DE102005005656B4 - Dental implant and method of making a dental implant - Google Patents

Abstract

A dental implant for a patient comprising an anchoring part (12) for anchoring the dental implant (10) in the bone and an abutment (11) for fixing a superstructure (20) connected to the anchoring part (12), the anchoring part (12) and the abutment (11) are made of zirconium ceramics, characterized in that the anchoring part (12) comprises (at least) two substantially cylindrical bodies (13, 13 ') whose central axes (X, X') extend in the same direction, and the upper ends (14, 14 ') are integrally connected together to form the abutment (11) and which are insertable into corresponding holes in the jawbone, wherein the abutment (11) is formed for forming a bridge for at least two prosthetic elements.

Description

The The invention relates to a dental implant according to the preamble of Claim 1 and a method for producing a dental implant according to Claim 11.

Dental implants are known in various embodiments. They serve to accommodate superstructures such as bridges, crowns or the like. Such a dental implant is for example from the DE 101 59 683 known, this dental implant is made of zirconium ceramic.

Then, if several teeth are to be replaced, several corresponding dental implants are common used. This is not only costly, it can also be done that to the available standing space in the jaw bone in particular by shrinkage z. B. due to prolonged existence from gaps no longer suitable for receiving several such implants is. About that out is the stability a single implant especially in problematic bone conditions unsatisfactory.

The DE 43 38 440 C2 shows an implant-bridge combination that can be used to anchor removable prostheses in the largely edentulous jaw. The anchoring of the implant-bridge combination comprises two implant abutments with a transgingival bridge, the bridge and pillar being made of one piece, preferably of a titanium alloy. In contrast to the usual screwing of prostheses can occur in this construction no tensions in the overall construction. The prosthesis is simply clipped onto one or more implant straps.

A individual production of the bracket is not necessary because the strap with Help a template be uniformly installed in the jaw. To the Anchoring dental implants comprising a superstructure, an abutment and an artificial one Tooth root, the implant strap described is among other things due its advantages (voltage-free, so flexible connection) conceivable not suitable.

The US 3,905,109 shows a dental implant for supporting and stabilizing crowns, bridges or the like. The dental implant comprises a conical threaded portion and a shaft for attachment. The threaded portion is screwed into the denture, a single dental implant or a bridge are cemented onto the shaft. The creation of a defined angle between the anchoring part and the superstructure which can be placed thereon proves to be difficult and will not be explained further in the document.

The DE 199 52 962 A1 describes a method for creating a drilling aid for a dental implant. In a first step, a three-dimensional digital image of the anatomy given by the jaw is created. In a second step, a drill assist is made for a given dental implant to aid in the placement of drilled holes for the dental implant.

The DE 100 65 971 A1 describes a method for producing a dental implant made of high-performance ceramics. For the production of the ceramic tooth replacement, a digital image of the tooth replacement adjacent tooth stumps is created. This digital jaw model is used for the design of ceramic dentures. Chewing surfaces are easier to model.

The DE 195 13 881 A1 shows a method of manufacturing a dental implant. In this method, an existing tooth is simulated by artificial material and then used in place of the natural tooth in a tooth gap. The imaging process scans the natural tooth root area and, taking into account various deviations, creates an artificial tooth whose root exactly fits into the natural tooth root area.

With regard to this state of the art, in particular the DE 43 38 440 C2 It is an object of the invention to provide a dental implant and a method for producing a dental implant, wherein the dental implant has an increased strength and stability with simple production.

These The object is achieved by a dental implant according to claim 1, and Process for producing the dental implant according to claim 11 solved.

Thereby, that the two cylindrical bodies, which are firmly connected, in the same direction can extend the dental implant into the holes in the jaw be tapped. The load capacity of this dental implant is considerable higher than the total strength of individual dental implants, because a considerably cheaper Recording of bending moments by the acting levers of the connection is ensured between the two cylindrical bodies. This is true at Load in virtually all directions and at all points of the chewing surfaces except the only one, directly on the central axis of the respective cylindrical body lying points.

In principle, the dental implant can also be used to reconstruct a single tooth. There are two adjacent or three teeth in particular replaced by the dental implant, in which case the abutment for education a bridge is formed for three prosthetic elements. This results in a significant reduction in the cost of replacing multiple teeth.

The Abutment preferably has a pontic structure between the anchoring parts on. As a result, the effort in making a bridge considerably reduced. In such a pontic structure, this is in their, under the connection between the anchoring parts lying section polished and preferably egg-shaped trained so that this, sitting on the gums or on this adjacent section simultaneously the lower section can form the superstructure. This is preferably also a coloring the Zirkonkeramik made according to the superstructure. On the dental implant can in a conventional manner a superstructure put on (glued or cemented). In a preferred Embodiment of Invention is the superstructure, especially a bridge already attached prior to insertion of the dental implant on the abutment, in particular burned on this. It can not only be a much firmer Connection created between dental implant and superstructure rather, it is also possible a significant reduction in the number of steps to to reach.

at a development of this embodiment the superstructure includes only a front, labial section. The abutment behind it is particularly accessible from above and can be without bring in a load of the superstructure in the jaw or pat.

alternative the abutment-mounted superstructure comprises such an opening, that the abutment is accessible especially from above. This is one facilitated insertion of the dental implant or knocking in the holes possible without damage the superstructure. This advantage can be used without the expense or quality of work to influence, since not visible sections (eg the labial Side of the tooth away from the tooth) after setting of the implant can be attached. Besides, in general the occlusal surfaces adjusted or created after insertion of the implant. This can be done without additional effort in connection with closing the opening.

One only partial completion of the abutment-mounted superstructure also offers, if a relief or protection of the fresh set implant desired is. A provisional part can thus be applied to the superstructure be that final surface the superstructure lies below the chewing surface of the adjacent teeth and is not burdened when chewing. This provisional part will after a given healing time of the dental implant through a final section replaced, which ensures full functionality. Alternatively, you can a thin, Removable protective rail on the superstructure and the adjacent ones teeth be attached to the discharge of the dental implant and after a given period are removed.

Preferably the implant has at least one support structure for holding and / or knocking the cylinder body in the holes. Thereby can defined Einklopfstellen given and a mounting tool be attached for insertion.

The cylindrical body preferably have on a substantial part of their outer surfaces a roughened surface on which the ingrowth or the connection with the jawbone significantly improved in a conventional manner. This roughened surface is preferably before a final sintering of a corresponding Green body of the Dental implant by sandblasting or the like cutting deformation formed, which greatly simplifies the production of the dental implant.

The Dental implant is preferably at least in the range of cylindrical body provided with a protective layer which is removed immediately before insertion can be. This can be the introduction of germs in the jawbone be prevented. Such a protective layer can be used for mechanical Distance to be trained.

Farther the object is achieved by a method for producing a dental implant, solved according to claim 11.

Preferably becomes at a bridge section of the dental implant a pontic structure between the anchoring parts with an egg-shaped Structure for forming a lower end for a superstructure provided being this egg-shaped Structure is polished before and / or after firing / sintering, which reduced the workload and to a better end result leads.

The ovoid Structure preferably becomes the color of the superstructure accordingly dyed, which improves the result in optical terms considerably.

In the preferred embodiment of the invention, after firing / sintering of the implant, a superstructure is at least partially applied, in particular glued or fired, so that a dental implant with a "semi-finished" superstructure is formed. It is also possible one Complete completion of Dentalimplanta tes, consisting of abutment with anchoring part and applied superstructure to create. In this case, special care when setting, especially when hammering, the dental implant is necessary to avoid damage to the superstructure. However, tests have shown that a provided with a protective cover, completely finished dental implant can be used with appropriate presence of holes in the jawbone, without damaging the superstructure or other part of the dental implant. The protective cover may for example be a removable plastic cover.

• – Generieren eines 3-dimensionalen, digitalen Modells der Anatomie der dem zukünftigen Sitz des Dentalimplantates benachbarten Regionen, insbesondere von Zähnen, Bereichen des Kieferknochens und des Zahnfleisches;
• – zumindest teilweise computergestütztes Entwerfen des individuell an die Anatomie anpassbaren Dentalimplantates;
• – Fertigen des Dentalimplantates;
• – Setzen des Dentalimplantates;
• – Validieren und Dokumentieren der durchgeführten Arbeit.

The application also describes a method for manufacturing and setting a dental implant comprising the following steps:

• Generating a 3-dimensional, digital model of the anatomy of the regions adjacent to the future location of the dental implant, in particular of teeth, areas of the jawbone and the gums;
• - at least partially computer-aided designing of the individually adaptable to the anatomy dental implant;
• - manufacture of the dental implant;
• - placing the dental implant;
• - Validate and document the work performed.

One particular advantage of this method is that the computer aided design of the individually adapted to the anatomy of the patient dental implant based on the 3-dimensional digital model of anatomy and thus an optimal, preoperative comparison between dental implant and anatomy of the patient can be done.

Preferably In this procedure, one of the other steps that will be taken to Making and setting the implant are necessary with the help of the computer carried out. For example, let by driving a mill, a drill or a Nozzle for Sandblast with the computer to optimize the manufacturing process. Manufacturing costs are due to personnel savings, reduced material wear, the precision increased in terms of manufacturing errors and minimized the time required. Also, the surgical intervention can be more efficient with the help of the computer be performed. So can a computer, if with appropriate input and output devices equipped to assist the doctor in the operation. Because documentation and Gaining more and more importance for validation in medical work may be storing the implant data and / or the model data and / or various operation and / or Manufacturing parameters the transparency provided by the dentist and / or dental technician and / or other persons involved. For example it, possible the actual Compare seat of the implant with a planned position or chosen Operational and / or manufacturing parameters regarding the quality of the emerged Work (eg lifetime of the implant, cosmetic effect, etc.) to catalog and improve.

to Obtaining a 3-dimensional, digital model of anatomy the future The dental implant's neighboring regions are almost all common in human medicine imaging techniques such. B. CT (Computer Tomography), MRI (Magnetic resonance tomography), medical US (ultrasound), etc. conceivable. However, preferred is a special CT method, the DVT (digital volume tomography) used as the corresponding Device for Modeling provides adequate data, bones and teeth well and precise and exists in most dental offices.

In The industry has long had software programs (eg CAD software) to the computer-aided Developing 3-dimensional components known. A single design Parts of a dental implant, in particular of superstructure, abutment and anchoring part, on the computer using a corresponding improved three-dimensional, digital model of adjacent anatomy the quality of the dental implant. By means of a for the dentist and / or dental technician customized CAD software will be available for each patient optimally adapted to him and his history Dental implant designed.

Prefers the software provides a lot of predefined components and / or manifestations to disposal. It stands for every application (eg number of teeth to be replaced, position of the implant) a well-suited coarse model of Dentalimplanta TES ready to be reworked to the optimum fit only minimally. Of the Denture design will be for Dentist and / or dental technician very easy.

A possibility the dental implant comprising supraconstruction, abutment and anchoring part, to adapt individually, is that the expression, in particular Number of prosthetic elements to be inserted, and / or the diameter of the abutment is adjusted.

A another possibility the fitting of the dental implant provides such an adjustment of the abutment and the anchoring part that represents the angle between the for the anchoring part provided drilling axis and the horizontal Alignment axis of the superstructure is freely selectable.

Preferably Is it possible the length and / or the diameter and / or color of the superstructure in the computer aided design of the Dental implant. length and diameter of the superstructure crucial about functionality and service life of the dental implant, diameter and color determine the appearance of the dentures.

includes the at least partially computer aided designing a computer aided planning of the Seat of the dental implant, the design can be exactly to the adjacent Anatomy to be matched. Furthermore The placement of the implant can be planned preoperatively.

Automatically For example, a drill guide can be used first as a 3-dimensional model and later as real drilling template for inserting the dental implant at the planned Position are generated. The drill rail helps position while drilling to find the right drilling angle and the exact planned drilling depth.

Becomes on the part of the computer additional a device navigation (i.e., the position of the instruments used may be intraoperative, relative to the position of the patient), so the computer can be similar as with a navigation system in a car the doctor in finding the optimal, preoperatively planned target position of the dental implant to be helpful. Could also the computer with the help of suitable input and output devices one Take over part of the intraoperative device control (eg rotational speed of the drill).

preferred embodiments The invention will become apparent from the dependent claims.

following Be exemplary embodiments of Invention explained in more detail with reference to figures. Show here

1 a side view of a first embodiment of a dental implant;

2 a second embodiment of a dental implant in a representation according to the 1 ;

3 a partial section through the dental implant after 2 along the line III-III 2 ;

4 a partially sectioned side view of a template with plaster model and

5 a schematic representation of a fastening tool.

In The following description will be for the same and the same Parts used the same reference numerals.

As in 1 illustrated, the embodiment shown here comprises an implant 10 two cylindrical bodies 13 . 13 ' , which is an anchoring part 12 form and inserted into corresponding cylindrical holes in a jawbone (tapped from above). This cylindrical body 13 . 13 ' are at their upper ends ( 14 . 14 ' ) over an abutment 11 connected, so that a one-piece body is formed. Between the two cylindrical bodies 13 . 13 ' is a pontic structure 15 provided so that a bridge can be applied as a superstructure.

The pontic structure 15 can at its lower, the gum-facing end of a polished section 16 has, which is no longer covered by a superstructure, but optically is a part of the same.

The entire implant 10 is preferred in accordance with the color of the final superstructure 20 provided so that transitions between supraconstruction 20 and abutment 11 optically barely recognizable.

For the production of the implant 10 is made from a zirconia-based green body, which is still very easy to process, in accordance with digital data (whose derivation will be explained later) of a shape according to the 1 milled out, if necessary, so with oversize that after a firing / sintering of the green body in order to convert it into its final, very resistant fine structure, the final dimensions are achieved.

Furthermore, the anchoring part 12 roughened before firing / sintering at the sites which are supposed to grow together with the bone, e.g. B. by sandblasting or the like per se known processing operations. This roughening succeeds very easily on the green body while the finished burned / sintered product can be processed only with the utmost effort.

If the implant 10 was prepared in the described manner, it can be sterilized and packaged for delivery to the attending physician. Advantageously, at least the parts of the implant 10 which are to be inserted into the bone after sterilization with a protective layer 17 coated, the z. B. is removed by mechanical peeling. In this way highest sterility is guaranteed.

In the 2 embodiment of the invention shown differs from the 1 there through that the dental implant 10 another, third, cylindrical body 13 '' includes, along with the other two cylindrical bodies 13 . 13 ' an anchoring part 12 forms. The third cylindrical body 13 '' sets in the middle between the other two cylindrical bodies 13 '' and offers when setting the dental implant 10 additional stability.

In 3 is that in 2 shown implant 10 seen in cross-section, but with an attached superstructure 20 , This is in the embodiment shown here in two parts and that such that the abutment 11 comprehensive, solid section 21 the superstructure 20 whose labial section is fully pronounced, definitive on the abutment 11 burned on, the rest of the superstructure 20 is as a provisional section 22 educated. The provisional section 22 will only after the placement of the dental implant 10 attached to the same. So remains when setting the dental implant 10 an opening 30 , about the force on the abutment 11 can be exercised without the superstructure 20 to damage. This and the fact that the dental implant has one in the opening 30 seated Einklopfstift (not shown) can be easier to insert particular hammering and protects the superstructure 20 , In general, therefore, the opening can be 30 not just as an access to the abutment 11 but also as a holder for better insertion of the implant.

It is possible the provisional section 22 lower (or abrade), so that during the healing phase, the forces acting on the new implant forces (eg caused by teeth grinding or chewing) are significantly reduced.

Alternatively, a completely finished superstructure may be used prior to insertion on the abutment 11 be attached. Which is then used as a component in the jaw. To protect the dental implant while knocking the same it can be provided with a protective cap.

In order to determine the shape of the implant, a data set for deriving the jaw structure, at least in the region in which the implant is to be inserted, is first obtained in a manner known per se by means of a CT-DVT method. By means of software methods known per se, a basic shape of the implant is furthermore predefined, which is then used virtually in the bone. By changing the shape of the implant, especially the cylindrical body 13 . 13 ' and a corresponding positioning can be made in this way an optimization, in particular with respect to the strength of the jawbone. Another important factor in the formation of the implant, in particular the abutment, of course, also the structure and position of the adjacent teeth and the gums.

Furthermore, an impression of the teeth is made next to the area of the implant to be inserted, the basic structure in 4 shown to make it a template 40 to be able to produce. This impression also serves to obtain a plaster model 44 with tooth models inserted therein 42 . 42 ' , which are reproduced in detail to the corresponding teeth of the patient. The template 40 thus has retaining elements 41 . 41 ' on, which are formed as recesses, which exactly match over the teeth adjacent to the implant. This is the position of the template 40 defined relative to the jaw structure of the patient.

In a next step, be in the template 40 drilling 43 . 43 ' introduced on the basis of the digitized data in such a way that these cylindrical bodies 13 . 13 ' correspond. Because the template 40 is defined in their position to the jaw, it is now the holes 43 . 43 ' , The holes 43 . 43 ' be equipped in a conventional manner with sleeves, so that a pre-drilling and custom drilling is possible.

For tapping the implant, a manually operable tool can be used. Due to the extremely limited space, however, it is advantageous if a powered by external power supply tool is used. Such a tool is described below with reference to 5 explained.

The tool 50 has a hammer head 52 at least in the section with which the implant 10 is tapped, a substantially spherical or Kugelkalottenförmige striking surface 54 having. Surprisingly, it has been found that such a curved surface allows extremely accurate work. Of course it is also possible to hit the clubface 54 deviating from an exact sphere, z. B. perform paraboloidally curved. The hammerhead 52 is at the end of a stalk 53 attached, which has a rotation axis 55 rotatable in a handle 57 is stored.

To move the arrangement is a drive 56 provided, which is designed in the embodiment shown here as a pneumatic drive. For measuring the hammer head 52 on the implant 10 applied pulse is a pulse sensor 61 intended.

Furthermore, it is under control 57 an adjustment device 58 for adjusting the hammer head 52 provided this path, so this every time you press a trigger 59 same way travels.

The power supply (pressure supply) for the pneumatic drive 56 happens via a controller 51 , the pressure from a compressed air source 60 is supplied. To adjust the impact pulse is an adjustment 62 intended. To display the pulse energy is an impulse display 63 intended.

At this point it should be noted that this tool also another drive or another, the movement of the hammer head 57 may have definitive suspension. However, it is important to work with a reproducible impact pulse.

10

implant

11

abutment

12

anchoring part

13 13 ', 13' '

cylindrical body

14 14 '

upper end

15

Pontic structure

16

polished section

17

protective layer

20

superstructure

21

solid section

22

provisional section

30

opening

40

template

41 41 '

retaining element

42, 42 '

tooth model

43 43 '

drilling

44

plaster base

50

Tool

51

control

52

hammerhead

53

stalk

54

Playing surface

55

axis of rotation

56

pneumatic drive

57

Handle

58

Travel Adjust

59

trigger

60

Compressed air source

61

pulse sensor

62

Impulseinstellorgan

63

pulse display

Claims (14)

Dental implant for a patient, comprising an anchoring part ( 12 ) for anchoring the dental implant ( 10 ) in the bone and an abutment ( 11 ) for fixing a superstructure ( 20 ), which is connected to the anchoring part ( 12 ), wherein the anchoring part ( 12 ) and the abutment ( 11 ) are made of zirconium ceramic, characterized in that the anchoring part ( 12 ) (at least) two substantially cylindrical bodies ( 13 . 13 ' ) whose center axes (X, X ') extend in the same direction and those at upper ends ( 14 . 14 ' ) in one piece with each other to form the abutment ( 11 ) and which are insertable into corresponding holes in the jawbone, wherein the abutment ( 11 ) is formed to form a bridge for at least two prosthetic elements. Dental implant according to claim 1, characterized in that the abutment ( 11 ) to form a bridge for at least three prosthetic elements a pontic structure ( 15 ) between the cylindrical bodies ( 13 . 13 ' ) having. Dental implant according to claim 2, characterized in that the pontic structure ( 15 ) at its under the connection between the cylindrical parts ( 13 . 13 ' ) section ( 16 ) is polished and preferably egg-shaped. Dental implant according to one of the preceding claims, characterized by a superstructure ( 20 ), which prior to insertion of the dental implant ( 10 ) on the abutment ( 11 ), in particular burned on this. Dental implant according to claim 4, characterized in that the superstructure ( 20 ) only a front, labial section ( 21 ), so that the abutment ( 11 ) behind it is accessible in particular from above. Dental implant according to claim 4, characterized in that the abutment ( 11 ) attached superstructure ( 20 ), such an opening that the abutment ( 11 ) is accessible in particular from above. Dental implant according to any one of claims 4-6, characterized in that the superstructure ( 20 ) a provisional dental implant protective portion ( 22 ) which is removable after a healing phase or replaceable by a corresponding final portion of a superstructure. Dental implant according to one of the preceding claims, characterized by at least one support structure ( 30 ) for holding and / or knocking the cylindrical bodies ( 13 . 13 ' ) in the holes. Dental implant according to one of the preceding claims, characterized in that the cylindrical bodies ( 13 . 13 ' ) have on a substantial part of their outer surface a roughened surface which is in front of a final Bren NEN / sintering of a corresponding green body by sand blasting or the like cutting deformation are formed. Dental implant according to one of the preceding claims, characterized in that the dental implant ( 10 ) at least in the region of the cylindrical body ( 13 . 13 ' ) with a removable before the placement of the dental implant, reducing the risk of infection protective layer ( 17 ) is provided. Method for producing a dental implant according to one the claims 1-10, comprising the steps - Produce a 3-dimensional, digital illustration of a range of jawbones and gums of a patient in which the dental implant is to be used; - make a digital representation the dental implant; - Milling a the body based on zirconia, if necessary with excess for compensation a shrinkage; - sandblasting the cylindrical body the green body; - burning / sintering of the processed green body. Method according to claim 11, being at one bridge section of the dental implant a pontic structure between the anchoring parts with an egg-shaped Structure for forming a lower edge provided for a superstructure is characterized in that the egg-shaped structure before and / or after firing / sintering is polished. Method according to claim 12, characterized in that that the egg-shaped Structure of the color of the superstructure is colored accordingly. Method according to one of claims 11-13, characterized that after firing / sintering a superstructure is fired.