WO2018137461A1 - 牙种植牵引器 - Google Patents

牙种植牵引器 Download PDF

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Publication number
WO2018137461A1
WO2018137461A1 PCT/CN2017/119101 CN2017119101W WO2018137461A1 WO 2018137461 A1 WO2018137461 A1 WO 2018137461A1 CN 2017119101 W CN2017119101 W CN 2017119101W WO 2018137461 A1 WO2018137461 A1 WO 2018137461A1
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WIPO (PCT)
Prior art keywords
implant
traction
base body
screw
connecting screw
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Application number
PCT/CN2017/119101
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English (en)
French (fr)
Inventor
张陈平
刘剑楠
许釜铭
曲行舟
马继壮
Original Assignee
上海交通大学医学院附属第九人民医院
上海景堂医疗器械有限公司
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Application filed by 上海交通大学医学院附属第九人民医院, 上海景堂医疗器械有限公司 filed Critical 上海交通大学医学院附属第九人民医院
Priority to US16/492,617 priority Critical patent/US11337782B2/en
Priority to JP2019600059U priority patent/JP3224672U/ja
Publication of WO2018137461A1 publication Critical patent/WO2018137461A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003—Not used, see subgroups
    • A61C8/0004—Consolidating natural teeth
    • A61C8/0006—Periodontal tissue or bone regeneration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003—Not used, see subgroups
    • A61C8/0009—Consolidating prostheses or implants, e.g. by means of stabilising pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape

Definitions

  • the invention belongs to medical devices, and more particularly to a jaw traction and planting device used in oral and maxillofacial reconstruction surgery.
  • the jaw traction and planting device used in oral and maxillofacial reconstruction surgery is a built-in jaw-type traction planting device designed and designed by the applicant in 2001 (patent number: 01238497.6), which integrates jaw retractor and dental implant
  • the implant body, the covering screw, the fixed blade constitutes a longitudinal traction implant and a guiding sleeve composed of a lifting screw, a connecting sleeve and a fixed blade.
  • the upper part of the sleeve is fixed by the external thread of the implant, and the internal thread of the sleeve is used as the lifting force of the lifting screw.
  • the lifting screw in the guiding sleeve rotates counterclockwise, the upper bone block is pushed up.
  • the device has been found to have the following disadvantages: 1.
  • the implant and the upper segment of the bone are unstable, and need to be assisted by the blade. After the implantation is stabilized, the second operation is taken out, which increases the trauma and difficulty of operation; After the device is removed, the soft tissue will grow from the bottom of the implant, causing inflammation and even retrograde infection around the implant; 3. After the device completes the traction removal sleeve, the upper traction bone often returns to the original At the same time, the traction fails; 4.
  • the device is only fixed to the upper bone segment, and the lower bone segment has no stable retention, which increases the instability of the implant.
  • the fixed blade reduces the difficulty and trauma of the operation, and the stability of the implant is increased by adding a base screw.
  • the main structure consists of implants, covering screws, base screws and retaining screws to form a longitudinal traction implant and a traction device consisting of a traction sleeve, a lead screw and a traction cap.
  • the improved device still has the following disadvantages: 1. Although the stability of the implant is enhanced by the addition of the base screw, the process of removing the traction sleeve to replace the base screw is cumbersome, and the doctor often cannot determine the position of the base screw after removing the sleeve. Position; 2, after the removal of the traction sleeve, sometimes the upper bone segment is retracted to the position before the traction, thereby affecting the traction effect; 3, the base screw and the retaining screw can increase the stability of the implant and the lower bone segment, but in the implant denture When the inflammation around the implant needs to be removed, it is often necessary to perform a second operation to simultaneously remove the upper and lower structures of the implant, which greatly increases the surgical trauma.
  • a first object of the present invention is to provide a dental implant tractor that automatically completes the closure of the lower end of the implant after the completion of the traction without the need to reinstall the base body.
  • a dental implant tractor comprising an implant block and a traction block
  • the implant block comprises an implant, a closing screw and a base body
  • the closing The screw is connected to the upper end of the implant for sealing the upper end cavity of the implant
  • the base body is movably connected to the lower end of the implant body
  • the lower end of the base body is provided with an internal thread
  • the traction block comprises a connecting screw, a traction screw, An inner sleeve and an outer sleeve
  • the connecting screw is screwed to the base body
  • the traction screw is located under the connecting screw
  • the inner sleeve is disposed under the base body
  • the inner sleeve guides the traction screw to push the connection during the pulling process
  • the screw is pulled into position and the outer sleeve is disposed on the outer sleeve of the inner sleeve for connecting the inner sleeve and the base body.
  • the connecting screw comprises a connecting end and a closed end, the connecting end is smaller in diameter than the closed end, and the connecting end is just inserted into the lower end cavity of the implant, and the closed end is provided with an external thread.
  • the length of the closed end of the connecting screw is the same as the length of the internal thread of the lower end of the base body.
  • the connecting screw is connected to the lower end of the implant, and the implant is pushed vertically upward during the traction process, and is fixed to the lower bone segment after the traction is completed.
  • the length of the closed end of the connecting screw is the same as the length of the internal thread of the lower end of the base body, indicating that the highest point of traction is reached and the thread is tightened because the thread is not in place when the thread is not rotated.
  • the uniform length also ensures that the connecting screw can completely enter the base body when the traction is in place, without protruding or recessed.
  • a groove is arranged at the bottom of the connecting screw, and the traction screw is provided with a protrusion.
  • the groove connecting the screw is engaged with the protrusion of the traction screw.
  • the traction screw pushes the connecting screw to complete the traction.
  • the traction screw is automatically disengaged from the upper connecting screw.
  • the upper end of the implant and the base body are each provided with an external thread that is combined with the bone.
  • the external thread combined with the bone is different from the ordinary thread, the spiral groove is shallow, and the pitch is large, which is favorable for bone stability.
  • the invention has the advantages that: (1) the installation of the base body and the closing of the connecting screw are automatically completed after the completion of the traction, and the base body is not required to be closed again, thereby simplifying the operation steps, reducing the difficulty of clinical operation, and avoiding the upper bone segment slipping in place. (2) The connection between the implant and the pedestal is non-fixed. Once the peri-implantitis is present, the implant can be taken out separately, avoiding the trauma and economic burden of the second operation on the patient; (3) The design of the outer sleeve not only facilitates the operation, but also cleverly connects the inner sleeve and the base body. When the traction is completed, the outer sleeve is unscrewed, and the inner sleeve and the base body naturally fall off.
  • Figure 1 is a schematic view of the device when it is pulled into position.
  • Figure 2 is a schematic view of the outer sleeve being unscrewed by the pulling.
  • Figure 3 is a schematic illustration of a preferred embodiment of a base body.
  • Figure 4 is a schematic illustration of a preferred embodiment of a connecting screw.
  • FIG. 1 is a schematic view of a device when the traction is in place.
  • the dental implant tractor includes an implant block 1 and a traction block 2
  • the implant block 1 includes an implant 11 , a closing screw 12 and a base body 13 .
  • the closing screw 12 is screwed to the upper end of the implant for closing the upper end cavity of the implant, the base body 13 is movably connected with the lower end of the implant 11 (when the traction is in place), and the lower end of the base body 13 is provided with internal threads, and the traction block 2
  • the connecting screw 21, the pulling screw 22, the inner sleeve 23 and the outer sleeve 24 are screwed, the connecting screw 21 is screwed to the base body 13, the pulling screw 22 is located below the connecting screw 21, and the inner sleeve 23 is disposed on the base body 13 below, the inner sleeve 23 guides the traction screw 22 to pull the connecting screw 21 into position during the pulling process, and the outer sleeve 24 is disposed on the outer ring of the inner sleeve 23 for connecting the inner sleeve 23 and the base body 13.
  • the base body 13 and the implant body 11 are respectively fixed on the sawn bone, and the traction screw is inserted into the traction screw to rotate to the right, and the connecting screw 21 is driven against the implant 11 and the upper jaw to move upward. Traction.
  • the connecting screw 21 is screwed into the base body 13 to be screwed, the pulling is completed.
  • 2 is a schematic view of the complete rotation of the outer sleeve by pulling, the left outer sleeve 24, the outer sleeve 24 and the base body 13 are disengaged, and the inner sleeve 23 and the traction screw 22 are pulled downward.
  • the connecting screw 21 includes a connecting end 211 having a diameter smaller than the diameter of the closed end 212, and the connecting end 211 can be inserted into the cavity of the lower end of the implant 11.
  • the closed end 212 is provided with an external thread 213.
  • the base body 13 is provided with an external thread 131 coupled to the bone, and the lower end is provided with an internal thread 132.
  • the length of the closed end 212 of the connecting screw 21 coincides with the length of the internal thread 132 of the lower end of the base body 13.
  • the connecting screw 21 is connected to the lower end of the implant 11, and the implant is pushed vertically upward during the pulling process, and is fixed to the lower bone segment after the traction is completed.
  • the length of the closed end 212 of the connecting screw 21 coincides with the length of the internal thread 132 of the lower end of the base body 13, suggesting that the highest point of traction is reached and locked due to the fact that when the thread is not rotated, the traction is reached.
  • the uniform length also ensures that the connecting screw 21 can completely enter the base body 13 when the traction is in place, without protruding or recessed.
  • a groove 214 is provided at the bottom of the connecting screw 21, and the pulling screw is provided with a projection.
  • the groove connecting the screw is engaged with the protrusion of the traction screw.
  • the traction screw pushes the connecting screw to complete the traction.
  • the traction screw is automatically disengaged from the upper connecting screw.
  • the upper end of the implant 11 and the base body 13 are each provided with an external thread that is combined with the bone.
  • the external thread combined with the bone is different from the ordinary thread, the spiral groove is shallow, and the pitch is large, which is favorable for bone stability.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Developmental Biology & Embryology (AREA)
  • Dental Prosthetics (AREA)

Abstract

本发明公开牙种植牵引器，包括种植体组块和牵引组块，所述种植体组块包括种植体、封闭螺丝和底座体，所述封闭螺丝与种植体上端螺纹连接，用于封闭种植体上端空腔，所述底座体与种植体下端活动连接，所述底座体下端设有内螺纹，所述牵引组块包括连接螺杆，牵引螺杆、内套筒和外套筒，所述连接螺杆与底座体螺纹连接，所述牵引螺杆位于连接螺杆下方，所述内套筒设置在底座体下方，内套筒在牵引过程中引导牵引螺杆推动连接螺杆牵引到位，所述外套筒设置在内套筒外圈，用于连接内套筒和底座体。本装置牵引完成后自动完成底座体安装和连接螺杆封闭，无需再次安装底座体封闭，从而简化了操作步骤，减少了临床操作难度，同时避免了上骨段滑落原位的问题。

Description

牙种植牵引器 技术领域
本发明属于医疗器械，更具体地讲，涉及口腔颌面修重建外科手术中使用的颌骨牵引及种植装置。
背景技术
目前口腔颌面修重建外科手术中使用的颌骨牵引及种植装置是申请人于2001年设计开发的颌骨内置式牵引种植装置(专利号：01238497.6)，该装置集颌骨牵引器与牙种植于一身，包括种植体、覆盖螺丝，固定叶片构成纵向牵引种植体和由升降螺杆、连接套筒及固定叶片构成的导向套筒组成。原理：通过种植体外螺纹固定上部移动骨块，套筒内螺纹用作升降螺杆推力传导，当导向套筒内升降螺杆逆时针方向转动时，推动上部骨块上移。
这套装置使用下来发现有以下不足：1、种植体与上段骨块固定不稳，需借助叶片辅助固位，在植入稳定后二次手术取出，增大了手术的创伤及操作难度；2、该装置在拆除导向套筒后会有软组织从种植体底部长入，引起种植体周围炎甚至发生逆行性感染；3、该装置在完成牵引拆除套筒后，常常出现上部牵引骨块退回原处，导致牵引失败；4、该装置仅与上骨段固定，与下骨段无稳定固位，增加了种植体的不稳定性。
申请人于2012年设计了一套新的牙种植牵引器(DID)(Chenping,Z.,et al.,Dental implant distractor combined with free fibular flap:a new design for simultaneous functional mandibular reconstruction.J Oral Maxillofac Surg,2012.70(11):p.2687-700.)，通过对动物实验及临床实验的结果分析，开发出牙种植牵引器，该装置除保留了颌骨内置式牵引种植装置的特性外，通过去除了固定叶片减少了手术操作难度及创伤，通过加装底座螺丝增加种植体稳定性。主要结构包括种植体、覆盖螺丝，底座螺丝和固位螺丝构成纵向牵引种植体和由牵引套筒，丝杆和牵引帽构成的牵引装置组成。
改良后的装置仍有以下不足：1、虽然通过加装底座螺丝增强了种植体稳定性，但是拔除牵引套筒更换底座螺丝过程较为繁琐，医生常常在拆除套筒后无法确定底座螺丝的就位位置；2、拔除牵引套筒后，有时会出现上骨段退回牵引前位置，从而影响牵引效果；3、底座螺丝和固位螺丝可增加种植体与下骨段的 稳定性，但在种植义齿出现种植体周围炎需去除时，往往需要二次手术将种植体上下部结构同时去除，大大的增加了手术创伤。
发明内容
本发明的第一个目的在于提供一种牵引完成后自动完成种植体下端封闭，无需再次安装底座体的牙种植牵引器。
为实现以上目的，本发明公开以下技术方案：牙种植牵引器，包括种植体组块和牵引组块，其特征在于，所述种植体组块包括种植体、封闭螺丝和底座体，所述封闭螺丝与种植体上端螺纹连接，用于封闭种植体上端空腔，所述底座体与种植体下端活动连接，所述底座体下端设有内螺纹，所述牵引组块包括连接螺杆，牵引螺杆、内套筒和外套筒，所述连接螺杆与底座体螺纹连接，所述牵引螺杆位于连接螺杆下方，所述内套筒设置在底座体下方，内套筒在牵引过程中引导牵引螺杆推动连接螺杆牵引到位，所述外套筒设置在内套筒外圈，用于连接内套筒和底座体。
作为一个优选方案，所述连接螺杆包括连接端和封闭端，所述连接端直径小于封闭端直径，且连接端恰能插入种植体下端空腔，所述封闭端设有外螺纹。
作为一个优选方案，所述连接螺杆封闭端的长度与底座体下端内螺纹的长度一致。连接螺杆与种植体下端相连，在牵引过程中推动种植体垂直向上，牵引完成后与下骨段固定。连接螺杆封闭端的长度与底座体下端内螺纹的长度一致，提示由于没有螺纹旋转不动时即为牵引到位时，达到牵引最高点，并且螺纹拧紧。长度一致也能保证牵引到位时连接螺杆恰能完全进入底座体，没有突出也不会凹陷进去。
作为一个优选方案，所述连接螺杆底部设置凹槽，所述牵引螺杆设置凸起。连接螺杆的凹槽与牵引螺杆的凸起卡住配合，在牵引过程中牵引螺杆推动连接螺杆向上完成牵引，牵引到位时牵引螺杆自动与上方的连接螺杆脱开。
作为一个优选方案，种植体上端和底座体均设置与骨结合的外螺纹。与骨结合的外螺纹区别于普通螺纹，螺旋槽浅，螺距大，利于骨稳定。
本发明的优点在于：(1)牵引完成后自动完成底座体安装和连接螺杆封闭，无需再次安装底座体封闭，从而简化了操作步骤，减少了临床操作难度，同时避免了上骨段滑落原位的问题；(2)种植体与底座体连接方式为非固定连接， 一旦出现种植体周围炎，可单独将种植体取出，避免了二次手术对患者带来的创伤与经济负担；(3)外套筒的设计既方便了手术操作，也巧妙的将内套筒和底座体连接，当牵引完成时，旋下外套筒，内套筒与底座体自然脱落。
附图说明
图1为牵引到位时装置示意图。
图2为牵引完成旋下外套筒的示意图。
图3为底座体的一个优选实施例示意图。
图4为连接螺杆的一个优选实施例示意图。
其中，1——种植体组块；2——牵引组块；11——种植体；12——封闭螺丝；13——底座体；21——连接螺杆；22——牵引螺杆；23——内套筒；24——外套筒；131——与骨结合的外螺纹；132——底座体下端内螺纹；211——连接端；212——封闭端；213——封闭端外螺纹；214——凹槽。
具体实施方式
下面结合具体实施例，进一步阐述本发明。下述实施例中所使用的实验方法如无特殊说明，均为常规方法。下述实施例中所用的材料、试剂等，如无特殊说明，均可从商业途径得到。应理解，这些实施例仅用于说明本发明而不用于限制本发明的范围。
实施例1.
请参见图1，图1为牵引到位时装置示意图，牙种植牵引器包括种植体组块1和牵引组块2，种植体组块1包括种植体11、封闭螺丝12和底座体13，所述封闭螺丝12与种植体上端螺纹连接，用于封闭种植体上端空腔，底座体13与种植体11下端活动连接(牵引到位时)，底座体13下端设有内螺纹，所述牵引组块2包括连接螺杆21，牵引螺杆22、内套筒23和外套筒24，所述连接螺杆21与底座体13螺纹连接，所述牵引螺杆22位于连接螺杆21下方，内套筒23设置在底座体13下方，内套筒23在牵引过程中引导牵引螺杆22推动连接螺杆21牵引到位，外套筒24设置在内套筒23外圈，用于连接内套筒23和底座体13。
使用时，将底座体13与种植体11分别固定在已锯开的腓骨上，用牵引螺丝刀十字刀头插入牵引螺丝向右旋转，同时带动连接螺杆21顶着种植体11与上腓骨向上移动实现牵引。当连接螺杆21旋入底座体13螺纹锁紧后就完成牵 引。图2为牵引完成旋下外套筒的示意图，左旋外套筒24，使外套筒24与底座体13脱开后向下拔出内套筒23和牵引螺杆22。
图4为连接螺杆的一个优选实施例的示意图，连接螺杆21包括连接端211和封闭端212，所述连接端211直径小于封闭端212直径，且连接端211恰能插入种植体11下端空腔，所述封闭端212设有外螺纹213。
图3为底座体的一个优选实施例示意图，底座体13设置与骨结合的外螺纹131，下端设有内螺纹132。连接螺杆21的封闭端212的长度与底座体13下端内螺纹132的长度一致。连接螺杆21与种植体11下端相连，在牵引过程中推动种植体垂直向上，牵引完成后与下骨段固定。连接螺杆21封闭端212的长度与底座体13下端内螺纹132的长度一致，提示由于没有螺纹旋转不动时即为牵引到位时，达到牵引最高点，并且锁紧。长度一致也能保证牵引到位时连接螺杆21恰能完全进入底座体13，没有突出也不会凹陷进去。
作为一个优选方案，连接螺杆21底部设置凹槽214，所述牵引螺杆设置凸起。连接螺杆的凹槽与牵引螺杆的凸起卡住配合，在牵引过程中牵引螺杆推动连接螺杆向上完成牵引，牵引到位时牵引螺杆自动与上方的连接螺杆脱开。
作为一个优选方案，种植体11上端和底座体13均设置与骨结合的外螺纹。与骨结合的外螺纹区别于普通螺纹，螺旋槽浅，螺距大，利于骨稳定。
以上所述仅是本发明的优选实施方式，应当指出，对于本技术领域的普通技术人员，在不脱离本发明原理的前提下，还可以做出若干改进和润饰，这些改进和润饰也应视为本发明的保护范围。

Claims (6)

  1. 牙种植牵引器，包括种植体组块和牵引组块，其特征在于，所述种植体组块包括种植体、封闭螺丝和底座体，所述封闭螺丝与种植体上端螺纹连接，用于封闭种植体上端空腔，所述底座体与种植体下端活动连接，所述底座体下端设有内螺纹，所述牵引组块包括连接螺杆，牵引螺杆、内套筒和外套筒，所述连接螺杆与底座体螺纹连接，所述牵引螺杆位于连接螺杆下方，所述内套筒设置在底座体下方，内套筒在牵引过程中引导牵引螺杆推动连接螺杆牵引到位，所述外套筒设置在内套筒外圈，用于连接内套筒和底座体。
  2. 根据权利要求1所述的牙种植牵引器，其特征在于，所述连接螺杆包括连接端和封闭端，所述连接端直径小于封闭端直径，且连接端恰能插入种植体下端空腔，所述封闭端设有外螺纹。
  3. 根据权利要求2所述的牙种植牵引器，其特征在于，所述连接螺杆封闭端的长度与底座体下端内螺纹的长度一致。
  4. 根据权利要求1所述的牙种植牵引器，其特征在于，所述连接螺杆底部设置凹槽。
  5. 根据权利要求1所述的牙种植牵引器，其特征在于，所述牵引螺杆设置凸起。
  6. 根据权利要求1所述的牙种植牵引器，其特征在于，种植体上端和底座体均设置与骨结合的外螺纹。
PCT/CN2017/119101 2017-01-24 2017-12-27 牙种植牵引器 WO2018137461A1 (zh)

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