DE102016118626A1 - Dental template and compilation of dental templates and their manufacture - Google Patents

Abstract

A dental template and a set of dental templates as well as the production of the dental template and / or the assembly of dental templates are described, wherein the dental template comprises a template body which has a free space in a first area (BE1), in which a releasably attachable first insert (FIG. EN1), which is designed such that the template body (SK) rests together with the first insert (EN1) on a residual dentition (RG) covered by the first region (BE1), so that the template body (SK) after insertion of at least two Implants (IM) in a jaw bone (KK) can be attached to this, wherein the first insert (EN1) removable and replaceable by other inserts (EN2, EN3) is replaceable.

Description

The invention relates to a dental template and a compilation of dental templates and to the production of the dental template and / or the assembly of dental templates.

From dentistry it is known that bone loss, especially the alveolar bone can be done. This bone loss is caused, for example, by tooth loss, periodontitis or peri-implantitis, as well as pressure by the application of dental prostheses. The prosthetically unproven toothless jaw can have a significantly reduced bone height, especially in the posterior region. In the past, therefore, various procedures have been developed that are designed to rebuild the edentulous portion of the maxilla or mandible following a jaw removal as part of a jaw augmentation. Finished bone formation procedures were used in particular to give dental prostheses a positional stability.

However, as a result of increasing improvement in the provision of osseointegrated implants, a prosthetic restoration has recently been carried out without prior jaw bone construction.

For inserting implants, in particular during the guided implantation, it is customary to use corresponding templates which support the insertion of an implant.

So is in the EN 20 2013 105 520 U1 described that an intervention template can be created using a particular software and considering a virtual three-dimensional model of the patient's jaw and teeth. A virtual three-dimensional model of the engagement template is created using appropriate software and the actual engagement template is made, for example, by 3-D printing from a solid material such as a hard polymer material or from a metal using other techniques such as melting. The surgical template is constructed to be mechanically attached to the patient's teeth during the osteotomy procedure.

In the case of prosthetically poorly or not at all treated pines, it is often observed that despite a strong reduction of the alveolar bone in the posterior region, a residual dentition was still preserved in the anterior region of the tooth. This becomes particularly problematic if the patient has only small resources to perform a restoration.

It is therefore an object of the invention to provide a dental template or a compilation of dental template and another template or specify their preparation in order to be able to easily perform a prosthetic restoration of such residual dentition.

This object is solved by the independent claims. Further advantageous embodiments of the invention are each the subject of the dependent claims. These can be combined in a technologically meaningful way. The description, in particular in conjunction with the drawing, additionally characterizes and specifies the invention.

According to the invention, there is provided a dental template comprising a template body having a clearance in a first region by being insertable with a releasably attachable first insert configured to collapse the template body along with the first insert on a first region covered Restgebiss rests, so that the template body after insertion of at least two implants in a jaw bone can be mounted on this, the insert is removable and replaceable by further inserts.

Accordingly, according to the invention, an adaptation of the dental template to different applications, so that different inserts can be introduced into the template body depending on the treatment situation. The first insert is designed in such a way that the template body comes to lie over the first insert on the remaining dentition in the first area. Accordingly, this corresponds to the situation in the creation of dental prosthetic restorations, in which two implants were already formed in the jawbone outside the first area, but the template body still rests on the residual dentition. In this phase, for example, the template body can now be attached by means of prosthetic caps on the two implants over screwed abutments. However, since the template body still rests on the residual dentition, there is an exact adjustment of the template body within the patient's mouth relative to the implants. It should be mentioned that the dental template does not necessarily have to be used for setting the two implants outside the first area, but this is not excluded. Accordingly, both a stencil independent of the dental template, which is described below, could be used, as well as the area of the template body, which now creates a connection to the screw-retained abutments via the prosthetic caps, could be modified accordingly. The term dental template is used since the template according to the invention, in a subsequent application, can be used differently as a guide template, osteotomy template, impression template or bite template. Can find a template. According to the invention, the first insert provides a tooth support on the residual dentition, so that the template body can now be fastened in the correct position on the two implants.

For this purpose, it may be provided that the first insert is shaped so that teeth of the remaining denture come to rest at least partially flush in cavities of the first insert.

Accordingly, it is not necessary that all teeth can be inserted through their anatomical outer surfaces in cavities of the first insert, since it is sufficient that the first use is flush with the teeth of the residual dentition that a reliable tooth support is given.

In a further embodiment of the invention, as a second use, a model of the residual dentition can be introduced into the first region in the same way as to form and position.

For this purpose, it is provided in particular that the prosthetic caps are fixed in accordance with the template body, so that now the template body is no longer held on the tooth support in the first area, but on the two implants. The second insert is inserted when the teeth of the residual dentition have already been removed. Accordingly, now by means of the second use a bite decrease can be performed, d. H. the teeth of the remaining dentition are brought into relation with the opposite side of the jaw. Since the second use exactly reflects the tooth shape, the position and the height of the formerly existing own teeth of the remaining teeth, an exact bite decrease is possible.

According to a further embodiment of the invention, as the third insert, a drilling aid can be introduced into the first region, which assists in setting further implants in the region of the removed residual dentition.

Accordingly, the third application is guided implantology, in which one or more further implants are placed in the area of the former residual dentition, which later together with the two implants already set form the basis for the dental prosthetic restoration. The correct positioning of the implants guided in turn is achieved in that the third insert comes to lie correctly with respect to the two implants or the former residual dentition within the mouth of the patient.

According to a further embodiment of the invention, it is provided that the template body is split with the first, second or third insert.

The provision of split pins allows easy releasable and removable attachment of the inserts within the template body.

According to a further embodiment of the invention, the third insert serves as an impression template in that prosthetic caps of the further implants can be detachably connected to the third insert.

In this case, the impression template can for example still be injected with silicone to produce a massive, ripped impression.

The impression template can then serve as the basis for the production of a dental prosthetic restoration, for example via a dental laboratory. Thereafter, further steps such as articulation and fabrication of the prosthetic restoration may be performed. The dental prosthetic restoration is then screwed over the two implants and the other implants in the mouth of the patient.

According to one embodiment of the invention, it is provided that the template body as well as the first, second or third inserts can be produced by means of a digital model derived from an imaging method.

Accordingly, it is possible to produce the dental template together with the required inserts, for example by means of a rapid prototyping method.

Preferably, the use of the dental template in the lower jaw, wherein the first region covers an anterior region. The template body advantageously serves to introduce implants in the posterior region.

To remove the residual dentition, the dental template can be used as an osteotomy template form of a guide.

In this case, it is particularly possible to use the lower edge of the template body pointing in the direction of the remaining teeth as a guide aid in order to remove an alveolar ridge in the first area. For this purpose, for example, the template body can be used without an insert on the two implants in the mouth of the patient and the lower edge of the template body serves as a management level for the corresponding cutting device, which may for example be designed as a piezo-Schneider. However, should the lower edge of the template body not be used as a guide, it would also be possible to provide a fourth use as a guide.

The dental template according to the invention is accordingly used for guided implantation, for guided osteotomy, for bite removal and as an impression template. Due to the correct positioning with respect to the teeth of the residual dentition and the two implants, a precise implementation of the individual steps takes place without the bite, in particular the bite height or the position of the jaw being changed unintentionally.

In a further aspect of the invention, the above-described dental template together with a one-piece template form a set or assembly of dental templates, wherein the one-piece template is formed in the first region according to the first use and as a guide during insertion of the at least two implants in one of first area serves different second area.

Accordingly, a one-piece template with anterior support is provided to attach the two implants in a properly planned position. As already mentioned, it would also be possible to modify the above-described dental template in the region of the template body so that the setting of the two implants can also be carried out without this one-piece template.

To produce the dental template or the one-piece template, it is provided in particular to first produce a three-dimensional image of the actual situation in the mouth of a patient, which is then processed digitally so that corresponding control commands can be derived, which are suitable for processing, for example in the Rapid prototyping process of the templates, the template body or the template inserts are used.

The dental template according to the invention or the set comprising the dental template and the one-piece template are suitable for supporting the execution of several steps in the context of a prosthetic restoration. This includes the guided placement of the implants, the guided osteotomy in the area of the residual dentition, the guided placement of the other implants, the bite taking and the creation of an impression.

Some embodiments will be explained in more detail with reference to the drawing. Show it:

1 a perspective view of a one-piece template,

2 a perspective view of a dental template according to the invention with several inserts,

3 the dental template according to the invention with a first insert,

4 the dental template according to the invention with a second insert,

5 the dental template according to the invention with a third insert,

6 the dental template according to the invention when used as an impression template,

7 the dental template according to the invention in the jaw articulation,

8th the dental template according to the invention in the manufacture of the dental prosthetic restoration,

9 a digital model for the production of the dental template according to the invention or the one-piece template.

In the figures, identical or functionally identical components are provided with the same reference numerals.

In 1 is shown in a perspective side view of a one-piece template SB, which has a corresponding cavity HR in a first area BE1, in which, for example, anterior teeth of a residual dentition in the lower jaw can be introduced. Thus, the one-piece template SB can be placed on the front teeth so that it is held over the anterior teeth. In a second region BE2 at opposite ends, which can come to lie, for example, in the posterior region after attachment of the one-piece template SB on the front teeth, a first guide hole FL1 and a second guide hole FL2 are arranged, which can be used for the guided placement of implants. In the first guide hole FL1 and second guide hole FL2, for example, a metal lining may be provided which prevents material removal of the one-piece template SB, which is typically made of a plastic material, by a drill during the guided placement of implants. Accordingly, the one-piece template SB is used for the correct positioning of implants in a lower jaw, so that the implants are correctly positioned with respect to the front teeth.

The one-piece template SB formed with a dental template a collection of templates, the dental template DS below in 2 is shown.

In 2 The dental template DS is shown with several inserts. You realize that the dental template DS has a template body SK, which is designed with a free space FR into which the corresponding inserts EN1, EN2 or EN3 can be inserted. The position of the free space FR corresponds to the first area already associated with 1 when the anterior tooth area of a residual dentition has been described. According to the invention, an anterior tooth support is likewise created as the first insert EN1 of the dental template DS, so that the first insert EN1 substantially follows the structure of the one-piece template SB in the first region BE1.

The dental template DS together with the first insert EN1 is in 3 shown again. In 3 is the first insert EN1 introduced into the free space, so that in turn the cavities HR can be seen, which can be passed over the anterior teeth. For example, the first insert EN1 can be connected to the template body SK by means of split pins SP. The spline SP makes it possible to remove the first insert EN1 in a simple manner, as will be explained below.

The dental template has on the template body SK in a second area bores BO, which are designed so that they come to rest in the correct position over the set by means of the one-piece template SB implants. It should be noted that with appropriate design in the second area it would also be possible by means of in 3 shown dental template DS the guided implantation of the implants, as above in connection with 1 described.

Regardless of whether the guided implantation by means of the one-piece template SB according to 1 or the dental template DS according to 3 is made, the in 3 shown dental template DS are used with the first insert EN1 to connect the implants with the template body SK, as long as there is still an anterior support on the cavities HR of the first insert EN1. For this purpose, for example, after setting the implants, abutments and corresponding prosthetic caps can be screwed onto the implants, the prosthetic caps being fixed in the bores BO of the template body SK, for example, by means of hardening plastic material.

This procedure is in 4 shown in more detail. In 4 is the dental template according to 3 shown from an opposite side, now being inserted instead of the holes BO by means of solidified plastic material prosthetic caps PK. The first insert EN1 is, as already explained, connected by means of splints SP with the template body SK.

Once the prosthetic caps PK are introduced into the template body SK, the tooth support of the front teeth is no longer needed. Accordingly, it is now possible to hold the template body SK in position by means of the initially set implants.

In a next step, the front teeth of the residual dentition in the first area BE1 are now removed. This will, as in 5 is shown, the first insert EN1 removed and set the template body SK on the prosthetic caps PK on the implants. A lower edge UN of the template body SK now serves as a guide to remove the front teeth of the residual dentition. The template body SK is therefore used as a guide template for guided osteotomy.

For this example, a piezoelectric saw can be used with an alveolar ridge of the front teeth of the remaining teeth is severed. In order to enable a precise and in particular positionally correct cutting, according to the invention, the lower edge of the template body SK SK used as a guide, it must not be excluded in other embodiments, to use a further special use as a guide instead of the lower edge UN.

Now that the anterior teeth of the remaining dentition have been removed, a second insert EN2 is provided in a first step, which in 2 is shown. The second insert EN2 represents a copy of the remaining dentition. The second insert EN2 has the teeth ZA in the same position as the original residual dentition and can be used to allow articulation between the opposing jaw on the basis of both a model and the patient's mouth ,

Furthermore, a third insert EN3 can be provided, which has corresponding guides and can be used to place further implants in the area of the anterior teeth. The use of the third use EN3 is made with reference to 6 explained again.

The third insert EN3 has, at the positions provided for guided placement of one or more further implants, through openings which are lined with metal sleeves MH. The metal sleeves MH prevent a material entry in the area below the dental template DS by removing the typically made of a plastic material dental template DS by a drill in the guided setting of other implants.

It can be seen that in the example shown three further implants WI by means of the third Insert EN3 were set, after setting the implants and screwing appropriate prosthetic caps, the now existing structure of template body SK and third insert EN3 with prosthetic caps at locations of the other implants WI an impression template is formed, which can be subsequently used to form a dental restoration.

For this purpose, the metal sleeves MH are removed in a next step and after placement of abutments and prosthetic caps is a blocking by means of a plastic material KM.

As in 7 is shown on the basis of a model of the maxilla OK, the second insert EN2 can represent the residual dentition RG accordingly, so that the relation to the opposing jaw is also guaranteed on the basis of the model. The same applies when used in the mouth of the patient, as already explained above.

Based on the in 6 illustrated impression template can now be produced in the laboratory a dental restoration, as in 8th is shown. This can in turn be checked with the model of the upper jaw with respect to their position. The dental restoration ZR is then introduced via the implants in the posterior region or the other implants in the front region into the mouth of the patient and fixed accordingly, for example by screwing.

It is particularly advantageous if the situation of the residual dentition RG is detected three-dimensionally by means of an imaging method, so that the dental template DS or the one-piece template SB and the corresponding inserts EN1, EN2 or EN3 can be generated by means of computer-aided processing.

In 9 By way of example, the residual dentition RG is shown with corresponding front teeth VZ, whereby the positioning of the implants IM has already been planned here in the digital model DM. It can be seen that the implants IM are inserted in the lower jaw UK on the alveolar bone AK. By means of such a digital model DM both the planning of the complete dental prosthetic restoration can take place and the corresponding components of the dental template and their inserts can already be produced for example by means of machining or 3D printing.

The features indicated above and in the claims, as well as the features which can be seen in the figures, can be implemented advantageously both individually and in various combinations. The invention is not limited to the exemplary embodiments described, but can be modified in many ways within the scope of expert knowledge.

List of reference numbers:

• AK

  alveolar bone

  BE1

  first area

  BE2

  second area

  BO

  drilling

  DM

  digital model

  DS

  Dental template

  EN1

  first use

  EN2

  second use

  EN3

  third use

  FL1

  first leadership hole

  FL2

  second leadership hole

  FR

  free space

  MR

  cavity

  IN THE

  implant

  KK

  jawbone

  KM

  Plastic material

  MH

  metal sleeves

  OK

  upper jaw

  PK

  prosthetic copings

  RG

  dentition

  SB

  template

  SK

  template body

  SP

  cotter

  UK

  lower jaw

  U.N.

  lower edge

  VZ

  front teeth

  WI

  another implant

  ZA

  tooth

  ZR

  dental restoration

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 202013105520 U1 [0005]

Claims (15)

Dental template comprising a template body (SK) which has a free space in a first area (BE1), in which a releasably attachable first insert (EN1) can be introduced, which is designed such that the template body (SK) together with the first insert (FIG. EN1) rests on a residual dentition (RG) covered by the first region (BE1), so that the template body (SK) can be fixed into a jawbone (KK) after inserting at least two implants (IM), wherein the first insert (EN1) removable and replaceable by further inserts (EN2; EN3). Dental template according to claim 1, wherein the first insert is shaped such that teeth of the residual dentition (RG) at least partially come to lie flush in cavities (HR) of the first insert (EN1). Dental template according to Claim 1 or 2, in which a model of the residual dentition (RG) can be introduced into the first region (BE1) as the second insert (EN2). Dental template according to one of Claims 1 to 3, in which the third insert (EN3) is a drilling aid which can be inserted into the first region (BE1), which supports placement of further implants (WI) in the region of the removed residual dentition (RG). Dental template according to one of Claims 1 to 4, in which the template body (SK) is split with the first, second or third insert (EN1; EN2; EN3). Dental template according to one of Claims 1 to 5, in which the third insert (EN3) serves as an impression template in that prosthetic caps (PK) of the further implants (WI) can be detachably connected to the third insert (EN3). Dental template according to Claim 6, in which the impression template serves as the basis for the production of a dental prosthetic restoration (ZR). Dental template according to one of Claims 1 to 7, in which the template body (SK) and the first, second or third inserts (EN1; EN2; EN3) can be produced by means of a digital model (DM) derived from an imaging process. Dental template according to one of claims 1 to 8, in which the first region (BE1) covers an anterior tooth region, preferably a lower jaw. Dental template according to claim 9, in which the template body (SK) serves to introduce implants (IM) in the posterior region. Dental template according to one of claims 1 to 10, which can be used as a guide aid in the at least partial removal of the residual dentition (RG). Dental template according to Claim 11, in which the lower edge (UN) of the template body (SK) pointing in the direction of the residual dent serves as a guide aid for removing an alveolar ridge in the first region (BE1). Dental template according to claim 11, wherein a fourth insert in the template body (SK) serves as a guide to remove an alveolar ridge in the first region (BE1). Assembly of dental templates, comprising a dental template (DS) according to one of claims 1 to 12 and a one-piece template (SB), wherein the one-piece template (SB) is formed in the first region (BE1) corresponding to the first insert (EN1) and as Guidance in introducing the at least two implants (IM) in a different from the first area (BE1) second area (BE2) is used. Production of the dental template according to one of claims 1 to 12 and / or the assembly of dental templates according to claim 14, wherein first a three-dimensional image of the actual situation in the mouth of a patient is generated, which is digitally processed so that commands are generated, the Control processing machine for processing the dental template and / or the composition of dental templates.

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