WO2019195518A1

WO2019195518A1 - Maxillomandibular fixation device

Info

Publication number: WO2019195518A1
Application number: PCT/US2019/025732
Authority: WO
Inventors: Peter J. MAYER
Original assignee: Mayer Peter J
Priority date: 2018-04-04
Filing date: 2019-04-04
Publication date: 2019-10-10

Abstract

A maxillomandibular fixation device is provided. The maxillomandibular fixation device broadly includes a strip of material for positioning around an individual's teeth; an arch bar positioned against the teeth; and a clamping assembly for clamping the material to the arch bar. The material may include a single length of material or may be multiple lengths of shorter material. The clamping assembly may include a lever portion and a hook portion or may be a single slidable side clamp.

Description

MAXILLOMANDIBULAR FIXATION DEVICE

FIELD OF THE INVENTION

[0001] The invention is generally related to maxillomandibular fixation dental devices. More particularly die invention relates to a hybrid arch bar used when treating facial bone fractures.

BACKGROUND OF THE INVENTION

[0002] When treating facial bone (maxilla and/or mandible) fractures, the number one goal is to align the teeth such that, when die bones heal, the patient’s bite is properly aligned. As seen in the prior art device depicted in FIG. 1, for many years the technique was to place a 0.5mm x 3mm strip of stainless steel, with hooks on it, along the buccal (cheek side) aspect of the gums in the maxilla and mandible. These“arch bars” would be secured using stainless steel wires wrapped around each individual tooth and then around the arch bar. The wires would then be twisted, cut and bent to avoid any sharp edges of die wires poking into the mucosa. After this was completed in the upper (maxilla) and lower (mandible) arches, wires would wrap around the upper and lower arch bar hooks resulting in the jaws being wired shut. This could either be the definitive treatment, the result of which would be healing of the bones in the proper position, or allow for metal plates to be placed, fixating the fracture segments. However, the disadvantages of this technique are numerous. It is a technically demanding procedure for a surgeon with results varying depending on the level of skill of the surgeon. The procedure also requires a significant amount of time to complete, which is demanding on both the surgeon and the patient. Damage to the mucosa and periodontal bone is frequently encountered with instability over time due to stretching of the wires. Further instability results if the patient is missing teeth.

[0003] Another conventional method of wiring the jaws shut is seen in FIG. 2. Screws are placed in the maxilla and mandible, through the mucosa. The protruding screws then act as a“hook” to wrap wires around. Disadvantages are also associated with this technique. Damage to tooth roots may result in occasional tooth loss. Loosening of the screws over time resulting in instability of the maxillomandibular fixation. Overgrowth of the mucosa over the screws causing pain and the need for surgical removal of the maxillomandibular fixation.

[0004] A third, more recent method of maxillomandibular fixation seen in FIG. 3 is to use an extramueosal plate containing hooks, secured by transmucosal screws. The disadvantages of this technique are damage to tooth roots, loosening of the screws over time resulting in maxillomandibular fixation instability and overgrowth of the mucosa over tire plate and screws causing pain and the need for surgical removal.

[0005] Therefore, what is needed are new and improved devices for maxillomandibular fixation that addresses the foregoing problems.

BRIEF SUMMARY OF THE INVENTION

[0006] A maxillomandibular fixation device is provided. The maxillomandibular fixation device broadly includes a strip of material for positioning around an individual’s teeth; an arch bar positioned against the teeth; and a clamping assembly for clamping the material to the arch bar. The strip of material may include a single length of material from 45 cm to 50 cm or may include a plurality of strips of material from 3 cm to 4 cm in length.

[0007] The arch bar may includes a projection extending from a surface thereof and include an upper track and a lower track. Alternatively, the arch bar may include a hook thereon.

The clamping assembly may comprise a single clamping assembly or include a plurality of clamping assemblies. The clamping assembly may include a base having a hook coupled to a lower portion thereof and a clamp portion positioned thereon. The hook may be integrally molded to the clamping assembly or may simply be coupled to the clamping assembly. [0009] The clamping assembly includes a lever moveable between a first open position and a second closed position. Alternatively, the clamping assembly may include a removable insert that secures the material in place by friction fit

[0010] These and other features of the maxillomandibular fixation device in accordance with the invention will now be described.

BRIEF DESCRIPTION OF THE DRAWINGS

[0011] For a better understanding of the invention, and to show how the same may be carried into effect, reference will now be male, by way of example, to the accompanying drawings, in which:

[0012] FIG. 1 is a conventional maxillomandibular fixation device.

[0013] FIG, 2 is a second conventional maxillomandibular fixation device.

[0014] FIG.3 is a third conventional maxillomandibular fixation.

[0015] FIG. 4 is a top view of a maxillomandibular fixation device in one aspect of the invention.

[0016] FIG. 5 is top view of the maxillomandibular fixation device in another aspect of the invention.

[0017] FIG. 6 is a perspective view of a clamp assembly in accordance with the invention,

[0018] FIG. 7 is a side view of the maxillomandibular fixation device in accordance with the invention.

[0019] FIG. 8 is perspective view of an arch bar in accordance with one aspect of the invention that receives the clamp assembly.

[0020[ FIG. 9 is a perspective view of another aspect of the maxillomandibular fixation device in accordance with the invention showing a side clamp assembly. [0021] FIG. 10 is a top view of the maxillomandibular fixation device of FIG. 9.

[0022] FIG. 11 Is a perspective view of an arch bar in accordance with one aspect of the invention that receives a slide clamp assembly.

DETAILED DESCRIPTION OF TOE INVENTION

[0023] Referring now to FIGS. 4-8 one aspect of a maxillomandibular fixation device 10 in accordance with an aspect of die invention will now be described. The maxillomandibular fixation device 10 overcomes many of the problems associated with conventional devices and broadly includes a clamp assembly 12, an arch bar 14 for receiving the clamp assembly 12 and a strip of material 16 that wraps around one or more teeth and is clamped in placed by a clamp assembly. Rather than using wires to secure the device around the teeth, the maxillomandibular fixation device 10 uses a single strip of material 16 having a length of approximately 45 50 cm and a width of approximately 2 - 3 mm. The material may be constructed of an aramid such as KEVLAR (poly-para-phenylene terephthalamide), MOMEX, TECHMORA, an ultra high-density polyethylene (UHDPE), DYNEEMA, or a metal such as stainless steel. Other materials known to those of skill in the art may also be used. In one aspect the material 16 is weaved in and out, between the teeth as best seen in FIG. 4. In another aspect, a shorter strip of material 18 having a length of approximately 3 - 4 can and a width of approximately 2 - 3 mm may be used and individual strips would be wrapped around each tooth as best seen in FIG. 5.

[0024] During placement of the device 10, the embrasure space will be entered from the occlusal aspect, avoiding necrosis of the dental papilla as well as greatly speeding up the placement.

[0025] Referring now to FIG. 6, the strip of material 16, 18 is secured a clamp assembly 12 moveably attached to an arch bar 14 constructed of stainless steel or titanium as best seen in FIG. 8. The clamp assembly 12 includes a base 20 having an upper portion 21 and a lower portion 23. The upper 21 portion and lower portions 23 may be integrally formed or may comprise separate pieces fastened together with fastening means such as adhesive, chemical bonding and the like. The lower portion includes a tab or hook 25 ona first surface and a pair of lips 42 that define a channel 44 therebetween on a second surface 29 of the lower portion 23 of base 20. Hook 25 receives wires (not shown) that are used to wire the jaw closed until the healing process finishes. The upper portion 21 of the base 20 includes a clamp 22 having lever 26 that moves from an open position (as shown in FIG, 6) to a dosed position which abuts the upper portion 21. Upper portion 21 also includes an aperture 40 that extends through the clamp assembly. Material 16 is threaded through the aperture. In operation, when the lever 26 is moved to the dosed position it secures the material 16 in place by compression or a friction fit Those of skill in the art will appreciate that although a lever 25 is shown other devices and inserts are contemplated so long as they secure the material 16 in place. For example, lever 25 could be eliminated and a separate piece insert used, which would be inserted into the damp assembly through tiie aperture. In addition, aperture 40 need not be on the upper portion 21 of the clamp assembly 12 but may be placed anywhere in the damp assembly so long as the material 16 can be threaded through the clamp assembly.

[6026] The arch bar 14 includes a projection 15 on one side thereof, the projection 15 defining upper 17 and lower 17 tracks or channels. The channel 44 of the claittp assembly slidingly and matingly receives projection 15 of the arch bar 14. Channel 44 is shown as having an open configuration defined by a pair of lips 42 but those of skill in the art will appreciated that the pair of lips 42 may also have a closed configuration that defines channel 44, as shown in dashed line. The damp assembly 12, in the closed position, will both secure the strip of material 16, 18 by compression fit as well as lock the assembly 12 to the upper and lower tracks 17, 19 of the arch bar 14. In another aspect of the device, the damp 22 may secure the strip of material 16, 18 with the clamp hook assembly 12 movably received by upper and lower channels 17, 19 of arch bar 14. The clamp assembly 12 would be positioned in the embrasure space 28 of the teeth 30 as best seen in FIG. 4 when using the long strip of material 16. Alternatively, if using individual strips of material 18 as seen in FIG. 5, the damp assembly 12 would be positioned against the buccal aspect 32 of each tooth 30. [0027] Referring now to FIG. 7, in edentulous areas an arm 34 that is coupled to and projects radially downward from arch bar 12 can be attached with an area for a bone screw 36 to be placed in the alveolar bone. Those of skill in the art will appreciate that the arm 34 may be coupled to the arch bar 12 by the clamp and hook assembly 12 or by other means known to those of skill in the such as fasteners, screws and the like. Because there is no tooth in the area, no roots will be damaged. The arch bar 14, as seen in FIG. 8, will have been adapted along the buccal aspect of the alyeolar arches.

[0628] Referring now to FIGS. 9-11 another aspect of a maxillomandibular fixation device will now be described. The material 16 construct as described above is weaved in and out, between the teeth as best seem in FIG. 10. The embrasure space will be entered from the occlusal aspect, avoiding necrosis of the dental papilla as well as greatly speeding up the placement Referring now to FIGS. 9 and 10, the strip of material 18 is secured in place with a single slide damp assembly 50 slidably received by arch bar 52 best seen in FIGS. 9 and 10. Arch bar 52 includes a body 54 and a hook 56 and is approximately 10-14 cm in length and 2-3 mm in width. The hook 56 receives wires (not shown) for wiring the jaw closed during the healing process. The slide clamp assembly 50 includes an aperture therethrough for receiving material 16. The slide clamp assembly 50 also includes a channel for receiving the arch bar 54 and an aperture for receiving the material 16. Slide clamp assembly 50, when slidingily clamped in place, will secure and lock the strip of material 16 by a compression fit to the arch bar 38. The arch bar 38, as seen in FIG. 6, will have been adapted along the buccal aspect of the alveolar arches.

[0029] Those of skill in the art will appreciate that the maxillomandibular fixation devices describe herein will dramatically reduce the time needed to place the patient in maxillomandibular fixation as well as improve the stability. The present technique may also reduce the morbidity associated with conventional surgical techniques and devices. In addition, removing the maxillomandibular fixation will be much faster and not require sedation or surgery. Rather, the placement and removal may easily done in an office setting. [0030] While the invention has been particularly shown and described, those of ordinary skill in the art will appreciate and understand that changes in form and details may be made without departing from the scope and spirit of the invention.

;

Claims

What is claimed:

1. A maxillomandibular fixation device comprising: a strip of material for positioning around an individual’s teeth; an arch bar positioned against the teeth; and a clamping assembly for clamping the material to the arch bar.

2. The maxillomandibular fixation device of claim 1 wherein the arch bar includes a projection extending from a surface thereof and an upper track and a lower track.

3. The maxillomandibular fixation device of claim 1 wherein the arch bar includes a body and a hook.

4. The maxillomandibular fixation device of claim 1 wherein the strip of material is selected from a single length of material from 45 cm to 50 cm.

5. The maxillomandibular fixation device of claim I wherein the strip of material comprises a plurality of strips of material from 3 cm to 4 cm in length.

6, The maxillomandibular fixation device of claim 3 wherein the clamping assembly is a single clamp.

7. The maxillomandibular fixation device of claim 2 wherein the clamping assembly comprises a base having a hook coupled to a lower portion thereof and a clamp positioned thereon.

8. The maxillomandibular fixation device of claim 7 wherein the clamp includes a lever moveable between a first open position and a second closed position.

9. The maxillomandibular fixation device of claim 8 wherein the lever secures the material when the lever is in the second closed position.

10. The maxillomandibular fixation device of claim 9 wherein the clamp assembly further includes a pair of lips defining a channel therebetween on a surface opposite the hook.

11. The maxillomandibular fixation device of claim 10 wherein the projection of the arch bar is matingly receiving by the channel defined by the pair of lips and the pair of lips are received by the upper and lower tracks of the arch bar,

12. The maxillomandibular fixation device of claim 7 wherein the lever is integrally coupled to the base portion.

13. The maxillomandibular fixation device of claim 1 wherein the clamping assembly is constructed of stainless steel or titanium.

14. The maxillomandibular fixation device of 1 wherein the arch bar further includes an arm extending downwardly therefrom and configured to be placed in edentulous areas.

15. The maxillomandibular fixation device of claim 14 wherein the arm further includes an aperture for receiving fastening means, the fastening means for fastening the arm to an alveolar bone.

16. The maxillomandibular fixation device of claim 15 wherein the fastening means comprise a bone screw.

17. The maxillomandibular fixation device of claim 1 wherein die material is selected from an aramid, an ultra high-density polyethylene or a metal.

18. The maxillomandibular fixation device of claim 17 wherein the aramid is poly-para-phenylene terephthalamide.

19. The maxillomandibular fixation device of claim 17 wherein the metal is stainless steel.

20. The maxillomandibular fixation device of claim 1 wherein the clamp assembly includes a plurality of clamp assemblies.