Patent Publication Number: US-2023157702-A1

Title: Guide for mandibular resection surgery

Description:
1. FIELD 
     The present disclosure relates to a guide for mandibular resection surgery, and more particularly, to a guide for mandibular resection surgery that may be fixed to a mandible, to protect the surrounding tissues, including nerves, and accurately direct a resection line during the surgery of resecting part of the mandible. 
     2. BACKGROUND 
     Mandibular resection surgery has been widely used in recent years for cosmetic purposes and correction. One method of the mandibular resection surgery being utilized is to fix a guide to a mandible to form a resection line, and then to resect along the resection line of the guide using a resection saw. 
     When mounting the guide onto a mandible, the soft tissue around the mandible is peeled off and the guide is inserted through the peeled surface and mounted onto the mandible. Here, conventionally, the shape of the guide was fixed, and thus it was difficult to insert the guide or approach the surgical site with the guide during surgery with only a minimal amount of incision. Further, since the guide was made of a hard material, very strict peeling was required when peeling off the tissue from the bone, and if not peeled off completely, the small soft tissue fragments caused a large error in attaching the entire guide to the human body. This made the overall surgery site to be lengthy, and increased the degree and surface area of the peeling, which do not meet patients&#39; demand for minimal incision surgery, and also causing problems of increased surgical time for incision and suturing. 
     In addition, in order to increase the accuracy of the surgery, a guide that is designed optimally for the mandible must be stably fixed in an accurate position. 
     SUMMARY 
     Therefore, a purpose of the present disclosure is to resolve the aforementioned problems of prior art, that is, to provide a guide for mandibular resection surgery that can be folded before being mounted onto a mandible and then unfolded afterwards so that the soft tissue around the mandible can be resected minimally, and that the guide is customized to the patient and designed optimally, and fixed stably in an accurate position. 
     The tasks that the present disclosure intends to resolve are not limited to the aforementioned tasks, and other tasks that are not mentioned herein will also be clearly understood by a person skilled in the art based on the following description. 
     The aforementioned purposes can be achieved by the guide for mandibular resection surgery that includes a guide plate having, at its lower side, a boundary surface that guides a resection pathway of a resection saw during a mandibular resection surgery; and a fixing portion that is formed to extend from the guide plate and combine with a mandible or tooth, thereby fixing a position of the guide plate, wherein the guide plate is foldable. 
     Here, the guide plate may be made of a soft material. 
     Here, the guide plate may include a folding portion where the guide plate is foldable, and the folding portion may be made of a soft material. 
     Here, the soft material may include rubber, polymer, or silicon. 
     Here, the guide plate may be formed in a porous tube structure. 
     Here, the guide plate may include a folding portion where the guide plate is foldable, and the folding portion may be formed in a porous tube structure. 
     Here, the porous tube structure may be arranged in rectangular, spherical, honeycomb shape, or in straight line longitudinally in one direction. 
     Here, the guide plate may include a first guide plate that extends in a longitudinal direction from one side of a front surface to a rear side of the mandible, with the boundary surface at its lower side guiding the resection pathway. 
     Here, the guide plate may further include a second guide plate, that is formed to extend from a middle portion of the first guide plate towards the tooth. 
     Here, on the front surface of the first guide plate, a hole may be formed, into which a neural tube, protruding from one side of the front surface of the mandible, may be inserted. 
     Here, one side of the hole may have an incised shape so as to be connected with an outer side of the first guide plate. 
     Here, a first fixing portion may be formed, that is made of a hard material, and that extends from a rear end of the first guide plate, and bent, so as to combine with a corner of a rear side of the mandible. 
     Here, a second fixing portion may be formed, that is made of a hard material, and that extends from one end of the second guide plate, and bent, so as to combine with the tooth. 
     Here, a third fixing portion may be formed, that is made of a hard material, and that extends from one end at a lower side of a middle portion of the first guide plate, and bent, so as to combine with a corner of a lower side of the mandible. 
     Here, on the third fixing portion, a slit groove may be formed, where the resection saw may be inserted, to form the resection pathway of the resection saw during the resection surgery. 
     Here, an inner side of the second guide plate may be formed to be dented towards the inside, in consideration of a thickness of gum. 
     Here, the second guide plate from which the second fixing portion extends and the third fixing portion may be arranged in one row in a vertical direction, and the second fixing portion, the second guide plate, the third fixing portion, and the middle portion of the first guide plate from which the third fixing portion extends, arranged in one row, may be formed of a hard material, integrally. 
     Here, a middle portion of a rear end of the first guide plate may be made of a hard material, to prevent deformation from occurring due to self-weight. 
     Here, a metal rod may be inserted into a middle portion of a rear end of the first guide plate to prevent deformation from occurring due to self-weight. 
     Here, a shape design of the guide plate may be customized to a patient in consideration of a shape of the mandible of the patient and distribution of a neural tube inside the mandible, based on 3-dimensional image information on the mandible of the patient, so as not to damage the neural tube during the mandibular resection surgery, and a shape design of the fixing portion may be customized to the patient and manufactured such that a position of the guide plate can be stably fixed according to the shape of the mandible of the patient. 
     Here, the guide for mandibular resection surgery may be manufactured integrally using a 3-dimensional printer. 
     According to the guide for mandibular resection surgery of the present disclosure described above, the guide can be folded, and therefore, there is an advantage that the surface area of the soft tissue around the mandible being cut in order to mount the guide onto the mandible can be minimized. 
     There is also an advantage that, in the major landmarks such as the mandible corner, lower alveolar neural tube or tooth, etc., by using the hardness and elasticity of the materials, the guide can be fixed to the mandible stably in an accurate position. 
     There is also an advantage that, as the guide is customized to the patient and manufactured based on 3-dimensional image information of the patient, the resection line can be directed accurately without damaging the neural tube inside the mandible during the resection surgery. 
     Further, there is an advantage that, by using the 3-dimensional image information of the patient, the shape of the guide can be optimally designed, and by using a 3-dimensional printer, the guide consisting of a plurality of materials can be manufactured continuously at one time. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a front side perspective view of a guide for mandibular resection surgery according to a first embodiment of the present disclosure. 
         FIG.  2    is a rear side perspective view of  FIG.  1   . 
         FIG.  3    is a view schematically illustrating a lower alveolar neural tube inside a mandible. 
         FIG.  4    is a view illustrating the guide for mandibular resection surgery of  FIG.  1   , mounted onto a mandible. 
         FIG.  5    is a photograph of an actual manufactured guide for mandibular resection surgery of  FIG.  1   , that is folded. 
         FIG.  6    is a photograph of the guide for mandibular resection surgery of  FIG.  5   , mounted onto a mandible model. 
         FIG.  7    is a front side perspective view illustrating a guide for mandibular resection surgery according to a second embodiment of the present disclosure. 
         FIG.  8    is a front side perspective view illustrating a guide for mandibular resection surgery according to a third embodiment of the present disclosure. 
         FIG.  9    is a side view of a second guide plate. 
         FIG.  10    is a front side perspective view illustrating a guide for mandibular resection surgery according to a fourth embodiment of the present disclosure. 
         FIG.  11    is a front side perspective view illustrating a guide for mandibular resection surgery according to a fifth embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Specific matters of the embodiments are included in the detailed description and the drawings. 
     The advantages and characteristics of the present disclosure, and the method for achieving those advantages and characteristics will be clarified with reference to the embodiments that will be explained hereinafter together with the drawings attached hereto. However, the present disclosure is not limited to the embodiments disclosed hereinafter, but may be implemented in various different forms, and the present embodiments are provided merely for the purpose of complete disclosure of the present disclosure, and for the purpose of informing a person skilled in the art of the complete scope of the present disclosure, and the present disclosure is to be defined only by the scope of the claims. Like reference numerals indicate like configurative elements throughout the entirety of the specification. 
     Hereinbelow, the present disclosure will be described with reference to the drawings attached to describe a guide for mandibular resection surgery according to the embodiments of the present disclosure. 
       FIG.  1    is a front side perspective view of a guide for mandibular resection surgery according to a first embodiment of the present disclosure,  FIG.  2    is a rear side perspective view of  FIG.  1   ,  FIG.  3    is a view schematically illustrating a lower alveolar neural tube inside a mandible,  FIG.  4    is a view illustrating the guide for mandibular resection surgery of  FIG.  1   , mounted onto a mandible,  FIG.  5    is a photograph of an actual manufactured guide for mandibular resection surgery of  FIG.  1   , that is folded, and  FIG.  6    is a photograph of the guide for mandibular resection surgery of  FIG.  5   , mounted onto a mandible model. 
     The guide for mandibular resection guide according to the first embodiment of the present disclosure  100  may consist of a guide plate  110 , and fixing portions  121 ,  122 ,  123 . 
     The guide plate  100 , when fixed to a mandible  200 , enables a boundary surface  119 , located at its lower side, to guide a resection pathway of a resection saw during a resection surgery of the mandible  200 . Therefore, upon fixing the guide for mandibular resection surgery of the present disclosure  100  to the mandible  200 , using the resection saw, it is possible to accurately resect a resection site along the boundary surface  119  located at the lower side of the guide plate  110 . 
     The guide plate  110  may consist of a first guide plate  112  that is formed such that, when mounted onto the mandible  200 , extends along a longitudinal direction from one side of a front surface of the mandible  200  to a rear side of the mandible  200 , and that enables the boundary surface  119  at the lower side, to guide the resection pathway of the resection saw; and a second guide plate  114  that is formed to extend upwards from a middle portion of the first guide plate  112  towards a tooth  230 . 
     Here, on a front surface of the first guide plate  112 , a hole  116  may be formed, into which a lower alveolar neural tube  210 , protruding from the side of the front surface of the mandible  200 , may be inserted. As such, when fixing the guide for mandibular resection surgery  100  to the mandible  200 , by inserting the neural tube  210  into the hole  116  formed on the first guide plate  112 , it is possible to initially situate the guide  100 . 
     Here, as illustrated in the drawings, at one side of the hole  116 , an incision  117  may be formed, having an incised shape so as to be connected with an outer surface at an upper side of the first guide plate  112 . As will be described below, the guide plate  110  may be made of a soft material, and thus, using the elasticity caused by the characteristics of the soft material and the incision  117 , it is easy to insert the neural tube  210 , protruding from the side of the mandible  200 , into the hole  116 , in a small space. 
     The hole  116  formed on the first guide plate  112  as described above, not only plays the role of initially positioning the guide  100  but, together with a first fixing portion  121  that will be described below, it also prevents the guide plate  110  from moving left and right. 
     In the present embodiment, the guide plate  110  may be made of a soft material, for example, a soft rubber, polymer or silicon, etc. 
     Therefore, in the present embodiment, since the guide plate  110  is made of a soft material, it can be folded as illustrated in  FIG.  5   . In order to fix the guide for mandibular resection surgery  100  to the mandible  200 , the soft tissue around the mandible  200 , which is the surgical site, has to be peeled off, and the guide  100  has to be fixed through this peeled site, but in the present embodiment, since the guide plate  110  can be folded, the surface area of the peeling can be reduced. Here, the guide  100 , in a folded state, may be inserted through the peeled site, and then the folded portion may be unfolded, and then using the fixing portions  121 ,  122 ,  123 , that will be described below, the guide  100  may be stably fixed in an accurate position in the mandible  200 . 
     The fixing portions  121 ,  122 ,  123  are formed to extend from the guide plate  110 , and the fixing portions  121 ,  122 ,  123  are combined with a corner of the mandible  200  or the tooth  230 , to stably fix the guide plate  110 , to the mandible  200 . Here, in the present embodiment, the fixing portion may consist of the first fixing portion  121 , the second fixing portion  122 , or the third fixing portion  123 , and it is desirable that the fixing portion is made of a hard material. Here, the hard material may be metal or ceramic, etc. 
     The first fixing portion  121  may be made of a hard material, and may be formed to extend from a rear end of the first guide plate  112  and bent, wherein the bent portion may be combined with a corner of a rear side of the mandible  200 , thereby fixing the guide plate  110 . Here, the aforementioned hole  116  formed at the front end of the first guide plate  112 , and the first fixing portion  121 , may be combined with the neural tube  210  and the corner of the rear side of the mandible  200 , respectively, thereby preventing the guide plate  110  from moving left and right. 
     The second fixing portion  122  may be made of a hard material, and may be formed to extend from one end of the second guide plate  114  and bent, wherein the bent portion may be combined with the tooth  230 , thereby fixing the guide plate  110 . 
     The third fixing portion  123  may be made of a hard material, and may be formed to extend from one end at a lower side of the middle portion of the first guide plate  112  and bent, wherein the bent portion may be combined with a corner of a lower side of the mandible  200 , thereby fixing the guide plate  110 . Here, the third fixing portion  123  and the second fixing portion  122  may be combined with the corner of the lower side of the mandible  200  and the tooth  230 , respectively, thereby preventing the guide plate  110  from moving up and down. 
     Here, in order to prevent the resection pathway formed by the boundary surface  119  at the lower side of the first guide plate  112 , from being blocked by the third fixing portion  123 , on the third fixing portion  123 , a slit groove  124  is formed so that the resection saw can be inserted therein, thereby allowing the resection pathway to be formed, together with the boundary surface  119  at the lower side of the first guide plate  112 . 
     A manufacturing method of the guide for mandibular resection surgery according to the present embodiment  100  involves, first of all, obtaining 3-dimensional image information of the mandible  200  of the patient in a well-known method such as CT and MRI, and then based on this information, understanding the shape of the mandible  200  of the patient, and the distribution of tissues such as the lower alveolar neural tube  210 , that is inside the mandible  200  as shown in  FIG.  3   , that should be protected during the resection surgery. Next, using a computer aided design software, the resection line is planned out in consideration of the shape of the mandible  200  of the patient and the margin with the neural tube  210  that should be protected, based on the image information of the patient, and accordingly, the shape of the guide plate  110  and the fixing portions  121 ,  122 ,  123  for fixing the guide plate  110  are finally designed. Next, using the finally designed design information, the guide for mandibular resection surgery  100 , made of soft and hard materials, can be continuously manufactured integrally by a 3-dimensional printer. 
     The guide for mandibular resection surgery  100  manufactured in the aforementioned method and mounted onto a mandible model is shown in a photograph in  FIG.  6   . 
     The guide for mandibular resection surgery according to the present embodiment  100  described above is manufactured to be customized to the patient based on the image information of the patient, and therefore does not damage the neural tube  210  inside the mandible  200  during the resection surgery, and can accurately direct the resection line. Further, as the 3-dimensional printer is used, it is possible to continuously manufacture the guide plate  110  of a soft material and the fixing portions  121 ,  122 ,  123  of a hard material, integrally, without any additional connecting portion. 
     Next, to describe the resection surgery process where the aforementioned guide for mandibular resection surgery according to the present embodiment  100  is used, first of all, the soft tissue around the mandible  200  is peeled off. Next, since the guide  100  of the present disclosure can be folded as in  FIG.  5   , the guide  100 , in a folded state, is inserted into the peeled surface. Next, while unfolding the folded guide  100 , by hanging the hole  116  formed on the first guide plate  112 , and the first fixing portion  121 , the second fixing portion  122  and the third fixing portion  123 , on the lower alveolar neural tube  210 , corner of the rear side of the mandible  200 , tooth  230 , and corner of the lower side of the mandible  200 , respectively, the position of the guide  100  is fixed. Here, using the elasticity of the guide plate  110  made of a soft material, and the fixing portions  121 ,  122 ,  123 , made of a hard material, it is possible to stably fix the guide  100  manufactured to be customized to the patient based on the image information of the mandible  200  of the patient, in an accurate position. 
     Next, using the resection saw, the mandible  200  is resected along the boundary surface  110  at the lower side of the first guide plate  112 , wherein, when the resection site reaches the third fixing portion  123 , the resection saw is removed, and then inserted again through the slit groove  124  of the third fixing portion  123 , to perform the resecting. When the primary resection is completed in the aforementioned method, the guide  100  that had been fixed to the mandible  200 , is removed and folded again, to be removed outside the peeling surface. Next, a portion between the boundary surface  119  at the lower side of the first guide plate  112  and the slit groove  124  of the third fixing portion  123 , that had not been resected, is finally resected, and then, after tidying up the surface of the mandible  200 , the surgery is finished by suturing back the peeled surface. 
     Hereinbelow, other embodiments of the present disclosure will be described with reference to  FIGS.  7  to  11   . The main focus of the description hereinbelow will be the differences from the embodiment described above with reference to  FIGS.  1  to  6   . 
       FIG.  7    is a front side perspective view illustrating the guide for mandibular resection surgery according to a second embodiment of the present disclosure,  FIG.  8    is a front side perspective view illustrating the guide for mandibular resection surgery according to a third embodiment of the present disclosure,  FIG.  9    is side view of the second guide plate,  FIG.  10    is a front side perspective view illustrating the guide for mandibular resection surgery according to a fourth embodiment of the present disclosure, and  FIG.  11    is a front side perspective view illustrating the guide for mandibular resection surgery according to a fifth embodiment of the present disclosure. 
       FIG.  7    is a side view of the guide for mandibular resection surgery according to the second embodiment of the present disclosure, and as illustrated in  FIG.  7   , on the guide plate  110 , additional folding portion  111  may be formed on parts where the guide plate may be folded, and as this folding portion  111  is manufactured by a soft material, just as in the aforementioned embodiment, the guide plate  111  may be folded. Here, the rest of the portions besides the folding portion  111  of the guide plate  110  may be manufactured by a relatively harder material compared to the folding portion  111 . 
       FIG.  8    is a side view of the guide for mandibular resection surgery according to a third embodiment of the present disclosure, and as illustrated in  FIG.  8   , on the guide plate  110 , additional folding portion  111  may be formed on parts where the guide plate  110  may be folded, and the folding portion  111  is formed in a porous tube structure  115 , and thus due to such structural characteristics, just as in the aforementioned embodiment, the guide plate  110  may be folded at the folding portions  111 . The drawing illustrates a shape where the porous tube structure is arranged longitudinally in one direction, but it may be arranged in other various shapes instead, such as spheres, rectangles, or honeycombs, etc. 
     In  FIG.  8   , the folding portion  111  is formed in a predetermined area in the guide plate  110  to have the porous tube structure  115 , but the entire guide plate  110  may of course be formed in the porous tube structure  115 . 
       FIGS.  9  to  10    are views for describing the guide for mandibular resection surgery according to a fourth embodiment of the present disclosure, and just as in  FIG.  9    that illustrates a side view of the second guide plate  114 , in the present embodiment, when designing the shape of the second guide plate  114 , the inner side portion that contacts the gum, is formed to be internally dented  113 , in consideration of the thickness of the gum. As aforementioned, when designing the guide plate  110  using the 3-dimensional image information of the patient, the designing is based on the shape of the mandible  200 , and in the present embodiment, the shape is designed in consideration of the thickness of the gum protruding from the bone underneath the tooth, and therefore, a more optimized shape design can be performed in accordance with the mounting site. 
     By designing the shape such that the inner surface of the second guide plate  114  is dented in consideration of the thickness of the gum as described above, it is possible to integrally form the second fixing portion  122 , the second guide plate  114 , the third fixing portion  123  and the middle portion of the first guide plate  112  from which the third fixing portion  123  extends, arranged in one row as in  FIG.  10   , with a hard material. 
       FIG.  11    is a side view of the guide for mandibular resection surgery according to a fifth embodiment of the present disclosure, wherein the rear end of the first guide plate  112 , that is formed to extend longitudinally towards the right side based on the portion from which the second guide plate  114  extends from the first guide plate  112 , is formed to have a long length, and therefore, due to the self-weight, up and down deformation may occur. This may act as an interfering element in stably fixing the guide  100  to the accurate position of the mandible  200 , and therefore in the present embodiment, by forming the middle portion  118  of the rear end of the first guide plate  112  separately with a hard material as in  FIG.  11   , it is possible to prevent the up and down deformation from occurring due to the self-weight. Here, supposing that the degree of hardness of the first fixing portion  121 , the second fixing portion  122  and the third fixing portion  123  is  100 , it is desirable to control the degree of hardness in the middle portion  118  of the rear end of the first plate to be in a range not higher than 100 (for example, 90˜100), so as to prevent the deformation from occurring due to the self-weight, and to allow a certain degree of bending, at the same time. 
     Further, although not illustrated herein, by forming a structure where a thin metal rod may be inserted by forming a hole in an inner side of the middle portion  118  of the rear end of the first guide plate  112  or a ring at an outer side of the middle portion  228  of the rear end of the first guide plate  112 , and then inserting the metal rod, it is possible to enable the metal rod to prevent the deformation of the middle portion  118 . 
     The scope of right of the present disclosure is not limited to the aforementioned embodiments but may be implemented as various forms of embodiments within the attached claims set. Any person having ordinary skill in the art to which the present invention pertains will understand that the present disclosure may be implemented in other specific forms without departing from the gist of the present invention as claimed in the claims set to a wide range that can be modified.