JPH0622505B2 - Intraoral mandibular retainer - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION <Industrial field of application> The present invention relates to an intraoral lower jaw 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 tongue base.To prevent such obstruction of the upper airway, insert it into the patient's oral cavity. An intraoral lower jaw holder used.

<Prior art> In a patient who is in a coma due to general anesthesia or brain disorder,
To prevent obstruction of the upper respiratory tract due to subsidence of the tongue base, conventionally,
In general, a patient in a supine position has a cervical region extended, the lower jaw is placed on the outside of the cheek, and the upper and lower corners of the lower jawbone (lower jaw angle) are supported by fingers and lifted up. Specifically, for example, when a face mask is applied to the face to inhale oxygen or anesthetic gas, the mask is pressed with the first and second fingers so as to be in close contact with the patient's face, and at the same time with the fourth finger and the second finger. The five fingers were used to hold the corner of the mandible upward. However, such manual mandibular retention requires the operator's constant attention and effort,
In addition, since both hands or one hand cannot be released, it is difficult to perform other medical treatments and it is impossible to perform for a long time, and fatigue of the operator's arm and fingers is also a serious problem.

Moreover, it is technically difficult to continue to open the upper airway while extending the neck by placing fingers on the corners of the lower jaw, which has less snags, and the individual differences among patients are large, so the experience and training efforts of the operator are required. there were.

In addition, a device called a oropharyngeal airway, which is formed into a curved shape according to the shape of the upper airway from the oral cavity to the pharynx, is inserted into the oral cavity, and it is formed inside or near the airway while preventing the tongue base from sinking at its tip. There is a method of passing the absorbing gas through the space that is formed. Furthermore, there is also a method in which a hollow soft tube, that is, a nasopharyngeal airway is inserted from one nostril through the nasal cavity to the pharynx to perform a similar function.

However, in the former method, the airway is not fixed in the oral cavity, and in the latter method, since the material is soft, the force is not sufficient to sufficiently lift the tongue base, and thus the tongue base is retained. Was often inadequate, and subsidence of the base of the tongue occurred in the pharynx, resulting in insufficient open airway. In addition, there were many problems that it did not last long even if it was opened.

On the other hand, if you apply force by manually lifting the tongue base in the direction of the airway, the airway will be maintained in a sufficiently open state, but this not only makes it impossible to use the face mask, but also constantly uses one hand. Since it is occupied, only limited operations such as suctioning can be done for a short time. In addition, a manual operation in which the center of the mandibular arch is sandwiched between the dentition or both the alveolar side and the chin portion and held between the fingers is also a reliable means for raising the mandible, but this is also the same as in the above case. Applicable only to

It is also possible to put the tip of the airway deep enough into the pharynx, but in this case the airway is easily maintained, but side effects such as blood pressure and cerebral pressure increase due to strong stimulation to the living body, This is a problem because the patient may induce the vomiting reflex and exhale the airway.

There is also a method of inserting an endotracheal tube, but in this case, although the airway can be sufficiently secured, problems such as irritation in the trachea and discomfort and many sputum after use of the tracheal tube are problems, Moreover, endotracheal intubation requires special skills of doctors and special instruments, so its application is limited. There is also a method of performing a tracheotomy, but it is safe in terms of airway maintenance, but it requires special surgery and complications such as dysphonia during use are unavoidable, so its application is further Limited.

<Problems to be Solved by the Invention> The present invention has been made in view of the above circumstances, and can automatically and continuously hold the lower jaw from the mouth, and the mechanism is simple, easy to use, and excellent in safety. Moreover, it is an object of the present invention to provide an economical intraoral lower jaw holder.

<Means for Solving the Problems> The present invention is an intraoral lower jaw holder for solving the above problems,
A substantially U-shaped upper jaw support part that is locked and fixed to the upper jaw teeth and / or alveolar, a substantially U-shaped lower jaw support part that is locked and fixed to the lower jaw tooth and / or alveolar, and both of the support parts. It comprises a pair of connecting arms connecting the opposite end portions in a bridge manner and connecting and holding the both supporting portions so as to face each other, and the pair of connecting arms are from the both supporting portion sides to the connecting arm side. The structure is characterized in that it is formed so that it can be elastically bent in the force direction by a force directed toward.

<Operation> Since the intraoral lower jaw retainer of the present invention is configured as described above, the retainer (A) is formed on the front portion of the upper jaw support portion (12) as shown in FIG. 4, for example. After inserting the maxillary tooth (B) into the groove (42) corresponding to the maxillary tooth that has been fixed and then pushing the mandible support part (22) backward, the connecting arm (32) bends backward, so the mandible support part (22) is inserted into the oral cavity, and by inserting the lower jaw tooth (C) into the lower jaw tooth-corresponding groove (52) formed in the front surface portion thereof, the lower jaw support portion (22) can be easily moved to the lower jaw tooth (C). ) Can be fixed to.

Further, the lower jaw supporting part (22) fixed to the lower jaw tooth (C) is acted by elastic force from the connecting arm (32) to return to its original state (elastic force), so the lower jaw tooth (C) Is pushed forward and downward by the elastic force of the connecting arm (32). Therefore, since the temporomandibular joint moves in the same manner as in the case of active opening, the tongue base does not sink and the airway is sufficiently secured (see FIG. 5).

<Example> Next, the Example of this invention is described based on drawing.

FIG. 1 is a perspective view of an intraoral lower jaw holder according to an 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 view for explaining the usage status of the holder shown in FIG.

As shown in FIGS. 1 and 2, the holder (A) of the present invention
Is an upper jaw fixed part (1) fixed to the upper jaw, a lower jaw fixed part (2) fixed to the lower jaw, and these supporting parts (1) and (2) are bridge-connected at opposite ends. A pair of connecting arms (3), (3)
It consists of

The upper jaw support portion (1) and the lower jaw support portion (2) are in a positional relationship such that they are opposed to each other with a predetermined distance, and the connecting arm
(3) and (3) are connecting arms (3) and (3) from the side of both support parts (1) and (2).
It is formed so that it can be easily bent in the force direction by a force toward the side, that is, a force in the arrow (X) direction shown in FIG.

The upper jaw support portion (1) includes upper teeth and / or alveolar (hereinafter,
It is a portion to be locked and fixed to (represented by upper jaw teeth), and is formed in a substantially U shape corresponding to the upper dental arch. Further, means for locking and fixing to the maxillary tooth is provided in the arcuate portion of the central part thereof, and in FIG. 1, the maxillary tooth corresponding groove (4) suitable as the locking and fixing means to this maxillary tooth is illustrated. ing. The upper jaw tooth corresponding groove (4) is a substantially U-shaped groove corresponding to the upper dental arch, and is formed by providing two vertically parallel walls on a flat substrate. Insert the maxillary tooth into this groove and hold the maxillary tooth between the anterior wall (4a) and the posterior wall (4b) that make up the groove (4) to firmly fix the maxillary support part (1) to the maxilla. can do.

Although various other locking and fixing means can be considered, an upper jaw tooth corresponding hole (41) as shown in FIG. 3 is also suitable in addition to the upper jaw tooth corresponding groove (4).

The maxillary tooth corresponding hole (41) is a substantially U-shaped hole corresponding to the maxillary dental arch opened on a flat base plate, and two walls perpendicular to the base plate formed according to the shape of the hole, Front wall (41a) and rear wall
(41b), insert the maxillary tooth into the maxillary tooth corresponding hole (41),
The upper jaw support (1) is fixed to the upper forehead by holding the upper jaw teeth between the front wall (41a) and the rear wall (41b). Then, when the upper jaw tooth corresponding hole (41) is adopted as the locking and fixing means, the shape of the upper jaw support portion (1) can be formed in a canopy shape that matches the shape of the palate, which is more reliable. Can be fixed to the upper jaw.

The lower jaw support (2) is a lower jaw tooth and / or an alveolar (hereinafter,
It is a portion to be locked and fixed to (represented by lower jaw teeth), and is formed in a substantially U shape corresponding to the lower jaw dental arch. A means for locking and fixing to the lower jaw tooth is provided in the arcuate portion of the central portion, and in FIG. 1, a lower jaw tooth corresponding groove (5) suitable as a locking and fixing means to the lower jaw tooth is illustrated. ing. As a means for locking and fixing to the lower jaw teeth, a lower jaw tooth corresponding hole (51) as shown in FIG. 3 is also suitable.

The functions and configurations of the lower jaw tooth-corresponding groove (5) and the lower jaw tooth-corresponding hole (51) are the same as those of the upper jaw tooth-corresponding groove (4) and the upper jaw tooth-corresponding hole (41), respectively, and will not be described.

Regarding the material for forming the upper jaw support portion (1) and the lower jaw support portion (2), the substrate portion is preferably made of hard synthetic resin or metal that is difficult to deform, and the groove (4) as the locking and fixing means, The walls (4a), (4b), (5a), and (5b) of (5) can absorb the fixed difference such as the size and shape of the tooth row due to the flexibility of the material. A material having elasticity is suitable. Examples of materials having spring elasticity include resins such as polypropylene, polyethylene, and polycarbonate, and JIS G4801.
Examples of the steel material for springs and metal materials such as brass, nickel silver, phosphor bronze, etc.

The connecting arm (3) connects the opposite ends of the upper jaw support section (1) and the lower jaw support section (2) just like a bridge.
Both supporting parts (1) and (2) are connected by a pair of connecting arms (3) and (3) at positions facing each other with a predetermined space. Since the connecting arm (3) is formed so as to be able to bend in the rearward direction, that is, in the direction of the arrow (X) in FIG. 2, the upper jaw support portion
After the (1) is fixed to the upper jaw, the lower jaw support part (2) can be pressed and fixed to the lower jaw to be fixed. After the lower jaw support (2) is fixed, the elastic force of the connecting arm (3) to return to the lower jaw support (2), that is, the force opposite to the arrow (X) in FIG.
Since the lower jaw tooth is pushed forward by the rear wall (5b) of the lower jaw tooth corresponding groove (5), it is possible to prevent the lower jaw from retreating and the tongue base to sink and the airway to be blocked.

As for the material for forming the connecting arm (3), at least the core material is preferably a material having spring elasticity. Specifically, for example, a resin such as polypropylene, polyethylene, or polycarbonate, or a spring specified in JIS G 4801 is used. Metal materials such as steel, brass, nickel silver and phosphor bronze (thin plates) are used. And the shape of the connecting arm (3) is
When the lower jaw support part (2) is pushed backward, it can be bent backward, so that the force direction surface is formed flat with a thin wall, and both support parts (1) and (2) are connected. The shape is preferably a U-shape as shown in FIG. 2, but it may be a V-shape or a U-shape.

The intraoral lower jaw holder is basically configured as described above, but in the relationship of being inserted into the oral cavity, both support parts (1),
It is preferable to cover the contact portion of (2) with the oral cavity with a rubber-like elastic body such as natural rubber, urethane rubber, neoprene rubber, or silicone rubber.
It is preferable to cover the whole (A) with a rubber-like elastic material.

In addition, particularly when the upper jaw and the lower jaw are sandwiched, that is, the walls (4a) of the groove (4) and (5) (4a), (4b), (5a), and (5b) are covered with a rubber-like elastic body, It is preferable to relatively thickly cover the side in contact with the teeth from the viewpoint of absorbing individual differences in the size and shape of the dentition.

Incidentally, the entire holder (A) may be made of a rubber-like elastic body,
In this case, it is necessary to form the butyl rubber or the butadiene rubber which is relatively hard to have a relatively large thickness, and it is particularly necessary to firmly form the upper and lower locking and fixing means.

In addition, at least the core of the holder (A) may be integrally formed of, for example, polypropylene or the like, or may be formed by connecting individual parts separately.

Next, a method of using the holder (A) of the present invention will be described with reference to FIG.

First of all, the holder (A) is inserted into the oral cavity, and the maxillary tooth (C) is fitted into the maxillary tooth corresponding groove (42) of the maxillary supporting part (12), and the maxillary supporting part (12)
To the upper jaw. Next, when the lower jaw support portion (22) is pushed backward, that is, toward the throat, the connecting arm (32) bends backward, so that the lower jaw support portion (22) enters the oral cavity. So the lower jaw support (22)
Insert the lower jaw support groove (52) into the lower jaw support groove (52) by inserting the lower jaw support groove (52) into the lower jaw support groove (52) until the lower jaw support groove (52) reaches the position of the lower jaw tooth (C). Can be fixed to the lower jaw.

<Effects of the Invention> As is apparent from what has been described above, when the intraoral lower jaw holder of the present invention is used, the lower jaw is pushed mainly by the forward force from within the oral cavity, which causes movement of the temporomandibular joint. Since this is just the same as in the case of active opening, it is possible to effectively prevent the airway of a patient under general anesthesia or in a coma from being blocked.

Further, since the lower jaw support portion can be pushed and fitted to the lower jaw, it can be easily attached to the oral cavity.

[Brief description of drawings]

FIG. 1 is a perspective view of an embodiment of the present invention, and FIG.
FIG. 3 is a side view of the holder, and FIG. 3 is a perspective view of another embodiment. FIG. 4 is an explanatory view of the usage of the holder shown in FIG. 1, and FIG. 5 is a comparative explanatory view of the passive movement of the temporomandibular joint and the active movement of the temporomandibular joint. <Explanation of main symbols> A: Holder, B: Upper jaw tooth C: Lower jaw tooth 1,11,12: Upper jaw support 2,21,22: Lower jaw support 3,31,32: Connecting arm

Claims (5)

[Claims] 1. A device, which is used by being inserted into the oral cavity to prevent subsidence of the base of the tongue in a patient under general anesthesia or in a coma, which is a substantially U-shaped upper jaw locked and fixed to the upper jaw teeth and / or alveolar The support portion, the substantially U-shaped lower jaw support portion that is locked and fixed to the lower jaw teeth and / or the alveolar bone, and the opposite ends of the both support portions are bridge-connected to each other so that the both support portions are It is composed of a pair of connecting arms that are connected and held so as to face each other, and the pair of connecting arms can be elastically bent in the force direction by a force directed from the both supporting portion sides toward the connecting arm side. An intraoral lower jaw holder characterized by being formed so that it can be formed. 2. The intraoral mandible according to claim 1, wherein the connecting arm is formed of a resin having spring elasticity, and at least the contact portions of both supporting portions with the inside of the oral cavity are covered with a rubber-like elastic body. Holding device. 3. The oral cavity according to claim 1, wherein the connecting arm is formed of a metal material having spring elasticity, and at least the contact portions of both supporting portions with the oral cavity are covered with a rubber-like elastic body. Lower jaw holder. 4. The intraoral mandibular retainer according to claim 1, wherein the entirety is formed of a rubber-like elastic body. 5. The intraoral mandibular holder according to claim 1, wherein the connecting arm is formed to be thin and flat in the force direction.