In surgical procedures to insert implants, such as dental implants, in the bone of a patient, it is important that the implant is precisely located. This requirement has led to the provision of complicated systems of surgical instruments for the implant procedures, specifically in relation to surgical planning systems or placement of implants through surgical guides which require the need for dedicated surgical dental drills with built in stops to contact a guide member or guide key to achieve a certain anatomical position. Hence, typically near complete duplications of drill assortments are common to provide a solution for guided surgery for an implant system.
The present invention, at least in its preferred embodiments, seeks to provide a simplified system for implant procedures, which while easy to use maintains high levels of accuracy and minimizes the inventory of instruments required.
In accordance with the present invention there is provided a set of surgical instruments for use in a surgical procedure to insert an implant, particularly a dental implant, in the bone of a patient. The set comprises at least one drill hub configured for connection between a surgical drill handpiece and a drill. The drill is driveable by the drill handpiece via the drill hub. The drill hub has an end surface having defined therein a socket configured for receiving the drill. The socket has a defined depth to provide a predetermined extent of the drill from the end surface.
Thus, according to the invention, the drill hub is configured to provide a predetermined extent or length of the drill relative to the end surface. In this way, the end surface of the drill hub can be used to engage a stop surface, for example on an implant guide in order to limit the axial movement of the drill and therefore the depth of an osteotomy. This solution enables the use of conventional and existing dental drills, which do not have any special adaptation in order to be used in conjunction with a guide.
The set may comprise a plurality of said drill hubs. The defined depth of the socket of each drill hub may be different. In this way a drill hub can be selected from the set to provide a required extent of the drill from the end surface, for example to achieve a depth of the osteotomy to match a selected length of implant.
The stop surface engaged by the end surface of the drill hub is provided on an implant guide or on a guide sleeve provided on an implant guide. The set comprises at least one guide member having a stop surface for engaging the end surface of the drill hub. The guide member has defined in (or adjacent to) the stop surface a guide passage for receiving the drill. Engagement of the stop surface with the end surface of the drill hub limits further axial movement of the drill relative to the stop surface. The guide passage may have a defined diameter which fits a predetermined drill. This has the advantage of providing axial and/or lateral guidance for the drill to improve accuracy in the creation of the osteotomy.
The set may comprise a plurality of guide members. The defined diameter of the guide passage of each guide member may be different. In this way a guide member can be selected from the set to fit a required drill. The external diameter of each guide member may be the same in order that each guide member fits with a guide sleeve of an implant guide. The guide member may be configured to be received within a guide sleeve of an implant guide. Engagement of the guide member with the guide sleeve may align the axis of the guide passage with the axis of the guide sleeve. The guide member may comprise an engagement surface arranged to engage with an end surface of the guide sleeve whereby to limit axial movement of the guide member relative to the guide sleeve. The engagement surface may be in the form of a flange or shoulder, for example.
In an embodiment, the guide member and/or the guide sleeve and/or the implant guide may each include a substantially vertical slot therein via which a drill can be inserted laterally into said guide passage. The guide sleeve and the implant guide, at least, could have a substantially C-shaped cross-sectional shape when viewed from above. Optionally the guide member may also have such a slot therein. It is advantageous to be able to insert the drill laterally into the guide passage in situations where the interocclusal height is limited. The guide sleeve may optionally be made from a low friction material such as a treated metal surface or a polymer like PEEK.
Implant guides can be designed and produced with guide sleeves at different positions or heights in relation to the implant. One drill hub can then be used to achieve different drill depths to host different implant lengths. A set of drill hubs of different socket depths can be used in combination with different guide sleeve positions or heights to improve accessibility in compromised cases such as low vertical height or deep implant placement with close adjacent teeth. The socket depth of the drill hub and the different positions or heights of the guide sleeve are correlated to achieve a required drill depth. These correlations may be represented to the user in a simple look-up table.
The drill may be a standard drill or a countersinking drill, for example. Typically, several different drills will be used during the same procedure. The guide member may mount on a shaft of the drill, for example in cases with limited access, or in the case of a countersinking drill, where this allows the guide passage of the guide member to be narrower than the width of the cutting surfaces of the countersinking drill.
The set may further comprise an implant mount configured for connection between a surgical drill handpiece and an implant. The implant is driveable by the drill handpiece via the implant mount. The implant mount may have a body portion having a first diameter and a stop portion which extends radially beyond the body portion. The body portion may be receivable within a guide sleeve of an implant guide with the stop portion engaging the guide sleeve to limit axial movement of the implant mount relative to the guide sleeve. Typically, the implant mount is provided with a suitable fitting for connection to the implant. The implant mount may be provided with a screw for retaining the implant on the implant mount. The stop portion may be in the form of a circumferential flange or shoulder.
The set may comprise a guide implant insert. The guide implant inserter may comprise a shaft for connection to a drill handpiece and a fitting at an opposite end thereof for connection to an implant. Between the shaft and the fitting, the guide implant inserter may comprise a body portion. The body portion may be substantially cylindrical. The body portion may have a diameter which corresponds to the internal diameter of a guide sleeve, whereby the guide implant inserter is laterally guided on insertion into a guide sleeve. The guide implant inserter may be provided with depth markings on the body portion. The relative position of the depth markings to an end surface of a guide sleeve can be used by a surgeon to determine the inserted depth of an implant.
The guide implant inserter may be used to drive the implant mount. In this case, the implant mount may be provided with a suitable female fitting to receive the fitting of the guide implant inserter, this internal female fitting being similar to an implant connection.
The implant may be inserted using the implant mount or the guide implant inserter without the implant mount. With the implant mount, the insertion of the implant can be considered to be fully guided, because the stop portion of the implant mount determines the insertion depth of the implant. Without the implant mount, the insertion of the implant can be considered to be partially guided, because the insertion depth of the implant is determined by the surgeon by reference to the depth markings on the guide implant inserter and not a discrete stop.
The invention extends to a drill hub configured for use in the set, to a guide member configured for use in the set and to an implant mount and/or a guide implant inserter configured for use in the set. The invention also extends to an implant guide provided with at least one guide sleeve dimensioned for use with the set of instruments. Guide sleeves dimensioned for use with the set may be provided to implant guide manufacturers.
The invention further extends to a surgical procedure to insert an implant using the set of instruments.
Embodiments of the invention are further described hereinafter with reference to the accompanying drawings, in which:
The set (or assortment) 1 of instruments comprises a plurality of drill hubs 4. In the example shown, five drill hubs 4 are provided. Each drill hub 4 has a male end 41 and a female end 42 (shown in more detail in
The set 1 of instruments further comprises a plurality of guide members or guide keys 6. In the example shown, four guide keys 6 are provided. Each guide key 6 has a first end and a second end connected by a handle 7. Each end of the guide key 6 has defined therein a guide passage to receive and guide a dental drill 5. The diameter of the guide passages range from 2.2 mm to 4.1 mm, with each guide key 6 having a smaller diameter guide passage at its first end and a larger diameter guide passage at its second end. The guide passage diameters of the guide keys 6 shown in the example are 2.2/2.85 mm, 3.0/3.2 mm, 3.4/3.6 mm and 3.9/4.1 mm, which correspond to the existing and conventional dental drills for a dental implant system, providing a guide solution which utilises conventional dental drills 5. The diameters of the guide passages correspond to the increasing diameters of the drills 5 which are used to widen the osteotomy from the initial drilled hole to the required diameter for an implant. In the example shown the set 1 is intended for use with implants of diameter 3.5 mm to 4.5 mm.
The set 1 further comprises a countersink conduit 13, the function of which will be described in more detail in relation to
As shown in
In accordance with the invention, the implant procedure has three stages: drilling (
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It will be seen from the above that the set 1 of instruments provides complete and accurate location of the implant 11 relative to the implant guide during the drilling, countersinking and insertion stages. By mating with the guide sleeve 10, the guide key 6 aligns the drill 5 along the correct axis and limits axial movement of the drill 5 to the required depth, the countersinking conduit 13 aligns the countersinking drill 16 along the correct axis and limits axial movement of the countersinking drill 16 to the required depth, and the implant mount 8 aligns the implant 11 along the correct axis and limits axial movement of the implant 11 to the required depth.
Thus, embodiments of the invention provide a fully guided solution for surgical preparation using existing drills with subsequent placement of implants of diameter for example 3.5 to 4.5 mm. The system has been designed to maximize ease of use and simplicity with the highest degree of accuracy based on existing instruments, i.e. drills, countersinks, and using existing implant planning software and implant guide construction. The result is improved dental implant placement using a most efficient and cost effective method. The system achieves: integration with existing surgical drill components; minimum complexity relative to currently available guided systems with large assortments and complex procedures; versatility to allow for use with most currently available surgical implant guides; a safe and accurate drilling protocol with “drill to hub” and “countersink to hub” providing fully guided implant placement for implants applying “implant insertion to hub”; and a versatile method that allows the sleeve position at various heights to cater for a wide spread of clinical applications ranging from deeply submerged implants to cases with limited occlusal height.
According to embodiments of the invention treatment planning is carried out using existing planning software and the implant guide can be manufactured by an existing guide provider.
Throughout the description and claims of this specification, the words “comprise” and “contain” and variations of them mean “including but not limited to”, and they are not intended to (and do not) exclude other components, integers or steps. Throughout the description and claims of this specification, the singular encompasses the plural unless the context otherwise requires. In particular, where the indefinite article is used, the specification is to be understood as contemplating plurality as well as singularity, unless the context requires otherwise.
Features, integers, characteristics or groups described in conjunction with a particular aspect, embodiment or example of the invention are to be understood to be applicable to any other aspect, embodiment or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. The invention is not restricted to the details of any foregoing embodiments. The invention extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.
Number | Date | Country | Kind |
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1413344.1 | Jul 2014 | GB | national |