JP4372372B2 - Positioning gauge for mandibular vertical osteotomy - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a gauge for positioning an osteotomy line used in performing a mandibular branch vertical osteotomy in the treatment of jaw deformities.
[0002]
[Prior art]
Traditionally, vertical osteotomy of the mandibular branch for the treatment of jaw deformities has been widely performed, but it is important to determine the osteotomy line so as not to damage the neurovascular bundle in the jawbone from the narrow surgical field in the oral cavity It was extremely difficult.
As an actual method, there is a method of cutting right after the ridge that seems to exist at the opposite side of the mandibular fora which is the entrance of the nerve, but the actual bulge almost coincides with the mandible. When the error was large, the position was shifted forward or downward by about 10 mm and could not be cut at an accurate position.
In addition, there is a method of measuring the width of the mandibular branch and cutting it about 8 to 10 mm from the center, but there is also a risk that the osteotomy may go too far backward depending on the size of the bone.
Further, there is a method of performing osteotomy by calculating the distance from the rear edge of the mandibular branch at a predetermined enlargement ratio by X-rays, but the enlargement ratio is not correct and it is difficult to determine an accurate osteotomy position.
There is also a method of damaging the part to be cut and viewing with a dental mirror, etc., but it is very inaccurate, especially for people whose lower edge of the mandibular branch wraps around to the bottom. .
As described above, there is no actual method for measuring the distance from the rear edge of the lower jaw branch.
[0003]
[Problems to be solved by the invention]
The problem to be solved by the present invention is to solve these conventional problems, and to perform mandibular branch vertical osteotomy in the treatment of jaw deformities, the mandibular branch vertical that can accurately and easily position the osteotomy line It is to provide a positioning gauge for osteotomy.
[0004]
[Means for Solving the Problems]
The configuration of the present invention that solves this problem is as follows.
1) A hook that bends an elongated plate so that the whole is substantially in a U-shape, and bends the front end on the side opposite to the bending direction of the bent portion and hooks it on the rear edge of the lower jaw branch Forming a portion, providing a scale of a predetermined length on the front plate surface from the bent portion, and hooking the hook portion on the rear edge of the lower jaw branch so that the bone can be accurately cut using the scale. 2) Positioning gauge for vertical osteotomy of mandibular branch 2) The front end of the scale of the plate is folded so that the scale forms a step on the side opposite to the folding direction of the hooking section to form an insertion space for the osteotomy machine The above-mentioned positioning gauge for vertical osteotomy of the mandibular branch described in 1) 3) The above-mentioned 1) or 2) which facilitates insertion into the incision site in the oral cavity by forming the front from the front end portion of the scale to be narrower than the rear. Positioning gauge for lower osteotomy vertical osteotomy 4) Scales on both sides of the plate The positioning gage for mandibular branch vertical osteotomy according to any one of 1) to 3).
[0005]
[Action]
In the present invention, first, the mandible is taken with an X-ray, the position of the neurovascular bundle is confirmed on the X-ray film, the length a of the lower jaw branch is measured, and the length b from the rear edge of the lower jaw branch to the cutting position is determined.
Next, an incision is made in the oral cavity, a positioning gauge and osteotomy machine are inserted into the incision, and the hook of the positioning gauge is hooked on the rear edge of the mandibular branch so that the tip of the osteotomy machine is parallel to the positioning gauge. In contact, the first marking is placed at the same position on the positioning gauge scale and the osteotomy machine.
Next, the osteotomy machine is retracted parallel to the positioning gauge toward the front side, the leading edge of the osteotomy machine is brought into contact with the front edge of the mandibular branch, and the second marking is aligned with the first marking of the osteotomy machine on the scale of the positioning gauge. The dimension between the first marking and the second marking is an actually measured value of the length a ′ of the mandibular branch.
Next, with a and b measured on the X-ray film, a distance c that is actually cut is calculated by a calculation formula of c = a ′ / a × b, and the bone is the distance c from the rear edge of the lower jaw branch. The cutting machine is moved backward to determine the osteotomy position, and the osteotomy machine performs osteotomy.
When the front part of the scale of the plate is bent so that the scale part forms a step on the opposite side of the folding direction of the hook part, when the osteotomy machine is slid back and forth in positioning the osteotomy An insertion space serving as a relief portion of the main body of the osteotomy machine is formed. When the front of the plate is formed with a narrower width from the rear than the front end of the scale, it can be easily inserted into the incision in the oral cavity.
A scale provided on both sides of the plate allows the length of the mandibular branch and the position of osteotomy to be seen from any direction.
[0006]
DETAILED DESCRIPTION OF THE INVENTION
The plate material is made of metal such as stainless steel, aluminum, other alloys, or plastic such as ABS resin or styrene resin, and the entire length of the positioning gauge is in the range of about 280 to 320 mm, with the outer corner at the approximate center. The length of the scale portion is approximately 150 to 170 mm from the bent position to the rear end, and the length of the scale portion is approximately 50 to 80 mm. It is common. The length of the hook portion at the front end is preferably set in a range of approximately 10 to 15 mm so that the saw blade of the osteotomy machine is in between the lower jaw branch.
The scale may be long enough to measure a numerical value of about 40 to 60 mm, and is provided on one or both sides of the plate material.
Forming the front from the front end of the scale with a narrower width than the rear is preferable because it facilitates insertion into the incision site in the oral cavity. The front width should be in the range of about 8-12 mm, and the rear width should be in the range of about 13-17 mm. The bending angle of the tip is preferably in the range of about 120 to 140 °, but is not limited to this range because of individual differences.
[0007]
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[0008]
【Example】
In the embodiment shown in FIGS. 1 to 5, the front end portion of the scale of the plate material is bent so that the scale portion forms a step on the side opposite to the folding direction of the hooking portion to form an insertion space of the osteotomy machine body, This is an example of mandibular branch vertical osteotomy using a mandibular branch vertical osteotomy positioning gauge that is formed narrower from the rear than the front end of the scale of the plate material and easily inserted into the incision site in the oral cavity.
FIG. 1 is an external view of a positioning gauge for vertical osteotomy of a mandibular branch according to an embodiment.
FIG. 2 is an external view of the osteotomy machine according to the embodiment.
FIG. 3 is an explanatory diagram of the mandible of the example.
FIG. 4 is an explanatory diagram illustrating a usage state of the positioning gauge according to the embodiment.
FIG. 5 is an explanatory diagram illustrating a bone cutting process according to the embodiment.
[0009]
Reference numeral 1 denotes a positioning gauge.
Reference numeral 2 denotes a plate material, which is made of a long and narrow stainless steel material having a thickness of 4 mm, and is bent at an angle of 225 ° so as to be substantially in the shape of a letter.
Reference numeral 3 denotes a hooking portion, which bends the front end portion of the plate member 2 at an angle of 110 ° opposite to the bending direction of the bent portion and further inwardly at a position of 15 mm from the bent portion. It is bent at an angle of 140 ° to form a total length of 23 mm, and is shaped so that it can be hooked on the rear edge of the lower jaw branch.
4 is a scale portion made of stainless steel having a thickness of 1.5 mm, engraved with a scale capable of measuring 50 mm on the front side, and from the bent portion of the plate material 2 to the front side of the plate having a length of 65 mm. It is attached.
5 is a step, and the front end portion of the scale part 4 of the plate 2 is spaced at intervals of 10 mm at an angle of 125 ° and 235 ° so that the scale part 4 part forms a step on the side opposite to the folding direction of the hook part 3. The insertion space 5a into which the osteotomy machine is inserted is formed in the scale portion 4 part. In addition, the length from the level | step difference 5 to the hook part 3 is 50 mm.
Reference numeral 6 denotes a grip portion, which is formed with a length of 160 mm backward from the bent portion of the plate member 2.
The width of the plate 2 is 10 mm from the step 5 and 15 mm from the rear.
Reference numeral 7 denotes a known osteotomy machine, which is composed of an osteotomy body 7a and a saw blade body 7b having a saw blade 7c at the tip.
10 is a mandible, M1 and M1 ′ are first markings, and M2 is a second marking.
[0010]
In this embodiment, first, the mandible 10 is taken with an X-ray, and the neurovascular bundle, the raised portion 10b, the mandibular hole 10c, etc. are confirmed on the X-ray film, the length a of the mandibular branch 10a is measured, and the rear end of the mandibular branch 10a. The distance b from the edge to the cutting position is determined. Next, after the incision is made in the oral cavity and the positioning gauge 1 and the osteotomy machine 7 are inserted into the incision site, the hook portion 3 of the positioning gauge 1 is connected to the rear edge of the lower jaw branch 10a as shown in FIG. The saw blade body 7b of the osteotomy machine 7 is brought into contact with the positioning gauge 1 in parallel and the saw blade 7c is hooked on the rear edge of the lower jaw branch 10a, so that the scale 4 of the positioning gauge 1 and the osteotomy machine body 7a First markings M1 and M1 ′ are attached to the same positions.
Next, as shown in FIG. 5 (b), the osteotomy machine 7 is moved backward in parallel with the positioning gauge 1, and the saw blade 7 c is brought into contact with the front edge of the lower jaw branch 10 a, so that the scale portion 4 of the positioning gauge 1 The second marking M2 is attached to the osteotomy machine body 7a at the position where it is aligned with the first marking M1, and the dimension between the first marking M1 and the second marking M2 is the actually measured length a ′ of the lower jaw branch 10a.
Next, with a and b measured on the X-ray film, a distance c actually cut is calculated by a calculation formula of c = a ′ / a × b, and as shown in FIG. An accurate osteotomy position is determined by adjusting the position of the osteotomy machine 7 by the distance c from the end edge, and osteotomy is performed as shown in FIG.
Then, the positioning gauge 1 and the osteotomy machine 7 are pulled out to remove the cut bone, and the incision is sutured to complete the operation.
[0011]
Thus, in this example, after determining the length of the mandibular branch and the approximate osteotomy position on the X-ray film, the dimension of the mandibular branch was measured with the positioning gauge, and the measured value and the numerical value on the X-ray film were calculated. Since the actual osteotomy line is determined by combining the two, the accurate osteotomy position can be determined and the operation can be performed accurately and easily.
Further, the positioning gauge also serves as a retractor, so that a surgical operation can be performed safely and reliably even in an operating field where the operability of an extremely narrow surgical instrument in the oral cavity is poor.
[0012]
FIG. 6 shows that the hooking portion at the tip can be moved by sliding the slide portion with the markings, and the marking operation at the osteotomy position can be omitted by checking the sliding distance with the graduation portion at hand. It is another example of the positioning gauge for mandibular-vertical osteotomy of the embodiment made in this way.
FIG. 6 is an external view of a positioning gauge for lower osteotomy vertical osteotomy of another example of the embodiment.
In the figure, 14 is a scale part, 14a is an opening part, 14b is a slide part which attached the hook part to the rear end through the said opening part 14a.
[0013]
In another example of the embodiment, after the sliding portion 14b is slid to the front end and the hooking portion is fully extended, the hooking portion 3 is hooked on the rear end edge of the lower jaw branch 10a, and then the slide portion 14b is slid forward. The hook part 3 is moved backward to come into contact with the front end edge of the lower jaw branch 10a, and the sliding distance of the slide part 14b is read by the scale part 14 to obtain the length a ′ of the lower jaw branch 10a.
Next, on the X-ray film, with the measurements a and b, a distance c that is actually cut is calculated by a formula of c = a ′ / a × b, and the hook 3 is moved from the rear edge of the lower jaw branch 10a to the distance c. Retreat by as much as.
Then, the distal end of the osteotomy machine 7 is inserted until it comes into contact with the hooking portion 3 of the positioning gauge 1, and the contacted position becomes the osteotomy position, and osteotomy is performed.
As described above, in another example of the embodiment, the marking operation of the length of the mandibular branch and the osteotomy position can be omitted.
Other reference numerals and configurations are the same as those in the embodiment.
[0014]
【The invention's effect】
As described above, according to the present invention, it is possible to provide a positioning gauge for mandibular branch vertical osteotomy that can accurately and easily position the osteotomy line when performing surgery for mandibular branch vertical osteotomy in the treatment of jaw deformities.
[Brief description of the drawings]
FIG. 1 is an external view of a positioning gauge for vertical osteotomy of a mandibular branch according to an embodiment.
FIG. 2 is an external view of an osteotomy machine according to an embodiment.
FIG. 3 is an explanatory diagram of a mandible of an example.
FIG. 4 is an explanatory view showing a usage state of the positioning gauge of the embodiment.
FIG. 5 is an explanatory diagram showing a bone cutting process according to an embodiment.
FIG. 6 is an external view of a positioning gauge for lower osteotomy vertical osteotomy of another example of the embodiment.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Positioning gauge 2 Board | plate material 3 Hook part 4 Scale part 5 Level | step difference 5a Insertion space 6 Grip part 7 Osteotomy machine 7a Osteotomy machine main body 7b Saw blade main body 7c Saw blade 10 Mandible 10a Mandibular branch 10b Raised part 10c Mandibular hole 10d Teeth 14 Scale part 14a Opening part 14b Slide part M1, M1 'First marking M2 Second marking

Claims (4)

A hook portion that bends an elongated plate material so that the whole is substantially in a U-shape, and bends the front end on the opposite side to the bending direction of the bent portion and hooks it on the rear edge of the lower jaw branch. Forming a scale of a predetermined length on the front plate surface from the bent portion, and hooking the hook portion on the rear edge of the lower jaw branch so that the bone can be accurately cut using the scale. Positioning gauge for vertical osteotomy of the mandibular branch. 2. A mandibular perpendicular bone according to claim 1, wherein the front end portion of the scale of the plate is bent so that the scale portion forms a step on the side opposite to the folding direction of the hook portion to form an insertion space for the osteotomy machine. Positioning gauge for cutting. The positioning gauge for vertical osteotomy of the mandibular branch according to claim 1 or 2, wherein the front part from the front end part of the scale of the plate member is formed narrower from the rear part to facilitate insertion into the incision part in the oral cavity. The positioning gauge for mandibular branch vertical osteotomy according to any one of claims 1 to 3, wherein a scale is provided on both sides of the plate.

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