Retractor for gums

Abstract

The retractor (1) for gums comprises: a handle (2) having a first end (3) and a second end (4) opposite each other; a first retractor element (5) associated with the first end (3); a second retractor element (6) associated with the second end (4); wherein each retractor element (5, 6) comprises: a proximal plate-shaped portion (7) extending along a longitudinal direction (B) inclined with respect to the main direction (A); a distal portion (10) comprising two projecting appendages (11) partly bounding a central recess (12) configured to be placed astride an alveolar ridge (C) of a patient; and wherein the retractor elements (5, 6) are mounted on the handle (2) in a specular manner and configured to be placed on a right side and a left side of the alveolar ridge (C), respectively.

Description

[0001] RETRACTOR FOR GUMS

[0002] Technical Field

[0003] The present invention relates to a retractor for gums.

[0004] Background Art

[0005] As is well known, a dental implant substantially consists of a screw that is placed inside the maxillary or mandibular bone to replace a tooth that has been extracted or is missing.

[0006] This allows an abutment to be attached thereto, projecting externally from the cavity and serving a structural function.

[0007] There are various types of abutments, which can be replaced if, e.g., they become damaged.

[0008] Finally, a dental crown is applied on the abutment to replace the missing tooth in appearance and functionality.

[0009] In dental surgery, gum retractors are also used for various purposes, in particular to move the gingival tissue and keep the jawbone visible during surgery, e.g. during bone drilling / milling and / or the installation of the dental implants.

[0010] In order to perform such operations, the soft tissue that partly covers the dental arch must be incised and temporarily moved away from the jawbone, so as to allow the dentist or surgeon direct access to the bone itself.

[0011] Specific examples of retractors of known type are the so-called “gum separators” or “Prichard separators”.

[0012] However, all traditional retractors do have certain drawbacks, including the fact that they are often very uncomfortable and impractical to use, particularly when dental surgery is required on the maxillary bone in the proximity of the maxillary tuberosity and pterygoid area, e.g. to install implants precisely known as “pterygoid implants”.

[0013] The pterygoid area of the maxillary arch is, in fact, the furthest part from the oral opening and, therefore, the most difficult for the dentist to reach and the most difficult area in which to handle and maneuver instruments.

[0014] Furthermore, it is important to bear in mind that the complexity of correctly positioning the known type of retractors within the patient’s oral cavity may also negatively affect the performance of the operation, making it more difficult, e.g., to use the drill and burr to make the hole for the dental implant, with the risk of: the burr coming into contact with the gums and the surrounding soft tissue, damaging them and causing increased bleeding; prolonging the duration of the operation; increasing the likelihood of error; increasing the risks of contamination and complications that may occur both during and after surgery, if the operation is not optimally performed.

[0015] In other words, the use of retractors of this type, particularly for dental surgery in the proximity of the pterygoid area of the oral cavity, can significantly complicate the delicate bone drilling operations for the dentist, who runs the real risk of installing the implant in an incorrect position or at an incorrect angle, resulting in instability of the implant itself and therefore making it impossible to use it to support prosthetic rehabilitation; in actual facts, the success or failure of the operation on the patient is delegated to and critically depends on the dentist’s manual skills alone.

[0016] Description of the Invention

[0017] The main aim of the present invention is to devise a retractor for gums that allows at least partial improvements to be made to the aforementioned drawbacks.

[0018] In particular, one object of the present invention is to devise a retractor for gums that can be used in an extremely practical and functional maimer, particularly for the installation of pterygoid implants.

[0019] Another object of the present invention is to devise a retractor for gums that allows simplifying surgical procedures and reducing treatment times, thereby reducing risks for both the dentist and the patient.

[0020] Another object of the present invention is to devise a retractor for gums that allows promoting and simplifying the use of other instruments normally used by dentists (i.e., drill, burr and dental implants), particularly during the handling of the burr and the drilling of the target bone for the correct and precise placement of the implant. A further object of the present invention is to devise a retractor for gums that allows dental implant surgery to be carried out with greater precision and control by the dentist, with greater predictability of results and reduced margin of error and through a few simple surgical steps.

[0021] Another object of the present invention is to devise a retractor for gums that reduces the risk of contact between the drill and the soft tissues adjacent to the area to be operated on.

[0022] Furthermore, a further object of the present invention is to devise a retractor for gums that allows limiting the possible complications that may occur during and after surgery and, specifically, reducing the risk of contamination.

[0023] Finally, the object of the present invention is to devise a retractor for gums that allows the aforementioned drawbacks of the prior art to be overcome with a simple, rational, easy and effective to use as well as inexpensive solution.

[0024] The aforementioned objects are achieved by the present retractor for gums having the characteristics of claim 1.

[0025] Brief Description of the Drawings

[0026] Other characteristics and advantages of the present invention will become more apparent from the description of a preferred, but not exclusive, embodiment of a retractor for gums, illustrated by way of an indicative, yet non-limiting example in the accompanying drawings, in which:

[0027] Figure 1 is an axonometric view of the retractor according to the invention;

[0028] Figure 2 is a plan view of the retractor according to the invention;

[0029] Figure 3 is a side view of the retractor according to the invention;

[0030] Figure 4 is a side view, from another angle, of the retractor according to the invention;

[0031] Figure 5 is a plan view of a detail of the retractor according to the invention;

[0032] Figure 6 is a plan view of another detail of the retractor according to the invention;

[0033] Figure 7 is a side view of the detail in Figure 5;

[0034] Figure 8 is a side view of the detail in Figure 6;

[0035] Figure 9 is a side view of the retractor according to the invention during its use in the oral cavity of a patient; Figure 10 is a schematic, partly tiansparent view from above of the retractor according to the invention during its use in the oral cavity of a patient;

[0036] Figure 11 is a perspective view of the retractor according to the invention during its use in the oral cavity of a patient.

[0037] Embodiments of the Invention

[0038] With particular reference to these figures, reference numeral 1 globally indicates a retractor for gums.

[0039] The retractor 1 is, in actual facts, a surgical instrument for oral implant surgery adapted to simplify the insertion of dental implants, particularly pterygoid implants.

[0040] The retractor 1 comprises: a handle 2 elongated along a main direction A and having a first end 3 and a second end 4 opposite each other; a first retractor element 5 associated with the first end 3; a second retractor element 6 associated with the second end 4; wherein each of the retractor elements 5, 6 comprises: a proximal plate-shaped portion 7 comprising a proximal side 8 associated with the first end 3 and a distal side 9 opposite the proximal side 8, wherein the proximal plate-shaped portion 7 extends between the proximal side 8 and the distal side 9 along a longitudinal direction B inclined with respect to the main direction A by an angle of inclination a; a distal portion 10 associated with the distal side 9 and comprising at least two projecting appendages 11 partly bounding a central recess 12 measuring between 6 mm and 14 mm of width configured to be placed astride an alveolar ridge C of a patient; and wherein the retractor elements 5, 6 are mounted on the handle 2 in a specular maimer and configured to be placed on a right side and a left side of the alveolar ridge C, respectively.

[0041] Usefully, the handle 2 is divided into a central segment 13, which is cylindrical and thickened, and into two end segments 14, which are thinned and defining the first end 3 and the second end 4.

[0042] The central segment 13 is e.g. provided with non-slip shapes 15 useful for improving the dentist’s grip on the retractor 1.

[0043] The proximal plate- shaped portions 7 extend from the end segments 14 and, e.g., consist of thin plates (1 mm thick) extending between the proximal side 8 and the distal side 9.

[0044] In this regard, it should be noted that, in the context of this disclosure, the terms “proximal” and “distal” should be meant with reference to the position of the handle 2; this means, for example, that the proximal side 8 represents one side of the proximal plate-shaped portions 7 that is close to the handle 2, while the distal side 9 represents a side of the proximal plate-shaped portions 7 that is far from the handle 2.

[0045] The proximal side 8 and the distal side 9 allow the longitudinal direction B of the proximal plate-shaped portions 7 to be identified and defined, which is, in fact, defined as the direction along which the proximal plate-shaped portions themselves extend from the proximal side 8 to the distal side 9.

[0046] As mentioned, this longitudinal direction B is inclined with respect to the main direction A, forming an angle of inclination a, which will be discussed in more detail later in this disclosure.

[0047] Usefully, the proximal plate-shaped portion 7 of each retractor element 5, 6 comprises a main face 16 and a secondary face 17 opposite the main face 16.

[0048] The main face 16 is particularly intended to be placed facing at least partly the alveolar ridge C of the patient in the proximity of the area where the dentist is carrying out the dental surgery.

[0049] Usefully, therefore, the main face 16 is mirrored, i.e., it is capable of reflecting light and of providing a reflected image of the area of the operation, thus facilitating the dentist during the operation.

[0050] Advantageously, the mirror effect of the main face 16 is achieved by making the face itself out of a shiny metallic material.

[0051] Preferably, the main face 16 comprises at least one longitudinal rectilinear mark 18 that is directed substantially parallel to the longitudinal direction B.

[0052] The longitudinal rectilinear mark 18 consists e.g. of a lasermark, i.e., a mark made by laser; alternative embodiments cannot, however, be ruled out wherein the longitudinal rectilinear mark 18 is made differently and / or consists of a scratch, an ink marking, or something else.

[0053] Usefully, the longitudinal rectilinear mark 18 is located at the center of the main face 16 and helps the dentist to direct the retractor 1 in alignment with the alveolar ridge C and to move other instruments to the surgery area, e.g., drills, burrs and dental implants.

[0054] For example, when performing implant surgery to install a pterygoid implant, the longitudinal rectilinear mark 18 helps the surgeon to maintain the vestibulo- palatal inclination that the pterygoid implant must take on.

[0055] In this case, once the retractor 1 has been placed with the central recess 12 straddling the alveolar ridge C (i.e., with one projecting appendage 11 in the palatal position and the other projecting appendage 11 in the vestibular position), the dentist simply has to direct the drill and the relevant implant so as to keep them parallel and aligned with the longitudinal rectilinear mark 18.

[0056] Advantageously, the main face 16 also comprises one or more transverse rectilinear marks 19 substantially orthogonal to the longitudinal direction B.

[0057] In the embodiment shown in the figures, for example, there are two transverse rectilinear marks 19 spaced apart from each other by approximately 5 mm, but alternative embodiments cannot be ruled out wherein the main face 16 may be provided with only one transverse rectilinear mark 19 or three or more transverse rectilinear marks 19.

[0058] The transverse rectilinear marks 19 assist the dentist during the osteotomy and implant insertion sequence by providing a visual reference in terms of depth and distance.

[0059] Usefully, the angle of inclination a is diversified depending on the retractor element 5, 6.

[0060] In the particular embodiment shown in the figures, for example: the angle of inclination a of the first retractor element 5 is of between 5° and 45°, preferably of between 10° and 35°, preferably of between 15° and 25°, preferably equal to 20°; the angle of inclination a of the second retractor element 6 is of between -5° and -45°, preferably of between -10° and -35°, preferably of between -15° and -25°, preferably equal to -20°. The angle of inclination a of the first retractor element 5 is graphically shown in Figure 5, while the angle of inclination a of the second retractor element 6 is graphically shown in Figure 6.

[0061] It should be noted that in the context of this disclosure, the angle of inclination a must be measured considering the lying plane of each proximal plate-shaped portion 7 and an observer looking towards the corresponding main face 16; in this configuration, the main direction A is located at noon and defines a reference position corresponding to an angle of inclination equal to 0°, wherein the angles of inclination a that extend clockwise with respect to the reference position of the main direction A are considered positive, while the angles of inclination a that extend counterclockwise with respect to the reference position of the main direction A are considered negative.

[0062] It is therefore easy to appreciate that the first retractor element 5, which has a positive angle of inclination a, slopes sideways to the right with respect to the main direction A; this makes it suitable for use on the right side of the patient’s alveolar ridge C, as shown, for example, in Figure 10.

[0063] Conversely, the second retractor element 6, which has a negative angle of inclination a, slopes sideways to the left with respect to the main direction A; this makes it suitable for use on the left side of the patient’s alveolar ridge C.

[0064] The amplitude of the angles of inclination a of the retractor elements 5, 6 has been designed to offer high comfort of use of the retractor 1 once it has been introduced into the oral cavity O of the patient.

[0065] In the particular embodiment shown in the figures, the proximal plate-shaped portions 7 of the retractor elements 5, 6 are substantially coplanar to the main direction A; in other words, this means that the proximal plate-shaped portions 7 lie on planes on which the handle 2 and the main direction A also lie.

[0066] Alternative embodiments cannot, however, be ruled out wherein the proximal plate-shaped portions 7 lie on planes on which the main direction A does not also lie.

[0067] Furthermore, in the particular embodiment shown in the figures, the proximal plate-shaped portions 7 of the retractor elements 5, 6 are substantially coplanar to each other; in other words, the proximal plate-shaped portion 7 of the first retractor element 5 lies on the same plane as the proximal plate-shaped portion 7 of the second retractor element 6.

[0068] More specifically, the faces 16, 17 of the proximal plate-shaped portion 7 of one retractor element 5, 6 are arranged inverted with respect to the faces 16, 17 of the proximal plate-shaped portion 7 of the other retractor element 5, 6; in other words, if the main face 16 of the first retractor element 5 is considered to be facing upwards, then the main face 16 of the second retractor element 6 faces downwards, as shown in Figures 1-4.

[0069] In this case too, alternative embodiments cannot, however, be ruled out wherein the proximal plate-shaped portions 7 lie on different planes.

[0070] In this regard, it should be noted that it is possible to envisage solutions wherein the proximal plate-shaped portions 7, while both remaining coplanar to the main direction A, lie on different planes, e.g. on two planes inclined / orthogonal to each other that specifically share the main direction A as their only line of intersection; such an alternative solution has the advantage of ensuring stable balance for the retractor 1 when placed on a horizontal surface, such as a dentist’s table or a tray, given that in this case the retractor 1 rests not on the central segment 13, which is cylindrical in shape, but on the retractor elements 5, 6 which, angularly offset from each other, protrude from the central segment 13.

[0071] Moving on to a detailed description of the distal portion 10 of the retractor elements 5, 6, it should first be noted that the central recess 12 is substantially rectangular in shape, with straight edges defined by the projecting appendages 11 and by a transverse side 20 which is substantially parallel to the distal side 9. The width of the central recess 12 is defined, in other words, by the distance d between the projecting appendages 11 and, as mentioned, is of between 6 mm and 14 mm, but preferably of between 8 mm and 12 mm, preferably of between 9 and 11 mm, and even better equal to 10 mm.

[0072] The depth of the central recess 12, on the other hand, is defined by the length 1 of the projecting appendages 11, which, e.g., is of between 3 and 7 mm, preferably of between 4 and 6 mm, and even better 5 mm.

[0073] The dimensions of the central recess 12 are designed to provide high stability to the retractor 1 when placed astride the alveolar ridge C, particularly in the proximity of the pterygoid area.

[0074] In this regard, it should be noted that the central recess 12 is intended to be positioned behind the posterior limit of the patient’s maxillary tuberosity, so as to identify the base of the pterygoid fossa and the base of the palatine pyramidal process, which represent the target point for pterygoid implants.

[0075] Advantageously, the distal portion 10 of the retractor elements 5, 6 comprises a plate-shaped stretch 21 placed between the distal side 9 and the projecting appendages 11.

[0076] In other words, in the embodiment shown in the figures, the distal portion 10 of the retractor elements 5, 6 is divided into: the plate-shaped stretch 21, which is connected to the distal side 9; and the projecting appendages 11, which protrude from the plate-shaped stretch 21; and the transverse side 20 of the central recess 12 is formed on the plate-shaped stretch 21.

[0077] It should be noted that the plate-shaped stretch 21 serves as a spacer for the projecting appendages 11 and the central recess 12 which are thus located a few millimeters away from the distal side 9 and from the proximal plate-shaped portion 7.

[0078] The presence of the plate-shaped stretch 21 allows, during use, the proximal plate-shaped portion 7 to be kept slightly spaced apart from the alveolar ridge C, with obvious advantages for the dentist as better visibility of the area of operation and greater room for maneuver.

[0079] Alternative embodiments of the present invention cannot, however, be ruled out wherein the plate-shaped stretch 21 is not provided, the distal portion 10 only consists of the projecting appendages 11 and the central recess 12 is bounded by the projecting appendages 11 and by the distal side 9, which thus coincides with the transverse side of the central recess 12.

[0080] Advantageously, the projecting appendages 11 have blunt and / or rounded tips; in other words, there are no pointed parts or sharp edges that could puncture and undesirably damage the patient’s gums. Usefully, the proximal plate-shaped portion 7 lies on a proximal lying plane Pl and the distal portion 10 lies on a distal lying plane P2, wherein the proximal lying plane Pl and the distal lying plane P2 are inclined to each other by an angle of bending 0 of between 110° and 160°, preferably of between 125° and 145°, preferably of between 130° and 140°, preferably equal to 135°.

[0081] The inclination of the distal portion 10 with respect to the proximal plate-shaped portion 7 helps to promote the use of the retractor 1; as shown e.g. in Figure 9, during use, the distal portion 10 can be located with the distal portion 10 substantially orthogonal to the direction of longitudinal extension of the alveolar ridge C (in Figure 9, the alveolar ridge C extends horizontally while the distal portion 10 extends vertically) to maximize the stability of the retractor 1 placed with the central recess 12 straddling the alveolar ridge, while the proximal plateshaped portion 7 is positioned obliquely with respect to the direction of longitudinal extension of the alveolar ridge C, forming an angle that facilitates the dentist’s visibility of the alveolar ridge C, also due to the fact that the main face 16 is mirrored.

[0082] Usefully, the retractor 1 is made in a single monolithic body piece and, in other words, consists of a single piece whose parts do not need to be assembled together; the retractor 1 can e.g. be made by machining a metal bar and by hot or cold bending the retractor elements 5, 6, so as to define the angles of inclination a and the angles of bending 0.

[0083] Advantageously, the retractor 1 is made of stainless steel or other material suitable for surgical use.

[0084] The operation of the invention is as follows.

[0085] The surgeon first prepares the oral cavity O of the patient by incising the gum G in the area to be operated on, i.e., in the proximity of the pterygoid fossa (retrotuberal incision), in order to expose the right or left alveolar ridge C of the maxillary bone.

[0086] At this point, the retractor 1 is inserted into the incision so as to space apart and keep the incision flaps spaced apart, and placed with the central recess 12 straddling the alveolar ridge C and positioned behind the posterior limit of the maxillary tuberosity, so as to identify the base of the pterygoid fossa and the base of the palatine pyramidal process where the pterygoid implant is to be implanted.

[0087] The correct positioning of the retractor 1 requires it to be positioned so that, in the side view (Figure 9), the distal portion 10 is orthogonal or substantially orthogonal to the direction of longitudinal extension of the alveolar ridge C, while, in the view from above (Figure 10), the longitudinal rectilinear mark 18 is aligned or substantially aligned with the direction of longitudinal extension of the alveolar ridge C.

[0088] To appreciate the correct positioning of the retractor 1 in the oral cavity O of the patient, reference can also be made to Figure 11, which shows, in addition to the retractor 1 placed on the alveolar ridge C: the tongue L, gum G and teeth D of the patient; the hole F already drilled in the alveolar ridge C and intended to receive the pterygoid implant; an abutment E of another implant previously applied to the patient; a retractor tool U, which is well known in itself and used to keep the patient’s cheeks apart during surgery.

[0089] It should be noted that the surgeon can advantageously use the retractor 1 to: keep the incision flaps spaced apart; view the area of intervention thanks to the proximal plate-shaped portion 7, which is mirrored; use the longitudinal rectilinear mark 18 as a guide to direct the drill and the relevant implant in order to respect the correct vestibulo-palatal inclination that the pterygoid implant must take on; use the transverse rectilinear marks 19 as a visual reference for the distance and depth of the implant.

[0090] It has, in practice, been ascertained that the described invention achieves the intended objects.

[0091] In this regard, it should be noted that the present invention facilitates and simplifies oral implant surgery and, in particular, the insertion of pterygoid implants, thus reducing treatment times and limiting risks for the dentist and patient, comprising those of contamination.

Claims

CLAIMS1) Retractor (1) for gums, characterized by the fact that it comprises: a handle (2) elongated along a main direction (A) and having a first end (3) and a second end (4) opposite each other; a first retractor element (5) associated with said first end (3); a second retractor element (6) associated with said second end (4); wherein each of said retractor elements (5, 6) comprises: a proximal plate-shaped portion (7) comprising a proximal side (8) associated with said first end (3) and a distal side (9) opposite said proximal side (8), wherein said proximal plate-shaped portion (7) extends between the proximal side (8) and the distal side (9) along a longitudinal direction (B) inclined with respect to said main direction (A) by an angle of inclination (a); a distal portion (10) associated with said distal side (9) and comprising at least two projecting appendages (11) partly bounding a central recess (12) measuring between 6 mm and 14 mm of width configured to be placed astride an alveolar ridge (C) of a patient; and wherein said retractor elements (5, 6) are mounted on said handle (2) in a specular maimer and configured to be placed on a right side and a left side of said alveolar ridge (C), respectively.2) Retractor (1) according to claim 1, characterized by the fact that: said angle of inclination (a) of said first retractor element (5) is of between 5° and 45°, preferably of between 10° and 35°, preferably of between 15° and 25°, preferably 20°; said angle of inclination (a) of said second retractor element (6) is of between -5° and -45°, preferably of between -10° and -35°, preferably of between -15° and -25°, preferably equal to -20°.3) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said width of the central recess (12) is of between 8 mm and 12 mm, preferably of between 9 mm and 11 mm, preferably equal to4) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said distal portion (10) comprises a plate-shaped stretch (21) placed between said distal side (9) and said projecting appendages (11).5) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said proximal plate-shaped portion (7) lies on a proximal lying plane (Pl) and said distal portion (10) lies on a distal lying plane (P2), wherein said proximal lying plane (Pl) and said distal lying plane (P2) are inclined to each other by an angle of bending (0) of between 110° and 160°, preferably of between 125° and 145°, preferably of between 130° and 140°, preferably 135°.6) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said proximal plate-shaped portion (7) is substantially coplanar to said main direction (A).7) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said proximal plate-shaped portion (7) comprises a main face (16) and a secondary face (17) opposite said main face (16).8) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said main face (16) is mirrored.9) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said main face (16) comprises at least one longitudinal rectilinear mark (18) which is substantially parallel to said longitudinal direction (B).10) Retractor (1) according to one or more of the preceding claims, characterized by the fact that said central recess (12) is substantially rectangular in shape, with straight edges defined by said projecting appendages (11) and by a transverse side (20) which is substantially parallel to said distal side (9).

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