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EP2429442A1 - Système de positionnement guidé pour implants dentaires - Google Patents

Système de positionnement guidé pour implants dentaires

Info

Publication number
EP2429442A1
EP2429442A1 EP09787717A EP09787717A EP2429442A1 EP 2429442 A1 EP2429442 A1 EP 2429442A1 EP 09787717 A EP09787717 A EP 09787717A EP 09787717 A EP09787717 A EP 09787717A EP 2429442 A1 EP2429442 A1 EP 2429442A1
Authority
EP
European Patent Office
Prior art keywords
implant
positioning system
depth
screwing
dental implant
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP09787717A
Other languages
German (de)
English (en)
Inventor
Gian Luigi Telara
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP2429442A1 publication Critical patent/EP2429442A1/fr
Withdrawn legal-status Critical Current

Links

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

  • implants structures having a cylindrical or conical shape (if the end, called dental apex, is smaller than the so called implant abutment, i.e. the portion of the implant protruding towards the osseus crest) provided with thread, so that they can be screwed into the bone, suitably prepared by means of the preparation of a suitable seat called osteotomic seat.
  • said implants are made of titanium or alloys of said material.
  • the bone must be preliminarily prepared in a guided manner by means of milling cutters, guided by a surgical guide suitably designed, provided with guide holes named guide cylindres or sleeves; in this way is prepared the seat into the bone (osteotomic seat) wherein the implant will be positioned.
  • the implants are provided with a thread through which they are engaged in a seat prepared into the bone, it is easy to understand that in order to make a point of the circumference of the implant correspond with a reference position on the osseus crest it can be necessary to engage the implant until it is slightly above the crest or slightly under the crest: thus the point of arrival is not predictable without losing the depth value. This happens because the initial point of engagement of the implant into the bone can not be guaranteed: if it could, then it would also be predictable the point of arrival.
  • the abutment is never realised perfectly conical: the spaces to be left free at disposition of the future bridge must have values that are as precise as possible in order to house metal and ceramic, spaces that, if not precise, bring to deformations during welding with subsequent inaccuracies in the final product.
  • An incorrect insertion of the implant with reference to any of these parameters implies a variation of the position and orientation of the abutment, with consequences of inaccuracy further worse due to the directionality of the abutment.
  • Surgical guides can be realised to have an osseus support (to be applied in direct contact with the bone in the intervention area, previously deprived of the above gingiva through the opening of a strip), or to have a dental or mucous support (in the last case with some lack of precision due to the resilience of the gingiva acting as a support).
  • the technique currently in use provides for the use of screws or pins for fixing the guide to the bone in order to offer a stable working base.
  • Not least purpose of the invention is to realise a dental implants positioning system being substantially simple, safe and reliable.
  • a guided dental implant positioning system of the kind making use of a surgical guide provided with one or more holes or guides in correspondence of the implants insertion points and for controlling the orientation of insertion of the implants, comprising means for simultaneously controlling the position of insertion, the final depth of insertion, the insertion axis direction and the rotation angle around said axis of each implant by setting up the rotation angle around its own axis of each implant at the beginning of its insertion into the osteotomic seat.
  • said means for setting up the rotation angle around its own axis of the implant at the beginning of its insertion into the osteotomic seat comprise a threaded portion made integral with the surgical guide and a correspondent threaded portion made integral to the implant, said threaded portions being screwed according to a set number of screwing positions, the final screwing position being defined by a counterboring, the pitch of said threaded portions being identical to the pitch of the implant.
  • said threaded portion made integral with the surgical guide can be realised on a cylindrical element made integral to or movably engaged without the possibility of rotating to the surgical guide around a sleeve and said corresponding threaded portion made integral to the implant can be realised on the internal lateral surface of a hollow cylindrical element, provided with an axial portion the extremity of which is movably engaged without possibility of rotating to a mounter in its turn movably engaged without possibility of rotating to the implant, said hollow cylindrical element being engaged without possibility of rotating to screwing guiding means, chosen amongst screwing manual guiding means, such as a manual ratchet, and screwing motor guiding means, such as a surgical micromotor.
  • said guided dental implant positioning system can comprise means for simultaneously controlling the position, depth and axis direction of realisation of osteotomic seats.
  • said means for simultaneously controlling the depth and axis direction of realisation of osteotomic seats can comprise one extension provided with depth reference notches or an extension for each desired depth, each extension comprising a portion thin enough to be inserted into the sleeve of the guide and a portion large enough to constitute a b criz on the surface of the guide.
  • said guided dental implant positioning system can comprise further means for controlling the position and rotation angle around its own axis, simultaneously with controlling the depth and axis direction of realisation of osteotomic seats con tapping.
  • FIG. 1 shows a surgical guide for implantology
  • - figure 2 shows a perspective view of a first embodiment of the guided dental implant positioning system according to the present invention
  • - figure 3 shows a sectional view of the guided dental implant positioning system of figure 2, in use
  • - figure 4 shows a sectional view of a second embodiment of the guided dental implant positioning system according to the present invention
  • - figure 5 shows a perspective view of the guided dental implant positioning system of figure 4
  • FIG. 6 shows a sectional view of an extension for osteotomy and a milling cutter for osteotomy according to the present invention.
  • the basis of the guided dental implant positioning system of the present invention is constituted by having modified guide systems at present on the market in order to make them suitable for use not only for preparing the osteotomic seat, but also for positioning the implant.
  • the guided dental implant positioning system of the present invention could be used together with any available software programme for producing a guide with a cylinder for the preparation of of the osteotomic seat, with modification always falling within the scope of the present invention.
  • figure 1 shows a surgical guide 10, provided with sleeves 11 for the orientation of milling cutters for the preparation of the osteotomic seat where implants will be positioned, and also for the orientation of implants insertion.
  • the guide 10 can be used with suitable modifications to guarantee at the same time the respect of all the parameters of correct insertion of an implant, i.e. position, insertion depth, insertion axis and rotation angle of each implant with respect to its own axis.
  • Grooves 15 can also be realised as slots through the thickness of the wall of the sleeve 13, to allow the protrusions 14 of the countersleeve 12 to be in contact with the material of the structure of the guide 10, thus decreasing stress on the sleeve 13 and consequently lowering the possibility of its disengagement, result that can also be obtained through alternative systems, for example providing the sleeve 13 with tongues clasping like hooks or a simple post to the structure of the guide 10.
  • the engagement between the protrusions 14 of the countersleeve 12 and the grooves 15 of the sleeve 13 acts as an antirotational system and must be able to avoid the unthreading of the countersleeve during the insertion of the implant, and at the same time also allow disengagement once the implant is inserted. This result can be obtained for example by means of a bayonet coupling or similar.
  • grooves 15 does not interest all the length of the sleeve 13, thus forming a stop to the movement of the countersleeve 12, that must have a set final position.
  • the internal surface of the countersleeve 12 is threaded to allow screwing engagement with a mounter 30 (shown with reference to figure 3), also threaded, and the pitch of the thread of the mounter 30 must correspond to that of the implant 31 , in order not to cause vertical stripping, due to a smaller or bigger shelving of the implant into the bone 32. It is not necessary that the shape of the thread is exactly the same, but the pitch must be. Moreover, the thread must be such to allow starting the screwing in a set position. This result can be obtained for example extending the thread beyond the base facing the oral cavity of the countersleeve 12, as if it was a toungue 33. Similarly, it is possible to realise a thread extending as a toungue on the mounter 30.
  • the threaded mounter 30 has a set length, and its point of arrival is determined by the vertical stop consequent to the filling of the thread in its last turn.
  • the insertion depth of the implant can therefore be managed by realising different countersleeves 12 having different length.
  • the height of the countersleeve 12 must be such to overcome the height of the sleeve, so to allow not only for controlling the depth of the implant, but also in order to ease the removal after insertion of the implant. Such feature can be important for implants with a double or triple thread.
  • the implant 31 diametre must be smaller than that of the mounter 30, since the implant 31 must be free to move within the sleeves without contacting the walls of the countersleeves 12. Differently, the implant 31 and mounter 30 should have a continuous thread, and the scraping of the implant 31 against the walls of the countersleeve 12 could damage the thread. In pratice, couples of countersleeves and mounters with different diameters must be realised, each for guiding implants having a smaller diametre. Only one big sleeve diametre would be theoretically possible, but the possible number of implants that can be inserted in a portion of bone would be limited.
  • Such embodiment of the present invention can be realised by a dental laboratory, or, through CAD-CAM methods with the aid of a design software programme, starting from the setting up of the position of the implant in its final position and calculating as a consequence, by reverse engineering the unscrewing of the implant along the insertion axis with respect to the pitch of the thread, the initial engagement position of the thread of the mounter with the thread of the countersleeve.
  • the countersleeve could also be realised as an extension of the sleeve, to be inserted into the surgical guide with a pin kind mechanism or other or be made integral to the guide, provided that the consequent increase of the working length necessary to the system is compatible with the possibility of opening the mouth of the patient.
  • the mounter is sort of an extension of the implant, with which a driver of common use can be engaged, if necessary suitably modified to obtain a correct threading, or the same components generally contained in surgical kit can be used and in particular manual drivers with their ratchet, or surgical spindles, not needing any modification.
  • the driver can be easily engaged with the mounter and equally easily removed (as already happens in common implant surgical kits). However it is essential that the engagement of the driver with the mounter happens according to a preset position.
  • the driver can be modified by applying a sleeve to it, engaged by means of a vertical groove acting as an antirotational mechanism and an horizontal groove, to avoid the vertical shift of the sleeve in resin with respect to the driver.
  • This embodiment of the positioning system of the present invention allows for a very simple disassembly of the system, being sufficient to remove the countersleeve 12 in vertical direction.
  • the countersleeve 12 being higher than the sleeve 13 ease the taking of the countersleeve and therefore its removal. During its removal, the countersleeve 12 also trails the mounter still engaged with it.
  • the guided dental implant positioning system of the present invention can be realised also through a hollow cylindrical element, having the sape of a threaded cap, called driver-cap 40, its thread having a pitch exactly corresponding to that of the thread of the implant 46, to which it is linked by means of a mounter 44 of the prior art, on which it operates by means of an axial portion 51 the extremity of which is shaped so to engage through a shaped mortise joint with the mounter 44.
  • the driver-cap 40 is screwed around a cylindrical element 41 with external thread, similar to a bottle neck, made integral with the surgical guide 42, in correspondence of the sleeve 43.
  • the insertion of the implant 46 respecting the insertion position, axis and depth, and the final rotational angle around its own axis is guaranteed by screwing the driver-cap 40 around the cylindrical threaded element 41 ; as a consequence, the dimensions of each sleeve 43 and corresponding mounters 44 does not have any importance and sleeves 43 and mounters 44 identical to those of the prior art can also be used.
  • the function of the sleeves 43 is still essential only for the guided passage of osteotomic milling cutters.
  • the bottle neck of the cylindrical element 41 can be realised to be movably engaged to the surgical guide 42, for example by means of pins 45 engaging with a corresponding seat realised on the guide, or can be made integral with the guide 42. in case of movable engagement, in order to avoid the unthreading of the cylindrical element during the insertion of the implant removable fixing must be present.
  • Implant systems providing for a preliminary tapping of the bone 47 subsequent to the passage of the osteotomic milling cutters and before the insertion of the implant 46, a driver-cap must be provided also for the milling cutter tapper.
  • the pitch of the thread of the driver-cap 40 must correspond to that of the implant 46, in order not to create vertical strippings during the insertion.
  • the form of the thread is exactly the same, but the pitch must be.
  • a corresponding step 49 can be realised on the cylindrical element 41 , so to make the screwing corsa of the driver-cap 40 always end at the same point.
  • suitable reducer can be realised, for example caps open on top, screwing around the cylindrical element 41 until they come into contact with the plane of the guide 42 and their portion towards the oral cavity being shaped so to stop the descent of the driver-cap 40 at a desired height.
  • cylindrical element 41 is not integral with the surgical guide 42, but simply movably engaged to the surgical guide 42, for example through pins 45 or through a system using tongues or equivalent means, housed in a corresponding seat of the guide 42, it is sufficient to lift the system comprising the driver-cap 40 and the cylindrical element 41 screwed with it, and they will respectively unthread from the mounter 44 and guide 42. Subsequently it will possible remove the mounter 44 from the implant 46, as in prior art.
  • the driver-cap 40 can be designed so that the threaded portion of the cap 40 and the axial portion 51 guiding the mounter 44 during the insertion of the implant 46 are respectively movably engaged, for example through a precision mortise joint system, such as in particular splines that can be easily disengaged, so that disengagement of the axial portion 51 and mounter 44 and therefore of the latter and the implant 46, can be obtained independently from the lifting of the surgical guide 42 (and the cylindrical elements 41 and threaded portions of the driver-caps together with it) from its support (bone, tooth or gingiva).
  • a precision mortise joint system such as in particular splines that can be easily disengaged
  • the dimensions of the cylindrical element 41 in particular its diametre, can be only one, thus adapting to different diametres of implants 46 and sleeves 43, the sole limit being the distance between two adjacent cylindrical elements 41 on the same surgical guide 42, which must be sufficient to allow for screwing the corresponding driver-caps.
  • An alternative to the cap system provides for realising an internally threaded cap, screwed with a correspondent thread realised on a countersleeve of a sleeve- countersleeve system similar to that of the first embodiment of the present invention.
  • the countersleeve according to this further embodiment is not threaded internally but externally on its portion coming out of the sleeve, acting as a guide for the cap.
  • a limit of application of this alternative is nevertheless posed by the possibility of mouth opening, or by the more or less rear position of the implant into the oral cavity.
  • the guided dental implant positioning system according to the present invention implies with respect to the preparation of the osteotomic osseus seat, or how instruments for the preparation of the osteotomic osseus seat can be conveniently modified to become more functional.
  • the figure shows how, in order to control the maximum insertion depth of the milling cutter 60, it is possible to make use of an extension or extender 61 similar to those of the prior art, but provided with notches identifying the different depths. As shown according to the figure, a part of the extension 61 surrounds the upper portion of the milling cutter 60.
  • the extension 61 is divided into two portions having different diametres, a first smaller portion 62 that can be inserted into the sleeve 64 of the guide 65 and a second bigger part 63 forming a stop to the insertion depth when coming in contact with the surface of the sleeve 65.
  • This extension 61 can be used with all the osteotomic milling cutters of standard osteotomic kits.
  • the implant system provides for implants having different length and diameter, for which a series of differently sized milling cutters must be used, with one extension 61 for each implant length it is possible to satisfy every needs mounting each extension 61 with all the milling cutters 60 in sequence from the smaller to the bigger diameter until using the right diameter for the specific implant.
  • the total length of the instruments could be a limiting feature in case it is necessary to realise deep osteotomic seats (longer milling cutters must be used in this case) in the rear part of the oral cavity.
  • a mucosal punch or a hollow cylindrical bistoury with cutting edge mounted on the extension 61.
  • the length of the spindle supporting the mucosal punch must be such as it protrudes from the extension 61 of a length (3 mm) sufficient to cut the gingiva 66, without damaging the plane of the bone 67 below. In such a way it is possible to round cut the gingiva, which is subsequently removed by a manual bistoury, in a guided manner.
  • a kit comprising modified milling cutters, that can be mounted directly on the surgical micromotor, so that a portion of the same milling cutters forms an enlargement that can engage with the sleeve 64 of the guide 65 and a further portion forms a counterboring surface against the surface towards the oral cavity of the guide 65.
  • a kit comprising modified milling cutters, that can be mounted directly on the surgical micromotor, so that a portion of the same milling cutters forms an enlargement that can engage with the sleeve 64 of the guide 65 and a further portion forms a counterboring surface against the surface towards the oral cavity of the guide 65.
  • For every diameter as many milling cutters will be necessary as the possible implant length.
  • the sleeve is larger then the osteotomic seat, it is necessary to use all the shorter milling cutter before that having the final length, in order to guarantee the control over the insertion axis during the realisation of the osteotomic seat.
  • the starting hole made by the shorter milling cutter will act as a
  • the guided dental implant positioning system allows for reducing to a minimum the expenses for achieving a guided implantology with passive systems, not bound neither to a specific implant system nor to a specific modelling software programme and not involving important technical difficulties to be realised, such as, for example, the need to buy a specific software programme and a specific mounting kit for every different kind of implant at present on trade (with different mounters depending on the kind of implant).
  • mapping the bone which is an outpatient technique, it is possible to obtain a plaster model where the part interested by the implants insertion seats shows the available osseus volume and consequently the method can also be managed by a dentist's surgery and an associated laboratory.
  • the guided dental implant positioning system of the present invention allows for mechanically controlling the position of the implant and consequently that of its mortise joint system as far as all the parameters (depth, insertion axis and position of the shaped mortise joint) is concerned.
  • the guided dental implant positioning system of the present invention has the advantage of allowing for the management of the guide and the prebuilt prosthesys by means of both possibilities at present most common: that providing for the realisation in a laboratory of the implant and the prosthesys and that providing for the use of software using CAD-CAM techniques.
  • the sleeve corresponds as much as possible to the diameter of the implant (and to that of the mounter substantially identical), as needed according to the prior art, because the guided insertion system is transferred to the threaded engagement between the mounter and the countersleeve, or between the driver-cap and the cylindrical element, both guided from the starting of the engagement (set) until the precise end of insertion.
  • the sleeve can have a medium diameter, suitable for small and medium implants, but also a bigger sleeve can be provided, useful during the milling cutting of the bone.
  • fixing screws since it is needed only one guide, it is also possible to design a series of three screws (called fixing screws) making the guide integral to the bone (regardless the support of the guide), in such a way avoiding any error due to possibly different positioning of the guides in sequence according to the prior art.

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  • 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 Prosthetics (AREA)

Abstract

La présente invention concerne un système de positionnement guidé pour implants dentaires du type faisant appel à un guide chirurgical (10), équipé d'un ou de plusieurs orifices ou manchons (11) en correspondance avec les points d'introduction des implants, ledit système permettant de contrôler l'orientation d'introduction des implants et comprenant un moyen permettant de contrôler simultanément la position, la profondeur finale d'introduction, la direction de l'axe d'introduction et l'angle de rotation autour dudit axe de chaque implant, grâce à l'ajustement de l'angle de rotation de chaque implant autour de son axe au début de son introduction dans son logement ostéotomique. L'invention concerne également un moyen permettant de contrôler simultanément la profondeur et la direction de l'axe de forage de logements ostéotomiques pour implants dentaires.
EP09787717A 2009-04-29 2009-04-29 Système de positionnement guidé pour implants dentaires Withdrawn EP2429442A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IT2009/000192 WO2010125593A1 (fr) 2009-04-29 2009-04-29 Système de positionnement guidé pour implants dentaires

Publications (1)

Publication Number Publication Date
EP2429442A1 true EP2429442A1 (fr) 2012-03-21

Family

ID=41507788

Family Applications (1)

Application Number Title Priority Date Filing Date
EP09787717A Withdrawn EP2429442A1 (fr) 2009-04-29 2009-04-29 Système de positionnement guidé pour implants dentaires

Country Status (2)

Country Link
EP (1) EP2429442A1 (fr)
WO (1) WO2010125593A1 (fr)

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9687322B2 (en) 2012-09-28 2017-06-27 Robert P. Carmichael Dental implant positioning system
IT201800006998A1 (it) * 2018-07-06 2020-01-06 Dima chirurgica per impianti zigomatici
EP3845198A1 (fr) 2019-12-30 2021-07-07 Dentsply Implants NV Outil de serrage d'implant avec contrôle simultané de la profondeur et de la position en rotation de l'implant selon une planification numérique
IL294405A (en) * 2020-03-31 2022-08-01 ?Stanbul ?N?Vers?Tes? Rekt?Rl??? Capped, guided dental implant shield
ES2992636R1 (es) * 2022-02-01 2025-01-02 Tech Xika Ptt S L Metodo de fabricacion de una ferula o guia quirurgica para la implantacion de al menos un implante dental

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4664274B2 (ja) * 2003-02-28 2011-04-06 マテリアライズ・デンタル・ナムローゼ・フエンノートシャップ 歯科上部構造を配置および製造するための方法、インプラントを配置するための方法、およびこれが用いる付属物
ITBO20050545A1 (it) * 2005-09-06 2007-03-07 Federico Franchini Serie di strumenti chirurgici per implantologia dentale
EP1915970A1 (fr) * 2006-07-20 2008-04-30 René De Clerck Gabarit pour positionner des implants dentaires
US8105081B2 (en) * 2007-05-25 2012-01-31 Bavar Trevor Surgical drill guide and index system
PT103821B (pt) * 2007-09-11 2009-08-28 Miguel Alcoforado Calhau Dispositivo de precisão para a colocação de implantes dentários

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2010125593A1 *

Also Published As

Publication number Publication date
WO2010125593A1 (fr) 2010-11-04

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