JP4172764B2 - Maxillary sinus floor elevation device and system - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a maxillary sinus floor raising device and a system for pushing a desired portion of the maxilla into the maxillary sinus in order to form a hole for implanting an artificial dental root fixture in the maxilla.
[0002]
[Prior art]
When an artificial root fixture (hereinafter abbreviated as “fixture”) is fixed to the jawbone, the mandible is deep enough to form a hole for embedding the fixture, as shown in FIG. Since the maxillary bone 13 has a small depth from the alveolar crest 11 to the maxillary sinus floor 12a, when a fixture is placed on the maxillary bone 13 side, as shown in FIG. Using the instrument 20, the maxillary sinus floor 12 a is pushed inward of the maxillary sinus 12. This is because if the hole penetrates the maxillary sinus 12, there is a risk of bacterial infection.
[0003]
This instrument 20 is provided with a distal end bar-like portion 21 for pushing up a desired portion of the maxilla 13 into the maxillary sinus 12 on the distal end side of the gripping portion 22, and the distal end rod-like portion 21 is cut to the periphery of the distal end surface 23 that forms a concave shape. The edge 24 is formed and is called a maxillary sinus floor raising device.
[0004]
After drilling a cortical bone and an interface bone at a desired site of the maxilla 13 with a drill bar, the maxillary sinus floor raising device 20 is pushed up toward the maxillary sinus 12. At this time, the maxillary sinus floor 12a is pushed inward of the maxillary sinus 12 by the cut bone being pushed into the distal end face 23 side of the distal end rod-like portion 21. And after securing the space for embedding a fixture, embedding a desired fixture was performed.
[0005]
As shown in FIG. 9 , in the maxillary sinus floor raising device 20, the distal end bar-like portion 21 was substantially straight (Non-Patent Document 1).
[Non-Patent Document 1]
Summers RB, "Sinus floor elevation with osteotomes", J. Esthet Dent, 1998; 10 (3): p.164-171
[0006]
[Problems to be solved by the invention]
However, in this maxillary sinus floor elevation device, the bone near the hole wall for fixture placement is hardly compressed because the tip rod-shaped portion is substantially straight, and the bone density is small. The power to grip Char was small. As a result, the fixture may have left.
[0007]
Moreover, since the hole formed by the drill bar is not used as a guide, the push-up direction of the tip end bar-shaped portion is likely to be erroneous, and in this case, the direction of the hole to be formed is also inappropriate. As a result, there was a risk that the fixture would turn in the wrong direction.
[0008]
In view of such a problem, the present invention provides a maxillary sinus floor raising device that prevents the fixture on the upper jaw side from being detached and prevents the fixture from being installed in the wrong direction. With the goal.
[0009]
[Means for Solving the Problems]
In order to solve the above-mentioned problem, the maxillary sinus floor raising device of the present invention is provided with a distal end rod-like portion for pushing up a desired portion of the maxilla into the maxillary sinus on one end side, and on the other end side of the distal end rod-like portion , a tapered portion which becomes late spread toward the other end side, at one end of the tip rod portion, the straight tip portion is formed extending from the distal end surface of the tip rod-like portion to the tapered portion, the tapered portion A first-stage tapered portion located at least on one end side, a second-stage tapered portion located on the other end side of the first-stage tapered portion, the first-stage tapered portion, and the second-stage tapered portion. And a cylindrical portion positioned between the tapered portions .
[0010]
According to this configuration, the tapered portion compresses the bone in the vicinity of the hole wall for fixture insertion, so that the density of the bone in that portion increases. As a result, the force with which the bone grips the fixture increases.
[0011]
Furthermore, the distal end side of the distal end rod-shaped portion (the front side of the tapered portion) has a small diameter, and therefore the hole bottom side is formed with a small diameter. For this reason, the adhesion force between the fixture and the bone is large on the bottom side of the hole, and this also increases the force with which the bone grips the fixture. In addition, when using the maxillary sinus floor raising device having a large diameter in stages, a cylinder with a hole corresponding to the cylindrical portion between the first-stage taper portion and the second-stage taper portion The next larger diameter can be inserted using the shaped portion as a guide. And since the bone of the hole wall corresponding to the taper part after the 2nd step is not cut, but is compressed by the taper part of the instrument, the density of the bone near the entrance of the hole is particularly high. As a result, this part of the bone can grip the fixture with a very large force. Therefore, it is possible to prevent the fixture from being detached.
[0014]
Next, the maxillary sinus floor raising device according to claim 2 is characterized in that a marking line is formed at each tapered end of the tapered portion.
[0015]
According to this configuration, the insertion depth of the maxillary sinus floor raising device can be visually confirmed.
[0016]
Further, Agohora bottom elevation device on the third aspect, the distance to the tapered portion from the distal end surface of the distal bar portion is characterized in that it is a 5 to 10 mm.
[0017]
In such a configuration, by matching the diameter of the tip surface of the tip bar-like portion with the diameter of the pilot hole drilled with a drill bar, the portion up to the taper portion is used as a pilot portion (guide) in the pilot hole. The hole can be expanded with certainty. Thereby, there is no mistake in the installation direction of the fixture.
[0018]
System Agohora bottom elevation device on the fourth aspect, the claim 1, wherein the upper jaw Horasokokyo on the instrument the diameter of the distal end surface of the tip rod-shaped portion is increased stepwise to a plurality of prepared, the front end surface Each of the maxillary sinus floor raising devices except the one with the largest diameter is the diameter of the cylindrical portion between the first tapered portion and the second tapered portion of the tapered portion. diameter, characterized in that is equal to the diameter of the front end surface of the large the maxillary sinus Sokokyo on the instrument.
[0019]
According to this configuration, the next largest diameter can be inserted using the cylindrical portion of the hole corresponding to the cylindrical portion as a guide. And since the bone of the hole wall corresponding to the taper part after the 2nd step is not cut, but is compressed by the taper part of the instrument, the density of the bone near the entrance of the hole is particularly high. As a result, this part of the bone can grip the fixture with a very large force.
[0020]
System Agohora bottom elevation device on according to claim 5, together with the plurality of upper Horasokokyo on the instrument, maxillary Horasokokyo for finishing with the distal rod portion on one end side having a spherical tip end face It includes an upper device.
[0021]
According to such a configuration, the bone near the hole wall for fixture insertion is compressed with the tip rod-shaped portion of the maxillary sinus floor raising device for finishing, and the hole for fixture insertion substantially matches the shape of the fixture. Can be made. As a result, the fixture can be embedded very easily even if the bone into which the fixture is embedded is relatively dense from the beginning.
[0022]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
[0023]
FIG. 1 shows three maxillary sinus floor raising devices 1 in this embodiment in which the diameters of the distal end bar-like portions are different. These maxillary sinus floor raising devices 1 are used together as one system in this embodiment.
[0024]
In FIG. 1, the numbers 0, 2, 6, 8, 10, 12, 14, 16, 18 on the left end are distance scales (mm) from the tip surface.
[0025]
Each maxillary sinus floor raising device 1 is provided with a distal end bar-like portion 2 for pushing up a desired portion of the upper jaw into the maxillary sinus at the distal end side of the gripping portion 8, and the distal end rod-like portion 2 is shown in the sectional view of FIG. As shown, the cutting edge 4 is formed on the periphery of the concave end surface 3 and a plurality of the tapered portions 5 are formed so as to be stepped toward the rear. In addition, the tapered portion 5 of the distal end rod-shaped portion 2 is the next cylindrical portion 5a between the first-stage tapered portion 5b and the second-stage tapered portion 5c (the diameter of the distal-end rod-shaped portion is the next largest). 1) It is equal to the diameter of the distal end surface 3 of the maxillary sinus floor raising device 1. As the material of the maxillary sinus floor raising device 1, a metal material that is not toxic to a living body, such as stainless steel, can be used.
[0026]
In the tapered portion 5 of the distal end rod-shaped portion 2, marking lines (indicated by black lines in FIG. 1) are formed on the tapered ends of the tapered portions 5b and 5c by means of laser or the like.
[0027]
3 to 8 are explanatory views for the handling of the maxillary sinus floor raising device 1. In the embodiment of FIGS. 3 to 8, an example in which a pilot hole of φ1.6 mm is formed and a fixture 6 of φ4.2 mm is finally installed will be described. However, depending on the diameter of the fixture 6 to be installed, the maxillary sinus The diameter and number of the raising device 1 or the form of the tapered portion 5 can be set arbitrarily.
[0028]
FIG. 3 shows a state in which a pilot hole is formed. After peeling the alveolar mucosa, a pilot hole of φ1.6 mm is formed using the drill bar 30. At that time, drilling is performed to a depth of 3 to 4 mm from the maxillary sinus floor 12a previously confirmed on the X-ray.
[0029]
FIG. 4 shows a state where the maxillary sinus floor mucosa is raised. Insert the above-mentioned maxillary sinus floor elevation device (left side in FIG. 1) 1 having a diameter of 1.6 mm into the pilot hole, carefully strike it, and check the marking line attached to the tip rod-like portion 2 while embedding it. Push down to the standard insertion depth of the fixture you plan to enter. At that time, care should be taken not to pierce the mucous membrane of the maxillary sinus floor 12a while always checking the feel of the bone.
[0030]
FIG. 5 shows a state in which the cavity (fixing hole) being formed is enlarged. The above-mentioned maxillary sinus floor raising device 1 (diameter in FIG. 1) 1 of φ2.1 mm is inserted into the cavity and beaten to advance in the horizontal direction.
[0031]
FIG. 6 shows a further enlarged state of the cavity. The above-mentioned maxillary sinus floor elevation device (the right side in FIG. 1) 1 having a diameter of 2.8 mm is inserted and beaten into the cavity and further expanded in the horizontal direction. When raised to a bone length of 14 mm, the cavity entrance is expanded to a diameter of 3.8 mm.
[0032]
FIG. 7A shows the state of filling the bone grafting material 7. When the formation of the cavity is completed, the bone filling material 7 such as apatite is filled little by little using the maxillary sinus floor raising device 1 just below the maxillary sinus floor 12a. As a guideline, fill up to about 2 mm shallower than the fixture depth.
[0033]
Figure 8 shows the state of Fiku scan char implanted. The fixture 6 is inserted to a suitable depth in the cavity that is about 2 mm below the length of the fixture bone to be embedded by inserting the bone prosthetic material 7. The implantation is carefully completed so as not to break the bone below the raised sinus floor 12a and the mucous membrane of the maxillary sinus floor 12a.
[0034]
As apparent from the above embodiment, since the tapered portion 5 compresses the bone in the vicinity of the hole wall for fixture embedding, the density of the bone in the portion increases. As a result, the force with which the bone grips the fixture 6 increases.
[0035]
Furthermore, although the distal end side of the distal end rod-like portion 2 of the maxillary sinus floor raising device 1 has a smaller diameter, the hole bottom side of the cavity has a smaller diameter. For this reason, the adhesion force between the fixture 6 and the bone is large on the hole bottom side, and this also increases the force with which the bone grips the fixture 6. Therefore, it is possible to prevent the fixture from being detached.
[0036]
Incidentally, according to the on Agohora bottom elevation device 1 of the system, the upper jaw Horasokokyo on the instrument 1 that the diameter of the front end surface 3 becomes stepwise larger by a plurality of prepared, the diameter of the distal end face 3 In each maxillary sinus floor raising device except the largest one, the diameter of the cylindrical portion 5a between the first-stage taper portion 5b and the second-stage taper portion 5c of the taper portion 5 is the tip surface. 3 is equal to the diameter of the front end surface of the large the maxillary sinus Sokokyo on the instrument 1, can be inserted larger the next diameter cylindrical portion of the holes corresponding to the cylindrical portion 5 a as a guide . And since the bone of the hole wall corresponding to the taper part 5c of the second step is not cut and is compressed by the taper part 5c of the instrument 1, the density of the bone near the entrance of the hole is particularly high. Become. As a result, this part of the bone can grip the fixture with a very large force.
[0037]
Incidentally, the upper Agohora bottom elevation device 1, it is preferable that the distance t from the front end surface 3 of the tip rod portion 2 to the tapered portion 5 is 5 to 10 mm. As a result, the portion up to the first-stage tapered portion 5b can be used as a pilot portion, and the hole can be surely expanded along the pilot hole. Thereby, the installation direction of the fixture 6 is not mistaken. When the distance t is less than 5 mm, the direction in which the maxillary sinus floor raising device 1 is inserted into the cavity may be unstable. On the other hand, when the distance t exceeds 10 mm, the tapered portion 5 is disposed rearward, The effect of increasing the bone density in the region near the hole bottom is weak, and as a result, the force with which the bone grips the fixture 6 may be weak.
[0038]
7 (b) and 7 (c) show a finishing maxillary sinus floor raising device 10 provided with a distal end rod-shaped portion 12 having a spherical distal end surface 11 on one end side. In FIG. 7 ( b ), the tip rod-like portion is straight, and ( c ) is a gentle taper. These finishing maxillary sinus floor raising devices 10 are used when the bone into which the fixture 6 is embedded is relatively dense from the beginning. In such a case, when the hole for inserting the fixture 6 and the shape of the fixture 6 are largely different due to the presence of a stepped portion or the like, a great force is required to screw the fixture 6. And there is a risk of causing a fracture during press-fitting. Therefore, the bone in the vicinity of the hole wall for fixture insertion is compressed by the above-described finishing maxillary sinus floor raising device 10 having the spherical tip surface 11, and the hole for fixture insertion is formed in the fixture 6. By making it substantially coincide with the shape, the fixture 6 can be embedded very easily.
[0039]
【The invention's effect】
As described above, according to the maxillary Horasokokyo on the instrument of the present invention, the desired site of maxillary includes a distal rod portion for pushing up the maxillary sinus to one end side, at the other end of the distal rod portion A taper portion that expands toward the other end side, and a straight tip portion that extends from the tip surface of the tip rod portion to the taper portion is formed on one end side of the tip rod portion, and the taper portion Includes at least a first-stage tapered portion located on one end side, a second-stage tapered portion located on the other end side of the first-stage tapered portion, the first-stage tapered portion, and the two-stage tapered portion. A cylindrical portion located between the taper portion of the eye and the taper portion compresses the bone near the hole wall for fixture embedding, so that the bone density of the portion is large. Become. As a result, the force with which the bone grips the fixture increases.
[0040]
Furthermore, the tip side of the tip bar-like portion of the maxillary sinus floor raising device has a small diameter, but the hole bottom side is formed with a small diameter. For this reason, the adhesion force between the fixture and the bone is large on the bottom side of the hole, and this also increases the force with which the bone grips the fixture. In addition, when using the maxillary sinus floor raising device having a large diameter in stages, a cylinder with a hole corresponding to the cylindrical portion between the first-stage taper portion and the second-stage taper portion The next larger diameter can be inserted using the shaped portion as a guide. And since the bone of the hole wall corresponding to the taper part after the 2nd step is not cut, but is compressed by the taper part of the instrument, the density of the bone near the entrance of the hole is particularly high. As a result, this part of the bone can grip the fixture with a very large force. Therefore, it is possible to prevent the fixture from being detached.
[0042]
Next, according to the maxillary sinus floor elevation device according to claim 2 , the marking line is formed at each tapered end of the taper portion, so that the insertion depth of the maxillary sinus bottom elevation device is visually confirmed. be able to.
[0043]
Further, according to the Agohora bottom elevation device on the third aspect, by the distal end surface of the distal rod portion was 5~10mm a distance to the tapered portion, the diameter of the distal end surface of the distal rod portion By matching with the diameter of the pilot hole (pilot hole) drilled by the drill bar, the portion up to the tapered portion can be used as a pilot portion (guide), and the hole can be reliably expanded along the pilot hole.
Thereby, there is no mistake in the installation direction of the fixture.
[0044]
Then, according to the system of Agohora bottom elevation device on according to claim 4, wherein the distal end diameter of the front end surface of the rod-shaped portion is gradually increased claim 1 a plurality of prepared maxillary Horasokokyo on the instrument according And each maxillary sinus floor raising device except the one with the largest diameter of the tip surface has a diameter of the cylindrical portion between the first tapered portion and the second tapered portion of the tapered portion, by then it distal end surface is equal to the diameter of the front end surface of the large the maxillary sinus Sokokyo on the instrument, and then insert the larger diameter of the front end surface of the cylindrical portion of the holes corresponding to the cylindrical portion as a guide be able to.
And since the bone of the hole wall corresponding to the taper part after the 2nd step is not cut, but is compressed by the taper part of the instrument, the density of the bone near the entrance of the hole is particularly high.
As a result, this part of the bone can grip the fixture with a very large force.
[0045]
The system of Agohora bottom elevation device on the claim 5, wherein with a plurality of upper Horasokokyo on the instrument, maxillary sinus for finishing with the distal rod portion on one end side having a spherical tip end face Because it includes a bottom raising device, the tip rod of the maxillary sinus bottom raising device for finishing compresses the bone near the hole wall for fixture insertion, and the hole for fixture insertion becomes the shape of the fixture. Can be almost matched. As a result, the fixture can be embedded very easily even if the bone into which the fixture is embedded is relatively dense from the beginning.
[Brief description of the drawings]
FIG. 1 shows three maxillary sinus floor raising devices according to an embodiment of the present invention in which the diameter of a distal end bar-like portion is different.
FIG. 2 is a cross-sectional view of a region A in FIG.
FIG. 3 is an explanatory diagram showing a state in which a pilot hole is formed.
FIG. 4 is an explanatory view showing a state in which the maxillary sinus floor mucosa is raised.
FIG. 5 is an explanatory view showing a state in which the cavity being formed is enlarged.
FIG. 6 is an explanatory view showing a state in which the cavity being formed is enlarged.
7 (a) is an explanatory view showing the Hama of the incoming state of the bone substitute material is a side view of (b) (c) is the maxillary sinus Sokokyo on the instrument for finishing.
FIG. 8 is an explanatory diagram showing a state of fixture embedding.
FIG. 9 is an explanatory diagram showing the depth from the alveolar crest to the maxillary sinus floor of the maxilla.
FIG. 10 is an explanatory view showing a use state of a conventional maxillary sinus floor raising device.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Maxillary sinus floor raising device 2 Tip rod-shaped part 3 Tip surface 4 Cutting edge 5 Tapered part 6 Fixture 7 Bone prosthesis 10 Maxillary sinus floor raising device 11 Spherical tip surface 12 Rod-shaped tip part

Claims (5)

The desired site of maxillary provided on one end side of the distal rod portion for pushing up the maxillary sinus, the other end side of the distal rod portion, a tapered portion which becomes late spread toward the other end side, the tip rod-like A straight tip portion extending from the tip surface of the tip rod-like portion to the taper portion is formed on one end side of the tip portion, and the taper portion includes at least a first-stage taper portion located on one end side; and A second-stage taper portion located on the other end side from the first-stage taper portion; and a cylindrical portion located between the first-stage taper portion and the second-stage taper portion. maxillary Horasokokyo on the instrument, characterized in that there. Claim 1, wherein the upper jaw Horasokokyo on the instrument, characterized in that marking lines are formed in the tapered end of the tapered portion. The maxillary sinus floor elevation device according to claim 1, wherein a distance from the distal end surface of the distal end rod-shaped portion to the tapered portion is 5 to 10 mm. 2. A plurality of maxillary sinus floor raising devices prepared according to claim 1 , wherein the diameter of the tip surface of the tip bar-like portion increases stepwise, and each maxillary sinus floor raising device excluding the one having the largest tip surface diameter. , the diameter of the cylindrical portion between the first stage tapered portion and the second-stage tapered portion of the tapered portion, then the diameter of the distal end surface of large the maxillary sinus Sokokyo on the instrument diameter of the distal end surface The system for raising the maxillary sinus floor raising device, characterized in that Wherein with a plurality of upper Horasokokyo on the instrument, the according to claim 4, characterized in that it comprises an upper jaw Horasokokyo on the instrument for finishing with the distal rod portion on one end side having a spherical tip end face Maxillary sinus floor raising device system.

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