Novel mandibular bone transport reconstruction plate

描述：头颈部硬组织和软组织的外科切除或高冲击性创伤可导致主要组织缺失。下颌骨的重建通常涉及骨骼、牙龈和牙齿。目前的下颌骨牵张器是与重建钢板结合使用的，但当重建钢板获得颌骨的轮廓时，牵张器具有线性向量。这些设备还具有有限的分散距离，会产生较短的直骨片段，因此无法通过一次手术来适应大的缺陷。组合器械的大小使其无法移动齿状骨段。口外装置既有外固定器的作用，又有骨传输的牵张装置的作用，可以重建下颌骨副关节和下巴。然而，由于软组织压力，新形成的下颌骨后缩，下颌骨无法达到正常的弧度。这项应用的目的是建立和测试一种口腔内下颌牵张装置的原型，该装置将作为重建钢板和骨传输装置的组合。这种装置将使齿状骨段能够远距离运输，并防止软组织造成的形状抑制。该装置的目的是在手术切除后立即重建下颌骨，而不需要植骨或二次重建。该装置将能够恢复原始下颌骨的机械完整性和形状，而不会增加手术的难度、持续时间或并发症。该装置的关键特征是它既可以作为坚硬的下颌骨重建钢板，也可以作为骨传输牵张装置。该装置不受骨隙的大小、形状或位置的限制，并且由于装置的位置较低；传输盘可以安全地携带活牙，而不会在固定过程中损伤牙根。“检查点截骨”技术将使第一次有可能恢复正常的弧度或原来的下颌骨，并保留原来的较低的面部尺寸，因为软组织施加在运输盘上的牵引力被运输钢板刚性遮挡。

DESCRIPTION: Surgical excision of hard and soft tissues of the head and neck or high impact trauma can lead to lead to major tissue deficits. Reconstruction of the lower jaw typically involves bone, gingiva, and teeth. Current mandibular distraction devices are used in combination with reconstruction plates, but while the reconstruction plates take the contour of the jaw, the distraction devices have a linear vector. The devices also have a limited distraction distance, producing short segments of straight bone and so cannot accommodate large deficits with a single procedure. The size of the combined apparatus makes it impossible to move dentate bone segments. Extra-oral devices function both as external fixator and bone transport distraction devices, with which it is possible to re-build the mandibular parasymphysis and chin. Nevertheless, the newly formed mandible is retruded due to soft tissue pressure and normal curvature of the mandible is not achieved. The objective of this application is to build and test prototypes of an intra-oral mandibular distraction device that will serve as a combined reconstruction plate and bone-transport device. This device will enable transport of dentate bone segments over large distances and prevent the inhibitions of form created by the soft tissues. The purpose of this device is to allow immediate reconstruction of mandibular bone following surgical excision, eliminating the need for bone grafting or secondary reconstruction. The device will enable regaining the same mechanical integrity and shape of the original mandible, without adding to the difficulty, duration, or complication of surgeries. Critical features of the device are that it functions both as a rigid mandibular reconstruction plate and a bone transport distraction device. The device is not limited by the size, shape, or location of the bone gap and because of the low position of the device; the transport disc can safely carry viable teeth without injuring the roots during fixation. The "check-point osteotomy" technique will make it possible for the first time to regain the normal curvature or the original mandible, and preserve the original lower facial dimensions as the traction force exerted by the soft tissue over the transport disc is rigidly shielded by the transport plate.