Attached gingiva broadening device for oral implant repair and use method

Abstract

The invention discloses an attached gingival broadening device for oral implant repair and a use method. The attached gingival broadening device comprises a soft tissue fixing nail head; the lower end of the soft tissue fixing nail head is provided with a soft tissue fixing nail neck part, and the middle of the upper end is provided with a fixing thread groove in threaded connection with the support fixing nail tail; a soft tissue fixing nail tail is arranged at the lower end of the soft tissue fixing nail neck part; a bracket fixing nail head is arranged at the upper end of the bracket fixing nail; the device can be directly inserted into a root retention valve and graft tissue to form mechanical locking fixation, so that the graft displacement risk caused by tissue elastic retraction or suture loosening in a traditional suture technology is avoided, the operation process is effectively simplified, and compared with an attached gingival widening operation which depends on a traditional suture technique, the operation efficiency is greatly improved. According to the invention, the risk of graft necrosis caused by inaccurate suturing and the probability of operation failure caused by the problems of insufficient stability of a recipient area and the like are obviously reduced, so that the success rate and the safety of an operation are greatly improved.

Description

Technical Field

[0001] The present invention belongs to the technical field of oral implant restoration, and in particular relates to an attached gingival widener for oral implant restoration and a method of use. Background Art

[0002] Oral implant restoration is widely used in clinical practice for patients with missing or defective edentulous teeth. The long-term efficacy and comfort of implant restoration are the most important concerns of patients. The soft tissue around the implant plays a vital role in the function, aesthetics and long-term stability of dental implants. As an important tissue to protect the health of periodontal tissues, attached gingiva can effectively resist mechanical stimulation and reduce plaque retention, affecting the long-term stability of implants and the aesthetic effect of implant restoration. Lack of attached gingiva will lead to the accumulation of plaque around implants, reduce the resistance of implants to external stimuli, increase the probability of peri-implant inflammation, and ultimately lead to implant loosening and implant restoration failure.

[0003] In the existing technology, traditional surgical methods for widening attached gingiva mainly include free gingival grafting, lateral transposition flap surgery, etc. Although free gingival grafting can increase the width of attached gingiva, it has problems such as long postoperative healing time and pain in the donor site wound; lateral transposition flap surgery has high requirements for the conditions of the donor and recipient sites, and may cause the attached gingiva of the donor site teeth to become narrower; these methods have high technical requirements for doctors during operation, are difficult to operate, and have certain uncertainties in postoperative stability; at the same time, in existing attached gingival widening surgeries, there is a lack of devices specifically used to fix and protect the recipient site. During the operation, the fixation and protection of the tissue flap mainly rely on suturing technology, which causes the tissue flap to shift or become unstable after the operation, affecting the healing effect; in addition, the lack of protective measures for the recipient site can easily lead to postoperative infection and tissue damage;

[0004] Therefore, in response to the above-mentioned existing technical problems, this solution proposes an attached gingival widener for oral implant restoration and a method of use. Summary of the Invention

[0005] In order to solve the above-mentioned problems in the prior art, the present invention designs an attached gingival widener for oral implant restoration. The invention fixes the patient's root-facing retention flap and graft by providing a soft tissue fixation pin, thereby ensuring the stability of the retention flap during subsequent operations, providing a good foundation for the implantation and healing of the graft, and preventing the graft from shifting or falling off, ensuring that it is in full contact with the recipient tissue. At the same time, a fixing thread groove is provided at the upper end of the soft tissue fixation pin to threadably connect the bracket fixing pin, and the adjusted protective bracket is fixed to the soft tissue fixation pin, so that the bracket can be stably maintained in the correct position.

[0006] In order to achieve the above technical effects, the present invention is implemented by the following technical solutions: an attached gingival widener for oral implant restoration and a method of use, comprising: a soft tissue fixation nail head;

[0007] The lower end of the soft tissue fixing nail head is provided with a soft tissue fixing nail neck, and the middle part of the upper end is provided with a fixed thread groove for threaded connection with the bracket fixing nail tail; the lower end of the soft tissue fixing nail neck is provided with a soft tissue fixing nail tail;

[0008] A bracket fixing nail head is provided at the upper end of the bracket fixing nail;

[0009] Furthermore, the diameter of the bracket fixing nail tail is slightly smaller than the fixing thread groove, and the two are transition fit;

[0010] Furthermore, the connection between the neck of the soft tissue fixation nail and the tail and head of the soft tissue fixation nail adopts a rounded transition, and the neck is tapered, gradually narrowing from the tail to the head;

[0011] Furthermore, the soft tissue fixation nail tail and the stent fixation nail tail are both provided with triangular threads, and the thread lead angle is smaller than the equivalent friction angle, so that they can be self-locking;

[0012] Furthermore, a hexagonal groove is provided on the upper end of the bracket fixing nail head;

[0013] In another aspect, the present invention discloses a method for using a widening device for attached gingiva for oral implant restoration, comprising the following steps:

[0014] S1: First, prepare a half-thickness flap at the recipient site according to surgical requirements. Use a soft tissue fixation nail head and insert the lower end of the soft tissue fixation nail into the radicular flap and the bone tissue at its retention site. Self-locking fixation is achieved through the triangular thread on the soft tissue fixation nail tail to ensure the stability of the radicular flap. Use appropriate periodontal suturing techniques to ensure closure of the graft recipient wound margin.

[0015] S2: Place the selected graft at the corresponding position of the recipient site; if it is a free gingival graft, complete the graft preparation in the second surgical area; if a ready-made graft is used, cut and trim the graft to the appropriate size of the recipient site;

[0016] S3: Use the soft tissue fixation nail head and insert the soft tissue fixation nail tail at the lower end into the graft and the bone tissue of the retention area. The graft is fixed in the prepared recipient area and the corresponding periodontal suturing technique is used to ensure a close fit between the graft and the recipient area.

[0017] S4: Try on the personalized recipient area protection bracket prepared in advance, and perform necessary trimming and fine-tuning according to the actual situation to ensure that the bracket fits well with the recipient area tissue and there is light or no pressure;

[0018] S5: Thread the bracket fixing nail tail into the fixing thread groove of the soft tissue fixing nail head, tighten the bracket fixing nail through the hexagonal slot on the bracket fixing nail head, and firmly fix the protective bracket on the soft tissue fixing nail head so that the bracket applies appropriate light pressure to the affected tissue.

[0019] The beneficial effects of the present invention are:

[0020] The triangular self-locking thread of the soft tissue fixation nail tail of the present invention can be directly inserted into the root-retaining flap and graft tissue to form a mechanical lock fixation. Combined with suturing technology, it avoids the risk of graft displacement caused by tissue elastic retraction or suture loosening during single suturing, ensures that the graft and the recipient tissue are closely attached, and provides a stable microenvironment for vascularized healing.

[0021] At the same time, the stent fixation nail is connected to the soft tissue fixation nail head through a fixed thread groove, accurately positioning the personalized protective stent in the recipient area, effectively resisting mechanical interference such as saliva flow and tongue movement in the mouth, and reducing shear force and traction damage to the graft;

[0022] Finally, both the soft tissue fixation nail tail and the bracket fixation nail tail are equipped with triangular threads, and the thread lead angle is less than the equivalent friction angle, forming a mechanical self-locking effect; when inserted into the bone tissue, the thread and the bone tissue are physically engaged, and the thread increases the pull-out resistance, so that the fixation nail is stably anchored in the bone tissue to avoid displacement; combined with periodontal suturing technology, the root-repositioned flap and graft are ensured to be stable, avoiding displacement due to elastic retraction of tissue or loose sutures, and providing a stable microenvironment for close fit between the graft and the recipient tissue and vascularized healing. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the following briefly introduces the drawings required for describing the embodiments.

[0024] Figure 1 It is a schematic diagram of the overall structure of an attached gingival widener for oral implant restoration and its use method;

[0025] Figure 2 A cross-sectional view of a soft tissue fixation nail head for an attached gingival widener for oral implant restoration and a method of use;

[0026] Figure 3 This is a schematic diagram of a bracket fixing nail head structure of an attached gingival widener for oral implant restoration and a method of use;

[0027] Figure 4 A schematic diagram of a graft fixation method for an attached gingival widener for oral implant restoration and its method of use;

[0028] Figure 5This is a schematic diagram of a structure of a protective bracket fixing method for an attached gingival widener for oral implant restoration and its use method;

[0029] In the accompanying drawings, the components represented by the reference numerals are as follows:

[0030] 1-soft tissue fixation nail tail, 2-soft tissue fixation nail head, 3-bracket fixation nail head, 4-hexagonal slot, 6-fixation thread groove, 7-soft tissue fixation nail neck, 8-bracket fixation nail tail, 9-prepared recipient area, 10-graft, 11-protective bracket. DETAILED DESCRIPTION

[0031] The present invention discloses an attached gingival widening device for oral implant restoration and a method for using the device, comprising: a soft tissue fixing nail head 2; a soft tissue fixing nail neck 7 is provided at the lower end of the soft tissue fixing nail head 2, and a fixing thread groove 6 is provided in the middle of the upper end for threaded connection with a bracket fixing nail tail 8; a soft tissue fixing nail tail 1 is provided at the lower end of the soft tissue fixing nail neck 7; a bracket fixing nail head 3 is provided at the upper end of the bracket fixing nail; the device can be directly inserted into the root-mounted retaining flap and the graft 10 tissue to form a mechanical locking fixation, thereby avoiding the risk of graft 10 displacement caused by tissue elastic retraction or suture loosening in traditional suturing techniques.

[0032] The technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention; it is obvious that the described embodiments are only part of the embodiments of the present invention, rather than all the embodiments.

[0033] Example 1

[0034] like Figure 1-3 As shown, the lower end of the soft tissue fixation nail head 2 is provided with a soft tissue fixation nail neck 7, and the middle part of the upper end is provided with a fixed thread groove 6 threadedly connected to the bracket fixing nail tail 8; the lower end of the soft tissue fixation nail neck 7 is provided with a soft tissue fixation nail tail 1;

[0035] A bracket fixing nail head 3 is provided at the upper end of the bracket fixing nail;

[0036] Furthermore, the diameter of the bracket fixing nail tail 8 is slightly smaller than the fixing thread groove 6, and the two are transition fit;

[0037] Furthermore, the rounded corner transition is adopted at the connection between the soft tissue fixation nail neck 7 and the soft tissue fixation nail tail 1 and the soft tissue fixation nail head 2. The neck is tapered and gradually narrows from the tail to the head. This avoids the stress concentration that may be caused by traditional right-angle or sharp-angle connections, reduces cutting, tearing or pulling damage to the soft tissue during insertion, reduces the risk of postoperative inflammation, pain and tissue necrosis, and provides a healthier healing environment for the graft 10 and the retention flap. At the same time, the neck gradually narrows from the tail to the head, forming a smooth and streamlined profile. During insertion, it can be naturally advanced along the direction of tissue fibers, reducing hard damage to collagen fibers, and reducing tissue trauma and postoperative scar formation.

[0038] Furthermore, both the soft tissue fixation nail tail 1 and the stent fixation nail tail 8 are provided with triangular threads, and the thread lead angle is less than the equivalent friction angle, which can be self-locking. In actual use, self-tapping threads are used and the thread lead angle is adjusted to ensure effective fixation in soft tissue while reducing tissue damage. In addition, microstructures (such as barbs) can be added to the thread surface to increase the pull-out resistance.

[0039] Furthermore, a hexagonal slot 4 is provided at the upper end of the stent fixing nail head 3; a rotational torque is applied by a hexagonal wrench to ensure that the stent fixing nail is tightly engaged with the fixing thread groove 6 of the soft tissue fixing nail. When operating in a narrow surgical area of ​​the oral cavity, the hexagonal tool has the advantages of high precision and stable force application, which can avoid uneven torque or slippage caused by manual operation, ensure that the screw-in depth and tightening force of the stent fixing nail are controllable, thereby accurately adjusting the pressure of the protective stent 11 on the affected area;

[0040] In actual manufacturing, under the premise of meeting the minimum insertion depth of the hexagonal wrench head, the groove depth is shortened as much as possible, and the opposite side size of the hexagonal socket is reduced to reduce the space for accommodating food residues. The groove bottom is designed to be arc-shaped to avoid the formation of dead corners at right angles and enhance the fatigue strength of the groove bottom.

[0041] In this embodiment, the soft tissue fixation pin is made of biocompatible materials such as titanium alloy or pure magnesium in actual use. Titanium alloy is widely used in oral implantation and has good biocompatibility and mechanical strength.

[0042] Example 2

[0043] This embodiment provides an implementation form of an attached gingival widener for oral implant restoration and a method of use; Figure 1-5 As shown, the lower end of the soft tissue fixation nail head 2 is provided with a soft tissue fixation nail neck 7, and the middle part of the upper end is provided with a fixed thread groove 6 threadedly connected to the bracket fixing nail tail 8; the lower end of the soft tissue fixation nail neck 7 is provided with a soft tissue fixation nail tail 1;

[0044] A bracket fixing nail head 3 is provided at the upper end of the bracket fixing nail;

[0045] Furthermore, the diameter of the bracket fixing nail head 8 is slightly smaller than the fixing thread groove 8, and the two are transition fit;

[0046] Furthermore, the connection between the soft tissue fixation nail neck 7 and the soft tissue fixation nail tail 1 and the soft tissue fixation nail head 2 adopts a rounded transition, and the neck is tapered, gradually narrowing from the tail to the head;

[0047] Furthermore, the soft tissue fixing nail tail 1 and the stent fixing nail tail 8 are both provided with triangular threads, and the thread lead angle is smaller than the equivalent friction angle, and can be self-locking;

[0048] Furthermore, a hexagonal groove 4 is provided on the upper end of the bracket fixing nail head 3;

[0049] In another aspect, the present invention discloses a method for using a widening device for attached gingiva for oral implant restoration, comprising the following steps:

[0050] S1: First, prepare a half-thickness flap at the recipient site according to surgical requirements. Use a soft tissue fixation nail head and insert the lower end of the soft tissue fixation nail into the radicular flap and the bone tissue at its retention site. Self-locking fixation is achieved through the triangular thread on the soft tissue fixation nail tail to ensure the stability of the radicular flap. Use appropriate periodontal suturing techniques to ensure closure of the graft recipient wound margin.

[0051] Depending on the extent of the gingival deficiency, autologous free gingiva, acellular dermal matrix, or allogeneic freeze-dried gingival flap can be used. The graft 10 should be trimmed to a size that is 1-2 mm wider than the recipient area and long enough to cover the alveolar bone surface exposed after the root-retaining flap is repositioned. The graft 10 should be laid flat on the bone tissue surface of the recipient area, with the edge aligned with the root-retaining edge of the semi-thickness flap, ensuring that the central area covers the implant neck. Use tweezers to gently press and expel air bubbles underneath, keeping the graft 10 flat and wrinkle-free.

[0052] In this embodiment, the depth of the semi-thickness flap preparation must be strictly controlled to avoid damaging the blood supply of the bone tissue; the edge of the graft 10 exceeds the boundary of the recipient area to increase the healing contact area and improve the survival rate;

[0053] S2: Place the selected graft at the corresponding position of the recipient site; if it is a free gingival graft, complete the graft preparation in the second surgical area; if a ready-made graft is used, cut and trim the graft to the appropriate size of the recipient site;

[0054] S3: Use the soft tissue fixation nail head 2 to insert the soft tissue fixation nail tail at its lower end into the graft and the bone tissue of the retention area. The graft is fixed in the prepared recipient area and the corresponding periodontal suturing technique is used to ensure a close fit between the graft and the recipient area.

[0055] Retaining flap: Select the specifications of the fixing nail according to the thickness of the gingival flap: for thin flaps (≤1.5mm), use a nail with a diameter of 0.8mm and a length of 3mm; for thick flaps, use a nail with a diameter of 1.0mm and a length of 4mm. Ensure that the threaded section at the tail of the nail (including the triangular self-locking thread) is completely embedded in the tissue.

[0056] Mark 2-3 implantation points in the middle and mesiodistal thirds of the root-retaining flap, 1.5-2 mm from the flap edge. Generally, a triangular distribution is more stable and can disperse stress.

[0057] Implantation procedure: Quickly insert the nail tail perpendicular to the flap surface, stop when you feel a sudden decrease in resistance, and penetrate the full thickness of the graft, ensuring that the tapered section of the nail neck is completely inserted into the tissue, the nail head is flush with the flap surface, and the nail tail is stabilized by the bone tissue below the recipient area. During the operation, be careful not to damage the roots of adjacent teeth;

[0058] Gently pull the edge of the flap to observe whether the fixation pin moves with the tissue. If it is loose, adjust the angle and re-implant it, or re-implant a fixation pin 1 mm away from the original pin path.

[0059] Graft: 2-3 fixation screws are implanted around the graft 10 at least 1 mm from the edge, with a spacing of at least 3-4 mm. The threaded end of the screw completely penetrates the entire layer of the graft 10 and penetrates the underlying bone tissue, using micro-anchoring between the thread and the bone to enhance stability. If the graft 10 is larger than 10 mm x 10 mm, 1-2 additional fixation screws are required in the central area to prevent the central area from being overhanging or poorly fitted.

[0060] During the implantation process, the fit between the graft 10 and the bone tissue of the recipient area is observed under a microscope. If wrinkles are present, the adjacent fixation pins can be unscrewed and the position readjusted to ensure that the graft 10 fits without tension.

[0061] S4: Try on the personalized recipient area protection bracket 11 prepared in advance, and perform necessary trimming and fine-tuning according to the actual situation to ensure that the bracket fits well with the recipient area tissue;

[0062] Before surgery, an intraoral scanner was used to obtain three-dimensional data of the recipient area, and the alveolar bone contour was determined in combination with CBCT. The stent was then designed with a thickness of 1.5 mm, an edge 2 mm from the recipient area boundary, and a contact area with adjacent teeth reserved.

[0063] Gently place the bracket on the affected area and observe whether the edge compresses the lip and cheek frenulum or the mylohyoid ridge. Mark the tender area with methylene blue dyed paper and use a high-speed tungsten steel bur to grind away the raised part until the bracket can be placed in place without pressure.

[0064] S5: Thread the bracket fixing nail tail 8 into the fixing thread groove 6 of the soft tissue fixing nail head 2, tighten the bracket fixing nail through the hexagonal socket 4 on the bracket fixing nail head 3, and firmly fix the protective bracket 11 on the soft tissue fixing nail head 2, so that the bracket applies appropriate light pressure to the affected tissue;

[0065] After checking that the fixing points of the stent are not loose, apply medical glass ionomer cement to the contact area between the edge of the stent and the soft tissue to form a 0.5mm thick sealing layer to prevent food debris from entering.

[0066] Example 3

[0067] This embodiment provides another preferred embodiment of the neck size of a soft tissue retention nail;

[0068] Retained attached gingival graft:

[0069] Applicable situations: fixation of free gingival grafts, allogeneic gingival flaps and other grafts. The graft thickness is usually 1-2mm and needs to be fixed 2mm below the bone tissue in the recipient area.

[0070] Smooth neck width: 2-3mm, graft thickness (1-2mm), recipient bone and connective tissue thickness (about 1mm), total fixation depth about 2mm;

[0071] The width of the neck covers the entire graft layer and part of the superficial bone tissue, ensuring that the threaded section of the nail body is completely embedded in the graft, while the smooth section supports the surface of the graft, preventing the thread from penetrating the top of the graft, causing exposure or irritation to the oral mucosa;

[0072] It can accurately match the thickness of the graft to avoid the fixation nail being too deep to damage the blood supply of the bone tissue or too shallow to cause loose fixation. The smooth section fits the graft surface, dispersing the lateral force during occlusion and reducing the torsion of the graft caused by uneven force.

[0073] Retained root-reduction flap

[0074] Applicable situations: Fixation of soft tissue flaps such as lateral transposition flap surgery and root reposition flap surgery. The flap thickness is usually 1-2mm and needs to be fixed to the root quadrate bone tissue;

[0075] Smooth neck width: 3-5mm;

[0076] The thickness of the radicular reduction flap is 1-2 mm, the thickness of the bone tissue and connective tissue in the fixation area is about 1-2 mm, the depth of intraosseous retention is 2 mm, the width of the neck extends to the deep layer of bone tissue, and the threaded section can be anchored to the superficial bone tissue below the bone tissue, providing stronger mechanical retention force;

[0077] The longer smooth segment can penetrate the entire flap layer and deep into the bone tissue. The dual fixation mechanism of the thread anchoring the bone tissue and the smooth segment squeezing the soft tissue resists the rotational displacement of the flap caused by chewing. The tapered neck reduces the pulling damage to the flap pedicle during insertion and protects the blood supply of the flap.

[0078] In summary, the triangular self-locking thread of the soft tissue fixation nail tail 1 of the present invention can be directly inserted into the root-retaining flap and the graft 10 tissue to form a mechanical lock fixation, thereby avoiding the risk of graft 10 displacement caused by tissue elastic retraction or suture loosening in traditional suturing techniques, ensuring that the graft 10 is closely attached to the recipient tissue, and providing a stable microenvironment for vascularized healing;

[0079] At the same time, the stent fixing nail is connected to the soft tissue fixing nail head 2 through the fixing thread groove 6, accurately positioning the personalized protective stent 11 in the affected area, effectively resisting mechanical interference such as saliva flow and tongue movement in the oral cavity, and reducing shear force and pulling damage to the graft 10;

[0080] Finally, both the soft tissue fixation nail tail and the bracket fixation nail tail are equipped with triangular threads, and the thread lead angle is less than the equivalent friction angle, forming a mechanical self-locking effect; when inserted into the bone tissue, the thread and the bone tissue are physically engaged, and the thread increases the pull-out resistance, so that the fixation nail is stably anchored in the bone tissue to avoid displacement; combined with periodontal suturing technology, the root-repositioned flap and graft are ensured to be stable, avoiding displacement due to elastic retraction of tissue or loose sutures, and providing a stable microenvironment for close fit between the graft and the recipient tissue and vascularized healing.

[0081] The preferred embodiments of the present invention disclosed above are only used to help illustrate the present invention. The preferred embodiments do not describe all details in detail, nor do they limit the invention to only the specific implementation methods described.

Claims

1. A device for widening attached gingiva for oral implant restoration, characterized in that: include: soft tissue fixation nail heads; The lower end of the soft tissue fixing nail head is provided with a soft tissue fixing nail neck, and the middle part of the upper end is provided with a fixed thread groove for threaded connection with the bracket fixing nail tail; the lower end of the soft tissue fixing nail neck is provided with a soft tissue fixing nail tail; A bracket fixing nail head is provided at the upper end of the bracket fixing nail.

2. According to the attached gingiva widener for oral implant restoration according to claim 1, the diameter of the bracket fixing nail tail is slightly smaller than the fixing thread groove, and the two are transitionally matched.

3. According to the attached gingiva widener for oral implant restoration according to claim 1, the soft tissue fixation nail neck adopts a rounded transition at the connection between the soft tissue fixation nail tail and the soft tissue fixation nail head, and the neck is conical, gradually narrowing from the tail to the head.

4. According to the attached gingival widener for oral implant restoration described in claim 1, triangular threads are provided on the soft tissue fixing nail tail and the bracket fixing nail tail, and the thread lead angle is less than the equivalent friction angle, and can be self-locking.

5. According to the attached gingiva widener for oral implant restoration according to claim 3, a hexagonal slot is provided on the upper end of the bracket fixing nail head.

6. A method for using the attached gingiva widener for oral implant restoration according to claims 1-5, characterized in that: The following steps are involved: S1: First, prepare a half-thickness flap at the recipient site according to surgical requirements. Use a soft tissue fixation nail head and insert the lower end of the soft tissue fixation nail into the radicular flap and the bone tissue at its retention site. Self-locking fixation is achieved through the triangular thread on the soft tissue fixation nail tail to ensure the stability of the radicular flap. Use appropriate periodontal suturing techniques to ensure closure of the graft recipient wound margin. S2: Place the selected graft at the corresponding position of the recipient site; if it is a free gingival graft, complete the graft preparation in the second surgical area; if a ready-made graft is used, cut and trim the graft to the appropriate size of the recipient site; S3: Use the soft tissue fixation nail head and insert the soft tissue fixation nail tail at the lower end into the graft and the bone tissue of the retention area. The graft is fixed in the prepared recipient area and the corresponding periodontal suturing technique is used to ensure a close fit between the graft and the recipient area. S4: Try on the personalized recipient area protection bracket prepared in advance, and perform necessary trimming and fine-tuning according to the actual situation to ensure that the bracket fits well with the recipient area tissue and there is light or no pressure; S5: Thread the bracket fixing nail tail into the fixing thread groove of the soft tissue fixing nail head, tighten the bracket fixing nail through the hexagonal slot on the bracket fixing nail head, and firmly fix the protective bracket on the soft tissue fixing nail head so that the bracket applies appropriate light pressure to the affected tissue.

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