JPS62133477A - Skeleton model for oral surgery - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION Field of Industrial Application: The present invention relates to a jawbone model for oral surgery training.

Furthermore, 1: ↑ or detachment of the mucoperiosteal flap [mandibular bone used as a realistic teaching material (appearance, structure, feel during surgery, etc. that gives a realistic feeling) used for training in single-cavity surgery and dental surgery. It is related to models.

Conventional techniques and problems [Surgical techniques in single-cavity surgery and dentistry include the implantation of dental implants (subperiosteal and intraosseous implants) and the construction of a southern cistern using hydroxyapatite for repairing emaciated jawbones. In order to reduce the risk of medical malpractice during surgery, surgical procedures, p order, etc. are performed. It is necessary to become proficient in training, etc.

However, there have been no suitable training models prepared for this type of purpose, and even though there are similar models, the properties of the jawbone and gums and the state of their adhesion are quite different from those in the actual living body. However, when the gingiva νJ is opened, the feel of the periosteum during the 'A female surgery is completely different from the actual one, so it lacks a sense of realism and is not suitable as a teaching model.

We also use the bones of pigs as experimental animals.

I tried to learn the feeling of periosteum ablation and resection surgery, but the bones are different in size and shape compared to humans, so there was no sense of realism.In monkeys, the resistance to periosteal ablation felt quite similar to that in humans. However, not only are they expensive as experimental animals, but their use for learning surgical techniques should be avoided as much as possible from the standpoint of animal welfare.

Because dental implants, intraosseous implants, and alveolar ridge construction using hydroxyapatite are the latest medical technologies, there is an increasing demand for educational models for this type of training.

Means for Solving the Problems In order to meet such demands, it is an object of the present invention to provide a realistic jawbone model for oral surgery that is suitable for use as a teaching material for training.

In order to achieve the above object, the present inventors conducted various trial production studies and found that a composite latex consisting of vulcanizable natural rubber latex and a water-soluble polymer solution or a natural A rubber paste made by dissolving rubber in a rubber solvent is applied and dried to form a layer equivalent to the periosteum, and on top of this is vulcanizable natural rubber latex and a water-soluble polymer solution, so that the dried film has the same color as the oral mucosa. What is Compound Latex ■ using colored Compound Latex II? Essentially, an elastic foam sheet made of a material that is difficult to bond is bonded, and at the same time, Compound Latex II is impregnated into the elastic foam sheet, and Compound Latex II is further added to the L of the elastic foam sheet. By forming a dry latex film with a smooth surface of an appropriate thickness using methods such as dipping, coating, or spraying, the layer corresponding to the gingival-periosteal flap has elasticity, and when the gingival-periosteal flap is incised with a scalpel, The feel, the cutting edge, and the feeling of the peeling resistance when performing the periosteal peeling operation are very similar to the actual one, and it is possible to create a realistic model that does not cut even with N coalescence traction. This discovery led to the completion of the present invention.

DESCRIPTION OF THE EMBODIMENTS OF THE INVENTION Hereinafter, embodiments of the present invention will be explained in detail by taking a mandible model as an example, but it is of course not limited to the mandible model.

The manufacturing procedure will be explained one by one.

First, a model of the mandibular body is made, which will serve as the skeleton of the model.

FIG. 1 shows a mandible replica model body (mandible body) 1 made of a microporous material used in the jawbone model for oral surgery of the present invention, in which an impression material is made using a dry human mandible as a prototype. The same-sized impression taken using the mold was used as a mold and was manufactured using plaster, hydrous polyester, hard urethane foam, etc. The material has a hardness similar to that of bone and has a hardness of 0.
An oven cell type or open cell type having a pore diameter of about 1 to 5 μm is desirable.

In this case, in order to suit the purpose of the training, the jawbone model should be designed to accommodate bone defects due to pathological deformity, alveolar bone resorption after extraction, and disuse atrophy, as well as elements necessary for learning surgical procedures. It is also desirable to express anatomical features such as the shape and fine irregularities on the surface, the foramen foramen, the fL, the prominence of the mandible, and the temporomandibular joint process.

The mandible model body (mandibular body) 1 is equipped with a core material such as wire (4 in Figures 1 and 2) for the purpose of supporting and reinforcing the body when processing the covering corresponding to the gums to be attached on top of it. ).

FIGS. 2(a) and 2(b) are cross-sectional views taken along line A-A in FIG. 1, and FIG. 2(a) shows only the core material 4 embedded. (b) shows an example in which a porous body part 5 is embedded in the center of the mandibular body for the purpose of expressing cancellous bone, if necessary.

Next, a red substitute 3 representing the inferior cisterna neurovascular bundle running from the foramen 2 toward the lower border of the mandible is attached. Alternative 3 is a red thin string or filament, such as a vinyl string,
Vinyl pipes, vinyl wires, vinyl-coated wires, etc. can be used.

The tissues surrounding the human jawbone consist of the gingiva or mucoperiosteal flap, which consists of periosteum, mucosal lamina propria, and epithelial tissue (see 6.7.8 in Figure 4 below), and the periosteum. The 'A' of the periosteum is firmly attached to the bone by the Sharpie fibers that enter the bone from the periosteum.
A considerable amount of force is required when performing surgery.

When creating a periosteum model according to the present invention, during the practice of dissection surgery between the periosteum and bone, the model shows the gap between the jawbone model body (mandibular body) 1 and the covering body corresponding to the gingiva attached thereon. In order to approximate the force required for peeling (peeling resistance) and create a sense of realism, we used vulcanizable natural rubber latex to act as the periosteum and Sharpie fibers. Compound latex I (composition shown in Table 1) consisting of a mixed solution of water-soluble polymer solution or rubber paste prepared by dissolving natural rubber in a rubber solvent is used.

The vulcanizable natural rubber latex mentioned here includes natural rubber latex that has been pre-vulcanized using a sulfur-based, thiuram-based, or Ija peroxide-based vulcanizing agent, and natural rubber latex that has been vulcanized after natural vulcanization or low-temperature vulcanization. Includes sulfur-type compounded latex. As the water-soluble polymer solution, an alkaline aqueous casein solution or aqueous solutions of methylcellulose, carboxylated methylcellulose, polyvinylpyrrolidone, polyvinyl alcohol, etc. are used, and casein is particularly preferred.

Table 1 Composition of compounded latex I Dry bulk Vulcanizable natural rubber latex 80-85 Water-soluble polymer solution 20-15 Water or ammonia water for viscosity adjustment As appropriate, the mandible shown in Figure 1 was processed there. Latex I mixed into the model body (lower bone body)
Alternatively, apply rubber glue (L) and dry.

In order to create a sense of realism by giving a feeling similar to the feeling of peeling resistance during actual peeling surgery, the strength of the adhesion between the jawbone model body (mandibular body) 1 and the dry rubber film of Compound Latex I or the dry rubber film of rubber glue is required. It is safe to use adhesives, but it is inappropriate if the adhesive strength is too strong or too weak.

Figure 6 shows a composite latex (proportion equivalent to Compound Latex I) made by mixing sulfur-based prevulcanized latex with ammonia casein solution in varying amounts on a porous material used for the jawbone model body made of gypsum and molded into a flat plate. 2 cm wide and about 0.5 layer thick and dried. Rubber glue was applied 1 to 3 times to 2 cm wide and dried, and sulfur-based glue was applied to increase the thickness. A dry test piece was prepared by applying pre-vulcanized latex to a thickness of approximately 0.5 mm, and this was peeled off at a rate of 180 degrees at a rate of 5 cm per minute. The peel resistance was determined by the force per sm width (Kgf). ) is shown in comparison with the periosteal abrasion strength of monkeys, which is said to be similar to that of nine people. The peel resistance (peel strength IB:) increases as the amount of casein increases in the compound latex system of sulfur pre-vulcanized latex and ammonia casein, and as the coating rate increases in the case of rubber glue. To reach the lowest value of periosteal peel strength, use rubber glue at 10X 10' g/cm? or more (more than 2 applications), casein% is 15% in compounded latex
~20% (range of blended latex 1) is required.

The reason why peel resistance is improved by rubber glue or compound latex is that the surface of plaster, which is a microporous material, looks smooth but actually has a surface resistance of 0.01-Lu.
Although there are communicating holes of about Lm and water is absorbed, 9
Latex particles having a particle diameter of about 0.1 to 3 JLm are hardly able to penetrate into the interior and remain on the surface, so they do not have an anchoring effect and do not exert an attractive force.

However, when water-soluble casein is mixed, since the casein molecules are dissolved in water, their size is much smaller, so they can penetrate into the open pores of the plaster and develop strength when solidified by drying. become. Externally from the stone surface, the rubber and casein are integrated to form a film, so the rubber film physically adheres due to the anchoring effect of casein and exhibits an adhesive effect. In the case of rubber glue, similar to casein, the rubber molecules are dissolved in a solvent in the form of a colloid in the form of a molecular solution, resulting in an anchoring effect. Rubber glue has a low rubber concentration, so in one application, most of the applied amount is absorbed into the plaster and does not remain on the surface, resulting in the so-called non-stick phenomenon, so one application will not show a peel strength of 1 minute. It is assumed that there was no such thing.

In addition, in compound latex, it seems that the strength will be better if the casein content is 20% or more, but since it is a mixture of water-soluble (wood-loving) casein and hydrophobic casein,
When the ratio increases to around 3θ%, casein becomes a continuous phase and inhibits contact between rubber particles, resulting in not only hardness.

Water resistance is significantly reduced. This tendency becomes remarkable when the casein percentage exceeds 2θ%, so in practice, the upper limit is around 20%.

Next, the material that forms the part corresponding to the submucosal lamina propria is made of vulcanizable natural rubber latex and lignophilic substance solution.
The dried film of this compounded latex using a pigment dispersion is a compounded latex ■ that is colored to have the same color as the raw cavity mucosa, and a compounded latex ■ that is essentially made of a material that is difficult to adhere to and has a thickness of about 2 ts. A composite layer 7 consisting of a porous elastic foam sheet is formed. Compound latex II
It is convenient to impregnate the foam sheet with Compound Latex II as an adhesive at the same time as the adhesive of the foam sheet.

As this elastic foam sheet, soft urethane foam, polychloroprene (CR) latex foam with a high 51 foam ratio, nitrile rubber (NBR) latex foam, soft vinyl chloride paste foam, polyethylene foam, etc. can be used, but especially soft urethane foam is used. It's advantageous. In particular, when injecting an injection solution or imitating blood, it is preferable to use an open-cell elastic foam sheet.

To form this layer, compound latex II, which also serves as an adhesive, is applied to an elastic foam sheet cut into the necessary dimensions to cover the alveolar bone crest from the lower edge of the outer side of the jawbone model body l and extend slightly inward. While impregnating, the dried compounded latex I or rubber glue is applied onto the coated and dried layer 6. In order to closely adhere the elastic foam to the complex surface shape of the jawbone model body L, stretch or compress it as appropriate until the compounded latex ■ gels and the elastic foam impregnated with compounded latex II adheres to the corresponding position on the jawbone model. Operate gently so that there is no chance of crimping.

In particular, the saddle-shaped part is easy to float, so operate with caution.

In carrying out this operation, the voids in the open-cell elastic foam sheet are filled by impregnating a suitable amount of compound latex II as an adhesive and drying. The external view after this operation is completed is shown in Figure 3(a), with A-A, B-
A sectional view of part B is shown in (a) and (a) of FIG. 3(b).

Vulcanizable natural rubber latex 90-100 water-soluble polymer solution 5-0 Colorant dispersion (amount necessary to color the oral mucosa) Surfactant (wetting agent) Appropriate amount of zinc butyride dispersion (as required) Gelation regulator) 0.5 to 1.0 Composite layer 7 of this blended latex ■ and (open cell type) elastic foam sheet
Its role is to provide appropriate elasticity to the fleshy part of the jawbone model! In addition, when an open-cell elastic foam sheet is used, it is possible to inject and store simulated blood into this area immediately before use, in order to further enhance the sense of reality. It can also serve as an infiltration phase for injection liquid during anesthesia training. In other words, since this composite layer is made of an elastic body made of open cells made of a material that is difficult to bond to the compound latex ■, the dry body of the impregnated compound latex H cannot fill the air voids in the elastic body. Even if it is attached, it does not harden as a unit because it is not bonded, and it is softer and has a moderate elasticity than a film made only of Compound Latex II, giving it a gum-like feel, but Compound Latex II If it is not filled, it will feel fluffy and strange. In addition, when the injection solution is press-fitted, the interface between the elastic body and the dry rubber part of compounded latex H peels and stretches, creating a feeling of resistance to the press-fit and the injection liquid infiltrating and spreading to an appropriate area, swelling the tissue. By doing so, it is possible to experience a sense of reality during the injection.

Next, layer 8, which corresponds to epithelial tissue, is made of compound latex ■, and in order to form a smooth finished surface, the thickness of the entire rubber layer (covering layer) that covers the jawbone body is 6+7+8 by dipping, painting, spraying, etc. ) is 1.3 to 2. Finish so that the length of the intestine is approximately 0.5 to 1.0 m in the area (6+8) where Ota iliac elastic foam is not attached.

Next, it is completely dried at a relatively low temperature ranging from room temperature to around 50°C. Compound latex T and compound latex ■ used in this processing are pre-vulcanized latex that has already been vulcanized, room temperature vulcanization type or low temperature vulcanization type post-vulcanization latex. Forms a certain film. The reason for avoiding high-temperature drying and high-temperature vulcanization is to avoid undesirable hardening of the film due to denaturation of the water-soluble polymeric substances, particularly casein, which are mixed.

Due to the effect of the lignophilic substance contained in the rubber membrane, the feel when the rubber membrane is incised and the simulated blood oozing from the incision site are not repelled by the rubber surface corresponding to the L skin tissue area, creating a sense of realism as if it were naturally oozing out. useful for.

If necessary, a wetting agent may be added to the compounded latex ■ to further improve surface wettability. Casein in the compounded latex ■ may be omitted if a wetting agent is added. .

Finally, the holding core material No. 4 is cut from the base of the exposed part, and the holes formed in the rubber film are covered with compounded latex (2) and dried to complete the work. The appearance of the finished product is shown in Figure 4 (a), and A-A and B.
A cross-sectional view of the -B section is shown in FIG. 4(a) and (a) of FIG. 4(b).

Teeth can also be attached to the jawbone model depending on the purpose of training. Moreover, a tooth having a periapical lesion can be attached to a part of the tooth.

FIG. 5(a) is an external view thereof, and FIG. 5(b) is a sectional view taken along the line CC.

This is used for apexectomy training. 9 is tooth, l
O indicates a cyst formed at the tip of the tooth. In this case, a small latex rubber bag prepared by the dipping method is attached to the root apex of a synthetic resin tooth, and a fluid colored viscous liquid is sealed therein as a pseudo-liquid. When preparing the jawbone model body, this is fixed so that a part of the pustules is slightly exposed on the outer side of the jawbone, and a model material is injected to prepare a jawbone model body with an apical lesion.

This will be explained below using examples.

Example 1 A mandible model body L having the shape shown in FIG.
Pre-vulcanized latex heated and cured at 75°C for 3 hours with 1 part of sulfur and 1 part of vulcanization accelerator, total solids content 60%, vulcanization degree of swelling in length (SDT) in toluene 80%) and 10 %
Ammonia casein solution with a solid content ratio of 80/2
After dipping the mixed latex so that the viscosity is about 200 to 300 cP using ammonia water into the mixed latex ■, slowly pull it out and tilt the model appropriately to ensure that it adheres to each part of the model as evenly as possible. Dry while operating to form a dry film of compounded latex I corresponding to periosteum (corresponding to Fig. 3, 6). A soft urethane foam sheet cut into a size that covers the outer periphery of the mandibular body (an open-air foam sheet with a thickness of about 2 as, an apparent density of 0.02 g/c+s3, and a basis weight of 43 g) is mixed into a latte 2x. A mixed latex II with a solid content ratio of 98/2 of the G & yellow vulcanized pre-vulcanized natural rubber latex used in I and the ammonia casein solution was used to adhere onto the membrane 6 corresponding to the periosteum formed earlier. ,
At the same time, while impregnating most of the voids in the urethane foam with Compound Latex II, the operation of gently pressing the foam is repeated until the Compound Latex H gels and the Urethane Foam 11 is tightly fixed to the surface of each part of the model, especially in the saddle-shaped parts. Carefully adjust areas that are difficult to adhere to, such as parts, to prevent them from lifting. In this way, 7
The model with this urethane foam pasted is dipped into the same mixed latex H to form a 0-th order, pulled up and dried repeatedly until the thickness of the entire rubber layer at the urethane foam area (6+7+8 thickness) is approximately 1. 3-2.0 am
degree.

The thickness of the part where urethane is not pasted (6 + 8) is approximately 0
．． 5-1. After drying it to about the same thickness as Ota, it is thoroughly dried in a dryer at 35°C. After the moisture has completely dried, the exposed part of the reinforcing wire 4 is cut off, and the holes in the missing part of the rubber film caused by the cutting of the wire are filled with compounded latex II and dried to produce the same jawbone model for oral surgery. is completed.

The urethane foam composite layer 7 of the bone model prepared in this way is injected with simulated blood, for example, made of 5% natural rubber latex and colored in blood color, and pressed well from the outside to cover the entire urethane foam composite layer. After spreading well, we performed the incision operation and periosteal dissection operation with a scalpel.The feel of the incision, the sense of realism from the bloodshed during the incision, and the sensation of resistance during the dissection operation made us feel the sensation of the actual procedure. I was able to confirm that it was very similar to the feel of time.

Example 2 Same as Example 1, but instead of compound latex I, a commercially available rubber glue prepared by dissolving natural rubber in a rubber solvent was used to form the layer 6 corresponding to the periosteum, and the process was repeated after applying twice and drying. It was treated in the same manner as in Example 1. When we tried performing avulsion surgery using the completed model, we were able to confirm that the feel was close to the actual one.

In an experiment in which simulated blood was injected, the resistance to peeling was stronger than in Example 1.

Example 3 (see Fig. 5) A pustule 10 is attached to the tip of a plastic model tooth root by enclosing a paste made of bentonite water dispersion in a rubber sac.
A periosteum type main body 1 of the affected southern jaw is prepared, and a part of the pustule is slightly exposed on the outer surface of the alveolar bone. Using this jaw bone model main body 1, the periosteal layer 6 is prepared in the same manner as in Example 1. Each layer corresponding to the submucosal lamina propria 7° and the mucosal cortical layer 8 was formed.

Finally, the model is completed by cutting the rubber layer covering the crown of the tooth shown at 6 in the cross-sectional view of FIG. 5(b) so that the crown is exposed.

[Brief explanation of drawings]

Figure 1 is a perspective view of the external appearance of the mandible model body that is not replicated using porous model material, Figure 2 is a sectional view taken along the line A-A in Figure 1, and (a) shows only the core material 4. Fig. 3(b) is an example in which a sponge-like porous body part 5 simulating cancellous bone is provided in the center as necessary, and Fig. 3(a) is a composite layer of elastic foam sheet/compounded latex H. The perspective view at the stage of forming the
A cross-sectional view taken along line AA and line BB-r. Figure 4(a) is a perspective view of the completed mandibular model;
(a) and (a) in Figure (b) are line A-A in Figure 4 (a),
5(a) is a partial perspective view of a jaw bone model with a tooth with a periapical lesion attached, and FIG. 5(b) is a cross-sectional view taken along the line B-B. A cross-sectional view taken along the line C-C, Figure 6 shows the peel strength of a mixed latex dry film coated on a dental gypsum board, which is a mixture of sulfur prevulcanized latex and ammonia casein, and the casein in the solid content of the mixed latex. %, a diagram showing the relationship between rubber glue coating and peeling strength, and a diagram comparing the periosteum peeling strength of the jawbone of a monkey. 1... Mandibular model body, 2... Odogial foramen, 3...
・Red substitute representing the alveolar nerve blood vessel east, 4... core material added for reinforcement and processing convenience, 5... porous body part,
6... Rubber film layer formed by coating and drying compound latex I or rubber glue corresponding to bone membrane, 7... Composite layer formed by gluing an elastic foam sheet and impregnating compound latex II, 8...1; layer consisting of a dry film of blended latex H corresponding to skin tissue, 9... tooth, 1
0... Warm cyst (apical lesion). More L

Claims (5)

[Claims] (1) Rubber glue or a mixture of water-soluble polymer and vulcanizable natural rubber latex I is applied as an adhesive layer on the jawbone model body, which simulates natural properties using microporous model material. A composite layer is provided by impregnating and drying a mixture of a foam sheet, a vulcanizable latex compound, and a hydrophilic substance solution with Compound Latex II colored in the same color as the oral mucosa, and further adding the same compound latex.
A jawbone model for oral surgery, characterized by being provided with an epithelial layer formed using II. (2) Claim 1, characterized in that plaster or open-cell hydrated polyester is used as the model material.
A jawbone model for oral surgery as described in section. (3) Open-cell flexible urethane foam, polychloroprene latex foam, nitrile rubber latex foam as elastic foam sheets,
The jawbone model for oral surgery according to claim 1, characterized in that a thin sheet sliced from PVC-based foam is used. (4) As vulcanizable latex, sulfur vulcanization type pre-vulcanization latex, organic peroxide type pre-vulcanization latex, thiuram-based sulfur-free vulcanization type pre-vulcanization latex, room temperature vulcanization type or low temperature vulcanization type after vulcanization type The jawbone model for oral surgery according to claim 1, characterized in that any one of vulcanized latexes is used. (5) Claim 1, characterized in that an alkaline casein aqueous solution is used as the water-soluble polymer substance aqueous solution.
A jawbone model for oral surgery as described in section.