JP6637751B2 - Pediatric tooth protection device - Google Patents

Description

  TECHNICAL FIELD The present invention relates to a tooth protection device for tracheal intubation for preventing anterior teeth from being compressed or impacted by a laryngoscope during tracheal intubation, and more particularly to a pediatric tooth protection device adapted for tracheal intubation to children. .

  Tracheal intubation is a common procedure that can be performed by an anesthesiologist and a certified intubation rescue technician in addition to anesthesiologists to ensure respiratory management for rescue patients such as cardiopulmonary arrest and cardiopulmonary arrest during general anesthesia . And usually, this tracheal intubation is to expand the larynx using a laryngoscope whose distal end is curved into an L shape, and intubate the endotracheal tube there while visually checking the glottis, When deploying the larynx with a laryngoscope inserted from the oral cavity, the laryngoscope is rotated so that the grip of the laryngoscope is tilted to the upper jaw side, so that the laryngoscope may accidentally hit the upper anterior teeth strongly. In addition, there are many cases in which the upper anterior teeth are damaged due to the impact or the compression, for example, the rotational operation with the upper anterior teeth as a fulcrum may be actively performed because of the ease of operation.

  In particular, in the case of securing the airway for an emergency patient, since it is a time-consuming procedure, the intubation of the tube is given priority, so the consciousness for the protection of the front teeth may be neglected, and the concern about the front tooth damage increases. I have. For children, it is particularly difficult because the oral cavity is small and the tongue is relatively large.In addition, the risk of anterior teeth damage is greater because milk teeth are thinner and softer in enamel and dentin compared to permanent teeth .

  Therefore, as a device for the purpose of preventing the front teeth from being damaged by the laryngoscope or to compensate for the loss of the front teeth, it has been conventionally used on the rear end side surface (blade portion) of the laryngoscope main body to prevent human beings from using it. A laryngoscope has been proposed in which a tooth protection member made of an elastomer having a predetermined thickness and having a predetermined hardness and elasticity is detachably attached to a portion corresponding to a fitting surface of an upper anterior tooth. (Patent Document 1)

  However, in this laryngoscope, there is a problem that a special laryngoscope having a blade portion to which a tooth protection member can be attached and detached is not required and is not versatile, and that the configuration of the laryngoscope becomes complicated and the equipment becomes expensive. . Therefore, as a device such as a mouthpiece that is used by covering the maxillary dental arch prior to tracheal intubation using a laryngoscope, the shape is adapted to the shape of the maxillary dentition by elastic and flexible resin. The part that is curved and shaped to have a concave cross-section, and where the device and the laryngoscope are likely to come into contact and receive impact or pressure, are formed thicker or harder than the non-contacting part. An anterior tooth protection device configured with a reinforcing portion at the site has been proposed. (Patent Documents 2 and 3)

According to this anterior tooth protection device, the concave portion of the device is fitted to the patient's upper dental arch, and the device is covered with the dental arch, so that the elastic and flexible protective device becomes a cushioning material, It is possible to reduce the impact and pressure when the laryngoscope is rotated, and further, the operation with the anterior teeth as a fulcrum, when contacting the anterior teeth, thereby reducing the possibility of anterior tooth damage. In addition, when the anterior tooth has a defect, by covering the device, the laryngoscope does not fit into the defect part, so that the inconvenience of laryngeal expansion due to the anterior tooth defect can be eliminated.
In addition, the device has many other advantages as follows.
-In use, it is suitable for emergency only because it only covers the upper dental arch of the patient without any hassle and has no time.
・ Since it can be used as described above, it can be used for any laryngoscope, and it is made of elastic and flexible resin, and the degree of curvature of the device can be changed by fingers. In addition, since the device can be fitted according to the shape of the dental arch of a patient, a highly versatile device can be obtained.
・ Since the shape and structure are simple, it can be manufactured in large quantities and inexpensively by, for example, resin molding.

Japanese Utility Model Publication No. 4-114302 JP 2009-279043 A JP 2013-27499 A

  However, when looking at tracheal intubation in children, the situation in the oral cavity differs from adults, such as the extremely small mouth and relatively large tongue of children, and unlike the permanent teeth of adults, the deciduous teeth of children are small, In addition to being soft, the upper anterior teeth to be protected during tracheal intubation tend to grow diagonally forward with respect to the gums, and the upper lip zone, which is a characteristic of children, is thick and long. For this reason, there is a concern about stable mounting simply by applying the above-described conventional appliance for reducing the size of the tooth protection device, and it is not applicable.

  Accordingly, the present invention provides a method for preventing the damage of the upper anterior teeth by a laryngoscope during tracheal intubation to a child and maintaining a stable fit to the teeth. It was an object to provide a compatible tooth protection device.

Tooth protection device of the present invention, the U-shape adapted both wings opened dental arch of the upper jaw dentition and, bottom and sides to form a part of the fitting can be cross to the upper dental as concave A device body made of a flexible resin and a reinforcing portion for protecting a front tooth tip provided at a central portion of a bottom portion of the device body so as to protrude from an outer surface, and a front wall portion abutting on a tooth row front side. In the tooth protection device for tracheal intubation, which has a cutout in the region sandwiching the upper lip zonule, the region corresponding to the back teeth of the device wings without providing the back side wall contacting the back of the dentition at the region corresponding to the front teeth , And a portion corresponding to the front teeth at the center portion of the front side wall portion abutting on the front side of the tooth row is formed to be inclined inward at an angle of 55 ° or more and 65 ° or less with respect to the bottom surface .

Further, it is preferable that each part is formed as follows.
The front side wall portion that contacts the front side of the tooth row is formed so that the front tooth contact side of the central portion is higher than the back tooth contact side of both wings.
The notch provided in the portion sandwiching the upper lip zone of the front side wall portion, the deepest portion is set to a depth that matches the bottom inner surface of the device body, or the front side wall portion is divided at the center, Alternatively, the depth may be set so that the deepest portion of the cutout portion is greater than 0 mm and less than or equal to 5 mm from the inner surface of the bottom of the device main body, and the front side wall portion is divided while leaving a part at the center.

(Action)
According to the pediatric tooth protection device of the present means, similarly to the above-mentioned conventional tooth protection device, the protection device serves as a cushioning material, which can reduce impact and pressure on the upper anterior teeth and reduce the possibility of frontal tooth damage. In addition to the functions such as being able to perform, the rear side wall portion that contacts the back side of the dentition is provided only at the portion corresponding to the back teeth of both wings, and the central portion corresponding to the front teeth has no wall portion, so that the characteristics of the child's teeth The device is adapted to the condition in which the front teeth are small (short), tend to grow diagonally forward with respect to the gums, and the height of the teeth downward from the gums on the back of the front teeth is extremely short. There is a concern that this may occur due to individual differences due to the presence of the anterior tooth back side wall when fitting the dentition to the dentition, a state where the wall cannot be properly fitted to the front teeth due to obstruction, a wall due to excessive fitting Contact with the gums It is possible to prevent troubles such instability mounted vice in advance, a highly versatile device against children.

By forming the front teeth side of the front side wall portion higher than the back teeth side, the shape of the device conforms to the shape of the dentition in which the front teeth are longer than the back teeth, and the fitting state of the front teeth and the back teeth is well balanced. .
In addition, when fitted to the dentition, the deepest part of the cutout provided in the region sandwiching the upper lip band is deepened to the bottom inner surface and the front side wall is divided at the center, or 0 mm larger than 5 mm or less from the bottom inner surface. If you set it deeply and cut off the middle part of the epicardial wall, it will get into the long, long upper lip zone characteristic of children with insufficient maxillary growth, for example, between teeth Even in this case, it is suitable for fitting avoiding this, and the wall hits the upper lip girdle so that it cannot be fitted properly, or the wall may damage the upper lip girdle The danger of doing can be prevented.
If the notch is larger than 5 mm, the possibility of hitting the upper lip band when fitted is increased.
Further, when the tooth contact surface at the center of the tooth row side wall portion is inclined inward at an angle of 55 ° or more and 65 ° or less with respect to the bottom surface, the above-described upper anterior teeth (tooth to gum) of the child can be obtained. A conforming form is adopted in conformity with the tendency of slanting toward the front, which is a feature of the way of growth, and the clamping effect is enhanced when clamping in cooperation with the back wall of the back teeth, and stable fitting is possible.
If this angle is smaller than 55 ° or larger than 65 °, the difference from the form of a typical child's upper anterior tooth becomes larger, so that the contact surface with the anterior tooth when fitted is reduced. For example, there is a concern that the fitting feeling may be deteriorated, and the holding effect in cooperation with the posterior side wall portion may be unbalanced, thereby impairing the mounting stability.

  According to the pediatric tooth protection device of the present invention, the above-mentioned configuration and operation prevent damage to the upper anterior teeth by a laryngoscope at the time of tracheal intubation to a child and realize a stable fit state to the teeth in general. By doing so, tracheal intubation in children can be performed more safely.

1 is an overall configuration diagram showing an embodiment of the present invention. The top view and bottom view of the said embodiment. The front view and back view of the said embodiment. FIG. 3 is a side sectional view of the embodiment.

  The pediatric tooth protection device according to the present embodiment is an operation for deploying the larynx using a laryngoscope during tracheal intubation for a child, so that the upper anterior teeth are not damaged by mistake before the tracheal intubation. Of the laryngoscope and the teeth, and is used as a shock absorber to prevent strong contact between the teeth and the laryngoscope.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 shows a pediatric tooth protection device according to an embodiment of the present invention, which is shown as a perspective view in which the bottom surface is drawn upward.
The device of this example is formed in a U-shape (parabolic shape) in which both wings are open so as to fit the upper dental arch of a child as a whole shape, and the cross section of the both wing portions is formed as a concave shape into which the back teeth are fitted. Device main body 1 and a grid-like rib 2 formed as a concave-convex surface of a grid-like projection at a central portion on the front surface side of the concave bottom portion 13 and protecting a front end of a front tooth when fitted to a tooth row. Is provided so that a certain degree of strength (hardness) can be maintained from the viewpoint of protecting teeth (especially front teeth), and a parabolic curve formed by fingers can be adapted to a patient's dental arch to be deformable. The whole was integrally formed of a resin having properties (an EVA resin in this example).
In addition, as described above, the resin forming the instrument has a certain strength (hardness) and flexibility, and also has a property of sliding without being caught when it comes into contact with the laryngoscope. It is preferable to use a material that is easy and has a small frictional resistance, and the EVA resin (ethylene-vinyl acetate copolymer resin) or a styrene-based elastomer used in this example is suitable.

Next, each part will be described in detail.
2 and 3 are external views of the present embodiment. FIG. 2A is a top view, FIG. 2B is a bottom view, FIG. 3A is a front view, and FIG. 3B is a rear view, and FIG. The side view of the section by DD shown is shown.
The device main body 1 has an overall shape along the curvature of the dental arch from the anterior teeth to the posterior teeth of a child, and has a depth of about 30 to 40 mm like a mouthpiece attached to only the upper jaw (example, about 35 mm). Is formed as a symmetrical parabolic shape with both ends open, and the tooth surface located between the front side of the fitted tooth and the upper lip so that the entire upper teeth and gums can be sandwiched and covered from the front and back surfaces and fitted. A side wall part 11, a tooth back side wall part 12 corresponding to the back side of the tooth, a bottom part 13 for covering and protecting the tooth tip, and teeth and gums which are three inner surfaces of the two wall parts 11, 12 and the bottom part 13 are accommodated. Of the recess 10 to be formed. The height of the front side wall portion 11 is formed larger than that of the back side wall portion 12, and the height HF of the front tooth side F (the central part of the device) is changed to the back tooth side B in consideration of the lengths of the front teeth and the back teeth. (At both ends of the device).
In addition, the height of the wall portion in the present embodiment is set to be about 12 mm at the longest portion HF which is the central portion (excluding the cutout portion 14) of the front side wall portion 11, and is inclined toward the back tooth side to reduce the height. Then, the shortest portion HB as both end portions was formed to be about 8 mm.

  Further, the rear side wall portion 12 is not provided at the portion corresponding to the front teeth, but is provided only at both wing portions corresponding to the back teeth, and the height in this embodiment is opposite to the front side wall portion 11 from the center to both ends. The height is gradually increased by gradually inclining, and it is formed to about 3 mm to 4 mm. Here, if the wall 11 is provided at a position corresponding to the back side of the front teeth, the device is fitted to the back teeth (the upper back teeth are the same as adults and grow below the gums) with the front side wall 11 and the back side wall 12. At the same time, when the front side wall portion 11 is brought into contact with the front teeth, the child teeth are small (short) and the upper front teeth tend to grow obliquely forward with respect to the gums. There are few cases, and depending on the shape of the teeth and gums, the wall may not fit well because it does not conform to the shape of the gum, and conversely, there is a concern that the mounting may become unstable The rear side wall portion 12 is not provided at a portion corresponding to the front teeth.

Further, the angle S formed between the central portion (the portion that comes into contact with the front teeth) of the tooth surface side wall portion 11 and the bottom portion 13 is 55 ° so as to be fitted in conformity with the above-mentioned characteristic of the front teeth growth of the child. To 65 ° (in the present embodiment, 60 °).
Further, a cutout portion 14 is provided at a position above the central portion of the front side wall portion 11 and at a position corresponding to the upper lip band which is fitted to the dentition so as to avoid the upper lip band and to avoid it. Inconvenience due to contact between the upper lip zone and the front wall portion 11 is prevented. In this embodiment, the deepest portion of the cutout portion 14 is cut to the position of the inner surface of the bottom portion 13 in conformity with the thick and long upper lip zonule characteristic of a child, and a groove for dividing the front side wall portion 11 left and right (in this example) Is a V-shaped groove). In addition, the notch part 14 can also set the deepest part to 5 mm or less from the surface of the bottom part 13 in consideration of the length of the front teeth of a child. In this case, there is a possibility that the strength of the wall portion can be kept slightly strong, but if it is larger than 5 mm, there is a concern that the fitting may not be successful due to hitting the upper lip girdle or the upper lip girdle may be damaged. I am concerned.

According to the device main body 1 of the present embodiment, similarly to the conventional tooth protection devices as described in Patent Documents 2 and 3, when the tracheal intubation is performed by a laryngoscope, the device having elasticity and flexibility serves as a cushioning material to the upper anterior teeth. In addition to being able to reduce the impact and compression of the teeth, it is possible to prevent accidental accidents such as damage to the front teeth, and it is suitable for the form of the maxillary dental arch such as the characteristic tendency of children to grow teeth, A stable and stable mounting state can be achieved.
Further, by setting the angle between the tooth surface side wall portion 11 and the bottom portion 13 as described above, a wearing state with a large contact area that fits the shape of a child's upper anterior tooth is prevented, the device is prevented from falling off, and the wearing stability is improved. Can be further increased.

  The grid-like ribs 2 are formed symmetrically in the center of the outer surface of the bottom portion 13 of the device main body 1 over a width of about 35 mm, and are formed along the curved shape of the bottom portion 13 in the longitudinal direction. In the present embodiment, three protrusions (in this embodiment) and short vertical protrusions (five in this embodiment) arranged in a radial direction with respect to the curvature are arranged in a lattice shape to form irregularities. In the embodiment, the height of the protrusion is formed such that the central portion in the lateral direction is larger than the both sides, and the height is configured to be 2 mm to 3 mm.

The central portion of the bottom portion 13 where the lattice-shaped rib 2 is disposed (the portion that protects the tip of the upper anterior teeth) is a portion that is most likely to be impacted by the laryngoscope when the device is covered with the dentition and tracheal intubation is performed. In addition, since it is also a portion that is assumed to be compressed as a fulcrum of the laryngeal deployment operation, the provision of the lattice-shaped rib 2 increases the thickness of the fitting portion, and also causes the larynx to be uneven due to unevenness. It is possible to provide a high tooth protection function capable of dispersing an impact when the mirror comes into contact.
In addition, the structure of the uneven surface formed here is not limited to the lattice shape, and any structure of the uneven surface may be formed as long as the structure has an equivalent effect of dispersing the pressure of the laryngoscope. Is also good.

  Then, the device main body 1 and the grid-like ribs 2 were integrally formed of EVA resin to obtain a child tooth protection device of the present embodiment. According to the device, the device can be fitted to the maxillary dental arch prior to tracheal intubation of the laryngoscope into the child, preventing damage to the maxillary anterior teeth by the laryngoscope and dropping during the procedure in the small oral cavity of the child It is possible to provide a low-cost general-purpose device capable of realizing stable mounting without any problem.

1. Device body 10. Concave section (recess)
11. (Tooth) Front side wall 11A. Front outer surface 11B. 11. Front tooth contact surface (Tooth) Back wall 12A. Back outer surface 12B. 12. Back tooth contact surface Bottom 14. Notch 2. Lattice rib F. Front tooth side B. Back teeth side

Claims (4)

A U-shape adapted both wings opened dental arch of the upper jaw dentition and flexibility made of the bottom to form a part of the fitting can be cross to the maxillary dentition as concave and the front and rear walls A resin device body,
The device body is configured with a reinforcing portion for protecting the front teeth tips provided by projecting from the outer surface at the center of the bottom of the device body,
A tooth protection device for tracheal intubation provided with a cutout portion at a portion sandwiching the upper lip zonule of the front side wall portion abutting on the front side of the dentition,
The back side wall that abuts on the back of the dentition is set only at the site corresponding to the back teeth of both wings of the device,
And site falls front teeth in the central portion of the dentition in contact with the front surface side wall, bottom to 55 ° or more, the tooth protecting pediatric, wherein Rukoto such inclined inwardly at an angle of 65 ° or less device.   2. The child tooth protection device according to claim 1, wherein the front side wall portion abutting on the front side of the dentition is formed so that the front side abutment side of the central portion is higher than the back side abutment side of both wings. Cutout provided at a portion sandwiching the upper lip frenulum of the table side wall portion is set to a depth of the deepest portion is the inner bottom surface of the device body, formed by dividing the table-side wall portion at the center claim 1 2. The pediatric tooth protection device according to any one of claims 1 to 2.   The notch provided at the portion sandwiching the upper lip band on the front side wall is set so that the deepest part is larger than 0 mm and 5 mm or less from the inner surface of the bottom of the device body, and the front side wall part is centered at one point. The pediatric tooth protection device according to any one of claims 1 to 2, wherein the dentition device is divided while leaving a part.

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