Autogenous coracoid row condyle and mandible reconstruction bone support guide plate and titanium plate assembly

Abstract

The application provides a self-conchal process condyle and mandible reconstruction bone support type guide plate and titanium plate assembly, which comprises a condyle reconstruction osteotomy guide plate, a condyle reconstruction fixed titanium plate, a mandibular median joint osteotomy guide plate and a mandibular median joint fixed titanium plate. The combination of the above-mentioned bone support type guide plate and titanium plate assembly improves the accuracy of the self-conchal process condyle and mandible reconstruction through CAD / CAM combined with screw rail transfer technology, helps to shorten the operation time, and is beneficial to the recovery of the occlusal function after the mandibular body reconstruction.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of maxillofacial reconstruction surgical instruments, in particular to a self-hyoid cornu process and mandible reconstruction bone support type guide plate and titanium plate assembly. BACKGROUND

[0002] The temporomandibular joint is the only bilateral joint in the human body, which is closely related to speech, mastication, swallowing and part of the expression and other mandibular functional activities. The mandibular condyle, as one of the main components of the temporomandibular joint, will be damaged due to trauma, tumor, osteoarthritis and congenital deformity. Due to the unique anatomical morphology and histological structure of the mandibular condyle, the reconstruction of the condyle has been a great challenge in the field of oral and maxillofacial surgery.

[0003] The current common mandibular condyle reconstruction methods are mainly divided into autologous bone and artificial temporomandibular joint transplantation. The use of autologous cornu process not only can reconstruct a condyle with good shape and function, but also can avoid a series of problems caused by autologous rib and artificial temporomandibular joint. A large number of clinical studies have shown that the autologous cornu process can not only meet the functional requirements of the temporomandibular joint after transplantation, but also continuously rebuild a new condyle in the morphology (see Figure 15 Compared with the traditional surgical method, the autologous cornu process transplantation has the following advantages: avoiding to open a second operation area, reducing surgical trauma, preventing complications and dysfunction of the donor area; because the cornu process is harder, it is convenient to perform strong internal fixation, and the mandibular movement can be achieved soon after the operation.

[0004] Mandibular reconstruction is commonly seen in congenital deformity, trauma and postoperative tumor, which is closely related to the appearance and speech, mastication and other functional activities of the human body. It has been a great challenge in the field of oral and maxillofacial surgery to achieve symmetrical contour and stable occlusal function during mandibular reconstruction. Among them, the mandibular median split surgery is a relatively rare surgical method, which is generally applied to patients with abnormal mandibular morphology and occlusal function caused by trauma or congenital deformity. In order to obtain more symmetrical mandibular morphology and better occlusal relationship, it is necessary to vertically split the mandibular bone at the median joint and remove or add a certain amount of bone mass, and perform strong internal fixation.

[0005] For complex maxillofacial trauma, not only will cause soft tissue injury and maxillofacial fracture, but also a series of sequelae. In order to improve the occlusion and facial symmetry, usually need to be self- thyroid cartilage graft for condylar reconstruction and mandibular reconstruction at the same time, due to the shape and height of the thyroid cartilage, mandibular fracture and individual differences in developmental deformity, in the traditional operation, the surgeon can only be analyzed by measuring the approximate position and bone removal of the thyroid cartilage graft through the influence of the school examination, or through the model surgery to determine the final occlusion of the patient, and then analyze and measure the bone removal or bone augmentation of the mandibular median joint after osteotomy, and the specific position of the osteotomy line, the bone removal and the fixed position after transplantation still need to be determined by the clinical experience of the surgeon. With the application of CAD / CAM to the field of oral and maxillofacial surgery, computer-aided surgical design and surgical navigation can provide convenience for autologous thyroid cartilage condylar reconstruction and mandibular reconstruction.

[0006] However, the CAD / CAM personalized autologous thyroid cartilage condylar reconstruction and mandibular reconstruction requires a perfect surgical plan design before operation, and the guide plate registration accuracy is required to be high, and the osteotomy line position, bone removal and fixed position need to be accurately navigated and positioned and fixed. Therefore, there are many challenges for the design of the surgical guide plate and the fixed titanium plate. SUMMARY

[0007] In view of the above problems, in order to make up for the deficiencies of the prior art, the present application provides a bone support type guide plate and titanium plate assembly for autologous thyroid cartilage condylar and mandibular reconstruction, which is based on the positioning of the bone around the mandibular ramus and thyroid cartilage and the bone at the mandibular median joint. The positioning is accurate during operation, the osteotomy range and position are not easy to drift, and the CAD / CAM preoperative design and 3D printing technology are used to realize the rapid registration and accurate navigation of autologous thyroid cartilage condylar reconstruction and mandibular reconstruction by using the combination of osteotomy guide plate and fixed titanium plate assembly. The autologous thyroid cartilage condylar reconstruction and mandibular reconstruction can be completed at one time, and the positioning holes on the fixed titanium plate are consistent with the positioning holes on the corresponding osteotomy guide plate, which can accurately determine the fixed position and is beneficial to the recovery of occlusion function after operation.

[0008] The technical scheme for solving the problems of the present application is as follows:

[0009] The application provides a self-conchal process condyle and mandible reconstruction bone support type guide plate and titanium plate assembly, which comprises a condyle reconstruction osteotomy guide plate, a condyle reconstruction fixed titanium plate, a mandibular median synostosis osteotomy guide plate and a mandibular median synostosis fixed titanium plate.

[0010] In some embodiments of the application, the condyle reconstruction osteotomy guide plate is a one-piece structure, which is provided with a first fixed part, a first connecting part and a first osteotomy groove; the first fixed part is divided into an upper fixed part and a lower fixed part by the first osteotomy groove, and the upper fixed part is connected with the lower fixed part through the first connecting part located on one side; and a plurality of first positioning holes are arranged on the first fixed part.

[0011] In some embodiments of the application, the first positioning holes are matched with positioning nails used in the operation, so that the positioning nails are inserted into the first positioning holes to fix the condyle reconstruction osteotomy guide plate.

[0012] In some embodiments of the application, the condyle reconstruction fixed titanium plate comprises a condyle reconstruction titanium base plate, the upper part of the condyle reconstruction titanium base plate is a vertical part, the lower part is an inverted V-shaped part, a condyle reconstruction connecting part is arranged between the corner of the inverted V-shaped part and the vertical part, and the condyle reconstruction connecting part is used for positioning and fixing support; and a plurality of second positioning holes are arranged on the condyle reconstruction titanium base plate.

[0013] In some embodiments of the application, when the condyle reconstruction fixed titanium plate is matched with the posterior edge of the ascending ramus of the mandible, the positions of the second positioning holes are consistent with the positions of the first positioning holes of the condyle reconstruction osteotomy guide plate on the mandible and the conchal process.

[0014] In some embodiments of the application, the mandibular median synostosis osteotomy guide plate is a one-piece structure, which is provided with a second fixed part, a second connecting part and a second osteotomy groove; the second fixed part is divided into a first left fixed part and a first right fixed part from the middle by the osteotomy groove, the first left fixed part is connected with the first right fixed part through the second connecting part located below the second osteotomy groove; and a plurality of third positioning holes are arranged on the second fixed part.

[0015] In some embodiments of the present application, the third positioning hole matches the positioning nail used in the operation, so that the positioning nail extends into the third positioning hole to fix the osteotomy guide plate at the mandibular symphysis.

[0016] In some embodiments of the present application, the titanium plate for fixing the mandibular symphysis includes a mandibular reconstruction titanium base plate, which is divided into a second left fixing part and a second right fixing part, both of which are in the shape of an H-shaped beam for positioning and fixing support; the second left fixing part and the second right fixing part are connected as a whole through a mandibular reconstruction connecting part; and a plurality of fourth positioning holes are arranged on the second left fixing part and the second right fixing part for matching and fixing according to the navigation of the operation.

[0017] In some embodiments of the present application, the two side edges of the second osteotomy groove are provided with upwardly protruding guide platforms, which facilitate the osteotomy of the saw blade along the guide surface of the guide platform.

[0018] In some embodiments of the present application, when the titanium plate for fixing the mandibular symphysis is attached to the bone surface of the mandibular symphysis, the positions of the fourth positioning holes correspond to the positions of the third positioning holes of the osteotomy guide plate of the mandibular symphysis.

[0019] In some embodiments of the present application, the distribution and orientation of the first positioning hole, the second positioning hole, the third positioning hole or the fourth positioning hole are set according to the post-reconstruction occlusion, morphology and stress direction.

[0020] Compared with the prior art, the present application has the following beneficial effects:

[0021] The bone support type guide plate and titanium plate assembly for autologous crura galli condyle and mandibular reconstruction provided by the present application realizes rapid registration and accurate navigation of autologous crura galli condyle reconstruction and mandibular reconstruction by combined use of the condyle reconstruction osteotomy guide plate, the condyle reconstruction fixed titanium plate, the mandibular symphysis osteotomy guide plate and the mandibular symphysis fixed titanium plate, so that the autologous crura galli condyle reconstruction and mandibular reconstruction can be completed at one time, the positioning holes on the fixed titanium plate are consistent with the positioning holes on the corresponding osteotomy guide plate, so that secondary positioning is not needed, the fixed position can be accurately determined, and the postoperative occlusion function is recovered. BRIEF DESCRIPTION OF DRAWINGS

[0022] Figure 1 Structure diagram of the condyle reconstruction osteotomy guide plate Figure 1 .

[0023] Figure 2 Structure diagram of the condyle reconstruction osteotomy guide plate Figure 2 .

[0024] Figure 3 Structure diagram of the condylar reconstruction osteotomy guide plate of the present application Figure 3 .

[0025] Figure 4 Structure diagram of the condylar reconstruction fixed titanium plate of the present application Figure 1 .

[0026] Figure 5 Structure diagram of the condylar reconstruction fixed titanium plate of the present application Figure 2 .

[0027] Figure 6 Structure diagram of the condylar reconstruction fixed titanium plate of the present application Figure 3 .

[0028] Figure 7 Structure diagram of the mandibular median synchondrosis osteotomy guide plate of the present application Figure 1 .

[0029] Figure 8 Structure diagram of the mandibular median synchondrosis osteotomy guide plate of the present application Figure 2 .

[0030] Figure 9 Structure diagram of the mandibular median synchondrosis osteotomy guide plate of the present application Figure 3 .

[0031] Figure 10 Structure diagram of the mandibular median synchondrosis fixed titanium plate of the present application Figure 1 .

[0032] Figure 11 Structure diagram of the mandibular median synchondrosis fixed titanium plate of the present application Figure 2 .

[0033] Figure 12 Structure diagram of the mandibular median synchondrosis fixed titanium plate of the present application Figure 3 .

[0034] Figure 13 Structure diagram of the mandibular median synchondrosis fixed titanium plate of the present application

[0035] Figure 14Effect diagram of the condyle reconstruction and mandible reconstruction using the autologous coronoid process, wherein A is sagittal split osteotomy of the left mandibular ramus; B is osteotomy at the mandibular symphysis; C is the condyle reconstruction using the autologous coronoid process; and D is the end-of-examination occlusion.

[0036] Figure 15 Surgical diagram of the condyle reconstruction using the autologous coronoid process.

[0037] Legend of reference signs:

[0038] 1 - condyle reconstruction osteotomy guide plate; 2 - condyle reconstruction fixed titanium plate; 3 - osteotomy guide plate at the mandibular symphysis; 4 - fixed titanium plate at the mandibular symphysis; 11 - first fixed part; 12 - first connecting part; 13 - first osteotomy groove; 14 - first positioning hole; 111 - upper fixed part; 112 - lower fixed part; 21 - condyle reconstruction titanium base plate; 211 - vertical part; 212 - inverted V-shaped part; 21a - condyle reconstruction connecting part; 22 - second positioning hole; 31 - second fixed part; 311 - first left fixed part; 312 - second right fixed part; 32 - second connecting part; 33 - third positioning hole; 34 - second osteotomy groove; 35 - guide table; 41 - mandibular reconstruction titanium base plate; 42 - fourth positioning hole; 411 - second left fixed part; 412 - second right fixed part; 413 - mandibular reconstruction connecting part; X - coronoid process; Y - condyle. DETAILED DESCRIPTION

[0039] The embodiments of the present application will be described herein below with reference to specific drawings that are provided to illustrate embodiments of the application, and not to limit the scope of the application. Based upon the disclosure provided herein, one skilled in the art will appreciate various modifications and variations to the embodiments of the present application that are to be considered within the spirit and scope of the present application. The present application can be implemented or performed in other different ways of equivalent to the embodiments described herein without departing from the spirit and essential characteristics of the present application. It will be appreciated that each of the individual variations and embodiments of the present application can be implemented independently or in combination with one another.

[0040] The embodiments of the present application provide a bone support type guide plate and titanium plate assembly for condyle and mandibular reconstruction using the autologous coronoid process, which is described with reference to Figures 1 to 12 , and includes a condyle reconstruction osteotomy guide plate 1, a condyle reconstruction fixed titanium plate 2, an osteotomy guide plate at the mandibular symphysis 3, and a fixed titanium plate at the mandibular symphysis 4. Figures 1 to 3 The condyle reconstruction osteotomy guide plate 1 is configured to fit the anterior edge of the mandibular ramus and is used for autologous coronoid process osteotomy. Figures 4 to 6 The condyle reconstruction fixed titanium plate 2 is configured to fit the posterior edge of the mandibular ramus and is used to butt and fix the lower end of the coronoid process to the bone end of the mandibular ramus. Figures 7 to 9 The osteotomy guide plate at the mandibular symphysis 3 is configured to fit the mandibular symphysis and is used for osteotomy at the mandibular symphysis. Figures 10 to 12The titanium plate 4 is arranged to be suitable for being attached to the mandibular symphysis bone for butt joint and fixation of the bone ends after osteotomy.

[0041] In some embodiments, as shown in Figures 1 to 3 The condyle reconstruction osteotomy guide plate 1 is a one-piece structure, which is provided with a first fixing part 11, a first connecting part 12 and a first osteotomy groove 13. The first fixing part 11 is divided into an upper fixing part 111 and a lower fixing part 112 by the first osteotomy groove, and the upper fixing part 111 is connected to the lower fixing part 112 through the first connecting part 12 on one side. The first fixing part is provided with a plurality of first positioning holes 14. The first fixing part 11 is prefabricated according to the collected personalized information, which can match the buccal side of the coronoid process, the mandibular angle and the edge of the mandible, and the medial surface of the mandible, and is accurate in positioning. The first connecting part 12 connects the upper fixing part 111 and the lower fixing part 112, which supports the condyle reconstruction osteotomy guide plate 1 and facilitates use. The shape of the first connecting part 12 is not limited, and it can realize the corresponding function. Preferably, it matches the corresponding position of the mandible, which facilitates close fitting during operation and facilitates operation. The first osteotomy groove 13 is used to determine the osteotomy line of the autologous coronoid process and control the osteotomy amount.

[0042] In some embodiments, as shown in Figure 13 and Figure 14 The first positioning hole 14 matches the positioning nail used in the operation, so that the positioning nail extends into the first positioning hole 14 to fix the condyle reconstruction osteotomy guide plate 1. When the condyle reconstruction osteotomy guide plate 1 is attached to the corresponding part of the lateral surface of the patient's jaw, the first positioning hole 14 is also attached to the accurate position and then fixed by the positioning nail, which ensures the accuracy of the entire coronoid process osteotomy process.

[0043] In some embodiments, as shown in Figures 4 to 6 The condyle reconstruction titanium plate 2 includes a condyle reconstruction titanium base plate 21, the upper part of which is a vertical part 211, and the lower part is a reverse V-shaped part 212. The corner of the reverse V-shaped part 212 is provided with a condyle reconstruction connecting part 21a between the vertical part 211, which is used for positioning and fixing support. The condyle reconstruction titanium base plate 21 is provided with a plurality of second positioning holes 22, which are used for in-operation navigation of the coronoid process to match and fix the condyle position.

[0044] In some embodiments, as shown in Figure 13 and Figure 14 When the condyle reconstruction titanium plate 2 is attached to the posterior margin of the ascending ramus of the mandible, the position of the second positioning hole 22 corresponds to the position of the first positioning hole 14 of the condyle reconstruction osteotomy guide plate 1 on the mandible and the coronoid process, so that no secondary positioning is needed during the condyle reconstruction process, which ensures the accuracy of the butt joint of the lower end of the coronoid process and the bone end of the ascending ramus of the mandible.

[0045] In some embodiments, as shown in Figures 7 to 9 The mandibular midline symphysis osteotomy guide plate 3 is a one-piece structure, and a second fixing part 31, a second connecting part 32 and a second osteotomy groove 34 are arranged on the one-piece structure; the second fixing part 31 is divided into a first left fixing part 311 and a first right fixing part 312 by the second osteotomy groove 34, and the first left fixing part 311 is connected with the first right fixing part 312 through the second connecting part 32 below the osteotomy groove; a plurality of third positioning holes 33 are arranged on the second fixing part 31. The second fixing part 31 is prefabricated according to the collected personalized information, and can match the mandibular midline symphysis and the lower edge of the mandibular bone surface, and is accurate in positioning. The shape of the second connecting part 32 is not limited, and the second connecting part 32 can realize the corresponding function, and is preferably matched with the corresponding position of the mandibular bone surface, so as to facilitate close fitting during the operation and convenient operation. The second osteotomy groove 34 is used to determine the osteotomy line of the midline symphysis and control the osteotomy amount. In some preferred embodiments, the two side edges of the second osteotomy groove 34 are provided with upwardly protruding guide tables 35, so as to facilitate the osteotomy of the saw blade along the guide surface of the guide table, make the osteotomy plane flat, and ensure the aesthetic effect after the operation.

[0046] In some embodiments, as shown in Figure 13 and Figure 14 The third positioning hole 33 is matched with the positioning nail used in the operation, so that the positioning nail extends into the third positioning hole 33 to fix the mandibular midline symphysis osteotomy guide plate 3. When the mandibular midline symphysis osteotomy guide plate 3 is attached to the corresponding part of the patient's jaw bone, the third positioning hole 33 is also attached to the accurate position and then fixed by the positioning nail, so as to ensure the accuracy of the entire mandibular midline symphysis osteotomy process.

[0047] In some embodiments, as shown in Figures 10 to 12 The mandibular midline symphysis titanium fixing plate 4 includes a mandibular reconstruction titanium base plate 41, the mandibular reconstruction titanium base plate 41 is divided into a second left fixing part 411 and a second right fixing part 412, and the second left fixing part 411 and the second right fixing part 412 are both I-shaped and used for positioning and fixing support; the second left fixing part 411 and the second right fixing part 412 are connected into one body through a mandibular reconstruction connecting part 413; a plurality of fourth positioning holes 42 are arranged on the second left fixing part 411 and the second right fixing part 412, and are used for in-operation navigation, position matching and fixing.

[0048] In some embodiments, as shown in Figure 13 and Figure 14As shown, when the titanium plate 4 is fixed at the mandibular symphysis joint and the bone surface of the titanium plate 4 is in close contact with the mandibular symphysis joint, the position of the fourth positioning hole 42 corresponds to the position of the third positioning hole 33 of the mandibular symphysis joint osteotomy guide plate 3, so that in the process of mandibular reconstruction, no secondary positioning is required, and the accuracy of the butt joint of the mandibular symphysis joint is ensured.

[0049] In some embodiments, the distribution and orientation of the first positioning hole 14 are set according to the post-reconstruction occlusion, morphology and stress direction; the distribution and orientation of the second positioning hole 22 are set according to the post-reconstruction occlusion, morphology and stress direction; the distribution and orientation of the third positioning hole 33 are set according to the post-reconstruction occlusion, morphology and stress direction; and the distribution and orientation of the fourth positioning hole 42 are set according to the post-reconstruction occlusion, morphology and stress direction.

[0050] The clinical application of the autologous condylar process and mandibular reconstruction surgery bone support guide plate and titanium plate assembly provided by the application is as follows:

[0051] A patient complained of facial asymmetry and malocclusion after a car accident nearly a year ago. CT scans of the craniofacial region showed various morphological differences and variations in bone and soft tissue. Three-dimensional reconstruction showed that the right mandibular branch was partially missing. Clinical examination found that the chin was moved 8 mm to the right, and there was a surgical scar about 10 cm long on the right side of the mouth to the ear. Intraoral examination showed a permanent dentition, bilateral lower central incisors and right lower lateral incisors were missing, and a right anterior crossbite and posterior crossbite malocclusion. The maximum mouth opening was 30 mm, and the mouth opening was biased to the right. In order to accurately reconstruct the right condylar process and correct the occlusion, a CAD / CAM-based surgery was proposed. The proposed surgery includes left mandibular ascending ramus sagittal split osteotomy (SSRO), mandibular symphysis joint osteotomy, right condylar process reconstruction, and right autologous condylar process transplantation through screw rail transfer technology navigation.

[0052] Mandibular CT scan data was obtained, and dental super-hard plaster end occlusion was confirmed. A 3D laser scanner (Activity880; Smartoptics, Germany) was used for scanning, and the file was saved in STL format. After collecting digital data and completing clinical examination, the data was imported into PROPLAN CMFTM 3.0 (Materialise, Belgium) for surgical design and three-dimensional display.

[0053] The position of the condylar process is critical for mandibular reconstruction. First, we incise the right condylar process anterior to the glenoid fossa and medial to the zygomatic arch. Then, the top of the condylar process is placed in the appropriate position under the glenoid fossa while the distal end is placed close to the mandibular body. The condylar process reconstruction osteotomy guide 1 is used to locate the positioning pin hole from the lower edge of the mandible to the condylar process. The second positioning hole 22 on the condylar process reconstruction fixation titanium plate 2 matches the first positioning hole 14 on the condylar process reconstruction osteotomy guide 1, which helps to locate and connect (refer to Figure 13 Finally, based on the virtual surgery planning, 3D print the end occlusion template, mandibular model and osteotomy guide for guidance of surgery.

[0054] Due to the large area of the surgical region, first perform surgery on the unaffected side, and then perform surgery on the condylar process defect side. After general anesthesia and intubation, unilateral SSRO is performed on the left side (refer to Figure 14 A). Then, perform the osteotomy at the mandibular symphysis under the guidance of the osteotomy guide 3 at the mandibular symphysis, the first left fixing part 311 and the first right fixing part 312 of the osteotomy guide 3 at the mandibular symphysis respectively closely fit the outer surface of the labial genial region, the lower edge of the mandible and the lingual bone surface, achieving accurate positioning, the osteotomy guide 3 at the mandibular symphysis is fixed on the mandible by using the surgical positioning pin through the third positioning hole 33, the osteotomy line is determined and the amount of osteotomy is controlled under the guidance of the second osteotomy groove 34, the excess bone is removed, then the corresponding surgical positioning pin in the third positioning hole 33 is removed, the osteotomy guide 3 at the mandibular symphysis is removed, and the fixation is performed (refer to Figure 14 B). Then, the left mandibular body is completely freed. Next, place the end occlusion guide and perform intermaxillary fixation. Then, the second left fixing part 411 and the second right fixing part 412 of the fixation titanium plate 4 at the mandibular symphysis are fitted with the corresponding bone surface of the patient's mandible, and the position of the fourth positioning hole 42 corresponds to the remaining third positioning pin hole on the mandible to determine the final position of the fixation titanium plate 4 at the mandibular symphysis, and the fixation is re-performed by using the positioning pin to complete the rigid internal fixation of the fixation titanium plate 4 at the mandibular symphysis.

[0055] When the right condyle is reconstructed, the right condyle is exposed by cutting from the lower edge of the mandible to the right condyle along the original surgical scar. Next, the condyle reconstruction osteotomy guide plate 1 is applied at the angle of the mandible and the coracoid process. The upper fixing part 111 and the lower fixing part 112 of the first fixing part 11 are tightly fitted with the buccal side of the coracoid process, the angle of the mandible and the edge of the mandible, and the medial surface of the mandible. At this time, the first positioning hole 14 is also fitted to the accurate position. The condyle reconstruction osteotomy guide plate 1 is fixed on the mandible by using the surgical positioning pin passing through the first positioning hole 14. The osteotomy line is determined and the osteotomy amount is controlled under the guidance of the first osteotomy groove 13. The autologous coracoid process is cut and outlined. Then, the corresponding surgical positioning pin in the first positioning hole 14 is removed, and the condyle reconstruction osteotomy guide plate 1 is removed. After the soft tissue around the joint socket is released, the coracoid process is placed, and the cut autologous coracoid process bone end is butted with the condyle bone end of the posterior edge of the ascending ramus of the mandible (see Figure 14 Fig. 6C). The vertical part 211 of the condyle reconstruction fixation titanium plate 2 is fitted with the cut autologous coracoid process, the inverted V-shaped part 212 is fitted with the posterior edge of the ascending ramus of the mandible, and the position of the second positioning hole 22 corresponds to the first positioning pin hole left on the autologous coracoid process and the mandible to determine the final position of the condyle reconstruction fixation titanium plate 2, and the positioning pin is used again for fixation. Finally, the end occlusion is checked to ensure that it is consistent with the preoperative design (see Figure 14 Fig. 6D).

[0056] The patient is satisfied with the postoperative effect. The end occlusion guide plate is removed one month after the operation, and the fixation titanium plate is planned to be removed after one year. No postoperative complications are observed during the follow-up period. The patient's occlusion is stable, and the mouth opening is close to 4 cm. In addition, the facial scar contracture is released.

[0057] In the present application, the positioning hole of the osteotomy guide plate is consistent with the positioning hole of the corresponding fixation titanium plate at the corresponding position of the mandible. After osteotomy, accurate positioning of the fixation titanium plate can be achieved, which not only saves the operation time, but also ensures the accuracy of the osteotomy and fixation position, and is beneficial to the recovery of the occlusion function after the operation.

[0058] The above examples only illustrate the principles and effects of the present application, but are not used to limit the present application. Any person skilled in the art can modify or change the above examples without departing from the spirit and scope of the present application. Therefore, all equivalent modifications or changes made by those skilled in the art without departing from the spirit and technical idea disclosed by the present application should be covered by the claims of the present application.

Claims

1. A self-coronoid process condyle and mandible reconstruction bone support type guide plate and titanium plate assembly, characterized in that, The application relates to a condylar reconstruction osteotomy guide plate (1), a condylar reconstruction fixation titanium plate (2), a mandibular median synphysis osteotomy guide plate (3) and a mandibular median synphysis fixation titanium plate (4); the condylar reconstruction osteotomy guide plate (1) is arranged to be suitable for being attached to the front edge of the ascending ramus of a mandible and is used for autologous coracoid process osteotomy; the condylar reconstruction fixation titanium plate (2) is arranged to be suitable for being attached to the rear edge of the ascending ramus of a mandible and is used for making the lower end of the coracoid process butt joint with the broken end of the ascending ramus of a mandible and being fixed; the mandibular median synphysis osteotomy guide plate (3) is arranged to be suitable for being attached to the mandibular median synphysis and is used for mandibular median synphysis osteotomy; and the mandibular median synphysis fixation titanium plate (4) is arranged to be suitable for being attached to the mandibular median synphysis and is used for making the broken end of the osteotomized bone butt joint and being fixed. A plurality of first positioning holes (14) are arranged on the first fixing part (11) of the condylar reconstruction osteotomy guide plate (1), a plurality of second positioning holes (22) are arranged on the vertical part (211) and the inverted V-shaped part (212) of the condylar reconstruction fixation titanium plate (2), when the condylar reconstruction fixation titanium plate (2) is attached to the rear edge of the ascending ramus of a mandible, the positions of the second positioning holes (22) are consistent with the positions of the first positioning holes (14); a plurality of third positioning holes (33) are arranged on the second fixing part (31) of the mandibular median synphysis osteotomy guide plate (3), a plurality of fourth positioning holes (42) are arranged on the second left fixing part (411) and the second right fixing part (412) of the mandibular median synphysis fixation titanium plate (4), when the mandibular median synphysis fixation titanium plate (4) is attached to the bone surface of the mandibular median synphysis, the positions of the fourth positioning holes (42) are consistent with the positions of the third positioning holes (33) corresponding to the mandibular median synphysis.

2. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly according to claim 1, wherein, The condylar reconstruction osteotomy guide plate (1) is of an integral structure, and a first fixing part (11), a first connecting part (12) and a first osteotomy groove (13) are arranged on the condylar reconstruction osteotomy guide plate (1); the first fixing part (11) is divided into an upper fixing part (111) and a lower fixing part (112) by the first osteotomy groove, and the upper fixing part (111) is connected with the lower fixing part (112) through the first connecting part (12) located on one side.

3. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly of claim 2, wherein, The first positioning holes (14) are matched with positioning nails used in operation, so that the positioning nails are inserted into the first positioning holes (14) to fix the condylar reconstruction osteotomy guide plate (1).

4. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly of claim 2, wherein, The condylar reconstruction fixation titanium plate (2) comprises a condylar reconstruction titanium base plate (21), the upper part of the condylar reconstruction titanium base plate (21) is a vertical part (211), the lower part is an inverted V-shaped part (212), and a condylar reconstruction connecting part (21a) is arranged between the corner of the inverted V-shaped part (212) and the vertical part (211) and is used for positioning and fixing support.

5. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly of claim 4, wherein, The mandibular midline joint osteotomy guide plate (3) is an integral structure, which is provided with a second fixing part (31), a second connecting part (32) and a second osteotomy groove (34); the second fixing part (31) is divided into a first left fixing part (311) and a first right fixing part (312) by the second osteotomy groove (34) from the middle, and the first left fixing part (311) is connected with the first right fixing part (312) through the second connecting part (32) located below the osteotomy groove.

6. The conchal line condylar reconstruction bone support guide and titanium plate assembly according to claim 5, wherein, The third positioning hole (33) is matched with a positioning nail used in the operation, so that the positioning nail extends into the third positioning hole (33) to fix the mandibular midline joint osteotomy guide plate (3).

7. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly according to claim 5, wherein, The mandibular midline joint fixed titanium plate (4) comprises a mandibular reconstruction titanium base plate (41), the mandibular reconstruction titanium base plate (41) is divided into a second left fixing part (411) and a second right fixing part (412), the second left fixing part (411) and the second right fixing part (412) are both I-shaped, used for positioning and fixing support; the second left fixing part (411) and the second right fixing part (412) are connected into an integral whole through a mandibular reconstruction connecting part (413).

8. The conchal line condylar continuation and mandible reconstruction bone-supported guide and titanium plate assembly according to claim 5, wherein, The two side edges of the second osteotomy groove (34) are provided with upwardly protruding guide tables (35), which facilitate the osteotomy of the saw blade along the guide surface of the guide table.

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