WO2011062083A1

WO2011062083A1 - Tmj dislocation preventer

Info

Publication number: WO2011062083A1
Application number: PCT/JP2010/069891
Authority: WO
Inventors: 賢一栗田
Original assignee: Kurita Kenichi
Priority date: 2009-11-17
Filing date: 2010-11-09
Publication date: 2011-05-26
Also published as: JP2011104121A; JP4488536B1

Abstract

Disclosed is a TMJ dislocation preventer that can reliably prevent forward dislocation of the TMJ. Said TMJ dislocation preventer (1) is provided with: an attachment part (2) that is attached to a bone surface in the vicinity of the articular tubercle of a temporal bone; and a movement restriction part (3) that restricts forward movement of the mandibular condyle. The movement restriction part (3) is provided with: a base section that connects to the attachment part (2); and a tip section (5) that extends from the base section (4) and reaches around the bottom end of the articular tubercle of the temporal bone.

Description

Temporomandibular joint dislocation prevention device

The present invention relates to a temporomandibular joint dislocation prevention tool for preventing temporomandibular joint dislocation.

The human temporomandibular joint is composed of a temporal bone 62, a mandibular head 61, a joint disc 64, a joint capsule, a ligament, and a muscle, and the mandibular head 61 of the mandible 60 is the temporal bone 62 as shown in FIG. It has a structure that enters the indentation (mandibular fossa 63). The joint disk 64 is connected to the mandibular head 61 of the mandible 60 and is disposed between the mandibular fossa 63 and the mandibular head 61, and moves together with the mandibular head 61. The joint disc 64 is made of collagen fibers called collagen. In FIG. 13, the joint capsule, ligament, and muscle are omitted.

The movement of the temporomandibular joint will be described with reference to FIG. 14 which is an enlarged view of the main part of FIG. 13. At the beginning of opening the mouth (a state where the mouth is slightly opened), The mandibular head 61 of the mandible 60 rotates (FIG. 14 (a)). When the mouth is further opened, the mandibular head 61 comes out of the mandibular fossa 63 and slides forward (orbital 66 direction) (FIG. 14B), and when the mouth is opened widely, the mandibular head 61 moves to below the joint nodule 65 ( FIG. 14 (c)). When the mouth is closed, the mandibular head 61 moves backward (toward the occipital region) and fits in the recess of the mandibular fossa 63 (FIG. 14 (d)).

In such a temporomandibular joint, for example, the temporomandibular joint may be dislodged (temporomandibular joint dislocation) by suddenly opening the mouth with a large yawn or using an unnatural chin. In particular, temporomandibular joint dislocation, in which the mandibular head 61 of the mandible 60 passes over the joint nodule 65 and does not return to its original state, occupies most of the temporomandibular joint dislocation. Anterior dislocation of the temporomandibular joint is caused by sudden opening of the mouth due to large yawns as described above, or unnatural use of the jaw, or elements that are incompatible with the joints of the bones that make up the joint This is caused by structural problems of the joint, such as the fact that the joints are shallow, the ligaments holding the joints are loose, and the shape of the joint surfaces of the jointed bones does not match. It may also occur due to reduced muscle tone around the jaw or due to temporomandibular disorders (such as deformation of the articular cartilage of the jaw).

If there is a structural problem in the temporomandibular joint or if the muscle tension around the jaw is reduced, anterior dislocation of the temporomandibular joint is likely to occur habitually. It is necessary to mechanically limit jaw movement. Specifically, a hat to restrict the opening of the lower jaw in search of a fixed source for the hat is worn, a bandage or bandage around the face is fixed, and the upper and lower jaws are covered with rubber to limit the opening. It is necessary to prevent the dislocation of the jaws by fixing the upper and lower jaws with a wire for about 3 to 4 weeks to make the masticatory muscles rest.

Also, in the case of repeated recurrence, a surgical method (surgery) may be applied. In the operation, the surgical operation for suturing the fascia of the temporal muscle, which is a masticatory muscle, the joint nodule 65 is made as flat as possible so that it can be easily closed even from the dislocation position, and conversely, the joint nodule 65 is raised with a transplanted bone or implant. There are surgery to do. Further, there is an operation for replacing an artificial temporomandibular joint as disclosed in Patent Document 1.

Japanese Patent Laid-Open No. 11-146889

However, if the joint nodules of the temporal bones that make up the temporomandibular joint are worn out, or if there is a structural problem with the joint such as the joint disc being deformed or worn, the genitalia hat described above may be worn. Also, there is a problem that it is difficult to achieve a fundamental treatment by fixing the periphery of the face with a vantage or the like, or restricting the opening by applying rubber to the upper and lower jaws. In addition, even when surgery is performed to suture the fascia of the temporal muscle, which is a masticatory muscle, or surgery to make the joint nodule as flat as possible and allow it to be easily closed from the dislocation position, the temporomandibular joint dislocation may recur There is also a need for a method that can reliably prevent anterior dislocation of the temporomandibular joint.

The present invention has been made to solve such a problem, and an object of the present invention is to provide a temporomandibular joint dislocation prevention device that can reliably prevent temporomandibular joint dislocation from occurring.

The object of the present invention is a temporomandibular joint dislocation prevention device that prevents anterior dislocation of the temporomandibular joint, an attachment portion that is attached to the bone surface in the vicinity of the temporal bone joint nodules, and a movement restriction portion that restricts the forward movement of the mandibular head. The movement restricting portion includes a proximal end portion connected to the attachment portion, and a temporomandibular joint including a distal end portion that extends from the proximal end portion and is disposed around the lower end side of the temporal bone joint nodule. This is achieved by a dislocation prevention device.

Further, in the above temporomandibular joint dislocation prevention device, it is preferable that the tip portion is formed in a plate shape.

In addition, it is preferable that the attachment portion is formed in a plate shape along the bone surface near the temporal bone joint nodule and includes a first through hole through which a screw fixed to the bone passes.

Further, it is preferable that the distal end portion includes a second through hole through which a screw for fixing a transplanted bone or an implant passes.

Further, it is preferable that the distal end portion is bent at a substantially right angle with respect to the proximal end portion.

Further, it is preferable that the base end portion is formed in a substantially wedge-shaped plate shape in which the attachment portion side is wider than the width dimension on the distal end portion side.

Further, it is preferable that the attachment portion and the movement restricting portion are integrally formed of a material selected from the group consisting of titanium, titanium alloy, stainless steel, and fiber reinforced resin.

According to the present invention, it is possible to provide a temporomandibular joint dislocation prevention tool that can reliably prevent temporomandibular joint dislocation from occurring.

It is a front view of the temporomandibular joint dislocation prevention tool concerning one embodiment of the present invention. It is a right side view of the temporomandibular joint dislocation prevention tool shown in FIG. It is a rear view of the temporomandibular joint dislocation prevention tool shown in FIG. It is a top view of the temporomandibular joint dislocation prevention tool shown in FIG. FIG. 2 is a cross-sectional view taken along the line AA in FIG. It is explanatory drawing which shows the use condition of the temporomandibular joint dislocation prevention tool shown in FIG. It is a top view which shows the modification of the temporomandibular joint dislocation prevention tool shown in FIG. It is sectional drawing of FIG. It is a top view which shows the other modification of the temporomandibular joint dislocation prevention tool shown in FIG. It is a front view which shows the other modification of the temporomandibular joint dislocation prevention tool shown in FIG. It is a side view which shows the other modification of the temporomandibular joint dislocation prevention tool shown in FIG. It is a front view which shows the other modification of the temporomandibular joint dislocation prevention tool shown in FIG. It is explanatory drawing explaining the structure of a temporomandibular joint. It is principal part expansion explanatory drawing explaining the movement of a temporomandibular joint.

DESCRIPTION OF SYMBOLS 1 Temporomandibular joint dislocation prevention tool 2 Attachment part 21 1st through-hole 22 Hole formation area 23 Inter-hole area | region 3 Movement restriction part 4 Base end part 41 Attachment part side edge part 42 Tip part side edge part 5 Tip part 51 2nd through hole 52 Hole formation region 53 Interhole region 60 Mandible 61 Mandible head 62 Temporal bone 63 Mandible fossa 64 Joint disc 65 Joint nodule 66 Orbit

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 is a front view of a temporomandibular joint dislocation prevention device 1 according to an embodiment of the present invention, and FIG. 2 is a right side view of the temporomandibular joint dislocation prevention device 1. FIG. 3 is a rear view of the temporomandibular joint dislocation prevention device 1, and FIG. 4 is a plan view of the temporomandibular joint dislocation prevention device 1. FIG. 5 is a cross-sectional view taken along the line AA in FIG.

The temporomandibular joint dislocation prevention device 1 according to the present embodiment prevents temporomandibular joint dislocation, and the bone near the temporal joint joint nodule 65 as shown in FIG. Used attached to the surface. Here, the vicinity of the temporal bone joint nodule 65 refers to a region around the joint nodule 65 including the temporal bone joint nodule 65. As shown in FIGS. 1 to 6, the temporomandibular joint dislocation prevention device 1 includes an attachment portion 2 attached to the bone surface in the vicinity of the temporal bone joint nodule 65, and a movement restriction portion 3 for restricting the forward movement of the mandibular head 61. It has. The attachment part 2 and the movement restriction part 3 are integrally formed. In addition, the part shown with a dashed line in FIG.2, FIG4 and FIG.5 is the 1st through-hole 21 of the attaching part 2 mentioned later.

The mounting portion 2 is formed in a plate shape along the bone surface in the vicinity of the temporal bone joint nodule 65. The plate-like attachment portion 2 is formed so as to be elongated along the width direction of the temporal bone joint nodule 65 (the left-right direction in FIGS. 6 and 13). The side edge shape of the attachment portion 2 is formed to have a waveform except for a part of the side edge to which a base end portion 4 to be described later is connected. Further, the attachment portion 2 is partitioned into a hole forming region 22 having a convex curved side edge contour in a waveform and an inter-hole region 23 having a concave curved side edge contour. A first through hole 21 for screw insertion is formed. The hole forming regions 22 and the inter-hole regions 23 are alternately arranged. In the present embodiment, it is configured to have four hole forming regions 22, but is not particularly limited to such a number, and the number of hole forming regions 22 formed is arbitrary.

The material forming the attachment portion 2 is preferably titanium or a titanium alloy that hardly causes harmful tissue reaction with human tissue and has high biocompatibility, but may be other metal materials such as stainless steel. Moreover, you may form the attaching part 2 with fiber reinforced resin. The thickness of the attachment portion 2 is preferably about 1 mm to 2 mm, for example. If the thickness is less than 1 mm, the strength may be reduced and breakage may occur. On the other hand, if the thickness is greater than 2 mm, the skin covering the outer surface of the bone may protrude, or the bone on which the attachment portion 2 is installed contacts the bone. This is not preferable because it makes it difficult to become familiar with meat.

The movement restricting portion 3 has a function of restricting the forward movement of the mandibular head 61, and includes a proximal end portion 4 and a distal end portion 5 as shown in FIGS. The base end portion 4 and the tip end portion 5 are integrally formed. The proximal end portion 4 is disposed between the attachment portion 2 and the distal end portion 5 and is configured to be flush with the attachment portion 2. The base end portion 4 is formed in a substantially wedge-shaped plate shape in which the attachment portion side end portion 41 as one end is wider than the width dimension of the tip end side end portion 42 as the other end. The base end portion 4 is preferably formed of titanium or a titanium alloy having high biocompatibility like the mounting portion 2 described above, but may be formed of other metal materials such as stainless steel, You may form with fiber reinforced resin. The thickness of the base end portion 4 is preferably about 1 mm to 2 mm, for example, like the attachment portion 2.

The distal end portion 5 extends from the other end (the distal end portion side end portion 42) of the proximal end portion 4 so as to be bent at a substantially right angle with respect to the proximal end portion 4 extending in the out-of-plane direction along the attachment portion 2. When the attachment portion 2 is installed on the bone surface in the vicinity of the temporal bone joint nodule 65, it is configured so as to be disposed around the lower end side of the temporal bone joint nodule 65. The distal end portion 5 is formed in a rectangular plate shape with one surface facing the lower end surface of the temporal bone joint nodule 65. The tip portion 5 is also preferably formed of titanium or a titanium alloy having high biocompatibility like the mounting portion 2 described above, but may be formed of other metal materials such as stainless steel or fiber reinforced resin. Good. The distal end portion 5 may be formed to have a thickness of, for example, about 1 mm to 2 mm, similar to the attachment portion 2. However, as will be described later, the mandibular head 61 of the mandible 60 passes the temporal bone joint nodule 65 forward ( From the viewpoint of preventing getting over in the direction of the orbit 66, it is preferable to set the thickness of the distal end portion 5 to be larger than the thicknesses of the attachment portion 2 and the proximal end portion 4. Therefore, the thickness of the tip 5 is preferably about 1 mm to 10 mm, for example.

In the temporomandibular joint dislocation prevention device 1 according to this embodiment configured as described above, the attachment portion 2 is fixed to the bone surface near the temporal bone joint nodule 65 via a screw (not shown) as shown in FIG. Used. When the temporomandibular joint dislocation prevention device 1 is attached, the attachment portion 2 is fixed to the bone surface so that the mandibular head 61 of the mandible 60 does not get over the distal end portion 5 of the temporomandibular joint dislocation prevention device 1. Since the temporomandibular joint dislocation prevention device 1 includes the distal end portion 5 disposed around the lower end side of the temporal bone joint nodule 65 as described above, the distal end portion 5 serves as a stopper, and the mandible 60 It is possible to reliably prevent the mandibular head 61 from getting over the joint nodule 65 in the forward direction (orbital 66 direction), and to effectively suppress the occurrence of anterior dislocation of the temporomandibular joint.

In addition, the shape of the proximal end portion 4 of the temporomandibular joint dislocation prevention device 1 is substantially wedge-shaped so that the attachment portion side end portion 41 as one end is wider than the width dimension of the distal end portion end portion 42 as the other end. Therefore, the mechanical strength in the vicinity of the boundary between the base end portion 4 and the attachment portion 2 can be increased. As a result, it is possible to effectively prevent the temporomandibular joint dislocation prevention tool 1 from being damaged near the boundary between the base end portion 4 and the attachment portion 2.

Further, when attaching the attachment portion 2 of the temporomandibular joint dislocation prevention device 1 to the bone surface in the vicinity of the temporal joint joint nodule 65, the situation of the base bone and the preferable installation position of the distal end portion 5 of the temporomandibular joint dislocation prevention device 1 are set. In order to ensure, it may be necessary to cut a part of the mounting portion 2 to adjust the dimensions, but even in such a case, the temporomandibular joint dislocation prevention device 1 according to the present embodiment is Since the width of the inter-hole region 23 of the mounting portion 2 is configured to be narrower than the width of the hole forming region 22, the inter-hole region 23 can be easily and quickly cut to adjust the size of the mounting portion 2. The temporomandibular joint dislocation prevention tool 1 can be easily attached.

As mentioned above, although embodiment of the temporomandibular joint dislocation prevention tool 1 concerning this invention was described, the specific structure of the temporomandibular joint dislocation prevention tool 1 is not limited to the said embodiment. For example, as shown in the plan view of FIG. 7 and the sectional view of FIG. 8, the second through hole 51 into which the screw is inserted may be formed in the tip portion 5. 8 is a cross-sectional view at a position corresponding to the AA cross section of FIG. The second through hole 51 is formed so as to penetrate from one surface of the plate-like tip 5 to the other surface. When such a configuration is adopted, it becomes possible to attach the transplanted bone, artificial bone, and various implants to be transplanted to the temporal joint joint nodule 65 to the distal end portion 5 of the temporomandibular joint dislocation prevention device 1 through the screw. Thus, it is possible to prevent the temporomandibular joint from dislocation due to the distal end portion 5 while reducing the temporal bone joint nodule 65 by transplantation. Further, when the second through hole 51 is formed in the distal end portion 5, for example, as shown in the plan view of FIG. 9, wide hole forming regions 52 and narrow inter-hole regions 53 are alternately arranged. In this way, the side edge of the tip 5 may be formed in a waveform.

Moreover, in the said embodiment, the attachment part side edge part 41 which is one end becomes wide with respect to the width | variety dimension of the front-end | tip part side edge part 42 which is the other end. Although it is formed to have a substantially wedge-shaped plate shape, it may be formed to have a rectangular plate shape as shown in the front view of FIG.

In the above embodiment, when the attachment portion 2 is installed on the bone surface in the vicinity of the temporal bone joint nodule 65, the distal end portion 5 is arranged so as to wrap around the lower end side of the temporal bone joint nodule 65. In addition, the distal end portion 5 is configured to protrude from the other end of the proximal end portion 4 so as to be bent at a substantially right angle with respect to the proximal end portion 4. According to the shape and size of the lower end portion of the nodule 65 and the size of the mandibular head 61 of the mandible 60, the inclination angle of the distal end portion 5 with respect to the proximal end portion 4 is set in various ways to constitute the temporomandibular joint dislocation prevention device 1. May be.

Further, instead of adopting a structure in which the distal end portion 5 is bent with respect to the proximal end portion 4, as shown in a side view of FIG. 11, the proximal end portion 4 and the distal end portion 5 are connected so as to draw a smooth curve. You may employ | adopt the structure to do. Even with such a structure, the distal end portion 5 can effectively suppress the forward movement of the mandibular head 61 and can prevent temporomandibular joint dislocation. In FIG. 11, a portion indicated by a chain line is the first through hole 21 in the attachment portion 2.

Further, as shown in FIG. 1 and the like, the side edge shape of the attachment portion 2 is formed in a waveform except for a part where the base end portion 4 is connected. For example, the side edge shape is substantially rectangular. You may form in. Also, as shown in the front view of FIG. 12, the side edge shape of the inter-hole region 23 may be formed in a straight line instead of forming a concave curve.

Claims

A temporomandibular joint dislocation prevention device for preventing temporomandibular joint dislocation,
An attachment part that is attached to the bone surface near the temporal bone joint nodules, and a movement restriction part that restricts the forward movement of the mandibular head;
The movement restricting portion is a temporomandibular joint dislocation prevention device including a proximal end portion connected to the attachment portion, and a distal end portion that extends from the proximal end portion and is disposed around the lower end side of the temporal joint joint.
The temporomandibular joint dislocation prevention tool according to claim 1, wherein the tip is formed in a plate shape.
The temporomandibular joint dislocation prevention according to claim 1 or 2, wherein the attachment portion is formed in a plate shape along a bone surface near the temporal bone joint nodule and includes a first through hole through which a screw fixed to the bone passes. Ingredients.
The temporomandibular joint dislocation prevention device according to any one of claims 1 to 3, wherein the distal end portion includes a second through-hole through which a screw for fixing a transplanted bone or an implant passes.
The temporomandibular joint dislocation prevention tool according to any one of claims 1 to 4, wherein the distal end portion is bent at a substantially right angle with respect to the proximal end portion.
The temporomandibular joint dislocation prevention tool according to any one of claims 1 to 5, wherein the proximal end portion is formed in a substantially wedge-shaped plate shape in which the attachment portion side is wider than a width dimension on the distal end portion side.
The temporomandibular joint dislocation according to any one of claims 1 to 6, wherein the attachment portion and the movement restriction portion are integrally formed of a material selected from the group consisting of titanium, titanium alloy, stainless steel, and fiber reinforced resin. Prevention tool.