Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
  • A61B17/1673—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the jaw
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
  • A61C8/0022—Self-screwing
  • A61C8/0025—Self-screwing with multiple threads
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
  • A61C8/0069—Connecting devices for joining an upper structure with an implant member, e.g. spacers tapered or conical connection
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
  • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
  • A61B17/86—Pins or screws or threaded wires; nuts therefor
  • A61B17/8605—Heads, i.e. proximal ends projecting from bone
  • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
  • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
  • A61B17/86—Pins or screws or threaded wires; nuts therefor
  • A61B17/8625—Shanks, i.e. parts contacting bone tissue
  • A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
  • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
  • A61B17/86—Pins or screws or threaded wires; nuts therefor
  • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0001—Impression means for implants, e.g. impression coping
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/001—Multiple implanting technique, i.e. multiple component implants introduced in the jaw from different directions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
  • A61C8/0054—Connecting devices for joining an upper structure with an implant member, e.g. spacers having a cylindrical implant connecting part
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
  • A61C8/006—Connecting devices for joining an upper structure with an implant member, e.g. spacers with polygonal positional means, e.g. hexagonal or octagonal
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
  • A61C8/0068—Connecting devices for joining an upper structure with an implant member, e.g. spacers with an additional screw
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
  • A61C8/0078—Connecting the upper structure to the implant, e.g. bridging bars with platform switching, i.e. platform between implant and abutment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0087—Means for sterile storage or manipulation of dental implants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
  • A61C8/0089—Implanting tools or instruments

Definitions

• Implant promoting bone retention around the implant neck.
• the present invention relates to the field of implants and more particularly dental implants used for the placement of one or more dental prostheses to replace one or more missing teeth in order to restore to the patient, partially or totally edentulous, a chewing function and / Or oral comfort and / or better aesthetic appearance and / or better dental occlusion.
• a dental implant usually consists of a main body anchor said socket, provided with an external thread and an internal thread, intended to take place in the maxilla and / or mandible previously pierced to receive the socket.
• the external thread is advantageously self-tapping in order to allow screwing into the well of the jaw provided for this purpose, said thread having a diameter just greater than the diameter of the well.
• the socket has at its end said upper, in contact with the oral medium after implantation, an implant neck adapted to receive a prosthetic system, commonly called false stump for the realization of a sealed dental prosthesis, said false stump being secured to the implant by means of the tapping of the socket, or a connector adapted to receive a so-called screwed dental prosthesis.
• a prosthetic system commonly called false stump for the realization of a sealed dental prosthesis, said false stump being secured to the implant by means of the tapping of the socket, or a connector adapted to receive a so-called screwed dental prosthesis.
• buried two-stage surgical technique There are several surgical procedures for implanting dental implants, the so-called buried two-stage surgical technique and the technique in a non-buried surgical procedure. Each of these techniques corresponds to one type of implant.
• the so-called buried technique the surgeon after opening the patient's gingiva prepares the well, commonly known as the implant bed, in the maxillary or mandible of the patient. The surgeon then places the implant consisting of a generally cylindrical sleeve and then closes the gingiva over the implant with sutures.
• This step of burying the implant under the gum consists of a step of placing in a nurse, for a period of between 3 to 6 months, which allows the integration of the implant into the bone. After this step of 3 to 6 months, a second surgical phase is necessary.
• the surgeon incises the gingiva above the upper part of the implant to set up either a healing room or directly a false stump or a connector for screwed prosthesis. This healing phase makes it possible to prepare the contour of the gingival tissues. After healing, usually after 15 days to 1 month, the final prosthesis is put in place either by sealing on the abutment screwed to the upper end of the socket or by screwing on the connector provided for this purpose.
• This surgical technique and the implants adapted to this technique, have the disadvantage of requiring two surgical procedures and considerably reduce the time required to put in place the final dental prosthesis. Moreover, a reconstruction time of the maxillae by bone grafting. may become involved at this implant placement time, a bone graft may be necessary if the implantation area has a bone of insufficient volume. To remedy this drawback, the implementation of the implant can be done in a single surgical time by the so-called non-buried technique. Indeed, studies have shown that implants put in place in a surgical time could be implanted in the jawbone with the same success as the implants placed in buried technique.
• the surgeon sets up the implant consisting of a generally cylindrical, conical, or sylindro-conical socket provided with a thread and at the upper end of which is located an implant neck adapted to receive the prosthetic system.
• the implant is placed either by opening the gingiva above the implantation area or by passing directly through the gingiva following the so-called transmucosal technique and then by practicing an implanted well at the chosen depth according to of the patient's bone volume, the length of the implant determining the depth of said implantary well.
• said gingiva In the case of the placement of the implant by incision of the gum, said gingiva, after the introduction of the implant, is closed around the implantary neck secured to the body of the socket by stitches (technical said flap), the implant neck remaining in contact with the oral medium.
• said gingiva In the technique of setting implant placement by the transmucosal technique, it is not necessary to suture the gingiva which fits perfectly around the implant neck in contact with the oral medium.
• the implant collar is closed by a cover screw during the bone and gum healing phase.
• the closing screw is withdrawn in order to place the prosthetic system on the implant neck, the prosthetic system being adapted to the type of prosthetic concept chosen by the surgeon such as a dental prosthesis sealed on a false stump or a prosthesis screwed on a suitable connector.
• the closure screw has a height adapted to the gingival height, usually of the order of 1, 5 mm to 2 mm.
• Such implants are described, for example, in French patent applications FR 2 747 031, FR 2 747 032 and FR 2 709 660.
• the prosthetic junction is located at a distance of about 1.5 mm from the bone, thus making it possible to respect the biological distance.
• One of the aims of the invention is therefore to remedy all these drawbacks by proposing a dental implant of simple and inexpensive design allowing implantation in a surgical time or two surgical times and ensuring bone retention and therefore stability peri-implant soft tissue.
• an implant comprising a central body said anchoring revolution adapted to be implanted in a hole made in a bone of a patient, and an implantary neck integral with the body of anchorage adapted to receive a prosthetic system; said implant is remarkable in that the cervix implant is derived from the upper end of the anchoring body by forming at least one reservoir adapted to receive a liquid effusion produced by the patient's bone and in that the anchoring body comprises means capable of grating the bone the patient during the establishment of said anchor body in the hole made in the bone and means for guiding the effusion and bone fragments to the reservoir.
• the diameter of the base of the implant neck is smaller than the diameter of the generatrix of the upper end of the anchor body to form a flat portion between the upper end of the anchor body and the base of the implant neck to provide a bone growth and retention around the implant neck after implant placement.
• Said implant collar preferably has a generally conical shape, coaxial with the anchoring body, flaring from its base, that is to say from the upper end of said anchor body.
• the flat is inclined from the base of the implant neck to the upper generatrix of the anchor body towards the lower end of said anchor body.
• said flat is inclined at an angle less than or equal to 45 ° with respect to a plane orthogonal to the axis of revolution of the anchoring body and the implant neck, and preferably at an angle between 10 ° and 30 °. °.
• the implant neck has a first portion whose outer wall flares from its base having a concavity and a second portion flaring with a convexity.
• the anchoring body consists of a generally cylindro-conical bushing and having at least one thread.
• Said sleeve advantageously has a rounded lower end.
• the sleeve has a first portion called conical apical flaring from its lower end and a second so-called upper cylindrical portion extending the conical apical portion, the conical apical portion of the sleeve having a first thread and the upper portion of the sleeve having a second thread whose pitch is smaller than the pitch of the first thread.
• the anchoring body consists of at least one disc and a stem coming from the disc and extending coaxially with said disc, the implanted collar being derived from the end upper of said rod.
• Said rod comprises either a knurling or a thread
• FIG. 1 is an exploded perspective view of the dental implant according to the invention
• FIG. 2 is a side view of the anchoring body consisting of a socket of the implant according to the invention
• FIG. 3 is a detail of the side view of the socket of the implant according to the invention shown in FIG. 2;
• FIG. 4 is a longitudinal sectional view of the socket of the implant according to the invention; shown in Figure 2,
• FIG. 5 is a view from above of the socket of the implant according to the invention shown in FIG. 2,
• FIG. 6 is a perspective view of an alternative embodiment of the anchoring body of the implant according to the invention in the form of a disc
• FIG. 7 is a side view of the alternative embodiment of the anchoring body of the implant according to the invention shown in FIG. 6,
• FIG. 8 is a side view of the cover screw of the implant according to the invention shown in FIG. 1;
• FIG. 9 is a longitudinal sectional view of the cover screw shown in FIGS. 8
• FIG. 10 is a longitudinal sectional view of the implant implant holder according to the invention.
• FIG. 11 is a side view of the implant holder of the implant according to the invention
• FIG. 12 is a view in longitudinal section of the abutment of the implant according to the invention
• FIG. 13 is a side view of the abutment of the implant according to the invention.
• FIG. 14 is a longitudinal sectional view of the long cover screw represented in FIG. 1 of the implant according to the invention; ,
• FIG. 15 is a side view of the transfer ring of the implant according to the invention.
• FIG. 16 is a radial sectional view of the transfer ring shown in FIG. 15;
• FIG. 17 is a view from above of the transfer ring shown in FIGS. 15 and 16,
• FIG. 18 is a perspective view of the first transfer part of the transfer system of the implant according to the invention.
• FIG. 19 is a longitudinal sectional view of the transfer part of the implant according to the invention shown in FIG. 18,
• FIG. 20 is a view in longitudinal section of the calcinable sheath of the implant according to the invention.
• FIG. 21 is a side view of the calcinable sheath of the implant according to the invention.
• FIG. 22 is a side view of an alternative embodiment of the socket of the implant according to the invention.
• FIG. 23 is a longitudinal sectional view of the socket of the implant according to the invention shown in FIG. 22;
• FIG. 24 is a side view of another variant of the socket of FIG. implant according to the invention,
• FIG. 25 is a perspective view of another alternative embodiment of the anchoring body of the implant according to the invention in the form of a disc
• FIG. 26 is a side view of the variant embodiment of the anchor body of the implant according to the invention shown in FIG. 25;
• FIG. 27 is a perspective view of a last variant embodiment of the anchoring body of the implant according to the invention in the form of a disc,
• FIG. 28 is a side view of another alternative embodiment of the socket of the implant according to the invention.
• FIG. 29 is a longitudinal sectional view of the socket of the implant according to the invention; shown in Figure 28,
• FIG. 30 is a side view of a drill bit for piercing the patient's bone prior to placing the implant according to the invention
• FIG. 31 an exploded perspective view of an alternative embodiment of the transfer system of the dental implant according to the invention.
• a dental implant intended to be used for the placement of one or more dental prostheses replacing one or more missing teeth will be described in this particular example; however, it is obvious that the implant according to the invention may be used in any other part of the body without departing from the scope of the invention.
• the dental implant according to the invention consists of a main body said anchor 1 is in the form of a generally frustoconical sleeve 1 comprising a first lower part called apical 2 conical s flaring from its apical end and a second upper part said basal 3 cylindrical extending the apical portion 2 conical.
• This socket 1 is, for the sake of clarity of description, shown vertically and is intended to take place in the maxilla and / or mandible previously pierced to receive said sleeve 1 so that the upper end of said sleeve 1 is slightly buried under the bone or flush with the bone.
• the conical apical portion 2 of the sleeve 1 has a first thread 4, preferably asymmetrical and self-tapping, and the upper portion 3 of said sleeve 1 has a second thread 5 said micro-threading whose pitch is smaller than the pitch of the first Thread 4.
• Asymmetrical and self-tapping threading means a thread 4 whose thread depth increases from its upper end to its lower end and whose thread thickness decreases from its upper end to its lower end.
• the apical portion 2 and the upper portion 3 of the sleeve 1 has a rough and / or porous surface to allow activation of the osseointegration after implantation.
• the surface state of said sleeve is preferably sandblasted or etched sandblasted.
• the threads 4 and / or 5 form means capable of grating the walls of the hole made in the bone and into which the anchoring body 1 is introduced.
• these threads 4,5 scrape the bone to provide bone particles which mix with the effusion liquid, said effusion fluid consisting essentially of blood.
• the sleeve 1 has a slightly rounded lower end 6 allowing its use in surgical techniques of raising the sinus floor well known to those skilled in the art.
• the implant comprises an implant collar 7 extending from the upper end of the sleeve 1, the sleeve 1 and the implant collar being obtained in one piece.
• This implant neck 7 is derived from the upper end of the sleeve 1 by forming at least one reservoir (R) adapted to receive a liquid effusion from the patient's bone.
• Said implant neck 7 has a generally conical shape, coaxial with said sleeve 1, flaring from its base, that is to say from the upper end of said sleeve 1. It will be observed that the effusion is guided to to the tank by the threads
• the sleeve 1 advantageously comprises one or more grooves 100, preferably uniformly distributed around the sleeve 1, extending generally from its apical end, that is to say from its lower end, to its base end , that is to say, its upper end, opening into the reservoir R.
• the bone particles, osteoblasts, growth factors, etc., torn off by the threads 4.5 and transported by the effusion liquid to the reservoir R form precursors of bone recovery in the peri-implant zone.
• the diameter of the base of the implant neck 7 is smaller than the diameter of the generatrix of the upper end of the sleeve 1 in order to form an annular flat 8 between the upper end of said sleeve 1 and the base of the implant neck 7.
• This annular flat 8 preferably has a rough and / or porous surface to allow activation of the osseointegration and is inclined from the base of the implant neck 7 to the upper generatrix of the socket 1 in the direction of the lower end of said sleeve 1 at an angle ⁇ relative to a plane orthogonal to the axis of revolution of the sleeve and the implant neck 7.
• the angle ⁇ is less than at 45 ° and is approximately equal to 10 ° for example.
• the flat may have a smooth surface or have surface irregularities such as waves for example or successions streaks or the like.
• this inclined annular flat 8 represents, for the peri-implant bone, a bone growth ramp after implantation of said socket 1.
• This annular flat 8 makes it possible to preserve the bone in the peri-implant region and consequently makes it possible to maintain peri-implant soft tissue during healing.
• This annular flat 8 forms the starting zone of the biological distance.
• This one-piece design of the sleeve 1 and the implant neck 7 avoids the presence of a seal in the region critical for bone preventing microbial infiltration.
• the implant neck 7 has a first portion 9 whose outer wall flares from its base by having an outwardly oriented concavity and a second portion 10 whose outer wall flares out with an outwardly oriented convexity.
• the outer wall of the implant neck has a machined surface condition that is generally smooth or not.
• the upper end of the implant neck 7 has an outer diameter greater than the outer diameter of the upper end of the sleeve 1.
• the diameter of the sleeve 1 may vary according to the anatomy of the patient's bone so that the upper end of the implant neck 7 may have a diameter less than or equal to the diameter of the upper end. of the sleeve 1, and this according to the diameter of the implant used, the diameter of the implant neck being constant regardless of the diameter of the sleeve, without departing from the scope of the invention.
• the implant neck 7 comprises a frustoconical central recess 11 opening on a hexagonal recess 12 located at the base of said implant neck 7, said hexagonal recess 12 opening on the central thread 13 of the sleeve 1.
• said anchoring body 1 of the implant consists of a disc 14 forming the lower part of the body of anchoring 1 and a cylindrical rod 15 issuing from the disk 14 and extending coaxially with said disk 14, the implant neck coming from the upper end of said rod 15 by forming at least one reservoir (R) capable of receiving an effusion fluid produced by the patient's bone.
• Implantation of this implant is performed by the lateral route and not by the axial route and requires the use of a cutting tool of the jaw bone adapted to the shape of the implant.
• the disc 14 may consist of a flat piece of any shape such as a semicircular or circular flat piece for example without departing from the scope of the invention.
• the implant comprises an implant collar
• This implant neck 7 comes from the upper end of the rod 15 and has a generally conical shape, coaxial with said rod 15 and disc 14, flaring from its base, that is to say from the upper end of said rod 15.
• the diameter of the base of the implant neck 7 is smaller than the diameter of the generatrix of the upper end of the stem 15 so that to form an annular flat 8 between the upper end of said rod 15 and the base of the implant neck 7.
• This annular flat 8 is inclined from the base of the implant neck 7 to the upper generatrix of the rod 15 towards the next disc 14 an angle ⁇ with respect to a plane orthogonal to the axis of revolution of the sleeve and the implant neck 7.
• the angle ⁇ is less than 45 ° and is approximately equal to 30 ° for example.
• the implant neck 7 comprises a first portion 9 whose outer wall flares from its base by having an outwardly oriented concavity and a second portion 10 whose outer wall flares out with a convexity oriented towards the outside. 'outside.
• the hexagonal recess 12 of the implant neck 7 may be adapted to receive the rotary mandrel of a turbine or the like, not shown in the figures, in order to rotate the anchoring body about its vertical axis of rotation. revolution.
• the anchoring body 1 initially acts as a tool for performing a micro-osteomy by milling by cutting the bone simultaneously in the horizontal and vertical planes, then in a second time as an implant, the anchoring body 1 is separated from the turbine and left in position in the housing thus dug in the bone, as described in French patent FR 2 561 907.
• the rod 15 advantageously comprises a thread or a knurling 16 of not very fine to ensure better primary stabilization of the implant.
• said threading 16 is advantageously microporous and preferably has an etched sandblasted or etched surface.
• said rod 15 advantageously comprises one or more grooves 100, preferably uniformly distributed around the sleeve 1, extending generally from its apical end, that is to say from its lower end, to its end. base, that is to say its upper end, opening into the tank R, to guide the flow liquid to said tank R.
• the implant according to the invention comprises a so-called cover screw 17 comprising a cylindrical body 18 and a frustoconical base 19 capable of being inserted into the frustoconical recess 11 of the implant neck 7 and ended by a coaxial threaded rod 20 so that the cylindrical body 18 bears on the distal edge of said implant neck 7 when the cover screw 17 is screwed into the tapping 13 of the anchoring body 1.
• Said cover screw 17 has at its upper end a hexagonal central recess 22 in which is capable of being introduced a hexagonal screwdriver or the like, not shown in the figures, for screwing.
• the cylindrical body 18 of the cover screw 17 may be substituted by a flat head to form a so-called flat cover screw.
• hexagonal recess 22 may be substituted by any other equivalent means, such as radial slots for example, allowing the screwing with a corresponding shape tool. It will be observed that this cover screw 17 is screwed onto the anchoring body 1 of the implant to close the implant neck 7 for implant placement in two surgical times, according to the so-called non-buried technique.
• the implant according to the invention comprises an implant holder 23 comprising a base 24 constituted by a truncated cone 25 terminated by a hexagon 26 capable of being inserted into the frustoconical recess 11 and respectively in the hexagonal recess 12 of the implant neck 7 of the anchoring body.
• the upper end of the implant holder 23 consists of a hexagonal body 27 and male connection means 28 adapted to cooperate with corresponding female connection means of a laying tool, not shown in the figures.
• the implant according to the invention comprises a false stump 29 consisting of a cylindrical body 30 of external diameter just equal to the external diameter of the upper edge of the implant neck 7, of a base 31 having a frustoconical first portion and a hexagonal lower portion respectively adapted to fit in the frustoconical recess 11 and in the hexagonal recess 12 of the implant neck 7 and a conical head 32 narrowing from the cylindrical body 30 to its upper end.
• the conical head 32 of the false stump 29 comprises a series of indentations 33 extending alternately from the cylindrical body 30 to the upper end of the conical head 32 and from the median portion of the conical head 32 to the upper end thereof. last.
• the false abutment 29 further includes a central through thread 34 adapted to receive a long screw 35 shown in Figures 1 and 14.
• Said long screw 35 consists of a threaded rod 36 and a cylindrical head 37 provided with a Hexagonal recess 38 adapted to receive a hexagonal screwdriver said hex screwdriver, not shown in the figures.
• the threaded rod 36 of this long screw 35 is adapted to cooperate with the tapping 13 of the anchoring body 1.
• the implant according to the invention comprises a so-called transfer system. 39 consisting of a transfer ring 40, a first transfer part 41, a second transfer part 42 and a calcinable sheath 43.
• the transfer ring 40 comprises a first portion 44 adapted to cooperate with the implant neck 7 of the anchoring body 1 and a second part 45 of hexagonal shape called the hexagonal head, said first and the second portion 44, 45 being separated by an annular flange 46 able to bear on the upper edge of the implant neck 7.
• Said first portion 44 consists of a truncated cone 47 adapted to fit into the frustoconical recess 11 implant neck 7 and terminated by a hexagonal member 48 being inserted into the hexagonal recess 12 of said implant collar 7.
• the annular flange 46 has an outer diameter just equal to the outer diameter of the upper edge of the implant collar 7.
• the transfer ring 14 has a central bore through 49 to allow the passage of a screw as will be detailed below. This transfer ring 40 makes it possible to maintain or control the tissue thickness of the soft tissues which have a variable height from one patient to another.
• the implant according to the invention comprises a first generally cylindrical transfer part 41 comprising a central tapping 50, and a hexagonal recess 51 at one of its ends, said hexagonal recess 51 being adapted to cooperate with the hexagonal head 16 of the transfer ring 40 shown in Figures 1, 15, 16 and 17.
• Said first piece of transfer 41 furthermore comprises two annular grooves 52 extending on the outer wall of said first transfer part 41 in its median part, and two diametrically opposed plates 53 extending generally from one end to the other of said transfer part 41.
• This first transfer part 41 is able to be positioned on the transfer ring 40 which is put in place on the implant neck 7 of the implant, the first transfer part 41 and the transfer ring 40 being held in place by the long screw 35 previously described and shown in Figure 1.
• the threaded rod 36 of the long screw 35 is adapted to cooperate with the tapping 13 of the anchoring body 1 to maintain the first transfer part 41 and the transfer ring 40 in place to perform, for example, taking an impression of the positioning of the implant in the maxillary or the mandible according to the technique of "pick-up" or "pop-up” well co nnue of the Man of the Occupation.
• the transfer system 39 comprises a second transfer part 42 particularly intended to receive a temporary prosthesis.
• This second transfer member 42 has a generally conical shape narrowing from its lower end to its upper end.
• Said second transfer part 42 comprises a helical groove 58 extending generally from the lower end to the upper end of said second transfer part 42.
• This second transfer part comprises a central through hole able to receive a screw said short piece 54, shown in Figure 1, to maintain the second transfer member 42 and the transfer ring 40, the second transfer member 42 fitting on the upper end of the transfer ring 40.
• This short screw 54 consists of a threaded rod 55 at its lower end and a cylindrical head 56 provided with a hexagonal recess 57 adapted to receive a hexagonal screwdriver said hex screwdriver, not shown in the figures.
• the implant according to the invention comprises a so-called calcinable sheath 43 that is generally cylindrical, one end of which comprises a lower annular flange 60 able to bear on the upper edge of the implant neck. 7.
• said burnout sheath 43 has a tapping central through 61 adapted to receive either the short screw 54 consisting of a threaded rod 55 and a cylindrical head 56 provided with a hexagonal recess 57 as described above and shown in Figure 1, or the long screw 35 consisting of a threaded rod 36 and a cylindrical head 37 provided with a hexagonal recess 38 previously described.
• This burnout sheath 43 is particularly suitable for producing a cast prosthesis or a poured cast abutment with immediate loading, which makes it possible to control the soft tissues.
• the implant according to the invention is constituted in the same manner as previously of an anchoring body 1 in the form of a sleeve and a collar.
• implant 7 extending from the upper end of the sleeve 1, the sleeve 1 and the implant collar being obtained in one piece.
• This implant neck 7 comes from the upper end of the sleeve 1 and has a generally conical shape, coaxial with said sleeve 1, flaring from its base, that is to say from the upper end of said socket 1.
• the implant neck 7 differs from that of the alternative embodiments shown in FIGS. 1 to 7, in that the frustoconical recess 11 and the hexagonal recess 12 are substituted by a hexagonal head 62 projecting from the upper edge of said implant neck. 7, an annular groove 63 separating the upper edge of the implant neck 7 of the hexagonal head 62.
• the hexagonal head 62 has a central thread 64 opening on the tapping 13 of the sleeve 1.
• the conical apical portion 2 of the sleeve 1 has a first asymmetrical thread 4 and self-tapping, and the upper portion 3 of said sleeve 1 has a second thread 5 said micro-thread whose pitch is smaller than the pitch of the first thread 4.
• the first asymmetrical and self-tapping thread 4 has a thread whose depth increases from its upper end towards its lower end, that is to say from the micro-threading 5 to the lower end 6 of the apical part. 2 of the implant, and whose thickness decreases from its upper end to its lower end.
• the hexagonal head 62 may be located either at the upper edge of the implant neck 7 or below it.
• the latter is constituted in the same manner as previously of an anchoring body 1 in the form of a sleeve and of a collar.
• implant 7 extending from the upper end of the sleeve 1, the sleeve 1 and the implant collar being obtained in one piece.
• This implant neck 7 comes from the upper end of the sleeve 1 and has a generally conical shape, coaxial with said sleeve 1, flaring from its base, that is to say from the upper end of said socket 1.
• the diameter of the base of the implant neck 7 is smaller than the diameter of the generatrix of the upper end of the sleeve 1 to form an annular flat 8 between the upper end of said sleeve 1 and the base of the implant neck 7 .
• the sleeve 1 differs from that illustrated in Figures 1 to 4 in that its first lower part called apical 2 conical flaring from its apical end has at its upper end a diameter greater than the second upper part called basal 3 cylindrical extending the conical apical portion 2 to form a second annular flat surface 65 between the upper end of the apical portion 2 and the base of the basal portion 3.
• This second annular flat 65 preferably has a rough and / or porous surface in order to allow activation of the osseointegration and is inclined from the base of the basal portion 3 of the sleeve 1 to the upper generatrix of the apical portion 2 of the sleeve 1 towards the lower end of said sleeve 1 according to a angle ⁇ with respect to a plane orthogonal to the axis of revolution of the sleeve 1.
• the angle ⁇ is lower than r at 45 ° and is approximately equal to 10 ° for example.
• the second flat 65 may also have a smooth surface or have surface irregularities obtained by sanding and or acid treatments such as waves for example or successions of streaks or the like. It will be observed that this second annular flat surface 65 inclined represents for the peri-implant bone a bone growth ramp promoting osteointegration after implantation.
• said anchor body 1 consists of a disc 14 forming the lower part of the anchoring body 1 and a cylindrical rod 15 coming from the disc 14 and extending coaxially with said disc 14, the implant neck 7 coming from the upper end of said rod 15.
• the implant comprises an implant neck 7 extending from the upper end of the rod 15, the disc 14, the stem 15 and the implant neck 7 being obtained in one piece.
• This implant neck 7 comes from the upper end of the rod 15 and has a generally conical shape, coaxial with said rod 15 and disc 14, flaring from its base, that is to say from the upper end of said rod 15.
• the diameter of the base of the implant neck 7 is smaller than the diameter of the generatrix of the upper end of the rod 15 to form an annular flat 8 between the upper end of said rod 15 and the base of the
• This annular flat 8 is inclined from the base of the implant neck 7 towards the upper generatrix of the rod 15 towards the disk 14 at an angle ⁇ with respect to a plane orthogonal to the axis of revolution of the socket and In this particular embodiment, the angle ⁇ is less than 45 ° and is approximately equal to 30 ° for example.
• the implant neck 7 has a first portion 66 said lower whose outer wall flares from its base having an outwardly oriented concavity and a second portion 67 said upper narrowing form globally frustoconical.
• the free end of the upper portion 67 of the implant collar 7 advantageously comprises three shoulders 68, uniformly distributed around the circumference of the implant neck 7 to form connecting means.
• the rod 15 advantageously comprises a thread or a knurling 16 of not very fine to ensure better primary stabilization of the implant.
• the disk 14 advantageously comprises two generally annular and diametrically opposite through recesses 69. These recesses 69 allow, in addition to a material gain, a better osseointegration.
• said anchoring body 1 consists of two disks 14 and 14 ', forming the lower part of the anchoring body 1 and a cylindrical rod 15 coming from the disk 14 and extending coaxially with said disk 14, the implant neck 7 coming from the upper end of said rod 15.
• the first disk 14 said distal extending to the lower end of the cylindrical rod 15 has a diameter just greater than the diameter of the second disk 14 'said proximal.
• Each disc 14, 14 'advantageously comprises two through recesses 69 and 69' respectively substantially hemi-annular and diametrically opposed.
• the recesses 69 of the distal disc 14 extend to the right of the recesses 69 'of the proximal disc 14'.
• the distance separating the two disks 14, 14 ' may be variable and may be easily adapted by those skilled in the art depending on the bone characteristics of the patient.
• the implant according to the invention is constituted in the same manner as previously of an anchoring body 1 in the form of a sleeve and a collar.
• implant 7 extending from the upper end of the sleeve 1, the sleeve 1 and the implant collar being obtained in one piece.
• This implant neck 7 is derived from the upper end of the sleeve 1 and has a generally conical shape, coaxial with said sleeve 1, flaring from its base, that is to say from the upper end of said sleeve 1.
• the implant collar 7 differs from that of the alternative embodiments shown in FIGS. 1 to 7, in that the implant neck 7 comprises a first so-called lower portion 66 whose external wall flares out from its base while presenting a directed concavity. outwardly and a second portion 67 said upper narrowing generally frustoconical shape.
• the free end of the upper portion 67 of the implant neck 7 advantageously comprises three shoulders 68, uniformly distributed around the circumference of the implant neck 7 in order to form connection means as described above with reference to FIGS. 25 to 27.
• the system according to the invention comprises a drill 100 adapted to cooperate with a mandrel of a turbine or the like to make a hole in the patient's bone, said hole being adapted to receive the implant according to the invention.
• This drill bit 100 has a generally cylindrical shape, of longitudinal axis XX 'comprising from behind a tail 101, adapted to cooperate with the drill bit mandrel of the contra-angle of a turbine or the like, not shown in the figures. extended by a body 102 whose front end terminates in pointed means 103 forming the piercing head 104.
• Said body 102 comprises a first stage 105 of generally cylindro-conical shape, having a diameter greater than the diameter of the shank 101 and in which a plurality of annular grooves 106 have been made. These annular grooves 106 are evenly spaced along the axis XX 'of the body 102.
• a laser etching has been performed at the bottom of the annular grooves 106.
• These annular grooves 106 constitute visual cues allowing the surgeon to appreciate more accurately the depth of the hole made in the patient's bone.
• the first stage 105 has a diameter that decreases progressively from the shank 101 to the piercing head 104.
• the upper end of the first stage 105 includes an annular groove 107 capable of receiving a cylindrical stop, not shown in the figures. well known to those skilled in the art and coming to cap a part of the body 102.
• a paint layer is advantageously deposited at the bottom of this groove 107, each color corresponding to a particular drilling diameter.
• said body 102 comprises a second stage 108 of generally cylindrical shape whose average diameter is slightly smaller than the diameter of the first stage 105, said diameter increasing slightly from the first stage 105 to the middle part of the second stage 108 and then decreasing slightly from the middle part of the second stage to the piercing head 104. Furthermore, the body 102 comprises at least one helical groove 108 allowing in particular the evacuation of the bone when drilling. This helical groove
• 108 has a helix angle of between 11 and 19 ° for a diameter of the body
• two helical grooves 109 are formed in the first and second stages 105 and 108 of the body 102.
• the ridges of the helical grooves are formed in the first and second stages 105 and 108 of the body 102.
• 109 may advantageously comprise listels to improve the cutting edge of these grooves 109.
• the piercing head 104 comprises a tip in two parts called double tip
• a frustoconical base 110 whose edges have an angular opening of about 120 ° for example, and a pointed end 111 whose edges have an angular opening smaller than that of the frustoconical base 110, about 60 ° for example.
• the angular aperture of the pointed end 1110 will for example be two times smaller than that of the frustoconical base 110.
• the double point 103 of the piercing head 104 makes it possible to mark the bone by its pointed end 111, the pointed end 111 being moreover also cutting, and to position the drilling zone on the bone cortical bone.
• the second stage 108 of the body 102 of the drill bit 100 provides priming of the bone preparation and preparation of a conical shape in the bone to receive the conical portion of the implant.
• the helical groove 108 or 108 in the second stage 108 allows bone recovery and external irrigation for cooling during the drilling phase.
• the first stage 105 of the body 102 of the drill 100 makes it possible to prepare the corresponding cylindrical part of the implant and to recover the prepared bone.
• this drill 100 although particularly suitable for laying an implant according to the invention, may be used for the installation of other implants without departing from the scope of the invention.
• the transfer system 39 of the implant according to the invention consists of a transfer ring 40, a transfer part 42, a a calcinable sheath 43, a cover screw 70, a short screw 54, a long screw 35, a cap 71 and a so-called extraction tool 72.
• the transfer ring 40 comprises a first part 44 able to cooperate with the implant neck 7 of the anchoring body 1 and a second part 45 of shape. hexagonal said hexagonal head, said first and second portion 44,45 being separated by an annular flange 46 adapted to bear on the upper edge of the implant neck 7 from the upper end of the sleeve 1.
• Said first portion 44 consists of a truncated cone 47 adapted to fit into the frustoconical recess 11 of the implant neck 7 and terminated by a hexagonal element 48 which is inserted into the hexagonal recess 12 of said implant collar 7.
• the annular flange 46 has a diameter externally just equal to the outer diameter of the upper edge of the implant neck 7. Furthermore, the transfer ring 40 has a central bore through 49 to allow the passage of a screw as it will be detailed later.
• This transfer ring 40 makes it possible to maintain or control the tissue thickness of the soft tissues which have a variable height from one patient to another. In this regard, it will be observed that the height of the annular flange 46 will be selected by the surgeon according to the tissue thickness of the patient's soft tissues.
• the transfer ring 40 advantageously comprises a laser marking on the cylindrical annular flange 46 to indicate the buccal surface of said transfer ring 40 and thus facilitate its installation during the surgical operation.
• the implant according to the invention comprises a transfer member 41 has a generally cylindrical shape and a slightly conical base.
• Said transfer member 42 has a helical groove 58 extending generally from the lower end to the upper end of said transfer member 42.
• This transfer part has a central through hole adapted to receive a so-called short screw 54 or a long screw 35, shown in Fig. 31, for holding the transfer member 42 and the transfer ring 40, the transfer member 42 fitting on the upper end of the transfer ring 40.
• the threaded rod 36 this long screw 35 is adapted to cooperate with the tapping 13 of the anchoring body 1 to hold the transfer member 42 and the transfer ring 40 in place in order to perform, for example, taking an impression of the positioning of the implant in the maxillary or the mandible according to the technique of "pick-up” or "pop-up” well known to those skilled in the art.
• the implant according to the invention comprises a so-called calcinable sheath 43 which is generally cylindrical and whose one end comprises a lower annular flange 60 adapted to bear on the upper edge of the implant neck 7.
• Said burnout sheath 43 comprises a tapping central through 61 adapted to receive either the short screw 54 consisting of a threaded rod 55 and a cylindrical head 56 provided with a hexagonal recess 57 as described above and also shown in Figure 31, the long screw 35 constituted a threaded rod 36 and a cylindrical head 37 provided with a hexagonal recess 38 described above.
• This burnout sheath 43 is particularly suitable for producing a cast prosthesis, such as a provisional or definitive bridge reinforcement or a junction bar for example, or a poured cast backstop with immediate loading, which which allows to control the soft tissues. It will be observed that the burnout sheath is able to rotate about its axis of revolution when it is secured to the anchoring body 1.
• the implant also comprises a so-called cover screw 70 consisting on the one hand of a generally cylindrical head 72 having at its upper end a hexagonal recess 73 and on the other hand of a threaded rod 74 adapted to cooperate tapping 13 of the anchor body 1.
• the underside of the head 72 has an annular recess 75 adapted to receive the hexagonal head 45 of the transfer ring 40 to lock the latter on the anchoring body 1 as will be detailed below.
• This cover screw 70 provides either a temporary protection of the transfer ring 40 pending prosthetic realization in the context of an immediate loading known as MCI is an osteointegration in the event that an MCI is not envisaged .
• the implant according to the invention comprises a cap 71 obtained in poly-tetra-fluoro-ethylene (PTFE) and adapted to cooperate with the upper end of the transfer part 42 or the upper end of the implant neck 7 to close it or close during an impression in particular.
• PTFE poly-tetra-fluoro-ethylene
• extractor tooling 72 In order to allow easy assembly and disassembly of the transfer ring 40, a so-called extractor tooling 72 is provided.
• Said extractor 72 consists of a worm 76 cooperating with a ratchet wheel 77.
• Implant placement with immediate impression taking
• the transfer ring 40 is placed on the implant neck 7 of the anchoring body 1 and the transfer part 42 is positioned on said transfer ring 40.
• the transfer part 42 and the transfer ring 40 are secured to the anchoring body 1 by means of the long screw 35 and then the impression is performed in a manner well known per se.
• the transfer ring 40 and the transfer piece 42 are secured to the anchoring body 1 by means of the short screw 54 and the piece transfer 42 is closed by the cap 71 before taking the impression. After taking the impression, the transfer part 42 is removed and the cover screw 70 is put in place on the transfer ring 40 for prosthetic realization.
• a first alternative consists in placing a temporary prosthesis removing the cover screw 70 and then securing the transfer part 42 and the transfer ring 40 to the anchoring body 1 by means of the short screw 54. It will be observed that the height of the collar of the transfer ring will be readjusted to the occlusion height by molding in the laboratory, the cosmetic material being placed on the transfer ring 40 readapted. When the peri-impantar soft tissues are healed and stabilized, the transfer ring 40 and the transfer piece 42 are removed and the final prosthesis is screwed onto the anchoring body 1 by means of the short screw 54.
• a second alternative consists in removing the cover screw 70 and then placing the final prosthesis which is screwed onto the anchoring body 1 by means of the short screw 54.
• a last alternative is to remove the cover screw and to install the final prosthesis by means of the burnout sheath 43 in particular.
• the transfer ring 40 is placed on the implant neck 7 of the anchoring body 1, and the cover screw 70 is screwed onto the anchoring body 1 and the transfer ring 40 to cover it and then wait for the osteo -integration and healing of soft tissues are realized (of the order of a few weeks).
• the cover screw 70 is deposited and then the transfer part 42 is put in place on the transfer ring 40.
• the transfer piece 42 is secured to the anchoring body 1 and to the transfer ring by means of the long screw 35.
• the transfer ring 40 and the transfer part 42 are secured to the anchoring body 1 by means of the short screw 54 and the transfer part 42 is closed by the cap 71 before taking the impression.
• the cover screw 70 is screwed onto the transfer ring 40 the time to make the final prosthesis.
• cover screw 70 is removed and the final prosthesis is screwed onto the anchoring body 1 by means of the short screw 54.
• the implant neck 7 may comprise any male or female connection means, the transfer ring, the door - Implant, the abutment and the various parts of the transfer system comprising female and male connecting means adapted to cooperate with the connecting means of the implant neck 7, without departing from the scope of the invention.

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• Health & Medical Sciences (AREA)
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• Veterinary Medicine (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Dentistry (AREA)
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• 2006
  • 2006-12-07 FR FR0610685A patent/FR2909540B1/fr not_active Expired - Fee Related
• 2007
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