Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/08—Machine parts specially adapted for dentistry
  • A61C1/082—Positioning or guiding, e.g. of drills
  • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0089—Implanting tools or instruments

Definitions

• the present invention concerns a method of guided implantology and a medical surgical device for dental implant, particularly finalised to the fixture assembling method.
• Implant or fixture - is a metal made screw, generally in titanium or zirconium, placed in the mandibular and /or maxillary bone, as a support of prosthetic fixture, and normally reduced into the bone-integration process in a few months, and enhanced from the bones-to-fixture inner contact, without any soft tissue interposition.
• Healing screw - is a metallic cylinder screwed on the fixture with the purpose to model the gum on one's shape to keep a proper space in absence of soft tissue, while fitting the prosthetic implant.
• Plugging screw - is a metallic cylinder screwed on fixture, according to fixture submerged method.
• Transfer - is a metallic cylinder variously grooved set in the fixture when taking the cast, and subsequently integrated into the cast material in order to allow the precise fixture location in the plaster mould.
• Fixture - is a metallic cylinder integrated in the dental arch plaster mould with the purpose to replicate the same position installed in the patient's mouth.
• the fixture is set before the plaster mould realisation.
• Stump - is a tapered or cylindrical metallic element, screwed on the fixture by means of a proper occlusive screw, coupled with the dental prosthesis; generally the stump axis is not corresponding to fixture and therefore it is necessary to control its position for a correct prosthesis orientation.
• Geometrical coupling - usually is an hexagonal section element, partially realised on the fixture and on the stump, to direct correctly stump to fixture position.
• Occlusive screw - is the screw for fixture elements, it particularly fixes the transfer, stump, etc.
• Radiological dima - is a shaped plate into the patient's mouth, over the gums, replicating its geometry, for a CAT determination, since soft tissues (gums) are transparent to X-rays.
• Individual surgical dima - is a dima produced in laboratory in the model of the patient's mouth, incorporating the bushings designed to drive the fixture drilling in their seats and mounting the said in their seats.
• Prosthesis - is the element that replaces the lack of teeth and mounted on the stumps.
• the dental prosthesis process provides the fixture fitting in the mandible bone site, as a mechanical backing to ensure the implant firmness, and later, if properly placed, will guarantee the prosthesis rehabilitation.
• the actual installation techniques are of several methods and herewith described, being some contemporary but not extensive methods. They are exemplified to show the actually faced problems.
• the main fixture placement typology are included in two orders:
• the first method leads back to a traditional and pioneering surgical system, by using simple intraoral X-ray images and the direct implanted area operating appraisal, under volume and intensity indications.
• Method quality lays on manual ability, dentistry acknowledge and operator competence.
• the system requires many sessions, through several months intervals, thus ensuring both fixture bone-integration and prosthesis realisation.
• the method is affected by the critical and uneasy accuracy of fixture inclination, according to chewing strain, and strengths may occur with orthogonal implant components, producing stability problems.
• the guided procedure provides the determination of the correct position, drilling inclination and depth, working in the laboratory on a model of bone of the patient's mouth, to insert the fixture in the holes model, to place in the holes the bushings which will be inserted in an individual surgical dima, realised on the patient's mouth model.
• the individual surgical dima transferred in the patient's mouth, will guide the drilling in the fixture seats in the correct position, inclination and depth, using the incorporated bushing to drive the mill.
• the fixtures will be inserted according with this method in the correct position, inclination and depth. Said fixtures inclination are suitable to optimise the implant mechanical strength, generally different between them, for an appropriate prosthesis mounting.
• the dental print particularly of the fixture geometrical couplings, being said print used for stumps realisation where the prosthesis will be implanted.
• the stumps are therefore designed to be mounted on the fixture using the geometrical coupling, their axis oriented in the correct way for the next geometrical coupling orientation, that is the fixture rotation on its own axis.
• Purpose of the invention is to overcome said disadvantages offering a method and a device, to realise said method, respectively corresponding to claims 1 and 3.
• the device according to the invention comprises an equipment able to insert the fixture by drilling the bone in its seat, simultaneously controlling the insertion depth and orientation of fixture.
• Said device comprises an individual surgical dima suitable to be fixed in the patient's mouth replicating the same position that said individual surgical dima had in the patient's mouth, said individual surgical dima incorporating one or more bushings designed to drive a mill to drill one or more seats for said fixtures and one or more mounters suitable to insert said one or more fixtures in their seats, mounting of said one or more fixtures taking place by screwing in their seats using said one or more bushings incorporated in the said individual surgical dima to guide said one or more mounters, and is characterized by the fact that said one or more mounters are externally threaded and engage corresponding threads created inside said one or more bushings, means being provided suitable to simultaneously control insertion depth and orientation of said one or more fixtures.
• fixture and stump are a monophasic system, fixture and stump are therefore two different objects whose mutual position is determinated by the geometrical coupling.
• fixture and stump are realised in one part only (monophasic system).
• the invented device allow to insert the fixture be screwing it in its seat, simultaneously obtaining the stump mounting in the correct position for the next prosthesis insertion.
• the invention main advantage is characterized by the work reduction on patient's mouth, being the operation transferred largely in the laboratory, from the patient's mouth. Once that all elements are prepared, it is only requested one session to implant six or eight fixtures of a total dental arch (mandible or maxillary bone) for the next prosthesis fixing.
• a further advantage consists in the fact that all operations to perform directly in the mouth are precisely driven by the device according to invention, so to eliminate virtually any possibility of error incurring.
• FIG. 14 to 16 indicate device according to the invention in the several insertion phases of a monophasic fixture; figure 17 is a general drawing of the invention;
• figure 18 shows an alternative device for fixture mounting
• a threaded mounter provided with a cylindrical body la, externally threaded, to be screwed in a bushing 29, internally threaded.
• the threaded mounter 1 ends with a flange lb and an hexagonal head lc. Internally to the threaded mounter 1 is drawn a cylindrical cavity Id, carrying an hexagonal section in the lower site le.
• Reference 3 shows a fixture with a better known external diphasic coupling, made of a threaded cylindrical body ending with an upper hexagonal head 3 a, suitable to be inserted in lower side le of mounter 1 cavity Id. Internally to the hexagonal head 3a of fixture 3 a threaded hole is suitable to engage the fixture 3 to the threaded mounter 1 by means of a proper screw 4.
• Said hexagonal head 3a of fixture 3 and the hexagonal section cavity le are forming a geometrical coupling to determine precisely the fixture position 3 with the threaded mounter 1.
• figure 2 are shown the mandibular bone 6, the gum 7 and the threaded bushing inserted in an individual surgical dima 5, previously realised in laboratory on a model of patient's mouth. Said individual surgical dima 5, transferred in the patient's mouth will be used to mill their seats 9 of fixture 3 for the following fixture 3 mounting in their own seats.
• FIGS 3 a and 3 b is shown the bone 6 drilling, to realise one of said seats 9 of fixture 3 (more evident in the following figures), realised by a well known type of mill 10 or 11.
• the mill 10, 11 carries a smooth cylindrical body 10a, or threaded 11a that is precisely inserted in the threaded driving bushing 2.
• the drilling depth is determined by a flange 10b, 1 lb of the mill 10, 11 served against the bushing 2.
• the bushing 2 both allows the passage of the smooth cylindrical body 10a of the mill 10 and the use of a mill 11 with threaded drive body 1 la to be screwed in the bushing 2.
• the threaded mounter 1 where the fixture 3 is mounted, is screwed in the bushing 2.
• the threaded mounter 1 is screwed in the seat 9 drawn the bone 6, said fixture 3 being fixed to the mounter 1 with the screw 4.
• the threaded mounter 1 is screwed in the bushing 2 until its flange lb reaches the bushing 2.
• the fixture 3 When the flange lb of mounter 1 is in contact with the threaded bushing 2 (figure 5), the fixture 3, compared with the individual surgical dima and the patient's mouth, has the same position, inclination, depth and orientation of the laboratory model. The result is therefore to determine the fixture 3 depth, its inclination and orientation of geometrical coupling, determined by the hexagonal head 3 a of the fixture 3.
• the operation follows by separating the mounter 1 from fixture 3 (figure 6), by unscrewing the occlusive screw 4 and the following mounter 1 removal (figure 7) and of individual surgical dima 5 (figure 8).
• the fixture 3 is the mounted the stump 12 (figures 9 and 10), fixed with the same screw 4.
• a cylindrical cavity 12a having an hexagonal section at lower side 12b, suitable to be coupled the hexagonal head 3a of fixture 3, to determinate precisely the position on the stump 12 referred to the fixture 3.
• the geometrical coupling of the fixture 3 with the stump 2 is the same both in the model and in the patient's mouth since the threaded bushing 2, is the same and the threaded mounter 1 is identical to its laboratory replication.
• the invention referred to a fixture with diphasic coupling, or with hexagonal head 3a of fixture 3 stretching out from the same fixture.
• the invention referred to a fixture mounting with internal diphasic coupling, or with hexagonal coupling 21a of the fixture 21 stretching inside the same fixture 21.
• the mounter 22 joins the fixture in internal diphasic coupling 21 by means of a lower hexagonal element 22e, and said mounter 22 has like the mounter 1 , a threaded body 22a, a flange 22b, an hexagonal head 22c and a cylindrical cavity 22d.
• the mounter 22 is fixed on the fixture 2 by means of an occlusive screw 4.
• the figure 12 shows the fixture with internal diphasic coupling 219, mounted in the mandibular bone 6 and coupled with the respective stump 22, while in the following figure 13 is shown the prosthesis 13 mounted on the stump 23.
• the figure 14 shows a monophasic fixture 24, where fixture and stump are made in one piece only. Also in this case is applied the same mounting method, and the difference stands to determination of stump-fixture 24 orientation, instead of the geometrical fixture-stump coupling.
• the threaded mounter 25 is shaped to be coupled with the part of stump of monophasic fixture 24 and inserted in the same monophasic fixture by means of a occlusive screw 4.
• the figure 15 shows the monophasic fixture 24, mounted in the mandibular bone 6, where (figure 16) it is mounted the prosthesis 13.
• the figure 17 shows the surgical dima 5 positioned in the gum 7. Internally to said surgical dima are drowned two threaded bushings 2. The figure shows the mounting of a couple of fixtures 3 in the bone 6 where have been preventively realised proper seats 9. In the group composed by the threaded mounter 1 and the fixture 3, closed by the screw 4, is inserted by screwing a threaded bushing 2, up to complete insertion of fixture 3. The threaded mounter 1 is lately released removing the screw 4 and remains in the threaded bushing 2. By removing the individual surgical dima 5 are recovered the threaded mounters 1.
• the orientation control of diphasic fixture 3, 21 or of the monophasic fixture 24 is performed shaping the mounter flange and the top edge of said bushing.
• the top flange 26a of mounter 26 is equipped with a tooth 26b that, following the threaded bushings screwing 27 is abutting against a corresponding tooth 27a on the top edge of said bushing 27.
• the figure 18a shows the mounter 26, coupled with the respective fixture, about being screwed in the bushing 27, inserted in the surgical dima 5 (not shown in the figure 18).
• the mounter is almost completely screwed in the bushing 27; as clearly shown in the magnified detail, a threading is missing to complete the screwing operation.
• mandible or maxillary bone including hard tissue (bone) and soft tissue (gum), isolating sites like mandible nerve sites, etc.;
• the invention requests to follow the installation phases, herewith enclosed, (for a simple reference, in this description will be indicated only the relation of fixture with external diphasic coupling), as shown in figures from 1 to 10, furthermore it is indifferently referred to mandibular bone 6 and to said bone model, which is always identified with number 6, since the geometry is identical;
• the fixture mounting 3 Since the threaded bushings 2 are incorporated in the individual surgical dima 5 in the same position and orientation had in the laboratory model, the fixture mounting 3 according to the described method, will position the fixture 3 exactly as the laboratory model, including the orientation. The next stump mounting 12 on the fixture 3, using the geometrical coupling, will allow the correct inclination of all axis of stumps 12 for the following prosthesis mounting 13.
• the components are medical stainless steel made or other material suitable both for the monophasic and diphasic system. Their realisation are achieved by lathe and threading machines on cylindrical components. The performance needs a high working accuracy to ensure that coupling between the threaded bushing (female thread) and the threaded mounter is of suitable precision with high sameness of component dimensions, to ensure the correct fixture mounting.

Landscapes

• Health & Medical Sciences (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Epidemiology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
• Dental Prosthetics (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=46833138

Family Applications (1)

Country Status (2)

Cited By (2)

Citations (2)

• 2012
  • 2012-05-18 IT IT000089A patent/ITTV20120089A1/it unknown
• 2013
  • 2013-05-08 IT ITTV20130070 patent/ITTV20130070A1/it unknown
  • 2013-05-16 WO PCT/EP2013/001457 patent/WO2013170962A1/fr not_active Ceased

Patent Citations (2)

Also Published As

Similar Documents

Legal Events