Disk preserving condylar resurfacing prosthesis

Abstract

The application discloses a disc-preserving condylar side reconstruction prosthesis, which comprises a fixed base and a reconstruction unit, one end of the reconstruction unit is connected with the fixed base, a plurality of connecting screws for connecting external tissues are arranged on the fixed base, and a bearing surface which is matched with a natural temporomandibular joint disc is arranged on the reconstruction unit; when the prosthesis is implanted, the fixed base is fixed to the residual end of the mandibular ramus through the connecting screws, one end of the reconstruction unit is connected with the fixed base, the bearing surface at the other end of the reconstruction unit is matched with the natural temporomandibular joint disc, thereby, stable support is provided below the natural joint fossa, and then the condylar side height is recovered; compared with the conservative treatment mode, the application can actively recover the condylar side height and the vertical support of the ramus, compared with the total temporomandibular joint replacement, the application can retain the original tissues as much as possible, reduce the implantation range and the tissue sacrifice range, and reduce the wound surface of the prosthesis implantation.

Description

Technical Field

[0001] This application relates to the field of oral medical device technology, specifically to a disc-preserving condylar reconstruction prosthesis. Background Technology

[0002] Currently, the surgical treatment of condylar head fractures is mainly based on the premise that the fracture fragments can be reduced and stably internally fixed. For cases with large condylar head fragments, fragments still attached to soft tissues such as muscles, or cases where stable fixation can be achieved through screws or bone plates, open reduction and internal fixation are used. At the same time, the articular disc is reduced, sutured, or anchored according to the displacement of the articular disc, in order to restore the anatomical relationship between the condylar head, articular disc, and articular fossa as much as possible. However, the above treatment methods are based on the existence of usable, reducible, and fixable condylar head fragments. If the condylar head is severely comminuted, the fragments are small, free, or cannot form stable fixation, conventional open reduction and internal fixation and articular disc anchoring techniques will be difficult to achieve high degree of restoration, bony stability, and maintenance of the disc-fossa relationship at the same time.

[0003] For severe comminuted condylar head fractures that cannot be stably internally fixed, current treatment methods generally tend towards conservative treatment, functional treatment, fragment removal, or total temporomandibular joint replacement when the joint structure is severely damaged. While conservative or functional treatment can avoid implant-related risks, it is difficult to actively restore condylar height and vertical support of the ramus, which may lead to decreased ramus height, mandibular deviation, unstable occlusion, lack of support under the articular disc, and secondary joint degeneration. Total temporomandibular joint replacement can reconstruct the joint motion interface and vertical height through artificial condyles and artificial glenoid fossae, but it requires replacing the natural glenoid fossa, establishing artificial joint friction pairs, and sacrificing the natural glenoid fossa and glenoid fossa structures that may still have preservation value. For cases where the disc and fossa structures can still be preserved after acute trauma, direct total joint replacement may have problems such as excessive implantation area, excessive tissue sacrifice, increased bone reshaping, and complex subsequent revision. Summary of the Invention

[0004] The main purpose of this application is to provide a disc-preserving condylar reconstruction prosthesis, which aims to solve the defects of existing technologies such as excessive tissue sacrifice and excessive implantation range.

[0005] This application achieves the above objectives through the following technical solutions: A disc-preserving condylar reconstruction prosthesis includes: A fixed base is provided with a plurality of connecting screws for connecting external tissues; The reconstruction unit has one end connected to the fixed base; the reconstruction unit also has a bearing surface that fits against the natural temporomandibular joint disc.

[0006] Optionally, the reconstructive prosthesis may also include a pre-installed anchoring assembly, one end of which is connected to the fixation base and the other end of which is used to connect to the natural temporomandibular joint disc.

[0007] Optionally, the pre-installed anchoring assembly includes at least one pre-installed anchoring rope, with an anchoring hole provided on the fixing base. One end of the anchoring rope is connected to the anchoring hole, and the other end is connected to the natural temporomandibular joint disc.

[0008] Optionally, the fixation base includes a base plate, and the fixation base is provided with at least three connecting screw holes, each of which is provided with a connecting screw; the fixation base is provided with a bone contact surface adapted to external tissue.

[0009] Optionally, a bone-bonding reinforcement layer adapted to external tissues is provided on the bone contact surface.

[0010] Optionally, the reconstruction unit includes an integrally connected bearing end and a connecting end, wherein the outer surface of the bearing end is the bearing surface; and the connecting end is connected to the fixed base.

[0011] Optionally, the bearing end can be spherical, ellipsoidal, flattened, column-cap shaped, or other anatomical shapes that fit the natural temporomandibular joint disc.

[0012] Optionally, a wear-resistant coating is provided on the bearing surface, the wear-resistant coating including CoCrMo, Pyrocarbon, PEEK, PEKK, CFR-PEEK, UHMWPE, zirconia ceramic, DLC coating, TiN coating or other biocompatible coatings suitable for frictional contact with the natural temporomandibular joint disc.

[0013] Optionally, a connecting hole is provided on the fixed base, and the connecting end is inserted into the connecting hole; a fixing screw adapted to the connecting end is also provided in the connecting hole.

[0014] Optionally, around the axis of the connecting hole, at least one limiting groove is provided in the connecting hole, and a limiting block adapted to the limiting groove is provided on the connecting end.

[0015] Compared with the prior art, this application has the following beneficial effects: This application includes a fixed base and a reconstruction unit. One end of the reconstruction unit is connected to the fixed base. The fixed base is provided with a plurality of connecting screws for connecting external tissues. The reconstruction unit is provided with a bearing surface that conforms to the natural temporomandibular joint disc. During prosthesis implantation, the fixation base is fixed to the mandibular ramus stump with connecting screws. One end of the reconstruction unit is connected to the fixation base, while the bearing surface of the other end is aligned with the natural temporomandibular joint disc, thereby providing stable support below the natural glenoid fossa and restoring condylar height.

[0016] Compared with the conservative treatment methods in the prior art, the reconstruction prosthesis described in this application can reconstruct the bony support of the condyle side, thereby actively restoring the height of the condyle side and the vertical support of the ramus, thus avoiding the decrease in the height of the ramus, mandibular deviation, unstable occlusal relationship, lack of support under the articular disc and secondary joint degeneration, and improving the treatment effect. Compared with total temporomandibular joint replacement, the reconstruction prosthesis of this application can reuse tissue structures with preservation value (such as natural glenoid fossa and glenoid fossa) as much as possible during the implantation process, thereby preserving the original tissue as much as possible, reducing the implantation range and the area of ​​tissue sacrifice, and reducing the wound area of ​​prosthesis implantation. At the same time, this application can also minimize the volume of the prosthesis, avoid subsequent complications caused by the prosthesis, and improve the treatment effect; that is, the reconstruction prosthesis described in this application has the advantages of conservative treatment and total temporomandibular joint replacement in the prior art, and overcomes their respective defects, realizing condylar reconstruction. Attached Figure Description

[0017] Figure 1 This is a schematic diagram of the structure of a condylar reconstruction prosthesis with disc preservation type disclosed in this application; Figure 2 This is an exploded view of a condylar reconstruction prosthesis with a condylar support structure disclosed in this application; Figure 3 This is a cross-sectional view of a condylar reconstruction prosthesis with disc preservation type disclosed in this application; Figure 4 This is a diagram showing the usage status of a disc-preserving condylar reconstruction prosthesis disclosed in this application; Reference numerals: 1-Fixed base, 2-Connecting screw, 3-Reconstruction unit, 4-Bearing surface, 5-Anchor rope, 6-Anchor hole, 7-Connecting screw hole, 8-Bone contact surface, 9-Bone integration reinforcement layer, 10-Wear-resistant coating, 11-Connecting hole, 12-Fixed screw, 13-Limiting groove, 14-Limiting block, 301-Bearing end, 302-Connecting end, 101-Natural articular fossa, 102-Natural temporomandibular joint disc.

[0018] The purpose, features, and advantages of this application will be further explained in conjunction with the embodiments and with reference to the accompanying drawings. Detailed Implementation

[0019] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative effort are within the scope of protection of the present invention.

[0020] It should be noted that all directional indications (such as up, down, left, right, front, back, etc.) in the embodiments of the present invention are only used to explain the relative positional relationship and movement of each component in a certain specific posture (as shown in the figure). If the specific posture changes, the directional indication will also change accordingly.

[0021] In this invention, unless otherwise explicitly specified and limited, the terms "connection," "fixed," etc., should be interpreted broadly. For example, "fixed" can mean a fixed connection, a detachable connection, or an integral part; it can mean a mechanical connection or an electrical connection; it can mean a direct connection or an indirect connection through an intermediate medium; it can mean the internal communication of two components or the interaction between two components, unless otherwise explicitly limited. Those skilled in the art can understand the specific meaning of the above terms in this invention according to the specific circumstances.

[0022] Furthermore, if the embodiments of this invention involve descriptions such as "first" or "second," these descriptions are for descriptive purposes only and should not be construed as indicating or implying their relative importance or implicitly specifying the number of technical features indicated. Therefore, a feature defined with "first" or "second" may explicitly or implicitly include at least one of those features. Additionally, the meaning of "and / or" throughout the text includes three parallel solutions. Taking "robot coordinate system and / or m" as an example, it includes the robot coordinate system solution, the m solution, or a solution where both the robot coordinate system and m are satisfied simultaneously. Furthermore, the technical solutions of the various embodiments can be combined with each other, but this must be based on the ability of those skilled in the art to implement them. When the combination of technical solutions is contradictory or impossible to implement, it should be considered that such a combination of technical solutions does not exist and is not within the scope of protection claimed by this invention.

[0023] Implementation method 1:

[0024] Reference Figures 1 to 4 This embodiment is an optional embodiment of this application, which discloses a fixed substrate 1 and a reconstruction unit 3. The fixed substrate includes a substrate, wherein the substrate is preferably a titanium alloy such as Ti-6Al-4V or Ti-6Al-4VELI, or stainless steel, cobalt-chromium alloy or other medical metal materials, so as to improve the structural strength of the fixed substrate 1. The shape of the fixed base 1 is flexibly adjusted according to the shape of the mandibular ramus remnant connected to it, but at least 3 connecting screw holes 7 are provided on the fixed base 1, and each connecting screw hole 7 is provided with a connecting screw 2; it should be noted that the number and position of the connecting screw holes 7 are determined according to the actual situation of the mandibular ramus remnant. A bone contact surface 8 is provided on the side of the fixed base 1 that is in contact with the mandibular ramus stump. The bone contact surface 8 is completely in contact with the surface of the mandibular ramus stump to improve the stability of the connection. At the same time, a bone integration reinforcement layer 9 is provided on the surface of the bone contact surface 8. The bone integration reinforcement layer 9 includes a porous structure, a roughened structure, a sandblasted and acid-etched structure, a titanium sprayed structure, a hydroxyapatite coating, or other bone integration reinforcement structures. The bone contact surface 8 improves the fit between the entire fixation base 1 and the mandibular ramus remnant, ensuring the stability and reliability of the installation. The bone integration reinforcement layer 9 effectively helps to improve the connection stability between the fixation base 1 and the mandibular ramus remnant, reducing the load on the connecting screw 2.

[0025] Furthermore, the reconstruction unit 3 includes an integrally connected bearing end 301 and a connecting end 302, wherein the connecting end 302 is used to connect the fixed base 1, and the bearing end 301 is fitted to the natural temporomandibular joint disc 102. A bearing surface 4 is provided on the bearing end 301. The bearing end 301 is spherical, ellipsoidal, flattened, cylindrical, or other anatomical shape that is adapted to the natural temporomandibular joint disc 102, so as to ensure that the bearing surface 4 located on the surface of the bearing end 301 is adapted to the natural temporomandibular joint disc 102 and improve the fit between the bearing surface 4 and the natural temporomandibular joint disc 102.

[0026] Furthermore, a wear-resistant coating 10 is provided on the surface of the bearing surface 4. The wear-resistant coating 10 includes CoCrMo, Pyrocarbon, PEEK, PEKK, CFR-PEEK, UHMWPE, zirconia ceramic, DLC coating, TiN coating or other biocompatible coatings suitable for frictional contact with the natural temporomandibular joint disc. The wear-resistant coating 10 can improve the service life of the reconstruction unit 3. On the other hand, the wear-resistant coating 10 can form a low-friction, low-wear, non-cutting disc support surface, thereby reducing the wear of the natural temporomandibular joint disc 102, improving the protection effect on natural tissue, and avoiding rejection reaction between natural tissue and prosthesis structure, thus improving the safety of prosthesis use. Secondly, the low-wear reconstruction unit 3 can avoid the formation of a large amount of prosthesis wear residue in the natural temporomandibular joint disc 102 during long-term use, thus improving the safety of prosthesis use.

[0027] Furthermore, a connection hole 11 is provided on the fixed base 1, and the connection end 302 is inserted into the connection hole 11. At the same time, a fixing screw 12 is provided in the connection hole 11, and the fixing screw 12 connects the connection end 302 to the fixed base 1 to achieve a stable connection between the fixed base 1 and the reconstruction unit 3. Furthermore, in the axial direction of the connecting hole 11, at least one limiting groove 13 is provided inside the connecting hole 11, and a limiting block 14 adapted to the limiting groove 13 is provided on the connecting end 302; through the engagement of the limiting groove 13 and the limiting block 14, rotation around the axial direction of the connecting hole 11 can be prevented; on the other hand, the cooperation of the limiting groove 13 and the limiting block 14 can achieve accurate positioning of the reconstruction unit 3, that is, when the reconstruction unit 3 is ellipsoidal or other irregular spherical structure, the cooperation of the limiting groove 13 and the limiting block 14 ensures the accuracy of the position of the reconstruction unit 3, thereby ensuring the correct fit of the bearing surface 4 with the natural temporomandibular joint disc 102, avoiding repeated adjustments, and improving the installation efficiency of the prosthesis; Secondly, the structure of the limiting groove 13 and the limiting block 14 is simple, which can simplify the prosthesis structure as much as possible while ensuring the above functions and improving the reliability of the prosthesis. It should be noted that, in addition to the connection methods described above, the connection methods between the fixed substrate 1 and the reconstruction unit 3 also include mechanical locking, threaded connection, dovetail groove, snap fastener, press fitting, sintering, porous fitting, coating deposition, medical-grade composite connection structure, or integrated connection structure.

[0028] Furthermore, the reconstruction prosthesis also includes a pre-installed anchoring assembly, which includes at least one pre-installed anchoring rope 5. An anchoring hole 6 is provided on the fixed base 1. One end of the pre-installed anchoring rope 5 is connected to the anchoring hole 6, and the other end is a free end. After the reconstruction prosthesis is installed, the free end of the pre-installed anchoring rope 5 is connected to the natural temporomandibular joint disc. It should be noted that the structure adapted to the prefabricated anchor rope 5 on the fixed base 1 also includes anchor holes 6, anchor grooves, cable channels, anchor columns, pre-installed anchor lines or other structures through which sewing threads, cables, and anchors can pass or be fixed. The pre-installed anchoring rope 5 provides a structural fulcrum for the natural temporomandibular joint disc during implantation, thereby helping the natural temporomandibular joint disc 102 maintain its positional stability, that is, ensuring a stable connection between the natural temporomandibular joint disc 102 and the reconstruction unit 3.

[0029] When the reconstruction prosthesis described in this application is implanted, the fixation base is fixed to the mandibular ramus remnant by connecting screws, and the bone contact surface on the fixation base is in close contact with the mandibular ramus remnant. The connecting end of the reconstruction unit is connected to the fixation base, and the bearing surface at its other end is in contact with the natural temporomandibular joint disc. The natural temporomandibular joint disc is located below the natural glenoid fossa, thereby establishing a support connection relationship between the prosthesis, the temporomandibular joint disc, and the natural glenoid fossa, providing stable support below the natural glenoid fossa, and thus restoring the condylar height.

[0030] Compared with conservative treatment methods in the prior art, the reconstruction prosthesis described in this application can actively restore condylar height and vertical support of the ramus, thereby avoiding ramus height reduction, mandibular deviation, unstable occlusal relationship, lack of support under the articular disc, and secondary joint degeneration, thus improving the treatment effect; Compared with total temporomandibular joint replacement, the reconstruction prosthesis of this application can reuse tissue structures with preservation value (such as natural glenoid fossa and glenoid fossa) as much as possible during the implantation process, thereby preserving the original tissue as much as possible, reducing the implantation range and the area of ​​tissue sacrifice, and reducing the wound area of ​​prosthesis implantation. At the same time, this application can also minimize the volume of the prosthesis, avoid subsequent complications caused by the prosthesis, and improve the treatment effect; that is, the reconstruction prosthesis described in this application has the advantages of conservative treatment and total temporomandibular joint replacement in the prior art, and overcomes their respective defects, realizing condylar reconstruction.

[0031] The above are merely preferred embodiments of this application and do not limit the patent scope of this application. Any equivalent structural or procedural transformations made using the content of this application's specification and drawings, or direct or indirect applications in other related technical fields, are similarly included within the patent protection scope of this application.

Claims

1. A disc-preserving condylar reconstruction prosthesis, characterized in that, include: A fixed base (1) is provided with a plurality of connecting screws (2) for connecting external tissues; A reconstruction unit (3) is provided, one end of which is connected to the fixed base (1); a bearing surface (4) is also provided on the reconstruction unit (3), which is in contact with the natural temporomandibular joint disc (102).

2. The disc-preserving condylar reconstruction prosthesis according to claim 1, characterized in that, The reconstructed prosthesis also includes a pre-installed anchoring component, one end of which is connected to the fixed base (1), and the other end of which is used to connect to the natural temporomandibular joint disc (102).

3. The disc-preserving condylar reconstruction prosthesis according to claim 2, characterized in that, The pre-installed anchoring assembly includes at least one pre-installed anchoring rope (5), and the fixed base (1) is provided with an anchoring hole (6). One end of the anchoring rope (5) is connected to the anchoring hole (6), and the other end is connected to the natural temporomandibular joint disc (102).

4. The disc-preserving condylar reconstruction prosthesis according to claim 1, characterized in that, The fixation base (1) includes a base plate, and at least three connecting screw holes (7) are provided on the fixation base (1), and each connecting screw hole (7) is provided with a connecting screw (2); the fixation base (1) is provided with a bone contact surface (8) adapted to external tissue.

5. A disc-preserving condylar reconstruction prosthesis according to claim 4, characterized in that, The bone contact surface (8) is provided with a bone integration enhancement layer (9) adapted to external tissues.

6. A disc-preserving condylar reconstruction prosthesis according to claim 1, characterized in that, The reconstruction unit (3) includes an integrally connected bearing end (301) and a connecting end (302), the outer surface of the bearing end (301) being the bearing surface (4); the connecting end (302) being connected to the fixed base (1).

7. A disc-preserving condylar reconstruction prosthesis according to claim 6, characterized in that, The bearing end (301) is spherical, ellipsoidal, flattened, cylindrical, or other anatomical shape that is adapted to the natural temporomandibular joint disc (102).

8. A disc-preserving condylar reconstruction prosthesis according to claim 1 or 6, characterized in that, The bearing surface (4) is provided with a wear-resistant coating (10), which includes CoCrMo, Pyrocarbon, PEEK, PEKK, CFR-PEEK, UHMWPE, zirconia ceramic, DLC coating, TiN coating or other biocompatible coatings suitable for frictional contact with the natural temporomandibular joint disc (101).

9. A disc-preserving condylar reconstruction prosthesis according to claim 1, characterized in that, The fixed base (1) is provided with a connecting hole (11), and the connecting end (302) is inserted into the connecting hole (11); a fixing screw (12) adapted to the connecting end (302) is also provided in the connecting hole (11).

10. A disc-preserving condylar reconstruction prosthesis according to claim 9, characterized in that, Around the axis of the connecting hole (11), at least one limiting groove (13) is provided in the connecting hole (11), and a limiting block (14) adapted to the limiting groove (13) is provided on the connecting end (302).

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