CA2484475A1 - Adjustable dental implant drill guide apparatus - Google Patents
Adjustable dental implant drill guide apparatus Download PDFInfo
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- CA2484475A1 CA2484475A1 CA 2484475 CA2484475A CA2484475A1 CA 2484475 A1 CA2484475 A1 CA 2484475A1 CA 2484475 CA2484475 CA 2484475 CA 2484475 A CA2484475 A CA 2484475A CA 2484475 A1 CA2484475 A1 CA 2484475A1
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- Prior art keywords
- swivel ball
- guide tube
- template
- drill
- patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
- A61C1/08—Machine parts specially adapted for dentistry
- A61C1/082—Positioning or guiding, e.g. of drills
- A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
Abstract
An improved drill guide apparatus, for drilling a dental implant socket in a patient's jawbone, provides for multi-axial adjustment of the angular orientation of the drill bit. This adjustability is accomplished by disposing a guide tube within a spherical swivel ball that is rotatably retained, in ball-and-socket fashion, within a template formed on a model of the affected portion of the patient's jaw. The guide tube projects outward from the swivel ball, through an opening in the template, so that it can be manipulated about any axis, in "joystick"
fashion, to orient the guide tube as desired. Once the guide tube is in the desired position, it may be fixed in place relative to the template, after which the template may be positioned in the patient's mouth and then a drill bit may be inserted through the guide tube to drill an implant socket in the patient's jawbone. In alternative embodiments, the swivel ball is slidably mounted within a housing so that both the lateral position and the angular orientation of the socket can be adjusted.
fashion, to orient the guide tube as desired. Once the guide tube is in the desired position, it may be fixed in place relative to the template, after which the template may be positioned in the patient's mouth and then a drill bit may be inserted through the guide tube to drill an implant socket in the patient's jawbone. In alternative embodiments, the swivel ball is slidably mounted within a housing so that both the lateral position and the angular orientation of the socket can be adjusted.
Description
ADJUSTABLE DENTAL IMPLANT DRILL GUIDE APPARATUS
FIELD OF THE INVENTION
The present invention relates in general to apparatus for guiding a drill bit to bore a socket in a human jawbone, for receiving an implant for supporting a dental prosthesis. More particularly, the invention relates to such apparatus having means for selectively adjusting the lateral position and angular orientation of the drill bit.
BACKGROUND OF THE INVENTION
Dental implants are an increasingly popular alternative to dentures for replacing missing teeth. To replace a single missing tooth using the implant procedure, a cylindrical socket (or osteotomy) is bored into the jawbone - the maxilla (upper jawbone) or the mandible (lower jawbone) as the case may be. A post-like metal implant (typically but not necessarily cylindrical, and preferably made of titanium or a titanium alloy) is then inserted into the socket.
The implant typically has external tapping threads so that it can be screwed into the socket.
Following insertion into the socket, the implant becomes integrated into the jawbone structure by a natural process known as osteointegration. Once osteointegration has occurred, a prosthetic tooth may be attached to the implant. To replace two or more adjacent teeth, two or more sockets are drilled into the jawbone to receive metal implants, and then a multiple-tooth prosthesis is attached to the implants.
For an optimally successful implant procedure, the metal implant (or implants) must be securely anchored in the jawbone, and for this reason the axis of the sockets for the implants should be oriented as centrally as possible within the thickness of the jawbone. If a socket is drilled too close to either the inner or outer side of the jawbone, there may not be enough bone material on that side to provide satisfactory structural support for an implant. Ideally, there will be about the same thickness of bone on each side of the socket. To achieve this desirable result, the socket should be started at a point substantially central to the ridge of the mandible or maxilla (as the case may be), and it should be drilled from that point at an appropriate transverse angle to ensure that it stays centrally located as drilling progresses into the bone.
In addition to its lateral or buccal-lingual position (i.e., transverse to the mandibular or maxillar ridge) and transverse angular orientation, an implant socket's longitudinal or mesio-distal position and angular orientation must also be controlled within fairly close tolerances.
Prostheses for dental implants are fabricated for attachment to implants having pre-selected angular orientations; so an implant will assume substantially the same angular orientation as the socket into which it is inserted. Therefore, if an implant socket is drilled at an angle varying more than slightly from the pre-selected angle, the position of implant after insertion into the socket will be offset from the corresponding attachment point of the prosthesis, thus making satisfactory installation of the prosthesis difficult or impossible. It will also be readily appreciated that inaccurate lateral or longitudinal positioning of an implant socket may complicate or preclude satisfactory prosthesis installation.
For all the foregoing reasons, it is important for oral surgeons drilling implant sockets to ensure proper positioning and angular alignment of the sockets. Some surgeons may rely merely on visual observation and judgment to determine socket location and alignment, but this method entails considerable risk. If the surgeon's judgment is inaccurate, or if the surgeon's manipulation of the drill is imprecise, the result may be an unusable socket.
It is preferable, therefore, to use some physical apparatus for guiding the drill bit along a desired path into the jawbone, and the prior art discloses several known apparatus directed to this purpose.
U.S. Patent No. 5,556,278 (Meitner) discloses a method of making a template for guiding a drill bit for drilling an implant socket. The first step is to cast a model of the affected portion of the patient's jaw, using methods and materials well known in the field of dentistry.
The model provides a very accurate three-dimensional representation of the gum surface in the edentulous (i.e., toothless) region intended to receive implants, a,s well as any teeth adjacent to the edentulous region. One or more holes are drilled into the model in the region corresponding to the edentulous region of the patient's jaw (one hole for each intended implant), with a starting point and angular orientation corresponding to the intended position and orientation of the eventual implant socket. A guide post, typically made of metal and having an outer diameter corresponding to the diameter of intended implant socket, is inserted into each of the holes. A cylindrical guide tube, having an interior diameter slightly larger than the diameter of the guide post, is placed over the guide post. A template is then formed by applying a molding material (e.g., an acrylic material) around the guide tube (or tubes). When the molding material has dried or set, the template is removed from the model with the guide tubes embedded into it. The template is then inserted into the patient's mouth, whereupon the oral surgeon proceeds to drill the desired implant sockets using the guide tubes in the template (i.e., with the drill bit passing through the tubes).
The Meitner method produces satisfactory results provided that the guide tubes have been properly positioned in the template, but this is dependent on the position and orientation of the holes drilled into the model, which in turn involves an element of judgment and therefore is susceptible to inaccuracy. To confirm that the guide tubes are properly positioned, the Meitner method provides that the guide tubes are made with radiopaque material so that their position and orientation can be checked before the sockets are drilled by means of radiologic or tomographic visualization with the template positioned in the patient's mouth.
The problem with this, however, is that if the guide tubes are found to be unsatisfactorily positioned, there is no way to correct this condition, so the template must be discarded and a new one built. This obviously is inefficient and costly.
U.S. Patent No. 5,800,168 (Cascione et al.} discloses a template with a guide tube that can be adjusted with respect to both lateral position and angular orientation.
A radiopaque guide tube is rotatably mounted inside a first radio-transparent housing which in turn is slidably mounted inside a second radio-transparent housing bonded into an acrylic template. The guide tube is rotatable about an axis generally parallel to the ridge of the jawbone so that its angular orientation transverse to the ridge can be adjusted. The first housing is slidable within the second housing transversely to the ridge of the jawbone, thus allowing for adjustment of the lateral position of the guide tube. The template is placed in the patient's mouth with the guide tube in a provisional or test position, whereupon the guide tube is radiologically visualized to confirm whether the guide tube is satisfactorily aligned with the jawbone. If it is not satisfactorily aligned, adjustments can be made in the plane transverse to the jawbone ridge, by rotating the tube and sliding the first housing within the second housing to achieve a desired transverse position. The guide tube's position can then be checked by further radiologic visualization. This process can be repeated as many times as necessary until the guide tube is positioned and oriented as desired, whereupon it may be fixed into position within the template by introducing a filler material into the first and second housings. An implant socket may then be drilled into the jawbone, with the drill bit passing through the guide tube in the template.
The Cascione apparatus enhances the oral surgeon's ability to ensure satisfactory positioning and orientation of implant sockets by providing for adjustment of the guide tube, but this adjustability is limited to lateral positioning and angular adjustment about one axis only. Cascione has an additional drawback in that it entails specialized (and thus costly) construction by virtue of the pivoting guide tube and slidable housing assembly.
For the foregoing reasons, there is a need for an adjustable dental implant drill guide apparatus that allows for multi-axial adjustment of an implant socket's angular orientation relative to the maxillar or mandibular arch. Furthermore, there is a need for dental implant drill guide apparatus that provides for adjustment of lateral position relative to the maxillar or mandibular arch, in addition to mufti-axial angular adjustability. The present invention is directed to these needs.
BRIEF SUMMARY OF THE INVENTION
In general terms, the present invention is an improved drill guide apparatus having a guide tube for receiving a drill bit to drill an implant socket in a patient's jawbone. The drill guide apparatus is adapted such that the angular orientation of the guide tube can be adjusted about any axis, to ensure that the guide tube is optimally oriented prior to drilling of the implant socket. This adjustability is accomplished by disposing the guide tube within a spherical swivel ball that is rotatably retained, in ball-and-socket fashion, within a template formed on a model of the affected portion of the patient's jaw. The guide tube projects outward (i.e., away from the jaw) from the swivel ball, through an opening in the template, so that it can be manipulated in "joystick" fashion, to orient the guide tube as desired.
Accordingly, in a first aspect the present invention is a drill guide apparatus for use in drilling an implant socket into a jawbone of a dental patient, said drill guide apparatus comprising:
FIELD OF THE INVENTION
The present invention relates in general to apparatus for guiding a drill bit to bore a socket in a human jawbone, for receiving an implant for supporting a dental prosthesis. More particularly, the invention relates to such apparatus having means for selectively adjusting the lateral position and angular orientation of the drill bit.
BACKGROUND OF THE INVENTION
Dental implants are an increasingly popular alternative to dentures for replacing missing teeth. To replace a single missing tooth using the implant procedure, a cylindrical socket (or osteotomy) is bored into the jawbone - the maxilla (upper jawbone) or the mandible (lower jawbone) as the case may be. A post-like metal implant (typically but not necessarily cylindrical, and preferably made of titanium or a titanium alloy) is then inserted into the socket.
The implant typically has external tapping threads so that it can be screwed into the socket.
Following insertion into the socket, the implant becomes integrated into the jawbone structure by a natural process known as osteointegration. Once osteointegration has occurred, a prosthetic tooth may be attached to the implant. To replace two or more adjacent teeth, two or more sockets are drilled into the jawbone to receive metal implants, and then a multiple-tooth prosthesis is attached to the implants.
For an optimally successful implant procedure, the metal implant (or implants) must be securely anchored in the jawbone, and for this reason the axis of the sockets for the implants should be oriented as centrally as possible within the thickness of the jawbone. If a socket is drilled too close to either the inner or outer side of the jawbone, there may not be enough bone material on that side to provide satisfactory structural support for an implant. Ideally, there will be about the same thickness of bone on each side of the socket. To achieve this desirable result, the socket should be started at a point substantially central to the ridge of the mandible or maxilla (as the case may be), and it should be drilled from that point at an appropriate transverse angle to ensure that it stays centrally located as drilling progresses into the bone.
In addition to its lateral or buccal-lingual position (i.e., transverse to the mandibular or maxillar ridge) and transverse angular orientation, an implant socket's longitudinal or mesio-distal position and angular orientation must also be controlled within fairly close tolerances.
Prostheses for dental implants are fabricated for attachment to implants having pre-selected angular orientations; so an implant will assume substantially the same angular orientation as the socket into which it is inserted. Therefore, if an implant socket is drilled at an angle varying more than slightly from the pre-selected angle, the position of implant after insertion into the socket will be offset from the corresponding attachment point of the prosthesis, thus making satisfactory installation of the prosthesis difficult or impossible. It will also be readily appreciated that inaccurate lateral or longitudinal positioning of an implant socket may complicate or preclude satisfactory prosthesis installation.
For all the foregoing reasons, it is important for oral surgeons drilling implant sockets to ensure proper positioning and angular alignment of the sockets. Some surgeons may rely merely on visual observation and judgment to determine socket location and alignment, but this method entails considerable risk. If the surgeon's judgment is inaccurate, or if the surgeon's manipulation of the drill is imprecise, the result may be an unusable socket.
It is preferable, therefore, to use some physical apparatus for guiding the drill bit along a desired path into the jawbone, and the prior art discloses several known apparatus directed to this purpose.
U.S. Patent No. 5,556,278 (Meitner) discloses a method of making a template for guiding a drill bit for drilling an implant socket. The first step is to cast a model of the affected portion of the patient's jaw, using methods and materials well known in the field of dentistry.
The model provides a very accurate three-dimensional representation of the gum surface in the edentulous (i.e., toothless) region intended to receive implants, a,s well as any teeth adjacent to the edentulous region. One or more holes are drilled into the model in the region corresponding to the edentulous region of the patient's jaw (one hole for each intended implant), with a starting point and angular orientation corresponding to the intended position and orientation of the eventual implant socket. A guide post, typically made of metal and having an outer diameter corresponding to the diameter of intended implant socket, is inserted into each of the holes. A cylindrical guide tube, having an interior diameter slightly larger than the diameter of the guide post, is placed over the guide post. A template is then formed by applying a molding material (e.g., an acrylic material) around the guide tube (or tubes). When the molding material has dried or set, the template is removed from the model with the guide tubes embedded into it. The template is then inserted into the patient's mouth, whereupon the oral surgeon proceeds to drill the desired implant sockets using the guide tubes in the template (i.e., with the drill bit passing through the tubes).
The Meitner method produces satisfactory results provided that the guide tubes have been properly positioned in the template, but this is dependent on the position and orientation of the holes drilled into the model, which in turn involves an element of judgment and therefore is susceptible to inaccuracy. To confirm that the guide tubes are properly positioned, the Meitner method provides that the guide tubes are made with radiopaque material so that their position and orientation can be checked before the sockets are drilled by means of radiologic or tomographic visualization with the template positioned in the patient's mouth.
The problem with this, however, is that if the guide tubes are found to be unsatisfactorily positioned, there is no way to correct this condition, so the template must be discarded and a new one built. This obviously is inefficient and costly.
U.S. Patent No. 5,800,168 (Cascione et al.} discloses a template with a guide tube that can be adjusted with respect to both lateral position and angular orientation.
A radiopaque guide tube is rotatably mounted inside a first radio-transparent housing which in turn is slidably mounted inside a second radio-transparent housing bonded into an acrylic template. The guide tube is rotatable about an axis generally parallel to the ridge of the jawbone so that its angular orientation transverse to the ridge can be adjusted. The first housing is slidable within the second housing transversely to the ridge of the jawbone, thus allowing for adjustment of the lateral position of the guide tube. The template is placed in the patient's mouth with the guide tube in a provisional or test position, whereupon the guide tube is radiologically visualized to confirm whether the guide tube is satisfactorily aligned with the jawbone. If it is not satisfactorily aligned, adjustments can be made in the plane transverse to the jawbone ridge, by rotating the tube and sliding the first housing within the second housing to achieve a desired transverse position. The guide tube's position can then be checked by further radiologic visualization. This process can be repeated as many times as necessary until the guide tube is positioned and oriented as desired, whereupon it may be fixed into position within the template by introducing a filler material into the first and second housings. An implant socket may then be drilled into the jawbone, with the drill bit passing through the guide tube in the template.
The Cascione apparatus enhances the oral surgeon's ability to ensure satisfactory positioning and orientation of implant sockets by providing for adjustment of the guide tube, but this adjustability is limited to lateral positioning and angular adjustment about one axis only. Cascione has an additional drawback in that it entails specialized (and thus costly) construction by virtue of the pivoting guide tube and slidable housing assembly.
For the foregoing reasons, there is a need for an adjustable dental implant drill guide apparatus that allows for multi-axial adjustment of an implant socket's angular orientation relative to the maxillar or mandibular arch. Furthermore, there is a need for dental implant drill guide apparatus that provides for adjustment of lateral position relative to the maxillar or mandibular arch, in addition to mufti-axial angular adjustability. The present invention is directed to these needs.
BRIEF SUMMARY OF THE INVENTION
In general terms, the present invention is an improved drill guide apparatus having a guide tube for receiving a drill bit to drill an implant socket in a patient's jawbone. The drill guide apparatus is adapted such that the angular orientation of the guide tube can be adjusted about any axis, to ensure that the guide tube is optimally oriented prior to drilling of the implant socket. This adjustability is accomplished by disposing the guide tube within a spherical swivel ball that is rotatably retained, in ball-and-socket fashion, within a template formed on a model of the affected portion of the patient's jaw. The guide tube projects outward (i.e., away from the jaw) from the swivel ball, through an opening in the template, so that it can be manipulated in "joystick" fashion, to orient the guide tube as desired.
Accordingly, in a first aspect the present invention is a drill guide apparatus for use in drilling an implant socket into a jawbone of a dental patient, said drill guide apparatus comprising:
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) a substantially spherical swivel ball retainingly disposed within the template so as to be mufti-axially rotatable relative thereto; and (c) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through a guide tube opening in the outer surface of the template;
wherein:
(d) the drill guide apparatus may be positioned in the patient's mouth with the inner surface mating with the corresponding edentulous portion of patient's jaw;
(e) the guide tube may be rotatingly manipulated about multiple axes into a selected angular orientation relative to the template; and (f) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, said socket being for receiving an implant to support a dental prosthesis.
In the preferred embodiment, the template is formed from a radio-transparent material, and the guide tube has a radiopaque marking (meaning, for purposes of this patent specification, a marking made with a material through which electromagnetic waves such as X-rays will not readily pass), to facilitate radiologic visualization of the guide tube's position and angular orientation relative to the patient's jawbone prior to drilling a socket.
In one embodiment, the template is vacuum-formed from an inner layer and an outer layer of acrylic material, with the swivel ball being disposed between said inner and outer layers, and with the guide tube opening being formed in the outer layer.
Alternatively, the template may be made with light-cured acrylic material, using methods and materials well known in the dental arts.
(b) a substantially spherical swivel ball retainingly disposed within the template so as to be mufti-axially rotatable relative thereto; and (c) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through a guide tube opening in the outer surface of the template;
wherein:
(d) the drill guide apparatus may be positioned in the patient's mouth with the inner surface mating with the corresponding edentulous portion of patient's jaw;
(e) the guide tube may be rotatingly manipulated about multiple axes into a selected angular orientation relative to the template; and (f) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, said socket being for receiving an implant to support a dental prosthesis.
In the preferred embodiment, the template is formed from a radio-transparent material, and the guide tube has a radiopaque marking (meaning, for purposes of this patent specification, a marking made with a material through which electromagnetic waves such as X-rays will not readily pass), to facilitate radiologic visualization of the guide tube's position and angular orientation relative to the patient's jawbone prior to drilling a socket.
In one embodiment, the template is vacuum-formed from an inner layer and an outer layer of acrylic material, with the swivel ball being disposed between said inner and outer layers, and with the guide tube opening being formed in the outer layer.
Alternatively, the template may be made with light-cured acrylic material, using methods and materials well known in the dental arts.
In alternative embodiments of the drill guide apparatus, the swivel ball is slidably mounted within an elongate swivel ball housing retainingly disposed within the template so that both the lateral position and the angular orientation of the socket can be adjusted. The swivel ball housing has a central chamber enclosed by two opposing sidewalk. The inner face of each sidewall has a concave, partially-cylindrical groove running substantially the length of the sidewall, with the grooves in the sidewalls being substantially parallel. The radius of the grooves is substantially equal to the radius of the swivel ball, so the swivel ball can slide laterally within the grooves while still being multi-axially rotatable for angular adjustment of the guide tube. In these alternative embodiments, the swivel ball housing may be disposed either substantially transverse to or substantially aligned with the ridge of the patient's jawbone, depending on the plane in which lateral positional adjustment of the swivel ball and guide tube is desired.
The swivel ball may be formed from any suitable radio-transparent material, such as an acrylic material.
The guide tube may have a handle for manipulating the guide tube into a desired angular orientation. Alternatively, the guide tube may have a tool slot formed into its outer end, for receiving a tool that may be used for adjusting the angular orientation of the guide tube.
In a second aspect, the present invention is a swivel ball assembly, for use with a dental implant drilling guide template, said swivel ball assembly comprising:
(a) a substantially spherical swivel ball; and (b) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw, such that the swivel ball assembly is mufti-axially rotatable relative to the template.
The swivel ball may be formed from any suitable radio-transparent material, such as an acrylic material.
The guide tube may have a handle for manipulating the guide tube into a desired angular orientation. Alternatively, the guide tube may have a tool slot formed into its outer end, for receiving a tool that may be used for adjusting the angular orientation of the guide tube.
In a second aspect, the present invention is a swivel ball assembly, for use with a dental implant drilling guide template, said swivel ball assembly comprising:
(a) a substantially spherical swivel ball; and (b) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw, such that the swivel ball assembly is mufti-axially rotatable relative to the template.
In a third aspect, the present invention is a drill guide apparatus for use in drilling an implant socket into a jawbone of a dental patient, said drill guide apparatus comprising:
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) an elongate swivel ball housing retainingly disposed within the template, wherein:
b.l the swivel ball housing has a central chamber enclosed by two opposing sidewalls;
b.2 the swivel ball housing defines a guide tube opening into the central chamber; and b.2 the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall, with the grooves in the sidewalk being substantially parallel and having substantially the same radius of curvature;
(c) a substantially spherical swivel ball having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, said swivel ball being disposed within the central chamber of the swivel ball housing so as to be slidable within the sidewall grooves of the housing and also as to be mufti-axially rotatable; and (d) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through the guide tube opening in the swivel ball housing;
wherein:
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) an elongate swivel ball housing retainingly disposed within the template, wherein:
b.l the swivel ball housing has a central chamber enclosed by two opposing sidewalls;
b.2 the swivel ball housing defines a guide tube opening into the central chamber; and b.2 the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall, with the grooves in the sidewalk being substantially parallel and having substantially the same radius of curvature;
(c) a substantially spherical swivel ball having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, said swivel ball being disposed within the central chamber of the swivel ball housing so as to be slidable within the sidewall grooves of the housing and also as to be mufti-axially rotatable; and (d) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through the guide tube opening in the swivel ball housing;
wherein:
(e) the drill guide apparatus may be positioned in the patient's mouth with the template substantially coinciding with the corresponding edentulous portion of patient's jaw;
(f) the swivel ball may be slidingly manipulated into a selected position within the swivel ball housing;
(g) the guide tube may be rotatingly manipulated about any axis into a selected angular orientation; and (h) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, for receiving an implant to support a dental prosthesis.
In a fourth aspect, the present invention is a swivel ball housing, for use with a dental implant drilling guide template, said swivel ball housing having two opposing sidewalls enclosing a central chamber enclosed by two opposing sidewalk, wherein:
(a) the swivel ball housing defines a guide tube opening into the central chamber;
(b) the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall;
(c) the grooves in the sidewalk are substantially parallel and have substantially the same radius of curvature comprising:
(d) a substantially spherical swivel ball; and (e) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw.
(f) the swivel ball may be slidingly manipulated into a selected position within the swivel ball housing;
(g) the guide tube may be rotatingly manipulated about any axis into a selected angular orientation; and (h) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, for receiving an implant to support a dental prosthesis.
In a fourth aspect, the present invention is a swivel ball housing, for use with a dental implant drilling guide template, said swivel ball housing having two opposing sidewalls enclosing a central chamber enclosed by two opposing sidewalk, wherein:
(a) the swivel ball housing defines a guide tube opening into the central chamber;
(b) the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall;
(c) the grooves in the sidewalk are substantially parallel and have substantially the same radius of curvature comprising:
(d) a substantially spherical swivel ball; and (e) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw.
BRIEF DESCRIPTION OF THE DRAWINGS
Embodiments of the invention will now be described with reference to the accompanying figures, in which numerical references denote like parts, and in which:
FIGURE 1 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a first embodiment of the invention.
FIGURE 2 is a cross-sectional view through the template and one of the swivel balls of the embodiment illustrated in Figure 1.
FIGURE 3 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a second embodiment of the invention.
FIGURE 4 is an isometric view of the swivel ball housing of the embodiment illustrated in Figure 3.
FIGURE 4A is a cross-sectional view along Line A-A in Figure 4.
FIGURE 5 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a third embodiment of the invention.
FIGURE 6 is an isometric view of the swivel ball housing of the embodiment illustrated in Figure S.
FIGURE 6A is a cross-sectional view along Line A-A in Figure 6.
FIGURE 6B is a cross-sectional view along Line B-B in Figure 6.
Embodiments of the invention will now be described with reference to the accompanying figures, in which numerical references denote like parts, and in which:
FIGURE 1 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a first embodiment of the invention.
FIGURE 2 is a cross-sectional view through the template and one of the swivel balls of the embodiment illustrated in Figure 1.
FIGURE 3 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a second embodiment of the invention.
FIGURE 4 is an isometric view of the swivel ball housing of the embodiment illustrated in Figure 3.
FIGURE 4A is a cross-sectional view along Line A-A in Figure 4.
FIGURE 5 is a perspective view of a model of an edentulous portion of a patient's jaw, fitted with a drill guide apparatus in accordance with a third embodiment of the invention.
FIGURE 6 is an isometric view of the swivel ball housing of the embodiment illustrated in Figure S.
FIGURE 6A is a cross-sectional view along Line A-A in Figure 6.
FIGURE 6B is a cross-sectional view along Line B-B in Figure 6.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Figure 1 illustrates a dental implant drill guide apparatus, generally designated by reference numeral 10, in accordance with a first embodiment of the present invention. In Figure 1, the apparatus 10 is shown in position on a cast model 70 of a portion of a dental S patient's lower dentition, including all existing teeth 70 an edentulous area in which it is intended to drill a socket to receive one or more implants for anchoring a dental prosthesis to replace one or more missing teeth. Although Figure 1 and other Figures in this specification illustrate the invention only in association with a patient's lower jaw, it will be appreciated that the invention may also be readily adapted for use in drilling sockets for implants to replace missing upper teeth. The Figures also show the edentulous area as being at the back of the jaw, but this is for general illustrative purposes only; it will be appreciated that the invention may be readily adapted for use in edentulous area of any size and in any region of the patient's upper or lower j aw.
Referring to Figures 1 and 2, the apparatus 10 includes a template 20A having an inner surface 21 and an outer surface 23. The template 20A is formed on the cast model 70, with the inner surface 21 substantially conforming to the contours of the model 70 in affected contact areas. For reasons to be explained subsequently, the template 20A is made from a radio-transparent material (meaning, for purposes of this patent specification, a material through which electromagnetic waves such as X-rays will readily pass). In the preferred embodiment, the template 20A is made from an acrylic material. At least one substantially spherical swivel ball 30 is rotatably retained in or by the template as conceptually illustrated in Figure 2. The swivel ball 30 is made from a radio-transparent material, and not necessarily from the same radio-transparent material as the template 20A. In the preferred embodiment, the swivel ball 30 is made from an acrylic material.
As previously indicated, the swivel ball 30 is rotatably retained in or by the template, in such fashion that the swivel ball 30 can rotate about multiple axes, in the same general way as a ball-and-socket joint. In the preferred embodiment, as best illustrated in Figure 2, the rotatable retention of the swivel ball 30 by the template 20A is achieved by making the template 20A
template from inner and outer layers 22, 24 of radio-transparent material, preferably an acrylic material, and preferably using vacuum-forming techniques that are well known in the art. In a template 20A formed using such techniques, the swivel ball 30 is sandwiched between the inner and outer layers 22, 24 of the template 20A, as shown in Figure 2, with the inner and outer layers 22, 24 of the template 20A being deformed so as to create a cavity that at least partially conforms to the spherical shape of the swivel ball 30, effectively forming a "socket" in which the swivel ball 30 can rotate.
The inventor has found that vacuum-forming techniques, as described above, can be effectively used to encapsulate an acrylic swivel ball 30 in an acrylic template 20A without creating a bond between the swivel ball 30 and the template 20A, such that rotation of the swivel ball 30 is readily possible. However, improved rotatability of the swivel ball 30 may be achieved by applying a bond-breaking or lubricating material (compatible with the materials of the template 20A and the swivel ball 30) to the interface between the template 20A and the swivel ball 30 during the template fabrication process.
Although the template 20A is of laminar construction in the preferred embodiment, as described above, persons skilled in the art will readily appreciate that alternative forms of construction may be used for the template 20A without departing from the concept of the present invention, provided that the swivel ball 30 is mufti-axially rotatable relative to the template.
Disposed within the swivel ball 30 is a cylindrical guide tube 40, for receiving a drill bit (as will be explained in greater detail further on in this specification). The guide tube 40 preferably projects from the swivel ball 30 so as to project through a guide tube opening 26 in the outer surface 23 of the template 20A. At least one dimension of the guide tube opening 26 is larger than the width of the guide tube 40, so as to permit rotation of the swivel ball 30 about at least one axis. In the preferred embodiment, however, the guide tube opening 26 is wider than the guide tube 40 in all directions (and is preferably a substantially circular opening), thus permitting rotation of the swivel ball 30 about multiples axes.
To facilitate rotation of the swivel ball 30, the guide tube 40 may be provided with a handle 44 as conceptually illustrated in Figure 2. The handle 44 may be of any configuration that permits manipulation of the guide tube 40 and swivel ball 30.
Alternatively (or in addition to handle 44), the guide tube 40 may be fashioned with a tool slot 42 as conceptually illustrated in Figure 2. The tool slot 42 is adapted to receive a tool for manipulating the guide tube 40 and swivel ball 30 into a desired angular orientation.
In Figure 2 and other Figures, the guide tube 40 is shown passing completely through the swivel ball 30. As well in Figure 2, the inner layer 22 of template 20A is shown as having an opening in the area where the guide tube 40 passes through the swivel ball 30. However, neither of these features is essential to the present invention. The guide tube 40 need only extend partially into the swivel ball 30, since the drill bit which will ultimately be used in the guide tube 40 will easily drill through any portion of the swivel ball 30 that it may encounter.
Similarly, the drill bit will pass through the inner layer 22 of template 20A, so an opening through the inner layer 22 is not strictly necessary.
The Figures also show each swivel ball 30 configured with its guide tube 40 in a "vertical" position, but this is for convenience of illustration only. It will be readily appreciated that the angular orientation of the guide tube 40 is variable, in accordance one of the 1 S fundamental principles of the invention.
The basic method of using the drill guide apparatus 10, as described above, is easily readily understood. Each guide tube 40 of the drill guide apparatus 10 can be manipulated by any convenient means (such as the handle 44, where provided, or an appropriate tool engaging the tool slot 42, where provided) to configure the guide tube 40 at a selected angular orientation for optimal alignment with the jawbone in which it is desired to drill an implant socket through the guide tube 40. Once the guide tube 40 has been positioned in a desired angular orientation, it can be fixed in position relative to the template 20A by application of a suitable filler material or bonding material around the guide tube 40 where it projects through the guide tube opening 26. With each guide tube 40 thus fixed in position, the drill guide apparatus 10 may be placed in the patient's mouth over the corresponding portion of the patient's dentition, whereupon a dental drill bit may be inserted through the guide tube 40 to drill the desired implant socket in the jawbone, with confidence that the axis of the resultant socket will substantially coincide with the pre-set angular orientation of the guide tube 40.
In some cases it may be possible to drill a socket using a single surgical bur or drill bit.
In other cases it may be necessary or desirable to drill the socket using a series of two or more drill sizes, by drilling a pilot hole with a small-diameter drill bit, and then reaming out the pilot hole with a larger bit, and perhaps reaming again with one or more progressing larger bits.
This progressive drilling process is readily accommodated by the present invention by inserting appropriately sized sleeves (not shown) into the guide tube 40 for each bit size being used.
Each sleeve would have an outside diameter slightly smaller than the inside diameter of the guide tube 40 (thus allowing for ready insertion and withdrawal into and out of the guide tube 40 under close dimensional tolerances) and a concentric bore suitable for the desired size of drill bit. The use of such sleeves for sequential or multiple-bit drilling of an implant socket will ensure that the axis of the socket remains aligned with the axis of the guide tube 40 at all stages of the procedure.
Sleeves, if used, may optionally be fashioned with handles to facilitate adjustment of the swivel ball orientation. To facilitate the use of sleeves as described, the guide tube 40 may be fashioned with locking means to ensure that a sleeve inserted in the guide tube 40 remains in place within the guide tube 40 while implant sockets are being drilled in the patient's j awbone.
Alternatively, this desirable condition can be achieved by fabricating the sleeves to sufficiently close tolerances for a press fit or friction fit inside the bore of the guide tube 40.
In some cases, in addition to adjustment of the axial inclination of the guide tube 40, it may also be necessary or desirable to adjust the linear position of the guide tube 40 in the sagittal plane (i.e., mesio-distally) and/or cross-sectional plane (i.e., bucco-lingually). Such adjustments are readily facilitated by alternative embodiments of drill guide apparatus 10, as described below.
In the embodiment shown in Figures 3, 4, and 4A (and in the similar alternative embodiment shown in Figures 5, 6, 6A, and 6B), an elongate swivel ball housing 50 (60) is retainingly disposed within template 20B (20C) which has a guide tube opening 26. The swivel ball housing 50 (60) has a central chamber enclosed by two opposing sidewalk, each of which has an inner face defining a concave, partially-cylindrical groove 52 (63) running substantially the length of the sidewall. The grooves 52 (63) are substantially parallel, and the radius of each groove 52 (63) corresponds to the radius of a swivel ball 30 as previously described. The swivel ball housing 50 (60) also defines a guide tube opening 51 (61) into the central chamber, and the swivel ball housing 50 (60) is positioned in the template 20B such that guide tube opening 51 (61) is generally aligned with the guide tube opening 26 of the template 20B (20C). This construction of the drill guide apparatus 10 allows a swivel ball 30 to be disposed in the central chamber with its guide tube 40 projecting through guide tube openings 26 and 51 (61), with the swivel ball 30 being laterally movable within grooves 52 (63) while also being mufti-axially rotatable. Accordingly, both the lateral position and angular orientation of the guide tube 40, and therefore the implant socket ultimately drilled through the guide tube 40, can be readily adjusted.
In a simple method of using the invention, the guide tubes 40 can be oriented into desired positions by visual judgment only. As previously mentioned, however, this method entails a greater risk that the resultant implant sockets will be less than ideal, if not totally unsatisfactory and unusable. Accordingly, in the preferred embodiment of the invention, each guide tube is marked with a radiopaque material so that known radiologic imaging methods can be used to enhance the accuracy of the angular orientation and/or linear position of the guide tubes 40, in accordance with techniques well known in the art (and as previously described herein). Typically, the radiopaque marking on each guide tube 40 will be in the form of one or more straight lines aligned with the axis of the guide tube 40.
To facilitate or enable the use of radiologic imaging, the template 20 and swivel ball 30 in the preferred embodiment of the invention are made from radio-transparent material. X-rays will pass through these components, such that when radiologic images are taken of the patient's jaw with the template 20 in place, the images will distinctly show the radiopaque markings as well as the jawbone in which implant sockets are to be drilled, so that the locations and angular orientation of the guide tubes 40 relative to the jawbone can be clearly discerned.
Radiologic images thus facilitate precise determination of guide tube manipulations that may be required to optimize the linear location and angular orientation of the sockets.
Preferably, in order to provide the oral surgeon with optimally precise measurements needed for three-dimensional adjustment of the drill guide apparatus at the time of surgery, radiologic images are taken from at least two, thus enabling precise three-dimensional imaging studies and interpretations.
A particularly preferred imaging modality would include a CT scan / volumetric scan, such as using the NewTomTM 9000 volumetric scanner, with the drill guide apparatus 10 in S place in the patient's mouth. Axial, sagittal and cross-sectional views are reformatted for precise three-dimensional evaluation of the position of the drill guide apparatus 10 relative to the underlying alveolar process (i.e., jawbone structure), and evaluated by an oral radiologist, performing linear and angular measurements of the position of the drill guide apparatus 10 relative to the underlying bone. In addition to the customary height and width measurements of the alveolar process, outlining vital structures such as the position of the inferior alveolar nerve canal in the mandible or the maxillary sinus in the maxilla, the most precise and ideal positioning of the proposed implantations with the help of the drill-guides as seen on the scan, should be determined.
The radiologist should be able to provide information regarding three-dimensional adjustment of the drill guide apparatus 10 by the surgeon in order to achieve ideal fixture placement. This would include modification of the position of the drill guide apparatus 10 in the mesio-distal and bucco-lingual dimensions, and modification of the angular and axial orientation of the drill guide apparatus. Working with true-size images, the measurements and adjustments provided should be true measurements. Using the apparatus of the invention in conjunction with precise three-dimensional evaluation methods (e.g., CT /
volumetric scanning), it becomes possible to fashion both temporary and permanent prostheses even before the implant sockets are drilled in the patient's jawbone, with confidence that the prostheses will fit the patient. In this way, the present invention can significantly reduce the total length of time required for the dental implant procedure.
After an evaluation of the initial orientation of the drill guide apparatus 10, and it has been determined that adjustments are desirable or necessary, it will commonly be necessary to transport the apparatus 10 to a dental laboratory where the required adjustments are to be made, and then transport the adjusted apparatus back to the dentist's or dental surgeon's facility for final radiologic imaging and ultimately for drilling of the implant sockets.
To ensure accurate adjustment of the apparatus 10, it is important to ensure that the position of the swivel ball 30 does not change during transport, either before or after adjustment. To minimize or eliminate the risk of movement of the swivel ball 30 during transport, the swivel ball 30 in preferred embodiments of the invention will be provided with retention means for maintaining the angular position of the swivel ball 30 relative the template 20.
In a particularly preferred embodiment, the retention means may be provided in the form of a plurality of grooves or striations formed in the spherical outer surface of the swivel ball 30. The inventor has found that liquid acrylic material introduced between the swivel ball 30 and the adjacent surfaces of the template 20 will flow into the grooves or striations in the swivel ball surface, thus forming a mechanical interlock with the swivel ball 30 while at the same time bonding to the surfaces of the template 20. This has the effect of fixing the position of the swivel ball 30 relative to the template 20, thus allowing the apparatus 10 to be transported for adjustment with confidence that the position of the swivel ball 30 will not shift in transit. The inventor has also found that the application of mild heat in the vicinity of the swivel ball 30 will make the acrylic material between the swivel ball 30 and the template 20 sufficiently flowable so as to free the swivel ball 30 for adjustment. Upon being returned to ambient temperature the swivel ball 30 will once again be effectively fixed in its adjusted angular position within the template 20. Accordingly, the provision of grooves or striations in the swivel ball 30 facilitates retention of the swivel ball position both before and after adjustment. For greater certainty, additional acrylic or other suitable bonding materials may be applied to junctures between the swivel ball 30 and the template 20 after final angular adjustments have been made, so as to fix the swivel ball 30 even more securely in its adjusted orientation.
It will be readily seen by those skilled in the art that various modifications of the present invention may be devised without departing from the essential concept of the invention, and all such modifications are intended to be included in the scope of the claims appended hereto.
In this patent document, the word "comprising" is used in its non-limiting sense to mean that items following that word are included, but items not specifically mentioned are not excluded. A reference to an element by the indefinite article "a" does not exclude the possibility that more than one of the element is present, unless the context clearly requires that there be one and only one such element.
Figure 1 illustrates a dental implant drill guide apparatus, generally designated by reference numeral 10, in accordance with a first embodiment of the present invention. In Figure 1, the apparatus 10 is shown in position on a cast model 70 of a portion of a dental S patient's lower dentition, including all existing teeth 70 an edentulous area in which it is intended to drill a socket to receive one or more implants for anchoring a dental prosthesis to replace one or more missing teeth. Although Figure 1 and other Figures in this specification illustrate the invention only in association with a patient's lower jaw, it will be appreciated that the invention may also be readily adapted for use in drilling sockets for implants to replace missing upper teeth. The Figures also show the edentulous area as being at the back of the jaw, but this is for general illustrative purposes only; it will be appreciated that the invention may be readily adapted for use in edentulous area of any size and in any region of the patient's upper or lower j aw.
Referring to Figures 1 and 2, the apparatus 10 includes a template 20A having an inner surface 21 and an outer surface 23. The template 20A is formed on the cast model 70, with the inner surface 21 substantially conforming to the contours of the model 70 in affected contact areas. For reasons to be explained subsequently, the template 20A is made from a radio-transparent material (meaning, for purposes of this patent specification, a material through which electromagnetic waves such as X-rays will readily pass). In the preferred embodiment, the template 20A is made from an acrylic material. At least one substantially spherical swivel ball 30 is rotatably retained in or by the template as conceptually illustrated in Figure 2. The swivel ball 30 is made from a radio-transparent material, and not necessarily from the same radio-transparent material as the template 20A. In the preferred embodiment, the swivel ball 30 is made from an acrylic material.
As previously indicated, the swivel ball 30 is rotatably retained in or by the template, in such fashion that the swivel ball 30 can rotate about multiple axes, in the same general way as a ball-and-socket joint. In the preferred embodiment, as best illustrated in Figure 2, the rotatable retention of the swivel ball 30 by the template 20A is achieved by making the template 20A
template from inner and outer layers 22, 24 of radio-transparent material, preferably an acrylic material, and preferably using vacuum-forming techniques that are well known in the art. In a template 20A formed using such techniques, the swivel ball 30 is sandwiched between the inner and outer layers 22, 24 of the template 20A, as shown in Figure 2, with the inner and outer layers 22, 24 of the template 20A being deformed so as to create a cavity that at least partially conforms to the spherical shape of the swivel ball 30, effectively forming a "socket" in which the swivel ball 30 can rotate.
The inventor has found that vacuum-forming techniques, as described above, can be effectively used to encapsulate an acrylic swivel ball 30 in an acrylic template 20A without creating a bond between the swivel ball 30 and the template 20A, such that rotation of the swivel ball 30 is readily possible. However, improved rotatability of the swivel ball 30 may be achieved by applying a bond-breaking or lubricating material (compatible with the materials of the template 20A and the swivel ball 30) to the interface between the template 20A and the swivel ball 30 during the template fabrication process.
Although the template 20A is of laminar construction in the preferred embodiment, as described above, persons skilled in the art will readily appreciate that alternative forms of construction may be used for the template 20A without departing from the concept of the present invention, provided that the swivel ball 30 is mufti-axially rotatable relative to the template.
Disposed within the swivel ball 30 is a cylindrical guide tube 40, for receiving a drill bit (as will be explained in greater detail further on in this specification). The guide tube 40 preferably projects from the swivel ball 30 so as to project through a guide tube opening 26 in the outer surface 23 of the template 20A. At least one dimension of the guide tube opening 26 is larger than the width of the guide tube 40, so as to permit rotation of the swivel ball 30 about at least one axis. In the preferred embodiment, however, the guide tube opening 26 is wider than the guide tube 40 in all directions (and is preferably a substantially circular opening), thus permitting rotation of the swivel ball 30 about multiples axes.
To facilitate rotation of the swivel ball 30, the guide tube 40 may be provided with a handle 44 as conceptually illustrated in Figure 2. The handle 44 may be of any configuration that permits manipulation of the guide tube 40 and swivel ball 30.
Alternatively (or in addition to handle 44), the guide tube 40 may be fashioned with a tool slot 42 as conceptually illustrated in Figure 2. The tool slot 42 is adapted to receive a tool for manipulating the guide tube 40 and swivel ball 30 into a desired angular orientation.
In Figure 2 and other Figures, the guide tube 40 is shown passing completely through the swivel ball 30. As well in Figure 2, the inner layer 22 of template 20A is shown as having an opening in the area where the guide tube 40 passes through the swivel ball 30. However, neither of these features is essential to the present invention. The guide tube 40 need only extend partially into the swivel ball 30, since the drill bit which will ultimately be used in the guide tube 40 will easily drill through any portion of the swivel ball 30 that it may encounter.
Similarly, the drill bit will pass through the inner layer 22 of template 20A, so an opening through the inner layer 22 is not strictly necessary.
The Figures also show each swivel ball 30 configured with its guide tube 40 in a "vertical" position, but this is for convenience of illustration only. It will be readily appreciated that the angular orientation of the guide tube 40 is variable, in accordance one of the 1 S fundamental principles of the invention.
The basic method of using the drill guide apparatus 10, as described above, is easily readily understood. Each guide tube 40 of the drill guide apparatus 10 can be manipulated by any convenient means (such as the handle 44, where provided, or an appropriate tool engaging the tool slot 42, where provided) to configure the guide tube 40 at a selected angular orientation for optimal alignment with the jawbone in which it is desired to drill an implant socket through the guide tube 40. Once the guide tube 40 has been positioned in a desired angular orientation, it can be fixed in position relative to the template 20A by application of a suitable filler material or bonding material around the guide tube 40 where it projects through the guide tube opening 26. With each guide tube 40 thus fixed in position, the drill guide apparatus 10 may be placed in the patient's mouth over the corresponding portion of the patient's dentition, whereupon a dental drill bit may be inserted through the guide tube 40 to drill the desired implant socket in the jawbone, with confidence that the axis of the resultant socket will substantially coincide with the pre-set angular orientation of the guide tube 40.
In some cases it may be possible to drill a socket using a single surgical bur or drill bit.
In other cases it may be necessary or desirable to drill the socket using a series of two or more drill sizes, by drilling a pilot hole with a small-diameter drill bit, and then reaming out the pilot hole with a larger bit, and perhaps reaming again with one or more progressing larger bits.
This progressive drilling process is readily accommodated by the present invention by inserting appropriately sized sleeves (not shown) into the guide tube 40 for each bit size being used.
Each sleeve would have an outside diameter slightly smaller than the inside diameter of the guide tube 40 (thus allowing for ready insertion and withdrawal into and out of the guide tube 40 under close dimensional tolerances) and a concentric bore suitable for the desired size of drill bit. The use of such sleeves for sequential or multiple-bit drilling of an implant socket will ensure that the axis of the socket remains aligned with the axis of the guide tube 40 at all stages of the procedure.
Sleeves, if used, may optionally be fashioned with handles to facilitate adjustment of the swivel ball orientation. To facilitate the use of sleeves as described, the guide tube 40 may be fashioned with locking means to ensure that a sleeve inserted in the guide tube 40 remains in place within the guide tube 40 while implant sockets are being drilled in the patient's j awbone.
Alternatively, this desirable condition can be achieved by fabricating the sleeves to sufficiently close tolerances for a press fit or friction fit inside the bore of the guide tube 40.
In some cases, in addition to adjustment of the axial inclination of the guide tube 40, it may also be necessary or desirable to adjust the linear position of the guide tube 40 in the sagittal plane (i.e., mesio-distally) and/or cross-sectional plane (i.e., bucco-lingually). Such adjustments are readily facilitated by alternative embodiments of drill guide apparatus 10, as described below.
In the embodiment shown in Figures 3, 4, and 4A (and in the similar alternative embodiment shown in Figures 5, 6, 6A, and 6B), an elongate swivel ball housing 50 (60) is retainingly disposed within template 20B (20C) which has a guide tube opening 26. The swivel ball housing 50 (60) has a central chamber enclosed by two opposing sidewalk, each of which has an inner face defining a concave, partially-cylindrical groove 52 (63) running substantially the length of the sidewall. The grooves 52 (63) are substantially parallel, and the radius of each groove 52 (63) corresponds to the radius of a swivel ball 30 as previously described. The swivel ball housing 50 (60) also defines a guide tube opening 51 (61) into the central chamber, and the swivel ball housing 50 (60) is positioned in the template 20B such that guide tube opening 51 (61) is generally aligned with the guide tube opening 26 of the template 20B (20C). This construction of the drill guide apparatus 10 allows a swivel ball 30 to be disposed in the central chamber with its guide tube 40 projecting through guide tube openings 26 and 51 (61), with the swivel ball 30 being laterally movable within grooves 52 (63) while also being mufti-axially rotatable. Accordingly, both the lateral position and angular orientation of the guide tube 40, and therefore the implant socket ultimately drilled through the guide tube 40, can be readily adjusted.
In a simple method of using the invention, the guide tubes 40 can be oriented into desired positions by visual judgment only. As previously mentioned, however, this method entails a greater risk that the resultant implant sockets will be less than ideal, if not totally unsatisfactory and unusable. Accordingly, in the preferred embodiment of the invention, each guide tube is marked with a radiopaque material so that known radiologic imaging methods can be used to enhance the accuracy of the angular orientation and/or linear position of the guide tubes 40, in accordance with techniques well known in the art (and as previously described herein). Typically, the radiopaque marking on each guide tube 40 will be in the form of one or more straight lines aligned with the axis of the guide tube 40.
To facilitate or enable the use of radiologic imaging, the template 20 and swivel ball 30 in the preferred embodiment of the invention are made from radio-transparent material. X-rays will pass through these components, such that when radiologic images are taken of the patient's jaw with the template 20 in place, the images will distinctly show the radiopaque markings as well as the jawbone in which implant sockets are to be drilled, so that the locations and angular orientation of the guide tubes 40 relative to the jawbone can be clearly discerned.
Radiologic images thus facilitate precise determination of guide tube manipulations that may be required to optimize the linear location and angular orientation of the sockets.
Preferably, in order to provide the oral surgeon with optimally precise measurements needed for three-dimensional adjustment of the drill guide apparatus at the time of surgery, radiologic images are taken from at least two, thus enabling precise three-dimensional imaging studies and interpretations.
A particularly preferred imaging modality would include a CT scan / volumetric scan, such as using the NewTomTM 9000 volumetric scanner, with the drill guide apparatus 10 in S place in the patient's mouth. Axial, sagittal and cross-sectional views are reformatted for precise three-dimensional evaluation of the position of the drill guide apparatus 10 relative to the underlying alveolar process (i.e., jawbone structure), and evaluated by an oral radiologist, performing linear and angular measurements of the position of the drill guide apparatus 10 relative to the underlying bone. In addition to the customary height and width measurements of the alveolar process, outlining vital structures such as the position of the inferior alveolar nerve canal in the mandible or the maxillary sinus in the maxilla, the most precise and ideal positioning of the proposed implantations with the help of the drill-guides as seen on the scan, should be determined.
The radiologist should be able to provide information regarding three-dimensional adjustment of the drill guide apparatus 10 by the surgeon in order to achieve ideal fixture placement. This would include modification of the position of the drill guide apparatus 10 in the mesio-distal and bucco-lingual dimensions, and modification of the angular and axial orientation of the drill guide apparatus. Working with true-size images, the measurements and adjustments provided should be true measurements. Using the apparatus of the invention in conjunction with precise three-dimensional evaluation methods (e.g., CT /
volumetric scanning), it becomes possible to fashion both temporary and permanent prostheses even before the implant sockets are drilled in the patient's jawbone, with confidence that the prostheses will fit the patient. In this way, the present invention can significantly reduce the total length of time required for the dental implant procedure.
After an evaluation of the initial orientation of the drill guide apparatus 10, and it has been determined that adjustments are desirable or necessary, it will commonly be necessary to transport the apparatus 10 to a dental laboratory where the required adjustments are to be made, and then transport the adjusted apparatus back to the dentist's or dental surgeon's facility for final radiologic imaging and ultimately for drilling of the implant sockets.
To ensure accurate adjustment of the apparatus 10, it is important to ensure that the position of the swivel ball 30 does not change during transport, either before or after adjustment. To minimize or eliminate the risk of movement of the swivel ball 30 during transport, the swivel ball 30 in preferred embodiments of the invention will be provided with retention means for maintaining the angular position of the swivel ball 30 relative the template 20.
In a particularly preferred embodiment, the retention means may be provided in the form of a plurality of grooves or striations formed in the spherical outer surface of the swivel ball 30. The inventor has found that liquid acrylic material introduced between the swivel ball 30 and the adjacent surfaces of the template 20 will flow into the grooves or striations in the swivel ball surface, thus forming a mechanical interlock with the swivel ball 30 while at the same time bonding to the surfaces of the template 20. This has the effect of fixing the position of the swivel ball 30 relative to the template 20, thus allowing the apparatus 10 to be transported for adjustment with confidence that the position of the swivel ball 30 will not shift in transit. The inventor has also found that the application of mild heat in the vicinity of the swivel ball 30 will make the acrylic material between the swivel ball 30 and the template 20 sufficiently flowable so as to free the swivel ball 30 for adjustment. Upon being returned to ambient temperature the swivel ball 30 will once again be effectively fixed in its adjusted angular position within the template 20. Accordingly, the provision of grooves or striations in the swivel ball 30 facilitates retention of the swivel ball position both before and after adjustment. For greater certainty, additional acrylic or other suitable bonding materials may be applied to junctures between the swivel ball 30 and the template 20 after final angular adjustments have been made, so as to fix the swivel ball 30 even more securely in its adjusted orientation.
It will be readily seen by those skilled in the art that various modifications of the present invention may be devised without departing from the essential concept of the invention, and all such modifications are intended to be included in the scope of the claims appended hereto.
In this patent document, the word "comprising" is used in its non-limiting sense to mean that items following that word are included, but items not specifically mentioned are not excluded. A reference to an element by the indefinite article "a" does not exclude the possibility that more than one of the element is present, unless the context clearly requires that there be one and only one such element.
Claims (28)
1. A drill guide apparatus for use in drilling an implant socket into a jawbone of a dental patient, said drill guide apparatus comprising:
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) a substantially spherical swivel ball retainingly disposed within the template so as to be multi-axially rotatable relative thereto; and (c) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through a guide tube opening in the outer surface of the template;
wherein:
(d) the drill guide apparatus may be positioned in the patient's mouth with the inner surface mating with the corresponding edentulous portion of patient's jaw;
(e) the guide tube may be rotatingly manipulated about multiple axes into a selected angular orientation relative to the template; and (f) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, said socket being for receiving an implant to support a dental prosthesis.
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) a substantially spherical swivel ball retainingly disposed within the template so as to be multi-axially rotatable relative thereto; and (c) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through a guide tube opening in the outer surface of the template;
wherein:
(d) the drill guide apparatus may be positioned in the patient's mouth with the inner surface mating with the corresponding edentulous portion of patient's jaw;
(e) the guide tube may be rotatingly manipulated about multiple axes into a selected angular orientation relative to the template; and (f) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, said socket being for receiving an implant to support a dental prosthesis.
2. The drill guide apparatus of Claim 1 wherein the template is formed from a radio-transparent material.
3. The drill guide apparatus of Claim 1 wherein the guide tube has a radiopaque marking.
4. The drill guide apparatus of Claim 1 wherein the template is formed from an inner layer and an outer layer, with the swivel ball being disposed between said inner and outer layers, and with the guide tube opening being formed in the outer layer.
5. The drill guide apparatus of Claim 4 wherein the inner layer and outer layer are made from an acrylic material.
6. The drill guide apparatus of Claim 4 wherein the template is vacuum-formed.
7. The drill guide apparatus of Claim 1 wherein the swivel ball is formed from an acrylic material.
8. The drill guide apparatus of Claim 1, further comprising a handle connected to the extending portion of the guide tube, for manipulating the guide tube into a desired angular orientation.
9. The drill guide apparatus of Claim 1 wherein a tool slot is formed into the outer end of the guide tube, said tool slot being adapted to receive a tool for manipulating the guide tube into a desired angular orientation.
10. A swivel ball assembly, for use with a dental implant drilling guide template, said swivel ball assembly comprising:
(a) a substantially spherical swivel ball; and (b) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw, such that the swivel ball assembly is multi-axially rotatable relative to the template.
(a) a substantially spherical swivel ball; and (b) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball;
said swivel ball assembly being adapted to be retainingly disposed within a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of a dental patient's jaw, such that the swivel ball assembly is multi-axially rotatable relative to the template.
11. The swivel ball assembly of Claim 10 wherein the guide tube has a radiopaque marking.
12. The swivel ball assembly of Claim 10 wherein the swivel ball is formed from an acrylic material.
13. The swivel ball assembly of Claim 10, further comprising a handle connected to the extending portion of the guide tube, for manipulating the guide tube into a desired angular orientation.
14. The swivel ball assembly of Claim 10 wherein a tool slot is formed into the outer end of the guide tube, said tool slot being adapted to receive a tool for manipulating the guide tube into a desired angular orientation.
15. A drill guide apparatus for use in drilling an implant socket into a jawbone of a dental patient, said drill guide apparatus comprising:
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) an elongate swivel ball housing retainingly disposed within the template, wherein:
b.1 the swivel ball housing has a central chamber enclosed by two opposing sidewalls;
b.2 the swivel ball housing defines a guide tube opening into the central chamber; and b.3 the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall, with the grooves in the sidewalls being substantially parallel and having substantially the same radius of curvature;
(c) a substantially spherical swivel ball having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, said swivel ball being disposed within the central chamber of the swivel ball housing so as to be slidable within the sidewall grooves of the housing and also as to be multi-axially rotatable; and (d) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through the guide tube opening in the swivel ball housing;
wherein:
(e) the drill guide apparatus may be positioned in the patient's mouth with the template substantially coinciding with the corresponding edentulous portion of patient's jaw;
(f) the swivel ball may be slidingly manipulated into a selected position within the swivel ball housing;
(g) the guide tube may be rotatingly manipulated about any axis into a selected angular orientation; and (h) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, for receiving an implant to support a dental prosthesis.
(a) a template having an inner surface substantially conforming to the surficial mucosal contours of an edentulous portion of the patient's jaw, and also having an outer surface;
(b) an elongate swivel ball housing retainingly disposed within the template, wherein:
b.1 the swivel ball housing has a central chamber enclosed by two opposing sidewalls;
b.2 the swivel ball housing defines a guide tube opening into the central chamber; and b.3 the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall, with the grooves in the sidewalls being substantially parallel and having substantially the same radius of curvature;
(c) a substantially spherical swivel ball having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, said swivel ball being disposed within the central chamber of the swivel ball housing so as to be slidable within the sidewall grooves of the housing and also as to be multi-axially rotatable; and (d) a cylindrical guide tube passing at least partially through the swivel ball and extending outward from the swivel ball through the guide tube opening in the swivel ball housing;
wherein:
(e) the drill guide apparatus may be positioned in the patient's mouth with the template substantially coinciding with the corresponding edentulous portion of patient's jaw;
(f) the swivel ball may be slidingly manipulated into a selected position within the swivel ball housing;
(g) the guide tube may be rotatingly manipulated about any axis into a selected angular orientation; and (h) a drill bit may be inserted through the guide tube to drill an implant socket into the jawbone, for receiving an implant to support a dental prosthesis.
16. The drill guide apparatus of Claim 15 wherein the template is formed from a radio-transparent material.
17. The drill guide apparatus of Claim 15 wherein the guide tube has a radiopaque marking.
18. The drill guide apparatus of Claim 15 wherein the template is formed from an inner layer and an outer layer, with the swivel ball being disposed between said inner and outer layers, and with the guide tube opening being formed in the outer layer.
19. The drill guide apparatus of Claim 18 wherein the inner layer and outer layer are made from an acrylic material.
20. The drill guide apparatus of Claim 18 wherein the template is vacuum-formed.
21. The drill guide apparatus of Claim 15 wherein the swivel ball is formed from an acrylic material.
22. The drill guide apparatus of Claim 15, further comprising a handle connected to the extending portion of the guide tube, for manipulating the guide tube into a desired angular orientation.
23. The drill guide apparatus of Claim 15 wherein a tool slot is formed into the outer end of the guide tube, said tool slot being adapted to receive a tool for manipulating the guide tube into a desired angular orientation.
24. The drill guide apparatus of Claim 15 wherein the swivel ball housing is disposed substantially transverse to the ridge of the patient's jawbone.
25. The drill guide apparatus of Claim 15 wherein the swivel ball housing is disposed in substantial alignment with the ridge of the patient's jawbone.
26. A swivel ball housing, for use with a dental implant drilling guide template, said swivel ball housing having two opposing sidewalls enclosing a central chamber, wherein:
(a) the swivel ball housing defines a guide tube opening into the central chamber;
(b) the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall;
(c) said grooves are substantially parallel and have substantially the same radius of curvature; and (d) a substantially spherical swivel ball, having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, and having a guide tube extending outward from the swivel ball, may be disposed within the central chamber of the swivel ball housing with said guide tube projecting through said guide tube opening, such that the swivel ball is slidable within the grooves and multi-axially rotatable relative to the housing.
(a) the swivel ball housing defines a guide tube opening into the central chamber;
(b) the inner face of each sidewall defines a concave, partially-cylindrical groove running substantially the length of the sidewall;
(c) said grooves are substantially parallel and have substantially the same radius of curvature; and (d) a substantially spherical swivel ball, having a radius of curvature substantially corresponding to the radius of the grooves in the side walls of the swivel ball housing, and having a guide tube extending outward from the swivel ball, may be disposed within the central chamber of the swivel ball housing with said guide tube projecting through said guide tube opening, such that the swivel ball is slidable within the grooves and multi-axially rotatable relative to the housing.
27. The drill guide assembly of Claim 1 wherein a plurality of grooves are formed in the surface of the swivel ball.
28. The swivel ball assembly of Claim 10 wherein a plurality of grooves are formed in the surface of the swivel ball.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2484475 CA2484475A1 (en) | 2004-10-12 | 2004-10-12 | Adjustable dental implant drill guide apparatus |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2484475 CA2484475A1 (en) | 2004-10-12 | 2004-10-12 | Adjustable dental implant drill guide apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2484475A1 true CA2484475A1 (en) | 2006-04-12 |
Family
ID=36177395
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 2484475 Abandoned CA2484475A1 (en) | 2004-10-12 | 2004-10-12 | Adjustable dental implant drill guide apparatus |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA2484475A1 (en) |
Cited By (15)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2896403A1 (en) * | 2006-01-24 | 2007-07-27 | Francois Blouzard | Drill guide for use when fitting dental implants comprises profiled rod which fits into profiled bore in tube and semi-cylindrical or cylindrical tube attached to rod by connecting strip holding it at desired angle and which acts as guide |
| WO2008045965A2 (en) * | 2006-10-10 | 2008-04-17 | Stumpel Lambert J | Surgical guide for dental implant and methods therefor |
| WO2009000505A1 (en) * | 2007-06-25 | 2008-12-31 | Thomas Engelhardt | Fixing plate and method for the use thereof |
| WO2011112454A1 (en) * | 2010-03-08 | 2011-09-15 | Ibur Llc | Custom linkable imaging and multifunctional tray |
| WO2011101447A3 (en) * | 2010-02-18 | 2011-11-03 | Materialise Dental Nv | 3d digital endodontics |
| CN103156694A (en) * | 2011-12-19 | 2013-06-19 | 上海理工大学 | Guidance device of tooth implantation surgical drill |
| US8714975B2 (en) | 2009-12-22 | 2014-05-06 | Lambert J. STUMPEL | Surgical guide and method |
| WO2015029023A1 (en) * | 2013-08-26 | 2015-03-05 | Navident Medical Device Ltd | Lockable device, system and method for in-situ drill guide sleeve orientation |
| CN105434065A (en) * | 2014-08-08 | 2016-03-30 | 林协兴 | Drilling positioning assist device for tooth implantation |
| WO2017142973A1 (en) * | 2016-02-16 | 2017-08-24 | Burton Technologies, Llc | Ball channel assembly |
| CN113229967A (en) * | 2021-05-10 | 2021-08-10 | 西安交通大学口腔医院 | Guide plate fixing device is planted in oral cavity |
| CN113729999A (en) * | 2021-09-26 | 2021-12-03 | 济南泉源科技有限公司 | Digital reamer for dental implantation and use method thereof |
| CN113813062A (en) * | 2020-06-18 | 2021-12-21 | 刘昭麟 | Immediate dental implant operation guiding device and method thereof |
| JP2022001221A (en) * | 2020-06-22 | 2022-01-06 | 昭麟 劉 | Surgery guide device in instantaneous dental implantation, and method for the same |
| CN115153922A (en) * | 2022-07-07 | 2022-10-11 | 四川大学 | Planting drill research device and method thereof |
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2004
- 2004-10-12 CA CA 2484475 patent/CA2484475A1/en not_active Abandoned
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2007085719A1 (en) * | 2006-01-24 | 2007-08-02 | Blouzard Francois | Device for guiding a drilling tool for setting at least one dental implant |
| FR2896403A1 (en) * | 2006-01-24 | 2007-07-27 | Francois Blouzard | Drill guide for use when fitting dental implants comprises profiled rod which fits into profiled bore in tube and semi-cylindrical or cylindrical tube attached to rod by connecting strip holding it at desired angle and which acts as guide |
| WO2008045965A2 (en) * | 2006-10-10 | 2008-04-17 | Stumpel Lambert J | Surgical guide for dental implant and methods therefor |
| WO2008045965A3 (en) * | 2006-10-10 | 2008-08-07 | Lambert J Stumpel | Surgical guide for dental implant and methods therefor |
| US7905726B2 (en) | 2006-10-10 | 2011-03-15 | Stumpel Lambert J | Surgical guide for dental implant and methods therefor |
| WO2009000505A1 (en) * | 2007-06-25 | 2008-12-31 | Thomas Engelhardt | Fixing plate and method for the use thereof |
| US8714975B2 (en) | 2009-12-22 | 2014-05-06 | Lambert J. STUMPEL | Surgical guide and method |
| US9519749B2 (en) | 2009-12-22 | 2016-12-13 | Lambert J. STUMPEL | Surgical guide and method |
| WO2011101447A3 (en) * | 2010-02-18 | 2011-11-03 | Materialise Dental Nv | 3d digital endodontics |
| US9226801B2 (en) | 2010-03-08 | 2016-01-05 | Ibur, Llc | Custom linkable imaging and multifunctional tray |
| US10213275B2 (en) | 2010-03-08 | 2019-02-26 | Ibur, Llc | Custom linkable imaging and multifunctional tray |
| WO2011112454A1 (en) * | 2010-03-08 | 2011-09-15 | Ibur Llc | Custom linkable imaging and multifunctional tray |
| CN103156694B (en) * | 2011-12-19 | 2015-04-22 | 上海理工大学 | Guidance device of tooth implantation surgical drill |
| CN103156694A (en) * | 2011-12-19 | 2013-06-19 | 上海理工大学 | Guidance device of tooth implantation surgical drill |
| WO2015029023A1 (en) * | 2013-08-26 | 2015-03-05 | Navident Medical Device Ltd | Lockable device, system and method for in-situ drill guide sleeve orientation |
| CN105434065A (en) * | 2014-08-08 | 2016-03-30 | 林协兴 | Drilling positioning assist device for tooth implantation |
| WO2017142973A1 (en) * | 2016-02-16 | 2017-08-24 | Burton Technologies, Llc | Ball channel assembly |
| US11293480B2 (en) | 2016-02-16 | 2022-04-05 | Burton Technologies Llc | Ball channel assembly |
| CN113813062A (en) * | 2020-06-18 | 2021-12-21 | 刘昭麟 | Immediate dental implant operation guiding device and method thereof |
| JP2022001221A (en) * | 2020-06-22 | 2022-01-06 | 昭麟 劉 | Surgery guide device in instantaneous dental implantation, and method for the same |
| CN113229967A (en) * | 2021-05-10 | 2021-08-10 | 西安交通大学口腔医院 | Guide plate fixing device is planted in oral cavity |
| CN113229967B (en) * | 2021-05-10 | 2022-06-21 | 西安交通大学口腔医院 | Guide plate fixing device is planted in oral cavity |
| CN113729999A (en) * | 2021-09-26 | 2021-12-03 | 济南泉源科技有限公司 | Digital reamer for dental implantation and use method thereof |
| CN115153922A (en) * | 2022-07-07 | 2022-10-11 | 四川大学 | Planting drill research device and method thereof |
| CN115153922B (en) * | 2022-07-07 | 2023-02-28 | 四川大学 | Planting drill research device and method thereof |
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