JP4942120B2 - Medical cutting tool guide - Google Patents

Description

  The present invention relates to a guide for a medical cutting tool used in drilling an insertion hole for an implant in a bone in a surgical operation such as dentistry, oral surgery, and orthopedic surgery.

  In surgical operations such as dentistry, oral surgery, and orthopedic surgery, it is necessary to accurately insert implants such as artificial roots, artificial joints, artificial bones, and fracture treatment tools. A hole is formed, and the implant is inserted into the insertion hole to be positioned and fixed.

  As a medical cutting tool used for such drilling, for example, in Patent Document 1, a tubular saw and a drill are provided coaxially, and a bone-shaped tissue is drilled by the tubular saw and the resulting bone fragments are collected inside by a drill. Tools.

When drilling with a cutting tool, it is necessary to set the cutting direction in advance, and a guide member for that purpose is used. For example, Patent Document 2 describes a dental drill guide device including a guide member having a cylindrical guide hole substantially equal to the diameter of a drill of a drilling tool and a support member that supports the guide member at a drilling position. Further, in Patent Document 3, a coronal member that is attached to a missing part of a human body part is provided, and the coronal member is provided with a guide hole penetrating in the vertical direction to guide the working device to a target drilling position. The guide member which has the slit of the up-down direction opened toward the side from is described.
JP-A-6-304187 Japanese Utility Model Publication No. 1-59113 JP 2006-341067 A

  In the guide members as described in Patent Documents 2 and 3, a groove formed in a slit shape in the vertical direction is used to guide the cutting tool. When such a groove is used as a guide surface, the cutting tool is used. Although it can be easily positioned by inserting from the side, there is a demerit that the cutting tool easily swings in the groove during the drilling operation and a stable drilling operation cannot be performed.

  Accordingly, an object of the present invention is to provide a medical cutting tool guide that allows a cutting tool to be easily set and can perform a stable drilling operation.

A guide for a medical cutting tool according to the present invention is a guide for a medical cutting tool that is provided with a cutting portion on a distal end side and that rotates around a central axis to perform a cutting operation. A guide surface having an inner diameter slightly larger than the outer diameter of the outer peripheral surface of the medical cutting tool, and a guide member that is movable and rotatable in the cutting direction on the outer peripheral surface of the medical cutting tool, and a treatment site A holding member that is positioned and attached and holds the guide member so as not to move in the cutting direction, and the holding member has an opening having a width smaller than the outer diameter of the outer peripheral surface of the guide member in the cutting direction. The guide member mounted on the medical cutting tool is inserted into the opening from a direction orthogonal to the cutting direction, and the holding member and / or the guide member is temporarily deformed before Wherein in the guide member is mounted on the holding within member medical cutting tool is characterized in that it is held along the cutting direction. Further, the guide member is a cylindrical member. Further, the holding member includes a pair of thin plate-like gripping portions. Further, the guide member is formed with a restricting portion that abuts the holding member and restricts movement in a cutting direction.

  By having the configuration as described above, the guide member is attached to the medical cutting tool and the guide member is attached to the holding member, so that the medical cutting tool can be stably rotated in the guide member. In addition, it is possible to stably hold the hole in the cutting direction by the holding member and perform a stable drilling operation. Since the guide member is held by the holding member so as not to move in the cutting direction, the medical cutting tool can smoothly move in the cutting direction accompanying the drilling operation.

  In addition, an opening having a width smaller than the outer diameter of the outer peripheral surface of the guide member is formed in the holding member, and the guide member is fitted into the opening from the lateral direction so that the guide member is mounted in the holding member. The attaching / detaching operation of the guide member to the holding member can be performed reliably.

  Hereinafter, embodiments according to the present invention will be described in detail. The embodiments described below are preferable specific examples for carrying out the present invention, and thus various technical limitations are made. However, the present invention is particularly limited in the following description. Unless otherwise specified, the present invention is not limited to these forms.

  FIG. 1 is an external perspective view (FIG. 1 (a)) and an AA sectional view (FIG. 1 (b)) relating to the embodiment according to the present invention, and FIG. 2 is an exploded perspective view relating to the present embodiment. . A guide for a medical cutting tool includes a guide member 1 and a holding member 2. In this example, for use in dental treatment, the guide member 1 is attached to a cutting tool 100 that performs a drilling operation for mounting on an implant. The holding member 2 is attached to a resin-made dental row mounting member 200 to be mounted on a patient's dental row.

  The guide member 1 is formed with both end flange portions 11 of a cylindrical main body portion 10. The material used for the guide member 1 is preferably a resin material having high strength, wear resistance, and excellent sliding characteristics, and the guide member 1 is scraped off while the cutting tool is rotating in the guide member 1 to the outside. It is desirable to select one that is harmless to the human body in consideration of scattering. For example, polyacetal is preferable as the resin material.

  The inner diameter of the main body 10 of the guide member 1 is set to be slightly larger than the outer diameter of the cutting tool 100, so that the guide member 1 rotates around the cutting tool 100 when mounted on the cutting tool 100. Mounted freely. FIG. 3 is an explanatory diagram when the guide member 1 is mounted on the cutting tool 100. The cutting tool 100 has a saw-like cutting portion 101 formed at the lower end portion, and an engaging portion 102 for fixing to the handpiece at the upper portion. Then, the guide member 1 is inserted and attached to the cutting tool 100 from above. In this case, if the lower part of the cutting tool 100 is formed so that the outer diameter is slightly widened toward the cutting part 101, the guide member 1 slips out from below the cutting tool 100 and comes off. Can be prevented. Further, in order to restrict the upward movement of the guide member 1, a resin O-ring may be attached to a predetermined position of the cutting tool 100 after the guide member 1 is mounted.

  The main body portion 10 of the guide member 1 is formed to be thin and can be deformed so that the outer diameter is narrowed when the guide member 1 is fitted into the opening 22 of the holding member 2. Further, the outer diameter of the main body 10 is set to be substantially the same as or slightly smaller than the inner diameter of the inner surfaces of the pair of gripping portions 20 of the holding member 2, so that the main body 10 does not rattle within the gripping portion 20. It is supposed to be retained.

  The flange portion 11 is formed so as to protrude outward at both end portions of the main body portion 10, and the outer diameter thereof is set larger than the inner diameter of the grip portion 20 and smaller than the outer diameter.

  The holding member 20 includes a pair of gripping portions 20 whose inner surfaces are formed in an arc shape in plan view, a plate-like introduction portion 21 extending from the end portion of the gripping portion 20 in a divergent shape, and an end portion of the gripping portion 20. And an opening portion 22 formed on the back surface of the grip portion 20 and a support portion 23 projecting from the back surface of the grip portion 20.

  The holding member 20 is made of a metal material, and each part is formed in a plate shape having substantially the same thickness. As the metal material used for the holding member 20, it is preferable to select a material that is harmless to the human body, and for example, titanium is preferable.

  FIG. 4 is a plan view of the holding member 2. The grip portion 20 is formed by cutting out a part of a cylindrical shape. In this example, a plane T passing through the cylindrical central axis O and a plane S orthogonal to the plane T at a position deviating from the central axis O are used. When set, a pair of gripping portions 20 are formed on both sides of the plane T by cutting out along the plane S. An opening 22 is formed between the ends of the grip 20 with a width d. Since the outer diameter D of the main body portion 10 of the guide member 1 is set to be substantially the same shape as the inner diameter of the inner surface of the grip portion 20, the distance d between the openings 22 is set to be narrower than the outer diameter D. It becomes like this.

  The pair of introduction portions 21 are formed in a flat plate shape and extend outward from the end portion of the gripping portion 20, and the interval between the introduction portions 21 is set so as to increase toward the outside. ing.

  The lengths of the grip portion 20 and the introduction portion 21 in the central axis direction are set to be substantially the same as or slightly smaller than the length of the main body portion 10 of the guide member 1 (the length between the flange portions 11). .

  When the cutting tool 20 to which the guide member 1 is attached is fitted into the holding member 2, the main body 10 of the guide member 1 is inserted from the lateral direction (direction orthogonal to the central axis O) with respect to the opening 22. At that time, if the main body portion 10 is moved while being guided to the opening portion 22 by the introduction portion 21, the main body portion 10 can be accurately opposed to the opening portion 22. In particular, if the guide member 1 is moved by abutting the flange portions 11 projecting at both ends of the main body portion 10 against both side ends of the introduction portion 21, the main body portion 10 is reliably aligned with the opening portion 22. It becomes possible to do.

  When the main body portion 10 aligned with the opening 22 is pushed into the grip portion 20, the main body portion 10 is deformed and inserted into the grip portion 20. At that time, the width of the outer diameter of the main body portion 10 is narrowed so as to pass through the opening portion 22, and the holding portion 20 is slightly bent outward to increase the width of the opening portion 22. Since a slight gap is formed between the inner peripheral surface of the main body 10 of the guide member 1 and the outer peripheral surface of the cutting tool 100, the main body 10 can be deformed so as to be recessed inward, It becomes possible to narrow the width of the diameter.

  The support portion 23 includes a pair of rectangular plate-like bodies that are arranged in parallel vertically so as to be orthogonal to the connecting portion 23 a that protrudes along the plane T toward the back side of the grip portion 20. FIG. 5 is a perspective view showing a state in which the holding member 2 is attached to the dentition mounting member 200 so as to be embedded.

  The dentition mounting member 200 is formed using a known resin material. Examples of the resin material include vinyl chloride resin, vinyl acetate resin, polyester resin, ABS resin, acrylic resin, fluororesin, polyamide resin, acetal resin, and polycarbonate. In view of convenience when performing an implant operation, the resin material is preferably transparent or translucent.

  6-9 is explanatory drawing regarding the process of manufacturing the dentition mounting member 200. FIG. A tooth row 202 is formed on the upper portion of the U-shaped base 201. And the embedding hole 203 is previously drilled in the site | part which embeds an implant. The embedding hole 203 is formed along an embedding direction determined based on an X-ray image obtained by imaging a treatment site of a patient.

  In FIG. 7, a metal rod 204 having the same diameter as that of the main body 10 of the guide member 1 is inserted into the embedded hole 203 formed in the patient's tooth mold. The holding member 2 is fitted and attached to the metal rod 204 in advance. The mounting position of the holding member 2 is set to a predetermined height so that the cutting unit 101 does not contact the gingiva when the cutting tool 100 to which the guide member 1 is mounted is mounted on the holding member 2.

  In FIG. 8, the entire tooth row is closely attached with a molten resin material in a state where the metal rod 204 is inserted. At that time, the engaging portion 23 of the holding member 2 attached to the metal rod 204 is brought into close contact with the resin material, and is molded so that the resin material does not enter the grip portion 20 and the introduction portion 21. In this way, the resin material is solidified to mold the dentition mounting member 200.

  In FIG. 9, by removing the solidified dentition mounting member 200 from the tooth mold 202 and pulling out the metal rod 204 from the holding member 2, the dentition mounting member 200 in which the holding member 2 is integrated and fixed can be obtained. Since the holding member 2 is fixed while being fitted to the metal rod 204, the inner surface of the holding portion 20 of the holding member 2 is set to guide in the cutting direction which is the implant embedding direction.

  By manufacturing as described above, the preformed holding member 2 can be accurately positioned in the cutting direction of the cutting tool, which is the implanting direction of the implant. In addition, since the lower surface of the dentition mounting member 200 is formed into a shape that matches the patient's dental mold, the dentition mounting member 200 can be mounted in close contact with the patient's dentition during the treatment. The drilling operation can be performed in a stable state without shaking during the rotation operation.

  In the above manufacturing process, the molten resin material is solidified and fixed together with the holding member, but after the molten resin material is solidified according to the tooth mold to form the dentition mounting member, the holding member is The portion to be fixed may be deleted, and the metal rod fitted with the holding member may be positioned in the deleted portion and bonded to the dentition mounting member with a molten resin material. Even when a dental resin is molded by pressing a plate-shaped resin material against a tooth mold, a portion for fixing the holding member may be deleted and the holding member may be bonded and fixed.

  FIGS. 10 to 12 are explanatory views showing a process in the case of attaching the cutting tool 100 with the guide member 1 attached to the holding member 2. As shown in FIG. 10, the dentition mounting member 200 is mounted on the patient's dentition and accurately positions the holding member 2 at the implant site. After the holding member 2 is positioned at the treatment site, as shown in FIG. 12, the handpiece H to which the cutting tool 100 is attached is moved, and the guide member 1 mounted on the cutting tool 100 is moved to the opening 22 of the holding member 2. It introduces along the introduction part 21 from the horizontal direction. At this time, if the flange portion 11 of the guide member 1 is introduced so as to be along the upper end of the introduction portion 21, the guide member 1 can be reliably aligned with the position facing the opening portion 22. Then, when the main body 10 of the guide member 1 is pushed into the opening 22, the main body 10 and the opening 22 are deformed and the main body 10 is fitted into the grip 20. Once the main body 10 is accommodated in the gripper 20, the deformed main body 10 and the opening 22 return to the original state, so that the outer diameter of the main body 10 is larger than the width of the opening 22 and is easily It does not come off and is held in a stable state.

  As described above, the guide member 1 is attached to and detached from the opening 22 so that it cannot be attached or detached unless the main body is aligned with the opening 22 in parallel. It is prevented from coming off.

  Further, since the flange portion 11 of the guide member 1 comes into contact with the upper end and the lower end of the grip portion 20 (see FIG. 1B), the guide member 1 is restricted from moving up and down, which is the cutting direction. Is done.

  When the cutting tool 100 is held in the holding member 2, it is guided in the cutting direction. Then, as shown in FIG. 12, when the cutting tool 100 is rotationally driven in the guide member 1 and moved downward, the cutting unit 101 bites into the gingiva M and operates to drill a circular hole. It becomes like this. In this case, since the guide member 1 does not move in the cutting direction, only the cutting tool 100 can be moved smoothly to perform the drilling operation. The depth of the drilling operation can be accurately drilled to a predetermined depth by checking the scale displayed on the outer peripheral surface.

  In the example described above, the flange portion 11 of the guide member 1 is brought into contact with the grip portion 20 of the holding member 2 to restrict the movement in the cutting direction. However, as shown in FIG. A flange portion 24 projecting inwardly may be formed at the upper and lower ends of the gripping portion of 'and the guide member 1' may be accommodated between the flange portions 24. Further, as shown in FIG. 13 (b), the ridges 25 are formed on the inner surface of the holding part of the holding member 2 ″, and the ridges 12 are formed on the outer peripheral surface of the guide member 1. When "" is accommodated in the holding member 2 ", the ridges 25 and the ridges 12 may be fitted to restrict movement in the cutting direction.

  Further, when the guide member 1 is mounted on the cutting tool 100, the smaller the area in contact with the outer peripheral surface of the cutting tool 100, the smaller the frictional resistance of the rotating operation of the cutting tool 100 is, and the rotating operation is reduced. It can be done smoothly. Therefore, for example, as shown in the cross-sectional view of the guide member 1 shown in FIG. 14, the cutting tool 100 is formed on the inner peripheral surface of the flange portion 11 by making the inner diameter of the inner peripheral surface of the flange portion 11 smaller than the inner diameter of the main body portion 10. By making contact with the outer peripheral surface of the guide member 1, the guide member 1 can be mounted on the cutting tool 100 without rattling, and the contact area can be reduced.

  When using a plurality of cutting tools having different outer diameters, a holding member is prepared according to the maximum diameter of the cutting tool, and a plurality of types of guide members 1 are adjusted according to the outer diameter of the cutting tool. If prepared, cutting tools having different outer diameters can be held by one type of holding member. Therefore, it is possible to easily cope with the case where the drilling operation is performed again with a cutting tool having a large diameter after the drilling operation is performed with a cutting tool having a small diameter.

  The guide member of the medical cutting tool according to the present invention can be suitably used for drilling an implantation hole for an implant in a bone in a surgical operation such as dentistry, oral surgery, and orthopedic surgery.

It is an external appearance perspective view regarding embodiment which concerns on this invention. FIG. 2 is an exploded perspective view of FIG. 1. It is explanatory drawing in the case of mounting | wearing a cutting member with a guide member. It is a top view of a holding member. It is a perspective view which shows the state attached to the holding member to the dentition mounting member. It is explanatory drawing regarding the manufacturing process of a dentition mounting member. It is explanatory drawing regarding the manufacturing process of a dentition mounting member. It is explanatory drawing regarding the manufacturing process of a dentition mounting member. It is explanatory drawing regarding the manufacturing process of a dentition mounting member. It is explanatory drawing regarding the process of inserting and attaching a guide member to a holding member. It is explanatory drawing regarding the process of inserting and attaching a guide member to a holding member. It is explanatory drawing regarding the process of inserting and attaching a guide member to a holding member. It is a perspective view regarding the modification of a guide tool. It is a perspective view regarding the modification of a guide member.

Explanation of symbols

1 Guide member
10 Main unit
11 Flange
12 Concave section 2 Holding member
20 Grip part
21 Introduction
22 opening
23 Support section
24 Flange
25 Projection
100 cutting tools
200 Dental seating member

Claims (4)

A guide for a medical cutting tool that is provided with a cutting portion on the tip side and performs a cutting operation by rotating around a central axis, and has an inner diameter slightly larger than the outer diameter of the outer peripheral surface of the medical cutting tool. a guide member mounted movably possible rotation in the cutting direction on the outer peripheral surface of the medical cutting tool with the guide surface is formed to have, in the cutting direction of the guide member with attached is positioned practitioner site An opening having a width narrower than the outer diameter of the outer peripheral surface of the guide member is formed along the cutting direction. The mounted guide member is fitted into the opening from a direction orthogonal to the cutting direction, and the holding member and / or the guide member is temporarily deformed, and the guide member is mounted in the holding member. Guide member of the medical cutting tool, wherein the at Rukoto medical cutting tool is held along the cutting direction. The guide device according to claim 1, wherein the guide member is a cylindrical member. The guide device according to claim 1, wherein the holding member includes a pair of thin plate-like gripping portions. The guide tool according to any one of claims 1 to 3, wherein the guide member is formed with a restricting portion that contacts the holding member and restricts movement in a cutting direction.

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