Tooth supporting type lower jawbone tractor fixing guide plate and manufacturing method

Abstract

The invention discloses a tooth supporting type mandible tractor fixing guide plate and a manufacturing method, the fixing guide plate comprises a tooth fixing part, a connecting rod and a guide plate body, the tooth fixing part is fixed on a part of dentition of the lower jaw, and the two ends of the connecting rod are respectively fixed on the tooth fixing part and the guide plate body; a plurality of fixing holes used for determining the three-dimensional position of the retractor are formed in the guide plate body, first baffles protruding out of the guide plate body are arranged at the positions of the fixing holes, and bone nail guide grooves are formed in the surface of the guide plate body; the bone nail guide groove is formed by a strip-shaped groove formed in the guide plate body or a second baffle arranged on the guide plate body. After the fixing guide plate is implanted into a target position, a bone nail slides into the fixing hole along the bone nail guide groove, and the first baffle plate limits the bone nail to increase the accuracy, so that the fixing guide plate only needs to see the edge of the guide plate body close to the tooth side, the visual field exposure surface in an operation is reduced, the bone nail is guided to be in place from a minimally invasive intraoral incision, and the operation efficiency is improved. And safety and accuracy are both considered.

Description

Technical Field

[0001] The invention belongs to the technical field of mandibular distraction osteogenesis, and in particular relates to a tooth-supported mandibular distractor fixing guide plate and a manufacturing method thereof. Background Art

[0002] Mandibular distraction osteogenesis is a solution to many diseases such as mandibular deformity, hemifacial microsomia, and temporomandibular joint ankylosis. During the operation, a distractor position guide is placed, and the bone screws fall into the fixing holes on the distractor position guide, leaving bone screw holes on the mandible to determine the position of the subsequent distractor screw holes, so that the real distractor can be accurately fixed on the mandible for distraction, achieving the expected surgical effect.

[0003] Since the bone screws must accurately fall into the fixing holes on the distractor position guide, in previous mandibular distraction osteogenesis, a 3-4 cm extraoral incision is usually made in the mandibular area of ​​the patient's face. The intraoperative exposure is relatively clear, so that the fixing holes of the distractor position guide can be exposed. However, due to the surgical method of extraoral approach, especially the 3-4 cm incision on the patient's face, it is easy to cause facial scars, nerve damage, vascular damage, and bleeding risks. Summary of the invention

[0004] In response to the above-mentioned technical problems, the present invention provides a tooth-supported mandibular traction device fixing guide plate and a manufacturing method, wherein a bone screw guide groove from the edge to the fixing hole is provided on the guide plate body, and the guide groove is from the side edge close to the tooth fixing portion, so that during the operation, the bone screw can slide along the bone screw guide groove to the fixing hole position and then fall into the fixing hole, thereby eliminating the need to expose a larger surgical operating surface, and only requires the edge of the guide plate body close to the tooth side to be able to see, thereby reducing the surgical trauma surface of the patient.

[0005] To achieve the above object, the technical solution of the present invention is:

[0006] A tooth-supported mandibular traction device fixed guide plate, comprising: a tooth fixing part, a connecting rod and a guide plate body,

[0007] The tooth fixing part is fixed to part of the dentition of the mandible, and is used to fix the fixed guide plate. One end of the connecting rod is connected to the tooth fixing part, and the other end is connected to the guide plate body. The connecting rod is used to connect the tooth fixing part and the guide plate body.

[0008] The guide plate body has a plurality of fixing holes for determining the three-dimensional position of the retractor, a bone screw guide groove is provided on the first surface of the guide plate body and is connected to the fixing holes from the side of the guide plate body, and the side where the bone screw guide groove is provided is a side close to the tooth fixing part, and the first surface is the surface of the guide plate body away from the mandibular bone;

[0009] After the fixing guide plate is implanted in the target position, the bone screw slides into the fixing hole along the bone screw guide groove, and at the same time, a bone screw hole corresponding to the fixing hole is left at the target position.

[0010] Preferably, a first baffle protruding from the first surface is provided at the position of the fixing hole, and the first baffle is used to allow the bone screw to accurately fall into the fixing hole.

[0011] Preferably, the bone screw guide groove is formed by a strip groove opened on the guide plate body.

[0012] Preferably, the depth of the strip groove is half the thickness of the guide plate body.

[0013] Preferably, the bone screw guide groove is formed by providing a second baffle on the first surface of the guide plate body, and further the second baffle is connected with the first baffle.

[0014] Preferably, the guide plate body comprises an osteotomy groove for accommodating an electric saw blade.

[0015] Preferably, the guide plate body comprises a connecting portion, a fixing portion and an extending portion which are sequentially connected along the longitudinal direction, the connecting portion is connected to the connecting rod, and the osteotomy groove is provided in the fixing portion.

[0016] Preferably, the second surface of the fixing portion is an arc-shaped curved surface matching the curvature of the surface of the mandible, and the second surface is the surface of the guide plate body in contact with the maxillary bone.

[0017] Preferably, the second surfaces of the connecting portion and the extending portion are both arc-shaped curved surfaces, and the width of the fixing portion is larger than the width of the connecting portion and the width of the extending portion, respectively.

[0018] Preferably, the fixing holes are respectively distributed on the connecting portion, the fixing portion and the extending portion.

[0019] Preferably, the connecting portion and the extending portion are connected in an arc transition with the fixing portion, and the end of the extending portion is in an arc shape.

[0020] Based on the same inventive concept, the present invention also provides a method for manufacturing the above-mentioned tooth-supported mandibular distractor fixed guide plate, comprising the following steps:

[0021] (1) Perform 1:1 ratio 3D CT reconstruction of the mandible and mandibular teeth of the patient;

[0022] (2) Import a 1:1 scale distractor model, pre-bend the distractor model in three dimensions according to the shape of the mandibular model and the placement of the distractor model, and determine the osteotomy line position;

[0023] (3) Designing the guide plate body according to the surface contour of the mandibular bone model and designing the tooth fixing part according to the mandibular tooth model;

[0024] (4) Designing the fixing holes on the guide plate body according to the installation hole positions of the tractor model after pre-bending;

[0025] (5) designing an osteotomy groove on the guide plate body according to the determined osteotomy line position;

[0026] (6) A connecting rod is designed between the guide plate body and the tooth fixing part, and a bone screw guide groove is designed on the guide plate body. The designed fixed guide plate is then 3D printed to obtain a finished product.

[0027] Due to the adoption of the above technical solution, the present invention has the following advantages and positive effects compared with the prior art:

[0028] The tooth-supported mandibular traction device fixing guide plate provided by the present invention has a bone screw guide groove from the edge to the fixing hole on the guide plate body, and the bone screw guide groove is opened from the side edge close to the tooth fixing part. During the operation, the bone screw can slide along the bone screw guide groove to the fixing hole position and then fall into the fixing hole. There is no need to expose a large surgical operation surface. Only the edge of the guide plate body close to the tooth side needs to be seen, so that the bone screw can slide into the fixing hole along each guide groove without exposing the fixing hole. Therefore, the fixing guide plate of the present invention can adopt a surgical method from an intraoral approach to achieve a minimally invasive surgical method, which is safe, has little damage, and does not leave a scar on the patient's face. It is particularly friendly to patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0029] Figure 1 The structure of the fixed guide plate of the tooth-supported mandibular distractor of Example 1 of the present invention is shown in FIG. Figure 1 ;

[0030] Figure 2 The structure of the fixed guide plate of the tooth-supported mandibular distractor of Example 1 of the present invention is shown in FIG. Figure 2 ;

[0031] Figure 3 for Figure 1 Structural diagram of the guide plate body from another angle Figure 1 ;

[0032] Figure 4 for Figure 1 Structural diagram of the guide plate body from another angle Figure 2 ;

[0033] Figure 5 A postoperative facial photo of a patient after mandibular distraction osteogenesis using the tooth-supported mandibular distractor fixing guide plate of Example 1 of the present invention, wherein the postoperative photo is taken after the distractor is installed;

[0034] Figure 6 This is a postoperative facial photo of the patient after mandibular distraction osteogenesis using a traditional distractor fixation plate via an extraoral approach. The photo shows the postoperative photo after the distractor was installed.

[0035] Note: Figure 5 and Figure 6 All photos are from the Ninth People's Hospital affiliated to Shanghai Jiao Tong University.

[0036] Explanation of the reference numerals: 1-tooth fixing part; 2-connecting rod; 3-guide plate body; 301-fixing hole; 302-bone screw guide groove; 303-first baffle plate; 304-strip groove; 305-second baffle plate; 306-osteotomy groove; 307-fixing part; 308-extension part; 309-connecting part. DETAILED DESCRIPTION

[0037] The following is a further detailed description of a tooth-supported mandibular distractor fixing guide plate of the present invention in conjunction with the accompanying drawings and specific embodiments. The advantages and features of the present invention will become more apparent from the following description.

[0038] Example 1

[0039] See also Figure 1 and Figure 2 A tooth-supported mandibular traction device fixed guide plate comprises: a tooth fixing part 1, a connecting rod 2 and a guide plate body 3,

[0040] The tooth fixing part 1 is fixed to part of the dentition of the mandible, and is used to fix the fixed guide plate. One end of the connecting rod 2 is connected to the tooth fixing part 1, and the other end is connected to the guide plate body 3. The connecting rod 2 is used to connect the tooth fixing part 1 and the guide plate body 3;

[0041] The guide plate body 3 has a plurality of fixing holes 301 (the fixing holes 301 are through holes arranged on the guide plate body 3) for determining the three-dimensional position of the retractor. A bone screw guide groove 302 is arranged on the first surface of the guide plate body 3 and connected to the fixing holes 301 from the side of the guide plate body 3. The side where the bone screw guide groove 302 is arranged is the side close to the tooth fixing part 1. The first surface is the surface of the guide plate body 3 away from the mandibular bone, and the second surface is the surface of the guide plate body 3 close to the mandibular bone. The first surface and the second surface are parallel.

[0042] The tooth-supported mandibular distractor fixing guide plate of the present embodiment can be operated by intraoral approach. After the fixing guide plate is implanted in the oral cavity, the tooth fixing part 1 is fixed to part of the dentition of the mandibular anterior teeth, and then the bone screw slides into the fixing hole 301 along the bone screw guide groove 302. The bone screw guide groove 302 can be parallel to the horizontal line ( Figure 1 ) or have a certain inclination with the horizontal line ( Figure 2), the bone screw guide groove 302 can accommodate the bone screw to slide smoothly therein, providing a guide track for the bone screw to accurately enter the fixing hole 301. The setting of the guide groove can also prevent the bone screw from deviating from the track and provide guidance for the bone screw; the bone screw reaches the fixing hole 301, and then leaves a bone screw hole corresponding to the fixing hole 301 on the mandible.

[0043] It should be mentioned that the mandibular distractor fixing guide is designed to determine the implantation position of the distractor on the mandible, that is, to use the fixing holes 301 on the fixing guide to fix the distractor on the mandible with bone screws, thereby leaving bone screw holes on the mandible, and then remove the distractor fixing guide to implant the distractor. Therefore, an important purpose of implanting the distractor fixing guide is to accurately find the fixing hole 301. However, in order to accurately make the bone screw fall into the fixing hole 301, an extraoral approach with a larger surgical trauma surface is usually used clinically to ensure that the visual field is fully exposed during the operation. This is very unfriendly to patients and may leave a risk of scars. See Figure 6 After the operation, the patient had a long scar on the mandibular area of ​​his face.

[0044] In this embodiment, it is only necessary to set a bone screw guide groove 302 corresponding to each fixing hole 301 on the guide plate body 3, so that the surgical exposure surface is reduced, and only one side of the bone screw guide groove 302 needs to be exposed. Therefore, the tooth-supported mandibular distractor fixing guide plate of this embodiment can be suitable for the intraoral approach surgery. There is an incision of about 3-4 cm from the inside of the mouth, and the side of the fixing guide plate close to the teeth can be seen, and then the bone screw guide groove 302 can also be seen, guiding the bone screws to slide into the fixing holes 301 one by one. Therefore, for mandibular distraction osteogenesis, the patient's face only needs a minimally invasive incision of the distractor, which improves the safety of the operation, causes less damage to the patient, avoids leaving an incision outside the mouth on the face, and avoids facial scars, nerve damage, vascular damage, etc. (such as Figure 5 As shown in FIG. 1 ). Therefore, the traction device fixing guide plate of this embodiment only needs to increase the manufacturing cost of the bone screw guide groove 302, but greatly increases the safety of the operation and greatly reduces the pain of the patient.

[0045] In order to prevent the bone screw from passing over the fixing hole 301, a first baffle 303 protruding from the first surface is provided at the position of the fixing hole 301. The first baffle 303 is used to limit the position so that the bone screw can accurately fall into the fixing hole 301. The first baffle 303 can be a straight baffle tangent to the arc edge of the fixing hole 301, or it can be an arc baffle. When viewed from directly above the first surface of the guide body 3, the arc baffle overlaps with part of the arc edge of the fixing hole 301. For example, Figure 1-4 Schematic diagram of the first baffle 303.

[0046] See also Figure 3In one embodiment, the bone screw guide groove 302 is formed by a strip groove 304 provided on the guide plate body 3. Further preferably, in order to ensure the strength of the guide plate body 3, the depth of the strip groove 304 is half of the thickness of the guide plate body 3.

[0047] See also Figure 4 In another embodiment, the bone screw guide groove 302 is formed by providing a second baffle 305 on the first surface of the guide body 3, and further, the second baffle 305 is connected with the arc-shaped first baffle 303.

[0048] In order to ensure that the implantation position of the distractor and the osteotomy position are consistent with the design and to ensure the best treatment effect during mandibular distraction osteogenesis, in previous studies, the surgical guide was divided into two pieces, one osteotomy guide and the other is the distractor fixing guide of this embodiment. During the operation, the osteotomy guide is placed first to determine the osteotomy line; then the osteotomy guide is removed and the distractor fixing guide is placed to determine the position for subsequent osteotomy and bone screw holes. However, in clinical practice, both the osteotomy guide and the distractor fixing guide must be fixed separately, which is complicated to operate and requires the guide to be implanted twice.

[0049] In a preferred implementation of the present embodiment, the guide plate body 3 includes an osteotomy groove 306 for accommodating an electric saw blade, so as to determine the mandibular osteotomy position, thereby realizing the combination of two major functions of osteotomy and traction device fixation. During the operation, it is only necessary to implant and fix the guide plate once, which greatly speeds up the progress of the operation.

[0050] Preferably, the guide plate body 3 comprises a connecting portion 309 , a fixing portion 307 and an extending portion 308 which are sequentially connected along the longitudinal direction, the connecting portion 309 is connected to the connecting rod 2 , and the osteotomy groove 306 is provided in the fixing portion 307 .

[0051] The fixing part 307 fixes the mandible, and the osteotomy groove 306 determines the position of the osteotomy line. During the operation, bone screws are driven into the multiple fixing holes 301 to fix the guide plate body 3 to the mandible, and the bone screws in the multiple fixing holes 301 also uniquely determine the three-dimensional position of the tractor.

[0052] Preferably, the second surface of the fixing portion 307 is an arc-shaped curved surface matching the curvature of the surface of the mandible, and the second surface is the surface of the guide plate body 3 that contacts the maxillary bone.

[0053] Preferably, the second surfaces of the connecting portion 309 and the extending portion 308 are both arc-shaped surfaces, and the width of the fixing portion 307 is larger than the width of the connecting portion 309 and the width of the extending portion 308. The arc-shaped surfaces enable the connecting portion 309, the fixing portion 307 and the extending portion 308 to fit well with the surface on the mandible. By setting the maximum width at the fixing portion 307, the fixing portion 307 has a good fixing effect. The design of the connecting portion 309 and the extending portion 308 should not only meet a certain fixing effect, but also consider the interference with the operation, so the width is set slightly smaller. In order to further avoid interference with the operation or damage to the mandible, the connecting portion 309 and the extending portion 308 are respectively connected to the fixing portion 307 with an arc transition, and the end of the extending portion 308 is in an arc shape.

[0054] Preferably, the fixing holes 301 are respectively distributed in the connecting portion 309 , the fixing portion 307 , and the extending portion 308 .

[0055] Furthermore, the fixing portion 307 includes an upper fixing portion 307 and a lower fixing portion 307 , and an osteotomy groove 306 is formed between the upper fixing portion 307 and the lower fixing portion 307 , however, the present invention does not impose any limitation on this.

[0056] The traction device fixing guide plate provided in this embodiment is provided with a bone screw guide groove 302. On the one hand, the bone screw can accurately fall into each corresponding fixing hole 301, thereby increasing accuracy. On the other hand, the traction device fixing guide plate can be used to adopt a minimally invasive surgical method, thereby increasing surgical safety and avoiding facial nerve damage caused by external incisions. On the third hand, while achieving treatment needs, it will not cause scars on the face, thereby maintaining aesthetic appearance.

[0057] Example 2

[0058] The method for manufacturing the fixed guide plate of the tooth-supported mandibular distractor of Example 1 comprises the following steps:

[0059] (1) Perform 1:1 ratio 3D CT reconstruction of the mandible and mandibular teeth of the patient;

[0060] (2) Import a 1:1 scale distractor model, pre-bend the distractor model in three dimensions according to the shape of the mandibular model and the placement of the distractor model, and determine the osteotomy line position;

[0061] (3) designing the guide plate body 3 according to the surface contour of the mandibular bone model, and designing the tooth fixing part 1 according to the mandibular tooth model;

[0062] (4) Design the fixing hole 301 on the guide plate body 3 according to the installation hole position of the tractor model after pre-bending;

[0063] (5) Designing an osteotomy groove 306 on the guide plate body 3 according to the determined osteotomy line position;

[0064] (6) A connecting rod 2 is designed between the guide plate body 3 and the tooth fixing part 1, and a bone screw guide groove 302 is designed on the guide plate body 3. Then, the designed fixing guide plate is 3D printed to obtain a finished product.

[0065] The embodiments of the present invention are described in detail above in conjunction with the accompanying drawings, but the present invention is not limited to the above embodiments. Even if various changes are made to the present invention, if these changes fall within the scope of the claims of the present invention and their equivalents, they still fall within the protection scope of the present invention.

Claims

1. A tooth-supported mandibular distractor fixed guide plate, characterized in that: include: Tooth fixing part, connecting rod and guide plate body, The tooth fixing part is fixed to a part of the dentition of the mandible, one end of the connecting rod is the tooth fixing part, and the other end is connected to the guide plate body; The guide plate body has a plurality of fixing holes for determining the three-dimensional position of the retractor, a bone screw guide groove is provided on the first surface of the guide plate body and is connected to the fixing holes from the side of the guide plate body, and the side where the bone screw guide groove is provided is a side close to the tooth fixing part, and the first surface is the surface of the guide plate body away from the mandibular bone; After the fixing guide plate is implanted in the target position, the bone screw slides into the fixing hole along the bone screw guide groove.

2. The tooth-supported mandibular distractor fixed guide plate according to claim 1, characterized in that: A first baffle protruding from the first surface is arranged at the position of the fixing hole, and the first baffle is used to make the bone screw fall into the fixing hole accurately.

3. The tooth-supported mandibular distractor fixing guide plate according to claim 1 or 2, characterized in that: The bone screw guide groove is formed by a strip groove opened on the guide plate body.

4. The tooth-supported mandibular distractor fixing guide plate according to claim 3, characterized in that: The depth of the strip groove is half of the thickness of the guide plate body.

5. The tooth-supported mandibular distractor fixing guide plate according to claim 1 or 2, characterized in that: The bone screw guide groove is formed by arranging a second baffle on the first surface of the guide plate body.

6. The tooth-supported mandibular distractor fixing guide plate according to claim 1 or 2, characterized in that: The guide plate body includes a osteotomy slot for accommodating an electric saw blade.

7. The tooth-supported mandibular distractor fixing guide plate according to claim 3, characterized in that: The guide plate body includes a connecting portion, a fixing portion and an extending portion which are sequentially connected along the longitudinal direction, the connecting portion is connected to the connecting rod, the osteotomy groove is arranged in the fixing portion, and the fixing holes are respectively distributed in the connecting portion, the fixing portion and the extending portion.

8. The tooth-supported mandibular distractor fixed guide plate according to claim 3, characterized in that: The second surface of the fixing portion is an arc-shaped curved surface matching the curvature of the surface of the mandible, and the second surface is the surface of the guide plate body in contact with the maxillary bone.

9. The tooth-supported mandibular distractor fixing guide plate according to claim 5, characterized in that: The second surfaces of the connecting portion and the extending portion are both arc-shaped curved surfaces, and the width of the fixing portion is respectively greater than the width of the connecting portion and the width of the extending portion.

10. A method for manufacturing a fixed guide plate of a tooth-supported mandibular distractor according to any one of claims 1 to 9, characterized in that: The following steps are involved: (1) Perform 1:1 ratio 3D CT reconstruction of the mandible and mandibular teeth of the patient; (2) Import a 1:1 scale distractor model, pre-bend the distractor model in three dimensions according to the shape of the mandibular model and the placement of the distractor model, and determine the osteotomy line position; (3) Designing the guide plate body according to the surface contour of the mandibular bone model and designing the tooth fixing part according to the mandibular tooth model; (4) Designing the fixing holes on the guide plate body according to the installation hole positions of the tractor model after pre-bending; (5) designing an osteotomy groove on the guide plate body according to the determined osteotomy line position; (6) A connecting rod is designed between the guide plate body and the tooth fixing part, and a bone screw guide groove is designed on the guide plate body. The designed fixed guide plate is then 3D printed to obtain a finished product.

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