JP4858876B2 - Orthodontic surgery reciprocating file - Google Patents

Description

  The present invention relates to a reciprocating file for orthognathic surgery that forms a groove for pressing a bone flea on the inner side of a mandibular branch during a sagittal split operation.

In orthognathic surgery, in particular, sagittal segmentation of the mandibular branch, the inside of the mandibular branch is cut to form a groove, and an instrument called bone flea is pressed into the groove to divide the mandibular branch.
In forming such a groove on the inner side of the lower jaw branch and the outer side of the lower jaw branch, conventionally, for example, a Lindermann bar 50 is formed on the inner side of the lower jaw branch 11 and the outer side of the lower jaw branch 11 as shown in FIG. It is rotating by pressing against the power.

  Alternatively, as shown in FIG. 31, the inside of the mandibular branch 11 and the outside of the mandibular branch 11 are cut using a bone saw 70 that reciprocates electrically to form a groove.

However, it is necessary for the Lindeman bar 50 to hang the retractor 60 on the back side 11e of the mandibular branch 11 to provide a certain distance between the mandible 10 and the surrounding tissue (not shown).
If a certain distance is not provided between the mandible 10 and the surrounding tissue, the surrounding tissue is involved when the Lindeman bar 50 is rotated, and the tissue, blood vessels, nerves, and the like may be damaged. Because.

  On the other hand, when a bone saw 70 that reciprocates electrically is used, the bone saw 70 has a so-called “top height” (large tooth width), and therefore when the Lindeman bar 50 is used. A wider gap must be provided. Further, when reciprocating (movement of the arrow Y), it swings sideways in the axial direction (movement of the arrow R), and so-called “blur” occurs. In order to accurately form the groove by cutting the bone, skill or ingenuity is required.

  Therefore, it is sufficient to provide a necessary minimum space between the mandible 10 and the surrounding tissue by using a retractor 60, and tissues and blood vessels in the vicinity of a position where a groove inside the mandibular branch 11 is to be formed. However, there has been a need for a technique that can accurately form a groove by cutting the inner side of the mandibular branch without any fear of damaging nerves or the like, without skillful or special measures. No technology has been proposed.

As another conventional technique, for example, a craniotomy machine has been proposed that can suppress the fall of the bone flap at the time of capping (patent document 1). However, the related art does not assume use in mandibular branch sagittal segmentation, and therefore does not meet the above-described demand.
JP 2002-238911 A

  The present invention has been proposed in view of the above-described problems of the prior art, and it is sufficient to provide the minimum necessary gap between the mandible and the surrounding tissue using a retractor (鈎), There is no risk of damaging tissue, blood vessels, nerves, etc. in the vicinity of the location where the groove inside the mandibular branch should be formed, and the groove can be accurately formed by cutting the inside of the mandibular branch without skill or special efforts The purpose is to provide a reciprocating file for orthognathic surgery that can be done.

  A reciprocating file (1) for orthognathic surgery of the present invention has a shaft portion (3) having a circular cross section and configured to be reciprocable, and an outer peripheral portion (31) of the shaft portion (3). A plurality of teeth (4) are formed integrally with each other, and the plurality of teeth (4) are intermittently formed at regular intervals (equal pitches) in the longitudinal direction of the shaft portion (3). In the circumferential direction of the shaft portion (3), it is formed over the entire region, and the radially outer tips of the teeth (4) are curved surfaces (4r) or flat surfaces (4h). It is comprised, The longitudinal direction front-end | tip part of the axial part (3) is comprised by the curved surface (5) (for example, partial spherical shape), It is characterized by the above-mentioned (Claim 1).

  Here, it is preferable that the gradient (α, β) of the plurality of teeth (4) with respect to the shaft outer peripheral portion (31) is 90 ° or more (claim 2).

  Further, the shaft portion (3) is preferably configured to reciprocate in the longitudinal direction of the shaft portion by an electric device.

  According to the reciprocating file (1) of the present invention having the above-described configuration, the reciprocating file (1) is divided into a groove (Da) inside the lower jaw branch (11) and a groove outside the lower jaw branch (11). (Db) is pressed against the portion to be formed, and reciprocated in the longitudinal direction of the shaft portion by electric or manual operation, the mandible (10) by the plurality of teeth (4) formed on the outer periphery of the shaft portion (3) ) Can be cut to form grooves (Da, Db) on the inner side of the lower jaw branch (11) and the outer side of the lower jaw branch (11).

  Here, the plurality of teeth (4) are formed intermittently at intervals in the longitudinal direction of the shaft portion (3), and are formed over the entire region in the circumferential direction of the shaft portion (3). Therefore, it does not have a so-called “high height” shape like a conventional saw for bone (reference numeral 70 in FIG. 31). Therefore, even if the space between the mandible (10) and the surrounding tissue is narrow, the grooves (Da, Db) on the inner side of the lower jaw (11) and the outer side of the lower jaw (11) can be formed.

  Further, by reciprocating in the longitudinal direction of the shaft portion (3), the inner side of the lower jaw branch (11) and the outer side of the lower jaw branch (11) can be cut to form grooves (Da, Db), and it is necessary to rotate. Therefore, unlike the rotation of the Lindeman bar (reference numeral 50 in FIG. 30), there is no possibility that the surrounding tissue, blood vessels, nerves, etc. are damaged by involving the surrounding tissue.

  Furthermore, according to the present invention, surgery can be performed with a retractor (60) smaller than the conventional one, so that the surgical wound can be made small and minimally invasive surgery is possible. At the same time, the width spread by the retractor may be narrower than before, so that damage to the patient is minimized and minimally invasive.

  Since the distal ends of the plurality of teeth (4) in the radial direction are formed of a curved surface (4r) or a flat surface (4h), the inner side of the lower jaw branch (11) and the outer side of the lower jaw branch (11) are osteocutted. Thus, it is possible to prevent the tips (4r, 4h) radially outward of the teeth (4) from being caught on the surface of the lower jaw branch (11) while the grooves are being formed. In relation to this, in a patient having a relatively weak mandibular branch (11), it is possible to prevent the tooth of the instrument from being caught and damaging the mandibular branch (11).

  In addition, since the distal end portion in the longitudinal direction of the shaft portion (3) is composed of a curved surface (5), the distal end portion of the shaft portion is placed in the patient's oral cavity when reciprocating in the longitudinal direction of the shaft portion (3). Can be prevented from piercing the tissue.

Embodiments of the present invention will be described below with reference to the accompanying drawings.
First, before explaining the reciprocating file for orthognathic surgery according to the present invention, the mandibular branch sagittal segmentation will be explained based on FIGS.

The mandibular branch sagittal segmentation shown in FIGS. 22 to 29 is a state where the mandible is retracted with respect to the maxilla (so-called “mandibular recession”), or a state where the mandible is advanced with respect to the maxilla. When there is an abnormality in the relative positional relationship between the mandible and the maxilla, as in (so-called “mandibular prognathism”), the mandible is moved forward by the mandibular branching method (so-called “mandibular recession”) ) Or rearward (in the case of so-called “mandibular prognathism”), in particular, the procedure from osteotomy to bone splitting is shown.
22 to 24 show the osteotomy process, FIGS. 25 to 28 show the bone separation process, and FIG. 29 shows the joined state of the separated divided bones after the separation.

  FIG. 22 shows a state before division of the mandible in the case of so-called “mandibular recession”. Lines La, Lb, and Lc in FIG. 22 are osteotomy and division lines, and grooves Da, Db, and Dc are cut along these lines. Of these grooves, a broken line portion (a part of La and Lc) is shown in a portion that cannot be seen from the front side of the drawing.

As shown in FIG. 23, the osteotomy is performed by removing the bone cortex on the inner surface (the back side of the paper) at the front edge 11e of the mandibular branch in a dish shape with a pear-shaped bone bar (not shown). .
Then, the bone is cut with a Lindeman bar 50 (not shown) just above the lower tongue of the lower jaw (not shown) to just behind the lower jaw hole 12. It should be noted that the osteotomy is up to a predetermined depth on the inner surface side of the lower jaw branch 11 and does not penetrate to the outer surface side of the lower jaw branch 11. A cutting mark (groove) after the osteotomy is indicated by a broken line Da.

  In FIG. 23 and FIG. 24 (XX sectional view of FIG. 23), an osteotomy line (hereinafter, the osteotomy line is referred to as a groove) Db formed by the osteotomy of the outer cortex of the lower jaw bone is performed as follows. At the position of the first molar 13 or the second molar 14, bone cutting (groove cutting) is performed with the Lindeman bar 50 or the Fischer bar from the external oblique line 15 to the lower jaw lower edge 16 so as to be perpendicular to the occlusal plane F. . At that time, the retractor 60 is used to stably support the mandible 10.

  As the final osteotomy, osteotomy of the bone cortex is performed with a fisher bar along the inner side of the outer oblique line 15 at the mandibular branch leading edge 11e so as to connect the inner and outer grooves Da, Db (groove Dc connecting the grooves Da, Db) make).

In FIG. 25 and FIG. 26, sagittal division is performed by driving the bone flea 8 into the groove Dc along the outer oblique line 15 by about 5 to 6 mm to confirm that the bone cortex has been reliably cut.
Next, at the vertical groove Db of the mandibular body part (mandible) 10, the bone fleas 8 are engulfed to the mandibular lower edge 16 along the inner surface of the outer bone cortex of the mandible, and slightly inside the mandibular lower edge 16. If the cutting edge is placed at a position and beaten with a hammer (not shown), the bone cortex of the lower mandibular margin 16 will crack.

  After that, as shown in FIG. 27, when the wedge bone chisel 81 is driven into the groove Dc at the position of the posterior portion 17 and the wedge bone chisel 81 is rotated to open the outer bone cortex, the inner and outer bone fragments are moved to the mandibular lower edge 16. 28, and is divided into a first divided piece 100 including a lower jaw dentition and a second divided piece 200 on the lower jaw branch 11 side as shown in FIG.

As shown in FIG. 29, the first divided piece 100 and the second divided piece 200 divided by the mandibular branch sagittal division are those before dividing the relative position between the maxillary bone 300 and the second divided piece 200. Similarly to the relative position, the first divided piece 100 is shifted with respect to the second divided piece 200 to a position where the maxillary dentition and the mandibular dentition are properly occluded. Joining is performed.
FIG. 22 shows a state before division of the mandible in the case of so-called “mandibular recession”, but even in the case of so-called “mandibular prognathism”, the same processing is performed to The mandibular teeth are shifted to a position where they are properly occluded, and osteosynthesis is performed at that position.

Next, with reference to FIGS. 1-19, embodiment of the reciprocating file for orthognathic surgery of this invention is described.
First, with reference to FIG. 1 to FIG. 5, a first embodiment of a type that does not slide when a shaft is pushed but can be cut when pulled is described.

  FIG. 1 shows an overall view of a reciprocating file in the first example of the first embodiment, FIG. 2 is a view showing a portion where the cutting teeth of FIG. 1 are formed, and FIG. 3 shows details of the cutting teeth. FIG. 3 is a partial side view (detailed view of a T portion in FIG. 2) shown in FIG.

As shown in FIG. 1, the reciprocating file 1 of the first example of the first embodiment is composed of a shaft portion 2 on which teeth are not formed and a shaft portion 3 on which teeth are formed.
As shown in detail in FIG. 2, the shaft portion 3 on which the teeth are formed has a circular cross section (not shown) and is configured to be reciprocally movable. The teeth 4 are formed continuously and integrally.

As shown in detail in FIG. 3, the plurality of teeth 4 are formed such that the profile of the cross section including the axial center line is an unequal triangle.
In the figure, the arrow Y indicates the tip direction.

In the first embodiment, if the slope angle with respect to the shaft outer peripheral portion 31 of the slope on the tip side of the unequal triangle is β, and the slope angle with respect to the shaft outer peripheral portion 31 opposite to the tip side of the unequal triangle is α, α is smaller than β.
In FIG. 3 (first embodiment), both α and β are larger than 90 °.
In particular, in order to cut the mandible at the tip of the tooth on the angle α side, it is preferable to select the angle α so that 70 ° <α <110 °.

Further, the teeth 4 are formed intermittently at intervals with a portion (outer peripheral portion) 31 where the shaft portion 3 is visible in the longitudinal direction of the shaft portion 3 interposed. And although it is not clear in illustration, the tooth | gear 4 is formed over the whole region as a perfect cyclic | annular tooth | gear without a notch about the circumferential direction of the axial part 3. FIG.
As described above, a flat portion 4 h parallel to the longitudinal direction of the shaft portion 3 is formed at the distal end portion of the tooth 4 in the radial direction.

FIG. 4 is a first modification of the first embodiment (the code as a reciprocating file is 1A). The first example of the first embodiment shown in FIGS. 1 to 3 is an example in which a flat portion 4h is formed at the tip (top) of the tooth.
On the other hand, in the first modification of the first embodiment of FIG. 4, the tip (top) of the tooth is rounded (the tip has a curved surface 4r) to reduce the impact during cutting. And the durability of the teeth is improved.

FIG. 5 is a second modification of the first embodiment (the reference number as a reciprocating file is 1B).
In the first modification of FIG. 4, the gradient angle α on the side opposite to the tip side is 90 ° or more as in the first example, but in the second modification of the first embodiment of FIG. 5, In this embodiment, α is a value smaller than 90 degrees. Further, a round process 4r is performed on the outer peripheral side of the shaft. Other than that is substantially the same as the first modification.

  The reciprocating file 1B of the second modified example has high machinability. Therefore, for a patient with strong bone quality (hard bone), the osteotomy time can be shortened by using the reciprocating file 1B of the second modified example.

  Next, a second embodiment will be described with reference to FIGS. The second embodiment is a type that does not slip when the shaft is pulled, but can be cut when pressed.

First, a first example of the second embodiment will be described with reference to FIGS. 6 and 7 (detailed view of a T portion in FIG. 6).
The reciprocating file 1C of the first example of the second embodiment of FIGS. 6 and 7 is different from the first example of the first embodiment of FIGS. The embodiment is such that the magnitude relationship with the angle β of the gradient on the opposite side is opposite, that is, the relationship of “α> β”.

  By setting the relationship between α and β to “α> β”, the bone is cut when the reciprocating file 1C is pressed.

  The first modification of the second embodiment in FIG. 8 is a modification in which the tip side slope angle β is a right angle (β = 90 °) and the tooth tip is rounded (4r). Further, in the second modification of the second embodiment in FIG. 9, the slope angle β on the tip side is a right angle (β = 90 °), and the flat portion 4 h parallel to the longitudinal direction of the shaft portion 3 at the tip portion of the tooth 4. This is a modified example in which is formed.

6 and FIG. 7, in the first example of the second embodiment, the first modification of the second embodiment shown in FIG. 8, and the second modification shown in FIG. The gradient on the side opposite to the gradient β on the side, that is, the gradient α on the hand side is gentle.
Therefore, the water injection for cooling at the time of cutting (bone cutting) does not rebound to the hand side (surgical side) or the amount of rebound is reduced, and there is a low risk of infection to the practitioner (doctor) or nurse. . In addition, the arrow Y in FIG.6, FIG.8, FIG.9 shows the front end side.

Next, a third embodiment will be described with reference to FIGS. In the third embodiment, the bone is cut by both pushing and pulling movements.
First, a first example of the third embodiment will be described with reference to FIG. In the first example of the third embodiment shown in FIG. 10, the profile of the tooth 4 in the cross section including the axial center line is one arc 4a, and the tooth 4 of the arc 4a is formed continuously in the axial direction. This is an example.

  In the second example of the third embodiment shown in FIG. 11, the profile of the tooth 4 in the cross section including the axial center line is a rectangle 4b, and the tooth 4 of the rectangular cross section 4b is formed continuously in the axial direction. It is an example.

  In the third example of the third embodiment shown in FIG. 12, the profile of the tooth 4 in the cross section including the axial center line is a trapezoid 4c symmetrical in the longitudinal direction, and the tooth 4 of the trapezoidal cross section 4c is continuous in the axial direction. It is the Example formed as follows.

  Here, if the tooth profile is a trapezoidal section symmetrical in the longitudinal direction, as shown in FIG. 13, if the slope angle γ of the trapezoidal slope is too large, teeth will slip during cutting, and the bone It will not cut. Therefore, the gradient angle γ is preferably set to 120 ° or less. Further, if the outer peripheral portion 31 of the shaft portion between the teeth is long, the number of teeth in the entire length is reduced, and the cutting efficiency is impaired. Therefore, it is preferable that the outer peripheral portion 31 of the shaft portion between the teeth has a minimum necessary length. .

Furthermore, as a modification of the second example (FIG. 11) of the third embodiment, an inverted trapezoidal tooth profile 4d can be used as shown in FIG. 14, but if the gradient angle γ is too small, the cutting will be performed. Although it improves, the teeth may get caught in the bones.
If a tooth gets caught in a bone, a great load is applied to a machine that reciprocates a reciprocating file, and the machine may be damaged. In addition, in the case of a patient whose bone is fragile, if the reciprocating file is reciprocated while the teeth are caught by the bone, damage to the patient's living body will be excessive.
In order to prevent such a situation, the gradient angle λ is preferably 70 ° or more.

  In the case of the inverted trapezoidal tooth 4d, as shown in FIG. 15, if a round process 40r or chamfer 40c is formed at the corner of the tip of the tooth, the tooth can be prevented from being caught by the bone.

Next, a fourth embodiment will be described with reference to FIG.
The fourth embodiment in FIG. 16 is an embodiment in which the shaft portion is tapered with a slight gradient. In the illustrated example, the shaft diameter 3Da on the distal end side is formed to be narrower than the shaft diameter 3Db on the rear side. Since the tooth shape in the cross section including the axial center line is common, the diameter 4Da of the tooth on the tip side is also thinner than the diameter 4Db of the rear tooth.
By adopting such a tapered shape, there is an advantage that the line-of-sight on the front side of the reciprocating file is improved (as viewed from the practitioner).

Although not shown, the shape of the cross section of the tooth 4 from the first embodiment to the fourth embodiment is a circular shape without a notch. However, as shown in FIG. 17, small unevenness 4g may be continuously formed on the maximum diameter portion of the tooth.
Alternatively, as shown in FIG. 18, notches (notches) 4n may be provided at a plurality of locations at equal pitches in the maximum diameter portion of the teeth.
In the example of FIGS. 17 and 18, the heat dissipation when the bone is cut is improved.

In each embodiment of the present invention, the teeth 4 are formed in an annular shape around the entire circumference of the shaft portion 3 (outer peripheral portion 31).
And the reciprocating file 1 of each embodiment of this invention is attached to the power machine M, as shown in FIG. 19, and cuts (cuts) the lower jaw branch 11 by the linear motion (arrow Y) of an axial direction.
That is, when cutting the left side 11 </ b> L of the mandibular branch 11, the region “A” of the tooth 4 is involved in bone cutting. Next, when cutting the right side 11 </ b> R of the mandibular branch 11, a region “B” of the tooth 4 that is not used yet is involved in the cutting.
Therefore, the reciprocating file 1 can be used for cutting both the left and right sides of the lower jaw branch 11 without removing the reciprocating file 1 from the power machine M and rotating it.

20 and 21 show a state in which one side of the mandibular branch 11 is divided (FIG. 21) by cutting the bone (cutting the groove; FIG. 20) using the reciprocating file 1 of the embodiment of the present invention. FIG.
In the examples of FIGS. 20 and 21, the relative movement amount of the divided pieces 100 and 200 after the division is smaller than that in the above-described example (FIGS. 22 to 29). It is located on the back side of one molar.

According to the reciprocating file 1 of the present embodiment having the above-described configuration, the plurality of teeth 4 are formed intermittently at intervals in the longitudinal direction of the shaft portion 3. Since it is formed over the entire area, it does not have a so-called “high height” shape like a conventional saw for bone (reference numeral 70 in FIG. 31).
Therefore, even if the space | interval between the mandible 10 and the surrounding tissue is narrow, the groove | channel Da inside the lower jaw branch 11 and the groove | channel Db outside the lower jaw branch 11 can be formed easily.

  Further, by reciprocating in the longitudinal direction without rotating the shaft portion 3, the inner and outer sides of the mandibular branch 11 can be cut to form the grooves Da and Db, so that the Lindemanber (reference numeral 50 in FIG. 30). Unlike the case of rotating), there is no possibility of damaging surrounding tissues, blood vessels, nerves and the like by involving surrounding tissues.

  Furthermore, since surgery can be performed with a smaller retractor than before, the surgical wound can be reduced, and minimally invasive surgery is possible.

  Since the distal end portions of the plurality of teeth 4 in the reciprocating file 1 in the radial direction are formed by the curved surface 4r or the flat surface 4h, the inner and outer sides of the lower jaw branch 11 are boned to form grooves. During the process, the tips 4r and 4h of the teeth 4 radially outward can be prevented from being caught on the surface of the lower jaw branch 11.

  In relation to this, in a patient whose strength of the lower jaw 11 is relatively weak, it is possible to prevent the teeth of the instrument from being caught and damaging the lower jaw 11.

  In addition, since the distal end portion in the longitudinal direction of the shaft portion 3 is constituted by the curved surface 5, when the shaft portion 3 is reciprocated in the longitudinal direction, the distal end portion of the shaft portion is pierced into the tissue in the oral cavity of the patient. Can be prevented.

  It should be noted that the illustrated embodiment is merely an example, and is not a description to limit the technical scope of the present invention.

The side view which showed the whole reciprocating file which concerns on 1st Embodiment of this invention. The side view of the axial part in which the tooth | gear of the reciprocating file which concerns on 1st Embodiment of this invention was formed. FIG. 3 is a detailed view of a T portion in FIG. 2. The fragmentary sectional view which shows the tooth profile of the 1st modification of 1st Embodiment. The fragmentary sectional view which shows the tooth profile of the 2nd modification of 1st Embodiment. The side view of the axial part in which the tooth | gear of the reciprocating file which concerns on 2nd Embodiment of this invention was formed. FIG. 7 is a detailed view of a T portion in FIG. 6. Partial sectional drawing which shows the tooth profile of 2nd Embodiment and a 1st modification. Partial sectional drawing which shows the tooth profile of 2nd Embodiment and a 2nd modification. 3rd Embodiment, The fragmentary sectional view which shows the tooth profile of 1st Example. Partial sectional drawing which shows the tooth profile of 3rd Embodiment and 2nd Example. The third embodiment, a partial cross-sectional view showing the tooth profile of the third example. The figure for supplementarily explaining 3rd Embodiment and 3rd Example. The fragmentary sectional view which shows the tooth profile of the modification of 2nd Example (FIG. 11) of 3rd Embodiment. FIG. 15 is a diagram for supplementary explanation of FIG. 14. The side view of the axial part in which the tooth | gear of 4th Embodiment was formed. The front view which showed the 1st modification of the outer peripheral part shape of the tooth which concerns on embodiment of this invention. The front view which showed the 2nd modification of the outer peripheral part shape of the tooth which concerns on embodiment of this invention. The figure which showed the state of the treatment using the reciprocating file of embodiment of this invention. The state diagram which specified the position of osteotomy using the reciprocating file of embodiment of this invention. A state diagram in which osteotomy is completed and a mandibular branch on one side is divided. The figure which showed the state before division | segmentation of a mandible. The process figure which showed the osteotomy of the lower jaw branch outer side. XX sectional drawing of FIG. Initial process drawing of sagittal division. XX sectional drawing of FIG. Late process drawing of sagittal division. The state figure which sagittal division was completed. The figure which joined the division | segmentation piece in the state correct | amended to the proper occlusion after division | segmentation. The osteotomy process figure using the Lindeman bar in a prior art. The osteotomy process figure using the saw for bones in a prior art.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Reciprocating file 2 ... Shaft part 3 in which tooth is not formed ... Shaft part 4 in which tooth is formed ... Teeth 4a ... Arc-shaped tooth 4b ... Rectangular cross section Teeth 4c of the trapezoidal cross section 4d ... teeth 4h of the inverted trapezoidal cross section ... plane part 4r ... curved surface / R-process 5 ... curved surface 8 ... bone flea 10 ... Mandible 11 ... Mandibular branch 12 ... Mandibular hole 13 ... First molar 14 ... Second molar 15 ... External oblique line 16 ... Mandibular branch lower edge 50 ... Lindeman bar 60 ... Retractor

Claims (3)

  The shaft portion has a circular cross section and is configured to be reciprocally movable. A plurality of teeth are integrally formed on the outer peripheral portion of the shaft portion, and the plurality of teeth are in the longitudinal direction of the shaft portion. Is formed intermittently at intervals, and the circumferential direction of the shaft portion is formed over the entire region, and the distal ends of the plurality of teeth in the radial direction are curved surfaces or shaft portions. A reciprocating file for orthognathic surgery comprising a plane parallel to the longitudinal direction and a longitudinal end of the shaft portion comprising a curved surface.   The reciprocating file for orthognathic surgery according to claim 1, wherein a gradient of the plurality of teeth with respect to the outer periphery of the shaft is 90 ° or more.   The reciprocating file for orthognathic surgery according to claim 1 or 2, wherein the reciprocating file is configured to reciprocate in the longitudinal direction of the shaft portion by an electric device.

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