JP3651640B2 - Orthodontic support - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an orthodontic support that can be a fulcrum of displacement / movement for a tooth that needs to be displaced / moved in orthodontic treatment (hereinafter also referred to as an orthodontic tooth).
[0002]
[Prior art]
In the recent dental treatment field, orthodontic treatment for patients with poor tooth alignment has been widely performed.
The main method of orthodontic treatment is to fix a bracket to the surface of each tooth with an adhesive, pass an archwire through the bracket, and press the individual teeth using the restoring force based on the elasticity of the archwire.・ By applying external force (sometimes referred to as correction force in this specification) such as pulling back and twisting, each tooth is moved relatively, and the entire dentition is displaced to the correct position and orientation for correction. (Hereafter, this method may be referred to as relative movement type correction). In addition to the arch wire, a rubber ring, a resin chain, a metal coil spring, an auxiliary wire, or the like is used as a member for applying the correction force. Lock the teeth on a lingual button that is attached to the teeth and apply corrective force.
[0003]
In the relative movement type correction, as described above, each tooth moves relatively in relation to the other teeth, and for example, force is applied in the direction of pulling the two teeth with a gap therebetween. When added, each of the two teeth moves in the facing direction. At this time, when there is a difference in size between the two teeth, the large teeth do not move much and the small teeth move greatly.
[0004]
Since such a large tooth does not move much, it is often used as a support tooth (fixing source) during orthodontic treatment, and is generally a molar, especially the first molar (No. 6 molar). Are used as support teeth.
[0005]
On the other hand, when orthodontic treatment is performed for patients who do not have molars, artificial roots (implants) are implanted in the edentulous portion to replace the molars, and the archwire insertion path provided in the abutment of the artificial roots A method of correcting through an archwire has been proposed (US Pat. No. 4988292).
[0006]
As described above, orthodontic treatment is mainly performed by relative movement type correction, but since the tooth (for example, the first molar) is the fulcrum of tooth movement, the tooth itself that is the fulcrum is There is a risk that the supporting teeth that have moved and are originally in the correct position will be displaced from the correct position. Therefore, treatment methods have been adopted in which the moved support teeth are further corrected and moved, and the support teeth are connected to other teeth in advance so that the support teeth do not move. You may need it. Therefore, there is a problem that the treatment period is long and the burden on the patient becomes large.
[0007]
Therefore, a method has been proposed in which a metal pin is driven into the jawbone under the gum of the support tooth, and a support bar adhered to the support tooth comes into contact with the metal pin so that the support tooth does not move any more. However, it is still insufficient.
[0008]
On the other hand, during orthodontic treatment, for patients with a small maxillary arch, a rapid enlargement device is used to rapidly spread the midline palatal suture to enlarge the dental arch.
[0009]
FIG. 34 is a diagram showing the upper jaw being treated using the rapid enlargement device. By connecting the rapid enlargement device 40 to the band ring 42 attached to the tooth and turning the enlargement screw of the rapid enlargement device 40. The median palate suture 41 is expanded in the direction of arrow G.
[0010]
However, there is also a problem in the treatment of expanding the upper jaw using the rapid enlargement device. That is, since the part where the force to spread is applied is a tooth, the tooth to which the force is applied is inclined to the cheek side, and the dentition is disturbed.
[0011]
[Problems to be solved by the invention]
As a treatment method that does not use a tooth as a fulcrum for the movement of the correction target tooth, a method of implanting a small implant in the jawbone under the gums and applying a correction force such as pulling back to the correction target tooth using the implant as a fulcrum is conceivable. In this method, the correction force is applied by connecting a bracket (or lingual button) fixed to the tooth and the implant with a resin chain, a spring, or the like. In this method, since the tooth is not used as a fulcrum for movement, the treatment can be performed without adversely affecting the tooth in the correct position.
However, as described below, some cases still require complex correction techniques and correction movements.
[0012]
FIG. 32 is a front view showing an example in which the anterior teeth of the upper jaw are subjected to a reduction treatment. The implant 50 is implanted in the jawbone under the upper gums, and the bracket 34 fixed to the anterior teeth 1 and the implant 50 are provided. They are connected by a resin chain 52. The correction force for reducing the front teeth 1 is given by pulling the bracket 34 by the resin chain 52 with the implant 50 as a fulcrum, and the front teeth 1 are moved down by this correction force.
[0013]
In this case, the most preferable direction for applying the correction force is directly above the front teeth 1, that is, in the direction of the arrow K shown in FIG. 32, and implanting the implant 50 directly above the front teeth 1 and applying a retracting force. Most preferred. However, since the tooth nerve passes through the position in the direction of the arrow K and there is a tooth root, there is a problem that the tooth nerve or the like is damaged when the implant 50 is implanted at the position. Further, since the position in the direction of the arrow K corresponds to the front tooth movement (crushing) direction, there is a problem in that it interferes with the movement of the front teeth.
[0014]
Therefore, in actual treatment, as shown in FIG. 32, it is necessary to plant the jawbone under the gums between the front teeth 1 and the front teeth 2, and in this case, the correction force is given in the direction of the arrow L. As a result, the front teeth 1 are inclined and tilted. Therefore, in order to correct this inclination, a method of connecting with other teeth is required, that is, there is a problem that such complicated correction treatment must be performed.
[0015]
In addition, since the force of the tooth that resists the reduction is large, when the relative movement type correction is performed in this case, the force that moves the support tooth is large, and therefore the support tooth can be easily moved from the correct position. It will shift.
[0016]
FIG. 33 is a diagram showing a state of main nerves existing in the upper jaw. As shown in the figure, the upper palate has a large palatal nerve 55a, a nasal palatal nerve 55b, and the like.
In addition to the nerve shown in FIG. 33, various nerves pass through the maxilla and mandible, and it is necessary to avoid these nerves in order to implant the implant. Therefore, the implantation position of the implant is very limited. It will be. Therefore, as described above, there are many cases that require complicated correction treatment.
[0017]
Therefore, in the present invention, the corrective force can be applied to the correction target tooth from the most suitable fulcrum without adversely affecting the tooth in the correct position, and as a result, the tooth that can be corrected without performing complicated correction treatment. An object of the present invention is to provide an orthodontic support. It is another object of the present invention to provide an orthodontic support body capable of enlarging the midline palatal suture without imposing a burden on the teeth.
[0018]
[Means for Solving the Problems]
An orthodontic support according to the present invention is an orthodontic support composed of an embedded portion that is embedded in an arbitrary position of a jawbone and an exposed portion that is exposed in the oral cavity. The maximum diameter is 2 mm or less, and the exposed portion has an arm portion extending into the oral cavity, and the arm portion has a hook portion.
[0019]
In the treatment, the orthodontic support is implanted in the jawbone while avoiding a portion where the nerve is running, and the hook portion provided on the arm portion is positioned at a desired fulcrum position. Then, the bracket fixed to the teeth and the hook portion are connected by a resin chain or a metal coil spring to give a correction force such as pressing and pulling back. With this correction force, the correction target tooth moves and is corrected using the hook portion as a fulcrum.
[0020]
That is, in the orthodontic support according to the present invention, the position of the hook portion serving as the fulcrum of the correction force is separated from the planting position on the jawbone by the arm portion. Even if the support is planted, the hook portion can be brought to the most preferable position for applying the correction force. Moreover, the distance and direction between the planting position and the hook portion can be freely determined by appropriately setting the direction and length of the arm portion, and have a wide degree of freedom.
[0021]
As a result, even in cases where a complicated correction process has conventionally been required, using the orthodontic support according to the present invention, the teeth can be moved directly to the correct position and direction. This simplifies the correction process and thus shortens the treatment period.
[0022]
Further, when the support body is embedded in the jawbone, the support body according to the present invention is thin with a maximum cross-sectional diameter of 2 mm or less of the embedded portion, so that it can be easily embedded avoiding nerves and the like. For example, even in a place where the distance between the nerves is only about 3 mm, it can be planted because it is a thin embedded part. In addition, since the embedded part is thin, there is little harmful effect on the living body.
[0023]
Preferably, the thickness of the embedded portion, that is, the maximum diameter of the cross section is 1.5 mm or less, and more preferably 1 mm or less. As described above, the narrower one is easier to avoid nerves and the like, and has less harmful effect on living body. On the other hand, if it is too thin, the embedding part may come out of the jawbone without resisting the correction force, so 0.5 mm or more is preferable.
[0024]
In addition, it is sufficient for the orthodontic support to have a strength that can cope with the orthodontic force, and this orthodontic force is usually 100 to 300 g, and it is a force within 1 kg at most. Even if the thickness of the embedded portion is as narrow as 2 mm or less, and further 1 mm or less, the maximum diameter can be used for orthodontic treatment. Examples of the shape of the embedded portion include a rod-like shape, and examples of the shape of the cross section (plane orthogonal to the axis) include a circle, an ellipse, and a polygon.
[0025]
In addition, as the length of the embedded portion, it is preferable to check the thickness of the bone at the embedded portion and use an appropriate length. For example, 5 to 15 mm is recommended as the length of the embedded portion that does not penetrate the jawbone. If the length is too short, the corrective force may not be supported, while if too long, the jawbone may be adversely affected.
As a material for the orthodontic support, titanium or a titanium alloy is preferably used. This is because titanium and titanium alloys are excellent in biocompatibility.
[0026]
Moreover, apatite, biodegradable polymer (polyglycolic acid, polylactic acid, etc.), etc. may be coated on the outer surface of the embedded part, thereby improving biocompatibility.
Further, the number of hook portions provided on the arm portion is not limited to one, and two or more hook portions may be provided.
[0027]
Furthermore, in the orthodontic support according to the present invention, it is preferable that the exposed portion and the embedded portion are formed separately from each other and are combined and integrated at the time of use. Although the exposed portion is essentially exposed in the oral cavity as described above, even if a part of the member constituting the exposed portion is embedded in the gingiva, Is included. Further, as described above, the embedded portion is essentially embedded in the jawbone. However, even if a part of the member constituting the embedded portion protrudes outside the jawbone, it is included in the present invention. The
[0028]
As described above, if the support is configured as a separate body and is detachable, it may be desirable even if it is desired to change the position (fulcrum) of the hook part during the treatment, for example, after the implant part has been implanted in the jawbone. It can be replaced with an exposed part where the hook part comes to the position. Also, for example, if orthodontic treatment using this support is not performed until the implant is attached to and fixed to the jawbone, the exposed part is removed during that time to reduce any discomfort to the buccal lip and tongue. be able to.
[0029]
In addition, in the present invention, it is more preferable that the coupling and integration is performed by screw bonding. The exposed portion and the embedded portion can be firmly attached by the screw joint.
In the orthodontic support according to the present invention, it is preferable that the coupling and integration be performed by socket type fitting.
[0030]
Furthermore, in the present invention, the socket-type fitting is configured by a polygonal socket of each of the exposed portion and the embedded portion, so that it is in a plane perpendicular to the axis of the embedded portion (hereinafter referred to as a horizontal plane). It is preferable that the mounting direction of the arm portion (hereinafter sometimes referred to as the horizontal direction) is selectable.
[0031]
Alternatively, in the present invention, the mounting orientation (horizontal direction) of the arm portion in a plane (horizontal plane) perpendicular to the axis of the embedded portion can be selected by the star-shaped fitting between the unevenness formed radially. It is preferable that it is comprised.
Thus, by changing the direction of the socket-type fitting or the star-shaped fitting, the arm portion can be easily oriented in a desired horizontal direction.
[0032]
Moreover, in this invention, it is preferable that the fitting surface of the said exposed part and the said embedding part forms the taper in the fitting direction. Thus, by making the fitting portion tapered, the exposed portion and the embedded portion can be fixed without a gap.
[0033]
Further, in the orthodontic support according to the present invention, an angle formed by the axis of the arm portion and the axis of the embedded portion (hereinafter, sometimes referred to as an upward angle) is 90 ° to 180 °. It is preferable. More preferably, the upward angle is 90 ° to 160 °.
[0034]
In this way, by turning the arm part upward from the embedded part implanted in the jawbone, the hook part provided in the arm part can be separated from the gums, etc., and thereby the resin chain connecting the hook part and the bracket etc. Etc. can be prevented from touching the gums. When the resin chain or the like comes into contact with the gums, it may cause inflammation, but it is advantageous to be able to separate the resin chain or the like in this way. In addition, since it will give an uncomfortable feeling to the cheek lips and tongue if it is too far away from the gums, it is preferable to select the upward angle as appropriate and use the one with the least uncomfortable feeling.
[0035]
By appropriately selecting and combining the length of the arm portion and the horizontal direction and upward angle of the arm portion as described above, the hook portion can be brought to the most preferable position as a fulcrum for correction force.
[0036]
Moreover, in this invention, it is preferable that the length of the said arm part is comprised so that adjustment is possible. In this case, after implanting the implant part in the jawbone and attaching the exposed part to the implant part (if the implant part and the exposed part are integrally molded, after implanting the implant part in the jawbone) Alternatively, the length of the arm portion can be changed to bring the hook portion to a suitable position.
[0037]
Furthermore, the orthodontic support according to the present invention may include a plurality of the arm portions. Thus, by using a plurality of arm portions, two or more fulcrums (hook portions) can be provided in different directions from one embedding position.
[0038]
In the orthodontic support according to the present invention, the arm portion may be a leaf spring. In this case, the orthodontic movement can be performed by the restoring force (elastic force) of the arm portion.
[0039]
BEST MODE FOR CARRYING OUT THE INVENTION
<Example 1>
1 and 2 are views showing Example 1 of an orthodontic support according to the present invention. FIG. 1A is a front view, FIG. 1B is a top view, and FIG. FIG. 2 (a) is a cross-sectional view taken along the line IIa-IIa in FIG. 1 (b), and FIG. 2 (b) is a cross-sectional view taken along the line IIb-IIb in FIG. 1 (a).
[0040]
The orthodontic support 10 of the first embodiment includes an embedded portion 11, an abutment (exposed portion) 12 exposed in the oral cavity, and a male screw 13 that fixes the embedded portion 11 and the abutment 12. Yes. The embedded portion 11 of the first embodiment has a substantially columnar shape, the transverse cross section diameter C thereof is 1 mm, and the length D of the embedded portion is 5 mm.
[0041]
The abutment 12 is provided with an arm portion 14 extending into the oral cavity, and a hook portion 15 is provided at the tip of the arm portion 14. In the first embodiment, as shown in FIG. 1 (a), the arm portion 14 protrudes at an angle of 90 ° with respect to the axial center of the embedded portion 11 (upward angle 90 °), and the length L of the arm portion 14 is increased. Is about 4mm.
[0042]
A coupling portion 11b is provided on the upper portion of the embedded portion 11, and the coupling portion 11b is tapered such that the cross-sectional diameter decreases toward the upper end. On the other hand, the coupling portion 16 provided in the abutment 12 has a reverse taper that fits into the coupling portion 11b. In addition, a female screw hole 11c that is screwed into the male screw 13 is provided in the coupling portion 11b. The abutment 12 and the embedded portion 11 can be coupled to each other at the coupling portions 16 and 11 b and are firmly coupled by the screw 13.
[0043]
As described above, since the coupling portion 16 of the abutment 12 and the coupling portion 11b of the embedded portion 11 are taper-fitted, when tightening with the male screw 13, tightening is performed when these tapers are exactly aligned. Will stop and be fixed, and the abutment 12 and the embedded portion 11 are joined without any gap.
[0044]
If the structure is such that the tip of the male screw 13 stops when it hits the bottom of the female screw hole, the length of the male screw 13 needs to be exactly matched to the length of the female screw hole, and advanced processing technology is required. Although it is required, in the case of taper fitting as described above, it is not necessary to adjust the depth of the female screw hole 11c to the length of the male screw 13, and technical production is easy. In the case of the taper fitting, the female screw hole 11 c needs to be deeper than the length of the male screw 13.
Further, the connecting portions 11b and 16 of the embedded portion 11 and the abutment 12 are each a regular hexagon as shown in FIG.
[0045]
In this way, in the case of hexagonal fitting, the horizontal direction in which the arm portion 14 extends can be changed by 60 °, and thus the mounting angle of the abutment 12 with respect to the embedded portion 11 is appropriately selected in the horizontal direction. By doing so, the arm portion 14 can be directed in a desired direction on the horizontal plane, and as a result, the hook portion 15 serving as a fulcrum for the correction movement can be brought to a desired position.
[0046]
<Example 2>
3 and 4 are diagrams showing Example 2 of the orthodontic support according to the present invention, in which FIG. 3A is a front view, FIG. 3B is a top view, and FIG. 4A is a right side view, FIG. 4A is a sectional view taken along line IVa-IVa in FIG. 3B, and FIG. 4B is a sectional view taken along line IVb-IVb in FIG.
[0047]
Unlike the arm portion 14 of the first embodiment, the second embodiment has an upward angle of 135 ° (see FIG. 3A), and the arm of the abutment 12 exposed to the oral cavity. The height of the part excluding the part 14 is slightly shorter. Others are the same as in the first embodiment, and a hook portion 25 is provided at the tip of the arm portion 24. Components similar to those in FIGS. 1 and 2 are denoted by the same reference numerals to avoid redundant description.
[0048]
In this way, when the arm portion 24 is directed obliquely upward, the hook portion 25 does not contact the gums, and the resin chain or the like connected to the hook portion 25 can be prevented from contacting the gums. In addition, since it is separated from the gums, it is easy to attach the resin chain or the like to the hook portion 25.
[0049]
<Examples 3 to 6>
5 to 7 are perspective views showing Examples 3 to 5 of the orthodontic support 10 according to the present invention. FIG. 5 shows Example 3, FIG. 6 shows Example 4, and FIG. Represent. FIG. 8 is a top view showing Example 6 of the orthodontic support 10 according to the present invention.
[0050]
The thickness (transverse section diameter) of the embedded portion 61 in Examples 3 to 5 is 1.5 mm, which is thicker than those in Examples 1 and 2 above. In the first to fourth embodiments, the hole of the hook portion 25 opens upward, whereas in the fifth embodiment, the hole of the hook portion 27 opens sideways (FIG. 7). In the sixth embodiment, the hook portion 65 provided at the tip of the arm portion 64 of the abutment 62 has a key shape (FIG. 8), and it is easy to hook a resin chain or the like. Note that the same components as those in FIGS. 1 to 4 are denoted by the same reference numerals to avoid redundant description.
[0051]
<Example 7>
FIG. 9 is a view showing Example 7 of the orthodontic support according to the present invention, wherein (a) is a front view thereof and (b) is a top view thereof.
In the seventh embodiment, the arm portion 74 of the abutment 72 has a shape in which a plurality of rings are connected. The arm portion 74 can be appropriately cut for each ring, whereby the length of the arm portion 74 can be shortened. The ring at the tip of the arm portion 74 becomes a hook portion 75. Therefore, in the seventh embodiment, even after the abutment 72 is attached to the embedded portion 11, the length of the arm portion can be adjusted, that is, the position of the hook portion serving as a fulcrum for correction movement is adjusted in the length direction. be able to.
Note that the method for adjusting the length of the arm portion is not limited to the seventh embodiment. For example, an arm portion configured to be extendable in the length direction may be used.
[0052]
Further, in the seventh embodiment, not only the ring at the tip of the arm part 74 can be used as a hook, but also a ring in the middle of the arm part 74 can be used as a hook part, and two places from one orthodontic support can be used. The fulcrum (hook part) of the above correction | amendment movement can also be taken.
[0053]
<Examples 8 and 9>
10 and 11 are top views showing Examples 8 and 9 of the orthodontic support according to the present invention. FIG. 10 shows Example 8 and FIG. 11 shows Example 9. FIG.
In the eighth and ninth embodiments, two arm portions 84a, 84b, 94a, and 94b are provided, and hook portions 85a, 85b, 95a, and 95b are provided at the tips thereof. In the eighth embodiment, the two arm portions 84a and 84b are in a positional relationship opened at 180 °, and in the ninth embodiment, the two arm portions 94a and 94b are in a positional relationship opened at 90 °.
[0054]
In this way, in Examples 8 and 9, two orthodontic movement fulcrums (hook portions) can be taken in different directions from one orthodontic support.
The positional relationship between the two arm portions is not limited to 90 ° or 180 ° as in the eighth and ninth embodiments, and can be variously arranged.
Three or more arm portions may be provided, and in this case, three or more fulcrums can be taken by one support.
[0055]
<Example 10>
FIG. 12 is a perspective view showing Example 10 of the orthodontic support according to the present invention.
In the orthodontic support 100, the arm portion 104 of the abutment (exposed portion) 102 attached to the embedded portion 11 is a leaf spring. A hook portion 105 is provided at the tip of the arm portion 104.
[0056]
Thus, since the arm part 104 is a leaf | plate spring, a tooth | gear can be corrected and moved by the restoring force of this spring. For example, when the hook portion 105 is attached to the tooth with the arm portion 104 bent as shown by a dotted line in FIG. 12, a restoring force acts in the direction of arrow N to move the tooth.
[0057]
<Example 11>
FIG. 13 is a view showing Example 11 of the orthodontic support according to the present invention, in which (a) is a front view thereof and (b) is a top view thereof.
The abutment (exposed portion) 112 of the orthodontic support 110 has leaf spring arms 114a and 114b extending on both wings, and hooks 115a are provided at the ends of the arms 114a and 114b, respectively. 115b are provided. The abutment 112 is attached to the embedded portion 11 with a screw 113.
[0058]
In Example 11 as well, as in Example 10, the teeth can be corrected and moved by the restoring force of the arm portions 114a and 114b (plate springs). For example, the dotted line is shown in FIG. When the hook portions 115a and 115b are attached to the teeth with the arm portions 114a and 114b being bent as described above, a restoring force acts in the direction of the arrow M to move the teeth.
[0059]
<Example 12>
14A and 14B are diagrams showing Example 12 of an orthodontic support according to the present invention, in which FIG. 14A is a perspective view of the support, and FIG. 14B is an axial cross-section of an embedded portion 151 of the support. It is a figure and represents a part to be embedded.
[0060]
Screws are formed on the outer surface of the embedded portion 151, and the rest of the configuration is the same as in the fourth embodiment. Thus, by using the embedded portion 151 as a male screw, the jawbone and the embedded portion 151 are firmly fixed.
[0061]
Further, the screw of the embedded portion 151 in the twelfth embodiment has a small screw thread angle, and the width of the screw groove 151b is wider than the pitch of the screw. In the case of such a screw shape, when the embedded portion 151 is screwed into the jawbone, it is screwed in such a manner that the jawbone is cut with a screw thread, so that the resistance is small, and therefore the screwing operation is easy, and the screwing operation is performed at the time of screwing. There is little worry that the head of the machine is damaged.
[0062]
<Example 13>
FIG. 15 shows an orthodontic support according to a thirteenth embodiment of the present invention, and is a cross-sectional view in the axial direction showing a portion where the embedded portion 161 of the support is embedded.
In the thirteenth embodiment, the height of the thread 161a of the embedded portion 161 is formed differently. In the case of such a screw shape, the lower thread 161a is screwed without contacting the jawbone, that is, the lower thread 161a is not subjected to contact resistance. Accordingly, the screwing resistance is reduced as a whole, the screwing operation is further facilitated, and there is less concern that the screw head is damaged during screwing.
[0063]
<Example 14>
16 (a) is a perspective view showing Example 14 of the orthodontic support according to the present invention, and FIG. 17 is a view showing a longitudinal section of the support 170. FIG. FIG. 16B is a perspective view showing a state in which each part of the support 170 is removed.
[0064]
The support body 170 of the fourteenth embodiment includes an embedded portion 171, an abutment (exposed portion) 172 exposed in the oral cavity, and a fixing screw 173. The abutment 172 further includes an upper member 177 and a lower member 176. It is made up of. The upper member 177 is provided with an arm portion 14 having a hook portion 15 at the tip.
[0065]
The joint portions 177b and 176b of the upper member 177 and the lower member 176 are each a star-shaped with a concave and convex shape formed thereon, and the upper member 177 and the lower member 176 are fitted into the base so that the angle can be changed in the horizontal direction. It is supposed to be done. Therefore, the arm portion 14 can be directed to a desired angle in the horizontal direction, and this angle can be finely adjusted for each pitch of the unevenness.
[0066]
The upper member 177 is provided with a hole 177c, and the upper member 177 and the lower member 176 are firmly fixed by inserting the screw 173 into the hole 177c and tightening the female screw 176a of the lower member 176. Fixed. Further, the embedded portion 171 is fixed (coupled and integrated) to the abutment 172 by screwing a male screw portion 171a provided on the embedded portion 171 with a female screw portion 176a of the lower member 176.
[0067]
<Example 15>
FIG. 18 is a view showing Example 15 of an orthodontic support according to the present invention, in which (a) is a top view and (b) is a cross-sectional view taken along line BB of (a).
An abutment (exposed portion) 142 of the orthodontic support 140 includes an upper member 142b having four arm portions 144 and a lower member 142a connected to the embedded portion 141. The upper member 142b and the lower member 142a is coupled by a screw 143. In this way, the abutment may be constituted by two members, or four arm portions may be provided.
[0068]
<Example 16>
FIG. 19 is a perspective view showing Example 16 of the orthodontic support according to the present invention.
In the orthodontic support 120 of Example 16, abutments (exposed portions) 122 a and 122 b are attached to both ends of the embedded portion 121 by screws 13, respectively. The abutments 122a and 122b have arm portions 124a and 124b, and hook portions 125a and 125b are provided at the ends thereof.
[0069]
The support 120 is planted through the jawbone, and the orthodontic force is applied to the correction target tooth by a resin chain or the like with the hook portions 125a and 125b provided on the two abutments 122a and 122b as fulcrums. Can be given.
[0070]
<Reference example>
FIG. 20 is a perspective view showing a modification of the orthodontic support of Example 16 described above.
The support body 130 of this reference example is also used by penetrating the jawbone, and abutments (exposed portions) 132a and 132b are attached to both ends of the embedded portion 131, respectively. The abutments 132a and 132b are provided with hook portions 135a and 135b, respectively, but the support 130 does not have an arm portion, and the planting position of the embedded portion 131 serves as a fulcrum. In the case of a case where the exposure position (embedding position) can be used as a fulcrum, an orthodontic support as in this reference example can be used.
[0071]
In the sixteenth embodiment, both abutments 122a and 122b show the support 120 having the arm portions 124a and 124b, and in the reference example, both the abutments 132a and 132b show the support 130 having no arm portion. However, in the present invention, an orthodontic support having an arm portion only on one abutment may be used, and the other abutment may not have an arm portion.
[0072]
As described above, even if the side having the arm part is restricted by the nerve or the like in the implantation position of the embedded part, the hook part serving as a fulcrum is moved to the desired position by extending the arm part in the desired direction. You can bring it.
[0073]
Although the orthodontic support according to the present invention has been specifically described with reference to the drawings showing the embodiments as described above, the present invention is not limited to the illustrated examples. The present invention can be implemented with appropriate modifications within a range that can be adapted to the gist of the present invention, and all of them are included in the technical scope of the present invention.
[0074]
For example, the support according to the present invention can be variously modified and changed in addition to the above embodiments, such as the thickness and length of the embedded portion, the length of the arm portion, and the angle (upward angle) of the arm portion with respect to the axis of the embedded portion It is possible to select these appropriately and use a suitable support in accordance with the case. In addition, in the support body in which the arm portion is not a spring as in Examples 1 to 9, 12, 14, and 16, the length of the arm portion is recommended to be 1.5 to 5 mm.
[0075]
In the above embodiment, for example, as shown in FIGS. 2 (b) and 4 (b), the cross-sectional shape in a plane orthogonal to the axis of the embedded portion is circular, but the present invention is not limited to this. It may be a shape or polygon. For example, in the case where the section of the embedded portion (plane perpendicular to the axis) is a triangle and the outer surface is threaded, the thread at the center of the triangle is smaller than the thread at the apex of the triangle. Since the distance from the axis of the screw is shorter, that is, the mountain is lower, the screw thread at the center of the side does not contact the jawbone, and the resistance at the time of screwing is reduced in the same manner as in the thirteenth embodiment. The
[0076]
The height of the exposed part (abutment) exposed to the oral cavity is not particularly limited, but it requires a certain height from the viewpoint of operability, while reducing the sense of discomfort with the tongue and buccal mucosa. From the viewpoint of reducing the force applied to the portion in which the support is embedded, the lowest possible one is preferable. When the arm part is facing upward or diagonally upward, the exposed height of the abutment is high. However, the height of the abutment part other than the arm part, that is, the base part is, for example, 1.5 to 3 mm. Recommended.
[0077]
The shape of the hook portion is not limited to the round shape or the key shape as in the above embodiment, and can be various shapes, such as a resin chain, a metal coil spring, a bracket, a lingual button, or the like. I need it. Further, for example, the arm portion may be oval and a resin chain or the like may be attached to the tip thereof. In this case, the tip of the oval arm portion becomes the hook portion. In addition, a shape with less irritation on the tongue and buccal mucosa is desirable.
[0078]
Further, in the first and second embodiments, the coupling portions 11b and 16 are fitted in a hexagonal shape, but the present invention is not limited to this. For example, an octagonal shape may be used. The part can be changed by 45 ° in the horizontal direction. In this way, various polygons can be applied and oriented in a desired horizontal direction.
[0079]
In the above embodiment, the abutment (exposed portion) and the embedded portion are separately configured. However, an orthodontic support body in which the abutment and the embedded portion are integrally formed may be used. It should be noted that the support with a separate abutment and embedded portion can be variously replaced with an abutment having a different shape, such as the length of the arm portion or the upward angle, so that after the embedded portion is embedded in the jawbone In addition, by appropriately selecting an abutment having a desired shape and coupling the abutment to the embedded portion, the hook portion can be changed to a desired position according to the case.
[0080]
Moreover, in the said Example, although the embedding part was comprised by one member, it is not restricted to this, For example, it comprises two members, the coupling | bond part with an abutment, and the part embedded in a jawbone, These It is good also as a structure which unites and integrates.
[0081]
[Explanation of the embedding process in the jawbone]
Next, the process of embedding the orthodontic support of the present invention in the jawbone will be described with reference to FIGS. Here, the orthodontic support shown in Example 3 is described as an example.
[0082]
The joint portion (joint portion to the abutment 12) of the embedded portion 61 is previously covered with the temporary lid 17, the mucous membrane 31 of the gum is incised, a hole is made in the jawbone 30 with a drill or the like, and the embedded portion 61 is removed. Embed. Then, the opening 31a of the mucous membrane 31 is sutured, and the wound is healed, and it waits for the embedded portion 61 and the jawbone 30 to be firmly fixed (FIG. 21). By waiting for healing in this way, the wound can be prevented from being contaminated with bacteria or the like.
[0083]
Thereafter, the mucous membrane 31 above the embedded portion 61 is removed, the temporary lid 17 is removed, the abutment 12 is attached to the embedded portion 61, and these are fixed with screws 13 (FIG. 22).
[0084]
In the description of the embedding process, the jaw bone is drilled with a drill or the like. However, since the embedding portion of the orthodontic support of the present invention is thin, the orthodontic orthodontic directly without opening a hole in advance. The support may be driven into the jawbone.
[0085]
Further, the abutment 12 may be attached immediately after the embedded portion 61 is embedded without waiting for the wound to heal, and the orthodontic treatment may be started. In particular, when the orthodontic treatment period using the support is short, there is no need to worry too much about contamination of the wound.
[0086]
If there is no concern about infection from the wound (for example, applying antibiotics to the wound or using a very thin support), use a support with an integral part of the implant and abutment, and attach this to the jawbone. It is possible to plant and wait for the implant to be firmly fixed to the jawbone while the abutment is exposed on the mucous membrane without suturing the mucous membrane.
[0087]
[Description of treatment method]
Next, a method of orthodontic treatment performed using the orthodontic support will be specifically described.
[0088]
<Treatment example 1>
FIG. 23 is a diagram showing an orthodontic technique in the case of lowering the molar tooth. For example, the arm portion as in Examples 1 to 7, 12, and 14 uses one type of orthodontic support. Show.
[0089]
A bracket 34 and a lingual button 35 are bonded to the band 33 attached to the molar 36, while the support 10 is planted on the jawbone 30. One end of the resin chain 37 is attached to the hook portion 25 of the support 10, and the other is attached to the bracket 34 or the lingual button 35. Then, the molar teeth 36 are pulled downward (alveolar bone side) by the tension of the resin chain 37 and are reduced (corrected).
[0090]
The planting position of the support 10 may be somewhat restricted depending on the place where the nerve passes, and may deviate from the most preferable fulcrum position for correction. By using the orthodontic support 10 having the arm portion and fixing the arm portion in a desired direction, the hook portion serving as a fulcrum can be brought to the most suitable position. Therefore, the correction force can be applied toward the desired fulcrum and the teeth can be moved directly.
[0091]
<Treatment example 2>
FIG. 24 is a view showing a treatment method when the canine is moved in a centrifugal manner, and is a view showing a dentition on the left side of the upper jaw. Also in this example, the case where the arm portions as in Examples 1 to 7 and 12.14 described above use one type of orthodontic support is shown.
[0092]
In this case, correction is performed by drawing the tooth 3 (canine) toward the tooth 5 (5th premolar), and supports 10a and 10b are implanted on the buccal side and the lingual side in the vicinity of the tooth 5. The bracket 34 attached to the tooth 3 and the support 10a are connected by a resin chain 37a, and the lingual button 35 attached to the tooth 3 and the support 10b are connected by a resin chain 37b. Then, the bracket 34 is pulled by the resin chain 37a with the support body 10a as a fulcrum, and the lingual button 35 is pulled by the resin chain 37b with the support body 10b as a fulcrum. The tooth 3 can be corrected and moved to a desired position without twisting.
[0093]
Further, although the planting positions of the supports 10a and 10b are somewhat restricted by nerves or the like, the hook part can be brought to the optimum position by the arm part as described above, so that the teeth are directed to a desired position. Can be moved directly. Furthermore, the hook portion can be brought to a desired position by the arm portion so that the resin chains 37a and 37b do not touch the gums.
[0094]
<Treatment Example 3>
FIG. 25 is a front view for explaining a treatment method in the case where the front teeth 1 are reduced, as in the case shown in FIG. 32 described above. In the illustrated example, the orthodontic support 10 of Example 6 is used.
[0095]
Even if the planting position of the orthodontic support 10 is between the front teeth 1 and the front teeth 2 (same as the position of the implant 50 shown in FIG. 32) due to the presence of nerves or the like, the arm portion 64 causes the hook portion 65 to move. It can be brought to a position in the direction of arrow K, and by connecting the hook portion 65 and the bracket 34 with a resin chain 37 and applying a pulling back force, the teeth can be directly moved down to a desired position.
[0096]
In this way, when the support of the present invention is used, the correction force can be applied from the most preferable fulcrum (direction), so that the correction treatment can be performed without taking a complicated method of connecting with other teeth, and the treatment period is also long. Can be short.
[0097]
<Treatment example 4>
FIG. 26 is a view showing a treatment method when canine teeth are centrifugally moved in the same manner as in the above treatment example 2, and is a view showing a dentition on the right side of the upper jaw. This treatment example 4 shows a case where the arm portion as in Example 10 uses a plate spring type orthodontic support (see FIG. 12).
[0098]
A support 100 is planted on the maxilla, and a lingual button 35 is bonded to the lingual side of the tooth 3. As shown in FIG. 26 and FIG. 12 (see dotted line), the arm portion 104 of the support body 100 is bent, and the hook portion 105 at the tip of the arm portion is attached to the lingual button 35. To move the tooth 3 to the distal side (see arrow N).
[0099]
<Treatment example 5>
FIG. 27 is a view for explaining a treatment method in the case of reducing two teeth, and represents a cross section of the upper jaw. In Treatment Example 5, an orthodontic support 110 of the type having two leaf spring arms as in Example 11 is used (see FIG. 13).
[0100]
A support 110 is implanted on the maxilla, while lingual buttons 35a and 35b are bonded to the lingual sides of the two teeth 6, respectively. As shown in FIGS. 27 and 13 (a) (see dotted lines), the arm portions 114a and 114b of the support 110 are bent and the hook portions 115a and 115b at the tips of the arm portions are respectively connected to the lingual buttons 35a and 35b. Install to. The two teeth 6 are moved down by the restoring force of the arm portions 114a and 114b (see arrow M).
[0101]
<Treatment Example 6>
FIG. 28 is a diagram for explaining a treatment method in the case of four orthodontic movements using two orthodontic supports, and is a diagram showing a maxillary dentition. In Treatment Example 6, an orthodontic support 140 of the type having four arm portions as in Example 15 is used (see FIG. 18).
[0102]
Two supports 140 are implanted in the maxilla, and these two supports 140 jointly have four arm portions 144. Each arm portion 144 is a leaf spring, and a hook portion is provided at the tip of the arm portion 144. Tooth 5 _R , 7 _R , 5 _L , 7 _L A lingual button 35 is bonded to each tongue side, and the hook portions are respectively attached to the lingual buttons 35, and the teeth 5 are restored by the restoring force of the arm portion 144. _R , 7 _R , 5 _L , 7 _L Moves straight.
[0103]
In the above treatment example 6, two orthodontic supports are used (that is, there are two portions to be embedded), but the four orthodontic movements are moved as described above with one orthodontic support. May be performed. In addition, by using a plurality of orthodontic supports as in Treatment Example 6 described above, that is, by planting in two places, the support can withstand strong orthodontic forces.
[0104]
<Treatment Example 7>
FIG. 29 is a diagram for explaining the case of the orthodontic correction method for reducing the molar teeth as in the first treatment example, wherein (a) is a side view (the gingiva and jawbone are shown in cross section), and (b). Is a top view. The present treatment example 7 shows a case where the orthodontic support 120 of the type that penetrates the embedded portion as in the above-described embodiment 16 is used (see FIG. 19).
[0105]
A bracket 34 and a lingual button 35 are bonded to the band 33 attached to the molar 36 as in the first treatment example. On the other hand, a support 120 is planted through the jawbone 30. The support 120 is planted between the teeth 36 and the adjacent teeth 7 so as to avoid nerves and not damage the teeth 36 and periodontal ligament.
[0106]
The abutments 122a and 122b of the support 120 are exposed on the cheek side and the tongue side, and the hook portions 125a and 125b of the support 120, the bracket 34, and the lingual button 35 are respectively connected by a resin chain 37. By pulling downward (alveolar bone side) by the tension of 37, the tooth is moved down.
[0107]
At this time, by appropriately selecting the lengths and angles of the arm portions 124a and 124b of the support body 120, the hook portions 125a and 125b at the tips of the arm portions 124a and 124b are brought to the most suitable positions for use as a fulcrum for correction. be able to. Further, by pulling the bracket 34 and the lingual button 35 on average, the tooth 36 can be moved down without being inclined.
[0108]
In addition, since the bone repeats osteoclast / osteoplasty, there is a concern that the embedded portion of the support 10 gradually tilts due to the force applied to the support 10 in the above treatment example 1, but this treatment example 7 In the support body 120 of Example 16 used in the above, since an average force is applied to the embedded portion 121, there is no fear that the embedded portion 121 is inclined.
[0109]
<Reference treatment example>
FIG. 30 is a diagram for explaining a treatment method in the case where the fourth premolar is centrifugally moved using the support 130 (see FIG. 20) of the reference example, and represents a dentition on the right upper jaw. .
[0110]
A support 130 is planted through the jawbone between the teeth 6 and 7, and a bracket 34 is bonded to the buccal side of one tooth 4 (fourth premolar), and a lingual button on the lingual side. 35 is bonded.
[0111]
The abutment 132a of the support 130 is exposed on the cheek side, and the abutment 132b of the support 130 is exposed on the tongue side, and the hook portion 135a of the abutment 132a and the bracket 34 are connected by the coil spring 38a. Further, the hook portion 135b of the abutment 132b and the lingual button 35 are connected by a coil spring 38b.
[0112]
By pulling the bracket 34 and the lingual button 35 by the coil springs 38a and 38b with the hook portions 135a and 135b as fulcrums (see the arrows shown in FIG. 30), the tooth 4 is corrected and moved to a desired position without twisting. Can do.
[0113]
In this reference treatment example, the case where the orthodontic support 130 having no arm part is used is shown. However, in this case, the orthodontic support having the arm part as shown in Example 16 is used. 120 may be used, and if the support body 120 as in Example 16 is used, the hook portion serving as a fulcrum can be brought to a desired position by the arm portion, and in addition, the coil spring or the like does not touch the gums. It can also be.
[0114]
<Therapeutic example 8>
FIG. 31 is a view for explaining a treatment method for expanding the midline palatal suture of the upper jaw using the rapid enlargement device, and represents the upper jaw.
Thus, the orthodontic support of the present invention can also be used in a treatment method for expanding the medial palatal suture. In this case, a non-penetrating support such as the above-described Example 1 is used.
[0115]
The support bodies 10 planted on the upper jaw are respectively connected to the rapid enlargement device 40, and the force of the rapid enlargement device 40 to push is transmitted to the support body 10, and the upper jaws are pushed right and left by the support body 10.
[0116]
As described above, conventionally, the force that pushes the upper jaw is applied to the teeth. However, if the support according to the present invention is used, the force that pushes can be directly applied to the maxilla through the support. The medial palatal suture 41 can be enlarged without any burden.
In addition, although the orthodontic method using the orthodontic support according to the present invention has been specifically described with reference to the above treatment examples, the orthodontic support method is not limited to the above examples.
[0117]
For example, in the above treatment examples, a pullback external force is applied by a resin chain or a coil spring. However, a treatment for applying a pressing force using a coil spring or the like may be performed, and any of them can be corrected and moved using the support of the present invention. it can. In addition, brackets and lingual buttons are exemplified as members fixed to the teeth, but other ordinary members may be used that are bonded to the teeth in orthodontic treatment, and the members and the support are linear elastic bodies. It is used by passing over.
[0118]
After the treatment is completed, the orthodontic support may be pulled out from the jawbone and removed. Alternatively, since the orthodontic support of the present invention is thin, there is no inconvenience to the living body even if it is left in the jawbone as it is.
[0119]
【The invention's effect】
As described above, the orthodontic support according to the present invention can bring the hook portion serving as a fulcrum of the orthodontic movement to a desired position while being planted on the jawbone while avoiding nerves and the like. it can. In addition, since the embedded part is thin, the planting position is highly flexible.
[0120]
In this way, if the hook portion is brought to the most suitable position (fulcrum) for applying the correction force, the correction force can be linearly applied to the fulcrum and the teeth can be moved. It can be corrected without going through complicated correction process. As a result, the period of corrective treatment is shortened and the burden on the patient is reduced.
Moreover, if the orthodontic support according to the present invention is used, the midline palatal suture can be expanded without placing a burden on the teeth.
[Brief description of the drawings]
FIG. 1 is a view showing Example 1 of an orthodontic support according to the present invention.
2A is a cross-sectional view taken along the line IIa-IIa shown in FIG. 1B, and FIG. 2B is a cross-sectional view taken along the line IIb-IIb shown in FIG.
FIG. 3 is a diagram showing Example 2 of an orthodontic support according to the present invention.
4A is a cross-sectional view taken along the line IVa-IVa shown in FIG. 3B, and FIG. 4B is a cross-sectional view taken along the line IVb-IVb shown in FIG.
FIG. 5 is a perspective view showing Example 3 of an orthodontic support according to the present invention.
FIG. 6 is a perspective view showing Example 4 of an orthodontic support according to the present invention.
FIG. 7 is a perspective view showing Example 5 of an orthodontic support according to the present invention.
FIG. 8 is a top view showing Example 6 of an orthodontic support according to the present invention.
FIG. 9 is a view showing Example 7 of an orthodontic support according to the present invention.
FIG. 10 is a top view showing Example 8 of an orthodontic support according to the present invention.
FIG. 11 is a top view showing Example 9 of the orthodontic support according to the present invention.
FIG. 12 is a perspective view showing Example 10 of an orthodontic support according to the present invention.
FIG. 13 is a view showing Example 11 of an orthodontic support according to the present invention.
FIG. 14 is a diagram showing Example 12 of the orthodontic support according to the present invention.
FIG. 15 is a sectional view showing Example 13 of an orthodontic support according to the present invention.
FIG. 16 is a perspective view showing Example 14 of the orthodontic support according to the present invention.
17 is a longitudinal sectional view of an orthodontic support of Example 14. FIG.
FIG. 18 is a diagram showing Example 15 of the orthodontic support according to the present invention.
FIG. 19 is a perspective view showing Example 16 of the orthodontic support according to the present invention.
FIG. 20 is a perspective view showing a reference example of an orthodontic support.
FIG. 21 is a partial cross-sectional view for explaining a process of embedding an orthodontic support according to the present invention in a jawbone.
FIG. 22 is a partial cross-sectional view for explaining a process of embedding an orthodontic support according to the present invention in a jawbone.
FIG. 23 is a view for explaining an orthodontic treatment example 1 using the orthodontic support according to the present invention.
FIG. 24 is a view for explaining an orthodontic treatment example 2 using the orthodontic support according to the present invention.
FIG. 25 is a view for explaining an orthodontic treatment example 3 using the orthodontic support according to the present invention.
FIG. 26 is a view for explaining an orthodontic treatment example 4 using the orthodontic support according to the present invention.
FIG. 27 is a view for explaining an orthodontic treatment example 5 using the orthodontic support according to the present invention.
FIG. 28 is a view for explaining an orthodontic treatment example 6 using the orthodontic support according to the present invention.
FIG. 29 is a view for explaining an orthodontic treatment example 7 using the orthodontic support according to the present invention.
FIG. 30 is a diagram for explaining a reference example of orthodontic treatment.
FIG. 31 is a view for explaining an orthodontic treatment example 8 using the orthodontic support according to the present invention.
FIG. 32 is a front view showing an example in which a reduction treatment is performed on the front teeth of the upper jaw.
FIG. 33 is a diagram showing a state of main nerves passing through the upper jaw.
FIG. 34 is a diagram showing a conventional treatment example using a rapid enlargement apparatus.
[Explanation of symbols]
1, 2 front teeth
3,5,6,36 teeth
10, 100, 110, 120, 140, 170 Orthodontic support
11, 61, 121, 141, 151, 161, 171 Embedded portion
11b, 16 joint
12, 62, 72, 102, 122a, 122b, 142, 172 Abutment
13,113,143,173 screw
14, 24, 64, 74, 84a, 84b, 94a, 94b, 104, 114a, 114b, 124a, 124b, 144 Arm part
15, 25, 27, 65, 75, 85a, 85b, 95a, 95b, 105, 115a, 115b, 125a, 125b hook part
17 Temporary lid
30 jawbone
31 mucosa
34 Bracket
35 Lingual buttons
37 Resin Chain
176 Lower member
177 Upper member

Claims (11)

An orthodontic support comprising an embedded portion that is embedded in an arbitrary position of the jawbone and an exposed portion that is exposed in the oral cavity,
The embedded portion has a maximum cross-sectional diameter of 2 mm or less,
The orthodontic support body, wherein the exposed portion has an arm portion extending into the oral cavity, and the arm portion has a hook portion. The orthodontic support according to claim 1, wherein the exposed portion and the embedded portion are configured separately from each other, and are combined and integrated when used. The orthodontic support according to claim 2, wherein the coupling and integration is performed by screw bonding. The orthodontic support according to claim 2, wherein the coupling and integration is performed by socket-type fitting. By configuring the socket-type fitting with polygonal sockets of the exposed portion and the embedded portion, the mounting direction of the arm portion in a plane orthogonal to the axis of the embedded portion can be selected. The orthodontic support according to claim 4, which is constructed. The orthodontic support according to claim 4 or 5, wherein a fitting surface of the exposed portion and the embedded portion is tapered in a fitting direction. 4. The configuration according to claim 2, wherein the mounting orientation of the arm portion in a plane orthogonal to the axis of the embedded portion can be selected by a star-shaped fitting between the unevenness formed radially. 5. Orthodontic support. The orthodontic support according to any one of claims 1 to 7, wherein an angle formed by the axis of the arm portion and the axis of the embedded portion is 90 ° to 180 °. The orthodontic support according to claim 1, wherein the length of the arm part is configured to be adjustable. The orthodontic support according to any one of claims 1 to 9, wherein the arm part is plural. The orthodontic support according to any one of claims 1 to 10, wherein the arm portion is a leaf spring.

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