JP3953441B2 - Bite block and cranial positioning reference plane detection method using bite block - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a bite block for an edentulous jaw used as a medical tool and a detection method for detecting a skull positioning reference plane using the bite block.
[0002]
[Prior art]
When general anesthesia is performed by semi-closed circulatory anesthesia for surgical operations, etc., an endotracheal tube is inserted into the trachea, but the patient unconsciously bites the tracheal tube to guide the insertion of the tracheal tube. In order to prevent this, the bite block is bitten in the mouth, and the bite block is fixed to the face with an adhesive tape or the like with the tracheal tube attached to the bite block.
[0003]
As a bite block generally used conventionally, it is of a form called a Kyoto University type bite block, and a pore tube made of a metal pipe is embedded inside a cylindrical part made of an elastic material such as rubber, A flange portion is integrally formed on the outer periphery at a position spaced apart from one end of the tubular portion, and an arc-shaped notch for a tube guide is provided in a part of the flange portion.
[0004]
While this Kyoto University bite block has the advantage of being inexpensive and easy to use, there is no fixation source in the oral cavity, so there is no sense of stability. There has been a drawback that the tube moves downward due to sagging skin.
[0005]
In addition, using a conventional bite block to maintain the occlusal diameter during mask ventilation of an edentulous patient and fixing an endotracheal tube is not very stable. When used in a special position, there was a risk of the tube moving due to sagging of the lips and cheeks.
[0006]
We have developed a byte block for edentulous in 1995, was Tsu room have to further improve this. That is, looking at the edentulous byte blocks, and most important point to manufacture the edentulous byte blocks, or to any form of the base plane of the upper and lower jaws, although the this that, The edentulous bite block that we developed and proposed earlier was created by impressing the upper and lower jaws of an edentulous model made based on the average value of adults, and the height is The endotracheal tube can be fixed without difficulty.
[0007]
However, the shape of the jaw crest varies depending on the individual, and there are cases where the bite block for an edentulous jaw made of an average value does not fit. Also, when it is necessary to accurately determine the height at which the upper and lower jaws are fixed, or when it is necessary to determine the best height (mandibular position) through trial and error (the mandibular position to facilitate spontaneous breathing after extubation) To prevent the sinking of the tongue base). In such a case, it is convenient to have an anatomical index as a reference.
[0008]
Therefore, as a result of intensive studies, we have developed a bite block for edentulous jaws using the hip plane (HIP plane) as the reference anatomical index. As shown in FIG. 8, the hip plane is a plane formed by three points, that is, left and right incisions (hammer notch) and incisive papilla (incisive papilla).
[0009]
As is apparent from FIG. 8, the hip plane according to Myodontics is parallel to the horizontal plate of the palate, that is, the horizontal plane with respect to the midline when the skull is viewed from the front. It turns out. An articulator that inputs this hip plane has also been developed and used. FIGS. 9A and 9B show the relationship between the articulator 101 that receives the hip plane 100 and the skull 102, FIG. 9A shows the frontal plane relationship, and FIG. 9B shows the sagittal plane relationship.
[0010]
The occlusal plane in which the uniplanar occlusal plane is very anatomically stable (less changes in age and age), and impresses the patient's oral cavity (maxillary jaw) and inputs the hip plane. Since it can be calculated | required correctly only by making a plaster model (for example, Myodontics Relator (trademark) etc.), the utilization is easy.
[0011]
On the other hand, in addition to anesthesia treatment, it is convenient to be able to easily detect the reference plane for positioning the individual patient's skull in the operation of the skull and oral cavity, etc., and there is a possibility that it can be used in other fields. . In the field of manufacturing dentures, a device for measuring the angle formed by the hip plane and the Kampel plane and a method for arranging porcelains during the manufacture of dentures using this device have been proposed (for example, Patent Document 1). Conventionally proposed ones have a drawback that the number of components of the instrument increases and the operation is troublesome.
[0012]
[Patent Document 1]
Japanese Patent Publication No.5-9105 [0013]
[Problems to be solved by the invention]
The present invention is to solve the shortcomings of the prior art as described above, the holding of the vertical dimension when the mask ventilation in general anesthesia edentulous patients have a fixed source to the mouth cavity and fixing the endotracheal tube The edentulous bite block can create an accurate bite block corresponding to an individual and the edentulous bite block can be used as a reference plane detection bite block. It is an object of the present invention to provide a method for detecting a reference plane for personal skull positioning.
[0014]
[Means for Solving the Problems]
To achieve the above object, byte block of the present invention includes a main body portion and the left have been extended from the upper portion of the body portion or the right side of the maxillary alveolar ridge of which is inserted into the left or right side of the mouth cavity In a bite block comprising an upper jaw ridge abutting portion to be brought into contact with a lower jaw ridge abutting portion extending from a lower portion of the main body portion and to be brought into contact with a left or right lower jaw ridge , the hook portion engaged with the corner of the mouth portion of the left or right side is extended from the front end portion of the main body portion is formed, using the edentulous model which is scaled by the articulator hip plane is entered The base surface of the upper jaw ridge contact portion is formed on the basis of the hip plane, and at least the hook portion is formed in parallel with the hip plane . The recess is formed and small The surface of Kutomo the hook portion, characterized in that parallel to the display unit and the hip plane is provided.
[0015]
The bite block for the edentulous jaw with the above configuration is standardized with the basal plane of the upper jaw ridge contact portion being formed with reference to the hip plane, and when used, the upper and lower jaw ridge contact portions are softly cured The agent is applied and inserted into the patient's mouth, and the hook is engaged with the corner of the mouth. Since the bite block suitable for the patient is formed by the curing of the soft curing agent, the endotracheal tube is attached to the inner surface of the main body and the endotracheal tube is fixed to the skin outside the oral cavity with an adhesive tape or the like. Thereby, the endotracheal tube can be stably fixed in the oral cavity.
[0016]
The right and left bite blocks for the edentulous jaw are produced, but either the right or left bite block is sufficient for fixing the endotracheal tube. Although the endotracheal tube can be fixed in Sowase the inner surface of the main body, because the inner surface of the body portion is formed with recesses for the tube guide, the Sowaseru possible endotracheal tube in recess Therefore, it can be held and fixed more reliably.
[0017]
The hook part is formed parallel to the hip plane, but at least the hook part has a display part parallel to the hip plane , so the left and right bit blocks are used as a reference plane detection bit block to be described later. More preferably, the display portion is provided so as to extend to the inner surface of the main body portion.
[0018]
According to the skull positioning reference plane detection method of the present invention, as described in claim 2 , the intraoral plaster model of the patient is prepared by an articulator based on the impression in the oral cavity of the patient, and is prepared for the right side and the left side. use as a reference plane for detection byte block byte block of claim 1 which is, after coating a flexible curing agent to the alveolar ridge abutting portion of the upper and lower portions of said reference plane detection byte block, the plaster model It is characterized in that the reference plane for positioning the skull of the patient is detected by the display part of the hook part in the right and left reference plane detection bite blocks.
[0019]
Since the display unit is a display parallel to the hip plane, the reference plane for positioning the patient's skull can be easily detected by connecting the left and right display units. For example, the display unit is formed in a groove shape or a ridge. If the mounting leg portions are provided at both end portions of the flat plate body and the leg portions are fitted to the display portion, the flat plate body is parallel to the hip plane. I can know for sure.
[0020]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of a bite block and a skull positioning reference plane detection method according to the present invention will be described with reference to the drawings.
FIG. 1 is a perspective view of a bite block for an edentulous jaw, and FIG. 2 is a perspective view of the bite block as seen from the bottom side, showing a right-side tool. FIG. 3 is a front view showing the mounting position of the bite block for the edentulous jaw. Incidentally, FIG. 4 is a perspective view of a bite block for toothed chin developed simultaneously, FIG. 5 is a sectional view of a bite block for organic tooth jaw, side view showing the mounted state of the bite block for 6 dentate jaw It is. FIG. 7 is a front view showing an example of detecting the skull positioning reference plane using the left and right edentulous jaw cutting blocks as the reference plane detecting cutting block.
[0021]
In the drawing, reference numeral 1 denotes a bite block for an edentulous jaw, and as shown in FIG. 3, extends from the main body 2 inserted on the left or right side in the oral cavity P22 and from the upper part of the main body 2. An upper jaw ridge contact portion 3 to be brought into contact with the left or right upper jaw ridge P23, and a lower portion which is extended from the lower portion of the main body portion 2 and to be brought into contact with the left or right lower jaw ridge P24 It is provided with a ridge contact portion 4 and a hook portion 5 that extends from the front end portion of the main body portion 2 and engages with the left or right corner portion P25, and is based on FIGS. 9 (A) and 9 (B). As already described, the edentulous jaw model (not shown) standardized by the articulator 101 to which the hip plane 100 is input is used to produce the transparent acrylic resin or the like. In this case, the base surface 3 a of the upper jaw rest abutment portion 3 is formed with reference to the hip plane 100, and at least the hook portion 5 is formed in parallel with the hip plane 100.
[0022]
In the edentulous bite block 1 having the above-described configuration, the base surface 3a of the upper jaw ridge contact portion 3 is formed with reference to the hip plane 100 and is standardized. A soft curing agent (not shown in FIG. 3) is applied to the parts 3 and 4 and inserted into the patient's oral cavity P22, and the hook part 5 is engaged with the mouth corner part P25. Since the bite block suitable for the patient is formed by curing the soft curing agent, the endotracheal tube 103 is attached to the inner side surface 2a of the main body 2 and the endotracheal tube 103 is attached to the oral cavity with an adhesive tape (not shown) or the like. Fix to the skin outside. Thereby, the endotracheal tube 103 can be stably fixed in the oral cavity.
[0023]
As shown in FIGS. 1 to 3 , a concave portion 6 for a tube guide is formed on the inner surface 2 a of the main body portion 2, and the endotracheal tube 103 is attached to the concave portion 6 so as to be held and fixed more reliably. Can be done. When changing the intraoral volume, that is, changing the height of the bite block 1, it can be accurately created by adjusting the height of the articulator 101 based on the hip plane 100.
[0024]
The hook portion 5 is formed in parallel with the hip plane 100, but the display portion 7 parallel to the hip plane 100 is formed on the surface of the hook portion 5. The display unit 7 is preferably formed so as to extend to the inner surface 2a of the main body unit 2. Further, the display unit 7 may be a line display such as a red line, but may be a groove shape or a ridge shape. When the display portion 7 is formed in a groove shape or a ridge shape, it is convenient for detecting a reference plane described later.
[0025]
FIG. 4 is a perspective view of a bite block 11 for a toothed jaw developed simultaneously with the bite block for an edentulous jaw, and a cylindrical part 12 made of an elastic material such as rubber and the like inside the cylindrical part 12. A vent hole 13 made of a hard member such as an embedded metal pipe, two substantially elliptical wings 14 and 15 integrally formed on the outside of the cylindrical portion 12 at a predetermined interval, and both wings 14 and 15 It is provided with a recess 16 for clamping and fixing formed in the cylindrical portion 12 so as to be positioned therebetween.
[0026]
Of the wings 14 and 15, at least one edge of each wing 14 is formed in an arcuate shape 14 a, and the one wing 14 is shorter than the other wing 15. In the manufacturing example , both end edges of the one wing 14 are formed in an arc shape, and both end edges of the other wing 15 are intentionally formed in a square shape, so that both ends of the one wing 14 are usually arc-shaped. It is possible to determine that the one wing 14 side that is formed is inserted into the oral cavity.
[0027]
In use, the bite block 11 for a toothed jaw having the above-described configuration is inserted into the oral cavity P22 with the wing 14 facing sideways from one wing 14 side, and then rotated 90 degrees to vertically move the one wing 14 vertically. The tongue can be stably fixed by pressing the tongue with the wing piece in the downward direction and tightening the recess 16 for clamping and fastening between the wings 14 and 15 as shown in FIG. (Not shown) is attached to the cylindrical part 12, and is fixed to the cylindrical part 12 with an adhesive tape (not shown) or the like outside the oral cavity.
[0028]
Even in the case of a patient with a complicated tooth defect, the endotracheal tube can be stably fixed by using the bite block 11 for toothed jaw and the bite block 1 for edentulous jaw in combination. Can do.
[0029]
Next, an example of detecting a reference plane for skull positioning using the edentulous bite block 1 having the above-described configuration will be described.
First, a gypsum model (not shown) of the patient's mouth is produced by the articulator 101 based on the impression in the mouth of the patient, and the bit blocks 1 and 1 produced for the right and left are used as the reference plane detection bit. After the flexible hardening agent 104 is applied to the upper and lower jaw ridge contact portions 3 and 4 of the reference plane detection bit block 1 and 1 as a block, the bite block 1 is set on the plaster model and positioned. Since the left and right reference plane detecting bit blocks 1 and 1 cured by the soft curing agent 104 are dedicated to the patient, the left and right reference plane detection bit blocks 1 and 1 are set in the plaster model or inserted into the oral cavity of the patient. The reference plane RP for positioning the skull of the patient can be detected by the display portions 7 and 7 of the hook portions 5 and 5.
[0030]
Since this reference plane RP is parallel to the hip plane 100 of the patient, and the hip plane 100 is parallel to the horizontal plate of the patient's palate (FIG. 8), it should be used as a reference plane for positioning the patient's skull. Can do. As a display device for displaying the reference plane RP, for example, the display portion 7 is formed in a groove shape or a ridge, and mounting legs are provided at both ends of a flat plate (not shown), and the legs are displayed on the display. If it fits in the part 7, the said reference plane can be displayed easily and reliably by the said flat plate body.
[0031]
【The invention's effect】
According to the bite block for edentulous according to the present invention, the holding and fixing of the endotracheal tube vertical dimension when the mask ventilation in general anesthesia edentulous patients have a fixed source to the mouth cavity An accurate byte block corresponding to an individual can be created while being stable.
[0032]
According to the skull positioning reference plane detection method of the present invention, it is possible to easily and accurately detect an individual individual's skull positioning reference plane using the edentulous bite block as a reference plane detection tool block.
[Brief description of the drawings]
FIG. 1 is a perspective view showing an embodiment of a bite block for an edentulous jaw according to the present invention.
FIG. 2 is a perspective view of a bite block for an edentulous jaw viewed from the bottom side.
FIG. 3 is a front view showing a mounting position of a bite block for an edentulous jaw.
FIG. 4 is a perspective view showing an example of manufacturing a bite block for a toothed jaw.
FIG. 5 is a cross-sectional view of a bite block for a toothed jaw.
FIG. 6 is a side view showing a mounted state of a bite block for a toothed jaw.
FIG. 7 is a front view illustrating an example of detecting a reference plane for skull positioning using a bite block for an edentulous jaw.
FIG. 8 is an anatomical observation of the hip plane viewed from the sagittal plane.
FIGS. 9A and 9B show the relationship between the articulator and the cranium inputted with the hip plane, where FIG. 9A shows the relationship with the frontal surface and FIG. 9B shows the relationship with the sagittal surface.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Bite block for edentulous jaw 2 Body part 3 Upper jaw ridge contact part 3a Base surface of upper jaw ridge part 4 Lower jaw ridge contact part 5 Hook part 6 Recessed part 7 Display part 11 Bite block 12 for toothed jaw Cylindrical part 13 Vent hole 14 One wing 15 The other wing 16 Concave portion P22 Oral P23 Maxillary ridge P24 Mandibular ridge P25 Mouth corner 100 Hip plane 101 Hip plane 101 Articulator 102 Input the hip plane Cranium 103 Intratracheal Tube 104 Soft curing agent RP Reference plane

Claims (2)

A main body inserted into the left or right side of the oral cavity; an upper ridge contact portion extending from an upper portion of the main body portion and to be brought into contact with the left or right upper jaw ridge; In a bite block provided with a lower jaw ridge contact portion that extends from the lower portion and should be brought into contact with the left or right mandibular ridge, the left or right side A hook part to be engaged with the corner of the mouth is formed, and by using an edentulous jaw model standardized by an articulator to which a hip plane is input, the base surface of the upper jaw ridge contact part is A hip plane is formed on the basis of the hip plane, and at least the hook portion is formed in parallel with the hip plane . A concave portion for a tube guide is formed on the inner surface of the main body portion, and at least a hip plane is formed on the surface of the hook portion. Parallel display part Byte block for edentulous, characterized in that are provided. The bite block according to claim 1, wherein the bite block according to claim 1 is prepared for the right and the left by using an articulator to produce a plaster model of the patient's oral cavity based on the impression in the patient's oral cavity. , After applying a flexible hardening agent to the upper and lower jaw ridge contact portions of the reference plane detecting bite block, setting and positioning on the plaster model, and display portions of hook portions in the left and right reference plane detecting bite blocks A method for detecting a reference plane for positioning the skull of the patient using the method of detecting a reference plane for positioning the skull.

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