A kind of plantation retention systemTechnical field
The present invention relates to the retention system of repairing for dental implant, cheekbone plantation, cranium Maxillofacial defect.
Background technology
Since Sweden professor Branemark proposes Integrated implant theory, endosteal implant is in orthopaedics, Oral and Maxillofacial Surgery, tooth-planting section, and the field such as plastic surgery and neurosurgery obtains wide sending out and applies.
Implantation body is for repairing missing tooth, because it is beautiful and comfortable, provides masticatory force large, does not injure the advantages such as adjacent teeth, obtain dentist and extensively recommend the favor with patient.But for the patient of retromaxillary region alveolar bone severe atrophy, although all kinds of bone grafting operation, periosteum inducting osseous tissue regeneration, distraction osteogenesis can be adopted, the technology such as Maxillary Sinus recover alveolar bone width and height, but it is long all to there is recovery time in these methods, cost is large, wound is large, has a big risk, the problems such as possible bone resorption.
If if there is serious absorption in the alveolar bone at missing tooth position or side, particularly maxillary sinus, mandible incisor, nasal cavity these for the deathtrap of tooth implant, all kinds of bone grafting operation can be adopted, periosteum inducting osseous tissue regeneration, distraction osteogenesis, the technology such as Maxillary Sinus recover alveolar bone width and height, or nervus mandibularis migration art is to avoid nervus mandibularis, but it is long all to there is recovery time in these methods, cost is large, wound is large, have a big risk, the problems such as possible bone resorption, adopt the region closing on bone amount abundant can avoid these problems as growing area, now just need base station and implantation body inclination implant system at an angle.
Multiple absence of tooth, Duo Ke implantation body and base station is needed to realize common path of insertion, guarantee artificial tooth works orderly and obtains normal appearance, therefore need clinically constantly to grind adjustment base station, but so also not necessarily can realize the common path of insertion of Duo Ke implantation body, particularly run into jawbone, the denture abnormal conditions because the factors such as growth, wound, tumor resection cause, this is just difficult to obtain common path of insertion.
Cheekbone implantation body is the artificial growth body being implanted to upper jaw bone and cheekbone.Cheekbone implantation body can be applicable to defect of maxilla, or the anodontia patient of maxillary alveolar bone serious absorption.Cheekbone implantation body success rate is high, and post-surgical recovery period is short, and retention is good, and several class methods of the relatively above-mentioned increase alveolar bone of wound are less, and spend less, become the standard treatment regimen of the anodontia patient of maxillary alveolar bone serious absorption abroad.Cheekbone implantation body is that diagonal is implanted in upper jaw bone and cheekbone, different with the tooth implant that conventional vertical alveolar ridge is implanted.Because cheekbone implantation body implant angle is inconsistent with occlusion direction, so need the turnover of implantation body's end generation certain angle, thus ensure that the artificial tooth long axis direction that cheekbone implantation body repairs is reverse consistent with occlusion.And this body length of cheekbone implantation body is larger, the cheekbone implantation body relatively common dental implantation procedure and step of operation is more, difficulty is larger, cheekbone implantation body implants the experience that major part relies on image data (CT etc.) and doctor, and actual implant angle can have deviation with original implant angle unavoidably.Therefore to obtain good angle more difficult for last cheekbone implantation body end.After cheekbone implantation body implants, if removable denture reparation, when the inclined palate side of cheekbone implantation body, then can make that removable denture is bigger than normal causes the uncomfortable sensation of patient, bring the problem of oral cavity cleaning, when the inclined lip side of cheekbone implantation body simultaneously, base can be caused bigger than normal, and lip is to a certain degree to front protrusion.After cheekbone implantation body implants, if fixed denture reparation, cheekbone implantation body, regardless of inclined lip side or inclined palate side, can produce the problem that artificial tooth is difficult to reach common path of insertion.Same, if cheekbone implantation body is for repairing defect of maxilla, because cheekbone implantation body diagonal is implanted and intraoperative factors, there is certain angle deviation, greatly can increase the difficulty of prosthesis and other repair structures (such as various bone lobes etc.) follow-up reparation.
About solution (comprising document and patent) and the product of cheekbone implantation body angle at the end, up to now, the angle excursion 45 degree only having Nobel Biocare and Southern implants to produce and the cheekbone implantation body of 55 degree.This Liang Lei cheekbone implantation body angle is fixed, and comparatively single.If cheekbone implantation body implant surgery angle has skew or all Bones morphology in jaw face special (such as grow, the reason such as wound and tumor cause), existing product is difficult to meet clinical requirement.
Meanwhile, the cranium Maxillofacial defect caused by congenital development, tumor and wound is clinical common diseases, brings serious body and mind injury to patient, rebuilds simultaneously bring challenges to clinical repair.The defect of cranium Maxillofacial defect particularly ear nose eye position, all can bring impact to the morphology and function in patient face portion.Clinical repair method can be divided into two large classes: autologous tissue and allosome tissue.Autologous tissue's method is by various tissue flap (flap, musculo cutaneous flap, bone lobe, cartilage flap etc.) repair deficiency, except existing for district's damage, the specific group patient that waits for a long time in chemotherapy and year is difficult to accept, outside the shortcomings such as the operative failure that the factors such as tumour patient cannot check recurrence, possible postoperative infection ischemia cause, also has facial tissue's complex shape, morphological requirements is high, and the moulding difficulty such as cartilage flap, at the moment, long-term effect is as one wishes not to the utmost for Self-tissue repair ear nose; Maxillofacial prosthesis wide accommodation, wound is little, and operation is simple, damages without for district, also exists simultaneously and needs often to clean, the deficiencies such as periodic replacement.Two class restorative procedures can be complementary, respectively has its scope of application.
Prosthesis needs most it is of concern that maintenance problem for repairing Maxillofacial defect.Anchoring methods traditional is in the past by prosthesis self gravitation, the atmospheric pressure after adsorbing with skin mucosa soft tissue, spectacle-frame, biological glue, the various maintenance such as recessed, but there is retention deficiency, the defects such as easily come off damage, scytitis.Since Branemark creates " Integrated implant " theory, titanium implant is successfully applied to Oral Repair field.1975, first Branemark proposed the conception of Kou Wai implantation body, and demonstrated implantation body's transdermal with 1977 and be applied to the probability in field, cranium jaw face, and designed a kind of special cranial bone implant.Hereafter, the application of implantation body outside the mouths such as cranium maxillofacial prosthesis body maintenance is flourish, the reasonable long-term maintenance solving the prosthesises such as ocular prosthesis, adopted nose, adopted ear.
Although rely on the prosthesis color, quality etc. of implant retention extremely similar with autologous tissue, solve the problem that profile is repaired very well, still there are some problems with in implant retention prosthesis.The deficiency describing implant retention prosthesis is summed up respectively according to ear, nose, eye three positions, as follows:
Ear defect, probably occupies 2/3 of cranium Maxillofacial defect case load.Have the following disadvantages with implant retention prosthesis: 1. implant operation has certain risk.Needed for justice ear maintenance, the implant site of implantation body is temporal bone.Although temporal bone is double-deck cortical bone, its average thickness is only 4-7mm, surprisingly penetrates temporal bone inner panel intracranial tissue can be caused as hemorrhage in cerebral dura mater, intraparenchymal injury and sigmoid sinus in boring procedure.There are 24 can get a glimpse of still unmarred middle cranial fossa cerebral dura mater bottom plantation nest in 214 ear field plantation patients of Tjellstrom report, in 32 sigmoid sinus resurrectionists, have 11 hole walls impaired hemorrhage.2. implantation body may loose or dislocation.Except temporal bone lacks adequate thickness, outside the shorter factor of this body length of implantation body, plantation nest is large, the major reason that mastoid process osteoporosis Ye Shi implantation body comes off.3. adopted ear maintenance is according to magnetic attachment maintenance, because each implantation body direction is almost parallel, magnetic attachment lateral force resisting is not enough and cause Yi Eryi slip, but magnetic attachment can keep retention 4-8 not disappear; Justice ear is according to Barclip attachment maintenance, and bar cassette can ensure side direction and axial maintenance simultaneously, but bar cassette wears abrasivus fatigue of materials owing to repeatedly getting, and can occur loosening and Malretention, and its life-span, roughly at about 1 year, needs periodically to replace.
After eyeball excise, implantation body is relied on to implant eye socket surrounding bone and make prosthesis obtain maintenance.But due to the restriction of socket of the eye week bone anatomical condition, at right eye socket of the eye 7-11 clock place, left eye socket of the eye 1-5 clock place, these region bone thickness are last, can reach 6-7mm.Therefore for common tooth implant, ocular prosthesis implant diameter is shorter, and its long-time stability can be influenced.After implantation body implants, bar cassette can be had to adhere to maintenance, magnetic attachment maintenance, ball groove attachment maintenance three kinds of forms, but because implantation body's axis centration polymerization, conventional common path of insertion is difficult to try to achieve, and magnetic base station maintenance is large to the tolerance required to implant axis, and because of implantation body's distribution rationally, can not slide, retention is good, and patient can pluck voluntarily and wear.
After defect of nose, prenasal base area longitudinally plantation is the first-selected position of defect of nose plantation.Prenasal base area is conventional, and in apertura piriformis lower edge rear, longitudinally plantation 2 pieces of implantation bodys and glabella point vertically implant 1 piece.If longitudinally implantation body's Vertical dimension top rake during plantation, then may injure Upper Anterior Teeth root of the tooth, if Vertical dimension rear-inclined, then may penetrate hard palate plate.If during longitudinal Bone mineral change, laterally plantation below apertura piriformis lower edge still can be considered.Implant diameter is 5-9mm, and length is shorter, and nose implantation body mostly is parallel implantation, according to magnetic attachment or Barclip attachment, can run into the problem that adopted ear maintenance is same.
The deficiency of the prosthesis maintenance appearance at the positions such as above-mentioned ear nose eye, domestic and foreign literature or patent there is no good solution.
In sum, existing Dental implantion, cheekbone plantation and cranium maxillofacial prosthesis body maintenance plantation etc. exists angle and position adjustments is little, uses the problems such as inconvenience.
Summary of the invention
The present invention aims to provide a kind of Novel implant retention device, the adjacent bone district that bone amount is abundant can be utilized preferably, freely adjust the angle of implantation body, thus the anatomical structure that implantation body is averted danger, improve the safety that plantation is repaired, improve implant retention ability, avoid coming off, ensure long-time stability.
Technical scheme of the present invention is: a kind of plantation retention system, comprises implantation body, connector, base station; There is screw thread implantation body outside, and center upper portion has cylinder, and cylindrical upper portion has screw thread; Connector central authorities are porose, and grooving is arranged at top, and the ear block on grooving both sides has screw; Projection with connector grooving adaptation is arranged at base station bottom, and projection has hole; Implantation body's Upper cylindrical through hole and the nut screw connection rigid connector of connector central authorities and implantation body, screw screw in the screw on connector ear block and the hole passed on the projection of base station bottom with rigid connector and base station; Before nut on fastening implantation body Upper cylindrical, connector can around the rotation of 360 degree, implantation body's axis, and before screw fastening, base station can around screw axis 180 degree rotation.
Further, the diameter of described implantation body is 4-8mm, and have annular groove around implantation body's Upper cylindrical, the boss suitable with annular groove is arranged at connector bottom.Implantation body and connector can be improved in the quality of fit of connecting portion and intensity, improve the flexural strength of pattern of farming, be comparatively applicable to the larger situation of stress.
Preferably, the diameter of described implantation body center upper portion cylinder is 1.5-5mm, is highly 4-14mm; The diameter of annular groove is 2-6mm, and the degree of depth is 4-12mm.
Further, the diameter of described implantation body is 3-4.5mm, and the cylindrical boss having diameter larger around implantation body's Upper cylindrical, the cylinder shape groove suitable with cylindrical boss is arranged at connector bottom.Implantation body and connector can be improved in the quality of fit of connecting portion and intensity, improve the flexural strength of Dental implantion structure, be relatively applicable to the less situation of stress.
Preferably, the diameter of described implantation body center upper portion cylinder is 1.5-2.5mm; The cylindrical boss diameter on implantation body top is 2-3mm, is highly 2-4mm.
Further, described base station top is provided with armature, and armature is cylindrical, and lower central has screw rod, and base station center upper portion has screw, and armature is arranged in the screw of base station center upper portion by screw rod, and the columniform diameter of armature is greater than base station upper dimension.
Preferably, described base station top is cylindrical, conical, the frustum of a cone, prismatic, frustum of a pyramid shape or stepped cylindrical shape; Base station bottom projection, bottom surface is rectangle or circle, and during for rectangle, the length of side is 2-6mm, and during for circle, diameter is 2-6mm, is highly 4-6mm.
Further, grooving is arranged at described implantation body bottom, and cutting groove depth is 0.5-1.0mm, and longitudinal length is 1.0-4.0mm, and transverse width is 2.0-3.0mm.
Further, have cavity vertically, be placed with medicine bag in cavity in described implantation body, on plantation body wall, radial direction is evenly distributed with pore.Carry out administration by implantation body, for own antiphlogistic antibacterial of performing the operation, promote synosteosis simultaneously, or be used for the treatment of the administration of Other diseases.
Further, described base station is provided with connecting rod, connecting rod has the otch suitable with base station shaped upper part.
Structure of the present invention is simple, low cost of manufacture, maintenance intensity of load is high, there is good primary stability and anti-rotation function, can angle between free adjustment base station and implantation body, adjusting range is large, thus the abundant bone district of bone regeneration around implant bone amount can be made full use of, avert danger region, obtains good common path of insertion simultaneously, has good clinical value.
Accompanying drawing explanation
Fig. 1 is structural representation of the present invention.
Implantation body's structural representation that Fig. 2 is structure shown in Fig. 1.
The connector structural representation that Fig. 3 is structure shown in Fig. 1.
Fig. 4 is another structural representation of the present invention.
The connector structural representation that Fig. 5 is structure shown in Fig. 4.
Implantation body's structural representation that Fig. 6 is structure shown in Fig. 4.
Fig. 7 is abutment structure schematic diagram of the present invention.
Fig. 8 is armature structure schematic diagram of the present invention.
Fig. 9 is that the present invention combines schematic diagram.
In figure: 1-implantation body, 2-connector, 3-base station, 4-armature, 5-screw rod, 6-base station top, 7-projection, 8-screw, 9-nut, 10-cylinder, 11-boss, 12-grooving, 13-boss, 14-screw thread, 15-annular groove, 16-hole, 17-grooving, 18-ear block, 19-groove, 20-medicine bag, 21-pore, 22-cavity, 23-connecting rod.
Detailed description of the invention
In order to make object of the present invention, technical scheme and advantage clearly understand, below in conjunction with accompanying drawing, the present invention is described in further detail.
The present invention plants retention system, comprises implantation body 1, connector 2, base station 3; There is screw thread implantation body 1 outside, and center upper portion has cylinder 10, and cylinder 10 top has screw thread 14; Connector 2 central authorities porose 16, grooving 17 is arranged at top, and the ear block 18 on grooving 17 both sides has screw; Projection 7 with connector grooving 17 adaptation is arranged at base station 3 bottom, and projection 7 has hole; Implantation body 1 Upper cylindrical 10 coordinates rigid connector 2 and implantation body 1 through the hole 16 of connector 2 central authorities with nut 9, screw 8 screws in the screw on connector 2 ear block 18 and connector 2 and base station 3 linked together through the hole on base station 3 bottom projection 7.Before nut 10 is fastening, connector 2 can around the rotation of 360 degree, implantation body 1 axis; Before screw 8 is fastening, base station 3 can around the rotation of 180 degree, screw 8 axis; Any adjustment of angle between base station 3 and implantation body 1 can be realized.
Further, as shown in Fig. 1-3, the diameter of implantation body 1 is 4-8mm, has annular groove 15 around implantation body 1 Upper cylindrical 10, and the boss 11 suitable with annular groove 15 is arranged at connector 2 bottom.Implantation body and connector can be improved in the quality of fit of connecting portion and intensity, improve the flexural strength of pattern of farming, be comparatively applicable to the larger situation of stress.
Preferably, the diameter of implantation body 1 center upper portion cylinder 10 is 1.5-5mm, is highly 4-14mm; The diameter of annular groove 15 is 2-6mm, and the degree of depth is 4-12mm.
Further, as shown in Fig. 4-6, the diameter of implantation body 1 is 3-4.5mm, the cylindrical boss 13 having diameter larger around implantation body 1 Upper cylindrical, and the cylinder shape groove 19 suitable with cylindrical boss 13 is arranged at connector 2 bottom.Implantation body and connector can be improved in the quality of fit of connecting portion and intensity, improve the flexural strength of Dental implantion structure, be relatively applicable to the less situation of stress.
Preferably, the diameter of implantation body 1 center upper portion cylinder 10 is 1.5-2.5mm; Cylindrical boss 13 diameter on implantation body 1 top is 2-3mm, is highly 2-4mm, and base station 3 bottom projection 7 can freely rotate in connector 2 top grooving 16.
The convex-concave structure of implantation body and connector binding site, not only greatly can improve both quality of fits, also substantially increase bonding strength, particularly flexural strength, thus improves plantation precision and intensity.According to bone district situation, select the implantation body's size be suitable for, thus the convex-concave structure that selection adapts, improve the suitability and quality of connection.
Further, base station 3 top is provided with armature 4, armature 4 is cylindrical, lower central has screw rod 5, base station 3 center upper portion has screw, armature 4 is arranged in the screw of base station 3 center upper portion by screw rod 5, and the columniform diameter of armature 4 is greater than base station 3 upper dimension, ensures that surrounding skin and mucosa can not embed base station.
Preferably, base station top 6 is cylindrical, conical, the frustum of a cone, prismatic, frustum of a pyramid shape or stepped cylindrical shape structure.Base station bottom projection 7, bottom surface is rectangle or circle, and during for rectangle, the length of side is 2-6mm, and during for circle, diameter is 2-6mm, is highly 4-6mm.
Preferably, when base station top 6 is stepped cylindrical shape, upper body diameter is 3-5mm, height 1-3mm, and the lower body diameter of ladder is 4-8mm, height 2-4mm.
Further, grooving 12 is arranged at implantation body 1 bottom, ensures that implantation body 1 maintenance is stablized, does not rotate.
Preferably, grooving 12 degree of depth is 0.5-1.0mm, and longitudinal length is 1.0-4.0mm, and transverse width is 2.0-3.0mm.
Further, have cavity 22 vertically, be placed with medicine bag 20 in cavity 22 in implantation body 1, on implantation body 1 wall, radial direction is evenly distributed with pore 21, and the medicine in medicine bag 20 discharges by pore 21.When implantation body 1 applies, because the damage of art district is large, itself is easily inflamed, and in addition when because of operations such as oral cavity or Oral and facial tumor excision upper jaw bone, may have tumors remaining or cancerous cell pollution.By implantation body's approach to place operative region topical, can antiphlogistic antibacterial, promote skeletonization simultaneously, pore in implantation body can make osteoblast grow into, form stronger bone-implantation body's combination interface, can chemotherapeutics be given time necessary, kill tumor cell.Slow releasing pharmaceutical is given in implantation body inside, can no pain, hurtless measure administration, does not affect minimal invasive treatment's work, more easily allows patient compliance, particularly tumor patient, and organ transplantation needs the patient of immunosuppressive, also has patients with chronic diseases.Spiral cover is set on implantation body 1 top or bottom, places for the medicine in cavity 22; When spiral cover is arranged on top, can also carry out changing dressings or dosing.
Further, base station 3 is provided with connecting rod 23, connecting rod 23 has the otch suitable with base station shaped upper part, ensure that connecting rod can not Vertical dimension dislocation.
Preferably, all being threaded is fine thread, coordinates closely, and soft tissue can be avoided preferably to grow into threaded engagement face.
When tooth and cheekbone plantation, select suitable bone district, after forming plantation nest, Implant 1, is arranged on connector 2 in implantation body 1, by nut 9 maintenance, then in the ear block screw hole of connector 2 top, screw 8 is screwed in, in the screw hole in case soft tissue is grown on implantation body 1 and connector 2.After the Integrated implant of 3-6 months, unload the screw 8 on the attaching nut 9 of connector 2 and implantation body 1 and connector ear block 18.According to the direction that required plantation connects, rotated around implantation body 1 axis by connector 2, orientation is determined in the direction according to connector 2 groove 17, then fixes with nut 8.Then base station 3 bottom projection 7 is inserted in the upper grooves 17 of connector 2, turn to the angle of needs, then fix with screw 8.Generally, first use nut 8 rigid connector 2 and implantation body 1, and then fix base station 3 and connector 2 with screw 8; If connector 2 has obstruction just with attachment screw 8 inlet ambient of base station 3, affect clinical manipulation, can first the angle Selection between base station 3 and connector 2 well be fixed afterwards, then connector 2 is inserted in the cylinder 10 on implantation body 1 top, after making base station in place, clamp nut 8.
When carrying out the plantation of cranium maxillofacial prosthesis body maintenance, select suitable bone district, after forming plantation nest, implantation body 1 implants, according to required direction, with nut 9 maintenance connector 2, then use screw 8 retained abutment 3 and connector 2, then armature 4 is screwed in case soft tissue growth holds implantation body 1, or the female thread of connector 2 of growing into.After the Integrated implant of 3-6 month, unload lower armature 4, delivery manufactures connecting rod or adopts finished product connecting rod, after connecting each implantation body, screws in armature, puts on prosthesis.Generally, be first use nut 9 rigid connector 2 and implantation body 1, then use screw 8 rigid connector 2 and base station 3; If screw 8 inlet ambient has bone or soft tissue to hinder just, affect clinical manipulation, can first then the angle Selection between base station 3 and connector 2 well be fixed, screw in implantation body together, then rotation coupling, after making base station in place, is then completely fixed nut 9 with special spanner.Then put on prosthesis, complete repair process.
Obviously, above embodiment is only citing made for the present invention, and the restriction not to embodiment of the present invention.To those of ordinary skill in the art, can also make other changes in different forms on the basis of the above description.Here exhaustive without the need to also giving all embodiments.And these belong to spirit institute's apparent change of amplifying out of the present invention or change and are still among protection scope of the present invention.