CH715847A2 - Implant bone replacement block. - Google Patents

Abstract

The invention relates to an implant bone replacement block for insertion into a jawbone, consisting of an implant which is coated at least in certain areas with bone replacement material. The implant is provided with a structure on the outside and has an attachment at one end which is provided with bores.

Description

The invention relates to an implant-bone replacement block for introduction into a jawbone, consisting of an implant which is coated at least in some areas with bone replacement material.

It is known in maxillofacial surgery to use bone material or bone substitute material in order to build up damaged or insufficiently developed jawbones, especially in connection with the fastening of dental implants. Dental implants are anchored directly in the jawbone. In order to achieve sufficient resilience, they must grow together with the jawbone over a sufficiently large surface or grow into it.

Due to periodontal disease, dental diseases and in connection with the removal of diseased and no longer repairable teeth, however, breakouts and damage to the jawbone can occur that no longer allow a secure anchoring of the implant in the jawbone. Natural anatomical conditions also mean that in certain areas of a jawbone in which an anchoring of an implant would have to take place, insufficient bone material is available that does not allow a sufficiently large-area contact between the implant and sufficiently stable bone material surrounding the implant.

The bone substitute materials that are commonly used include, in particular, hydroxyapatite, which is also a basic material for natural bones, or tricalcium phosphate ceramic. Denatured animal bones or donor bones can also be used.

In implantology, for example, the so-called bone ring technique is known. In this surgical method, a dental implant is inserted into the jawbone and at the same time the jawbone is built up with the help of a ring-shaped bone graft or bone replacement graft. The combination of jaw augmentation and simultaneous implantation enables the treatment time to be shortened.

[0006] The bone ring technique has certainly proven itself. However, when using this technique, it is necessary to create a cavity in the jawbone that is large enough to accommodate the annular bone graft or bone replacement graft. This sometimes means that the cavity needs to be enlarged beyond the size actually required to accommodate the implant.

Against this background, the present invention is based on the object of creating an implant-bone replacement block that enables a simplified and less stressful fastening for the patient, while doing without milling an additional cavity and at the same time is easy to manufacture. According to the invention, this object is achieved with the features of claim 1.

With the invention, an implant-bone replacement block is created, which allows a simplified and less stressful for the patient attachment. It is used without milling an additional cavity. In addition, the implant-bone replacement block is easy to manufacture. This is due to the fact that the implant is provided with a structure on the outside. As a result, the bone substitute material adheres very well to the circumference of the implant. As a result, the bone substitute material can be reliably applied to the implant without great technical effort.

The structure is advantageously formed by a thread or rings. The design in the form of a thread or in the form of rings has proven particularly useful, since the presence of peaks and valleys arranged adjacent to one another means that the bone substitute material adheres well to the surface of the implant.

[0010] Other developments and refinements of the invention are specified in the remaining subclaims. Exemplary embodiments of the invention are shown in the drawings and are described in detail below. Show it: <tb> <SEP> FIG. 1 shows an implant and a block made of bone substitute material; <tb> <SEP> FIG. 2 shows the section through an implant bone replacement block according to the present invention; <tb> <SEP> FIG. 3 shows the perspective illustration of an implant / bone replacement block with a completely coated implant; <tb> <SEP> FIG. 4 shows the implant-bone replacement block shown in FIG. 3 in a different perspective; <tb> <SEP> FIG. 5 shows the implant-bone replacement block shown in FIG. 3 in a further perspective; <tb> <SEP> FIG. 6 shows the implant-bone replacement block shown in FIG. 3 in perspective from below; <tb> <SEP> FIG. 7 shows the section through an implant-bone replacement block with screws; <tb> <SEP> FIG. 8 the schematic representation of an upper jaw in sections with an inserted implant-bone replacement block; <tb> <SEP> FIG. 9 shows the view of an implant / bone replacement block with a partially coated implant; <tb> <SEP> FIG. 10 shows the bottom view of the implant / bone replacement block shown in FIG. 9; <tb> <SEP> <tb> <SEP> FIG. 11 shows the side view of the implant / bone replacement block shown in FIG. 9; <tb> <SEP> FIG. 12 shows the schematic representation of an upper jaw in sections with an inserted implant-bone replacement block; <tb> <SEP> FIG. 13 shows a view of an implant / bone replacement block in a further embodiment; <tb> <SEP> FIG. 14 shows the view of an implant / bone replacement block in a different configuration; <tb> <SEP> FIG. 15 shows a view of an implant / bone replacement block in an additional embodiment; <tb> <SEP> FIG. 16 shows the view of an implant / bone replacement block in a modified configuration; <tb> <SEP> FIG. 17 shows a view of an implant / bone replacement block in a modified embodiment; <tb> <SEP> FIG. 18 shows the schematic representation of a section of an upper jaw with an inserted implant-bone replacement block; <tb> <SEP> FIG. 19 the bottom view of an implant / bone replacement block with a partially coated implant; <tb> <SEP> FIG. 20 shows the view of the implant / bone replacement block shown in FIG. 19; <tb> <SEP> FIG. 21 shows the view of an implant / bone replacement block in a modified design with a partially coated implant; <tb> <SEP> FIG. 22 shows the view of an implant / bone replacement block in a further embodiment with a partially coated implant; <tb> <SEP> FIG. 23 shows the schematic representation of a lower jaw in sections with inserted implant-bone replacement blocks.

[0011] The implant-bone replacement block selected as an exemplary embodiment is intended to be inserted into a jawbone. The block consists of an implant 1 which is coated with bone substitute material 2 at least in certain areas. The implant-bone replacement block is consequently a two-component part.

The implant 1 is provided with a structure on the outside. In the exemplary embodiment, the structure is formed by a thread. Other structures are also possible, for example rings arranged adjacent to one another. All structures on the surface of the implant that enable good adhesion of the bone substitute material to the implant are suitable. The inside of the implant is provided with a bore 6 which is suitable for attaching a tooth crown or the like. The implant length and width can be modified.

The implant 1 is completely or partially covered with the bone substitute material 2. The implant-bone replacement blocks shown in FIGS. 12 and 23 can only be seen partially provided with bone replacement material. Any suitable material can be used as the bone substitute material, in particular hydroxyapatite or tricalcium phosphate ceramic. Increasingly, however, bone material from humans or animals is used in implantology. The bone substitute material can be modified. The bone substitute material can be applied by pressing, melting or the like. For this purpose, the bone substitute material is in particle form.

At one end, the implant 1 has an attachment 3 which is provided with bores 4. The approach 3 is formed from the bone substitute material. The bores 4 are provided for the passage of screws 5 with which the implant-bone replacement block is attached to the jawbone. It is usually attached to the back of the jawbone. For this purpose, the bores 4 in the exemplary embodiments according to FIGS. 2 to 8 and 20 to 23 are aligned parallel to the longitudinal center line of the implant 1. In the exemplary embodiments according to FIGS. 13 to 18, the bores 4 are aligned essentially at right angles to the longitudinal center line of the implant 1. This version is used when the implant-bone replacement block has to be screwed to the side of the jaw (see Fig. 18).

In the exemplary embodiments according to FIGS. 12 and 23, cavities 15 are formed around the respective implant / bone replacement block. These are then filled up with bone meal or bone substitute material. The bone meal or bone substitute material is mixed with a suitable binding material to form a paste and the cavities are filled with it. In this way the original jawbone shape is built up. The natural bone then grows into the structures formed by the replacement material.

The implant-bone replacement block according to the invention is used as part of a one-time combined augmentation and implantation process with reduced bone availability in the upper or lower jaw. Its application is shown by way of example in FIGS. 12, 18 and 23. The block is inserted into the jawbone designated by 10, in which teeth 11 and tooth roots 12 can be seen; likewise nasal cavities 13. In the illustration according to FIG. 23, the inferior alveolar nerve designated by 14 can also be seen.

Augmentation is understood to mean the reconstruction of degraded jawbones using one's own bone or foreign material, in particular in order to create sufficient bone supply so that a dental prosthesis can be stabilized on the alveolar ridge or a dental implant can be used.

When using the implant-bone substitute material block according to the invention, the following process steps are used regardless of the application in the upper or lower jaw: <tb> • <SEP> Relocation of the incision to form a mucoperiosteal flap (mucous membrane-periosteal flap) somewhat lingually (towards the tongue) <tb> • <SEP> Detachment of the mucoperiosteal flap from the bony surface to the vestibule (oral vestibule) <tb> • <SEP> Prepare the implant site with a trephine drill or with an implant drill <tb> • <SEP> Insertion or screwing in of an implant-bone substitute material block <tb> • <SEP> Fixation with screws <tb> • <SEP> Repositioning (returning to an (approximately) normal position) the mucoperiosteal flap over the block <tb> • <SEP> Saliva-tight closure of the wound

The procedure in the maxillary posterior region with an internal sinus lift (internal sinus lift "transalveolar" sinus lift) (cf. FIGS. 3, 4, 5, 6, 7 and 8) is characterized by the following steps: <tb> • <SEP> Local anesthesia (local anesthesia) of the operating area - As a rule, general anesthesia (general anesthesia) is not required, but can be carried out in individual cases, for example for anxious patients. <tb> • <SEP> Incision for the formation of a mucoperiosteal flap (mucous membrane-periosteal flap) not on the alveolar ridge (tooth-bearing part of the jaw), but rather offset somewhat palatally (towards the palate). <tb> • <SEP> Detachment of the mucoperiosteal flap from the bony surface to the vestibule (oral vestibule) <tb> • <SEP> Prepare the implant site first with a trephine drill down to the sinus floor. <tb> • <SEP> Dome-shaped lifting of the Schneider’s membrane. <tb> • <SEP> Insertion of IK block (bone substitute material plus implant), fix with screws and cover with bone substitute material and collagen membrane if necessary. <tb> • <SEP> Repositioning (returning to an (approximately) normal position) the mucoperiosteal flap over the block. <tb> • <SEP> Saliva-tight wound closure <tb> • <SEP> The primary stability is achieved through a clamp fit of the IK block in the bone and additional fixation of the IK block with a standardized pilot drill.

The procedure in the upper front teeth area (see. Fig. 9, 10, 11, 12, 13, 14, 15, 16, 17 and 18) is characterized by the following steps: <tb> • <SEP> Local anesthesia (local anesthesia) of the operating area - As a rule, general anesthesia (general anesthesia) is not required, but can be carried out in individual cases, for example for anxious patients. <tb> • <SEP> Incision for the formation of a mucoperiosteal flap (mucous membrane-periosteal flap) not on the alveolar ridge (tooth-bearing part of the jaw), but rather offset somewhat palatally (towards the palate). <tb> • <SEP> Detachment of the mucoperiosteal flap from the bony surface to the vestibule (oral vestibule) <tb> • <SEP> Prepare the implant site first with a trephine drill or with an implant drill (depending on the amount of bone available). <tb> • <SEP> Insertion of the IK block (bone substitute material plus implant) fix with screws, possibly cover with bone substitute material and collagen membrane (is fixed with the same screws). <tb> • <SEP> Repositioning (returning to an (approximately) normal position) the mucoperiosteal flap over the block. <tb> • <SEP> Saliva-tight wound closure • The primary stability is achieved by clamping the IK block in the bone and additional screw fixation of the IK block, or by screwing in the IK block.

The procedure in the lower jaw side or front tooth area (see. Fig. 19, 20, 21, 22 and 23) is characterized by the following steps: <tb> • <SEP> Local anesthesia (local anesthesia) of the operating area - As a rule, general anesthesia (general anesthesia) is not required, but can be carried out in individual cases, for example for anxious patients. <tb> • <SEP> Incision for the formation of a mucoperiosteal flap (mucous membrane-periosteal flap) not on the alveolar ridge (tooth-bearing part of the jaw), but offset somewhat lingually (towards the tongue). <tb> • <SEP> Detachment of the mucoperiosteal flap from the bony surface to the vestibule (oral vestibule) <tb> • <SEP> Prepare the implant site with a trephine drill or with an implant drill <tb> • <SEP> Insertion or screwing in of the IK block (bone substitute material * plus implant) fix with screws, possibly cover with bone substitute material and collagen membrane (is fixed with the same screws). <tb> • <SEP> Repositioning (returning to an (approximately) normal position) the mucoperiosteal flap over the block. <tb> • <SEP> Saliva-tight wound closure <tb> • <SEP> The primary stability is achieved through a clamp fit of the implant block in the bone and additional screw fixation of the IK block and by screwing in the IK block.

The advantages of the invention in the upper jaw can be named as follows: <tb> 1. <SEP> Rehabilitation of horizontal and / or vertical bone defects in the posterior and anterior region <tb> 2. <SEP> Only internal sinus lift required. <tb> 3. <SEP> Primary stability of the implant and thus of the bone substitute material. <tb> 4. <SEP> Single-stage surgical procedure. <tb> 5. <SEP> Suitable for single or multiple implantation. <tb> 6. <SEP> Shortened healing phase. <tb> 7. <SEP> Standard implant in the posterior and anterior region. <tb> 8. <SEP> Bone transplantation (removal either from the jaw itself or from the pelvic blade) is not necessary.

Advantages of the invention in the lower jaw can be named as follows: <tb> 1. <SEP> Rehabilitation of horizontal and / or vertical bone defects in the posterior and anterior region <tb> 2. <SEP> reliable protection of the inferior alveolar nerve and the mental nerve. <tb> 3. <SEP> Primary stability of the implant and thus of the bone substitute material. <tb> 4. <SEP> Single-stage surgical procedure. <tb> 5. <SEP> Suitable for single or multiple implantation. <tb> 6. <SEP> Shortened healing phase. <tb> 7. <SEP> Standard implant in the posterior and anterior region. <tb> 8. <SEP> Bone transplantation (removal either from the jaw itself or from the pelvic blade) is not necessary.

Claims (7)

1. Implant-bone replacement block for insertion into a jawbone, consisting of an implant which is at least partially coated with bone replacement material, characterized in that the implant is provided on the outside with a structure and at its one end has an attachment with holes is provided. 2. implant-bone replacement block according to claim 1, characterized in that the structure is formed by a thread. 3. implant-bone replacement block according to claim 1, characterized in that the structure is formed by rings. 4. Implant-bone replacement block according to one of the preceding claims, characterized in that the implant is completely coated with bone replacement material. 5. Implant-bone replacement block according to one of the preceding claims, characterized in that the approach consists of bone replacement material. 6. implant-bone replacement block according to one of the preceding claims, characterized in that the bores are aligned parallel to the longitudinal center line of the implant. 7. Implant-bone replacement block according to one of the preceding claims, characterized in that the bores are aligned essentially at right angles to the longitudinal center line of the implant.