WO2020085321A1 - インプラント材料及び当該インプラント材料の製造方法 - Google Patents
インプラント材料及び当該インプラント材料の製造方法 Download PDFInfo
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- WO2020085321A1 WO2020085321A1 PCT/JP2019/041360 JP2019041360W WO2020085321A1 WO 2020085321 A1 WO2020085321 A1 WO 2020085321A1 JP 2019041360 W JP2019041360 W JP 2019041360W WO 2020085321 A1 WO2020085321 A1 WO 2020085321A1
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- implant material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- A61F2002/3082—Grooves
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61L2400/00—Materials characterised by their function or physical properties
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- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/38—Materials or treatment for tissue regeneration for reconstruction of the spine, vertebrae or intervertebral discs
Definitions
- the present invention relates to an implant material and a method for manufacturing the implant material, and particularly to an implant material having a groove and a unidirectional hole, and a method for manufacturing the implant material.
- bioimplant materials have been proposed as substitute materials for bone.
- high strength materials such as stainless alloys, titanium-based metals such as titanium and titanium alloys, and bioactive materials such as apatite sintered bodies, bioactive glass, and bioactive crystallized glass are known.
- High-strength materials such as stainless alloys and titanium-based metals have the characteristic of having high mechanical strength, but they do not directly adhere to bones as they are. Further, a bioactive material such as an apatite sintered body, bioactive glass, or bioactive crystallized glass is bound to bone in a short period of time, but has insufficient strength and has a problem that its application site is limited.
- an implant material has been proposed in which a coating film made of a bioactive material is formed on the surface of a high-strength material by plasma spraying or baking (Japanese Patent Application No. 8-357040).
- a coating film made of a bioactive material is formed on the surface of a high-strength material by plasma spraying or baking
- the human spine plays an important role in supporting the trunk and protecting the nerves (spinal cord) that transmit the senses and movements of the internal organs and extremities from the brain. Is playing.
- the deformed vertebra or intervertebral disc may press the spinal cord. In this case, pressure on the spinal cord causes symptoms such as numbness and pain in the limbs.
- a spacer (generally called a cage) into the intervertebral disc part between vertebrae.
- a cage By inserting a cage between the vertebrae and mechanically fixing them, an attempt is made to relieve pressure on the spinal cord by reproducing an appropriate space and position between the vertebrae.
- this cage plays a role of supporting the load caused by the weight and is not directly fixed to the bone of the living body because it is made of metal or resin having high mechanical strength. Therefore, a method has been adopted in which a through hole is provided in the cage, and the bone is guided into the hole and fixed by the anchoring effect.
- screws and rods may be used to connect the vertebrae so that the vertebrae and the cage do not move.
- the fixation between the vertebra and the cage is not sufficient, and the cage moves after operation and falls out between the vertebral bodies, or the cage moves between the vertebral bodies and the vertebrae and surrounding tissues are moved. Or damage it. As a result, the spinal cord is pressed again, and the cage interferes with other parts to induce numbness and pain, which necessitates another operation.
- the bone should be collected separately from the ilium (the iliac bone is the pelvis) so that the bone quickly enters the through hole of the implant material such as the cage and is firmly fixed, and the cage is penetrated.
- a method has been adopted in which the bone collected in the hole is transplanted to promote the guide of the bone into the through hole.
- the burden on the patient increases and there is concern about pain.
- the fixation of implant materials such as cages may be insufficient even when using bone graft.
- implant materials such as cages not only induce bone near the surface like artificial joints, but also allow deep bone penetration and filling in the thickness direction (the thickness direction corresponds to, for example, the intervertebral gap direction).
- the thickness direction corresponds to, for example, the intervertebral gap direction.
- an object of the present invention is to provide an implant material having improved fixability to a living body.
- the inventors of the present invention have found the implant material of the present invention as a result of diligent research on its application to an implant material, paying attention to the structure of the original hard tissue existing in the living body.
- the implant material of the present invention is an implant material having a hole in at least one direction, and a member constituting the hole has a groove.
- the member forming the hole is characterized by being formed of a pillar and / or a plate.
- the groove is provided in the pillar and / or the plate.
- a plurality of the holes are formed by the pillar and / or the plate.
- the grooves are alternately arranged on the front and back surfaces of the pillar and / or the plate.
- the pillar and / or the plate is characterized by being composed of a single body and / or a block.
- the pillars and / or plates are characterized in that they are designed to be flexible.
- the hole is characterized by not penetrating the implant material or penetrating the implant material.
- the implant material is at least one selected from a polymer material, a ceramic material, a metal material, an amorphous material, or a mixed material thereof.
- the width of the groove is 0.25 to 500 ⁇ m.
- the implant material of the present invention when a plurality of the holes are provided, they are communicated with each other.
- the pillar and / or the plate has an elastic structure by itself, or by changing the thickness, width, or height of the pillar or the plate.
- the columns and / or plates are designed to be flexible.
- the implant material is designed to be flexible on at least a part of a contact surface where the implant material and a living body come into contact with each other.
- the hole is formed by a truss structure, and the inscribed circle of the hole is 500 ⁇ m to 2000 ⁇ m.
- the implant material has a cage-like structure, and has a second hole on a side surface of the cage-like structure.
- the method for producing the implant material of the present invention is a method for producing the implant material of the present invention, which is characterized by being produced by a 3D modeling method.
- the implant material of the present invention early bone entry and early fixation are possible, and the advantageous effect of reducing adverse effects on surrounding bone is exhibited. Further, the implant material of the present invention has an advantageous effect that strong immobilization between a living body and an implant material can be realized early without requiring setting of an external environment such as mechanical stimulation or a magnetic field.
- an implant material of the present invention it is possible to provide an implant material that enables early bone penetration and early fixation, and can reduce adverse effects on surrounding bone.
- FIG. 1 shows a cutaway view of an example of a member forming a hole. It can be seen that the members forming the holes have grooves. Although it is a cross-section, it also includes a shape (a truss structure in addition to the tetra-shaped porous body inside) that is on the other side of the cross-section in a cut state.
- FIG. 2 shows an example of the relationship between the members forming the holes and the outer periphery of the implant material.
- FIG. 3 shows a perspective view of an example of the truss structure and the groove.
- FIG. 4A shows a conventional implant material (evaluation sample C).
- FIG. 4B shows an implant material according to an embodiment of the present invention, in which unidirectional holes are penetrated (evaluation sample D).
- FIG.4 (c) shows the figure which looked at the implant material of FIG.4 (b) from the angle which rotated 90 degrees, and designs the hole in the cage side surface.
- evaluation sample E shows the result of a pull-out test in which the maximum load measured is the pull-out strength.
- FIG. 6 shows the result of the microscopic observation of the evaluation material E.
- FIG. 6B shows an enlarged view of a part surrounded by a rectangle on the left side of the center of FIG. 6A.
- FIG. 7 shows an example of use of the implant material in one embodiment of the present invention.
- FIG. 8 is a schematic view of an implant material according to an embodiment of the present invention in which a cylindrical cage is used for a vertebral body.
- FIG. 9 is a schematic view of an implant material according to an embodiment of the present invention in which a box-shaped cage used for intervertebral bodies is used for a vertebral body.
- FIG. 9A is a view seen from the lateral direction (direction perpendicular to the cranio-coccy axis direction) when the example of the implant material of the present invention is incorporated in the spine.
- FIG. 9A is a view seen from the lateral direction (direction perpendicular to the cranio-coccy axis direction) when the example of the implant material of the present invention is incorporated in the spine.
- FIG. 9 (b) is a schematic view of an example of the implant material of the present invention as viewed from the lateral direction (direction perpendicular to the caudal-caudal axis direction).
- Reference numeral 41 in FIG. 9B shows a ceiling structure of a box-type cage that forms a contact surface with the vertebral body / end plate in the vertical direction.
- FIG. 9C is a cross-sectional view of an example of the implant material of the present invention as seen from the lateral direction (direction perpendicular to the cranio-coccyx direction).
- FIG. 9 (d) is a perspective view (viewed obliquely from above) of an example of the implant material of the present invention.
- FIG. 10 shows a schematic view of a box-type cage in an implant material according to an embodiment of the present invention.
- FIG. 10A is a sectional view of an example of the implant material of the present invention.
- FIG. 10 (b) is a schematic view of an example of the implant material of the present invention as seen from the lateral direction (direction perpendicular to the caudal-caudal axis direction).
- Reference numeral 51 in FIG. 10B shows a ceiling structure of a box-type cage that forms a contact surface with the vertebral bodies and end plates in the vertical direction.
- FIG.10 (c) is a perspective view of an example of the implant material of this invention.
- FIG. 11 shows a bone cage group of a cage equivalent to the evaluation sample C of FIG.
- FIG. 11 (a) shows the results when both the heights of the box type cage are 8 mm and 11 mm
- Fig. 11 (b) shows the results when the height of the box type cage is 8 mm
- Fig. 11 (c) shows the results. The results are shown when the height of the mold cage is 11 mm.
- the implant material of the present invention is an implant material having a hole in at least one direction, and a member constituting the hole has a groove.
- the groove By the groove, when osteoblasts first enter the implant material (porous body), the depth direction of the hole of the osteoblast implant material (when using a cage as described later, the thickness of the cage). It becomes possible to extend and arrange the osteoblasts in the direction).
- the arranged osteoblasts produce the bone matrix oriented parallel to the extension / arrangement direction, and therefore, the implantation without mechanical stimulation (bone regeneration). ) It has the effect of promoting bone matrix orientation from the beginning.
- by setting a groove in addition to the hole it is possible to obtain early strong fixation between the bone and the implant material without setting an external environment such as mechanical stimulation or a magnetic field. Become.
- the groove is not particularly limited, but for example, the groove can be set on the surface of a pillar or a plate described later.
- the width of the groove is not particularly limited as long as it is set in the member forming the hole, but the width of the groove can be preferably 0.25 ⁇ m to 500 ⁇ m, more preferably 0.5 to 200 ⁇ m. Further, the grooves can be provided at equal intervals in the thickness direction.
- the member forming the hole is characterized by being formed of a pillar and / or a plate.
- the structure made of the pillars and / or the plates allows the porous body to be easily formed inside the implant material.
- INDUSTRIAL APPLICABILITY The present invention easily provides a porous body for inducing bone penetration and orientation in a hole inside an implant material such as a cage for obtaining early strong fixation between vertebrae without requiring setting of an external environment. can do.
- columns or / and plates can be pattern-arranged at regular intervals in the thickness direction of the cage (longitudinal axis direction of holes when forming holes, head-to-caudal axis direction in case of vertebra).
- the rigidity of the pillar can be adjusted by changing the thickness, width, height, etc. of the pillar or the plate. That is, in a preferred embodiment of the implant material of the present invention, after the oriented bone formation in the porous body, from the viewpoint of maintaining a good bone quality for a long term by giving continuous mechanical stimulation, the pillar and / or the plate are It is characterized in that the column and / or plate is designed to bend by itself having a stretchable structure or by changing the thickness, width or height of the column or plate.
- the stretchable structure is not particularly limited as long as it expands and contracts. For example, taking the case of insertion into a vertebral body as an example, the stretchable structure can have the meaning of contracting when a load is applied from the upper and lower vertebral bodies and returning to the original state when no load is applied.
- the implant material is flexible. It is designed to. By designing to flex in this way, for example, when an intervertebral cage is used as the implant material of the present invention for vertebra, as will be apparent from the examples described later, the contact surface with the vertebra by flexing, that is, the vertebra. It can be expected that the front and back surfaces of the inter cage will conform to the shape of the bone. By adapting to the shape of the bone, the front and back surfaces of the cage closely adhere to the vertebra without a gap, which facilitates guiding the bone to the porous body. This is also apparent from the fact that, as in the example described later, the intervertebral cage is similarly embedded between the sheep vertebrae, and as a result of observing the punching strength and the tissue, the bone vigorously penetrates into the porous body.
- the thickness of the pillar or plate is not particularly limited.
- the thickness of the pillar or plate can be preferably 0.1 to 2 mm, more preferably 0.5 to 1 mm.
- the pillar or plate flexes in the thickness direction of the implant material such as the cage due to the load acting between the bones such as the vertebrae, thereby more transmitting the load to the bone in the porous body. It can be done easily. After oriented bone formation in the porous body in this way, the bone inside the cage receives and receives the principal stress load (that is, mechanical stimulation) from the upper and lower vertebral bodies to maintain and promote the bone orientation, and during long-term implantation.
- the principal stress load that is, mechanical stimulation
- the pillar and / or the plate is characterized by being composed of a single body and / or a block.
- the pillars and / or plates can be blocks connected in a radial, cross, zigzag or the like, or can be a single piece.
- the plate may be rotatable around the pillar as the center of rotation, and the plate may be rotated at fixed intervals to fix the position, and the size of the hole may be freely designed.
- a plurality of the holes are formed by the columns and / or plates. Is characterized by.
- the groove is provided in the pillar and / or the plate from the viewpoint that the pillar or / and the plate define a hole direction and orient bones in that direction. It is characterized by being Further, from the viewpoint of promoting orientation of the bone matrix from the initial stage of implantation (bone regeneration) without mechanical stimulation, the groove can be provided along the depth direction (longitudinal direction) of the hole.
- a strong fixation is obtained by thinning the plate thickness to minimize the volume of the artificial material such as metal occupying in the porous body to maximize the space where bone can penetrate.
- the grooves are alternately arranged on the front and back surfaces of the pillar and / or the plate.
- the thickness of the plate is increased in order to increase the bone mass by thinning the metal part to widen the area inside the cage where bone can be filled (providing flexibility). This is because the depth of the groove may not be secured unless they are arranged alternately.
- the pillars and / or plates are characterized in that they are designed to be flexible.
- the columns and the plates may be arranged in a pattern. This is because the pattern arrangement makes it possible to easily design according to the size of the hole. That is, it is possible to make uniform the size of the hole formed by the pillar and the plate, that is, the size of the inscribed circle.
- the optimum value of the inscribed circle of the hole is set to 500 ⁇ m or more in the sheep embedding test, but in order to easily specify the optimum value, the space of a certain size is arranged as the pattern arrangement. Can be created. Since a space larger than that may be provided, it may be random (the sizes of the inscribed circles are different) and is not particularly limited.
- the hole is formed by a truss structure and the inscribed circle of the hole is 500 ⁇ m It is characterized in that it is 2000 ⁇ m.
- the rigidity of the pillar can be adjusted by changing the thickness, width, height, etc. of the pillar or the plate.
- the axis connecting the columns, the plates, the plate-columns, etc. is a beam (when a cage is used, it includes a portion corresponding to the ceiling (both upper and lower sides) of the cage.)
- the structure may be flexible or expandable. This is similar to the expansion and contraction of the plate as described above.
- the thickness of the beam can be 0.1 mm to 1.5 mm, preferably 0.3 mm to 1.0 mm from the viewpoint of the stretchable structure.
- the beam can be about 0.5 mm.
- the hole is characterized by not penetrating the implant material or penetrating the implant material.
- the holes when the osteoblast first penetrates into the implant material (porous body) by the groove, the depth direction of the hole of the implant material of the osteoblast (when a cage is used as described later is described. Since it is possible to extend and arrange osteoblasts in the cage thickness direction), the holes may be through holes or holes that do not penetrate. In the case of a through hole, it is possible to further secure the fixing strength between the vertebra and the cage by allowing the bone tissue to continue between the vertebrae through the through hole between the adjacent vertebrae.
- the material of the implant material is not particularly limited.
- the implant material is polytetrafluoroethylene ((Teflon (registered trademark)), a polymer material, a ceramic material, a metal material, an amorphous material, or a mixture thereof. At least one selected from the materials may be mentioned.
- the metal material may include a pure metal, an alloy, an intermetallic compound, etc.
- the amorphous material may include a partially crystallized portion. Even if it contains a crystallized portion, there is a material called an amorphous material, which may be, for example, bioglass.
- a hard tissue substitute material can be cited as a material for the implant material.
- the hard tissue substitute material include ceramics represented by apatite, inorganic materials such as alumina and zirconia, and metallic materials such as stainless steel, Co—Cr alloys, titanium, alloys and tantalum. Ceramics can be further divided into bioactive ceramics, bioinert ceramics, and the like. Examples of bioceramics include calcium phosphate ceramics, silica glass, and crystallized glass. Well-known calcium phosphate-based ceramics are hydroxyapatite and tricalcium phosphate, which are used for artificial tooth roots, skin terminals, metal coating materials and the like. Those various materials can be used as the implant material.
- the width of the groove is preferably 0.25 to 500 ⁇ m, and more preferably from the viewpoint that the osteoblast can detect the orientation direction of collagen and apatite. It can be 0.5 to 200 ⁇ m.
- the implant material of the present invention when a plurality of the holes are provided, they are communicated with each other. This is because, for example, continuous inflow of bone marrow fluid between the pores is possible, and bone invasion into the deep part of the porous body can be further realized.
- the method for producing the implant material of the present invention is a method for producing the implant material of the present invention, which is characterized by being produced by a 3D modeling method (AM, Additive Manufacturing).
- a 3D modeling method a conventional method can be used and is not particularly limited.
- the method for processing an implant material and the like are widely known in the art, and can be applied to the implant material of the present invention by a conventional method to be manufactured.
- the columns or plates forming the porous body can be connected to the truss structure.
- the truss structure can be a structure in which the cage upper and lower surfaces that are continuous with the cage outer peripheral portion are connected in a triangular shape, a square shape, or a polygonal shape. With this truss structure, the cage outer peripheral portion and the columns or plates constituting the porous body can be integrated.
- the size of the inscribed circle with respect to the void formed inside the truss structure of a triangular shape, a square shape, or a polygonal shape is not particularly limited.
- the size of the inscribed circle is preferably 500 ⁇ m or more from the viewpoint of the size of bone cells (osteoblast + osteoclast + osteosite).
- the pillars or plates forming the porous body can be arranged along the truss of the truss structure.
- the inscribed circle of the voids formed by the arranged columns or / and the plates can also be equivalent to the inscribed circle of the truss porous body.
- the size of this void can be set to an optimum size for bone penetration into the inside of the porous body.
- the truss structure itself can also be provided with the same grooves as the grooves provided in the pillars or plates constituting the porous body so as to be continuous.
- the groove of the truss structure the bone orientation can be promoted immediately after the bone invasion, and high bone quality can be expressed from the early stage of the bone invasion to realize the cage fixation with the vertebra.
- the pillars arranged to form the porous body and / or the pillars may not be connected.
- spaces can be provided at regular intervals between the columns, bone marrow fluid can be continuously introduced, and bone invasion into the deep part of the porous body can be realized.
- a hole may be provided so that the outside of the cage outer peripheral portion communicates with the porous body.
- the implant material has a cage-like structure, and the side surface of the cage-like structure is effective in that the lateral pores are effective for guiding bone to the porous body.
- it has a second hole. This is effective in guiding the bone to the porous body by the lateral hole, based on the data of the cylindrical cage (or box type cage) embedded in the lateral hole vertebra of the intervertebral cage, as will be apparent from the examples described later. This is because it turned out to be
- Example 1 Bone tissue is composed of undifferentiated mesenchymal cells, osteoprogenitor cells, osteoblasts, osteocytes and osteoclasts. In the process of forming new bone, osteoblasts secrete type I collagen and the like, and apatite is additionally generated in collagen fibers to promote calcification. As the calcification progresses, the bone cells become embedded in the bone matrix and new bone formation is completed.
- the traveling direction of type I collagen Col
- the crystal orientation of the hexagonal apatite crystal BAp
- the orientation means that the orientation of the apatite crystal is not random but constant. It means that they are aligned in the same direction.
- This complex of Col and BAp determines the strength and flexibility of the bone matrix, the bone.
- the mechanical properties of the bone the orientation of the bone matrix resulting from the orientation of the apatite crystals generated from osteoblasts, that is, the type I collagen and apatite and its orientation secreted from the osteoblasts It turns out that they are closely related. Therefore, in the present invention, in order to orient the bone matrix by extending and arranging the osteoblasts in the cage thickness direction of the osteoblasts, a groove structure extending in the orientation direction with respect to the porous body intended for bone invasion is adopted. ing.
- FIG. 1 shows a sectional view of an example of a member forming a hole. It can be seen that the members forming the holes have grooves.
- 1 is the plate thickness
- 2 is the inscribed circle between the plates
- 3 is the groove width
- 4 is the groove depth.
- the shape corresponding to the radial direction of 120 degrees shows a tetra-shaped internal structure in which three plates are connected.
- the tetra-shaped structure is a tetra-shaped structure composed of three plates, but may have a cross shape.
- the cross shape is a structure in which two plates intersect at 90 degrees.
- the column can mean a cylinder or a prism that stands upright in the central portion of the tetra-shaped structure or on the paper surface.
- the shape illustrated this time is only one example, and the arrangement of plates and columns can be considered infinitely.
- FIG. 2 shows an example of the relationship between the members forming the holes and the outer periphery of the implant material.
- FIG. 3 shows a perspective view of an example of the truss structure and the groove.
- 5 is a surrounding bone
- 6 is a hole (second hole) that connects the surrounding bone and the inside of the implant material
- 7 is the inside of the implant material (inside the porous body)
- 8 is the space between the holes inside the implant material.
- Communication holes (third holes), 12 are grooves, 13 are plates, 14 are pillars, and 15 are holes (first holes), respectively.
- 12 is a groove
- 13 is a plate
- 14 is a pillar
- 15 is a hole (first hole).
- a continuous circulation of bone marrow fluid can also be achieved by the hole (second hole) 6 that communicates the surrounding bone with the inside of the implant material and the hole (third hole) 8 that communicates between the holes inside the implant material.
- the cage porous body can be formed into a tetra-shaped structure by connecting three radially extending plates in which grooves are arranged at the center. It is possible to form a communicating porous body by directly providing a gap between the radially expanding plates without directly connecting the adjacent tetra-shaped structures to each other (8 in FIG. 2). In this way, if each tetra-shaped structure is placed with a gap, it will exist without any restriction in space and each tetra-shaped structure will fall off. The body and the structure around the cage can be connected and integrated.
- a hole in a horizontal skewer that is, a hole that vertically skews in the direction of the honeycomb hole, for example, 5 and 6 in FIG. 2 is connected to the honeycomb. You may have.
- the plates or / and columns of finite width that compose the porous body are arranged in blocks that are connected in a radial or cross shape, or are arranged individually.
- the osteoblasts will invade along the groove provided in the plate or / and the pillar, and have a role of promoting bone orientation from the early stage of bone invasion.
- the arrangement of plates or / and posts may be staggered or evenly spaced. It is desirable that the plate or / and the column be bent by a load under a biomechanical environment. This flexure can provide a mechanical stimulus in the principal stress direction to the bone that has penetrated into the porous body along the plate or / and the pillars and can contribute to continued bone orientation. Therefore, it is desirable that the thickness or thickness of the plate or / and the pillar is, for example, 1 mm or less so that the plate or / and the pillar is bent by a load.
- the outer periphery of the cage shares the load support under the biomechanical environment, and at the same time, the porous body and the bone that has penetrated into the porous body are integrated and the cage and intervertebral space are fixed. That is, the outer peripheral portion of the cage and the porous body can be structurally integrated.
- the cage surface that is, the cage upper and lower surfaces where the cage inserted between the vertebrae contacts the vertebra
- a truss structure that connects the parts is arranged.
- the truss structure is arranged so as to be connected to the plate or / and the pillar forming the porous body.
- the truss shape thereof may be triangular, quadrangular, or polygonal.
- Grooves are provided in the truss structure on the surface of the cage so as to be continuous with the grooves provided in the plate or / and the column forming the porous body.
- the plate constituting the porous body can have a finite width so that bone marrow fluid containing osteoblasts can be continuously supplied.
- a finite width in this way, an appropriate gap can be provided between adjacent plates or / and columns, and bone marrow fluid containing osteoblasts can be continuously supplied over the entire porous body.
- the present porous body can be provided with holes on the side surface of the cage. The pores serve to suppress the retention of the bone marrow fluid in the deep part of the porous body and promote continuous circulation of the bone marrow fluid.
- FIG. 4A shows a conventional implant material (evaluation sample C).
- FIG. 4B shows an implant material according to an embodiment of the present invention, in which unidirectional holes are penetrated (evaluation sample D).
- FIG. 4 (c) shows a view of the implant material of FIG.
- FIG. 4 (b) as viewed from an angle rotated by 90 degrees, and shows holes on the side surface of the cage.
- 10 is a bone graft
- 11 is a hole on the side of the cage
- 12 is a groove
- 13 is a plate
- 14 is a column.
- Sample C As in a conventional cage, the cage is provided with only a through hole, and the hole is filled with bone graft.
- Sample D A cage having the porous body in which the sheep's tail axis corresponding to the load transmission direction and the groove of the porous body are embedded in parallel.
- Sample E A cage having the porous body is embedded so that the caudal axis of the sheep head and the groove of the porous body are vertical.
- the cage shape is the same as that of sample D, but the load transmission direction differs from the groove of the porous body by 90 degrees.
- Example preparation The above evaluation sample was designed with CAD software, output in STL format (Stereolithography), and the data was used to perform integrated modeling by AM (Additive Manufacturing).
- the material used was Ti-6Al-4V alloy, which is a titanium-based alloy with a proven track record as an implant material, and was modeled with a laser metal modeling machine (EOS M290, manufactured by EOS).
- EOS M290 laser metal modeling machine
- the groove width and thickness after molding were 0.1-0.5 mm and 0.1-0.2 mm in depth with respect to the design values (width 0.2 mm, depth 0.15 mm).
- FIG. 5 shows the result of the pull-out test in which the maximum load measured during the pull-out test was taken as the pull-out strength.
- the pull-out strength of the evaluation samples D and E having the porous body is significantly higher than that of the conventional evaluation sample C requiring bone graft.
- the pull-out strength of the evaluation sample C is increased at 8th and 16th weeks, it is less than that of the evaluation samples D and E.
- This is presumed to be a result of the porous body introducing bone with good bone quality into the porous body at an early stage.
- the pull-out strength tends to increase as the age increases. It is speculated that this is because the bone orientation is further promoted by the mechanical stimulation by the load in the principal stress direction of the biomechanical environment (in sheep, the same caudal-caudal axis direction as in humans).
- FIG. 6 shows the observation result of the evaluation sample E.
- FIG. 6B shows an enlarged view of a part surrounded by a rectangle on the left side of the center of FIG. 6A.
- the surrounding bone (vertebrate of sheep) of the evaluation sample is oriented horizontally with respect to the figure, but the porous body is oriented vertically from the inlet. This indicates that the porous body itself induces an orientation different from the orientation originally possessed by the vertebrae of sheep.
- FIG. 7 shows an example of use of the implant material in one embodiment of the present invention.
- 15 is a hole
- 30 is a thickness direction
- 31 is a cage according to another aspect of the present invention
- 32 is a cage insertion direction.
- the hole 15 is provided with a groove in this embodiment as well.
- the implant material is an example of a human cage, but the thickness direction is the human caudal-caudal direction as shown in the figure. That is, the thickness direction can be a gap direction between vertebrae. Since the evaluation sample this time has a cylindrical shape, the evaluation sample D is in the communication hole direction (head-to-tail axis direction) shown in the figure.
- FIG. 8 shows a cross section parallel to the major axis of the cylinder when a cylindrical cage is used in the implant material according to the embodiment of the present invention.
- 8A shows the central portion of the cylindrical cross section
- FIG. 8B shows the intermediate portion located between the central portion and the upper portion of the cylindrical cross section
- FIG. 8C shows the upper portion of the cylindrical cross section.
- These implant materials can also be an embodiment of the present invention. That is, FIG. 8 shows a cross-section taken along the long axis of the cylinder at the top / middle / center.
- the internal structure is lined with tetra-shaped plates having grooves (center cross section), and the tetra can be connected by a truss structure (upper cross section) above and below the cage.
- the geometric pattern structure itself of the internal structure having the groove (such as the tetra structure described above) is oriented into the porous body regardless of the external environment such as mechanical stimulus. It can be seen that it is possible to accelerate the production of
- the groove width is preferably 0.25 to 500 ⁇ m in consideration of the detectability in the orientation direction of osteoblasts and the size of the cell itself, the inscribed circle of the porous body is 500 ⁇ m or more, and the plate thickness is the porous body. It was found that 0.5 to 1 mm can be preferably used in consideration of strength and groove depth.
- Example 2 Next, a box-type cage was designed as the implant material of the present invention, and the effect of inducing bone orientation was investigated. Specifically, as a large animal test (sheep), specifically, an extrusion test of a box type cage installed between the vertebrae of sheep was performed. That is, by a large animal test using sheep, a box type cage was implanted in the intervertebral space in the same manner as in human clinical practice, and an extrusion test of the box type cage was carried out 8 weeks after the implantation. For the two types of box-shaped cages with heights of 8 mm and 11 mm, a group of grafted bones of the box-shaped cage equivalent to the evaluation sample C of FIG. A comparative extrusion test of the bone orientation-inducing group equivalent to the evaluation sample D was performed.
- a large animal test specifically, an extrusion test of a box type cage installed between the vertebrae of sheep was performed. That is, by a large animal test using sheep, a box type cage was implanted
- FIG. 9 shows a schematic diagram of a case where a box-shaped cage is used for a vertebral body in the implant material according to the embodiment of the present invention.
- FIG. 9A is a view seen from the lateral direction (direction perpendicular to the cranio-coccy axis direction) when the example of the implant material of the present invention is incorporated in the spine.
- FIG. 9 (b) is a schematic view of an example of the implant material of the present invention as viewed from the lateral direction (direction perpendicular to the caudal-caudal axis direction).
- FIG. 9A is a view seen from the lateral direction (direction perpendicular to the cranio-coccy axis direction) when the example of the implant material of the present invention is incorporated in the spine.
- FIG. 9 (b) is a schematic view of an example of the implant material of the present invention as viewed from the lateral direction (direction perpendicular to the caudal-cau
- FIG. 9 (b) 41 is a ceiling structure of a box-type cage that forms a contact surface with the vertebral body and end plate in the vertical direction (showing a bent state), and 42 is a column that forms oriented porosity.
- a structure 43 is a vertebral body
- 44 is a state in which the contact surface of a box type cage (implant material in an example of the present invention) is fitted to the shape of a vertebral body end plate
- 45 box type cage, 46 shows an end plate, respectively.
- FIG. 9C is a cross-sectional view of an example of the implant material of the present invention as seen from the lateral direction (direction perpendicular to the cranio-coccyx direction).
- FIG. 9 (d) is a perspective view (viewed obliquely from above) of an example of the implant material of the present invention. It can be seen that the contact surface of the box-shaped cage fits the shape of the vertebral body end plate and the oriented porous body of the box-shaped cage comes into contact with the contact surface to further promote bone fusion. It was also found that the wider the contact surface, the more promoted the bone union.
- FIG. 10 shows a schematic view of a box-shaped cage in the implant material according to the embodiment of the present invention.
- FIG. 10A is a sectional view of an example of the implant material of the present invention.
- FIG. 10 (b) is a schematic view of an example of the implant material of the present invention as seen from the lateral direction (direction perpendicular to the caudal-caudal axis direction).
- reference numeral 51 denotes the vertical direction
- FIG.10 (c) is a perspective view of an example of the implant material of this invention.
- the ceiling structure of the box-type cage that forms the contact surface with the vertebral body / end plate in the up-down direction may be plate-shaped, plate-shaped, column-shaped or the like as long as it is a flexible structure.
- FIG. 11 is a diagram showing the results of a comparative extrusion test of a bone graft group and a bone orientation induction group for two types of box type cages having heights of 8 mm and 11 mm.
- Fig. 11 (a) shows the results when both the heights of the box type cage are 8 mm and 11 mm
- Fig. 11 (b) shows the results when the height of the box type cage is 8 mm
- Fig. 11 (c) shows the results. The results are shown when the height of the mold cage is 11 mm.
- the Paired T-test was carried out for a height of 8 mm, a height of 11 mm, and a combination of both, and significant differences were found in all cases. It was found that the extrusion load of the bone-orientation-inducing porous body was higher than that of the bone-grafted bone, and the shear strength at the joint surface between the bone and the bone-oriented derivative was significantly higher than that of the bone-grafted bone. That is, it was found that the box-shaped cage having the oriented porosity had a significantly higher extrusion strength than the bone-implanted bone.
- Example 2 a box-type cage was embedded in the vertebra as a verification experiment, and when used in humans, a damaged disc (between the vertebrae and vertebrae) was removed, and a box-type cage was provided between the vertebrae. Can be embedded and fixed. Designing assuming that the direction of the flexure is the caudal-caudal axis direction (the vertical direction where the weight of the head is applied when the human is standing upright), and the tetra structure is compressed by the vertebrae above and below the cage and flexes by compression.
- the structure that connects the tetra-shaped structures is designed thin (0.5 mm), and the bending of the structure itself causes the contact surface with the vertebrae, that is, the front and back surfaces of the box-shaped cage to be bone-free. You can expect the effect of adapting to the shape of. By adapting to the shape of the bone, the front and back surfaces of the cage can be in close contact with the vertebra without a gap, and the bone can be easily guided to the porous body.
- the present invention can be expected to contribute to the fields of treatment of hard tissue diseases, regenerative medicine and dentistry (in particular, orthopedics, cerebral surgery, and dentistry) and basic medicine.
Abstract
Description
実施例1
骨組織は未分化間葉系細胞、骨原生細胞、骨芽細胞、骨細胞(オステオサイト)や破骨細胞などから構成される。新生骨の生成過程では、骨芽細胞がI型コラーゲンなどを分泌し、コラーゲン線維へ添加的にアパタイトを生成して石灰化が進行する。石灰化が進むと、骨細胞となって骨基質中に埋め込まれ、新生骨生成は完了する。
本評価では、多孔体として120度毎の放射状に連結した3枚の有限板を千鳥状に配置した試料を作成した。有限板に設けた溝は幅0.2mm、深さ0.15mmである。板厚は0.5mmとし、溝は板の両面に互いに溝底部が重ならないように配置した。椎骨内埋植用に、ケージ外形は円筒状とした。トラス構造としては、三角形状を採用した。三角形状のトラス構造は放射状に配置した有限板と一致するように連通し、その内接円は500μm(評価試料A)または1000μm(評価試料B)の2種類とした。従来の骨移植による方法や力学的刺激などの外部環境の影響を調査するため、試料はさらにケージ側面に孔を設けた下記の評価試料CからEを準備した(図4)。図4(a)は、従来のインプラント材を示す(評価試料C)。図4(b)は、本発明の一実施態様におけるインプラント材料であって、一方向性の孔が貫通している様子を示す(評価試料D)。図4(c)は、図4(b)のインプラント材料を90度回転させた角度から見た図を示し、ケージ側面の孔を示したものである。(評価試料E)。図4において、10は移植骨、11はケージ側面の孔、12は溝、13は板、14は柱を、それぞれ示す。
試料D:当該多孔体を有するケージで、荷重伝達方向に相当する羊頭尾軸と多孔体の溝が平行に埋め込まれる。
試料E:当該多孔体を有するケージで、羊頭尾軸と多孔体の溝が垂直になるように埋め込まれる。ケージ形状は試料Dと同じであるが、荷重伝達方向は多孔体の溝と90度異なる。
上記の評価試料をCADソフトで設計し、STL形式(Stereolithography)で出力し、そのデータを用いてAM(Additive Manufacturing)にて一体造形した。材質はインプラント材として実績のあるチタン系合金であるTi-6Al-4V合金を採用し、レーザー金属造形機(EOS社製、EOS M290)にて造形した。造形後の溝幅と厚みは設計値(幅0.2mm、深さ0.15mm)に対して、幅は0.1~0.5mm、深さは0.1~0.2mmとなっていた。
月齢12ヶ月以上のサフォーク種のヒツジを対象に羊腰椎のL1からL4にそれぞれ1本ずつの試料を埋植した。埋植後8週または16週で屠殺してケージを埋植したL1からL4の椎骨を採取した。
ケージの当該多孔体内部に誘導された骨を評価するため、ビラヌエバ染色を施し、円筒状ケージ中央部に対して、頭尾軸方向に平行な断面で非脱灰薄切片を作成した。ケージ内部の空隙(TV:Total Volume)に占める骨(BV:Bone Volume)の割合を計測した。結果を表1に示す。
従来の骨移植を行うケージを模擬した評価試料Cと、当該多孔体を配した評価試料DとEで引抜試験を実施して、当該多孔体による骨とケージの固着強度を評価した。ケージを埋植した椎骨を解凍後、治具の上部にケージに設けためねじが露出するように椎骨を骨セメントで固定した。治具を引張試験機(INSTRON社製、型番5965)にてケージの引抜試験を実施した。クロスヘッド速度は5mm/minとし、試験中に測定された最大荷重を引抜強度とした。
骨配向化を評価するため、骨組織観察で作成した評価試料Eの薄片化切片を使用して、複屈折法(WPA-micro:Photonic Lattice)にて、骨配向と関係を有するコラーゲン繊維の配向性を解析した。図6に評価試料Eの観察結果を示す。図6(b)は、図6(a)の中央左寄りの長方形で囲んだ部分の拡大図を示す。この結果、評価試料の周囲骨(ヒツジの椎骨)は図に対して水平に配向しているが、当該多孔体内は入口から垂直に配向しているのが分かる。これは、ヒツジの椎骨が本来有する配向性とは異なる配向性を、多孔体自体が誘導していることを示している。
次に、本発明のインプラント材料として、ボックス型ケージを設計して、骨配向の誘導効果を調べた。具体的に、大型動物試験(ヒツジ)として、具体的に、ヒツジの椎間に設置したボックス型ケージの押出試験を行った。すなわち、ヒツジを用いた大型動物試験によって、ヒトの臨床と同様に椎間へボックス型ケージを埋植し、埋植8週後にボックス型ケージの押出試験を実施した。ボックス型ケージの高さ8mmおよび11mmの2種類について、図4(a)の評価試料Cと等価のボックス型ケージの移植骨群(移植骨をケージにあらかじめ充填)と、図4(b)の評価試料Dと等価の骨配向化誘導群の比較押出し試験を実施した。
2 板と板の間の内接円
3 溝幅
4 溝深さ
5 周囲骨
6 周囲骨とインプラント材料内部とを連通する孔(第二の孔)
7 インプラント材料の内部(多孔体内部)
8 インプラント材料内部の孔間を連通する孔
10 移植骨
11 ケージ側面の孔
12 溝
13 板
14 柱
15 孔
30 厚み方向
31 本発明の別の態様におけるケージ
32 ケージの挿入方向
41、51 椎体・終板との接触面を形成するボックス型ケージの天井構造
42、52 配向多孔質を形成する柱構造
43 椎体
44 椎体終板形状にボックス型ケージ(本発明の一例におけるインプラント材料)の接触面がフィットする様子
45 ボックス型ケージ
46 終板
Claims (16)
- 少なくとも一方向へ孔を有するインプラント材料であって、前記孔を構成する部材は、溝を有することを特徴とするインプラント材料。
- 前記孔を構成する部材は、柱及び/又は板によって構成されている請求項1記載のインプラント材料。
- 前記溝は、前記柱及び/又は板に設けられている請求項1又は2に記載のインプラント材料。
- 前記孔は、前記柱及び/又は板によって、複数構成されている請求項1~3のいずれか1項に記載のインプラント材料。
- 前記溝は、前記柱及び/又は板の表裏面において、交互に配置されていることを特徴とする請求項1~4のいずれか1項に記載のインプラント材料。
- 前記柱及び/又は板は、単体及び/又はブロックで構成されている請求項2記載のインプラント材料。
- 前記柱及び/又は板は、たわむように設計されている請求項2記載のインプラント材料。
- 前記孔は、前記インプラント材料を貫通しないか、又は前記インプラント材料を貫通する構成である請求項1~7のいずれか1項に記載のインプラント材料。
- 前記インプラント材料が、高分子材料、セラミックス材料、金属材料、非晶質材料、又はそれらの混合材料から選択される少なくとも1種である請求項1~8のいずれか1項に記載のインプラント材料。
- 前記溝の幅は、0.25~500μmであることを特徴とする請求項1~9のいずれか1項に記載のインプラント材料。
- 前記孔は、複数ある場合に、互いに連通している請求項1~10のいずれか1項に記載のインプラント材料。
- 前記柱及び/又は板はそれら自体が伸縮構造を有することによって、又は前記柱もしくは前記板の厚さ、幅、又は高さを変化させることによって、前記柱及び/又は板がたわむように設計されている請求項7記載のインプラント材料。
- 前記インプラント材料と生体とが接触する少なくとも一部の接触面において、前記インプラント材料は、たわむように設計されている請求項1~12のいずれか1項に記載のインプラント材料。
- 前記孔はトラス構造体により形成され、当該孔の内接円は、500μm~2000μmである請求項1~13のいずれか1項に記載のインプラント材料。
- 前記インプラント材料は、ケージ状構造を有し、前記ケージ状構造の側面において第二の孔を有する請求項1~14のいずれか1項に記載のインプラント材料。
- 請求項1~15のいずれか1項に記載のインプラント材料を製造するための方法であって、3D造形法によって製造するインプラント材料の製造方法。
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AU2019367508A AU2019367508A1 (en) | 2018-10-23 | 2019-10-21 | Implant material and method for producing said implant material |
US17/287,401 US20220054713A1 (en) | 2018-10-23 | 2019-10-21 | Implant material and method of manufacturing the implant material |
CA3115445A CA3115445A1 (en) | 2018-10-23 | 2019-10-21 | Implant material and method of manufacturing the implant material |
CN201980069666.3A CN112888404A (zh) | 2018-10-23 | 2019-10-21 | 植入材料及该植入材料的制造方法 |
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JP3181826U (ja) * | 2012-12-12 | 2013-02-21 | 優一郎 河原 | 歯科用インプラント |
JP2015529150A (ja) * | 2012-09-25 | 2015-10-05 | フォー−ウェブ・インコーポレイテッド | プログラム可能な移植片、および骨構造を修復するためにプログラム可能な移植片を用いる方法 |
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US20220054713A1 (en) | 2022-02-24 |
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