JP2015109889A - Drill with guide, kit of drill with guide, and method of osteotomy for dental implantation using kit - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a drill with a guide for osteotomy for dental implantation.SOLUTION: A drill 100 with a guide comprises: a shaft part 104 which is constituted so as to be releasably and mechanically associated with a contra-angle hand piece; a guide part 110 having an external surface which is geometrically enclosed into a cylinder having a radius R1 so that the external surface coincides with the cylinder along at least one of area zones of the external surface; a stopper 120 arranged between the shaft part and the guide part; and a blade part 130 which is constituted so as to perform drilling at a diameter smaller than 2×R1. The shaft part, the stopper, the guide part and the blade part are integrally formed of hard alloys, and make the drill with the guide reusable. Furthermore, there is provided a kit for an operation having a series of the drills with the guides, a container for accommodating the series of the drills with the guides in a row form, and a chart having an alignment map and a graphic display.

Description

  In some embodiments, the present disclosure relates to dental osteotomy, and more specifically, but is not limited to, a guided drill for insertion of a dental implant and a guided drilling. Not a thing

  Guided osteotomy has become a preferred option for dental implant insertion. According to some techniques of guided osteotomy (sometimes referred to as guided implant surgery), sometimes into the patient's jaw during a procedure or set of procedures that precedes the procedure for several days to several weeks. Suitable sites for implant insertion are selected and the progress of the surgery is planned in advance. As illustrated in more detail herein below, following completion of the surgical plan, means are provided to the surgeon to guide the surgical action to the desired surgical site with high accuracy.

  An exemplary method for planning a guided implant procedure is depicted in FIGS. 1A-1G. FIG. 1A schematically shows a mandible 10 of a patient in need of two dental implants in the implant region 12. A jaw impression can be taken and a physical model of the jaw made of plastic or gypsum, for example, is created using any suitable technique known in the art. Also, by scanning the 3D physical model of the jaw using a computerized image acquisition device, such as a CCD camera and appropriate virtual model building software, a 3D virtual model of the jaw is acquired and stored in the computer. The

  Appropriate radiographic techniques such as X-ray computed tomography (CT), especially cone beam CT (CBCT), can be used to acquire 3D images of bone and tissue around the jaw, especially the implant area. A qualified person, such as a clinician, such as a dentist, then plans and selects an osteotomy site for the implant. According to some techniques, a dental clinician may use dedicated software for viewing 3D images of bone and tissue and for virtually inserting an implant into the bone on the 3D image. FIG. 1B schematically shows a part of a 3DX-ray image acquired using CBCT of the implant region 12 according to a sagittal view. An implant region is identified between the remaining tooth 14 and the remaining tooth 16. Two implant virtual implant representations 18 and 20 are placed on the image, and the clinician can move the position of each implant representation on the image to select the preferred position and orientation of the implant within the bone. It is possible to adjust the orientation. FIG. 1C schematically shows a front view of the implant region and shows the placement of the implant display 20 relative to the jawbone 22 and in particular relative to the mandibular nerve 24. In addition to selecting the preferred placement-position and orientation of the implant, the clinician selects the preferred combination of implant length and diameter to best fit the anatomical features of the jaw and implant area. sell. After an appropriate implant having the desired length and diameter combination is selected, a drilling program including a drilling sequence can be planned. Such drilling programs can often depend on the patient's additional anatomical data, such as bone density and / or bone hardness. It should be noted that some of these anatomical data may not be known completely or sufficiently accurately before the surgery actually begins.

  FIG. 1D schematically shows an implant display 18 and an implant display 20 on an X-ray image in an axial image. FIG. 1E schematically shows virtual images of dentures 28 and 30 virtually placed on the jaw image along with the placement of implant displays 18 and 20, respectively.

  According to some techniques, guiding a surgeon to precisely drill a hole at a planned site includes a guide sleeve having a cylindrical hollow shape fixedly positioned relative to the osteotomy site. To achieve. The drill passes through a guide sleeve that is positioned and oriented to precisely drill a hole at the planned osteotomy site. According to some embodiments, the fixed placement of the guide sleeve relative to the osteotomy site can be done using a personalized surgical template, as described below.

  This surgical template can be designed by examining a 3D virtual model of the patient's jaw and teeth using dedicated design software. FIG. 1F schematically shows a 3D virtual model of the surgical template 40 virtually attached to the 3D virtual model of the patient's lower jaw. The surgical template shown schematically in FIG. 1G can be manufactured from a robust material such as a rigid polymer, for example by 3D printing, or from a metal such as titanium using other techniques such as electron beam melting. Can be manufactured. The surgical template is configured to be mechanically secured to the patient's teeth during osteotomy. According to some embodiments, the surgical template is applied to the patient's teeth so that the teeth are firmly captured when attached to the teeth in a predefined mutual orientation between the teeth and the surgical template. Can be mechanically compatible. Additionally or alternatively, the surgical template can be mechanically fitted and attached to the patient's gingiva or to a temporary implant already installed in the jaw, or surgery The working template can be mechanically adapted and attached to another organ or body part that has a certain (substantially fixed) spatial relationship with the osteotomy site.

  Surgical template 40 includes two housings 42 and 44, respectively, each housing a guide sleeve (not shown in this view) typically made of titanium. During osteotomy, the surgical template is properly attached to the patient's teeth in a pre-planned mutual orientation between the teeth and the surgical template to capture the teeth securely. When the surgical template is thus attached to the teeth, each of the guide sleeves in the housings 42 and 44 is configured to guide the drill toward the respective osteotomy site.

  According to several techniques used during osteotomy, providing a suitable hole in the jawbone for inserting a dental implant therein is accomplished in multiple steps using multiple different drills. The An adaptive ring or cylinder would be used to allow different drills, generally having different diameters, to be properly guided through the same guide sleeve. According to some known techniques, a hollow cylinder having an outer diameter adapted to be inserted into a guide sleeve and an inner diameter adapted to receive a drill for drilling in one end. A drill guide key, such as a drill adapter or drill spoon, with a handle on the part is used. In use, this handle is held by the surgeon or assistant while the drilling is taking place. According to other known techniques, during drilling, the adaptive ring is mounted on the drill prior to drilling so that the adaptive ring is positioned between the rotating drill and the guide sleeve.

  It should be noted that these known techniques described above are not optimal for one or more reasons. The use of an adaptive component such as an adaptive ring to compensate for the discrepancy between the guide sleeve diameter and the drill diameter introduces additional tolerances and therefore rotates slidably within the guide sleeve without the adaptive ring. Uncertainty is increased compared to drilling configured to do so. Furthermore, the use of adaptive components such as drill guide keys or adaptive rings makes perforation surgery more complicated, more cumbersome and more time consuming. Also, the need to hold the drill guide key during drilling requires additional personnel for assistance in addition to the surgeon during the surgery, which further complicates the surgery.

  Thus, according to one aspect of some embodiments, a guided drill for osteotomy for a dental implant is provided that is configured to drill a hole by rotating about a rotation axis. The guided drill includes a shank configured to be releasably mechanically associated with the contra-angle handpiece, the contra-angle handpiece configured to rotate the guided drill about an axis of rotation. Composed. The guided drill includes a guide portion having an outer surface geometrically confined by a cylinder having a radius R1, such that the outer surface coincides with the cylinder along at least one of its area sections. Is further provided. Accordingly, the guided drill is configured to be slidably rotated inside a guide sleeve having a hollow cylindrical shape having an inner radius R2 larger than R1, and the guided drill moves substantially parallel to the rotation axis. The rotation axis coincides with the axis of symmetry of the guide sleeve so that it is forced to do so. The drill with guide further includes a stopper disposed between the shaft portion and the guide portion, which extends in the radial direction from the rotation shaft at a distance longer than R1. This drill with guide is a blade part configured to drill with a diameter smaller than 2 × R1, and is arranged adjacent to the guide part so that the guide part exists between the blade part and the stopper. And a blade portion. The shaft portion, the stopper, the guide portion, and the blade portion are all integrally formed from a hard alloy. In some embodiments, the blade portion comprises a straight cut at least three-blade cutting edge or a spiral cut at least two-blade cutting edge, and the cutting edge is provided with a relief to reuse the guided drill. Be possible.

  According to one aspect of some embodiments, an osteotomy set is provided. The osteotomy set includes a guided drill as described above and a surgical template configured to mechanically fit the individual designated patient's maxillary or mandibular teeth. This surgical template is capable of grasping a tooth firmly when attached to a patient's tooth in a predefined mutual orientation between the tooth and the surgical template, so that Fixed. The surgical template is a guide sleeve having a hollow cylindrical shape with an inner radius R2, through which a guided drill passes through the patient's jaw when the surgical template is properly attached to the patient's teeth. A guide sleeve oriented to allow movement toward the internal osteotomy site. Therefore, this guide sleeve guides a rotating guided drill having a guide portion confined within a radius R1 smaller than R2 toward the osteotomy site.

  The procedure as described above for guided osteotomy for drilling a hole for insertion of a dental implant is in principle “drilling diameter of xx mm and drilling of yymm to drill a hole for a dental implant. Can be formulated as a pre-determined recipe for surgery, such as “use a guided drill with length” (in accordance with some techniques, the last drill in the series has the desired predetermined dimensions). Several guided drills can be used in succession until a hole is obtained). However, in practice, such predetermined recipes for performing osteotomy can be inconvenient and even harmful, due to characteristics that are unknown at the planning stage of the surgery. sell. Such characteristics can be, for example, patient anatomical data that is not revealed at the preparation stage—data that is not evident by, for example, X-ray images, but is only revealed by the surgeon during surgery. For example, as a hypothetical example, a pre-planned program of surgery may include a 3.2 mm diameter drill to insert a 3.3 mm diameter implant. During the operation, the surgeon can reveal that the patient's bone is a soft bone rather than a hard bone, so that the surgeon can insert a 3.3 mm diameter implant, It may be decided that a 2.4 mm hole should be drilled in soft bone. In a different hypothetical example, the surgeon determines that the planned hole depth is not sufficient to support the implant during the osteotomy and determines the depth, for example (with available drills) It can be determined that an increase of 1.5 mm or 2 mm is safe for the jaw and patient and also beneficial for the life of the implant.

  According to an aspect of some embodiments, the series of guided drills described above, wherein the guide portions of all the guided drills in the series are geometrically confined in the same cylinder having the same radius R1. A series of guided drills is provided. Each of the guided drills in this series provides a different drilling diameter and drilling length than the combination of drilling diameter and drilling length provided by another guided drill in this series. Thereby, this series can be used by users of a series of book-guided drills, such as maxillofacial surgeons, with the drill diameter and perforation length determined by the maxillofacial surgeon during osteotomy using the book series. It is configured to be able to perform part of the osteotomy for the implant. Using a guided drill from a series of guided drills, all having a guide portion with the same radius, allows the user to guide the osteotomy site while all the guided drills are guided by the same guide sleeve. Since one guided drill can be exchanged quickly and efficiently for the next guided drill, surgery is greatly facilitated for the user of this guided drill. An adaptation element such as an adaptation ring is not required, an adjustable device or adjustable part to be adjusted is not required, and an assistant for holding the adaptive device such as a drill guide key is not required.

  According to some embodiments, an osteotomy set is provided that includes the surgical template described above and a series of guided drills according to the teachings herein.

  According to one aspect of some embodiments, a surgical kit is provided that comprises the series of guided drills described above. The surgical kit further includes a container configured to accommodate at least a series of the guided drills. The container has an open state in which the series of guided drills is visible and usable for the user. In this open state, the series of guided drills is arranged according to at least one of the drilling diameter and drilling length of each of the guided drills. Next to each guided drill with an individual drill diameter and individual drill length in this arrangement is another guided drill with the next drill diameter or the next drill length in this series of guided drills. Is placed. The surgical kit further includes a chart having a map of the sequence and a graphic display. This graphic display is a continuous series of sub-series of this series of guided drills to perform part of osteotomy and thereby obtain a hole with a predetermined diameter and length for a dental implant The recommended sequence for proper use is configured to show the user of the surgical kit.

According to an aspect of some embodiments, there is further provided an osteotomy method for a dental implant. This method
(A) providing the above-described surgical kit;
(B) following the chart of the osteotomy kit, selecting the first guided drill and making an initial drill in the osteotomy site in the patient's jawbone;
(C) following the surgical kit chart, selecting the next guided drill and performing the next perforation in the patient's jawbone;
(D) repeating step (c) as many times as desired by the user of the surgical kit;
Can be included.

  This first guided drill can be used as a guide drill. “First guided drill”, “guided drill”, and “starter guided drill” may be used interchangeably herein.

According to some embodiments, the method comprises:
A surgical template substantially as herein described is adapted to fit and attach to a patient's teeth and whose guide sleeve is oriented to guide the guided drill toward the osteotomy site. Providing steps;
During drilling in steps (b) and (c), the guide portion of the guided drill is slidably rotated within the guide sleeve, thereby guiding the drilling to a predetermined drilling depth at the osteotomy site. Passing the guided drill through the guide sleeve of the surgical template to guide the guided drill;
May further be included.

  According to some embodiments, the method comprises the steps of collecting patient anatomical data following step (b) and selecting the next guided drill in step (c). Reviewing anatomical data.

  According to some embodiments, the anatomical data may include bone hardness and / or bone density.

  Provided herein individually are guided drills that can be used in guided osteotomy for dental implants.

  Herein, a guided drill that can be used in guided osteotomy for dental implants is provided separately with a surgical template having a suitable guide sleeve.

  There is provided separately herein a reusable guided drill that can be used to repeatedly perform guided osteotomy for dental implants.

  In this specification, a user of a series of guided drills uses this series to perform osteotomy for dental implants with a drilling diameter and drilling length determined by the user during osteotomy. One or more series of reusable guided drills that can be provided are provided separately.

  In the present description, an array of guided drills is provided that can facilitate osteotomy and improve the efficiency of performing osteotomy.

  Used herein to indicate to the user the recommended sequence for continuous use of a guided drill from an array to obtain a hole having a predetermined diameter and length for a dental implant Possible charts containing a map of the sequences are provided separately.

  Particular embodiments of the present disclosure may include some, all, or none of the advantages described above. One or more other technical advantages will be readily apparent to one skilled in the art from the figures, descriptions, and claims included herein. Furthermore, while certain advantages have been enumerated so far, various embodiments may include some, all, or none of the enumerated advantages.

  Unless defined otherwise, technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the areas relevant to the present invention. In case of conflict, the patent specification, including definitions, will control.

  As used herein, the terms “comprising”, “including”, “having”, and grammatical variations thereof, are used to identify a feature, integer, step, or component presented. This does not exclude the addition of one or more additional features, integers, steps, components, or groups thereof. These terms include the words “consisting of” and “consisting essentially of”.

  In this specification, the indefinite articles “a” and “an” are used to mean “at least one” or “one or more” unless the context clearly indicates another.

  In the present specification, some embodiments of the present invention will be described with reference to the accompanying drawings. This description, together with the drawings, will make apparent to those skilled in the art how some embodiments of the present invention can be implemented. The drawings are for illustrative purposes only and are not intended to illustrate the structural details of the embodiments in more detail than is necessary for a basic understanding of the present invention. For the purpose of clarity, some of the objects depicted in the drawings are not proportional to the actual size.

FIG. 1A schematically illustrates the lower jaw of a patient who requires two dental implants in the implant area. FIG. 1B is a diagram schematically showing, in sagittal view, a portion of a 3DX ray image including the implant region of FIG. 1A and two virtual implant displays arranged thereon. FIG. 1C is a diagram schematically showing a part of a 3DX ray image including the implant region of FIG. 1A and a virtual implant display arranged thereon in a front view. FIG. 1D is a diagram schematically showing an axial image of a part of a 3DX ray image including the implant region of FIG. 1A and two virtual implants arranged there. FIG. 1E is a diagram schematically showing a virtual image of a denture virtually arranged on the image of the jaw of FIG. 1A together with the arrangement of the implant display of FIGS. 1B to 1D. FIG. 1F is a diagram schematically illustrating the 3D virtual model of the surgical template virtually attached to the 3D virtual model of the lower jaw of FIG. 1A. FIG. 1G schematically shows the surgical template of FIG. 1F. FIG. 2A schematically illustrates one embodiment of a guided drill according to the teachings herein. FIG. 2B is a perspective view schematically showing the guided drill of FIG. 2A passing through the guide sleeve. 2C is an enlarged view schematically showing the guided drill and guide sleeve of FIG. 2B. FIG. 2D schematically shows a portion of the guided drill of FIG. 2A including the drill tip. FIG. 2E schematically shows the guided drill of FIG. 2A from the “viewpoint F” defined in FIG. 2D, representing the drill tip and its relief in detail. FIG. 2F is a cross-sectional view schematically showing the guided drill of FIG. 2A showing the inclination angle of the relief. FIG. 2G is a perspective view schematically illustrating one embodiment of a guided drill according to an aspect of some embodiments passing through a guide sleeve. FIG. 2H is a front view schematically showing the guided drill and guide sleeve of FIG. 2G. FIG. 2I is an enlarged sectional view schematically showing the guided drill and guide sleeve of FIG. 2G. FIG. 2J is a diagram schematically illustrating a portion of the guided drill of FIG. 2G including the drill tip. FIG. 2K schematically illustrates the guided drill of FIG. 2G from “viewpoint F” defined in FIG. 2J, which details the drill tip and its relief. FIG. 2L is a cross-sectional view schematically showing the guided drill of FIG. 2G showing the inclination angle of the relief. FIG. 3A is a perspective view schematically illustrating one embodiment of a surgical template according to one aspect of the present invention. FIG. 3B is a plan view schematically showing the surgical template of FIG. 3A. FIG. 3C is an exploded view schematically showing the surgical template of FIG. 3A. It is a figure which shows typically a series of guided drills, such as the drill with a guide of FIG. 2A. FIG. 5A is a perspective view schematically illustrating one embodiment of a surgical kit comprising an array of guided drills and a chart to assist in drilling in the patient's jawbone. FIG. 5B is a plan view schematically showing the arrangement of FIG. 5A. FIG. 5C is a diagram schematically illustrating the chart of FIG. 5A. It is a figure which shows typically one Embodiment of the method for implementing a part of osteotomy using the kit of FIG. 5A.

  The principles, applications, and implementations of the teachings herein can be better understood with reference to the following detailed description and drawings. Upon careful reading of the detailed description and drawings presented herein, one of ordinary skill in the art will be able to practice the invention without undue effort or experimentation. In the drawings, like reference numerals refer to like parts throughout.

  Before describing at least one embodiment in detail, it is understood that the present invention is not necessarily limited in its application to the structure and arrangement of components and / or methods set forth herein. Should. The invention is capable of other embodiments and of being practiced or carried out in various ways. The terminology and terminology used herein are for the purpose of description and are not to be considered limiting.

  FIG. 2A schematically illustrates one embodiment of a guided drill 100 configured to perform drilling by rotating around a rotating shaft 102 for performing osteotomy for insertion of a dental implant. Shown in The guided drill includes a shank 104 configured to be releasably mechanically associated with a contra-angle handpiece (not shown), the contra-angle handpiece being guided around the axis of rotation 102. The drill is configured to rotate. The shank typically has an elongated cylindrical shape that extends along the axis of rotation and has an annular recess 106 and a planar recess 108, the annular recess 106 and the planar recess 108, respectively. It is configured to allow proper gripping of the guided drill by the angle handpiece and to allow the contra-angle handpiece to rotate the guided drill.

  Guided drill 100 further includes a guide portion 110 having an outer surface 112 that is geometrically confined to a cylinder having a diameter D1, the outer surface coinciding with the cylinder along at least one area section 114. Thus, while the rotating shaft 102 coincides with the axis of symmetry of the guide sleeve, the guided drill is slidable inside a guide sleeve (not shown) having a hollow cylindrical shape having an inner diameter D2 larger than D1. Configured to rotate. Thus, when the guided drill rotates slidably within the guide sleeve, the guided drill is forced to move substantially along the axis of rotation.

  The guided drill 100 further includes a stopper 120 disposed between the shaft portion 104 and the guide portion 110. This stopper extends radially from the rotating shaft 102 by a distance d, where d is greater than R1.

  The guided drill 100 further includes a blade portion 130 configured to drill with a diameter D smaller than 2 × R1. The blade portion is disposed adjacent to the guide portion such that the guide portion 110 is placed between the blade portion 130 and the stopper 120. The blade portion includes four straight-cut cutting edges 132a to 132d that are inclined obliquely with respect to the rotation axis, thereby being configured for conical drilling. The cutting edge 132a and the cutting edge 132b are arranged to face each other and extend to the drill tip 134 along the rotation axis. The cutting edge 132c and the cutting edge 132d are arranged opposite to each other and at a flat angle with respect to the cutting edge 132a and the cutting edge 132b. The cutting edge 132c and the cutting edge 132d are shorter than the cutting edge 132a and the cutting edge 132b, and thus extend to a distance from the drill tip 134. The blade portion 130 further comprises a relief 136 adjacent to the cutting edge 132 and the drill tip 134 to improve the quality of the drill and to improve the durability and life of the guided drill.

  The shaft portion 104, the stopper 120, the guide portion 110, and the blade portion 130 are all integrally formed from a hard alloy such as stainless steel, titanium, or an alloy thereof. The hard alloy forming the four cutting edges 132a to 132d, the relief 136, and the blade portion 130 makes the drill 100 with a guide reusable. According to some embodiments, the guided drill 100 is configured for 10 or more drills in the jawbone where each drill is performed during osteotomy. According to some embodiments, the guided drill 100 is configured for 20 or more drills in the jawbone. According to some embodiments, the guided drill 100 is also configured for 30 or more drills in the jawbone.

  FIG. 2B schematically shows the guided drill 100 passing through the guide sleeve 204 in a perspective view. As described further below, the guide sleeve 204 is configured to guide the guided drill 100 along its axis of symmetry while the guided drill 100 rotates and drills. FIG. 2C schematically shows the guided drill 100 and the guide sleeve 204 in an enlarged view of the circled portion in FIG. 2B.

  FIG. 2D schematically illustrates a portion of a guided drill 100 that includes a drill tip 134 and a relief 136 (not shown in this view). FIG. 2E schematically shows the guided drill 100 from “viewpoint F” defined in FIG. 2D, which shows the drill tip 134 and the relief 136 in detail. FIG. 2F is a diagram schematically showing a cross section AA defined in FIG. 2D, and the relief 136 is shown in detail in a cross sectional view. In some embodiments, the relief 136 in the guided drill 100 is inclined at an angle of approximately 10 degrees with respect to the drill tip 134.

  FIG. 2G schematically illustrates, in perspective view, a guided drill 150 that passes through the guide sleeve 204 described above, according to an aspect of some embodiments. The guided drill 150 includes a blade portion 160 having two spiral-cut cutting edges 162 (instead of the blade portion 130 in the guided drill 100 having four straight-cut cutting edges 132). Different. The blade portion 160 includes a drill tip 164 and a relief 166 known in the art adjacent to the cutting edge 162 and the drill tip 164 to improve the quality of the drill and improve the durability and life of the guided drill. 168.

  FIG. 2H schematically shows the guided drill 150 and the guide sleeve 204 in a front view. FIG. 2I schematically shows the guided drill 150 and the guide sleeve 204 in an enlarged cross-sectional view of the circled portion in FIG. 2H.

  FIG. 2J schematically illustrates a portion of a guided drill 150 with a drill tip 164 and reliefs 166 and 168 (not shown in this view). FIG. 2K schematically shows the guided drill 150 from “viewpoint F” defined in FIG. 2J, which shows the drill tip 164 and reliefs 166 and 168 in detail. FIG. 2L is a diagram schematically showing a cross section AA defined in FIG. In some embodiments, the relief 166 in the guided drill 150 is inclined at an angle α of approximately 15 degrees relative to the drill tip 164 and the relief 168 is an angle β of approximately 30 degrees relative to the drill tip 164. It is inclined at.

  3A-3C schematically illustrate one embodiment of a surgical template 200 according to one aspect of the present invention in perspective, plan, and exploded views, respectively. The surgical template is configured to mechanically fit the individual patient's maxillary or mandibular teeth, as substantially described hereinabove in connection with the surgical template 40. When the surgical template is attached to the patient's teeth in a pre-defined mutual orientation between the tooth and the surgical template, the surgical template grasps the teeth and is substantially fixed to the teeth. The As described herein, surgical template 200 includes cylindrical housings 202a-202c configured to receive a guide sleeve therein. The surgical template 200 further comprises guide sleeves 204a-204c made of a hard metal such as stainless steel or titanium, which guide sleeves 204a-204c are respectively inside the cylindrical housings 202a-202c, for example by gluing. Attached to surgical template. The guide sleeves 204 are formed as hollow cylinders, all having the same inner radius R2, which is greater than the radius R1 of the guide portion 110 of the guided drill 100, so that the blade portion therethrough 130 and the guide part 100 can be moved. However, the constant inner radius R2 of the guide sleeve 204 is smaller than the distance d with respect to the stopper 120 of the guided drill so that the stopper 120 does not pass through the guide sleeve. According to some embodiments, R2 may be about 0.01 mm to about 0.1 mm larger than R1. According to some embodiments, R2 may be greater than R1 by about 0.02 mm to about 0.08 mm. According to some embodiments, R2 may be about 0.03 mm to about 0.06 mm larger than R1. According to some embodiments, a guide portion of a guided drill such as the guided drill 100 rotates slidably within the guide sleeve 204 while substantially aligning the rotational axis 102 and the symmetry axis of the guide sleeve. R2 may be larger than R1 so that the guide drill is forced to move substantially parallel to the axis of rotation.

  The cylindrical housing 202, and thus the guide sleeve 204, is positioned so that the surgical template is attached to the patient's teeth and the guided drill passing therethrough is directed to the osteotomy site in the patient's jaw, Placed and oriented. A guided drill that is rotated by a contra-angle handpiece during osteotomy is such that the guide portion of the guided drill is substantially within the guide sleeve and slidably rotates therein. Pass through one of them. Drilling is performed by the guided drill being advanced through the guide sleeve into the bone while the guide sleeve guides the guided drill in a predefined orientation. According to some embodiments, the distance d for the stopper of the guided drill is greater than R2. Accordingly, advancement of the guided drill into the bone during drilling is performed until the stopper of the guided drill contacts the guide sleeve. The cylindrical housing 202, and thus the guide sleeve 204, allows the guided drill passing therethrough to drill to a predetermined depth in the jawbone when the surgical template is attached to the patient's teeth. Positioned, positioned and oriented, the depth of the hole depends on the position of the guide sleeve relative to the osteotomy site and on the length of the guided drill, in particular between the stopper of the guided drill and the drill tip. It is set by the distance.

  FIG. 4 schematically illustrates a series of guided drills 400a, 400b, and 400c as previously described in FIG. 2A. Series 400a includes guided drills 402a-402e, all of which have the same drilling diameter (e.g. suitable for implants with a diameter of 3.75 mm), each of a series of guided drills 402a-402e being 6 mm, 8 mm It has a perforation length of 10 mm, 11.5 mm, and 13 mm. Similarly, series 400b includes guided drills 404a-404e, all of which have the same drilling diameter (eg, suitable for 5 mm diameter implants), similar to the drilling length of each of series 4001a guided drills. Each of the series of guided drills 404a-404e has a drilling length of 6 mm, 8 mm, 10 mm, 11.5 mm, and 13 mm. Series 400c comprises guided drills 402a and 404a, which have the same 6 mm drilling length and continuous drilling diameter, which are suitable, for example, for a 3.5 mm diameter implant and a 5 mm diameter implant, respectively.

  All guided drills in the series 400a, 400b, 400c have the same radius R1 associated with the guide portion. Thus, a series of guided drills, such as series 400a-400c, can be used by a user of a series of this guided drill, such as a maxillofacial surgeon, to guide guided osteotomy for dental implants. At least a part of the operation can be efficiently performed using the above-described guide sleeve. According to some exemplary embodiments, a surgeon in charge of drilling for a 3.5 mm diameter implant during surgery may use a guided drill 402a, thereby providing a length of about 6 mm. Can be perforated. The surgeon can then use the next guided drill 402b having the same drilling diameter and length of 8 mm as the previous guided drill 402a, thereby correspondingly increasing the depth of the drilling. . In the next step, the surgeon may continue further and a further next guided drill such as guided drill 402c may be used to further increase the drilling depth to about 10 mm.

  Additionally or alternatively, the surgeon may use the series 400c during osteotomy, and following the use of the guided drill 402a described above, the next guided drill in this series, i.e. A guided drill 404a may be used, thereby increasing the diameter of the drilling. Since all guided drill radii R1 in this series are the same, the surgeon can replace the first guided drill in the contra-angle handpiece with the next guided drill in the series, Osteotomy through the same guide sleeve without the need to replace additional parts or components, or to change or adjust adjustable parts, or to be assisted by an assistant for perforation surgery Note that it is possible to continue. In addition, the surgeon may select a drilling sequence, including a series of guided drills, each having a different combination of drilling diameter and drilling length, during the osteotomy, For this reason, the guided drill in the series can be used continuously. These particular perforation sequences and associated osteotomy are selected according to data collected during the osteotomy, such as patient anatomical data, for example, as further described and detailed herein. sell.

  FIG. 5A schematically illustrates a surgical kit 500 for assisting in drilling into a patient's jawbone. The kit includes a container 510 having a cover 512 that covers the contents of the container when in the closed state (not shown in this figure), while in the open state. As shown in FIG. 5, it is configured so that the user can visually recognize and use the contents.

  The kit 500 further comprises a series of guided drills as described above, each guided drill in the series having a unique combination of drill diameter and drill length. This series of guided drills is placed in a container in the form of an array 520. FIG. 5B schematically shows the array 520 in plan view. Next to each guided drill in an array with individual drill diameters and individual drill lengths is lined with another guided drill with the next drill diameter or the next drill length in the series of guided drills. . In this specification, “next” means the next value when the series is arranged in descending or ascending order.

  For example, the series 530 includes guided drills 532a-532d, all having the same 6 mm drill length and a drill diameter in the range of 2.2 mm (3.2 mm) to 4.1 mm (4.9 mm). Note that these guided drills are conical and thus have a non-constant drilling diameter. For example, the guided drill 532a has a drilling diameter of 2.2 mm near the drill tip of the blade section (and a drilling diameter of 3.2 mm near the guide section). The next guided drill in this series, the guided drill 532b, has the next 2.8 mm drill diameter near the drill tip of the blade section (and a 3.6 mm drill diameter near the guide section). Series 540 includes guided drills 542b-542e, all having the same 8mm drill length and a drill diameter in the range of 2.2mm (3.2mm) to 4.1mm (4.9mm). For example, the guided drill 542d has a drill diameter of 3.3 mm near the drill tip of the blade section (and a drill diameter of 4.1 mm near the guide section). The next guided drill in this series, the guided drill 542e, has the next 4.1 mm drill diameter near the drill tip of the blade section (and a 4.9 mm drill diameter near the guide section). In addition to the guided drills in the array 520, the kit 500 may include additional drills such as a tissue drill drill 522, a bone cutting drill 524, and a starting guided drill 526.

  The kit 500 further comprises a chart 580 schematically shown in FIG. 5C, which comprises a map 582 of an array 520 and further comprises a graphical display as described further below. This graphic representation is for continuous use of a series or subseries of guided drills to perform part of the osteotomy and obtain a hole with a predetermined diameter and length for a dental implant. Configured to show the recommended order to the user.

  The chart 580 includes length indications 582a-582e, each placed next to the series 530-570. Each length display indicates the drilling length of the guided drill in each series. For example, the length indication 582a of 6 mm indicates that the drilling length of the guided drill in the series 530 is 6 mm. The 8 mm display 582b indicates that the drilled length of the guided drill in series 540 is 8 mm.

  Next to the series 530 are diameter indications 584a-584d, and next to each of the diameter indications 584b-584d is an implant symbol. The chart further comprises a note 590 with “hard bone” written next to the diameter indications 584a-584d. Accordingly, the diameter indications 584a-584d indicate to the user which guided drill should be used to insert an implant having a particular diameter in hard bone. Similarly, next to the series 570 are diameter designations 586a-586d, and next to each of the diameter designations 586b-586d is an implant symbol. The chart further comprises a note 592 labeled “soft bone” next to the diameter indications 586a-586d. Thus, the diameter indications 586a-586d indicate to the user which guided drill should be used to insert an implant having a particular diameter in soft bone.

  Chart 580 further comprises dashed lines 596a-596d indicating a series of guided drills having the same drill diameter (and continuous drill length) to the user. The chart further comprises diameter indications 588a-588d disposed between series 550 and series 560. Diameter indications 588a-588d show along the individual dashed lines 596 the actual drilling diameter of the guided drill in a series of guided drills.

  According to an aspect of some embodiments, a method for performing a portion of osteotomy using a kit 500 is provided, as schematically illustrated in FIG. All perforations described herein are performed using a surgical template having a guide sleeve. The guide sleeve is used to guide the guided drill to the bone cutting site and to determine the depth of the hole drilled in the bone, as previously described and detailed.

  Preliminary steps that may precede the methods disclosed herein include gingival drilling using a tissue drilling drill 522 to expose the bone at the osteotomy site and preparing the exposed bone for drilling. Bone cutting using a bone cutting drill 524. Following step 610 of providing the kit for osteotomy disclosed herein, step 620 may include the use of a starting guided drill 526 to perform preliminary drilling in the bone. The starting guided drill 526 has a relatively short drilling length of about 6 mm and a cylindrical drilling cross section with a diameter of about 2.4 mm. The initial drilling in the bone using the starting guided drill 526 provides a preliminary hole in the bone. The spare hole can optionally be drilled and / or expanded in subsequent steps of osteotomy using other guided drills in the kit. Initial drilling in the bone using the starting guided drill 526 may further provide the user with patient anatomical data in the jaw and bone. Such anatomical data can include, for example, bone hardness, which can be understood by the surgeon during drilling of the preliminary hole. As mentioned above, bone hardness data can have a significant impact on the diameter of the hole drilled for a predefined implant. In general, implants having a specific diameter require a narrower hole in soft bone compared to a hole in hard bone. In addition, valid and accurate data regarding bone hardness, particularly at accurate bone cutting sites, may not be obtained from X-ray images. Thus, the decision of the surgeon's impression during surgery and the use of a particular drill (which may be different from a pre-planned drill) may thus be important for successful surgery. . Other data collected during pre-drilling can be obtained using images taken with an x-ray machine to examine the actual location of the hole drilled in the bone, or using another technique after pre-drilling. It may include captured images. Such images or other data can be considered to determine the preferred depth of the hole, which leads to the selection of the preferred guided drill to be used next.

  Following step 620, the method may include a step 630 of selecting the next guided drill according to the surgical kit chart and making the next drill in the patient's jawbone. In some embodiments, step 630 may be preceded by collecting patient anatomical data and reviewing the anatomical data to select the next guided drill. According to some embodiments, this anatomical data may include data on bone hardness, eg, collected during the pre-drilling described above.

  Following step 630, the method may include step 640 of repeating step 630, with the next to be used for each implementation of step 630 until a hole having the desired depth and diameter is obtained. The guided drill is selected.

  For example, according to some embodiments, a portion of an osteotomy according to the teachings herein is pre-planned for insertion of a 10 mm long, 4.2 mm diameter implant at a predetermined bone site. May include programs. The next step may include drilling a preliminary hole using a starting guided drill 526, thereby obtaining data regarding bone hardness and / or bone density at the bone cut site. Subsequently, the surgeon may select the series 550 (in FIG. 5B) and continuously use the guided drills 552a, 552b, and 552c to obtain a hole with a diameter of 2.8 mm to 3.6 mm. If the surgeon notices that the bone is soft, according to display 586c (FIG. 5C), the hole obtained is appropriate and no further drilling should be performed. However, if the bone is stiff, another drilling should be performed to obtain a hole with a diameter of 3.3 mm to 4.1 mm according to indication 584c (FIG. 5C). In this way, by following the chart of this surgical kit, the surgeon can easily and easily obtain the desired drill to obtain optimized holes for the implant dimensions and for the patient and their jaw and bone. Can be selected and used quickly.

  According to some embodiments, following step 620, each of the perforations can expand the drilled hole, while not substantially increasing the depth of the drilled hole. A guided drill is selected from a series of guided drills having (eg, series 550 in FIG. 5B).

  It will be understood that some features of the invention described in the context of separate embodiments for clarity may be provided in combination in a single embodiment. On the contrary, the various features of the invention described in the context of a single embodiment for the sake of brevity are separately or in any suitable subcombination or any other described of the invention. It may be provided as appropriate for the embodiment. Certain features that are described in the context of various embodiments should not be considered essential features in those embodiments, unless the embodiment cannot be performed without those elements. .

  While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the scope of the appended claims.

  Citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.

  In this specification, section headings are used to assist in understanding the specification and should not necessarily be construed as limiting.

Claims (9)

A guided drill for osteotomy in a dental implant configured to drill by rotating around a rotation axis,
A shaft configured to be releasably mechanically associated with a contra-angle handpiece configured to rotate the guided drill about the rotation axis;
A guide portion having an outer surface geometrically confined in a cylinder having a radius R1, such that the outer surface coincides with the cylinder along at least one of its area sections, whereby said guided drill Is configured to slidably rotate within a guide sleeve having a hollow cylindrical shape having an inner radius R2 larger than R1, and the rotating shaft moves the guide drill substantially parallel to the rotating shaft. A guide portion coinciding with the axis of symmetry of the guide sleeve so as to be forced to
A stopper disposed between the shaft portion and the guide portion, the stopper extending in a radial direction at a distance longer than R1 from the rotation shaft;
A blade portion configured to perform drilling with a diameter smaller than 2 × R1, and is disposed adjacent to the guide portion so that the guide portion exists between the blade portion and the stopper. A blade portion,
The shaft portion, the stopper, the guide portion, and the blade portion are all integrally formed from a hard alloy, and the blade portion has a straight-cut at least three-blade edge or a spiral-cut at least two-blade edge. And the cutting edge is provided with a relief so that the guided drill can be reused.
Guided drill. A surgical template configured to mechanically fit an individual patient's maxillary or mandibular teeth, attached to the teeth in a predefined mutual orientation between the teeth and the surgical template. When the surgical template captures the teeth firmly, the surgical template is a guide sleeve having a hollow cylindrical shape having an inner radius R2, and the surgical template is attached to the patient's teeth In some cases, the guide section is oriented so as to allow the guided drill to move toward the osteotomy site in the patient's jaw and trapped within a radius R1 smaller than R2. A surgical template having a guide sleeve configured to guide a rotating guided drill having the guide drill toward the osteotomy site;
A guided drill according to claim 1;
A set for osteotomy.   The series of guided drills according to claim 1, wherein the guide portions of all the guided drills in the series are geometrically confined in the same cylinder having the same radius R1, Each of the guided drills provides a combination of drilling diameter and drilling length that is different from the combination of drilling diameter and drilling length provided by another guided drill in the series, whereby the series Allows users of the series of drilled drills to perform osteotomy for dental implants with the drill diameter and drill length determined by the user during osteotomy using the series A series of guided drills according to claim 1. The surgical template according to claim 2,
A series of guided drills according to claim 3;
A set for osteotomy. A surgical kit,
A series of guided drills according to claim 3;
A container configured to accommodate at least the series of guided drills, the container having an open state that allows a user to confirm and use the series of guided drills; In the open state, the series of guided drills are arranged according to at least one of the drilling diameter and drilling length of each of the guided drills, wherein the individual drilling diameter and the individual drilling are in the arrangement. Next to each guided drill having a length, a container in which another guided drill having the next drilling diameter or the next drilling length in the series of guided drills is arranged; and
For the continuous use of the sub-series of guided drills to perform a map of the arrangement and a part of the osteotomy to obtain a hole with a predetermined diameter and length for a dental implant A chart comprising a graphic display configured to indicate a recommended order to a user of the surgical kit;
A surgical kit comprising: A method of osteotomy for dental implants,
a. Providing a surgical kit according to claim 6;
b. According to the chart of the surgical kit, selecting an initial guided drill and performing an initial drilling at an osteotomy site in a patient's jawbone;
c. According to the chart of the surgical kit, selecting the next guided drill and making the next drill in the patient's jawbone;
d. Repeating step (c) as many times as desired by the user of the surgical kit;
Including a method. The surgical template according to claim 2, substantially adapted to fit and attached to a patient's tooth, the guide sleeve being oriented to guide a guided drill toward the osteotomy site. Providing steps, and
During drilling in steps (b) and (c), the guide portion of the guided drill is slidably rotated within the guide sleeve, thereby drilling to a predetermined drilling depth at the osteotomy site. Passing a drilled guided drill through the guide sleeve of the surgical template to guide the guided drill to perform;
The method of claim 6, further comprising: Following step (b),
Collecting said patient anatomical data;
Examining the anatomical data for selection of the next guided drill in step (c);
The method of claim 6, further comprising:   9. The method of claim 8, wherein the anatomical data includes bone hardness and / or bone density.

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