JPH01236047A - Lower jaw holder in cavum oris - Google Patents

Abstract

PURPOSE:To prevent blocking the airway of a patient in the middle of general anesthesia or a coma by composing the above holder or upper and lower jaw supporting parts and a pair of connecting arms and forming the connecting arms so that they each can be bent in a springy way in a force direction by means of a force from both supporting part sides towards the connecting arm sides. CONSTITUTION:A connecting arm 3 connects opposite edges of an upper jaw supporting part 1 and a lower jaw supporting part 2 in a condition just to be bridged, and both supporting parts 1 and 2 are linked in a position to be opposed at a prescribed interval by means a pair of connecting arms 3 and 3. Since the connecting arm 3 is formed so as to be bent backward, the upper jaw supporting part 1 is fixed to an upper jaw, and thereafter, the lower jaw supporting part 2 can be fixed by being press-fitted in a lower jaw. After the lower jaw supporting part 2 is fixed, since a springing force, by which the connecting arm 3 intends to return to a former condition, works to the lower jaw supporting part 2 and lower jaw teeth are pressed forward by a rear wall 5b of a lower jaw teeth corresponding groove 5, the lower jaw is made to retreat, a tongue root is made to sink, and the air route can be prevented from being blocked.

Description

DETAILED DESCRIPTION OF THE INVENTION <Industrial Application Field> The present invention relates to an intraoral mandibular holder. For more details,
During general anesthesia or coma, the patient's lower jaw descends due to muscle relaxation and the upper airway is obstructed by the base of the tongue.Intraoral mandibles are inserted into the patient's mouth to prevent this upper airway from being obstructed. Regarding the holder.

<Conventional technology> In patients who are under general anesthesia or in a coma due to brain damage,
In order to prevent obstruction of the upper airway due to the sinking of the base of the tongue,
Generally, the neck of a patient in a supine position is extended, a hand is placed on the mandible from the outside of the cheek, and the corner of the mandible (mandibular angle) is supported with the fingers and lifted upward. Specifically, for example, when applying a face mask to the patient's face to inhale oxygen or anesthetic gas, press the mask tightly against the patient's face with the first and second fingers, and at the same time press the mask tightly against the patient's face with the fourth and second fingers. The angle of the mandible was held upward with the five fingers. However, such adversarial mandibular holding requires constant attention and effort from the surgeon.
In addition, since both hands or one hand cannot be separated, movement is restricted, other medical treatments are difficult to perform, and it is impossible to perform the procedure for a long period of time, which causes fatigue in the surgeon's arms and fingers (which is a problem).

Moreover, it is technically difficult to keep the upper airway open while extending the neck by placing one's fingers on the angle of the mandible, where there is little chance of getting caught, and since there are large individual differences between patients, the experience and training efforts of the surgeon are required. there were.

In addition, an instrument called an oropharyngeal airway, which is curved to match the shape of the upper respiratory tract from the oral cavity to the pharynx, is inserted into the cavity, and its tip prevents the base of the tongue from sinking while allowing the inside and vicinity of the airway to be inserted. There is a method of passing breathing gas through a space formed in the Additionally, a soft hollow tube, or nasopharyngeal airway, may be inserted through one nostril into the nasal cavity and into the pharynx to perform the same function.

However, in the former method, the airway is not fixed in the oral cavity, and in the latter method, the material is soft, so the force is often insufficient to sufficiently lift the tongue base. tends to be insufficient
1. The base of the tongue sometimes sank in the pharynx, making it difficult for the airway to open sufficiently. Another problem was that even if they were opened, they often did not last long.

On the other hand, if you apply force in the direction of the airway by lifting the base of the tongue at the tip of the airway, the airway can be kept sufficiently open, but this not only makes it impossible to use a face mask, but also makes it difficult to use one hand constantly. Since it is occupied, operations such as suction can only be performed for a short period of time. In addition, manual operation that lifts the center of the mandibular arch by holding it between the fingers from both sides of the teeth or the alveolar side and the cervical side is a reliable means of mandibular elevation, but as in the case above, this is also a temporary method. It can only be applied to

Another option is to insert the tip of the airway deep enough into the pharynx, but in this case, the airway is easily maintained, but the stimulation to the living body is strong, causing side effects such as increased blood pressure and cerebral pressure. This is problematic because the patient may induce a gag reflex and spit out the airway.

Another method is to insert an endotracheal tube, but in this case, the airway can be sufficiently secured, but problems such as irritation in the trachea and discomfort and excessive sputum production after using the endotracheal tube are problems. Furthermore, endotracheal intubation requires special skills of the physician and special instruments, which limits its application.

Another method is to perform a tracheostomy, which is safe in terms of maintaining the airway, but requires special surgery and complications such as being unable to speak during use are unavoidable.
Its application is further restricted.

<Problems to be Solved by the Invention> The present invention has been made in view of the above circumstances, and is capable of automatically and continuously holding the lower jaw from inside the mouth, has a simple mechanism, is easy to use, and has excellent safety. The purpose of the present invention is to provide an economical intraoral mandibular holder.

<Means for solving the problems> The present invention is an intraoral mandibular holder that solves the above problems,
A substantially U-shaped upper jaw support part that is locked and fixed to the upper jaw teeth and/or the alveolus, a substantially U-shaped lower jaw support part that is locked and fixed to the lower jaw teeth and/or the alveolus, and both of the support parts. The bridge consists of a pair of connecting arms that connect the opposite ends of the bridge and connect and hold both the supporting parts so as to face each other, and the pair of connecting arms are The structure is characterized in that it is formed so that it can be elastically bent in the direction of the force by a force directed from the sub-support part side toward the connection arm side.

Function> Since the intraoral mandibular holder of the present invention is configured as described above, the holder (A) is formed on the front surface of the upper jaw support α, for example, as shown in Fig. 134. After fitting and fixing the maxillary tooth (B) into the maxillary tooth corresponding groove (42), when the mandibular support part (22) is pushed backward,
Since the connecting arm (321) bends backward, the lower jaw support part (22)
By inserting into the oral cavity and inserting the mandibular teeth (C) into the mandibular teeth corresponding grooves (5) formed on the front part,
The mandibular support part (221) can be easily fixed to the mandibular teeth (C).

In addition, the mandibular support part (221) fixed to the mandibular tooth (C) is now subjected to a force (elastic force) that tries to return to its original state due to the elasticity from the connecting arm (321), so the mandibular tooth (C) is connected. arm(
32) is pushed forward and downward by the elastic force.

Therefore, since the temporomandibular joint moves in the same manner as when actively opening the mouth, the base of the tongue does not sink and the airway is sufficiently secured (see Figure 5).

<Example> Next, embodiments of the present invention will be described based on the drawings.

FIG. 1 is a perspective view of an intraoral mandibular holder according to one embodiment of the present invention, FIG. 2 is a side view of the holder of FIG. 1, and FIG. 3 is a perspective view of another embodiment. . Further, FIG. 4 is a diagram illustrating how the holder shown in FIG. 1 is used.

As shown in FIGS. 1 and 2, the holder (A) of the present invention
includes an upper jaw support part (1) fixed on the upper jaw, a lower jaw support part (2) fixed on the lower jaw, and these support parts (1),
It is composed of a pair of connecting arms (3), (3) which connect (2) at opposite ends in a bridging manner.

The upper jaw support part (1) and the lower jaw support part (2) are in a positional relationship such that they face each other at a predetermined distance, and the connecting arms (3), (3) are connected to both support parts (1), The force directed from the side of (2) to the side of connecting arms (3), (3), that is, the second
It is formed so that it can be easily bent in the direction of the force by a force in the direction of the arrow (X) shown in the figure.

The maxillary support part (1) is a part that is locked and fixed to the maxillary teeth and/or alveolus (hereinafter referred to as maxillary teeth),
It is formed approximately in a U-shape to correspond to the upper dental arch. A means for locking and fixing to the maxillary teeth is provided in the central arc-shaped portion, and in FIG. ing.

The maxillary tooth corresponding groove (4) is a substantially U-shaped groove corresponding to the maxillary dental arch, and is formed by providing two vertically parallel walls on a flat substrate.

By inserting the maxillary teeth into this groove and sandwiching the maxillary teeth between the front wall (4a) and the rear wall (4b) that constitute the groove (4), the maxillary support part (1) is firmly fixed to the upper jaw. can do.

In addition, there are various other methods of locking and fixing means that can be considered, such as a hole that is approximately U-shaped and corresponds to the maxillary dental arch, and a hole that is perpendicular to the base plate formed to match the shape of this hole (41b). By holding the maxillary teeth in the maxillary rest, the shape of the maxillary support part (1) can be formed into a canopy shape that matches the shape of the palate, allowing for more reliable fixation with the maxilla. .

The mandibular support part (2) is a part that is locked and fixed to the mandibular teeth and/or alveolus (hereinafter referred to as mandibular teeth),
It is formed approximately in a U-shape to correspond to the lower dental arch. The central arc-shaped portion t is provided with a means for locking and fixing to the mandibular teeth, and FIG. 1 shows a mandibular tooth corresponding groove (5) suitable as the means for locking and fixing to the mandibular teeth. are doing.

In addition, a mandibular tooth corresponding hole (51) as shown in FIG. 3 is also suitable as the means for locking and fixing to the mandibular tooth.

The functions and configurations of the mandibular tooth corresponding groove (5) and the mandibular tooth corresponding hole (51) are as follows.
) and the maxillary tooth corresponding hole (41), so the explanation will be omitted.

Regarding the material for forming the upper jaw support part (1) and the lower jaw support part (2), hard synthetic resin or metal that is difficult to deform is suitable for the base plate part, and grooves (4) as locking and fixing means are suitable.
), (5) walls (4a), (4b), (5a), (5b
), the flexibility of the material can absorb individual differences in the thickness and shape of the dentition, so a material with spring elasticity is suitable for the core material. Examples of materials having spring elasticity include resins such as polypropylene, polyethylene, and polycarbonate, spring steel materials specified in JIS G 4801, and metal materials such as brass, nickel silver, and phosphor bronze.

The connecting arm (3) has an upper jaw support part (1) and a lower jaw support part (2).
The opposite ends of the support parts (1) and (2) are connected to a pair of connecting arms (3) in a manner similar to a bridge.
, (3), they are connected at positions facing each other at a predetermined interval. Since the connecting arm (3) is formed to be able to bend backward, that is, in the direction of arrow (X) in Fig. 2, after fixing the upper jaw support part (1) to the upper jaw,
The mandibular support part (2) can be press-fitted and fixed onto the mandible. In addition, after fixing the mandibular support part (2), the mandibular support part (2) is fixed.
2), the elastic force that causes the connecting arm (3) to return to its original position, that is, the force opposite to the arrow (X) in Figure 2, acts on the mandibular tooth at the rear wall (5b) of the mandibular tooth corresponding groove (5). It pushes the teeth forward
This prevents the lower jaw from receding, causing the base of the tongue to sink and obstructing the airway.

Regarding the material for forming the connecting arm (3), it is preferable that at least the core material thereof has spring elasticity, and specifically,
For example, resins such as polypropylene, polyethylene, and polycarbonate, spring steel materials specified by JIS G 4801, and metal materials (formed in a thin plate shape) such as brass, nickel silver, and phosphor blue are used. and connecting arm (3)
The shape of the mandibular support part (2) is thin and flat in the force direction so that it can bend backward when the mandibular support part (2) is pushed backward. ) are preferably connected in a U-shape as shown in FIG. 2, but they may also be in a dogleg shape or a U-shape.

The intraoral mandibular holder is basically constructed as described above, but since it is used by being inserted into the oral cavity, it has both support parts (1).
It is preferable to cover the part of (2) in close contact with the oral cavity with a rubber-like elastic material, such as natural rubber, urethane rubber, neoprene rubber, or silicone rubber.Practically speaking, the entire holder (A) is covered with rubber. Preferably, the material is coated with a shaped elastic material.

In particular, the walls (4a), (4b), (5a) of the grooves (4) and (5) that hold the upper and lower teeth,
When covering (5b) with a rubber-like elastic material, it is preferable to cover the side that contacts the teeth relatively thickly from the viewpoint of absorbing individual differences such as the size and shape of the tooth row. .

Incidentally, the entire holder (2) may be made of a rubber-like elastic body, and in this case, it is necessary to make it relatively thick with relatively hard butyl rubber or butadiene rubber, especially the upper and lower locking means. need to be firmly established.

The holder (5), at least its core, may be formed entirely of polypropylene or the like, or the individual parts may be formed separately and then connected.

Next, a method of using the holder (A) of the present invention will be explained using FIG. 4.

First, insert the retainer hole into the oral cavity, fit the 4-sided maxillary tooth (C) into the maxillary support part (α), and fit the maxillary tooth (C) into the maxillary support part (α).
12) is fixed to the upper jaw. Next, when the mandibular support part (22) is pushed backwards, that is, towards the throat, the three connecting arms (3) bend backward, so the mandibular support part (22) enters the oral cavity. The mandibular tooth corresponding groove (52) is the mandibular tooth (
The mandibular support part (22) can be easily fixed to the mandible by advancing the mandibular tooth (C) until it reaches the position C) and fitting the mandibular tooth (C) into the mandibular tooth corresponding groove (A).

<Effects of the Invention> As is clear from the above explanation, when the intraoral mandibular holder of the present invention is used, the mandible is pushed mainly by the forward force from within the oral cavity, which reduces the movement of the temporomandibular joint. Since this is exactly the same as in the case of active opening, it is possible to efficiently prevent the airway of a patient under general anesthesia or in a coma from being obstructed.

Furthermore, since the mandibular support part can be press-fitted into the mandible, it is easy to install it in the oral cavity.

[Brief explanation of the drawing]

FIG. 1 is a perspective view of an embodiment of the present invention, and FIG. 2 is a perspective view of an embodiment of the present invention.
FIG. 3 is a side view of the holder, and FIG. 3 is a perspective view of another embodiment. Further, FIG. 4 is an explanatory diagram of the usage situation of the holder shown in FIG. 1, and FIG. 5 is a comparative explanatory diagram of passive temporomandibular joint movement and active temporomandibular joint movement. <Explanation of main symbols> A: Holder B: Maxillary tooth C: Mandibular tooth 1, 11.12: Maxillary support section 2, 21.22: Mandibular support section 3, 31.32: Connection arm':) 1 21 CT:￥a tooth 5th A, passive opening 94 mouth

Claims (1)

[Scope of Claims] 1) An instrument inserted into the oral cavity to prevent the sinking of the tongue base in a patient under general anesthesia or in a coma, which is approximately U-shaped and is latched and fixed to the upper teeth and/or alveolus. a substantially U-shaped mandibular support part that is locked and fixed to the mandibular teeth and/or the alveolus, and opposing ends of both the support parts are connected in a bridging manner, and the two support parts are connected in a bridge manner. It consists of a pair of connecting arms that are connected and held so that the supporting parts face each other, and the pair of connecting arms are elastically bent in the force direction by a force directed from the supporting parts side to the connecting arm side. An intraoral mandibular holder characterized by being formed so that it can be held in place. 2) The connecting arm is made of resin with spring elasticity, and
2. The intraoral mandibular holder according to claim 1, wherein at least the portions of both support portions that are in close contact with the oral cavity are covered with a rubber-like elastic material. 3) Claim 1, characterized in that the connecting arm is made of a metal material having spring elasticity, and at least the portions of both support parts that are in close contact with the oral cavity are covered with a rubber-like elastic material.
Intraoral mandibular retainer as described. 4) The intraoral mandibular holder according to claim 1, characterized in that the entire device is made of a rubber-like elastic material. 5) The intraoral mandibular holder according to any one of claims 1 to 4, wherein the connecting arm is thin and flat in the direction of the force.