DE19948910B4 - Implant for lateral insertion into milled maxillary sinuses - Google Patents

Abstract

Implant for lateral insertion into milled maxillary sinuses with a shaft which is equipped with a thread zone section and with several axially successive annular smooth zones (smooth ring zones) and which has a disc-like cantilevered foot part and at least one less cantilevered tier section at a distance, characterized in that the shaft (2) has several thread zone sections (3, 4, 5, 6) alternating with the smooth ring zones (7, 8, 9) of smaller diameter and the foot part (10, 10 ', 10' ', 10' '', 10 ' '' ') and / or the tier section designed as a separate tier part (11, 11', 11 '', 11 '' ') has internal thread zones (12, 13) which the shaft (2) in the area of its thread zone sections (3, 4 , 5, 6) can be assigned at a mutually variable distance.

Description

The present invention relates to an implant for lateral insertion into milled maxillary sinuses with a shank which is provided with a threaded zone section and with several axially consecutive annular smooth zones (Glatt ring zones), and which disc-like protruding a foot part and at a distance at least a less far projecting floor section having.

A generic implant is from the US 4,722,687 known. According to an embodiment described herein ( 8th and 9 of the US 4,722,687 ) is provided in the known implant, that the foot part is attached to a longitudinal end of the shaft, that integrally formed in the adjoining longitudinal region of the shaft by axially spaced apart annular grooves and that on the foot part opposite shaft end a threaded portion for the attachment of a transition element (Abutements) is provided for a crown or denture. Even if, as in the US 4,722,687 further carried out, the possibility exists to attach to a shaft two parallel foot parts, such an implant has an unchangeable geometry with respect to the number of floor parts to be determined in its manufacture and their distances from the foot part and each other and the shape and dimensions of the floor parts , In particular, this geometry must in each case be matched to the maxillary sinus previously to be milled into the jaw, so that when the implant is inserted laterally into the jaw cavities, a pressed positive fit results, through which the implant is anchored in the jaw. In view of the fact that a jaw bone has cross sections of different size and shape in different places and these parameters are also dependent on the age, sex and the size of a patient, it is in the US 4,722,687 known implant to be regarded as a disadvantage that it is not adaptable to the desired extent due to its fixed geometry to the dependent on the jaw cross-section of each installation situation. Consequently, there is the problem that a variety of different implants to manufacture and stockpile for treatments. From the doctor's point of view this is in addition to the storage space required for the storage and the necessary monitoring of the completeness of the range due to the expensive production of such implants associated with a cost disadvantage.

Out DE 3527668 A1 are in relation to the 1 to 3 described implants for the attachment of a tooth replacement on a jawbone known. The shaft of each of these implants has in the region of its one longitudinal end a threaded portion to screw the shaft in a foot part. At the opposite longitudinal end of the shaft, a ridge of dental gold resting on the alveolar ridge can be attached. US 4,408,990 describes with reference to the 1 and 2 a dental implant whose shaft has a threaded portion at its two longitudinal ends. Between the two threaded portions, a thread-free shank portion extends. The first threaded portion is for screwing on an artificial tooth, and the second threaded portion is for screwing into the jawbone. This known implant has as in DE 3527668 A1 implant described no floor section. From the claims 1 to 9 and the 2 and 5 from DE 29820487 U1 For example, a lateral jaw implant is known, on the shaft of which two annular bodies serving as a foot part are fastened axially spaced from one another. The foot parts are connected by means of a respective radially extending, merging into the stem web firmly with this. US 3,919,772 A describes with reference to the 8th to 12 in column 7 from line 54, a dental implant whose foot includes two mutually parallel spaced plates. Between the plates extends at right angles to a handle portion which is integrally connected to the two plates, so that the distance between the plates is fixed.

Against this background, the present invention seeks to further develop a generic implant in such a way that a use-advantageous use is possible at the same time reduced storage.

This object is achieved by the subject matter of claim 1, wherein in a generic implant is based on the fact that the shaft has a plurality of thread zone sections alternately with the smooth ring zones of smaller diameter and that the foot part and / or formed as a separate floor part floor section have internal thread zones that the Shank in the region of its threaded zone sections in mutually variable distance can be assigned. The assignment of the foot part or of a floor part to a desired threaded zone section takes place by means of the respective internal thread zone, a screw connection is made in the corresponding threaded zone section. In a first preferred embodiment, as described above, there is an assignability of a floor part to the threaded zone sections of the shaft, while the foot part is formed integrally with the shaft. Depending on the distance between an integrally connected to the shaft foot part and a desired assignment of a floor part underlying threaded zone section results intended distance between foot and floor part, which can be changed by varying the assignment. In an expedient development of the implant according to the invention, a corresponding assignability of the foot part to threaded zone sections of the shaft can also be provided. Depending on the mutually existing distance of the selected at an assignment threaded zone sections also results in a variable distance between the foot and the floor part, so that an individual adaptation to different cross-sectional heights of a jaw is given. Regardless of the configuration or of a possible assignability of the foot part, several floor parts can also be present on an implant according to the invention simultaneously, which can be assigned to the same or different thread zone sections. In an expedient embodiment, in order to achieve the greatest possible variability of the implant according to the invention, the internal thread zones of the foot part and the floor part or several floor parts can be of the same diameter and pitch and, in this respect, preferably correspond to an internal thread zone of an abutment. In addition, a stepless fine adjustment can take place in that the foot part and / or the floor part (the floor parts) within a respective threaded zone section is assigned to a certain partial area thereof. It is thus achieved in addition to a comparison with conventional implants easier production of the implant according to the invention in terms of its customizable geometry, a use-advantageous use. A further advantage of the implant according to the invention is that the decision as to whether the implant is provided with one or more multi-tier parts - even different ones - and at what intervals from the foot part, is still to be made during the treatment for a short time. At the same time, the variety of already achievable with a shaft, a foot and a floor part different geometries compared to conventional implants that would be available in the respective different variants, also reduces the storage.

Furthermore, an assortment of foot and / or quarter parts may also be provided which have different dimensions in terms of their shape and / or size. An even further adaptation to an individual jaw cross-section of a treatment site is then possible in such a way that from this assortment a selection or combination of a foot and / or a certain floor part takes place, with the combinative to the distance variable assignment to the threaded zone sections an optimal vote and Anchoring of the implant in the respective jaw cross-section is done. It is also considered the possibility that an assortment consists of different shanks, which differ for example in number and / or length of the threaded zone sections and / or smooth ring zones. With the possibilities shown here, a modular system for the implant according to the invention is thus realized at the same time, from which a considerable variety of different implants can be obtained even with a very small assortment of the individual components. Apart from this, in the case of the implant according to the invention, the advantage over conventional implants is that the threaded zone sections of the shaft can optionally serve for screwing a foot and / or floor part as well as alternatively an abutment (intermediate piece). While in a conventional implant for attaching a Abutements at the end remote from the foot end of the shaft is to provide a thread, this has there only this one function. In contrast, the thread thus present anyway in the implant according to the invention has a multiple function, which also contributes to the variability explained. Due to this multiple function of the threaded zone sections of the shaft, it is also possible to shorten an existing shaft with a large number and / or length of threaded zone sections or smooth ring zones at one or both ends for a particular jaw cross section, so that one for an individual Jaw section suitable length and arrangement of the threaded zone sections and Glattringzonen results. This is also thought of as a "yard goods" available rod material, which has a versatile sequence of threaded zone sections and Glattringzonen and from which depending on the treatment situation suitable segments are separated. The separation can be done, for example, with a saw, but also in other appropriate manner.

In the case of the implant according to the invention, it is further preferred that at least one of the threaded zone sections of the shaft has open threads at its axial ends. This makes it possible, on the one hand, for a foot and / or floor part to protrude beyond the edge of a threaded zone section in its longitudinal direction in the longitudinal direction desired for installation in the jaw. On the other hand, in connection with the smaller diameter of the smooth-ring zones in comparison to the threaded-zone sections, there is also the possibility that a foot or floor part is also screwed over in the direction of a smooth-ring zone over the edge of a threaded-zone section until the threaded engagement is lost. The foot or floor part can then be displaced axially freely over the smooth ring zone away to the next following threaded zone section where it can again be brought into threaded engagement. Similarly, a floor part by means of screwing each be assigned to any threaded zone portion of a shaft. In principle, there is also the possibility that one or more floor parts and optionally additionally an abutment are assigned to a single threaded zone section adjacent or at a distance.

With regard to the foot part, it is preferred that this has a blind hole in which the internal thread zone of the foot part is formed. In particular, the internal thread zone of the foot part can have a closed thread turn at the end facing the bore base. As a result, it is achieved that, when the foot part is assigned to a thread zone section at one end of the shaft, a correlation reproducible with respect to the screwing depth and hence the relative position results automatically and, furthermore, that with a suitable tightening torque the risk of an unintentional independent release is also met. Advantageously, this also avoids that a protrusion of the shaft with respect to the crowning or prosthesis side facing away from the foot part may arise. In this context, it is further preferred that the shaft has in the longitudinal direction at least one terminal threaded zone section, at the free end of an open thread is formed. In an expedient design, it is provided that the terminal threaded zone section of the shaft has an axial length which corresponds at least to the axial length of the internal thread zone of the foot part, so that optimum utilization of the screw-in depth of the foot part is made possible with regard to the rigidity of the implant. Alternatively, with regard to a reproducible and secured against unintentional release assignment of the foot to the shaft also be provided that the designated end threaded zone portion of the shaft has a smaller diameter than the adjacent Glattringzone and that the axial length of this end Gewindezonenabschnittes equal to or smaller than the axial Length of the internal thread zone of the foot part is dimensioned. In such an embodiment, upon reaching a desired screwing an automatic stop of an end face of the smooth ring zone is realized against the surface of the foot part, whereby at a suitable tightening torque also takes place a backup against unintentional release. These functions are achieved even with a reduced in diameter end threaded zone section, if the foot part is equipped with a through hole or with a continuous internal thread. With regard to the blind hole or the through hole is further preferred that it extends perpendicular to a main extension direction of the foot part. In an advantageous embodiment of the floor part is provided that this has a through hole in which the internal thread zone of the floor part is formed with open to both ends threads. Moreover, it is preferred that the through-hole or the inner-threaded zone extends perpendicular to a main extension direction of the floor part.

According to a further preferred embodiment of the implant, a smooth ring zone and an adjacent threaded zone section have the same axial length. In particular, it is envisaged that the smooth ring zone adjoining the terminal threaded zone section in the longitudinal direction and the further threaded zone section adjoining thereto have the same axial length. In a further development, two further smooth-ring zones and one threaded-zone section, which in each case have the same axial length, can alternately be connected to the further threaded-zone section. This last-mentioned length is preferably selected to be smaller than the length of the smooth-ring zone adjoining the terminal threaded-zone section and of the further thread-zone section adjoining thereon. It is further preferred that, in the case of the implant according to the invention, a further threaded zone section is present at the end of the shaft opposite the terminal threaded zone section. As explained above, this can be used for attaching an abutment or other suitable substructure for a crown or prosthesis or the like, but on the other hand its thread also allows attachment of a floor or foot part, or allows such on the threaded section and screwed over it, so that after an overflow of adjacent Glattringzonen an assignment to a desired one of the following in the longitudinal direction threaded zone sections is possible. In principle, all threaded zone sections and smooth ring zones of the implant can also have the same axial length, but preference is given to a combination of different lengths, in particular one as described in connection with the accompanying figures.

It is preferred that the axial length possessed by the terminal threaded zone portion of the shaft, the axial length, which have the Glatttringzone adjoining the terminal thread zone section in the longitudinal direction and the subsequent further threaded zone section, the axial length, which at the other Threaded zone section in alternation with a threaded zone portion subsequent two Glattringzonen and having this threaded zone portion, and the axial length, which is the threaded zone portion at the end of the terminal threaded portion section End of the shaft owns, are different to each other.

An expedient development of the foot part can be given in such a way that it has two laterally spaced apart internal thread zones whose symmetry lines lie in a common plane. The assignment of the foot part to the shaft can therefore be realized either with one of these two internal thread zones. In particular, if the foot part has an asymmetrical shape in a plane perpendicular to the plane defined by the center lines, the spaced-apart internal thread zones of the foot part further contribute to the variability of the implant, thereby further reducing the required stocking. In an analogous manner, a floor part two laterally spaced through holes, which are each formed as an internal thread zone, have their lines of symmetry in a common plane, resulting in the same advantages as in a foot with two spaced internal thread zones and these advantages in combination Reinforce foot and floor parts to each other.

With regard to a floor part may further be provided that this has an opening, is given by the through hole over its entire length away an open passage to an outer edge of the floor part that in a direction perpendicular to the longitudinal axis of the through hole cross-section between the through hole and the aperture opposite the outer thread diameter of the shaft, a constriction of the passage is formed and that the width of the gap of the aperture between the constriction and the outer edge of the floor member exceeds the outer thread diameter of the shaft. It is preferred that the constriction of the passage in the region of the internal thread or adjacent thereto is formed. If an implant with such a floor part, which is assigned to a threaded zone section of the shaft, is inserted into the milled jaw cavity in such a way that the opening is directed to the front edge of the floor section with respect to the insertion direction, this floor section can still be inserted after insertion with only little effort again be removed from the maxillary sinus, while the rest of the implant can remain in the jaw. For preparation, with a cutter or other suitable means only the existing on the floor part constriction of the opening is removed, so that then exceeds the smallest cross-sectional dimension of the entire aperture the outer thread diameter of the shaft. The floor part can then easily be pulled laterally out of its milled maxillary sinus, without any risk of influencing the rest of the implant. Incidentally, in an implant according to the invention, two or more floor parts may also be present, which have inner thread zones which can be assigned to the shank in mutually variable distance in the region of one or more thread zone sections, with regard to the second and further floor parts to the procedure, possible developments and from this resulting advantages to the above explanations. If, for example, two floor parts are assigned to the shaft, they can be matched in their extent perpendicular to the shaft in such a way that from the foot part to the end of the floor facing away therefrom cut decreasing dimensions result. In principle, there is also the possibility that the foot part and / or one or more floor parts are formed from a material resorbable by the jaw. This results in addition to an optimal anchorage of the implant in the jaw at the same time a desired compliance, which allows an advantageous adaptation to expansions and compressions of the jaw, as these arise under varying chewing load.

It is preferably provided that the internal thread zones of the foot part and the floor part are of the same diameter and pitch. Preferably, the internal thread zones of the foot part and the floor part of the female threaded zone may correspond to an abutment.

It is preferably provided that the shaft and the foot part can be screwed together via a threaded zone section. This ensures that the shaft and the foot part of the implant can be used independently of each other in the prefabricated maxillary sinuses. In particular, there is the possibility that initially a sole lateral insertion of the foot part takes place, that then a crestales insertion of the shaft is made and then the shaft is screwed via a threaded zone portion with the foot part. The possibility of a crestal insertion of the shaft at the same time the prerequisite is created to use the shaft in a crestal prefabricated maxillary sinus, which may be, for example, an outgoing from the alveolar ridge, extending into the jaw bore whose bore diameter the diameter of the shaft is tuned. By contrast, the foot part can preferably be inserted laterally into a maxillary sinus cavity preferably also laterally prefabricated for this purpose. At the same time, it is achieved in the implant according to the invention as an advantage that from an assortment of different foot parts and / or different shanks a respective selection can be made which is adapted to a jaw cross section to be treated and after insertion into the prefabricated maxillary sinuses can be screwed together. In this case, a large variety of shapes and sizes of implants is already possible with a small assortment of foot parts and / or shanks, so that at the same time a reduced storage life occurs for a use-advantageous use.

In an expedient development, a floor part can be present, which can be screwed to the shaft via a threaded zone section. The floor part can preferably be inserted laterally into a likewise preferably laterally prefabricated maxillary sinus, whereupon a screwing takes place during a subsequent crestal insertion of the shaft. There may be an assortment of floor parts, such as different sizes, shapes, materials or the like, given, from which a jaw cross section adapted to the selection and combination of the selected floor part can be done with a foot and a shaft, whereby the overall achievable variety of Implants is further enlarged. It is furthermore preferred that the foot part and / or the floor part have a base plate with an outer frame which surrounds a frame opening, and in the frame opening an insert made of a material resorbable by the bone and permitting the insertion of a threaded hole is held. The outer frame comes here at the onset of the foot or floor part a protective function with respect to the use, so that the selection of the material for use preferably on the desired absorbability of the jaw bone and on the introduction and use of a threaded hole in the insert can orient advantageous properties. In addition, the outer frame after insertion also has a certain support function with respect to the base plate. In particular, it is intended to a frame which consists of a metal material, but in principle all materials can be used which have the prerequisites for implants properties, in particular with regard to the strength. In a preferred embodiment, the frame is formed continuously along an outer peripheral edge of the base plate, whereby a high stability is given. With regard to the frame opening can be provided that it is completely closed or filled by the insert in a plane parallel to the base plate level. In this way it is effectively prevented that there is a displacement of the insert parallel to the base plate level in the frame opening. It is further preferred that the use contains lactitol or predominantly, possibly completely, consists of lactite. This material is characterized in particular by its good absorbability by the surrounding bone. The insert can be held in the frame opening, for example, by means of an adhesive connection, wherein alternatively or in combination, a positive or non-positive mounting is conceivable.

In a preferred embodiment, the shank may have at a first free end a first threaded zone section with which the foot part can be screwed by way of a threaded engagement. The foot part can already have a blind hole or a through hole with a thread that is matched to the threaded zone portion of the shaft before insertion into the maxillary sinus. Alternatively, a suitable threaded hole can also be introduced into the foot part through a shank that has been developed further when it is inserted into the maxillary sinus cavity. For this purpose, the foot part is introduced before the onset of the shaft in the space provided for receiving the foot part maxillary sinus, so that a penetration of the maxillary sinus is given to the shaft with the foot part. A preferred shaft is developed in such a way that the first threaded zone portion of the shaft, at least in an axially adjacent to the free end region as a drill and / or as a milling cutter is formed. It is particularly thought of such a configuration in which the end of the shaft entering the jaw when inserting is provided with cutting edges and / or grinding bodies. When inserting such a shaft of this is introduced under a rotational movement about its longitudinal axis in the jaw ridge extending from the jaw into the jaw cavity for the shaft, it being at a contact of trained as a drill and / or cutter free end with the foot to form a hole a material removal comes. Moreover, it is possible to manufacture in one step or in several steps with such a shaft and the mandibular cavity required for him. The rotational movement can, for example, be transmitted manually to the shaft via a handle connected to the opposite shaft end; alternatively, a rotary drive of the shaft can be provided by suitable connection to a motor-driven auxiliary tool, such as a drill used for dental treatment. If, prior to the above-described insertion of the shaft, a foot part has already been inserted into the prefabricated maxillary sinus for this purpose, the bore required for a screw connection can also be introduced therein during the crestal insertion of the shaft. In this case expedient development of the shaft whose first threaded zone portion may be formed at least in an axial region as a tap. It is thereby advantageously achieved that when inserting the shaft within the bore of the foot part and the thread required for screwing with a threaded portion of the shaft section is cut.

Alternatively or in combination with the features described above, the shank can have at a second free end a second threaded zone section with which an abutment and / or a rotationally driven tool can be connected. In addition, between the first and the second end of the shaft, a threaded zone section can be formed, with which the floor part can be connected via a threaded engagement. A floor part can preferably be inserted laterally into a prefabricated maxillary sinus cavity, wherein it can already be equipped with a threaded hole suitable for threaded engagement. But it can also be present a floor part, in which before insertion no threaded hole is introduced. In this case, the threaded hole can be introduced upon insertion of a shaft, which is formed according to the foregoing embodiments at a free end as a drill and / or as a cutter and adjacent thereto as a tap. There is the possibility that such a shank is designed as a thread cutter only in a section adjacent to the end region designed as a drill and / or as a milling cutter. In a possible alternative embodiment of the shaft can be dispensed with a separate thread cutting section and the threaded zone sections, where appropriate, be provided with self-tapping thread. It is envisaged that smooth ring zones with the smaller diameter on the other hand are arranged axially between the thread zone sections. In connection with all the illustrated embodiments of the shank, it is preferred that the diameter differences between the thread zone sections, smooth ring zones, the section formed as a drill and the section formed as a tap are less than the smallest diameter present on the shank.

Also proposed is a method for introducing a jaw implant with a shaft and with a foot part into a jaw, wherein an insertion of the foot part into a first maxillary sinus and insertion of the shaft into a second maxillary sinus connected to the first maxillary sinus. In conventional methods there is the disadvantage that the shaft connected to the foot part has to be inserted as a coherent unit laterally into a prepared maxillary sinus, for which the maxillary sinus must also be open in the area of the shaft to the side of a jaw from which the insertion takes place. In the known method for introducing jaw implants into a jaw, therefore, a larger part of the jaw bone is to be removed than is necessary for the subsequent installation position of the implant, which is associated not only with greater stress on the patient but also with disadvantages in use. In addition, known methods in which a shaft which is already fixedly connected to the foot part are introduced into the jaw require, in view of the widely varying jaw cross-sections, an extensive stocking of implants of various shapes and sizes.

For further development of a method for introducing a jaw implant in such a way that a use-advantageous use is possible while at the same time reducing stock-keeping, there is the possibility that lateral insertion of the foot part and crestal insertion of the shaft take place and that the foot part and the shank after Inserting are bolted together. While the foot part is preferably used in a laterally prefabricated maxillary sinus, the shank can now be crestally inserted into a crestal prefabricated maxillary sinus, so that the second maxillary sinus compared to conventional methods only in the shaft used largely corresponding dimensions in the jaw is to bring. It is particularly advantageous that the second maxillary sinus must have no lateral opening to a jaw side. In addition to a lower load on the patient and a simpler production of the second maxillary sinus, this also achieves an immediate all-round support of the same over conventional methods after the crestal insertion of the shaft. In an expedient variant of the method, a lateral insertion of a floor part into a third maxillary sinus occurs before the insertion of the shaft, and the shaft is screwed to both. The introduction of the implant can be carried out starting from a jaw prepared for this, in which the first and second and possibly the third maxillary sinus are provided, the second maxillary sinus with the first and the third maxillary sinus (as far as necessary) in a for the insertion of the implant is suitably connected. In this case, it is intended, in particular, for a relative position of the maxillary sinuses, in which, with regard to different cross sections of the second maxillary sinus with the first and the third maxillary sinus, a respective penetration or overlap is realized. If a foot part and possibly floor part is used, which has a threaded hole for the screw connection with the shaft even before insertion into the jaw, provision can be made so that automatically takes place at the respective insertion of a suitable placement of the holes. A suitable orientation of the threaded bores is understood to be one in which an at least proportional, as complete as possible overlap of the bore cross section with an inclined to the longitudinal direction of the second maxillary sinus, in particular vertical cross section of the second maxillary sinus is realized. In such an orientation of the foot part and / or floor part of the shaft passes through during its crestalen insertion with simultaneous rotation of the respective threaded bores, wherein the shaft can be screwed after or during its insertion by a rotational movement about its longitudinal axis with the foot part or the floor part. The aforementioned precautions may consist in that a precise coordination of the relative position of the second maxillary sinus to the first and possibly the third maxillary sinus to the position of the threaded holes in the foot and possibly floor part. As a result, a suitable orientation of the threaded holes is automatically obtained by the foot and possibly the floor part laterally completely, ie introduced with lateral positive locking, in the associated maxillary sinus. The method preferably uses a shank having a first threaded zone portion at a first free end, the shank being rotated about its longitudinal axis of symmetry during and / or after insertion such that between the first threaded zone portion and a threaded bore of the foot member by thread engagement a connection is made. In order to introduce a floor part in addition to a foot, a shaft can be used according to the method, which has an additional threaded zone section between the two free ends, wherein the shaft is rotated during and / or after insertion about its longitudinal axis of symmetry, so that a connection is made between the threaded zone portion of the shaft located between the two free ends and a threaded bore of the floor member by a threaded engagement.

The method described above can be developed in such a way that the use of foot and / or floor parts without prepared threaded holes is made possible. For this purpose, a shaft can be used, the first threaded zone portion is formed at least in an axially adjacent to the free end of the shaft area as a drill and / or as a router, which is referred to the previous embodiments in connection with the implant according to the invention with regard to the operation. Furthermore, a shaft can be used in which, alternatively or in combination with the aforementioned feature, the first threaded zone section is designed as a thread cutter at least in an axial region. As explained in connection with the implant according to the invention, the design as a tap can be limited to a single section adjacent to the region formed as a drill and / or as a milling cutter. On the other hand, can be dispensed with a separate Gewindeschneidabschnitt, and the threaded zone portions of the shaft, if necessary, be provided with self-tapping thread. When using a shaft with one or more of the aforementioned features, the method offers the possibility that the threaded bore of the foot part and / or the floor part is produced by the rotation of the shaft during its crestal insertion. In addition, there is also the possibility that the second maxillary sinus is made by the rotation of the shaft at its crestal insertion. These measures are of particular advantage in that it can be dispensed with previous precautions for a suitable alignment of threaded holes. Of course, alternatively, it is also possible to produce after insertion of the foot part and possibly the floor part in the aforementioned maxillary sinillas each required holes and / or internal thread by means of a separate drilling and / or milling and / or thread cutting tool, the tool then to remove the jaw and then insert a shaft with threaded zones sections in the second maxillary sinus, in which no training as a drill and / or cutter and / or tap is taken. With the separate plant mentioned above, in a further variant of the method, the second maxillary sinus can also be introduced into the jaw.

Moreover, a shaft, a foot part and a floor part can be used for the method which have even more of the features described in connection with the implant according to the invention. In particular, a foot part and / or a floor part can be used, each having a base plate with an outer frame made of a metal material, wherein the frame surrounds a frame opening and the frame opening is completely closed in a plane parallel to the base plate by an insert which is made a bone resorbable and the introduction of a threaded hole gestattendem material, in particular of lactitol, consists. It may be preferred to proceed in such a way that the threaded bore of the foot part and / or the floor part is produced by the rotation of the shaft during its crestal insertion in the region of the resorbable insert. By the latter measure is advantageously achieved that the shaft is completely surrounded by bone material after absorption in the region of the jaw.

The invention is explained below with reference to the attached figures, which, however, represent only exemplary embodiments. Hereby shows:

1 a side view of an implant according to the invention according to a first preferred embodiment;

2 : a side view of the shaft 1 with a schematic representation of an optional shortening;

3 a side view of an implant in a second preferred embodiment;

4a : An enlarged detail of the thread zone section according to line IVa-IVa in 1 ;

4b : An enlarged partial section of the threaded engagement between the shaft and foot according to line IVb-IVb in 1 ;

5 a plan view of a foot part according to a first preferred embodiment;

6 FIG. 4: a sectional view of the foot part according to line VI-VI in FIG 5 ;

7 a top view of a foot part according to a second preferred embodiment;

8th a plan view of a foot part according to a third preferred embodiment;

9 a plan view of a foot part according to a fourth preferred embodiment;

10 a top view of a foot part in a fifth preferred embodiment with two spaced apart internal thread zones;

11 FIG. 4 is a plan view of a floor part according to a first preferred embodiment; FIG.

12 FIG. 4 is a plan view of a floor part according to a second preferred embodiment; FIG.

13 a top view of a floor member according to a third preferred embodiment with an opening between the through hole and the outer edge;

14 FIG. 4 is a plan view of a floor part according to a fourth preferred embodiment; FIG.

15 FIG. 2: a side view of an implant according to a third preferred embodiment with two shoulder parts; FIG.

16 FIG. 2: a sectional view of a first lower jaw with an implant laterally inserted according to FIG 1 ;

16a Fig. 2: sectional view of a second mandible with the implant laterally inserted therein, in a further preferred embodiment;

16b FIG. 2: sectional view of a third mandible with the implant laterally inserted therein in a further preferred embodiment; FIG.

16c Fig. 3: sectional view of a third mandible with the implant laterally inserted therein in a further preferred alternative embodiment;

17 : Top view of a foot part with a metal frame and a lactic acid insert held therein;

18 : Section view of a foot part after 17 with additional threaded hole along the section line XVIII-XVIII in 19 ;

19 : Top view of a footboard according to 17 with additional through-hole;

20 : perspective view of a jaw segment with prefabricated maxillary sinuses therein;

21 : Section view of the jaw segment after 20 on the cutting plane XXI-XXI before inserting the implant;

21a : Top view of the foot part and the floor part according to 21 ;

22 : Section view of the jaw segment after 20 on the cutting plane XXI-XXI after insertion of the implant;

23 : Section view of the jaw segment behind 20 on the cutting plane XXI-XXI before inserting an implant with a shaft having a drill bit and a self-tapping thread;

23a : Top view of a foot part and a floor part behind 23 ;

24 : Section view of the jaw segment after 20 on the cutting plane XXI-XXI after insertion of the implant according to 23 . 23a ;

25 : enlarged top view of the shaft after 23 ;

26 Fig. 3: sectional view of a jaw segment with prepared maxillary sinuses for a foot and a floor part prior to insertion of an implant with a shank having a drill bit and a thread cutting section;

27 : Section view of the jaw segment behind 26 after inserting the foot part and the floor part;

28 : Section view of the jaw segment after 26 after insertion of the implant;

29 : Enlarged top view of the shaft behind 26 ,

1 shows a side view of an implant according to the invention 1 For lateral insertion into milled maxillary sinuses with a shaft 2 , the threaded zone sections 3 . 4 . 5 and 6 and with several axially consecutive annular smooth zones (smooth ring zones) 7 . 8th and 9 Is provided. The implant 1 also has a disc-like cantilevered footboard 10 and a less cantilevered floorboard section 11 on. In further detail, it is shown that the threaded zone sections 3 . 4 . 5 . 6 alternating with the smooth ring zones 7 . 8th . 9 are arranged and that the Glattringzonen 7 . 8th . 9 opposite the thread zone sections 3 . 4 . 5 and 6 have a comparatively smaller diameter (see. 4a ). According to the in 1 illustrated embodiment of the implant 1 is the floor part 11 the threaded zone section 4 assigned, this by means of threaded engagement of a female threaded zone 12 of the floor part 11 , Furthermore, the foot part 10 the terminal threaded zone section 6 of the shaft 2 associated with a threaded engagement with an internally threaded zone 13 of the foot part is given. As in connection with 4b is further shown, the foot part 10 a blind hole 14 on, in which the female thread zone 13 is trained. As 1 can be seen, has the terminal threaded zone section 6 of the shaft 2 an axial length a, which is the axial length e of the female thread zone 13 of the foot part 10 surpasses. Next it is shown that the blind hole 14 perpendicular to a main extension direction H of the foot part 10 extends.

In further detail, the floor part 11 a through hole 15 on, in which the female thread zone 12 of the floor part 11 is formed, wherein the internal thread zone 12 to both ends (not shown in detail) has open threads. Incidentally, it is provided that the through hole 15 of the floor part 11 perpendicular to a main extension direction G of the floor part 11 extends.

At the in 1 shown embodiment, which are located at the terminal threaded zone section 6 in the longitudinal direction subsequent Glattringzone 9 and the subsequent further threaded zone section 5 an equal axial length b. At the threaded zone section 5 are joined by two more smooth ring zones 8th and 7 and a threaded zone section 4 on, which in turn each have an equal axial length c. In addition, at the end of the threaded zone section 6 opposite end of the shaft 2 a threaded zone section 3 provided, which has an axial length d. At the in 1 illustrated embodiment of the implant 1 This thread zone section serves 3 for attachment of a so-called non-descriptively described. Abutment (intermediate piece) on which a crown or a dental prosthesis can be attached.

In the illustrated embodiment, the axial lengths a, b, c and d are dimensioned different from each other, wherein - as in the following figures - in an overall enlarged representation of the implant 1 no full scale reproduction is realized. It is therefore for explanation of 1 added that the length a of the embodiment is in reality gradations, the length c 1.5 gradations and the length d 2 gradations, with a gradation corresponding to a length of 1.5 millimeters. The length a can also be 2 gradations, so that at one opposite 1 rotated about 180 ° in the plane of the shaft 2 the same thread length is available for the attachment of an abutment, but results in a different sequence of threaded zone sections and smooth ring zones. Alternatively, however, the length a may also be deviating from this, in particular an adaptation to the length e of the internal thread zone 13 of the foot part 10 be realized.

2 shows a side view of the shaft 2 as this one first in the in 1 shown implant 1 is included. By the registered section line is indicated that approximately in the case in which the original total length of the shaft 2 too big for the installation of the implant 1 in a concrete predetermined jaw cross-section is a shortening of the shaft 2 can be done. According to the cutting line, the smooth ring zone can be used for this purpose 7 and the threaded zone section 3 be separated by a cut with a saw or other convenient means, so that a shorter stem is formed, as this in the in 3 illustrated implant 1 contained therein and also with the reference numeral 3 is designated.

This in 3 illustrated implant 1 is different from the one in 1 shown embodiment by its correspondingly reduced height and further characterized in that the floor part 11 in the deeper threaded zone section 5 assigned. The overlying threaded zone section 4 which the floor part 11 in the embodiment according to 1 is assigned to the in 3 reproduced embodiment completely obtained, but starting from the in 2 shown shaft 2 the opposite 1 desired lower height is reached. Possible installation situations of the implant according to the invention 1 will also be on the 16 to 16c and the associated description parts.

The 4a shows an enlarged detail of the Gewindezonenabschnitts 5 and adjacent areas of the Glattringzonen 8th and 9 , where it can be seen that the threaded zone 5 of the shaft 2 Threads open towards their axial ends 16 . 17 has. Under open threads are in the context of the invention generally understood by those without obstruction from an adjacent non-threaded portion starting by a relative rotation a threaded engagement with an internal thread of another component can be reached, or on the thread engagement is correspondingly easily repealed. In 4b is shown that the female thread zone 13 of the foot part 10 at the bottom of the hole 18 facing end a closed thread 19 having. To represent the 4b It should be noted that these relate to the foot part 10 a sectional view through a hole center enclosing plane describes, while the shaft end is reproduced for clarity in an uncut side view. It becomes clear that the lower end 20 of the thread zone section 6 as an open thread in connection with the closed thread 19 the internal thread zone 13 the depth of engagement is automatically limited to a desired level, since a beyond this rotational movement by jamming the end 20 with the wall area 21 in the bottom of the hole 14 is prevented. So there is a reproducible and defined assignment of the foot part 10 to the terminal threaded zone section 6 reached. About the free thread at the end 20 There is thus the possibility of a floor part 11 on the threaded zone section 6 and to turn over it, so that an assignment of the floor part 11 to one of the following threaded zone sections is possible.

5 shows an enlarged plan view of a foot part 10 according to a first preferred embodiment. This is a disk-like flat body with an approximately horseshoe-shaped peripheral edge 22 formed by an outer walkway 23 closed is. The opposite long sides 24 of the edge 22 are through an inner walkway 25 cohesively connected, wherein in the middle of the inner web, the blind hole 14 with the internally threaded zone formed therein 13 is provided. This is in more detail as well 6 to take a sectional view of the foot part 10 entlag the section line VI-VI in 5 describes.

7 shows in an enlarged plan view of a foot part according to a second preferred embodiment, which - like the embodiments described below - also with the reference numeral 10 is designated. Incidentally, in this case and in subsequent figures and their description, other mutually corresponding details are each designated by the same reference numerals. The foot part 10 differs from the first embodiment in 5 in that instead of one parallel to the outer web 23 extending inner bridge 25 a parallel to the long sides 24 extending inner bridge 26 is trained.

8th shows in an enlarged plan view of a footboard 10 according to a third preferred embodiment. It points opposite to in 5 illustrated first embodiment, an enlarged dimension in the direction of the longitudinal sides 24 on, wherein the dashed lines for comparison purposes, the right edge of in 5 represented foot part 10 sketch. In more detail agrees in 8th in the direction of the long sides 24 measured distance between the blind hole 14 and the far right end of the edge 22 with the appropriate distance in 5 match.

9 shows in an enlarged plan view of a foot part according to a fourth preferred embodiment, that the same outer dimensions as in 8th shown footboard 10 has. However, it is provided that in the direction of the long sides 24 measured distance between the blind hole 14 and the outer dock 23 equal to the corresponding distance at the in 5 represented foot part is.

10 shows an enlarged plan view of a foot part according to a fifth preferred embodiment, which have the same outer dimensions as in the 8th and 9 shown foot parts 10 has. In addition, this fourth embodiment has two spaced apart internal thread zones 13 on, whose symmetry lines lie in a common plane. The internal thread zones are in through holes 14 formed, in turn, in spaced inner webs 25 are provided. The distances between the internal thread zones 13 from the edge 22 and the outer dock 23 same time the corresponding distances in the 8th and 9 ,

The 11 to 14 show in enlarged plan views the floor parts 11 . 11 ' . 11 '' . 11 ''' as the first to fourth preferred embodiment of a floor part. This in 11 illustrated floor part 11 has similarities with the in 5 shown foot part 10 However, in contrast, has a reduced horseshoe-shaped ring 27 and outer dock 28 on. In contrast, the internal thread zone 12 the through hole 15 with a corresponding thread type as the female thread zone 13 the foot parts 10 . 10 ' . 10 '' . 10 ''' . 10 '''' fitted. This also applies to the following in the following 12 to 14 shown floor parts 11 ' . 11 '' . 11 ''' , so that in an implant according to the invention 1 Any combination of all shown foot and floor parts are possible. There are thus individual threaded zone sections 3 . 4 . 5 . 6 each optionally any foot and / or floor parts assignable, so that depending on the assignment between the foot and floor part and possibly a plurality of floor parts results in a variable distance. In the enlarged representation selected overall in the figures, the size relationships between foot and tail parts are reproduced only qualitatively, even from the point of view that, of course, also of the illustrated different sizes or proportions in the implant according to the invention 1 can be considered. For a reliable assignment of the foot and floor parts to selected thread zone sections 3 . 4 . 5 . 6 of the shaft 2 to ensure, however, is a vote of the thread type of the threaded zone sections 3 . 4 . 5 . 6 and the internal thread zones 12 . 13 to the dimensions of the foot or floor parts perpendicular to the plane preferred in which, after the assignment at least one complete thread is substantially engaged. The in the 11 to 14 Stage parts shown 11 . 11 ' . 11 '' . 11 ''' as well as the foot parts 10 . 10 ' . 10 '' . 10 ''' . 10 '''' The preceding figures are formed in a disc-like basic shape.

This in 12 shown floor part 11 ' has a circular floor plan. In further detail are between the central through-hole 15 with internal thread zone 12 and the outer edge 29 four through holes 30 provided, which are spaced from each other in the circumferential direction by 90 °.

The floor part 11 '' according to 13 has a breakthrough 31 on, through the from the through hole 15 over its entire perpendicular to the plane extending length away an open passage to the outer edge 32 given is. It is in one of the longitudinal axis of the through hole 15 vertical cross-section, which extends parallel to the plane, between the through hole 15 and the breakthrough 31 in the area of the internal thread zone 12 a narrowing 33 the passage formed. The width of the gap A of the breakthrough 31 surpasses in the area between the narrowing 33 and the outer edge 32 of the floor part 11 '' the outer thread diameter of the shaft and the outer thread diameter of the female thread zone 12 , On the other hand, the narrowest gap B is the constriction 33 smaller than this outer thread diameter. It is a vote of the gap B on the diameter of the female thread zone 12 of the floor part 11 '' realized by the same a secure assignment thereof to a threaded zone section 3 . 4 . 5 . 6 of the shaft 2 is possible. It is ruled out that an unintentional dissolution or separation of the thread engagement occurs within the plane of the drawing. On the other hand, with an implant 1 , the one floor part 11 '' , according to 13 contains, even after insertion into a jaw with little effort and correspondingly low load for the patient, the gap B with a cutter or other suitable tool to the width of the gap A are increased, so that the constriction 33 thereby getting into abolition. It can then be the floor part 11 '' be pulled laterally out of its milled maxillary sinus in the circumferential direction suitable installation position, without causing the removal of the entire implant 1 requirement.

This in 14 illustrated floor part 11 '' Finally, it also has a round floor plan and has the same level as the floor section 11 a continuous inner bridge 34 on, in the middle of a through hole 15 with internal thread zone 12 is provided.

15 shows an enlarged side view of an implant according to the invention 1 in a further preferred embodiment. This shows next to a shaft 2 and a foot part 10 as a special feature two floor parts 11 on, one of each of the threaded zone section 5 and the higher-lying threaded zone section 4 assigned. Next is the foot part 10 the lower end threaded zone section 6 assigned, and at the upper end threaded zone section 3 An abutment, which is not shown in the drawing, can be fastened by screwing. Like the 1 and 3 is it also in 15 at the floor part 11 already closer in 11 described floor part 11 and at the foot part 10 to that in more detail in the 5 and 6 illustrated footboard 10 , The thread zone section 5 associated floor part 11 opposite to the overlying substantially the same shape and a corresponding internal thread zone 12 slightly larger outer dimensions, but smaller than the dimensions of the foot 10 are.

16 shows in a sectional view a first cross section 35 a lower jaw with laterally inserted therein implant according to the invention 1 , which is the one in 1 represented implant acts. Here is compared to 1 only an assignment of the floor part 11 to a slightly deeper area of the thread zone section 4 realized, so that a slightly smaller distance to the foot part 10 results. In the drawn sectional view extend from the left flank of the jaw cross-section 35 Milled maxillary sinuses 36 . 37 . 38 into the interior of the jaw into which the implant 1 has been inserted from the left side. In terms of perpendicular to the drawing plane horseshoe-like shape of the foot part 10 or floor part 11 results in a nearly flush conclusion of the outer bars with the left outer edges of the maxillary sinuses 36 and 38 , so that also over the hard edge area of the jaw an optimal support of the implant 1 is guaranteed. It also becomes clear that the upper threaded zone section 3 the jaw cross section 35 surmounted so that an abutment not reproduced graphically is attached to this. 16a shows a contrast jaw cross section 35 ' in the one also with the reference numeral 1 provided implant is inserted laterally. To adapt to the shallower cross-sectional profile of the jaw has the implant 1 a shaft 2 like this one out of the 16 Shank represented by a shortening according to 2 won. In a further difference to 16 is in 16a the floor part 11 the threaded zone section 5 associated with, in addition, a comparatively smaller floor part 11 is available. The threaded zone section 3 protrudes above the jaw cross section 35 ' out, so that an abutment is to attach to this. The 16b and 16c give a contrast slender jaw cross-section 35 '' again, in which also with the reference numeral 1 provided implants are inserted. In each case an adaptation in the jaw cross section is in different ways 35 '' reached. While doing so in 16b one compared to 16 smaller floor part 11 also the threaded zone section 4 assigned, has the implant 1 to 16c the same floor part as 16 However, the lower threaded zone section 5 is assigned, so that opposite 16 a small distance between the floor part 11 and foot part 10 results.

17 shows a plan view of another embodiment of a foot part of an implant for insertion into prefabricated maxillary sinuses. In this case - as in the following figures - chosen to illustrate a comparison with the real dimensions enlarged representation. The foot part 39 has a base plate 40 with an outer frame 41 on top of a frame opening 42 embraces. In the frame opening 42 is an assignment 43 held by a bone resorbable material, which in the example shown is lactitol. The 18 and 19 show in a sectional view and in another plan view of the foot part 39 to 17 with a contrast additional threaded hole 44 , which is formed as a through hole with an internal thread. In that regard, it is important that the use 43 is made of a material that allows the insertion of a threaded hole and its use for a screw connection. In the embodiment of 17 to 19 is the frame 41 made of a metal material and is along an outer circumferential edge 45 the base plate 40 consistently formed. The frame opening 42 is from the insert 43 in one to the base plate 40 parallel plane completely closed. In further detail is the use 43 by a press fit 46 in the outer frame 41 held. In addition, the radii have R and r of the threaded hole 44 and the outer edge 45 a common center. Notwithstanding that in the 17 to 19 shown embodiment, in which the frame 41 has the shape of a closed end horseshoe, for example, rectangular, square, circular, elliptical or other suitable frame shapes can be realized. Furthermore, a floor part in the 17 to 19 have described structure.

20 shows a jaw segment in a perspective view 46 with prefabricated maxillary sinuses 47 . 48 . 49 in the area of a treatment site. The first maxillary sinus 47 is geometric, ie, in terms of shape and size, adapted to a foot of an implant to be inserted into the jaw, the second maxillary sinus 48 is geometrically adapted to a shaft of the implant, and the third maxillary sinus 49 is geometrically adapted to a floor part of the implant to be inserted, wherein the foot part, the shaft and the floor part in 20 each drawing is not reproduced. The maxillary sinuses 47 and 49 were lateral and the maxillary sinus 48 crestal prefabricated in the jaw, with a connection of the maxillary sinuses 47 . 48 and 49 is realized in the sense of a penetration or adjacent overlap. The second maxillary sinus 48 is only in the area of the jawbone 50 shown. But it is clear that this also shows the gum, broken up for clarity 51 passes.

21 shows a sectional view of the jaw segment 46 to 20 on the cutting plane XXI-XXI in conjunction with an implant according to the invention 52 for insertion into the prefabricated maxillary sinuses 47 . 48 and 49 , For a better overview (as in the following sectional views) has been dispensed with a reproduction of lying behind the cutting plane teeth. The implant 52 has a shaft 53 on that with threaded zone sections 54 . 55 . 56 equipped and to its further details on the in 3 illustrated shaft 2 Reference is made. The implant 52 also includes a footboard 57 that over the threaded zone sections 54 . 55 . 56 with the shaft 53 is screwed. Next a floor part 58 also with the shaft 53 via a threaded zone section 54 . 55 . 56 is screwed. While the shaft 53 , the foot part 57 and the floor part 58 in 21 are shown in a side view, shows. 21a to clarify the foot part 57 and the floor part 58 additionally in a plan view. The foot part 57 is as a disc-like flat body with an approximately horseshoe-shaped peripheral outer edge 59 educated, the one from an outside jetty 60 closed is. The opposite long sides 61 of the edge 59 are through an inner walkway 62 cohesively connected, being in the middle of the inner web 62 a through hole 63 with an internal thread 64 is provided. The radius r of the through hole and the radius R of the outer edge 59 are arranged on a common center. The outer edge 59 and the footbridges 60 . 62 form a one-piece frame, from which frame openings 65 . 66 are enclosed. In the embodiment of 21 . 21a are in the frame openings held no bets. The floor part 58 has a basically similar structure as the foot part 57 , so that corresponding reference numerals are used for identification. The floor part 58 is different from the foot part 57 essentially by its overall smaller dimensions of the outer frame 67 , whereby by the respective dimensions a most extensive adaptation to the maxillary sinuses 47 . 49 is realized.

As in 21 is further illustrated, are used for insertion of the implant 52 in the prefabricated maxillary sinuses first the foot part 57 and the floor part 58 laterally through the openings 68 . 69 into the maxillary sinuses 47 . 49 and then the shaft 53 crestal through the opening 70 into the maxillary sinus 48 used. In addition to the direction of movement, the arrows labeled with Roman numerals also indicate the preferred sequence of insertion, although a changed sequence is also possible with regard to the foot and the floor part.

22 shows in a sectional view the jaw segment 46 along the cutting plane XXI-XXI after insertion of the implant 52 , In it it becomes clear that the foot part 57 and the floor part 58 each as far as possible, ie up to a positive connection of the arcuate end of the outer frame 59 have been used with the frontal, also arcuate end of the maxillary sinuses in this. It is such a mutual geometric coordination of foot and floor part to the maxillary sinuses 47 . 48 . 49 realized that the through holes 63 with the internal threads 64 automatically overlapping with cross sections of the maxillary sinus 48 which cross sections are perpendicular to the longitudinal direction of the maxillary sinus 48 is arranged. After inserting the foot part 57 and the floor part 58 is thus a trouble insertion of the shaft 53 allows this, while rotating around the longitudinal axis of the shaft 53 done so that the shaft 53 with the foot part 57 and with the floor part 58 can be screwed. The screw connection of the shaft 53 with the floor part 58 takes place after the shaft in its lower longitudinal section in the maxillary sinus 58 has been used while the screw connection with the foot part 57 only then takes place after the shaft 53 almost completely into the maxillary sinus 48 has been used. 22 shows the installation situation of the implant 52 in the jaw segment 46 in which the shaft 53 with the foot part 57 and the floor part 58 connected by screwing. The threaded zone section 56 dominates the jawbone 50 and the gum (not shown) 51 adjacent to an upper smooth ring zone 71 so that the upper threaded zone section 56 is available for attachment of an abutment or a dental prosthesis. The dimensions of the foot part 57 and the floor part 58 are adapted to the mandibular cross section to be treated so that the maxillary sinuses 47 . 48 also in the at the openings 68 . 69 adjacent areas, ie in the area of particularly hard bone layers, are almost completely filled by them.

23 shows the jaw segment 46 in a sectional view also on the cutting plane XXI-XXI, but in conjunction with a relation to the 21 . 21a . 22 modified implant 52 ' , This initially differs from the implant described above 52 that instead of the foot part 57 and the floor part 58 in it a foot part 72 and a floor part 73 are provided in the also in 23a illustrated initial state in principle the in 17 in connection with a foot part 39 show features described. They each have (using the same reference numerals) an outer frame 74 made of a metal material, in the frame opening 75 by means of a press fit a continuous use 76 made of lactitol. The outer frame 74 of the foot part 72 is geometric to the maxillary sinus 47 , and the outer frame 74 of the floor part 73 is geometric to the maxillary sinus 49 adapted, for which reference is made in principle to the preceding statements. The implant 52 ' also has a shaft 53 ' on, whose threaded zone section 54 ' is designed as a tap. In an axial to the free lower end 77 adjacent area is the shaft 53 ' as a drill 79 educated. In the illustrated embodiment are the tap and the drill 79 immediately adjacent to each other, so that the drill, so to speak, in the region of the threaded zone section 54 ' is trained. Although an axially spaced configuration of tappers and drills is conceivable, an immediately adjacent arrangement will nevertheless be preferable with a view to minimizing the required drilling depth. The drill 79 is with respect to the cutting geometry in the way to the material of the insert 76 coordinated that this is a precise drilling without breaking out of edge areas is possible. Furthermore, the diameter of the drill 79 in the manner of the thread cutter of the thread zone section 54 ' tuned that with it a precise and force-saving introduction of a Internal thread in the with the drill 79 prefabricated hole is guaranteed. It is also between the two free ends 77 and 78 arranged threaded zone section 55 ' designed as a tap, wherein - also with regard to the threaded zone section 54 ' - Under the term thread cutter in the sense of the present application, a self-tapping external thread is to be taken. The shaft 53 ' finally points to its upper end 78 a third threaded zone section 56 ' on, which has no cutting action. Between the thread zone sections 54 ' . 55 ' and 56 ' there are smooth ring zones 71 ' , which have smaller diameter compared to the threaded zone sections. For insertion of the implant according to the invention 52 ' into the prefabricated maxillary sinuses 47 . 48 . 49 becomes after the same time in 23 Procedure sketched by movement arrows proceeded so that first the foot part 72 and the floor part 73 laterally through the openings 68 . 69 into the associated maxillary sinuses 47 . 49 be used (whereby a reverse order is possible). After the in 23a embodiment shown have the foot part 72 and the floor part 73 during insertion, none for screwing to the shaft 53 ' suitable threaded holes. Advantageously, therefore, the insertion of the implant 52 ' in terms of accuracy of alignment in the maxillary sinus lower requirements than the implant 52 to deliver. It is, however, when inserting the implant 52 ' to note that the foot part 72 and the floor part 73 at least as far pushed into the associated maxillary sinus, until a complete overlap of cross sections of the maxillary sinus 48 with the respective inserts 76 results. Then the shaft is 53 into the prefabricated maxillary sinus 48 used, wherein a rotation takes place about the longitudinal direction. The insertion takes place first, until the drill 79 on the inserted floor part 73 meets. Upon further insertion while rotating, the drill produces 79 in the insert 76 of the floor part 73 a hole in which of the subsequent thread cutter of the thread zone section 54 ' an internal thread is introduced. Finally, the threaded zone section passes through 54 ' the use 76 of the floor part, whereupon, in yet another insertion to a screwing of the threaded zone section 55 ' in the formed threaded hole of the floor part 73 comes. As in 25 is shown in more detail, the threaded zone section 55 ' in the embodiment shown, a slightly larger diameter than the threaded zone portion 54 ' on. Upon further insertion of the shaft 53 ' is therefore in the existing threaded hole of the floor part 73 from the thread cutter of the thread zone section 55 ' a slightly larger thread cut, in which a secure screwing of the shaft 53 ' with the floor part 73 he follows. Upon further insertion of the shaft 53 ' , hits the drill 79 then on the bet 76 of the foot part 72 in which a borehole is first introduced. The thread cutter of the thread zone section 54 ' here cuts an internal thread, in which a screw connection of the shaft 53 ' with the foot part 72 he follows. 24 illustrates the installation state of the implant 52 ' in the jaw segment 46 , The shaft 53 ' has therein a depth of use, in which the drill 79 just below the foot part 72 located, leaving the threaded hole 80 of the foot part just in full threaded engagement with the threaded zone section 54 ' stands. The at the introduction of the threaded holes 80 . 81 in the foot part 72 and in the floor part 73 formed chips or fragments exist as well as the inserts 76 made of bone resorbable material, in the illustrated embodiment of lactitol, so that they, as far as they remain, for example, in the area of the smaller diameter smooth ring zones in the treated jaw, can also be absorbed over time.

25 shows an enlarged side view of the shaft 53 ' being in symbolic representation of the drill 79 and the thread zone sections designed as taps 54 ' and 55 ' as well as the threaded section not designed as a thread cutter 56 ' are reproduced. Likewise, it is indicated that the threaded zone section 55 ' one opposite the threaded zone section 54 ' has slightly enlarged diameter and that the Glattringzonen 71 ' have a comparatively smaller diameter than the threaded zone sections.

26 shows a sectional view of the jaw segment 46 with prefabricated maxillary sinuses 47 and 49 for a foot part 72 and for a floor part 73 , The foot part 72 and the floor part 73 correspond respectively to the embodiments of 23 . 23a and 24 so that the corresponding reference numerals are used. The foot part 72 and the floor part 73 make up 26 in conjunction with a shaft 53 '' a further preferred embodiment of an implant 52 '' , The shaft 53 '' who is in more detail in 29 is different from that in FIG 25 shown shaft 53 ' in that the threaded zone section 54 '' only partially in one to the drill 79 adjacent axial region B is designed as a tap. In contrast, the remaining thread zone section 54 '' and the threaded zone sections 55 '' and 56 '' designed as external thread without thread cutting functions.

The 26 to 28 describe in context the insertion of the implant 52 '' in the jaw segment 46 , to which first the foot part 72 and the floor part 73 into the prefabricated maxillary sinuses 47 and 49 be used. As a result, this is in 27 shown. Then the shaft is 53 '' with a permanent rotation about its longitudinal axis crestal placed on the alveolar ridge and delivered continuously in the direction of the arrow. In the course of further insertion then the second maxillary sinus 48 by the rotation of the drill 79 manufactured, in addition also aligned through holes in the footboard 72 and floor part 73 , Through the trailing thread cutter in area B of the thread zone section 54 '' is cut into the resulting bore an internal thread, which in the inserted state of the shaft 53 ' a screw connection of the foot part 72 with the threaded zone section 54 '' and the floor part 73 with the threaded zone section 55 '' given is.

Claims (32)

Implant for lateral insertion into milled maxillary sinuses with a shaft which is provided with a threaded zone portion and with several axially consecutive annular smooth zones (smooth ring zones) and which disc-like protruding a foot part and at a distance at least a less far projecting floor portion, characterized in that the shaft ( 2 ) several threaded zone sections ( 3 . 4 . 5 . 6 ) alternately with the smooth ring zones ( 7 . 8th . 9 ) of smaller diameter and the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ) and / or as a separate floor part ( 11 . 11 ' . 11 '' . 11 ''' ) formed floor section internal thread zones ( 12 . 13 ), which are the shaft ( 2 ) in the region of its thread zone sections ( 3 . 4 . 5 . 6 ) are assignable in mutually variable distance. Implant ( 1 ) According to claim 1, characterized in that at least one of the threaded zone sections ( 3 . 4 . 5 . 6 ) of the shaft ( 2 ) open at its axial ends threads ( 16 . 17 ) having. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ) a blind hole ( 14 ), in which the female thread zone ( 13 ) of the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ) is trained. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the internal thread zone ( 13 ) of the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ) at the end facing the bottom of the hole a closed thread ( 19 ) having. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the shaft ( 2 ) in the longitudinal direction at least one terminal threaded zone section ( 3 . 6 ), at the free end of an open thread is formed. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the terminal threaded zone section ( 6 ) of the shaft ( 2 ) has an axial length (a) which at least the axial length (e) of the female thread zone ( 13 ) of the foot corresponds. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the blind hole ( 14 ) perpendicular to a main extension direction (G) of the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ). Implant ( 1 ) according to one or more of the preceding claims, characterized in that the floor part ( 11 . 11 ' . 11 '' . 11 ''' ) a through hole ( 15 ), in which the female thread zone ( 12 ) of the floor part ( 11 . 11 ' . 11 '' . 11 ''' ) is formed with open at both ends threads. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the through-hole ( 15 ) perpendicular to a main extension direction (G) of the floor part ( 11 . 11 ' . 11 '' . 11 ''' ). Implant ( 1 ) according to one or more of the preceding claims, characterized in that a smooth ring zone ( 7 . 8th . 9 ) and an adjacent threaded zone section ( 3 . 4 . 5 . 6 ) have the same axial length (a, b, c, d). Implant ( 1 ) according to one or more of the preceding claims, characterized in that at the end of the threaded thread zone section ( 6 ) in the longitudinal direction subsequent Glattringzone ( 9 ) and the subsequent further threaded zone section ( 5 ) have the same axial length (b). Implant ( 1 ) according to one or more of the preceding claims, characterized in that to the further threaded zone section ( 5 ) alternately two more smooth ring zones ( 8th . 7 ) and a threaded zone section ( 4 ), each having the same axial length (c). Implant ( 1 ) according to one or more of the preceding claims, characterized in that at the end of the threaded end zone ( 6 ) opposite end of the shaft ( 2 ) a threaded zone section ( 3 ) is available. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the axial length (a), which of the terminal threaded zone section ( 6 ) of the shaft ( 2 ), the axial length (b) which extends to the end of the threaded section ( 6 ) in the longitudinal direction subsequent Glattringzone ( 9 ) and the subsequent further threaded zone section ( 5 ), the axial length (c), which at the other threaded zone portion ( 5 ) in alternation with a threaded zone section ( 4 ) subsequent two 'smooth ring zones ( 8th . 7 ) and this threaded zone section ( 4 ), and the axial length (d), which the threaded section ( 3 ) at the end of the threaded section ( 6 ) opposite end of the shaft ( 2 ), are different from each other. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the foot part ( 10 '''' ) two spaced apart internal thread zones ( 13 ), whose symmetry lines lie in a common plane. Implant ( 1 ) according to one or more of the preceding claims, characterized in that a floor part two laterally spaced through holes (( 15 ), whose lines of symmetry lie in a common plane and that both through holes are each formed as an internal thread zone. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the floor part ( 11 '' ) a breakthrough ( 31 ), through which from the through hole ( 15 ) over its entire length an open passage to an outer edge ( 32 ) of the floor part ( 11 '' ) is given, that in one to the longitudinal axis of the through hole ( 15 ) vertical cross section between the through hole ( 15 ) and the breakthrough ( 31 ) relative to the outer thread diameter of the shaft ( 2 ) a narrowing ( 33 ) of the passage is formed and that the width of the gap dimension (A) of the aperture ( 31 ) between the narrowing ( 33 ) and the outer edge ( 32 ) of the floor part ( 11 '' ) the outer thread diameter of the shaft ( 2 ) exceeds. Implant ( 1 ) according to one or more of the preceding claims, characterized in that two floor parts ( 11 ), which inner thread zones ( 12 ) which the shaft ( 2 ) in the region of its thread zone sections ( 3 . 4 . 5 . 6 ) are assignable in mutually variable distance. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the foot part ( 10 . 10 ' . 10 '' . 10 ''' . 10 '''' ) and / or a floor part ( 11 . 11 ' . 11 '' . 11 ''' ) are formed from a resorbable by the jaw material. Implant ( 1 ) according to one or more of the preceding claims, characterized in that the internal thread zones ( 13 . 12 ) of the foot part ( 10 . 10 ' . 10 '' . 10 ''' ) and the floor part ( 11 . 11 ' . 11 '' . 11 ''' . 11 '''' ) are diameter and slope equal. Implant ( 1 ) according to claim 20, characterized in that the internal thread zones ( 13 . 12 ) of the foot part ( 10 . 10 ' . 10 '' . 10 ''' ) and the floor part ( 11 . 11 ' . 11 '' . 11 ''' . 11 '''' ) correspond to the internal thread zone of an abutment. Implant ( 52 . 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that a floor part ( 58 . 73 ) which is connected to the shaft via a threaded zone section ( 55 . 55 ' . 55 '' ) is screwed. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the foot part ( 39 . 57 . 72 ) and / or the floor part ( 58 . 73 ) a base plate ( 40 ) with an outer frame ( 41 . 74 ) having a frame opening ( 42 . 75 ) and that in the frame opening ( 42 . 75 ) an insert ( 43 . 76 ) from a bone resorbable and the introduction of a threaded hole ( 44 . 80 . 81 ) is held gestattendem material. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the frame ( 47 . 74 ) consists of a metal material. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the frame ( 41 . 74 ) along an outer peripheral edge ( 45 ) of the base plate ( 40 ) is formed throughout. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the frame opening ( 42 . 75 ) of the mission ( 43 . 76 ) in one to the base plate ( 40 ) parallel plane is completely closed. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the insert ( 43 . 76 ) Contains lactakt. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the shaft ( 53 . 53 ' . 53 '' ) at a first free end ( 77 ) a first threaded zone section ( 54 . 54 ' . 54 '' ), with which the foot part ( 39 . 57 . 72 ) is screwed via a threaded engagement. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the first threaded zone section ( 54 ' . 54 '' ) of the shaft ( 53 ' . 53 '' ) at least in an axial direction to the free end ( 77 ) adjacent area as a drill ( 79 ) and / or cutter is formed. Implant ( 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the first threaded zone section ( 54 ' . 54 '' ) of the shaft ( 53 ' . 53 '' ) is formed at least in an axial region (B) as a thread cutter. Implant ( 52 . 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that the shank at a second free end ( 78 ) a second threaded zone section ( 56 . 56 ' . 56 '' ), with which an abutment and / or a rotationally driven tool is connectable. Implant ( 52 . 52 ' . 52 '' ) according to one or more of the preceding claims, characterized in that between the first ( 77 ) and the second ( 78 ) End of the shaft ( 53 . 53 ' . 53 '' ) a threaded zone section ( 55 . 55 ' . 55 '' ) is formed, with which the floor part ( 58 . 73 ) is connectable via a threaded engagement.

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