The present invention relates to dental implants and, in particular, to dental implants designed for direct attached to a prosthesis.
Dental implants are medical devices that are designed to replace the function of a tooth root. Following the loss or removal of a tooth the dental implant is surgically implanted into the alveolar bone where various biological processes lead to the development of new bone on the implant surface rendering the device capable of supporting loading forces, including those experienced during mastication.
For most dental implant systems in current use, the implant is only one component required for restoring the function of a lost tooth. Additional components are required to accomplish the restoration. These include devices designed to attach to the dental implant (abutments) and support the dental prosthesis (crown). These implant designs include mechanisms for mating with and securing abutments. These abutments have specific mechanisms for securing to the dental implant and also for attachment of dental prostheses. When properly combined, the implant-abutment-crown assembly is capable of providing the function of a natural tooth for many years.
Medical dentistry is a complex and demanding therapeutic discipline where both functionality and esthetics are required and expected outcomes. Various approaches for producing these safe and effective implant-abutment-crown assemblies have been developed. Some have been successful while others were found to be impeded by material or other limitations. As new technologies become available so do the options for the design and fabrication of implant-based restorations. Some new technologies or materials allow for overcoming the limitations that impeded older designs and restore the promise of benefits from these designs.
Previous approaches have used a transgingival implant, which was impeded by the limitations of contemporaneous technology. The transgingival implant is a one-piece dental implant designed for osseous fixation and to emerge from the bone, extend and emerge from the overlying mucosa (gingival) tissues, and attach to restorative abutments to complete the restoration of chewing function.
The current invention is directed toward a mid-gingival implant system (MGIS) that uses a mid-gingival implant. The mid-gingival implant is designed for osseous fixation and to extend past the bone but is not designed to emerge from the gingiva into the oral cavity. That is, the most coronal dimension of the implant is instead designed to remain below the gingival margin.
Recent developments in digital dentistry have resulted in commercially available devices that provide computer-assisted crown design and milling capabilities for use in the dental clinic. These technologies now allow a dentist to complete the restoration of a dental implant without the involvement of a dental laboratory, which is the traditional resource for design and fabrication of a restorative prosthesis (an abutment and crown). One pivotal component of these developments is the commercial introduction of a “Ti-Base” (titanium based) abutment that enables a dentist to design and attach an office-based milled crown to the dental implant. The Ti-Base abutment is first cemented to the patient-specific CAD/CAM milled crown to form a mesostructure. This mesostructure is then attached to the dental implant using another component: a retention screw. The MGIS is specifically designed for the direct attachment of milled crowns to a dental implant, obviating the need for auxiliary abutments and mesostructures.
The MGIS is a root-form, dental implant system designed with a novel connection mechanism designed for direct attachment of a prosthesis. This is a solid/one-piece implant system with associated components that allow for the safe and effective means for surgical insertion into the alveolar bone ridge. Associated components can include, but are not limited to, healing abutments that are designed for attachment at the time of implant insertion to form and condition the gingiva and prepare it for the subsequent attachment of a prosthesis. In one example, the healing abutment can be a scanning element such that the shape, design, dimensional information, or other special elements on a surface of the healing abutment can be used to facilitate the design and fabrication of a crown. Thus, after a few weeks of implant healing, the information provided by the healing abutment via an intra-oral scan or impression scan can used to design a patient-specific crown, as discussed herein. The crown design is communicated to a milling machine that manipulates pre-formed blocks of dental material (ceramics, polymers) into a tooth-like structure. The healing abutment is then removed, and the crown is attached to the implant, completing the restoration. The MGIS will have specifications that will be supplied to and used by third-party vendors of ceramic blocks to produce blocks specifically designed for fabrication of MGIS crowns. These specifications will direct the prefabrication of blocks with an internal configuration designed to mate with the MGIS superstructure and engage with the various MGIS design elements.
To further illustrate the apparatuses, systems and methods disclosed herein, the following non-limiting examples are provided:
In Example 1, a dental implant system is provided including a dental implant including: a body portion extending from a coronal end to an apical end, the body portion including a thread; a superstructure extending from the coronal end of the body portion, the superstructure including: a coronal O-ring housing; an apical O-ring housing; and a body portion positioned between the coronal O-ring housing and the apical O-ring housing, the body portion including at least one flat surface.
In Example 2, the Example 1 can optionally be configured to include a first O-ring configured to be mounted within the coronal O-ring housing; and a second O-ring configured to be mounted within the apical O-ring housing.
In Example 3, any one or a combination of Examples 1-2 can optionally be configured such that the dental implant includes a threaded bore extending from a coronal surface of the surface structure toward the apical end of the body portion.
In Example 4, any one or a combination of Examples 1-3 can optionally be configured such that the superstructure extends from a coronal surface of the body portion.
In Example 5, any one or a combination of Examples 1-4 can optionally be configured such that a stop surface is formed between an edge of the coronal surface and the superstructure, the stop surface configured to engage an apical end of the final prosthesis.
In Example 6, any one or a combination of Examples 1-5 can optionally be configured such that the final prosthesis is a crown.
In Example 7, any one or a combination of Examples 1-6 can optionally be configured such that at least a surface of the superstructure is roughened via acid-etching.
In Example 8, any one or a combination of Examples 1-7 can optionally be configured such that the body portion of the superstructure includes two flat surfaces.
In Example 9, any one or a combination of Examples 1-8 can optionally be configured such that the two flat surfaces are diametrically opposed to each other.
In Example 10, any one or a combination of Examples 1-9 can optionally be configured such that the retention screw configured to couple a final prosthesis to the dental implant, the retention screw having a head, a shank, and a threaded body configured to engage a threaded bore of the implant.
In Example 11, any one or a combination of Examples 1-10 can optionally be configured such that a short screw configured to plug a threaded bore of the implant when securing a final prosthesis to the dental implant via cement.
In Example 12, any one or a combination of Examples 1-11 can optionally be configured such that the herein the short screw has a length that is less than a length of the retention screw.
In Example 13, any one or a combination of Examples 1-12 can optionally be configured to further include a dental implant analog corresponding to the dental implant; and an indicator tube, the indicator tube having one opening at the coronal end, a plurality of perforations extending from an apical end toward the coronal end, and a plurality of graduated marks, wherein the indicator tube and the dental implant analog can be used to confirm a proper seating of a final prosthesis before coupling the final prosthesis to a patient.
Example 14 provides a dental implant system including a dental implant including a dental implant including a threaded body portion; and a superstructure extending from the body portion, the superstructure including two O-ring housing spaced apart by a body portion including two flat surfaces.
In Example 15, Example 14 can optionally be configured to include a first O-ring configured to be mounted within a first O-ring housing of the two O-ring housings; and a second O-ring configured to be mounted within a second O-ring housing of the two O-ring housings.
In Example 16, any one or a combination of Examples 9-15 can optionally be configured to include a first screw configured to be used to couple a final prosthesis to the dental implant; and a second screw configured to be used when a final prosthesis is coupled to the dental implant via cement, wherein one or more dimensions of the first screw are different form the second screw.
In Example 17, any one or a combination of Examples 9-15 can optionally be configured such that the implant actuator handle portion is configured to include a dental implant analog corresponding to the dental implant; and an indicator tube, the indicator tube having one opening at the coronal end, a plurality of perforations extending from an apical end toward the coronal end, and a plurality of graduated marks, wherein the indicator tube and the dental implant analog can be used to confirm a proper seating of a final prosthesis before coupling the final prosthesis to a patient.
In Example 18, a method installing a dental implant into a jawbone of a patient, the dental implant including: a threaded body portion; and a superstructure extending from the body portion, the superstructure including two O-ring housing spaced apart by a body portion including two flat surfaces, wherein the threaded body portion is positioned within bone and the superstructure is positioned beneath a top gingival surface; attaching a healing abutment to the dental implant, the healing abutment including information that allows identification of at least two characteristics of the dental implant; creating a three-dimensional computer model from a scan of at least a portion of the mouth including the healing abutment; based on the information from the healing abutment, modifying the three-dimensional computer model so as to include a three-dimensional computer model of at least a portion of the dental implant to be used in creating the prosthesis; and designing a three-dimensional computer model of the prosthesis form the modified three-dimensional model.
In Example 19, Example 18 can optionally be configured such that the portion of the three-dimensional computer model of at least the portion of the dental implant includes the superstructure and a coronal surface of the threaded body portion.
In Example 20, any one or a combination of Examples 18 and19 can optionally be configured such that transmitting at least a portion of the designed three-dimensional computer model of the prosthesis to a milling machine capable of producing at least a portion of the prosthesis.
This overview is intended to provide an overview of subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the invention. The detailed description is included to provide further information about the present patent application.
In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
Specific embodiments of the invention now will be described with reference to the accompanying drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. The terminology used in the detailed description of the embodiments illustrated in the accompanying drawings is not intended to be limiting of the invention.
The following description focuses on embodiments of the present invention applicable to a dental implant, and in particular to a one-piece mid-gingival dental implant (referred to herein as “mid-gingival implant” and “implant”). However, it will be appreciated that the invention is not limited to the embodiments focused on in this application. The present invention provides an implant that is specifically designed for direct attachment of CAD/CAM milled crowns. The MGIS includes design elements that obviate the need for an additional, auxiliary dental devices otherwise required to enable attachment of a CAD/CAM milled crown to a dental implant. The design elements also obviate the need for extra-corporeal assembly of the auxiliary dental devices and final prosthesis.
For direct attachment of the milled crown to the implant, preventing cement extrusion (when using cement retention) can be important. For example, securing components without using a screw, generally dental cements such as, but not limited, epoxy or similar, are used for establishing and maintaining the attachment of the final prosthesis to the implant. However, exposure of the dental cements to the surrounding gingiva can cause inflammation to the gingiva that can lead to serious disease. Therefore, the present invention provides an implant system that can minimize or prevent extrusion of cements from within the interior of the implant and final prosthesis.
Two-piece dental implant systems have internal void spaces that have been found to harbor microbes and to release microbial-generated toxins into the body. The two-piece dental implant systems have an implant-abutment microgap through which microbes may pass into and colonize within these implant void spaces. Microbial products leave the void spaces and exit the microgap causing local and systemic toxicity. The MGIS of the present invention can prevent or minimize microbial exudates. For example, as discussed herein, the MGIS has unique design elements that are specifically designed to prevent the ingress and colonization of microbes.
As seen in
In one example, the implant 10 can be made of a metal selected from titanium, tantalum, cobalt, chromium, stainless steel, and alloys thereof. Other known materials for forming dental implants be utilized. In one example, a portion of or the entire surface of the implant 10 can undergo processing to roughen the surface of the implant 10. In one example, the surface of the implant 10 can undergo chemical processing, e.g., acid-etching, to roughen the surface. In one example, at least the superstructure 22 has an acid-etched surface with a surface topography that promotes the adhesive strength of applied cement for promoting final prosthesis attachment. In one example, the implant body 12 and the superstructure 22 can have the same surface topography. In another example, the implant body 12 and the superstructure 22 can have different surface topographies from each other. Moreover, the implant body 12 can have the one surface topography or can have varying surface topographies. Similarly, the superstructure 22 can have one surface topography or can have varying surface topographies. The surface topography can include microscale roughness, nanoscale roughness, and combinations thereof. The various topographies can be formed using various techniques known in the art.
The implant body 12 extends from a coronal end 16 to an apical end 18. The implant body 22 defines a coronal surface 21 from which the superstructure 22 extends. The surface 14 of the implant body 12 can include threads 20. The design of the implant body 12 can vary. It is contemplated that the implant body 12 can include various features. For example, the type, number, and size of the threads 20 can vary and any cutting elements or cutting flutes to assist in inserting the implant 10 can be utilized. Further, the implant body 12 can taper, be cylindrical, or other and the threads 20 can taper, have a constant diameter along the length of the implant body 12, or other.
Referring to
The superstructure 22 extends from a coronal end 40 to an apical end 42. The superstructure 22 includes a body 28, a coronal groove 26, and an apical groove 24. As seen in the figures a coronal extension 28 can be adjacent to the coronal groove 26 and an apical extension 27 can be adjacent to the coronal groove 26. A coronal surface 44 of the superstructure 22 includes an opening 28 to a bore 50 extending from the coronal surface 44 to an internal portion of the implant body 12. The bore 50 can includes threads 52 along a portion of a surface. As discussed herein, the bore 50 can act as a screw chamber and can receive a retention screw 64 (see
In one example, the body 28 includes dual flats 46, which are two large flat vertical areas of the superstructure 22 cross-section. The dual flats 46 can assist several functions including, but not limited to, implant insertion, insertional guidance, final prosthesis retention, and rotational stability.
For example, the dual flats 26 can provide a large surface area for applying a torque (rotational) force to the implant 10 to drive the implant threads 20 through the osteotomy wall until the intended depth is attained. In one example, the implant construction can allow for the safe application of insertional forces greater than those possible with two-stage implant systems (greater than 90 Newton Centimeters (Ncm)), which can be required when placing the implant in dense bone conditions.
Additionally, the dual flats 26 can provide guidance to the final prosthesis during insertion to ensure proper orientation of the final prosthesis during attachment. Further, the dual flats 26 can provide a large surface area to oppose rotational forces that can ensure maintenance of correct orientation and function of the final prosthesis during use. The large surface area of the dual flats 26 can also promote cement retention of the final prosthesis.
While shown with dual flats 46, more or less than two flats 46 can be used. For example, depending on the conditions of the patient and tooth being replaced, the number of flats 26 and the area of the flats can be based on the needs of the patient taking into account the benefits provided from the flats 46.
As seen in
Referring to
In one example, the groove surfaces 25, 27 can be curved, e.g., concave. In one example, the groove surface 27 of the coronal groove 26 is smaller than the groove surface 25 of the apical groove 24. Therefore, in one example, the O-ring 54 can have one or more dimensions that are smaller as compared to the dimensions of the O-ring 56. As seen in
As discussed above, preventing or minimizing cement extrusion out of the crown margin onto the exterior of the implant is important for preventing cement-induced gingival inflammation. The apical O-ring 56 is designed to block the apical movement of cement material and re-direct it in the coronal direction. Further, as discussed above, prevention of microbial ingress is important and the deformed O-rings after the final prosthesis is seated can occupy any voids that may exist inside the final prosthesis-implant interfaces, e.g., crown-implant interface. That is, the coronal O-ring 54 can block microbial ingress from the bore 50 (e.g., screw retention chamber) and the apical O-ring 56 can block microbial ingress from the crown margin.
The retention screw 64 can prevent or minimize the damage to the final prosthesis, e.g., crown. That is, the retention screw 64 can prevent or minimize the crown form shattering or from microfractures that may occur when metal is in direct contact with the materials used to fabricate crowns (such as, e.g., ceramics, zirconia). Further the retention screw 64 can prevent or minimize microbial ingress into the bore 50 of the implant 10. To address these two functions the retention screw 64 can be made from stainless steel. In one example, using conventional metallurgical processes the steel foundation will be plated with elemental silver (Ag) and gold (Au). For example, multiple layers of malleable metal (Ag—Au—Ag) can be plated onto the retention screw in the region of the head 66, the shank 68, and a coronal portion of the threads 74. Layering of these malleable metals on the steel foundation of the retention screw 64 produces a “softer” surface for engaging the final prosthesis. This can dissipate the peak stress forces at the interface with the final prosthesis. By buffering the peak stress force, the retention screw 64 can prevent and minimize the final prosthesis material from shattering or from developing microfractures.
The short screw 80 is designed for cement-retained cases where the purpose of the short screw 80 is to seal the bore 50 (see
As discussed, the short screw 64 is used for cement-retained crowns where the retention screw 64 will not be used. Without the use of the retention screw 64 a large void remains within the bore 50. To eliminate this space from microbial colonization the short screw 80 is configured to seal the bore 50 and also assist the removal of the final prosthesis should the need arise. The short screw 80 is fabricated from stainless steel with some of its surface plated with multiple layers of malleable metal (Ag—Au—Ag). For example, the head 82, the shank 84 and a coronal portion of the threads 90. The short screw 80 can be inserted into place prior to attaching the final prosthesis. Near completion of inserting the short screw 80, the coronal threads containing multiple layers of malleable metal can deform as increasing force is required for the short screw 80 to be rotated into its final position. The tight tolerances in the bore 50 will cause the metal to deform and occlude the helical void that would otherwise form in the screw chamber and in doing so eliminate pathways for microbes.
Blocks manufactured for use in Ti-Base abutments (as in the previous approach) are provided with a pre-fabricated hollow central channel. This channel is intended to provide means to insert a retention screw for the finished milled crown. For cement retained cases this channel is not used and is filled with a UV cured polymer and sealed. For cement retained crown cases the short screw 80 will be used to seal-off the entrance to the chamber. It is placed before the attachment of the final prosthesis. As seen in
In one example, a method for creating a prosthesis for mating with the dental implant in the mouth of the patient can include creating a three-dimensional computer model from a scan of at least a portion of the mouth, the mouth including gingival tissue, and the healing abutment coupled to the dental implant. The healing abutment 100 can include identifying features (e.g., markings, shape, text, other) that indicates information regarding characteristics of the dental implant. Based on the information indicated from the healing abutment 100, the three-dimensional computer model can be modified to include a three-dimensional computer model of at least a portion of the dental implant to be used in creating the prosthesis. In one example, this can include the coronal surface 21 of the implant 10 and the superstructure 22. Once the three-dimensional data is modified, a three-dimensional computer model of the prosthesis can be designed.
In one example, a scanner can simply take the necessary information directly from the mouth of a patient without the need for impression material whatsoever. The information from of the healing abutment provide the required information to design the final prosthesis. Instead of a scanner, an impression of the mouth can be taken with the healing abutment mounted on the implant. The impression process creates a “negative” image of the healing abutment. A corresponding mold is created from the impression. This mold, or a stone model created from the mold, can then be scanned. A computer program is able to create a three-dimensional perspective of the relevant jaw section of the patient, including the implant and healing abutment. Due to the identifying features of the healing abutment now present in the mold, the computer program is able to accurately analyze and produce the appropriate dimensions so that the final prosthesis can be designed.
This system allows the dentist to produce the permanent components more quickly because the healing abutment does not have to be removed in order to produce the permanent dental components. In other words, the second step of taking an impression with an impression coping is eliminated. The dentist also does not have to confront the difficulties of gingival closure that appear when a healing implant is removed. Finally, the patient is not forced to endure the somewhat painful procedure of healing abutment removal. With the procedure of the present invention, the removal of the healing abutment can occur during the same surgery as the installation of the permanent components. Once the permanent prosthesis has been designed, the information can be sent to a milling machine to fabricate the final component to be attached to the implant 10.
For screw retained crowns the adequacy of crown seating may be confirmed by the amount of torque applied to the retention screw. For cement retained crowns no similar mechanism (retention screw) is available. A mechanism to provide the user with confirmation that the cemented crown has established complete seating on the stop surface 23 (see
To use this reference, a crown seating indicator 160 (hereinafter “indicator) shown in
This device can also be employed to provide confirmation of the crown 140 seating. For example, when the crown 140 is placed on the analog 150 the tube is inserted and seated on the top surface 83 of the short screw 80. A reference point 168 can be placed onto the short screw 83. In one example, the reference point 168 can be a flat surface. One the graduated mark 174 is marked, the user can apply cement to the crown 140 and is oriented and inserted the implant 10 in the patient including the implant and the short screw. The user applies downward force and uses the marked position on the indicator 160 to confirm that the crown 140 is seated on the stop shoulder 21 on the coronal surface 23 of the implant (see
Each of the following non-limiting examples can stand on its own, or can be combined in various permutations or combinations with one or more of the other examples.
The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.
In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.
In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.
The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to comply with 37 C.F.R, § 1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/673,675, filed on May 18, 2018, the benefit of priority which is claimed hereby, and each of which is incorporated by reference herein in its entirety.
Number | Date | Country | |
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62673675 | May 2018 | US |