DE3643416A1 - BIOACTIVE PERMANENT IMPLANTS - Google Patents

Description

The invention relates to long-term bioactive implants special glass ceramics used in human medicine, in particular as a hard tissue replacement. The permanent implants can e.g. B. in orthopedics, Stomatology, maxillofacial surgery, ear, nose and throat and ophthalmology can be used.

To characterize the known technical solutions in the field of the development of permanent implants for use in human medicine, two aspects in particular need to be analyzed in more detail:
First, the shortcomings of the prior art, which are caused by the type of material, and secondly, the shortcomings of known permanent implants, which are caused by their shape, their external shape. With regard to suitable materials for implants for hard tissue replacement in human medicine, in addition to metals, sintered ceramics, glasses and glass ceramics have recently become known. While the metals have the disadvantage that they have no bioactive properties, ceramics, e.g. B. are based on hydroxyapatite, bio glasses and bio glass ceramics that are bioactive, that is, form a direct connective tissue-free bond to the living bone. Such bioactive glass ceramics are used for. B. in DE-OS 28 18 630, DE-OS 23 26 100 and DE-OS 34 35 348 described.

But also these bioactive glasses, ceramics and glass ceramics some have considerable disadvantages in terms of their suitability as permanent implants despite the bioactive properties. This will be in the following Examples of concrete use cases clearly. The examples also demonstrate the interrelationship between material type and shape of the implants, being in this discussion bioactive implants, such as e.g. B. glasses and glass ceramics and biocompatible implants, such as B. the metals are included:

• - For hard tissue replacement in human medicine, the Dentures or the tooth root replacement a special one Importance. All implants developed so far have the disadvantage, however, that they are not each specific extracted tooth / or. the tooth root are reproduced in their form, but that they Display finished products of a given shape (DE-OS 31 12 868, DE-OS 27 33 394, DE-OS 27 56 751, DE-OS 27 17 506, DE-OS 26 59 591) and for the production of Complicated implant bed in human bones Milling tools are required. An adaptation of the Implant to physiological or anatomical conditions are excluded and so is the application previously known implants for premolar and Molar replacement not possible in the upper jaw and in the Lower jaw with problems. By coating of metals that are biocompatible and only one Contact osteogenesis with bioactive material the desired composite osteogenesis (bioactivity) for dental implants. Were used Glass ceramics and glasses of different compositions (DE-OS 26 59 591, DE-OS 27 17 506, DE-OS 27 33 394, DE-OS 31 12 868 u. a.). The disadvantage is that the implants developed are sometimes complicated Mechanics for taking up the prosthetic dental crown replacement, especially to reduce the chewing pressure in the bone.  
• Another disadvantage of previously known bioactive There are implants for the tooth root replacement uncontrolled surface solubility and the resulting resulting connective tissue incision, whereby a reduction in the stimulus for composite osteogenesis due to material aging and changes in the surfaces results. The well-known bioglass ceramics are insufficiently correctable intraperatively and so anatomical conditions not adaptable to what is disadvantageous for the stabilization of the tooth root. The one for the intradentral covering of the pulp cavity used calcium hydroxide preparations with self-curing Dental cement has the disadvantage that toxic damage and mechanical irritation sensitive tooth pulp tissue can occur.
• - To correct malpositions or malformations of the human musculoskeletal system in addition to the body's own grafts, which are the risks a second operation and the biological weakening of chip removal storage, to a large extent metallic implants used. Such metal implants such as metal networks (DE-PS 31 06 917) or The disadvantage of screws and plates is that they through electrolysis processes taking place, and mostly non-bionized behavior of the materials only temporarily can remain in the organism, i.e. none Represent permanent implants. A direct network between bone bed and implant is with metallic Materials also through appropriate porous or other types Surface designs, such as B. in the DE-OS 21 27 843 and described in DE-OS 27 55 762, not possible. The intensive mechanical interlocking is at best due to contact osteogenesis.
• A coating of the metal implants with bioactive Glasses and glass ceramics such as B. DE 26 59 591, DE-OS 27 17 506, DE-OS 27 55 751, DE-OS 27 33 394, DE-OS 31 12 868, achieved the achievement of bioactive  Properties, however, there were uncontrolled surface solubilities disadvantageous on. Another The disadvantage of these implants is that they cannot be machined mechanically with conventional tools are so that a correction of the shape under Operating conditions are not possible. This disadvantage also applies to calcium phosphate coatings on titanium bodies (DE-OS 29 28 007).
• - Other known technical solutions from Implants, in particular for use on orthopedic Area, also have the disadvantage that to anchor the bioinactive implants, such as e.g. B. metals or sintered corundum, additional bone cement is required.
• - There are similar disadvantages as the metals organic polymer materials used as implants for use the hard tissue replacement. Although e.g. B. in terms of physical properties considerable differences between the two material groups consist of and also from polymers (plastic materials) good editing options, relatively complicated Parts that fill fixation and retention functions can, can be produced, these are However, materials are not bioactive.
• - The development of bioactive glass ceramics, the machine are editable and from the experience of animal experiments can be used in medicine are described in DD-WP 2 19 017 and DD-WP 2 38 619.

The aim of the invention is the development of bioactive Permanent implants from a universal insert Material that differs from the previously known Implants for hard tissue replacement in human medicine characterized by outstanding combinations of properties should and with what by appropriate design some completely new areas of application and possibilities  should be developed.

The object of the invention is bioactive Permanent implants for hard tissue replacement in human medicine to develop, this development in the Unit of material type, composition and structure, The form and shape of the products must be carried out and only a basic material a comprehensive design of permanent implants using the advantageous Guarantee material properties.

This object is achieved in that the bioactive permanent implants made of machinable bioactive glass ceramic of the composition in Dimensions-%

SiO₂ = 29.5-32.5 Al₂O₃ = 14.5-17.5 MgO = 14.5-15.6 Na₂O = 2.0-3.0 K₂O = 5.5-6.5 F = 5.0-6.0 CaO = 13.0-15.0 P₂O₅ = 10.0-12.0

and the excreted mica crystal phases 50 vol.% To 80 vol.% And apatite from 15 vol.% To 30 vol .-% exist and that the solid body from this Glass ceramic for the substitution of sick, malformed or damaged human bones of the shape correspond to the healthy human bones and that to correct malpositions or deformities the solid body a simple, from the natural Shape of human bones different shape exhibit.

It was surprisingly found that with a single permanent implant material, as shown by the very a limited range of compositions is occupied, one that is universally applicable for hard tissue replacement Material is particularly suitable. That became obvious  thereby enables that the specially achieved structure of Material made of 50-80 vol .-% mica, 15-30 vol .-% Apatite and glass phase only with this special composition the production of the permanent implants according to the invention in their form and with their special properties allowed. The structure, such as size and "arrangement" of the crystals to each other and in relation to the Glass phase, is of great importance. The beneficial Properties of the bioactive according to the invention Permanent implants are above all the diverse possibilities the original formation, the z. B. centrifugal salute and pressing include the excellent machine Machinability, the surprisingly high bioactivity, the excellent long-term stability as well as the combination the physico-chemical and mechanical parameters. Only this interaction of all these properties or the complex realization of this condition in the unit of type of material, composition, Structure, special properties and shape of the products enabled the wide application and overcoming the disadvantages the state of the art.

The advantages that a single material ensures extensive use as a long-term bioactive implant are many. It starts with the advantageous master shaping, which can be done for different starting products under similar or the same technical / technological conditions. Furthermore, the processing and upgrading of the glass ceramic can be carried out according to uniform parameters and the handling for direct use in medicine can be standardized, even for shipping there are advantages. Another advantage of the permanent implants according to the invention is that additional components in the material such as. B. FeO, FE₂O₃, TiO₂, MnO, Cr₂O₃ to 2 mass% and Cl ^- to 1 mass% z. B. for coloring can be included without its advantageous basic properties are deteriorated. In the case of the Cl ^- additions, an improvement in the melting technology properties is even achieved.

This staining of implants is particularly beneficial for Applications in the tooth area, where for aesthetic reasons largely natural tooth staining can be achieved can.

The advantageous shape of the permanent implants according to the invention enabled in unity of original shaping and processing human bones in their original Imitate shape directly, what for use as Hard tissue replacement material very beneficial in humans is and a significant advance over that Provides state of the art. Such special implants z. B. in facial jaw surgery or Otorhinolaryngology is needed, where so far in part consisting of individual parts, often not fit, mechanically poorly anchored implants will. About this type of permanent implants according to the invention include z. B. the cranial bones or partial areas, the zygomatic bone or the orbital floor or the teeth directly replicated implants. Additional anchors, e.g. B. Drilling is possible.

Among the permanent implants according to the invention, the Human bones are directly modeled, take the dental implants as typical representatives of their Main group, in addition to orbital floor implants etc., one special importance. This invention bioactive permanent implants in the form of human Teeth are made individually according to their respective Tooth tray removed human tooth by direct replication / Impression made. This can be done after modeling of the human tooth, e.g. B. by wax modeling, for example a centrifugal casting process for use come to manufacture the semi-finished implant products. The advantage over the prior art exists all in that a much improved mechanical Anchoring the dental implants is achieved because that  Implant has a tight fit in the tooth compartment, it comes due to the high bioactivity for a direct bond between implant and tooth compartment. With known dental implants is to prevent rotation and Improve the anchoring of the implants to the surface provided with retentions. These retentions are not necessarily for the implants according to the invention required.

The permanent implants according to the invention in the form of human teeth can, according to the invention, represent a combination of solid individual bodies made of glass ceramic. These individual bodies have the shape of tooth roots and tooth crowns or parts thereof. At the same time, it is possible that z. B. a metal crown or parts of it. Special shapes, such as those according to the invention through semicircular or elliptical cross sections and pin arrangements on the tooth root for receiving crown implants, ensure good fit and increased functionality of the implants. This functionality for particularly stressed areas can be achieved by introducing a high-strength body. B. a metal pin can be increased in the tooth root implant. For this purpose, the pewter root implant has a threaded bore. In addition to the direct replication of human tooth roots, the tooth root implants can, according to the invention, have a shape that deviates from the shape of human tooth roots. For example, by using the advantageous machinability, the tooth root implants have the shape of truncated cones with rounded tips and retention wedges ( FIG. 2). It is also advantageous if the retention wedges have a triangular cross-section which tapers to the root tip at an angle 7 of 5 °, the end face 5 of which forms an angle 6 of 90 ° to 150 ° with the implant surface and whose legs form an angle 4 of 90 ° to 105 °. Transition zones 11 for attachment of the gingiva are also advantageous. According to the invention, further tooth root implants are characterized in that the cross sections have two semicircular sides 9 , which can decrease in size towards the tip, and two flat surfaces 10 , which can have the shape of a triangle.

There are special small round conical implant plates very much as part of a tooth to cover the pulp roof suitable.

According to the invention, due to the special combinations of properties of the glass ceramic material alongside permanent bioactive implants that shape human Bones, including such bioactive permanent implants be developed, one of the human bones have a different shape. The latter Permanent implants thus fulfill in the same way as natural bone or implants with bone-like Form and shape, all main functions, such as. B. Hold and support function, d. H. Transfer and transfer of forces in the broadest sense, fixation, bioactive overgrowth with the living hard tissue etc. With this function determination of the permanent implants according to the invention certain points in the musculoskeletal system At the same time, its external form is determined for people and determined. The basic type of these implants is a Prism, a cylinder, a pyramid, a truncated pyramid and a truncated cone. This leads to the invention Implants for example with X-, Y-, H or cuboid or kidney shaped cross section from. Additional surface designs such. B. grid for vertebral body implants, for wedges, etc. improved anchoring of bone and implant. Additional structural designs, such as. B. Drilling and breakthroughs in implants allow one better anchoring and fixation and blunting of edges due to the good mechanical processing of the implants are very possible  Increased tissue friendliness and favor overgrowth.

While maintaining these advantageous design elements are wedge-shaped permanent implants with different Design of the cutting edge, e.g. B. pointed, rounded, blunted, especially for correcting malpositions and Malformations of the human musculoskeletal system applied.

According to the invention, cylindrical and conical shapes were also used Permanent implants with head, shaft and tip part, especially developed for fixation. Specific Versions make headboards as cylindrical Implants with a central hexagon socket and slots represents the shaft z. B. prismatic, cylindrical or be a truncated cone while special Stabilization in the bone or tissue surfaces are provided with channels and knobs.

The tip can be a cone, truncated cone or pyramid are available.

In particular the advantageous mechanical processing, Bioactivity and biocompatibility made this possible Development of permanent implants according to the invention in the form of hollow cylinders with internal thread and supporting disc.

The production of the permanent implants according to the invention takes place in two process stages, namely production of the starting glass and the thermal aftertreatment the output glass to achieve an in situ Crystallization in the range from 600 ° to 1100 ° C Possibilities of thermal treatment are e.g. B .:

• a) 1000 ° C / 1 h
• b) 750 ° C / 0.5 h and 900 ° C / 5 h

Selected, special properties of the invention Permanent implants are as follows:

• - very good to excellent machinability;
• - chemical resistance according to hydrolytic class 2 to 3;  
• - excellent bioactivity;
• - very good mechanical strength, as bending strength up to 220 MPa;
• - high compressive strength of more than 500 MPa;
• - hardness higher than 300 HV 10;
• - modulus of elasticity of 70-80 GPa;
• - the linear thermal expansion coefficient of approximately 12.5 × 10 ^- ⁶ K ^- ¹ simultaneously allows combinations with high-strength base bodies, such. B. on a metal basis.

The bioactivity was determined using animal experiments and clinical trials in humans. Regarding the quantitative determination of a value for the biologically active behavior was observed in animal experiments Examinations after lay times of up to 2 years Bond area in% between bioactive glass ceramic and living bones. So z. B. the Specifying "excellent" to achieve more than 70% composite, 16 weeks after implantation a composite share of approx. 70% is achieved and this Share continues with increasing implantation time increased and this bond is stable even after years preserved. One reason for this is that the inventive Permanent implants to all so far known bioactive materials the advantage possess that the reaction zone between bioactive Glass ceramics and bones only to a maximum even after years Is 10 µm. This is for use at the same time as solid material or as thin-layer material or Granules a very important advantage of these permanent implants, because the bond remains and none, the biomaterial and the interfering influences which cause adverse properties occur on.

For the advantageous properties is next to the The structure of the structure is very crucial Size. It turns out that only the  Structure according to the invention made of apatite, mica and glass phase achieved the special properties and the permanent implants according to the invention with large part of sophisticated shape from the material can be generated.

The following examples of short explanations to Figs. 1-5 a further elaboration on the forms and advantageous application possibilities of permanent implants of the invention.

Example 1

In the following, such a bioactive according to the invention Permanent implant described that for the main group of those implants that have the shape of human Possess bones, is representative.

It becomes an example of a dental implant that the outer shape of human teeth of the upper and lower jaw owns, shown.

1 a ) shows a tooth implant which consists of a tooth root implant and a tooth crown implant of the glass ceramic according to the invention and whose shape was directly modeled on the original natural tooth that was in the same tooth compartment.

Fig. 1b) shows in the section of XY in Fig. 1a) that the tooth root implant has a pin 1 for receiving the crown implant 2 .

Fig. 1c) shows a further variant of the design of the tooth root implant, namely in that the tooth root implant has a bore with a thread for receiving z. B. a high-strength pin made of metal. This solution is advantageous for dental implants that are exposed to increased mechanical stress.

Example 2

Such a bioactive permanent implant according to the invention, which belongs to the main group of those implants which have a modified, simplified form with respect to natural human bones, is shown below. Fig. 2 describes to permanent implants for tooth replacement in human medicine.

In Fig. 2a) is a tooth root implant which is adapted to receive a dental crown implant is shown. This tooth root implant has retention wedges 3 which are triangular in cross section and which, starting from the center of the implant part located in the bone, are tapered to the tip. The outer edge of the retention wedges 3 directed towards the jawbone forms an angle 7 of 5 ° or less with the implant surface. The end faces 5 of the retention wedges prevent the implant from slipping out. The end faces of the retention wedges form an angle 6 of 90 ° to 150 ° with the implant surface. The two legs of the retention wedge 3 enclose an angle 3 of at least 90 ° to 105 °. The angle 8 is formed by the implant surface and implant axis and is known by the size of the implant compared to the natural tooth. The implant has a transition zone 11, which is characterized by a larger angle 6 or 7 than described above.

Fig. 2b) shows a tooth root implant, the cross section of two semi-circular surfaces 9, and two flat surfaces 10 is. In addition, retention wedges can be attached.

Fig. 2c) represents a permanent implant for tooth roots. The shape of the implant, as a round conical plate with one-sided pin, allows use as a pulp roof in natural teeth.

Example 3

This exemplary embodiment describes permanent implants according to the invention which have an external shape which deviates from the natural shape of the human bones in order to correct malpositions and deformities on the human musculoskeletal and supporting apparatus. For this purpose, FIG. 3 cross-sections through corresponding implants such. B. 3a) implant in the form of a hollow cylinder; 3b) U-shaped bent implant; 3c) implant in the form of a double T-beam; 3d) cruciform implant; 3e) cuboid implant with bore. By additional surface design according to the invention, such as grid arrangement or by z. B. convex shape and in connection with the advantageous material properties, these permanent implants are preferably suitable for the fact that they z. B. overgrown with adjacent natural vertebral bodies and are therefore advantageously applicable as an implant for ventral spondylodesis.

Another type of a permanent implant according to the invention is shown in FIG. 3f) with a kidney-shaped cross section in a side view and FIG. 3g) in a top view. These figures show the preferred arrangement of the grid surface 12 , which contributes to the fact that the natural human being in contact with the grid surface Bones are anchored more easily and grown together with the permanent implant. This makes the preferred use as a vertebral body implant obvious.

Example 4

This embodiment provides a further reduction implants according to the invention in the same Main group of those described in Example 3 are. They are implants that have a different shape possess as natural bones and preferably for Serve to correct the human musculoskeletal system. In addition to the implants set out in Example 3 wedge-shaped and prism-shaped in this example Permanent implants shown in more detail.

Figure 4a) shows to a cross-section through a prism-shaped implant and 4b) and 4c) show a derivative of the typical wedge shape permanent implant in the form of a semi-circular disc (4b) in top view...; Fig. 4c) in side view. By using the wedge effect of the implants according to the invention, for example, a lifting of the tibial head and thus a correction of the human musculoskeletal system can be effectively achieved.

In Fig. 4d) (top view) and 4e) (side view), a disc-shaped permanent implant with a square cross-section and a central bore and one-sided countersink is shown, which contains grooves on its underside and is advantageously used as a washer for fixation.

Example 5

In the following, further exemplary embodiments of permanent implants according to the invention are presented which differ in their external shape from natural bones. Permanent implants according to the invention with a cylindrical or conical shape are reduced in size ( FIG. 5). The cylindrical implants according to the invention are advantageously used in the field of hand surgery. FIG. 5a) is in the form of a truncated sphere, a fixation implant for knee reconstruction is. According to the invention, the implants are provided with head and tip portion. These latter implants, shown in Fig. 5b) are, for. B. advantageously used as an implant for fixation of ligaments on the skeletal system.

Fig. 5c) shows an inventive permanent implant in a hollow cylindrical shape. The hollow cylinder 13 is surrounded here with a curved support disk 14 , in the openings 15 with z. B. circular diameter can be incorporated. The hollow cylinder contains an internal thread. Since a known interchangeable optic can thus be screwed into this hollow cylindrical implant in a watertight manner and the implants have the advantageous properties mentioned, use in ophthalmology as a kerat prosthesis is advantageous.

• List of reference numerals ( 1 ) tooth crown
  ( 2 ) tooth root
  ( 3 ) retention wedge
  ( 4 ) angle
  ( 5 ) End surface of the retention wedges
  ( 6 ) angle
  ( 7 ) angle
  ( 8 ) angle
  ( 9 ) semicircular side parts
  ( 10 ) flat surfaces
  ( 11 ) transition zone
  ( 12 ) grid area
  ( 13 ) hollow cylinder
  ( 14 ) Carrier washer
  ( 15 ) Broths

Claims (28)

1. Bioactive permanent implants, characterized in that
that they are made of machinable bioactive glass ceramic of the composition in mass% SiO₂ = 29.5-32.5 Al₂O₃ = 14.5-17.5 MgO = 14.5-15.6 Na₂O = 2.0-3.0 K₂O = 5.5-6.5 F = 5.0-6.0 CaO = 13.0-15.0 P₂O₅ = 10.0-12.0 and the excreted crystal phases mica from 50% by volume to 80% by volume % and apatite consist of 15% by volume to 30% by volume,
that they are made as a solid body from the glass ceramic mentioned,
that for the substitution of sick, malformed or damaged human bones the shape of the solid body corresponds to that of the healthy human bone and that for the correction of misalignments or deformities of the human supporting and musculoskeletal system the solid body has a simple shape deviating from the natural shape of the human bone. 2. Bioactive permanent implants according to claim 1, characterized characterized in that the machinable bioactive glass ceramics additionally in their composition the components FeO, Fe₂O₃, TiO₂, MnO₂, NiO, Cr₂O₃ up to 2 mass% and Cl up to 1 mass% contains individually or in a mixture. 3. Bioactive permanent implants according to claim 1 and 2, characterized in that they have the outer shape possess human teeth of the upper and lower jaw, being the outer shape of the permanent implants  that of the extracted natural teeth corresponds directly to individual replication. 4. Bioactive permanent implants according to claim 1 to 3, characterized in that they are a combination from solid individual bodies, which in in their entirety the outer form is more natural possess human teeth. 5. Bioactive permanent implants according to claim 4, characterized characterized in that the massive individual body Shape of tooth roots, tooth crowns or parts own it. 6. Bioactive permanent implants according to claim 5, characterized characterized in that the tooth root implants a semicircular or elliptical cross section have and have a pin on their base surface. 7. Bioactive permanent implants according to claim 5, characterized characterized in that the tooth root implants a Have a bore with an internal thread. 8. Bioactive permanent implants according to claim 1 and 2, characterized in that the dental implants, consisting of tooth crowns and tooth roots, the dental root implants one of the natural Shape of the human tooth roots differing have a simplified form. 9. Bioactive permanent implants according to claim 8, characterized in that the tooth roots represent shapes of truncated cones with rounded tips and are provided with retention wedges ( 3 ) ( Fig. 2a). 10. Bioactive permanent implants according to claim 8 and 9, characterized in that the retention wedges ( 3 ) have a triangular cross section which tapers to the root tip at an angle ( 7 ) of 5 °, the end face ( 5 ) with the implant surface at an angle ( 6 ) from 90 ° to a maximum of 150 ° and the legs of which form an angle ( 4 ) from 90 ° to a maximum of 105 ° ( Fig. 2a). 11. Bioactive permanent implants according to claim 8 to 10, characterized in that the tooth root implants have a transition zone ( 11 ) for the attachment of the marginal gingiva ( Fig. 2a). 12. Bioactive permanent implants according to claim 8 to 11, characterized in that the cross sections of the tooth root implants have two semicircular sides ( 9 ) and two flat surfaces ( 10 ) and these implants can also have retention wedges ( 3 ) ( Fig. 2b). 13. Bioactive permanent implants according to claim 8 to 12, characterized in that the radii of the round sides ( 9 ) decrease towards the tip ( Fig. 2b). 14. Bioactive permanent implants according to claim 8 to 13, characterized in that the flat surfaces ( 10 ) have the shape of a triangle, the base being located towards the crown and that both surfaces form a common angle towards the tip corresponding to the selected radii. 15. Bioactive permanent implants according to claim 1 and 2, characterized in that they are used as dental implants the shape of round conical plates with one-sided Have pins as a holding element, wherein the implants as a pulp roof in natural teeth can be used.   16. Bioactive permanent implants according to claim 1 and 2, characterized in that they are for substitution sick or damaged bones or parts of bones in the skull area of the natural bone shape are reproduced. 17. Bioactive permanent implants according to claim 1 and 2, characterized in that it is used to correct Malpositions and a simple one in case of malformations of the natural shape of human bones have a different external shape, the shape through the area receiving the implants in the Human musculoskeletal system established and the basic type is a prism, a cylinder, a Pyramid, a truncated pyramid or a truncated cone represents. 18. Bioactive permanent implants according to claim 17, characterized characterized as having an X, Y, H, U, rectangular, square or kidney-shaped cross-section have. 19. Bioactive permanent implants according to claim 17, characterized characterized that the surfaces with a grid provided, flat or convex. 20. Bioactive permanent implants according to claim 17 and 19, characterized in that they are wedge-shaped, the cutting edge has a pointed shape, blunted or rounded. 21. Bioactive permanent implants according to claim 17, characterized characterized in that they have single or multiple holes or breakthroughs of any geometric Own designs. 22. Bioactive permanent implants according to claim 17, 20 and  21, characterized in that all corners, edges, Breakthroughs and holes blunted or rounded are. 23. Bioactive permanent implants according to claim 17, characterized characterized in that they are cylindrical and conical Display implants with head, shaft and tip part. 24. Bioactive permanent implants according to claim 23, characterized characterized in that the headboard is a 3- to versatile Prism or a cylinder with central Hexagon socket, slots, cross slots, 3 to represents versatile prisms and retention ellipsoids. 25. Bioactive permanent implants according to claim 23, characterized characterized in that the shaft prismatic or is cylindrical or a truncated ball or truncated pyramid represents. 26. Bioactive permanent implants according to claim 25, characterized characterized in that the surface of the shaft indentations, Any pimples and thread-like gradients Has geometry. 27. Bioactive permanent implants according to claim 23, characterized characterized that the top as a cone, pyramid, Truncated cone or truncated pyramid designed and occurring Blunt surfaces are round or elliposid. 28. Bioactive permanent implants according to claim 17, characterized in that they represent hollow cylinders ( 14 ) with an internal thread and an outer curved support disc ( 15 ) ( Fig. 5c).