DE202024103172U1 - Transplant system, bone screw for a transplant system and transplant for a transplant system - Google Patents

Abstract

Transplant system (1) comprising a bone screw (2) and a transplant (3), wherein the transplant (3) can be fastened to a bone (4) by means of the bone screw (2), wherein the bone screw (2) has a screw head (5) and a thread (6) for screwing into the bone (4), and wherein the bone screw (2) is designed to fasten the transplant (3) to the bone (4), characterized in that the bone screw (2) has an adjusting section (8) between the screw head (5) and the thread (6), wherein the transplant (3) is arranged in a section of the adjusting section (8) near the thread in a transplant state of the transplant system (1) in such a way that the transplant (3) can be aligned relative to the bone (4).

Description

The present invention relates to a transplant system, wherein the transplant system comprises a bone screw and a transplant, wherein the transplant can be fastened to a bone by means of the bone screw, wherein the bone screw has a screw head and a thread for screwing into the bone, and wherein the bone screw is designed to fasten the transplant to the bone.

Teeth or dental implants require healthy bone substance to be securely attached to the jawbone. The bone substance can be reduced for various reasons, i.e. the jaw can have a bone defect. These can be, for example, anatomical reasons, genetic reasons, age-related reasons and/or disease-related reasons. The bone loss (bone defect) resulting from the reduction in bone volume should, if possible, be replaced by bone augmentation from bone, for example the patient's own bone or bone material obtained from another person, or other bone replacement material. Bone augmentation is necessary in cases where there is not enough of the patient's own jawbone for the patient's own teeth or implants, especially dental implants. Bone augmentation involves a surgical procedure.

A surgical procedure to build up bone is also known as augmentation. Augmentation in the dental sense is, as explained, the restoration of lost (jaw) bone. Various augmentation procedures are available for building up bone substance. The appropriate procedure is chosen depending on the patient's individual findings.

For example, the shell technique with autologous bone according to Khoury for horizontal and/or vertical augmentation is well known. In the case of corresponding bone defects, a reduction in the bone substance forms a defect space (bone defect). When augmenting horizontal and/or vertical bone defects, a sufficient bone width/height is aimed for so that the implant can be inserted and treated stably in the long term.

With the Khoury shell technique, horizontal/vertical bone defects can be repaired, for example, by initially closing or sealing the defect space on one, two or more sides with a shell. The shell is aligned to the existing bone once during the attachment process, temporarily fixed in this alignment, for example by clamping, and then attached to the existing bone using standard bone screws. Changing the position of the transplant/shell is no longer possible without further ado.

Once the shell is attached to the existing bone using the usual bone screws and the defect space is closed/sealed in the direction of the shell, the defect space can be filled with a bone replacement material. The bone replacement material used is then supposed to be accepted or remodeled by the patient's body over a longer period of time in such a way that new bone is formed in this area and this new bone grows together with the existing surrounding bone.

The disadvantage of the Khoury shell technique, when performed with the usual bone screws, is that the shell or the transplant is only aligned once during the attachment to the existing bone and then secured with the usual bone screws. If the alignment of the shell needs to be corrected, the process of attaching the shell essentially has to be started again from the beginning, with only a limited amount of local bone available for the attachment, since the original drill holes can only be used once.

It is therefore the object of the present invention to provide a transplant system which makes it possible to align a transplant in an optimized manner during fixation.

The object is achieved by a transplant system according to claim 1, a bone screw according to claim 15 and a transplant according to claim 16.

Firstly, the present invention relates to a transplant system, wherein the transplant system comprises a bone screw and a transplant, wherein the transplant can be fastened to a bone by means of the bone screw, wherein the bone screw has a screw head and a thread for screwing into the bone and wherein the bone screw is designed to fasten the transplant to the bone.

The transplant system is further characterized in that the bone screw has an adjustment section between the screw head and the thread, whereby the transplant in a transplant state of the transplant systems is arranged in a section of the adjustment section near the thread in such a way that the transplant can be aligned relative to the bone.

The screw head can have a top side and a side facing the thread. The top side can be curved. The top side can in particular have a lens shape or be a so-called lens head. The screw head should fit as well as possible to prevent perforation of the soft tissue during the healing phase of the transplant due to a protruding or protruding conventional screw head.

The screw head can in particular have a height or thickness of 0.5 mm to 1.5 mm. The screw head can preferably have a height or thickness of 1 mm.

The screw head can also have a screw drive. The screw drive can be arranged in the screw head or outside the screw head. The screw drive can be permanently arranged in or on the screw head or can be detachable from it.

It is conceivable, for example, that the screw drive, if it is no longer needed, is detached from the screw head in order to provide a screw head surface that is as flat as possible. The screw drive can be detached from the screw head by cutting, sawing, milling or breaking it off, for example. A predetermined breaking point arranged between the screw head and the screw drive is also conceivable.

Preferably, the screw drive is arranged in the screw head.

The screw drive can have different drive types. In particular, the screw drive can be an internal square drive, an internal hexagon drive, an internal hexalobular drive or another known drive type for screws, in particular screws from the field of jaw/oral surgery.

The screw drive can be designed to taper in the direction of the thread. This can be advantageous in that it can reduce or prevent friction of a suitable wrench on the screw drive. It can also prevent or make it more difficult for the bone screw to fall out of the wrench when screwing the bone screw in or out.

The adjustment section can be arranged adjacent to the screw head. The thread can also be arranged on the adjustment section, opposite the screw head. The thread can in particular be a right-hand thread. In addition, the thread, opposite the adjustment section, can end with a tip, in particular a self-tapping tip.

The thread can preferably have a length of 8 mm to 14 mm. In addition, the thread can in particular have a thread diameter of 1 mm to 2 mm, preferably the thread can have a thread diameter of 1.5 mm.

The transplant can in particular have a shell shape. A shell shape can be understood as a curved or even a flat shape of the transplant as a flat body. The contour of the transplant is not limited to any specific geometry, but depends on the bone defect. The contour of the transplant can, for example, have the shape of a polygon, a cornerless surface or a combination of both shapes as well as an individual shape adapted to the bone defect.

The bone, particularly a jawbone, can have a bone surface that is generally uneven. The bone surface can be set back in the area of the bone defect compared to the original course of the bone surface. The difference between an original bone volume and a bone volume after the occurrence of the bone defect can thus form a defect space with a defect space floor (which delimits the defect space) (as well as defect space side walls).

The transplant and the bone screw can be arranged in a transplant state of the transplant system in such a way that the transplant is arranged in an adjustment area of the adjustment section close to the thread and can be freely aligned, i.e. moved, relative to the bone. The bone screw can protrude through the defect space and already be partially screwed into the bone. In this state, the bone screw is therefore no longer freely movable relative to the bone, but can only be moved translationally by screwing it in and out.

The adjustment area close to the thread can preferably have a length of 1.5 mm.

In another state of the transplant system, the fixation state, the transplant and the bone screw can be attached in such a way that It should be arranged in such a way that the transplant is positioned in an adjustment area close to the screw head and can no longer be aligned completely freely relative to the bone. In concrete terms, the transplant can be slightly offset relative to the bone, i.e. slightly adjusted, by screwing the bone screw further into the bone or by slightly loosening the bone screw.

The adjustment area near the screw head can preferably have a length of 1 mm. Further preferably, the adjustment area near the screw head can have a length that corresponds to a transplant thickness, i.e. they are the same.

In the fastening state, the bone screw can be screwed into the bone with the entire thread. The transplant can be arranged in relation to the bone in such a way that the defect space is closed in the direction of the transplant. The transplant can rest at least partially on the bone surface, in particular outside the defect space, with an inner side of the transplant. The inner side of the transplant can have a first transplant contact area and a second transplant contact area. The bone surface can have a corresponding first bone contact area for the first transplant contact area and a second bone contact area for the second transplant contact area. The first transplant contact area and the second transplant contact area can also merge into one another. Likewise, the first bone contact area and the second bone contact area can merge into one another.

In the fastening state, it can be provided that the bone screw protrudes through the defect space. Preferably, in the fastening state, only the adjustment section or a part of the adjustment section can be arranged in the defect space.

It can therefore be provided in particular that the transplant seals the defect space in the direction of the transplant. The defect space can thus be filled with bone replacement material in the fixation state without the bone replacement material being able to flow out or fall out of the defect space.

In a removal state of the transplant system, it can be provided that the entire transplant system or parts thereof, for example the bone screw and the transplant or parts of the transplant, can be removed again.

Further embodiments of a transplant system according to the invention are specified in the dependent claims.

According to a first embodiment of the invention, it can be provided that the adjustment section has a thread-free adjustment section surface. The adjustment section surface can in particular be polished. A thread-free adjustment section surface can be particularly advantageous in that the transplant system has the smallest possible contact surface between the new bone within the defect space and the bone screw during removal.

According to a further embodiment of the invention, it can be provided that the transplant has a transplant opening for receiving the bone screw, wherein the transplant can be arranged in the adjustment section, in particular by screwing and/or pushing the bone screw through the transplant opening.

The transplant opening can in particular have an opening diameter adapted to the bone screw. The transplant opening can preferably be arranged in a central region of the transplant.

Depending on the thread diameter and the opening diameter, the transplant can be pushed or screwed onto the bone screw. If the thread diameter is larger than the opening diameter, the transplant can be screwed onto the bone screw. If the thread diameter is smaller than the opening diameter, the transplant can be pushed onto the bone screw. The previous explanations are to be understood to mean that the transplant can be screwed/pushed onto the bone screw, and vice versa, i.e. the bone screw can be screwed/pushed onto the transplant.

According to a further embodiment of the invention, it can be provided that the transplant in the transplant state is arranged in the adjustment section in such a way that the transplant is freely rotatable about a screw axis defined by the bone screw, and at the same time is movable along the screw axis and at the same time tiltable relative to the bone screw.

The screw axis is defined by the bone screw in that it is aligned along a longitudinal extension of the bone screw. The screw axis runs centrally through the screw head and the thread.

The transplant can be moved translationally relative to the bone, i.e. on a straight path of movement towards or away from the bone. The transplant can also be mounted so that it can rotate relative to the bone. The transplant can therefore have a pivot point around which it can rotate. The pivot point can correspond to the transplant opening. The transplant can also be mounted so that it can tilt relative to the bone. The transplant can therefore have a tilting point around which it can be tilted as desired, with the bone remaining constant in its orientation. The orientation of the transplant relative to the bone can therefore be changed. The tilting point can correspond to the transplant opening.

According to a further embodiment of the invention, the transplant can be arranged in an alignment state of the transplant system in a locking section of the adjustment section in such a way that the transplant can be freely rotated about the screw axis and is inhibited against movement along the screw axis. In the alignment state, the transplant then has one degree of freedom less than in the transplant state, namely the now at least inhibited movement along the screw axis. Inhibition of movement along the screw axis can be understood to mean that the movement is made more difficult, but not impossible. The transplant can therefore no longer be moved freely along the screw axis, as is possible in the transplant state. This can enable a more precise alignment of the transplant relative to the bone. The inhibition can be caused by a limitation in the area of the adjustment section or also by a thickening of the adjustment section.

The locking section of the adjustment section can correspond to a central adjustment area. The central adjustment area can be arranged between the adjustment area near the screw head and the adjustment area near the thread.

The central adjustment area can preferably have a length of 1 mm.

According to a further embodiment of the invention, it can be provided that the adjusting section has a first projection and a second projection, wherein the first projection is arranged within the adjusting section near the screw head and the second projection is arranged within the adjusting section near the thread, wherein the first projection and the second projection each extend radially outwardly away from the adjusting section surface.

The first projection and/or the second projection can have exclusively flat surfaces or also curved surfaces which can merge into one another. A transition from the first projection and/or the second projection to the adjustment section surface can also be fluid. The first projection and the second projection can be at different distances from one another in different configurations. A distance between the first projection and the second projection can in particular be adapted to a transplant thickness.

The first projection and the second projection may have the same or a different projection diameter.

According to a further embodiment of the invention, it can be provided that the locking section extends from the first projection to the second projection.

According to a further embodiment, it can be provided that the locking section extends from the thread to the first projection.

According to a further embodiment of the invention, it can be provided that the first projection and/or the second projection is arranged circumferentially around the adjustment section. The first projection and/or the second projection can therefore be arranged in particular in a ring-like manner around the adjustment section.

According to a further embodiment of the invention, it can be provided that a side of the first projection facing the screw head runs at a right angle to the adjusting section surface and a side of the first projection facing the thread runs at an obtuse angle to the adjusting section surface. In addition, the first projection can have a further side that does not adjoin the adjusting section surface. The further side can be arranged, for example, between the side facing the screw head and the side facing the thread. In addition, the further side can run, for example, parallel to the adjusting section surface.

According to a further embodiment of the invention, it can be provided that a side of the second projection facing the screw head runs at an obtuse angle to the adjusting section surface and a side of the second projection facing the thread also runs at an obtuse angle to the adjusting section surface. obtuse angle to the adjustment section surface. In addition, the second projection can also have a further side that is not adjacent to the adjustment section surface. The further side can also be arranged, for example, between the side facing the screw head and the side facing the thread. In addition, the further side can run, for example, parallel to the adjustment section surface.

According to a further embodiment of the invention, it can be provided that the screw head has a substantially flat underside facing the adjustment section for contact with the transplant. The underside can therefore run in particular at right angles to the adjustment section adjoining the underside, in particular an adjustment section surface. This makes it possible to provide the largest possible contact surface between the underside and the transplant. This can also prevent the transplant from breaking or bursting when the transplant is secured using the bone screw.

According to a further embodiment of the invention, it can be provided that the transplant, in a fastening state of the transplant system, is arranged between the screw head and the first projection and rests against the screw head. The first projection can be arranged at a distance from the screw head in such a way that the transplant arranged between the screw head and the first projection rests against both the screw head and the first projection. However, the first projection can also be arranged at a distance from the screw head in such a way that the transplant in the fastening state of the transplant system only rests against the screw head and not against the first projection.

According to a further embodiment of the invention, the transplant can comprise an allogenic bone, an autogenous bone and/or another biocompatible material. The transplant can comprise bone material that was taken from the transplant recipient himself, i.e. autogenous or autologous bone material. The transplant can, for example, comprise material taken locally in the jaw area of the transplant recipient himself.

The transplant can also contain bone material that was not taken from the transplant recipient himself, but from another individual, i.e. allogeneic bone material.

Alternatively, the graft may comprise another biocompatible material. The graft may also comprise synthetic, xenogeneic or other materials such as PEEK, titanium or medical steel.

The transplant can comprise or consist of an industrially manufactured shell or plate made of one of the aforementioned materials. Alternatively, the transplant can comprise or consist of another material not explicitly listed here.

A transplant that includes another biocompatible material may also include material that is not of natural origin.

In possible designs, the transplant consists exclusively of one of the different materials mentioned above.

According to a further embodiment of the invention, it can be provided that the transplant is designed to interact with the bone screw in such a way that the bone screw can be received in the transplant opening and the transplant can be arranged in the adjustment section, wherein the bone screw is designed to be at least partially screwed into the bone with the transplant arranged in the adjustment section, wherein the transplant can be aligned relative to the bone in the transplant state of the transplant system and can be fastened to the bone by the bone screw by further screwing into the bone, whereby a defect space delimited by the transplant and the bone is closed in the direction of the transplant.

The bone screw and/or the transplant can be made of or consist of medical steel, titanium or a titanium alloy. The bone screw can also only partially contain medical steel, titanium or a titanium alloy. Medical steel, colloquially also known as surgical steel or medical steel, can contain martensitic stainless steel. The main alloying element can be chromium. It can also contain larger amounts of nickel, cobalt and molybdenum.

Furthermore, the object underlying the present invention is achieved by a bone screw according to claim 15.

Furthermore, the object underlying the present invention is achieved by a transplant according to claim 16.

• 1 eine vorschlagsgemäße Knochenschraube in einer Seitenansicht;
• 2 ein vorschlagsgemäßes Transplantatsystem mit einer Knochenschraube aus 1 in einer Draufsicht, wobei das Transplantat im Bereich zwischen dem Gewinde und dem zweiten Vorsprung an der Knochenschraube angeordnet ist;
• 3 ein vorschlagsgemäßes Transplantatsystem mit einer Knochenschraube aus 1 in einer Draufsicht, wobei das Transplantat im Bereich zwischen dem zweiten Vorsprung und dem ersten Vorsprung an der Knochenschraube angeordnet ist;
• 4 ein vorschlagsgemäßes Transplantatsystem mit einer Knochenschraube aus 1 in einer Draufsicht, wobei das Transplantat im Bereich zwischen dem ersten Vorsprung und dem Schraubenkopf an der Knochenschraube angeordnet ist.

The invention is further explained with reference to the figures.

• 1 a proposed bone screw in a side view;
• 2 a proposed transplant system with a bone screw made of 1 in a plan view, wherein the transplant is arranged in the area between the thread and the second projection on the bone screw;
• 3 a proposed transplant system with a bone screw made of 1 in a plan view, wherein the transplant is arranged in the region between the second projection and the first projection on the bone screw;
• 4 a proposed transplant system with a bone screw made of 1 in a plan view, wherein the transplant is arranged in the area between the first projection and the screw head on the bone screw.

1 shows a proposed bone screw 2. The bone screw 2 is shown in a side view. The bone screw 2 has a screw head 5, an adjustment section 8, a thread 6 and a screw tip 13.

The bone screw 2 also has a screw axis S, which is arranged centrally through the screw head 5, the adjustment section 8, the thread 6 and the screw tip 13.

The screw head 5 has a rounded upper side 14 and a flat lower side 11. The screw head 5 is arranged with its lower side 11 on the adjustment section 8, wherein the lower side 11 runs at a right angle to the adjustment section 8.

A screw drive 15 is arranged in the screw head 5. In the embodiment shown here, the screw drive 15 is a square drive. In addition, the screw drive 15 is designed to taper conically in the direction of the adjustment section 8. Alternatively, according to a further embodiment not shown, a screw drive 15 with a straight path in the direction of the adjustment section 8 could also be provided.

The adjustment section 8 has three areas: an adjustment area 16 near the screw head, a central adjustment area 17 and an adjustment area 18 near the thread. The adjustment section 8 has a smooth adjustment section surface 19. The smooth adjustment section surface 19 can be smoothed by polishing. With such a smooth or polished adjustment section surface 19, the bone screw 2 can provide the smallest possible contact area for a filling material that contacts the adjustment section surface 19. The smooth or polished adjustment section surface 19 also enables low friction between the adjustment section surface 19 and a transplant 3, provided that the latter is arranged in the adjustment section 8. Such low friction is particularly advantageous with regard to free positioning of the transplant 3 within the adjustment section 8.

The adjustment area 16 near the screw head is delimited on the screw head side by the screw head 5, in particular the underside 11. At an end opposite the screw head 5, the adjustment area 16 near the screw head is delimited by a first projection 9.

The central adjustment area 17 adjoins the first projection 9. This is arranged on a side of the first projection 9 facing away from the screw head 5. Opposite the first projection 9, the central adjustment area 17 is delimited by a second projection 10.

The adjustment area 18 close to the thread adjoins the second projection 10. This is arranged on a side of the second projection 10 facing away from the screw head 5. Opposite the second projection 10, the adjustment area 18 close to the thread is delimited by the thread 6.

According to an alternative embodiment not shown, it can be provided that the bone screw 2 has only one projection in the manner of the first projection 9 or the second projection 10.

The thread 6 is designed as a right-hand thread. The screw tip 13 is arranged on a side of the thread 6 facing away from the screw head 5. The screw tip 13 is designed as a self-tapping tip.

The first projection 9 is arranged within the adjustment section 8 near the screw head 5. The second projection 10 is arranged within the adjustment section near the thread 6. The first projection 9 and the second projection 10 each extend radially outward from the adjustment section surface 19.

The first projection 9 and the second projection 10 are each arranged circumferentially around the adjustment section 8. The first projection 9 and the second projection 10 is therefore ring-shaped.

A side of the first projection 9 facing the screw head 5 runs at a right angle to the adjustment section surface 19. A side of the first projection 9 facing away from the screw head 5 runs at an obtuse angle to the adjustment section surface 19.

The first projection 9 thus has a circumferential surface 24 facing the screw head 5, which is formed parallel to the underside 11.

In the present embodiment of 1 the side of the first projection 9 facing away from the screw head 5 runs at an angle of 135° to the adjustment section surface 19. Alternatively, according to a further embodiment not shown, the angle can also be a different value between 115° and 155°, preferably between 120° and 150°, more preferably between 125° and 145°, more preferably between 130° and 140°.

The first projection 9 thus has the area of an isosceles triangle in cross section. Alternatively, according to a further embodiment not shown, the cross section of the first projection 9 can have the area of an equilateral triangle, an irregular triangle, a trapezoid or a parallelogram.

A side of the second projection 10 facing the screw head 5 or the first projection 9 runs at an obtuse angle to the adjustment section surface 19. A side of the second projection 10 facing away from the screw head 5 or the first projection 9 also runs at an obtuse angle to the adjustment section surface 19. In the present exemplary embodiment, the side of the second projection 10 facing the screw head 5 or the first projection 9 and the side of the second projection 10 facing away from the screw head 5 or the first projection 9 run at an angle of 120° to the adjustment section surface 19. Alternatively, according to a further exemplary embodiment not shown, the angle can also be a different value between 100° and 140°, preferably between 105° and 135°, more preferably between 110° and 130°, more preferably between 115° and 125°.

In a further embodiment not shown, the side of the second projection 10 facing the screw head 5 or the first projection 9 runs at a different angle to the adjustment section surface 19 than the side of the second projection 10 facing away from the screw head 5 or the first projection 9.

The second projection 10 thus has the area of an equilateral triangle in cross section. Alternatively, according to a further embodiment not shown, the cross section of the second projection 10 can have the area of an isosceles triangle, an irregular triangle, a trapezoid or a parallelogram.

2 shows a proposed transplant system 1 in a top view. The transplant system 1 comprises the bone screw 2 according to 1 and a transplant 3. The transplant 3 has a transplant opening 12. The transplant opening 12 has in the 2 illustrated embodiment has an opening diameter 26 which is larger than a thread diameter 30 of the thread 6 and smaller than a projection diameter 31 of the first projection 9 and the second projection 10 and smaller than a screw head diameter 29 of the screw head 5. The transplant 3 has a transplant thickness 32 which corresponds to a first shaft length 33 of the adjustment region 16 near the screw head.

In the 2 In the embodiment shown, the transplant 3 is arranged in the area of the adjustment area 18 near the thread. The transplant 3 can be in the 2 shown state either by simply plugging it on, provided that the opening diameter 26 is larger than the thread diameter 30, or by screwing it into the adjustment area 18 close to the thread.

The bone 4 has a bone surface 25. The bone surface 25 has in the 2 shown sectional view of the bone 4 has a first bone contact area 34 and a second bone contact area 35. Between the first bone contact area 34 and the second bone contact area 35, the bone surface 25 is set back relative to these. The bone surface 25 thus forms a defect space 36 with a defect space floor 39.

The bone screw 2 extends through the defect space 36 and is partially screwed into the bone 4. In the 2 In the state of the transplant system 1 shown, the transplant 3 is freely rotatable about the screw axis S. The transplant 3 is also freely movable along the screw axis S in the adjustment area 18 near the thread. In addition, the transplant 3 is at least partially tiltable relative to the bone screw 2.

Transplant 3 is in 2 arranged at a distance from the bone 4, in particular from a bone surface 25 of the bone 4. The transplant 3 has a transplant inner side 27 facing the bone surface 25 and a transplant outer side 28 opposite the transplant inner side 27.

The transplant inner side 27 has a first transplant contact area 37 for contact with the first bone contact area 34. The transplant inner side 27 has a second transplant contact area 38 for contact with the second bone contact area 35. The transplant inner side 27 is thus designed in particular to rest against the bone surface 25 of the bone 4 during and/or after attachment in an attachment state of the transplant 3 and to sufficiently seal or close the defect space 36 in the direction of the transplant 3.

Transplant 3 is in the 2 shown arrangement relative to the bone screw 2 and/or the bone 4, or can be aligned with respect to them, while the bone screw 2 can be screwed into the bone 4. The transplant 3 is also movable relative to the bone screw 2 and/or the bone 4 along the screw axis S, while the bone screw 2 can be screwed into the bone 4.

3 shows the transplant system 1 from 2 in another possible position, namely in a so-called alignment state. In 3 the transplant 3 is arranged in the region of the central adjustment region 17. The transplant 3 is thus arranged between the first projection 9 and the second projection 10.

The bone screw 2 is in 3 , compared to the 2 shown state, is screwed to a greater extent into the bone 4. The transplant 3 is thus, compared to the state shown in 2 shown state, arranged closer to the bone surface 25.

The transplant 3 is freely rotatable about the screw axis S and movable between the first projection 9 and the second projection 10 along the screw axis S. The transplant 3 is also tiltable relative to the bone screw 2.

Transplant 3 is through the 3 The arrangement shown can still be aligned with the bone 4 by turning and tilting, while the bone screw 2 can be screwed into the bone 4.

4 shows the transplant system 1 from 2 and 3 in another position, namely in the fastening state. The 4 The arrangement of the transplant system 1 shown shows a possible final position of the transplant system 1.

The bone screw 2 is in 4 , compared to the 3 shown state, further screwed into the bone 4.

The thread 6 of the bone screw 2 is completely screwed into the bone 4. Within the area of the defect space 36, only the adjustment area 18 near the thread, the central adjustment area 17 as well as the first projection 9 and the second projection 10 are arranged.

The transplant 3 rests with the transplant outer side 28 on the underside 11 of the screw head 5. Opposite the transplant outer side 28, the transplant 3 rests with the transplant inner side 27 on the circumferential plane 24. In addition, the transplant 3 rests with the first transplant attachment area 37 on the first bone attachment area 34 and with the second transplant attachment area 38 on the second bone attachment area 35.

Transplant 3 is in the 4 shown state, the implant can no longer be freely rotated about the screw axis S, can no longer be tilted relative to the bone screw 2, and can no longer be moved independently along the screw axis S. However, slightly loosening the bone screw 2 still causes a slight translational offset of the transplant 3 relative to the bone 4, in that the transplant 3 would then move slightly away from the bone 4. This can be used, for example, to reverse an initial excessive tightening and possibly undesired excessive compression of the transplant 3. In this respect, it can already be said that the transplant 3 is easy to adjust or can still be aligned relative to the bone 4, even if the transplant 3 or the transplant system 1 as in 4 shown in the fastening state.

However, the fact that the bone screw 2 is no longer movable along the screw axis S as before is supported in the embodiment shown here in particular by the fact that the transplant 3 is arranged in the adjustment area 16 near the screw head, the first shaft length 33 of which corresponds to the transplant thickness 32. The transplant 3 is thus arranged with a precise fit between the underside 11 and the circumferential plane 24.

The 2 , 3 and 4 The states of the transplant system 1 shown are to be understood in such a way that these states can flow into one another during the attachment of the transplant 3 to the bone 4. The transplant 3 can therefore be inserted in particular into the adjustment area 18 of the bone screw 2 near the thread. 1 whereupon the bone screw 2 is inserted according to 2 is screwed into the bone 4. The transplant 3 can be aligned with the bone 4 according to the previous description. The transplant 3 can then be pushed over the second projection 10 into the central adjustment area 17, whereby the bone screw 2 is 3 is increasingly screwed into the bone 4. The transplant 3 can still be aligned to the bone 4 according to the previous description. Finally, the transplant 3 can be finally aligned or placed on the bone 4, whereupon the bone screw 2 can be tightened according to 4 with the entire thread 4 screwed into the bone 4 and the transplant 3 is pushed over the first projection 9 into the adjustment area 16 near the screw head. The transplant 3 is thus fixed to the bone 4 by the bone screw 2 and in the desired alignment to the bone 4.

The transplant system 1 thus interacts with the bone 4 in such a way that the transplant system 1, in particular the transplant 3, closes and seals the defect space 36 in a fastening state of the transplant system 1 with respect to an area arranged outside the defect space 36.

The defect space 36 can then be 4 to be recognized sealed state with an augmentation or bone replacement material (not shown). The augmentation is intended to form new bone, which is connected to the original bone, or to be converted into such new bone. The augmentation can be made as viscous as desired, which is why the defect space 36 is to be sealed as best as possible by the transplant 3 in the direction of the transplant 3.

The implant system 1 remains in the attachment state during the bone formation process. If the new bone has been sufficiently formed again in the closed defect space 36 or the augmentation or bone replacement material has sufficiently solidified, a so-called removal state is reached, in which removal state, for example, only the bone screw 2, or the bone screw 2 with parts of the transplant 3 or the entire transplant system 1 can be removed or dismantled again.

In the state of removal, the transplant 3 can be partially or completely fused with the augmentation material filling the defect space 36 and thus become part of the new bone. It can also be provided that fusion of the augmentation material and the transplant 3 is prevented and the transplant 3 is completely removed together with the bone screw 2.

List of reference symbols

1

Transplant system

2

Bone screw

3

graft

4

Bone

5

Screw head

6

thread

8th

Adjustment section

9

first lead

10

second lead

11

bottom

12

Transplant opening

13

Screw tip

14

Top

15

Screw drive

16

Adjustment range close to screw head

17

central adjustment range

18

adjustment range close to thread

19

Adjustment section surface

24

surrounding area

25

Bone surface

26

Opening diameter

27

Transplant inside

28

Transplant exterior

29

Screw head diameter

30

Thread diameter

31

Projection diameter

32

Graft thickness

33

first shaft length

34

first bone attachment area

35

second bone attachment area

36

Defect room

37

first transplant area

38

second transplant area

39

Defect room floor

S

Screw axis

Claims (16)

Transplant system (1) comprising a bone screw (2) and a transplant (3), wherein the transplant (3) can be fastened to a bone (4) by means of the bone screw (2), wherein the bone screw (2) has a screw head (5) and a thread (6) for screwing into the bone (4), and wherein the bone screw (2) is designed to fasten the transplant (3) to the bone (4), characterized in that the bone screw (2) has an adjusting section (8) between the screw head (5) and the thread (6), wherein the transplant (3) is arranged in a section of the adjusting section (8) near the thread in a transplant state of the transplant system (1) in such a way that the transplant (3) can be aligned relative to the bone (4). Transplant system (1) according to Claim 1 , characterized in that the adjusting section (8) has a thread-free adjusting section surface (19). Transplant system (1) according to Claim 1 or 2 , characterized in that the transplant (3) has a transplant opening (12) for receiving the bone screw (2), wherein the transplant (3) can be arranged in the adjustment section (8), in particular by screwing and/or pushing the bone screw (2) through the transplant opening (12). Transplant system (1) according to one of the Claims 1 until 3 , characterized in that the transplant (3) in the transplant state is arranged in the adjustment section (8) in such a way that the transplant (3) is freely rotatable about a screw axis (S) defined by the bone screw (2), and at the same time is movable along the screw axis (S) and at the same time tiltable relative to the bone screw (2). Transplant system (1) according to one of the Claims 1 until 4 , characterized in that the transplant (3) is arranged in an alignment state of the transplant system (1) in a locking section of the adjustment section (8) such that the transplant (3) is freely rotatable about the screw axis (S) and is inhibited against movement along the screw axis (S). Transplant system (1) according to one of the Claims 1 until 5 , characterized in that the adjusting section (8) has a first projection (9) and a second projection (10), wherein the first projection (9) is arranged within the adjusting section (8) near the screw head (5) and the second projection (10) is arranged within the adjusting section (8) near the thread (6), wherein the first projection (9) and the second projection (10) each extend radially outwardly away from the adjusting section surface (19). Transplant system (1) according to Claim 6 , characterized in that the locking portion extends from the first projection (9) to the second projection (10). Transplant system (1) according to Claim 6 or 7 , characterized in that the first projection (9) and/or the second projection (10) is arranged circumferentially around the adjusting section (8). Transplant system (1) according to one of the Claims 6 until 8th , characterized in that a side of the first projection (9) facing the screw head (5) runs at a right angle to the adjusting section surface (19) and a side of the first projection (9) facing the thread (6) runs at an obtuse angle to the adjusting section surface (19). Transplant system (1) according to one of the Claims 6 until 9 , characterized in that a side of the second projection (10) facing the screw head (5) runs at an obtuse angle to the adjusting section surface (19) and a side of the second projection (10) facing the thread (6) also runs at an obtuse angle to the adjusting section surface (19). Transplant system (1) according to one of the preceding claims, characterized in that the screw head (5) facing the adjustment section (8) has a substantially flat underside (11) for contact with the transplant (3). Transplant system (1) according to one of the Claims 6 until 11 , characterized in that the transplant (3), in a fastening state fastened to the bone (4), is arranged between the screw head (5) and the first projection (9) and rests against the screw head (5). Transplant system (1) according to one of the preceding claims, characterized in that the transplant (3) comprises an allogenic bone, an autogenous bone and/or another biocompatible material. Transplant system (1) according to one of the Claims 3 until 13 , characterized in that the transplant (3) is designed to cooperate with the bone screw (2) in such a way that the bone screw (2) can be received in the transplant opening (12) and the transplant (3) can be arranged in the adjustment section (8), wherein the bone screw (2) is designed to be at least partially screwed into the bone (4) with the transplant (3) arranged in the adjustment section (8), wherein the transplant (3) can be aligned relative to the bone (4) in the transplant state of the transplant system (1) and can be fastened to the bone (4) by the bone screw (2) by further screwing into the bone (4), whereby a defect space (36) delimited by the transplant (3) and the bone (4) is closed in the direction of the transplant (3). Bone screw (2) for use in a transplant system (1) according to one of the Claims 1 until 14 . Transplant (3) for use in a transplant system (1) according to one of the Claims 1 until 14 .

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