FR3038219A1 - ANGLE TRANSFER DEVICE - Google Patents

Abstract

Transfer device (1) for cooperating with an open tray for locating the orientation of an implant (4) in the maxillary or mandibular bone of a patient, comprising a transfer body (5) ) and a fastening element (6). The fastening element (6) comprises, between a distal maneuvering section (11) and a proximal fastening section (12), a flexible intermediate section (17) allowing the distal sections for maneuvering (11) and proximal fixation ( 12) to be oriented in axial directions (II, II-II) making an angle (A) therebetween. The transfer body (5) has a through internal passage (9) shaped to cooperate with the fastening element (6) by bending the intermediate section (17) when the fastening element (6) is inserted into the the internal through passage (9).

Description

The present invention relates to impression taking in the mouth of a patient using a tray, and more particularly relates to the impression taking with the aid of an open tray for identifying the orientation of one or more implants in the maxillary or mandibular bone of a patient.

To take an impression using an open tray, it is known to use a transfer device (commonly called "transfer pick-up") as described in WO 2009/035968 A1.

Such a transfer device is particularly indicated when a very high precision is required, for example when it is necessary to locate the orientation of several implants inclined relative to each other or even of a single implant inserted obliquely. (in relation to the general plane of occlusion of the patient's jaw) in the maxillary or mandibular bone.

A transfer transfer device for pick-up (or open-air) transfer generally includes a transfer body and a fastener. In this transfer device: the transfer body extends between a proximal end, comprising a first bearing surface intended to abut against said implant or against a pillar carried by said implant, and a distal end; transfer body comprises, on its outer lateral wall, retention reliefs intended to cooperate with the imprinting impression tray, - the transfer body comprises a through internal passage opening at the proximal and distal ends of the body of the transfer, the transfer body comprises a clamping seat intended to receive, in bearing, a shoulder of the fixing element for retaining the transfer body against said implant or against a pillar carried by said implant, the fixing element, adapted to cross the internal through passage, extends between a distal portion of maneuver, for rotating the fixing element n, and a proximal attachment section to be received in the implant.

During the impression taking, the transfer body is attached and fixed on its respective implant (or on a pillar carried by said implant) with the aid of the fastener. A tray filled with impression paste is then attached to the dental arch of the patient to take an impression. During this printing, the transfer body is embedded in the impression paste and the retention reliefs cooperate with the impression paste to keep the transfer body immovable relative to the impression tray. The fastener protrudes out of the tray which is open (or "open"), and out of the impression paste.

Before removal of the tray in a movement substantially perpendicular to the plane in which the dental arch develops, the practitioner removes the fastener. Thus, during removal of the impression tray, the transfer body remains bound to the imprint paste of the tray by the cooperation of the retention reliefs with the impression paste. After removal, the impression tray is then used for the fabrication of a master model (positive reproducing the patient's jaw) using the transfer body as a reference for orienting and disposing the implant analog in the implant. master model.

In order for a dental implant to be well anchored in the maxillary or mandibular bone of a patient and / or not to conflict with the dental nerve, it is often necessary to insert the implant obliquely to the implant. plane in which the patient's dental arch develops. The orientation of the transfer body is such that the insertion, withdrawal and operation of the fastener of the transfer device WO 2009/035968 A1 can be difficult or impossible.

In addition, there is also the case of an implant located in the posterior part of the jaw of the patient, where the accessibility is reduced by the limited opening of the jaw of the patient. Again, the orientation of the transfer body is such that the insertion, withdrawal and operation of the fastener of the transfer device of WO 2009/035968 A1 can be difficult or impossible.

The problem of limited accessibility due to implantation in the posterior part of the jaw can also be combined with oblique implantation of the implant. And when it is also necessary to identify the positions and orientations of several implants simultaneously (most often oblique to each other), the transfer device WO 2009/035968 A1 may be unusable.

A problem proposed by the present invention is to provide a transfer device intended to cooperate with an open tray for a satisfactory registration of the orientation of an implant in the maxillary or mandibular bone of a patient, and this even if said implant is implanted obliquely relative to the plane of the dental arch of the patient and / or even if said implant is located in the posterior part of the jaw of the patient.

To achieve these objects as well as others, the invention provides a transfer device for cooperating with an open tray for locating the orientation of an implant in the maxillary or mandibular bone of a patient. patient, comprising a transfer body and a fixing element, in which: the transfer body extends between a proximal end, comprising a first bearing surface intended to abut against said implant or against a pillar carried by said implant, and a distal end, - the transfer body comprises, on its outer lateral wall, retention reliefs intended to cooperate with the imprinting impression tray, - the transfer body comprises an internal passage through opening at the proximal and distal ends of the transfer body, - the transfer body comprises a clamping seat for receiving a shoulder of the element d e fixation for retaining the transfer body against said implant or against a pillar carried by said implant, - the fastening element, adapted to pass through the internal through passage, extends between a distal section of maneuver, for driving in rotating the fixation element, and a proximal fixation section intended to be received in the implant; according to the invention: the fixing element comprises, between its distal maneuvering section and its proximal fixing section, a flexible intermediate section allowing the distal maneuvering and proximal fixing sections to be respectively oriented in axial directions forming a angle between them, - the inner through passage is shaped to cooperate with the fastening element by bending the intermediate section when the fastener is introduced into the internal passage through from the distal end to the proximal end .

The flexible nature of the fastener makes it possible to use a transfer body (and an internal through-passage) having a shape extending along a non-rectilinear path. The distal end of the transfer body can then be oriented to provide the dental practitioner with sufficient accessibility to insert, manipulate and remove the fixation element, even if the implant is oblique to the plane of the dental arch. and / or placed in the posterior part of the dental arch. The internal passage through the transfer body, although not rectilinear, can be traversed by the fastening element whose intermediate portion flexes when the fastener is introduced into the internal passage through from the distal end to the end proximal.

Preferably, the clamping seat can receive bearing the distal actuating section to limit the penetration of the fastener in the internal through passage. Thus, if the flexible intermediate section accidentally breaks before removal of the tray out of the patient's jaw, this does not prevent the practitioner to remove the tray of the patient's jaw.

Advantageously, the internal through passage may be shaped so that the fastener element is bent and that its proximal fastening sections and distal maneuvering make between them an angle of between about 15 ° and about 60 °. Such a deflection amplitude makes it possible to use transfer bodies with sufficient deflection to ensure satisfactory accessibility whatever the constraints that led to the particular insertion of the implant.

According to a first possibility, the internal through passage may be curved.

According to a second possibility, the internal through passage may comprise two intersecting rectilinear passage sections and in communication with each other. In this case, the two intersecting rectilinear passage sections can advantageously form between them an angle that can preferably be between about 15 ° and about 60 °.

Advantageously, the proximal fastening section may comprise an external thread intended to be received in an internal thread of an implant or a pillar carried by said implant.

Preferably, the flexible intermediate portion may be a rod made of a titanium alloy, preferably a nickel-titanium alloy. For example, it is possible to use an alloy exhibiting a super-elastic behavior, such as that sold under the commercial reference "NITINOL 508-SE" for example.

Alternatively, the flexible intermediate portion may include a coil spring. A coil spring has indeed a good sag capacity and a very moderate cost.

To increase the torque transmissible by the intermediate section, the flexible intermediate section may comprise a plurality of interlaced coil springs.

Preferably, it can be provided that: the proximal fastening section comprises an external thread intended to be received in an internal thread of an implant or a pillar carried by said implant, the winding direction of the helical spring or helical springs is contrary to the external thread direction of the proximal fastening section.

If the winding direction of the coil spring or coil springs is the same as the direction of the external thread of the proximal fixation section, the application of a rotational torque by the practitioner via the distal section of maneuver tends to lengthen the length of the spring or springs, which impairs a tensioning of the intermediate section allowing a good support in support of the transfer body against the implant or against the pillar. Other objects, features and advantages of the present invention will become apparent from the following description of particular embodiments, with reference to the accompanying drawings, in which: FIG. 1 is a side view in section of the transfer body; a transfer device according to a particular embodiment of the invention; FIG. 2 is a perspective view of the transfer body of FIG. 1; - Figure 3 is a side view and in section of a first fastener variant adapted to cooperate with the transfer body of Figures 1 and 2; FIG. 4 is a perspective view of the fastening element of FIG. 3; - Figure 5 is a side view and in section of a second fastener variant adapted to cooperate with the transfer body of Figures 1 and 2; FIG. 6 is a perspective view of the fastening element of FIG. 5; Figures 7 to 9 are side views illustrating a use of the transfer body of Figures 1 and 2 and the fastener of Figures 5 and 6 for attachment of the transfer body to an implant; - Figure 10 is a side view and in section of Figure 9; - Figure 11 is a side view of a tray using a transfer device according to the invention on an implant disposed in a first orientation; FIG. 12 is a view from above of the impression tray of FIG. 11; - Figure 13 is a front view of a tray using a transfer device according to the invention on an implant disposed in a second orientation; FIG. 14 is a view from above of the impression tray of FIG. 13.

FIGS. 7 to 14 show a particular embodiment of transfer device 1 intended to cooperate with an open impression tray 2 for locating the orientation of an implant 4 in the maxillary or mandibular bone. of a patient. The transfer device 1 comprises a transfer body 5 and a fastening element 6.

FIGS. 1 and 2 show more particularly that the transfer body 5 extends between a proximal end 5a, comprising a first bearing surface S1 intended to bear against said implant 4 or against a pillar carried by said implant. 4, and a distal end 5b.

On its outer side wall 7, the transfer body 5 comprises retention protrusions 8 intended to cooperate with impression paste contained in the impression tray 2. The retention embossments 8 consist of annular ribs or substantially annular (with one or more lateral flats or interruptions). The retention reliefs 8 may be in the form of radial fins or in the form of more or less large portions of disks.

The transfer body 5 comprises a through internal passage 9 opening at the proximal ends 5a and 5b of the transfer body 5.

It will be seen more particularly in FIG. 10 that the transfer body 5 comprises a clamping seat 10 intended to bear a shoulder 110 of the fastening element 6 to hold the transfer body 5 against said implant 4 or against a pillar carried by said implant 4. The fastening element 6 is able to pass through the internal through-passage 9 (FIG. 10), and extends between a distal operating section 11, which makes it possible to rotate the fastening element 6 , and a proximal fixation section 12 intended to be received in the implant 4.

In more detail, the distal maneuvering section 11 has a non-circular outer cross section allowing a user to manually drive the fixing element 6 in rotation. In this case, its non-circular cross-section is provided by an external knurling 13 of the distal section of maneuver 11.

The distal maneuvering section 11 also comprises an internal screw-in recess 14 enabling a practitioner to rotate the fixing element 6 by means of a tool penetrating into the internal screw-in cavity 14. internal screwing 14 has a non-circular cross section, polygonal in this case. The rotational drive of the fastening element 6 by means of its distal operating section 11 allows the proximal fastening section 12 to be received in the implant 4 by screwing by virtue of the external threading carried by the section 15. proximal fixation 12. The external thread 15 is dimensioned so as to be received in the internal thread 16 of the implant 4 (FIG. 10) or of a pillar carried by said implant 4.

Between its proximal fastening section 12 and its distal operating portion 11, the fastening element 6 comprises a flexible intermediate section 17 allowing the proximal attachment 12 and distal maneuvering sections 11 to be oriented along axial directions II and II. II making an angle A between them (Figure 10). In practice, the angle A is between about 15 ° and about 60 °.

FIGS. 1 and 10 show more particularly that the internal through-passage 9 is shaped so as to cooperate with the fastening element 6 by bending the intermediate section 17 when the fastening element 6 is introduced into the internal through-passage 9 from the distal end 5b towards the proximal end 5a, so that by this bending the axial directions II and II-II of the proximal securing and distal maneuvering sections are between them the angle A between about 15 ° and about 60 °.

To cooperate with the fastening element 6 in order to bend it, the internal through passage may be curved.

Alternatively, as illustrated in FIGS. 1 and 10, the internal through-passage 9 comprises two intersecting passage sections T1 and T2 that intersect and communicate with each other. The two sections of passage T1 and T2 make between them an angle B between about 15 ° and about 60 °.

The rectilinear passage section T1 develops in an axial direction III-III while the rectilinear passage section T2 develops in an axial direction IV-IV. The axial directions III-III and IV-IV are intersecting, forming angle B between them.

FIG. 10 shows more particularly that the clamping seat 10 bears the shoulder 110 of the distal operating section 11 in order to limit the penetration of the fastening element 6 into the internal through-passage 9. In this way, if the flexible intermediate section 17 is accidentally broken, the proximal fixation section 12 and the intermediate portion rest 17 attached thereto do not prevent the removal of the transfer body 5 away from the implant 4. The practitioner is then able to remove the proximal fastening section 12 and its remainder of flexible intermediate section 17 by coming for example by gripping with a clamp, or any other suitable tool, the portion of the proximal fastening section 12 protruding out of the internally threaded bore 16 of the implant 4.

Two variants of fixing element 6 are respectively illustrated in FIGS. 2 to 6.

In the first variant, illustrated in FIGS. 3 and 4, the flexible intermediate section 17 comprises three helical springs 18a to 18c.

In the variant illustrated in Figures 5 and 6, the flexible intermediate section 17 is a rod 19 made of titanium alloy, preferably nickel alloy and titanium. Good results have been obtained using a superelastic nickel and titanium alloy marketed under the name NITINOL 508-SE. The use of the transfer device 1 comprising the transfer body 5 of FIGS. 1 and 2 and the fastening element 6 of FIGS. 5 and 6 will now be explained using FIGS. 7 to 14.

In Figure 7, there is an implant 4. This is placed in the maxillary or mandibular bone of a patient (not shown not to unnecessarily complicate the figures). The implant 4 is oriented in an axial direction V-V.

To locate the orientation of the implant 4 relative to the dental arch of the patient using an open tray 2, the practitioner uses the transfer device 1 which comprises a transfer body 5 and In a first step, the practitioner introduces the fixation element 6 into the internal through-passage 9 from the distal end 5b towards the proximal end 5a. During this introduction, the proximal fastening section 12 enters the rectilinear passage section T1 being oriented in the axial direction III-III. The axial directions III-III and II-II are then coincident. As penetration into the internal through-passage 9 of the proximal fastening section 12 occurs, there is a deflection of the intermediate section 17 (rod 19).

At the end of the introduction of the fastening element 6 into the transfer body 5, the fastening element 6 is in abutment along the shoulder 110 of the distal actuating section 11 against the clamping seat 10 while the proximal section The threaded fastener 12 protrudes out of the inner through-passage 9 beyond the proximal end 5a (FIG. 8). In this configuration, the proximal attachment section 12 is oriented along the axial direction IV-IV of the rectilinear passage section T2 (the axial directions II-II and IV-IV coincide on the one hand, while the axial directions II and III -III coincide on the other hand.

The practitioner then brings the proximal end 5a of the transfer body 5 to bear against the first bearing surface S1 against the implant 4 (Figure 9). The practitioner then drives in rotation the distal section of maneuver 11 of the fastening element 6 around the axial direction I-I. This rotation is transmitted by the flexible rod 19 to the proximal fastening section 12 which screws into the internal thread 16 of the implant 4 until it reaches the position shown in FIGS. 9 and 10.

At the end of screwing, the support of the distal maneuvering section 11 along the shoulder 110 against the clamping seat 10 of the distal end 5b makes it possible to tension the intermediate section 17 in order to keep the transfer body 5 pressed against the implant 4.

The practitioner then uses a tray 2 (shown in broken lines in Figures 11 to 14) to identify the orientation of the implant 4 and its insertion into the maxillary or mandibular bone of the patient by overmolding the transfer body 5 in impression paste of tray 2.

The impression tray 2 comprises an open sky 3 through which at least partly exceeds the distal section of maneuver 11.

After a sufficient time to allow proper placement and taking the impression paste around the transfer body 5, the practitioner must remove the tray 2 away from the dental arch of the patient, and therefore to 4. To do this, the practitioner must release the transfer body 5 relative to the implant 4, the transfer body 5 now being engaged in the imprint paste of the tray 2 The practitioner therefore unscrews the fastening element 6 by rotating the distal operating section 11 in the direction causing the proximal fastening section 12 to disengage from the internal thread 16 of the implant 4.

Once the fixing element 6 has been completely withdrawn, the tray may be withdrawn by a traction movement substantially perpendicular to the plane of the patient's dental arch (which is substantially parallel to the plane P1 defined by the impression tray 2). .

In FIGS. 11 and 12, the practitioner uses the transfer device 1 to locate the orientation of the implant 4 (axial direction YV) and its insertion into the maxillary or mandibular bone of the patient, said implant 4 being implanted so as to rather strongly oblique with respect to the plane P1 defined by the tray 2.

Despite this oblique orientation of the implant 4, the distal end 5b of the transfer body 5 is oriented so as to allow sufficient accessibility to the practitioner for the introduction, screwing and withdrawal of the fastening element 6 out of the transfer body 5,

The angular nature of the transfer body 5 makes it possible to orient the axial directions I-I and III-III so that they are substantially perpendicular to the plane P1.

In the use illustrated in Figures 13 and 14, the axial direction V-V which develops the implant 4 is oriented substantially perpendicular to the plane P1. However, in order to provide better accessibility for inserting, screwing and removing the fixing element 6, the practitioner uses the angular transfer body 5 so as to orient the axial directions II and III-III towards the outside of the 2. Such an orientation of the axial directions II and III-III is particularly useful when the implant 4 is disposed in the posterior part of the jaw of the patient, that is to say in the vicinity of the free ends 2a. and 2b of the arch defined by the tray 2.

The present invention is not limited to the embodiments which have been explicitly described, but it includes the various variants and generalizations thereof within the scope of the claims below.

Claims (11)

1 - Transfer device (1) intended to cooperate with an open impression tray (2) (3) for locating the orientation of an implant (4) in the maxillary or mandibular bone of a patient , comprising a transfer body (5) and a fastening element (6), wherein: - the transfer body (5) extends between a proximal end (5a), having a first bearing surface (S1) intended to bear against said implant (4) or against a pillar carried by said implant (4), and a distal end (5b), - the transfer body (5) comprises, on its outer lateral wall (7), retention reliefs (8) for cooperating with the impression impression tray (2), - the transfer body (5) comprises an internal through-passage (9) opening at the proximal ends (5a) and distal (5b) of the transfer body (5), - the transfer body (5) comprises a clamping seat (10) for supporting a shoulder (110) of the fastening element (6) for retaining the transfer body (5) against said implant (4) or against a pillar carried by said implant (4), - the fastening element (6) , able to pass through the internal through passage (9), extends between a distal maneuvering section (11), for rotating the fastening element (6), and a proximal fixing section (12) for to be received in the implant (4), characterized in that: - the fastening element (6) comprises, between its distal maneuvering section (11) and its proximal fastening section (12), a flexible intermediate section (17) allowing the distal maneuvering (11) and proximal securing sections (12) to be oriented in axial directions (II, II-II) at an angle (A) therebetween, - the through-passage (9) is shaped so as to cooperate with the fastening element (6) by bending the intermediate section (17) when ue the fastening element (6) is introduced into the internal through-passage (9) from the distal end (5b) towards the proximal end (5a). 2 - Transfer device (1) according to claim 1, characterized in that the clamping seat (10) receives bearing the distal maneuvering section (11) to limit the penetration of the fastening element (6) in the through internal passage (9). 3 - Transfer device (1) according to one of claims 1 or 2, characterized in that the inner through passage (9) is shaped so that the fastening element (6) is bent and that its proximal sections of attachment (12) and distal maneuver (11) make between them an angle (A) between about 15 ° and about 60 °. 4 - Transfer device (1) according to any one of claims 1 to 3, characterized in that the inner through passage (9) is curved. 5 - Transfer device (1) according to any one of claims 1 to 3, characterized in that the inner through passage (9) comprises two cross sections (T 1, T2) rectilinear intersecting and in communication one with the other. 6 - Transfer device (1) according to claim 5, characterized in that the two cross sections (T1, T2) rectilinear intersecting between them an angle (B) between about 15 ° and about 60 °. 7 - Transfer device (1) according to any one of claims 1 to 6, characterized in that the proximal fastening section (12) comprises an external thread (15) intended to be received in an internal thread (16) d an implant (4) or a pillar carried by said implant (4). 8 - transfer device (1) according to any one of claims 1 to 7, characterized in that the flexible intermediate section (17) is a rod (19) made of titanium alloy, preferably nickel alloy and titanium. 9 - Transfer device (1) according to any one of claims 1 to 8, characterized in that the flexible intermediate portion (17) comprises a coil spring (18a-18c). 10 - transfer device (1) according to claim 9, characterized in that the flexible intermediate section (17) comprises a plurality of coil springs (18a-18c) interwoven. 11 - Transfer device (1) according to one of claims 9 or 10, characterized in that: - the proximal fastening section (12) comprises an external thread (15) intended to be received in an internal thread (16) of an implant (4) or a pillar carried by said implant (4), - the winding direction of the coil spring or helical springs (18a, 18c) is contrary to the direction of the external thread (15) of the section proximal fixation (12).