The present disclosure is in the dental area, more specifically in the area of dental implants.
The dental implant of the present disclosure is arranged to be fixed to the cortical bone and contains a cellular structured surface formed by elevated platforms forming a mesh network of under-channels between the platforms for improved implant lifetime vascularization, surprisingly with capillarity properties.
The conventional dental implant system includes implants and placement of dental implants that rely on screwing the implant within the cortical bone and also the trabecular bone, the mandible and the maxilla. These implants present some limitations, among which is non follow-up of bone recession; the promotion of bone recession due to lack of application of loads in the area adjacent to the implant; the need for long periods of bone osseo-integration before chewing charges may be applied; and, because they need to be screwed the rotation of the implant does not allow the implant to be a single piece that contains the intraosseous and extraosseous zone, nor does it allow the geometry of the intraosseous part of the implant to fit the geometry of the natural cavity or socket of an extracted tooth.
The concept of subgingival implant is not recent. The patent document U.S. Pat. No. 4,702,697 states that a small plaque is placed on the cortical bone and under the gingiva, and moulded to the cortical bone. This plate contains a zone, with a protrusion containing a thread, facing the outside of the gum, where the abutment or crown will be attached. This implant, in order to be solidary with the cortical bone, requires a period of time for bone integration to occur, after which the abutment can be placed and the crown, and chewing charges are applied. Further, as it is placed over the cortical bone there are some issues related to defect of vascularization, to be solved, not provided by the mentioned patent.
The implant of the present disclosure is further distinguished from most of the implants because it does not have a thread for attachment to the bone. Their fixation is obtained by rings or cylinders or other expandable components, coupled in the body of the implant that enters the cavity or socket of the extracted tooth or the hole created in the cortical bone, and by small screws, in the external zone of the bone and internal to the gingiva. This allows the implant to have different geometries, adapted to the anatomy of the bone of each patient, and that the implant's exterior, or crown, may inclusively be anchored in the adjacent teeth, thus increasing the fixation and stiffness of the same.
The method of bone mechanical fixation by expandable components, screw-type bushing, is quite common. The use of materials with shape memory by using the temperature also has some years. Patent document EP1017868 discloses a dental implant which consists of NiTi (Nitinol) and will expand when inside the bone, due to the application of temperature.
Documents U.S. Pat. No. 6,419,491B1 and US 20040000540 A1 disclose dental implants for improved fixation and initial osseo-integration (after the removal of the tooth—first weeks/months). However, the surface described in these documents does not have vascularization functions, necessary mainly when implants are placed over the cortical bone, a type of bone with much less blood than trabecular bone.
These facts are disclosed in order to illustrate the technical problem addressed by the present disclosure.
The present disclosure describes a solution that bridges the limitations previously mentioned, because disclose a surface cellular structure with comprising subsurface vascularization functions, which have capillarity properties, able to act during the lifetime of the implant and improving the osteo-regeneration and bone remodeling, necessary for all implants but mainly for those placed in poorly vascularized bone, as is cortical bone.
The present disclosure is distinguished in that small rings, alternately offset, or small cylinders, or small hooks, or components with other geometries but with the same function are placed in the surface of the implant body, in the area of the implant that will enter the cortical bone socket, and will be expanded by the application of temperature, ensuring anchoring from this area of the implant to the cortical bone. This method allows the body of the implant to be in any material, Titanium (Ti), zirconia (YTZP), polyether-ether-ketone (PEEK), or other, and the fasteners and expandable elements are in another material, for example Nitinol.
One aspect of the present invention describes a dental implant for fitting in an intraosseous zone of a dental socket comprising: a plurality of raised platforms with a fiat top such that said tops form an external surface of the implant for contacting with the intraosseous zone and the spaces between said platforms form a network of channels for revascularisation fluid flow. However, network of channels for revascularisation fluid flow, preferably with capillarity properties, able to act during the lifetime of the implant, was not provided so far, and of paramount importance for implants placed in a poorly vascularized bone as is cortical bone.
In one embodiment, the network channels, surprisingly a network with capillarity properties, for fluid flow or vascularization is interconnected all around the surface implant, in contact with bone.
In an embodiment for better results, the external surface is a flat surface elevated from the implant.
In an embodiment for better results, the platforms comprise lateral concave surfaces.
In an embodiment for better results, the platforms have a ‘T’ or ‘V’-shaped cross-section.
In an embodiment for better results, the platforms have a flat top area that is shaped as a triangle, square, rhombus, hexagon, or combinations thereof.
In an embodiment for better results, the platforms have a central elevation crowned by a flat top comprising two tabs extending in two opposite directions.
In an embodiment for better results, each said tab has a triangular-shaped, square-shaped, rhombus-shaped, hexagon-shaped, or combinations thereof top surface.
In an embodiment for better results, the channels have a round, oval or rectangular cross-section, providing capillarity functions.
In an embodiment for better results, the network of channels is a mesh of channels.
In an embodiment for better results, the space between said platforms is between 0.025-0.4 mm.
In an embodiment for better results, the height of the channels varies between 0.05-0.8 mm.
In an embodiment for better results, the width of cross-section of the channels varies between 0.05-0.8 mm.
In an embodiment for better results, the length of platforms varies between 0.1-1.6 mm.
In an embodiment for better results, the length of platforms may form a honeycomb structure or a reverse honeycomb structure (i.e a network of channels for fluid flow).
In an embodiment for better results, the dental implant may further comprise an upper part wherein the upper part comprises at least two flaps wherein said flaps comprise holes for housing fastening means.
In an embodiment for better results, the external surface of the flaps, preferably in contact with bone, comprises the network of channels for revascularisation fluid flow.
In an embodiment for better results, the dental implant comprises an internal central hole capable of securing a post and/or a crown.
In an embodiment for better results, the central hole is threaded.
In an embodiment for better results, the dental implant may further comprise a lower part of the implant comprising a conical, frustoconical, frusta-cylindrical shape.
In an embodiment for better results, the lower part of the implant may have the root shape of a tooth or of the bone socket.
In an embodiment for better results, the dental implant may comprise a post for securing the crown.
In an embodiment for better results, the dental implant may comprise a pillar and a crown.
In an embodiment for better results, the dental implant may comprise a plurality of recesses and/or protuberances able to receive expandable components, preferably thermal expandable components.
In an embodiment for better results, the thermally expandable components expand at temperatures between 40-50° C.
In an embodiment for better results, the expandable components have a diameter ranging from 0.4-2 mm.
In an embodiment for better results, the expandable components have a height ranging from 1-3 mm.
In an embodiment for better results, the spaces between said platforms is less than 0.4 mm.
In an embodiment for better results, the expandable components are of shape memory material, preferably Nitinol.
In an embodiment for better results, the dental implant may comprise an internal central hole capable of securing a post and/or a crown.
In an embodiment for better results, the lower part of the implant has conical, frustoconical, frusto-cylindrical shape.
In an embodiment for better results, the lower part of the implant has the root shape of a tooth or of the bone socket.
In an embodiment for better results, the implant material is selected from the following list: metal material, metal alloy, metal matrix composite, ceramic, ceramic composite, polymer, polymeric composite, or mixtures thereof.
In an embodiment for better results, the metallic material, alloy or metal matrix composite comprises titanium, CoCrMo, stainless steel, or mixtures thereof.
In an embodiment for better results, the ceramic or composite ceramic composition comprises zirconia, alumina, hydroxyapatite, or combinations thereof.
In an embodiment for better results, the polymer or polymeric composite may be selected from materials comprising polyether ether ketone (PEEK), poly (methyl methacrylate) (PMMA) or mixtures thereof.
Dental surgery kit comprising the dental implant described in any one of the preceding claims and expandable components described in the present disclosure.
The present disclosure describes a dental implant, with rigid fixation to the cortical bone, where the implant can be subjected to immediate loading.
In order for this to happen this implant is supported only on the more resistant bone component, the cortical bone, and has a fixation in several points of the cortical bone of the socket.
The present disclosure differs in that the implant here proposed, in addition to the part that is moulded to the external surface of the cortical bone, contains a zone that will enter the natural hole or socket of the tooth that has been extracted, or alternatively in a hole made in the same area, in the cortical bone, and there it will be fixed through rings or cylinders or other expandable components, which ensure a strong and immediate mechanical fixation in this area. In addition, the implant will still be attached to the cortical bone through small screws that will fix the part of the implant on the outside of the bone and subgengival, and that will give greater rigidity to the implant-bone connection. In this way the connection is practically free of relative bone-implant displacement, which allows it to be subjected to immediate chewing loads. This allows the abutment and crown to be applied immediately, or alternatively that the implant has a single body, that is, it already contains the abutment and the crown as a unique part.
In the case of implantation immediately after extraction of the tooth, or sometime after extraction, as long as there is some cavity where the tooth was extracted, the implant will have a component that enters the cavity from where the tooth was extracted, the geometry of the implant zone entering the hole being the closest to the root or bone socket of the extracted tooth, or remaining tooth bone socket. Alternatively, if there is no longer a natural bone cavity, e.g. the tooth has been extracted for a long time, a hole should be drilled only from the thickness of the cortical bone, and the central area of the implant should be inserted in that hole.
In one embodiment, the implant of the present disclosure comprises the following features:
In one embodiment, the implant further comprises a flap (1) which will remain superimposed over the cortical bone and under the gingiva. This flap may comprise for example 4 holes in the side zone which will allow screws (5) to secure this flap to the cortical bone and a cellular structure (7) in the region of contact to the cortical bone, in order to accelerate bone-integration and vascularization.
In one embodiment, the implant may be made with a single body (
In one embodiment, the implant, in addition to being generally supported on the cortical bone, in order to maintain a close contact between implant and bone, some fastening bolts by means of screws, which allow it to remain rigidly attached to the bone. This fixation does not allow relative displacements between bone and implant, allowing the immediate application of loads without compromising the osseo-integration of the implant, even with loads of mastication.
In one embodiment, the implant may further have a cellular structure, in the zone where it is in contact with the bone, allowing effective bone osseo-integration acceleration, including adequate vascularization across the implant surface and over time for as long as the implant is in service, with capillarity properties. This cellular structure must have a geometry that does not jeopardize the holes for the screws.
In one embodiment, the cellular structure may be in the form of several platforms surrounded by a network of sub-surface channels, particular for each platform being a square, a hexagon, a pentagon, an octagon, their combinations. In particular as shown in detail in
In one embodiment, in terms of materials, the implant or its parts, as well as the accessory screws are metal or metal alloy or metal matrix composites based on titanium or Cobalt-Chromium-Molybdenum Alloy (CoCrMo) or stainless steel or other accepted metal or alloy for medical implants, or by a ceramic such as zirconia, alumina, or other material accepted for medical implants, or ceramic composite, or by a polymer such as PEEK, poly (methyl methacrylate) PMMA, or other polymer accepted in medical implants, or polymeric composite. The other elements, namely the rings or expandable parts, are Ninitol (NiTi) or other expandable material, with shape memory, accepted for medical implants.
In one embodiment, as to the implant manufacturing process either simple or implants by parts) they will be tailored to the anatomy of each patient. Anatomical images of the bone and tooth will initially be obtained. With these implants should be manufactured containing the flap that will embrace the cortical bone and eventually the crown, in the option of the integrated implant. The manufacturing will be conventional, by CNC machining, laser, or by additive technologies, or other conventional technologies.
In one embodiment, the zone of the implant in contact with the bone will have a cellular structure, which promotes rapid and effective integration with the bone, and allowing adequate vascularization throughout the implant surface and over the implant lifetime.
The dental implant described in the present disclosure has the following advantages:
This is due to the fact that the implant of the present disclosure is set only in the cortical bone, being able to follow the bone recession of the same, and not to be fixed to the cortical and also trabecular bone, as in conventional implants where the area of the implant fixed in the trabecular bone does not allow the implant to follow the cortical bone recession.
In an embodiment, the dimension of the network channel do not allow bone growth inside the network of channels.
In an embodiment, the plateaux flaps deform, under chewing forces, inducing further fluid flow or vascularization along the sub-surface channels.
The following figures provide preferred embodiments for illustrating the disclosure and should not be seen as limiting the scope of invention.
The dental implant of the present disclosure is arranged to be fixed to the cortical bone and contains a cellular structured surface formed by elevated platforms forming a mesh network of under-channels between the platforms for improved implant lifetime vascularization.
In one embodiment, in order to enhance the fixation and implant lifetime vascularization, the implant of the present disclosure for fitting in an intraosseous zone of a dental socket comprising plurality of raised platforms with a flat top such that said tops form an external surface of the implant for contacting with the intraosseous zone and the spaces between said platforms form a network of channels for revascularisation fluid flow, surprisingly with capillarity properties.
In an embodiment, the network channels structure provides vascularization, which further have capillarity properties, over the entire implant surface in contact with bone, over the entire lifetime of the implant.
In an embodiment, plurality of raised platforms with a flat top may deform due to chewing forces.
The present disclosure describes a dental implant, which if supported on the cortical bone, and which may be subject to immediate loading. In particular, the implant will be implanted in the socket from which the tooth was extracted, if this hole still exists, or in the remaining socket when the tooth was extracted some time before, or alternatively in a hole made for placement of the implant, at cortical bone level, and externally, between the cortical bone and the gingiva, slightly embracing the mandible and the maxilla.
The present disclosure describes a dental implant that may be subject to immediate loading because it is firmly anchored in an area of cortical bone quite substantial.
The present disclosure describes a dental implant, which is anchored on the cortical bone, and which may be subject to immediate loading. In particular, the implant will be implanted in the socket from which the tooth was extracted, if this hole still exists, or alternatively in the remaining socket of a previous extracted tooth, or also in a hole made for placement of the implant, at the level of the cortical bone, and externally, between the cortical bone and the gingiva, slightly around the mandible and maxilla.
In one embodiment, in order to enhance the fixation, the implant may comprise screws that fasten to the maxilla/mandible the outside of the implant, and rings or parts that will fix the implantable part, that is, the part of the implant that enters the socket of the extracted tooth or in the hole made in the cortical bone, and includes an interface region of the implant with the bone having a cellular structure (7) that will allow and accelerate bone integration, including vascularization, additionally with capillarity properties, along the entire surface of the implant and over the entire implant life.
In one embodiment, according to
In one embodiment, in the case of an extraction followed by implantation the implant may also comprise the equivalent of the tooth root (
In one embodiment, because of the high rigidity of the fixation, it is possible to apply immediate loading, such as chewing. Three options are provided: the first (
In one embodiment, the interface zone of the implant with the bone has a cellular structure (7) that will allow and accelerate bone integration, including proper vascularization, with capillarity properties, over the entire surface of the implant and over the entire lifetime of the implant. In addition to this, the cellular structure will also allow to house bioactive or antibacterial materials which will allow for faster bone integration and healing, in the implant area that will enter the cortical bore, there are holes (13) or semi-circumferential grooves (15) for cylinders or hooks (14) or rings (16), made from a shaped memory material, preferably Nitinol. Rings and cylinders and hooks shall have an external surface with an irregular structure with roughness which allows a strong bond to bone and rapid bone-integration.
In one embodiment, once the implant is definitively placed, it should be applied temperature in the crown, which will diffuse into the intra-osseous zone. It will expand the cylinders, hooks, or rings, and will promote a contact load link between the implant and the bone. The screws (5) should also be placed on the flaps, and bolted to the cortical bone. The screws may have a length between 1 and 3 mm and a diameter between 0.5 and 2 mm.
In one embodiment, the flap (1) (
In one embodiment, the implant body as well as the accessory screws may be made of a metal or metal alloy, or metal matrix composite, based on titanium, or CoCrMo, or stainless steel, or other metal or alloy accepted for medical implants, or by a ceramic such as zirconia, alumina, or other accepted for medical implants, or ceramic compound, or by a polymer such as polyether ether ketone (PEEK), poly(methyl methacrylate) (PMMA), or other polymer accepted in medical implants, or polymeric composite, or mixtures thereof. Preferably it should be ceramic based on zirconia. The other accessories, namely expandable rings and cylinders, should be made of NiTi or other expandable material, accepted for medical implants. They should preferably be of Nitinol.
In one embodiment, as to the manufacturing process of the implants, and in both cases, the implants will be made according to the anatomy of each patient. Anatomical images of the bone should initially be obtained. With these the implants containing the flap that will embrace the cortical bone, and optionally the abutment and the crown, in the option of the integrated implant, will be manufactured. The manufacturing techniques are conventional, by CNC machining, or by additive/subtractive technologies, including laser ablation, among other conventional technologies.
The term “comprising” whenever used in this document is intended to indicate the presence of stated features, integers, steps, components, but not to preclude the presence or addition of one or more other features, integers, steps, components or groups thereof.
Furthermore, it is to be understood that the invention encompasses all variations, combinations, and permutations in which one or more limitations, elements, clauses, descriptive terms, etc., from one or more of the claims or from relevant portions of the description is introduced into another claim. For example, any claim that is dependent on another claim can be modified to include one or more limitations found in any other claim that is dependent on the same base claim.
Where ranges are given, endpoints are included. Furthermore, it is to be understood that unless otherwise indicated or otherwise evident from the context and/or the understanding of one of ordinary skill in the art, values that are expressed as ranges can assume any specific value within the stated ranges in different embodiments of the invention, to the tenth of the unit of the lower limit of the range, unless the context clearly dictates otherwise. It is also to be understood that unless otherwise indicated or otherwise evident from the context and/or the understanding of one of ordinary skill in the art, values expressed as ranges can assume any subrange within the given range, wherein the endpoints of the subrange are expressed to the same degree of accuracy as the tenth of the unit of the lower limit of the range.
The disclosure should not be seen in any way restricted to the embodiments described and a person with ordinary skill in the art will foresee many possibilities to modifications thereof.
The above described embodiments are combinable.
The following claims further set out particular embodiments of the disclosure.
Number | Date | Country | Kind |
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115485 | Apr 2019 | PT | national |
Filing Document | Filing Date | Country | Kind |
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PCT/IB2019/053585 | 5/2/2019 | WO | 00 |