Novel mandibular bone transport reconstruction plate

描述：头颈部硬组织和软组织的手术切除或高冲击创伤可导致主要的组织缺损。下颌的重建通常包括骨、牙龈和牙齿。目前的下颌牵引装置与重建板联合使用，但重建板采用下颌轮廓，而牵引装置具有线性矢量。该装置的牵引距离也有限，只能产生短段直骨，因此不能一次手术就适应较大的缺损。这种组合装置的大小使得它不可能移动齿状骨段。口腔外装置具有外固定架和骨运输牵引装置的功能，可以重建下颌副骨节和下巴。然而，由于软组织的压力，新形成的下颌骨会向后缩，无法达到正常的下颌骨弯曲。本应用的目的是建立和测试口腔内下颌牵引装置的原型，该装置将作为重建板和骨运输装置的组合。该装置将使齿状骨段能够远距离运输，并防止软组织形成的抑制。该装置的目的是在手术切除后立即重建下颌骨，无需植骨或二次重建。该装置可以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。该装置的关键特点是它既可以作为刚性下颌骨重建板，又可以作为骨运输牵引装置。该装置不受骨间隙的大小、形状或位置以及该装置的低位的限制；在固定过程中，运输盘可以安全地携带活牙，而不会损伤牙根。“检查点截骨”技术将首次使恢复正常弯曲或原始下颌骨成为可能，并保留原始的下面部尺寸，因为软组织施加在运输盘上的牵引力被运输板刚性屏蔽。

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.