WO2007020831A1 - Reciprocating file for orthognathic surgery - Google Patents

Abstract

A reciprocating file for orthognathic surgery that lasts as long as a minimum necessary interspace is provided between the lower jaw bone and the tissue surrounding the same with the use of a retractor, and that without the danger of damaging the tissue, blood vessel, nerves, etc. lying in the vicinity of site to be grooved inside the lower jaw ramus and without the need of mastership or special device, enables osteotomy of the inside of the lower jaw ramus attaining accurate grooving. There is provided a reciprocating file for orthognathic surgery, comprising axial part (3) of circular cross section structured so as to permit reciprocating motion and comprising multiple teeth (4) integrally fitted to the circumference (31) of the axial part (3). The multiple teeth (4) in the longitudinal direction of axial part (3) are provided intermittently with spacing (with equal pitch), and in the circumferential direction of axial part (3) are provided in the whole region. The radially outer tip portion of each of the multiple teeth (4) consists of curved plane (4r) or flat plane (4h), and the longitudinal tip portion of the axial part (3) consists of curved plane (5) (for example, in the form of partial sphere).

Description

 Specification

 Orthodontic surgery reciprocating file

 Technical field

 [0001] The present invention relates to a reciprocating file for orthognathic surgery that forms a groove for pressing a bone flea on the inner side of a mandibular branch during sagittal segmental surgery.

 Background art

 In orthognathic surgery, in particular, sagittal segmentation of the mandibular branch, a groove is formed by cutting the inside of the mandibular branch, and an instrument called a bone flea is pressed into the groove to divide the mandibular branch.

 In such a procedure, when forming grooves on the inner side of the lower jaw branch and on the outer side of the lower jaw branch, conventionally, as shown in FIG. 30, for example, a Lindermann bar 50 is formed to form grooves on the inner side of the lower jaw branch 11 and on the outer side of the lower jaw branch 11. It is rotating against the point to be done.

[0003] Alternatively, as shown in FIG. 31, using an electric saw 70 for bone that reciprocates, cut the inner side of the lower jaw branch 11 and the outer side of the lower jaw branch 11 to form a groove! / Speak.

[0004] Then, the Lindeman bar 50 hooks the retractor (60) 60 on the far side l ie of the mandibular branch 11, and keeps a certain distance between the mandible 10 and the surrounding tissue (not shown). O It is necessary to install o

 If a certain distance is not provided between the mandible 10 and the surrounding tissue, the surrounding tissue may be involved when the Lindeman bar 50 is rotated, and the tissue, blood vessels, nerves, etc. may be damaged. Because it does.

 [0005] On the other hand, when a bone saw 70 that reciprocates electrically is used, the bone saw 70 has a so-called “top height” (large tooth width). A wider gap must be provided than when it is used. In addition, when reciprocating (movement of arrow Y), it swings sideways in the axial direction (movement of arrow R), and so-called “shake” occurs. It is necessary to be skilled or devised to accurately form grooves by cutting bones.

[0006] For this reason, it is sufficient to provide the necessary minimum gap between the mandible 10 and the surrounding tissue using the retractor (鈎) 60, and the vicinity of the position where the groove inside the mandibular branch 11 should be formed. Organization There is a strong demand for a technology that can accurately form grooves by cutting bones inside the mandibular branch without any skill or special contrivance that does not cause damage to blood vessels, nerves, etc. No such technology has been proposed.

 [0007] As another conventional technique, for example, a craniotomy machine that can suppress the fall of the bone flap at the time of cranial closure has been proposed (Patent Document 1). However, such prior art is not premised on use in mandibular sagittal segmentation, and therefore does not meet the above-mentioned requirements.

 Patent Document 1: Japanese Patent Application Laid-Open No. 2002-238911

 Disclosure of the invention

 Problems to be solved by the invention

[0008] The present invention has been proposed in view of the above-described problems of the prior art, and a necessary minimum gap is provided between the mandible and the surrounding yarn and weave using a retractor (鈎). It is sufficient if it is provided, and there is no risk of damaging tissue, blood vessels, nerves, etc. in the vicinity of the location where the groove inside the mandibular branch should be formed. The purpose is to provide a reciprocating file for orthognathic surgery that can be formed easily.

 Means for solving the problem

 [0009] The reciprocating file (1) for orthognathic surgery of the present invention has a shaft portion (3) having a circular cross section and configured to reciprocate, and an outer peripheral portion of the shaft portion (3). (31) has a plurality of teeth (4) formed in a body-like manner, and the plurality of teeth (4) are intermittently spaced (equal pitch) in the longitudinal direction of the shaft (3). In the circumferential direction of the shaft portion (3), it is formed over the entire region, and the radially outer tips of the plurality of teeth (4) are curved surfaces (4r) or flat surfaces. (4h), and the longitudinal tip portion of the shaft portion (3) is formed of a curved surface (5) (for example, a partially spherical shape) (Claim 1).

 [0010] Here, it is preferable that the gradient (string) of the plurality of teeth (4) with respect to the outer peripheral portion (31) of the shaft is 90 ° or more (claim 2).

[0011] Further, it is preferable that the shaft portion (3) is formed with a slight taper in the longitudinal direction (claim 3). [0012] Further, it is preferable that the electric device is configured to reciprocate in the longitudinal direction of the shaft (claim 4).

 The invention's effect

 [0013] According to the reciprocating file (1) of the present invention having the above-described configuration, the reciprocating file (1) is divided into a groove (Da) on the inner side of the lower jaw branch (11) and the lower jaw branch (11). If the outer groove (Db) is pressed against the position where the outer groove (Db) is to be formed and reciprocated in the longitudinal direction of the shaft part by electric or manual operation, the plurality of teeth (4) formed on the outer periphery of the shaft part (3) The mandible (10) can be cut to form grooves (Da, Db) on the inner side of the lower jaw branch (11) and on the outer side of the lower jaw branch (11).

 [0014] Here, the plurality of teeth (4) are formed intermittently at intervals in the longitudinal direction of the shaft portion (3), and in the entire area in the circumferential direction of the shaft portion (3). Because it is formed across the board, it does not have a so-called “high height” shape like the conventional saw for bone (reference numeral 70 in FIG. 31). Therefore, even if the space between the mandible (10) and the surrounding tissue is narrow, grooves (Da, Db) on the inner side of the lower jaw branch (11) and the outer side of the lower jaw branch (11) can be formed.

 [0015] Further, by reciprocating in the longitudinal direction of the shaft portion (3), it is possible to cut the inner side of the lower jaw branch (11) and the outer side of the lower jaw branch (11) to form grooves (Da, Db). Therefore, unlike rotating a lindeman bar (reference numeral 50 in FIG. 30), there is no risk of damaging the tissue, blood vessels, nerves, etc. by surrounding the yarn and weaving.

 [0016] Furthermore, according to the present invention, since surgery can be performed with a retractor (60) smaller than the conventional one, the surgical wound can be reduced, and minimally invasive surgery is possible. At the same time, the width spread by the retractor may be narrower than before, so that damage to the patient is minimized and minimally invasive.

[0017] Since the distal ends of the plurality of teeth (4) in the radial direction are formed of curved surfaces (4r) or flat surfaces (4h), the lower jaw branch (11) inner side and the lower jaw branch (11) outer side During the formation of a groove by cutting the bone, it is possible to prevent the tip (4r, 4h) radially outward of the tooth (4) from being attracted to the surface of the lower jaw branch (11). . In relation to this, in a patient whose strength of the mandibular branch (11) is relatively weak, it is possible to prevent the tooth of the instrument from being caught and damaged the mandibular branch (11). [0018] In addition, since the longitudinal tip portion of the shaft portion (3) is formed of a curved surface (5), the distal end portion of the shaft portion is placed on the patient when reciprocating in the longitudinal direction of the shaft portion (3). Can be prevented from piercing the tissue in the mouth.

 BEST MODE FOR CARRYING OUT THE INVENTION

 Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings.

 First, before explaining the reciprocating file for orthognathic surgery according to the present invention, the mandibular branch sagittal segmentation will be explained based on FIGS.

 [0020] FIG. 22-FIG. 29 shows that the mandibular sagittal segmentation is performed when the mandible is retracted relative to the maxilla

 (, The so-called “mandibular recession”) and the mandible is advanced relative to the maxilla! If there is an abnormality in the relative positional relationship, move the mandible forward (in the case of the so-called “mandibular recession”) or backward (in the case of the so-called “mandibular protrusion”) by the mandibular branching method. In the case of correction, it shows the procedure from osteotomy to bone splitting.

 22 to 24 show the osteotomy process, FIGS. 25 to 28 show the bone separation process, and FIG. 29 shows the combined state of the separated divided bones after the separation.

 FIG. 22 shows a state before division of the mandible in the case of so-called “mandibular recession”. Lines La, Lb, and Lc in FIG. 22 are osteotomy and division lines, and grooves Da, Db, and Dc are cut along these lines. Of these grooves, the broken line portions (a part of La and Lc) are shown from the front side of the page.

 [0022] As shown in Fig. 23, the osteotomy is performed by removing the bone cortex on the inner surface (the back side of the paper) with the anterior edge l ie of the mandibular branch. )

 Then, bone cutting is performed with a lindemanber 50 (not shown) just above the lower tongue of the lower jaw (not shown) to just behind the lower jaw hole 12. It should be noted that the osteotomy is up to a predetermined depth on the inner surface side of the lower jaw branch 11 and does not penetrate to the outer surface side of the lower jaw branch 11. The cut marks (grooves) after the osteotomy are indicated by broken line Da.

[0023] In Fig. 23 and Fig. 24 (XX sectional view of Fig. 23), the osteotomy line formed by the next osteotomy of the mandibular lateral cortex (hereinafter, the osteotomy line is referred to as the groove) Db is At the position of the lower first molar 13 or the second molar 14 below the external oblique line 15 so as to be perpendicular to the occlusal plane F Bone cutting (groove cutting IJ) is performed with Lindeman bar 50 or Fischer bar up to lower jaw edge 16. At that time, the retractor 60 is used to stably support the mandible 10.

[0024] As the final osteotomy, osteotomy of the bone cortex is performed with a fisher bar along the inside of the outer oblique line 15 at the leading edge of the lower jaw branch l ie so as to connect the inner and outer grooves Da, Db (grooves Da, Db Make a groove Dc).

 [0025] In the sagittal division, in Fig. 25 and Fig. 26, the bone flea 8 is driven into the groove Dc along the outer oblique line 15 by about 5 to 6mm, and it is confirmed that the bone cortex has been reliably cut. To do.

 Next, at the vertical groove Db of the mandibular body (mandible) 10, along the inner surface of the mandibular lateral bone cortex, the bone flea 8 is engulfed to the mandibular lower edge 16, and slightly inside the mandibular lower edge 16. If the blade is placed at the position and not shown in the figure, it will be cracked in the bone cortex of the lower mandibular margin 16 when beaten with a hammer or hammer.

 Then, as shown in FIG. 27, when wedge wedge chisel 81 is driven into groove Dc at the position of posterior portion 17 and wedge bone chisel 81 is rotated to open the outer bone cortex, the inner and outer bone fragments are removed. As shown in FIG. 28, it is divided along the lower lower edge 16 and divided into a first divided piece 100 including the lower dentition and a second divided piece 200 on the lower jaw branch 1 1 side.

 [0027] The first divided piece 100 and the second divided piece 200 divided by the sagittal division of the mandibular branch divide the relative positions of the maxillary bone 300 and the second divided piece 200 as shown in FIG. As with the previous relative position, the first segment 100 is shifted to a position where the maxillary dentition and the mandibular dentition are properly occluded relative to the second segment 200. Osteosynthesis is performed at the position.

 FIG. 22 shows a state before the division of the mandible in the case of so-called “mandibular recession”. The mandibular teeth are shifted to a position where they are properly occluded, and osteosynthesis is performed at that position.

[0028] Next, an embodiment of a reciprocating file for orthognathic surgery according to the present invention will be described with reference to Figs.

 First, referring to FIG. 1 to FIG. 5, a first embodiment of a type that does not slide when a shaft is pushed but can be cut when pulled is described.

FIG. 1 is an overall view of a reciprocating file in the first example of the first embodiment, FIG. 2 is a view showing a portion where the cutting teeth of FIG. 1 are formed, and FIG. Teeth in detail FIG. 3 is a partial side view (detailed view of a T portion in FIG. 2).

[0030] As shown in FIG. 1, the reciprocating file 1 of the first example of the first embodiment is composed of a toothed shaft portion 2 and a toothed shaft portion 3 formed with teeth. Constructed.

 As shown in detail in FIG. 2, the shaft portion 3 on which the teeth are formed has a circular cross section (not shown) and is configured to reciprocate. The teeth 4 are continuously and integrally formed.

As shown in detail in FIG. 3, the plurality of teeth 4 are formed such that the profile of the cross section including the axial center line is an unequal triangle.

 In the figure, the arrow Y indicates the tip direction.

[0032] In the first embodiment, the angle of inclination with respect to the shaft outer peripheral portion 31 of the slope on the tip side of the unequal side triangle is j8, and the angle of inclination with respect to the shaft outer peripheral portion 31 on the side opposite to the tip side of the unequal side triangle is a. Then α is / J, rather than β.

 In FIG. 3 (first embodiment), both | 8 are larger than 90 °.

 In particular, in order to cut the mandible at the tip of the tooth on the angle α side, it is preferable to select the angle a to be 70 ° minus 110 °.

[0033] Further, the teeth 4 are formed intermittently at intervals with a portion (outer peripheral portion) 31 where the shaft portion 3 is visible in the longitudinal direction of the shaft portion 3 being interposed. In addition, although not clearly shown in the drawing, the tooth 4 is formed over the entire region as a complete annular tooth without a notch in the circumferential direction of the shaft portion 3.

 As described above, the flat portion 4 h parallel to the longitudinal direction of the shaft portion 3 is formed at the distal end portion of the tooth 4 in the radial direction.

FIG. 4 is a first modification of the first embodiment (reference numeral as a reciprocating file is 1 A). The first example of the first embodiment shown in FIGS. 1 to 3 is an example in which a flat portion 4h is formed at the tip (top) of the tooth.

 On the other hand, in the first modification of the first embodiment in FIG. 4, the tooth tip (top) is rounded (the tip section has a curved surface 4r) to reduce the impact during cutting. This improves the durability of the teeth.

FIG. 5 shows a second modified example of the first embodiment (reference numeral 1 is a reciprocating file). B).

 In the first modification shown in FIG. 4, the slope angle ex on the side opposite to the tip side is the same as in the first embodiment.

Although it is 90 ° or more, the second modification of the first embodiment in FIG. 5 is an example in which α is set to a value smaller than 90 degrees. Further, a round process 4r is performed on the outer peripheral side of the shaft. The rest is almost the same as the first modification.

[0036] The reciprocating file 1B of the second modified example has high machinability. Therefore, for patients with strong bone quality (hard bones), osteotomy time can be shortened by using the reciprocating file 1B of the second modified example.

Next, a second embodiment will be described with reference to FIGS. The second embodiment is a type that does not slide when the shaft is pulled, but breaks when pressed.

First, a first example of the second embodiment will be described with reference to FIGS. 6 and 7 (detailed view of a T portion in FIG. 6).

 The reciprocating file 1C of the first example of the second embodiment of FIGS. 6 and 7 is different from the first example of the first embodiment of FIGS. This is an embodiment in which the magnitude relationship with the angle β of the opposite side is opposite, ie, “α> j8”.

[0039] By setting the relationship between a and β to “α> β”, the bone is cut when the reciprocating file 1C is pressed.

 A first modification of the second embodiment in FIG. 8 is a modification in which the tip end side gradient angle | 8 is a right angle (| 8 = 90 °) and the tooth tip is rounded (4r). Further, in the second modification of the second embodiment in FIG. 9, the tip side slope angle β is a right angle (j8 = 90 °), and the flat portion of the tooth 4 is parallel to the tip of the shaft 3 in the longitudinal direction. This is a modification in which 4h is formed.

 [0041] The first example of the second embodiment shown in FIGS. 6 and 7, the first modification of the second embodiment shown in FIG. 8, and the second modification shown in FIG. However, the gradient on the side opposite to the gradient j8 on the tip side, that is, the gradient a on the hand side is gentle.

 Therefore, the cooling water injection at the time of cutting (bone cutting) does not bounce back to the hand side (surgical side) or the amount of bounce is reduced, and infection to the practitioner (doctor) or nurse etc. Fear is low. Note that the arrow Y in FIGS. 6, 8, and 9 indicates the tip side.

Next, a third embodiment will be described with reference to FIGS. 10 to 15. The third embodiment is It is a type that cuts bones by both pushing and pulling movements.

 First, a first example of the third embodiment will be described with reference to FIG. In the first example of the third embodiment shown in FIG. 10, the profile of the tooth 4 in the cross section including the axial center line is one circular arc 4a, and the tooth 4 of this circular arc 4a is formed continuously in the axial direction. This is an example.

[0043] In the second example of the third embodiment shown in Fig. 11, the fill of the tooth 4 in the cross section including the axial center line is a rectangle 4b, and the tooth 4 in the rectangular cross section 4b is continuous in the axial direction. This is an example formed.

 In a third example of the third embodiment shown in FIG. 12, the profile of the tooth 4 in the cross section including the axial center line is a trapezoid 4c that is symmetrical in the longitudinal direction, and the tooth 4 in the trapezoidal cross section 4c. Is an embodiment formed continuously in the axial direction.

 [0045] Here, in the case where the tooth profile is a trapezoidal section that is symmetrical in the longitudinal direction, as shown in Fig. 13, if the slope angle γ of the trapezoidal slope is too large, the teeth slip during cutting. I ca n’t cut my bones. Therefore, the gradient angle γ is preferably 120 ° or less. In addition, if the outer peripheral portion 31 of the shaft portion between the teeth is long, the number of teeth in the entire length is reduced and cutting efficiency is impaired. Therefore, it is preferable that the outer peripheral portion 31 of the shaft portion between the teeth is the minimum necessary length. .

 Furthermore, as a modification of the second example (FIG. 11) of the third embodiment, as shown in FIG. 14, the force gradient angle γ that can be an inverted trapezoidal tooth profile 4d is too small. In this case, the force that improves cutting performance may cause the tooth to pull on the bone.

 If the teeth are pulled against the bone, the machine that reciprocates the reciprocating file is overloaded and the machine may be damaged. Also, in the case of a patient with weak bones, if the reciprocating file is reciprocated while the teeth are attracted to the bone, the damage to the patient's living body becomes too great.

 In order to prevent such a situation, the gradient angle is preferably set to 70 ° or more.

 [0047] In the case of the inverted trapezoidal tooth 4d, as shown in Fig. 15, if a radius process 40r or chamfer 40c is formed at the corner of the tip of the tooth, the tooth will pull on the bone. You can also prevent anything.

 Next, a fourth embodiment will be described with reference to FIG.

The fourth embodiment in FIG. 16 is an embodiment in which the shaft portion is tapered with a slight gradient. It is. In the illustrated example, the shaft diameter 3Da on the front end side is formed to be narrower than the shaft diameter 3Db on the rear side. Since the tooth type in the cross section including the axis center line is common, the tip diameter 4Da is smaller than the diameter 4Db of the rear teeth.

 Such a tapered shape has the advantage that the line of sight of the reciprocating file tip side (in terms of practitioner power) is improved.

[0049] Although not shown, the cross-sectional shape of the tooth 4 from the first embodiment to the fourth embodiment is a circular shape without a notch. However, as shown in Fig. 17, 4 g of small irregularities may be continuously formed on the maximum diameter portion of the tooth.

 Alternatively, as shown in FIG. 18, notches (notches) 4n may be provided at a plurality of locations at equal pitches in the maximum diameter portion of the teeth.

 In the example of FIGS. 17 and 18, the heat dissipation when the bone is cut is improved.

[0050] In each embodiment of the present invention, the teeth 4 are formed in an annular shape around the entire circumference of the shaft portion 3 (outer peripheral portion 31).

 Then, as shown in FIG. 19, the reciprocating file 1 of each embodiment of the present invention is attached to the power machine M and cuts (cuts) the mandibular branch 11 by an axial linear motion (arrow Y). .

 That is, when cutting the left side 11L of the mandibular branch 11, the “A” region of the tooth 4 is involved in bone cutting. Next, when cutting the right side 11R of the mandibular branch 11, the areas of the teeth 4 that are not yet used V and “B” are involved in the cutting.

 Therefore, the reciprocating file 1 can be used for cutting both the left and right sides of the lower jaw branch 11 without removing the reciprocating file 1 from the power machine M and rotating it.

 [0051] FIGS. 20 and 21 respectively show bone cutting (cutting the groove; FIG. 20) using the reciprocating file 1 of the embodiment of the present invention, and dividing one side of the mandibular branch 11 (FIG. 21). FIG.

In the examples of FIGS. 20 and 21, the relative movement amount of the divided pieces 100 and 200 after the division is smaller than that in the above-described example (FIGS. 22 to 29). 1 Located behind the molar. [0052] According to the reciprocating file 1 of the present embodiment having the above-described configuration, the longitudinal direction of the plurality of teeth 4 force shaft portion 3 is intermittently formed at intervals, and the circle of shaft portion 3 is formed. Since it is formed over the entire area in the circumferential direction, it should not have a so-called “high” shape like the conventional saw for bone (reference numeral 70 in FIG. 31)!

 Therefore, even if the space between the mandible 10 and the surrounding tissue is narrow, the inner groove of the mandible 11

Da and the outer groove Db of the mandibular branch 11 can be easily formed.

[0053] Further, by reciprocating in the longitudinal direction without rotating the shaft portion 3, the inner and outer sides of the mandibular branch 11 can be cut to form the grooves Da and Db. Unlike the case of rotating the code 50), there is no risk of damaging the blood vessels, nerves, etc. if the surrounding yarns and weaving are involved.

[0054] Furthermore, since surgery can be performed with a smaller retractor than before, the surgical wound can be reduced, and minimally invasive surgery is possible.

[0055] Since the distal ends of the plurality of teeth 4 in the reciprocating file 1 in the radial direction are formed by the curved surface 4r or the flat surface 4h, the inner and outer sides of the mandibular branch 11 are boned and grooved. It is possible to prevent the tips 4r and 4h, which are radially outward of the teeth 4, from being caught on the surface of the lower jaw branch 11 during the formation of the teeth.

[0056] In relation to this, in a patient whose strength of the mandibular branch 11 is relatively weak, it is possible to prevent the tooth of the instrument from being caught and damaging the mandibular branch 11.

[0057] Since the distal end portion of the shaft portion 3 in the longitudinal direction is configured by the curved surface 5, when the shaft portion 3 reciprocates in the longitudinal direction, the shaft portion tip is pierced into the tissue in the patient's oral cavity. Can be prevented.

 [0058] The illustrated embodiment is merely an example, and it is noted that the description is not intended to limit the technical scope of the present invention.

 Brief Description of Drawings

 [0059] FIG. 1 is a side view showing an entire reciprocating file according to the first embodiment of the present invention.

FIG. 2 is a side view of a shaft portion on which teeth of the reciprocating file according to the first embodiment of the present invention are formed. FIG. 3 is a detailed view of a portion T in FIG.

4] Partial sectional view showing the tooth profile of the first modified example of the first embodiment.

 FIG. 5 is a partial sectional view showing a tooth profile of a second modification of the first embodiment.

 FIG. 6 is a side view of a shaft portion on which teeth of a reciprocating file according to a second embodiment of the present invention are formed.

 FIG. 7 is a detailed view of the buttock of FIG.

圆 8] Partial sectional view showing the tooth profile of the second embodiment, first modification.

 FIG. 9 is a partial cross-sectional view showing a tooth profile of a second embodiment and a second modification.

圆 10] Partial sectional view showing the tooth profile of the third embodiment and the first example.

[11] Partial sectional view showing the tooth profile of the third embodiment and the second example.

12] Partial sectional view showing the tooth profile of the third embodiment and third example.

13] A diagram for supplementarily explaining the third embodiment and the third embodiment.

14] Partial sectional view showing a tooth profile of a modification of the second example (FIG. 11) of the third embodiment.

 FIG. 15 is a diagram for supplementary explanation of FIG.

圆 16] A side view of the shaft portion on which the teeth of the fourth embodiment are formed.

圆 17] A front view showing a first modification of the outer peripheral shape of the tooth according to the embodiment of the present invention.圆 18] Front view showing a second modification of the outer peripheral shape of the tooth according to the embodiment of the present invention.

FIG. 19 is a diagram showing a state of treatment using a reciprocating file according to the embodiment of the present invention.

 FIG. 20 is a state diagram in which the position of osteotomy is specified using the reciprocating file of the embodiment of the present invention.

圆 21] A state diagram in which osteotomy is completed and the lower jaw branch on one side is divided.

[22] The figure before the mandible was divided.

[23] Process chart showing osteotomy on the outer side of the mandibular branch.

 FIG. 24 is a cross-sectional view taken along the line XX in FIG.

 FIG. 25 is an initial process diagram of sagittal division.

 FIG. 26 is a cross-sectional view taken along the line XX in FIG.

圆 27] Late process drawing of sagittal division. 圆 28] State diagram with sagittal division completed.

圆 29] The figure after joining the split pieces with the correct occlusion after splitting.

FIG. 30 is a bone cutting process diagram using a Lindeman bar in the prior art.圆 31] A bone cutting process diagram using a conventional bone saw.

Explanation of symbols

 1 · · · Reciprocating files

2… Tooth is formed, shaft part

3 ... Shaft part where teeth are formed

4 ... "

 4a '··· Arc teeth

 4b—tooth with rectangular cross section

4c, ', trapezoidal tooth

4d—teeth with inverted trapezoidal cross section

41ι ··· Plane

 4r- · 'Curved surface Z radius treatment

5… Curved surface

8 ... Bone flea

10 ... mandible

11 ... Mandibular branch

12 ... Mandibular foramen

13 ... 1st molar

14 ... 2nd molar

15 ... Outer diagonal line

16 ... Lower edge of the mandibular branch

50 ... Linde Mambar

60.

Claims

The scope of the claims  [1] A shaft having a circular cross section and configured to be reciprocally movable, and a plurality of teeth are integrally formed on an outer peripheral portion of the shaft, and the plurality of teeth includes a shaft The longitudinal direction of the plurality of teeth is formed intermittently at intervals, the circumferential direction of the shaft portion is formed over the entire region, and the radially outer tips of the plurality of teeth are curved surfaces or A reciprocating file for orthognathic surgery, comprising a plane parallel to the longitudinal direction of the shaft, and a distal end in the longitudinal direction of the shaft being a curved surface.  [2] The reciprocating file for orthodontic surgery according to claim 1, wherein the gradient of the plurality of teeth with respect to the outer periphery of the shaft is 90 ° or more.  [3] The reciprocating file for orthognathic surgery according to any one of claims 1 and 2, wherein the shaft portion is formed with a slight taper in the longitudinal direction. [4] The reciprocating file for orthognathic surgery according to any one of claims 1 to 3, wherein the reciprocating file is configured to reciprocate in the longitudinal direction of the shaft by an electric device.