WO2011037206A1 - Guide affixing pin and method for performing implant surgery using same - Google Patents

Guide affixing pin and method for performing implant surgery using same Download PDF

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Publication number
WO2011037206A1
WO2011037206A1 PCT/JP2010/066598 JP2010066598W WO2011037206A1 WO 2011037206 A1 WO2011037206 A1 WO 2011037206A1 JP 2010066598 W JP2010066598 W JP 2010066598W WO 2011037206 A1 WO2011037206 A1 WO 2011037206A1
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Prior art keywords
guide
implant
fixing pin
preoperative
jawbone
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PCT/JP2010/066598
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French (fr)
Japanese (ja)
Inventor
基文 十河
雅也 西願
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株式会社アイキャット
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Priority claimed from JP2009219796A external-priority patent/JP4971401B2/en
Application filed by 株式会社アイキャット filed Critical 株式会社アイキャット
Publication of WO2011037206A1 publication Critical patent/WO2011037206A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08Machine parts specially adapted for dentistry
    • A61C1/082Positioning or guiding, e.g. of drills
    • A61C1/085Positioning or guiding, e.g. of drills for multiple drills, for simultaneous drilling

Definitions

  • the present invention relates to a guide fixing pin used before and during an implant operation to position an implant operation guide having at least two guide sleeves for implant operation with respect to a jaw bone, and the pre- and intra-operative guides.
  • the present invention relates to a method of performing an implant operation using a fixing pin.
  • guides for implant surgery are based on detection of an appropriate position for implanting an implant into a jawbone in dental implant treatment.
  • the implant surgical guide is fitted on the dentition of an individual patient, and a guide sleeve of the implant surgical guide is disposed above the desired implant placement position, and a drill is guided to the guide sleeve. Create proper implant formation fossa.
  • the position of the guide for implant surgery may be displaced with the rotation of the drill during drilling work with a drill. there were.
  • a separate sleeve is provided in the guide for implant surgery, and a pin is passed through the sleeve, and the pin is inserted into the gingiva and alveolar bone not related to the implant surgery, so that the implant surgery can be performed even during drilling.
  • the guides were maintained in the proper positions.
  • an anchor member is inserted in the buccal tongue direction to position an implant surgical guide (template).
  • the present invention has been created to avoid such a problem, and provides a guide fixing pin for fixing to an dentition without providing a wound only for fixing an implant surgical guide.
  • the guide fixation pin of the present invention provides a preoperative guide fixation pin used to position an implant surgical guide having at least two or more implant surgical guide sleeves relative to the jawbone.
  • the pre-operative guide fixing pin is a guide that is used only to fix the implant surgical guide at the same position of the implant forming cavity before the implant forming cavity is first created (referred to herein as “pre-operative”). It is a fixed pin.
  • the guide fixing pin is coaxial with the guide fixing portion that is longer in the axial direction than the long axis length of the guide sleeve and has an outer diameter substantially the same as the inner diameter of the guide sleeve, and at the lower end of the guide fixing portion.
  • a jawbone fixing part which is integrally connected and has a diameter smaller than the outer diameter of the guide fixing part.
  • the guide fixing portion restricts the radial movement of the preoperative guide fixing pin with respect to the guide sleeve when the preoperative guide fixing pin is inserted into the guide sleeve, and the jawbone fixing portion is When the guide fixing pin is inserted into the guide sleeve, the guide fixing pin is inserted into a hole for a preoperative guide fixing pin provided below the guide sleeve.
  • the jawbone fixing part can be formed with a screw groove in a part of the axial direction, and can be firmly fixed to the jawbone.
  • Another aspect of the present invention is an intraoperative guide fixing pin (guide fixing pin for implant forming cavity) used for positioning an implant surgical guide having at least two guide sleeves for implant surgery with respect to the jawbone.
  • a guide fixing portion that is longer in the axial direction than the major axis length of the guide sleeve and has an outer diameter that is substantially the same as the inner diameter of the guide sleeve, and is integrally connected coaxially at the lower end of the guide fixing portion; And a jawbone fixing part having a diameter smaller than the outer diameter of the fixing part.
  • the guide fixing portion regulates radial movement of the intraoperative guide fixing pin with respect to the guide sleeve when the intraoperative guide fixing pin is inserted into the guide sleeve, and the jawbone fixing portion is configured to move the intraoperative guide fixing pin to the guide sleeve.
  • the guide sleeve When inserted into the guide sleeve, it is preferably inserted into a drill-forming cavity that has been opened in advance for creating an implant-forming cavity provided below the guide sleeve.
  • Still another aspect of the present invention provides a guide fixing pin set composed of one preoperative guide fixing pin and at least one intraoperative guide fixing pin according to claim 3.
  • the guide fixing portion of the preoperative guide fixing pin and the guide fixing portion of the intraoperative guide fixing pin have substantially the same outer diameter.
  • the present invention also provides a method for performing an implant operation while positioning and fixing an implant operation guide having at least two guide sleeves for implant operation with respect to the jawbone.
  • this implant operation method at least the step of positioning the implant operation guide at a predetermined position, the preoperative guide fixing pin is inserted into any of the guide sleeves, and the jawbone fixing portion is attached to the jawbone.
  • preoperative and intraoperative guide fixing pins of the present invention and the method of performing an implant operation using these, it is possible to avoid inserting the guide fixing pins into gingiva etc. unrelated to a separate implant operation as in the prior art. It is possible to fix the guide for implant surgery and the jawbone just by using the implant formation fossa, which is indispensable to create in implant surgery, there is no burden on the patient, and it does not give unnecessary wounds after surgery There is.
  • Step 1 First, as pre-operative steps, 1) one of guide sleeves is determined in the guide for implant surgery, and a drilling operation is performed on this guide sleeve in the same manner as in creating a normal implant formation cavity. At this time, the drill uses a drill with a diameter smaller than that of creating a normal implant formation fossa, and a pin hole in the jawbone (drill formation fossa: The drill formation fossa means the formation fossa in the target drill in general) Create The details of the configuration of the guide fixing pin will be described later.
  • Step 2 A guide fixing pin for a preoperative drill composed of a guide fixing portion having an outer diameter substantially the same as that of the guide sleeve and an outer diameter jaw fixing portion corresponding to the diameter of the drill forming fossa is provided as a guide for the implant surgical guide. Insert into the sleeve. At this time, the guide fixing portion is engaged with the guide sleeve to support the implant operation guide.
  • a jawbone fixing part is inserted into the drill formation fossa.
  • the jawbone fixing part preferably has a screw thread, and is screwed into the drill forming fossa as it is. Therefore, the preoperative guide fixing pin fixes the dentition and the guide for implant surgery through the guide sleeve.
  • the guide is fixed to the implant surgical guide and the dentition just by creating a drill formation fossa for the guide fixation pin at a place where an implant formation fossa is to be created in the future. And avoid the sheepness of hurting the patient in a place unrelated to the implant formation fossa.
  • Steps 1 and 2 are work steps used when the implant surgical guide is fixed to the dentition using both the preoperative guide fixing pin and the intraoperative guide fixing pin described later, and only the intraoperative guide fixing pin is used.
  • the guide fixing work may be performed from the following step 3.
  • Step 3 In the operation of Step 3, an intraoperative guide fixing pin is used. First, the case where a preoperative guide fixing pin is used will be described. In step 2, the implant operation guide is fixed to the dentition. For this reason, actual implant placement work is required as the next work.
  • a guide sleeve other than the guide sleeve in which the preoperative guide fixing pin has already been inserted (hereinafter referred to as a second guide sleeve) is selected.
  • a drilling cavity is created with the selected second guide sleeve.
  • Step 4 An intraoperative guide fixing pin, which will be described later, is inserted into the implant formation cavity created in step 3 above. Thereby, the guide for implant surgery can be fixed using the implant formation fossa.
  • Step 3 and Step 4 are performed at other guide sleeve positions. This makes it possible to sequentially create all desired implant formation pits.
  • the intraoperative guide fixing pins already inserted in step 4 are extracted, and the intraoperative guides inserted into other guide sleeves are extracted.
  • Implant can be carried out with the implant surgical guide fixed with fixing pins (preferably two or more), and the implanted implant itself can be used for fixing the implant surgical guide in the same manner as the guide fixing pin. Conceivable.
  • the preoperative guide fixing pin it is preferable to perform the drilling operation of the implant forming cavity by extracting other drill forming cavity and the intraoperative guide fixing pin at a timing according to the implantation status of the implant. .
  • the preoperative guide fixing pin 10 includes a jaw fixing part 14, a guide fixing part 12, and a head part 16 on one axis.
  • the jawbone fixing portion 12 has a length that protrudes below the guide sleeve (downward in the drawing).
  • a head portion 16 is disposed above the guide fixing portion 12 (on the left side of the drawing).
  • a serrate structure (groove) is formed on the outer surface of the head portion 16 in whole or in part.
  • the preoperative guide fixing pin 10 is inserted into the guide sleeve of the implant surgical guide, and the guide fixing portion 12 having an outer diameter substantially the same as the inner diameter of the guide sleeve.
  • the guide sleeve and the preoperative guide fixing pin 10 are fixed at the time of fixation.
  • the jawbone fixing portion 14 since the guide fixing portion 12 has an axial distance similar to that of the guide sleeve, the jawbone fixing portion 14 having a diameter smaller than that of the guide fixing portion 12 protrudes downward from the guide for implant surgery. And this jawbone fixing
  • the jawbone fixing part 14 may be inserted into the jawbone in a state where a predetermined hole is drilled with a thin-diameter drill and guided by the distal end part 14a.
  • the jawbone fixing part 14 may be directly drilled and inserted into the jawbone.
  • a drill groove (tap shape) is usually provided for a predetermined length from the tip end portion 14a in the whole or a part of the outer surface, at least in the axial direction.
  • the intraoperative guide fixing pin 20 includes a jaw fixing part 24, a guide fixing part 22, and a head part 26 on one axis.
  • the jaw bone fixing portion 22 has a length that protrudes below the guide sleeve (downward in the drawing).
  • a head portion 26 is disposed above the guide fixing portion 22 (on the left side of the drawing).
  • a serrate structure (groove) is formed on the outer surface of the head portion 26 in whole or in part.
  • the preoperative guide fixing pin 20 may be suddenly inserted into the guide sleeve of the implant surgical guide.
  • the pin 10 is inserted into another guide sleeve in a fixed state.
  • the guide fixing portion 22 having an outer diameter substantially the same as the inner diameter of the guide sleeve.
  • the guide sleeve and the preoperative guide fixing pin 20 are fixed.
  • the jawbone fixing portion 24 since the guide fixing portion 22 has an axial distance approximate to that of the guide sleeve, the jawbone fixing portion 24 having a smaller diameter than the guide fixing portion 22 protrudes downward from the implant operation guide. And this jawbone fixing
  • the jawbone fixing part 24 needs to be inserted into the already formed implant forming pit so as not to damage the implant forming pit. Therefore, the jawbone fixing portion 24 of the intraoperative guide fixing pin 20 is not pointed at the tip and is not provided with a drill groove on the outer surface.
  • FIG. 3 and 4 show a state in which the intraoperative guide fixing pin 20 is inserted from the preoperative guide fixing pin 10 sequentially from the left (FIGS. 3 (a) to (c), FIGS. 4 (c) to (f). )).
  • FIG. 5 it is the schematic view which looked at the guide sleeve 30 for implant surgery from the upper direction.
  • a drill forming cavity 34 is formed by drilling a hole in the jawbone in which the guide sleeve A hole is positioned with a fixed drill 32.
  • the formed state is shown in step (b).
  • the preoperative guide fixing pin 10 is screwed into the drill forming cavity 34 created in steps (a) to (b).
  • the outer diameter of the jawbone fixing portion 14 is larger than the inner diameter of the drill forming cavity 34. It is because it is fixed firmly.
  • a screw groove may be provided above the jawbone fixing portion 14 in a portion positioned on the jawbone, particularly a relatively hard cortical bone. As a result, the jawbone and the preoperative guide fixing pin 10 are fixed.
  • the guide fixing portion 12 is inserted along the inner wall of the guide sleeve 30.
  • the axial length of the guide fixing portion 12 is preferably equal to or greater than the height of the guide sleeve 30, and the outer diameter of the guide fixing portion 12 and the inner diameter of the guide sleeve 30 are preferably substantially the same.
  • the intraoperative guide fixing pin 20 is inserted into the guide sleeve 30 forming the B hole on the left side of FIG. 4 with the preoperative guide fixing pin 10 fixed. Is shown.
  • an implant formation cavity 42 is formed with a normal drill 40.
  • This process is generally the same as the process of creating the implant formation cavity, and the drill 40 is inserted into the guide sleeve 30 while being guided by the through wrench 44.
  • the implant formation fossa 42 can also be formed without shaft shake or the like.
  • the implant formation pit 42 is formed to have a diameter of 2 mm or 3 mm in the same manner as a normal implant formation pit.
  • the intraoperative guide fixing pin 20 is inserted into the implant formation cavity 42.
  • a new implant formation cavity is created with the implant operation guide fixed by the pins 10 and 20 inserted by extracting the preoperative guide fixation pin 10 and the intraoperative guide fixation pin 20. To do.
  • the implant is fixed, it has the same effect as the preoperative guide fixing pin 10.
  • the implant surgical guide can be fixed by utilizing a normal process for creating an implant formation cavity without damaging the jawbone at all.
  • FIG. 6 shows the main surgical steps in the order of (a) to (i)
  • FIG. 7 shows the main surgical steps in the order of (a) to (j).
  • Each figure shows the right dentition, implant planned site, remaining tooth, 1.5mm formation fossa, 2.0mm formation fossa, 3.0mm formation fossa, preoperative guide fixation pin, intraoperative guide fixation Visually follow the pin display.
  • FIG. 6A a dentition missing part including a plurality of implant placement sites is shown.
  • a 1.5 mm formation fossa is created with a drill at the site to be implanted (FIG. 6B), and the preoperative guide fixing pin 10 is inserted and fixed at that site (FIG. 6C).
  • formation pits are formed in order of ⁇ 2.0 mm and ⁇ 3.0 mm in the planned implantation site where the preoperative guide fixing pin 10 is not fixed (FIGS. 6D and 6E).
  • the intraoperative guide fixing pin 20 is inserted and fixed in any of the forming cavities formed with ⁇ 3.0 mm, and then the preoperative fixing pin 10 is removed (FIG.
  • FIGS. 6D and 6E formation pits are created in order of ⁇ 2.0 mm and ⁇ 3.0 mm in the planned implantation site where the preoperative guide fixing pin 10 has been removed (FIGS. 6G and 6H). )). Finally, if the intraoperative guide fixing pin is removed, the formation of the formation cavity for implant placement is completed (FIG. 6 (i)).
  • FIG. 7A a dentition missing portion including a plurality of implant placement sites is shown.
  • FIG. 7B a formation cavity having a diameter of 1.5 mm is created by a drill at the site to be implanted (FIG. 7B), and the preoperative guide fixing pin 10 is inserted and fixed at the site (FIG. 7C).
  • a formation cavity having a diameter of 2.0 mm is created by a drill in the planned implantation site where the preoperative guide fixing pin 10 is not fixed (FIG. 7D).
  • the steps so far are the same as in the first embodiment of FIG.
  • the intraoperative guide fixing pin 20 having a diameter of 2.0 mm is inserted and fixed in the forming cavity formed with a diameter of 2.0 mm, and then the preoperative guide fixing pin 10 is removed (FIG. 7E). Then, a ⁇ 2.0 mm formation fossa is drilled in the formation fovea from which the preoperative guide fixing pin 10 has been removed (FIG. 7 (f)), and a ⁇ 2.0 mm formation fossa is drilled into the ⁇ 3.0 mm formation fovea (Fig. 7 (g)).
  • an intraoperative guide fixing pin 20 having a diameter of 3.0 mm is inserted and fixed in a forming cavity formed with a diameter of 3.0 mm, and the intraoperative guide fixing pin 20 having a diameter of 2.0 mm is removed (FIG. 7H). Then, the remaining ⁇ 2.0 mm formation fossa is made into a ⁇ 3.0 mm formation fossa with a drill (FIG. 7 (i)), and finally the ⁇ 3.0 mm intraoperative guide fixing pin 20 is removed to complete (FIG. 7 (j )).

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  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
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Abstract

A guide affixing pin used to position to a jawbone an implant surgery guide having at least two or more guide sleeves for implant surgery. The guide affixing pin is provided with: a guide affixing section having an axial length greater than the length of the guide sleeves in the longitudinal direction thereof and having an outer diameter substantially the same as the inner diameter of the guide sleeves; and a section to be affixed to the jawbone, the section being connected coaxially and integrally with the guide affixing section at the lower end thereof and having a diameter smaller than the outer diameter of the guide affixing section.

Description

ガイド固定ピンおよびこのガイド固定ピンを用いてインプラント手術を行う方法Guide fixing pin and method of performing an implant operation using the guide fixing pin
本発明は、少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めするためにインプラント手術の術前・術中に用いるガイド固定ピン、およびこの術前、術中ガイド固定ピンを用いてインプラント手術を行う方法に関する。 The present invention relates to a guide fixing pin used before and during an implant operation to position an implant operation guide having at least two guide sleeves for implant operation with respect to a jaw bone, and the pre- and intra-operative guides. The present invention relates to a method of performing an implant operation using a fixing pin.
近年、歯科用インプラント治療においてインプラントを顎骨に埋入する適正な位置を検出し、これに基づいて作成されたインプラント手術用ガイドが提供されている。このインプラント手術用ガイドは、個々の患者の歯列上に勘合させ、所望するインプラントの埋入位置の上方にインプラント手術用ガイドのガイドスリーブを配設し、このガイドスリーブにドリルを案内することにより適正なインプラント形成窩を作成する。 2. Description of the Related Art In recent years, guides for implant surgery have been provided that are based on detection of an appropriate position for implanting an implant into a jawbone in dental implant treatment. The implant surgical guide is fitted on the dentition of an individual patient, and a guide sleeve of the implant surgical guide is disposed above the desired implant placement position, and a drill is guided to the guide sleeve. Create proper implant formation fossa.
このようなインプラント手術用ガイドを用いてインプラント埋入のための形成窩を作成する場合、ドリルによる穴空け作業の際にドリルの回転にともなってインプラント手術用ガイドの位置ずれを招いてしまう愚があった。 When creating a formation cavity for implant placement using such a guide for implant surgery, the position of the guide for implant surgery may be displaced with the rotation of the drill during drilling work with a drill. there were.
この問題を解決するために従来、インプラント手術用ガイドに別途スリーブを設け、このスリーブにピンを通し、インプラント手術と関係しない歯肉および歯槽骨にピンを刺すことで、穴開け作業時においてもインプラント手術用ガイドを適正位置に維持させるようにしていた。例えば国際公開公報WO03/055407では頬舌方向にアンカー部材を挿入してインプラント手術用ガイド(テンプレート)を位置決めしていた。 Conventionally, in order to solve this problem, a separate sleeve is provided in the guide for implant surgery, and a pin is passed through the sleeve, and the pin is inserted into the gingiva and alveolar bone not related to the implant surgery, so that the implant surgery can be performed even during drilling. The guides were maintained in the proper positions. For example, in International Publication No. WO03 / 055407, an anchor member is inserted in the buccal tongue direction to position an implant surgical guide (template).
特公表2005-518834公報Japanese Patent Publication No. 2005-518834 国際公開公報WO03/055407International Publication No. WO03 / 055407
しかしながら、従来のように別途のインプラント手術と無関係の歯肉等にガイド固定ピンを差し込む方法では、患者への負担が大きく、術後に無用な傷を与えてしまうという愚があった。 However, the conventional method of inserting the guide fixing pin into the gingiva or the like unrelated to the separate implant operation has a frustration that a burden on the patient is great and an unnecessary wound is given after the operation.
本発明は、このような問題を回避するために創作されたものであり、インプラント手術用ガイドを固定するためだけの傷を設けずに歯列に固定するためのガイド固定ピンを提供する。 The present invention has been created to avoid such a problem, and provides a guide fixing pin for fixing to an dentition without providing a wound only for fixing an implant surgical guide.
具体的には、本発明のガイド固定ピンは、少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めするために用いられる術前ガイド固定ピンを提供する。 Specifically, the guide fixation pin of the present invention provides a preoperative guide fixation pin used to position an implant surgical guide having at least two or more implant surgical guide sleeves relative to the jawbone.
上記術前ガイド固定ピンは、まずインプラント形成窩を作成する前(ここでは「術前」と称している)に、インプラント形成窩の同じ位置にインプラント手術用ガイドの固定だけのために使用するガイド固定ピンである。 The pre-operative guide fixing pin is a guide that is used only to fix the implant surgical guide at the same position of the implant forming cavity before the implant forming cavity is first created (referred to herein as “pre-operative”). It is a fixed pin.
詳細には、ガイド固定ピンは、前記ガイドスリーブの長軸長さよりも軸方向に長く且つガイドスリーブの内径と略同一の外径を有するガイド固定部と、前記ガイド固定部の下端において同軸上に一体連結し、前記ガイド固定部の外径よりも小さい径を有する顎骨固定部とを備えている。 Specifically, the guide fixing pin is coaxial with the guide fixing portion that is longer in the axial direction than the long axis length of the guide sleeve and has an outer diameter substantially the same as the inner diameter of the guide sleeve, and at the lower end of the guide fixing portion. And a jawbone fixing part which is integrally connected and has a diameter smaller than the outer diameter of the guide fixing part.
また、前記ガイド固定部は、術前ガイド固定ピンを前記ガイドスリーブに挿入した際にガイドスリーブに対して術前ガイド固定ピンの径方向の移動を規制し、前記顎骨固定部は、前記術前ガイド固定ピンを前記ガイドスリーブに挿入した際に前記ガイドスリーブの下方に設けられた術前ガイド固定ピン用の孔に挿入される。 The guide fixing portion restricts the radial movement of the preoperative guide fixing pin with respect to the guide sleeve when the preoperative guide fixing pin is inserted into the guide sleeve, and the jawbone fixing portion is When the guide fixing pin is inserted into the guide sleeve, the guide fixing pin is inserted into a hole for a preoperative guide fixing pin provided below the guide sleeve.
また、前記顎骨固定部は、軸線方向一部にネジ溝を形成することができ、これによって、顎骨としっかり固定することができる。 Further, the jawbone fixing part can be formed with a screw groove in a part of the axial direction, and can be firmly fixed to the jawbone.
また、他の本発明は、少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めするために用いられる術中ガイド固定ピン(インプラント形成窩用ガイド固定ピン)であって、該ガイドスリーブの長軸長さよりも軸方向に長く且つガイドスリーブの内径と略同一の外径を有するガイド固定部と、前記ガイド固定部の下端において同軸上に一体連結し、前記ガイド固定部の外径よりも小さい径を有する顎骨固定部とを備えている。 Another aspect of the present invention is an intraoperative guide fixing pin (guide fixing pin for implant forming cavity) used for positioning an implant surgical guide having at least two guide sleeves for implant surgery with respect to the jawbone. A guide fixing portion that is longer in the axial direction than the major axis length of the guide sleeve and has an outer diameter that is substantially the same as the inner diameter of the guide sleeve, and is integrally connected coaxially at the lower end of the guide fixing portion; And a jawbone fixing part having a diameter smaller than the outer diameter of the fixing part.
前記ガイド固定部は、術中ガイド固定ピンを前記ガイドスリーブに挿入した際にガイドスリーブに対して術中ガイド固定ピンの径方向の移動を規制し、前記顎骨固定部は、前記術中ガイド固定ピンを前記ガイドスリーブに挿入した際に前記ガイドスリーブの下方に設けられたインプラント形成窩作成のために予め開放されたドリル形成窩に挿入されることが好ましい。 The guide fixing portion regulates radial movement of the intraoperative guide fixing pin with respect to the guide sleeve when the intraoperative guide fixing pin is inserted into the guide sleeve, and the jawbone fixing portion is configured to move the intraoperative guide fixing pin to the guide sleeve. When inserted into the guide sleeve, it is preferably inserted into a drill-forming cavity that has been opened in advance for creating an implant-forming cavity provided below the guide sleeve.
さらに他の本発明は、上記術前ガイド固定ピン1つと、少なくとも1つ以上の請求項3に記載の術中ガイド固定ピントとで構成されたガイド固定ピンセットを提供する。 Still another aspect of the present invention provides a guide fixing pin set composed of one preoperative guide fixing pin and at least one intraoperative guide fixing pin according to claim 3.
術前ガイド固定ピンのガイド固定部と、前記術中ガイド固定ピンのガイド固定部とは、互いに外径が略同一である。 The guide fixing portion of the preoperative guide fixing pin and the guide fixing portion of the intraoperative guide fixing pin have substantially the same outer diameter.
また本発明は、少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めし、固定しながらインプラント手術を行う方法も提供する。このインプラント手術を行う方法では、少なくとも、前記インプラント手術用ガイドを予め定められた位置に位置決めするステップと、任意の前記ガイドスリーブに前記術前ガイド固定ピンを挿入し、前記顎骨固定部を顎骨に固定するステップと、前記術前ガイド固定ピンを固定したガイドスリーブ以外のガイドスリーブにドリルを用いてインプラント埋入のための形成窩を作成するステップと、前記インプラント埋入のための形成窩に前記術中ガイド固定ピンを挿入し、顎骨に固定するステップと、前記術前ガイド固定ピンをガイドスリーブから抜挿するステップと、前記術前ガイド固定ピンが抜挿された後の形成窩にインプラント埋入のための形成窩をドリルで作成するステップと、を有する。 The present invention also provides a method for performing an implant operation while positioning and fixing an implant operation guide having at least two guide sleeves for implant operation with respect to the jawbone. In this implant operation method, at least the step of positioning the implant operation guide at a predetermined position, the preoperative guide fixing pin is inserted into any of the guide sleeves, and the jawbone fixing portion is attached to the jawbone. A step of creating a formation fossa for implant placement using a drill in a guide sleeve other than the guide sleeve to which the preoperative guide fixation pin is fixed; and the formation fovea for implant placement Inserting an intraoperative guide fixing pin and fixing it to the jawbone; removing and inserting the preoperative guide fixing pin from the guide sleeve; and implanting into the formation cavity after the preoperative guide fixing pin is inserted and removed Drilling a formation fossa for.
本発明の術前・術中ガイド固定ピンおよびこれらを用いたインプラント手術を行う方法によれば、従来のように別途のインプラント手術と無関係の歯肉等にガイド固定ピンを差し込むことを回避することができ、インプラント手術において作成が必須となるインプラント形成窩を利用するだけでインプラント手術用ガイドと顎骨とを固定することができ、患者への負担がなく、術後に無用な傷を与えない点でメリットがある。 According to the preoperative and intraoperative guide fixing pins of the present invention and the method of performing an implant operation using these, it is possible to avoid inserting the guide fixing pins into gingiva etc. unrelated to a separate implant operation as in the prior art. It is possible to fix the guide for implant surgery and the jawbone just by using the implant formation fossa, which is indispensable to create in implant surgery, there is no burden on the patient, and it does not give unnecessary wounds after surgery There is.
本発明の術前ガイド固定ピンの正面図である。It is a front view of the preoperative guide fixing pin of this invention. 本発明の術中ガイド固定ピンの正面図である。It is a front view of the intraoperative guide fixing pin of this invention. 本発明の術前ガイド固定ピンを挿入する工程を示している。The process of inserting the preoperative guide fixing pin of this invention is shown. 本発明の術中ガイド固定ピンを挿入する工程を示している。The process of inserting the intraoperative guide fixing pin of this invention is shown. 本発明の術前・術中ガイド固定ピンを挿入するガイド穴を示した略図である。It is the schematic which showed the guide hole which inserts the preoperative and intraoperative guide fixing pin of this invention. 本発明の術前・術中ガイド固定ピンを用いてインプラント埋入のための手術を行う方法の一例を示した模式図である。It is the schematic diagram which showed an example of the method of performing the operation for implant placement using the preoperative and intraoperative guide fixing pin of this invention. 本発明の術前・術中ガイド固定ピンを用いてインプラント埋入のための手術を行う方法の他の一例を示した模式図である。It is the schematic diagram which showed another example of the method of performing the operation for implant placement using the preoperative and intraoperative guide fixing pin of this invention.
まず、本発明の術前・術中ガイド固定ピンの実施形態を説明する前提として、本ガイド固定ピンを使用したインプラント手術について説明しておく。 First, as a premise for explaining an embodiment of the preoperative and intraoperative guide fixing pins of the present invention, an implant operation using the guide fixing pins will be described.
ステップ1
まず、術前のステップとして、1)インプラント手術用ガイドにおいてガイドスリーブのうち1つを定め、このガイドスリーブに通常のインプラント形成窩作成と同様にドリルで穴あけ作業を行う。このとき、ドリルは通常のインプラント形成窩の作成よりも細い径のドリルを使用し、顎骨にピン用孔(ドリル形成窩:ドリル形成窩とは目的とするドリルでの形成窩全般を意味する)を作成する。なお、ガイド固定ピンの構成の詳細については後述する。
Step 1
First, as pre-operative steps, 1) one of guide sleeves is determined in the guide for implant surgery, and a drilling operation is performed on this guide sleeve in the same manner as in creating a normal implant formation cavity. At this time, the drill uses a drill with a diameter smaller than that of creating a normal implant formation fossa, and a pin hole in the jawbone (drill formation fossa: The drill formation fossa means the formation fossa in the target drill in general) Create The details of the configuration of the guide fixing pin will be described later.
ステップ2
ガイドスリーブと略同一の外径のガイド固定部と、下方にありドリル形成窩の径に対応する外径の顎骨固定部とで構成された術前ドリル用ガイド固定ピンをインプラント手術用ガイドのガイドスリーブに挿入する。このとき、ガイド固定部がガイドスリーブに係合することでインプラント手術用ガイドを支持する。
Step 2
A guide fixing pin for a preoperative drill composed of a guide fixing portion having an outer diameter substantially the same as that of the guide sleeve and an outer diameter jaw fixing portion corresponding to the diameter of the drill forming fossa is provided as a guide for the implant surgical guide. Insert into the sleeve. At this time, the guide fixing portion is engaged with the guide sleeve to support the implant operation guide.
さらに、上記ドリル形成窩に顎骨固定部を挿入する。このとき顎骨固定部は、ネジ山を有することが好ましく、ドリル形成窩にそのままネジ込んでいく。したがって、術前ガイド固定ピンはガイドスリーブを介して歯列とインプラント手術用ガイドとを固定する。 Furthermore, a jawbone fixing part is inserted into the drill formation fossa. At this time, the jawbone fixing part preferably has a screw thread, and is screwed into the drill forming fossa as it is. Therefore, the preoperative guide fixing pin fixes the dentition and the guide for implant surgery through the guide sleeve.
したがって、この術前ガイド固定ピンを使用すれば、将来的にインプラント形成窩を作成する場所に、ガイド固定ピン用のドリル形成窩を作成するだけでガイドをインプラント手術用ガイドと歯列とを固定することができ、インプラント形成窩と無関係の場所において患者を傷つける愚を回避できる。 Therefore, with this preoperative guide fixation pin, the guide is fixed to the implant surgical guide and the dentition just by creating a drill formation fossa for the guide fixation pin at a place where an implant formation fossa is to be created in the future. And avoid the foolishness of hurting the patient in a place unrelated to the implant formation fossa.
なお、ステップ1及びステップ2は、術前ガイド固定ピンと後述の術中ガイド固定ピンとの両者を使用して歯列にインプラント手術用ガイドを固定する場合に用いられる作業工程であり、術中ガイド固定ピンのみを使用する場合には以下のステップ3からガイド固定作業を行っても良い。 Steps 1 and 2 are work steps used when the implant surgical guide is fixed to the dentition using both the preoperative guide fixing pin and the intraoperative guide fixing pin described later, and only the intraoperative guide fixing pin is used. When using the guide, the guide fixing work may be performed from the following step 3.
ステップ3
ステップ3の作業では、術中ガイド固定ピンを使用する。まずは術前ガイド固定ピンを用いた場合で説明する。
ステップ2によりインプラント手術用ガイドは歯列に固定されている。このため次の作業としては実際のインプラント埋入作業が必要となる。
Step 3
In the operation of Step 3, an intraoperative guide fixing pin is used. First, the case where a preoperative guide fixing pin is used will be described.
In step 2, the implant operation guide is fixed to the dentition. For this reason, actual implant placement work is required as the next work.
既に術前ガイド固定ピンが挿入されているガイドスリーブ以外のガイドスリーブ(以下、第二ガイドスリーブと称する)を選択する。まず、選択された第二ガイドスリーブでドリル形成窩を作成する。このときいきなりインプラント形成窩に対応する外径のドリルを用いてインプラント形成窩を作成することもできるが、好ましくは、何段階かに別けて外径の小さいドリルから大きいドリルを順に使用する。例えば、3mmのインプラント形成窩を作成する場合、まず2mmのドリル形成窩を作成し、次に3mmのドリル形成窩を空けていくがごときである。 A guide sleeve other than the guide sleeve in which the preoperative guide fixing pin has already been inserted (hereinafter referred to as a second guide sleeve) is selected. First, a drilling cavity is created with the selected second guide sleeve. At this time, it is possible to create the implant-forming pit using a drill having an outer diameter corresponding to the implant-forming pit, but preferably, a drill having a smaller outer diameter is used in order from several stages. For example, when creating a 3 mm implant-forming fossa, first create a 2 mm drill-forming fove, and then open a 3 mm drill-forming fossa.
ステップ4
上記ステップ3で作成したインプラント形成窩に後述の術中ガイド固定ピンを挿入する。これにより、インプラント形成窩を用いてインプラント手術用ガイドを固定することができる。
Step 4
An intraoperative guide fixing pin, which will be described later, is inserted into the implant formation cavity created in step 3 above. Thereby, the guide for implant surgery can be fixed using the implant formation fossa.
さらに、その後、他のガイドスリーブ位置においてステップ3及びこのステップ4を行う。これにより所望する全てのインプラント形成窩を順に作成していくことができる。 Further, thereafter, Step 3 and Step 4 are performed at other guide sleeve positions. This makes it possible to sequentially create all desired implant formation pits.
さらに、作成を希望するインプラント形成窩の数の方が術中ガイド固定ピンより多くなった場合などでは、既にステップ4で挿入された術中ガイド固定ピンを抜き出し、他のガイドスリーブに挿入された術中ガイド固定ピン(2つ以上が好ましい)でインプラント手術用ガイドを固定した状態でインプラントを埋入していき、さらに埋入されたインプラント自体をガイド固定ピンと同様にインプラント手術用ガイドの固定に用いることも考えられる。 Furthermore, when the number of implant forming cavities desired to be created is larger than the intraoperative guide fixing pins, the intraoperative guide fixing pins already inserted in step 4 are extracted, and the intraoperative guides inserted into other guide sleeves are extracted. Implant can be carried out with the implant surgical guide fixed with fixing pins (preferably two or more), and the implanted implant itself can be used for fixing the implant surgical guide in the same manner as the guide fixing pin. Conceivable.
さらに、術前ガイド固定ピンについても、他のドリル形成窩作成の作業や術中ガイド固定ピン、インプラントの埋入状況に応じたタイミングで抜き出して、インプラント形成窩の穴あけ作業を行っていくことが好ましい。 Furthermore, for the preoperative guide fixing pin, it is preferable to perform the drilling operation of the implant forming cavity by extracting other drill forming cavity and the intraoperative guide fixing pin at a timing according to the implantation status of the implant. .
術前ガイド固定ピン
次に各術前・術中ガイド固定ピンの構成について説明する。
図1を参照すれば、術前ガイド固定ピン10が示されている。この術前ガイド固定ピン10は、一軸線上に顎骨固定部14と、ガイド固定部12と、ヘッド部16とで構成されている。
Preoperative Guide Fixing Pin Next, the configuration of each preoperative and intraoperative guide fixing pin will be described.
Referring to FIG. 1, a preoperative guide fixing pin 10 is shown. The preoperative guide fixing pin 10 includes a jaw fixing part 14, a guide fixing part 12, and a head part 16 on one axis.
術前ガイド固定ピン10は、上述するようにインプラント手術用ガイドのガイドスリーブに挿入すると、ガイドスリーブより下方(紙面下方)まで顎骨固定部12が突出する長さを有している。 When the preoperative guide fixing pin 10 is inserted into the guide sleeve of the implant operation guide as described above, the jawbone fixing portion 12 has a length that protrudes below the guide sleeve (downward in the drawing).
また、ガイド固定部12の上方(紙面左方)にはヘッド部16が配設されている。このヘッド部16の外表面には全部または一部にセレート構造(溝)が形成されている。 A head portion 16 is disposed above the guide fixing portion 12 (on the left side of the drawing). A serrate structure (groove) is formed on the outer surface of the head portion 16 in whole or in part.
実際に、インプラント手術用ガイドと歯列とを固定する場合、術前ガイド固定ピン10は、インプラント手術用ガイドのガイドスリーブに挿入され、ガイドスリーブの内径と略同一の外径のガイド固定部12により案内され、固定時にはガイドスリーブとこの術前ガイド固定ピン10との固定を担う。 Actually, when the implant surgical guide and the dentition are fixed, the preoperative guide fixing pin 10 is inserted into the guide sleeve of the implant surgical guide, and the guide fixing portion 12 having an outer diameter substantially the same as the inner diameter of the guide sleeve. The guide sleeve and the preoperative guide fixing pin 10 are fixed at the time of fixation.
また、ガイド固定部12は、ガイドスリーブと軸線距離が近似するため、ガイド固定部12より径の小さい顎骨固定部14がインプラント手術用ガイドより下方に突出することとなる。そして、この顎骨固定部14が顎骨(歯列)に到達し、これが穴あけを行うことで顎骨とインプラント手術用ガイドが固定されることとなる。 Further, since the guide fixing portion 12 has an axial distance similar to that of the guide sleeve, the jawbone fixing portion 14 having a diameter smaller than that of the guide fixing portion 12 protrudes downward from the guide for implant surgery. And this jawbone fixing | fixed part 14 arrives at a jawbone (dental row), and this will fix a jawbone and an implant operation guide by drilling.
顎骨固定部14は、細い径のドリルで所定の穴を開け、これに先端部14aで案内させた状態で顎骨に挿入されることもあるが、直接、顎骨に穴あけ・挿入することできるようにすることが好ましく、通常、その外表面の全部または一部、少なくとも軸線方向に先端部14aから所定長さ分は、ドリル溝(タップ形状)が付与されている。 The jawbone fixing part 14 may be inserted into the jawbone in a state where a predetermined hole is drilled with a thin-diameter drill and guided by the distal end part 14a. However, the jawbone fixing part 14 may be directly drilled and inserted into the jawbone. Preferably, a drill groove (tap shape) is usually provided for a predetermined length from the tip end portion 14a in the whole or a part of the outer surface, at least in the axial direction.
術中ガイド固定ピン
次に各術中ガイド固定ピンの構成について説明する。
図2を参照すれば、術中ガイド固定ピン20が示されている。この術中ガイド固定ピン20は、一軸線上に顎骨固定部24と、ガイド固定部22と、ヘッド部26とで構成されている。
Intraoperative guide fixing pin Next, the configuration of each intraoperative guide fixing pin will be described.
Referring to FIG. 2, an intraoperative guide fixation pin 20 is shown. The intraoperative guide fixing pin 20 includes a jaw fixing part 24, a guide fixing part 22, and a head part 26 on one axis.
術中ガイド固定ピン20は、上述するようにインプラント手術用ガイドのガイドスリーブに挿入すると、ガイドスリーブより下方(紙面下方)まで顎骨固定部22が突出する長さを有している。 When the intraoperative guide fixing pin 20 is inserted into the guide sleeve of the implant operation guide as described above, the jaw bone fixing portion 22 has a length that protrudes below the guide sleeve (downward in the drawing).
また、ガイド固定部22の上方(紙面左方)にはヘッド部26が配設されている。このヘッド部26の外表面には全部または一部にセレート構造(溝)が形成されている。 A head portion 26 is disposed above the guide fixing portion 22 (on the left side of the drawing). A serrate structure (groove) is formed on the outer surface of the head portion 26 in whole or in part.
実際に、インプラント手術用ガイドと歯列とを固定する場合、術前ガイド固定ピン20は、いきなりインプラント手術用ガイドのガイドスリーブに挿入される場合もあるが、通常は、上述する術前ガイド固定ピン10が固定された状態で他のガイドスリーブに挿入される。そして、ドリルでインプラント形成窩の穴あけがなされた後で、ガイドスリーブの内径と略同一の外径のガイド固定部22により案内される。このときガイドスリーブとこの術前ガイド固定ピン20との固定を担う。 Actually, when the implant surgical guide and the dentition are fixed, the preoperative guide fixing pin 20 may be suddenly inserted into the guide sleeve of the implant surgical guide. The pin 10 is inserted into another guide sleeve in a fixed state. Then, after drilling the implant formation cavity with a drill, it is guided by the guide fixing portion 22 having an outer diameter substantially the same as the inner diameter of the guide sleeve. At this time, the guide sleeve and the preoperative guide fixing pin 20 are fixed.
また、ガイド固定部22は、ガイドスリーブと軸線距離が近似するため、ガイド固定部22より径の小さい顎骨固定部24がインプラント手術用ガイドより下方に突出することとなる。そして、この顎骨固定部24が顎骨(歯列)に作成されたインプラント形成窩に挿入され、顎骨とインプラント手術用ガイドが固定されることとなる。 Further, since the guide fixing portion 22 has an axial distance approximate to that of the guide sleeve, the jawbone fixing portion 24 having a smaller diameter than the guide fixing portion 22 protrudes downward from the implant operation guide. And this jawbone fixing | fixed part 24 will be inserted in the implant formation fossa created in the jawbone (dental row), and a jawbone and the guide for implant surgery will be fixed.
また、顎骨固定部24は、既に作成されたインプラント形成窩に挿入され、インプラント形成窩を傷つけないようにする必要がある。したがって、術中ガイド固定ピン20の顎骨固定部24は、先端が尖っておらず、外表面にドリル溝も付与されていない。 In addition, the jawbone fixing part 24 needs to be inserted into the already formed implant forming pit so as not to damage the implant forming pit. Therefore, the jawbone fixing portion 24 of the intraoperative guide fixing pin 20 is not pointed at the tip and is not provided with a drill groove on the outer surface.
次に、術前ガイド固定ピンと術中ガイド固定ピンと使用する工程について概説する。
図3、図4は左から順に術前ガイド固定ピン10から術中ガイド固定ピン20を挿入していく様子を示している(図3(a)~(c)、図4(c)~(f))。図5に示すようにインプラント手術用のガイドスリーブ30を上方から見た略示図である。
Next, an outline of the process of using the preoperative guide fixing pin and the intraoperative guide fixing pin will be described.
3 and 4 show a state in which the intraoperative guide fixing pin 20 is inserted from the preoperative guide fixing pin 10 sequentially from the left (FIGS. 3 (a) to (c), FIGS. 4 (c) to (f). )). As shown in FIG. 5, it is the schematic view which looked at the guide sleeve 30 for implant surgery from the upper direction.
まず、工程(a)を参照すればガイドスリーブA穴が位置決めされた顎骨に固定ドリル32で穴を空けドリル形成窩34を形成する。形成された様子が工程(b)に示している。 First, referring to step (a), a drill forming cavity 34 is formed by drilling a hole in the jawbone in which the guide sleeve A hole is positioned with a fixed drill 32. The formed state is shown in step (b).
次に工程(c)を参照すれば、工程(a)~(b)で作成されたドリル形成窩34に術前ガイド固定ピン10をねじ込んでいく。この際、顎骨固定部14の外径はドリル形成窩34の内径よりも大きいことが好ましい。硬く固定されるからである。また、顎骨固定部14の上方には、顎骨とくに比較的硬い皮質骨に位置決めされる部分にネジ溝を設けることもできる。これにより顎骨と術前ガイド固定ピン10が固定される。 Next, referring to step (c), the preoperative guide fixing pin 10 is screwed into the drill forming cavity 34 created in steps (a) to (b). At this time, it is preferable that the outer diameter of the jawbone fixing portion 14 is larger than the inner diameter of the drill forming cavity 34. It is because it is fixed firmly. Further, a screw groove may be provided above the jawbone fixing portion 14 in a portion positioned on the jawbone, particularly a relatively hard cortical bone. As a result, the jawbone and the preoperative guide fixing pin 10 are fixed.
さらに、ガイド固定部12はガイドスリーブ30の内壁に沿って挿入される。ガイド固定部12の軸線長さは、ガイドスリーブ30の高さと同程度以上であることが好ましく、ガイド固定部12の外径とガイドスリーブ30の内径は略同一であることが好ましい。この工程(c)によって術前ガイド固定ピン10はインプラント手術用ガイドを顎骨にしっかりと固定することができ、さらに、その後、インプラント形成窩となるドリル形成窩を使うことができるので別途ガイド固定のための窩を作成し、患者に負担を与える愚を回避できる。 Further, the guide fixing portion 12 is inserted along the inner wall of the guide sleeve 30. The axial length of the guide fixing portion 12 is preferably equal to or greater than the height of the guide sleeve 30, and the outer diameter of the guide fixing portion 12 and the inner diameter of the guide sleeve 30 are preferably substantially the same. By this step (c), the preoperative guide fixing pin 10 can fix the implant surgical guide firmly to the jawbone, and further, a drill forming fossa that becomes an implant forming fossa can be used thereafter. Create fossa for avoiding stupidity that burdens patients.
次に工程(d)~(f)を参照すれば、上記術前ガイド固定ピン10が固定された状態で図4左側のB穴を形成するガイドスリーブ30に術中ガイド固定ピン20を挿入する様子を示している。 Next, referring to steps (d) to (f), the intraoperative guide fixing pin 20 is inserted into the guide sleeve 30 forming the B hole on the left side of FIG. 4 with the preoperative guide fixing pin 10 fixed. Is shown.
まず、工程(d)に示すように通常のドリル40でインプラント形成窩42を形成する。この工程は一般的にインプラント形成窩を作成する工程と同じであり、スルーレンチ44で案内しながらドリル40をガイドスリーブ30内に挿入する。このとき工程(a)~(c)で既にA穴を有するガイドスリーブ30が術前ガイド固定ピン10で固定されているため、インプラント形成窩42も軸ぶれ等なく形成可能である。 First, as shown in step (d), an implant formation cavity 42 is formed with a normal drill 40. This process is generally the same as the process of creating the implant formation cavity, and the drill 40 is inserted into the guide sleeve 30 while being guided by the through wrench 44. At this time, since the guide sleeve 30 having the A hole is already fixed by the preoperative guide fixing pin 10 in the steps (a) to (c), the implant formation fossa 42 can also be formed without shaft shake or the like.
このインプラント形成窩42は、通常のインプラント形成窩と同じようにφ2mmか3mmが形成される。その後、工程(f)に示すように術中ガイド固定ピン20がインプラント形成窩42に挿入する。新たなインプラント形成窩を作成するときに術前ガイド固定ピン10や術中ガイド固定ピン20を抜き取って挿入されているピン10、20によりインプラント手術用ガイドを固定した状態で新たなインプラント形成窩を作成する。また、一担、インプラントが固定された場合、それが術前ガイド固定ピン10と同じ効果を奏することとなる。 The implant formation pit 42 is formed to have a diameter of 2 mm or 3 mm in the same manner as a normal implant formation pit. Thereafter, as shown in step (f), the intraoperative guide fixing pin 20 is inserted into the implant formation cavity 42. When creating a new implant formation cavity, a new implant formation cavity is created with the implant operation guide fixed by the pins 10 and 20 inserted by extracting the preoperative guide fixation pin 10 and the intraoperative guide fixation pin 20. To do. In addition, if the implant is fixed, it has the same effect as the preoperative guide fixing pin 10.
従って、この両ガイド固定ピン10、20を使用すれば、顎骨を全く傷つけず、通常のインプラント形成窩作成の工程を活用してインプラント手術用ガイドを固定することができる。 Therefore, if both guide fixing pins 10 and 20 are used, the implant surgical guide can be fixed by utilizing a normal process for creating an implant formation cavity without damaging the jawbone at all.
ここで上述の術前ガイド固定ピン10と術中ガイド固定ピン20とを用いて実際にインプラント手術を行うための方法の実施形態を例示する。具体的には、第一実施形態が図6に、第二実施形態が図7に示されている。図6、図7ともに歯列の上視模式図を示しており、図6は(a)~(i)の順に、図7は(a)~(j)の順に本手術ステップを示している。それぞれ図は右側の歯列欠損部、インプラント埋入予定部位、残存歯部、1.5mmの形成窩、2.0mmの形成窩、3.0mmの形成窩、術前ガイド固定ピン、術中ガイド固定ピンの表示に従って視認する。 Here, an embodiment of a method for actually performing an implant operation using the preoperative guide fixing pin 10 and the intraoperative guide fixing pin 20 described above will be illustrated. Specifically, the first embodiment is shown in FIG. 6, and the second embodiment is shown in FIG. 6 and 7 both show schematic top views of the dentition. FIG. 6 shows the main surgical steps in the order of (a) to (i), and FIG. 7 shows the main surgical steps in the order of (a) to (j). . Each figure shows the right dentition, implant planned site, remaining tooth, 1.5mm formation fossa, 2.0mm formation fossa, 3.0mm formation fossa, preoperative guide fixation pin, intraoperative guide fixation Visually follow the pin display.
図6を参照しつつ第一実施形態を説明する。まず、図6(a)では複数のインプラント埋入予定部位を含む歯列欠損部が示されている。次に埋入予定部位に1.5mmの形成窩をドリルで作成し(図6(b))、その部位に術前ガイド固定ピン10を挿入・固定する(図6(c))。その後、術前ガイド固定ピン10の固定されていない埋入予定部位にφ2.0mm、φ3.0mmと順に形成窩を作成する(図6(d)(e))。次に、φ3.0mmで作成されたいずれかの形成窩に術中ガイド固定ピン20を挿入・固定した後に術前固定ピン10を除去する(図6(f))。その後、図6(d)(e)と同様に術前ガイド固定ピン10が除去された埋入予定部位にφ2.0mm、φ3.0mmと順に形成窩を作成する(図6(g)(h))。最後に術中ガイド固定ピンを除去すればインプラント埋入のための形成窩の作成が完了する(図6(i))。 The first embodiment will be described with reference to FIG. First, in FIG. 6A, a dentition missing part including a plurality of implant placement sites is shown. Next, a 1.5 mm formation fossa is created with a drill at the site to be implanted (FIG. 6B), and the preoperative guide fixing pin 10 is inserted and fixed at that site (FIG. 6C). Thereafter, formation pits are formed in order of φ2.0 mm and φ3.0 mm in the planned implantation site where the preoperative guide fixing pin 10 is not fixed (FIGS. 6D and 6E). Next, the intraoperative guide fixing pin 20 is inserted and fixed in any of the forming cavities formed with φ3.0 mm, and then the preoperative fixing pin 10 is removed (FIG. 6 (f)). Thereafter, as in FIGS. 6D and 6E, formation pits are created in order of φ2.0 mm and φ3.0 mm in the planned implantation site where the preoperative guide fixing pin 10 has been removed (FIGS. 6G and 6H). )). Finally, if the intraoperative guide fixing pin is removed, the formation of the formation cavity for implant placement is completed (FIG. 6 (i)).
次に図7を参照しつつ第二実施形態を説明する。この実施形態においては術中ガイド固定ピン20はφ2.0mmとφ3.0mmの2種類を用意する。まず、図7(a)では複数のインプラント埋入予定部位を含む歯列欠損部が示されている。次に埋入予定部位にφ1.5mmの形成窩をドリルで作成し(図7(b))、その部位に術前ガイド固定ピン10を挿入・固定する(図7(c))。その後、術前ガイド固定ピン10の固定されていない埋入予定部位にφ2.0mmの形成窩をドリルで作成する(図7(d))。ここまでのステップは図6の第一実施形態と同様である。次に、φ2.0mmで作成された形成窩にφ2.0mmの術中ガイド固定ピン20を挿入・固定した後に術前ガイド固定ピン10を除去する(図7(e))。その後、術前ガイド固定ピン10が除去された形成窩にφ2.0mmの形成窩をドリルで作成する(図7(f))そして、φ2.0mmの形成窩をφ3.0mmの形成窩にドリルで作成する(図7(g))。次に、φ3.0mmで作成された形成窩にφ3.0mmの術中ガイド固定ピン20を挿入・固定し、φ2.0mmの術中ガイド固定ピン20を除去する(図7(h))。そして残されたφ2.0mmの形成窩をドリルでφ3.0mmの形成窩にし(図7(i))、最後にφ3.0mmの術中ガイド固定ピン20を除去して完了する(図7(j))。 Next, a second embodiment will be described with reference to FIG. In this embodiment, two types of intraoperative guide fixing pins 20 of φ2.0 mm and φ3.0 mm are prepared. First, in FIG. 7A, a dentition missing portion including a plurality of implant placement sites is shown. Next, a formation cavity having a diameter of 1.5 mm is created by a drill at the site to be implanted (FIG. 7B), and the preoperative guide fixing pin 10 is inserted and fixed at the site (FIG. 7C). Thereafter, a formation cavity having a diameter of 2.0 mm is created by a drill in the planned implantation site where the preoperative guide fixing pin 10 is not fixed (FIG. 7D). The steps so far are the same as in the first embodiment of FIG. Next, the intraoperative guide fixing pin 20 having a diameter of 2.0 mm is inserted and fixed in the forming cavity formed with a diameter of 2.0 mm, and then the preoperative guide fixing pin 10 is removed (FIG. 7E). Then, a φ2.0 mm formation fossa is drilled in the formation fovea from which the preoperative guide fixing pin 10 has been removed (FIG. 7 (f)), and a φ2.0 mm formation fossa is drilled into the φ3.0 mm formation fovea (Fig. 7 (g)). Next, an intraoperative guide fixing pin 20 having a diameter of 3.0 mm is inserted and fixed in a forming cavity formed with a diameter of 3.0 mm, and the intraoperative guide fixing pin 20 having a diameter of 2.0 mm is removed (FIG. 7H). Then, the remaining φ2.0 mm formation fossa is made into a φ3.0 mm formation fossa with a drill (FIG. 7 (i)), and finally the φ3.0 mm intraoperative guide fixing pin 20 is removed to complete (FIG. 7 (j )).
10 術前ガイド固定ピン
12 ガイド固定部
14 顎骨固定部
16 ヘッド部
20 術中ガイド固定ピン
22 ガイド固定部
24 顎骨固定部
26 ヘッド部
 
 
 
 
DESCRIPTION OF SYMBOLS 10 Preoperative guide fixing pin 12 Guide fixing part 14 Jaw bone fixing part 16 Head part 20 Intraoperative guide fixing pin 22 Guide fixing part 24 Jaw bone fixing part 26 Head part


Claims (5)

  1. 少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めするために用いられる術前ガイド固定ピンであって、
    該ガイドスリーブの長軸長さよりも軸方向に長く且つガイドスリーブの内径と略同一の外径を有するガイド固定部と、
    前記ガイド固定部の下端において同軸上に一体連結し、前記ガイド固定部の外径よりも小さい径を有する顎骨固定部とを備え、
    前記ガイド固定部は、術前ガイド固定ピンを前記ガイドスリーブに挿入した際にガイドスリーブに対して術前ガイド固定ピンの径方向の移動を規制し、
    前記顎骨固定部は、前記術前ガイド固定ピンを前記ガイドスリーブに挿入した際に前記ガイドスリーブの下方に設けられた術前ガイド固定ピン用の孔に挿入される、ことを特徴とする術前ガイド固定ピン。
    A pre-operative guide fixation pin used to position an implant surgical guide with at least two or more implant surgical guide sleeves relative to the jawbone;
    A guide fixing portion that is longer in the axial direction than the long axis length of the guide sleeve and has an outer diameter substantially the same as the inner diameter of the guide sleeve;
    A lower end of the guide fixing portion, which is integrally connected coaxially, and a jawbone fixing portion having a diameter smaller than the outer diameter of the guide fixing portion,
    The guide fixing portion regulates the radial movement of the preoperative guide fixing pin with respect to the guide sleeve when the preoperative guide fixing pin is inserted into the guide sleeve,
    The preoperative guide fixing pin is inserted into a hole for a preoperative guide fixing pin provided below the guide sleeve when the preoperative guide fixing pin is inserted into the guide sleeve. Guide fixing pin.
  2. 前記顎骨固定部は、軸線方向一部にネジ溝を形成する、ことを特徴とする請求項1に記載の術前ガイド固定ピン。 The preoperative guide fixing pin according to claim 1, wherein the jawbone fixing part forms a screw groove in a part in the axial direction.
  3. 少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めするために用いられる術中ガイド固定ピンであって、
    該ガイドスリーブの長軸長さよりも軸方向に長く且つガイドスリーブの内径と略同一の外径を有するガイド固定部と、
    前記ガイド固定部の下端において同軸上に一体連結し、前記ガイド固定部の外径よりも小さい径を有する顎骨固定部とを備え、
    前記ガイド固定部は、術中ガイド固定ピンを前記ガイドスリーブに挿入した際にガイドスリーブに対して術中の径方向の移動を規制し、
    前記顎骨固定部は、前記術中ガイド固定ピンを前記ガイドスリーブに挿入した際に前記ガイドスリーブの下方に設けられたインプラント形成窩作成のために予め開放されたドリル形成窩に挿入される、ことを特徴とする術中ガイド固定ピン。
    An intraoperative guide fixation pin used to position an implant surgical guide having at least two or more implant surgical guide sleeves relative to the jawbone;
    A guide fixing portion that is longer in the axial direction than the long axis length of the guide sleeve and has an outer diameter substantially the same as the inner diameter of the guide sleeve;
    A lower end of the guide fixing portion, which is integrally connected coaxially, and a jawbone fixing portion having a diameter smaller than the outer diameter of the guide fixing portion,
    The guide fixing portion regulates the radial movement during the operation with respect to the guide sleeve when the intraoperative guide fixing pin is inserted into the guide sleeve,
    The jawbone fixing portion is inserted into a drill forming fossa that is opened in advance for creating an implant forming fossa provided below the guide sleeve when the intraoperative guide fixing pin is inserted into the guide sleeve. Features an intraoperative guide fixation pin.
  4. 請求項1または2に記載の術前ガイド固定ピン1つと、少なくとも1つ以上の請求項3に記載の術中ガイド固定ピントとで構成されたガイド固定ピンセットであって、
    前記術前ガイド固定ピンのガイド固定部と、前記術中ガイド固定ピンのガイド固定部とは、互いに外径が略同一である、ガイド固定ピンセット。
    A guide fixing pin set comprising one preoperative guide fixing pin according to claim 1 or 2 and at least one intraoperative guide fixing pin according to claim 3,
    The guide fixing pin set, wherein the guide fixing portion of the preoperative guide fixing pin and the guide fixing portion of the intraoperative guide fixing pin have substantially the same outer diameter.
  5. 少なくとも2つ以上のインプラント手術用のガイドスリーブを有するインプラント手術用ガイドを顎骨に対して位置決めし、固定しながらインプラント手術を行う方法あって、
    少なくとも、
    前記インプラント手術用ガイドを予め定められた位置に位置決めするステップと、
    任意の前記ガイドスリーブに請求項1に記載の術前ガイド固定ピンを挿入し、前記顎骨固定部を顎骨に固定するステップと、
    前記術前ガイド固定ピンを固定したガイドスリーブ以外のガイドスリーブにドリルを用いてインプラント埋入のための形成窩を作成するステップと、
    前記インプラント埋入のための形成窩に請求項2に記載の術中ガイド固定ピンを挿入し、顎骨に固定するステップと、
    前記術前ガイド固定ピンをガイドスリーブから抜挿するステップと、
    前記術前ガイド固定ピンが抜挿された後の形成窩にインプラント埋入のための形成窩をドリルで作成するステップと、
    を有するインプラント手術を行う方法。
     
     
     
    A method for performing an implant operation while positioning and fixing an implant operation guide having at least two guide sleeves for implant operation with respect to a jawbone,
    at least,
    Positioning the implant surgical guide at a predetermined position;
    Inserting the preoperative guide fixing pin according to claim 1 into any of the guide sleeves, and fixing the jawbone fixing portion to the jawbone;
    Creating a formation cavity for implant placement using a drill in a guide sleeve other than the guide sleeve to which the preoperative guide fixing pin is fixed;
    Inserting an intraoperative guide fixation pin according to claim 2 into the formation cavity for implant placement and fixing to the jawbone;
    Inserting and removing the preoperative guide fixing pin from the guide sleeve;
    Drilling a formation cavity for implant placement in the formation cavity after the preoperative guide fixation pin has been inserted and removed;
    For performing an implant operation.


PCT/JP2010/066598 2009-09-24 2010-09-24 Guide affixing pin and method for performing implant surgery using same WO2011037206A1 (en)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS63275335A (en) * 1987-05-01 1988-11-14 K K Dentaru Service:Kk Channel molding device for artificial dental root
JP2000512868A (en) * 1996-06-27 2000-10-03 メデヴェロープ アーベー Denture systems, components of denture systems and methods for such denture systems
JP2005518834A (en) * 2002-02-28 2005-06-30 マテリアライズ・ナムローゼ・フエンノートシャップ Method and apparatus for placing a dental implant
US20060223029A1 (en) * 2005-03-30 2006-10-05 Uzi Berger Method and system for fixing removable dentures
JP2010125322A (en) * 2008-12-01 2010-06-10 Straumann Holding Ag Fixation pin

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS63275335A (en) * 1987-05-01 1988-11-14 K K Dentaru Service:Kk Channel molding device for artificial dental root
JP2000512868A (en) * 1996-06-27 2000-10-03 メデヴェロープ アーベー Denture systems, components of denture systems and methods for such denture systems
JP2005518834A (en) * 2002-02-28 2005-06-30 マテリアライズ・ナムローゼ・フエンノートシャップ Method and apparatus for placing a dental implant
US20060223029A1 (en) * 2005-03-30 2006-10-05 Uzi Berger Method and system for fixing removable dentures
JP2010125322A (en) * 2008-12-01 2010-06-10 Straumann Holding Ag Fixation pin

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