JP5777438B2 - Tooth protection device for tracheal intubation - Google Patents

Description

  The present invention relates to a tooth protection device for tracheal intubation for preventing damage to an anterior tooth from compression or impact by a laryngoscope during tracheal intubation.

Endotracheal intubation is a common procedure that can be performed by an anesthesiologist and an emergency paramedic paramedic in addition to an anesthesiologist to manage artificial respiration during general anesthesia and for emergency patients such as cardiopulmonary arrest. Yes. In general, this tracheal intubation is to expand the larynx using a laryngoscope whose tip side is curved to an L-shape, etc., and intubate an endotracheal tube there while visually checking the glottis. When deploying the larynx with a laryngoscope inserted from the oral cavity, the grasping part of the laryngoscope is rotated so as to be tilted to the upper jaw side, so that the laryngoscope is strongly applied to the maxillary anterior tooth by mistake. In addition, there have been many reports of cases in which the anterior maxillary teeth are damaged by this impact or compression, such as a pivoting operation that actively uses the maxillary anterior teeth as a fulcrum for ease of operation. .
In particular, in the case of securing the airway for emergency patients, because it is a time-consuming procedure, tube intubation is given priority, and awareness of front tooth protection may be neglected, increasing concerns about the front tooth damage. Yes.
In addition, in the case of a patient lacking an anterior tooth, a problem has been pointed out that a laryngoscope may be inserted into the missing part and the laryngeal deployment may not be successful.

  Therefore, as a device for preventing damage to the front teeth by this laryngoscope or for the purpose of compensating for the loss of the front teeth, it has traditionally been the rear end surface (blade part) of the laryngoscope body. A laryngoscope has been proposed in which a tooth protection member made of an elastomer having a predetermined thickness and having a predetermined hardness and elasticity is detachably attached to a portion of the upper jaw corresponding to the fitting surface. (Patent Document 1)

However, this laryngoscope has a problem that a special laryngoscope having a blade portion to which a tooth protection member can be attached and detached is not necessary, and that the laryngoscope is complicated and the instrument becomes expensive. .
Therefore, as a device such as a mouthpiece used by covering the maxillary anterior teeth prior to tracheal intubation using a laryngoscope by the present inventors, the shape of the maxillary anterior teeth is formed by a resin having elasticity and flexibility. A portion that is curved and conforms to a concave shape and has a cross section formed into a concave shape, and is likely to be subjected to impact or pressure when the device and the laryngoscope are in contact with each other. An anterior tooth protection device that is configured to include a reinforcing portion that is formed to be hard has been proposed. (Patent Document 2)

According to this anterior tooth protection device, the dent part of the device is inserted into the patient's upper anterior tooth and covered with the anterior tooth, whereby the protection device having elasticity and flexibility becomes a cushioning material, and the rotation of the laryngoscope Operation, and further, impact and compression during contact with the front teeth due to operation using the front teeth as fulcrums can be reduced, and the possibility of damage to the front teeth can be reduced. Further, when the anterior teeth have a defect, the laryngoscope is not inserted into the defect part by covering the device, so that the inconvenience of the laryngeal deployment due to the anterior tooth defect can be eliminated.
In use, it is suitable for first aid because it only covers the patient's upper anterior teeth and does not have trouble and does not have time.
Furthermore, since it is easy to use as described above, it can be used for any laryngoscope, and it is made of an elastic and flexible resin, and the curvature of the device can be varied by fingers. Then, it can be set as a highly versatile device by being able to be fitted according to the shape of the patient's wearing part (front teeth).
In addition, since the shape structure is simple, the device has many advantages such that it can be manufactured in large quantities and at low cost by, for example, resin molding.

Japanese Utility Model Publication No. 4-114302 JP 2009-279043 A

  However, the conventional anterior tooth protection device has a problem in that the device is attached only to the anterior teeth, so that there is no sense of stability when the device is attached and the device may fall out during use.

  Accordingly, the present invention provides a dental protection for tracheal intubation that prevents damage to the maxillary anterior teeth by a laryngoscope during tracheal intubation and maintains a stable wearing state that does not fall off when the device is covered on the teeth. The challenge was to provide devices.

The tooth protection device for tracheal intubation according to the present invention is a device used by covering the upper dentition of the tracheal intubation by the laryngoscope, and the shape of the dentition of the upper dentition by the resin having elasticity and flexibility A U-shape that fits the arch and has both ends open, and has a concave cross section that can be fitted to the dentition, and the height of the wall that contacts the dentition surface is larger on the front teeth than on the back teeth And a protruding portion projecting in the shape of a hat at the lower end of the central portion of the outer surface of the wall portion that contacts the dentition surface and located between the tip of the front teeth and the upper lip that is covered with the dentition. It was constructed Te.

Further, the device is preferably formed and configured as follows.
A protrusion is provided at a central upper end portion of the inner side surface of the wall portion in contact with the dentition surface side, and sandwiching the upper lip zonule covered with the dentition .
· A central portion of the bottom surface side of the device (position corresponding bottom portion of the concave cross-section), provided with a rib to form a lattice-shaped uneven surface to the site to protect again anterior tip was Kutsugaechaku dentition.
-The tooth contact surface of the central portion of the wall portion that contacts the dentition front side, and the surface of the wall portion of the portion that contacts the front side of the gum from the front teeth that are covered with the dentition is 75 with respect to the surface of the bottom portion. It is formed to be inclined inward at an angle of not less than ° and not more than 85 °.
A U-shaped curve that fits the upper dental arch is variably formed.

(Function)
According to the tooth protection device for tracheal intubation of this means, like the above-mentioned conventional anterior tooth protection device, the protection device having elasticity and flexibility becomes a cushioning material, and the impact and pressure on the anterior teeth can be reduced. In addition to the aforementioned effects such as the possibility of reducing the possibility of damage, by inserting and covering the recesses of the device from the front teeth to the back teeth along the upper dental arch, the device and the teeth and gums are connected. Since the contact area is increased and the front tooth side is formed higher than the wall portion on the back tooth covering side, the shape of the device is adapted to the shape of the dentition, so that a stable mounting state is obtained.
Furthermore, by providing a protrusion at the center upper end of the inner surface of the wall part that contacts the upper dentition surface (the part sandwiching the upper lip band when covering the dentition), the protrusion is pressed against the gum of the contact part The stability of tooth covering can be further enhanced by contacting and having a function of preventing detachment during device covering.

In addition, if a hook-like overhanging portion is provided at the lower end of the center of the outer surface of the wall portion that contacts the dentition surface (the portion located between the tip of the front teeth and the upper lip that is covered with the dentition), The overhanging portion is in contact between the tip of the front teeth and the upper lip to protect the upper lip, thereby preventing troubles such as the upper lip being caught between the laryngoscope and the device.
In addition, ribs that form an uneven surface such as a lattice at the center of the bottom surface side of the concave section of the device (the part that protects the tip of the front teeth when it is covered by the dentition), which is the part most easily touched by the laryngoscope If the laryngoscope is brought into contact with the site, the impact can be dispersed and the anterior tooth damage prevention function can be further enhanced.
Furthermore, when the tooth contact surface at the center of the dentition surface side wall is inclined inwardly at an angle of 75 ° or more and 85 ° or less with respect to the surface of the bottom, the shape of a human upper anterior tooth (tooth to gum) A fitting feeling is increased when the shape is matched and the covering is performed, and a more stable mounting is possible by enhancing the clamping effect in cooperation with the back side wall portion.
If this angle is smaller than 75 ° or larger than 85 °, the difference between the general shape of the maxillary anterior teeth and the contact surface of the mandible will be reduced, and the fit will be reduced. There is a concern that the mounting stability may be impaired, for example, there is a possibility that the holding effect in cooperation with the back side wall portion may become unbalanced.
In addition, if it is made of an elastic and flexible resin and the curvature of the device can be varied by fingers, it can be covered and adapted to the shape of the patient's dental arch. It can be a device.

  According to the anterior tooth protection device of the present invention, the above-described configuration and action prevent damage to the maxillary anterior teeth due to the laryngoscope during tracheal intubation, and stable wearing without fear of the device falling off when the device is covered on the tooth. By realizing the state, tracheal intubation can be performed more safely.

1 is an overall configuration diagram showing an embodiment of the present invention. The top view and bottom view of the said embodiment. The front view and back view of the said embodiment. Side surface sectional drawing of the said embodiment.

  The tooth protection device for tracheal intubation of this form is designed to prevent the maxillary anterior teeth from being accidentally damaged by the operation of deploying the larynx with a laryngoscope for tracheal intubation. Covers the whole (from the front teeth to the back teeth) and is used as a shock absorber to prevent direct contact between the laryngoscope and the teeth.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 shows a tooth protection device for tracheal intubation showing an embodiment of the present invention.
The device of this example is formed in a U-shape (parabolic shape) that is open at both ends so as to fit the dental arch of a person's upper jaw as a whole, and a device main body that is formed as a concave shape in which a tooth is inserted inside 1. The lower end of the center of the outer surface 11B of the wall portion front side 11 with which the dentition surface side abuts between the two wall portions of the concave shape 10 of the cross section, that is, between the tip of the front teeth and the upper lip when covering the dentition The center part of the outer surface of the ridge-like overhanging portion 3 formed like a heel of the hat along the curve of the upper lip at the corresponding portion and the bottom portion 13 of the concave shape 10 of the cross section, which is covered with the dentition Finally, a grid-like rib 4 formed as a concavo-convex surface of a grid-like projection is provided at a site that protects the front tooth tip, and while maintaining a certain degree of strength (hardness) from the viewpoint of protecting the tooth (particularly the front tooth), The curvature formed in the U-shape by fingers is adapted to the patient's dental arch (In this example, styrene elastomer) resin having resilient and flexible manner, is formed by integrally molding the entire.
In addition, as described above, the properties of the resin that forms the device include elasticity and flexibility while maintaining a certain level of strength (hardness), and in contact with the laryngoscope, It is preferable that the material is slippery without being caught and has a certain degree of frictional resistance, and the styrene elastomer used in this example is suitable.

Next, each part will be described in detail.
2 and 3 are external views of this embodiment, FIG. 2A is a top view, FIG. 2B is a bottom view, FIG. 3A is a front view, FIG. 3B is a back view, and FIG. Side surface sectional drawing by DD shown is shown.
The device body 1 has an overall shape of about 40 to 45 mm in depth, such as a mouthpiece attached only to the upper jaw, along the curve of the dental arch from the front teeth to the back teeth of a typical adult (Example, It is formed as a symmetrical U-shape with both ends open and is positioned between the front side of the covered dentition and the upper lip so that the entire upper teeth and gums can be sandwiched and covered from the front and back surfaces. The tooth front side wall part 11 to be performed, the tooth back side wall part 12 that hits the back side of the tooth, the bottom part 13 that covers and protects the tooth tip, and the teeth and gums that are the inner surfaces of the two surfaces of the two wall parts and the bottom part are accommodated. It consists of each part of the recess 10. And the height of the front side wall part 11 is formed larger than the back side wall part 12, and the height of the front side wall part 11 is set so that the height HF of the front tooth side F (device center part) is the back tooth side B (device both ends). Side) height HB.
In addition, the height of the wall part in this Embodiment makes the longest part used as the center part (except for the notch | notch part 14) of the front side wall part 11 about 21 mm, and it inclines gradually toward the back tooth side both sides, and height is set. The shortest part which becomes small and becomes both ends was formed as about 12 mm. Further, in the present embodiment, the height of the back side wall portion 12 is gradually increased from the central portion toward both end portions, opposite to the front side wall portion 11 to increase the height, and is formed to be about 7 mm to 8 mm. .

In addition, an angle S formed by the central portion (part contacting the front teeth) of the tooth front side wall part 11 and the bottom 13 is 82 °, while the central part (part contacting the back side of the front teeth) of the tooth back side wall part 12 The angle formed with the bottom 13 was 124 °. The angle S between the tooth front side wall portion 11 and the bottom portion 13 is set between 75 ° and 85 ° as described above, and is adapted to the shape of a general adult maxillary anterior tooth. It is desirable that the angle between the bottom 13 and the bottom 13 is set based on a general adult standard.
Furthermore, a notch 14 is provided at the upper end of the central portion of the front side wall portion 11 so as to avoid the upper lip band when it is covered with the dentition so as to avoid the upper lip band. As prevention of device detachment, the notch portion 14 is sandwiched between the upper end portion of the central portion of the tooth contact surface 11B, which is the inner surface side of the front side wall portion 11, which is both sides of the inner surface of the notch portion 14, and is symmetrical. Protrusion 2 is provided and formed.

According to the device main body 1 of the present embodiment, as in the case of the conventional anterior tooth protection device such as cited reference 2, the device having elasticity and flexibility acts as a shock absorber when tracheal intubation is performed by a laryngoscope, and impacts on the maxillary anterior teeth. In addition to being able to reduce pressure and prevent accidents such as damage to the front teeth, the device and teeth can be attached by inserting and covering the device from the front teeth to the back teeth along the upper dental arch. In addition, by forming the front side wall portion 11 to be higher on the front tooth side F than on the back tooth side B, the front side wall 11 can be covered in conformity with the shape of the dentition. can do.
Further, by setting the angle between the tooth front side wall portion 11 and the bottom portion 13 as described above, a wearing state with a large contact area that fits the shape of the human maxillary front teeth is obtained, and the device is prevented from falling off, and the wearing stability. Can be further enhanced.
Furthermore, by providing the protrusion 2 at the center upper end of the tooth contact surface 11B of the front side wall part 11 (the portion sandwiching the upper lip band when covering the dentition), the protrusion 2 is related to the contact part of the gum. By pressing contact, it becomes a means for preventing detachment during covering, and the stability of the tooth covering can be further enhanced.

  The hook-shaped overhanging portion 3 is provided to protrude in a hook-shaped (crescent-shaped) shape of a hat over a width of about 30 mm at the center portion of the lower end of the outer surface 11A of the front side wall portion 11 of the device body 1, and the bottom is a flat surface. The upper side surface is formed as a bowl-shaped cross-sectional shape having a surface that gently slopes toward the protruding tip so as to be a contact surface that fits the upper lip. In the embodiment, the maximum protrusion length of the overhang portion (the length of the central portion) was about 3 mm.

  The hook-like overhanging portion 3 is located at the portion of the front teeth where the device is covered with the dental arch and is located between the upper-lip and the upper lip. By forming it into a shape, the upper lip contact surface becomes along the shape of the upper lip, and the upper lip is sandwiched between the gap between the device and the laryngoscope, causing problems such as cutting the upper lip. Can be prevented.

  The grid-like ribs 4 are formed symmetrically on the center of the outer surface of the bottom portion 13 of the device main body 1 over a width of about 35 mm and are formed along the curved shape of the bottom portion 13 in the longitudinal direction ( 3 in this embodiment) and vertical projections in the short direction (5 in this embodiment) arranged radially with respect to the curve are arranged in a lattice pattern to form an uneven portion. In addition, the height of the protrusion in the embodiment is such that the central portion in the short side direction is formed to be larger than both side portions, and the height is set to 2 mm to 3 mm.

The central portion of the bottom 13 where the grid ribs 4 are arranged (the portion that protects the front end of the maxillary anterior teeth) is the portion most likely to be impacted by the laryngoscope when the device is covered with the dentition and tracheal intubation is performed. In addition, since it is a part that is assumed to be pressed as a fulcrum for the laryngeal deployment operation, the lattice part 4 is provided to make the covering part thicker, and the larynx is uneven due to the unevenness. It is possible to provide a high tooth protection function that can disperse the impact when the mirror comes into contact.
In addition, the structure of the uneven surface formed here is not limited to the lattice shape, and any form of uneven surface may be formed as long as it produces an equivalent effect to disperse the pressure of the laryngoscope. Also good.

  And the said device main body 1, the bowl-shaped overhang | projection part 3, and the grid | lattice-like rib 4 were integrally shape | molded with resin, and it was set as the tooth protection device for tracheal intubation of this Embodiment. According to this device, just by covering the device with the maxillary dental arch prior to tracheal intubation of the laryngoscope, it can prevent damage to the maxillary anterior teeth by the laryngoscope and achieve stable wearing without dropping during the operation, It is possible to provide a highly safe and safe tooth protection device for tracheal intubation.

1. Device body 10. Concave shape of the cross section (concave)
11. (Tooth) Front side wall portion 11A. Front outer surface 11B. 11. Front tooth contact surface (Tooth) Back side wall 12A. Back side outer surface 12B. Back side tooth contact surface 13. Bottom 14. Notch portion Projection 3. Sponge overhang 4. Lattice rib F. Anterior tooth side Back teeth side

Claims (5)

A tracheoscope with a laryngoscope, which is formed of a U-shape that is open at both ends in conformity with the dental arch of the maxillary dentition, and has a concave cross section so that it can be fitted into the dentition, with an elastic and flexible resin A dental protection device that covers and uses the maxillary dentition during intubation, and the height of the wall portion that contacts the dentition surface side is larger than the back tooth side and the wall portion that contacts the dentition surface side Tooth protection for tracheal intubation comprising a protruding portion protruding in the shape of a cap at the lower end of the center of the outer surface, located between the tip of the anterior teeth and the upper lip that is covered with the dentition device.   The tooth protection device for tracheal intubation according to claim 1, wherein the tooth protection device for tracheal intubation is provided with a protrusion at a central upper end portion of the inner side surface of the wall portion that contacts the dentition surface, and sandwiching the upper lip band on the dentition. The center part of the bottom part surface side of the device (position corresponding to the concave bottom part of the cross section), comprising ribs formed with a grid- like uneven surface at a site protecting the tip of the anterior tooth covered with the dentition. The tooth protection device for tracheal intubation according to any one of 1 to 2 . The tracheal intubation according to any one of claims 1 to 3 , wherein a tooth contact surface at a central portion of the wall portion that contacts the dentition surface side is inclined inwardly at an angle of 75 ° or more and 85 ° or less with respect to the surface of the bottom portion. Tooth protection device. The tooth protection device for tracheal intubation according to claim 1, wherein a U-shaped curve adapted to the upper dental arch is variably formed.

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