WO2006136637A2

WO2006136637A2 - Dental implant comprising a rotatably-inserted crown

Info

Publication number: WO2006136637A2
Application number: PCT/ES2006/000370
Authority: WO
Inventors: Eloy Antonio Martinez Albal
Original assignee: Eloy Antonio Martinez Albal
Priority date: 2005-06-24
Filing date: 2006-06-22
Publication date: 2006-12-28
Also published as: WO2006136637A3

Abstract

The invention relates to a dental implant comprising a rotatably-inserted crown. More specifically, the invention consists of an implant body which is made from of biodegradable and osteointegrable material and which consists of: an anchoring structure (2) which is solidly connected to a prosthetic support structure (4), and a rotatably-inserted crown (3) comprising an external surface that is equipped with a screw thread (7) which is used to insert the implant body in the bone (28) by screwing the crown into a hole (56) in the bone. The crown is connected to the anchoring structure, preferably at the base thereof, such that it can rotate in relation to said anchoring structure, thereby solidly connecting the prosthetic support structure to the upper end of the anchoring structure. Optionally, the surface of the anchoring structure (2) is equipped with a bone regeneration structure (54) which is made from a biocompatible material that can be shaped individually by means of computerised cutting.

Description

DESCRIPTION

Rotary crown dental implant.

The present invention relates to a rotary crown dental implant, for placement in the patient's maxillary bone, which supports a prosthetic element.

In the replacement of dental pieces by means of dental implants, rigid structures made of an osteointegrable biocompatible material, such as titanium, are used to be inserted in a drilling hole made in the patient's maxillary bone, serving said biocompatible structures, of support for a prosthetic element such as a dental crown.

There are currently two types of dental implants depending on the way in which they are inserted in the drill hole made in the bone; the impact type are inserted when subjected to repeated impacts by means of a surgical club. This method is very traumatic and annoying for the patient, and it is not possible to precisely control the exact depth of implant insertion. In addition, this is a method that can be dangerous in certain cases for the integrity of adjacent tissues. On the other hand, if necessary, it is especially difficult to remove the implant once inserted, which makes any subsequent correction difficult. For these reasons, impactful dental implants have fallen into disuse.

The other type of dental implants are those of the self-tapping type, being this type the one commonly used in dentistry. These implants have a thread fillet on their surface to allow their insertion by means of the relative rotation of the implant with respect to the drill hole made in the bone. One of the disadvantages of these implants is that it is not possible to achieve a specific orientation of the same in their position of maximum insertion, or to achieve a precise depth of insertion in an exact orientation, which would simplify the elaboration of the dental prosthesis. Therefore, it is necessary, in order to achieve a precise orientation, loosen them slightly, with respect to their position of maximum insertion, until obtaining said orientation, or tighten them in excess. Either of these two alternatives is not desirable for the success of the surgical technique. Loosening reduces primary stability to the implant, and It decreases the quality of its integration in the bone. On the other hand, excessive tightening of the implant can cause bone necrosis and the consequent treatment failure. Another drawback of self-tapping type implants is that they cannot incorporate angled prosthetic abutments integrated in one piece with the implant body, which would significantly simplify the treatment and reduce the cost of the implant. This impediment is due to the fact that, in the implant insertion procedure, an angled abutment will collide, when rotating with the implant, with the adjacent teeth, the insertion of the dental implant being not possible. The main purpose of the present invention patent is to provide an implantable rotary crown dental implant, without threading of the main body thereof, in a comfortable and safe way, with which a precise depth of insertion is obtained, with a specific orientation, ensuring optimal primary stability thereof without excessive tightening of the adjacent bone. According to the present invention patent, this objective is achieved by providing a rotary crown dental implant comprising an implant body for placement in an intraosseous arrangement made of a biocompatible material that allows its integration into bone tissue, such as titanium. . Said implant body is formed by at least one anchoring structure, integral with a prosthetic support structure, and at least one insertion crown by rotation with an external surface provided with a thread fillet, which causes the structure to be inserted. of anchorage in the bone because of the screwing of the mentioned crown in a drill made in the bone. The insertion crown is a unit connected to the anchor structure so that it has freedom of rotation with respect to it, but not axial displacement, the prosthetic support structure being arranged at the upper end of the anchor structure, and in solidarity with it, the insertion crown being preferably located at the foot end of said anchoring structure. The anchoring structure has an axial tubular opening open at least at its upper end, being extended at said upper end by a second through tubular opening formed in the prosthetic support structure. In order to allow the screw-in of the insertion crown into the bone, it is related to a screw head, located in axial position with respect to said tubular opening, such that the rotation of said screw head causes the rotation of the insertion crown with respect to the anchor structure. According to another development of the present invention, the aforementioned screw head is shaped so as to fit on it in a guided manner and with at least a predetermined orientation around its axis the screw end of a screw extension rod, said insert being insertable. rod in the tubular opening of the anchor structure. Said rod has the capacity to rotate with respect to said tubular opening of the anchoring structure, being locked in relative rotation of said screwed end with respect to the screw head of the insertion crown in the position of maximum insertion of the rod extension, in which the aforementioned screw end is coupled to the screw head. According to a first alternative embodiment of the screw extension rod, this is a separate and independent unit of the bush implant, related by its opposite end to the screw end with a screwing instrument, insertable from the outside of the implant into the opening tubular of the anchoring structure, through the outer limit of the tubular opening of the prosthetic support structure, being longitudinally and axially movable through said tubular opening until reaching a position of maximum insertion in which its end of Screwing is coupled in a guided way with the screw head of the insertion crown. According to a second alternative embodiment of the screw extension rod, this is a unit that is inserted into the tubular opening of the anchor structure, its longitudinal displacement being restricted, with its screw end coupled to the screw head of the bushing. Insertion Said rod has a second screw head, at its opposite end to the screwed end formed so as to engage therein in a guided manner and with at least a predetermined orientation the end of a screw pin related to a screwing instrument. According to a third alternative embodiment of the screw extension rod, this is integral with the insertion bushing, being arranged on the axis of rotation thereof, having an upper end on which the screw head is formed, and an end lower solidarity with the insertion bushing.

With the construction described, during the screwing of the insertion crown with respect to the walls of the drill hole made in the bone, when it is rotated by means of a screwing instrument inserted through the tubular opening until the screw head is reached, the Dental implant will be inserted in the aforementioned drill until it reaches its position of maximum insertion. In said insertion procedure, the anchoring structure of the implant, integral with the prosthetic support structure, will penetrate the bone and can maintain a specific insertion orientation.

According to another development of the invention, the dental implant comprises a prosthetic support structure integral with the anchoring structure, and arranged at its upper end. This is shaped to support a prosthetic-dental element, and may alternatively constitute the dental prosthesis itself. According to a first alternative embodiment of the prosthetic support structure, this is constituted by a connection structure on which a prosthetic structure is attachable in exact position and with at least one specific orientation in the coupling position. Alternatively, according to a second possible embodiment of the prosthetic support structure, this is constituted by a prosthetic abutment, in solidarity with the anchoring structure, intended to receive a prosthetic dental crown or other prosthetic element. According to a third alternative embodiment of the prosthetic support structure, this may be constituted by a prosthetic dental crown.

According to another characteristic of the dental implant, and in order to prevent its rotation with respect to the drill hole once it has been completely inserted, optionally and preferably, on the surface of the anchoring structure is conformed to the less a fillet or edge, preferably with a sharp edge, oriented longitudinally to the implant insertion axis. The upper end of said steak or fillets is preferably immediately below the upper ring of the anchor structure, it being preferable that it does not exceed the maximum diameter of the upper ring of the anchor structure. Although a single vertical edge will prevent free rotation of the anchoring structure, this may be insufficient when the implant is subjected to masticatory loading immediately after insertion. Therefore, in order to increase the primary stability of the implant, the anchor structure may have its entire surface covered by vertical longitudinal edges or fillets, ranging from the upper edge of the anchor structure to the lower end thereof, or to an intermediate position. It should be borne in mind that depending on the extension of the mentioned edges, as well as the conformation of the dental implant, the insertion orientation thereof may be corrected during the insertion process. That is, the longer the stretch marks extend to their lower end and the more parallel the walls of the anchoring structure, the orientation of the anchor will be fixed during the insertion procedure. On the contrary, slightly converging walls towards the lower end of the implant, together with slightly extended edges from the upper edge of the anchor structure, will allow correcting the insertion orientation of the implant during the entire insertion procedure until the moment when the edges begin to penetrate the bone, which is desirable. Therefore, edges arranged along the entire contour of the anchor structure, with a length of approximately 3mm. from the upper edge of said anchor structure, and with a diametral width of 0.5 mm. approximately will be sufficient to provide optimal primary implant stability.

Although the main therapeutic objective when placing a dental implant is the replacement of the missing piece or teeth, it is essential that there is enough bone tissue to be able to support the masticatory load to which said dental implant will be subjected, since said load is transmitted directly to the patient's maxillary bone. However, immediately after the loss of a tooth, bone resorption of the bone area that supported the tooth occurs. This bone loss not only negatively affects mechanical aspects when replacing the lost tooth, but also significantly affects cosmetic aspects. According to another optional development of the present invention, the anchor structure It can present a structure of bone regeneration on the surface, made of a biocompatible material, which totally or partially wraps the surface anchor structure, both structures being joined together by a biodegradable cement, or in solidarity. Said bone regeneration structure can be individually shaped to the anatomical characteristics of the patient through a computerized control carving process, allowing subsequent bone regeneration when the dental implant is inserted into the patient's jaw. Accordingly, when a lost tooth is to be replaced by a dental implant shaped according to the present invention, as well as the lost bone tissue, the operator determines the dimensions of the implant as well as the precise position it will occupy in the bone. For this, a three-dimensional digital image of the patient's jaw is taken as a reference, for example, by computerized axial tomography, a technique of a nature well known to those skilled in the art. Likewise, the ideal bone conformation of the dental implant receiving area is determined, thereby creating a virtual three-dimensional image of the selected dental implant in the optimal position and the virtually reconstructed bone tissue around said implant. Subsequently, the bone regeneration structure attached to the selected implant is shaped by carving taking as reference the three-dimensional digital image of the virtually reconstructed bone structure. For this, a numerical computerized carving device is used, of a nature well known to those skilled in the art. Then, the implant is inserted into the patient's jaw, with its carved bone regeneration structure, in the exact position it occupies in the three-dimensional virtual image. At present there are various techniques that allow the placement of dental implants in an exact position previously determined, which are well known to those skilled in the art, so they will not be described herein.

Once the dental implant is implanted, the physiological mechanisms of tissue regeneration of the patient will cause the bone to be regenerated by the implant with a conformation as previously indicated in the virtual three-dimensional image. To achieve bone regeneration, and according to a first embodiment In addition to the aforementioned structure of bone regeneration, it is composed of a biodegradable material that induces bone growth, such as the patient's own natural bone or donor bone, or artificial bone. Also, as a biodegradable material that induces bone growth, for example, a collagen or hydroxyapatite structure can be used, preferably in a trabecular, spongy or porous conformation. In the interstitium or cells of said structure, in the case of having a trabecular, spongy or porous conformation, a biocompatible and biodegradable material can be placed, such as any of the aforementioned, or blood or a plasma rich in inducing cells of bone growth or osteoblasts, of a nature known to those skilled in the art. The materials cited are of a nature well known to those skilled in the art, so they will not be described. It will be understood that any other biodegradable material that induces bone growth will be valid for the same purpose, as well as combinations of the aforementioned or other, either constituting the structure or filling it. As the bone regeneration mechanisms act, the bone regeneration structure will be progressively biodegraded and replaced by a patient's natural bone structure.

According to a second alternative embodiment of the bone regeneration structure, it can be composed of a non-biodegradable spongy, trabecular or porous material, such as a titanium sponge, or inert marine coral, in whose interstitium or cells it can be placed a biocompatible and biodegradable material, such as any of the aforementioned. As the bone regeneration mechanisms act, the biodegradable material, placed in the interstitium or cells of the bone regeneration structure, will be progressively biodegraded and replaced by the patient's natural bone tissue.

In order to guarantee a perfect seal between the anchoring structure of the implant and the rotary insertion crown, to avoid blood filtration when placing the implant in the bone bed, it is necessary to plan the faces that contact each other of both parts . However, this same objective can be achieved by incorporating a sealing gasket or sealing between them to guarantee the sealing of the portion Apical implant, thus avoiding any blood leakage into the implant, as well as any other element from inside the implant to the bone space. According to another development of the invention, it is envisioned that the implant optionally incorporates at least one sealing gasket disposed between the anchoring structure of the implant and the insertion crown, made of a biocompatible material, preferably plastic such as expanded tertrafluoroethylene. , or elastomeric rubber such as a high density silicone, formed to maintain the tightness between the external limits in mutual contact of both parts, that is, the rotating crown and the anchoring structure.

Said seal has a ring or o-ring conformation with an external diameter preferably adjusted to the outer limit of the foot end of the anchoring structure, facing the insertion crown, or slightly smaller, and an internal diameter preferably adjusted to the diameter greater than the extension rod or other through structure at that level.

In order to avoid the filtration of any substance from the outside to the internal spaces of the implant, the incorporation of a second sealing gasket arranged between the extension rod, preferably at the level of the screw head thereof, and the axial tubular opening of the dental implant, being preferably made of elastomeric rubber such as a high density silicone, formed to maintain the tightness between said screw head and said tubular opening. Said seal has a ring or o-ring conformation with an external diameter adjusted to the diameter of the tubular opening, being preferably housed in a circumferential groove formed on the surface of the screw head.

To complement the description that is being made, and in order to help a better understanding of the characteristics of the invention, accompanying specification, as an integral part thereof, is accompanied by representative drawings of the present invention where Illustrative and non-limiting nature has been represented as follows: Figure 1 is a side view of a rotary crown dental implant, according to the present invention. Figure 2 is a side view of a dental implant similar to that shown in Figure 1.

Figure 3 is a sectional side view of the implant shown in Figures 1 and 2. Figure 4 is a sectional view of a dental implant, according to a different embodiment than those shown in Figures 1, 2 and 3.

Figure 5 is a partially sectioned side plane of a rotary crown dental implant, according to a different embodiment to those shown in Figures 1 to 4. Figure 6 shows a side view of a dental implant with the insertion crown located in the middle position, according to the present invention.

Figure 7 shows a side view, partially in section, of the implant shown in Figure 6.

Figure 8 is a detailed perspective plane of half-rotary insertion crown, according to the embodiment shown in Figures 7 and 8.

Figure 9 shows a vertical sectional view of the dental implant shown in Figures 6 and 7.

Figure 10 shows a front view, partially in section, of an embodiment of the insertion crown different from those shown in Figures 1 to 9, according to the present invention.

Figure 11 is a detailed perspective plane, on a larger scale, of the insertion crown, according to the embodiment shown in Figure 10.

Figure 12 is a detailed plan, partially in section, of the insertion crown mounted on the implant body, according to the embodiment shown in Figures 10 and 11.

Figure 13 is a detail plane, similar to that shown in Figure 12, with the insertion crown retained in the implant body according to a different embodiment.

Figure 14 is a side view of a dental implant with two anchor structures according to the present invention.

Figure 15 is a detailed plan, partially in section, in which a dental implant, according to the present invention, inserted in a bone housing is shown. Figure 16 shows a detailed perspective plane of the foot end of the anchoring structure of the implant, according to an alternative embodiment of the present invention.

Figure 17 shows a perspective view of a spring insertion crown, according to an embodiment compatible with the anchor structure shown in Figure 16.

Figure 18 is a perspective view of a spring jamming head, according to an alternative embodiment of the invention.

Figure 19 shows a top view, partially in section, of the dental implant with a screw head according to the embodiment shown in Figure 18.

Figure 20 is a side view of an angle measuring tool according to the present invention.

Figure 21 is a front view of the tooling shown in Figure 20. Figure 22 is a detailed plan, partially in section, of the tooling of Figures 20 and 21 inserted in a drill hole made in the patient's bone.

Figure 23 is a perspective view of a bolting tool according to the present invention.

Figure 24 is a detailed drawing of part of the screwing tool of Figure 23 before being coupled to the prosthetic support structure of the implant.

Figure 25 is a lateral detail plane in which a rotary crown dental implant is shown being inserted into the patient's bone with the aid of the screwdriving tools of Figures 23 and 24, mounted, in turn, on a self-rotating instrument . Figure 26 is a side view, partially in section, of the implant shown in Figure 25, inserted into the patient's bone, with a prosthetic dental crown mounted on the prosthetic abutment of the implant.

Figure 27 is a side view of a dental implant inserted in the bone, with a bone regeneration structure, according to the present invention, adapted to a bone defect of the patient's jaw.

Figure 28 is an enlarged perspective view of the dental implant according to the embodiment shown in Figure 27, with the bone regeneration structure before being carved for adaptation to the bone defect. Figure 29 is a front view, partially in section, of six dental implants with their corresponding prosthetic dental crowns, of the type shown in Figures 27 and 28, placed in the patient's jaw with bone regeneration structures adapted to a bone defect of the maxilla. Figure 30 shows a perspective view of a dental implant, partially in section, according to the present invention.

Figure 31 shows a front view of the implant shown in Figure 30. Figure 32 shows a perspective view of the screwed tooling coupled onto a dental implant, in accordance with the embodiment depicted in Figures 30 and 31.

Figure 33 shows a perspective view of the angulation determination tool according to an alternative embodiment.

Figure 1 shows the rotary crown implant -1- constituted by the anchoring structure -2-, integral with the prosthetic support structure -4-. In this embodiment, the insertion caron -3-, in which its thread fillet-7- is observed, is mounted at the foot end of the implant -1-. In this case, the prosthetic support structure -4- is constituted by an angled prosthetic abutment -5- on which a prosthetic dental crown will be mounted (not shown). Immediately below the upper ring or neck of the anchor structure -2- a series of vertical edges -8- are observed that surround the outer circumference of said anchor structure -2-, and that will be submerged in the bone with the implant - 1- in its position of maximum insertion. The edges -8- preferably have a sharp outer edge so that they offer minimal resistance when inserted into the bone. Figure 2 shows the implant of figure 1 viewed from the front, where the outer limit -10- of the axial tubular opening (not shown) is observed.

As can be seen in figure 3, the insertion crown -3- is integral with a screw head -12- on which a screw instrument (not shown) is attachable. In this case, the screw head -12- is mounted at the end of an extension rod -11- inserted with the ability to rotate in an axial tubular opening -9-, said opening being formed inside the anchoring structure -2 -, and whose outer limit -10- is formed in the prosthetic abutment -5-. In this embodiment, the insertion rod is assembled. in solidarity with the insertion crown -3-. The extension rod -11- is inserted in a section of the tubular opening -9- of smaller diameter than the diameter of its screw head -12-. In this way, once assembled in the insertion crown -3-, either by mechanical retention, welding or other method, the axial displacement of the crown -3- will be prevented, but not its rotation with respect to the anchor structure -2-. However, it will be understood that this construction can be modified. For example, the insertion crown -3- can comprise an outer ring mounted with the ability to rotate on the lower end of the anchoring structure -2-, said ring having at its upper end, in its inner circumference, remaining tabs retained, with rotational displacement capacity of the crown -3-, in a circumferential retentive groove made in the anchor structure -2- (this is not shown in any figure). The essential feature is that the insertion crown -3- is mounted with respect to the anchoring structure -2- so that its axial displacement is prevented but not its rotational capacity with respect to said anchoring structure -2-.

Alternatively, the extension rod -11- can be an insertable element from the outside of the implant -1- with a screw end that can be connected detachably into a screw head -12- located in the same insertion crown -3- (no shown).

Figure 4 shows a dental implant -1- in which the prosthetic support structure -4- has a different embodiment to those shown in the previous figures. In this case, it is the upper end of the anchoring structure - 2 - which is shaped to support a prosthetic element, this being the usual conformation of the prosthetic support of a conventional implant, not being the characteristic construction of said structure of support -4- the object of the present invention patent, so it will not be described in detail.

According to another development of the present invention, the prosthetic support structure -4- can be formed in a dental crown. As can be seen in figure 5, the prosthetic support structure -A- presents a prosthetic dental crown -6- on the prosthetic tooth -6- In the same figure 5 an alternative embodiment of the invention has been represented by the that, optionally, the tubular opening -9- at the level of the prosthetic support structure -4- can have an angled arrangement with respect to the axial tubular opening -9- in the anchor structure -2-, in order to be able to insert the screwing instrument (not shown) from the rear face of the implant dental -1-. Accordingly, the upper end of the screw extension rod -11- is finished off in a toothed crown or attack pinion -13- on which a second toothed crown or an attack pinion of the screw pin of an instrument of engagement is attachable. screwing, guided in the tubular opening -9- of the prosthetic support structure -4- to a position of maximum insertion in which it has free turning capacity, and the said gear ring or pinion -59- is engaged in the toothed crown or toothed pinion -13- of the screw extension rod -11- (this alternative is not shown). Optionally, which is shown in Figure 5, said screw pin -60- is a unit inserted in the tubular opening -9- of the prosthetic support structure -A-, its longitudinal displacement being restricted, with its inner end -59-, in toothed crown, and the upper end -13-, also in toothed crown, of the screw extension rod -11- coaxially coupled to each other, said screw pin presenting -60- an outer end finished off in a head screwing -12-. Optionally, such coaxial coupling established between the extension rod -11- and the screw pin -60- is established through any other appropriate means such as, for example, a spring or other intermediate piece with flexural strength and resistance to torsion (not shown in any figure).

According to another alternative embodiment of the insertion head -3-, as shown in figures 6, 7, it is placed in an intermediate position of the anchoring structure -2-, said anchoring structure -2- being closed on its end of foot. As can be seen in figure 7, said crown -3- comprises an internal circumference formed in a toothed ring in which at least one intermediate pinion -15- meshes, rotatably mounted in the anchoring structure -2-, on which In turn, it engages an attack pinion -16- arranged at the foot end of an extension rod -11- whose upper end is finished off by a screw head -12-. Two axial cylindrical heads -17- arranged in a diametrically opposite position on the intermediate pinion -15- allow rotation thereof with respect to the anchor structure -2-, being retained therein thanks to the insertion crown -3-.

Figure 8 shows a larger scale half insertion crown -3-, in which the internal toothed ring -14- can be seen. In the embodiment shown in Figures 6 and 7, the insertion crown -3- would be formed by two half crowns of insertion as shown in figure 8, mounted on the anchoring structure - 2- and supported, for example, by welding.

In figure 9, the relative position of the insertion crown -3- can be seen, in which the toothed ring -14- engages the intermediate toothed pinion -15-, which in turn meshes with the attack pinion -16 - of the extension rod -11- (not shown).

According to the described construction, turning the extension rod -11- will cause the intermediate pinion -15- to rotate, which will in turn cause the rotation of the insertion crown -3- with respect to the anchoring structure -2- of the dental implant -1-.

According to a third embodiment of the insertion crown, as reflected in Figures 10 to 13, it is made in the form of a crown -18- whose axis of rotation has an arrangement perpendicular to the axis of insertion of the dental implant -1 -. As seen in Figure 10, implant -1- comprises two serrated crowns -18-, one on each side. The toothed insertion crowns -18- engage with the threaded thread of an endless screw -21-, arranged in the tubular opening -9- of the anchoring structure -2-, its upper end being finished off in a screwing head -12-. The main body of the toothed crowns -18- is integrated in the body of the anchoring structure -2-, the teeth of the same having exceeded the outer wall of said anchoring structure -2- so that they serve as a drag element to the implant -1- for insertion into the bone when rotating them. A stop -22- arranged in the tubular opening -9-, above the screwing head -12- of the worm -21-, prevents axial displacement of said screw -21-. Figure 11 shows a larger toothed crown of insertion -18- in which the teeth -19- have a sharp outer edge in order to provide them with the necessary drag with respect to the bone to allow the insertion of the anchoring structure -2- by rotating them. Two Axial cylindrical heads -20- arranged in a diametrically opposite position on the axis of rotation of the toothed crown -18- allow their rotation with respect to the anchoring structure -2-. Figure 12 shows a possible way to carry out the retention of the toothed crowns -18- with respect to the anchoring structure -2- by means of two retentive protrusions -23- formed in the housings that receive the cylindrical heads -20 - of said crown -18-. These protrusions -23- are located with respect to the cylindrical heads -20- such that once inserted in the anchoring structure -2-, only the rotation displacement thereof is free. With the same objective, as shown in Figure 13, each toothed crown -18- can be retained in the anchor structure -2- by means of two plates -24- fixed to the anchor structure -2- by, for example, welds -25-. Each plate is located in front of the corresponding cylindrical head -20-.

According to another development of the present invention and alternatively, whose exemplary embodiment is represented in Figure 14, the dental implant -1- may be composed of more than one anchoring structure -2-, in this case two, whose arrangement axial is parallel to each other. According to said development, at least one of the anchoring structures -2- incorporates the corresponding insertion crown, only one of which incorporates insertion crown -3- in the example shown. Said anchor structures -2- are in solidarity with an upper anchor section, common to both, integral with the prosthetic support structure -4-. Alternatively, each of the anchoring structures -2- can be connected directly, through each of its upper ends, with the prosthetic support structure -A- (not shown). An alternative embodiment to that shown in Figure 14 is shown in Figure 15, according to which, optionally, at least one of the anchoring structures -2-, in this case the one shown on the right, is mounted with respect to to the prosthetic support structure -A- by means of a hinge joint -61- whose axis of rotation -26- is perpendicular or oblique to the axis of insertion of the dental implant -1-. Said anchor structure -2- has a displacement capacity in rotation with respect to the axis of rotation -26- of said joint -61-, and can have at least one longitudinal groove -27- that divides the anchor structure -2- in two bodies of free upper ends, aligned in a plane perpendicular to the axis of rotation -26-, joined through its lower ends close to the hinge joint -61-, said free ends being transversely movable elastically. With the construction described, a dental implant -1- composed of two anchoring structures -2- can be inserted into a bone bed composed of two drilling holes, made in the bone -28- of the patient, with paths that present different directions . Since the drill holes have a straight conformation, and the dental implant -1- is made of rigid material, as the implant -1- is inserted, the anchoring structure -2- that is mounted on the hinge joint -61 - it will take the trajectory of one of the drilling holes while its two bodies collapse elastically, until reaching its position of maximum insertion, in which its two bodies recover their original relative positions.

According to another optional development of the present invention, whose exemplary embodiments are shown in Figures 16 to 19, 17, the dental implant -1- can comprise a spring-operated device, relating the anchoring structure -2- with the insertion crown -3-, to increase the resistance to rotation of said crown -3- with respect to the anchoring structure -2- at different points along its turning path. In this way, once the dental implant -1- is inserted, the free rotation of the insertion crown -3- with respect to the anchoring structure -2- will be prevented, which will prevent any accidental axial displacement of the dental implant -1 - once inserted. Likewise, said spring-actuated device may constitute a tactile and / or auditory reference that allows the operator to modify the implant insertion depth with micrometric precision. In the example represented in Figure 16 and 17, said spring device is constituted by a pressure spring, as shown in Figure 17, mounted on the insertion crown 3, made by a plate -30- with a central protrusion . Said spring device fits into housings -29- made at the foot end of the anchoring structure -2-, represented in Figure 16, according to the passage of said spring -30-. By rotating the insertion crown -3-, the spring -30- will move from one of the housings -29- to the adjacent one thanks to its elastic deformation. In the exemplary embodiment shown in Figures 18 and 19, the spring device, constituted by a pressure spring as an elastic flange -31-, is located in the screwing head -12- of the extension rod -H- . As can be seen in figure 19, said spring -31-, in number of two mounted in diametrically opposite arrangement, fits in the tubular opening -9-, in grooves -32- formed therein.

According to the described construction of the spring device, knowing the depth that the implant -1- is displaced with respect to the drill hole for each turning fraction of the insertion crown -3-, we can micrometrically modify the insertion depth of the dental implant -1-. If, for example, one turn of the insertion crown displaces the implant -1-2 mm., Each rotation fraction, according to the example shown in Figure 16, will produce a movement of 0.5 mm. According to the example represented in the Figure 19 each turn fraction, according to the previous assumption, will produce a 0.25mm offset. in the implant -1- with respect to the drill hole.

When an implant of the type that the prosthetic abutment -5- is integral with the implant body is to be placed, it is necessary to determine beforehand the angle that said abutment must have with respect to the anchoring structure -2-, since said angulation it will vary in each case depending on the angulation of the drill hole and the angulation of the future dental crown.

According to this, and in accordance with another feature of the invention, whose possible embodiment is shown in Figures 20 to 22, as an auxiliary element for determining the ideal angle of the prosthetic abutment -5- with respect to the anchoring structure -2 - An angle measuring tool -33- can be incorporated. Said tooling comprises a replica of anchor structure -34- shaped to be inserted in the drill hole -56-, made in the bone -28- of the patient, in the same position where the anchor structure -2- is left. ~ of the implant -1- with respect to the drill, and a replica of the prosthetic abutment -35- with an end shaped to engage with respect to the upper end of the replica of the anchor structure -34- in a displaceable manner, in the sagittal plane of said pillar replica -35-, about an axis perpendicular to the insertion axis of said anchor structure replica -34- within a predetermined area, and being able to block at different points along said zone to provide a series of predetermined angular orientations. As best seen in Figure 20, the anchor structure replica -34- has two rotation pivots at its upper end -36- (only shown on one side), arranged in an axis perpendicular to the insertion axis of the implant -1-, on which the replica of the prosthetic abutment -35- is coupled through openings -41- that allow the rotation of said replica -35- with respect to the anchor structure replica -34-. The body of the pillar replica -35- has a similar conformation, at least in lateral profile, than the prosthetic pillar -5- of the implant -1- (not shown in this figure), and its opening -41- has the walls of entry with a separation between them such that they allow the insertion, from a certain angulation, of the rotation pivots -36- to allow a coupling of one structure with respect to the other in an uncoupleable way. To do this, the rotation pivots -36- have a cylindrical conformation with two planned parallel side walls, with a width between them similar to the separation between the entrance walls of the opening -41- of the replica of the prosthetic abutment -35 -.

In order to block the free displacement of the abutment replica -35- with respect to the anchor structure replica -34- in a series of predetermined angular orientations, the prosthetic abutment replica -35- has a flexible flange -40- elastically that it has formed a protuberance -38- that meshes in each of the recesses -39- made in the replica of the anchor structure - 34-, in the passageway of said protuberance -38- in its advance when displaced in rotation the pillar replica -35- with respect to said anchor structure replica -34-. It will be understood that this possibility can be achieved in other ways. For example, the grooves -39- and the protuberance -38- attached to the elastic flange -40- can have an inverted arrangement, said protuberance -38- and flange -40- being in the anchor structure replica -34-, and the grooves -39- formed in the prosthetic abutment replica -35-.

To facilitate the displacement of the prosthetic abutment replica -35- with respect to the anchor structure replica -34-, said abutment replica -35- can comprise a rod -43-, for manipulation by the operator, which can be in solidarity with it or be insertable in a housing -42- in an uncoupleable manner, as shown in the figures. Figure 21 shows the angle measurement tooling -33- viewed from the front, where the replica of the anchoring structure -34- is realized by means of four vertical sheets connected to each other in cross and with sharp external profiles in order to facilitate the insertion of the anchor structure replica -34- in the drill hole with low strength, which is preferable and can be achieved in other ways.

Figure 22 shows the angle measuring tool -33- inserted in a drill hole -56- of the bone -28- made with the appropriate instrument through the gum -44-. With the anchor structure replica -34- in the position of maximum insertion, the prosthetic abutment replica -35- can be moved until the optimal angular orientation of the prosthetic abutment -5- will be achieved with respect to the anchor structure -2 - of the implant -21- that will be placed (not shown in this figure). The grooves -39- that determine the possible predetermined angles may have a characteristic reference (not shown) for each of the possible angles so that the definitive implant to be placed that corresponds to the optimum angulation chosen can be easily identified. As can be seen, the angulation obtained in the example represented in Figure 22 will correspond to a dental implant -1- in which its prosthetic abutment -5- has a greater angulation with respect to the anchoring structure -2- than the one presents the implant -1- represented in figure 1. Therefore, dental implants with different angles between the prosthetic abutment -5- and the anchoring structure -2- will have to be provided.

In accordance with another feature of the invention, whose possible embodiment is shown in Figures 23 to 25, a screw tool can be provided as an auxiliary element for insertion of the implant. Figure 23 shows the screwing tool -45- comprising a fixing device -58- connectable to the prosthetic support structure -4- of the dental implant -1-, and a screw pin -46- attachable in the Screw head -12- of the dental implant -1-. Said screwing device -45- is a separate unit that is mounted in a detachable manner on the prosthetic support structure -4- of the dental implant -1- and can be a separate unit connectable in a detachable way on a self-rotating mechanical instrument, or turn by manual operation, by means of a coupling -48- (the autogiratory instrument is not shown in this figure), or said coupling head is a structure integral with said self-rotating or manually operated mechanical instrument (this possibility is not represented in any figure). As best seen in Figure 24, in the exemplary embodiment represented in these figures, said fixing device -58- is composed of a sliding adjustable fixing pin on a fixing structure -51- arranged in the structure of prosthetic support -4-, adapted to place said fixing pin in the position of maximum insertion in said fixing structure -51-. The fixing structure -51- of the implant is composed of the upper section of the tubular opening -9- in which two vertical rails -55- are formed in which two vertical rails -47- are formed in the fixing pin -58- of the screwing tools -45-. According to an alternative embodiment of said fixing device -58-, this may be constituted by a manually adjustable locking mechanism on a fixing structure, arranged in the prosthetic support structure, adapted to place said locking mechanism in position. of maximum adjustment in the aforementioned fixing structure to block the fixing device of the bolting tool in this position in an adjustment situation in blocking conditions (this alternative is not shown in any figure).

Following the description of the example shown of the screwing device -45-, the screw pin -46- has a screw end formed to engage in a guided way with the screw head -12- of the dental implant in the position of maximum adjustment or maximum insertion of the fixing device -58- of the aforementioned screwing tool -45- with respect to the fixing structure -51- of the prosthetic support structure -4-, in whose position the free rotation of the structure of the anchor -2- with respect to said fixing device -58-. In this case, the screw pin -46-, composed of a polygonal male end congruent with the screw head -12-, is a through element through an axial opening formed in the pin -58-. At the opposite end it comprises a coupling structure -50- connectable to a self-random instrument. Both the coupling structure -50- and the Autotatory instruments are commonly used in dentistry, not being the object of the present invention and therefore will not be described.

Alternatively to the represented conformation of the jamming tooling - 45-, the screw pin -46- and the fixing pin -58- can have a non-coaxial arrangement, with parallel insertion paths with respect to the tubular opening -9- and the fixing structure -51-, which would also have a non-coaxial arrangement congruent with the arrangement of the bolting tool elements -45-.

According to another optional development of the screwing tool -45-, as shown in Figure 23, the fixing pin -58- can have rotation capacity with respect to the coupling head -48- in the axis of rotation of the bolting pin -46- in order to allow different orientations of the self-rotating instrument with respect to the dental implant -1- when the screwing tool -45- is in a coupling condition with respect to it, which is preferable. However, the coupling head -48- and the fixing pin -58- can be two integral elements (not shown in any figure).

Figure 25 shows the coupling head -48- connected to the head -53- of a self-rotating mechanical instrument -52-, commonly used in dentistry. In this case, the connection of both elements is kept in blocking conditions thanks to retentive tabs -49- in solidarity with said coupling head -48- and which fit into housings arranged for this purpose in the self-rotating instrument -52- ( not shown). This possibility, of course, can be achieved in other ways. The fixing pin -47- is inserted in the fixing structure - 51- (not shown) of the prosthetic support structure -4-, It is preferable that the dental implant is retained with respect to the screwing tool -45- by friction in the position of maximum insertion of the fixing pin -47-. With the screwing tool -45- coupled to the dental implant, the drive of the self-rotating instrument -52-, in the direction of insertion, will cause the rotation of the insertion crown -3- in the direction of insertion in the drill hole - 56-. Then, the thread steak -7- of the insertion crown -3- will penetrate the bone wall around the hole -56-, which will cause the drag of said crown -3- and The anchoring structure -2- to a position of maximum insertion in the drilling hole -56-. Once the edges -8- have penetrated the bone wall, the rotation of the anchor structure -2- will be impeded. Therefore, the implant must be oriented during insertion before said edges -8- penetrate the bone wall. However, once the implant is introduced, the orientation of the implant can be corrected by disintegrating it, by unscrewing the insertion crown -3-, until the edges -8- are outside the bone walls.

In order to be able to introduce the dental implant into the drill hole -56- with the minimum effort, it is preferable that the outer diameter of the thread fillet -7- is equal to or less than the outer diameter of the anchoring structure -2- in Your foot end. With this, the dental implant can be introduced into the drill hole -56- by simple pressure until the thread fillet -7- reaches the section of the drill hole in which the foot end of the anchoring structure will be located -2-. Then, by rotating the insertion crown -3-, according to the example shown in Figure 25, the dental implant will remain in the position of maximum insertion. However, this will depend on the inclination of the thread steak -7- and its vertical length with respect to the insertion crown -

3-.

Figure 26 shows the same dental implant shown in Figure 25 completely inserted in the bone drill -56-. As can be seen, said implant has a prosthetic abutment -5- with an angulation with respect to the anchoring structure -2- equal to that determined with the angle measuring tool -33- shown in Figure 22. A prosthetic dental crown - 6-, coupled and supported by the prosthetic abutment -5-, completes the replacement treatment of the missing tooth.

Figure 27 shows a dental implant, according to another development of the present invention, with a bone regeneration structure -54- formed by carving by computerized assistance, as described hereinbefore, to replace the lost bone structure in the dental implant receiving area. According to such development, based on a three-dimensional image of the bone area to be rehabilitated, obtained, for example, by computerized axial tomography, the edge of alveolar bone tissue is virtually reconstructed taking as reference a virtual dental implant located in the relative position, with respect to the bone, which it will occupy in the patient's jaw. Said virtual implant will have the same dimensions and conformation as the implant that will be finally placed. Figure 28 shows a dental implant -1- with a bone regeneration structure -54- that has not been carved, being attached to the outer surface of the anchoring structure -2- by a biocompatible and biodegradable cement -57- . Taking the aforementioned virtual three-dimensional image obtained from the dental implant and the virtually reconstructed bone tissue (which is not represented in any figure), a robotic carving device will carve the bone regeneration structure -54- until it becomes a physical duplicate of the image three-dimensional virtually reconstructed bone tissue. Once carved, said bone regeneration structure -54- occupies with respect to the anchor structure -2- the same relative position that occupies the three-dimensional image of bone tissue, virtually reconstructed, with respect to the anchoring structure of the virtual implant. Generally, the bone loss that occurs after losing a tooth affects the bone ridges of the alveolar bone that supports the tooth. Therefore, the bone regeneration structure -54- will preferably be provided, in an uncarved state, oversized with respect to the normal conformation of the upper and middle sections of the alveolar bone, extending from the upper edge of the anchoring structure - 2- up to about the middle zone of the anchor structure -2- preferably. However, an approximate thickness of 4 mm. of the lateral, anterior and posterior walls of the bone regeneration structure -54- in an uncarved state, it will be sufficient to reconstruct, after computerized carving thereof, the bone structure lost after tooth loss. Likewise, the vertical extension of the mentioned bone regeneration structure -54- may be varied. For example, it can extend from the upper edge of the anchor structure -2- to the foot end thereof.

Figure 29 shows the front of the upper jaw of a patient, whose gum is not shown. Said jaw -28- presents the loss of the six anterior teeth, with a typical bone resorption of an anterior front with such dental loss after several years of evolution. A rehabilitation by means of six -1- independent dental implants with their corresponding bone regeneration structure adapted by computerized carving to each bone section allows recover the function and natural cosmetic of the maxilla, and it is completed with the corresponding independent prosthetic dental crowns -6- placed on each prosthetic abutment (not shown). As can be seen, it is planned to carve the bone regeneration structures -54- of alternate implants -1- with a convergence towards the foot end thereof, leaving the bone regeneration structures -54- of the remaining implants -1- with a divergent conformation towards the foot end thereof. Said conformation is preferable in order to prevent bone regeneration structures -54- from impeding the insertion of the others. To do this, after first inserting the implants -1- with bone structures -54- formed divergently towards the foot end, beds of divergent side walls towards their entrance edge will be delimited, which will allow the insertion of the rest of the dental implants.

Once the physiological processes of bone repair have been completed, the bone regeneration structures -54- will have been replaced by neoformed bone tissue, or they will integrate into their interstitium neoformed bone tissue, as such bone regeneration structure is constituted -54- by biodegradable or non-biodegradable material respectively.

It will be understood that bone losses caused by any other reason, such as traumatic or surgical origin, may also be reconstructed by the method and implant described.

According to another development of the invention, in figure 30 the joint -62- housed between the foot end of the anchoring structure -2- and the rotating crown -3- can be seen, presenting an elliptical section in the embodiment shown. As can be seen, the external diameter of said joint -62- is adjusted to the external diameter of the foot end of the anchoring structure -2-.

In this embodiment, according to another development of the present invention in accordance with the essence of the patent, a conformation of the dental implant -1- with a lower coupling ring -63- is shown, to increase the strength of the connection between the rotating crown -3- and the anchor structure -2-. According to such a conformation, the internal diameter of the joint will be adjusted to the external diameter of said through-coupling ring -63-, in solidarity with the foot end of the anchoring structure -2-, which will prevent displacements of said joint -62- . However, in the absence of said ring -63-, the internal diameter of the joint -62- may fit to the external diameter of the extension rod -H-.

A second seal -70- is arranged between the jamming head -12- of the extension rod -11- and the upper section of the tubular opening -71- of the implant. A circumferential groove -72- formed on the screwing head -12- serves as housing and retention functions for said joint -70-, while increasing the contact surface, and therefore sealing, of the joint -70- with screwing head -12-. While this provision is preferred, it will be understood that it may be varied. For example, the gasket -70- could be arranged between the base of the screw head -12- and the base of the upper section -71- of said tubular opening.

Both the rotating crown -3- and the foot end of the anchoring structure -

2- they have at their opposite ends a peripheral circular groove -65-, in which the joint -62- will be housed (in this example of embodiment only the crown groove -62- is shown in section, the groove of the anchor structure -2- by the joint -62-). This conformation is preferred. However, both surfaces may be planned to be congruent with each other, the joint -62- being tight between them to ensure sealing (not shown).

As can be seen in this figure 30, the rotating crown -3- has an external upper bushing -64- on which the coupling ring -63- is coupled, said bushing -64- having an inner diameter adjusted to the external diameter of the coupling ring -63-, being able to alternatively be a sealing gasket arranged between the foot end of said ring -63- and the rotating crown -

3- (this alternative is not represented).

According to a preferred embodiment of the extension rod -11-, as shown in Figure 30, it has at its foot end an assembly pin -66- shaped to be fixed by mechanical retention on a tubular opening of assembly -73- formed in the insertion crown -3-, the extension rod -11- being finished off by its opposite end in a screw head -12- with a diameter greater than the diameter of the extension rod -H-. The axial tubular opening of the dental implant comprises an upper section -71- of greater diameter, adjusted to the diameter of said screw head -12-, and a lower section -74- adjusted to the diameter of the body of the extension rod -11- , being, in assembly position, the screw head -12- coupled on the upper section -71- of the axial tubular opening of the implant, with the rod -11- coupled on the lower section -74- of said opening and the assembly pin -66- assembled and fixed on the assembly opening -73- of the insertion crown -3-. The diameter of the assembly pin -66- will be equal to or smaller than that of the extension rod -11- so that it can be inserted through the upper -71- and lower -74- sections of the implant tubular opening, to be assembled with the crown of insertion in the assembly of the implant in industrial production.

In order to guarantee optimum mechanical retention of the pin -66- with respect to the assembly opening -73-, it has a surface -75- in which a series of longitudinal and transverse edges are formed, said pin presenting -66- , through said edges, a larger diameter greater than the larger diameter of the assembly opening -73-. However, pin fixation -66- on the insertion crown -3- can be achieved by other methods such as, for example, a welding performed on the apex of the insertion crown.

In Figure 31, according to the present invention, slight variations in the design of the implant body -1- of the embodiment shown in Figures 30 and 31 can be observed with respect to those represented in the previous figures, and which remains inside of the nature of the claims of the invention. In the embodiment shown, the longitudinal edges -8- are formed on the middle and lower sections of the anchoring structure -2-, and in greater numbers. Said edges -8- are located below the major diameter of the anchoring structure -2-, as shown in the previous figures, and its wing does not exceed the larger diameter of the upper section of the anchoring structure -2 -. However, it will be understood that this conformation may vary.

Likewise, the implant body -1- has a cylindrical conformation in the upper section of the anchoring structure -2-, progressively decreasing its diameter towards its foot end, where it is finished off in rounded conformation of the apex of the rotating crown -3-. Said lower conical conformation has a preferential convergence of approximately 5 degrees between its walls and the walls of the upper cylindrical section. The longitudinal edges -8- start from the section of the anchor structure -2- in which the external diameter of the same begins to reduce, ending, with chamfering, at the foot end of said anchor structure. The thread -7- of the rotating ring has a flange with a maximum diameter equal to or less than the major diameter of the anchoring structure -2- decreasing ^• progressively the diameter of the wing at its terminal the same apical section to continue with the apical outer surface of the rotating crown -3-.

According to a preferred embodiment of the upper section of the tubular opening, it has a series of vertical rails, on which at least one rail formed on the fixing pin of the bolting tooling is attachable. In the exemplary embodiment shown in Figures 31 and 32, the upper section -71- has four vertical rails, arranged in an equidistant position, on which four rails -47- of the screw pin -58- of the bolting tooling are attachable -45- with different angular orientations, predetermined by the position of said rails -47- on said rails -55-, Alternatively, said upper section of the tubular opening can have a polygonal conformation, congruent with a polygonal conformation of the pin screwing, which is attachable on it in a series of predetermined angular orientations (this alternative is not shown in any figure).

As shown in Figure 33, both the anchor structure replica -34-, the prosthetic abutment replica -35- and the manipulation rod -43- are constructed in the same piece, preferably made of injected plastic material under mold, which can be resistant to high temperatures, to allow its sterilization in an autoclave machine, of known construction.

The free end of said rod -43- is finished off in a digital clamping structure -67-, to be grasped with the fingers of the operator, carried out by a broadening thereof, preferably of elliptical or ovoid conformation, whose larger diameter is, of preferred shape, transverse to the major axis of the anchor structure replica -34-. However, it will be understood that said conformation may be modified. The body of the anchor structure replica -34- has a conformation in crossed longitudinal blades consisting of four longitudinal blades -69- joined together, forming an angle of 90 degrees to each other preferably. It will be understood that said conformation may be varied. For example, it may be made up of three sheets solidarity with each other forming a 120 degree angle between them. The longitudinal emptying existing between them favors the insertion of the tools in the bone perforation, without causing the expulsion of the blood lodged in said perforation, which is preferable in the surgical technique. According to another characteristic of the angulation determination tooling, the manipulation rod -43- can optionally have a narrowing -68- in its union with the prosthetic abutment replica -35-. With such construction, the angulation of the rod -43- can be modified with respect to the prosthetic abutment replica -35- by the flexible deformation of the narrowing -68-, Likewise, the same angulation determination tooling can alternatively be used as prosthetic replica after removing the stem -43- with respect to the prosthetic abutment replica -35- by tearing or fracturing the narrowing - 68- that joins them. According to this, after taking a record of the patient's jaw with the dental implant placed in the bone bed, and after removing the rod -43- of the angle determination tooling, the prosthetic abutment replica -35- of the determination tooling of angles may be placed in exact position on the negative footprint left by the prosthetic abutment of the implant on said register. Likewise, the anchor structure replica -34- will be submerged and retained in the hardenable material used to develop the hard positive model of the jaw. The technique of taking maxillary records and developing hard positive models is in itself known to those skilled in the art, and therefore will not be explained.

According to the described construction of the angulation determination tooling, one tooling will be provided for each type of implant, each with the size of the dental implant of which said tooling is a replica, as well as with the same angulation between prosthetic abutment and anchoring structure.

While a series of preferred embodiments of the present invention have been illustrated, it will be understood that changes and modifications can be made in the construction and arrangement of elements without departing from the scope of the invention as defined in the appended claims. Likewise, an implant with the same characteristics as described above may alternatively be used in other medical uses, such as in orthopedic surgery, in an intraosseous arrangement and with a prosthetic support structure shaped according to the anatomical structure replace prosthetically. For example, the upper condyle of the femur can be prosthetically replaced by a prosthetic condyle mounted on an implant body, according to the present invention, inserted into a drill hole made in the medullary canal of the femur.

Claims

1. Rotary crown dental implant, of the type in which an implant body itself, made of a biocompatible material for placement in an intraosseous arrangement, supports a prosthetic element, which comprises an implant body formed by at least an anchoring structure (2), integral with a prosthetic support structure (4), and at least one insertion crown (3) by rotation with an external surface provided with a thread fillet (7), which causes the insertion of the anchoring structure in the bone (28) because of the screwing of said crown in a drilling hole (56) made in the bone; dental implant which is characterized in that the insertion crown is a unit connected to the anchoring structure so that it has freedom of rotation with respect thereto; and because the prosthetic support structure is arranged at the upper end of the anchor structure, and in solidarity therewith, the insertion crown being preferably located at the foot end of said anchor structure.

2. Dental implant rotatable crown according to claim Ia, wherein the anchoring structure (2) has an axial tubular opening (9) open at the least at its upper end (10), being extended in said upper end by a second through tubular opening formed in the prosthetic support structure (4); and because the insertion crown (3) is related to a screw head (12), located in axial position with respect to said tubular opening, such that the rotation of said screw head causes the crown of the screw to rotate. insertion with respect to the anchor structure.

3. Rotary crown dental implant according to claim I ^a and 2 ^a , wherein according to a preferred embodiment of the dental implant (1) the tubular opening (9) of the anchoring structure (2) is opened by both extremes; characterized in that said opening has as its base or base part the insertion crown (3); and because the insertion crown is integral with the screw head (12).

4. Rotary crown dental implant according to claims I ^a and 2 ^a , wherein according to a second alternative embodiment of the insertion crown (3), it is placed in an intermediate position of the anchor structure (2), said anchor structure being closed at its foot end; characterized in that said insertion crown comprises an internal circumference formed in a toothed ring (14) in which at least one intermediate pinion (15) meshes, rotatably mounted in the anchoring structure, on which, in turn, a Attack pinion (16), with rotation capacity with respect to the tubular opening (9) of the anchoring structure, whose upper end is topped with a screw head (12).

5. Rotary crown dental implant according to claims I ^a and 2 ^a , wherein according to a third alternative embodiment of the insertion crown

(3), this is made in the form of a toothed crown (18) whose axis of rotation has an arrangement perpendicular to the axis of insertion of the dental implant (1); characterized in that the crown or toothed insertion crowns engage with the threaded thread of an endless screw (21), arranged in the tubular opening (9) of the anchoring structure (2), whose upper end is finished off in a head of screwing (12); and because the main body of the crown or toothed crowns are integrated in the body of the anchor structure, the teeth of the same (19) exceeding the outer wall of said anchor structure.

6. Rotary crown dental implant according to claims I ^a to 5 ^a , characterized in that the screw head (12) is shaped so that it engages thereon in a guided manner and with at least one predetermined orientation around its axis the screwing end of a screw extension rod (11), said rod being inserted into the tubular opening (9) of the anchoring structure (2); and because said rod has rotation capacity with respect to said tubular opening of the anchoring structure, being locked in relative rotation of said screwed end with respect to the screw head of the insertion crown (3) in the position of maximum insertion of the extension rod, in which the aforementioned screw end is coupled to the screw head.

7. Dental implant rotatable crown according to claim 6, characterized in that, in a first alternative embodiment of prolonging rod screw, this is a separate and independent unit dental implant (1), connected at its opposite end to the end of screwing with a screwing instrument, and is inserted from the outside of the implant into the tubular opening (9) of the anchoring structure, through the outer limit (10) of the tubular opening of the prosthetic support structure (4), being longitudinally and axially movable through said tubular opening until reaching a position of maximum insertion in which its screw end is guided in a guided manner with the screw head of the insertion crown.

8. Rotary crown dental implant according to claim 6 ^a , wherein, according to a second alternative embodiment of the screw extension rod (11), this is a unit that is inserted into the tubular opening (9) of the anchoring structure (2), its longitudinal displacement being restricted, with its screw end coupled to the screw head of the insertion bushing, characterized in that said rod has a second screw head (12), at its end opposite the end of bolting formed so that the end of a screwing pin (46) related to a screwing instrument is coupled in a guided manner and with at least one predetermined orientation.

9. Rotary crown dental implant according to claim 6 ^a , characterized in that, according to a third alternative embodiment of the screw extension rod (9), this is integral with the insertion crown

(3), being arranged on the axis of rotation thereof, having an upper end on which the screw head (12) is formed, and a lower end integral with the insertion bushing.

10. Rotary crown dental implant according to claim 8 ^a or 9 ^a , wherein, according to an alternative embodiment of the implant (1), the tubular opening of the prosthetic support structure has an angled arrangement with respect to the axial tubular opening (9) of the anchor structure (2); characterized in that the upper end of the screwing extension rod (11) is finished off in a toothed crown (13) or attack pinion on which a second toothed crown (59) or an attack pinion of the screw pin of a screwing instrument, inserted in a guided way in the tubular opening of the prosthetic support structure (4) to a position of maximum insertion in which it has free turning capacity, and the said toothed crown or pinion is engaged in the crown gear or toothed pinion of the screw extension rod.

11. Dental implant rotatable crown according to claim 10, wherein, optionally, said pin screw (60) is inserted in the tubular opening unit structure prosthetic bearing (4) restricting its longitudinal movement , with its inner end and the upper end of the screw extension rod (11) coaxially coupled to each other, said screw pin having an outer end capped on a screw head (12).

12. Rotary crown dental implant according to claim 11 ^a , characterized in that optionally such coaxial coupling established between the extension rod (11) and the screw pin (60) is established through any other appropriate means, such as, for example , of a spring or other intermediate piece with flexural capacity and resistance to torsion.

13. Rotary crown dental implant according to any of the preceding claims, wherein, optionally and preferably, at the surface of the anchoring structure (2) at least one fillet or edge (8) is formed, preferably of sharp edge, oriented longitudinally to the implant insertion axis (1); characterized in that the upper end of said fillet or fillets is preferably immediately below the upper ring of the anchoring structure, it being preferable that it does not exceed the maximum diameter of the upper ring of the anchoring structure.

.

14. Rotary crown dental implant according to claims I ^a to 13 ^a , wherein the prosthetic support structure (4) is a solidarity unit with the anchoring structure (2), arranged at its upper end, characterized in that according to a first alternative embodiment of the prosthetic support structure, this is constituted by a connection structure on which it is attachable in exact position in a lockable manner and with at least one specific orientation in the coupling position a prosthetic structure; according to a second alternative embodiment of the prosthetic support structure, this is constituted by a prosthetic abutment (5) intended to receive a prosthetic dental crown (6) or other prosthetic element; according to a third alternative embodiment of the prosthetic support structure, this is constituted by a dental crown prosthetic (6).

15. Rotary crown dental implant according to any of the preceding claims, wherein, according to an optional embodiment of the implant body, the dental implant (1) is composed of more than one anchoring structure (2), preferably two, whose axial arrangement is parallel to each other, characterized in that at least one of the anchoring structures incorporates the corresponding insertion crown (3); and because said anchor structures are joined through their upper ends with the prosthetic support structure (4), or with an upper anchor section integral with the prosthetic support structure.

16. Rotary crown dental implant according to claim 15 ^a , wherein, optionally, at least one of the anchoring structures (2) is mounted with respect to the prosthetic support structure (4), or with respect to an upper anchor structure, by means of a hinge joint (26) whose axis of rotation is perpendicular or oblique to the insertion axis of the dental implant (1). characterized in that said anchor structure has a displacement capacity in rotation with respect to the axis of rotation of said articulation, and in that it can have at least one longitudinal groove (27) that divides the anchor structure into two free upper end bodies, preferably aligned in a plane perpendicular to the hinge axis, joined through its lower ends close to the hinge joint, said free ends being transversely movable elastically.

17. Rotary crown dental implant according to any of the preceding claims, characterized by the optional existence of a spring-operated device (30,31), relating the anchoring structure (2) with the insertion crown (3), for increase the resistance to rotation of said crown with respect to the anchoring structure at different points along its turning path.

18. Rotary crown dental implant according to any of the preceding claims, wherein as an auxiliary element for implant insertion, it can comprise a screwing tool (45) comprising a fixing device (58) connectable to the support structure prosthetic (4) of the dental implant (1), and a screw pin (46) attachable in the screw head (12) of the dental implant, characterized in that said screw device it is a separate unit mounted in a detachable manner on the prosthetic support structure of the dental implant, comprising, according to a first alternative embodiment of said fixing device, a manually adjustable locking mechanism on a fixing structure, arranged in the structure of prosthetic support, adapted to place said locking mechanism in its position of maximum adjustment in said fixing structure to block the fixing device of the bolting tool in this position in adjustment situation in blocking conditions; optionally, according to a second alternative embodiment of said fixing device, this is composed of a sliding pin (58) adjustable by sliding on a fixing structure (51,55) arranged in the prosthetic support structure, adapted to place said fixing pin in position of maximum insertion in said fixing structure.

19. Dental implant rotatable crown according to claim 18, wherein said screwing tool (45) comprises a pin screw (46) having one end formed to engage the screw in a guided screw head (12 ) of the dental implant (1) in the position of maximum adjustment or maximum insertion of the fixation device (58) of said screw tooling with respect to the fixation structure (51,55) of the prosthetic support structure (4), in which position the free rotation of the dental implant with respect to said fixation device is prevented; and because said screwing tooling can be a separate unit that can be connected in a detachable manner on a self-rotating mechanical instrument (52) or rotatable by manual operation by means of a coupling head (48,49) attachable to said mechanical instrument.

20. Rotary crown dental implant according to claims 18 ^a and 19 ^a , wherein according to a preferred embodiment of the fixing device (58), specifically that made in a fixing pin, it has an axial tubular opening in the that the screw pin (46) is insertable; characterized in that the fixing pin is a integral element with said coupling head (48) or with a self-rotating mechanical instrument (52) or of rotation by manual actuation, or it has coaxial turning capacity with respect to said coupling head or with the mentioned mechanical instrument in the axis of rotation of the screw pin.

21. Rotary crown dental implant according to any of the preceding claims, wherein as an auxiliary element to determine the ideal angle of the prosthetic abutment (5) with respect to the anchoring structure (2), an angle measuring tool can be incorporated (33), characterized in that said tooling comprises a replica of anchor structure (34) formed to be inserted in the drill hole (56), made in the bone (28) of the patient, in the same position in which the anchoring structure of the implant (1) with respect to the borehole, and a replica of the prosthetic abutment (35) with an end shaped to engage with respect to the upper end of the replicating anchoring structure movable around a perpendicular axis (36 ) to the insertion axis of said anchor structure replica within a predetermined zone, and being able to block at different points along said zone to provide u a series of predetermined angular orientations.

22. Rotary crown dental implant according to any one of the preceding claims, wherein according to an alternative embodiment of the dental implant, optionally, the anchoring structure (2) has a surface, a bone regeneration structure (54) that can be carved, made of a biocompatible material, which totally or partially envelops the anchoring structure, both structures being preferably joined together by means of a biodegradable cement (57), or in solidarity; characterized in that according to a first alternative embodiment of said bone regeneration structure, it is composed of a biodegradable bone growth inducing material; According to a second alternative embodiment of the bone regeneration structure, it is composed of a trabecular, spongy or non-biodegradable porous material, such as titanium sponge or inert marine coral.

23. Rotary crown dental implant according to claim 22 ^a , characterized in that said bone regeneration structure (54) can be individually shaped by a computerized control carving process, allowing subsequent bone regeneration when the dental implant is inserted (1) in the maxilla (28) of the patient.

24. Rotary crown dental implant according to any of the preceding claims, characterized by the optional existence of at least one gasket of tightness (62) disposed between the anchoring structure (2) of the implant and the insertion crown (3), made of a biocompatible material, preferably plastic such as expanded tertrafluoroethylene, or elastomeric rubber such as a silicone of high density, formed to maintain the tightness between the external limits in mutual contact of both parts, that is, of the insertion crown and the anchoring structure.

25. Rotary crown dental implant according to claim 24 ^a , wherein said sealing gasket (62) has a ring or o-ring conformation with an external diameter preferably adjusted to the outer limit of the anchoring structure (2) in its foot end, or slightly smaller, and an internal diameter preferably adjusted to the larger diameter presented at that level by the extension rod (11) or the existing through structure (63); characterized in that said seal is preferably formed in an elliptical, semicircular or round section and is housed in a channel arranged between the rotating crown and the anchoring structure, formed by two grooves formed on said structures, or formed by a single groove ( 65) formed on one of them.

26. Rotary crown dental implant according to claims 24 ^a and 25 ^a , wherein, according to an alternative embodiment of the implant, there may be at least one seal (70) disposed between the extension rod (11) and the axial tubular opening (71) of the dental implant, preferably located at the level of the screwing head (12), preferably made of elastomeric rubber such as a high density silicone, formed to maintain the tightness between said extension rod and said tubular opening; characterized in that said sealing gasket (70) has a ring or o-ring conformation with an external diameter adjusted to the diameter of the tubular opening, being preferably housed in a circumferential groove (72) formed on the surface of the screwing head .

27. Rotary crown dental implant according to any of the preceding claims, wherein according to a preferred and optional embodiment of the dental implant, the rotary crown has an external upper sleeve (64) on which a coupling ring is coupled. (63) in solidarity with the foot end of the anchoring structure (2), said bushing having an internal diameter adjusted to the external diameter of said coupling ring, being able to alternatively a sealing gasket arranged between the foot section of said ring and the rotating crown; characterized in that the internal diameter of the joint will be adjusted to the external diameter of said coupling ring.

28. Rotary crown dental implant according to any of the preceding claims, characterized in that according to a preferred and optional embodiment of the dental implant, the implant body (1) has a cylindrical outer conformation in the upper section of the anchoring structure (2), progressively decreasing the diameter thereof towards its foot end, preferably in frustoconical conformation and walls with a preferential convergence of approximately 5 degrees with respect to the cylindrical conformation, being topped at its foot end, at the apex of the rotary crown (3), with a rounded conformation, starting the longitudinal edges (8) with respect to the anchoring structure of the section of the same in which its external diameter begins to reduce, ending, in bevelled conformation, at the end standing of said anchoring structure, not exceeding the wing of said edges of the largest diameter of the section top of the anchor structure; and because the thread steak (7) of the rotating crown has a wing whose outer edge does not exceed the larger diameter of the anchoring structure, progressively decreasing the length of the wing thereof in its terminal apical section until it matches the apical outer surface of the rotating crown.

29. Rotary crown dental implant according to any one of the preceding claims, wherein according to a preferred embodiment of the extension rod (11), an assembly pin (66) is formed at its foot end shaped to be fixed by mechanical retention on a tubular assembly opening (73) formed in the insertion crown (3), the extension rod being terminated at its opposite end in a screw head (12) with a diameter greater than the diameter of the extension rod ; characterized in that the diameter of said assembly pin is equal to or less than the diameter of the extension rod; and because the axial tubular opening of the dental implant comprises an upper section (71) of greater diameter, adjusted to the diameter of said screw head, and a lower section (74) adjusted to the diameter of the body of the extension rod, remaining, in assembly position, screwing head coupled on the upper section of the axial tubular opening of the implant, with the rod coupled on the lower section of said opening and the assembly pin assembled and fixed on the assembly opening of the insertion crown.

30. Rotary crown dental implant according to any one of claims 8 ^to 20 ^a , wherein according to a preferred embodiment of the upper section (71) of the tubular opening, it has a series of vertical rails (55) formed , preferably four arranged in equidistant positions, on which at least one rail (47) formed on the fixing pin (58) of the screwing tool (45) is attachable; characterized in that said screw pin is attachable on said upper section of the axial tubular opening of the implant with different angular orientations, determined by the position of the rail or rails thereof on said rails.

31. Dental implant rotatable crown according to claim 30, characterized in that, alternatively, said upper section of the tubular opening may have a polygonal shape, consistent with a polygonal conformation of the pin screw, which is engageable on the same in a series of specific angular orientations.

32. Rotary crown dental implant according to claim 21 ^a , wherein the angulation determination tooling can comprise in one piece, preferably made of rigid plastic, the anchor structure replica (34), the replica of prosthetic abutment (35) and a manipulation rod (43) sympathetic at one of its ends with the replica of the prosthetic abutment, and topped by its opposite end in a digital clamping structure (67) preferably made by broadening the rod, formed to be held with two fingers; characterized in that preferably said anchor structure replica has a conformation in crossed longitudinal blades (69), with emptying between them, and because said rod, optionally, has a narrowing (68) in its union with the replica of prosthetic abutment, formed to allow said stent to flex with respect to said prosthetic abutment replica, and / or is formed to allow disconnection of the stent with respect to said aforesaid prosthetic abutment by rotation, bending or tearing thereof with respect to this.

33. Rotary crown dental implant according to any of the preceding claims, characterized in that the dental implant (1) can be used alternatively in other medical therapies, the implant body serving, inserted in a bone drill, supporting any other structure. prosthetic, such as a prosthetic condyle.