the present invention, a minimally invasive device that facilitates bone movement, such as jaw movement, is configured by utilizing such a bone growth mechanism in the sutured portion. By reducing the invasiveness to the human body and reducing the size of the device, it becomes possible to treat patients of a lower age group, and by treating the younger age group with active bone formation, The end of the treatment can be realized.

FIG. 1 is a schematic diagram showing a technique using the present invention.
As shown in FIG. 1, in the present invention, a jaw shaping force applying device 4 is disposed across the stitching portion 2 to impart shaping force to the stitching portion 2 during the growth period of the skeleton. When a weak continuous force is applied in the direction of opening the suture part 2 at the suture part 2, the interosseous fiber tissue in the suture part 2 grows, and at the same time, bone formation occurs at each bone bone edge. This releases the bone and expands laterally. In this manner, by applying a shaping force to the stitched portion 2, bone growth is promoted and the bone 1 is expanded to a target position. In FIG. 1, the hatched portion is a site where bone formation is promoted.

  Conversely, during the skeletal growth period, it is also possible to suppress the bone formation by giving the stitching portion 2 a shaping force that opposes the bone growth direction. By generating a force so that the stitched portion 2 does not open at the stitched portion 2, the interosseous fibrous tissue at the stitched portion 2 is suppressed. This inhibits bone growth. In this way, by applying a shaping force to the stitched portion 2, bone growth is suppressed.

In the present invention, since the bone growth in the sutured portion 2 is promoted by applying a weak and continuous shaping force to the sutured portion 2 during the skeletal growth period, only the necessary minimum force is applied to the sutured portion 2. Good. Further, there is no need to fix the bone and it is not necessary to greatly deform the bone. Thereby, while being able to reduce the load concerning the bone 1, the force which the jaw shaping force provision apparatus 4 generate | occur | produces can be made small.
Furthermore, it is not necessary to increase the connection strength at the connection portion between the bone 1 and the jaw shaping force applying device 4, and the jaw shaping force applying device 4 can be made small and the invasion to the bone can be made small. Thereby, the apparatus applicable to a wide age group can be comprised.

  In particular, by using a minimally invasive implant anchor for the jaw shaping force imparting device 4, it is easy to mount and remove and can be easily used by a dentist. And it can be used for patients from simple cases to difficult cases, and a reliable fixing source can be obtained.

Therefore, the present invention takes the following means.
As described in claim 1, a force is applied to the two parts sandwiching the suture part of the skull in the direction of enlarging the suture part, and the formation of the jaw is performed by promoting or suppressing the formation of bone in the suture part.

  As described in claim 2, a force is applied to the two parts connected through the periodontal ligament in a direction in which the distance between the two parts expands up and down to promote or inhibit bone formation in the periodontal ligament. Correct.

  According to a third aspect of the present invention, the first fixing source that contacts the bone, the second fixing source, and a biasing member that is connected to the first fixing source and the second fixing source, The one fixing source and the second fixing source are positioned via the sutured portion of the skull or the periodontal ligament, and the urging member expands between the first fixing source and the second fixing source. A force is applied along the skull to promote or suppress the formation of bone at the sutured portion and perform jaw shaping.

  As described in claim 4, a fixed source comprising a screw part embedded in a bone such as a jawbone in the oral cavity in the lower part, and a connecting part connected to an urging member on the upper side surface, and connected to the fixed source The jaw shaping force applying device is configured to apply a weak and continuous force in a direction in which the sutured portion is expanded or held between two portions sandwiching the sutured portion of the skull.

  As described in claim 1, force is applied to the two parts sandwiching the suture part of the skull in the direction of enlarging the suture part, and the formation of the jaw is promoted by promoting bone formation at the suture part. Can be applied continuously and continuously, so applying a force smaller than the conventional jaw shaping force can produce a great effect, promoting bone growth without giving excessive strain to bones such as the skull. Bone shaping can be performed with suppression. For this reason, shaping can be performed with less invasiveness to the patient. Moreover, the burden on the patient is small, and the patient's cooperation is easily obtained as compared with the conventional fixing device.

  As described in claim 2, a force is applied to the two parts connected through the periodontal ligament in a direction in which the two parts expand vertically, and the formation of bone in the periodontal ligament is promoted to perform orthodontics. Therefore, bone extension can be performed by the vertical movement of the dentition, the treatment is easy, and the burden on the patient can be reduced.

  According to a third aspect of the present invention, the first fixing source that contacts the bone, the second fixing source, and a biasing member that is connected to the first fixing source and the second fixing source, The one fixing source and the second fixing source are located via the suture portion or periodontal ligament of the skull, and the biasing member expands or holds between the first fixing source and the second fixing source. Since the jaw is shaped by applying a force along the skull in the direction to promote or suppress the formation of the bone in the sutured portion, the jaw shaping force applying device can be configured with a simple configuration. Then, by selecting the spring, the applied force is weak and persistent, and adjustment can be easily performed. Further, the direction of the force applied to the second fixed source can be adjusted by the shape of the guide. Further, the length of the guide can be changed to a longer one as the treatment progresses.

  As described in claim 4, a fixed source comprising a screw part embedded in a bone such as a jawbone in the oral cavity in the lower part, and a connecting part connected to an urging member on the upper side surface, and connected to the fixed source The jaw shaping force applying device is configured to apply a weak and continuous force in the direction of enlarging or holding between the suture portions at two sites sandwiching the suture portion of the skull. A device for imparting chin shaping force that allows easy attachment of the connecting portion can be configured.

  It is intended to realize a jaw shaping power application device that reduces the invasion to a patient and exhibits a great effect even in a low-age group.

Next, embodiments of the present invention will be described with reference to the drawings.
FIG. 2 is a side view showing a configuration of anterior movement of the maxilla by the jaw shaping force applying device.
In FIG. 2, the jaw shaping force application device 4 is connected to the cheekbone 5 and the maxilla 6 via a plate 31. Then, by applying shaping force to the zygomatic maxillary suture 7, bone formation in the zygomatic maxillary suture 7 is promoted, and the maxillary bone moves forward.
The upper end of the plate 31 is fixed to the cheekbone 5 by screws 12 and 12, and one end of the jaw shaping force applying device 4 is connected to the lower end. As a result, the jaw shaping force applying device 4 generates a force in the direction of expanding the gap between the cheekbone 5 and the maxilla 6 to promote bone formation in the zygomatic maxillary suture 7.
The jaw shaping force imparting device 4 can be applied not only to the zygomatic maxillary suture 7 but also to other suture sites. For example, the jaw shaping force applying device 4 can be adapted to coronary suture to promote bone formation in the coronary suture.

Next, the configuration of the jaw shaping force applying device 4 will be described.
3 is a partial side sectional view showing the configuration of the jaw shaping force applying device, FIG. 4 is a partial side sectional view showing the configuration of the fixed source, FIG. 5 is a perspective view of the jaw shaping force applying device, and FIG. It is a figure which shows a structure.
The jaw shaping force imparting device 4 includes two fixed sources 8 and 9, a guide 10 that connects them, and a spring 11 that generates a shaping imparting force. The fixed source 8 fixes one end of the guide 10, and the fixed sources 8 and 9 are configured to be slidable along the guide 10 as long as they do not fall out of the guide 10. In the present embodiment, the fixed sources 8 and 9 are configured such that the guide 10 can be mounted from above in FIG.
A spring 11 inserted in the guide 10 is disposed between the fixed source 8 and the fixed source 9. As a result, a force that pushes between the fixed sources 8 and 9 is generated, and the restoring force of the spring 11 can be transmitted to the bone via the fixed source 8 and the fixed source 9.
Further, the direction of the urging force by the spring 11 can be adjusted by the guide 10. The direction in which the urging force is applied to the fixed sources 8 and 9 can be adjusted by the shape of the guide 10.

After fixing the fixing source 8 to the bone, the fixing source 9 is connected and fixed to a portion fixed to the bone or tooth at a position where the spring 11 is shorter than the natural length, thereby fixing the fixing source 8 between the fixing source 8 and the fixing source 9. In addition, the restoring force of the spring 11 can be transmitted to the bone.
The fixing sources 8 and 9 have sufficient strength to be fixed to the bone, and are made of a material such as stainless steel, titanium, a titanium alloy, a cobalt-chromium alloy, or a ceramic.
Further, the guide 10 has sufficient strength, and is made of a material such as stainless steel, titanium, titanium alloy, cobalt-chromium alloy or the like, and after being deformed, a guide that does not undergo plastic deformation with a force of about 1 kgW can be used. Is desirable. Note that a guide with lower rigidity can be used depending on the attachment site of the jaw shaping force applying device 4.
As the cross-sectional shape of the guide 10, a circular shape, an elliptical shape, or a rectangular shape with smooth corners can be used. The shape of the guide 10 can be changed in accordance with various cases. Even when the guide 10 is bent, the spring 11 inserted into the guide 10 exerts an urging force along the guide 10. It can be generated.

Next, the fixation source fixed to the bone will be described.
As shown in FIGS. 3 and 4, the fixed source 8 includes a screw 12 and a cap 13. The screw 12 is embedded in the bone, and the cap 13 is attached to the upper part of the screw 12. For fixing the fixing source 8 to the bone, a clip-like object or a needle-like object can be used in addition to the screw 12.
The screw 12 is embedded on the surface of the alveolar bone so that the contact surface with the cortical bone becomes large, and the fixing source 8 is securely fixed to the alveolar bone.

A groove for the guide 10 is formed on the upper surface of the cap 13, and one end of the guide 10 is inserted into the groove, and the guide 10 is held by the cap 13. The width of the groove of the cap 13 is slightly wider than the width of the guide 10, and a protrusion is provided inside the groove. When the guide 10 is inserted into the groove, the cap 10 comes into contact with the protruding portion, the cap 13 is elastically deformed once, the guide 10 returns to its original shape, and the guide 10 is held in the groove. is there. A stopper is provided at one end of the guide 10, and the cap 13 abuts against this stopper, and the guide 10 can be prevented from coming off from the cap 13.
The cap 13 covers the upper part of the screw 12 and is made of stainless steel, titanium, titanium alloy, cobalt-chromium alloy, ceramics, resin, rubber, or the like. Thereby, the impact given to the screw 12 can be reduced.

Next, the structure which adapts a jaw shaping power provision apparatus to a tooth | gear is demonstrated. FIG. 7 is a side sectional view showing an example of attachment of the jaw shaping force applying device to the teeth.
An example in which the jaw shaping power application device is applied to orthodontics will be described with reference to FIG.

As shown in FIG. 7, when this jaw shaping power application device is applied to a tooth, it is performed via a bracket 21 attached to the tooth.
The jaw shaping force applying device includes a guide 10, a spring 11, a cylinder 10c into which the guide is inserted, and fixed sources 8 and 9b. One end of the guide 10 is inserted into the cylinder 10c, and a lower limit of the guide 10 is set by a screw 10d screwed into the cylinder 10c.
A bracket 21 is mounted on the tooth surface, and a fixed source 9b is connected to the bracket 21. The fixation source 8 is fixed to the alveolar bone, and a cylinder 10 c is connected to the fixation source 8. A spring 11 is attached to the guide 10 connected to the fixed source 9b, and an urging force is generated between the fixed source 9b and the fixed source 8 by the spring 11. This gives a force to push the teeth upward in the drawing. Thereby, the growth and differentiation of periodontal ligament cells between the tooth and the alveolar bone can be promoted to promote the formation of the alveolar bone, and the dentition can be corrected. That is, by urging the teeth in the vertical direction from the jawbone, it is possible to extend the jawbone in the vertical direction using the action of the periodontal ligament.

FIG. 8 is a diagram showing a configuration of jaw shaping performed by attaching one fixed source to a tooth.
As shown in FIG. 8, a plurality of teeth are connected by a wire 23, and at the same time a shaping force is applied to bias the dentition downward in the drawing. A bracket 21 is attached to the tooth, and is connected to the wire 23 through the bracket 21. A locking portion 9 b is connected to the wire 23. A force is applied to the locking portion 9b by the spring 11 along the extending direction of the guide 10. Thereby, the formation of the bone can be promoted by promoting the formation of bone through the proliferation and differentiation of periodontal ligament cells between the tooth and the alveolar bone.

Next, an application example to the median palate stitching portion will be described.
FIG. 9 is a diagram showing an application example to the lateral enlargement of the front portion of the median palate suture.
The expansion of the medial palatal suture part using the jaw shaping force applying device will be described with reference to FIG. The jaw shaping force applying device is arranged in the direction in which the bone is formed in the median palate suture portion. The fixed sources 8 and 9 of the jaw shaping force applying device are disposed over the midline palatal suture, and give a force for opening the palate outward.
As a result, a shaping force is applied to the medial palatal suture portion, and the palate expands laterally. As shown in FIG. 9, by attaching the jaw shaping force applying device to the median palate suture front portion, the median palate suture front portion can be enlarged. Since the site | part which mounts a jaw shaping force provision apparatus is expanded, only a front part or only a back part can be expanded in a median palate suture.
As shown in FIG. 10, a plurality of jaw shaping force imparting devices can be used for enlarging the median palate suture portion, and the amount of enlargement can be easily adjusted, such as only the front portion or only the rear portion. It can be done. That is, the median palate stitching portion can be expanded in a fan shape.

The jaw shaping force applying device includes a fixed source 8 and 9, a guide 10 disposed between the fixed sources, and springs 11 and 11 inserted into the guide 10. The fixed source 8 is fixed to one end of a cylinder into which the guide 10 is inserted, and the fixed source 9 is slidably disposed on the guide 10.
As shown in FIG. 10, a plurality of jaw shaping force applying devices can be arranged in parallel, thereby generating an urging force necessary for bone extension at the medial palatal suture portion.

Next, the structure which gives a shaping force to a stitching | suture part using a plate is demonstrated.
In a region where it is difficult to mount the jaw shaping force applying device, the arrangement position and the arrangement direction of the guide 10 can be easily adjusted using a plate.
FIG. 11 is a diagram showing a configuration for extending a bone through a stay. In this configuration, by connecting the guide 10 to the plate 31, the position of one end of the guide 10 can be a place where it can be easily placed in the oral cavity.
A guide 10 is connected to the tip of the plate 31, and a spring 11 is inserted into the guide 10. The rear end of the plate 31 is fixed to the bone via screws 12 and 12. Then, the guide 10 of the jaw shaping force applying device extends forward from the tip of the plate 31. A fixed source 9 slidably connected to the guide 10 is connected to the guide 10, and the fixed source 9 is fixed to the jawbone through the suture portion 41.
Thereby, the chin shaping force applying device can be arranged in the oral cavity, and adjustment of the chin shaping force applying device is prepared. That is, even in a region where mounting is difficult, by using the plate 31, it is possible to dispose the jaw by providing the jaw shaping force applying device.
In the above-described jaw shaping force applying device, it is also possible to connect stays to both ends of the guide 10, respectively.

Next, another embodiment of the jaw shaping force applying device will be described.
FIG. 12 is a diagram showing a configuration of a jaw shaping force imparting device with a large slide amount, FIG. 12 (a) is a diagram showing a configuration during contraction, and FIG. 12 (b) is a diagram showing a configuration during extension. It is. FIG. 13 is a perspective view showing a configuration of a jaw shaping force applying device having a large slide amount.
12 and 13, the guide 10 is inserted into the cylinder 10c, and the guide 10 is configured to be slidable with respect to the cylinder 10c. A spring 11 is inserted into the guide 10, and the spring 11 is in contact with the fixed source 8 and the cylinder 10c. The cylinder 10c is fixed to a fixed source 9c.
A screw 10d is attached to the cylinder 10c and defines the sliding limit of the guide 10. Thereby, even if a force is applied in the contraction direction of the spring 11, one end of the guide 10 comes into contact with the screw 10d to prevent the jaw shaping force applying device from contracting.
In this configuration, an elastic force is transmitted from the fixed source 8 to the cylinder 10c via the spring 11, and a force is generated in a direction in which the fixed source 8 and the cylinder 10c are expanded, and the fixed source 9 and the fixed source 9 fixed to the cylinder 10c are fixed. A force to expand the source 8 is generated. Then, by disposing the fixing source 8 and the fixing source 9 over the stitched portion, it is possible to promote bone formation at the stitched portion and extend the bone. In the state where the guide 10 is inserted into the cylinder 10 c, the urging force is maintained in the direction of the guide 10, and the sliding amount of the fixed source 9 with respect to the fixed source 8 can be increased. This configuration can be used not only for the sutured portion but also for extending the jawbone in the vertical direction via the periodontal ligament.

Next, the configuration of a jaw shaping force applying device using a cylinder that holds liquid will be described.
FIG. 14 is a diagram showing a configuration of a jaw shaping force applying device using a cylinder, FIG. 14 (a) is a diagram showing an extended state, and FIG. 14 (b) is a diagram showing a contracted state. The jaw shaping force applying device shown in FIG. 14 includes a fixed source 8b, a fixed source 9c, and a guide 10. A cylinder 10f is fixed to the fixed source 8b, and one end of the guide 10 is inserted into the cylinder 10f. The other end of the guide 10 is inserted into a cylinder 10c fixed to the fixed source 9c. A stopper is formed in the middle of the guide 10, and a spring 11 inserted into the guide 10 is configured to contact the stopper and the cylinder 10 c. The elastic force of the spring 11 is transmitted to the fixed source 8b via the cylinder 10f and to the fixed source 9c via the cylinder 10c. The cylinder 10c is screwed with a screw 10d so that the contraction limit of the guide 10 can be defined.

A part of the cylinder 10f is made of rubber. Then, by inserting an injection needle or the like from the rubber part and injecting a fluid such as physiological saline into the cylinder 10f, the insertion amount of the guide 10 inserted into the cylinder 10f is adjusted, and the fixed source 8b is fixed. The position of the guide 10 can be adjusted.
That is, the amount of fluid in the cylinder 10f is adjusted when the bone needs to be further extended after the bone is extended by the jaw shaping force applying device, or when the biasing force is adjusted by the compression amount of the spring 11. By doing so, the biasing force can be easily adjusted.

Next, the configuration of the jaw shaping force applying apparatus according to the seventh embodiment will be described.
FIG. 15 is a plan view of a jaw shaping force applying apparatus according to a seventh embodiment, and FIG. 16 is a perspective view of the same. In the jaw shaping force application device according to the fourth embodiment, a guide for determining the direction of the urging force and an elastic member that generates the urging force are integrally configured.
The jaw shaping force imparting device is composed of fixed sources 44 and 44 and a connecting portion 43. Fixed sources 44 and 44 are fixed to both ends of the connecting portion 43. A bending force can be imparted to the bone by bending the connecting portion 43 and fixing the fixing sources 44 and 44 to the bone in a state where the fixing sources 44 and 44 are brought close to each other.
In this configuration, the direction of the shaping force is determined by the connecting portion 43, and the shaping force is generated by the restoring force of the connecting portion 43. In this way, by configuring the jaw shaping force applying device, the jaw shaping force applying device can be configured with a simple configuration.

Next, the configuration of the jaw shaping force applying apparatus according to the eighth embodiment will be described.
FIG. 17 is a plan view of a jaw shaping force applying apparatus according to the eighth embodiment, and FIG. 18 is a perspective view showing a connecting portion according to the eighth embodiment. The jaw shaping power application device according to the fifth embodiment is configured to facilitate adjustment of the biasing force.
The jaw shaping force applying device is composed of fixed sources 44 and 44 and a connecting portion 43b. Fixed sources 44 and 44 are fixed to both ends of the connecting portion 43b. A bending force can be imparted to the bone by bending the connecting portion 43b and fixing the fixing sources 44 and 44 to the bone with the fixing sources 44 and 44 approaching each other.
The connection portion 43b is formed with a portion configured in a vine-wound spring shape, and the connection portion 43b is easily deformed in the vine-spring-like portion to facilitate adjustment of the urging force. Furthermore, the end portion of the connection portion 43 b that fixes the fixed source 44 is configured in a U shape so that excessive force is not applied to the fixed source 44.

Next, the configuration of the jaw shaping force applying apparatus according to the ninth embodiment will be described.
FIG. 19 is a perspective view showing a jaw shaping power applying apparatus according to the ninth embodiment.
FIG. 20 is a diagram showing an assembly configuration of the ninth embodiment.
FIG. 21 is a plan view of a jaw shaping force applying apparatus according to the ninth embodiment.
FIG. 22 is a plan view of the urging member.
FIG. 23 is a side view of a fixed source.
FIG. 24 is a partial cross-sectional side view showing a connection state of the biasing member to a fixed source.
FIG. 25 is a side view showing another example of the fixed source.
The jaw shaping force applying device 60 includes a fixing source 61 and 61 and a biasing member 62, and the fixing source 61 is fixed to a bone such as a jawbone in the oral cavity. The fixed source 61 has a screw part 61c at the lower part, a bolt part 61d and a connection part 61b thereon, and a spherical head part 61e at the upper end. The screw part 61c is screwed into a bone such as a jawbone in the oral cavity, and the fixing part 61 is fixed by attaching the bolt part 61d to the wearing tool.
After the fixing source 61 is fixed, one end of the urging member 62 is attached to the connecting part 61b provided between the bolt part 61d and the head part 61e. The connecting portion 61b is a peripheral surface of the fixed source 61, and is configured in a shape recessed inwardly between the bolt portion 61d and the head portion 61e.
The urging member 62 uses a member that expresses a weak and continuous force, and a Ni—Ti wire or a Ti—Mo wire can be used. The biasing member 62 connects one end of the biasing member 62 and the fixed source 61 by winding one end around the connection portion 61 b of the fixed source 61. The width of the connecting portion 61b coincides with the diameter of the loop formed by bending the tip of the wire which is the urging member 62.
Thereby, the urging member 62 can be easily attached to the fixed source 61, and a weak urging force can be continuously applied.
In addition, by setting the height of the connection portion to 0.9 mm or more, it is possible to insert the wire which is the urging member 62 and to make the configuration easy to install.
Further, as shown in FIG. 25, by providing a notch in the upper part of the connection portion 61b to facilitate excision of the head portion 61e, the urging member 62 and the fixing source 61 can be easily removed.
The fixed source 61 can also be used in other embodiments, and can be used as a fixed source at one or both ends of the shaping force applying device.

As a weak and persistent force, a force that is less than the force used for normal correction or a state where no force is applied at the time of wearing is used. When worn across the periodontal ligament, normal orthodontic treatment is used. A force smaller than 50 g weight, which is the correction force used in the above, can be used, and the correction force varies depending on the situation. For example, a force of about 10 g or 5 g can be used through the periodontal ligament. In the case of the jaw forming force, a force of about 300 g weight to 400 g weight, which is smaller than the normally used force in kg, can be used. These differ depending on the age of application, gender, and the situation of the wearer.
In other words, the present invention is continuously applied with a weak correction force compared to the conventional method with respect to the conventional large correction force applied intermittently.

Next, another configuration of the spring that is an elastic member in the jaw shaping force applying device will be described. FIG. 26 is a diagram showing another embodiment of the elastic body. FIG. 26A is a side view of the biasing member mounted on the guide, FIG. 26B is a perspective view of the same, and FIG. 26C is a side view showing the compressed biasing member. .
As shown in FIG. 26, in the jaw shaping power applying device, it is also possible to use laminated rubber as an elastic member instead of a spring. The biasing member 45 is disposed between the fixed source 8 and the fixed source 9 and applies a biasing force along the guide 10.
The urging member 45 is made of laminated rubber, and has a structure in which rubber pipes 46 and metallic rings 47 are alternately connected. Thereby, even when subjected to compression, the urging member 45 is less deformed and can be compressed along the guide 10 in a stable state.
Further, by using a member exhibiting entropy elasticity, such as rubber, as the member that generates the biasing force, the compressed state can be easily maintained by cooling the biasing member in the compressed state.
This facilitates the work when the urging member is attached to the jaw shaping force applying device. When the urging member is in a low temperature state, the restoring force of the urging member is small, and it is not necessary to attach the urging member 45 to the guide while compressing it by applying force to the urging member 45, so that the labor during installation can be reduced.

Next, an example of suppressing bone growth will be described.
FIG. 27 is a schematic diagram showing a configuration for suppressing bone growth, FIG. 27 (a) is a schematic diagram showing a case where the jaw shaping force applying device is mounted, and FIG. 27 (b) is a schematic diagram showing a case where it is not mounted. FIG.
In the present invention, the jaw shaping force applying device 41 is disposed across the suture part 2 to resist the growth of bone in the suture part 2 during the growth period of the skeleton. The jaw shaping force imparting device 41 does not extend and suppresses the growth of bones with the suture part 2 interposed therebetween. That is, when the jaw shaping force applying device 41 is not attached, as shown in FIG. 27B, the bone grows at the suture part 2 and the bone extends. However, as shown in FIG. 20A, when the jaw shaping force applying device 41 is attached, the bone growth in the sutured portion 2 is suppressed and the bone growth is suppressed.
The jaw shaping force applying device 41 fixes two fixing sources to the bone with the suture part 2 interposed therebetween, and the two fixing sources are connected by a deformable connecting member.

Next, a configuration example of a jaw shaping force applying device that suppresses bone growth will be described.
FIG. 28 is a view showing a jaw shaping force applying device for suppressing bone growth, FIG. 28 (a) is a perspective view of the jaw shaping force applying device for suppressing bone growth, and FIG. 28 (b) is the same. It is a figure which shows an assembly structure.
The jaw shaping force applying device shown in FIG. 28 connects two fixing sources constituted by a screw 12 and a cap 13 by a guide 10. A groove into which the guide 10 is fitted is provided in the upper part of the cap 13, and the cap 13 is attached to the upper end of the screw 12. And the stopper 10g is provided in the both ends of the guide 10, and it restrict | limits that fixed sources spread by this stopper 10g. That is, by attaching the fixation source in a state of being in contact with the stopper 10g of the guide 10, the spread growth between the fixation sources is suppressed and a resistance force is generated against bone growth. The jaw shaping force urging device generates resistance against the bone growth, and the bone growth is suppressed and the jaw can be shaped.
It should be noted that the configuration other than the above is not limited as long as the distance between the fixed sources can be maintained, and the cap 13 is fixed by caulking the guide 10 by plastic deformation or the end portion of the guide 10 is bent. It is also possible to maintain the distance between the fixed sources by contacting the guide 13 with the guide 13.
Further, by using the fixing source 61 shown in FIGS. 23 and 25 shown in the ninth embodiment, the tip of the wire serving as a guide is bent in a loop shape and wound around the connecting portion to be fixed. Growth can also be suppressed.

The schematic diagram which shows the method using this invention. The side view which shows the structure of the maxillary bone front movement by a jaw shaping force provision apparatus. The side surface partial sectional view which shows the structure of a jaw shaping force provision apparatus. The side surface partial sectional view which shows the structure of a fixed source. The perspective view of a jaw shaping power provision apparatus. The figure which similarly shows an assembly structure. Side surface sectional drawing which shows the example of mounting to the tooth | gear of a jaw shaping power provision apparatus. The figure which shows the structure of jaw shaping performed by mounting | wearing one tooth | gear with a fixed source. The figure which shows the example of application to side expansion of the medial palatal suture front part. The figure which shows the example applied to lateral expansion of a medial palatal suture part. The figure which shows the structure which gives shaping power to a tooth | gear through a stay. The figure which shows the structure of the jaw shaping power provision apparatus which enlarged the slide amount. The perspective view which shows the structure of the jaw shaping force provision apparatus which enlarged the slide amount. The figure which shows the structure of the bone extending apparatus using a cylinder. The top view of the jaw shaping power provision apparatus which is a 7th Example. Similarly perspective view. The top view of the jaw shaping power provision apparatus which is an 8th Example. The perspective view which shows the connection part of an 8th Example. The perspective view which shows the jaw shaping power provision apparatus which is a 9th Example. The figure which shows the assembly | attachment structure of a 9th Example. The top view of the jaw shaping power provision apparatus which is a 9th Example. The top view of a biasing member. The side view of a fixed source. The side surface partial sectional view which shows the connection state to the fixed source of a biasing member. The side view which shows the other examples of a fixed source. The figure which shows the other Example of an elastic body. The schematic diagram which shows the structure which suppresses a bone growth. The figure which shows the jaw shaping power provision apparatus which suppresses the growth of a bone.

Explanation of symbols

2.7 Stitching 3 Fixing device 4 Jaw shaping force applying device 8.9 Fixing source 10 Guide 11 Spring

Claims (4)

  It is characterized in that the two parts sandwiching the suture part of the skull are given a weak continuous force in the direction of expanding or holding the suture part, and the jaw shaping is performed by promoting or suppressing the formation of bone in the suture part. Jaw shaping force applying device.   The two parts connected through the periodontal ligament are subjected to orthodontic treatment by applying force in the direction in which the two parts expand vertically, promoting or suppressing bone formation in the periodontal ligament Jaw shaping device.   A first fixing source that contacts the bone; a second fixing source; and a biasing member connected to the first fixing source and the second fixing source. A fixation source is located through the skull suture or periodontal ligament, and the biasing member applies a force along the skull in a direction to expand or hold between the first fixation source and the second fixation source. In addition, a jaw shaping force imparting device characterized by shaping or shaping the jaw while promoting or suppressing bone formation at the sutured portion. A fixing source including a screw part embedded in a bone such as a jawbone in the oral cavity at a lower part, and a connection part to which a biasing member is connected to an upper side surface;
And an urging member connected to the fixed source,
A jaw shaping force imparting device characterized in that a weak and continuous force is applied to two parts sandwiching a suture part of a skull in a direction in which the suture part is expanded or held.

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