Device for osteosynthesis and dental implantation

Abstract

The invention relates to medical equipment, and more particularly to a device for osteosynthesis and dental implantation. The present device comprises a screw having a body with a thread on the exterior wall thereof, a cap with an internal thread, and an interior rod, the lower part of which is divided into L-shaped extendable elements and the upper part of which is provided with a head. The interior wall of the screw contains a support for the head of the rod. The interior rod is arranged for linear movement in a main channel formed in the body of the screw. The body of the screw has in the lower part thereof a guiding support and, parallel thereto, inclined distal channels for the extendable elements, said distal channels being connected to the main channel. The guiding support is configured to part the extendable elements of the interior rod when the cap is screwed onto the thread of the upper part of the screw and to enable linear movement of the extendable elements through the distal channels in order for the extendable elements to exit into the bone tissue. The invention provides enhanced fixation of the screw while minimizing excessive trauma to the bone tissue.

Description

[0001] Device for osteosynthesis and dental implantation

[0002] Description

[0003] The invention relates to medical devices, systems and methods for fixing bone fragments, in particular to screws for osteosynthesis, as well as to dental implants and implantation methods.

[0004] In general surgery, orthopedics and traumatology, there is a problem of creating optimal, least invasive and most atraumatic conditions for osteosynthesis, including the creation of structures that allow for the secure fixation and alignment of bone fragments.

[0005] When fixing screws in living bone tissue, the problem of insufficient stability of bone fragments or insufficient stability of fixation of osteosynthesis devices in bone tissue often arises. In particular, in the spongy substance of bone tissue, any load acting on the screw is transmitted only to a small number of trabeculae, which negatively affects both the bearing capacity of the screw-bone connection and its long-term stability. The most unfavorable prognosis is observed in the case of pathological processes in bone tissue that have occurred as a result of osteoporosis, osteopenia or other pathology.

[0006] The prior art includes structures made from materials with a shape memory effect, such as titanium nickelide alloy, in particular structures used in osteosynthesis of skeletal bones, however, in such medical structures, the fixation of bone fragments is achieved by expanding the structures under the influence of body temperature, which does not allow one to judge the reliability of the fixation.

[0007] Standard orthopedic plates and screws for osteosynthesis are also used, which require delicate installation and have many components.

[0008] A medical device for implantation into the body of a human or animal or for strengthening the hard tissue of a human or animal for subsequent implantation of a separate implant and a dental implant are known (RU 2712028, published 01 / 24 / 2020). This device contains a liquefied element, which is located inside the device and is squeezed out through passage channels into bone tissue under the action of external energy. The disadvantages of this invention include the low strength of the fixing structure and the difficulty of use due to the fact that it is impossible to predict what volume of bone tissue will be affected by the squeezed out liquefied material.

[0009] SUBSTITUTE SHEET (RULE 26) A transpedicular screw for fixing the spine is known (RU 2475205, published 20.02.2013), which includes a prefabricated pusher with retractable pointed anchors.

[0010] The disadvantages of this invention include the high time costs of fixation, increased trauma to bone tissue due to nonlinear oscillatory movements of its pointed retractable anchors, resulting in bone tissue crushing. The low strength of the structure and the complexity of manufacturing and practical use due to the small size, the presence of holes in the internal screw for the hinge element do not allow this device to be manufactured in industrial production.

[0011] The closest solution taken as a prototype is a trendical screw with anchor deployment (WO 2019161100 A1, published 14.02.2019), which includes a housing that forms a plurality of channels and communicates with a plurality of corresponding distal openings located along the screw housing. The transpedicular screw assembly additionally includes an anchor that forms a plurality of anchor elements that exit through a plurality of channels and a plurality of corresponding distal openings for further adhesion of the transpedicular screw to bone tissue. The disadvantage of this solution is the complexity of manufacturing the structure due to the presence of two anchors and a large number of openings and channels through which the anchor elements exit.

[0012] The task that this technical solution is aimed at solving is to create an effective, minimally invasive method for ensuring increased, strong primary fixation of bone fragments and dental implantation.

[0013] This problem is solved due to the fact that in the device for osteosynthesis and dental implantation, containing a screw, having a body with a thread on the outer wall, made for screwing the screw into bone tissue, the following differences are provided: it contains a cap with an internal thread and an internal rod, the lower part of which is divided into L-shaped retractable elements, and the upper part is provided with a head, while in the upper part of the outer wall of the screw there is a thread for screwing the cap and a protruding support for abutting the cap, the inner wall of the screw contains a support for the rod head, the internal rod with the possibility of rectilinear movement is placed in the main channel made in the screw body, while the screw body in the lower part has a guide support, parallel to which inclined distal channels for the retractable elements are made, connected to the main channel, and the cap

[0014] The SUBSTITUTE SHEET (RULE 26) is designed to be screwed onto the thread of the upper part of the screw to provide pressure on the upper part of the inner rod, and the guide support is designed to split the retractable elements of the inner rod when screwing on the cap and to provide a rectilinear movement of the retractable elements through the distal channels for their exit into the bone tissue. A slot is made on the outer side of the cap.

[0015] The technical result consists in achieving enhanced screw fixation while minimizing excessive trauma to bone tissue, as well as simplifying the design, in creating an optimal method for installing an external osteosynthesis system with the achievement of the required fixation rigidity.

[0016] This invention is illustrated by drawings.

[0017] Fig. 1 shows a screw for osteosynthesis with an internal rod, where: 1 - screw body; 2 - main channel; 3 - rod; 4 - retractable elements; 5 - external thread; 6 - thread in the upper part of the screw; 7 - protruding support; 8 - cap, 9 - distal channels, 10 - guide support; 11 - head; 12 - support for the head.

[0018] Fig. 2 shows a cap 8 for osteosynthesis, where: 13 is the thread of the inner part, 14 is the spline.

[0019] Fig. 3 shows the fixation of a screw in bone tissue, where: 15 - bone fragments, 16 - fracture line.

[0020] Fig. 4 shows the fixation of bone fragments when the cap is screwed onto the upper part of the screw, where the retractable elements 4 of the inner rod are fixed in the bone tissue.

[0021] Fig. 5 shows a screw for dental implantation with an internal rod.

[0022] Fig. 6 shows a cap for dental implantation.

[0023] Fig. 7 shows the fixation of a screw in a bone, where 17 is the spongy substance of the bone tissue into which a screw with an internal rod is screwed.

[0024] Fig. 8 shows the fixation of a dental implant in bone tissue by screwing the cap onto the upper part of the screw.

[0025] From the practice of traumatology and orthopedics, there are known cases of a screw being unscrewed from holes in the bone over time due to the impact of oscillatory movements in the joints and bone fragments.

[0026] SUBSTITUTE SHEET (RULE 26) The proposed osteosynthesis screw (Fig. 1) includes a screw body 1, where a rod 3 with retractable elements 4 is placed in the main channel 2. The outer wall of the body 1 is provided with an external thread 5, necessary for screwing the screw into the bone tissue and a thread in the upper part of the screw 6. The upper part of the screw is small in size so that the osteosynthesis cap can be screwed onto it. The protruding support 7 is a stop for the cap 8. The main channel 2 is connected to the distal channels 9, made in the lower part of the body at an angle parallel to the guide support 10. The rod 3 in the upper part is provided with a cap 11, necessary for fixing its final position and can be divided from the cap or in its lower part into retractable elements 4 of an L-shape. The inner wall of the screw is provided with a support for the head 12.

[0027] The screw body has at least one inclined opening - distal channel 9, determining the direction for the retractable element 4. The guide support 10 serves as a stop for the rod 3 when screwing the cap 8 and ensures the exit of the retractable elements 4 at the required angle into the bone tissue, splitting them at the required angle, as a result of which they, performing a rectilinear movement, pass through the distal channels 9 and penetrate the spongy substance of the bone tissue. The L-shaped form of the retractable elements 4 allows them to enter the bone tissue rectilinearly under the action of screwing the cap 8, thereby minimizing trauma to the bone tissue.

[0028] The cap 8 for osteosynthesis (Fig. 2) has a thread on the inner part 13, necessary for screwing the cap onto the upper part of the screw, and a slot 14 on the outer side, necessary for supporting a trauma electric drill with a drill when screwing the cap onto the upper part of the screw. The cap 8 for osteosynthesis has a small height to minimize trauma to surrounding tissues and organs during osteosynthesis.

[0029] Screwing of cap 8 onto screw body 1 is performed by aligning its internal thread 13 with external thread 5, by installing a drill of trauma electric drill into slot 14. Screwing is performed until reaching protruding support 7 on screw body. In this case head 11 of rod 3 reaches support 12, fixing the final position of rod and sliding elements 4.

[0030] A screw with an internal rod is screwed between bone fragments 15 in the area of ​​the fracture line 16 in order to connect the bone fragments together and ensure their subsequent osteosynthesis (Fig. 3).

[0031] SUBSTITUTE SHEET (RULE 26) The retractable elements 4, due to the pressure exerted by screwing the cap 8 onto the upper part of the rod, pass from the internal position through the distal channels 9 to the external position into the bone tissue (Fig. 4).

[0032] The retractable elements 4 in the device, when extended and penetrating into the bone, reduce the amplitude of the oscillatory movements of the device in the bone due to a strong connection with the bone tissue, which prevents the rejection of the device from the bone tissue.

[0033] The proposed device prevents the screw from being unscrewed from the bone tissue, since the retractable element 4 will prevent this. The presence of such an additional internal mechanism of enhanced fixation creates uniform pressure in the cortical and spongy layers of the bone with stable fixation of the device, dosed compression of the bone tissue, uniform distribution of loads and an increase in the force of the primary fixation of the device.

[0034] The screw may be made of a metal alloy such as titanium, cobalt / chromium or a mixture of titanium and cobalt / chromium, a plastic metal, but other materials may also be used if other, more reasonable alternative alloys are developed.

[0035] In one embodiment, the device is used for osteosynthesis as follows.

[0036] A channel is drilled in the bone in the area of ​​the fracture line, into which a screw is inserted. After screwing the screw into the bone, using a trauma electric drill with a drill, the cap is screwed in and thus pressed on the internal rod, pushing it until it stops in the head. At the same time, the guide support from below for the retractable elements, due to their L-shaped form, splits the retractable elements, as a result of which they, making a rectilinear movement, pass through the distal channels and penetrate the spongy substance of the bone tissue. The retractable elements are fixed in the bone and create an increased strong primary fixation of the device, capturing bone fragments in the fracture line and pressing them against the walls of the proposed device. Thus, the retractable elements prevent rotation of the device inside the channel.

[0037] As a result of tight contact of bone tissue with the screw, which is a solid, mechanically strong, structurally organized framework with retractable elements, a regenerate adequate to the surrounding bone tissue develops, integrated into the recipient's bone tissue. Subsequently, the screw can be removed according to clinical indications by any known industrial method.

[0038] SUBSTITUTE SHEET (RULE 26) The effectiveness of using this screw is that the retractable elements allow for reliable fixation of the position of bone fragments, provide a stable connection between the bone and the screw. At the same time, convenient fixation of the screw is ensured.

[0039] The proposed device also allows for increased, strong primary fixation of the device in bone tissue during dental implantation.

[0040] In this case, the upper part of the screw has a greater height (Fig. 5) than the screw used in osteosynthesis, so that the cap 8 for dental implantation can be screwed onto the upper part of the screw (Fig. 6). The screw with the internal rod is screwed into the spongy substance of the bone tissue 17 (Fig. 7).

[0041] The retractable elements 4, due to the pressure exerted by tightening the cap 8 onto the upper part of the screw, exit through the distal channels 9 into the spongy substance of the bone tissue 17 (Fig. 8).

[0042] In the case of using this device in dental implantology, the cap will have a greater height compared to the cap for osteosynthesis, so that it can act as an abutment on which the prosthesis can subsequently be fixed.

[0043] Alternatively, the device is used for dental implantation as follows.

[0044] A channel is drilled in the jaw bone, into which a screw is inserted. After screwing the screw into the bone, the cap is screwed in using a drill, thus pressing on the internal rod, pushing it until it stops in the head. The guide support for the retractable elements, due to the L-shape, splits the retractable elements, as a result of which, making a rectilinear movement, they pass through the distal and penetrate the spongy substance of the bone tissue. Thus, the retractable elements are fixed in the bone and create an increased strong primary fixation of the device, as a result of which optimal conditions arise for subsequent prosthetics and replacement of defects of the dental arches. Subsequently, the implant can be removed according to clinical indications by any known industrial method.

[0045] In one embodiment, this device can also be used in the treatment of jaw fractures with loss of tooth(s).

[0046] In this case, it simultaneously performs the function of a bone fragment fixator for osteosynthesis and the function of an implant on which

[0047] REPLACEMENT SHEET (RULE 26) it will subsequently be possible to fix a prosthesis to replace the lost tooth(s).

[0048] A screw with an internal rod is screwed between bone fragments 15 in the area of ​​the fracture line 16 in order to connect the bone fragments together and ensure their subsequent osteosynthesis.

[0049] The retractable elements 4, due to the pressure exerted by tightening the cap onto the upper part of the screw, exit through the distal channels into the bone tissue and thereby provide increased, strong primary fixation of the device.

[0050] The device can be used to fix various bone fragments of different densities.

[0051] Alternatively, the device is used for dental implantation with fixation of jaw bone fragments in the following way.

[0052] To fix the implant in the jaw bone, a channel is drilled in the area of ​​the fracture line, into which a screw is inserted. After screwing the screw through the implant into the bone, the cap is screwed in using a drill and thus pressed on the internal rod, pushing it until it stops in the head. The guide support for the retractable elements, due to the L-shape, splits the retractable elements, as a result of which they, making a rectilinear movement, pass through the distal canals and penetrate the spongy substance of the bone tissue. The retractable elements are fixed in the bone tissue and create an increased strong primary fixation of the device, pressing it against the walls of the implant. Thus, the retractable elements prevent rotation of the device inside the channel, as a result of which optimal conditions arise for subsequent prosthetics and replacement of dental defects in jaw fractures. Subsequently, the implant can be removed according to clinical indications by any known industrial method.

[0053] The presence of retractable elements reduces the amplitude of the oscillatory movements of the device in bone tissue due to a strong connection with the bone, which prevents its rejection from the bone tissue.

[0054] In one embodiment, this device can also be used in the treatment of jaw fractures using a plate.

[0055] Screws with internal rods are tightened between bone fragments 15 in the area of ​​fracture lines 16 in order to connect bone fragments together and ensure their subsequent osteosynthesis.

[0056] SUBSTITUTE SHEET (RULE 26) The extension elements 4, due to the pressure exerted by tightening the caps on the upper part of the screws, exit through the distal channels into the bone tissue.

[0057] Alternatively, the device is used in the treatment of jaw fractures using a plate as follows.

[0058] A plate is placed on the bone and channels are drilled in the fracture line areas into which screws are inserted. After screwing the screws into the bone, using a trauma electric drill with a drill, the caps are screwed in and thus pressure is applied to the internal rods, pushing them all the way into the caps. The guide supports for the extension elements, due to the L-shape, split the extension elements, as a result of which they, performing a rectilinear movement, pass through the distal channels and penetrate the spongy substance of the bone tissue. The extension elements are fixed in the bone and create an increased strong primary fixation of the device, capturing bone fragments in the fracture line and pressing them against the screw walls. Thus, the extension elements prevent rotation of the device inside the channel.

[0059] The presence of retractable elements allows to reduce the number of screws inserted into the plate by 2 or more times due to the increased strength of the primary fixation of the screws in the bone tissue, and also to use these screws with a wide variety of plates and in combination with standard screws.

[0060] Thus, the presence of an additional internal mechanism of enhanced fixation creates uniform pressure in the cortical and spongy bone layers with stable fixation of the device, dosed compression of bone tissue, uniform distribution of loads and an increase in the force of primary fixation of the device. The shape of the support of this device ensures that the device cannot fall out when installed in bone tissue. The proposed method and device determine the possibility of their use in dental implantology and in various subsections of traumatology with a variety of plates, as well as in combination with standard screws and make the proposed device universal in application.

[0061] SUBSTITUTE SHEET (RULE 26)

Claims

Invention formula 1. A device for osteosynthesis and dental implantation, comprising a screw having a body with a thread on the outer wall, made for screwing the screw into bone tissue, characterized in that it contains a cap with an internal thread and an internal rod, the lower part of which is divided into L-shaped retractable elements, and the upper part is provided with a head, wherein in the upper part of the outer wall of the screw there is a thread for screwing the cap and a protruding support for abutting the cap, the inner wall of the screw contains a support for the rod head, the internal rod with the possibility of rectilinear movement is placed in the main channel made in the screw body, wherein the screw body in the lower part has a guide support, parallel to which inclined distal channels for retractable elements are made, connected to the main channel, and the cap is made with the possibility of screwing onto the thread of the upper part of the screw to provide pressure on the upper part of the internal rod,and the guide support is designed with the possibility of splitting the retractable elements of the inner rod when screwing on the cap and the possibility of ensuring the rectilinear movement of the retractable elements through the distal channels for their exit into the bone tissue.

2. The device according to item 1, characterized in that a slot is made on the outer side of the cap. SUBSTITUTE SHEET (RULE 26)

Images