RU2765540C1 - Maxillary sinus floor mucosa lifting instrument - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to dental instruments and can be used to lift the mucous membrane of the maxillary sinus floor with its pronounced curvature through the implant bed. Tool comprises handle with corrugated surface. L-shaped connecting rods of cone shape of 1–2 mm in diameter are rigidly attached to the ends of the handle on both sides. At the ends of connecting rods there are mirrored working parts. Working parts have an oval shape of 2 mm in diameter, one surface is flat, the other surface is convex and has a smoothed edge.

EFFECT: atraumatic elevation of the mucous membrane of the maxillary sinus floor with its pronounced curvature through the implant bed.

1 cl, 8 dwg

Description

The invention relates to medicine, namely to dental instruments, and can be used in dental practice to lift the mucous membrane of the bottom of the maxillary sinus with its pronounced curvature through the implant bed.

Known osteotome for implant placement with bone deficiency vertically no more than 2-3 mm. The use of this tool is as follows. An osteotome with a round working part is inserted into the prepared bed. With a few blows with a surgical hammer, the cortical plate of the day of the maxillary sinus breaks, and an increase in the length of the implant site by the required 2-3 mm is obtained. (Kulakov, A. A. Dental implantation / edited by Kulakov A. A. - Moscow: GEOTAR-Media, 2018. - 400 p. 156).

The disadvantage of this tool lies in the round working part, which cannot be used with a pronounced curvature of the bottom of the maxillary sinus, since the likelihood of perforation of the mucous membrane of the bottom of the maxillary sinus increases, and also tapping to break the sinus wall brings significant discomfort during the operation for the patient.

Special curettes are known for exfoliating the mucous membrane of the maxillary sinus during an open sinus lift. After the formation of the mucoperiosteal flap and the creation of the lateral window, the sinus mucosa is exfoliated with special curettes from the border of the bone window. The membrane is raised to the level desired for future augmentation. Avoid excessive lifting of the membrane due to the possible appearance of tension in the area of the attached mucosa. First, the mucosa is separated from the bottom of the sinus, and then from its medial wall. The movement of the curettes should be made only in contact with the bone walls, thereby preventing rupture of the sinus mucosa. The most dangerous zones in terms of mucosal perforation are in the area of the medial wall of the sinus, where the sinus can go under the bottom of the nasal cavity and in the area of the anterior wall, where the mucosa is most strongly associated with the bone bed. (Kulakov, A.A. Dental implantation / edited by Kulakov A.A. - Moscow: GEOTAR-Media, 2018. - 400 p. 158).

The disadvantage of these instruments is the formation of a large wound surface for access to the sinus mucosa, since their use through the implant bed is impossible due to the size of the curette and the working part. An increase in the area of the wound surface leads to a prolongation of the postoperative rehabilitation of the patient and increases discomfort after manipulation.

The objective of the invention is to develop a tool for atraumatic elevation of the mucous membrane of the bottom of the maxillary sinus with its pronounced curvature through the implant bed.

The task is achieved by the fact that the instrument for raising the mucous membrane of the bottom of the maxillary sinus, including a handle and a working surface, contains two cone-shaped rods with a diameter of 1-2 mm rigidly attached on both sides to the ends of the handle, which are L-shaped bent in opposite directions, on At the ends of the rods there are working parts of an oval shape 2 mm in diameter, mirrored relative to each other, and one surface of the working part is convex, the other is flat, and the edge of the working part is smoothed.

To solve this problem, a tool is proposed for raising the mucous membrane of the bottom of the maxillary sinus, including a handle, two cone-shaped connecting rods and working parts on the rods. The tool is a handle with a corrugated surface. L-shaped thin cone-shaped connecting rods 1-2 mm in diameter are rigidly attached to the ends of the handle on both sides at an angle, connecting the handle and the working part. Mirrored working parts are located at the ends of the connecting rods. The working part has an oval shape 2 mm in diameter, one surface is flat, the other is convex, the edge is smoothed.

To explain the proposed invention in Fig.1 shows a General view of the tool, where 1 - handle, 2 - connecting rod, 3 - support surface. Figure 2 (a, b) shows a view of the working part, where 4 is a flat surface, 5 is convex, 6 is a smooth edge.

An example is illustrated with images:

Fig.3 OPTG before surgery based on CBCT;

Fig.4 Parameters of bone tissue in the area of 2.5; 2.6 teeth according to CBCT, Pronounced bending of the anterior wall and bottom in the area of 2.5 teeth;

Fig.5 The introduction of a tool to raise the mucous membrane of the bottom of the maxillary sinus through the prepared implant bed;

Fig.6 X-ray control using diagnostic pins;

Fig.7 X-ray control of the introduction of implants;

Fig.8 X-ray control of the result 6 months after the operation.

The tool works as follows. The tool for raising the mucous membrane of the bottom of the maxillary sinus is inserted through the prepared implant bed until it comes into contact with the mucous membrane of the bottom of the maxillary sinus. Then, with gentle movements, the mucous membrane of the bottom of the maxillary sinus is exfoliated distally and upward to the required height.

Clinical example.

Patient P., aged 55, complained of missing 2.5 teeth, decay of 2.6; 2.8 teeth, aesthetic defect, difficulty chewing food (figure 3).

The decision was made: extraction of teeth 2.6; 2.8 and implantation in area 2.5; 2.6 teeth. According to CBCT, it was found that there is a pronounced bending of the anterior wall and the bottom of the maxillary sinus in the area of 2.5 of the tooth and the parameters of the bone tissue do not allow the installation of implants without additional intervention in order to increase the height of the alveolar process in the area of 2.5; 2.6 teeth (Figure 4). It was decided to perform an anterior sinus lift in the area of 2.5 teeth and a hemo-sinus lift in the area of 2.6 teeth, simultaneous implantation in the area of 2.5; 2.6 teeth.

Under infiltration anesthesia Sol. Ultracaini DS 4% 1:200000 2.7 ml. removed 2.6; 2.8 teeth, incision along the crest of the alveolar process and exfoliation of the mucoperiosteal flap in the area of 2.5 teeth.

Next, an anterior sinus lift was performed in the area of 2.5 teeth in order to optimize the level of bone tissue in height. To do this, the instrument for raising the mucous membrane of the bottom of the maxillary sinus is inserted through the prepared implant bed until it comes into contact with the mucous membrane of the bottom of the maxillary sinus (Figure 5).

Gently exfoliate the mucous membrane of the bottom of the maxillary sinus distally and upward to the required height, followed by x-ray control using diagnostic pins (figure 6).

This was followed by the introduction of implants in area 2.5; 2.6 teeth (Fig. 7).

6 months after surgery and prosthetics was carried out x-ray control (Fig.8).

The present invention allows to obtain the following technical result - atraumatic elevation of the mucous membrane of the bottom of the maxillary sinus with its pronounced curvature through the implant bed. Due to the shape of the connecting rod and the narrow working part, access is possible through the implant site from 2 mm in diameter, which corresponds to the diameter of the pilot drill in most implant systems. Due to this, there is no need for additional access to the mucous membrane of the maxillary sinus, which, in turn, significantly reduces the area of the wound surface. The shape of the working part allows you to work in difficult conditions of pronounced curvature of the day of the maxillary sinus, thereby reducing the likelihood of perforation of the mucous membrane.

Claims (1)

A tool for lifting the mucous membrane of the bottom of the maxillary sinus, including a handle and a working surface, characterized in that it contains two cone-shaped rods, 1-2 mm in diameter, rigidly attached to the ends of the handle on both sides, which are L-shaped bent in opposite directions, at the ends of the rods there are working parts of an oval shape 2 mm in diameter, mirrored relative to each other, and one surface of the working part is made convex, and the other is flat, and the edge of the working part is smoothed.

Images