EA037711B1 - Individual pattern for jaw osteotomy and the installation of dental implants with immediate load - Google Patents

Abstract

The invention relates to medical technology and can be used in dental surgery. Technical effect: the ability to direct a cutter or saw blade in a given direction when performing osteotomy, as well as making a frame from any hard or soft plastic, or hard or soft photopolymer, which in combination eliminates the risk of displacement of the said cutter or saw blade, increases the accuracy of the jaw saw-line, reduces the traumatic nature of the method, reduces the time of the surgery operation and simplifies it, providing low invasiveness. This is achieved by the fact that, unlike the prototype, the first plastic frame is additionally equipped with structural elements that are displaced outside the frame, forming guides, namely central and side protrusions, while through holes are made in the central guide protrusion, and half-holes are made in the side guide protrusions. The second plastic frame is provided with hooks, central and side hooks, a through hole is made in one of the central hooks.

Description

The invention relates to medical technology and can be used in surgical dentistry with complete edentulousness or when removing teeth with subsequent installation of dental implants and their immediate loading, that is, for the so-called All-on-4 technique.

As a prototype for the closest technical essence, we chose an individual template for performing jaw osteotomy and installing dental implants with immediate loading, made collapsible, printed on a 3D printer and consisting of two plastic frames and a plastic frame with fitting teeth. Through holes are made in the first and second plastic frames, as well as in the plastic frame with fitting teeth for the installation of pins. In the second plastic frame, there are also through holes for installing implants. Marks are made near the location of the through holes for placing the implants. The inner surface of the first plastic frame is a copy of the outer surface of the bone, and the location of all through holes and marks corresponds to the obtained 3D modeling result based on the data of computed tomography and 3D scanning, as well as the chosen implant system (https://www.youtube.com / watch? v = gyhhbH7dncA, date of treatment 08/30/2019).

The template for jaw osteotomy and dental implant placement, which we have chosen as a prototype, works as follows.

On the alveolar process / alveolar part of the lower jaw, a first plastic frame and a frame with try-in teeth are installed, which are fixed with pins to the first plastic frame through through holes made in both frames. Then the first plastic frame is additionally fixed with pins. Then the frame with the fitting teeth together with the pins fixing it is removed. Alveolar process / alveolar part is leveled along the lower edge of the first frame with a mill to the planned level. Then the second frame is installed on the first frame and fixed with pins through the holes made in both frames. The holes made in the second frame are sequentially passed with a drill and dental implants with a pin are installed. At the same time, there are marks next to the holes for installing implants on the second frame, which are suitable for any implant system. Then the pins are removed and the second frame is removed along with the pins that fix it. Then, the unevenness of the bone of the alveolar process / alveolar part, where the implants are installed, are leveled. Then, first abutments are installed into the implants, which are fixed with microscrews, then other pins are installed on them. After that, a rubber gasket is installed on the pins through the holes made in it, the outer surface of which is a copy of the bone surface, and its inner surface is a copy of the surface of the previously prepared prosthesis. Straw pins are installed in the holes made in the pins. Then, a denture with teeth is placed on the rubber pad through all the pins. The smaller diameter straw pins and microscrews installed in the abutments are then removed. Remove the denture with teeth with pins. Then remove the rubber gasket and the first plastic frame with the pins fixing it. Thus, only the abutments installed in the implants remain, on which the prosthesis with teeth and pins is then installed, then the microscrews are installed back into the abutments.

The disadvantages of the prototype include:

the risk of displacement of the cutter / saw blade when performing osteotomy of bone tissue due to the inability to direct the above instruments, which reduces the accuracy of sawing the bone of the alveolar bone / alveolar part, which, in turn, can lead to insufficiently effective dental implantation and subsequent errors in the positioning of the prosthesis with teeth ;

lack of the possibility of performing minimally invasive access;

the complexity and duration of the surgical intervention; invasiveness of the method.

The objective of the invention is to improve the accuracy of the sawdust of the jaw; reducing the trauma of surgical intervention, reducing the time of its implementation, as well as its simplification; the ability to perform minimally invasive access;

The technical result of the invention is:

the ability to direct the cutter or saw blade in the required predetermined direction when performing osteotomy of bone tissue, which eliminates the risk of displacement of the cutter or saw blade;

the possibility of manufacturing plastic frames and their structural elements not only from any hard plastic, or hard photopolymer, or hard polyamide, but also in combination with any soft plastic or soft photopolymer.

The technical result of the invention is achieved by the fact that an individual template for performing osteotomy of the jaw and installing dental implants with immediate loading is collapsible and consists of two plastic frames.

Through holes are made in the first plastic frame for fixing with pins to the jaw bone, and it is equipped with structural elements that are displaced outside the above frame, forming central and side guide protrusions, while through holes are made in the central guide protrusion, and in the side guide protrusions - half holes. In the second

- 1 037711 plastic frame made through holes for the installation of implants, and near the location of the through holes for the installation of implants, marks are made. The second plastic frame is equipped with central and lateral hooks; a through hole is made in one of the central hooks. The inner surface of the plastic frames is a copy of the outer surface of the bone and corresponds to the selected implant system. The plastic frame and / or its structural elements are made of any hard plastic, or hard photopolymer, or hard polyamide, or in combination with any soft plastic or soft photopolymer.

Below are shown the distinctive essential features and the causal relationship between them and the achieved technical result.

The first plastic frame is additionally equipped with structural elements that are displaced outside the above frame, forming central and side guide protrusions, while through-holes are made in the central guide protrusion, and half-holes are made in the side guide protrusions.

The presence of structural elements will allow, in all planes, by sliding the blade / cutter along the guide protrusion, to perform an accurate osteotomy of the jaw at the planned level.

The presence of through holes in the central guide tab will allow the second plastic frame to be installed and fixed, and the half-holes made in the side guide tabs will allow the hooks of the second plastic frame to be hooked. The second plastic frame is equipped with central and lateral hooks; a through hole is made in one of the central hooks.

The described hooks of the second frame are installed in the holes made in the central guide protrusion of the first frame, and the presence of a through hole in the central hook makes it possible to additionally fix the second plastic frame with a pin to the bone, while passing through the through hole of the first plastic frame, eliminating the risk of displacement of the second frame when setting implants.

The plastic frame and / or its structural elements are made of any hard plastic, or hard photopolymer, or hard polyamide, or in combination with any soft plastic or soft photopolymer, which allows the user not to limit the choice of materials. The combination of hard and soft material creates conditions that are gentle on the mucous membrane, ensuring minimally invasiveness and reducing trauma.

The set of essential distinctive features is new and allows:

To direct the cutter or saw blade in the required predetermined direction when performing osteotomy of bone tissue, which eliminates the risk of displacement of the cutter or saw blade;

to produce plastic frames and their structural elements not only from any hard plastic, or hard photopolymer, or hard polyamide, but also in combination with any soft plastic or soft photopolymer, which together:

Improves the accuracy of the jaw sawdust;

reduces the invasiveness of surgery, reduces the time of its implementation, and also simplifies it;

provides the ability to perform minimally invasive access.

The essence of the invention is illustrated in FIG. 1-11, d de 1 - the first plastic frame;

- the second plastic frame;

- through holes made in the first plastic frame to fix it to the bone;

- metal bushings;

- through holes made in the second plastic frame for installing implants;

- removable metal sleeve equipped with a handle;

- the alveolar part of the lower jaw;

- central guide;

- the first lateral guide;

- a second lateral guide;

- microsaw blade;

- through holes made in the central guide protrusion;

- central hooks made in the second plastic frame;

- a through hole made in one of the central hooks;

- side hooks made in the second plastic frame;

- half-holes made in the lateral guide protrusions;

- marks made near the location of the through holes of the second plastic frame;

- implants.

The invention can be used as follows.

- 2 037711

After obtaining the results of 3D modeling, based on the data of computed tomography of the jaws of 3D scanning of the oral cavity, as well as the selected system of implants, a collapsible individual template is designed, consisting of two plastic frames (1, 2), then using 3D printing them made of any hard plastic, or hard photopolymer, or hard polyamide, or in combination with any soft plastic or soft photopolymer. Then purification and sterilization procedures are carried out. Metal bushings (4) are installed in the through holes (3) of the first plastic frame (1) (Fig. 1). Metal bushings (4) are installed in the through holes (5) of the second plastic frame (2), or instead of metal bushings during surgical treatment, a removable metal bushing equipped with a handle (6) is provided (Fig. 2, 3).

With complete edentulousness or after removal of the underlying teeth, an operative access is performed, for example, in the area of the alveolar part of the lower jaw, (7) the first plastic frame (I) is installed and fixed with pins through the metal bushings (4) installed in its through holes (3) (Fig. . four). Then, along the guiding central (8) and lateral protrusions (9,10) of the first plastic frame (1) by sliding the microsaw blade (11) or with a cutter, an osteotomy is performed in the lateral and central parts of the alveolar part of the lower jaw (7) (Figs. 5-7 ). Then the osteotomized bone fragment is removed. Central hooks (13) are installed in the through holes (12) of the central guide protrusion (8), while one of the central hooks is fixed with a pin to the bone of the second plastic frame (2), while passing through the through hole (14) made in one of the central hooks (13) and through the through hole (3) of the first plastic frame (1) (Fig. 1, 2, 8, 9). In this case, the side hooks (15) of the second plastic frame (2) cling to the half-holes (16) of the lateral guide projections (9, 10) of the first plastic frame (1) (Figs. 1, 2, 8, 10). Then, through the metal bushings (4) installed in the through holes (5) of the second plastic frame (2), according to the marks (17) made next to the previously indicated through holes (5), a drill is placed and the bone is drilled to a predetermined depth (Fig. 1, 2, 10). After that, implants (18) are sequentially installed in the through holes (5) through the metal bushings (4) according to the marks (17). Then the plastic frames (1, 2) with their fixing pins are removed. After the installation and fixation of the abutments, pre-prepared pins are partially installed on them, onto which the denture, printed on a 3D printer or manufactured in a classical way, is installed through the through holes made in it. Then the remaining pre-prepared pins are installed and the prosthesis itself is fixed.

Thus, an individual template has been developed for performing osteotomy of the jaw and placing dental implants with immediate loading, which allows to direct the cutter or saw blade in the required predetermined direction when performing osteotomy of bone tissue, which eliminates the risk of displacement of the cutter or saw blade;

to make plastic frames and their structural elements not only from any hard plastic, or hard photopolymer, or hard polyamide, but also in combination with any soft plastic or soft photopolymer, which together increases the accuracy of the jaw sawing;

reduces the invasiveness of surgical intervention, reduces the time of its implementation, and also simplifies it;

provides the ability to perform minimally invasive access.

Claims (2)

CLAIM 1. Individual template for performing osteotomy of the jaw and installing dental implants with immediate loading, made collapsible and consisting of two plastic frames (1, 2), through holes (3) are made in the first plastic frame (1) for fixation with pins to the bone jaw, and the second one (2) has through holes (5) for installing implants, marks (17) are made near the location of the through holes (5), while the inner surface of the plastic frames is a copy of the outer surface of the bone and corresponds to the selected system of implants, which is different in that the first plastic frame (1) is additionally equipped with structural elements that are displaced outside of the above frame, forming guides central (8) and side (9, 10) protrusions, while in the central guide protrusion (8) through holes (12 ), and half-holes (16) are made in the side guide protrusions (9, 10); the second plastic frame (2) is equipped with central (13) and lateral (15) hooks, in one of the central hooks (13) a through hole (14) is made. 2. An individual template for performing osteotomy of the jaw and placing dental implants according to claim 1, characterized in that the plastic frame and / or its structural elements are made of any hard plastic, or hard photopolymer, or hard polyamide, or in combination with any soft plastic or a soft photopolymer.