JP2013059391A - Bone construction device - Google Patents

Bone construction device Download PDF

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JP2013059391A
JP2013059391A JP2011198355A JP2011198355A JP2013059391A JP 2013059391 A JP2013059391 A JP 2013059391A JP 2011198355 A JP2011198355 A JP 2011198355A JP 2011198355 A JP2011198355 A JP 2011198355A JP 2013059391 A JP2013059391 A JP 2013059391A
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bone
bone surface
periosteum
covering member
coating film
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Shohei Kasugai
昇平 春日井
Zakaria Osama
ザカリア オサマ
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Tokyo Medical and Dental University NUC
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Tokyo Medical and Dental University NUC
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Priority to JP2011198355A priority Critical patent/JP2013059391A/en
Priority to PCT/JP2012/073229 priority patent/WO2013039076A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003Not used, see subgroups
    • A61C8/0004Consolidating natural teeth
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2/2803Bones for mandibular reconstruction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2/2846Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/60Surgical 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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66Alignment, compression or distraction mechanisms
    • A61B17/663Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access
    • A61B17/666Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access for alveolar distraction

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Plastic & Reconstructive Surgery (AREA)
  • Epidemiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Dentistry (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Dental Prosthetics (AREA)
  • Surgical Instruments (AREA)

Abstract

PROBLEM TO BE SOLVED: To provide a bone construction device which is more easily operated and can be used for a bone construction method less invasive to a patient.SOLUTION: The bone construction device includes: a bone surface coating film 11 for coating a bone surface 104 inserted between a periosteum 102b and the bone surface 104; and a lifting nut 12 and a lifting bolt 13 for lifting the bone surface coating film 11 and the periosteum 102b from the bone surface 104.

Description

本発明は、骨造成器具にかかり、特に骨を効果的に造成できる骨造成器具に関する。   The present invention relates to a bone formation device, and more particularly to a bone formation device capable of effectively forming bone.

歯が欠損した場合の治療法としてインプラント治療は広く行われている。
しかしながら、インプラント導入予定部位において歯槽骨が不足する場合には、インプラントを植設するのが困難なので、そのような場合には歯槽骨において骨造成が行われる。
Implant treatment is widely performed as a treatment method when a tooth is missing.
However, when there is a shortage of alveolar bone at the site where the implant is to be introduced, it is difficult to implant the implant. In such a case, bone formation is performed in the alveolar bone.

骨造成方法としては、たとえば、歯槽骨からプレート状の移動骨片を切り出し、この移動骨片を、前記移動骨片を切り出した後の歯槽骨土台とプレートで連結するとともに、前記プレートに螺子機構を設け、この螺子機構によって前記移動骨片を前記歯槽骨土台から離間させることによって、前記移動骨片と歯槽骨土台との間で骨造成を行わせる方法がある(特許文献1)。   As the bone formation method, for example, a plate-shaped moving bone fragment is cut out from the alveolar bone, and this moving bone fragment is connected to the alveolar bone base after cutting out the moving bone fragment with a plate, and a screw mechanism is connected to the plate. There is a method in which bone formation is performed between the moving bone piece and the alveolar bone base by separating the moving bone piece from the alveolar bone base by this screw mechanism (Patent Document 1).

また、別の骨造成方法としては、延長させる範囲の上顎歯槽骨について粘膜骨膜を切開して髄質骨を露出させ、露出した髄質骨について上顎洞底に至る骨切りを行い、上顎洞底膜と髄質骨とを上顎洞内に押し上げて骨造成を行う方法がある(特許文献2)。   As another bone preparation method, the maxillary alveolar bone to be extended is incised through the mucosal periosteum to expose the medullary bone, and the exposed medullary bone is cut to the maxillary sinus floor. There is a method of bone formation by pushing up the medullary bone into the maxillary sinus (Patent Document 2).

特開2003−135478号公報JP 2003-135478 A 特開2006−149460号公報JP 2006-149460 A

しかしながら、これらの骨造成方法は、いずれも歯槽骨の骨切りを伴うから、施術が困難で、患者への侵襲が大きく、しかも長時間を要するという問題がある。   However, all of these methods for bone formation involve osteotomy of the alveolar bone, so that there is a problem that the treatment is difficult, the invasion to the patient is large, and a long time is required.

本発明は、上記問題を解決すべく成されたものであり、施術がより容易であり、患者への侵襲の小さい骨造成方法が提供される骨造成器具の提供を目的とする。   The present invention has been made to solve the above-described problems, and an object of the present invention is to provide a bone building instrument that can provide a bone building method that is easier to perform and less invasive to a patient.

請求項1に記載の発明は、骨造成器具に関し、骨膜と骨面との間に挿入されて前記骨面を被覆する骨面被覆部材と、前記骨面被覆部材および前記骨膜を前記骨面から挙上する被覆部材挙上手段と、を備えることを特徴とする。   The invention according to claim 1 relates to a bone formation device, a bone surface covering member inserted between the periosteum and the bone surface to cover the bone surface, and the bone surface covering member and the periosteum from the bone surface. And a covering member lifting means for lifting.

請求項1の骨造成器具においては、骨、たとえば歯槽骨における骨造成をしようとする範囲の骨膜を切開して骨面を露出させ、露出した骨面を前記骨面被覆部材で覆い、次いで前記骨面被覆部材の上側で骨膜を接合して切開前の状態に戻してから、前記被覆部材挙上手段で前記骨膜と骨面被覆部材とを挙上して前記骨膜と前記骨面との間に空間を形成する。そうすると、前記空間内部で骨が増殖することにより、前記骨面上に新たな骨が造成される。   In the bone formation device according to claim 1, the bone surface is exposed by incising a bone, for example, a periosteum in a range where bone formation is to be performed in an alveolar bone, and the exposed bone surface is covered with the bone surface covering member, and then After the periosteum is joined on the upper side of the bone surface covering member and returned to the state before incision, the periosteum and the bone surface covering member are lifted by the covering member lifting means, and between the periosteum and the bone surface To form a space. If it does so, a new bone will be created on the said bone surface by a bone growing inside the said space.

前記骨造成器具を用いることにより、骨造成をしようとする箇所において骨切りをすることなく骨造成を行うことができるから、患者への侵襲が小さく、高い安全性で、より容易に骨造成を行うことができる。   By using the bone formation device, it is possible to perform bone formation without performing osteotomy at a location where bone formation is to be performed. Therefore, invasion to a patient is small, and it is easy to perform bone formation with high safety. It can be carried out.

請求項2に記載の発明は、請求項1に記載の骨造成器具において、前記骨面被覆部材が、可撓性を有する膜からなる骨面被覆膜であることを特徴とする。   According to a second aspect of the present invention, in the bone formation device according to the first aspect, the bone surface covering member is a bone surface covering film made of a flexible film.

請求項2の骨造成器具においては、前記骨面被覆部材として骨面被覆膜を用いているから、骨膜と骨面との間に前記骨造成器具を設置すると、骨面と前記骨面被覆膜との間に密閉空間が形成される。したがって、前記骨造成器具を設置後、縫合または接着した骨膜の縫合部または接着部から万が一異物が侵入した場合においても、前記異物によって骨の造成が妨げられたり、感染を生じたりすることがない。また、前記骨面被覆膜を挙上させても前記骨面被覆膜の周縁部と前記骨面との密着状態が維持されるので、前記密閉空間内への他の細胞の侵入によって骨の造成が妨げられることがない。   Since the bone surface covering membrane is used as the bone surface covering member in the bone forming device according to claim 2, when the bone forming device is installed between the periosteum and the bone surface, the bone surface and the bone surface covering are provided. A sealed space is formed between the covering film. Therefore, even if a foreign object enters the sutured or bonded periosteum stitched or bonded portion after the bone-forming device is installed, the foreign material does not prevent bone formation or cause infection. . Further, even when the bone surface coating film is raised, the close contact state between the peripheral surface of the bone surface coating film and the bone surface is maintained. Will not be hindered.

請求項3の発明は、請求項1または2に記載の骨造成器具において、前記被覆部材挙上手段が、前記骨面被覆部材と前記骨面とに、前記骨面被覆部材と前記骨面とが互いに離間する方向の力を及ぼすことにより、前記骨面被覆部材および前記骨膜を挙上する内部挙上部材であることを特徴とする。   According to a third aspect of the present invention, in the bone formation device according to the first or second aspect, the covering member lifting means includes the bone surface covering member and the bone surface, and the bone surface covering member and the bone surface. Is an internal lifting member that raises the bone surface covering member and the periosteum by exerting forces in directions away from each other.

請求項3の骨造成器具においては、前記骨面被覆部材および前記骨膜を挙上する際、前記内部挙上部材は、前記骨膜被覆部材と前記骨面との間の空間に位置する。したがって、骨造成後、前記骨造成器具を除去すると、前記内部挙上部材が占めていた空間に対応する穴が新たに造成された骨に形成される。インプラント治療においては、この穴にインプラントを植設することができるから、新たに造成された骨にインプラントを植設するための穴をわざわざ穿孔する必要がない。   According to a third aspect of the present invention, when raising the bone surface covering member and the periosteum, the internal lifting member is located in a space between the periosteum covering member and the bone surface. Therefore, after the bone formation, when the bone formation tool is removed, a hole corresponding to the space occupied by the internal lifting member is formed in the newly formed bone. In implant treatment, an implant can be implanted in this hole, so that it is not necessary to bother drilling a hole for implanting an implant in a newly created bone.

なお 、請求項3に記載の骨造成器具において、前記内部挙上部材は、例えば、前記骨面被覆部材に固定された上昇ナットと、前記上昇ナットに螺合すると共に、先端において前記骨面を押圧する上昇ボルトと、を備える螺子式内部挙上部材である。   The bone formation device according to claim 3, wherein the internal lifting member is, for example, a rising nut fixed to the bone surface covering member and a screw that is screwed to the rising nut, and the bone surface at the tip thereof. It is a screw type internal raising member provided with a raising bolt to press.

前記螺子式内部挙上部材においては、上昇ボルトの回転角度によって前記骨面被覆部材および前記骨膜の挙上量を設定できるから、造成骨の成長に応じて、前記骨面被覆部材および前記骨膜の挙上量を徐々に増大させることができる。   In the screw type internal lifting member, the elevation amount of the bone surface covering member and the periosteum can be set by the rotation angle of the rising bolt, so that the bone surface covering member and the periosteum The elevation amount can be gradually increased.

請求項4の発明は、請求項1または2に記載の骨造成器具において、前記被覆部材挙上手段が、前記骨面被覆部材を前記骨面から離間する方向に前記骨膜の外側から牽引する牽引部材であることを特徴とする。   According to a fourth aspect of the present invention, in the bone formation device according to the first or second aspect, the covering member lifting means pulls the bone surface covering member from the outside of the periosteum in a direction away from the bone surface. It is a member.

請求項4の骨造成器具においては、前記骨面被覆部材を前記骨膜の外側から牽引して挙上しているから、挙上の際に前記牽引部材が骨面に接触することがない。また、骨膜の切開量を小さくすることも可能となる。したがって、前記内部挙上部材を用いる場合と比較して患者への侵襲がさらに小さい。   Since the bone surface covering member is pulled up from the outside of the periosteum and lifted, the pulling member does not come into contact with the bone surface during the lifting. It is also possible to reduce the periosteum incision amount. Therefore, compared with the case where the internal lifting member is used, the patient is less invasive.

なお、請求項4に記載の骨造成器具において、前記牽引部材は、例えば、前記骨面被覆部材に固定された牽引ナットと、前記牽引ナットに螺合する牽引ボルトと、前記骨膜の外側において前記牽引ボルトを所定の位置に保持する牽引ボルト保持部材と、を備える螺子式牽引部材である。   The bone formation device according to claim 4, wherein the traction member includes, for example, a traction nut fixed to the bone surface covering member, a traction bolt screwed into the traction nut, and the outside of the periosteum. A screw-type traction member including a traction bolt holding member that holds the traction bolt in a predetermined position.

前記螺子式牽引部材においては、牽引ボルトの回転角度によって前記骨面被覆部材の牽引量、ひいては挙上量を設定できるから、前記牽引量を徐々に増大させることによって前記骨面被覆部材および前記骨膜の挙上量を骨造成量に応じて徐々に増大させることができる。   In the screw-type pulling member, the pulling amount of the bone surface covering member, and hence the lifting amount, can be set by the rotation angle of the pulling bolt. Therefore, the bone surface covering member and the periosteum are gradually increased by increasing the pulling amount. Can be gradually increased according to the amount of bone formation.

請求項5に記載の発明は、請求項1〜4の何れか1項に記載の骨造成器具において、前記骨面被覆部材の周縁部の少なくとも一部を前記骨面に固定する被覆部材固定手段を備えることを特徴とする。   A fifth aspect of the present invention is the bone forming device according to any one of the first to fourth aspects, wherein at least a part of a peripheral portion of the bone surface covering member is fixed to the bone surface. It is characterized by providing.

請求項5の骨造成器具においては、前記骨面を前記骨面被覆部材で被覆後、前記骨面被覆部材の周縁部の少なくとも一部を被覆部材固定手段で骨面に固定するから、骨造成器具の設置後に骨面被覆部材の位置がずれることが防止される。   The bone formation device according to claim 5, wherein after the bone surface is covered with the bone surface covering member, at least a part of a peripheral portion of the bone surface covering member is fixed to the bone surface by the covering member fixing means. It is possible to prevent the bone surface covering member from being displaced after the device is installed.

なお、請求項5に記載の骨造成器具において、前記被覆部材固定手段は、好ましくは、リング状の部材である固定リングである。   In addition, the bone formation instrument of Claim 5 WHEREIN: Preferably, the said covering member fixing means is a fixing ring which is a ring-shaped member.

被覆部材固定手段として固定リングを用いれば、骨面被覆部材を骨面に均等な強さで固定できる。また、前記骨面被覆部材の周縁部を全周にわたって確実に前記骨面に密着させることができるから、前記骨面被覆部材を挙上させても前記骨面と前記骨面被覆部材との間の密閉空間に他の細胞が侵入せず、骨の造成が妨げられることがない。   If a fixing ring is used as the covering member fixing means, the bone surface covering member can be fixed to the bone surface with equal strength. In addition, since the peripheral portion of the bone surface covering member can be securely brought into close contact with the bone surface over the entire circumference, even if the bone surface covering member is raised, the bone surface covering member is between the bone surface and the bone surface covering member. Other cells do not enter the sealed space, and bone formation is not hindered.

さらにまた、請求項2〜5の何れか1項に記載の骨造成器具において、前記骨面被覆膜は、シリコーンから形成されていることが好ましい。   Furthermore, in the bone formation device according to any one of claims 2 to 5, it is preferable that the bone surface coating film is made of silicone.

前記骨面被覆膜をシリコーンから形成すれば、伸縮性が高く、骨面の形状に馴染みやすいから、前記骨面被覆膜を挙上させたときの前記骨面被覆膜の周縁部と前記骨面との密着性をより向上させることができる。   If the bone surface coating film is made of silicone, it has high stretchability and is easy to adapt to the shape of the bone surface. Therefore, when the bone surface coating film is raised, Adhesion with the bone surface can be further improved.

請求項6の発明は、請求項1〜5の何れか1項に記載の骨造成器具において、前記骨面被覆部材が生体吸収性材料から形成されていることを特徴とする。   A sixth aspect of the present invention is the bone formation device according to any one of the first to fifth aspects, wherein the bone surface covering member is formed of a bioabsorbable material.

請求項6の骨造成器具においては、前記骨面被覆部材が生体吸収性材料から形成されているから、前記骨造成器具を設置後、最終的に、前記骨面被覆部材は生体に吸収されて消失してしまう。したがって、骨造成完了後に前記骨面被覆部材を除去する必要がなく、患者への侵襲がさらに小さい。   In the bone remodeling device according to claim 6, since the bone surface covering member is formed of a bioabsorbable material, the bone surface covering member is finally absorbed by the living body after the bone forming device is installed. It will disappear. Therefore, it is not necessary to remove the bone surface covering member after completion of bone formation, and the invasion to the patient is further reduced.

なお、請求項6に記載の骨造成器具において、前記生体吸収性材料は、例えば、ゼラチン、キトサン、およびコラーゲンから選択された材料である。   Note that in the bone formation device according to claim 6, the bioabsorbable material is a material selected from, for example, gelatin, chitosan, and collagen.

前記骨面被覆部材を形成する生体吸収性材料としてゼラチン、キトサン、およびコラーゲンから選択された材料を用いることにより、前記骨面被覆部材は生体吸収性を有するだけでなく、強度や弾性、柔軟性などの物理的特性にも優れたものとなる。   By using a material selected from gelatin, chitosan, and collagen as a bioabsorbable material for forming the bone surface covering member, the bone surface covering member has not only bioabsorbability but also strength, elasticity, and flexibility. It also has excellent physical properties.

ところで、前記骨造成器具を用いた骨造成方法は、骨を造成しようとする箇所の骨膜を切開して骨面を露出させる骨面露出工程と、前記骨面露出工程で露出された骨面を、請求項1〜6に記載の骨造成器具の備える骨面被覆部材で被覆する骨面被覆工程と、前記骨面露出工程で切開した骨膜を切開前の位置に戻して前記骨面被覆部材を被覆する骨膜戻し工程と、前記骨膜戻し工程で前記骨面被覆部材を被覆した骨膜を接合する骨膜接合工程と、前記骨膜接合工程で接合した骨膜、および前記骨面被覆部材を、前記骨造成器具の備える被覆部材挙上手段によって挙上する骨膜挙上工程と、を有する。   By the way, in the bone formation method using the bone formation device, the bone surface exposure step of incising the periosteum at the location where the bone is to be formed to expose the bone surface, and the bone surface exposed in the bone surface exposure step are The bone surface covering step of covering with the bone surface covering member provided in the bone forming device according to claim 1 and the periosteum incised in the bone surface exposing step is returned to the position before the incision to return the bone surface covering member. A periosteum returning step for covering, a periosteal joining step for joining periosteum coated with the bone surface covering member in the periosteum returning step, a periosteum joined in the periosteal joining step, and the bone surface covering member, And a periosteal elevation step of raising by a covering member elevation means.

前記骨造成方法においては、骨における骨造成をしようとする範囲の骨膜を切開して骨面を露出させ、露出した骨面を前記骨面被覆部材で覆い、次いで切開した骨膜を縫合して切開前の状態に戻してから、前記被覆部材挙上手段で前記骨膜と骨面被覆部材とを挙上して前記骨膜と前記骨面との間に空間を形成し、前記骨面上に骨組織を増殖させる。したがって、骨切りの必要がないから施術が容易であり、患者への侵襲が小さく、安全性が高い。   In the bone formation method, the periosteum in a range where bone formation is to be performed in the bone is incised to expose the bone surface, the exposed bone surface is covered with the bone surface covering member, and then the incised periosteum is sutured and incised. After returning to the previous state, the periosteum and the bony surface covering member are lifted by the covering member raising means to form a space between the periosteum and the bony surface, and bone tissue on the bony surface To grow. Therefore, since there is no need for osteotomy, the treatment is easy, the invasion to the patient is small, and the safety is high.

以上説明したように本発明によれば、施術がより容易であり、患者への侵襲の小さい骨造成方法に使用される骨造成器具が提供される。   As described above, according to the present invention, there is provided a bone building instrument that is used in a bone building method that is easier to perform and less invasive to a patient.

図1は、実施形態1に係る骨造成器具の構成を示す斜視図である。FIG. 1 is a perspective view showing a configuration of a bone forming device according to Embodiment 1. FIG. 図2は、実施形態1に係る骨造成器具を用いて歯槽骨の骨造成を行う骨造成方法の一例について前半の手順を示す説明図である。FIG. 2 is an explanatory diagram illustrating the first half of the procedure for an example of a bone formation method for performing bone formation of an alveolar bone using the bone formation device according to the first embodiment. 図3は、前記骨造成方法の後半の手順を示す説明図である。FIG. 3 is an explanatory view showing the latter half of the bone formation method. 図4は、実施形態1に係る骨造成器具を用いて歯槽骨の骨造成を行う骨造成方法の別の例について前半の手順を示す説明図である。FIG. 4 is an explanatory diagram showing the first half procedure for another example of a bone formation method for performing bone formation of an alveolar bone using the bone formation device according to the first embodiment. 図5は、前記骨造成方法の後半の手順を示す説明図である。FIG. 5 is an explanatory view showing the latter half of the bone formation method. 図6は、実施形態2に係る骨造成器具の構成を示す斜視図である。FIG. 6 is a perspective view showing the configuration of the bone forming device according to the second embodiment. 図7は、実施形態3に係る骨造成器具の構成を示す断面図である。FIG. 7 is a cross-sectional view illustrating a configuration of a bone forming device according to the third embodiment.

以下、図面を参照して本発明の骨造成器具の実施の形態の一例を詳細に説明する。   Hereinafter, an example of an embodiment of a bone building instrument of the present invention will be described in detail with reference to the drawings.

(1)実施形態1
図1に示すように、実施形態1に係る骨造成器具1は、後述する骨膜102bと骨面104との間に挿入される骨面被覆膜11と、骨面被覆膜11の中央部に設けられた上昇ナット12と、上昇ナット12に螺合して骨面被覆膜11を挙上する上昇ボルト13と、を有する。
(1) Embodiment 1
As shown in FIG. 1, a bone forming device 1 according to Embodiment 1 includes a bone surface coating film 11 inserted between a periosteum 102 b and a bone surface 104 described later, and a central portion of the bone surface coating film 11. And a rising bolt 13 which is screwed to the rising nut 12 and lifts the bone surface coating film 11.

上昇ナット12の図1における下端部には、半径方向に沿って外側に延在するフランジ部121が形成され、上昇ナット12は、フランジ部121において骨面被覆膜11に固定されている。   A flange portion 121 extending outward in the radial direction is formed at the lower end of the ascending nut 12 in FIG. 1, and the ascending nut 12 is fixed to the bone surface coating film 11 at the flange portion 121.

骨面被覆膜11は、図1では下向きのカップ状とされているが、骨面被覆膜11は、骨面104を被覆できるのであれば、カップ状には限定されず、円板状、または下向きの円錐状であってもよい。   Although the bone surface coating film 11 has a downward cup shape in FIG. 1, the bone surface coating film 11 is not limited to a cup shape as long as it can cover the bone surface 104. Or a downward conical shape.

骨面被覆膜11は、通常はシリコーンから形成されるが、多孔性フッ素樹脂フィルムから形成されてもよく、ゼラチン、キトサン、およびコラーゲンなどの生体吸収性材料から形成されてもよい。生体吸収性材料から形成された骨面被覆膜11は、骨造成が終了した時点で生体に吸収されてしまうから、骨造成終了後に除去する必要がない点で好ましい。また、骨面被覆部材として、シリコーン等の可撓性の骨面被覆膜11ではなく、チタニウム等の金属プレート、ポリエチレン等の樹脂プレートを用いてもよい。さらにまた、骨面被覆部材に、骨形成を促進するタンパクを組み込むことにより、骨形成をさらに促進させるようにすることも可能である。   The bone surface coating film 11 is usually formed of silicone, but may be formed of a porous fluororesin film, and may be formed of a bioabsorbable material such as gelatin, chitosan, and collagen. Since the bone surface coating film 11 formed from the bioabsorbable material is absorbed by the living body when the bone formation is completed, it is preferable in that it does not need to be removed after the bone formation is completed. Further, as the bone surface covering member, instead of the flexible bone surface coating film 11 such as silicone, a metal plate such as titanium or a resin plate such as polyethylene may be used. Furthermore, it is possible to further promote bone formation by incorporating a protein that promotes bone formation into the bone surface covering member.

上昇ナット12および上昇ボルト13は、チタニウム、アルミナ、アパタイト、窒化珪素などの生体適合性材料から形成される。但し、上昇ナット12については、ポリ乳酸樹脂やポリオール酸樹脂のような生体吸収性ポリマから形成されていてもよい。生体吸収性ポリマから形成された上昇ナット12もまた、骨造成が終了した時点で生体に吸収されてしまうから、骨造成終了後に除去する必要がない点で好ましい。また、被覆部材挙上手段として、上昇ナット12ではなく、上昇ボルト13が螺合するチタニウム等の金属プレート、ポリエチレン等の樹脂プレートを用い、これらのプレートを挙上させるようにすれば、プレート形状によって骨面被覆膜11の挙上形態を自由に変化させることができる。   The ascending nut 12 and the ascending bolt 13 are formed of a biocompatible material such as titanium, alumina, apatite, or silicon nitride. However, the rising nut 12 may be formed of a bioabsorbable polymer such as polylactic acid resin or polyol acid resin. The rising nut 12 formed from a bioabsorbable polymer is also preferable in that it does not need to be removed after the bone formation is completed because it is absorbed by the living body when the bone formation is completed. Further, as a covering member raising means, a metal plate such as titanium and a resin plate such as polyethylene to which the ascending bolt 13 is screwed instead of the ascending nut 12 are used, and if these plates are raised, the plate shape Thus, the elevation form of the bone surface coating film 11 can be freely changed.

以下、骨造成器具1を用いて歯槽骨の造成を行う手順について説明する。
先ず、図2の(a)および(b)に示すように、歯槽骨100における骨造成を行う箇所の粘膜102aおよび骨膜102bを切開する。
Hereinafter, a procedure for creating an alveolar bone using the bone forming device 1 will be described.
First, as shown in FIGS. 2A and 2B, the mucous membrane 102a and the periosteum 102b at the location where bone formation is performed in the alveolar bone 100 are incised.

そして図2の(c)に示すように、切開した粘膜102aおよび骨膜102bを持ち上げて歯槽骨100の骨面104を露出させる。   Then, as shown in FIG. 2C, the incised mucosa 102a and periosteum 102b are lifted to expose the bone surface 104 of the alveolar bone 100.

骨面104を露出させたら、図2の(d)に示すように、骨造成器具1を骨面104上に載置し、骨面104を骨面被覆膜11で覆う。この際、骨面被覆膜11の下に形成されたスペースに骨形成を促進するタンパクを適用することで、骨形成をさらに促進させることが可能である。骨面104を骨面被覆膜11で覆ったら、図2の(d)において矢印aで示すように、粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11と上昇ナット12とを覆う。   When the bone surface 104 is exposed, as shown in FIG. 2D, the bone forming device 1 is placed on the bone surface 104, and the bone surface 104 is covered with the bone surface coating film 11. At this time, it is possible to further promote bone formation by applying a protein that promotes bone formation to the space formed under the bone surface coating film 11. When the bone surface 104 is covered with the bone surface coating film 11, as shown by an arrow a in FIG. 2D, the mucosa 102a and the periosteum 102b are returned to the positions before the incision, and the bone surface coating film 11 and the rising nut are returned. 12 is covered.

粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11および上昇ナット12を覆ったら、図3(e)に示すように、粘膜102aおよび骨膜102bの切開箇所を縫合して密閉する。なお、粘膜102aおよび骨膜102bの切開箇所を縫合する代わりに外科用接着剤で接着してもよい。図3の(f)は、粘膜102aおよび骨膜102bを縫合、または接着して歯槽骨100の骨面104と骨膜102bとの間に骨造成器具1を設置した状態を示す。   When the mucosa 102a and the periosteum 102b are returned to the positions before the incision and the bone surface covering film 11 and the rising nut 12 are covered, as shown in FIG. 3 (e), the incised portions of the mucosa 102a and the periosteum 102b are sutured and sealed. To do. Instead of suturing the incised portions of the mucous membrane 102a and the periosteum 102b, a surgical adhesive may be used. FIG. 3F shows a state in which the bone forming device 1 is placed between the bone surface 104 of the alveolar bone 100 and the periosteum 102b by suturing or adhering the mucous membrane 102a and the periosteum 102b.

骨造成器具1を歯槽骨100の骨面104と骨膜102bとの間に設置したら、図3の(g)に示すように、上昇ボルト13を上昇ナット12が上昇する方向に回転させ、矢印bに示すように骨面被覆膜11とその上の骨膜102bおよび粘膜102aを挙上させ、骨面104と骨膜102bとの間に骨が成長するための空間106を形成する。なお、図3の(g)は、恰も骨面被覆膜11と骨膜102bと粘膜102aとを一挙動で挙上するように描かれているが、骨面104の上に新たな骨が成長するのに応じて上昇ボルト13を徐々に締め込み、骨面被覆膜11を挙上する高さを高くするのが好ましい。挙上のペースとしては、通常、1日に約1mmずつ高くし、最終的に10mm程度まで挙上させる。   When the bone forming device 1 is installed between the bone surface 104 of the alveolar bone 100 and the periosteum 102b, as shown in FIG. 3G, the ascending bolt 13 is rotated in the direction in which the ascending nut 12 ascends, and the arrow b As shown in FIG. 5, the bone surface covering film 11, the periosteum 102b and the mucous membrane 102a thereon are raised, and a space 106 for bone growth is formed between the bone surface 104 and the periosteum 102b. 3 (g) is drawn so that the bone surface covering membrane 11, the periosteum 102b and the mucous membrane 102a are raised in one behavior, but a new bone grows on the bone surface 104. It is preferable to gradually tighten the ascending bolt 13 as it is done to increase the height at which the bone surface coating film 11 is raised. The raising pace is usually increased by about 1 mm per day and finally raised to about 10 mm.

約1mmの挙上によって空間106が形成されると、空間106内の骨面104上で骨の成長が起こり、挙上と成長とが繰り返されることによって、図13(h)に示すように、造成骨108が形成される。   When the space 106 is formed by the elevation of about 1 mm, bone growth occurs on the bone surface 104 in the space 106, and as the elevation and the growth are repeated, as shown in FIG. An artificial bone 108 is formed.

骨造成が終了したら、粘膜102aおよび骨膜102bを再度切開して骨面被覆膜11と上昇ナット12とを除去し、造成骨108から上昇ボルト13を抜去する。なお、骨面被覆膜11が生体吸収性材料から形成され、上昇ナット12が生体吸収性ポリマまたはアパタイトのような生体吸収性セラミックスで形成されている場合は、骨造成が終了したときには、骨面被覆膜11は生体内に吸収されて消失し、上昇ナット12は造成骨108と一体化しているから、上昇ボルト13のみを抜去すればよい。   When the bone formation is completed, the mucous membrane 102a and the periosteum 102b are cut again to remove the bone surface coating film 11 and the rising nut 12, and the rising bolt 13 is removed from the formed bone 108. When the bone surface coating film 11 is formed from a bioabsorbable material and the rising nut 12 is formed from a bioabsorbable ceramic such as a bioabsorbable polymer or apatite, Since the surface covering film 11 is absorbed into the living body and disappears, and the ascending nut 12 is integrated with the formed bone 108, only the ascending bolt 13 needs to be removed.

造成骨108から上昇ボルト13を抜去すると穴が残るが、この穴は、インプラントを植設するための穴として利用できる。   When the ascending bolt 13 is removed from the formed bone 108, a hole remains, but this hole can be used as a hole for implanting the implant.

なお、図2および図3に示す例では、骨造成器具1において上昇ボルト13を交換することなく、締めこむ深さを深くすることによって骨面被覆膜11と粘膜102aおよび骨膜102bとの挙上高さを高くしているが、図4の(a)に示すように、骨造成器具1においては上昇ナット12に長さの異なる複数の上昇ボルト13(13a、13b、13c)が螺合できるようにし、造成骨108の成長高さに応じて上昇ボルト13を長さの短いものから長いものへと交換してもよい。なお図4の(a)に示す例においては、上昇ボルト13のうち、上昇ボルト13aが最も短く、上昇ボルト13cが最も長い。そして上昇ボルト13bは上昇ボルト13aと上昇ボルト13cとの中間の長さを有する。   In the example shown in FIGS. 2 and 3, the bone surface covering film 11, the mucosa 102 a and the periosteum 102 b are enumerated by increasing the tightening depth without replacing the ascending bolt 13 in the bone forming device 1. Although the upper height is increased, as shown in FIG. 4 (a), in the bone forming device 1, a plurality of rising bolts 13 (13a, 13b, 13c) having different lengths are screwed onto the lifting nut 12. The rising bolt 13 may be exchanged from one having a shorter length to one having a longer length according to the height of the formed bone 108. In the example shown in FIG. 4A, among the rising bolts 13, the rising bolt 13a is the shortest and the rising bolt 13c is the longest. The rising bolt 13b has an intermediate length between the rising bolt 13a and the rising bolt 13c.

骨造成器具1において上昇ボルト13を交換しつつ、骨面被覆膜11と粘膜102aおよび骨膜102bの挙上高さを高くする場合には、図14の(b)に示すように、骨造成器具1においては上昇ナット12に最も長さの短い上昇ボルト13aを螺合させて歯槽骨100に設置する。   When the elevation heights of the bone surface coating film 11, the mucous membrane 102a and the periosteum 102b are increased while exchanging the ascending bolt 13 in the bone building instrument 1, as shown in FIG. In the instrument 1, the shortest rising bolt 13 a is screwed to the rising nut 12 and installed in the alveolar bone 100.

空間106が造成骨108で充填されたら、図14の(c)に示すように、上昇ボルト13aを上昇ボルト13bに交換し、図5の(d)に示すように、上昇ボルト13bを回転させて上昇ナット12を上昇させ、造成骨108の表面である新たな骨面104と骨面被覆膜11とを離間させて骨面104上に空間106を形成する。空間106が形成されると、新たな骨面104で骨が成長し、造成骨108が更に成長する。   When the space 106 is filled with the formed bone 108, the ascending bolt 13a is replaced with the ascending bolt 13b as shown in FIG. 14 (c), and the ascending bolt 13b is rotated as shown in FIG. 5 (d). As a result, the ascending nut 12 is raised, and a new bone surface 104 which is the surface of the formed bone 108 is separated from the bone surface coating film 11 to form a space 106 on the bone surface 104. When the space 106 is formed, bone grows on the new bone surface 104, and the formed bone 108 grows further.

空間106aが造成骨108で充填されたら、図15の(e)に示すように、上昇ボルト13bを上昇ボルト13cに交換し、上昇ボルト13cを回転させて上昇ナット12を上昇させ、造成骨108の表面である新たな骨面104と骨面被覆膜11とを離間させて新たな空間106を形成する。空間106が形成されると、新たな骨面104で骨が成長し、造成骨108が更に成長する。   When the space 106a is filled with the artificial bone 108, as shown in FIG. 15 (e), the ascending bolt 13b is replaced with the ascending bolt 13c, and the ascending bolt 13c is rotated to raise the ascending nut 12, and the artificial bone 108 is raised. A new space 106 is formed by separating the new bone surface 104 and the bone surface covering film 11 from each other. When the space 106 is formed, bone grows on the new bone surface 104, and the formed bone 108 grows further.

図15(f)は、図15(e)で形成された空間106が造成骨108で充填された状態を示す。図4および図5に示す例のように、造成骨108の成長高さに応じて上昇ボルト13を長さの短いものから長いものへと交換すれば、粘膜102aからの上昇ボルト13の突出を最小限にできるので、患者の口腔内の違和感を少なくすることが可能となる。   FIG. 15 (f) shows a state in which the space 106 formed in FIG. 15 (e) is filled with the created bone 108. As shown in FIGS. 4 and 5, if the rising bolt 13 is changed from a short one to a long one according to the growth height of the formed bone 108, the protrusion of the rising bolt 13 from the mucous membrane 102 a is caused. Since it can be minimized, it is possible to reduce discomfort in the oral cavity of the patient.

なお、図2〜図5に示す骨造成方法は、上述のように歯槽骨100を対象とするものであるが、歯槽骨100は、通常、馬の鞍状の形状を有するから、骨面104上に骨造成器具1の骨面被覆膜11および上昇ナット12は、縫合または接着した粘膜102aおよび骨膜102bによって所定位置に保持される。また、骨面被覆膜11の周縁部が全周にわたって骨面104に密着する。したがって、骨面被覆膜11を骨面104に特に固定しなくても、骨面被覆膜11の位置に大きなずれが生じることがなく、空間106への他の細胞の侵入等により、骨の成長が妨げられることもない。   2 to 5 are intended for the alveolar bone 100 as described above. However, since the alveolar bone 100 usually has a horseskin-like shape, the bone surface 104 is used. The bone surface covering film 11 and the rising nut 12 of the bone forming device 1 are held in place by the mucous membrane 102a and the periosteum 102b which are sutured or adhered. Further, the peripheral edge portion of the bone surface coating film 11 is in close contact with the bone surface 104 over the entire circumference. Therefore, even if the bone surface coating film 11 is not particularly fixed to the bone surface 104, the position of the bone surface coating film 11 is not greatly shifted, and the bone 106 is invaded by other cells entering the space 106, etc. There is no hindrance to growth.

実施形態1の骨造成器具1は、歯槽骨100に骨切を行う必要がないから、患者への侵襲が小さい。   Since the osteotomy device 1 of Embodiment 1 does not need to perform osteotomy for the alveolar bone 100, the invasion to the patient is small.

また、従来の骨造成法には、粘膜102aおよび骨膜102bを切開後、伸張して骨面104と骨膜102bとの間に空間を形成し、この空間にコラーゲン等を充填した後、粘膜102aおよび骨膜102bを縫合する方法がある。   Further, in the conventional bone formation method, the mucous membrane 102a and the periosteum 102b are incised and then stretched to form a space between the bone surface 104 and the periosteum 102b, and this space is filled with collagen or the like. There is a method for suturing the periosteum 102b.

これに対して、実施形態1で述べた骨造成器具1を用いた骨造成法では、粘膜102aおよび骨膜102bを切開して骨面104を露出させた後、骨面被覆膜11で骨面104を被覆して粘膜102aおよび骨膜102bを接合し、その後、骨面被覆膜11と骨面104との間に空間106を形成している。   In contrast, in the bone formation method using the bone formation device 1 described in the first embodiment, the mucosa 102a and the periosteum 102b are cut open to expose the bone surface 104, and then the bone surface covering film 11 is used to expose the bone surface. 104, the mucous membrane 102 a and the periosteum 102 b are joined, and then a space 106 is formed between the bone surface covering film 11 and the bone surface 104.

したがって、実施形態1で述べた骨造成器具1を用いた骨造成法では、粘膜102aおよび骨膜102bを縫合する前に伸張することは行っていないから、粘膜102aおよび骨膜102bを伸張後、縫合することによる血行不良や感染が生じることがない、故に、前記血行不良による歯槽骨の栄養不良や歯槽骨の感染が防止されるから、造成骨108の成長が速い。   Therefore, in the bone formation method using the bone formation device 1 described in the first embodiment, the mucous membrane 102a and the periosteum 102b are not stretched before being sutured. Therefore, the mucous membrane 102a and the periosteum 102b are stretched and then sutured. Thus, poor blood circulation and infection do not occur. Therefore, malnutrition of the alveolar bone and infection of the alveolar bone due to the poor blood circulation are prevented, so that the formed bone 108 grows rapidly.

(2)実施形態2
図6に示すように、実施形態2に係る骨造成器具2は、骨面被覆膜11の周縁部を骨面104に確実に密着させるため、被覆部材固定手段として固定リング14および固定リング14を骨面104に固定するための固定螺子15を有する以外は、実施形態1の骨造成器具1と同様の構成を有している。
(2) Embodiment 2
As shown in FIG. 6, the bone forming device 2 according to the second embodiment has the fixing ring 14 and the fixing ring 14 as covering member fixing means in order to ensure that the peripheral portion of the bone surface covering film 11 is in close contact with the bone surface 104. Except for having a fixing screw 15 for fixing the bone surface 104 to the bone surface 104, it has the same configuration as the bone forming device 1 of the first embodiment.

固定リング14には、ポリエチレン樹脂やフッ素樹脂製のリングが使用され、固定螺子15にはチタニウムなどの生体適合性材料が使用されるが、これらの材料には限定されない。固定リング14にポリ乳酸樹脂やポリオール酸樹脂のような生体吸収性ポリマを使用し、固定螺子15にアパタイトなどの生体吸収性セラミックスを使用すれば、固定リング14や固定螺子15は、骨造成後には生体に吸収されて消失しているから骨造成後に除去する必要がなく、好ましい。また、被覆部材固定手段として、固定リング14を用いることなく、ステープラーの針のような形状のもので骨面被覆膜11の周縁部を直接固定したり、固定螺子15ではなく、ステープラーの針のようなもので固定リング14を固定してもよい。   A polyethylene resin or fluorine resin ring is used for the fixing ring 14, and a biocompatible material such as titanium is used for the fixing screw 15, but is not limited to these materials. If a bioabsorbable polymer such as polylactic acid resin or polyol acid resin is used for the fixing ring 14 and a bioabsorbable ceramic such as apatite is used for the fixing screw 15, the fixing ring 14 and the fixing screw 15 are formed after bone formation. Since it is absorbed into the living body and disappears, it is not necessary to remove it after bone formation, which is preferable. Further, as the covering member fixing means, the peripheral portion of the bone surface coating film 11 is directly fixed with a shape like a stapler needle without using the fixing ring 14, or the stapler needle instead of the fixing screw 15. Alternatively, the fixing ring 14 may be fixed.

骨造成器具2を用いて歯槽骨の造成を行う手順については、骨面104を骨面被覆膜11で覆った後、粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11を覆う前に、固定リング14と固定螺子15とで骨面被覆膜11の周縁部を骨面104に固定する点を除いては、実施形態1と同様である。   Regarding the procedure for creating alveolar bone using the bone forming device 2, the bone surface 104 is covered with the bone surface coating film 11, and then the mucosa 102 a and the periosteum 102 b are returned to the positions before the incision to return to the bone surface coating film. Except that the peripheral portion of the bone surface coating film 11 is fixed to the bone surface 104 with the fixing ring 14 and the fixing screw 15 before the cover 11 is covered, the same as in the first embodiment.

実施形態2の骨造成器具2を用いた骨造成法では、骨面104を骨面被覆膜11で覆った後に固定リング14と固定螺子15とで骨面被覆膜11の周縁部4箇所を骨面104に固定してから、粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11を覆っている。したがって、実施形態2の骨造成器具2を用いた骨造成法は、実施形態1の骨造成器具1を用いた骨造成法の有する長所に加えて、歯槽骨の収縮が激しく、粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11を覆っただけでは骨面被覆膜11を固定できない場合や、そのままでは骨面被覆膜11の周縁部を骨面104に密着させることが困難な箇所においても、骨造成を容易に実施できるという特長がある。   In the bone formation method using the bone formation device 2 according to the second embodiment, the bone surface 104 is covered with the bone surface coating film 11, and then the peripheral part of the bone surface coating film 11 is formed by the fixing ring 14 and the fixing screw 15. Is fixed to the bone surface 104, the mucosa 102a and the periosteum 102b are returned to the positions before the incision to cover the bone surface covering membrane 11. Therefore, in addition to the advantages of the bone formation method using the bone formation device 1 of the first embodiment, the bone formation method using the bone formation device 2 of the second embodiment has a severe contraction of the alveolar bone, and the mucosa 102a and the periosteum. When the bone surface coating film 11 cannot be fixed simply by returning the position 102b to the position before the incision and covering the bone surface coating film 11, the peripheral edge of the bone surface coating film 11 is brought into close contact with the bone surface 104 as it is. Even in places where this is difficult, there is a feature that bone formation can be easily performed.

(3)実施形態3
図7に示すように、実施形態3の骨造成器具3は、歯槽骨100における骨造成を行う箇所の骨膜102bと骨面104との間に挿入される骨面被覆膜11と、骨面被覆膜11の中央部に設けられた牽引ナット16と、牽引ナット16に螺合して骨面被覆膜11を挙上する方向に牽引する牽引ボルト17と、歯槽骨100における骨造成を行う箇所に隣接している2本の歯牙110および112に固定されるとともに、牽引ボルト17を回転可能に保持する牽引ボルト保持部材18と、を有する。
(3) Embodiment 3
As shown in FIG. 7, the bone formation device 3 according to the third embodiment includes a bone surface covering film 11 inserted between the periosteum 102 b and the bone surface 104 at a location where bone formation is performed in the alveolar bone 100, and the bone surface. The traction nut 16 provided in the central part of the coating film 11, the traction bolt 17 that is screwed to the traction nut 16 and pulls the bone surface coating film 11 in the raising direction, and bone formation in the alveolar bone 100. A traction bolt holding member 18 that is fixed to the two teeth 110 and 112 adjacent to the place to be performed and that rotatably holds the traction bolt 17.

牽引ナット16の図7における下端部には、半径方向に沿って外側に延在するフランジ部161が形成され、牽引ナット16は、フランジ部161において骨面被覆膜11に固定されている。   A flange portion 161 extending outward in the radial direction is formed at the lower end portion of the traction nut 16 in FIG. 7, and the traction nut 16 is fixed to the bone surface coating film 11 at the flange portion 161.

図7に示すように、牽引ボルト保持部材18は、両端に設けられた固定バンド19において歯牙110および歯牙112に固定される。一方、牽引ボルト17は、牽引ボルト保持部材18の中央部に設けられたボルト支持部18aにおいて回転可能に支持される。これによって、牽引ボルト17は、粘膜102aおよび骨膜102bの外側において回転可能に保持される。   As shown in FIG. 7, the traction bolt holding member 18 is fixed to the tooth 110 and the tooth 112 by fixing bands 19 provided at both ends. On the other hand, the traction bolt 17 is rotatably supported by a bolt support portion 18 a provided at the center of the traction bolt holding member 18. Thereby, the traction bolt 17 is rotatably held outside the mucous membrane 102a and the periosteum 102b.

骨面被覆膜11については実施形態1のところで述べたとおりである。   The bone surface coating film 11 is as described in the first embodiment.

牽引ナット16および牽引ボルト17は、チタニウム、アルミナ、アパタイト、窒化珪素などの生体適合性材料から形成される。但し、牽引ナット16については、ポリ乳酸樹脂やポリオール酸樹脂のような生体吸収性ポリマから形成されていてもよい。生体吸収性ポリマから形成された牽引ナット16もまた、骨造成が終了した時点で生体に吸収されてしまうから、骨造成終了後に除去する必要がない点で好ましい。   The traction nut 16 and the traction bolt 17 are formed from a biocompatible material such as titanium, alumina, apatite, or silicon nitride. However, the traction nut 16 may be formed of a bioabsorbable polymer such as polylactic acid resin or polyol acid resin. The pulling nut 16 formed of a bioabsorbable polymer is also absorbed by the living body when the bone formation is completed, and is preferable in that it does not need to be removed after the bone formation is completed.

以下、骨造成器具3を用いて歯槽骨の造成を行う手順について説明する。
実施形態1のところで述べたように、先ず、歯槽骨100における骨造成を行う箇所の粘膜102aおよび骨膜102bを切開し、切開した粘膜102aおよび骨膜102bを持ち上げて歯槽骨100の骨面104を露出させる。
Hereinafter, a procedure for creating an alveolar bone using the bone forming device 3 will be described.
As described in the first embodiment, first, the mucous membrane 102a and the periosteum 102b in the alveolar bone 100 where bone formation is performed is incised, and the incised mucosa 102a and the periosteum 102b are lifted to expose the bone surface 104 of the alveolar bone 100. Let

次に、骨面被覆膜11を骨面104上に載置し、牽引ボルト保持部材18の固定バンド19を歯牙110および歯牙112に固定し、牽引ボルト17をボルト支持部18aに挿通し、牽引ナット16に螺合させる。   Next, the bone surface coating film 11 is placed on the bone surface 104, the fixing band 19 of the traction bolt holding member 18 is fixed to the teeth 110 and 112, the traction bolt 17 is inserted into the bolt support portion 18a, Screwed onto the traction nut 16.

そして、粘膜102aおよび骨膜102bを切開前の位置に戻して骨面被覆膜11と牽引ナット16とを覆い、粘膜102aおよび骨膜102bの切開箇所を縫合または接着して密閉する。そして、牽引ボルト17を回転させ、骨面被覆膜11を骨面104から離間する方向に牽引して空間106を形成する。この空間106内の骨面104上で骨の成長が起こり、造成骨108が形成される。   Then, the mucous membrane 102a and the periosteum 102b are returned to the positions before the incision to cover the bone surface covering film 11 and the pulling nut 16, and the incised portions of the mucosa 102a and the periosteum 102b are sutured or adhered and sealed. Then, the pulling bolt 17 is rotated, and the bone surface coating film 11 is pulled in a direction away from the bone surface 104 to form a space 106. Bone growth occurs on the bone surface 104 in the space 106, and the formed bone 108 is formed.

実施形態3の骨造成器具3を用いた骨造成法は、実施形態1の骨造成器具1を用いた骨造成法の有する長所に加えて、牽引ボルト17の先端が骨面104に接触しないために、患者への侵襲が更に小さいという特長を有する。また、可撓性の骨面被覆膜11の表面に、粘膜102aから突出する牽引突起を一体的に形成し、この牽引突起を利用して骨面被覆膜11を牽引するようにすれば、骨膜102bと骨面104との間に挿入する部材を可撓性の骨面被覆膜11だけにできるから、実施形態1の骨造成器具1を用いた骨造成法に比べて、粘膜102aおよび骨膜102bの切開量を小さくすることができる。   In addition to the advantages of the bone formation method using the bone formation device 1 according to the first embodiment, the bone formation method using the bone formation device 3 according to the third embodiment does not contact the bone surface 104 with the tip of the traction bolt 17. Furthermore, it has the feature that the invasion to the patient is even smaller. In addition, if a pulling protrusion protruding from the mucous membrane 102a is integrally formed on the surface of the flexible bone surface coating film 11, the bone surface coating film 11 is pulled using this pulling protrusion. Since the member to be inserted between the periosteum 102b and the bone surface 104 can be only the flexible bone surface coating film 11, the mucous membrane 102a is compared with the bone formation method using the bone formation device 1 of the first embodiment. In addition, the incision amount of the periosteum 102b can be reduced.

1 骨造成器具
2 骨造成器具
3 骨造成器具
11 骨面被覆膜
12 上昇ナット
13 上昇ボルト
13a 上昇ボルト
13b 上昇ボルト
13c 上昇ボルト
14 固定リング
15 固定螺子
16 牽引ナット
17 牽引ボルト
18 牽引ボルト保持部材
18a ボルト支持部
19 固定バンド
100 歯槽骨
102a 粘膜
102b 骨膜
104 骨面
106 空間
108 造成骨
DESCRIPTION OF SYMBOLS 1 Bone-forming instrument 2 Bone-forming instrument 3 Bone-forming instrument 11 Bone surface coating film 12 Ascending nut 13 Ascending bolt 13a Ascending bolt 13b Ascending bolt 13c Ascending bolt 14 Fixing ring 15 Fixing screw 16 Towing nut 17 Towing bolt 18 Towing bolt holding member 18a Bolt support portion 19 Fixed band 100 Alveolar bone 102a Mucosa 102b Periosteum 104 Bone surface 106 Space 108 Deformed bone

Claims (6)

骨膜と骨面との間に挿入されて前記骨面を被覆する骨面被覆部材と、
前記骨面被覆部材および前記骨膜を前記骨面から挙上する被覆部材挙上手段と、
を備える骨造成器具。
A bone surface covering member that is inserted between the periosteum and the bone surface and covers the bone surface;
A covering member raising means for raising the bone surface covering member and the periosteum from the bone surface;
A bone building instrument comprising:
前記骨面被覆部材は、可撓性を有する膜からなる骨面被覆膜である請求項1に記載の骨造成器具。   The bone formation device according to claim 1, wherein the bone surface covering member is a bone surface covering film made of a flexible film. 前記被覆部材挙上手段は、前記骨面被覆部材と前記骨面とに、前記骨面被覆部材と前記骨面とが互いに離間する方向の力を及ぼすことにより、前記骨面被覆部材および前記骨膜を挙上する内部挙上部材である請求項1または2に記載の骨造成器具。   The covering member raising means exerts a force on the bone surface covering member and the bone surface in a direction in which the bone surface covering member and the bone surface are separated from each other, thereby causing the bone surface covering member and the periosteum to The bone formation device according to claim 1, wherein the bone formation device is an internal lifting member. 前記被覆部材挙上手段は、前記骨面被覆部材を前記骨面から離間する方向に前記骨膜の外側から牽引する牽引部材である請求項1または2に記載の骨造成器具。   The bone formation device according to claim 1 or 2, wherein the covering member lifting means is a pulling member that pulls the bone surface covering member from the outside of the periosteum in a direction away from the bone surface. 前記骨面被覆部材の周縁部の少なくとも一部を前記骨面に固定する被覆部材固定手段を備える請求項1〜4の何れか1項に記載の骨造成器具。   The bone formation instrument of any one of Claims 1-4 provided with the covering member fixing means which fixes at least one part of the peripheral part of the said bone surface covering member to the said bone surface. 前記骨面被覆部材は生体吸収性材料から形成されている請求項1〜5の何れか1項に記載の骨造成器具。   The bone formation device according to any one of claims 1 to 5, wherein the bone surface covering member is formed of a bioabsorbable material.
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JP7474984B2 (en) 2020-03-13 2024-04-26 国立大学法人東北大学 Membranes for bone regeneration and/or bone augmentation

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JP7002259B2 (en) 2017-09-12 2022-01-20 国立大学法人山梨大学 Bone structure
JP7474984B2 (en) 2020-03-13 2024-04-26 国立大学法人東北大学 Membranes for bone regeneration and/or bone augmentation

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