JP6174829B1 - Harvesting equipment - Google Patents
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- JP6174829B1 JP6174829B1 JP2017022376A JP2017022376A JP6174829B1 JP 6174829 B1 JP6174829 B1 JP 6174829B1 JP 2017022376 A JP2017022376 A JP 2017022376A JP 2017022376 A JP2017022376 A JP 2017022376A JP 6174829 B1 JP6174829 B1 JP 6174829B1
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- 238000003306 harvesting Methods 0.000 title claims abstract description 68
- 239000000463 material Substances 0.000 claims abstract description 52
- 238000000034 method Methods 0.000 claims description 27
- 238000011282 treatment Methods 0.000 claims description 24
- 230000007246 mechanism Effects 0.000 claims description 15
- 230000002265 prevention Effects 0.000 claims description 11
- 208000032484 Accidental exposure to product Diseases 0.000 claims description 3
- 210000004513 dentition Anatomy 0.000 abstract description 9
- 230000036346 tooth eruption Effects 0.000 abstract description 9
- 239000000123 paper Substances 0.000 description 52
- 210000001847 jaw Anatomy 0.000 description 37
- 210000000214 mouth Anatomy 0.000 description 25
- 210000003128 head Anatomy 0.000 description 16
- 210000002176 pterygoid muscle Anatomy 0.000 description 13
- 239000001993 wax Substances 0.000 description 12
- 238000005070 sampling Methods 0.000 description 10
- 210000003205 muscle Anatomy 0.000 description 9
- 230000006870 function Effects 0.000 description 8
- 210000004373 mandible Anatomy 0.000 description 7
- 230000015572 biosynthetic process Effects 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 210000001738 temporomandibular joint Anatomy 0.000 description 5
- 230000018984 mastication Effects 0.000 description 4
- 238000010077 mastication Methods 0.000 description 4
- 229920001296 polysiloxane Polymers 0.000 description 4
- 229920000178 Acrylic resin Polymers 0.000 description 3
- 239000004925 Acrylic resin Substances 0.000 description 3
- 235000000621 Bidens tripartita Nutrition 0.000 description 3
- 240000004082 Bidens tripartita Species 0.000 description 3
- 208000008312 Tooth Loss Diseases 0.000 description 3
- 239000000853 adhesive Substances 0.000 description 3
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- -1 polyethylene Polymers 0.000 description 3
- 238000010079 rubber tapping Methods 0.000 description 3
- 210000000332 tooth crown Anatomy 0.000 description 3
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 2
- 238000007796 conventional method Methods 0.000 description 2
- 239000011162 core material Substances 0.000 description 2
- 238000000605 extraction Methods 0.000 description 2
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- 239000012188 paraffin wax Substances 0.000 description 2
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- 239000004793 Polystyrene Substances 0.000 description 1
- 201000002154 Pterygium Diseases 0.000 description 1
- BQCADISMDOOEFD-UHFFFAOYSA-N Silver Chemical compound [Ag] BQCADISMDOOEFD-UHFFFAOYSA-N 0.000 description 1
- 208000028911 Temporomandibular Joint disease Diseases 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- HCHKCACWOHOZIP-UHFFFAOYSA-N Zinc Chemical compound [Zn] HCHKCACWOHOZIP-UHFFFAOYSA-N 0.000 description 1
- 229920000122 acrylonitrile butadiene styrene Polymers 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
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- XAGFODPZIPBFFR-UHFFFAOYSA-N aluminium Chemical compound [Al] XAGFODPZIPBFFR-UHFFFAOYSA-N 0.000 description 1
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- 210000001352 masseter muscle Anatomy 0.000 description 1
- 210000003784 masticatory muscle Anatomy 0.000 description 1
- 210000002050 maxilla Anatomy 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
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- 239000011087 paperboard Substances 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/04—Measuring instruments specially adapted for dentistry
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/04—Measuring instruments specially adapted for dentistry
- A61C19/05—Measuring instruments specially adapted for dentistry for determining occlusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C9/00—Impression cups, i.e. impression trays; Impression methods
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Dentistry (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Biophysics (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
- Dental Prosthetics (AREA)
Abstract
【課題】術者の技術によらず、正確に咬合採得を行うことのできる咬合採得器具を提供することを課題とする。【解決手段】咬合採得が必要な歯列の長さを有し、硬質素材からなり、一方の面に咬合位置を採得する上部採得面と、他方の面に咬合位置を採得する、又は印象を採得する下部採得面とを有する咬合採得部2a、3a、4aと、咬合紙ホルダー把持部2b、3b、4bを備える採得器具1。【選択図】図1An object of the present invention is to provide an occlusal acquisition device capable of accurately performing occlusal acquisition regardless of the skill of an operator. An upper acquisition surface having a length of a dentition that requires occlusal acquisition and made of a hard material and acquiring an occlusal position on one surface and an occlusal position on the other surface, or A harvesting instrument 1 comprising an occlusal harvesting part 2a, 3a, 4a having a lower harvesting surface for capturing an impression, and an occlusal paper holder gripping part 2b, 3b, 4b. [Selection] Figure 1
Description
本発明は、歯科治療に用いる咬合採得、印象採得を行う器具に関する。 The present invention relates to an occlusal acquisition and impression acquisition instrument used for dental treatment.
歯科治療は、通常、歯科医師の作業である診断、治療計画の作成、支台歯形成、印象採得、咬合採得、装着、調整など、主として歯科クリニックで患者に対して行う作業と、歯科医師の指示のもとに、歯にかぶせるクラウン、ブリッジ、義歯等の補綴物、また、顎位を適正な位置に誘導する治療のためにスプリントを作製する歯科技工士が行う作業が連携して行われている。 Dental treatment is usually performed by the dentist, such as diagnosis, treatment plan creation, abutment formation, impression taking, occlusion taking, wearing, adjustment, etc. Under the direction of the doctor, the prosthetics such as crowns, bridges, and dentures that are placed on the teeth, and the work performed by the dental technician who creates the splint for treatment to guide the jaw position to the proper position Has been done.
欠損歯の治療は、歯科医師によって印象材による印象採得が行われ、この印象をもとにして作業模型が作られた後、正しい噛み合わせの位置を決定するため、ワックス等を使用して咬合採得が行われる。咬合採得とは、歯科治療において、補綴物を作製する際に、咬合平面や咬合高径を決めるために噛み合わせの型をとることをいう。解剖学的には、咬合採得とは位置の定まった上顎に対して、下顎の位置を採得すること、すなわち中心咬合位における上顎に対する下顎の位置を採得することである。 For the treatment of missing teeth, an impression material is taken by a dentist and a working model is made based on this impression, and then wax is used to determine the correct meshing position. Occlusal acquisition is performed. Occlusal acquisition refers to taking an occlusal mold in order to determine the occlusal plane and the occlusal height when producing a prosthesis in dental treatment. Anatomically, occlusal acquisition refers to obtaining the position of the lower jaw with respect to the fixed upper jaw, that is, obtaining the position of the lower jaw relative to the upper jaw in the central occlusal position.
咬合採得は、上下顎の3次元的な位置関係を決定することにより顎位を調整し、中心位と中心咬合位が一致するような安定した咀嚼を得て、咀嚼機能を回復することが目的である。また、咀嚼機能の回復だけではなく、歯の欠損に伴う顔貌の変形の修復を行う審美的な目的のためにも重要な工程である。さらに、顎関節症の治療におけるスプリント療法においても、咬合採得を行い、咬合接触の状態を確認することは重要な工程である。したがって、歯科医院で正確に咬合採得が行われ、歯科技工士に患者の咬合の状況が正確に伝達され、補綴物が作製される必要がある。 Occlusal acquisition can be achieved by adjusting the jaw position by determining the three-dimensional positional relationship between the upper and lower jaws, obtaining a stable mastication in which the central position matches the central occlusal position, and restoring the masticatory function. Is the purpose. It is also an important process not only for the recovery of the masticatory function but also for the aesthetic purpose of repairing facial deformation associated with tooth loss. Furthermore, in splint therapy in the treatment of temporomandibular disorders, it is an important process to obtain occlusion and confirm the state of occlusal contact. Accordingly, it is necessary that the occlusion is accurately obtained at the dental clinic, the occlusion situation of the patient is accurately transmitted to the dental technician, and the prosthesis is produced.
歯科クリニックでは、一般的にはパラフィンワックスを用いた咬合床による咬合採得法が行われている。例えば、総義歯治療の場合、咬合採得は以下のようにして行われる。咬合床を患者に試適し調整した後、咬合高径を決定する。安静咬合位での上下間距離と、咬合床を口腔内に試適した状態が一致するように調整を行う。次に咬合床を取り出し、咬合平面を軟化して口腔内に戻した後、患者に中心咬合位で咬合を行わせ咬合採得を行う。また、クラウンなど部分的な補綴物作製の場合には、軟化したワックスを患者に咬合嵌合位で噛んでもらい、硬化を待ち口腔外に取り出す。 In a dental clinic, generally, an occlusal acquisition method using an occlusal floor using paraffin wax is performed. For example, in the case of a complete denture treatment, occlusal acquisition is performed as follows. After adjusting the occlusal floor to suit the patient, determine the occlusal height. Adjust so that the distance between the upper and lower sides at the resting occlusal position matches the state in which the occlusal floor is suitable for the oral cavity. Next, after the occlusal floor is taken out and the occlusal plane is softened and returned to the oral cavity, the patient is occluded at the central occlusal position to obtain the occlusion. When a partial prosthesis such as a crown is manufactured, a softened wax is chewed by the patient at the occlusal fitting position, and the patient is taken out of the oral cavity after waiting for hardening.
しかしながら、咬合採得は、例えば、義歯製作の場合、部分歯牙欠損と全部床義歯製作とでは咬合採得の難易度が大きく異なる。部分歯牙欠損の場合、天然歯が残存していることから、残存している天然歯の位置による相互関係が複雑であり、症例ごとにその難易度は大きく左右される。また、総義歯の咬合採得を行う場合には、咬合高径などの有歯顎時の状態が不明であることから、その設定が難しいものとなる。そのため、歯科医師はそれぞれ最適と考える方法にしたがって、咬合採得を行っているのが現状である。また、咬合採得を行ったのち、術者の経験により誤差やずれを補正して補綴物を作製しているのが現状である。 However, in occlusal acquisition, for example, in the case of denture production, the difficulty level of occlusion acquisition differs greatly between partial tooth loss and complete denture production. In the case of partial tooth loss, since natural teeth remain, the interrelationship depending on the position of the remaining natural teeth is complex, and the degree of difficulty greatly depends on each case. Moreover, when performing occlusal acquisition of a complete denture, since the state at the time of toothed jaws, such as an occlusal high diameter, is unknown, the setting will become difficult. Therefore, the current situation is that dentists are performing occlusal acquisition according to the method they consider to be optimal. In addition, after the occlusal acquisition, the current situation is that the prosthesis is produced by correcting errors and deviations based on the experience of the operator.
正確な咬合採得を行うために、種々の器具や方法が開示されている(特許文献1、2)。特許文献1には、第1の採得層と第2の採得層を備えた平坦な芯材に、上下の歯の傾斜面で生じるスライドを防止するために、金網や小突起のようなスライド防止手段を備えている咬合採得用具が開示されている。スライド防止手段により、咬合採得用具の貫通や破断を防止し、咬合状態における下顎のずれを防止することができる。スライド防止手段を備えた芯材の両面に位置する第1の採得層、第2の採得層はパラフィンまたはワックスからなり、患者の咬合状態を記録することができるようになっている。 Various instruments and methods have been disclosed in order to obtain accurate occlusion (Patent Documents 1 and 2). In patent document 1, in order to prevent the slide which arises in the inclined surface of an up-and-down tooth | gear on a flat core material provided with the 1st acquisition layer and the 2nd acquisition layer, An occlusal acquisition tool provided with anti-sliding means is disclosed. By means of the slide prevention means, it is possible to prevent penetration and breakage of the occlusal acquisition tool and to prevent the lower jaw from shifting in the occlusal state. The 1st acquisition layer and the 2nd acquisition layer which are located in both surfaces of the core material provided with the slide prevention means consist of paraffin or wax, and can record a patient's occlusion state.
特許文献2には、上下顎に適合する上下顎基礎床のうち、一方の基礎床の左右臼歯部に板状の描記ブレードを取り付け、他方の基礎床の左右臼歯部に記録ブロックを取り付け、これらを口腔内に装着した状態で、描記ブレード、または記録ブロックの高さを調節することにより下顎位を決定する咬合採得方法が開示されている。描記ブレード、記録ブロックからなる咬合採得器具を用いた方法では、生理的な咬合感覚が患者によく分かり、正確で再現性のある下顎位を記録することができる。 In Patent Document 2, plate-shaped drawing blades are attached to the left and right molar portions of one of the upper and lower jaw base floors that fit the upper and lower jaws, and recording blocks are attached to the left and right molar portions of the other base floor. An occlusal acquisition method is disclosed in which the mandibular position is determined by adjusting the height of the drawing blade or the recording block in a state where the is placed in the oral cavity. In the method using an occlusal acquisition device comprising a drawing blade and a recording block, the physiological occlusal sensation is well understood by the patient, and the accurate and reproducible mandibular position can be recorded.
特許文献1の咬合採得用具は、顎関節が顆頭安定位で安定した中心位が存在する患者の咬合採得には有効であるが、顎関節が不安定な患者の場合には、下顎安定位にならず、咬合採得することができない。また、多数の歯を欠損しており、同時に治療している場合や、遊離端部位の治療では、支持領域が少なく、安定した咬合採得ができないという問題がある。また、特許文献2の咬合採得器具は、総義歯治療に用いることはできるが、残存歯がある場合には、咬合採得を行うことができない。 The occlusal acquisition tool of Patent Document 1 is effective for acquiring occlusion by a patient whose temporomandibular joint has a stable condylar position and has a stable central position. It is not stable and cannot be bitten. In addition, there are problems that a large number of teeth are missing and treatment is performed at the same time, or treatment of the free end portion has a small support area, and stable occlusion cannot be obtained. Moreover, although the occlusal acquisition instrument of patent document 2 can be used for complete denture treatment, when there are residual teeth, it is not possible to perform occlusal acquisition.
また、現在、一般的に行われているワックスを用いた咬合採得法では、患者の咬合によりワックスが破断したり変形することから、患者の咬合形状の再現が困難であるという問題がある。また、ワックスは温めて軟化させて使用することから、軟化が均一ではなく、硬い部分が生じ、咬合位が誘導されやすいという問題も生じている。また、ワックスは温度が下がると接触したまま硬化するため、接触面の誘導位置から顆頭が安定位に移動することができない。 Further, in the occlusal acquisition method using wax that is generally performed at present, there is a problem that it is difficult to reproduce the occlusal shape of the patient because the wax is broken or deformed by the patient's occlusion. Further, since the wax is used after being warmed and softened, there is a problem that the softening is not uniform, a hard part is generated, and the occlusal position is easily induced. Further, since the wax hardens while being in contact with the temperature as the temperature decreases, the condyle cannot move to the stable position from the guide position of the contact surface.
さらに、フルマウス(全顎)治療の場合には、咬合採得で中心位(筋肉位)を採得することが難しい。中心位には領域が存在するため、採得の度に位置が変化するからである。クラウン・ブリッジによる歯冠修復治療の場合には、形成前の中心咬合位でクリアランスを確保していても、形成後に中心位の咬合採得をするとクリアランス不足になることが多い。また、術者の技術が低い場合には、咬合採得時に患者が強く噛みすぎて本来の咬合平面より沈下した状態であることに気付かないまま咬合を決定してしまうこともある。 Furthermore, in the case of full mouse (full jaw) treatment, it is difficult to obtain a central position (muscle position) by obtaining an occlusion. This is because there is a region at the center position, and the position changes with each acquisition. In the case of crown restoration treatment using a crown bridge, even if the clearance is secured at the central occlusal position before formation, if the occlusion at the central position is obtained after formation, the clearance is often insufficient. In addition, when the technique of the operator is low, the occlusion may be determined without noticing that the patient is biting too much at the time of occlusion acquisition and is sinking from the original occlusal plane.
また、印象採得では、上の歯、あるいは下の歯14歯全てのマージン(補綴物と歯の境界部)を鮮明に再現することが困難である。例えば、シリコーン印象材は、通常、適用部位で流動性の有無や硬化後の硬さを使い分けることから、14歯すべてについて一度に印象採得を行うことは困難であった。 In addition, in taking an impression, it is difficult to clearly reproduce the margin (prosthesis-to-tooth boundary) of all the upper teeth or the lower 14 teeth. For example, silicone impression materials usually have different fluidity at the application site and hardness after curing, so it is difficult to take an impression for all 14 teeth at once.
本発明は、上記問題を解決し、術者の技術等によらず下顎の位置合わせを精度よく咬合採得を行うことのできる咬合採得器具を提供することを目的とする。また、咬合採得と印象採得を同時に行うことのできる採得器具を提供することを課題とする。 An object of the present invention is to solve the above-mentioned problems and to provide an occlusal acquisition device that can accurately acquire the occlusal alignment of the lower jaw without depending on the technique of the operator. It is another object of the present invention to provide an acquisition tool that can simultaneously perform occlusal acquisition and impression acquisition.
本発明は以下の採得器具、及び採得器具の使用方法に関する。
(1)補綴治療する歯の数に応じた長さの部分歯用採得器具であって、硬質素材からなり、一方の面に咬合採得を行う上部採得面と、他方の面に咬合採得を行う、又は印象採得を行う下部採得面とを有する採得部と、頬側に設けられた咬合紙ホルダー把持部を備える採得器具。
(2)硬質素材からなり、一方の面に咬合採得を行う上部採得面と、他方の面に印象採得を行う下部採得面とを有する採得部と、咬合紙ホルダー把持部を備える採得器具であって 、前記採得部が患者の歯冠に類似した形状である採得器具。
(3)一歯毎に前記上部採得面で咬合採得を行い、前記下部採得面で印象採得を行う採得器具であって、対合歯、又は咬合床と点接触するように前記上部採得面が1若しくは複数の凸状、又は平面状に形成されている請求項1記載の採得器具。
(4)前記上部採得面、及び前記下部採得面で咬合採得を行う採得器具であって、前記採得部が略平坦な部材からなる(1)記載の採得器具。
(5)前記採得器具の厚さが、0.1〜5.0mmである(1)〜(4)のいずれか1つ記載の採得器具。
(6)患者の顎の大きさに合わせて選択することができるように、異なる大きさのものが用意されている(1)〜(5)のいずれか1つ記載の採得器具。
(7)補綴治療をする歯の数に応じた近遠心径に切断可能な(1)〜(6)のいずれか1つ記載の採得器具。
(8)誤飲防止機構を備えている(1)〜(7)のいずれか1つ記載の採得器具。
(9)(1)〜(8)のいずれか1つ記載の採得器具の前記咬合紙ホルダー把持部を把持し、前記上部採得面、及び前記下部採得面に印象材を載置し、患者の上下の歯の咬合採得、又は咬合採得と印象採得を同時に行う採得法。
The present invention relates to the following harvesting instruments and methods of using the harvesting instruments.
(1) A partial tooth collection device having a length corresponding to the number of teeth to be prosthetic treated, which is made of a hard material and has an upper acquisition surface that performs occlusal acquisition on one surface and an occlusion on the other surface A harvesting instrument comprising a harvesting section having a lower harvesting surface for harvesting or impression capturing, and an occlusal paper holder gripping section provided on the cheek side .
(2) a hard material, and one side upper adoption resulting surface to perform bite registration in a-taking section having a lower adoption resulting surface performing impression adoption obtained on the other surface, articulating paper holder gripper A harvesting instrument having a shape similar to a patient's crown.
(3) An acquisition tool that performs occlusal acquisition on the upper acquisition surface for each tooth and performs impression acquisition on the lower acquisition surface so as to make point contact with the opposing teeth or occlusal floor The harvesting instrument according to claim 1, wherein the upper harvesting surface is formed in one or a plurality of convex shapes or planar shapes.
(4) The harvesting instrument according to (1), wherein the harvesting instrument performs occlusal harvesting on the upper harvesting surface and the lower harvesting surface, wherein the harvesting part is made of a substantially flat member.
(5) The harvesting instrument according to any one of (1) to (4), wherein the harvesting instrument has a thickness of 0.1 to 5.0 mm.
(6) The harvesting device according to any one of (1) to (5), in which different sizes are prepared so that the size can be selected according to the size of the patient's jaw.
(7) switching to the near centrifugal diameter corresponding to the number of teeth of the prosthetic treatment sectional possible (1) to any one described adoption resulting instrument (6).
(8) The harvesting instrument according to any one of (1) to (7), which includes a mechanism for preventing accidental ingestion.
(9) Grasp the occlusal paper holder grip part of the harvesting instrument according to any one of (1) to (8), and place an impression material on the upper harvesting surface and the lower harvesting surface. An acquisition method in which the upper and lower teeth of the patient are occluded or the occlusion and impression are acquired simultaneously.
本明細書で開示する採得器具は、術者の技術や経験によらず、歯冠修復におけるフルマウス治療の全顎用咬合採得印象器具、歯冠修復におけるクラウン・ブリッジ治療、インプラントや義歯治療など、あらゆるタイプの歯科補綴治療の際に行われる咬合採得、印象採得に対応することができる。 The acquisition tool disclosed in this specification is based on a full-mouth occlusion acquisition impression device for crown restoration, crown / bridge treatment, implant and denture, regardless of the skill and experience of the operator. It is possible to deal with occlusal acquisition and impression acquisition performed during all types of dental prosthetic treatment such as treatment.
本明細書では、上下の歯の咬合採得を同時に行うことのできる器具、及び咬合採得と印象採得を同時に行うことのできる器具を開示する。本明細書では、上下の歯の咬合採得を同時に行うことのできる器具を咬合採得器具と称し、咬合採得と印象採得を同時に行うことのできる器具をダブル採得器具と称し、両者を併せて採得器具と称する。 In this specification, the instrument which can perform the occlusion acquisition of the upper and lower teeth simultaneously, and the instrument which can perform occlusion acquisition and impression acquisition simultaneously are disclosed. In this specification, an instrument capable of simultaneously performing occlusal acquisition of upper and lower teeth is referred to as an occlusal acquisition instrument, and an apparatus capable of simultaneously performing occlusal acquisition and impression acquisition is referred to as a double acquisition instrument. Are collectively referred to as a harvesting instrument.
ここで、顎位とは、上顎に対する下顎の三次元的な位置を指し、咀嚼時に必要な上下顎の接触位置関係を定めたものである。上顎骨は頭骸骨の一部であるため位置が固定されるのに対して、下顎骨は左右に顎関節があり垂直に移動するだけではなく水平方向にも移動する。また、中心位の定義には諸説あるため、ここでは「中心位=タッピングポイント(筋肉位)=顆頭安定位」と仮定する。 Here, the jaw position refers to the three-dimensional position of the lower jaw with respect to the upper jaw, and defines the contact position relationship between the upper and lower jaws necessary for mastication. Since the maxilla is a part of the skull, the position is fixed, while the mandible has temporomandibular joints on the left and right and moves not only vertically but also horizontally. Since there are various theories on the definition of the central position, it is assumed here that “central position = tapping point (muscle position) = condylar stable position”.
顆頭安定位の咬合採得に必要なことは、咬合採得の際に上下の歯列が接触してからも水平位は自由に移動できることである。水平的自由移動を与えると下顎頭は下顎窩の中で無理無く安定した一定の位置、顆頭安定位に移動する。下顎頭の移動後に咬合採得を行い、その位置に適切な咬頭嵌合位を人工歯で与えると中心咬合位が定めることができ、中心位と中心咬合位は一致することになる。 What is necessary for acquiring the condylar stable position is that the horizontal position can move freely even if the upper and lower dentitions come into contact with each other during the acquisition of the occlusion. When the horizontal free movement is given, the mandibular head moves to the stable position of the condyle without any difficulty in the mandibular fossa. If the occlusal is obtained after the mandibular head is moved, and the appropriate intercuspal position is given to the position by the artificial tooth, the central occlusal position can be determined, and the central position and the central occlusal position coincide.
すなわち、水平的な負荷をゼロにして顎関節が最も噛み易い位置(顆頭安定位=中心位=生理的咬合)を咬合採得して、その位置に人工歯の排列や補綴を行い咬頭嵌合位(中心咬合位=補綴的咬合)を与えれば、中心位と中心咬合位は一致する。しかしながら、このようにして咬合採得を行う方法や器具は今までにはなかった。本発明は、中心位と中心咬合位を一致させて咬合採得を行うことができる器具に関する。 In other words, the position where the temporomandibular joint is most likely to bite with zero horizontal load (condylar stable position = central position = physiological occlusion) is obtained by occlusion, and artificial teeth are arranged and prosthetics are inserted at that position. If an alignment (central occlusion position = prosthetic occlusion) is given, the central position and the central occlusal position coincide. However, there has never been a method or instrument for performing occlusal acquisition in this way. The present invention relates to a device that can perform occlusal acquisition by matching a central position and a central occlusal position.
以下、図面を参照しながら、咬合採得器具について詳細に説明する。
[実施例1]
図1に、平板状の咬合採得器具の例を示す。
本実施例の咬合採得器具1は、咬合採得が必要な歯列の長さの採得部を備えた平坦なシート状の部材からなる。咬合採得は、咬合採得器具の上下の面にシリコーン系印象材、WAX系材料、レジン系材料、印象用石膏などの印象材を載せ、上歯の咬合位置、下歯の咬合位置を同時に採得する。
Hereinafter, the occlusal acquisition tool will be described in detail with reference to the drawings.
[Example 1]
FIG. 1 shows an example of a flat occlusal acquisition tool.
The occlusal acquisition device 1 of the present embodiment is composed of a flat sheet-like member provided with an acquisition portion having a length of a dentition that requires occlusal acquisition. For occlusal acquisition, impression materials such as silicone impression materials, WAX materials, resin materials and impression plaster are placed on the upper and lower surfaces of the occlusal acquisition device, and the occlusal position of the upper teeth and the occlusal positions of the lower teeth are simultaneously set. Take it.
咬合採得器具1は、一定の硬さを備えたシートであればどのようなものを用いてもよい。一定の硬さとは、患者が噛み込んだ際に破断せず、口腔外に出しても変形しない程度の硬さをいう。例えば、歯科用コンポジットレジン、アクリル樹脂、ポリカーボネート、ポリスチレン、ポリエチレン、ポリプロピレン、ポリエチレンテレフタレート、ポリ塩化ビニル、ABS樹脂、厚紙/板紙、セラミック紙、防水紙、PPフィルム加工紙、銅板、亜鉛板、アルミ板、真鍮板、鉄板、ステンレス板、ニッケル板、銀板、チタン板、鉛板などの金属板などの素材を用いることができる。 The occlusal acquisition device 1 may be any sheet as long as it has a certain hardness. The constant hardness means a hardness that does not break when a patient bites and does not deform even when the patient goes out of the oral cavity. For example, dental composite resin, acrylic resin, polycarbonate, polystyrene, polyethylene, polypropylene, polyethylene terephthalate, polyvinyl chloride, ABS resin, cardboard / paperboard, ceramic paper, waterproof paper, PP film processed paper, copper plate, zinc plate, aluminum plate A material such as a metal plate such as a brass plate, an iron plate, a stainless steel plate, a nickel plate, a silver plate, a titanium plate, or a lead plate can be used.
シートの厚さは、0.1〜5.0mm程度であればよい。後述する平板形状の咬合採得器具の場合には、クリアランスによって厚みを選択すれば良く、クリアランスが大きい場合には、1.0〜5.0mm程度の厚さのものを用いることができる。また、クリアランスが小さい場合には、0.1〜3.0mm程度、より好ましくは0.3〜1.0mm程度の厚さのものを用いれば良い。 The thickness of the sheet may be about 0.1 to 5.0 mm. In the case of a flat plate-shaped occlusal acquisition tool to be described later, the thickness may be selected depending on the clearance, and when the clearance is large, a thickness of about 1.0 to 5.0 mm can be used. When the clearance is small, a thickness of about 0.1 to 3.0 mm, more preferably about 0.3 to 1.0 mm may be used.
シートの厚みが5.0mmより厚い場合には、咬合採得を行った際に、シートの厚みが咬合高径に影響を及ぼし、正確に咬合採得を行うことができない場合がある。また、シートの厚みが0.1mmよりも薄い場合には、咬合採得器具1に使用するシートの材質にもよるが、患者が噛み込んだ際に変形したり、破断したりすることから好ましくない。シートの厚みが0.3〜1.0mmであれば、咬合高径に影響を与えることがなく、また、どのような材質のシートを選択しても、患者が噛み込んだ際に変形したり、破断したりすることがない。 When the thickness of the sheet is thicker than 5.0 mm, when the occlusal acquisition is performed, the thickness of the sheet affects the occlusal height, and the occlusal acquisition may not be performed accurately. In addition, when the thickness of the sheet is less than 0.1 mm, it is preferable because it may be deformed or broken when the patient bites, although it depends on the material of the sheet used for the bite acquisition device 1. Absent. If the thickness of the sheet is 0.3 to 1.0 mm, it does not affect the occlusal height, and it can be deformed when the patient bites, no matter what material sheet is selected. It will not break.
また、後述するように本発明の採得器具は咬合紙ホルダーによって把持して用いる。咬合採得は患者が口を閉じた状態で行うため、ピンセットや鉗子などの器具では、閉口状態の患者、特に奥歯の部分に採得器具を挿入することができない。その結果、正確に咬合採得、印象採得を行うことができない。そのため、把持部は咬合紙ホルダーによって把持することができる厚みである必要がある。咬合紙ホルダーによって把持可能な厚みとは15mm以下、好ましくは10mm以下、より好ましくは5mm以下である。また、用いる材質にもよるが撓むなど形状が変化することのないように0.1mm以上の厚さであることが好ましい。 Further, as will be described later, the harvesting instrument of the present invention is used by being gripped by an occlusal paper holder. Since the occlusal acquisition is performed with the patient closed, the instrument such as tweezers or forceps cannot be inserted into the patient in the closed state, particularly the back teeth. As a result, it is impossible to accurately obtain an occlusion and take an impression. Therefore, the gripping portion needs to have a thickness that can be gripped by the occlusal paper holder. The thickness that can be gripped by the occlusal paper holder is 15 mm or less, preferably 10 mm or less, more preferably 5 mm or less. Moreover, although it depends on the material used, it is preferable that the thickness is 0.1 mm or more so that the shape does not change such as bending.
咬合採得器具1は、歯科補綴治療の歯冠修復におけるクラウン・ブリッジ作製などに用いる部分歯用咬合採得器具2、3、フルマウス治療用の補綴物作製の場合に用いる全顎用咬合採得器具4がある。 The occlusal acquisition device 1 is a partial tooth occlusion acquisition device 2 or 3 used for the preparation of a crown or bridge in the restoration of a dental prosthetic treatment. There is a tool 4.
部分歯用咬合採得器具2、3は、補綴治療する歯の数に応じた長さのものが選択できるように、歯列方向に長さの異なるものが用意されている。また、部分歯用咬合採得器具、全顎用咬合採得器具、いずれの場合にも、患者の体格、顎の大きさに応じて適切なサイズが選択できるように数種類の異なるサイズのものが用意されている。 The partial tooth occlusal acquisition devices 2 and 3 have different lengths in the dentition direction so that the lengths corresponding to the number of teeth to be prosthetic treated can be selected. In addition, partial tooth occlusal acquisition devices and full jaw occlusal acquisition devices are available in several different sizes so that appropriate sizes can be selected according to the patient's physique and jaw size. It is prepared.
咬合採得器具1は、咬合採得部2a、3a、4a、及び咬合紙ホルダー把持部2b、3b、4bを備えている。咬合採得部2a、3a、4aは、両面に印象材を配置し、咬合採得を行う部分である。咬合採得部は、シリコーン、ゲル、ワックスなどの印象材が絡みやすくなるように、小孔5を設けてもよい。小孔5を設けることによって、咬合採得部の上下両面の印象材が咬合採得部を挟んで小孔5で繋がることから外れにくくなる。小孔5は、用いる印象材と咬合採得器具1の材質、及び咬合採得を必要とする領域によって、適宜設けることができる。 The occlusal acquisition device 1 includes occlusal acquisition units 2a, 3a, and 4a, and occlusal paper holder grips 2b, 3b, and 4b. The occlusal acquisition units 2a, 3a, and 4a are portions that perform occlusal acquisition by arranging impression materials on both sides. The occlusal acquisition part may be provided with a small hole 5 so that impression materials such as silicone, gel, and wax are easily entangled. Providing the small holes 5 makes it difficult for the impression materials on the upper and lower surfaces of the occlusal acquisition part to be connected by the small holes 5 across the occlusal acquisition part. The small holes 5 can be appropriately provided depending on the impression material to be used, the material of the occlusal acquisition device 1, and the region that requires occlusal acquisition.
また、咬合採得器具1は、術者が咬合紙ホルダーで把持することができるように咬合紙ホルダー把持部2b、3b、4bを備えている。ここでは、部分歯用咬合採得器具の咬合紙ホルダー把持部2b、3bを片側に設ける構成としているが、両側に設ける構成としてもよい。また、咬合紙ホルダー把持部2b、3b、4bには、患者の誤嚥を防止するために、誤嚥防止機構を備えたものとしてもよい。 Further, the occlusal acquisition device 1 includes occlusal paper holder grips 2b, 3b, and 4b so that the operator can hold the occlusion paper holder with the occlusal paper holder. Here, the occlusal paper holder gripping portions 2b and 3b of the partial tooth occlusion obtaining instrument are provided on one side, but may be provided on both sides. Further, the occlusal paper holder grips 2b, 3b, 4b may be provided with an aspiration prevention mechanism in order to prevent aspiration of the patient.
部分歯用咬合採得器具2、3は、咬合採得を必要とする歯の領域が狭い場合には、非常に小さい器具となることから、患者の誤嚥を防止する機構を設けることが好ましい。誤嚥防止機構は、咬合紙ホルダーと部分歯用咬合採得器具2、3が接着する、あるいは糸状部材によって繋止される構成とすることができる(図2)。 Since the partial tooth occlusal acquisition devices 2 and 3 are very small devices when the tooth area requiring occlusal acquisition is narrow, it is preferable to provide a mechanism for preventing aspiration of the patient. . The aspiration prevention mechanism can be configured such that the occlusal paper holder and the partial tooth occlusal acquisition devices 2 and 3 are bonded together or are locked by a thread-like member (FIG. 2).
接着面を備えた誤嚥防止機構6は、部分歯用咬合採得器具2の咬合紙ホルダー把持部2bに設けられ、接着面が咬合紙ホルダーに接着するように構成されている(図2上)。接着面は、例えば両面テープを咬合紙ホルダー把持部に接着することによって作製される。使用時に剥離紙7を剥がし、咬合紙ホルダーの先端部に接着して用いることにより、咬合紙ホルダーからはずれることがなく、誤嚥を防止することができる。 The aspiration prevention mechanism 6 having an adhesive surface is provided in the occlusal paper holder grip 2b of the partial tooth occlusal acquisition device 2, and is configured such that the adhesive surface adheres to the occlusal paper holder (FIG. 2 upper). ). The adhesive surface is produced, for example, by adhering a double-sided tape to the occlusal paper holder grip. By peeling off the release paper 7 during use and adhering to the tip of the occlusal paper holder, the release paper 7 is not detached from the occlusal paper holder, and aspiration can be prevented.
また、部分歯用咬合採得器具2の咬合紙ホルダー把持部2bに繋合する糸状部材を用いた誤嚥防止機構8としてもよい(図2中央)。誤嚥防止機構8は、糸状部材からなり、糸状部材の一端は、部分歯用咬合採得器具2の咬合紙ホルダー把持部2bに固定することにより繋合させる。糸状部材の他端は、輪を作っておき、咬合紙ホルダーの持ち手部分に引っ掛けて用いればよい。患者の口腔内で、部分歯用咬合採得器具2が咬合紙ホルダーAから外れた場合であっても、誤嚥防止機構8によって繋止されているため、誤嚥を防止することができる。 Moreover, it is good also as the aspiration prevention mechanism 8 using the thread-like member connected with the occlusion paper holder holding | grip part 2b of the occlusal sampling instrument 2 for partial teeth (center of FIG. 2). The aspiration preventing mechanism 8 is made of a thread-like member, and one end of the thread-like member is joined by being fixed to the occlusal paper holder grip 2b of the partial tooth occlusal acquisition device 2. The other end of the thread-like member may be used by making a ring and hooking it on the handle portion of the occlusal paper holder. Even if the partial tooth occlusal acquisition device 2 is detached from the occlusal paper holder A in the oral cavity of the patient, aspiration can be prevented because it is locked by the aspiration prevention mechanism 8.
また、誤嚥防止機構9は、糸状部材の他端をクリップ状にして咬合紙ホルダーに繋合する構成となっている(図2下)。誤嚥防止機構9の糸状部材の一端が部分歯用咬合採得器具2の咬合紙ホルダー把持部2bに固定することにより繋合されていることは同じであるが、他端はクリップに繋合している。クリップ部分で咬合紙ホルダーの持ち手部分を挟み、部分歯用咬合採得器具2を把持して用いることによって、患者の口腔内で、部分歯用咬合採得器具2が咬合紙ホルダーAから外れた場合であっても、誤嚥を防止することができる。 Further, the aspiration preventing mechanism 9 has a configuration in which the other end of the thread-like member is clipped and joined to the occlusal paper holder (lower side in FIG. 2). It is the same that one end of the thread-like member of the aspiration prevention mechanism 9 is fixed by being fixed to the occlusal paper holder grip 2b of the partial tooth occlusal acquisition device 2, but the other end is connected to the clip. doing. By sandwiching the handle portion of the occlusal paper holder with the clip portion and grasping and using the occlusal acquisition device 2 for partial teeth, the partial occlusion acquisition device 2 comes off the occlusal paper holder A in the oral cavity of the patient. Even if it is a case, aspiration can be prevented.
次に、実施例1の咬合採得器具の使用方法について説明する(図3)。ここでは、部分歯用咬合採得器具2’を用いた場合について説明する。部分歯用咬合採得器具2’は、小孔5を備え、咬合採得部2aの歯列に直交する方向の両側に咬合紙ホルダー把持部を備えた形状のものであるが、他の形状の部分歯用咬合採得器具を用いた場合でも同様に使用することができる。また、全顎用咬合採得器具を使用した場合でも基本的な使用方法は同様である。 Next, the usage method of the occlusal acquisition instrument of Example 1 is demonstrated (FIG. 3). Here, the case where the partial tooth occlusion obtaining instrument 2 'is used will be described. The partial tooth occlusal acquisition device 2 ′ has a shape having a small hole 5 and an occlusal paper holder gripping portion on both sides in a direction orthogonal to the dentition of the occlusal acquisition unit 2a. Even in the case of using the partial tooth occlusion obtaining instrument, it can be used in the same manner. The basic method of use is the same even when using a full jaw occlusal acquisition tool.
最初に部分歯用咬合採得器具2’、咬合紙ホルダーA、印象材を装填したカートリッジディスペンサーBを用意する(図3ステップ1)。次に、咬合紙ホルダーAで、部分歯用咬合採得器具2’の咬合紙ホルダー把持部を把持し、印象材を咬合採得部の上部採得面10、下部採得面11の両面に載せる(図3ステップ2)。次に、患者の口腔内に印象材を盛った部分歯用咬合採得器具2’を挿入し、患者に印象材を盛った部分歯用咬合採得器具2’を噛んでもらい咬合採得を行う(図3ステップ3)。所定の時間経過後、患者の口腔内で印象材が硬化したことを確認した後、部分歯用咬合採得器具2’を患者の口腔内から取り出す(図3ステップ4)。上部採得面10には上歯の、下部採得面11には下歯の咬合を同時に採得することができる。 First, a partial tooth occlusal picking device 2 ', an occlusal paper holder A, and a cartridge dispenser B loaded with an impression material are prepared (step 1 in FIG. 3). Next, with the occlusal paper holder A, the occlusal paper holder holding part of the partial tooth occlusal acquisition device 2 ′ is held, and the impression material is applied to both the upper acquisition surface 10 and the lower acquisition surface 11 of the occlusal acquisition part. Place (Step 2 in FIG. 3). Next, the partial tooth occlusal acquisition device 2 ′ with impression material in the patient's mouth is inserted, and the patient bites the partial tooth occlusion acquisition device 2 ′ with impression material. Perform (step 3 in FIG. 3). After a predetermined time has elapsed, after confirming that the impression material has hardened in the oral cavity of the patient, the partial tooth occlusal acquisition device 2 'is removed from the oral cavity of the patient (step 4 in FIG. 3). It is possible to simultaneously obtain the occlusion of the upper teeth on the upper obtaining surface 10 and the lower teeth on the lower obtaining surface 11.
本実施例の咬合採得器具は、上述のようにアクリル樹脂、ポリカーボネートのような硬質素材で製造されているため、患者が噛みこんでも破断せず、口腔外に出しても変形しない。そのため、術者の技術に関わらず、正確に咬合採得を行うことができる。 Since the occlusal acquisition device of the present embodiment is manufactured of a hard material such as acrylic resin or polycarbonate as described above, it does not break even if the patient bites in and does not deform even if it goes out of the oral cavity. Therefore, it is possible to accurately obtain the bite regardless of the skill of the operator.
従来はワックスなど、噛むことにより変形する素材を用いての咬合採得や、ペーストが硬化するシリコーン印象やレジン重合の咬合採得が行われており、硬質素材のタッピング法を用いた咬合採得が行われることはなかった。しかしながら、硬質素材のタッピング法を用いた咬合採得を行うことにより外側翼突筋が活動する。外側翼突筋の活動する状態で咬合採得を行うことにより、イミディサイドシフトを抑制することができる。その結果、この方法で得られた咬合採得は最終補綴物と同条件になるため、従来法で困難とされたターミナル・ヒンジアキシスを再現することができる。そのため、実施例で示すような硬質素材からなる咬合採得器具を用いることによって、患者の最も噛みやすい顎位を再現した咬合採得で最終補綴物を作製することができる。 Conventionally, occlusal acquisition using a material such as wax, which deforms when chewed, and occlusion acquisition of a silicone impression or resin polymerization that hardens the paste, occlusal acquisition using a tapping method of a hard material Was never done. However, the outer pterygoid muscle is active by performing occlusal acquisition using the tapping method of a hard material. Immediate side shift can be suppressed by performing occlusal acquisition while the outer pterygoid muscles are active. As a result, the occlusal acquisition obtained by this method is under the same conditions as the final prosthesis, so that it is possible to reproduce the terminal-hinge axis that has been difficult with the conventional method. Therefore, by using an occlusal acquisition device made of a hard material as shown in the examples, a final prosthesis can be produced by occlusal acquisition that reproduces the most easily chewable jaw position of a patient.
ここで、最適な咬合採得を行うためには、咀嚼の際の筋肉、下顎骨の動き、関節の役割の理解が重要となってくる。咀嚼は、側頭筋・咬筋・内側翼突筋・外側翼突筋の4種類の筋肉によって行われる動作である。側頭筋、咬筋、内側翼突筋は全て閉口筋として下顎骨を挙上させる筋肉である。これに対し、外側翼突筋は、上頭と下頭の二種類に分かれており、異なる機能を備えているものと考えられる。 Here, in order to obtain the optimum occlusion, it is important to understand the muscles, the movement of the mandible, and the role of the joints during mastication. Mastication is an operation performed by four types of muscles, temporal muscles, masseters, medial pterygoid muscles, and lateral pterygoid muscles. The temporal, masseter, and medial pterygoid muscles are all muscles that raise the mandible as a closing muscle. In contrast, the outer pterygoid muscles are divided into two types, upper and lower head, and are considered to have different functions.
外側翼突筋下頭は、蝶形骨翼状突起外側板外面に起始し、後上方および外側に向かい、おもに下顎頭頸部に停止している。左右の外側翼突筋下頭が同時に収縮すると、下顎頭は関節結節の下方に牽引され、下顎骨は前突する。一側が収縮すると同側の下顎頭の内側回転運動が生じ、反対側の下顎骨の側方運動を生じる。外側翼突筋が下顎下制筋とともに機能すると下顎骨は下降し、下顎骨は関節結節に沿って前下方に滑走する。 The inferior lateral pterygoid muscle begins at the outer surface of the sphenoid pterygium outer plate, posteriorly upwards and outwards, and mainly stops at the mandibular head and neck. When the left and right lateral pterygoid inferior heads contract simultaneously, the mandibular head is pulled below the joint nodule and the mandible projects forward. When one side contracts, there is a medial rotational movement of the ipsilateral mandibular head and a lateral movement of the opposite mandible. When the outer pterygoid muscle functions with the mandibular mandibular constrictor, the mandible descends and the mandible slides forward and downward along the joint nodules.
外側翼突筋上頭は、外側翼突筋下頭よりも小さく、蝶形骨大翼の側面下面に起始し、ほぼ水平に後外側に向かい、関節包、円板と関節突起頸部上に停止する。外側翼突筋上頭は、下顎挙上筋と連動するときにのみ活動する。すなわち、上下の歯が接触しているときに活動する。外側翼突筋は、内部に位置する筋肉であるため筋電位を取りにくく、その動作についての詳細な解析が困難である。しかし、咀嚼運動は開口筋と閉口筋の交互作用で成り立つため、上顎翼突筋上頭は閉口運動が口腔内のバーチカルストップで止まったことを、関節包・関節円板と関節突起頸部上の動きで感知し、生体信号を上顎翼突筋下頭に送る役割を果たすものと考えられる。すなわち、外側翼突筋上頭は、咀嚼筋の働きを調節するカウンターバランスの役割を果たすものと考えられる。 The outer pterygoid upper head is smaller than the outer pterygoid inferior head, starts at the lower side of the sphenoid wing, faces almost horizontally toward the posterior outer side, and stops on the joint capsule, disc, and articular process neck To do. The lateral pterygoid upper head is active only when interlocked with the mandibular elevation muscle. That is, it operates when the upper and lower teeth are in contact. Since the outer pterygoid muscle is a muscle located inside, it is difficult to obtain a myoelectric potential, and detailed analysis of its operation is difficult. However, since the masticatory movement is made up of the interaction of the opening and closing muscles, the upper pterygoid upper head indicates that the closing movement stopped at the vertical stop in the mouth, on the joint capsule / disc and the neck of the joint process. It is thought to play a role of sensing biological signals and sending biological signals to the lower head of the maxillary pterygoid muscle. That is, it is considered that the upper head of the outer pterygoid muscle plays a role of counterbalance that regulates the function of the masticatory muscles.
しかし、顎関節が老化などにより摩耗している場合には、磨耗した顎関節空間での関節包・関節円板と関節突起頸部上の動きである顎運動は、正常な場合とは異なるものとなる。そのため、外側翼突筋上頭は、本来の役割を果たすことができない。側方運動時に平衡側顆頭が中心位から動き始めてすぐに横ズレするように内方に移動することをイミディドサイドシフトと称するが、外側翼突筋上頭は、カウンターバランスの役割を果たすと同時に、イミディドサイドシフトの原因となると考えられる。 However, when the temporomandibular joint is worn due to aging, the jaw movement, which is movement on the joint capsule / disc and the neck of the articular process in the worn temporomandibular joint space, is different from the normal case. It becomes. Therefore, the outer pterygoid upper head cannot play the original role. When the lateral condyle starts moving from the center position and moves inward so as to shift laterally immediately after lateral movement, it is called an immediate side shift. At the same time, it is thought to cause an immediate side shift.
側頭筋・咬筋・内側翼突筋・外側翼突筋は全て咀嚼機能を担う上で重要であるが、特に咀嚼機能の調節を行っている外側翼突筋上頭が活動している状態で咬合採得を行うことは、生体が噛みやすい位置での咬合採得を行うことに他ならない。従来法の上下の未接触状態や軟化素材の咬合採得では、外側翼突筋上頭の活動が再現されない状態で咬合採得されることになると考えられることから、適正な咬合採得が行われない場合も生じてくる。これに対し、本実施例で示す硬質素材からなる咬合採得器具を用いることによって、外側翼突筋上頭の活動を再現することが可能となり、簡便な方法でありながら、精度の高い咬合採得を行うことができる。 The temporal, masseter, medial and lateral pterygoid muscles are all important for carrying out the masticatory function, but the occlusal sampling is obtained especially when the lateral pterygoid upper head that controls the masticatory function is active. This is nothing but to obtain occlusion at a position where the living body can easily bite. In conventional non-contact state and softening material occlusion acquisition in the conventional method, it is considered that the occlusal acquisition is performed without the activity of the lateral pterygoid superiority being reproduced, so appropriate occlusion acquisition is performed. There are also cases where there is no. On the other hand, by using the occlusal acquisition device made of a hard material shown in the present embodiment, it becomes possible to reproduce the activity of the outer pterygoid upper head, and it is a simple method, but highly accurate occlusion acquisition It can be performed.
[実施例2]
次に、咬合採得と印象採得を同時に行うことのできる採得器具について説明する。図4Aに、咬合採得と印象採得を同時に行うダブル採得器具の一例を示す。ダブル採得器具21には、全顎印象用ダブル採得器具22と部分印象用ダブル採得器具23がある。ダブル採得器具21の材質、厚みは実施例1の咬合採得器具と同様のものを用いればよい。ダブル採得器具21は歯冠形状の採得部24と頬側に設けられた咬合紙ホルダー把持部である頬側把持部22a、23a、舌側に設けられた咬合紙ホルダー把持部である舌側把持部22bからなっている。
[Example 2]
Next, a description will be given of a sampling device that can simultaneously perform occlusal acquisition and impression acquisition. FIG. 4A shows an example of a double acquisition tool that simultaneously performs occlusal acquisition and impression acquisition. The double collection device 21 includes a double collection device 22 for full jaw impression and a double collection device 23 for partial impression. The material and thickness of the double harvesting instrument 21 may be the same as those of the occlusal harvesting instrument of Example 1. The double harvesting device 21 includes a crown-shaped harvesting part 24, cheek-side gripping parts 22a and 23a which are occlusal paper holder gripping parts provided on the buccal side, and a tongue which is an occlusal paper holder gripping part provided on the lingual side. It consists of a side grip 22b.
図4A上に示す全顎印象用ダブル採得器具22は上歯用のものである。全顎印象用ダブル採得器具22は、患者の歯冠(臨床的歯冠)に類似した形状をしている。全顎印象用ダブル採得器具22は、患者の体格、顎の大きさによって、患者の歯と同程度の大きさを備えたものを選択できるように、サイズの異なるものが数種類用意されている。 The full jaw impression double extraction device 22 shown in FIG. 4A is for upper teeth. The full jaw impression double acquisition device 22 has a shape similar to a patient's crown (clinical crown). There are several types of double-collecting instruments 22 for impressions of the entire jaw so that different sizes can be selected depending on the physique of the patient and the size of the jaw. .
全顎印象用ダブル採得器具22には、歯冠毎に頬側、舌側に頬側把持部22a、舌側把持部22bを備えており、咬合紙ホルダーにより把持できるようになっている。下歯用の全顎印象用ダブル採得器具はここには示していないが、上歯と同様にサイズの異なるものを数種類用意しておき、患者の顎、歯の大きさによって適宜選択できるようにしておく。 The double jaw acquisition tool 22 for all jaw impressions is provided with a buccal gripping portion 22a and a lingual gripping portion 22b on the buccal side and the lingual side for each crown, and can be gripped by an occlusal paper holder. The double jaw appliance for lower jaw full jaw impression is not shown here, but several kinds of different sizes similar to the upper teeth are prepared and can be selected appropriately according to the patient's jaw and tooth size. Keep it.
図4A下に示す部分印象用ダブル採得器具23は、右側下歯用のものであって、中切歯から第二大臼歯までを備えた部分印象用ダブル採得器具を示している。咬合紙ホルダーにより把持するための頬側把持部23aが歯冠毎に設けられている。ここでは頬側把持部23aのみを備えた形状のものを示しているが、舌側把持部を合わせ持つ形状としてもよい。 4A is a partial impression double sampling instrument for right lower teeth, and includes a partial incisor to a second molar. A buccal gripping portion 23a for gripping by the occlusal paper holder is provided for each tooth crown. Here, a shape having only the cheek-side gripping portion 23a is shown, but a shape having a tongue-side gripping portion may also be used.
また、全顎印象用ダブル採得器具22、部分印象用ダブル採得器具23は、歯冠毎に必要な部分だけカットして用いてもよい。歯冠と歯冠との間には、切れ込みを入れておくことによって、容易にカットすることができるように構成することができる。また、実施例1の咬合採得器具と同様の誤嚥防止機構を設けておけば、カットして用いた場合であっても、患者が誤って飲み込むことはない。 Moreover, you may cut and use only the part required for every dental crown the double acquisition instrument 22 for the whole jaw impression, and the double acquisition instrument 23 for partial impressions. It can be configured so that it can be easily cut by making a notch between the crown and the crown. In addition, if an aspiration prevention mechanism similar to that of the occlusal acquisition device of Example 1 is provided, the patient will not accidentally swallow it even when cut and used.
ダブル採得器具21の使用方法について説明する。咬合紙ホルダーでダブル採得器具21を把持し、ダブル採得器具の両面、すなわち歯冠の外側である上部採得面25と、内側である下部採得面26に印象材を載せる。次に、患者の口腔内に印象材を両面に盛ったダブル採得器具21を挿入し、患者にダブル採得器具21を噛んでもらうことにより、印象採得と咬合採得を同時に行うことができる。所定の時間経過後、患者の口腔内で印象材が硬化したことを確認した後、ダブル採得器具21を患者の口腔内から取り出す。歯冠に面した内側の下部採得面26では印象採得が、歯冠の外側の上部採得面25では咬合採得をすることができる。 A method of using the double harvesting instrument 21 will be described. The double acquisition tool 21 is held by the occlusal paper holder, and the impression material is placed on both surfaces of the double acquisition instrument, that is, the upper acquisition surface 25 which is the outside of the crown and the lower acquisition surface 26 which is the inside. Next, the impression acquisition and the occlusion acquisition can be performed simultaneously by inserting the double acquisition device 21 with the impression material on both sides into the patient's mouth and having the patient bite the double acquisition device 21. it can. After a predetermined time has elapsed, after confirming that the impression material has hardened in the oral cavity of the patient, the double collection device 21 is taken out from the oral cavity of the patient. Impression acquisition can be performed on the inner lower acquisition surface 26 facing the crown, and occlusion acquisition can be performed on the upper acquisition surface 25 on the outer side of the crown.
実施例2に示すダブル採得器具21は、クリアランス不足を印象前にチェックすることができるとともに、ブリッジ治療の場合にはブリッジの平衡性の確認も同時に行うことができる。 The double harvesting device 21 shown in the second embodiment can check the lack of clearance before impression, and can simultaneously check the balance of the bridge in the case of bridge treatment.
また、咬合採得部が歯冠形状となっているために即時仮歯として使用することができる。仮歯形態が、印象時と同様になるため、仮歯による歯肉短縮が起こらないので、院内に歯科技工士がいない場合であっても、誰でも歯形態を再現することが可能となる。さらに、口腔内の治療中の三次元的空間を、インナートレーで簡易的に再現修復したものを、二次印象で口腔外の模型にトランスファーするので技工物の精度が上がり、最終補綴物セット時の口腔内調整量が微量に抑えられる。 Moreover, since the occlusal acquisition part has a crown shape, it can be used as an immediate temporary tooth. Since the provisional tooth form is the same as that at the time of impression, gingival shortening due to the provisional tooth does not occur, so even if there is no dental technician in the hospital, anyone can reproduce the tooth form. Furthermore, since the three-dimensional space during treatment in the oral cavity is simply reproduced and restored with the inner tray, it is transferred to the model outside the oral cavity with a secondary impression, so that the accuracy of the technical product is improved and the final prosthesis is set. The amount of adjustment in the oral cavity can be suppressed to a very small amount.
本実施例のダブル採得器具21は、印象採得と咬合採得を同時に行うことができるため、迅速に治療を進めることができる。また、ダブル採得器具21は、実施例1で示した咬合採得器具と同様にアクリル樹脂、ポリカーボネートのような、硬質素材で製造されているため、患者が噛みこんでも破断せず、口腔外に出しても変形しない。さらに、クリアランス不足を印象前にチェックできるので、術者の技術に関わらず、正確に咬合採得を行うことができる。なお、適用する歯の位置、患者の体格に合わせてサイズの異なるものが用意されていることは、実施例1と同様である。 Since the double acquisition device 21 of the present embodiment can perform impression acquisition and occlusal acquisition at the same time, it can rapidly proceed with treatment. Moreover, since the double collection device 21 is manufactured by a hard material such as an acrylic resin or polycarbonate like the occlusal collection device shown in Example 1, the double collection device 21 does not break even if the patient bites into it. Even if it goes out, it does not deform. Furthermore, since the lack of clearance can be checked before the impression, it is possible to accurately obtain the bite regardless of the skill of the operator. In addition, it is the same as that of Example 1 that the thing from which the size differs according to the position of the tooth to apply and a patient's physique is prepared.
[実施例3]
ワイヤーを備えた歯冠形状のダブル採得器具のバリエーションについて説明する(図4B、4C)。図4Bは、ワイヤーを備えた全顎印象用ダブル採得器具31を一例として示す。全顎印象用ダブル採得器具31は歯冠の中央部分にワイヤー33を備えている他は、実施例2で示した全顎印象用ダブル採得器具22と同じ構造をしている。すなわち、歯冠毎に頬側に頬側把持部32a、舌側に舌側把持部32bを備えており、咬合紙ホルダーにより把持できるようになっている。ワイヤーは歯列矯正に用いるワイヤーのように柔軟性があるものを用いている。
[Example 3]
Variations of the crown-shaped double acquisition tool provided with the wire will be described (FIGS. 4B and 4C). FIG. 4B shows as an example a double extraction tool 31 for an entire jaw impression provided with a wire. The double jaw appliance 31 for full jaw impression has the same structure as the double jaw appliance 22 for full jaw impression shown in Example 2 except that a wire 33 is provided in the central part of the crown. That is, each tooth crown is provided with a buccal gripping portion 32a on the cheek side and a lingual gripping portion 32b on the lingual side, and can be gripped by the occlusal paper holder. The wire is a flexible one like a wire used for orthodontics.
例えば、患者の歯並びが悪く歯列が全顎印象用ダブル採得器具31とずれた形状となっている場合には、ワイヤー以外の部分に切れ目を入れ患者の歯列に沿うようにして用いることができる。その結果、より正確に咬合採得、印象採得を行うことができる。 For example, if the patient's teeth are poorly aligned and the dentition is misaligned with the full jaw impression double-acquisition tool 31, use a cut along the dentition other than the wire. Can do. As a result, occlusal acquisition and impression acquisition can be performed more accurately.
図4Cに、ワイヤーを備えた部分印象用採得器具のバリエーションを示す。部分印象用ダブル採得器具32は、頬側把持部33aが歯冠毎に独立しておらず連続した形状となっている。ワイヤー34は、頬側把持部33a中央に配置されている。部分印象用ダブル採得器具32は、上述の全顎印象用ダブル採得器具と同様に、歯冠の間をワイヤーを残して切断することによって、歯並びの悪い患者であっても部分印象用ダブル採得器具を配置し、咬合採得、印象採得を行うことができる。 FIG. 4C shows a variation of the partial impression taking instrument provided with a wire. In the partial impression double acquisition device 32, the buccal gripping portion 33a is not independent for each tooth crown but has a continuous shape. The wire 34 is disposed at the center of the cheek side grip 33a. The partial impression double acquisition device 32 is similar to the above-described double jaw acquisition device for full jaw impression, by cutting the dental crown while leaving a wire, so that even for patients with poor alignment, the partial impression double acquisition device 32 is used. A sampling device can be arranged to perform occlusal acquisition and impression acquisition.
ここでは、全顎印象用ダブル採得器具31の歯冠部分、あるいは部分印象用ダブル採得器具32の頬側把持部33aにワイヤーを備えた採得器具を示したが、全顎印象用ダブル採得器具の把持部、部分印象用ダブル採得器具の歯冠部にワイヤーを備えた構造としてもよい。なお、適用する歯の位置、患者の体格に合わせてサイズの異なるものが用意されていることは、実施例1等と同様である。 Here, although the acquisition device provided with the wire in the crown part of the double acquisition device 31 for the entire jaw impression or the buccal gripping portion 33a of the double acquisition device 32 for the partial impression, the double acquisition device for the entire jaw impression is shown. It is good also as a structure provided with the wire in the crown part of the holding | grip part of a collection tool, and the double collection tool for partial impressions. In addition, it is the same as that of Example 1 etc. that the thing from which a size differs according to the position of the tooth to apply and a patient's physique is prepared.
[実施例4]
次に、支台歯形成に用いるダブル採得器具について説明する。図5Aに、一歯用ダブル採得器具41の斜視図、側面図、咬合床側から見た図を示す。一歯用ダブル採得器具の材質、厚みは実施例1の咬合採得器具と同様のものを用いればよい。また、適用する歯の位置、患者の体格に合わせてサイズの異なるものが用意されていることは、実施例1等と同様である。一歯用ダブル採得器具41は略半球状の採得部42と咬合紙ホルダー把持部43からなっている。半球状の形態の上部(凸側)の上部採得面44は咬合面であり、咬合採得部として機能する。また、咬合面の反対側は凹部形状になっており、支台歯の印象を採得する下部採得面45となっている。また、咬合紙ホルダー把持部43には、実施例1の咬合採得器具と同様に誤飲防止機構を設けてもよい。
[Example 4]
Next, the double collection tool used for abutment tooth formation will be described. FIG. 5A shows a perspective view, a side view, and a view seen from the occlusal floor side of the single-tooth double harvesting instrument 41. What is necessary is just to use the material and thickness of the double sampling instrument for single teeth similar to the occlusal acquisition instrument of Example 1. Moreover, it is the same as that of Example 1 etc. that the thing from which a size differs according to the position of the tooth to apply and a patient's physique is prepared. The single-tooth double harvesting instrument 41 includes a substantially hemispherical harvesting section 42 and an occlusal paper holder gripping section 43. The upper (convex) upper acquisition surface 44 of the hemispherical shape is an occlusal surface and functions as an occlusal acquisition unit. Further, the opposite side of the occlusal surface has a concave shape, which is a lower acquisition surface 45 for obtaining the impression of the abutment tooth. Further, the occlusal paper holder grip 43 may be provided with a mechanism for preventing accidental ingestion in the same manner as the occlusal acquisition device of the first embodiment.
上部採得面44、下部採得面45には、咬合採得、印象採得を行った後に印象材の口腔内での位置を明確にし、また、印象材と採得器具の接着性を増すように、位置合わせマーク46、47が形成されている。上部採得面44の位置合わせマーク46は、上部採得面44の咬合床側に形成されており、咬合採得を行った後の印象材の位置関係が明らかになるように構成されている。さらに、ここでは示していないが上部採得面44には縦方向の溝を位置合わせマークとしてさらに形成することにより、前後の位置もわかるように構成することができる。 After the occlusal acquisition and impression acquisition are performed on the upper acquisition surface 44 and the lower acquisition surface 45, the position of the impression material in the oral cavity is clarified, and the adhesion between the impression material and the acquisition instrument is increased. Thus, alignment marks 46 and 47 are formed. The alignment mark 46 of the upper acquisition surface 44 is formed on the occlusal floor side of the upper acquisition surface 44, and is configured to clarify the positional relationship of the impression material after the occlusion acquisition is performed. . Furthermore, although not shown here, it is possible to make it possible to recognize the front and rear positions by further forming vertical grooves as alignment marks on the upper acquisition surface 44.
下部採得面45の内部の位置合わせマーク47は、下部採得面45の咬合床側に形成されている。下部採得面45に印象材を盛り印象採得を行った後に、ダブル採得器具から型取りした印象材をはずしても、位置合わせマーク47が付与されていることから位置関係が明らかとなる。下部採得面45の位置合わせマークにも、上部採得面の溝と同様に縦方向の溝を形成してもよい。また、ここでは位置合わせマークは溝形状のものを例として挙げているが、位置が分かればとのようなものでもよく凸状に形成してもよい。 The alignment mark 47 inside the lower acquisition surface 45 is formed on the occlusal floor side of the lower acquisition surface 45. After taking impression material on the lower acquisition surface 45, even if the impression material taken from the double acquisition tool is removed, the positional relationship becomes clear because the alignment mark 47 is given. . A vertical groove may be formed in the alignment mark on the lower acquisition surface 45 as well as the groove on the upper acquisition surface. In addition, here, the alignment mark has a groove shape as an example, but the alignment mark may be a convex shape if the position is known.
次に、一歯用ダブル採得器具のバリエーションを示す。図5Bは、一歯用ダブル採得器具48の斜視図、側面図、咬合面側から見た図を示す。一歯用ダブル採得器具48は、図5Aに示した一歯用ダブル採得器具と同様に、採得部42と咬合紙ホルダー把持部43からなっている。採得部42の上面には3つの浅いドーム型の凸部49が形成されている。凸部49により咬合採得を行う際に複数の点で接触することができるため、より安定して咬合採得を行うことができる。ここでは凸部49が3つのものを示しているが、2〜5個程度とすることができる。 Next, the variation of the single tooth double collection instrument is shown. FIG. 5B shows a perspective view, a side view, and a view from the occlusal surface side of the single-tooth double harvesting device 48. The single-tooth double harvesting instrument 48 includes a harvesting part 42 and an occlusal paper holder gripping part 43 as in the single-tooth double harvesting instrument shown in FIG. 5A. Three shallow dome-shaped convex portions 49 are formed on the upper surface of the obtaining unit 42. Since it is possible to contact at a plurality of points when performing occlusal acquisition by the convex portion 49, it is possible to perform occlusal acquisition more stably. Here, although the convex part 49 has shown three things, it can be set as about 2-5 pieces.
図5A、5Bには、上部採得面が一点、あるいは3点で接触し咬合採得を行う半球状の器具を例として示したが、例えば採得部の形状を円柱状とし、上部採得面を平面形状とするように構成してもよい。 5A and 5B show an example of a hemispherical device that performs occlusal acquisition by contacting the upper acquisition surface at one point or three points. For example, the shape of the acquisition unit is cylindrical and the upper acquisition surface is obtained. You may comprise so that a surface may be made into a planar shape.
一歯用ダブル採得器具41を例に、使用方法を説明する。まず、ダブル採得器具の咬合紙ホルダー把持部43を咬合紙ホルダーにより挟み、患者の口腔内の高さに併せて調整した後、上部採得面44、下部採得面45に夫々印象材を載せ、咬合採得、印象採得が必要な領域に設置し咬合採得と同時に印象採得を行う。一歯用ダブル採得器具41も、実施例1の採得器具と同様に硬質素材を用いていることから、正確に咬合採得を行うことができる。 The method of use will be described taking the single tooth double harvesting instrument 41 as an example. First, the occlusal paper holder grip 43 of the double sampling device is sandwiched between the occlusal paper holders and adjusted according to the height in the oral cavity of the patient, and then the impression material is applied to the upper acquisition surface 44 and the lower acquisition surface 45, respectively. Place it in an area where it is necessary to take an occlusion and take an impression. Since the single-tooth double harvesting tool 41 uses a hard material similarly to the harvesting tool of Example 1, it is possible to accurately perform occlusal harvesting.
[実施例5]
次に、複数歯用ダブル採得器具について説明する。図5Cは、複数歯用ダブル採得器具51の斜視図、側面図、咬合床側から見た図を示す。複数歯用ダブル採得器具51は、一歯毎に採得部52、咬合紙ホルダー把持部53を備えた採得器具が連結部54により連結された構成となっている。採得部52の咬合床側には、載置部55が採得部52の外縁に沿って設けられている。載置部55を設けていることから、患者の口腔内で咬合採得、印象採得を行う場合に安定した位置に載置することができる。ここでは載置部55は角を丸くした四角形状のものを例として挙げているが円形であってもよい。
[Example 5]
Next, the double tooth collecting tool for multiple teeth will be described. FIG. 5C shows a perspective view, a side view, and a view as seen from the occlusal floor side of the multiple-tooth double harvesting instrument 51. The multiple-tooth double harvesting instrument 51 has a configuration in which a harvesting instrument having a harvesting part 52 and an occlusal paper holder gripper 53 is connected by a connecting part 54 for each tooth. On the occlusal floor side of the obtaining unit 52, a placement unit 55 is provided along the outer edge of the obtaining unit 52. Since the placement portion 55 is provided, the placement portion 55 can be placed at a stable position in the case of performing occlusion acquisition and impression acquisition in the oral cavity of the patient. Here, the mounting portion 55 is exemplified as a rectangular shape with rounded corners, but may be circular.
また、載置部55、連結部54には、小孔56を設けることにより、印象材、ワックス等と絡みやすくなる。また、一歯用ダブル採得器具と同様に位置合わせマークを設けることができる。ここでは、溝形状の位置合わせマーク59を下部採得面58に設ける構成を示しているが、上部採得面57にも位置合わせマークを設けてもよい。 Further, the mounting portion 55 and the connecting portion 54 are provided with a small hole 56, so that the mounting portion 55 and the connecting portion 54 are easily entangled with an impression material, wax, or the like. Moreover, the alignment mark can be provided similarly to the single tooth double collection tool. Here, a configuration in which the groove-shaped alignment mark 59 is provided on the lower acquisition surface 58 is shown, but an alignment mark may also be provided on the upper acquisition surface 57.
複数歯用ダブル採得器具51も、一歯用ダブル採得器具と同様に、上部採得面57、下部採得面58に印象材を載せ、咬合採得、印象採得を行うことにより、複数歯の咬合採得、印象採得を同時に行うことができる。 As with the single-tooth double-sampling tool 51, the multiple-tooth double-sampling tool 51 is also equipped with an impression material on the upper and lower acquisition surfaces 57, 58, and by performing occlusal acquisition and impression acquisition, Occlusal acquisition of multiple teeth and impression acquisition can be performed simultaneously.
次に、複数歯用ダブル採得器具のバリエーションを示す。図5Dは、複数歯用ダブル採得器具60の斜視図、側面図、咬合床側から見た図を示す。複数歯用ダブル採得器具60は、図5Cに示した複数歯用ダブル採得器具と同様に、一歯毎に採得部52、舌側の咬合紙ホルダー把持部53の他に頬側把持部62を備えている。複数歯用ダブル採得器具60では、採得部52が、頬側把持部62の連結部63により連結された構成となっている。細い連結部で連結されているため、若干の歯列の歪みにも対応することができる。 Next, the variation of the double tooth collection tool for multiple teeth is shown. FIG. 5D shows a perspective view, a side view, and a view seen from the occlusal floor side of the multiple-tooth double harvesting device 60. The multiple-tooth double collection device 60 is similar to the multiple-tooth double collection device shown in FIG. 5C, in addition to the collection unit 52 for each tooth, the occlusal paper holder grip unit 53 on the tongue side, and the buccal side grip A portion 62 is provided. In the multiple-tooth double collection tool 60, the collection unit 52 is connected by the connection unit 63 of the buccal gripping unit 62. Since it is connected by a thin connecting part, it can cope with slight distortion of the dentition.
ここでは、2歯用のダブル採得器具を示したが、3歯以上の歯に対応するように連結部で採得部を連結させる構成としてもよい。さらに連結部にワイヤーを配置し、多少の歪みに対して対応できるような構成とすることもできる。また、採得部の形状も半球状、円柱状、凸部を備えたものとしてもよい。 Here, although the double collection tool for 2 teeth was shown, it is good also as a structure which connects a collection part with a connection part so that it may respond to 3 or more teeth. Furthermore, it can also be set as the structure which can arrange | position a wire in a connection part and can respond to some distortion. In addition, the shape of the obtaining part may be hemispherical, cylindrical, or convex.
[応用例]
次に、ダブル採得器具を咬合採得に用いる応用例について示す。上述のとおり、外側翼突筋上頭の活動を促しても、口腔内に早期接触があれば中心位(筋肉位)採取の妨げとなる。特に、上下同時治療以外の対合歯が存在する治療では咬合面の凹凸が問題となる。その場合に、術者が口腔内で高さ調整(主に削合)が必要となるため、単純な凸形態の咬合採得器具は調整がしやすく使いやすい場合がある。
[Application example]
Next, an application example in which the double collection tool is used for occlusal acquisition will be described. As described above, even if the activity of the outer pterygoid muscle is promoted, if there is an early contact in the oral cavity, the central position (muscle position) is prevented from being collected. In particular, the unevenness of the occlusal surface becomes a problem in the treatment in which the opposite teeth other than the upper and lower simultaneous treatments exist. In this case, since the surgeon needs to adjust the height (mainly grinding) in the oral cavity, a simple convex occlusal acquisition device may be easy to adjust and easy to use.
ダブル採得器具41、51は、上部採得面44、57が咬合採得部として機能することから、義歯作製の場合などの咬合採得器具として用いることができる。咬合紙ホルダー把持部43、53を咬合紙ホルダーなどにより挟み、患者の口腔内の高さに併せて調整した後、上部採得面44、57に印象材を盛り、咬合採得が必要な咬合床の領域に設置し咬合採得を行う。上部採得面には印象材を載せて咬合採得を行う際に、患者が採得器具を噛み込むことから蝋堤に圧痕が残り、咬合採得後に位置合わせを行うことができる。 Since the upper acquisition surfaces 44 and 57 function as the occlusal acquisition part, the double acquisition instruments 41 and 51 can be used as an occlusal acquisition instrument for the production of dentures. Occlusion that requires grasping of the occlusal paper holder gripping parts 43 and 53 with an occlusal paper holder or the like, adjusted according to the height of the patient's oral cavity, and then placing impression material on the upper acquisition surfaces 44 and 57 Installed in the floor area to obtain occlusion. When an occlusal acquisition is performed by placing an impression material on the upper acquisition surface, the patient bites the acquisition instrument, so that an indentation remains on the wax bank, and alignment can be performed after the acquisition of the occlusion.
ダブル採得器具41、51は、歯列方向に大きさの異なるもののほか、高さの異なるものが用意されていることから、患者の歯の大きさに合わせて適切サイズのものを選択することができる。また、高さに関しては口腔内で削合することにより簡単に高さ調整を行うことができる。咬合床から咬合採得部の頂点までの高さは、2mm〜15mm程度の大きさとなる。ここでは、図5A、5Cに示す器具を用いて咬合採得を行う方法について説明したが、他の形状の器具を用いた場合でも同様に咬合採得を行うことができる。 Since the double-collecting instruments 41 and 51 have different sizes in the dentition direction and different heights, select an appropriate size according to the size of the patient's teeth. Can do. Further, the height can be easily adjusted by grinding in the oral cavity. The height from the occlusal floor to the apex of the occlusal acquisition part is about 2 mm to 15 mm. Here, although the method of performing occlusal acquisition using the instrument shown in FIGS. 5A and 5C has been described, occlusal acquisition can be performed in the same manner even when instruments of other shapes are used.
1…咬合採得器具、2、3、2’…部分歯用咬合採得器具、4…全顎用咬合採得器具、2a、3a、4a…咬合採得部、2b、3b、4b、43、53…咬合紙ホルダー把持部、5、56…小孔、6、8、9…誤嚥防止機構、7…剥離紙、10、25、44、57…上部採得面、11、26、45、58…下部採得面、21…ダブル採得器具、22、31…全顎印象用ダブル採得器具、23、32…部分印象用ダブル採得器具、24、42、52…採得部、22a、23a、32a、33a、62…頬側把持部、22b、32b…舌側把持部、33、34…ワイヤー、41、48…一歯用ダブル採得器具、46、47、59…位置合わせマーク、49…凸部、51、60…複数歯用ダブル採得器具、54、63…連結部、55…載置部、A…咬合紙ホルダー、B…印象材カートリッジディスペンサー DESCRIPTION OF SYMBOLS 1 ... Occlusal acquisition instrument 2, 3, 2 '... Partial tooth occlusion acquisition instrument, 4 ... All jaw occlusion acquisition instrument, 2a, 3a, 4a ... Occlusal acquisition part, 2b, 3b, 4b, 43 53 ... Occlusal paper holder gripping part, 5, 56 ... Small hole, 6, 8, 9 ... Anti-aspiration mechanism, 7 ... Release paper, 10, 25, 44, 57 ... Upper sampling surface, 11, 26, 45 58 ... Lower acquisition surface, 21 ... Double acquisition device, 22, 31 ... Double acquisition device for whole jaw impression, 23, 32 ... Double acquisition device for partial impression, 24, 42, 52 ... Acquisition unit, 22a, 23a, 32a, 33a, 62 ... buccal gripping part, 22b, 32b ... lingual gripping part, 33, 34 ... wire, 41, 48 ... single tooth double picking instrument, 46, 47, 59 ... positioning Mark, 49 ... convex part, 51, 60 ... double-tooth collecting instrument for multiple teeth, 54, 63 ... connecting part, 55 ... mounting part, A ... Slip sheet holder, B ... impression material cartridge dispenser
Claims (9)
硬質素材からなり、
一方の面に咬合採得を行う上部採得面と、
他方の面に咬合採得を行う、又は印象採得を行う下部採得面とを有する採得部と、
頬側に設けられた咬合紙ホルダー把持部を備える採得器具。 A partial tooth collection device having a length corresponding to the number of teeth to be prosthetic treated,
Made of hard material,
An upper acquisition surface that performs occlusal acquisition on one surface;
An acquisition part having an occlusal acquisition on the other side, or a lower acquisition side for taking an impression; and
A harvesting instrument comprising an occlusal paper holder grip provided on the buccal side .
一方の面に咬合採得を行う上部採得面と、
他方の面に印象採得を行う下部採得面とを有する採得部と、
咬合紙ホルダー把持部を備える採得器具であって、
前記採得部が患者の歯冠に類似した形状である採得器具。 Made of hard material,
An upper acquisition surface that performs occlusal acquisition on one surface;
A-taking section having a lower adoption resulting surface performing impression adopted to give the other surface,
A harvesting instrument comprising an occlusal paper holder gripping part ,
A harvesting instrument in which the harvesting part has a shape similar to a dental crown of a patient.
前記下部採得面で印象採得を行う採得器具であって、
対合歯、又は咬合床と点接触するように前記上部採得面が1若しくは複数の凸状、又は平面状に形成されている請求項1記載の採得器具。Occlusal acquisition on the upper acquisition surface for each tooth ,
A harvesting instrument for taking an impression on the lower gathering surface,
The acquisition instrument according to claim 1 , wherein the upper acquisition surface is formed in one or a plurality of convex shapes or a planar shape so as to make point contact with an opposing tooth or an occlusal floor .
前記採得部が略平坦な部材からなる請求項1記載の採得器具。A harvesting instrument that performs occlusal harvesting on the upper harvesting surface and the lower harvesting surface,
The harvesting instrument according to claim 1, wherein the harvesting part is made of a substantially flat member.
異なる大きさのものが用意されている請求項1〜5のいずれか1項記載の採得器具。To be able to select according to the size of the patient's jaw,
The harvesting instrument according to any one of claims 1 to 5, wherein those having different sizes are prepared.
請求項1〜7のいずれか1項記載の採得器具。The harvesting instrument according to any one of claims 1 to 7, further comprising an accidental ingestion prevention mechanism.
前記上部採得面、及び前記下部採得面に印象材を載置し、
患者の上下の歯の咬合採得、又は咬合採得と印象採得を同時に行う採得法。
Grabbing the occlusal paper holder gripping part of the harvesting instrument according to any one of claims 1 to 8,
An impression material is placed on the upper acquisition surface and the lower acquisition surface,
An acquisition method in which the patient's upper and lower teeth are occluded or the occlusion and impression are acquired simultaneously.
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JP2017022376A Active JP6174829B1 (en) | 2017-02-09 | 2017-02-09 | Harvesting equipment |
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WO2018225355A1 (en) * | 2017-06-09 | 2018-12-13 | 栄二 山口 | Occlusion recording instrument and articulator |
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JPS6099915U (en) * | 1983-12-14 | 1985-07-08 | 塩田 博文 | Dental clearance checker |
JP2003245290A (en) * | 2002-02-25 | 2003-09-02 | Satoshi Ishikawa | Bite block using thermoplastic material |
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JP2005521469A (en) * | 2002-03-25 | 2005-07-21 | スリーエム イノベイティブ プロパティズ カンパニー | Dental impression tray with impression material retainer |
JP2008508080A (en) * | 2004-08-02 | 2008-03-21 | ディスカス デンタル インプレッションズ インコーポレーテッド | Tooth impression tray |
JP3143427U (en) * | 2008-05-09 | 2008-07-24 | 斎史 杉本 | Dental clearance plate and measuring device |
JP2013031525A (en) * | 2011-08-01 | 2013-02-14 | Hideo Katase | Maxillary and mandibular relation obtaining set |
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JPS6099915U (en) * | 1983-12-14 | 1985-07-08 | 塩田 博文 | Dental clearance checker |
US20030198917A1 (en) * | 2000-04-25 | 2003-10-23 | Align Technology, Inc. | Methods and systems for modeling bite registration |
JP2003245290A (en) * | 2002-02-25 | 2003-09-02 | Satoshi Ishikawa | Bite block using thermoplastic material |
JP2005521469A (en) * | 2002-03-25 | 2005-07-21 | スリーエム イノベイティブ プロパティズ カンパニー | Dental impression tray with impression material retainer |
JP2003275225A (en) * | 2002-03-26 | 2003-09-30 | Takeshi Kato | Ready-made tray for maxilla teeth |
JP2008508080A (en) * | 2004-08-02 | 2008-03-21 | ディスカス デンタル インプレッションズ インコーポレーテッド | Tooth impression tray |
JP3143427U (en) * | 2008-05-09 | 2008-07-24 | 斎史 杉本 | Dental clearance plate and measuring device |
JP2013031525A (en) * | 2011-08-01 | 2013-02-14 | Hideo Katase | Maxillary and mandibular relation obtaining set |
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WO2018225355A1 (en) * | 2017-06-09 | 2018-12-13 | 栄二 山口 | Occlusion recording instrument and articulator |
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WO2018147157A1 (en) | 2018-08-16 |
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