JP2008005960A - Instrument for medical operation - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an instrument for medical operation which can shorten the healing period for tooth regeneration with improved safety and sureness in a maxillary sinus lifting surgery by eliminating broken bone lifting by hammering of a maxillary sinus bone. <P>SOLUTION: The instrument comprises a screw body which has an endosteal thread part (4) tapered and made up of crests having a tapping groove closer to its tip, a cylindrical thread part (1) as a propulsion applicator with crests and a part (6) as a rotation applicator with a plurality of faces to be fitted onto a jig for turning and a plate body which has a crown fixing guide part (8) with crests (10) in the internal peripheral surface of a through hole to be screwed with the thread part (1) as a propulsion applicator and two (or one) flange parts (9) each with a protrusion part at its tip being extended horizontally from the crown fixing guide part (8). A positioning is made with the plate body fixed on a loss part and the screw body is turned to enable the pushing up of a maxillary sinus mucosa into the maxillary sinus. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a surgical instrument, and in particular, as a dental regeneration when a tooth is removed due to dental caries, periodontal disease or orthodontics, or tooth extraction for treatment, an artificial root is placed on the maxillary molar part. The present invention relates to an instrument for raising the maxillary sinus floor used for maxillary sinus floor elevation that is performed when the maxillary molar portion is deficient in bone height due to bone resorption or the like.

  There are cases where the height of the maxillary molar portion is insufficient with respect to the artificial tooth root embedded in the maxilla. Japanese Laid-Open Patent Publication No. 2001-509401 describes a method for forming an artificial tooth root and an artificial tooth root bed to be applied to such a location, and it is necessary to perform a maxillary sinus floor raising operation in the application.

  FIG. 5 is a perspective view showing a surgical instrument used in a conventional maxillary sinus floor raising operation, and FIG. 6 is a cross-sectional view showing a state in which the conventional maxillary sinus floor raising operation is performed.

  As shown in FIG. 6, the portion of the artificial root bed (29) to be formed is compared with the portion where the crown (17, 19) and the root (18, 20) are healthy compared to the portion of the maxilla (14). In some cases, the thickness of the maxillary molar portion is insufficient.

  An example of a conventional surgical instrument is described in Japanese Patent Laid-Open No. 2003-199773. As shown in FIG. 5, such a surgical instrument passes through the two bent portions (25, 26) from the tip portion (23), and the striking portion (28 having a planar shape or a spherical shape at the end portion). Up to the handle (27) provided with a) is integrally formed. Furthermore, a tip recess (24) is formed in the tip (23).

  As shown in FIG. 6, at the time of a conventional maxillary sinus floor raising operation, an artificial dental root bed (29) is drilled in the maxillary bone (14) by using an implant drill, and the maxillary sinus floor bone is obtained. Let (30) remain thin. Thereafter, the distal end portion (23) is inserted into the artificial root bed (29), and the striking portion (28) is beaten with a scissors (not shown), so that the maxillary bone (14) penetrates in a circular shape. Then, it is lifted into the maxillary sinus (16) together with the maxillary sinus mucosa (15). Therefore, the maxillary sinus floor bone (30) reaches the position of the maxillary sinus floor bone (31). Thereafter, the bone filling material (22) is filled.

  However, there is a gap between the sensation of the hand when the maxilla (14) does not reach a fracture and it is just beaten, and the sensation of the hand when the maxilla (14) is broken so that it penetrates in a circle. Because there is no big difference, and it is difficult for the surgeon to perceive the change that occurs in the strike feeling felt through the strike portion (28), the adjustment of hitting the strike portion (28) is the experience of the surgeon. Therefore, there is a problem that the maxillary sinus mucosa (15) may be pierced.

  Japanese Patent Laid-Open No. 2001-170078 describes a flat implant that does not require a maxillary sinus floor elevation, but has a problem that the process of cutting the maxilla is complicated.

As described above, the operation of the maxillary sinus floor raising operation requires a great deal of time, and a high level of skill is required of the operator.
Special table 2001-509401 gazette JP 2003-199773 A Japanese Patent Laid-Open No. 2001-170078

  An object of the present invention is to perform tooth regeneration in the case of a missing tooth in the maxillary molar part. It is an object of the present invention to provide a surgical instrument that can improve safety and certainty by not increasing the speed and shorten the period of tooth regeneration and healing.

  The surgical instrument according to the present invention includes a screw body and a plate body.

  Among these, the screw body is arranged coaxially with the intraosseous screw portion including a screw thread provided on the outer peripheral surface of the taper shape, a tapping groove provided near the tip of the screw thread, and the intraosseous screw portion. And a propulsive force applying screw portion having a thread on a cylindrical outer peripheral surface, and a rotational force applying portion for turning the intraosseous screw portion and the propelling force applying screw portion.

  It is preferable that the rotational force imparting portion includes a plurality of surfaces that are arranged coaxially with the intraosseous screw portion and the propulsive force imparting screw portion and fit with a jig for turning.

  Moreover, it is preferable that the front-end | tip part of the said intraosseous screw part is a substantially spherical shape.

  Or it is preferable that the front-end | tip part of the said intraosseous screw part contains circular arc shape in the outline in a cross section perpendicular | vertical to an axial direction.

  On the other hand, the plate body has a crown fixing guide portion having a thread on the inner peripheral surface of the through hole, and a projection extending in the horizontal direction from the crown fixing guide portion and protruding in the axial direction of the through hole at the tip. And one or two flange portions provided with a portion.

  In the surgical instrument according to the present invention, the thread of the propulsion force imparting screw portion of the screw body can be screwed to the thread of the crown fixing guide portion of the plate body.

  Further, a plurality of screw bodies are prepared, each of the plurality of screw bodies has an outer diameter of a different intraosseous screw portion, and the thread of each of the propulsive force applying screw portions of the plurality of screw bodies is the plate body It is preferable to be able to be screwed in common with the thread of the crown fixing guide portion.

  In this case, in the plurality of screw bodies, the outer diameter of the base side of the intraosseous screw portion of one screw body is equal to or larger than the outer diameter of the distal end side of the intraosseous screw portion of the other one screw body, Furthermore, it is said that the distal end portion is thicker in order so that the outer diameter of the base portion of the bone screw portion of the latter screw body is equal to or larger than the outer diameter of the distal end side of the bone screw portion of one different screw body. It is preferable to have a dimensional relationship.

  The surgical instrument of the present invention is used in particular for maxillary sinus floor elevation, and can be applied to other surgical instruments in the orthopedic field in which the bone width is expanded while expanding the bone.

  By using the surgical instrument of the present invention for maxillary sinus floor elevation and raising the fracture by pushing, it is safe, unlike conventional cases where the maxillary sinus floor bone is raised by striking , The maxillary sinus floor mucosa can be lifted accurately without impacting the patient, resulting in shortening the operation time, reducing the physical and mental burden on the patient, and reducing the cost Can also be obtained.

  The surgical instrument of the present invention will be described with reference to the drawings.

  FIG. 1 is a perspective view showing an embodiment of a screw body and a plate body of the present invention. FIG. 2 is a perspective view showing three screw bodies having different tip thicknesses. FIG. 3 is a perspective view showing different embodiments of the screw body and the plate body of the present invention.

  The surgical instrument of the present invention comprises a screw body and a plate body.

  The screw body of the present invention comprises a substantially cylindrical pin body that extends in the axial direction as a whole. On the distal end side in the axial direction, an intraosseous thread portion (4a, 4b, 4c) comprising a thread provided on a tapered outer peripheral surface and a tapping groove (3) provided near the distal end of the thread is provided. In addition, the axially intermediate portion is arranged coaxially with the intraosseous screw portion (4a, 4b, 4c), and is larger than the outer diameter of the proximal end portion of the intraosseous screw portion (4a, 4b, 4c), and is cylindrical. A propulsive force imparting screw portion (1) having a thread on the outer peripheral surface of the shape is provided. Furthermore, on the rear end side in the axial direction, it is arranged coaxially with the intra-osseous screw portion (4a, 4b, 4c) and the propulsion force applying screw portion (1), and is fitted with an external jig for turning around the shaft. And a rotational force applying unit (6) having a plurality of surfaces. Furthermore, it is provided with a vertical guide portion (7) having a structure capable of suppressing the core runout when the rotation is applied, and these are integrally formed.

  The maxillary sinus floor elevation is preferably provided with the above-described structure, but when used for other procedures, the rotational force imparting portion is a crank shape, the rear end side is a handle, and an intraosseous screw portion. Alternatively, a structure may be adopted in which the shaft is pivoted about the axis of the propulsion force applying screw portion, and the vertical guide portion may be omitted.

  One embodiment of the plate body of the present invention is applied in the case of an intermediate tooth defect. As shown in FIG. 1, a substantially cylindrical crown having a thread (10) on the inner peripheral surface of the through hole. A fixed guide part (8) is provided. The crown fixing guide portion (8) is disposed between the adjacent crowns at the position to be treated at the position to be treated. A protrusion extending horizontally in the direction of the adjacent crown from the crown fixing guide portion (8), protruding to the opposite side of the crown at the position of the crown adjacent to the tip thereof, and extending in the axial direction of the through hole Two flange portions (9) each having a portion are provided. The screw thread of the propulsion force imparting screw part (1) of the screw body can be screwed to the screw thread (10) of the crown fixing guide part (8) of the plate body.

  A different mode of the plate body of the present invention is applied in the case of a free end defect. As shown in FIG. 3, unlike the above mode, one flange portion is provided on one side of the crown fixing guide portion (11). (12) is provided.

  It is preferable to prepare, select and use these two plate bodies.

  The distal end portion (2a) of the intraosseous screw portion (4a) has a substantially spherical shape. Moreover, the front-end | tip part (2b, 2c) of an intraosseous screw part (4b, 4c) contains circular arc shape in the outline in the cross section perpendicular | vertical to an axial direction, and has a circular flat part at the front-end | tip.

  In the screw body, the axial movement amount of the screw body is visually recognized on the outer peripheral surface of the intermediate portion between the intraosseous screw portion (4a, 4b, 4c) and the propulsion force applying screw portion (1). The depth mark (5) is provided at any position by engraving or applying it by any known technique.

  Further, the material for the surgical instrument of the present invention may be selected from any of known materials, and examples thereof include titanium or a titanium alloy.

  The maxillary sinus floor elevation using the screw body and plate body of the present invention will be described with reference to the drawings.

  FIG. 4 is a cross-sectional view showing a state in which maxillary sinus floor elevation is performed using the surgical instrument of the present invention.

  At the time of maxillary sinus floor elevation, a resin filling material (21) is used to fix the adjacent crowns (17, 19) so as to cover the flange portion (9) of the plate body. In addition to such a fixing method, it is also possible to firmly fix between the flange portion (9) and the adjacent crown (17, 19) by using a metal fitting or a metal wire (not shown). Various fixing methods according to the bone quality of the maxilla (14) are possible.

  Thereafter, the screw body is inserted into the crown fixing guide portion (8) and turned to thereby enlarge the hole diameter of the artificial root bed (29) by the tapping groove (3) and the intraosseous screw portion (4). . At the same time, the rotation imparted by the rotational force imparting portion (6) becomes the axial propulsive force of the screw body at the propelling force imparting screw portion (1), and the tip end portion (2) having a round tip is the maxillary sinus. The mucosa (15) is pushed up into the maxillary sinus (16).

  Further, by providing tapping grooves (3) at a plurality of locations on the tapered surface of the intra-osseous screw portion (4), the artificial dental root bed (29) can be smoothly expanded.

  Although the external dimensions of the screw body are arbitrary, the spherical surface of the distal end portion (2) can be exemplified as R1, and the taper angle of the intraosseous screw portion (4) can be exemplified as 4 degrees.

  Since the depth mark (5) is provided on the cylindrical surface of the screw body, it is possible to grasp the amount of elevation which is the height at which the maxillary sinus mucosa (15) is pushed up into the maxillary sinus (16).

  Thereafter, the screw body and the plate body are removed, and the gap between the raised maxillary sinus mucosa (15) and the maxilla (14) is filled with a bone filling material (22), and the bone height of the maxillary molar portion is adjusted. Make up for the shortage.

  The surgical instrument for raising the maxillary sinus floor according to the present invention comprises a plurality of (three in the example shown in FIG. 2) screw bodies and, for example, two plate bodies. The outer diameter on the base side of the intra-bone screw portion (4a) of the illustrated screw body is equal to or larger than the outer diameter on the distal end side of the intra-bone screw portion (4b) of the screw body illustrated in the center in FIG. The outer diameter on the base side of the intraosseous screw portion (4b) of the screw body shown in the center in FIG. 2 is equal to or larger than the outer diameter on the distal end side of the intraosseous screw portion (4c) of the screw body shown on the right in FIG. Are each dimensioned.

  In this way, by using a plurality of screw bodies having a dimensional relationship that the distal end portion is thicker in order, it is possible to easily enlarge the hole diameter and the bone width in the maxillary sinus floor elevation.

  The present invention can be used not only for maxillary sinus floor elevation, but also for a procedure for expanding the bone width while expanding the bone. For example, the present invention can also be applied to a procedure in the field of orthopedics.

It is a perspective view which shows one Example of the screw body and plate body of this invention. It is a perspective view which shows three screw bodies from which the thickness of a front end differs. It is a perspective view which shows the Example from which the screw body and plate body of this invention differ. It is sectional drawing which shows the state which performs maxillary sinus floor raising operation using the surgical instrument of this invention. It is a perspective view which shows the conventional instrument for raising the maxillary sinus floor. It is sectional drawing which shows the state which performs the conventional maxillary sinus floor raising operation.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Propulsion force provision screw part 2, 2a, 2b, 2c Tip part 3 Tapping groove 4, 4a, 4b, 4c Intraosseous screw part 5 Depth mark 6 Rotation force provision part 7 Vertical guide part 8, 11 Crown fixing guide part 9 , 12 Flange 10, 13 Thread 14 Maxilla 15 Maxillary sinus mucosa 16 Maxillary sinus 17, 19 Crown 18, 20 Tooth root 21 Resin filling material 22 Bone prosthesis material 23 Tip 24 Tip recess 25, 26 Bend 27 Handle 28 Striking portion 29 Artificial root bed 30, 31 Maxillary sinus floor bone

Claims (9)

  A screw thread provided on the outer peripheral surface of the taper shape, an intraosseous screw portion comprising a tapping groove provided near the tip of the screw thread, and coaxially arranged with the intraosseous screw portion, on the cylindrical outer peripheral surface A screw body comprising: a propulsive force applying screw portion provided with a screw thread; and a rotational force applying portion for rotating the intraosseous screw portion and the propulsive force applying screw portion.   The said rotational force provision part is arrange | positioned coaxially with the said intraosseous screw part and a propulsion force provision screw part, and is provided with the several surface fitted with the jig | tool for rotation. Screw body.   The screw body according to claim 1, wherein a distal end portion of the intraosseous screw portion has a substantially spherical shape.   The screw body according to claim 1, wherein the distal end portion of the intraosseous screw portion includes an arc shape in a contour in a cross section perpendicular to the axial direction.   A crown fixing guide portion having a thread on the inner peripheral surface of the through-hole, and a projection portion extending in the horizontal direction from the crown fixing guide portion and protruding in the axial direction of the through-hole at the tip Or a plate body characterized by having two flange parts.   A screw body according to any one of claims 1 to 4 and a plate body according to claim 5, wherein a screw thread of the propulsion force applying screw portion of the screw body is a crown fixing guide of the plate body. A surgical instrument characterized in that it can be screwed onto the thread of the part.   A plurality of screw bodies according to any one of claims 1 to 4 and a plate body according to claim 5, each of the plurality of screw bodies has an outer diameter of a different intraosseous screw portion, The surgical instrument characterized in that the screw threads of the propulsion force applying screw portions of the plurality of screw bodies can be screwed into the screw threads of the crown fixing guide portion of the plate body.   The plurality of screw bodies have a distal end so that the outer diameter of the base side of the intraosseous screw portion of one screw body is equal to or larger than the outer diameter of the distal end side of the intraosseous screw portion of the other one screw body. The surgical instrument according to claim 7, wherein the dimensional relationship is such that the portions are thicker in order.   The surgical instrument according to any one of claims 6 to 8, which is used for maxillary sinus floor elevation.