DEVICE FOR USE IN CRESTAL SINUS LIFT

Description

[0001] The invention relates to a device for use in a crestal sinus lift, the device comprising a drilling device which is designed to remove bone material by means of a drilling head, and a rinsing device which at least partially accommodates the drilling device and has a drilling opening for the passage of the drilling head, wherein the rinsing device is designed to dispense a liquid at a predetermined pressure through the drilling opening, and wherein the device can be brought from a first position in which the drilling head is accommodated within the rinsing device without protruding through the drilling opening from the rinsing device, into a second position in which the drilling head protrudes through the drilling opening from the rinsing device. In a crestal sinus lift, artificial bone material is to be introduced between the jawbone and the jawbone mucosa in order to strengthen the jawbone.Once the artificial bone material has hardened, which usually takes several months, an implant can be attached to the jawbone in this area, which in its natural form would not have sufficient strength for this.

[0002] For this purpose, a channel is drilled into the jawbone to insert the artificial bone material between the jawbone and the maxillary sinus lining. During the drilling, particular care must be taken to avoid damaging the extremely thin maxillary sinus lining, as in such cases, the procedure must be interrupted until the maxillary sinus lining has completely healed.

[0003] For this purpose, it is known from the prior art (e.g., DE 10 2007 059 226 B4) to drill into the jawbone until it only has a predetermined residual thickness. Afterwards, or even during drilling, a saline solution can be introduced under pressure into the cavity between the drill and the jawbone to be removed, so that the remaining thickness of the jawbone detaches from the jawbone before the drill hits the maxillary sinus mucosa, thus creating the cavity for the artificial bone material.

[0004] According to the current state of the art, drilling is performed using two separate instruments: the drill itself, and a rinsing device through which the drill is typically inserted. This rinsing device is designed in such a way that the saline solution can be directed precisely to the remaining thickness.

[0005] In practice, however, it has been found that such drilling procedures are extremely cumbersome for the attending physician, as they must operate the drill with one hand while simultaneously controlling the irrigation device with the other. This prevents the physician from performing any other treatment tasks that would require a free hand during the drilling process.

[0006] JP 2014087633 A discloses a device comprising a drilling device and a flushing device, wherein the flushing device at least partially accommodates the drilling device and a spring is provided between the two devices. Furthermore, the flushing device has an optical scale to indicate the current drilling depth to the user.

[0007] KR 102082212 B1 discloses a drilling device for drilling the alveolar bone.

[0008] However, this device does not disclose an integrated flushing device, since fluid is supplied to the drill head only from the outside through holes in an element surrounding the drill.

[0009] Further drilling rigs are known from the publications US 2017 / 105812 A1 and WO 2014 / 000007 A1.

[0010] It is therefore an object of the invention to provide a device for use in a crestal sinus lift which is easier to operate than those of the prior art.

[0011] The subject matter of the invention is defined in independent claims 1, 2 and 3.

[0012] The object is achieved according to the invention by the device mentioned at the outset, which further comprises a tensioning element which is designed to pretension the device into the first position and to oppose a force when the device is brought from the first position into the second position.

[0013] Firstly, the clamping element creates a rest position for the device by pre-tensioning it into the first position, allowing the drilling device and the flushing device to be handled as a unit, i.e., with one hand. Since the drill head is completely enclosed in the flushing device in the first position, an additional safety feature is created, as the drill head does not protrude from the drill hole in this position, even if it is accidentally switched on.

[0014] Secondly, the clamping element makes it possible to operate the device with one hand even during drilling, i.e. after the device has been moved from its rest position, because the drilling mechanism automatically returns to its rest position after leaving it. When the treating dentist presses the drill head into the jawbone to be drilled, the clamping element counteracts this pressing, i.e. the movement of the device from the first position to the second position, with a force. If the treating dentist wants to extract the drill head from the jawbone, he or she simply needs to reduce the contact pressure. This means that even during the drilling process, no second hand is required to guide the drill head out of the drilled hole in the jawbone.

[0015] A particularly advantageous feature, however, is that the use of the clamping element when pressing the device in the first position allows you to check whether a tight connection between the irrigation device and the jawbone or the skin on top of it is ensured. Only once a tight connection has been established can further drilling steps be initiated. This ensures reliable irrigation during drilling and safe separation of the jawbone mucosa from the remaining jawbone before drilling.

[0016] A further advantage of the clamping element is that a predetermined contact pressure is applied when the device is to be moved from the first position to the second position. This ensures that the drill hole rests against the jawbone with the specified contact pressure during drilling, so that the irrigating device is tightly connected to the jawbone during drilling.

[0017] To begin drilling, the irrigating device can simply be placed with the drill opening against the jawbone to be drilled while the device is in the first position. For example, the device can be placed against a previously drilled blind hole to make orientation easier. The device is then moved from the first position to the second position by applying pressure, with the irrigating device remaining on the jawbone and the drilling device penetrating the jawbone to remove the bone material. At the same time, the irrigating device injects the pressurized fluid into the drill hole. As soon as the jawbone only has a residual thickness left, the pressure of the fluid separates this, along with the maxillary sinus mucosa, from the remaining jawbone before the drill head damages the maxillary sinus mucosa.The drilling device can then be guided out of the borehole by simply reducing the contact pressure, without any further hand movement being necessary.

[0018] In one embodiment according to the invention, the device is designed to drive the drill head to drill as soon as a predetermined contact pressure is exceeded when moving from the first position to the second position and / or as soon as the drill head falls below a predetermined distance from the drill opening. This also enables the drill to be switched on and off automatically. A separate on / off switch for the drill can therefore be omitted, even if one can still be present for safety reasons, for example. In particular, in this embodiment it is not necessary for the drill to be switched on and off using the second hand or a foot pedal.

[0019] Furthermore, the invention provides that, in addition to or as an alternative to the aforementioned embodiment, the device is designed to dispense said liquid as soon as a predetermined further contact pressure is exceeded when moving from the first position to the second position and / or when the drill head falls below a predetermined further distance from the drill opening. This ensures that no separate on / off switch needs to be provided for flushing, which further simplifies operation of the present device. Here, too, a switch could be provided in addition to the automatic introduction and discharge of the liquid in order to increase safety.

[0020] In a particularly preferred embodiment, the device is designed to measure the pressure of the fluid and drive the drill head to drill as soon as the measured pressure exceeds a predetermined threshold. This makes it possible to measure whether the drill opening is tightly against the jawbone or any skin located thereon before the drill head is driven. This makes it possible to create an additional safety device to prevent premature drilling. This is particularly advantageous in conjunction with the aforementioned embodiment if the fluid is only dispensed upon further contact pressure or further removal, as this creates a two-stage safety system in which the fluid dispensing is first regulated, then it is measured whether the drill opening is tightly closed, and only finally is the drill head driven.

[0021] Preferably, the tensioning element is a spring, which allows the inventive device to be achieved in a simple manner. In particular, the spring can be a coil spring made of metal, for example, stainless steel, to ensure hygienic standards for medical instruments.

[0022] In one embodiment, both the drilling device and the flushing device have their own separate handles, with the clamping element holding the handles in a predetermined relationship to each other. The two handles could, for example, be designed like pliers or scissors handles to facilitate one-handed operation.

[0023] However, it is preferred if the device has only one handle, wherein the handle is rigidly mounted on the drilling device, and the irrigating device is displaceably attached to the drilling device by means of the clamping element. This allows for a particularly simple device design for use in a crestal sinus lift. In this embodiment, a drill known from the prior art can be extended such that the irrigating device is provided in a movable manner in the region of the drill head, with the clamping element representing the connection between the drilling device and the irrigating device.

[0024] Advantageous and non-limiting embodiments of the invention are explained in more detail below with reference to the drawings. Fig. 1A shows a drilling procedure during a crestal sinus lift before the jawbone is completely drilled through. Fig. 1B shows the drilling process mentioned above, after a residual thickness of the jawbone together with the maxillary sinus mucosa has been detached from the jawbone by the pressure of an introduced fluid. Fig. 2 shows a device for use in a crestal sinus lift according to the prior art. Fig. 3 shows the device according to the invention for use in a crestal sinus lift. Fig. 4 shows the device of Fig. 3 in a first position. Fig. 5 shows the device of Fig. 3 in a second position.

[0025] Fig. 1A shows a device 1 for use in a crestal sinus lift. For a crestal sinus lift, a jawbone 2, for example of a human, is drilled through from a drilling side 3 in order to insert artificial bone material between the jawbone 2 and a jawbone mucosa 4 opposite the drilling side 3.

[0026] To avoid damaging the jawbone mucosa 4, a drilling device 5 of the device 1 must not penetrate too deeply into the jawbone 2. For this purpose, the device 1 comprises, in addition to the drilling device 5, a separate rinsing device 6. The rinsing device 6 has a substantially cylindrical recess in which the drilling device 5 is at least partially received. At its end, the rinsing device 6 has a drilling opening 7 through which a drilling head 8 of the drilling device 5 can pass.

[0027] The rinsing device 6 remains essentially in its position during the drilling process, i.e., resting against the drilling side 3 of the jawbone 2, either directly against the bone 3 or against a piece of skin located on the drilling side 3. The drill head 8, in contrast, penetrates the jawbone 2 and, in doing so, removes bone material by means of the drill head 8. For this purpose, the drill head 8 can, for example, rotate around a rotational axis in a conventional manner at a uniform or variable rotational speed.

[0028] During the drilling process, the rinsing device 6 applies a liquid, for example a saline solution, at a predetermined pressure, for example 0.5 - 2 bar, preferably substantially 1.5 bar, through the drill opening 7 onto the bone material to be removed. This has the purpose of, on the one hand, allowing the removed bone material to be transported away from the drill head 8. On the other hand, the application of pressure by means of the liquid has the effect of allowing a residual thickness 9 of the jawbone 2, including the jawbone mucosa 4, to be detached from the remaining jawbone 2 before the drill head 8 injures the jawbone mucosa 4, see Fig. 1B This creates a cavity 10 between the jawbone 2 and the jawbone mucosa 4, into which the artificial bone material can be introduced.

[0029] The discharge of the liquid by the flushing device can be either static, ie the liquid is only discharged from the borehole after the drilling process, or dynamic, ie liquid is continuously introduced through the borehole 7 and discharged from it during the drilling process.

[0030] As in Fig. 1 combined with Fig. 3 As shown, the drilling device 5 comprises, for example, in addition to the drilling head 8, a drive 11 for the drilling head 8 and a guide 12 that connects the drilling head 8 to the drive 11. Such a drilling device 5 is usually guided manually using a handle 13 attached to the drive 11.

[0031] The flushing device 6 generally comprises a sealing tube 14 with the drill opening 7. The sealing tube 14 has, for example, a cylindrical or conical recess for receiving the drill head 8 or the guide 12. The fluid can be supplied via a hose 15, which introduces the fluid into the sealing tube 14 so that the fluid can be discharged between the sealing tube 14 and the drill head 8 or the guide 12 through the drill opening 7. The sealing tube 14 is sealed on the side opposite the drill opening 7 from the guide 12 (or generally from the drilling device 5) so that the fluid only leaves the flushing device 6 through the drill opening 7. In addition, a return line could be provided, with which fluid flowing back into the drill opening 7 can be recirculated (not shown).

[0032] According to the state of the art, Fig. 2 As exemplified by a device 16, the drilling device 5 and the rinsing device 6 are designed as separate instruments. Here, the rinsing device 6 is manually guided by a handle 17 attached to the sealing tube 14. In practice, this means that the physician performing the drilling procedure must use both hands to perform the drilling for the crestal sinus lift.

[0033] Fig. 3 shows the device 1 according to the invention, in which the drilling device 5 and the flushing device 6 are connected by means of a clamping element 18. The clamping element 18 clamps the device 1 in a first position ( Fig. 4 ), ie into a position in which the drill head 8 is accommodated within the flushing device 6 without protruding from the flushing device 6 through the bore opening 7. In this rest position, the drill head 8 is protected by the flushing device 6 even if the drilling device 5 is accidentally switched on, since it does not protrude from the bore opening 7.

[0034] When the device 1 is moved into a second position ( Fig. 5 ) in which the drill head 8 protrudes through the drill opening 7 out of the rinsing device 6, the clamping element 18 counteracts this offset with a force F, so that the device 1 is returned to the first position unless the doctor maintains the contact pressure during drilling. The clamping element 18 can, for example, be selected such that the device 1 is moved completely from the first position to the second position upon application of 1 kg - 3.5 kg, preferably substantially 2.5 kg.

[0035] In the first position, the drill head 8, i.e., an end-side tip of the drill head 8, is located within the flushing device 6, for example, at a distance of 0.1 - 2 mm from the drill opening 7. However, the tip can also be located within the drill opening 7. In the second position, the tip of the drill head 8 is located outside the flushing device 6 and is at a distance from the drill opening 7 that, for example, essentially corresponds to the thickness of the jawbone to be drilled.

[0036] The clamping element 18 thus allows the device 1 to be operated with one hand during the drilling process, since the drilling device 5 and the flushing device 6 are coupled by means of a suitable elastic connection.

[0037] The tensioning element 18 can, for example, be a spring to fulfill the aforementioned function and can be made of stainless steel, for example. Alternatively, the tensioning element 18 could be designed as a plastic ring or other mechanical element with suitable elastic properties. Furthermore, the tensioning element 18 could also be achieved using suitable magnetic or electromagnetic elements.

[0038] According to Fig. 3 The device 1 has only one handle 13, wherein the handle 13 is rigidly mounted on the drilling device 5, and the flushing device 6 is displaceably attached to the drilling device 5 by means of the clamping element 18. In this embodiment, the flushing device 6 does not have a separate handle, making the device 1 easy to handle. In this embodiment, the flushing device 6 can be mounted with the clamping element 18 as an attachment on commercially available drills to obtain the device 1.

[0039] In an alternative embodiment (not shown), the flushing device 6 also has a handle that, for example, complements the handle 13 of the drilling device 5, as is known from scissors or pliers. Furthermore, however, the clamping element 18 connects the drilling device 5 and the flushing device 6 in the manner mentioned, thus ensuring one-handed operation here as well.

[0040] In the simplest case, the device 1 has an on / off switch, e.g., a pressure switch, on the handle 13 or another handle to drive the drill head 8 to drill, and another on / off switch to dispense the fluid from the flushing device 6. An on / off switch could also be provided that simultaneously controls the drive of the drill head 8 and the dispensing of the fluid.

[0041] In order to be able to control the start of drilling without a switch, the device 1 drives the drill head 8 towards the drill as soon as a predetermined contact pressure is exceeded when moving from the first position to the second position and / or as soon as the drill head 8 falls below a predetermined distance from the drill opening 7. Various sensors can be used to measure the pressure or the distance, for example a piezoelectric element for measuring the pressure or an inductive element for measuring the distance. Although a separate switch is not mandatory in this embodiment, one can still be attached to the handle 13 of the drilling device 5 for safety reasons, e.g. as a pressure switch.

[0042] Alternatively or additionally, the device 1 can dispense the aforementioned fluid as soon as a predetermined further contact pressure is exceeded when moving from the first position to the second position and / or when the drill head 8 falls below a predetermined further distance from the drill opening 7. Here, too, a switch can additionally be attached to the handle 13 or another handle.

[0043] The predetermined contact pressure or the predetermined further contact pressure is in each case greater than the preload force of the clamping element 18. The predetermined distance or the predetermined further distance can be located either inside or outside the flushing device 6 relative to the bore opening 7. For example, the distance or the further distance can be selected such that the drill head 8 is driven or the fluid is dispensed before or after the drill head 8 passes through the bore opening 7.

[0044] If both the drive of the drill head 8 and the dispensing of the fluid are switchless, as described above, two operating buttons—one for driving the drill head 8 and one for dispensing the fluid—can be eliminated. In this embodiment, the predetermined additional contact pressure or the predetermined additional distance for dispensing the fluid can be selected to be identical to or different from the predetermined contact pressure or the predetermined distance for activating the bore. For example, the drill head 8 can already be driven before it passes through the bore opening 7, and the fluid can only be dispensed after the drill head 8 has passed through the bore opening 7.

[0045] Further control of the fluid dispensing and the drive of the drill head 8 can be carried out as follows. Firstly - with the drill head 8 at rest - the fluid is dispensed, either by pressing a separate button or foot switch or automatically when, as described above, a predetermined further contact pressure is exceeded when moving from the first position to the second position and / or when the drill head 8 falls below a predetermined further distance from the drill opening 7. After the fluid has been dispensed, the pressure of the fluid is measured, i.e. it is checked whether the drill opening is tight against the jawbone. If this is not the case, the fluid escapes laterally between the drill opening 7 and the jawbone and a pressure drop occurs which can be measured immediately. Only after it has been ensured that the measured pressure is above a predetermined threshold value is the drill head 8 driven to drill.In addition to measuring the fluid pressure, it can be provided that the contact pressure has been reached and / or the drill head 8 has fallen below the predetermined distance to the drill opening 7 before the drill head 8 is driven.

[0046] In this embodiment, the fluid can be dispensed, for example, when 1 kg acts on the clamping element 18, and the drill head 8 can be driven when a threshold fluid pressure of 0.8 bar is reached. To measure the fluid pressure, a pressure gauge can be arranged in the flushing device 6, for example, within the sealing tube 14 or in a fluid supply arranged on one side of the hose 15 facing away from the sealing tube 14.

[0047] The drive of the drill head 8 can be switched off or the output of the liquid can be switched off when the predetermined (further) contact pressure is again undershot or the predetermined (further) distance is again exceeded, i.e. when the drill head 8 is retracted into the flushing device 6 again. Alternatively, other threshold values can also be provided. For example, the drive of the drill head 8 can be switched off or the output of the liquid can be switched off only when the device 1 is back in its first position, i.e. when the distance of the drill head 8 from the drill opening 7 within the flushing device 6 is maximum or when no contact pressure is present. This prevents premature, unintentional switching off of the drive of the drill head or the output of the liquid.

Claims

1. Device (1) for use in a crestal sinus lift, the device (1) comprising a drilling means (5) configured to remove bone material by means of a drill head (8), and an irrigation means (6) which at least partially accommodates the drilling means (5) and has a drilling opening (7) for the passage of the drill head (8), wherein the irrigation means (6) is configured to discharge a liquid at a predetermined pressure through the drilling opening (7), and wherein the device (1) can be moved from a first position, in which the drill head (8) is accommodated within the irrigation means (6) without projecting out of the irrigation means (6) through the drilling opening (7), into a second position, in which the drill head (8) projects out of the irrigation means (6) through the drilling opening (7), wherein a tensioning element (18) is provided, which is configured to pretension the device (1) into the first position and to apply a force (F) against it when the device (1) is brought from the first position into the second position, characterized in that the device (1) is configured to drive the drill head (8) for drilling as soon as a predetermined contact pressure is exceeded when moving from the first position to the second position and / or as soon as the drill head (8) falls below a predetermined distance to the drilling opening (7).

2. Device (1) for use in a crestal sinus lift, the device (1) comprising a drilling means (5) configured to remove bone material by means of a drill head (8), and an irrigation means (6) which at least partially accommodates the drilling means (5) and has a drilling opening (7) for the passage of the drill head (8), wherein the irrigation means (6) is configured to discharge a liquid at a predetermined pressure through the drilling opening (7), and wherein the device (1) can be moved from a first position, in which the drill head (8) is accomodated within the irrigation means (6) without projecting out of the irrigation means (6) through the drilling opening (7), into a second position, in which the drill head (8) projects out of the irrigation means (6) through the drilling opening (7), wherein a tensioning element (18) is provided, which is configured to pretension the device (1) into the first position and to apply a force (F) against it when the device (1) is brought from the first position into the second position, characterized in that the device (1) is configured to dispense the said liquid as soon as a predetermined further contact pressure is exceeded when moving from the first position to the second position and / or when the drill head (8) falls below a predetermined further distance to the drilling opening (7).

3. Device (1) for use in a crestal sinus lift, the device (1) comprising a drilling means (5) configured to remove bone material by means of a drill head (8), and an irrigation means (6) which at least partially accommodates the drilling means (5) and has a drilling opening (7) for the passage of the drill head (8), wherein the irrigation means (6) is configured to discharge a liquid at a predetermined pressure through the drilling opening (7), and wherein the device (1) can be moved from a first position, in which the drill head (8) is accommodated within the irrigation means (6) without projecting out of the irrigation means (6) through the drilling opening (7), into a second position, in which the drill head (8) projects out of the irrigation means (6) through the drilling opening (7), wherein a tensioning element (18) is provided, which is configured to pretension the device (1) into the first position and to apply a force (F) against it when the device (1) is brought from the first position into the second position, characterized in that the device (1) is configured to drive the drill head (8) for drilling and to dispense the said liquid as soon as a predetermined contact pressure is exceeded when moving from the first position to the second position and / or as soon as the drill head (8) falls below a predetermined distance to the drilling opening (7).

4. Device (1) according to claim 2, characterized in that the device (1) is configured to measure the pressure of the liquid and to drive the drill head (8) for drilling as soon as the measured pressure is above a predetermined threshold value.

5. Device (1) according to one of claims 1 to 4, characterized in that the tensioning element (18) is a spring.

6. Device (1) according to one of claims 1 to 5, characterized in that the device (1) has only one handle (13), the handle (13) being rigidly provided on the drilling means (5) and the irrigation means (6) being displaceably attached to the drilling means (5) by means of the tensioning element (18).