Oral endothelial valve repair postoperative occlusion limiting device

Abstract

The invention relates to the technical field of oral endothelial valve repair, and particularly discloses an oral endothelial valve repair postoperative occlusion limiting device which comprises an upper tooth socket and a lower tooth socket which are matched with healthy side upper jaw teeth and healthy side lower jaw teeth respectively, and the end of the upper tooth socket is connected with the end of the lower tooth socket through a curved surface connecting piece. The surface, facing the lower tooth socket, of the upper tooth socket is of a bionic structure of maxillary teeth; the lower tooth socket comprises a lower base, an upper tooth seat and a plurality of adjusting blocks, the lower surface of the lower base is matched with mandibular teeth, the upper tooth seat is arranged on the uppermost adjusting block, and the upper surface of the upper tooth seat is of a bionic structure of the mandibular teeth; flanges are arranged on the two sides of the upper tooth base, a groove body is formed between the two flanges, limiting protrusions are arranged on the surfaces, located in the groove body, of the flanges, clamping grooves matched with the limiting protrusions are formed in the inner side surface and the outer side surface of each adjusting block, and the limiting protrusions are clamped into the clamping grooves to lock the upper tooth base and the adjusting blocks. And according to the swelling condition of an operation area, the healthy side can be precisely limited, and the occlusion height can be dynamically adapted.

Description

Technical Field

[0001] The present invention relates to the technical field of oral and maxillofacial surgical medical devices, and specifically to an adjustable occlusal limiter for protecting the surgical area from occlusal damage after oral flap repair surgery. The device is particularly suitable for clinical scenarios such as free flap transplantation after maxillomandibular and maxillofacial resection and maxillofacial trauma repair where interference from external occlusal forces needs to be avoided. Background Art

[0002] In oral and maxillofacial surgery, procedures such as free flap transplantation and maxillofacial trauma repair often require protection of the surgical area from occlusal forces to prevent flap compression necrosis or wound dehiscence. However, existing occlusal protection devices have significant technical flaws, impacting postoperative recovery and the patient's long-term oral function.

[0003] Currently, there are two main methods used in clinical practice: extraction of the opposing teeth or insertion of a conventional occlusal splint. The former directly removes the healthy teeth corresponding to the surgical area to eliminate occlusal contact, but this method will lead to irreversible loss of occlusal function and damage the integrity of the dentition. The latter, while retaining the teeth, still has the following problems: Insufficient protection effect: Ordinary occlusal splints lack precise occlusal force guidance structure, and the surgical area is still at risk of stress, which can easily lead to flap blood supply obstruction or repair failure.

[0004] Poor dynamic adaptability: The degree of tissue edema after surgery changes over time, while traditional bite splints are static in design and cannot be adaptively adjusted. They need to be repeatedly adjusted or replaced, which increases the burden of clinical operations.

[0005] Comfort and safety deficiencies: Bite plates of uniform thickness may cause temporomandibular joint disorders due to uneven stress distribution, and most commercially available protectors lack anatomical adaptability and can easily cause mucosal pressure injuries when worn for a long time.

[0006] Existing protection solutions for intraoral flap repair, such as silicone jaw pads, improve comfort, but lack an occlusal limiting structure and cannot actively disperse the occlusal force to the non-surgical area; adjustable devices are mostly focused on orthodontics or restorations, and are difficult to meet the dynamic protection needs after maxillofacial surgery. Summary of the Invention

[0007] The purpose of the present invention is to provide an occlusal limit device after intraoral flap repair surgery to solve the technical problems in the prior art, in which existing improvement solutions such as silicone jaw pads improve comfort but lack an occlusal limit structure and cannot actively disperse the occlusal force to the non-surgical area; and adjustable devices mostly focus on the orthodontic or restoration fields and are difficult to meet the dynamic protection needs after maxillofacial surgery.

[0008] In order to solve the above technical problems, the present invention specifically provides the following technical solutions: An intraoral flap repair surgery occlusal limiter device, comprising upper and lower braces respectively fitted with the healthy maxillary teeth and mandibular teeth, wherein the end of the upper brace located on the inner side of the oral cavity is connected to the end of the lower brace located on the inner side of the oral cavity via a curved connecting piece, and the surface of the upper brace facing the lower brace is a bionic structure of the maxillary teeth; The lower braces include a lower base, an upper tooth seat and an adjustment block. The lower surface of the lower base cooperates with the mandibular teeth. A plurality of adjustment blocks are arranged on the lower base. The plurality of adjustment blocks are stacked sequentially from bottom to top, and the contact surfaces of two adjacent adjustment blocks can interlock. The upper tooth seat is arranged on the uppermost adjustment block, and the upper surface of the upper tooth seat is a bionic structure of the mandibular teeth. The upper seat is provided with ribs on the inner and outer sides of the maxillary teeth, a groove body is formed between the two ribs, the groove body cooperates with the key groove on the upper part of the adjustment block, and the inner surface of the rib is provided with a limiting protrusion along the length direction of the rib. A card slot cooperating with the limiting protrusion is provided on the inner and outer surfaces of each of the adjustment blocks, and the limiting protrusion is inserted into the card slot to lock the upper seat and the adjustment block.

[0009] As a preferred solution of the present invention, the adjustment block includes a lower card seat and an upper key seat, and a matching groove is provided in the middle of the lower surface of the lower card seat along the length direction of the lower card seat, and the matching groove extends to the end of the lower card seat at both ends in the length direction of the lower card seat and is open; The upper surface of the upper key base of the adjusting block located below and the surface of the matching slot of the adjusting block located above are in contact and interlocked.

[0010] As a preferred solution of the present invention, the card slot is provided on the inner and outer surfaces of the lower card seat along the length direction of the lower card seat, and one end of the card slot extends to the end of the lower card seat and is open, and the other end is closed.

[0011] As a preferred solution of the present invention, an end block A is provided at the end of the lower base located outside the oral cavity; Each of the adjustment blocks is provided with an end block B at the end located outside the oral cavity; The ends of the upper tooth seats located outside the oral cavity are each provided with an end block C; The end block A, the end block B and the end block C are stacked sequentially from bottom to top, and the end surface of the whole stacked by the end block A, the end block B and the end block C is a smooth curved surface extending from the bottom of the lower base end to the upper surface of the upper tooth seat.

[0012] As a preferred solution of the present invention, a first threaded hole is provided on the end block A, a second threaded hole is provided on the adjustment block, and a third threaded hole is provided on the end block C, and the first threaded hole, the second threaded hole and the third threaded hole are coaxial; The first threaded hole, the second threaded hole and the third threaded hole are connected by bolts.

[0013] As a preferred solution of the present invention, the end of the upper seat located on the inner side of the oral cavity is connected to the curved connecting piece through a corrugated silicone belt, and the position where the corrugated silicone belt is connected to the curved connecting piece is close to the connection between the curved connecting piece and the lower base.

[0014] As a preferred solution of the present invention, a sublingual protrusion is provided on the bottom side of the surface of the lower base located on the tongue side of the oral cavity, and the sublingual protrusion extends along the length direction of the lower base, and the sublingual protrusion is used to be stuck under the tongue.

[0015] As a preferred solution of the present invention, a plurality of connecting lines are provided on the bottom surface of the lower base, the two ends of the connecting lines are respectively connected to the two side edges of the bottom of the lower base, and the connecting lines are used to be inserted between the two teeth of the mandibular teeth.

[0016] As a preferred solution of the present invention, the surface of the upper key seat is wavy or sawtooth-shaped.

[0017] As a preferred solution of the present invention, the thickness of the adjustment block gradually decreases from the end portion outside the oral cavity to the end portion inside the oral cavity.

[0018] Compared with the prior art, the present invention has the following beneficial effects: The occlusal limit device provided by the present invention can be set on the healthy side teeth according to the degree of swelling in the surgical area, and the occlusal height can be adjusted according to the development of the swelling by setting an adjustment block, thereby accurately limiting and dynamically adapting the occlusal height to solve the problems of insufficient postoperative skin flap protection and low adaptability of the existing technology. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] To more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following briefly introduces the drawings required for the embodiments or the description of the prior art. Obviously, the drawings described below are merely exemplary, and those skilled in the art can derive other implementation drawings based on the provided drawings without inventive effort.

[0020] Figure 1 Schematic diagram of the overall structure of an embodiment of the present invention; Figure 2A schematic diagram of the structure of the end block B provided with the adjustment block according to an embodiment of the present invention; Figure 3 Schematic diagram of the overall structure of the adjustment block according to an embodiment of the present invention.

[0021] The numbers in the figure represent the following: 1-Upper brace; 2-Curved connector; 3-Lower brace; 4-End block A; 5-End block B; 6-End block C; 7-First threaded hole; 8-Second threaded hole; 9-Third threaded hole; 10-Bolt; 9-Corrugated silicone tape; 31-lower base; 32-upper tooth seat; 33-adjusting block; 34-rib; 35-slot body; 36-slot; 331-lower card seat; 332-upper key seat; 333-matching slot. DETAILED DESCRIPTION

[0022] The following will clearly and completely describe the technical solutions in the embodiments of the present invention in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative efforts are within the scope of protection of the present invention.

[0023] like Figure 1 As shown, the present invention provides an occlusal limiter device after intraoral flap repair surgery, comprising an upper brace 1 and a lower brace 3 respectively matched with the maxillary teeth and mandibular teeth on the healthy side, the end of the upper brace 1 located on the inner side of the oral cavity is connected to the end of the lower brace 3 located on the inner side of the oral cavity through a curved connecting piece 2, and the surface of the upper brace 1 facing the lower brace 3 is a bionic structure of the maxillary teeth.

[0024] The lower braces 3 include a lower base 31, an upper tooth seat 32 and an adjustment block 33. The lower surface of the lower base 31 cooperates with the mandibular teeth. Multiple adjustment blocks 33 are set on the lower base 31. The multiple adjustment blocks 33 are stacked sequentially from bottom to top, and the contact surfaces of two adjacent adjustment blocks 33 can be interlocked. The upper tooth seat 32 is set on the adjustment block 33 located at the top.

[0025] A rib 34 is provided on the inner and outer sides of the upper tooth seat 32 located on the maxillary teeth, and a groove 35 is formed between the two ribs 34. The groove 35 cooperates with the key groove on the upper part of the adjustment block 33. A limiting protrusion is provided on the inner surface of the rib 34 along the length direction of the rib 34. A slot 36 cooperating with the limiting protrusion is provided on the inner and outer surfaces of each adjustment block 33. The limiting protrusion is inserted into the slot 36 to lock the upper tooth seat 32 and the adjustment block 33.

[0026] In this embodiment, the surface of the upper brace 1 facing the lower brace 3 is a bionic structure of the maxillary teeth, while the upper surface of the upper tooth base 32 is a bionic structure of the mandibular teeth. Specifically, the upper tooth base 32 and upper brace 1 are 3D-printed based on the three-dimensional tooth surface structure and the three-dimensional occlusal relationship data of the healthy side acquired through an intraoral scanner. The thickness of the adjustment block 33 is determined based on the average data of tooth-side swelling after intraoral flap surgery and the average physiological opening and closing angles of the maxillary and mandibular teeth of the patient.

[0027] During the specific implementation of this embodiment, the lower base 31 is installed on the patient's mandibular teeth. The length of the lower base 31 is preferably the molar part of the patient's healthy mandibular teeth, so as to reduce the overall length of the lower base 31 in order to match the curved part of the mandibular teeth, and keep the overall structure of the lower base 31 as close to the molar part as possible, and the overall structure of the lower braces 3 needs to avoid the force line of the temporalis masseter muscle on the healthy side.

[0028] The upper brace 1 is a bionic structure of the molar part of the maxillary teeth on the healthy side, and is directly fitted over the molar part of the maxillary teeth.

[0029] Since the occlusal contact surfaces of the maxillary teeth and the mandibular teeth in the dynamic model of human oral occlusion are not completely on a fixed plane, the thickness of the adjustment block 33 in this embodiment gradually decreases from the end outside the oral cavity to the end inside the oral cavity, that is, the thickness of the adjustment block 33 gradually decreases from the premolar of the healthy side teeth to the posterior part of the molar teeth.

[0030] This embodiment provides a specific implementation of the adjustment block 33, including a lower base 331 and an upper key base 332, and a matching groove 333 is provided in the middle of the lower surface of the lower base 331 along the length direction of the lower base 331, and the matching groove 333 extends to the end of the lower base 331 at both ends of the length direction of the lower base 331 and is open.

[0031] A card slot 36 is provided on the inner and outer surfaces of the lower card seat 331 along the length direction of the lower card seat 331 , and one end of the card slot 36 extends to the end of the lower card seat 331 and is open, and the other end is closed, and the card slot 36 and the limiting protrusion also cooperate with each other.

[0032] An end block A4 is provided at the end of the lower base 31 located outside the oral cavity.

[0033] Each adjustment block 33 is provided with an end block B5 at the end located outside the oral cavity.

[0034] The ends of the upper tooth seat 32 located outside the oral cavity are each provided with an end block C6.

[0035] Furthermore, the latching slot 36 provided on the lower latching seat 331 extends to the side surface of the end block B5.

[0036] End blocks A4, B5 and C6 are stacked in sequence from bottom to top, and the end surface of the whole stacked by end blocks A4, B5 and C6 is a smooth curved surface extending from the bottom of the end of the lower base 31 to the upper surface of the upper tooth seat 32.

[0037] Among them, after the end block A4, the end block B5 and the disconnected block C6 are stacked, the outer end surface of the whole, that is, the end close to the mandibular incisor or the end surface on the outside of the oral cavity is a laminated gradient surface, that is, the smooth transition of the overall curved surface is achieved through the lamination of discrete plates (upper tooth seat 32, adjustment block 33 and lower base 31).

[0038] A first threaded hole 7 is provided on the end block A4, a second threaded hole 8 is provided on the adjustment block 33, and a third threaded hole is provided on the end block C6. The first threaded hole 7, the second threaded hole 8 and the third threaded hole are coaxial.

[0039] Then, the first threaded hole 7, the second threaded hole 8 and the third threaded hole are connected by bolts 10 to fix the upper tooth seat 32, the multiple adjustment blocks 33 and the lower base 31. The connection by bolts 10 can ensure the stability of the force on the end.

[0040] The upper seat 32 in this embodiment is located at the end on the inner side of the oral cavity and is connected to the curved connector 2 through a corrugated silicone belt 9. The position where the corrugated silicone belt 9 is connected to the curved connector 2 is close to the connection between the curved connector 2 and the lower base 31. In this way, when the adjustment blocks 33 are taken out layer by layer from top to bottom, since the upper seat 32 is fitted with the next adjustment block 33, the length of the upper seat 32 needs to make up the length of the removed adjustment block 33. The length difference can be made up by extending the corrugated silicone belt 9. Of course, when the adjustment blocks 33 need to be stacked, the part of the upper seat 32 close to the curved connector 2 can be made possible by shrinking the corrugated silicone belt 9.

[0041] In this embodiment, a sublingual protrusion is provided on the bottom side of the surface of the lower base 31 located on the tongue side of the oral cavity, and the sublingual protrusion extends along the length direction of the lower base 31. The sublingual protrusion is used to be stuck under the tongue.

[0042] Since the occlusion of the maxillary and mandibular teeth also includes a dislocation state when the human body is biting, that is, the left and right movement of the jaw, this process will cause the dislocation movement between the lower base 31, the upper tooth seat 32 and the adjustment block 33, as well as the shaking of the overall structure of the lower braces 3. For this reason, in this embodiment, a plurality of connecting lines are provided on the bottom surface of the lower base 31, and the two ends of the connecting lines are respectively connected to the two side edges of the bottom of the lower base 31. The connecting lines are used to be inserted between the two teeth of the mandibular teeth, that is, between the teeth, and are used to pull the two sides of the lower base 31 to avoid changes in the overall position.

[0043] In order to achieve a wavy or serrated surface on the upper key seat 332, a matching wavy structure or serrated groove is provided on the surface of the mating slot 333. The surface fit between the upper key seat 332 and the mating slot 333 is broadly an interlocking surface connection, and positioning and load transfer are achieved through the complementarity of geometric shapes.

[0044] The purpose is to ensure that the upper surface of the upper key seat 332 of the adjusting block 33 located below and the surface of the matching slot 333 of the adjusting block 33 located above are in contact and interlocked, thereby preventing the adjusting block 33 from sliding relative to each other when biting in the mouth.

[0045] Furthermore, the wavy or zigzag structure can be arranged in a V shape.

[0046] In the specific use of this embodiment, taking the specific embodiment as an example, the thickness of the adjustment block 33 is set to 1 mm: Postoperative time Adjustment block height adjustment 0-7 days (acute swelling period) Set up 5 adjustment blocks to maintain height 8-14 days (remission period) Adjustment block 33 is lowered by 1mm every 3 days After 15 days (stable period) Remove the adjustment block 33 and keep the lower base 31 Example 1: Application of mandibular defect repair The patient's occlusal data was obtained by preoperative scanning, and the model was used to determine the right first molar area as the limiting fulcrum. Print the braces and install a 3mm stopper from the second premolar to the first molar on the healthy side (left side) On the 7th day after surgery, the 1mm module was removed to reduce the limit height to 4mm. On the 21st day after surgery, the stopper was completely removed and the base was retained to monitor the occlusal contact. Example 2: Dynamically Adjusting Scenario On the 5th day after surgery, it was found that the tissue swelling subsided quickly: Start the height adjustment of the adjustment block 33 in advance (originally planned for 7 days, now advanced to 5 days) Replace the two adjustment blocks 33 by adjusting the bolts 10 or directly add an adjustment block 33 with a thickness of 2 mm; Occlusal contact testing showed that the surgical area was not stressed and the adjustment was effective; Combining 3D modeling and mechanical analysis to achieve directional transfer of bite force; Adjust the mechanism in stages to match the postoperative tissue healing process; Maximize the preservation of healthy teeth and occlusal function; In this embodiment, since only the number of the adjustment blocks 33 needs to be adjusted and the structure of the adjustment blocks 33 can be unique, the preparation of the adjustment blocks 33 with the target thickness can be completed within 2 hours through 3D printing technology.

[0047] This embodiment can design the anatomical adaptability of the intraoral flap: based on the patient's personalized occlusal curve modeling, precise occlusal force guidance can be achieved.

[0048] This embodiment can quickly adjust and adapt to the process of tissue swelling subsiding after intraoral flap surgery by adjusting the adjustment block 33. By thickening the occlusal surface of the healthy side to form a mechanical fulcrum, the occlusal surface of the surgical area is suspended. The probability of the bite force being transmitted to the surgical area is reduced from 42% with the traditional method to less than 3%. Six months after the operation, the bite efficiency reaches 85% of the healthy side (only 65% ​​with the traditional method). After wearing it, the incidence of temporomandibular joint discomfort is reduced from 55% to %.

[0049] The above embodiments are merely exemplary embodiments of the present application and are not intended to limit the scope of the present application. The scope of protection of the present application is defined by the claims. Those skilled in the art may make various modifications or equivalent substitutions to the present application within the essence and scope of protection of the present application, and such modifications or equivalent substitutions shall also be deemed to fall within the scope of protection of the present application.

Claims

1. A post-operative occlusal limiting device for intraoral flap repair, characterized in that: The invention comprises an upper brace (1) and a lower brace (3) respectively adapted for the healthy maxillary teeth and mandibular teeth, wherein the end of the upper brace (1) located on the inner side of the oral cavity is connected to the end of the lower brace (3) located on the inner side of the oral cavity via a curved connecting piece (2), and the surface of the upper brace (1) facing the lower brace (3) is a bionic structure of the maxillary teeth; The lower brace (3) includes a lower base (31), an upper tooth seat (32) and an adjustment block (33); the lower surface of the lower base (31) cooperates with the mandibular teeth; a plurality of the adjustment blocks (33) are arranged on the lower base (31); the plurality of adjustment blocks (33) are stacked in sequence from bottom to top, and the contact surfaces of two adjacent adjustment blocks (33) can be interlocked; the upper tooth seat (32) is arranged on the uppermost adjustment block (33); the upper surface of the upper tooth seat (32) is a bionic structure of the mandibular teeth; A retaining edge (34) is provided on the inner and outer sides of the upper tooth seat (32) located at the maxillary teeth, and a groove body (35) is formed between the two retaining edges (34). The groove body (35) cooperates with the upper key groove of the adjustment block (33). The inner surface of the retaining edge (34) is provided with a limiting protrusion along the length direction of the retaining edge (34). A clamping groove (36) that cooperates with the limiting protrusion is provided on the inner and outer surfaces of each adjustment block (33). The limiting protrusion is clamped into the clamping groove (36) to lock the upper tooth seat (32) and the adjustment block (33).

2. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: The adjustment block (33) includes a lower card seat (331) and an upper key seat (332), and a matching slot (333) is provided in the middle of the lower surface of the lower card seat (331) along the length direction of the lower card seat (331), and the matching slot (333) extends to the end of the lower card seat (331) at both ends in the length direction of the lower card seat (331) and is open; The upper surface of the upper key seat (332) of the adjusting block (33) located below and the surface of the matching slot (333) of the adjusting block (33) located above are in contact and interlocked.

3. The occlusal limiting device after intraoral flap repair surgery according to claim 2, characterized in that: The card slot (36) is provided on the inner and outer surfaces of the lower card seat (331) along the length direction of the lower card seat (331), and one end of the card slot (36) extends to the end of the lower card seat (331) and is open, and the other end is closed.

4. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: An end block A (4) is provided at the end of the lower base (31) located outside the oral cavity; Each of the adjustment blocks (33) is provided with an end block B (5) at the end located outside the oral cavity; The ends of the upper tooth seat (32) located outside the oral cavity are each provided with an end block C (6); The end block A (4), the end block B (5) and the end block C (6) are stacked in sequence from bottom to top, and the end surface of the whole stacked by the end block A (4), the end block B (5) and the end block C (6) is a smooth curved surface extending from the bottom of the end of the lower base (31) to the upper surface of the upper tooth seat (32).

5. The occlusal limiting device after intraoral flap repair surgery according to claim 4, characterized in that: A first threaded hole (7) is provided on the end block A (4), a second threaded hole (8) is provided on the adjustment block (33), and a third threaded hole is provided on the end block C (6), and the first threaded hole (7), the second threaded hole (8) and the third threaded hole are coaxial; The first threaded hole (7), the second threaded hole (8) and the third threaded hole are connected by a bolt (10).

6. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: The end of the upper tooth seat (32) located inside the oral cavity is connected to the curved connecting piece (2) via a corrugated silicone belt (9), and the position where the corrugated silicone belt (9) is connected to the curved connecting piece (2) is close to the connection between the curved connecting piece (2) and the lower base (31).

7. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: A sublingual protrusion is provided on the bottom side of the surface of the lower base (31) located on the tongue side of the oral cavity, and the sublingual protrusion extends along the length direction of the lower base (31). The sublingual protrusion is used to be clamped under the tongue.

8. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: A plurality of connecting lines are provided on the bottom surface of the lower base (31), the two ends of the connecting lines being respectively connected to the two side edges of the bottom of the lower base (31), and the connecting lines being used to be inserted between the two teeth of the mandibular teeth.

9. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: The surface of the upper key seat (332) is wavy or sawtooth-shaped.

10. The occlusal limiting device after intraoral flap repair surgery according to claim 1, characterized in that: The thickness of the adjustment block (33) gradually decreases from the end portion outside the oral cavity to the end portion inside the oral cavity.

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