The present invention relates to an implant instrument and a guide system for implant instrument, suitable to stably, securely and accurately form a hole for a dental implant at a predetermined position and to accurately insert an implant into the predetermined position.
In recent years, a dental treatment to set a denture after placing an implant (artificial tooth root) in a site of tooth missed is performed. In this treatment, an implant hole is formed at a site of a lost tooth by use of a drill attached to a drilling device such as a handpiece, and at this time, a surgical guide is usually employed to drill the implant hole in order to guide the drill so that the implant hole would be formed at a predetermined position and in a predetermined direction.
Into this surgical guide, a metallic guide ring is fitted to guide the drill through the surgical guide supported by the jawbone, etc.
As a method for drilling holes by use of this guide ring, there has been known a method wherein the drilling is performed while a drill bur is brought into directly contact with the inner face of the guide ring, and a method as described in Japanese Patent No. 3793603 wherein a guide member is attached to a drilling device such as a handpiece, this guide member is positioned around a drill which is to be attached to the drilling device so that the guide member would not be in contact with the drill, and the guide member is guided by the guide ring to perform the drilling.
The type wherein a drill bur is brought into directly contact with the guide ring, skill is demanded for drilling, and if the drilling device is only slightly inclined, the drill bur may be in contact with the inner face of the guide ring and shave off its inside, and such shavings are likely to enter into the implant hole of the jawbone, which results in adverse affects at a connecting area with the implant or the drilling direction may sometimes be tilted. Further, in case the drill bur is to pass directly through the guide ring, only drills with same diameter can be used for one type of surgical guide, accordingly several surgical guides should be prepared corresponding to the diameters of drills, such being uneconomical.
Furthermore, at the time of drilling, a frictional heat is generated between the guide ring and the drill bur, and this frictional heat damages the guide ring and the drill bur, and at the same time, may adversely affect the jawbone.
Further, the method by which the guide member is directly attached to the handpiece, the device being bulky in its entirety, causes heavy workload in drilling operation and makes the operation difficult. Moreover, since the drill attached to the handpiece is inserted from the upper part of the guide ring at the time of drilling, especially in a case where the implant is inserted at the back tooth position, the drilling operation is difficult or impossible, and it is also required to make the patient open the mouth wide and suffer the patient huge distress.
Furthermore, after the implant hole is drilled, when an implant is inserted into the hole by use of an instrument such as an adaptor for implant insertion, such an instrument may deviate back and forth, and left and right, resulting in inclined placement of implants in some cases. Moreover, when an abutment, a healing cap, a healing abutment, etc. is attached to the implant by use of an instrument such as an abutment holder, a hex driver, etc., such an instrument may incline and attachment may take time in some cases.
The present invention solves such problems and provides an implant instrument and a guide system for implant instrument, by which when the implant hole is drilled into the jawbone, when an implant is inserted thereinto and when a part to be attached to the implant is installed, such operations can be safely, securely and efficiently conducted, and dental treatment can be conducted without causing heavy workload on the patient.
According to an aspect of the present invention, the guide system for implant instrument comprises a surgical guide having a guide ring, and an implant instrument such as an implant drill and an adaptor for insertion, wherein a ring guide body is provided on a shaft of the implant instrument. Further, the side face of the guide ring is provided with a slit portion, the width of which allows insertion of an implant drill bur and an implant from its lateral side and is smaller than the inner diameter of the guide ring.
According to another aspect of the present invention, the implant instrument is provided with, on its shaft, a ring guide body which is guided in the guide ring of the surgical guide.
The surgical guide having the guide ring is classified into a type wherein the surgical guide is supported by jawbone, a type wherein the surgical guide is supported by a gum, and a type wherein the surgical guide is supported by teeth. These types are generally made of a plastic material like conventional surgical guide (surgical stent). In such cases, if the surgical guide is made of a transparent material, the operation site of drilling can be observed more clearly.
When a guide ring is provided on a surgical guide, a part of the jawbone at which the implant is to be attached is subjected to CT scanning, the three dimensional image obtained by the scanning is used to determine the position, direction, etc. of the implant.
The guide ring may be made of a metal such as titanium or aluminum. When friction is generated between the guide ring and the ring guide body to be inserted thereinto, the guide ring may be made of a rigid plastic material so long as it can stand the friction. As the material, it is preferred to use a material not adversely influencing the human body.
When the outer peripheral face of the ring guide body has a circular cross section, the inner peripheral face of the guide ring is formed to have a circular cross section so that the ring guide body is movable within the guide ring in its axial direction and may be rotatably fitted therein and guided.
However, when the ring guide body is formed to be rotatable within the guide ring, the combination of cross sections is not limited thereto.
The guide ring is usually formed into a ring configuration with an inner diameter D1 of about 4 mm to 9 mm and an outer diameter D2 of about 5 mm to 10 mm, but the size is not limited thereto.
When the outer peripheral face of the ring guide body has a non-circular cross section (a polygonal shape such as ellipse, oval, quadrilateral or hexagonal, or a complex shape thereof), the inner peripheral face of the guide ring is formed to have a non-circular cross section corresponding to the outer periphery of the ring guide body so that ring guide body is movable within the guide ring in its axial direction and may be non-rotatably fitted therein and guided.
However, when the ring guide body is formed to be non-rotatable within the guide ring, the combination of cross sections is not limited thereto.
As a drill for forming the implant hole, ones with various shapes and various diameters, for example, a round bur (
Other than the drills, the ring guide body may be attached to an implant instrument such as an implant adaptor, an abutment holder, a hex driver, and instruments to increase the bone width around the implant hole, such as an osteotome, a bone spreader, and a bone expander.
When the implant is inserted, as an implant insertion adaptor to be attached to the implant, a type which is used with a handpiece (
In addition, when the absorption of a jawbone is remarkable, the ring guide body may be attached to instruments, such as, an extension holder and a drill extension used for drilling a hole in jawbone or inserting the implant at a deep position.
At the side face of the guide ring, a slit portion may be provided so that the drill bur, the implant or the front end portion of the implant instrument may be inserted from the lateral side. In this instance, a supporting portion of the surgical guide corresponding to the slit portion is provided with a cutaway portion having a width corresponding to the slit portion or a cutaway portion expanded outwardly wider than the width of the slit portion (usually the open angle is about 30 to 60 degrees, but may be other degrees). In a case of a ring-shaped guide ring having no slit portion or in a case where the slit portion of the guide ring has no supporting portion, the cutaway portion is of course not necessary.
In general, drill burs are formed to have a diameter of about from 2 mm to 5 mm in considering the diameter of implant, and taking it into consideration, the width W of the slit portion (
Further, the face of the slit portion may be processed so that the slit faces would be formed in parallel (
On the other hand, the ring guide body to be inserted into the guide ring has a hole to guide the shaft of the implant instrument such as a drill, and another hole to guide a drill bur or a thick shaft portion of other implant instrument. The ring guide body is supported by the thick shaft portion of the implant instrument (in some cases, the upper end portion of the drill bur corresponds to it). The ring guide body may be detachably fixed at a predetermined position of the shaft by use of a fastener.
By fixing the ring guide body with the fastener, the length of insertion of the drill bur to be inserted can be adjusted by moving the position of the ring guide body, by which it becomes possible to drill a hole in a predetermined depth depending on the length of the implant.
As the fastener, a hexagon socket head cap screw, a setscrew, etc. may be used. In any case, it is preferred that the head of the fastener does not project from the outer periphery face of the ring guide body so that the ring guide body can be smoothly guided into the guide ring.
The ring guide body may be made movable in the axial direction of the shaft of drill, etc., or rotatable relative to the shaft of drill, etc. (the cross section of the ring guide body and the shaft of e.g. a drill, etc. are formed to have a circular configuration) or non-rotatable relative to the shaft of drill, etc. (the cross section of the ring guide body and the shaft of drill, etc. are formed to have a non-circular configuration). Or, these members may be connected by screw-engagement. When both members are connected by screw-engagement, a double nut, etc. may be used to fix the ring guide body at a predetermined position.
The hole to guide the drill bur in the ring guide body may be omitted. Or this ring guide body may be integrally provided on the shaft of drill.
The diameter of the ring guide body is slightly smaller than the inner diameter D1 of the guide ring so that it can be movably guided within the guide ring, and usually formed to have a gap between both parts at a level of 0.05 mm to 0.1 mm. The ring guide body may be formed to have a size other than the size so long as the ring guide body can be smoothly slide within the guide ring and the drill and other implant instrument do not deviate within such gap. Further, in such instance, the outer diameter of the ring guide body is larger than the width W of the slit portion of the guide ring so that the ring guide body would not partly protrude or come out from the slit at the time of drilling a hole.
The ring guide body may be made of a solid material such as various types of metals and rigid plastic materials, and it is preferred to use a material having frictional resistance and not having adverse effect to human body.
At the time of drilling a hole, since the frictional heat is generated at the contact surface between the ring guide body and the guide ring (in a case where the ring guide body is fixed to the shaft of the drill), the contact surface between the ring guide body and the shaft of the drill (in a case where the ring guide body is not fixed to the shaft of the drill), and the contact surface between the drill bur and the jawbone, a water supply means is provided to cool these contact surfaces. The water supply means comprises a plurality of water supply channels in the center axis direction on the outer surface of the ring guide body so that water supply can be conducted on the contact surface between the ring guide body and the guide ring, and a plurality of water supply holes in the center axis direction in the ring guide body to cool the contact surface between the ring guide body and the drill shaft or to supply water to the outer surface of the drill bur. The number of the water supply channels and water supply holes is three or four or any other appropriate number.
After drilling a hole, when an implant is inserted into the implant hole, an implant instrument such as an adaptor for implant insertion, etc. is used. On the outer peripheral portion of the shaft of the instrument, the above ring guide body is provided. In this instance, the engagement of the implant and the implant instrument is conducted by means of a projection-and-recess engagement by a hex, a socket, etc., a screw engagement, etc. This ring guide body may be provided with the water supply channels and water supply holes.
Further, when parts such as an abutment, a healing cap or a healing abutment, is attached to the implant, an implant instrument such as an abutment holder or a hex driver is used. In this case also, on the outer peripheral surface of the shaft of instrument, the above ring guide body is provided.
When the shaft of the implant instrument such as a drill is formed to be rotatable to the ring guide body, a friction-reducing part such as an O-ring or a slide bearing is provided on the ring guide body so that the shaft can smoothly rotate.
In or On the surface of the ring guide body, a magnet may be embedded or stuck, a magnet sheet may be stuck, or a magnet layer may be provided, and the magnetic force thereof temporarily keeps the ring guide body on the handpiece when the drill is replaced.
According to the present invention, since the ring guide body for the implant instrument such as a drill is guided into the guide ring, no deviation of the drill is caused when drilling a hole, and no misplacing is caused at the time of inserting the implant or attaching parts of implant, accordingly the drilling of holes and the placement of implant can securely be made. Further, the operation can readily be made and can be conducted rapidly and efficiently. Moreover, since a slit is formed on the guide ring, the drill bur and the implant can be inserted from the lateral side through this slit portion, and the workload and distress on patients can be reduced.
Further, when the ring guide body is fixed to the shaft of the implant instrument such as a drill by use of a fastener, the installation position of the ring guide body can easily be adjusted, and can readily be fitted to the insertion length of the drill bur or the insertion depth of the implant. Moreover, a thick shaft portion is provided on the implant instrument and the ring guide body is supported by this thick shaft portion, whereby the ring guide body can be applied to drills with various diameters of burs.
Furthermore, since the water supply holes and channels are provided in the ring guide body, the cooling water supplied by the holes and channels can cool the frictional heat generated on the contact surface between the ring guide body and the guide ring, or between the drill bur or implant and the jawbone; the cooling does not adversely affect the jawbone; and the dust formed by the frictional engagement can be washed away by the cooling water.
Further, if a magnet is placed in or on the surface of the ring guide body, or a magnet sheet is stuck, or a magnet layer is provided thereon, the ring guide body can be temporarily kept on the handpiece when the drill is replaced.
Hereinafter, a case where an implant is placed in the back tooth area of the lower jaw will be explained.
The guide system of the present invention for an implant drill, etc. has a guide ring 3 attached to a supporting portion 2 of a surgical guide 1 as shown in
The guide ring 3 is provided at the position where the implant is placed to the supporting portion 2 of the surgical guide 1, as shown in the state of
Slit faces 12 of the guide ring 3 are formed to be in parallel to each other as shown in
The ring guide body 6 attached to the drill 4 is made to fit in the guide ring 3 and to move slidingly. A tapered portion 13 is provided at the lower end portion of the ring guide body 6 so that the ring guide body 6 can be guided smoothly into the guide ring 3 when the ring guide body 6 is fitted therein. The tapered portion 13 may be provided at the upper end portion of the ring guide body 6 as well.
Inside the ring guide body 6, a hole 14 through which the drill shaft 5 is inserted and a hole 15 through which the drill bur 7 is inserted are provided. The ring guide body 6 is fixed to the shaft 5 by a fastener 16. In this instance, the length of the drill bur 7 is adjusted to be equivalent to the depth of an implant hole 17, and the ring guide body 6 is fixed at a predetermined position with the fastener 16.
In this embodiment, a hexagon socket heads cap screw is used as the fastener 16, and the hexagon socket heads cap screw is engaged with a threaded hole 18 formed in the ring guide body 6. At the time of engagement, it is preferred to insert the bolt into slightly deeper position so that the head of the bolt would not protrude from the outer periphery surface of the ring guide body 6.
As for the type of drill to be used, various types may be used, for example, a spiral drill type as shown in
In a case where an implant hole is drilled by using this instrument, when the ring guide body 6 rotates and slides in the axial direction within the guide ring 3, frictional heat is generated at the contact surface between the ring guide body 6 and the guide ring 3. Accordingly, as shown in
Further, at the time of drilling a hole, since frictional heat is also generated on the contact surface between the drill bur 7 and the implant hole 17, the water supply holes 20 are provided near the center of the ring guide body 6 in its axial direction (in
In this embodiment, the water supply channels 19 and the water supply holes 20 are provided in the axial direction of the ring guide body 6 (in the axial direction of the drill), but instead of this direction, these may be provided, for example, in an oblique direction or in a spiral direction.
Then, a case where the implant hole 17 is drilled in the lower jaw will be explained with
At first, as shown in
In this state, using a handpiece (a hole drilling device) 24 in which the upper portion (an installation portion 23) of the shaft 5 of the drill 4 is chucked, the drill is moved in the direction of arrow X, and the drill bur 7 is guided into the guide ring 3 through the cutaway 11 of the supporting portion 2 of the surgical guide 1 and the slit 8 of the guide ring 3.
Then, as shown in
Subsequently, as shown in
When the inner face of the guide ring 3 and the outer surface of the ring guide body 6 are formed in a tapered shape in which the upper part is wide and the lower part is narrow, the downward movement of the drill is stopped when the ring guide 6 comes into contact with the guide ring 3, and therefore this position is regarded as the stopped position of the drill.
In this embodiment, the implant hole is drilled by use of a spiral drill. However, in the beginning of the drilling, the drill as shown in
At the outer periphery portion of the shaft 34 of the adaptor for implant insertion 26 shown in
When an implant part such as an abutment, a healing cap or a healing abutment is attached to the implant 27, an implant instrument such as an abutment holder and a hex driver is used, and in such a case as well, the ring guide body is provided on the shaft of the implant instrument to attach the above part.
The guide ring 3 of
In this embodiment, as shown in
The ring guide body 6 is provided with a flange 44, a hole 45 into which the drill shaft 5 is inserted, a hole 47 through which a thick shaft portion 46 of the drill shaft 5 is inserted, a tapered portion 48 and water supply holes 49. In this embodiment, when the ring guide body 6 is attached to the drill shaft 5, a projection 50 formed on the shaft 5 of the drill is inserted through a cutaway 51 formed on the O-ring 43, and the movement of the drill in the axial direction is controlled by positioning the projection 50 within the hole 45 of the ring guide body 6. The projection 50 is installed by inserting a pin into the drill shaft 5 or welding or bonding a projection thereto. This projection 50 may not be provided in some cases. The thick shaft portion 46 of the drill may be integrally formed with the shaft 5 or fixed to the shaft 5 with a screw, etc. so that the installation position of the thick shaft portion can be adjusted.
A case where the implant hole 17 is formed by use of the surgical guide 1 having the above guide ring 3 of ellipse configuration and the drill 4 having the ring guide body 6, will be explained with reference to
At first, as shown in
In this state, using handpiece (a hole drilling device) 24 in which the upper portion (installation portion 23) of the shaft 5 of the drill 4 is chucked, the drill is moved in the direction of arrow X, and the drill bur 7 is guided into the guide ring 3 through the cutaway 11 of the supporting portion 2 of the surgical guide 1 and the slit 8 of the guide ring 3.
Then, as shown in
Subsequently, as shown in
In the ring guide body 6 shown in
Number | Date | Country | Kind |
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2009-201263 | Sep 2009 | JP | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/JP2010/064345 | 8/25/2010 | WO | 00 | 1/12/2012 |