EP3089697A1

EP3089697A1 - Abutment system for immediate implants

Info

Publication number: EP3089697A1
Application number: EP13834385.0A
Authority: EP
Inventors: Oliver HANISCH; Stefan Paul
Original assignee: Olista AG
Current assignee: Olista AG
Priority date: 2013-12-30
Filing date: 2013-12-30
Publication date: 2016-11-09
Also published as: US20160324602A1; WO2015101379A1

Abstract

The invention relates to an abutment system (200) for use in the area of the front teeth and premolars, with an abutment base (102) which comprises a first interface for placement on an implant and a further interface for securing a post (130), wherein the abutment base (102) has a three-dimensional form that is non-symmetrical to an implant axis (AI), and wherein the implant (103) fixes the implant axis (AI). The abutment base (102) is designed as a one-time abutment base (102). The abutment system (200) comprises a separate insertion post (130) which can be secured in the area of an upper face (104) of the abutment base (102), wherein the insertion post (130) extends coaxially with respect to the implant axis (AI) in the secured state. The upper face (104) of the abutment base (102) is a scalloped upper face (104), and the further interface (126) for securing the insertion post (130) is located in the area of the scalloped upper face (104). The abutment base (102) has a mantle area (111), of which the smooth and/or microrough contact surface (127, 128) is designed to be hydrophilic or ultra-hydrophilic.

Description

ABUTMENT SYSTEM FOR IMMEDIATE IMPLANTS

The invention relates to a Abutmentsystem for creating an implant-supported dentures. In particular, it concerns abutment systems for single implants, which are used in the front row of teeth or premolars.

State of the art

It is known that one can replace lost or extracted teeth by implant-supported dentures. For more than 40 years, the so-called osseointegrated implants have been used. Osseointegration results in a stable implant-bone bond when expertly handled. In the posterior teeth, restoration is primarily about maintaining or restoring the chewing function. In the visible range, however, it is also about the aesthetics, in particular the preservation of soft tissue.

Fig. 1A shows a schematic frontal view of two human anterior teeth FZ: 21 and FZ: 11 together with the surrounding gums. In FIG. 1B is a highly simplified form of a first vertical section through one of the anterior teeth

CONFIRMATION COPY FZ: 11 and the surrounding structures shown. Fig. IC shows a second vertical section through the same front tooth FZ: 11, wherein the second vertical section is perpendicular to the first vertical section.

Since the tooth anatomy is referred to several times in the following, the essential terms are explained with reference to FIGS. 1A to 1C. The tooth FZ itself is constructed from the dentin (dentin) 11 and surrounded in the upper (usually visible) area with enamel 7. The corresponding melt cement boundary SZG typically has a scaled profile, as shown in FIG. 1B indicated. The tooth root 12 is seated in a tooth compartment of the jawbone 5. Seen from the outside inwards, the so-called gum tissue (epithelium) 9 sits on the connective tissue 6. Collagen fibers 14 are arranged in the connective tissue 6. On the top left, some of these collagen fibers 14 are indicated in FIGS. 1B and 1C. These fibers 14 surround the tooth FZ in a ring or loop shape or insert vertically on the root surface as a soft tissue appendage (viewed in plan view). Between the jawbone 5 and the tooth root 12 consisting of the root dentin, the periodontal 13 is arranged. The root dentin is externally covered with a thin layer of root cementum. Inside the tooth FZ sits the nerve 8.

2A shows from below a highly schematic sectional view of a molar BZ: 16 and a premolar PM: 15 of the upper jaw of a human dentition together with the surrounding soft tissue morphology just below the molten cement boundary SZG. FIG. 2A shows the gum 9 and the connective tissue 6. The course of the collagen fibers 14 in the connective tissue 6 is indicated by lines / curves, the collagen fibers 14 encircling the two teeth BZ and PM shown in ring or loop form as well as perpendicular to the Insert root surface. In both teeth BZ and PM can be seen in cross section, the inner channel of the nerve 8 and the surrounding root dentin of the tooth root 12. Externally on the root dentin of the tooth root 12, the thin layer of the root cementum is arranged, which is not shown separately here. Fig. 2B shows by way of example a schematic view of the upper jaw of a human dentition from below.

After the loss or extraction of a tooth FZ in the front jaw area and the introduction of an implant is already after a short time a loss of gum 9 and / or jaw bone 5 determine. Among other things, a role plays, whether the implant is introduced with a time delay, or whether it is implanted in the context of an immediate implantation immediately after the extraction of the tooth FZ. If the tooth FZ is still in place and an extraction e.g. due to local infection or trauma, it can be assumed that the connective tissue 6 and the contour / structure of the surrounding collagen fibers 14 are still intact. Immediate placement of an implant into the extraction socket, as well as the immediate insertion of an abutment, including provisional restoration, may be beneficial in these cases. The so-called immediate-immediate techniques for introducing dental implants are therefore becoming more important, although so far the delayed-immediate approach is the most widely used implantation technique (Lang et al, 2012, Esposito et al., 2010) ).

Background of this immediate-immediate implantation technique in conjunction with immediate restoration by a temporary restoration is the fact that by inserting an abutment (as an intermediate member sitting in the soft tissue area, between the implant and the restoration), the collagenous connective tissue structure and thus the gum contour is supported.

The usual practice to date is that the primary abutment (healing and / or provisional abutment) is replaced several times for the preparation of the definitive prosthesis and replaced at the onset of the definitive restoration by a final abutment. This final abutment is made after taking the impression individually in the laboratory together with the definitive dentures. It has been shown that it is due to the exchange between primary and final abutment to destroy the Soft tissue adhesion occurs between connective tissue and abutment contact surface. This trauma leads to a peri-implant bone loss.

To date, compared to implants final abutments are not sterile packaged by the manufacturer. The clinically accepted procedure envisages disinfecting abutments in practice with disinfectants or autoclaving them before they are used in the patient. Both methods fail to adequately decontaminate microorganisms and moreover result in changes in abutment contact surfaces that reduce connective tissue adhesion (Canullo et al, 2013, Vezeau et al, 2000, Steinemann 1998, Rowland et al, 1995).

Even the insertion of an abutment is not recommended to date - in contrast to implants - under sterile conditions.

In a classic dental prosthesis implant, the implant sits completely epi- or subcrestal. To date, there is a belief that dental implants should be placed so that the top of the implant is at or (slightly) below the topmost immediately surrounding bone level KN 1 (see, e.g., FIG. 1C) of the jawbone 5. This is justified, inter alia, by the fact that in the case of a recession of the bone 5 and the soft tissues 6, 9, it would be desirable to prevent the upper edge of the implant from becoming visible.

In the figures 3A to 3C different, highly schematic views of a prior art implant 1 and 2 abutments are shown with reference to schematic diagrams. As an intermediate element between a superstructure and / or crown and the implant 1, an abutment 2 is typically used, as shown in greatly simplified form with reference to FIGS. 3A to 3C. With reference to FIG. 1B, the abutment 2 typically sits in the region of the passageway through the soft tissue (connective tissue 6 and ephitel 9), the interface between implant and abutment epi- or subcrestal, depending on the height at which the implant was set. Abutments 2 with a rotationally symmetrical basic shape are frequently used. However, such abutments 2 have by their rotationally symmetric One of the disadvantages of the basic form is that they can not optimally fit into the row of teeth and thus make it difficult or in some cases impossible to make the superstructure, since natural anterior teeth (FZ) and premolars (PM) have deltoid or oval root cross-sections in the area of the molten cement boundary SZG have. An adaptation ("grinding") in the mouth of the patient is hardly possible because of the hard material of the abutment 2. However, such problems do not exist with laboratory-made, patient-specific abutments. However, this results in a high cost and time.

The abutments 2 have so far mostly a flat top 3, as can be seen in Fig. 3A and Fig. 3C. Recently, there are also partially abutments 2 with a so-called scalped (saddle-shaped running) surface 4, as can be seen in Fig. 4. In this prior art solution, the scaled surface 4 partially takes on the shape of the natural melt cement boundary SZG of the tooth FZ, which has been previously extracted.

For example, there is already a scaled implant 10, shown schematically in FIG. 4, offered by Nobel Biocare, Sweden, under the name NobelPerfect ™. This is a one-piece implant 10, in which the actual implant 1 and the abutment 2 are made in one piece. The NobelPerfect ™ implant 10 is designed rotationally symmetrical to the implant axis AI, as can be seen in FIG. The abutment region 2 of the implant 10 is designed rotationally symmetrical to the implant axis AI and has a hat shape. Details of such a scaled implant 10 can be found, for example, in US Pat. No. 6,174,167 B1. US Pat. No. 6,174,167 B1 describes an implant which comprises a scaled surface with bulges and depressions so as to image the physiological contour of the natural bone-tissue morphology. No. 6,174,167 B1 shows a two-part solution in which the implant-abutment interface has a scaled surface. The scaled surface according to US 6,174,167 Bl is symmetrical. The abutment according to US Pat. No. 6,174,167 B1 has conical subgingival lateral surfaces. From the US Pat. No. 5,810,592, one-piece and two-piece abutment systems with asymmetrical shoulder and conical subgingival jacket regions are known. The abutment system of US 5,810,592 is designed to take a supracrestal position. The patent US 5,810,592 shows no scaled surface having an apex and also no concave lateral surface in vertical section.

The published international patent application WO 2006/138351 describes an abutment system which has a kind of asymmetrical scallop and concave / convex subgingival sheath regions. The abutment according to WO 2006/138351 is not in two parts.

The published applications WO2004 / 037110 and JP2008 / 149121 describe implant systems in which an implant body is provided with a neck part. An abutment can be attached to it. Common implants consist of one piece and not two parts. The aforementioned neck portion in both applications has a surface which is useful for osseointegration, i. for bone integration. The neck part is therefore not intended for soft tissue storage. Both applications indicate that this neck piece is placed subcrestally and not supracrestally. Furthermore, the subgingival mantle area only has conical surfaces.

From the European patent application EP 1205158 AI another implant is known, whose shape is adapted to the level differences in the course of the jawbone. According to this patent application, the implant is widened at its distal end at mutually opposite areas. The implant has a corresponding to the broadening shaped inner recess. That the implant is hollow at least in the upper area. In this recess, a correspondingly shaped structural body can be used, which serves as an abutment. The interface between implant and abutment is internal.

It is a disadvantage of this solution that the implant itself is in some way adapted to the level differences in the course of the jawbone. Therefore, the implant must be implanted exactly so that its Widening in relation to the course of the jawbone occupies the optimal position. If the implant is not screwed in far enough or too far, it will not be in the optimal position.

It has as its object to provide an abutment system and an implant system based thereon, which / allows an implantation method in which no or only insignificantly small recessions on the gum and / or jawbone occur. In addition, aesthetically pleasing and durable dentures solutions are to be made possible, especially in the anterior teeth and premolars.

In particular, it is in the invention to have an abutment available, which has an optimal basic anatomical shape and contour analogous to the extracted tooth.

It is also an object of the invention to provide an abutment system which allows a good "integration" into the soft tissue, in particular the invention concerns the improved soft tissue integration of the anatomically shaped abutment base.

The abutment system of the invention therefore has a hydrophilic or ultrahydrophilic contact surface which allows for improved soft tissue adhesion.

The abutment system of the invention has a cladding region whose smooth and / or microrough soft tissue contact surface is hydrophilic or ultrahydrophilic.

The abutment system of the invention is designed as an abutment, which can be used once. It is therefore a so-called one-time abutment, which is used once and thus definitively (during implantation or implant opening) and is no longer exchanged during the production of the definitive restoration. The invention is based on the recognition that in abutment systems that provide for multiple replacement before a final abutment is used, bone destruction can occur. Several studies have shown that a single abutment placement results in less bone resorption than the conventional primary and final abutment replacement procedure (Grandi et al, 2012, Rodriguez et al, 2013, Degidi et al, 2011).

The one-time abutment of the invention is provided sterile packaged ready. The abutment may e.g. be delivered sterile packed by the manufacturer.

It could be shown clinically, e.g. Argon plasma sterilized titanium abutments result in lower peri-implant bone loss than autoclaved abutments. For this reason, an abutment of the invention (e.g., from the manufacturer) should be sterilized by adequate techniques (e.g., argon plasma, etc.) and packaged accordingly.

In addition, according to the invention, on the one hand, a sterile surgical field should be generated and, on the other hand, contamination of the abutment contact surfaces should be prevented.

The one-time abutment of the invention is designed for this reason to be introduced by means of a Einbringpfostens in the extraction socket. This serves to prevent the contamination of the contact surface with the soft tissue during insertion.

In addition, according to the invention, at least the hydrophilic or ultrahydrophilic region of the contact surface is designed to be concave, with the result that this sensitive surface is protected.

To prevent contact of the Abutmentkontaktfläche by gloves or saliva, the abutment is introduced with a placement post. This placement post is preferably at all Embodiments of the invention are preassembled on the abutment and are included in the sterile package.

The placement post is designed to facilitate the 3-dimensional positioning of the abutment in the mouth.

According to the invention, there is an abutment system for use in the area of the front teeth and premolars with an abutment base comprising a first interface for placement on a (standard) implant and a further interface for releasably securing a Einbringpfostens. This further interface may also serve as an interface for securing a prosthetic element (e.g., a crown or superstructure). The abutment base of the invention has a scaled top surface. The other interface is located in the area of the scalop top.

The abutment system of the invention is, in principle, independent of the first interface between the (standard) implant and the abutment and, in principle, it is also independent of the further interface which serves to releasably secure the placement post. The abutment system of the invention can be adapted to almost all interfaces.

The implant defines a so-called implant axis after implantation. The abutment system of the invention is characterized in that the abutment base has a three-dimensional shape which is not symmetrical to this implant axis, i. The three-dimensional shape of the abutment base is therefore not a body of revolution. In addition, the abutment base on a cladding region, which has a concave shape viewed in vertical section.

The abutment system may include, in addition to the abutment base, a separate prosthetic post that is securable in the region of the scalloped top of the abutment base such that the prosthetic post extends coaxially with the implant axis in the attached state. The prosthetic post is used to attach a prosthetic element. In all embodiments, the abutment base has a three-dimensional asymmetric shape, which in the mesial, distal, vestibular and palatal directions substantially approximates the natural three-dimensional asymmetrical shape of the molten cement boundary SZG. The abutment base of the invention is therefore also referred to as an anatomically shaped abutment base.

In all embodiments, the abutment base has a concave jacket region, which ensures a smooth transition between a rotationally symmetrical interface surface (in the region of the first interface) and a non-symmetrical circumferential edge / shoulder or a non-symmetrical, scaled surface. At least a portion of this concave mantle area is hydrophilic.

The concave mantle region results in a kind of waisting of the abutment base along the course of the scalped melt cement boundary SZG, resulting in a better integration into the surrounding tissue structure.

The concave mantle region has partially or completely a smooth and / or rough contact surface to the soft tissue. This contact surface according to the invention is designed to exhibit hydrophilic or ultrahydrophilic properties, thereby achieving better soft tissue adhesion.

To achieve better soft tissue adhesion, the abutment base must be sterilized in all embodiments. It has been found that only industrially applied methods lead to a decontaminated and intact contact surface of the abutment base. Therefore, the abutment base is industrially sterilized and provided with an intact hydrophilic or ultrahydrophilic contact surface. Preferably, the provision is made by the manufacturer. The usual sterilization procedures in a dental office do not achieve the same effects and they damage the contact surface, which has been specially designed for better soft tissue adhesion. Plasma sterilization methods (eg argon plasma sterilization) are particularly suitable as sterilization methods for the abutment base and the placement posts.

In order to prevent contamination of the abutment base during insertion, according to the invention, the abutment base is introduced with a placement post under sterile conditions. This placement post is preferably preassembled on the abutment in all embodiments and is included in the sterile package.

It is all about abutment bases, which are fixed on implants, immediately after they were introduced into the bone of the upper or lower jaw. On or at these Abutmentbasen a removable or fixed dentures can be anchored. Fastening of the denture is carried out according to the invention by means of a prosthetic post, which is carried out separately from the respective abutment base.

In particular, this is the so-called immediate implantation, in which immediately or shortly after the extraction of a tooth or dental rest, the implant implanted in the bone of the upper or lower jaw and an abutment base of the invention is attached thereto.

According to the invention, immediate implantation is preferred to obtain the soft tissue morphology. It is all about maintaining the gingival situation using a special abutment system, e.g. is fixed on a commercially available implant, i. It is a two-piece abutment system with posts and abutment base.

Prerequisite for a soft tissue adhesion is the one-time insertion of the one-time abutment. This one-time abutment is not replaced after insertion and remains as a final abutment in the mouth. The impression for the denture is due to the bipartite of the abutment system according to the invention at the level of Abutmentbasis, the prosthetic post can be separated from the abutment base and thereby leaving the abutment base in the mouth. As a result, the soft tissue adhesion is not destroyed.

Suitable implants for all embodiments of the abutment system implants having a base body which is parallel-walled or wurzelförmig (conical) and which has a rotationally symmetrical shape with respect to a central axis of rotation coincident with the implant axis. Currently, so-called screw-type implants are preferred. Such screw implants - but also other standard implants - can be used in conjunction with the present invention. The implant serves as an anchoring element in the jawbone.

According to the invention, the abutment base is seated so that the upper edge is arranged supracrestally. Preferably (but not exclusively), the upper edge of the abutment base is placed> 1 mm above the bonecrete of the alveolar compartment of the extracted tooth. Particularly preferred is an implantation method in which the upper edge is approximately 1.5 mm circular above the jawbone.

As a so-called abutment base is a prefabricated in series element / component, which is used as a connecting element between the implant and a superstructure or crown. The abutment base of the invention serves as an intermediate between the implant and the restoration with the abutment base seated in the soft tissue area.

Due to the fact that an abutment base is used, which is prefabricated in series, a closed sterile chain can be ensured, which is essential for the invention.

According to the invention, three or four different types / forms of abutment bases may be provided to accommodate the different forms of anterior teeth and premolars. The abutment bases of the invention can be manufactured in the highest quality, shape retention and durable materials in specialized factories and then sterilized by industrial scale. The durable materials can be selected taking into account the dimensional stability and body compatibility. Workability of the abutment bases is not required. It is therefore especially suitable titanium, titanium alloys and zirconium oxide or their combination as a material of Abutmentbasen.

Preferably, in all embodiments, the abutment base comprises a material selected from the group of metals, metallic alloys, ceramic materials, and combinations thereof.

According to the invention, at least one ready-to-use and sterile-packed abutment base is used, and together with the abutment base, a suitable placement head is provided in sterile packaging. The above-mentioned superstructure or crown, however, is usually manufactured patient-specific.

According to the invention, the abutment base may e.g. be connected via a polygonal interface with the implant. Depending on the design, the polygonal interface allows three or more angular positions (indexing positions) of the abutment base with respect to the implant. This provides additional degrees of freedom, which makes it possible to achieve an optimal alignment of the prefabricated, scaled abutment base in relation to the bone and tissue structures.

The use of an implant-abutment restoration unit according to the invention (referred to here in its entirety as an implant system) provides aesthetically very appealing results, since there is no or only a very small recession, especially in the marginal soft tissue.

With the invention, the gingival tissue structures and their contour can be largely retained, which causes, inter alia, a rapid ingrowth and stable anchoring. Further advantageous embodiments can be found in the dependent claims.

DRAWINGS

Embodiments of the invention will be described in more detail below with reference to the drawings.

FIG. Figure 1A shows a schematic frontal view of two human

Anterior teeth including the surrounding gums;

FIG. Figure 1B is a highly diagrammatic sectional view in the mesial direction of the right anterior tooth of Figure 1A, including the surrounding soft tissue and bone morphology;

FIG. IC is a highly schematic sectional view in the palatal direction of the right anterior tooth of Fig. 1A, including the surrounding soft tissue and bone morphology;

FIG. 2A shows a highly schematic sectional view of a premolar PM:

15 and a molar BZ: 16 of the upper jaw of a human dentition together with the surrounding soft tissue morphology viewed from below;

FIG. Figure 2B is a schematic view of a human maxilla viewed from below;

FIG. 3A shows a highly schematic perspective view of one

The prior art implant system comprising a parallel-walled implant and an abutment mounted thereon;

FIG. FIG. 3B is a highly schematic plan view of the implant system of FIG. 3A; FIG.

FIG. FIG. 3C is a highly schematic side view of the implant system of FIG. 3A; FIG.

FIG. 4 shows a schematic side view of a one-piece, scaled, rotationally symmetrical dental prosthesis implant according to the prior art; shows a side view of a first abutment base of the invention viewed in the mesial direction (analogous to the viewing direction in Fig. 1B), wherein the position and shape of a suitable exemplary implant is indicated by dashed outline;

shows the same side view of the first abutment base of Figure 5A, with auxiliary lines are drawn.

Fig. 5 is a reduced side view of the first abutment base of Fig. 5A, taken together with an applied exemplary prosthetic post in the mesial direction;

shows a side view of the first abutment base of the invention viewed in the palatal direction;

shows a highly schematic plan view of another abutment base of the invention, which has a slightly deltoid plan view;

shows a side view of a prosthetic post for attachment to an inventive Abutmentbasis;

shows a rotated by 90 degrees side view of the prosthetic post of Fig. 6B;

shows a side view of a placement post for introducing an abutment base according to the invention;

shows a rotated by 90 degrees side view of the placement post of Fig. 6D;

shows a side view of another introduction post for introducing an abutment base according to the invention;

shows a section through the upper portion of the placement post of Fig. 6F;

shows a greatly simplified perspective view of an exemplary

A prior art implant that can be used in conjunction with the present invention;

shows a highly schematic sectional view of typical tooth shapes and sizes viewed from below (in plan view);

shows a highly schematized view of four typical

Abutment shapes and sizes viewed in plan;

shows a highly schematic plan view of another

Abutment base of the invention having an oval outline; FIG. Fig. 10B is a highly schematic perspective view of a crown constructed for mounting on an abutment base of Fig. 10A;

FIG. 11 shows a side view of an inventive device

Abutment system comprising a delivery post and an abutment base, both being packaged together in a sterile housing;

FIG. 12 shows a side view of a further placement post for

Introducing an abutment base according to the invention;

FIG. 13 shows a side view of a further placement post for

Introducing an abutment base according to the invention;

FIG. Figure 14 shows a side view of another abutment base of the invention viewed in the mesial direction (analogous to the viewing direction in Figure 5A).

Detailed description

In the context of the present description, terms are used which are also used in relevant publications and patents. It should be noted, however, that the use of these terms is for the convenience of understanding only. The inventive idea and the scope of the protection claims should not be limited by the specific choice of the terms in the interpretation. The invention can be readily applied to other conceptual systems and / or fields. In other fields the terms are to be applied analogously.

The present invention relates to an abutment system 200 (see eg FIG. 5C) which is designed primarily for use in the area of the front teeth and premolars. The abutment system 200 includes an abutment base 102. An exemplary first abutment base 102 is shown in Figs. 5A to 5D. The abutment base 102 has a first interface 107, which is designed for placing on an implant 103, as indicated for example in FIG. 5A. The implant 103, after being advertised by the position of its implant axis AI, defines the position of all other elements (such as the abutment base 103, placement posts 130, prosthetic posts 210, and restorative elements) that are attached to the implant 103, as indicated in FIG. 5C. In addition to the first interface 107, the abutment system 200 comprises a second interface 123 for securing the restoration element (eg a crown or superstructure).

The placement post 130 and the prosthetic post 210 are referred to herein as posts.

The abutment base 102 has a scalloped upper surface 104 in all embodiments of the invention and has a three-dimensional shape that is not symmetrical to the implant axis AI. Furthermore, the abutment base 102 is surrounded by a jacket region 111, which has a concave shape when viewed in vertical section. This concave shape of the cladding region 111 can be clearly seen, for example, in FIGS. 5A and 5B.

Additionally, in all embodiments, the abutment system 200 includes a separate prosthetic post 210 that is securable to the scalloped upper surface 104 of the abutment base 102 such that the prosthetic post 210 extends coaxially with the implant axis AI in the attached state. An exemplary abutment base abutment system 200 200 and prosthetic post 210 is shown in FIG. 5C.

In all embodiments, the abutment base 102 preferably has a proximal interface surface 109 in the region of the first interface 107, which is substantially planar and perpendicular to the implant axis AI. In addition, in all embodiments, the abutment base 102 preferably comprises a through-hole 117 in the region of the scalop surface 104, which serves for fastening the prosthetic post 210 and / or for connecting to the implant 103. In FIG. 5D, the position of the through-hole 117 can be seen by way of example. In FIG. 6A, the through hole 117 of another abutment base 102 according to the invention can be seen in a plan view.

According to the invention, the cross-sectional shape (in vertical section through the Abutmentbasen 102) is asymmetric, as will be explained below. For example, in an anterior tooth FZ, the enamel cement boundary level SZGN2 on the right and left sides (ie, interdental) of the tooth FZ: 11 may be at about the same level as indicated in FIG. On the tooth front (left in FIG. 1B) and the back of the tooth (on the right in FIG. 1B), the course of the molten cement boundary SZG (in healthy gums) follows more or less the curved contour of the gum 9 forming a cuff around the tooth. In Fig. 1B, the course of the melt-cement boundary SZG is represented by a curved upward curve. The course of the bone level is shown in the side view of Fig. 1B by a further upwardly bulbous curve in dashed form, the maximum of this curve is referred to as bone level KN2. In Fig. IC, the course of the melt-cement boundary SZG is represented by a downwardly curved curve. The course of the bone level is shown in the view of Fig. IC by a further downward bulbous curve in dashed form, the minimum of this curve is referred to as bone level KN1. In the schematic illustration in FIG. 1B, the cemented-melt boundary level SZGN1 is at the same level on the front and rear side of the tooth FZ: 11 for the sake of simplicity. That is, the line that represents the Schmelzzementgrenzniveau SZGN 1, runs horizontally here. However, the cementitious melt boundary level SZGN1 and the contour of the gum 9 are typically at a different elevation at the tooth front than at the back of the tooth, ie, the line that represents the molten cement boundary level SZGN1 is usually oblique in practice. In Fig. 5A, the oblique course of the Schmelzzementgrenzniveaus SZGN 1 is exemplified by a dashed auxiliary line. Accordingly, at the abutment base 102 of the invention, the level NA (A stands for outer vestibular) differs from the level NI (I stands for inner = oral), as can be seen in FIG. 5A. This results in an asymmetry of the cross-sectional shape and a specially directed orientation (angular position), which must be taken into account when attaching the abutment base 102 on the implant 103.

In FIG. 5A, the asymmetry of the cross-sectional shape can be recognized on the basis of the first abutment 102, wherein it should be noted that FIG Section view but a side view shows. In FIGS. 5A to 5C, the abutment base 102 is shown in the same orientation as the tooth FZ: 11 in FIG. 1B.

It can be seen in FIG. 2B that each tooth has a different typical cross section or plan. The premolars PM (eg the teeth PM: 14 and PM: 15 according to the FDI scheme) typically have an oval layout (eg analogous to the plan view QI in FIG. 8), the canines EZ (eg the tooth EZ: 13 according to the FDI scheme ) typically have a deltoid cross-section with rounded corners (eg analogous to the Q2 plan view in FIG. 8) and the front teeth (eg FZ: 11 and FZ: 12 teeth according to the FDI scheme) typically also have a deltoid cross-section with rounded corners (eg analogous to the planforms Q3 and Q4 in Fig. 8).

Investigations have shown that the variety of shapes and variations in terms of shape and size difference in the anterior teeth and premolars are only quite small. Therefore, according to the invention, it is possible to offer three or four industrially manufactured abutment bases 102 (as indicated in FIG. 9) in order to be able to provide a replacement for a human anterior FZ or premolar PM in almost all cases.

Viewed in plan view, the respective abutment bases 102 of the invention have approximately the contour and dimension of the melt cement boundary SZG of the respective shapes Q1, Q2, Q3 and Q4, as shown schematically in FIG. In Fig. 9 four possible floor plan shapes and sizes (projected into the plane of the drawing) of Abutmentbasen 102 are shown in schematic form and denoted by El to E4. The floor plan form El is an oval or slightly ovoid shape. An abutment base 102 according to the plan view form El preferably has a size of 4.5 mm by 6 mm and is suitable for constructing a dental prosthesis of a premolar. The layouts E2, E3 and E4 are deltoid shapes. An abutment base 102 according to the planform E2 preferably has a diameter of 4 mm, an abutment base 102 according to the planform E3 preferably has a diameter of 5 mm and an abutment base 102 according to the planform E4 preferably has a diameter of 6 mm. The Layouts E2, E3 and E4 are particularly suitable for the construction of a dental prosthesis of a corner or anterior tooth. When viewed in plan view or in the projection into the plane of the drawing, the peripheral edge / shoulder 105 defines the floor plans El - E4. None of the planforms El, E2, E3, E4 is rotationally symmetrical with respect to the implant axis AI, which is perpendicular to the plane of the drawing in FIG.

It can be determined, for example, by means of a local examination of the extraction channel and / or the extracted tooth and / or by means of imaging methods, which type and which size of the abutment base 102 according to the invention is suitable for constructing a dental prosthesis. In selecting the type and size of the abutment base 102, the location and thickness of the connective tissue 6 above the jawbone 5 (viewed from the crestal direction) are also preferably determined (see FIGS. 1B and 1C). Values for the thickness or position of connective tissue 6 mesially (towards the midline of the jaw), distal (away from the jaw center line), vestibular (outward) and palatal (pointing to the palate) may be taken into account.

The invention does not rely on abutment bases made on a patient-specific basis, but on abutment bases 102 which are manufactured in a ready-to-fit manner. In order nevertheless to enable optimized solutions, an implant system 100 preferably comprises in all embodiments different (preferably at least three) abutment bases 102 having the shapes E1, E2, E3 and E4 (see FIG. 9), so that the surgeon in each case has a suitable abutment base 102 for the abutment Hand, whose shape and size corresponds approximately to the local situation after the extraction of a tooth.

Such an implant system 100 preferably comprises in all embodiments at least one abutment base 102, which viewed in horizontal section an elliptical plan view analogous to El at least one abutment base 102 and at least one roundish deltoid plan shape analogous to E2 and / or E3 and / or E4. The floor plans El-E4 of the abutment bases 102 are adapted to the layouts Ql-Q4 of an anterior tooth FZ, canine EZ, or premolar tooth PM to be replaced with a denture implant 100.

Viewed from bottom to top, an abutment base 102 of the invention has at least the following characteristics in all embodiments:

A first interface 107; Preferably, here is a proximal interface surface 109, which in the mounted state parallel (surface to surface) to a distal top surface 110 of the implant 103 extends. The interface surface 109 is perpendicular to the implant axis AI and is substantially flat. Preferably, there is also a connection post for an internal or external implant connection 115, as shown schematically and by way of example in FIG. 5A.

A concave mantle region 111 which provides a harmonic (edge-free) transition from the interface surface 109 to a circumferential edge / shoulder 105. In Fig. 5A, the surface of the mantle region 111 is hatched to optically lift it out. The surface of the cladding region 111 has partially or completely a smooth and / or rough morphology and has hydrophilic or ultrahydrophilic properties.

A circumferential edge / shoulder 105 which, in the projection into a plane which is perpendicular to the plane of the drawing of FIG. 5A, corresponds or approximates one of the layouts El, E2, E3 or E4 of FIG. The circumferential edge / shoulder 105 has in the interdental side view the scaled course shown in Fig. 5A, wherein the level NA (A stands for outside) may be different from the level NI (I stands for inside). On the palatal and / or vestibular side, the circumferential edge / shoulder 105 has a downwardly arched arcuate shape as seen in Figure 5D. The soft tissue contact surface of the circumferential edge / shoulder 105 is preferably smooth in all embodiments.

A distal, scaled surface 104, which corresponds or approximates to one of the layouts El, E2, E3 or E4 of FIG. 9 in the projection into a plane perpendicular to the drawing plane of FIG. 5A. In FIG. 5B, auxiliary lines and information can be recognized, which make it possible to better describe the shape and dimension of the abutment base 102. The interface surface 109 is located in a plane Fl, which is perpendicular to the implant axis AI. The distance al (parallel to the implant axis AI) between the plane F1 and the plane F2, depending on the abutment base 102, is preferably between 2 mm and 8 mm in all embodiments. The distance a2 (parallel to the implant axis AI) between the plane F2 and the plane F3 is, depending on the abutment base 102, preferably between 0.3 mm and 5 mm in all embodiments. The circumferential edge / shoulder 105 preferably has, in the palatal and vestibular regions of the abutment 102, a thickness d 1 (parallel to the implant axis A 1) which is between 0.1 mm and 0.6 mm. In the area of the apex 112 of the abutment base 102, the thickness of the circumferential edge / shoulder 105 corresponds to the mentioned distance a2.

The radial center distance ra between the implant axis AI and the outermost circumference of the interface surface 109 is preferably between 1.5 mm and 3 mm in all embodiments. It should be noted that the interface surface 109 is preferably circular in all embodiments and is concentric with the implant axis AI.

The maximum radial center distance rmax between the implant axis AI and the outer circumference of the edge / shoulder 105 is preferably between 2 mm and 5 mm in all embodiments. It should be noted that the implant axis AI is preferably in the center of the ovoid or deltoid forms El, E2, E3, E4.

Preferably, all abutment bases 102 of the invention have an overall height of al + a2 which is at most 10 mm. Typically, the total height al + a2 is even less than 6 mm.

Preferably, all abutment bases 102 of the invention have a maximum diameter that is at most 10 mm. Typically, the maximum diameter is less than or equal to 6mm. The described concave jacket region 111 provides in all embodiments for a flowing (ie stepless) transition between the rotationally symmetrical interface surface 109 and the non-symmetrical, circumferential edge / shoulder 105 or the non-symmetrical, scaled surface 104.

In FIGS. 5A and 5B it can be seen in the side view that the cross-section is designed asymmetrically to the implant axis AI, i. That part of the abutment base 102 which lies to the right of the implant axis AI is not mirror-symmetrical to that part of the abutment base 102 which lies to the left of the implant axis A1. The concavity on the vestibular side (curve 114) and the concavity on the palatal side (curve 113) are clearly different.

The apex 112 of the abutment bases 102 of the invention does not necessarily have to lie on the implant axis AI in all embodiments, as is the case in the example shown in FIGS. 5A and 5B.

Figure 5C shows a reduced side view of the first abutment base 102 of Figure 5A together with an attached prosthetic post 210 connected (e.g., screwed) coaxially to the implant axis AI with the abutment base 102. The prosthetic post 210 has an interface (referred to here as the second interface 123) which serves to attach / attach a crown 122 or a superstructure. Thus, for example, a head or a plate 211 may be provided on the prosthetic post 210, as can be seen in FIGS. 5C, 6B and 6D. In Fig. 6B, it can be seen that the head or plate 211 may protrude beyond the diameter of the prosthetic post 210. The head or plate 211 may be arranged asymmetrically with respect to the shaft 214 in all embodiments, as can be seen in FIG. 6B. Laterally, the head or plate 211, as can be seen in Fig. 6C, and / or the shaft 214 may be flattened. Circumferential grooves 212, 213 may be provided on the prosthetic post 210, as shown.

In Fig. 6D an exemplary placement post 130 can be seen. The placement post 130 may include, for example, a head or plate 131, which can protrude beyond the diameter of the Einbringpfostens 130 addition. The head or plate 131 is preferably arranged asymmetrically with respect to the rotationally symmetrical shaft 135 of the placement post 130 in all embodiments, as can be seen in FIG. 6D. Laterally, the head or plate 131 may be flattened, as seen in Fig. 6E. At the placement post 130, corrugations may be provided in the region of the head or plate 131 to better grip and rotate the placement post 130.

FIG. 6F shows a side view of a further placement post 130 for introducing an abutment base 102 according to the invention. The placement post 130 shown here has an extended head or grip area 132, which enables a secure gripping of the placement post 130. Fig. 6G shows a section through the upper portion of the placement post 130 of Fig. 6F. Laterally, the extended head or handle portion 132 may be flattened as shown in FIG. 6G. The corresponding flattening is denoted by reference numeral 137 in FIG. 6G. In Fig. 11, the flattening 137 to the left. Ridges 134 may be provided on the placement post 130 in the area of the head or grip area 132, so that the placement post 130 can be better grasped and rotated.

The placement post 130 of Figures 6D and 6E and the placement post 130 of Figure 6F may be mounted on the abutment base 102 analogous to the post 210 of Figure 5C.

The abutment base 102 is inserted into the implant 103 with the aid of a placement post 130. This placement post 130 is connected to the abutment base 102 via the interface 123. The placement post 130 is designed so that its flattened side is aligned with the vestibular surface of the abutment base 102. The placement post 130 facilitates three-dimensional alignment of the asymmetric abutment base 102 and prevents contamination of the contact surface in the shell area 111 upon insertion.

Preferably, all embodiments of the abutment bases 102 include a connection post for an internal or a receiving opening for an external implant connection 115, which can be seen in FIGS. 5A, 5B, 5C and 5D. The connecting post may be polygonal and / or rotationally symmetric conical. If such a connecting post 115 is provided on the abutment base 102, the implant 103 has a corresponding, correspondingly formed receiving opening 116 (internal connection). In Fig. 7, this receiving opening 116 is indicated as a black hexagon shown purely schematically. In Fig. 5A, this receiving opening 116 is shown by dashed lines.

There are already numerous different (standard) interfaces 107, which allow an abutment base 102 to be connected to an implant 103. Most of the interfaces used today have a so-called hexagonal interface and are, depending on the constellation, as an internal hex interface (as shown in Figures 5A, 5B and 6A), external hex interface, standard hex interface, slim hex Interface, wide hex interface, etc.

Common interfaces are known, for example, from the documents US 4,960,381, US 5,407,359, US 5,209,666 and US 5,110,292. These previously known solutions can be used in connection with the present invention in all embodiments.

After a suitable abutment 102 has been selected, the latter is connected to the implant 103 in such a way that the edge / shoulder 105 that runs asymmetrically along the abutment 102 has approximately the same distance in all directions (mesial, distal, vestibular and palatal) to the jawbone 5 or a uniform position with respect to the connective tissue 6 has.

The abutment base 102 preferably has in all embodiments a pronounced circumferential edge / shoulder 105, as can be seen for example in FIG. 5A. The circumferential edge / shoulder 105 approximately follows the area of the largest diameter / circumference of the abutment base 102 in the horizontal direction. The abutment base 102 of the invention approximates approximately the asymmetrically scaled shape and the shape of the molten cement boundary SZG. Therefore, the abutment base 102 also has an asymmetrically scaled shape and the abutment base 102 is bonded to the implant 103 such that the location of the scaled surface 104 of the abutment base 102 substantially corresponds to the location of the enamel cement edge SZG of the tooth prior to extraction. For this reason, the angular position (indexing position) of the abutment base 102 with respect to the implant 103 is important. The (hex) interface 107 therefore plays an important role, since it allows the abutment base 102 to be rotated about the implant axis AI relative to the implanted implant 103. The introduction of the asymmetrical abutment base 102 is facilitated by means of a placement post 130. This placement post 130 is preferably preassembled on the abutment base 102 that aligns its flattened side 130 with the vestibular surface 114 of the abutment base 102.

After the abutment base 102 has been placed in the correct angular position (indexing position) on the implant 103 and connected to it (e.g., by a set screw or screw 120 as shown in Fig. 5A), a temporary crown may be used e.g. using a known adhesive or cement on the abutment base 102 until a final crown 122 (see Fig. 10B) is available. Preferably, for attaching the crown 122 or a superstructure, the aforementioned prosthetic post 210 is used. These steps are well known and therefore will not be further elaborated.

In order to enable the abutment base 102 to be connected to the implant 103, the abutment base 102 preferably has a through hole 117 and the implant 103 preferably has an internally threaded screw hole 118, as indicated schematically in FIG. 5A by way of an example. The through hole 117 and the screw hole 118 are coaxial with the implant axis AI. Thus, a threaded pin or screw 120 may be screwed from above through the abutment 102 into the screw hole 118 to secure the abutment 102 to the implant 103. The through hole 117 preferably has an inner collar or a circumferential reduction 121 so that a screw head 119 of the screw 120 can rest. This type of connection of the abutment base 102 with the implant 103 can be used in all embodiments. But there are other known approaches that can be used. It is important that the prosthetic post 210 can be inserted from above into the abutment base 102 and fastened there.

In the correspondingly executed implant systems 100, the through-hole 117 can be seen in the plan view of the scaled surface 104 of the abutment base 102, as shown in Figures 6A and 10A. Also in the side view of the abutment base 102 (see FIG. 5D), the through hole 117 can be seen, depending on the orientation.

Shown in Fig. 6A is a plan view of an abutment base 102 having a slightly deltoidal shape. In the plan view, both the through hole 117 and the collar or the circumference reduction 121 can be seen. In contrast, FIG. 10A shows a plan view of an abutment base 102 having an ovoid shape. In the plan view, both the through hole 117 and the collar or the circumference reduction 121 can be seen.

Preferably, the implant system 100 according to the invention, which comprises at least one abutment base 102, the (standard) implant 103, the placement post 130 and possibly also the prosthetic post 210, is implanted shortly after the extraction of a tooth (eg an anterior tooth FZ) Care is taken to ensure that the unit of implant 103 and abutment base 102 is fixed in the bone in contrast to the doctrine that the scalloped surface 104 of the abutment base 102 is approximately 1.5 Shown in Figure 7 is an exemplary standard conical shaped body 103, wherein the implant 103 includes an external thread 106 and a mechanical interface 107 for connection to the abutment base 102 of the invention.

In all embodiments, the implant 103 can have either a parallel-walled or a conical (root-shaped) base body. In FIG. 5A, an implant 103 with a parallel-walled main body is indicated by dashed lines. In contrast, an implant 103 with a conical basic body is shown schematically in FIG. When introducing the necessary hole in the jawbone 5, the type / shape of the implant 103 must be taken into account accordingly.

It can also temporarily an abutment post screwed / attached to the abutment base 102, which corresponds in the mouth of the patient the negative, kauflächigen profile of the abutment base 102 (profile in the supervision) in the broadest sense. However, it may also serve the prosthetic post as an impression post. Importantly, the fit of the impression post in the 3-dimensional view relative to the abutment base 102 is well defined.

The abutment base 102 in all embodiments comprises a biocompatible material, preferably titanium, or a titanium alloy or zirconia, or combinations thereof, and may, if desired, e.g. be coated with titanium-zirconia and / or titanium-niobium-oxynitride ceramic. The soft tissue contact surface of the cladding region 111 may be partially or completely polished, machined, plasma treated, blasted, etched, lasered, coated with bioactive materials, or having any of these combinations. It is crucial that the surface at least in the region of the soft tissue contact surface of the shell region 111 has hydrophilic or ultrahydrophilic properties in order to achieve a soft tissue adhesion.

To achieve a hydrophilic or ultrahydrophilic surface, the soft tissue contact surface of the concave mantle region 111 is completely hydroxylated, for example by hydroxy groups. These hydroxy groups can be generated by electrolytic or chemical acid etching of the concave cladding region 111. The hydroxy groups are located in the outermost layer of the surface of the concave mantle region 111 of the abutment base 102.

In order to obtain the hydrophilic or ultrahydrophilic properties of the soft tissue contacting surface of the skirt portion 111, the abutment base 102 may be liquid together with the introducing post 130 or gases in a container 150 that is impermeable to gases and liquids. The container 150 is made of a material on its inner surfaces which does not alter the hydrophilic or ultrahydrophilic properties of the soft tissue contacting surface of the abutment base 102. Particularly suitable are containers 150 made of glass or Plexiglas.

Preferably, the concave shell portion 111 of the abutment base 102 in all embodiments comprises a smooth and / or microrough surface 127.

14 shows an exemplary schematic representation of an abutment base 102, wherein the concave mantle region 111 of the abutment base 102 has a microrough portion 128 (represented by a darker area fill) and a smoother portion 127 (shown by a lighter area fill). In all embodiments having a smooth portion 127 and a microrough portion 128, there is a dividing line 129 in the shell portion 111. This dividing line 129 defines the transition between the connective tissue (microrough) portion 128 and the epithelial (smooth) portion 127 of the soft tissue contacting surface. Preferably, this separation line 129 has a scaled course in all embodiments, as shown in FIG. Preferably, this dividing line 129 in all embodiments follows the scallop of the circumferential shoulder 105 and therefore has an asymmetrical course.

In all embodiments, the microrough section 128, if present, is preferably located in that surface region of the concave mantle region 111 to which connective tissue is intended to rest after insertion of the abutment base 102.

Preferably, the smoother portion 127, if present, extends in all embodiments between the microrough portion 128, if present, and the circumferential shoulder 105 of the abutment base 102, as seen in FIG. Preferably, the microrough portion 128 and the smoother portion 127, if present, extend annularly about the implant axis AI in all embodiments with the dividing line 129 scaled between the microrough portion 128 and the smooth portion 127.

Preferably, the microrough section 128, if any, is made in all embodiments by a combination of sand or corundum blasting and acid etch of a titanium surface of the concave shell portion 111, for example using the Straumann SLA® process , which was developed for the surface treatment of implant posts. Details are e.g. European Patent EP0388576 Bl.

Preferably, the smooth region 127, if present, is prepared by electropolishing the surface and then acid etching.

The terms microrough and smooth refer to the macroscopic nature of the surface.

The hydrophilic or ultrahydrophilic properties of the soft tissue contact surface in the cladding region 111 preferably result in all embodiments in that nanostructures are produced by a local surface treatment. These nanostructures improve the adhesion of the proteins during the wound healing phase.

[00118] The OsseoSpeed ™ process from Astra Tech AB can be used to produce the hydrophilic or ultrahydrophilic properties in all embodiments. Details are e.g. European Patent Application EP 2022447 AI.

Preferably, in all embodiments, an implant 103 is used, which has a chamfered edge 108 in the region of the interface 107, which rotates 360 degrees. In Fig. 5A is an implant 103 with chamfer 108 at the distal top 110 indicated. The top 110 of the implant 103 is not completely flat in these cases.

An implant system 100 with such an implant 103 with chamfer 108 and one or more abutment bases 102 and with a placement post 130 is particularly advantageous over previous implant solutions, especially since a waisted overall constellation results due to the chamfer 108 and the specially concave shaped lateral surface 111 ,

In Fig. 10A is a highly schematic plan view of another abutment base 102 of the invention is shown, which here has an oval outline. 10B shows a schematic perspective view of a crown 122 designed to be mounted on the abutment base 102 of FIG. 10A. In Fig. 10B, the crown 122 is located with the tooth front side (tooth front) on a base. The back of the crown 122 is visible in FIG. 10B. It can be seen that the crown 122 has a complementary inner shape 124 that closely matches the shape and dimension of the abutment base 102 of FIG. 10A. The crown 122 has a circumferential edge 125 which approximately corresponds to the shape of the peripheral edge / shoulder 105 of the abutment base 102. When attaching the crown 122 to the abutment base 102, the scalloped top 104 of the abutment base 102 sits inside the crown 122 and the peripheral edge 125 sits flush on the circumferential edge / shoulder 105 of the abutment base 102.

According to the invention, the abutment base 102 must not be post-processed (e.g., ground or polished) prior to implantation or insertion, as reworking can destroy the sterile surfaces and damage the hydrophilic or ultrahydrophilic contact surface.

Abutment bases 102 which were or were in contact with body fluids intraoperatively must not be reused.

The Abutmentbasis 102 should not be exposed to strong alkaline cleaning or disinfecting agents or other solutions, as these the Surface chemically attack and possibly lead to the dissolution / destruction of the hydrophilic or ultrahydrophilic surface.

Preferably, only brand new, sterile packaged abutment bases 102 should always be used.

11 shows a side view of an abutment system 200 according to the invention comprising a placement post 130 and an abutment base 102, both of which are packaged together in a housing 150 in a sterile manner. The housing 150 may be e.g. comprise a tight-sealing lid or plug 151 and may be filled with a liquid (preferably water or a gel) or an inert gas to protect the hydrophilic or ultrahydrophilic surface. Also in the embodiment according to FIG. 11, preferably the vestibular side of the placement post 130 is flattened (flattening 137), as can be seen in FIG. 6G.

FIG. 12 shows a side view of a further placement post 130 according to the invention. This placement post 130 is substantially cylindrical or conical and has no circumferential extension in the upper end area. Also in the embodiment according to FIG. 12, preferably the vestibular side of the placement post 130 is flattened. In Fig. 12, the corresponding flattening is designated by the reference numeral 136.

In order for such a placement post 130 to be better packed and rotated about the axis of rotation, preferably the surface is provided with a corrugation at least in the region of the flat 136, as indicated in FIG. 12.

FIG. 13 shows a side view of another placement post 130 according to the invention. This insertion post 130 has an enlarged head area. As in FIG. 6D, the placement post 130 of FIG. 13 has a head or plate 131. The head or plate 131 is preferably arranged asymmetrically with respect to the rotationally symmetrical shaft 135 of the placement post 130, as can be seen in FIG. This head or plate 131 is designed such that the placement post 130 also serves as a prosthetic post 210 can. In order to allow a better gripping of the insertion post 130 during insertion of the abutment base 102, the head or the plate 131 has been expanded by an attachment 133. This attachment 133 can be made of a metal (eg titanium) or also of a plastic. After the abutment base 102, including insertion head 130, has been removed from a suitable sterile housing 150 (eg, a housing 150 of FIG. 11), the abutment base 102 is secured (eg, by screwing) to an implant 103 located in the extraction socket. In this case, the abutment base 102 is not touched directly, but the placement post 130 serves as a handling means. After the abutment base 102 has been connected to the implant 103, the attachment 133 can be removed. There then remains a post on the abutment base 102, which is similar to the post of Fig. 6D. This remaining post may serve as a prosthetic post 210 for a provisional denture. Later, another prosthetic post may be placed before a final denture (eg, a crown 122 of FIG. 10B) is then permanently connected to the abutment base 102 originally inserted through this prosthetic post.

Preferably, the placement post 130 has a visible and / or noticeable marking that serves to bring the abutment base 102 in the correct orientation into the patient's jaw. In the illustrations of FIGS. 6D, 6E, 6F, 6G, 11, 12, 13, the placement post 130 in the region of the head or plate 131 and / or the shaft 135 has a flat which defines the vestibular side. Instead of a flattening, however, a different tactile and / or visible marking can also be used in all embodiments.

Reference numerals:

further interface 123 complementary inner shape 124

circumferential edge 125

further interface 126

smooth section 127

microrough section 128

Dividing line 129

Insertion post 130

Head or plate 131

Head or handle area 132

Article 133

Riffles 134

Shaft 135

Flattening 136

Flattening 137

Housing 150

Lid or plug 151

Abutment system 200

Prosthetic post 210

Head or plate 211

Groove 212

Groove 213

Shank 214

Distance al

Implant axis AI

Molar BZ

Thickness dl

Floor plans (in projection) El, E2, E3, E4

Canine EZ

Levels Fl, F2, F3

Bone level KN1, KN2

Level indoor (oral) NI

Level outer (vestibular) NA

Top edge OK

Premolar PM

Cross sections Ql, Q2, Q3, Q4

Incisor FZ

Melt Cement Limit SZG

Melt Cement Limit Level SZGN 1; SZGN2

Claims

claims

An abutment-based abutment system (200) for use with an abutment base (102) comprising a first interface (107) for placement on an implant (103) and a further interface (126) for securing a post (210 , 130), wherein the abutment base (102) has a three-dimensional shape that is not symmetrical to the implant axis (AI) and wherein the implant (103) defines an implant axis (AI), characterized in that

the abutment base (102) is designed as a one-time abutment base (102),

- the abutment system (200) comprises a separate placement post (130) attachable in the region of a top surface (104) of the abutment base (102), the insertion post (130) extending coaxially with the implant axis (AI) in the attached state,

- The top (104) of the abutment base (102) is a scaloped top (104) with the further interface (126) for fixing the Einbringpfostens (130), and

- That the abutment base (102) has a jacket region (111) whose soft tissue contact surface (127, 128) designed smooth and / or micro-rough and their soft tissue contact surface (127, 128) is designed hydrophilic or ultrahydrophilic.

The abutment system (200) of claim 1, characterized in that the abutment base (102) and the delivery post (130) is industrially sterilized and provided with an intact hydrophilic or ultrahydrophilic soft tissue contacting surface (127, 128).

3. abutment system (200) according to claim 1 or 2, characterized in that the jacket region (111) viewed in vertical section has a concave shape (113, 114).

The abutment system (200) of claim 1, 2 or 3, characterized in that the top surface (104) of the abutment base (102) has a scaled top surface (104) with an apex (112) and a circumferential one Edge / shoulder (105), with the further interface (126) being in the area of the apex (112).

5. Abutment system (200) according to claim 1, 2 or 3, characterized in that the abutment base (102) in the interdental side view of a vestibular level (NA) and a different oral level (NI), wherein the vestibular level (NA) below the oral level (NI).

6. abutment system (200) according to claim 1 or 2, characterized in that the jacket region (111), which has a concave shape (113, 114) seen in vertical section, an edge-free transition creates from a proximal interface surface (109) to the circulating Edge / shoulder (105), wherein the proximal interface surface (109) is perpendicular to the implant axis (AI).

The abutment system (200) of claim 1, characterized in that the circumferential edge / shoulder (105) has a scaled profile in the interdental side view and that the soft tissue contacting surface of the circumferential edge / shoulder (105) is smooth.

8. abutment system (200) according to claim 1 or 2, characterized in that the abutment base (102);

a proximal interface surface (109) in the region of the first interface (107), wherein the interface surface (109) is substantially planar and perpendicular to the implant axis (AI),

- A through hole (117) in the region of the scalop surface (104) for securing the Einbringpfostens (130), wherein the through hole (117) extends substantially parallel, preferably coaxially, to the implant axis (AI).

9. abutment system (200) according to claim 1 or 2, characterized in that the abutment base (102) viewed in horizontal section has an elliptical plan view (El) or a round-deltoid plan form (E2, E3, E4).

10. abutment system (200) according to claim 9, characterized in that the ground plan form (El, E2, E3, E4) of the abutment base (102) to the plan view (Ql, Q2, Q3, Q4) of a dental prosthesis implant (100 ) to be replaced incisor (SZ), canine (EZ), or premolar tooth (PM) is adapted.

The abutment system (200) according to one of the preceding claims 1 or 2, characterized in that the first interface (107) for non-rotational placement of the abutment base (102) on the implant element (103) in at least three different indexing positions with respect to the implant axis ( AI) is designed.

12. abutment system (200) according to claim 1 or 2, characterized in that the abutment base (102) in the region of the first interface (107)

a connection post for an internal implant connection (115), or

- Includes a receiving opening for an external implant connection (115).

13. abutment system (200) according to claim 1 or 2, characterized in that the first interface (107) is designed as a hex interface, the placement of the abutment base (102) on the implant element (103) in one of six different indexing positions in Reference to the implant axis (AI) allows.

14. abutment system (200) according to any one of the preceding claims 1 to 9, characterized in that the abutment base (102) is designed for immediate implantation in the mucosal area, wherein the abutment base (102) together with the introduction post (130) are provided sterile packaged.

The abutment system (200) according to any of the preceding claims 1 to 9, characterized in that the abutment base (102) and the placement post (130) are provided interconnected, wherein the delivery head (130) is separable from the abutment base (102) after immediate implantation, and wherein the abutment base (102) remains in the patient.

The abutment system (200) according to one of the preceding claims 1 to 9, characterized in that said skirt portion (111) comprises a microrough portion (128) and a smooth portion (127), a dividing line (129) defining the transition between defined in the microrough section (128) and the smooth section (127) of the soft tissue contact surface, preferably has a scaled, asymmetrical course.

17. Dental implant (100) with an abutment system (200) according to any one of the preceding claims 1 to 9 and with an implant (103), characterized in that the implant (103) comprises a post-shaped portion (101) with external thread, and in that the implant (103) is embodied separately from the abutment base (102), wherein the implant (103) comprises a base body which is designed substantially rotationally symmetrical to the central implant axis (AI) and wherein the abutment base (102) is fastened with it releasably secured Insertion post (130) is provided.

18. Denture implant (100) according to claim 17, characterized in that the implant (103) has a central bore (118) which extends coaxially to the implant axis (AI) and provided with an internal thread for releasably attaching the Einbringpfostens (130) is.

19. Denture implant (100) according to claim 17 or 18, characterized in that in the region of the first interface (107) on the implant (103) and / or on a proximal interface surface (109) of the abutment base (102) has a circumferential chamfer (108) is provided to promote bone attachment and / or soft tissue attachment after implantation.

The dental implant according to claim 17, wherein, viewed from a proximal position to a distal position, the implant has a circumferential reduction in the area of a distal top side in that the abutment base (102) is seated flat on the distal upper side (110) of the implant (103) with its proximal interface surface (109), and that the mantle region (111) of the abutment base (108) is directly or slightly spaced from the peripheral reduction (108). 102) having a concave shape (113, 114) when viewed in vertical section.

A dental implant (100) according to any of the preceding claims 17 or 18 for implanting in a position where the scalloped top (104) of the abutment base (102) is supracrestal and in which the microrough portion (128) and / or or the smoother portion (127) of the cladding region (111) is located in the soft tissue.

22. An implant set comprising at least two abutment bases (102), wherein each abutment base of the (102) implant set has a different planform (El, E2, E3, E4) and / or size and wherein each abutment base (102) has a first interface (107) for placement on an implant (103) and a further interface (126) for securing a placement post (130), the abutment base (102) having a three-dimensional shape that is not symmetrical about the implant axis (Al ) and wherein the implant (103) defines an implant axis (AI), characterized in that

the implant set comprises at least one placement post (130) which can be fastened in the region of an upper side (104) of the abutment bases (102) or which is fastened in the area of the upper side (104) of one of the abutment bases (102),

the insertion post (130) in the attached state extends coaxially with the implant axis (AI),

the top surface (104) of each of the abutment bases (102) has a scaled top surface (104), - And that the abutment base (102) has a cladding region (111), the soft tissue contact surface is designed hydrophilic or ultrahydrophilic.

23. Implant set according to claim 22, characterized in that

the abutment base (102) has a first level (NA) and a different second level (NI) in the interdental side view, and / or

- The shell region (111) viewed in vertical section, a concave shape (113, 114).

24. Implant set according to claim 22, characterized in that the jacket region (111) comprises a microrough section (128) and a smooth section (127), wherein a dividing line (129) which forms the transition between the microrough section (128). and the smooth portion (127) of the soft tissue contacting surface, preferably having a scaled, asymmetrical shape.