JP6573859B2 - Jawbone cutting aid and design support device for jawbone cutting aid - Google Patents

Description

  The present invention relates to a jawbone cutting aid that can accurately indicate a cutting position when cutting a jawbone, and a design support device for a jawbone cutting aid.

  During excision due to tumors, trauma, congenital abnormalities, etc. in the jawbone, or during orthodontic treatment due to jaw deformities, the jawbone is cut by cutting the exact position with an instrument. There is a need to. In addition, in bone collection for the purpose of bone grafting, accuracy that places importance on minimal invasiveness is required.

Although what guides an instrument correctly is not what cuts a jawbone, patent document 1 describes what guides a dental handpiece which perforates a jawbone.
In Patent Document 1, a base member fixed in a horizontal direction by being fitted to a dentition from the vertical direction and detachable from the dentition and a guide member or a slide member fixed to the base member is used for jaw bone drilling. A guide device is described.

Non-Patent Document 1 describes that an oscillating saw is guided by a template as a tool for cutting the jawbone.
In Non-Patent Document 1, when performing osteotomy from behind the mandibular foramen, from the mandibular incision to the upper part and to the mandibular lower edge to the lower part of the mandibular angle, the mandibular incision, the mandibular branch trailing edge, the lower posterior corner A mandibular branch vertical osteotomy (IVRO) using a template that is fixed at three locations on the leading edge is described.

Japanese Patent Publication No. 7-102215

Toshiji Hirohito, “Drawing the jaw (mandibular branch vertical osteotomy (IVRO))-Surgical method | Orthognathic surgery | Dr. Hirohi's facial osteoplasty”, [online], [2016 Search July 13], Internet <URL: http://fbcs.jp/jaw/underbite/ivro/operation/>

  When cutting the bone constituting the limb, the bone is cut after incising the skin on the surface, so that the bone can be cut with a large bone exposed. However, when cutting the jawbone, cut the oral mucosa from the viewpoint of aesthetics, insert a cutting device through the mucosal incision, and allow the operator to look into the jawbone visible from the open incision. Since cutting is performed, it is difficult to accurately grasp the cutting position.

  In the guide device for drilling the jawbone described in Patent Document 1, since the guide bar inserted through the slide member of the handpiece is extended vertically from the base member fixed to the dentition as the guide member, the open incision portion is moved to. It is difficult to insert.

  Moreover, since the template described in Non-Patent Document 1 is fixed at three locations of the lower jaw notch, the lower edge of the lower jaw branch, and the lower edge of the lower horn, it is necessary to peel the periosteum and masseter muscle widely from the jawbone. Therefore, when this template is used, the burden on the patient is great.

  Therefore, an object of the present invention is to provide a jawbone cutting aid that can accurately cut the jawbone and suppress the amount of surgical invasion to the patient.

  The auxiliary tool for cutting jawbone according to the present invention is a fixed part formed with a recess for covering a gum or a tooth in a tooth defect part, and a position that is provided in the fixed part and indicates a part or all of a planned cutting part by surgery. And an instruction unit.

  According to the jawbone cutting aid of the present invention, the concave portion of the fixing portion can be firmly positioned by covering the gingiva or teeth in the tooth defect portion, and the jawbone cutting aid of the present invention can be fixed. Therefore, it is not necessary to cut the mucosa extensively in order to fix it to the jawbone. And since the position instruction | indication part provided in the fixing | fixed part points out part or all of the part to be cut by surgery, the position instruction | indication part can cut on the basis of a pointed position.

The position indicating unit may include a rod-shaped first portion whose proximal end is connected to the fixed portion, and a second portion connected to a distal end of the first portion and pointing to the scheduled cutting portion.
Since the 2nd part which points to the cutting plan part is formed in the front-end | tip of a rod-shaped 1st part, this 2nd part and 1st part are only inserted from the opening part of a cheek. Therefore, the range of the periosteum and masseter muscle to be peeled from the jawbone can be suppressed.

  If the end of the second portion is located at the straight cutting scheduled portion, the position of the straight cutting planned portion can be easily determined by marking the end of the second portion. Can be marked.

  If the second portion is formed so as to indicate at least two points included in the planned cutting portion, two points included in the planned cutting portion are marked as marks, and a line connecting the two points is drawn later. For example, it can be set as a cutting planned line which shows a cutting planned part. Therefore, the surgeon can grasp the exact cutting position.

  The second portion can be formed in a bifurcated shape that is open from the base end portion on the first portion side toward the planned cutting portion. By making the second portion into a bifurcated shape, the state of the jawbone can be observed from between the two parts, so that the mark can be accurately attached.

  The bifurcated second portion is formed of one indicating piece and the other indicating piece, and base ends of the one indicating piece and the other indicating piece are connected to each other by a shaft so as to be freely opened and closed. It is desirable. By opening and closing the position indicating portion formed in a bifurcated shape, even if the opening formed in the mucous membrane is narrow, if the position indicating portion is closed, it can be easily inserted into the opening.

  When the first portion is connected to either one or both of the fixing portion and the second portion by a connecting portion, the position indicating portion is connected to the arm portion, and the fixing portion is separated. Are connected to each other, and the position indicating unit is separated, or the arm unit, the position indicating unit, and the fixing unit are separated from each other. Accordingly, a narrow opening formed in the mucous membrane of the cheek can be easily passed.

  The position indicating portion may be formed with an opening that exposes the region of the planned cutting portion. Even if the planned cutting portion has an area, the position indicating portion can accurately grasp the planned cutting portion because the opening is exposed in the range, so that the cutting can be performed accurately. .

  When the position indicating part is curved along the unevenness of the surface of the jawbone, when the position indicating part is applied to the surface of the jawbone, the position indicating part fits into the uneven surface of the jawbone and is cut in a stable state. A mark indicating the position of the planned line can be attached.

  The fixing part may be either a denture, an upper structure of an implant, or a splint. When the treatment by the dentist is completed and the position indicating unit is removed from the fixed unit, the fixed unit can be used as either a denture, an upper structure of an implant, or a splint.

A design support device for a jawbone cutting aid according to the present invention supports the design of a jawbone cutting aid,
A first image processing unit for drawing a shape of the fixed part by image operation based on a gingiva or a tooth in a tooth defect part of a jaw bone image from a CT imaging device that images the jaw bone, and the cutting to the jaw bone image A second image processing unit for plotting a virtual cutting planned portion as a planned portion and a third image processing unit for plotting the position indicating unit arranged in accordance with the position of the virtual cutting planned portion It is characterized by.

  According to the design support device for a jawbone cutting aid of the present invention, the shape of the fixed portion is image-operated by the first image processing unit based on the gingiva or the tooth in the tooth defect portion of the jawbone image captured by the CT imaging device. In order to draw, it is possible to design a fixed part that can be stably fixed by fitting the fixed part to the gums or teeth. Next, the second image processing unit draws a virtual cutting scheduled portion as a planned cutting portion on the jawbone image, and the third image processing unit draws a position indicating unit arranged according to the position of the virtual cutting planned portion. The jawbone cutting aid of the present invention can be designed accurately.

  When the position indicating portion includes a rod-shaped first portion whose proximal end is connected to the fixed portion, and a second portion connected to the distal end of the first portion and pointing to the planned cutting portion In addition, a fourth image processing unit for drawing the first part may be provided between the second part and the fixed part. Since the fourth image processing unit draws the first part between the second part and the fixed part, the length of the second part and the first part is the length from the fixed part to the virtual cutting scheduled part. Can be designed accurately.

  According to the present invention, since only the position indicating part is inserted through the opening of the mucous membrane, the range of the periosteum and masseter muscle to be peeled from the jawbone can be suppressed, so that the jawbone can be accurately cut and the patient can be cut. The amount of surgical invasion can be reduced.

It is a figure which shows the auxiliary tool for jawbone cutting which concerns on Embodiment 1 of this invention, (A) is the perspective view seen from the front side, (B) is the perspective view seen from the back side. It is a figure of the state which mounted | wore the mandible with the auxiliary tool for jaw bone cutting shown in FIG. It is the perspective view seen from the front side of the modification of the auxiliary tool for jawbone cutting shown in FIG. It is a figure which shows an example of the cutting bar which cuts a jawbone. It is a figure which shows the auxiliary tool for jawbone cutting which concerns on Embodiment 2 of this invention, (A) is the perspective view seen from the front side, (B) is the perspective view seen from the back side. It is a figure for demonstrating the 1st modification of the auxiliary tool for jawbone cutting shown in FIG. It is a figure for demonstrating the 2nd modification of the auxiliary tool for jawbone cutting shown in FIG. It is a figure which shows the state with which the design assistance apparatus and CT imaging device of the auxiliary tool for jawbone cutting which concern on Embodiment 3 of this invention were connected. It is a block diagram for demonstrating the structure of the design assistance apparatus of the auxiliary tool for jawbone cutting shown in FIG. It is a figure for demonstrating operation | movement and a use condition of the design support apparatus of the auxiliary tool for jawbone cutting shown in FIG. It is a figure which shows the auxiliary tool for jawbone cutting which concerns on Embodiment 4 of this invention.

(Embodiment 1)
A jawbone cutting aid according to Embodiment 1 of the present invention will be described with reference to the drawings.
The jawbone cutting aid of the present invention is used when cutting the jawbone. The jawbone cutting aid 10 according to the first embodiment shown in FIGS. 1A and 1B is a lower jaw. Used when performing vertical bone cutting from the notch toward the mandibular floor.
The jawbone cutting auxiliary tool 10 includes a fixing portion 11 having a recess 11a for covering and fixing a tooth, and a position indicating portion 12 indicating a planned cutting portion by surgery. The jawbone cutting aid 10 can be made of resin.

  In the jawbone cutting auxiliary tool 10 shown in FIGS. 1A and 1B, the fixing portion 11 is formed in a semi-cylindrical shape having an occlusal surface as a groove bottom in order to cover the teeth.

The position indicating part 12 is formed at the tip of the arm part 121, which is a first part extending from the fixing part 11 toward the linear cutting planned part of the jawbone, and is included in at least the cutting planned part. And a pointing portion main body 122 which is a second portion indicating two or more points. Hereinafter, the linear cutting scheduled portion is referred to as a cutting planned line. )
The arm part 121 is connected to the top part of the fixed part 11. The arm 121 is curved along the unevenness of the surface of the jawbone. The arm portion 121 of the present embodiment is formed in a U-shape that gently curves along the surface of the jawbone so as to cross the oblique line when extending from the lower jaw body toward the lower jaw branch.

The indicator main body 122 is formed in a fan shape that expands from the proximal end 122a on the arm 121 side toward the distal end 122b. The edge 122c at the tip of the instruction unit main body 122 indicates the position of the planned cutting line. Similarly to the arm portion 121, the pointing portion main body 122 is also curved along the surface of the jawbone from the proximal end 122 a of the pointing portion main body 122 toward the end side 122 c of the distal end 122 b.
When the jaw cutting aid 10 is made of resin, it is preferable to use a transparent resin because the state of the jaw bone can be seen through the indicator main body 122.

  The usage state of the jawbone cutting aid 10 according to Embodiment 1 of the present invention configured as described above will be described with reference to the drawings. In the first embodiment, as shown in FIG. 2, a mandibular branch vertical osteotomy that cuts the mandibular branch B1 from the mandibular incision B2 toward the mandibular angle B3 (mandibular base) by an operation at the time of orthodontic treatment. Surgery (IVRO) will be described as an example. In addition, the buccal mucosa is incised in advance to form an opening, and the periosteum and masseter muscle are separated from the jawbone.

  First, as shown in FIG. 2, the surgeon inserts the pointing portion main body 122 provided at the distal end portion 121a (one end portion) of the arm portion 121 through the opening formed in the buccal mucosa. The fixing part 11 connected to the other end is put on the tooth T1. By fixing the fixing part 11 on the tooth T1, the fixing part 11 is fixed to the tooth T1 in a stable state.

  By covering the fixing portion 11 on the tooth T1, the end side 122c of the distal end 122b of the pointing unit main body 122 is positioned at the planned cutting line of the jawbone and points to a part of the planned cutting line. Accordingly, the operator visually observes the position of the end side 122c of the pointing unit main body 122 while opening the opening of the buccal mucosa, and selects two points or two points on the end side 122c of the pointing unit main body 122. Since two straight lines included in each can be attached as marks indicating the planned cutting line L, the position of the planned cutting line L can be easily marked.

  If two points or two straight lines as marks are too close, even if the straight line connecting them is drawn as the planned cutting line L, a straight line indicating that the lower jaw branch is cut from the lower jaw notch toward the lower jaw angle. It is difficult to draw accurately. For this reason, if the two points or the two straight lines as marks are located as far as possible, the straight line can be drawn as a straight line that exactly overlaps the planned cutting line L. It is desirable to mark in the vicinity of both end portions. This mark can be a groove by a ridge or can be marked with ink.

At this time, since the surface in contact with the jawbone in the pointing unit main body 122 is curved along the unevenness of the surface of the jawbone, the unevenness surface of the jawbone is instructed when the pointing unit main body 122 is applied to the surface of the jawbone. The mark which shows the position of a scheduled cutting line can be attached in the state which the part main body 122 fitted and was stable.
Further, since the arm part 121 is also curved along the unevenness of the surface of the jawbone, the arm part 121 can be placed along with the surface of the jawbone together with the pointing part main body 122. It can suppress that it shifts | deviates.

  If the planned cutting line is drawn, the surgeon can cut the mandibular branch by advancing cutting with the handpiece along the planned cutting line. Therefore, the surgeon can grasp the exact cutting position. In addition, since the indicating unit main body 122 indicating the position of the planned cutting line is formed at the tip of the arm portion 121 and the indicating unit main body 122 and the arm portion 121 are only inserted through the opening of the cheek, the periosteum is peeled off from the jawbone. And the range of the masseter muscle can be suppressed. Therefore, the amount of surgical invasion to the patient can be suppressed.

  In addition, in this Embodiment 1, although the fixing | fixed part 11 is what covers a tooth | gear, if it arrange | positions a fixing | fixed part to a tooth | gear defect | deletion part, in order to cover a gum, it is similar to the denture base of a partial denture. It can be set as the recessed part of a U-shaped cross section. Moreover, if it arrange | positions a fixing | fixed part to an edentulous jaw, it can be set as the whole shape similar to the denture base of a complete denture. In addition, if the patient is a person who wears a denture, the fixed portion can use the denture itself. Furthermore, the superstructure of the implant can be a fixed part.

  Further, the fixing portion may be a splint (a removable device having a form in which a plurality of teeth are covered with a material such as a resin used for orthodontic treatment, temporomandibular joint disease treatment, bruxism treatment, and sports). When the fixed part is a sprint, the fixed part can be used as a sprint as it is by removing the fixed part from the arm part when the cutting of the jawbone is completed.

  Moreover, although the instruction | indication part main body 122 is formed in fan shape, a semicircle shape may be sufficient as a triangle shape.

  Further, in the first embodiment, the mandibular branch vertical osteotomy (IVRO) has been described as an example. However, the jawbone cutting auxiliary tool according to the present invention has the shape of the position indicating unit according to the position of the planned cutting line. Combined with the orientation of the arm, the planned cutting line for mandibular branch sagittal segmentation (SSRO) and mandibular branch vertical sagittal segmentation (IVSRO) and the maxillary segment will be cut using the Lefau type I method and Kale method It is possible to cope with a line and other scheduled cutting lines.

(Modification of Embodiment 1)
The modification of Embodiment 1 of this invention is demonstrated based on drawing. In FIG. 3, the same components as those in FIG.
In the jawbone cutting auxiliary tool 10x shown in FIG. 3, a linear groove 122d is formed in a fan-shaped or semicircular pointing section main body 122. The linear groove 122d is parallel to the end side 122c of the pointing unit main body 122. Two straight grooves 122d are formed, but one may be used.

The linear groove 122d has a function of guiding an instrument for cutting the jawbone. For example, as a tool for cutting the jawbone, a cutting bar 50 as shown in FIG. 4 attached to the tip of the handpiece is used.
The cutting bar 50 includes a round bar-shaped shaft portion 51 and a blade portion 52 attached to the tip of the shaft portion 51 so as to be inclined with respect to the axis of the shaft portion 51.
An annular recess 51a is formed at the base end of the shaft portion 51 so as to be inserted into and fixed to the handpiece. Further, the shaft portion 51 is formed with two annular convex portions 51b that fit into the linear grooves 122d formed in the pointing portion main body 122 shown in FIG.
The blade portion 52 is formed in a fan shape, and an arcuate saw blade is formed at the tip.
When the cutting bar 50 is mounted on and driven by the handpiece, a swinging operation that repeats axial rotation to one side and axial rotation to the other is started around the axis of the cutting bar 50.

When cutting the jawbone using the cutting bar 50 shown in FIG. 4, the blade portion 52 is applied to the end side 122 c of the pointing unit main body 122 and the jawbone is cut, so that the annular convex portion 51 b of the cutting bar 50 is formed. When it is dug down until it fits in the linear groove 122d of the indicating unit main body 122, the handpiece is moved along the planned cutting line.
Then, since the handpiece can be moved in a state where the annular convex portion 51b is fitted in the linear groove 122d, the blade portion 52 moves along the end side 122c of the pointing portion main body 122.
Therefore, since the cutting bar 50 is guided along the linear groove 122d, the planned cutting line can be cut by the blade portion 52 in a stable state.

(Embodiment 2)
A jawbone cutting aid according to Embodiment 2 of the present invention will be described with reference to the drawings. In FIG. 5, the same components as those in FIG.
As shown in FIGS. 5A and 5B, the position indicating unit 22 of the jawbone cutting auxiliary tool 20 extends from the proximal end 222a on the arm 121 side of the indicating unit main body 222 to the distal end 222b (scheduled cutting line). It is formed in a bifurcated shape (U-shape) that opens toward the front.
The pair of end sides 222c located at the front end 222b of the indicating unit main body 222 is formed such that a virtual straight line L1 extending from one end side 222c passes through the other end side 222c.

As described above, even if the pointing unit main body 222 is formed in a bifurcated shape, two points or two straight lines positioned on the respective end sides 222c and 222c can be used as marks of the planned cutting line.
Since the pointing unit main body 222 is formed in a bifurcated shape, the state of the jawbone can be observed from between the two directions, so that the mark can be attached accurately and easily.
Even when the jawbone cutting assisting tool 10 shown in FIG. 1 is made of a transparent resin, the jawbone may be refracted and distorted when viewed through the pointing unit main body 222, but the bifurcated instruction shown in FIG. Since the space between the unit main bodies 222 is a space, distortion due to refraction does not occur.

  In the second embodiment, the pointing unit main body 222 of the position pointing unit 22 is formed in a U shape. However, a plurality of arms spread from the base end 222a, such as a V shape or a fan-shaped skeleton. It may extend like this.

(Modification of Embodiment 2)
The modification of Embodiment 2 of this invention is demonstrated based on drawing. 6 and 7 are principle diagrams of the connecting portion of the jawbone cutting aid.

In the first modification of the second embodiment of the present invention shown in FIG. 6, the fixing part 11 and the arm part 121 are connected by the connecting part 14.
The fixing portion 11 is formed with a fitting hole 11b at an end portion on the planned cutting line side. The fitting hole 11b is formed in a rectangular tube shape. The arm portion 121 is formed with a rectangular bar-shaped shaft portion 121c that protrudes from the base end portion 121b toward the back of the fitting hole 11b. The arm portion 121 and the fixed portion 11 are connected by inserting and fitting the shaft portion 121c of the arm portion 121 into the fitting hole 11b. In this way, the connecting portion 14 is formed by the fitting hole 11 b of the fixing portion 11 and the shaft portion 121 c of the arm portion 121.

  Since the fixing part 11 and the arm part 121 can be separated, first, the fixing part 11 is firmly fixed to the teeth, and the instruction part main bodies 122 and 222 (see FIGS. 1 and 3) on the front side of the arm part 121 are cheeked. After being inserted into the opening formed inside the arm portion 121, the arm portion 121 can be connected to the fixing portion 11.

In the first modification, the fitting hole 11 b is formed at the end of the fixing portion 11, but the fitting hole 11 b may be formed at the top of the fixing portion 11. In that case, the shaft portion 121 c is projected from the side surface of the base end portion 121 b of the arm portion 121 toward the fitting hole 11 b at the top portion of the fixing portion 11.
Further, although the fixed portion 11 and the arm portion 121 are connected by the connecting portion 14, the arm portion 121 and the instruction portion main bodies 122 and 222 may be connected by insertion in the same manner as the connecting portion 14. Good.
Further, the fitting hole 11b is formed in a rectangular tube shape, and the shaft portion 121c is formed in a square bar shape. However, the fitting hole is formed in a cylindrical shape, and the shaft portion is formed in a columnar rod shape, or other shapes as long as they can be inserted and fitted. Or you may. Moreover, you may fix the fixing | fixed part 11 and the arm part 121 by screwing.

In the second modification of the second embodiment of the present invention shown in FIG. 7, the indicator main body 322 of the position indicator 32 is formed in a bifurcated shape by one indicator piece 3221 and the other indicator piece 3222. The indication pieces 3221 and 3222 are formed to be foldable.
One indication piece 3221 and the other indication piece 3222 have base end portions 3221a and 3222a overlapping each other, and the base end portions 3221a and 3222a are connected to the shaft 3223 so that the front side opens and closes like a ridge. Connected freely.

  The end sides 3221c and 3222c located at the tips 3221b and 3222b of the indication pieces 3221 and 3222 are located on the virtual straight line L1 located at the planned cutting line if the indication pieces 3221 and 3222 are completely opened.

  In addition, in a state where the indication pieces 3221 and 3222 are completely opened, a convex portion 3221d protruding from the proximal end portion 3221a of the indication piece 3221 toward the indication piece 3222 is formed on the proximal end portion 3222a of the indication piece 3222. By fitting into the recess 3222d, the indication piece 3221 and the indication piece 3222 can be fixed in a completely opened state.

  Thus, even if the opening formed in the inner mucous membrane of the cheek is narrow by opening and closing the pointing unit main body 322 of the position pointing unit 32 formed in a bifurcated shape, the pointing unit main body 322 is closed. Then, it can be easily inserted into the opening.

(Embodiment 3)
Next, a design support device for a jawbone cutting aid according to Embodiment 3 of the present invention will be described with reference to the drawings.
The design support apparatus 100 shown in FIG. 8 supports, for example, the design of the jawbone cutting aids 10, 10x, and 20. The design support apparatus 100 is a computer that operates a design support program.

The design support apparatus 100 is connected to a CT imaging apparatus 200.
As shown in FIG. 9, the design support apparatus 100 controls the CT imaging apparatus 200 to capture a jaw bone image indicating the state of the patient's jaw.
The design support apparatus 100 includes a communication unit 110 that is communicably connected to the CT imaging apparatus 200, a CT control unit 120 that captures a jaw bone image that is a bone image from the CT imaging apparatus 200, and an image processing unit 130 that operates the jaw bone image. And an operation unit 140 for an operator such as a dentist or a dental technician to operate the jawbone image, a display unit 150 for displaying the jawbone image, and a storage unit 160 for storing the jawbone image.

The communication unit 110 has a function of transmitting transmission data from each part of the design support apparatus 100 to the CT imaging apparatus 200 and receiving reception data from the CT imaging apparatus 200 to each part. The communication unit 110 may be a LAN or USB, for example.
The CT control unit 120 can control the setting of the imaging conditions of the CT imaging apparatus 200, the start and stop of imaging, the acquisition of jaw bone images and storage in the storage unit 160, and the like.
The image processing unit 130 has a function of controlling editing processing for cutting, moving, copying, and processing a part of the jawbone image in accordance with the operation unit 140 operated by the operator. .

The image processing unit 130 includes a first image processing unit 131, a second image processing unit 132, a third image processing unit 133, and a fourth image processing unit 134.
The first image processing unit 131 has a function of drawing the shape of the fixing unit 11 by image operation based on the gingiva or teeth in the tooth defect portion of the jaw bone image from the CT imaging apparatus 200 that images the jaw bone. The second image processing unit 132 has a function of drawing a virtual planned cutting line that is a linear virtual cutting unit as a planned cutting line on the jawbone image. The third image processing unit 133 has a function of drawing a position instruction unit arranged in accordance with the position of the virtual cutting planned line. The fourth image processing unit 134 has a function of drawing the arm part 121 serving as the first part between the instruction unit main body 122 serving as the second part and the fixing unit 11.

The operation unit 140 can be, for example, a keyboard, a mouse, a joystick, or a pen tablet in order to input imaging conditions of the CT imaging apparatus 200 or input a jaw bone image editing operation. The display unit 150 can be an LCD or an organic EL panel.
The storage unit 160 can be a hard disk drive, a flash memory, or the like.

The operation and use state of the design support apparatus 100 for the jawbone cutting aid 10 according to Embodiment 3 of the present invention configured as described above will be described with reference to the drawings.
First, the operator operates the operation unit 140 to instruct the CT imaging apparatus 200 to image the lower jaw that is a bone to be treated by the patient. In response to this instruction, the CT control unit 120 controls the CT imaging apparatus 200 to capture a jawbone image and store it in the storage unit 160.

  Next, the operator operates the operation unit 140 based on the jaw bone image P read from the storage unit 160 and displayed on the display unit 150 shown in FIG. Instruct to do this based on the first and second molars of the right lower jaw. By doing so, the first image processing unit 131 draws the contour-shaped fixing unit 11 that includes the shapes of the first and second molars of the right lower jaw.

In the present embodiment, the fixing portion 11 is attached to the teeth, but it may be attached to the gingiva (mandibular ridge) in the tooth defect portion. In the case of the fixed part to be attached to the gingiva, the operator operates the operation part 140 based on the jawbone image displayed on the display part 150 to designate the gingival range of the tooth loss part. By doing so, the 1st image processing part 131 draws the fixed part of the outline shape which includes the range of the gingiva.
Further, in the case of an edentulous jaw, the operator designates a range of the ridged ridge, and the first image processing unit 131 draws a fixed portion having a contour shape that includes the gingival range. .

Next, the operator operates the operation unit 140 to designate the position of the virtual planned cutting line L2 as the planned cutting line in the jawbone image, so that the second image processing unit 132 draws the virtual planned cutting line L2. .
Next, the operator operates the operation unit 140 to instruct the placement of the instruction unit main body 122 by aligning the end side 122c with the position of the virtual cutting planned line L2, so that the third image processing unit 133 is The instruction unit main body 122 is arranged in accordance with the position of the virtual cutting planned line.

  Then, the operator operates the operation unit 140 to extend the arm unit 121 to the jawbone image between the fixing unit 11 disposed on the tooth and the pointing unit main body 122 disposed on the virtual cutting planned line L2. Instruct the direction. By doing so, the fourth image processing unit 134 draws the arm 121 between the instruction unit main body 122 and the fixing unit 11.

  When the operator linearly points between the fixing unit 11 and the pointing unit main body 122, the linear arm unit 121 is drawn. Further, when the operator instructs to trace the direction in which the arm 121 extends, the curved arm 121 can be drawn. At this time, the jaw bone side surface of the arm part 121 is drawn on a curved surface along the anatomical form, that is, the unevenness of the jaw bone.

  In this way, since the design support apparatus 100 can design the jawbone cutting aid 10, the length of the pointing unit main body 122 and the arm unit 121 is set to the length from the fixed unit 11 to the virtual cutting planned line. It can be designed accurately.

  When the design of the jawbone cutting aid 10 is completed, the jawbone cutting aid 10 fitted to the patient can be manufactured by molding with a 3D printer, for example.

(Embodiment 4)
A jawbone cutting aid according to Embodiment 4 of the present invention will be described with reference to the drawings. In FIG. 11, the same components as those in FIG.
A jawbone cutting aid 40 according to the fourth embodiment shown in FIG. 11 includes a fixing portion 11 and a position indicating portion 42.

The position indicator 42 is formed in a trapezoidal shape from the alveolar portion of the lower jaw to the bottom of the lower jaw and from the second molar to the side incisor of the right lower jaw. The position indicating part 42 is connected to the fixing part 11 covering the second molar and the first molar, with a part of the trapezoidal corner located in the second molar and the first molar being cut away. .
The position indicating unit 42 is formed with an opening 421 that exposes a region surrounding the region of the planned cutting portion S for cutting the mandible in order to excise or remove the tumor T2 generated in the mandible.

Since the position indicating unit 42 is fixed by the fixing unit 11, the jawbone cutting auxiliary tool 40 formed in this way can be firmly positioned with respect to the region of the planned cutting portion S.
Since the region of the planned cutting portion S when the tumor T2 is excised or removed is indicated by the opening 421, the surgeon can accurately grasp the entire cutting planned portion S. Therefore, the periphery of the scheduled cutting portion S can be accurately cut by cutting along the periphery of the opening 421.
Therefore, the jawbone cutting auxiliary tool 40 can be the lower jaw, and even if it is the tumor T2 that cannot be visually recognized from the external appearance, the planned cutting portion S can be reliably removed.

The jawbone cutting aid 40 can be designed by the design support apparatus 100 shown in FIGS.
When the CT imaging apparatus 200 images the lower jaw that is the bone to be treated by the patient, a tumor is imaged in the jawbone image. The operator designs the jawbone cutting aid 40 by the design support device 100 using the tumor imaged in the jawbone image or an area including the bone tissue around the tumor as a planned cutting portion.

First, the operator operates the operation unit 140 to cause the first image processing unit 131 to draw the fixed unit 11. Next, the operator designates the region of the planned cutting portion S, and causes the second image processing unit 132 to draw the virtual cutting planned portion.
Next, the operator designates the opening 421 that surrounds the range of the planned cutting portion S, thereby causing the third image processing unit 133 to draw the position instruction unit 42 having the opening 421.

  In this way, the design support apparatus 100 can design the jawbone cutting assisting tool 40, and therefore the position instruction unit 42 based on the tumor imaged in the lower jaw image even if the tumor is not visible from the appearance. Can be designed.

Identification information for identifying a patient can be given to the jawbone cutting aids 10, 10x, 20, and 40 as described above.
As the identification information, the name can be engraved or printed with a laser beam. Further, the identification information can be a number, character, or symbol that identifies the patient, or optically read information (for example, a one-dimensional barcode or a two-dimensional barcode).
When a number, character, symbol, or optical reading information for identifying a patient is used, various information related to the patient can be obtained by searching the registered database based on the identification information.
For example, patient information includes, in addition to name and date of birth, personal information such as address, gender, blood type, hospital name that identifies the dental clinic that was treated, and a code that identifies the hospital, and family contact information In addition to medical history, medication history, social history, family history, etc.

In this way, the names are given to the jawbone cutting aids 10, 10x, 20, and 40, so that at a glance, the jawbone cutting aid can be identified as to which patient the patient identification number or When characters and symbols are used as identification information, a patient can be specified by inputting the identification information and searching the database. When optical reading information is used as identification information, the information is read by an optical reader. Thus, the patient can be specified.
Therefore, it is possible to prevent mistaking.

  The present invention can be used for excision surgery due to tumors, trauma, congenital abnormalities, etc. in the jawbone, surgery for orthodontic treatment due to jaw deformity, and implantation of implant fixtures in the alveolar bone. It can be preferably used when the jawbone is cut accurately and simply in the operation of cutting the mandibular angle to make up for the alveolar bone that is missing.

10, 10x, 20, 40 Jaw bone cutting aid 11 Fixing portion 11a Recess 11b Fitting hole 12, 22, 32, 42 Position indicating portion 121 Arm portion 121a Tip portion 121b Base end portion 121c Shaft portion 122, 222, 322 Main body 122a Base end 122b Tip 122c End side 122d Linear groove 222a Base end 222b Tip 222c End side 3221, 3222 Pointer 3221a, 3222a Base end 3221b, 3222b Tip 3221c, 3222c End side 3221d Convex part 3222d Convex part 3222d Opening part 14 Connecting part 50 Cutting bar 51 Shaft part 51a Annular recessed part 51b Annular convex part 52 Blade part 100 Design support device 110 Communication part 120 CT control part 130 Image processing part 131 First image processing part 132 Second image processing part 133 Second 3 image processing 134 Fourth image processing unit 140 Operation unit 150 Display unit 160 Storage unit 200 CT imaging device T1 Tooth T2 Tumor P Jaw bone image L Cutting line L1 Virtual straight line L2 Virtual cutting line B1 Mandibular branch B2 Mandibular incision B3 Mandibular angle S Cutting Planned part

Claims (5)

A fixing part in which a recess for covering the gum or tooth in the tooth defect part is formed;
Provided in the fixing part, comprising a position indicating part pointing to a part or all of the part to be cut by surgery,
The position indicating portion includes a rod-shaped first portion whose proximal end is connected to the fixed portion, and a second portion that is connected to a distal end of the first portion and points to the planned cutting portion,
The second part is formed in a bifurcated shape that opens from the base end part on the first part side toward the scheduled cutting part, and a pair of end sides positioned at the distal end are positioned in the planned cutting part, An assisting tool for cutting jawbone, in which a virtual straight line extending the end side passes through the other end side. The bifurcated second part is formed of one indicating piece and the other indicating piece,
The auxiliary tool for jawbone cutting according to claim 1, wherein base ends of the one indicating piece and the other indicating piece are connected to each other by a shaft so as to be freely opened and closed.   3. The jawbone cutting aid according to claim 1, wherein one or both of the fixing portion and the second portion are connected by a connecting portion.   4. The jaw bone cutting aid according to claim 1, wherein the position indicating unit is curved along the unevenness of the surface of the jaw bone. 5.   5. The jawbone cutting aid according to claim 1, wherein the fixing portion is one of a denture, an upper structure of an implant, or a splint.

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