MXPA99010216A - Oral anchorage - Google Patents

Abstract

The present invention provides an intra-oral anchorage which comprises a flexible belt that extends around and between the teeth of a patient. The belt has locking means fixed thereon to receive a free end portion of the belt and lock said portion against retraction therefrom. The locking means is in the form of a buckle. The intra-oral anchorage of the present invention can be used to hold a jaw in a fixed position, in the case of a broken jaw for example. It offers ease of application and therefore a reduction in the cost of surgery as well as eliminating the risk of"needle stick"injury inherent with cutting and bending multiple ends of wire. It causes less gum damage in placement and removal, which is similarly easier, faster and less uncomfortable for the patient.

Description

ORAL ANCHOR DESCRIPTION OF THE INVENTION This invention relates to a novel form of intraoral anchoring, for use in oral surgical procedures. Intraoral anchor refers to a stable point inside the mouth, usually a tooth, so that traction can be applied to a less fixed or mobile structure. Alternatively, two or more anchoring points can be used, so that the teeth can be held firmly together, so that a fracture can be aligned at one site and / or that some other surgical procedure can be performed that needs an occlusion that is Consistent during or after the procedure- This intraoral anchoring is usually achieved by the use of tightly twisted metal wires around the teeth (see Figure IA). Additionally, metal bars (arched bars) can be used to create multiple hooks as an easy anchor for traction or fixation (see Figures IB and IC). Once an anchorage point has been established, the traction is usually achieved by means of elastic bands although the fixation is by the use of more metal wires.

This wire system is time consuming and requires skill, dexterity and training. This is so uncomfortable for the patient, that it is almost always done during general anesthesia. The removal of the wire several weeks later is usually under local anesthesia and is generally stressful and destructive of delicate gingival structures (gums). As a result of cutting the wire, there are many pointed ends of wire, which present dangers to the patient; to the operator and his assistant, and the gloves and skin are frequently punctured by the wire. This results in a risk of transmission of blood-borne infections, particularly hepatitis and the AIDS virus, which are a well-known risk associated with current techniques. Additionally, the wire hardens and fractures in its placement, and is often stretched with functional loads that require adjustment. Accordingly, the present invention provides an anchor for use in the treatment of oral fractures comprising a flexible band of one dimension extending around and between the teeth of a patient, the band having mobilization means attached thereto to receive a portion free extreme of the band and immobilize such portion against the retraction of the same.

Preferably, the locking means are attached to one end of the band, and can generally be in the form of a loop. Preferably, the locking means is in the form of a head having an opening therethrough to receive the end portion of the band. Preferably, the head also has a one-way immobilization mechanism to allow advancement, but resist retraction of the band in the opening. The band may comprise two sections, a first section including a free end of the band and which is typically curved; and a second section between the first section and the immobilization means. The second section is preferably shaped to cooperate and immovably couple with the mobilization head. Preferably, the first section has a smooth surface to facilitate the passage of the band through the interdental spaces. The immobilization head can have on its external face means for retaining a fixing means, for example, an elastic band, a plastic brace, a wire or a bar, for interconnecting and fixing the other immobilization heads.

Advantageously, there are no pointed edges on an anchor that can be dangerous to the patient or the operator. The immobilization means may comprise a plurality of teeth inclined on both of the second section of the band and an internal face of the immobilization head, so that the teeth cooperate so that the band can not only pass through the opening in one direction. The immobilization means may include an external plate to ensure a coherent fit of the anchor to a tooth, the plate may be concave, although it may vary to fit any given tooth. In use, when more than one anchor is used, traction can be applied between the anchor by winding elastic bands or other suitable means around the retention means, so that the teeth or fracture points can be brought into proper alignment and maintained. instead. The band is typically between 10 and 14 centimeters in length and around 0.6 to 1.0 millimeters in width. The first section of the band can typically be 1.5 to 3 centimeters in length.

The immobilization head is preferably approximately 7 to 11 millimeters in length, and approximately 3 to 5 millimeters in width. In addition, according to the invention, a method is provided for treating facial or jaw fractures or facilitating facial surgery of the chin, comprising extending a flexible band around one or more of a patient's teeth, passing a portion through end of the band through the immobilization means supported in the band and tension the band around the teeth, pulling it through the immobilization means, the immobilization means prevent the retraction of the band on itself. The band is preferably of plastic material. More preferably, the band is made of Nylon having an elastic yield strength of between 50 to 80 MN / m2 and a Rockwell hardness of between 100-140. Optionally, the band is polyketone, which has a tensile elastic limit of between 50 to 80 MN / m2 and a Rockwell hardness of between 100-140. Optionally, a portion of the strip, especially the first section of the strip, can be made of steel, which has an elastic yield limit of between 175 to 2000 MN / m2 and a modulus of elasticity of between 175 to 230 GN / m2.

The plastic "loop" is preferably oriented towards the face of the tooth and incorporates a hook and a locating point for an arched bar. The whole device can be produced without sharp edges and can have minor modifications of shape to facilitate its placement. The embodiments of the invention will now be described by way of example with reference to the accompanying drawings, in which: Figure IA: Illustrates the prior art method of intraoral wiring. Figure IB: Illustrates an arched bar of the prior art. Figure IC: Illustrates an arched bar of the prior art anchored by intraoral wiring. Figure 2A: Illustrates a previous view of the first embodiment of the anchor. Figure 2B: Illustrates the first anchor mode seen from the right side. Figure 2C: Illustrates the first modality of the anchor seen from the left side. Figure 2D: Illustrates the rear view of the first anchor mode. Figure 3A: Shows a first modality of the "open" anchor.

Figure 3BA: Shows the first modality of the "closed" anchor. Figure 3C: Shows the immobilization mechanism. Figure 4A-D: Illustrates the device being placed on a tooth. Figure 5: Shows the traction that is applied using elastic bands wound around the hooks. Figure 6A: Shows an arched bar placed in its place. Figure 6B: Shows an arcuate bar secured in place by means of an elastic band. Figure 7A: Shows a fracture in two positions. Figure 7B: Shows the realigned fracture sites with a plate bolted in place. Figure 8A: Illustrates a plan view of the second embodiment of the anchor. Figure 8B: Illustrates the second mode of the anchor seen from the right side. Figure 8C: Illustrates the second mode of the anchor seen from the left side. Figure 9: Illustrates the second mode of the anchor seen from the left side.

Figure 10: Illustrates the retraction of the band within the anchor. Figure HA: Illustrates the anchors attached to the teeth, viewed from the front. Figure 11B: Illustrates the anchors attached to the teeth, viewed from the side. Figure 11C: Illustrates the anchors attached to the teeth with an elastic band placed on the hooks viewed from one side. Figure 12A: Illustrates the second anchor mode seen from the right side. Figure 12B: Illustrates the second mode of the anchor seen from the right side. Figure 12C: Illustrates the second mode of the anchor seen from the right side. Figure 13A: Illustrates the anchor band with the teeth on its upper side seen from the top, in cross section and from one side. Figure 13B: Illustrates the anchor strip seen from the top and in cross section. Figure 13C: Illustrates the anchor band with the teeth on its side view from the top and from the right side. Figure 14A: Illustrates the first section of the anchor band seen from one side and in cross section.

Figure 14B: Illustrates the curvature of the first section of the anchor strip viewed from one side. Figure 15A: Illustrates how the teeth of the band cooperate with the teeth of the anchor. Figure 15B: Illustrates the immobilization system of the metal member. Figure 15C: Illustrates a third mode of anchoring with the flap open and also closed, seen from the front. Figure 15D: Illustrates the fourth mode of anchoring and also when in use, seen from the front. Figure 15E: Illustrates the fifth mode of the anchor also when in use attached to a band, seen from the front. Figure 16: Illustrates an anchor band seen in cross section. Figure 17A: Illustrates a perspective view of the second embodiment of the anchor. Figure 17B: Illustrates the second mode of the anchor seen from the left side. Figure 17C: Illustrates the second mode of the anchor seen from the top. Figure 17D: Illustrates the second mode of the anchor seen from the right side.

Figure 18A: Illustrates a second embodiment of the anchor seen from above. Figure 18B: Illustrates the second mode of the anchor seen from the right side. Figures 1A-1C show the prior art wiring method for connecting an arched bar to the teeth to provide a plurality of anchoring points for applying traction. The oral anchor of the first embodiment of the invention was formed from a single piece of plastic materials 2. The plastic materials 2 are formed to form a flat section 4 and a hook 6, which join the flat section 4. the flat section 4 and the hook 6, there is a slot 8 for placing an arched bar 10. The hook 6 has a bar 12, which runs perpendicular from the hook 6. The band 12 may have teeth 14 on its upper or lateral sections and in sections 16 and 18; section 16 is linear and section 18 is curved. The hook 6 also has openings 20 and 22 for inlet and outlet access for the band 12, and has teeth 24 between the openings 20 and 22, which cooperate with the teeth of the band 12, to produce an immobilization mechanism of one way. The opening 20 is flared to facilitate the entry of the band. In use, the first embodiment of the oral anchor of the invention is also offered to be oriented outwardly of the tooth 26. The band 12 is pushed through the space between the teeth 26 and 28, passed around the back of the tooth 26 and through of the space between the teeth 26 and 30. The band 12 is then threaded into the opening 20, pulled through the opening 22 and pulled tightly until tensioned around the tooth 26. The band 12 is held in position by virtue of the cooperation of its teeth 14 with the teeth 24. The immobilization mechanism is of a one-way type, so that once the band 12 is passed through the openings 20 and 22, it can not be pulled backwards, in the opposite direction. Any excess band 12 that is left projecting from the opening 22 is cut using any conventional technique. The locking mechanisms of the band 12 between the openings 20 and 22 may vary. The teeth 14 on the band 12 can be on the longitudinal side 32 or the vertical side 34 of the band 12. Alternatively a metal member 36, placed between the openings 20 and 22 within the anchor 22, and angled so that the band may once pass over the metal member 36 may comprise the immobilization mechanism. Once attached to tooth 26 the oral anchor can cooperate with another oral anchor, which has been attached in a manner similar to tooth 38. By virtue of an elastic band, plastic ties or ligature wires 40, traction can be provided between the two anchors oral, fixing the jaw 42 in its position to heal. An arched bar 10 can be fixed in the grooves 8. The arched bar is held in place by means of an elastic band 40 or by adopting closure of the facets in the loop. The oral anchor of the second embodiment of the invention is formed from a single piece of plastic materials 2. The plastic materials 2 are formed to form a hook 6 having a groove 8 for the positioning of the elastic band 40. The hook 6 has a band 12, which runs perpendicular from hook 6. Band 12 has teeth 14 and is in sections 16 and 18; section 16 is linear and section 8 is curved. The hook 6 also has openings 20 and 22 for the entry and exit access for the band 12 with the teeth 24 between the openings 20 and 22, which cooperate with the teeth of the band 12, to produce the locking mechanism of a via. The oral anchor of the third embodiment of the invention is formed from a single piece of plastic materials 2. The plastic materials 2 are formed to form a hook 6 for the positioning of the elastic band 40 and have a skirt 42 hinged around the front end 44 of the anchor 2. The hook 6 has a band 12, which runs perpendicular from the hook 6. In use, the anchor is applied to a tooth 24 as in the first embodiment. The difference between the first embodiment is that the band 12 is restricted in the anchor by closing the skirt 42 hermetically against the anchor 2. The oral anchor of the fourth embodiment of the invention is formed from a single piece of plastic materials 2. plastic materials 2 are formed to form a hook 6 for the placement of the elastic band 40 and has an incision 46 cut in the anchor 2 towards its anterior end. The incision 46 tapers from its incision point. The hook 6 has a band 12, which runs perpendicular from the hook 6. In use, the anchor is applied to a tooth 24 as in the first embodiment. The difference of the first embodiment is that the band 12 is restricted in the anchor 2 pulling the band strongly in the incision 46. The oral anchor of the fifth embodiment of the invention is formed from a single piece of plastic materials 2. The plastics materials 2 are formed to form a hook 6 for placement of elastic band 40 and have an incision 48 cut in the side of the anchor 2. The incision is designed to cooperate with a band 12, which has a bulbous end 50. The bulbous end 50 is restricted in the incision 48 when the band is pulled tightly at its junction to another oral anchor.

In the case of a fracture (see Figure 7A), once the teeth are brought to their correct relationship, the fracture sites will necessarily be correctly aligned. Using the hooks as anchor points, the ligature wires, strong elastic bands or plastic ties would keep them stable for weeks to allow healing or briefly to allow the placement of a rigid metal plate, fixed by screws (see Figure 7B ). Oral anchoring of the embodiments of the present invention then provides anchoring points for the application of traction to the teeth, particularly in the case of a broken jaw, which must be maintained in a fixed position. This offers a number of advantages over the conventional intraoral metal wire anchoring method as a result of its construction and ease of application. Particularly, since there are no pointed ends of metal wires, there is a much lower risk of damage by "needle pricks" for both the patient and the surgeon. The present invention is easier to apply to a patient, resulting in a shorter operating time (and resulting minor costs) in the application and removal of the anchor and less damage to the delicate tissue of the gum in the placement and removal. The anchors are also sterile packed, and are biologically inert and compatible with other prosthetic or surgical technology / equipment.

REFERENCES 1. S. J. ilson, A. Uy, D. Sellu and M. A. Jaffer, Ann. R. Coll. Surg. Engl., 1996, 78, 20-22. 2. M. I. Dauleh, A. D. Irving and N. H. Townell, J. R. Coll. Surg. Edinb., 1994, 39, 310-311. 3. D. J. Jeffries, J. Hospital Infection, 1995, 30, 140-155. 4. J. E. Carlton, T. B. Dodson, J. L. Clevland, S. A. Lockwood, J. Oral. Maxillofac. Surg., 1997, 56, 553-556.

Claims (19)

1. CHAPTER CLAIMEDICATORÍO Having described the invention, it is considered as a novelty and, therefore, the content is claimed in the following CLAIMS: 1. An anchor for use in the treatment of oral fractures, characterized in that it comprises a flexible band and a total or substantially plastic band, of a dimension capable of being adjusted between the intraoral spaces of a patient, and capable of extending around a tooth, to exert isotropic pressure thereon, the band has immobilization means attached thereto to receive a free end portion of the band and immobilize said portion against retraction thereof.
2. 2. The anchor according to claim 1, characterized in that the means for immobilization thereof are joined at one end of the band and are in the form of a loop.
3. The anchor according to claim 1 or 2, characterized in that the locking means thereof are in the form of a head having an opening therethrough to receive the end portion of the band.
4. 4. The anchor according to claim 3, characterized in that the head of the immobilization means has a mechanism for locking one way to allow advancement, but resisting the retraction of the band in the opening.
5. The anchor according to any of the preceding claims, characterized in that it has a band, which comprises two sections; a first curved section including the free end of the band and a second section between the first section and the immobilization means.
6. The anchor according to claim 5, characterized in that the second section of the band thereof is profiled to cooperate and immovably couple with the locking head.
7. The anchor according to any of the preceding claims, characterized in that the first section of the band thereof, has a smooth surface to facilitate the passage of the band through the interdental spaces.
8. The anchor according to any of claims 3 to 7, characterized in that the locking head thereof has on its external face means for retracting a fixed member, for example, an elastic band, a plastic strap, a wire or bar to interconnect and fix the other immobilization heads.
9. 9. The anchor according to any of the preceding claims, characterized in that it does not have sharp edges that could be dangerous for the patient or for the operator.
10. The anchor according to any of the preceding claims, characterized in that the immobilization means thereof comprises a plurality of teeth inclined on both of the second section of the band and the internal face of the immobilization head, so that the teeth cooperate so that the band can only pass through the opening in one direction.
11. The anchor according to any of the preceding claims, characterized in that the anchoring means thereof include a concave outer plate to ensure coherent adjustment of the anchor to a tooth.
12. 12. The anchor according to any of the preceding claims, characterized in that the band thereof is 10 to 14 centimeters long and about 0.6 to 1.0 millimeters wide.
13. The anchor according to any of the preceding claims, characterized in that the first section of the band is 1.5 to 3 centimeters in length.
14. The anchor according to any of the preceding claims, characterized in that the locking head is between 7 to 11 millimeters in length and between 3 to 5 millimeters in width.
15. 15. The anchor according to any of the preceding claims, characterized in that the band thereof is made entirely of a plastic material.
16. 16. The anchor according to any of the preceding claims, characterized in that a portion of the band thereof is made of steel, particularly, the first section, which has an elastic yield limit of 175 to 2000 MN / m2, and an elastic modulus of 175 to 230 GN / m2.
17. The anchor according to any of claims 2 to 16, characterized in that a plastic loop is provided on the band thereof facing away from the face of the tooth, and incorporates a hook and a location point for an arched bar .
18. 18. A method for treating an oral fracture, characterized in that it comprises extending a flexible band around one or more patient's teeth, passing an end portion of the band through the immobilization means carried in the band and tensioning the band around the teeth, pulling it through the immobilization means, the immobilization means prevent retraction of the band thereof.
19. 19. A method for treating applying traction between two or more anchors, according to any of claims 1 to 19, in use, characterized in that elastic bands or other suitable means are wound around the anchors, so that the teeth or the points of fracture can be pulled in proper alignment and held in place.