Apparatus for intraoral distraction osteotomy to widen the upper jaw

Abstract

The technique of surgically assisted rapid palatal expansion comprises force application indirectly to the jaw by means of an expansion device fixed to the teeth by means of acrylic pads, or orthodontic bands on the premolar or molar teeth. The problems, being movements of teeth and relapse at the bone level during and after the expansion, necessitating over-expansion; the low level of force application leading to tipping of the teeth and the jaw-segments; and the postponement of further orthodontic treatment till after removal of the expansion device; and the limited expandability of the device, necessitating the fabrication of a new device in case of very narrow jaws, have been solved with the invention. The forces apply via metal bone-plates ( 1,2 ) directly at a higher level. Interchangeable modules (composition of 3, 4, 5 ) of different sizes allow to continue expansion once one module has reached the limit of its expansion.

1 . Distraction apparatus for the expansion of the upper bone after osteotomy by application of distraction forces directly to the palatal bone with the aim to reconstruct the jaw by increasing the distances between the two opposing bone segments by means of gradually stretching, comprising a distraction module having two outer ends, the mutually distance of which can be altered by means of an extension screw in the distraction module, and two abutment plates that can be fixed directly to the palatal bone and are provided with an extension arranged for piercing through the palatal soft tissue into the oral cavity, wherein the extensions of the abutment plates are hingedly connected to the respective ends of the distraction module.  
     
     
         2 . Distraction apparatus according to  claim 1 , wherein said ends of the distraction module are conical.  
     
     
         3 . Distraction apparatus according to  claim 2 , wherein the extensions are provided with a female sleeve in which the conical end of the distraction module fits.  
     
     
         4 . Distraction apparatus according to  claim 1 , wherein the ends of the distraction module hingingly abut the extensions of the abutment plates.  
     
     
         5 . Distraction apparatus according to  claim 1 , wherein the distraction module is a mechanical jackscrew comprising three parts which fit into one another, that is a central connecting sleeve having a largest diameter and two ends provided with internal threads of opposite direction and different sizes, and two threaded telescopic arms which cooperate with the respective internal threads to move completely into and out the central connecting sleeve.  
     
     
         6 . Distraction apparatus according to  claim 5 , wherein the two threaded arms are designed so that one of the arms can move into the other.  
     
     
         7 . Distraction apparatus according to  claim 5 , wherein the two arms have virtually the same length as the central connecting sleeve.  
     
     
         8 . Distraction apparatus according to  claim 1 , wherein the distraction module is provided with a bore for blocking screws.  
     
     
         10 . Distraction apparatus for the expansion of the upper bone after osteotomy by application of distraction forces directly to the palatal bone with the aim to reconstruct the jaw by increasing the distances between the two opposing bone segments by means of gradually stretching, comprising a distraction module having two outer ends, the mutually distance of which can be altered by means of an extension screw in the distraction module, and two abutment plates that can be fixed directly to the palatal bone and are provided with an extension arranged for piercing through the palatal soft tissue into the oral cavity, wherein the extensions have a design that allows fixation of a respective end of the distraction module onto or into the extension of the abutment plates, wherein the ends of the distraction module are fixed by means of a hinge mechanism to the extensions of the abutment plates.  
     
     
         11 . Distraction apparatus according to  claim 10 , wherein said end; of the distraction module are conical and wherein the extensions are provided with a female sleeve in which the conical and of the distraction module fits.  
     
     
         12 . Distraction apparatus according to  claim 10 , wherein the distraction module is a mechanical jackscrew comprising three parts which fit into one another, that is a central connecting sleeve having a largest diameter and two ends provided with internal threads of opposite direction and different sizes, and two threaded telescopic arms with cooperate with the respective internal threads to move completely into and out the central connecting sleeve.  
     
     
         13 . Distraction apparatus according to  claim 12 , wherein the two threaded arms are designed so that one of the arms can move into the other.  
     
     
         14 . Distraction apparatus according to  claim 12 , wherein the two arms have virtually the same length as the central connecting sleeve.  
     
     
         15 . Distraction apparatus according to  claim 10 , wherein the distraction module is provided with a bore for blocking screws.  
     
     
         16 . Distraction apparatus for the expansion of the upper bone after osteotomy by application of distraction forcee directly to the palatal bone with the aim to reconstruct the jaw by increasing the distances between the two opposing bone segments by means of gradually stretching, comprising a distraction module having two outer ends, the mutually distance of which can be altered by means of an extension screw in the distraction module, and two abutment plates that can be fixed directly to the palatal bone and are provided with an extension arranged for piercing through the palatal soft tissue into the oral cavity, wherein the extensions have a design that allows fixation of a respective end of the distraction module onto or into the extension of the abutment plates, wherein said ends oil said distraction module and said extensions are provided with first and second connecting means hingingly interengaging each other for said fixation.  
     
     
         17 . Distraction apparatus according to  claim 16 , wherein one of said first and second connecting means is conical and the other of said first and second connecting means is sleeve-shaped for fittingly receiving said conical connecting means.  
     
     
         18 . Distraction apparatus according to  claim 17 , wherein the first connecting means are formed by conical ends of the distraction module.  
     
     
         19 . Distraction apparatus according to  claim 17 , wherein the second connecting means are formed by a female sleeve provided on the extensions in which a conical end of the distraction module fits.