RU2504341C2 - Distraction apparatus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used in increase of volume of bone and soft tissues in case of vertical atrophy of alveolar process with the aim to prepare patient to carrying out dental implantation. Distraction apparatus contains bearing screw and installed on it means of movement of mobilised bone fragment of patient's jaw from basal bone, and fastening screws for fastening said means on bone fragment and basal bone. Said means of bone fragment movement are made in form of mobile and immobile consoles, each of which has a hole, in which fastening screw is installed. Mobile console is installed on bearing screw with possibility of longitudinal reciprocating movement. Hole in immobile console is made polyhedral and in direction to axis of bearing screw. Shank of fastening screw which is in interaction with it is also made polyhedral with possibility of interaction with said polyhedral hole in immobile console. Shank of fastening screw is located transversally to thread part of said fastening screw.

EFFECT: invention provides possibility of growing alveolar process at certain angle to the vertical outwards or inwards.

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Description

The invention relates to medicine, namely to dentistry, and can be used to increase the volume of bone and soft tissue in the case of vertical atrophy of the alveolar bone in order to prepare the patient for dental implantation.

Atrophy of the alveolar bone is the main obstacle to dental implantation.

Increasing the height of the alveolar ridge using a distraction apparatus is more effective than other methods.

Known intraosseous distraction apparatus, consisting of a rotor, a basal and transport plate (US patent No. 5,769,850, IPC: A61B 17/60, A61C 8/00, publ. 23.06.1998 g). The basal plate is connected to the peripheral end of the rotor and has only rotational movement. The transport plate is connected by a threaded hole to the rotor and, when the latter rotates, moves along the rotor.

The apparatus is installed as follows: after mobilization of the bone fragment of the alveolar ridge, the main rotor is inserted into the mobilized bone fragment and passes through it, after which a transport plate is placed between the indicated fragment and the basal bone on the screw section, screwing it onto the screw to the bottom edge of the mobilized fragment bones, and then on the end of the screw fix the basal plate, resting on the basal bone. The free ends of both plates have holes for mounting screws, through which both plates are fixed on the corresponding bone. When the transport screw rotates, the transport plate moves up and takes away a free bone fragment from the basal bone

The disadvantages of this device are the negative effect of the plates located in the osteotomy zone on osteogenesis. In addition, this device does not allow you to adjust the distraction vector. Moreover, it is traumatic, because it is necessary to cut a hole in the mobilized bone fragment with the rotor, and when dismantling the apparatus, it is necessary to carry out a repeated surgical operation to remove the rotor and plates. Another disadvantage is the technical complexity of mounting and dismounting the device in the jaw of the patient.

The problem to which the invention is directed, is to create a simple and reliable distraction device that eliminates these disadvantages of the known device.

This object is achieved in that in a distraction apparatus containing a rotor and means for moving the mobilized bone fragment of the jaw of the patient from the basal bone, and also fixing screws for fixing said means on the bone fragment and on the basal bone, said means of moving the bone fragment are made in the form of a movable and fixed consoles, each of the consoles has an opening in which a mounting screw is installed, and the movable console is mounted on a carrier m screw with the possibility of longitudinal reciprocating motion.

Thanks to this design, it is possible to avoid the need to place plates in the osteogenesis zone, i.e. foreign bodies that interfere with the formation of a new bone regenerate, since the threaded rods are screwed into the bone fragment and the basal bone from the side, placing the rotor outside the bone fragment and outside the basal bone. Therefore, the need to pass this screw through the bone fragment disappears, further injuring it.

Such a device is easy to install by screwing into bones on two mounting screws. It is also easy to remove the device by simply unscrewing the two screws without folding the mucoperiosteal flap.

Further, it is preferable to make the hole in the fixed console multifaceted and towards the axis of the rotor, and provide the fastening screw that interacts with it with a polyhedral shank with the possibility of its interaction with the specified multifaceted hole in the console and at the same time place the shank of the fastening screw transverse to its threaded parts direction.

Due to this, it is possible to position the rotor at a certain angle to the vertical, accordingly tilting the mobilized bone fragment, and to grow tissue at the desired angle, depending on the need.

The proposed device is illustrated by drawings, where:

- figure 1 shows a side view of the rotor with consoles;

- figure 2 shows a top view of figure 1;

- figure 3 shows a side view of the mounting screw;

- figure 4 shows figure 3 along arrow A;

- figure 5 shows a side view of a preferred embodiment of the rotor;

- figure 6 shows a view of figure 5 along arrow B;

- Fig.7 shows a side view of the mounting screw for the fixed console of the main rotor of Fig.5 and 6;

- Fig. 8 is a view of Fig. 7 along arrow B;

- figure 9 is a view of the distraction devices installed on the basal bone and the bone fragment in the distraction position.

The proposed device contains a main rotor 1, on which a movable console 2 and a stationary console 3 are installed, in which holes 4 and 5 are made, respectively, as well as fixing screws 6, each of which has a shank and a threaded part, separated by a smooth threadless section of ba, diameter which is selected with the possibility of tight entry into the holes 4 and 5. The shank 7 of the rotor 1 and the shank 8 of the fixing screw 5 are made hexagonal (socket wrench). The movable console 2 in the female part 1 has a thread (not shown) that forms a screw-nut pair with a threaded rotor 1. The rotor 1 is mounted on the fixed console 3 with the possibility of rotation.

The described device is used as follows.

Under the infiltration anesthesia, the alveolar bone is skeletonized, the bone fragment is mobilized after trapezoidal sawing and the soft tissues are sutured tightly. Then, one of the fixing screws 6 is screwed into the basal bone and the console 3 is screwed onto its smooth portion of the ba with the hole 5, thereby installing the rotor 1 on the fixing screw 6. After that, the movable console 2 is lifted to the optimum height and performed through the hole 4 in the mobilized bone fragment, the bone bed, into which the second fixing screw 6 is inserted through the hole 4, and rotating it with a key (not shown) for the multi-faceted shank 8, screw the fixing screw into the bone and thereby attach the upper part of the screw 1 to the bone fragment. In this case, the portion ba is located in the hole 4 as a support. Within 7 days, while the bone fragment is fixed by means of a distraction device on the basal bone, there is no foreign body between the last and the bone fragment that interferes with the process of regeneration of bone and soft tissues. After 7 days, the distraction process begins according to a known protocol. At the same time, turning the rotor 1 for the multi-faceted shank 7, move the console 2 vertically up the screw 1.

At the end of the osteogenesis process, the device is easily removed by just unscrewing a pair of side fixing screws 6 from the patient’s bone. This excludes unscrewing the rotor from the jaw of the patient, causing additional injury to the patient.

The described device is successfully used if necessary to grow the alveolar process in the vertical direction. But there is a need to grow the alveolar process at a certain angle to the vertical outward or inward.

For this case, on the basis of the described device, a distraction apparatus was created, in which a blind hexagonal hole 9 was created instead of hole 5 in the fixed console 3 and directed to the longitudinal axis of the rotor 1. Accordingly, a fixing screw 10 was created under the hole 9, the shank 11 of which is located transverse to the longitudinal axis the threaded part of the screw 10 and is also made hexagonal with the possibility of entering the hexagonal hole 9 of the console 3 and interlocking with the inner faces of this hole.

Under the infiltration anesthesia, the alveolar bone is skeletonized, the bone fragment is mobilized after trapezoidal sawing and the soft tissues are sutured tightly. Then, the L-shaped fixing screw 10 is screwed into the basal bone and the lower end of the main rotor 1 is put on its hexagonal shank 11 by means of the hexagonal hole 9. Then, the main rotor 1 is rotated to the required angle of inclination, thereby setting the desired vector of the direction of tissue growth, and leave it in this position. The inner faces of the hole 9 and the edges of the shank 11 of the fastening screw, interlocking, maintain this position of the screw 1. Then, as described above, the movable arm 2 is raised to the optimum height and a bone bed is inserted into the mobilized bone fragment through the hole 4 into which the fastening screw 6 is inserted inserted into the hole 4, and rotating it with a key (not shown) for the hexagonal shank 8, screw the fixing screw 6 into the bone and thereby attach the upper part of the screw 1 to the bone fragment. Within 7 days, while the bone fragment is fixed by means of a distraction device on the basal bone, there is no foreign body between the last and the bone fragment that interferes with the process of regeneration of bone and soft tissues. After 7 days, the distraction process begins according to a known protocol. At the same time, turning the rotor 1 for the multi-faceted shank 7, move the console 2 vertically up the screw 1, which is located at an angle to the vertical. From the same angle, new bone and soft tissue grows.

Upon completion of the osteogenesis process, the device is easily removed by unscrewing the side fixing screw 6 from the patient’s bone, removing the main screw 1 from the shank 11 of the fixing screw 10 and unscrewing the screw 10 from the patient’s bone.

Claims (1)

A distraction apparatus containing a rotor and means for moving the mobilized bone fragment of the jaw of the patient from the basal bone, as well as fixing screws for fixing said funds on the bone fragment and on the basal bone, wherein said means of moving the bone fragment are made in the form of movable and fixed consoles, each of which has an opening in which a fixing screw is installed, the movable console mounted on the main rotor with the possibility of longitudinal reciprocating stupid movement, characterized in that the hole in the fixed console is made multifaceted and towards the axis of the rotor, and the shank of the fastening screw interacting with it is also made multifaceted with the ability to interact with the specified multifaceted hole in the fixed console, while the shank of the fixing screw is located transversely to the threaded portion of this mounting screw.

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