During the insertion and removal of a healing abutment, as well as the insertion of a final abutment, great care is stressed amongst dentists and oral surgeons to not allow the abutment to fall free from their control into the patient's throat and result in complications for the patient.
One serious potential complication when an abutment falls free is asphyxiation, where the fallen abutment prevents the patient from breathing. Another potential complication from a fallen abutment is aspiration of the abutment by the patient; where instead of blocking the patient's airway, the abutment enters the patient's lungs. Yet another potential complication from a fallen abutment is when a patient swallows the abutment and the abutment enters the digestive tract, potentially causing digestive complications.
Even with these and other potential complications due to fallen abutments, current healing abutments and final abutments are not configured for easy control and retrieval should the abutment fall from the dentist's control during insertion or removal. Indeed, for each of the current methods by which a dentist may choose to insert or remove an abutment, even those designed for the improved control or grasp of the abutment, the possibility remains for the abutment to fall free from the dentist's control and not be easily retrievable.
For example, one preventative measure known in the art is to insert sterile gauze at the base of the patient's mouth prior to and during the insertion or removal of an abutment to help prevent the abutment from entering the pharynx should the abutment fall free; commonly referred to as a “throat pack”. This practice is often uncomfortable or bothersome for the patient. In addition, if the gauze of the throat pack is not properly positioned at the back of the mouth the opportunity remains for the abutment to pass under or around the gauze placing the patient at risk for severe complications including asphyxiation. It can also be awkward for the dentist to attempt to retrieve an abutment after it has landed on the gauze. The act of attempting to retrieve an abutment from the gauze provides additional opportunities for the abutment to fall free. Moreover, use of gauze can further reduce the available work space for the dentist during the procedure.
Accordingly, there is a need in the art for an improved preventative measure during the insertion and removal of abutments.
The present disclosure is directed to an improved abutment and method for quickly and easily retrieving a healing abutment or final abutment should it fall free during the insertion or removal process.
According to one embodiment of the invention, a tunnel is provided on the face of a healing abutment whereby dental floss (or other sterile thread) may be laced through to serve as a tether to the healing abutment.
According to another embodiment of the invention, a tunnel is provided on, or through, an area of a final abutment whereby dental floss (or other sterile thread) may be laced through to serve as a tether to the final abutment.
In accordance with certain embodiments, a method is provided for enabling easy retrieval and control of abutments during surgery by using a tether laced through an abutment having a tunnel therein. By using an abutment and tether in accordance with various embodiments of the invention, a dental professional can safely insert and remove abutments with minimal training or the use of specialized tools.
Certain embodiments of the invention provide for increased patient safety during the insertion or removal of dental abutments. While care is still paramount during insertion and removal of an abutment, having a floss tether attached to the abutment allows the dentist to proceed with increased confidence.
Embodiments of the invention provide methods and devices for improved dental healing abutments and final abutments for use with dental implants.
Certain embodiments of the invention enable a dentist to improve the handling of an abutment during insertion and removal even with the challenges presented by the inherent environment of a patient's mouth.
In particular, a patient's mouth is a confined workspace for a dentist and provides a dentist limited access when the dentist is inserting or removing an abutment. The amount of space available in which a dentist may work (e.g., access) is largely dictated by how far the patient's mandible (lower jaw) can open, as well as the size and shape of the patient's palate (roof of the mouth). Access is especially restricted in the back region of the mouth, approaching the temporomandibular joint where the molars are located. The restricted region provides not only limited work space, but also a limited line of sight and limited access to light. Small handheld mirrors and lighting instruments may be used; however, the addition of these instruments may further decrease the available work space.
In addition to working within a confined workspace, a dentist may experience unexpected movement on the part of the patient. A patient typically does not require anesthesia during the insertion or removal of an abutment except for localized anesthesia and, thus, is conscious during the procedure. The unexpected movement of a patient's tongue or jaw, either involuntarily or in an attempt to communicate, can cause interference in the form of bumping the dentist's hand, tool, or even the abutment itself. Coughing, sneezing, or yawning by the patient creates unexpected movements of the jaw, mouth, head, and/or neck, as well as unexpected air movements. These actions provide interference with the dentist's control of the abutment or tool used therewith. Finally, jaw movement or closure due to patient fatigue and/or discomfort further restricts the available working space and provides interference to the dentist's control
In order to address these challenges, certain embodiments provide a system in which the abutment can be retained during unexpected movement by the patient while minimizing the encroaching impact to the available workspace.
In accordance with one embodiment of the invention, dental abutments, including healing abutments and final abutments, are provided that include a tunnel configured to receive dental floss that may be laced through to be used as a tether.
In accordance with another embodiment of the invention, methods are provided for performing insertion and removal of dental abutments. In one such embodiment, a dental abutment is provided that includes a tunnel configured to receive dental floss; and dental floss is laced through the tunnel, the dental floss having a length such that excess length of floss is available after lacing the floss through the tunnel. In a further embodiment, after lacing the floss through the tunnel, the excess length of floss is then tied or knotted.
In accordance with yet another embodiment of the invention, systems for performing insertion and removal of dental abutments are provided. In one such embodiment, a system is provided that includes a dental abutment having a tunnel; and a tether releasably attached via the tunnel. In a specific embodiment, the tether is provided by floss laced through the tunnel.
Various implementations of embodiments of the invention provide for increased patient safety during the insertion or removal of dental abutments. In addition, both the patient and dentist may experience increased psychological comfort with the knowledge of reduced risk during the procedure. While care is still paramount during insertion and removal of an abutment, having a tether attached to the abutment allows the dentist to proceed with increased confidence. By providing increased confidence, a dentist can work at an increased pace without apprehension of the potential consequences of losing control of the abutment. This may result in decreasing the length of time for dental procedures.
Embodiments of the subject methods, systems, and abutments can be used for dental implant surgery. In one embodiment, the implant of the dental implant surgery is a root-form endosseous implant. A root-form endosseous implant is typically metal, often titanium, and shaped in a threaded hollow screw-like formation such as shown in
A healing abutment is used to facilitate the healing stage following implant surgery in order for the jaw bone and dental implant to fuse by a natural process of osseointegration. During the healing stage, the gingival tissue heals relative to the healing abutment. At the dentist's discretion, either a two-stage or one-stage technique for inserting the healing abutment may be used. In a two-stage technique, the gingival tissue is sutured to heal over the implant after insertion into the jaw bone as part of a first stage. Then in a second stage (at a subsequent appointment several weeks or months later), the gingiva is reopened to expose the top of the implant for inspection by the dentist to confirm osseointegration of the implant and the healing abutment is then attached to the implant. In the one-stage technique, the healing abutment is inserted into the implant directly following the insertion of the implant into a patient's jaw bone.
Healing abutments may be inserted or removed from a dental implant by a variety of methods. Examples include: manually held by the dentist's fingertips; manually with the abutment held within a clip or housing for the abutment; the use of a driver, which may include a hex, star, square, or other shaped driver wherein a recessed shape on the abutment directly corresponds with an appropriately shaped driver shaft; the use of a driver including a retention mechanism, or the use of a tweezers-like device to grip the abutment.
The healing abutment may be handled by the dentist several times before the final abutment is attached to the dental implant. Each time an abutment is inserted or removed from the implant (or an attempt is made) presents a new opportunity for the abutment to fall from the dentist's control and jeopardize the patient's safety.
As illustrated in
In various embodiments, the circumference measurements of the head, moving from the coronal end to the gingival end (where the head meets the post), may not be equal. The size and shape of the head depends on the dentist's expectations and/or desires of how the gingiva should heal relative to the implant.
The “face” of an abutment refers to the occlusal or incisal plane of the head. In accordance with various embodiments of the invention, the abutment face may be flat, domed, or taper into a plateau. The center of the face of the head (not shown in the side view of
As shown in
The final abutment head includes a coronal end 503 and an apical end 504. The coronal end of the final abutment head, also referred to as the “supra-gingival” (that which extends above the gum line), varies widely in size and shape. The selected size and shape for the coronal end 503 of the final abutment head depends both on the tooth being replaced by prosthesis and that which will result in a natural aesthetic and functionality. Strides have been made in the art to create a wide variety of custom sizes and shapes designed to maximize natural aesthetics and function.
The apical end 504 of the final abutment head, referred to as the “sub-gingival” (that which is below the gum line), is generally a smooth tapered region which fills the gingival socket. The point where the supra-gingival and sub-gingival intersect is generally the widest circumference of the final abutment.
The supra-gingival portion of the final abutment may taper into a conical shape to allow for the crown 520 and cement used therewith to fully encapsulate the coronal end 503 of the final abutment. However, as indicated above, final abutment head shapes vary widely and may include, but are not limited to, conical, cylindrical, curvilinear, or multi-angular shapes.
As explained with respect to
For the embodiments illustrated in
Although the entry/exit holes 201 are shown having a circular shape, embodiments are not limited thereto. In addition, the shape and curvature of the tunnel 202 is not limited and may be implemented in any direction as appropriate for the shape of the healing abutment. As shown in
The tunnel 202 provides for dental floss 203 to be laced through to serve as a tether. As indicated above, this tether may be used to retrieve the healing abutment from the patient's mouth or throat should the healing abutment fall free from the dentist's control during the insertion or removal of the healing abutment.
When lacing the floss through the tunnel 202, an excess length of floss is to be used as the tether for easy access to grasp if the healing abutment falls free. In a further embodiment when using an abutment in accordance with embodiments of the invention, the floss is also tied or knotted. Tying-off the floss tether reduces the risk of the floss coming out of the tunnel when the tether is pulled during retrieval of the fallen abutment (knotted healing abutment not illustrated).
The diameter of the tunnel hole can be limited by the size and thickness of the abutment head from its outer circumference to the perimeter of the recess within the abutment head.
However, the entry and exit holes of the tunnel can be widened to provide for a greater area by which the floss 203 may enter the tunnel 202. In addition, with a larger entry/exit hole, a dental professional has a larger area to access and take hold of the floss 203 as it exits the tunnel 202 with or without the use of a floss threader. By providing easier access to fully lace the floss 203 through the healing abutment, the lacing process can be made faster.
In a preferred embodiment, the tunnel 202 of the healing abutment is smooth and relatively shallow to avoid obstructing the movement of the floss 203 during the lacing process. In instances where the tunnel 202 is partially or fully blocked after residing in the patient's mouth due to plaque, food, etc., it may be recommended that the tunnel 202 first be cleared using a dental air/water syringe tip apparatus as to not impede the movement of the floss 203 through the tunnel 202 during the lacing process.
The post 311, head 310, and face 305 of the healing abutments shown in
Although the entry/exit holes 301, 303 are shown having a circular shape, embodiments are not limited thereto. In addition, the shape and curvature of the tunnel 302 is not limited and may be implemented in any direction as appropriate for the shape of the healing abutment. The diameter or width of the tunnel 302 may be a different diameter than the entry/exit holes 301, 303 and the entry/exit holes 301, 303 can have different diameters.
The entry/exit holes 301, 303 of the tunnel 302 can be widened to provide for a greater area by which the floss 203 may enter the tunnel 302. In addition, with a larger entry/exit hole, a dental professional has a larger area to access and take hold of the floss 203 as it exits the tunnel 202 with or without the use of a floss threader. By providing easier access to fully lace the floss 203 through the healing abutment, the lacing process can be made faster.
The tunnel 302 provides for dental floss 203 to be laced through to serve as a tether. As indicated above, this tether may be used to retrieve the healing abutment from the patient's mouth or throat should the healing abutment fall free from the dentist's control during the insertion or removal of the healing abutment.
Use of the recess area 304 for one (or more) of the holes 303, such as shown in
When lacing the floss through the tunnel 302, an excess length of floss is to be used as the tether for easy access to grasp if the healing abutment falls free. In a further embodiment when using an abutment in accordance with embodiments of the invention, the floss is also tied or knotted. Tying-off the floss tether reduces the risk of the floss coming out of the tunnel when the tether is pulled during retrieval of the fallen abutment (knotted healing abutment not illustrated).
In instances where the tunnel 302 is partially or fully blocked after residing in the patient's mouth due to plaque, food, etc., it may be recommended that the tunnel 302 first be cleared using a dental air/water syringe tip apparatus as to not impede the movement of the floss 303 through the tunnel 302 during the lacing process.
The healing abutments with tunnel as described herein may be fabricated by a variety of means, including by casting or milling; and the tunnel may be formed at the same time as the healing abutment, or added by modifying a previously fabricated healing abutment.
As mentioned above, in addition to healing abutments, final abutments can be provided with tunnels for enabling better control of the abutments during insertion and removal.
A final abutment may be designed to be covered by a crown, as illustrated in
As described above with respect to
A final abutment includes a hollow non-threaded post 612 (see also 501 of
The tunnel 702 provides a means for dental floss 203 to be laced through to serve as a tether. As indicated above, this tether may be used to retrieve the final abutment from the patient should the final abutment fall free from the dentist's control while the placing the final abutment into the implant 510.
When lacing the floss through the tunnel 702, an excess length of floss is to be used as the tether for easy access to grasp if the final abutment falls free. In a further embodiment when using an abutment in accordance with embodiments of the invention, the floss is also tied or knotted. Tying-off the floss tether reduces the risk of the floss coming out of the tunnel when the tether is pulled during retrieval of the fallen abutment.
As indicated in
According to another embodiment, such as shown in
According to yet another embodiment, such as shown in
The entry/exit holes 701, 801 of embodiments of the invention are positioned away from the proximal surface (i.e. the surface adjacent another tooth), thereby avoiding obstruction of the access to the entry/exit holes by the surrounding teeth (either natural or prosthetic).
As described with respect to the embodiments illustrated in
The final abutment with tunnel as described herein may be fabricated by a variety of means, including cast or milled. The tunnel may be formed at the same time or in a similar fashion as the healing abutment. The tunnel may also be added after fabrication by modifying a previously fabricated final abutment.
Any reference in this specification to “one embodiment,” “an embodiment,” “example embodiment,” etc., means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the invention. The appearances of such phrases in various places in the specification are not necessarily all referring to the same embodiment. In addition, any elements or limitations of any invention or embodiment thereof disclosed herein can be combined with any and/or all other elements or limitations (individually or in any combination) or any other invention or embodiment thereof disclosed herein, and all such combinations are contemplated with the scope of the invention without limitation thereto.
It should be understood that the examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application.