Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C3/00—Dental tools or instruments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0089—Implanting tools or instruments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors

Definitions

• the present invention relates to a tissue retractor, particularly adapted to maintain a certain distance between the maxillary bone and the gingival tissue in the context of ondontological interventions.
• the invention relates to the field of surgery, in particular dental surgery.
• gingival retraction cords In the field of dental surgery, when it is necessary to intervene at a region of the tooth covered with gingiva, the use of gingival retraction cords is known. These cords are intended to be inserted into the gingival crevice or gingival crevice located between the tooth and the gum, in order to keep the gum away from the tooth during an intervention.
• Gingival retractors are also known to be introduced between a tooth and the gingival tissue, in order to intervene on said tooth. They can also be used for taking an impression of the tooth for the realization of a tooth prosthesis. In these two cases, the gingival retractors allow the widening of the gingival sulcus either by retraction or by gingival eviction.
• the dental surgeon uses tools allowing after incision to keep the gingival tissue at a distance from the area to be treated.
• tissue retractor was devised to separate and maintain two tissues at a distance, one of the tissues possibly being bone or cartilage, as in special case of gingival tissue and maxillary bone, adapted to an intervention after incision, in this case the gum, and requiring only its implementation by the practitioner to be operational.
• the invention relates to a tissue retractor intended to be inserted between two tissues, for example between the maxillary bone and the gingival tissue, characterized in that it is in the form of at least one blade designed capable of simultaneously allowing the spacing of the tissues from one another and its maintenance between said tissues.
• the blade or blades are made of a material having elastic properties conferring a shape memory, the stable form being that allowing the spacing of the tissues from one another.
• the tissue retractor according to the invention consists of a spring blade having a stable tunnel shape.
• the tissue retractor according to the invention is in the form of a "V" -folded blade so as to form two parts, conferring on the assembly a stable form in the form of an open clamp.
• the blade comprises at least one body and at least one cutout for defining at least one fin connected to the body by at least one zone of least resistance, in order to allow a variation of positioning of the fin relative to the body, in particular by folding.
• the tool that derives from the present invention is sufficient in itself to maintain a tissue, in particular gingival, at a distance from the treatment zone during an intervention on a underlying tissue or bone such as the maxillary bone, or between two tissues, as in the case of the maxillary bone and the gingival tissue.
• the tissue retractor Easy to set up, the tissue retractor according to certain embodiments of the invention, and in its ondontological application sees its action as effective gingival retractor as soon as resumption of the stable form of the constituent blades of the retractor : the gap of the gingiva follows immediately, without difficulties, the establishment of the retractor. The same goes for any other surgical application of insertion between tissues where the only placement guarantees the separation.
• tissue retractor according to another embodiment of the invention, and in its ondontological application offers the possibility to the practitioner to activate the retractor on demand, while adapting the spacing of tissues to his needs.
• FIG. 1 schematically shows a tissue retractor according to a first embodiment of the invention, positioned between the maxillary bone and the gingival tissue, so as to keep the gingival tissue away from the bone during the surgical procedure.
• FIG. 2 shows the same situation as in Figure 1 but front view with respect to the tissue retractor.
• FIG. 3A shows, schematically and seen from above, a tissue retractor according to a first variant of a second embodiment of the invention, positioned between the maxillary bone and the gingival tissue.
• FIG. 3B schematically and seen from above, a tissue retractor according to a second variant of a second embodiment of the invention, in the same position as in FIG. 3A.
• FIGS. 4A, 4B and 4C show, schematically and in a side view, various stages of insertion, between the maxillary bone and the gingival tissue, of a tissue retractor according to the second embodiment of the invention. invention as illustrated in FIGS. 3A and 3B.
• FIGS. 5A, 5B, 5C and 5D show, schematically and seen from above, tissue retractors according to a third embodiment of the invention.
• FIG. 6 shows schematically and in perspective, a tissue retractor according to a third embodiment, as positioned in situ during a dental surgical operation.
• the present invention relates to the field of surgery, particularly dental and relates, more particularly, to a tissue retractor intended, by its implementation, to maintain a certain distance between the bone maxillary A and gingival tissue B.
• This spacer is therefore inserted between the maxillary bone A and the gingival tissue B, by means of a prior C incision of the gingival tissue B.
• a tissue retractor according to the invention may be in the form of a blade having spring properties and a shape memory, such that the stable shape is such as to allow, once the gingival retractor positioned between the bone maxillary A and the gingival tissue B, a gap of the gingival tissue B with respect to the maxillary bone A.
• a tissue retractor 1 in a first embodiment of a tissue retractor 1 according to the invention, as illustrated in FIGS. 1 and 2, it is constituted by a blade 10 having, in its stable conformation, a concave curvature conferring on it a section in cylinder portion.
• the curvature of the blade 10 makes it possible to obtain a tissue retractor 1 in the form of a tunnel, the solid part 11 of the blade 10 coming into contact with the gingival tissue B to lift it, the two lateral ends 12 of the blade 10 coming to rest on the maxillary bone A. It will be understood that the insertion and the establishment of such a tissue retractor 1 are then facilitated by the elastic properties of the blade 10. This being flexible, it will be possible to flatten it to slide into the incision C made in the gingival tissue B. By releasing the pressure on the blade 10, it will resume its stable shape by lifting the gingival tissue B and making the maxillary bone A accessible to the practitioner.
• tissue retractor 1 is intimately linked to its action of spacing the gingival tissue B so as to disengage the maxillary bone A.
• the curved blade 10 having more particularly a stable half-cone shape advantageously makes it possible to obtain a tapered tissue retractor, the tip 13 of the half-cone allowing easy insertion into the incision C of gingival tissue B.
• the blade 10 may have varying stable shapes, the half-cone shape being a preferred embodiment.
• the blade 10 may have openings or openings on its surface, this solution being particularly advantageous if it is desired to treat, not only the maxillary bone A released by the tissue retractor 1, but also patches of gingival tissue B on its face D ordinarily vis-à-vis the maxillary bone A.
• the end 13 of the half-cone may be truncated so as to allow the practitioner to access the hidden side D of the gingival tissue at the end of the tunnel.
• this truncated half-cone solution also allows a lifting of the gingiva beyond the insertion limit of the tunnel-shaped tissue retractor while reducing the risk of damage that can be caused by a tapered tip coming into contact with the gum tissue.
• the blade 10 can still have tabs at its supports on the maxillary bone A. These tabs, by widening the contact surface of the blade 10 with the maxillary bone A, serve advantageously to maintain in place of a regeneration membrane, covering the maxillary bone A, and placed by the surgeon.
• a tissue retractor 2 may be in the form of a "V" -shaped blade 20 so as to form two parts 21 and 22, conferring on the together a stable shape in the form of open clamp.
• the blade 20 comprises two partial lateral cuts, defining two lamellae 24 and
• the "V" conformation can also be obtained by means of two parts 21 and 22 cooperating mechanically at one of their ends.
• the slats 24 and 25 do not proceed from cutting, and are not folded relative to the body of the blade 20, but cooperate, for example by gluing, with a portion 22 of blade 20.
• FIGS. 4A to 4C show the successive steps of an insertion between the maxillary bone A and the gingival tissue B of a tissue retractor 2 according to the second embodiment of FIGS. 3A and 3B.
• the practitioner first makes an incision C in the gingival tissue B as shown schematically in Figure 4A.
• the tissue retractor 2 compressed so as to fold the two parts 21 and 22 together, is then slid between the gingival tissue B and the maxillary bone A, as illustrated in FIG. 4B.
• both the internal surface D of the gingival tissue B and the maxillary bone A are masked when the practitioner intervenes. .
• the perforated portion 23 may also be located opposite the internal face D of the gingival tissue B, or that the two parts 21 and 22 may be perforated in this way.
• the two strips 24 and 25 may, according to an embodiment not shown, be joined together by another blade, so as to form a window aperture, framed on all sides by slats.
• the tissue retractor presented in the first two embodiments is made of any material having adequate elastic performance, and biocompatible with a surgical use of contact with a mucosa.
• the spacers 1 and 2 as presented, it is nevertheless realized that it would be advantageous for the practitioner to be able to define the spacing between tissues in situ, which is not easy with the embodiments presented. . Indeed, if one takes in particular the example of the spacer 2 illustrated in FIG. 3A, the spacing in situ, once the spacer is in place, depends largely on the spacing in stable form of the parts 21. and 22 of the spacer 2, as well as the stiffness imposed by the materials used. However, the practitioner can not intervene on these parameters, in particular during the operation on the patient.
• a third embodiment as illustrated in the diagrams of FIGS. 5A, 5B, 5C, 5D and 6, solves this problem by proposing a tissue retractor 3, defined by a blade 30 comprising a central body 31 and at least a cutout 32 for delimiting, at the periphery of this central body 31, at least one fin 33.
• the shape of the blade 30 is advantageously dictated by the needs of the practitioner. This variability is illustrated by the different shape variants of FIGS. 5A to 5D.
• the shape and the dimensioning of the cuts 32 advantageously makes it possible to define one or zones 34 of less resistance to the torsion of the material constituting the blade 30, in order to allow a variable positioning of the blade (s) 33 with respect to the central body 31 , in particular by a folding action at these zones 34.
• this action can be performed in situ by the practitioner after insertion of the spacer 3 between the maxillary bone A and the gingival tissue B, in order to obtain, as illustrated in FIG. 6, a spacing of the two fabrics A and B in contact with the body 31 and on the other hand with the fins 33, the spacing being adapted in situ to the practitioner's needs or the possibilities of spacing the area to be treated.
• the blade 30 is manufactured in one piece, in a material suitable for surgical use and having characteristics of malleability, possibly because of its thickness, appropriate, for example surgical stainless steel or titanium 20 microns thick .
• the blade 30 may also include openings or openings 35, as for example in the variant of Figure 5C.
• the tissue retractor according to the invention allows, at least in its ondontological application, the closure of the mouth of the patient during the procedure, which constitutes an appreciable advantage, both for the patient, but also for the practitioner, if it wishes to align the teeth of the two jaws or to visualize the distance between the maxillary bone and the opposing teeth.
• the present invention cleverly addresses the problem posed.
• the solution according to the invention allows the dental surgeon to access easily and without particular assistance to the maxillary bone.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• General Health & Medical Sciences (AREA)
• Surgery (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Animal Behavior & Ethology (AREA)
• Epidemiology (AREA)
• Dentistry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Surgical Instruments (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

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• 2006
  • 2006-10-20 FR FR0654419A patent/FR2907331B1/fr not_active Expired - Fee Related
• 2007
  • 2007-10-22 EP EP07858644A patent/EP2076205A2/de not_active Withdrawn
  • 2007-10-22 US US12/446,319 patent/US20100304328A1/en not_active Abandoned
  • 2007-10-22 KR KR1020097010310A patent/KR20090084876A/ko not_active Withdrawn
  • 2007-10-22 WO PCT/FR2007/052224 patent/WO2008047064A2/fr not_active Ceased

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