FR2977144A1 - Implant for implantation of dental prosthesis in bone structure of completely edentulous jaw of person to be treated, has top part comprising thread coacting with implant bar, where implant possesses diameter ranging between specific values - Google Patents

Abstract

The implant has a bottom part (21) comprising a thread coacting with a bone structure, where diameter of the implant preferably ranges from 2.7 mm to 2.8 mm. A top part (22) has a thread coacting with an implant bar. The thread of the bottom part has teeth of triangular and/or trapezoidal cross section, and the thread of the top part has teeth of square cross section. An intermediate part (23) between the bottom and top parts comprises progressive evolution of the threads from one section to the other section. The bottom and top parts are arranged on a cylindrical rod with constant diameter. An independent claim is also included for a kit for implantation of dental prosthesis.

Description

The present invention relates to an implant for fitting a dental prosthesis and to a dental prosthesis fitting kit.

The treatment of the largely toothless people is delicate, relies today on a complex process and a non optimal tooling. The existing methods have indeed all or some of the following disadvantages - They use implants fixed in the bone structure, also called "bone mass", large diameter, greater than 3 mm, which requires several drilling operations with drills of diameter increasingly important to gradually form an opening in the bone mass of diameter corresponding to screw implants; - They require long and complex interventions, with an interruption to make a prosthesis in the course of intervention; - They offer bulky prostheses, including thick gums, which gives an unattractive and unrealistic result; - They are not adapted to the case of people whose volume of bone mass is greatly reduced.

The object of the invention is therefore to provide an improved solution for the installation of a dental prosthesis, which does not have all or some of the disadvantages mentioned above. More specifically, the invention seeks to achieve the following objects:

A first object of the invention is a solution for the installation of a dental prosthesis allowing the implementation of a simplified and accelerated laying method. A second object of the invention is a solution for laying a dental prosthesis. a dental prosthesis to achieve an attractive aesthetic result with a volume and shape close to reality.

For this purpose, the invention is based on an implant for the fitting of a dental prosthesis, characterized in that it comprises towards its first lower end a first part comprising a first thread intended to cooperate with a bone structure and in that it comprises a second part comprising a second thread for cooperating with an implant bar.

The first and second threads may comprise teeth of different section.

The first thread may comprise triangular and / or trapezoidal section teeth and / or the second thread may comprise square section teeth.

The implant may comprise an intermediate portion between the first and second progressive portions of the section of the teeth, the two threads being arranged in continuity with one another.

The implant may include teeth having micro-threads to form a seal. Its first and second parts are arranged on a cylindrical rod of constant diameter.

The implant may include a conical or pointed portion toward its lower end to facilitate its insertion into the jaw. The first and second threads may have the same thread pitch.

The implant may comprise a diameter of between 2.5 and 3 mm inclusive, or between 2.6 and 2.9 mm inclusive, or between 2.7 and 2.8 mm inclusive.

The implant may be of metal material, and / or titanium or titanium alloy, and / or may comprise vanadium and / or chromium / cobalt.

The second part of the implant intended to pass through the jaw may have a length of between 1 and 5 mm, and / or the first part intended to be in the bone mass may have a length of between 6 and 14 mm inclusive, or between 8 and 12 mm inclusive.

The implant may include a head toward its upper end, forming a stop under its lower surface.

The head of the implant may include a device for attaching a tooth at its upper end. The invention also relates to a kit for fitting a dental prosthesis, characterized in that it comprises a guide, an implant bar and at least one implant as described above.

The guide may comprise openings in which the wells of the implant bar may be housed, in which the at least one implant may be housed.

The dental prosthesis delivery kit may comprise all or part of the following additional components: osteosynthesis screws having a diameter of less than 2 mm, or less than 1.5 mm, or less than or equal to 1.3 mm; and / or - a dental prosthesis.

The invention also relates to a computer medium readable by a management unit, characterized in that it comprises a registered computer program comprising computer program code means for implementing a method of manufacturing an implant such as as previously described.

These objects, features and advantages of the present invention will be set forth in detail in the following description of a particular embodiment made in a non-limiting manner in relation to the appended figures among which: Figures la and lb respectively represent parts jaw to be treated in two particular configurations chosen by way of example.

Figures 2a and 2b respectively show the jaw portions to be treated covered by a guide according to one embodiment of the invention.

Figures 3a and 3b respectively show the jaw portions to be treated after gingival drilling using the guide.

Figures 4a and 4b show the guide and implant bar in assembled configuration.

FIGS. 5a and 5b respectively show in perspective from above the guides used in the two particular configurations according to one embodiment of the invention. FIGS. 6a and 6b respectively show in perspective from above the implant bars used in the two configurations. in one embodiment of the invention.

FIG. 7a shows a step of fixing an implant bar with the aid of osteosynthesis screws.

Figures 8a and 8b respectively show the implant bars after fixation in the two particular configurations. Figures 9a and 9b respectively show the placement of implants through the implant bars in the two particular configurations.

Figure 10b shows the prosthesis fitting in the case of the second envisaged configuration.

FIG. 11 is a side section at the level of an implant of a phase of placement of an implant through an implant bar according to one embodiment of the invention. FIG. 12 is a side section at the level of an implant of an implant positioned within the bone mass of a jaw through an implant bar according to the embodiment of the invention.

FIG. 13 shows in side section at the level of an implant an implant and an osteosynthesis screw positioned within the bone mass of a jaw through an implant bar according to the embodiment of the invention.

Fig. 14 shows an implant according to one embodiment of the invention. The invention is based on a new treatment approach, and an artificial dentition closer to reality, with a very acceptable aesthetic, adapted to easier implantation.

To understand this new approach, the processing implemented and the associated devices will be detailed, from two particular configurations of a jaw part: the first configuration, illustrated by the figures bearing the index a, relates to a jaw and the second configuration, illustrated by the figures bearing the index b, represents a restricted portion of a lower jaw. Naturally, the same principle can be implemented for any part of a jaw, lower and / or higher, involving at least two or at least three implants and at least two or at least three screws osteosynthesis.

On the other hand, the vertical direction and the terms "high" and "low" will be used later in the reference of the teeth, in a direction oriented from the gum to the top of the teeth. Thus, the terms "high" and "upper" refer to the elements oriented towards the top of the teeth and the terms "low" and "lower" the elements oriented towards the gingiva.

FIGS. 1 a and 1 b thus schematically represent respectively a maxillary arch and a portion of the jaw to be treated, having lost their original teeth, comprising a bone mass 1 covered by a gingiva 2.

A first upstream phase of the treatment is based on the preparation of the future dental prosthesis, intended to replace the original teeth by reproducing at best their forms and mechanical characteristics, by a computer treatment based on a medical imaging method. Specifically, a scan of the jaw of the person concerned is performed to obtain an image of the jaw bone and any remaining teeth. Software processing is used to determine the most appropriate locations for implant placement in the jaw bone and dental prosthesis closest to the original dentition, in order to obtain the most accurate result possible and the best possible result. more adapted to the existing framework for a durable maintenance. This computer processing is done by any existing solution, the invention does not relate specifically to this upstream phase.

When this positioning is determined, a preliminary step to the treatment that will be described below consists of the manufacture of an implant bar 10 and a resin guide 3, which form the two basic components for implant placement, and a dental prosthesis 30.

A dental prosthesis installation kit is then formed and transmitted to an operator, comprising a guide, an implant bar and at least one implant. Alternatively, the dental prosthesis installation kit may further comprise all or part of the following components, which will be described in detail later, and which may also be distributed separately: osteosynthesis screws, and / or pillars for attachment to an implant, and / or a dental prosthesis.

The first step of the treatment is to position the resin guide 3 on the gum, as shown in Figures 2a and 2b, and to fix it by locking pins to obtain its maintenance. This guide includes openings 4 provided on its upper surface, which guide a first drilling operation of the gum 2 at the precise locations for the placement of implants and possibly screws osteosynthesis, as will be described later. This first bore performs a gingival cut that stops at the contact with the bone mass 1, so as to make corresponding openings 5 in the gingiva.

A second step consists of a removal of the guide, as can be seen in FIGS. 3a and 3b, and then the integration of the implant bar 10 inside the guide, on the side of its lower face, to form an assembly represented on Figures 4a and 4b. This assembly is then repositioned on the gum 2 on the area to be treated.

The guide 3 used is more precisely shown in perspective from above by Figures 5a and 5b for respectively the two particular configurations envisaged. It comprises a shape that conforms to the upper surface of the jaw, has a substantially semi-circular section, shaped inverted gutter. First circular openings 4 are provided, the diameter of which corresponds precisely to the drilling of the gingiva, as has been explained above, for the future positioning of implants. Second smaller openings 7 are intended for the passage of future osteosynthesis screws. In the first case of Figure 5a, the guide further comprises a slot 6 or groove which extends over the entire length at the central portion of the underside of the guide. This groove 6 is shown in transparency through the upper wall of the guide in certain figures. The guide is preferably resin, optionally comprises titanium tubes.

The implant bar 10 is more particularly illustrated by FIGS. 6a and 6b. It comprises a substantially rectangular or square section, or alternatively a different section, comprising for example rounded, forming an upper surface 13 and a lower surface 14 substantially horizontal, interrupted by cylindrical portions of substantially vertical axis, which we will simply call "Well" 11, for the housing of implants, as will be detailed later. The implant bar 10 further comprises second additional through openings 12, of smaller dimensions than the wells 11, which are similarly oriented substantially vertically, intended to receive retaining osteosynthesis screws, as explained below. The wells 11 comprise a lower portion 15 which extends below the lower surface 14 of the implant bar. Similarly, the openings 12 are extended by extensions 16 under the lower surface 14 of the implant bar. The implant bar finally forms an armature of the dental prosthesis and is preferably made of metallic material, advantageously comprises titanium and / or a titanium alloy.

In the second step of repositioning, the wells 11 of the implant bar 10 are housed in the openings 4 of the guide 3, by the lower face of the guide 3, and their lower extensions 15, as well as the extensions 16 of the openings 12, are housed all or part of the gingival cuts made in the previous step, so as to bear on the bone or to remain above the gum in two embodiments. In addition, the second openings 12 of the implant bar 10 are likewise accessible through the openings 7 of the guide 3. Then, osteosynthesis screws 19 are positioned through the second openings 7 of the guide 3 and the second openings 12 of the guide. the implant bar 10, as shown in Figure 7a. The heads of these osteosynthesis screws 19 bear on the upper surface 13 of the bar and ensure its maintenance in the bone mass 1 of the person treated.

In a third step, the guide 3 is withdrawn in a substantially vertical direction, leaving the implant bar alone in position, as shown in FIGS. 8a and 8b. The implant bar 10 is now permanently fixed in place precisely on the jaw and sufficiently maintained for further processing which consists of the placement of the implants, as shown in Figures 9a and 9b. For this, drilling of the bone mass is performed through the wells 11 of the implant bar 10, and then the fixation of the implants 20 through the wells 11 of the implant bar is implemented. Note that the osteosynthesis screws 19 have the main function of maintaining the implant bar during this step of placing the implants 20. They can be stored or alternatively removed after the end of the operation.

The implants 20 have a greater diameter than the osteosynthesis screws 19 and a longer length, and their function is to ensure the maintenance of the prosthesis and its armature formed by the implant bar, during its daily use during which in particular, it is necessary to mechanically withstand the very large mechanical forces applied during chewing.

Finally, a fourth step consists in fixing the dental prosthesis 30 on the implant bar 10, to achieve the finished result visible for example in Figure 10b. This fixing can be done by a saddle with a suitable cement or screwing, or any other fixing solution.

Figures 11 to 14 illustrate different enlarged and sectional views of details of the components presented above, according to one embodiment. FIG. 11 shows an intermediate phase of placing an implant 20 in the bone mass 1 through a well 11 of the implant bar 10. For this, the well 11 comprises an internal thread 17 compatible with the threading of the implant, which allows its screwing inside the well 11.

Figure 12 shows the implant 20 in the end position. It comprises a first lower portion 21 screwed into the bone mass 1, which will ensure effective maintenance of the entire structure of the dental prosthesis, including a reinforcement over time by osteointegration of the implant. . A second, higher part 22 of the implant 20 comprises a second thread which remains in cooperation with the internal thread 17 of the implant bar in the well 11, the lower end of the lower extension 15 bears on the surface. 1 This second thread of the implant prevents any vertical movement of the implant bar 10, which remains in this same position, even if the bone mass 1 is degraded, for example with its aging. .

Note, in this illustrated embodiment, the implant 20 comprises a head 25 which comprises a lower surface forming a stop 26 bearing on a flat surface 18 arranged in the upper part of the well 11, which forms a corresponding stop. This stop ensures the correct positioning of the implant 20, the screwing must be continued to the stop, and ensures the maintenance of the implant bar 11 and in particular participates in preventing any upward movement. The head 25 of the implant 20 further comprises a hollow cylindrical portion 27 threaded at its upper end, oriented in a vertical direction, provided for fixing by screwing a prosthesis 30, as shown in Figure 13 .

Figure 14 illustrates more specifically an implant 20 used in this embodiment. Its first lower portion 21 comprises a first thread whose teeth have a triangular and / or trapezoidal section. More generally, this first thread may be of any type suitable for optimal compatibility with a bone structure since this first portion 21 is intended for screwing and integration into a bone structure. The second portion 22 of the implant 20, positioned between its head 25 and its first portion 21, comprises a second thread intended to cooperate with the threading of an implant bar 10. In this embodiment, it comprises section teeth. square. Note, an intermediate portion 23 between these two parts 21, 22 of the implant 20 comprises a progressive evolution of the thread from one section to another, and further includes teeth with micro-nets 24 to ensure the sealing of the teeth, useful since this intermediate portion 23 is intended for positioning between the gingiva 2 and the bone mass 1, as can be seen in FIG. 13. Generally, the first and second portions 21, 22 of the implant 20 are arranged on a cylindrical rod of constant diameter, corresponding to the diameter of a well 11 of the implant bar. The implant 20, however, includes a conical or pointed portion towards its lower end to facilitate its positioning in the jaw. Over all this threaded length, the implant 20 has a constant thread pitch since it integrally passes through the same thread of a well 11 of an implant bar 10.

The dimensioning of the implant represents a compromise between a reduced size to form a sufficiently discrete or even invisible reinforcement, compatible with the use of a dental prosthesis having a form close to reality and therefore an acceptable aesthetic, and between a size large enough to withstand the significant mechanical stresses they undergo. In contrast to the solutions adopted by the state of the art, the implant is advantageously chosen with a diameter of less than 3 mm, between 2.5 and 3 mm, and preferably between 2.6 and 2.9 mm, or even between 2.7 and 2.8 mm, these terminals being included. Note, all these diameters are measured in the constant section portion of the first or second parts of the implant. Advantageously, all the implants and all the corresponding wells of the implant bar will respect these ranges of values. The use of these implants, small diameters compared to the state of the art, also simplifies their installation by greatly reducing drilling operations in the bone mass. Indeed, these operations require the progressive use of several drills to reach the final diameter when it is large, which is long and tedious.

On the other hand, the implant may be of metal material, may be titanium or titanium alloy, include vanadium and / or titanium and / or chromium / cobalt, for example be TA6V. Its length is adapted to the relevant jaw configuration. For this, its second portion 22, intended to pass through the jaw 2, will generally have a length of between 1 and 5 mm, while the first portion 21 intended to be in the bone mass 1 will have a length of between 6 and 14 mm , and in general a length of between 8 and 12 mm inclusive, 8, 10 or 12 mm for example.

As a reminder, the osteosynthesis screws 19 fulfill a totally different function of an implant 20, of simple temporary retention during the treatment and the placement of the implants 20. They allow a maintenance that is much less resistant than that of an implant and are not more very useful when the operation is over. This is why they can be removed or left without any consequences on the subsequent use of the dental prosthesis. For this, they have a thread diameter much lower than that of an implant, less than 2 mm, or even less than 1.5 mm or even less than 1.3 mm. In addition, their total length is also less than that of an implant, as can be seen, for example, in FIG. 13.

The implant bar 10 used finally forms a metal frame which provides a connection between all the implants and the dental prosthesis. This implant bar therefore comprises wells 11 oriented in a vertical direction, perpendicular to the upper surface 13 of the implant bar 10, to receive the implants 20, as has been explained, and smaller openings 12, to receive the screws. osteosynthesis 19, in a vertical direction. The diameter of these openings corresponds to the diameters of the implants 20 and screws 19 specified above. Alternatively, the direction of the wells 11 and / or openings 12 is not quite vertical, but remains close to the vertical, has an angle less than or equal to 5 degrees of the vertical direction. This angle is therefore measured relative to the direction perpendicular to the upper surface 13 of the implant bar, which has a square or rectangular section, as has been seen previously, or with respect to the direction perpendicular to a plane tangential to its surface higher if the latter is different, for example rounded. Wells and openings may naturally have different shapes from those shown, not to extend over such a long length, for example.

Claims (16)

1. Implant for the installation of a dental prosthesis, characterized in that it comprises towards its first lower end a first portion (21) comprising a first thread intended to cooperate with a bone structure and in that it comprises a second portion (22) including a second thread for cooperating with an implant bar. 2. Implant according to the preceding claim, characterized in that the first and the second thread comprise teeth of different section. 3. Implant according to the preceding claim, characterized in that the first thread comprises teeth of triangular and / or trapezoidal section and / or in that the second thread comprises teeth of square section. 4. Implant according to one of the preceding claims, characterized in that it comprises an intermediate portion (23) between the first and second portions (21, 22) of progressive evolution of the section of the teeth, the two threads being arranged in continuity of one another. 5. Implant according to one of the preceding claims, characterized in that it comprises teeth having micro-threads (24) to form a seal. 6. Implant according to one of the preceding claims, characterized in that its first and second parts (21, 22) are arranged on a cylindrical rod of constant diameter. 30 7. Implant according to the preceding claim, characterized in that it comprises a conical or pointed portion towards its lower end to facilitate its insertion into the jaw. 8. Implant according to one of the preceding claims, characterized in that its first and second threads have the same thread pitch constant. 9. Implant according to one of the preceding claims, characterized in that it comprises a diameter of between 2.5 and 3 mm inclusive, or between 2.6 and 2.9 mm inclusive, or between 2.7 and 2 , 8 mm included. 10. Implant according to one of the preceding claims, characterized in that it is made of metal material, and / or titanium or titanium alloy, and / or comprises vanadium and / or chromium / cobalt. 11. Implant according to one of the preceding claims, characterized in that the second portion (22) is intended to pass through the jaw and has a length of between 1 and 5 mm, and / or that the first portion 20 (21 ) is intended to be in the bone mass and has a length of between 6 and 14 mm inclusive, or between 8 and 12 mm inclusive. 12. Implant according to one of the preceding claims, characterized in that it comprises a head (25) towards its upper end, forming a stop (26) under its lower surface. 13. Implant according to the preceding claim, characterized in that its head (25) comprises a device for fixing a tooth at its upper end. 30 14. Kit for fitting a dental prosthesis, characterized in that it comprises a guide (3) comprising openings (4) arranged on its upper surface, for guiding a first operation of drilling a gum at the precise locations intended for implant placement, an implant bar (10) and at least one implant (20) according to one of the preceding claims. 15. Kit for fitting a dental prosthesis according to the preceding claim, characterized in that the guide (3) comprises openings (4) in which can be housed the wells (11) of the implant bar, in which can lodge the at least one implant (20). 16. Kit for fitting a dental prosthesis according to claim 14 or 15, characterized in that it comprises all or part of the following additional components: - osteosynthesis screws (19) with a diameter of less than 2 mm, or less at 1.5 mm, or less than or equal to 1.3 mm; and / or - a dental prosthesis (30). 25