A depth-fixing sleeve and an apical surgery guide plate used in conjunction with the depth-fixing sleeve

Abstract

The present invention discloses a depth-fixing sleeve and an apical surgical guide that can be used in conjunction with the depth-fixing sleeve. The depth-fixing sleeve includes a sleeve body with openings at both ends; the sleeve body can be nested and matched with the positioning holes on the guide plate, and can be matched with apical surgical instruments. The guide plate includes a guide body, and the guide body includes a bone face portion, an occlusal face portion, a lingual face portion, and a labial face portion; a positioning hole is provided on the bone face portion. The present invention adopts a sleeve and a guide plate, and inserts the sleeve into the positioning hole located on the guide plate body. On the one hand, it can better combine the use of apical surgical instruments, avoid damage to the surrounding gingival soft tissue, and help the patient's postoperative recovery; on the other hand, the sleeve body has a depth-fixing effect, which is convenient for surgeons to better grasp the resection depth, making the operation easier to use, and is conducive to completing the operation faster and more efficiently, and is suitable for a large number of patients with pulpal periapical diseases.

Description

Technical Field

[0001] The present invention relates to the field of oral medical instruments, and more specifically, to a depth-fixing sleeve and an apex surgery guide plate that can be used in conjunction with the depth-fixing sleeve. Background Art

[0002] As we all know, apical surgery is the most common root canal surgery for the auxiliary treatment of pulp disease and periapical disease. It includes flap incision, bone removal and window opening, periapical scaling, apical resection exploration, retrograde root canal preparation, retrograde root canal filling, and suturing. The difficulty of apical surgery lies in the positioning of the apical area during bone removal and window opening. When there is no lesion around the apex and the cortical bone is intact, it is difficult to determine the position of the root apex and the lesion area of ​​the affected tooth. Blind drilling and grinding may damage the affected root and the roots of adjacent teeth.

[0003] Yang Xuechao et al. first used apical surgical guide as an auxiliary surgical tool for minimally invasive apical surgery in "New method of minimally invasive apical surgery assisted by 3D printing guide" ([J]. Oral Medicine Research, 2016, 32(9): 944-948.), and accurately removed the apical lesion area. In patent document CN 208464284 U, a one-size-fits-all digital apical surgical guide was disclosed to reduce gingival soft tissue damage.

[0004] In order to achieve the effect of minimally invasive and precise apical surgery and protect the patient's soft tissue, it is necessary not only to accurately locate the surgical site, but also to have a good grasp of the depth of resection. To perform a good operation, it often takes years of practical experience to accurately grasp the scale during the operation, especially during the operation, it is difficult for inexperienced doctors to determine the resection depth. Therefore, an auxiliary tool with a depth setting function and soft tissue protection is needed to reduce the requirements for the operator. Summary of the invention

[0005] The present invention primarily solves the technical problems in the prior art that it is difficult to determine the depth of apical surgery, medical staff have a certain degree of uncertainty in judging the surgical depth during surgery based on experience, and the surgery causes great damage to the soft tissue in the surgical area. The present invention provides a sleeve that can not only determine the depth but also protect the soft tissue.

[0006] Another technical problem that the present invention needs to solve is to provide an apical surgery guide that can be used in conjunction with a depth-fixing sleeve.

[0007] In order to achieve the above object, the technical solution adopted by the present invention is:

[0008] A depth-fixing sleeve comprises a sleeve body with openings at both ends; the sleeve body can be nested and matched with the positioning holes on the guide plate, and can be matched with the apical surgical instrument; wherein the guide plate comprises the guide plate body, the guide plate body comprises a tooth surface portion matching with the clinical crown and a bone surface portion matching with the alveolar bone and the mucosa thereon; the tooth surface portion comprises an occlusal surface portion, a lingual surface portion and a labial surface portion matching with the occlusal surface of the clinical crown, the lingual surface portion and the labial surface portion are arranged on both sides of the occlusal surface portion and respectively match with the lingual surface and labial surface of the clinical crown; a positioning hole matching with the apical surgical instrument is arranged on the bone surface portion; when the sleeve body is inserted into the positioning hole, and the apical surgical instrument matches with the sleeve body, the apical surgical instrument resection coverage area exceeds the longest axis of the apical area of ​​the root of the affected tooth by 1 to 4 mm.

[0009] When using a conventional guide plate to perform traditional apical surgery, first, the guide plate body is attached to the gingival soft tissue of the patient, the position of the guide plate body is adjusted so that the positioning hole is aligned with the position of the root apex to be removed, the gingival soft tissue is cut to make an incision for apical surgery and the flap is appropriately pulled to expose the root apex to be removed. Then, the root apex is removed using an apical surgical instrument, such as a bone trephine. However, it is found in the actual operation process that the depth of the root apex removed by the apical surgical instrument in the above-mentioned operation lacks relevant auxiliary positioning measures, resulting in the operator being unable to grasp the removal depth well and can only rely on the doctor's experience and feel, which has certain uncertainty. Therefore, the present invention provides a fixed depth sleeve, after the window is opened on the bone surface in the above-mentioned operation process, the root apex is removed and exposed, and the sleeve body matched with the positioning hole is inserted, and the sleeve body is deeply inserted into the incision. According to the depth designed before the operation and the positioning function of the sleeve, the root apex of about 3mm is accurately removed using the apical surgical instrument bone trephine. In order to ensure the thoroughness of the root apex resection, a resection margin needs to be left, so the area that can be resected by the apical surgical instrument should be 1 to 4 mm larger than the longest axis of the root apex of the affected tooth. By observing the relative position (the distance between the first reference and the second reference) of the portion of the sleeve body exposed outside the gingival soft tissue (for example, the edge of the exposed portion is used as the first reference) and the apical surgical instrument (for example, the connection between the connecting rod of the bone trephine and the drill bit is used as the second reference), it can assist in determining the depth and achieve a better surgical effect. Moreover, due to the protection of the sleeve body, the bone trephine is isolated from damaging the surrounding soft tissue during high-speed operation, reducing the damage to the gingival soft tissue caused by the apical surgical instrument.

[0010] Preferably, the length of the sleeve body is 8 to 18 mm.

[0011] The depth-fixing sleeve is designed to be used in conjunction with apical surgical instruments. If the sleeve body of the depth-fixing sleeve is too long, it will affect the penetration of the apical surgical instruments. For example, when the apical surgical instrument is a bone ring drill, the length of the sleeve body must ensure that the drill bit can penetrate the incision in the surgical area and remove the root apex. The length of the sleeve body should not be too short, because the surgeon needs to refer to the position of the sleeve body when determining the resection depth during surgery. A sleeve body that is too short is not conducive to depth determination.

[0012] In the present invention, the thickness of the sleeve body is 0.5-1 mm. Generally, the length of the root apex of the affected tooth along the long axis direction is about 3 mm; the size of the resection end of the apical surgical instrument (such as a bone trephine) must ensure that a margin is left while resecting the root apex of the affected tooth to ensure thorough resection of the apex, so the size of the covering area that can be resected is about 4 mm; when the thickness of the sleeve body is 0.5-1 mm, the width of the positioning hole is in the range of 4-8 mm, which can ensure the mutual matching of the positioning hole, the sleeve body and the apical surgical instrument.

[0013] Preferably, a through hole is provided on the sleeve body; the distance between the geometric center of the through hole and the edge of the insertion end of the sleeve body is 2 to 8 mm.

[0014] Because the apical surgical instrument will rotate at high speed when removing the affected part of the tooth, it will generate more heat accompanied by blood and bone tissue fragments. On the one hand, in order to dissipate the heat; on the other hand, in order to allow the blood and bone tissue to flow out, the present invention also opens a through hole on the fixed depth sleeve to continuously guide cooling water during the operation, so as to achieve better heat dissipation and the effect of dredging blood and bone tissue.

[0015] During use, a portion of the sleeve body penetrates into the incision, and the other portion is exposed to the outside of the gingival soft tissue; when the geometric center of the through hole is 2 to 8 mm away from the edge of the insertion end of the sleeve body, it can be ensured that part or all of the through hole is located at the position where the fixed depth sleeve is exposed outside the gingival soft tissue.

[0016] Preferably, the number of the through holes is multiple and evenly distributed; the through holes are circular holes or polygonal holes, and the total area of ​​the through holes is 2 to 4 mm 2 .

[0017] When there are multiple through holes, the diverted cooling water not only has a good cooling effect, but also can better discharge blood and bone tissue.

[0018] Preferably, a connecting portion is provided on the sleeve body; the connecting portion can be nested and matched with the limiting portion on the positioning hole.

[0019] Generally, the thickness of the guide plate is 1 to 2 mm, and the thickness of the positioning hole is consistent with the thickness of the guide plate, which is also 1 to 2 mm. In actual use, the thickness of the gum soft tissue to be protected is 1 to 2 mm, which means that the sleeve body needs to pass through the positioning hole and extend into the gum soft tissue 1 to 2 mm. Therefore, the edge distance L between the connecting portion and the insertion end of the sleeve body is 2 to 4 mm.

[0020] More preferably, the structure of the connecting portion is a slot, a protrusion or a thread; and the limiting portion is a slot structure, a groove or a thread that is compatible with the structure of the connecting portion.

[0021] In the present invention, a positioning hole that matches the connecting part of the sleeve body is provided with a limiting part that matches the slot, protrusion or thread. For example, when the connecting part is a slot, the limiting part is a slot structure corresponding thereto; when the connecting part is a protrusion, the limiting part is a groove corresponding thereto; when the connecting part is a thread, the limiting part is a thread corresponding thereto. The function of the connecting part and the limiting part is to make the sleeve body more stably plugged into the positioning hole. The structure of the connecting part is not limited to the structures of the slot, protrusion or thread, and the above structures can also be a combination, for example, a protrusion is provided in the slot, and a thread is provided in the slot. In this way, the position of the fixed depth sleeve can be better fixed, which is convenient for the operation.

[0022] The present invention also provides an apical surgery guide plate that can be used in conjunction with the depth-fixing sleeve, comprising the depth-fixing sleeve and the guide plate.

[0023] Preferably, the number of the positioning holes is one or more; the number of the depth-fixing sleeves is at least one.

[0024] One apical surgical guide can be used to precisely position the apical area of ​​multiple teeth, which requires multiple positioning holes. You can use only one depth sleeve or multiple depth sleeves at the same time.

[0025] Because the distance between adjacent teeth is very small, if apical surgery of adjacent teeth is performed, the arrangement of the positioning holes needs to be very compact, so when a guide plate with multiple positioning holes is used, the positioning holes will be arranged crosswise. At this time, the depth-fixing sleeve can still be inserted into the positioning hole more tightly.

[0026] Preferably, the guide plate is further provided with one or more of a retention indication window, a soft tissue incision indication line or a mucosal indication window. The retention indication window is provided on the occlusal surface; the soft tissue incision indication line is located at and passes through the positioning hole; and the mucosal indication window is provided around the positioning hole.

[0027] The retention indicator window can help the surgeon better locate the position of the guide plate and the patient's crown, making it easier to place the guide plate. The soft tissue incision indicator line helps the surgeon to make soft tissue incisions along the indicated position in the surgical area. The mucosal indicator windows set around the positioning holes can clearly and easily determine the degree of fit between the bone surface and the gingival mucosa, thereby improving the accuracy of the surgery.

[0028] Preferably, the soft tissue incision indicator line forms an angle of 0 to 15° with the long axis of the tooth.

[0029] In this way, the lesion area can be accurately indicated through the positioning hole, and the position, direction and angle of the surgical approach can be determined, thereby ensuring accurate resection of the apex of the lesion area.

[0030] Preferably, soft tissue support portions protruding toward the lip and facial areas are respectively provided on the left and right sides of the positioning hole.

[0031] Through the coordinated use of the soft tissue support part and the soft tissue incision indicator line, the bone surface for apical surgery can be exposed without incision and flap treatment. The incision is small, the damage to the gingival soft tissue is small, and the postoperative recovery of the dental patient is beneficial.

[0032] Compared with the prior art, the present invention has the following beneficial effects:

[0033] The present invention adopts a depth-fixing sleeve used in conjunction with apical surgical instruments, and the sleeve body is inserted into the positioning hole of the guide plate body. On the one hand, it can better combine the use of apical surgical instruments, such as bone ring drills, to isolate the drill bit from damage to the surrounding gingival soft tissues, which is helpful for the patient's postoperative recovery; on the other hand, the sleeve body has a depth-fixing effect, which is convenient for surgeons to better grasp the surgical depth, making the operation easier to use, and completing the operation faster and more efficiently. It is suitable for a large number of patients with pulp disease and apical periodontitis. BRIEF DESCRIPTION OF THE DRAWINGS

[0034] Figure 1 It is a schematic diagram of the three-dimensional structure of the depth-fixing sleeve and the guide plate used in conjunction with each other in the present invention;

[0035] Figure 2 This is a schematic diagram of the main structure of the depth-fixing sleeve of the present invention;

[0036] Figure 3 It is a schematic diagram of the top view of the depth-fixing sleeve of the present invention;

[0037] Figure 4 It is a side structural schematic diagram of the depth-fixing sleeve of the present invention;

[0038] Figure 5 It is a schematic diagram of the three-dimensional structure of the depth-fixing sleeve of the present invention;

[0039] Figure 6It is a structural schematic diagram of another depth-fixing sleeve of the present invention;

[0040] Figure 7 A schematic diagram of the structure of a depth-fixing sleeve further optimized in the present invention;

[0041] Figure 8 It is a schematic diagram of the guide plate structure with a limiting portion in the present invention;

[0042] Fig. 9 It is a schematic diagram of the structure of the present invention containing multiple positioning holes of different sizes.

[0043] In the figure:

[0044] 1. Sleeve body; 11. Through hole; 12. Connecting part;

[0045] 2. guide plate; 21. guide plate body; 2101. positioning hole; 2102. limiting part;

[0046] 3. Soft tissue incision indicator line;

[0047] 4. Soft tissue support;

[0048] 5. Mucosal indicator window;

[0049] 6. Retention indicator window. DETAILED DESCRIPTION

[0050] The present invention will be further described below in conjunction with specific implementation modes.

[0051] Example 1

[0052] refer to Figures 1 to 5 , this embodiment provides a depth-fixing sleeve and an apical surgical guide that can be used with the depth-fixing sleeve. The depth-fixing sleeve includes a sleeve body 1 with openings at both ends. In this embodiment, the sleeve body 1 is a cylindrical sleeve body. The sleeve body 1 can be nested and matched with the positioning hole 2101 on the guide plate 2, and can be matched with the apical surgical instrument. In this embodiment, the apical surgical instrument is a bone trephine. Among them, the guide plate 2 includes a guide plate body 21, and the guide plate body 21 includes a tooth surface portion that matches the clinical crown and a bone surface portion that matches the alveolar bone and its mucosa; the tooth surface portion includes an occlusal surface portion, a lingual surface portion and a labial surface portion that match the occlusal surface of the clinical crown, and the lingual surface portion and the labial surface portion are arranged on both sides of the occlusal surface portion and respectively match the lingual surface and labial surface of the clinical crown; and a positioning hole 2101 that matches the apical surgical instrument is arranged on the bone surface portion. The number of positioning holes 2101 in this embodiment is 1. When the sleeve body 1 is inserted into the positioning hole 2101, the bone trephine can be just set in the sleeve body 1. The sleeve body 1 is provided with a through hole 11, which is a circular hole or a polygonal hole, and the area of ​​the through hole is 3mm 2. A connecting portion 12 is provided on the sleeve body 1, and a limiting portion 2102 is provided on the positioning hole 2101. The connecting portion 12 can be nested with the limiting portion 2102 on the positioning hole 2101. The structure of the connecting portion 12 is a slot, a protrusion or a thread; the limiting portion is a slot structure, a groove or a thread. Specifically, the diameter of the bone trephine is 4mm, the inner diameter of the cylindrical sleeve body is 4.5mm, the thickness is 0.5mm, the outer diameter of the cylindrical sleeve body is 5.5mm, the diameter of the positioning hole is 5.5mm, and the positioning hole is located at 1mm and 1.5mm at both ends of the longest axis of the root apex of the affected tooth, so that the bone trephine covers 0.5mm and 0.5mm above and below the root apex of the affected tooth.

[0053] In this embodiment, the length of the sleeve body 1 is 10 mm. Figure 1 When in use, the drill bit of the bone trephine is inserted into the sleeve body 1, and the distance between the position of the bone trephine and the edge of the sleeve body exposed on one side of the guide plate is observed. Figure 1 The D in the figure helps the surgeon determine the depth of resection.

[0054] The sleeve body 1 is provided with a through hole 11; the distance L between the geometric center of the through hole 11 and the edge of the insertion end of the sleeve body 1 is 5 mm.

[0055] The guide plate 2 also includes one or more of a retention indicator window 6 disposed on the occlusal surface, a soft tissue incision indicator line 3 disposed on and passing through the positioning hole, and a mucosal indicator window 5 around the positioning hole. The soft tissue incision indicator line 3 forms an angle of 0 to 15° with the long axis of the tooth. The left and right sides of the positioning hole 2101 are respectively provided with soft tissue support portions 4 protruding toward the labial surface. In this embodiment, the number of retention indicator windows 6 is one.

[0056] The specific working method of this embodiment is:

[0057] The guide plate body 21 is attached to the gum soft tissue of the patient, and the position of the guide plate body 21 is adjusted so that the positioning hole 2101 is aligned with the position of the root apex to be removed. The gum soft tissue is cut to make an incision for apical surgery and the flap is opened to expose the root apex to be removed. The sleeve body 1 is inserted into the incision and the root apex is removed using an apical surgical instrument, such as a bone trephine. By observing the relative position of the apical surgical instrument and the sleeve body 1, the resection depth can be assisted.

[0058] Example 2

[0059] The technical scheme of this embodiment 2 is basically the same as that of embodiment 1, except that the position of the positioning hole 2101 is different, so the area covered by the bone trephine resection is different. The details are as follows:

[0060] When the sleeve body 1 is inserted into the positioning hole 2101, and the apical surgical instrument is matched with the sleeve body 1, the apical surgical instrument covers the root apex of the affected tooth beyond 1mm and 0.5mm at both ends of the longest axis. The inner diameter of the sleeve body 1 is 5mm, and the thickness is 1mm, so when 3mm of the root apex is removed, the relative position of the positioning hole 2101 and the root apex is that the upper edge and the lower edge of the positioning hole 2101 are 1mm above and 3mm below the root apex, respectively, and the size of the positioning hole is a round hole with an outer diameter of 7mm.

[0061] Example 3

[0062] In this embodiment, when the sleeve body 1 is inserted into the positioning hole 2101 and the apical surgical instrument is matched with the sleeve body 1, the apical surgical instrument covers 2 mm and 1 mm above and below the apex of the root of the affected tooth. The thickness of the sleeve body 1 is 0.5 mm, so the relative position of the positioning hole 2101 and the apex is that the positioning hole is located 2.5 mm and 2 mm above and below the apex of the root of the affected tooth, and the size of the positioning hole 2101 is a round hole with a diameter of 7.5 mm.

[0063] Example 4

[0064] This embodiment provides another design of a depth-fixing sleeve, which is consistent with Embodiment 1 except that the through hole design is different from that of Embodiment 1.

[0065] refer to Figure 6 In this embodiment, the number of through holes is multiple and evenly distributed. The through hole 11 is a circular hole, and the area of ​​the through hole 11 is 4 mm 2 The design has a better effect of guiding cooling water and a good cooling effect; it can also better discharge blood, water and soft tissue.

[0066] Example 5

[0067] This embodiment provides another design of a depth-fixing sleeve, in which a connecting portion 12 is provided on the sleeve body; the connecting portion 12 can be nested with the limiting portion 2102 on the positioning hole 2101. The structure of the connecting portion 12 can be a slot, a convex block or a thread; the limiting portion 2102 is a slot structure, a groove or a thread that matches the structure of the connecting portion.

[0068] In this embodiment, if Figure 7 As shown, the connecting portion 12 is a card slot. Figure 8 As shown, the limiting portion 2102 is a groove, and the distance L between the lower edge of the connection between the connecting portion and the sleeve body and the edge of the plug-in end of the sleeve body is 3 mm.

[0069] Example 6

[0070] This embodiment provides another designed depth-fixing sleeve agent that can be used in conjunction with an apical surgery guide plate used with a depth-fixing sleeve. The guide plate can be used to perform apical surgery on two affected teeth.

[0071] refer to Fig. 9 The guide plate includes a guide plate body 21, which includes a tooth surface portion that matches the clinical crown and a bone surface portion that matches the alveolar bone and its upper mucosa; the tooth surface portion includes an occlusal surface portion that matches the occlusal surface of the clinical crown, a lingual surface portion and a labial surface portion, and the lingual surface portion and the labial surface portion are arranged on both sides of the occlusal surface portion and respectively match the lingual surface and labial surface of the clinical crown.

[0072] In this embodiment, there are two positioning holes, which are divided into a left positioning hole and a right positioning hole, and the left positioning hole and the right positioning hole intersect.

[0073] The distance between the upper and lower edges of the left and right positioning holes and the root tip to be removed is 2mm. The depth-fixing sleeves used in conjunction with these two positioning holes are the left and right depth-fixing sleeves. In order to meet the adaptation of the depth-fixing sleeves and the bone trephine, the thickness of the sleeve body is 1mm, the size of the positioning hole is 7mm, and the size of the bone trephine is 4.5mm.

[0074] Obviously, the above embodiments of the present invention are merely examples for clearly illustrating the present invention, and are not intended to limit the embodiments of the present invention. For those skilled in the art, other different forms of changes or modifications can be made based on the above description. It is not necessary and impossible to list all the embodiments here. Any modifications, equivalent substitutions and improvements made within the spirit and principles of the present invention should be included in the protection scope of the claims of the present invention.

Claims

1. A depth-fixing sleeve, characterized in that: It comprises a sleeve body (1) with openings at both ends; The sleeve body (1) can be nested and matched with the positioning hole (2101) on the guide plate (2), and can be matched with apical surgical instruments; Wherein, the guide plate (2) comprises a guide plate body (21), wherein the guide plate body (21) comprises a tooth surface portion matching with a clinical tooth crown and a bone surface portion matching with an alveolar bone and a mucosa thereon; The tooth surface portion includes an occlusal surface portion, a lingual surface portion and a labial surface portion which match the occlusal surface of the clinical crown, wherein the lingual surface portion and the labial surface portion are arranged on both sides of the occlusal surface portion and match the lingual surface and the labial surface of the clinical crown respectively; A positioning hole (2101) matching with the sleeve body (1) is provided on the bone surface; when the sleeve body (1) is inserted into the positioning hole (2101) and the apical surgical instrument is matched with the sleeve body (1), the apical surgical instrument resection coverage area exceeds the longest axis of the apical area of ​​the root of the affected tooth by 1 to 4 mm; The sleeve body (1) is provided with a through hole (11) for guiding cooling water and discharging blood and bone tissue; the distance between the geometric center of the through hole (11) and the edge of the plug-in end of the sleeve body (1) is 2 to 8 mm; The number of the through holes (11) is multiple and evenly distributed; the through holes (11) are circular holes or polygonal holes, and the total area of ​​the through holes (11) is 2 to 4 mm 2 ; The length of the sleeve body (1) is 8 to 18 mm; The sleeve body (1) is provided with a connecting portion (12); the positioning hole (2101) is provided with a limiting portion (2102); the connecting portion (12) can be nested with the limiting portion (2102) on the positioning hole (2101).

2. The depth-fixing sleeve according to claim 1, characterized in that: The structure of the connecting portion (12) is a slot, a protrusion or a thread; the limiting portion (2102) is a slot structure, a groove or a thread that can be matched with the connecting portion.

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