JP5553293B1 - Dental implant - Google Patents

Abstract

The present invention relates to a dental implant for a one-time implant treatment, in which a collar portion is configured to prevent downgrowth of epithelial tissue, and the position is adjusted according to the level of downgrowth, that is, a collar portion of an abutment. An object of the present invention is to provide an abutment structure whose mounting height can be changed.
A fixture 14 to be embedded in an alveolar bone, and a collar portion 12 having a side surface extending to a position exposed on the epithelial tissue surface above the alveolar bone and tapering from the fixture toward the other end. This prevents bacteria from entering from the mouth when the abutment is attached. Furthermore, the side surface of the collar portion 12 is used as a sealing portion, and an abutment 16 is provided to be fitted in a state of covering the collar portion. The abutment 16 has a structure in which the fitting position in the height direction of the collar portion 12 can be adjusted. is there.
[Selection] Figure 3

Description

The present invention relates to a dental implant in which the height of an abutment can be adjusted with respect to exposure of a collar portion due to downgrowth of epithelial tissue when treatment is performed by implanting the dental implant in alveolar bone.

  In order to regain the function of the lost tooth, as a means of supplementing the lost oral function by replacing with artificial materials such as metal and ceramics, if the denture is buried in the root or completely lost, it is healthy. In addition to treatment means such as placing a denture by bridging a tooth, oral implant treatment is performed as one of the advanced treatment methods. Oral implant treatment is a means of implanting a titanium artificial tooth root in the jawbone at the site of the lost tooth.

  In 1952, Sweden's Per Ingvar Brönemark discovered by chance that titanium and bone were completely bound, and revealed that a strong bond was born through an oxygen film covering the surface of titanium. Since then, oral implant treatment has made tremendous progress. The bone connection method, in which titanium and bone are directly connected without intervening connective tissue, is called osseointegration, which is a combination of Latin male (os) for bone and English integration for bone. It is. Osseointegration is a phenomenon in which bone and metal are directly bonded, and the function that acts on the contact surface between the oxide film on the titanium surface and the bone binds molecules of the living body to the oxide film, thereby causing bone adhesion.

  A dental implant consists of a collar part and a fixture part that is embedded in the jawbone and integrated. After the fixture and bone tissue are joined by osseointegration, the crown (denture) formed in the abutment is used as the collar part. Secure with screws. Around the abutment, there exists an epithelial tissue, which is a gingival tissue, surrounding it.

  In the epithelial tissue surrounding the abutment, when periodontal tissue is destroyed due to the development of periodontitis by bacteria in the oral cavity, periodontal pockets are formed and the gingival epithelial tissue generates downgrowth toward the root As a result, the surface level of the epithelial tissue decreases and the abutment is exposed.

  Patent Document 1 discloses a dental implant that prevents downgrowth and promotes gingival margin closure with respect to the implant. The dental implant includes a fixture and a collar portion provided at the upper end of the fixture, and at least a part of the outer peripheral surface of the collar portion has a three-dimensional structure that induces bone cells and / or epithelial tissue cells. It is characterized by comprising an induction layer. Since at least a part of the collar part is composed of an induction layer having a three-dimensional structure for inducing bone cells and / or epithelial tissue cells, the epithelial tissue (gingiva) covers the collar part at the top of the dental implant. So as to prevent down-growth of epithelial tissue. The three-dimensional structure of the induction layer has a porosity of 10 to 90% by entanglement of fibers having a high biocompatibility and a bioabsorbable material diameter of 5 to 100 μm.

  Patent Document 2 discloses a dental implant that provides an induction layer in a fixture portion and captures bacteria by using a step as a collar portion to prevent downgrowth. FIG. 26 shows a dental implant disclosed in Patent Document 2. As shown in FIG. The dental implant includes a fixture 208 and a collar portion 204, and a crown 200 integrated with the abutment 202 is screwed to the collar portion 204. The fixture 208 is provided with a guide layer 206, and a stepped portion is formed by the tapered collar portion 204 and the abutment 202. The step portion receives a substance that promotes bacterial propagation and suppresses the substance that promotes bacterial propagation from directly reaching the induction layer, so that downgrowth can be suppressed.

  A dental implant provided with a stepped portion is also proposed in Patent Document 3. According to Patent Document 3, the transmucosal element is a waist-shaped or inwardly narrowed portion for reducing the required height of the transmucosal element and creating a volume for soft tissue stabilization and generation of a holding belt It has. The main feature is that the longitudinal distance along the contact surface of the waist shape or the inwardly narrowed portion corresponds to at least the required width of the adjacent soft tissue. The height reduction is chosen as a function of the size and strength of the implant material remaining in the region between the waist shape or the inwardly narrowed portion and the likely penetration recess of the implant body. The waist shape or inwardly narrowed portion is preferably provided entirely on the transmucosal portion of the transmucosal element or integral implant.

  Further, Patent Document 4 also proposes a dental implant fixture that prevents destruction of bone bonds induced by bacteria invading deep into the dental implant fixture and causing bacterial infection. According to Patent Document 4, a female screw part is screwed from the inside of the oral cavity, and the outer periphery is embedded in the frustoconical main body tapering toward the end opposite to the inner side of the oral cavity so as to have the same outer diameter. The internal male screw part is screwed, the collar part is provided inside the oral cavity of the embedded male screw part, and the embedded male screw part from the boundary part between the collar part and the embedded male screw part toward the inner side of the oral cavity It extends by 1/5 to 1/3 of the length L of 1a, and starts from the same outer diameter as the outer diameter of the embedded male screw at the boundary, and the outer diameter is smaller than the truncated conical body. One or more sealing male screw parts that are on the tapered conical surface of the taper and gradually disappear and disappear on the side opposite to the inner side of the oral cavity are screwed together with the embedded male screw parts in a multi-threaded shape. .

  Dental implants have various proposals for strength in addition to downgrowth. For example, in Patent Document 5, the abutment is not easily broken, and the fitting strength between the abutment and the fixture is strong. Further, a fitting form of a fixture and an abutment of a dental implant that can easily obtain an impression by a direct impression and thus can produce a prosthesis at low cost is disclosed. In the fitting of the abutment and the fixture, the inner taper fitting portion of the fixture is brought into contact with and abutted by tightening the middle screw of the taper fitting portion of the abutment, thereby realizing a strong fitting. In addition, the fitting of the shoulder portion of the fixture and the buttocks of the abutment finally come into contact with each other to realize double butting.

  Patent Document 6 proposes a structure that does not transmit external force and impact applied to the dental implant directly to the alveolar bone. As shown in FIG. 27, it is composed of an implant part (fixture) 226 to be embedded in the alveolar bone and an abutment 220 for attaching an artificial tooth (crown). The abutment is composed of a female combined part 222 and a male part. It is comprised with the type | mold combination part 224. The male unit 224 is screwed to the oral cavity side of the implant unit 226, and the female unit unit 222 for uniting the implant unit with the implant unit and the strength adjusting unit provided in the female unit unit so as to be elastically deformable. The structure is such that the external force and impact applied to the artificial tooth are not directly transmitted to the alveolar bone by elastically deforming the strength adjusting portion provided in the female-type combined portion in the combined state.

  For this reason, when an external force or impact is applied to the artificial tooth during occlusion or mastication, the surroundings of the combined portion of the denture portion are elastically deformed to relieve the external force or impact. As shown in the right diagram of FIG. 27, the strength adjustment is cut to deform the female united portion 222. Any number of cuts may be used as long as there are two or more, but optimally in the range of 4 to 6 It is said that. In the state where the male united part 224 and the female united part 222 are united, the external force and impact applied to the artificial teeth are not moved by the implant unit 226, so the female slide surface moves downward along the male slide surface. By deforming the strength adjusting portion of the combined portion so as to open outward, the external force and impact are alleviated.

  Patent Documents 7 to 9 disclose dental implants corresponding to a one-time surgical procedure.

  In Patent Document 7, a direct connection type bone anchoring element for a prosthetic structure, which includes an implant to be inserted into a bone tissue, and which serves as an outer end surface of the implant when in an implanted position. In a bone anchoring element whose end face is arranged for attaching a prosthetic structure, the end face is provided on a neck integral with the rest of the implant, the neck being above the bone tissue at the position where the implant is implanted. It is adjusted so that the end face is at the same level as the soft tissue or below the soft tissue, so that it is possible to ingrowth in a state completely covered by the mucous membrane and to be exposed without applying a supplementary member. The blind screw hole is provided in the neck, and the blind screw hole is open at the end face to attach the prosthetic structure to the end face directly with the screw while engaging the end face .

  U.S. Pat. Nos. 5,098,086 and 1 propose a one-piece dental implant having a roughened surface extending above the alveolar crest. FIG. 28 is a diagram shown in Patent Document 8. In FIG. This roughened surface 234 allows the connective tissue 236 to adhere to the dental implant 232. The collar and the portion of the implant above the alveolar crest is made to resemble natural teeth by forming a surface area roughly 360 ° up to at least about 2 millimeters above the alveolar crest. Is done.

As described above, the technical development of dental implants for solving various problems has been advanced.

Japanese Patent Application Laid-Open No. 2010-279653 Japanese Patent Application Laid-Open No. 2013-085577 Special table 2007-519467 Japanese Unexamined Patent Publication No. 2010-188062 Japanese Patent Laid-Open No. 2004-113718 Japanese Patent Laid-Open No. 2004-113718 JP 2001-512348 B Special table 2005-528183 Japanese Patent Application Laid-Open No. 2011-062572

  Osseointegrated implants based on osseointegration are prosthetic treatments to restore oral function resulting from tooth defects, and acquisition and maintenance of osseointegration is essential for long-term success.

  However, even if osseointegration is obtained after the end of the unloading period, the two-stage implant operation is performed after the end of the unloading period by incising the gum and removing the cap that covers the collar. It needs to be replaced. At this time, incision of the gums must remove epithelial tissue / connective tissue until the cover cap is exposed. The invasion may cause an inflammatory reaction, and epithelial tissue downgrowth will develop to heal. For such a case, Patent Documents 1 to 4 do not disclose anything, and neither teach nor suggest it.

  In addition, the abutment is fixed to the upper surface of the collar portion with a screw. However, the abutment is firmly fixed (see, for example, Patent Document 5) or the strength adjusting portion that does not directly transmit external force and impact applied to the dental implant to the alveolar bone. (See, for example, Patent Document 6), but there is no disclosure, teaching, or suggestion of height adjustment of the abutment.

  Implant surgery that does not require incision of the gum after the end of the unloading period is a one-time method. In the case of the one-time method, a dental implant is often a one-piece implant, and the fixture, collar and abutment are used. Ment is a unitary structure. Is exposed on the surface of the epithelial tissue from the alveolar bone (see, for example, Patent Documents 7 to 9). Many bacteria are present in the mouth, but when the collar portion is perpendicular to the epithelial tissue, the epithelial tissue is likely to be down-growth due to bacterial contamination. There is a case where the fixture part reaches the fixture part beyond the collar part and further downgrowth progresses, but there is no correspondence for downgrowth during treatment for a dental implant that is compatible with the one-time method.

  It is desirable that there is no downgrowth of epithelial tissue due to bacterial contamination during treatment, but it cannot be avoided. In particular, in the case of a one-time method, countermeasures against downgrowth are necessary.

  In addition, the implant treatment is performed at the site where the tooth is lost, but because the counter teeth are protruding, the height of the provided abutment hits the counter teeth, and a superstructure prosthesis is inserted. Even if it tries, it may become unable to enter physically.

The present invention is a dental implant for one-time implant treatment, which has a structure for suppressing the downgrowth of epithelial tissue in the collar portion, and the adjustment of the position according to the downgrowth level, that is, the collar of the abutment An object of the present invention is to provide an abutment structure in which the mounting height to the part can be changed.

  The present invention provides a fixture that is embedded in the alveolar bone and a collar portion that has a side surface that extends to a position exposed on the epithelial tissue surface above the alveolar bone and tapers from the fixture toward the other end. Thus, the dental implant can prevent bacteria from entering from the mouth when the abutment is mounted, and can suppress the downgrowth of epithelial tissue. By making the collar portion into a tapered shape or a stepped shape, it is possible to prevent bacteria from entering the mouth and suppress the downgrowth of epithelial tissue.

  Furthermore, the dental implant according to the present invention includes an abutment that fits in a state of covering the collar portion with the side surface of the collar portion as a sealing portion, and the abutment can be adjusted in the height fitting position in the collar portion. It has a simple structure.

  In order to allow the height of the abutment to be adjusted, the collar portion is a linear or curved tapered surface, and the abutment is located inside the collar portion so as to be positioned at the top of the collar portion. As a structure that adjusts the height of the abutment in the collar part by adjusting the height by removing the abutment sealing surface and expanding the inner diameter, and moving it to the fixture side of the collar part. Yes. The sealing surface may be deleted by CAM by changing CAD data.

  If the height cannot be adjusted only with the abutment, the upper part of the collar part is deleted, and the abutment that fits in the state of covering the collar part is made using the side surface of the collar part of the deleted shape as a sealing part Can do.

  For height adjustment, the collar part is a linear or curved taper surface, and the abutment is sealed inside the collar part so that the side face of the collar part is positioned so as to be positioned at the lowest part of the collar part. Adjust the height of the abutment in the collar by adjusting the height of the abutment by placing an adjustment ring with a certain thickness on the sealing surface of the abutment to reduce the inner diameter. It can be a structure. In order to fix the abutment at different positions on the collar, a plurality of adjustment rings with different thicknesses are provided, and the height of the abutment is adjusted depending on which adjustment ring is used.

  The collar part of the dental implant according to the present invention may be provided with a side surface that tapers in a step shape. The stepped stepped portion becomes a bacteria receiving portion in the mouth to prevent invasion and suppress the downgrowth of epithelial tissue due to contamination.

  The collar portion having a stepped tapered side surface is provided with an abutment that fits in a state of covering the collar portion with the flat portion of the stepped side surface of the collar portion as a sealing portion. The fitting position in the height direction can be adjusted depending on which plane of the stepped side surface is sealed.

  Furthermore, the abutment includes a sealing surface that is in close contact with the flat portion of the stepped side surface of the collar portion so as to be positioned at the lowermost portion of the collar portion on the inner surface covering the collar portion having the stepped side surface. The collar part is positioned higher by placing an adjustment ring with a certain thickness with a lower end that makes the sealing surface of the abutment and the horizontal plane the same, reducing the inner diameter, and moving it to the tip side of the collar part. The structure is adjusted.

  Further, the abutment includes a sealing surface in close contact with the flat portion of the stepped side surface of the collar portion so as to be located at the lowermost portion of the collar portion inside the collar portion, and the position of the abutment in the collar portion is An adjustment ring with a thickness located at the uppermost part of the collar part is put in the abutment, and it is structured so that it adheres to the flat part of the stepped side surface of the collar part on the lower surface of the adjustment part, and the inner diameter of the adjustment ring is deleted. It is good also as a structure which spreads and moves an abutment to the fixture side and adjusts height.

Furthermore, the side surface of the collar portion is used as a sealing portion, and a cover cap and a healing cap for temporary teeth that are fitted in a state of covering the collar portion are provided, corresponding to the tapered collar portion.

  The dental implant according to the present invention extends to a position where the collar portion is exposed to the epithelial tissue surface above the alveolar bone, and has a tapered shape or a stepped shape from the fixture toward the other end portion. Prevents bacterial invasion and suppresses epithelial tissue downgrowth. Thereby, it is possible to prevent bacteria from entering the fixture unit that is bonded to the living body during the implant treatment period. In addition, since the cap that covers the collar portion is not removed after the end of the unloading period, it is not necessary to incise the gums, and an inflammatory reaction due to invasion by incision does not occur.

  Even when the epidermal tissue is down-growth in the collar portion, the position of the abutment can be adjusted, and can be adapted to the position of the epithelial tissue due to the down-growth. For this reason, an impression can be taken after the optimum position of the abutment is determined, and there is no exposure of the collar portion, which has an aesthetic effect. Furthermore, if teeth have been lost for a long period of time, the counter teeth will erupt and may not be compatible with standard abutments, but the sealing surface of the abutment is the side of the collar The upper part of the abutment can be adjusted by deleting the upper part of the collar part, and the upper part of the abutment can also be deleted.

Furthermore, if the collar portion is lower than the gingiva, it is difficult to ensure visual observation, resulting in poor operability and often damaging the boundary gingiva, resulting in a lot of epithelial tissue downgrowth. In the dental implant according to, the collar portion is located at a high position, so that the operability by visual observation is excellent.

1 shows a dental implant according to the invention. The figure which shows the abutment by this invention. Sectional drawing combining a dental implant and an abutment according to the present invention. Explanatory drawing for adjusting the height of the abutment by this invention. A panoramic X-ray image showing the missing teeth of the missing teeth. The figure explaining the opposing tooth | gear upper surface position. The figure explaining the cutting removal of the dental implant by this invention. Sectional drawing which attached the abutment to the collar part which cut | disconnected the upper part. The figure which shows the state which covered the conventional cover cap. Sectional drawing which mounted | wore the dental implant of this invention with the cover cap by this invention. The figure explaining the state which attached the healing cap for temporary teeth to the collar part. Explanatory drawing of the cover cap and healing cap by a 2 times method. The figure which shows the flowchart of a 2 times method implant operation. The figure explaining the ideal suture state before secondary surgery. The figure explaining the contamination state after a healing cap attachment, and a downgrowth. The figure which shows the conventional 1 piece type dental implant. The figure explaining the state which inserted the dental implant of this invention. The figure which showed the state which embedded the dental implant by this invention and the downgrowth by contamination generate | occur | produced. The figure which attached the abutment which adjusted height. The figure which shows the adjustment ring for height adjustment of an abutment. The abutment sectional view when the adjustment ring is inserted into the abutment and attached to the collar portion. The figure which shows a step-shaped collar part. Sectional drawing of the state which inserted the adjustment ring for height adjustment in the abutment. The figure which attached the abutment which inserted the adjustment ring to the step-like collar part. The figure which shows the example of the dental implant by this invention which employ | adopted another fixture shape. The figure which shows a prior art example. The figure which shows a prior art example. The figure which shows a prior art example.

  A dental implant as a substitute tooth is embedded in the alveolar bone and is combined with osseous tissue (osseointegration). For this reason, various attempts such as surface properties have been made on the fixture that is in direct contact with the alveolar bone, and the effect of promoting osseointegration has been obtained. However, in actual clinical settings, contamination caused by the invasion of bacteria in the mouth has reached the fixture beyond the collar, which is a major obstacle to osseointegration. Preventing invasion is an important issue for successful implant treatment.

  Against this background, the present invention focuses on dental implants that are compatible with the one-time method of implant surgery. The collar portion has a structure in which bacteria are difficult to enter, and downgrowth of epithelial tissue occurs due to contamination due to the invasion of bacteria. Even so, a dental implant having a structure capable of adjusting the position of the abutment to be mounted on the collar portion is provided. Hereinafter, a dental implant according to the present invention will be described with reference to FIGS.

  FIG. 1 is a dental implant 10 according to the present invention. The dental implant 10 includes a collar portion 12 and a fixture 14. The length of the collar portion 12 is longer than the surface of the epithelial tissue from the alveolar bone surface, and is exposed without stitching the epithelial tissue even after the dental implant is implanted. It is also a feature of a single implant operation.

  The side surface of the collar portion 12 tapers upward from the end of the fixture 14 in the drawing, and has a linear taper shape in FIG. The side surface shape of the collar portion 12 may be tapered and may be a curved taper shape. An abutment is mounted so as to cover the upper portion of the tapered collar portion 12.

  The fixture 14 promotes the coupling | bonding with a biological tissue. The dental implant 10 is generally made of titanium, but surface treatment is performed by various methods in order to promote bonding with living tissue. For example, in order to structurally promote bonding with living tissue, surface treatment such as making fixture 14 have an appropriate surface roughness, oxidation to titanium oxide or anodization, alkali treatment, etc. Has been done. These are the promotion of the coupling | bonding with the biological tissue based on osseointegration, Furthermore, there exists a hydroxyapatite process (Hydroxyapatite) called biointegration. Hydroxyapatite is also referred to as hydroxyapatite.

  Hydroxyapatite is a component of teeth and bones made of calcium phosphate. 97% of enamel and 70% of dentin are composed of hydroxyapatite. Hydroxyapatite acts on mineral ions in saliva, and calcium is deposited between the surrounding bones and biochemically bonded to the bones. For this reason, implants coated with hydroxyapatite are characterized by a short healing period for implant treatment. However, once bacteria enter, contamination progresses faster than other treated implants and sterilization by disinfection is less effective. For this reason, it is necessary to prevent invasion of bacteria into the fixture part, particularly in an implant coated with hydroxyapatite.

  FIG. 2 shows the appearance of the abutment 16 according to the present invention. The abutment 16 is attached with an upper structure and functions as a denture. The abutment 16 inserts the attachment portion 18 into the screw hole of the dental implant and fixes it with a screw. The mounting portion 18 is inserted into the dental implant 10, but is not cylindrical but has a polygonal column shape such as a hexagonal column for preventing rotation. Further, it is advantageous for downgrowth that the connecting portion between the collar portion 12 and the abutment 16 is separated from the upper portion of the fixture, that is, the upper surface of the alveolar bone, and is exposed from the gingiva and is tapered. This structure can be easily realized by covering the distal end of the collar portion of the dental implant according to the present invention.

  FIG. 3 shows a cross-sectional view when the abutment 16 according to the present invention is mounted on the dental implant 10 according to the present invention. In the abutment 16, the sealing surface 20 on the inner surface of the abutment 16 formed at the same angle as the tapered shape of the dental implant 10 is brought into close contact with the outer periphery of the tapered collar portion 12 that is tapered. For fixing, a screw (not shown) is inserted from the screwing portion 22 and screwed to the screw portion 24 of the dental implant 10.

  FIG. 4 is a diagram illustrating an embodiment for adjusting the height of the abutment 16. As shown in FIG. 3, the abutment 16 according to the present invention has a structure that is sealed and mounted on the outer periphery of the tapered collar portion 12, and the diameter of the sealing surface 20 of the abutment 16 is widened downward. Moving. Therefore, by cutting the sealing surface 20 to the cutting surface 26 in FIG. 4, the cutting surface 26 becomes a new sealing surface 20, and the height of the abutment 16 can be adjusted.

  As for cutting, to manually cut the inner surface of the abutment 16 requires the accuracy of the sealing surface 20 and requires considerable labor and high skill. Currently, a CAD / CAM (Computer-Aided-Design / Computer-Aided Manufacturing) system is widespread, and it is a part of the manufacturing process (design and processing) of restorations and prosthetics that are installed in the oral cavity during dental treatment. The part has been replaced with computer-controlled equipment. A CAD / CAM abutment has also been manufactured. By using this CAD / CAM system, the sealing surface of the abutment whose position is to be adjusted can be determined by CAD data, and can be manufactured by CAM.

  Conventional one-time-use dental implants include a one-piece type and a two-piece type. The one-piece type is a type in which a dental implant and an abutment are integrally formed (for example, Patent Documents). 7 and 8) In the two-piece type, the dental implant and the abutment are separated (for example, see Patent Document 9). In both types, the abutment was unable to adjust its position and could not cope with the downgrowth of epithelial tissue.

  On the other hand, dental implants that are compatible with the two-time method consist of a fixture to be embedded in the alveolar bone and a collar part. Generally, the collar part has a structure with almost no height, and the epithelial tissue Height adjustment corresponding to downgrowth is not possible. Also, in the two-time method, it is necessary to incision of the once-sewn gums based on the operation method, and at this time, the cover cap must be taken out, and it is necessary to remove epithelial tissue and connective tissue. When the cap is replaced, an inflammatory reaction is likely to occur, and since the collar portion is almost not high, downgrowth reaches the alveolar bone, and the alveolar bone may be absorbed. Once epidermal tissue is down-growth, it does not recover and bone resorption does not recover.

  If it is necessary to adjust the height of the abutment, it may be necessary in addition to preventing the collar portion from being exposed. For example, a tooth is when a pair of teeth has been lost. In many cases, if the lower teeth are lost, the upper teeth hang down, and if the upper teeth are lost, the lower teeth are erected. For this reason, even if an attempt is made to insert a denture (superstructure) in the lost part, in extreme cases, the denture comes in contact with the alveolar crest gingiva, and the physical space of the denture often cannot be secured. Since the implant treatment is performed at the site of loss, in many cases, the counter teeth are protruded. In such cases, the height of the provided abutment will hit the counter teeth and even physically try to insert a superstructure prosthesis.

  To deal with such cases, it is necessary to cut the counter teeth or insert a low abutment, but the fixture position cannot be moved, so it must be handled with an abutment. A too short abutment will reduce the physical strength.

  FIG. 5 is a panoramic X-ray image in which a pair of lost teeth is exposed. At the loss site 28, the lower right jaws 7 and 8 have been lost long ago, and the upper right jaws 7 and 8 of the paired teeth are in a state of hanging down. In order to respond to such cases with abutments without cutting the mating teeth, it is often necessary to reduce the height of the abutment and the height of the collar, and adjust the vertical position. Is essential.

  FIG. 6 shows a counter tooth upper surface position 30 with respect to the upper surface of the abutment 16 attached to the collar portion 12. The distance from the upper surface of the abutment 16 is a range in which the inner diameter of the sealing surface 20 of the abutment 16 can be adjusted from Y0 that is the upper surface position 30-1 of the abutment to Y1 that is the upper surface position 30 of the counter tooth. Even if it is, the position of the counter teeth further extends to the counter teeth upper surface position 30-3, and the case where the distance becomes Y3 cannot be handled. In such a case, the upper part of the collar portion 12 must be deleted to cope with it.

  FIG. 7 shows a cut surface 32 for lowering the upper portion of the collar portion 12 by cutting it, and attaching the abutment 16-1 having a low height to the collar portion 12 cut by the cut surface 31. It is a state to do.

  FIG. 8 is a cross-sectional view of the abutment 16-1 described in FIG. In FIG. 8, the fixture 14 is omitted and not shown. An abutment 16-1 having a low height and having a sealing surface as a side surface portion of the collar portion 12 is attached to the collar portion 12 whose upper portion is cut and removed by the cut surface 31.

  As can be seen from the cross-sectional view shown in FIG. 3, the dental implant has a space inside for mounting the abutment, and the upper portion is not closed. For this reason, when the dental implant is initially placed, it is necessary to cover the inner space by covering the top with a cover cap.

  FIG. 9 is a diagram showing a state where a dental implant is covered with a conventional cover cap. A cover cap 32 is fixed to the upper portion of the collar portion 12 with a screw portion. The normal cover cap is cylindrical, and the dental implant according to the present invention has a state in which the upper portion of the collar portion 12 protrudes from the gingiva at the time of implantation. Like the abutment structure according to the present invention, a structure that covers the upper end of the collar portion with the side surface of the collar portion as a sealing surface is desired.

  FIG. 10 shows a cross-sectional view in which the cover cap according to the present invention is mounted on the dental implant of the present invention having a tapered collar end. The cover cap 32-1 according to the present invention has a sealing surface as a side surface of the collar portion 12 and a structure that covers the upper portion of the collar portion 12. The cover cap 32-1 has a structure having a screw to be inserted into the dental implant, and is screwed and fixed to the screw portion 24 inside the dental implant. In such a structure, the surface of the cover cap 32-1 has a smooth shape, and the possibility of causing a problem with the tongue feeling is extremely low.

  Further, the cover cap 32-1 may be replaced with a healing cap for adjusting the shape of the surrounding gingiva after the end of the unloading period. It is the same structure as the cover cap 32-1, and only the external shape for adjusting the shape of the surrounding gingiva is changed.

  The dental implant according to the present invention is characterized in that the collar portion has a tapered shape, and the side surface of the collar portion is used as a sealing surface in combination with other dental implant components. For this reason, it is set as the same structure also about the healing cap for temporary teeth.

  FIG. 11 shows a state in which a healing cap for temporary teeth is attached to the collar portion. The internal mounting structure is the same as the abutment mounting structure as shown in FIG. 3, and the temporary tooth healing cap 34 is mounted with the side surface of the collar portion 12 as a sealing surface. The temporary teeth 36 indicated by broken lines in FIG. 11 are made of an immediate polymerization resin as a material, and the temporary tooth healing cap 34 includes a maintenance unit 35 for the immediate polymerization resin. By preparing the temporary teeth 36 with an immediate polymerization resin, the temporary teeth 36 can be manufactured simultaneously with the dental implant placement operation. The maintenance part 35 is a structure for preventing the temporary teeth 36 from falling off the temporary tooth healing cap 34 with respect to a force applied from the outside, and has a concavo-convex structure.

  Further, the temporary tooth healing cap 34 is in contact with the gingiva in order to widen the opening on the gingival surface and attach the temporary tooth. For this reason, it is preferable that the material of the healing cap 34 for temporary teeth is the titanium currently used for the dental implant.

  Next, with regard to the implant technique, the two-time method will be described with reference to FIGS. 5 and 6, and the contamination state and downgrowth due to the invasion of bacteria will also be described. The one-time method will be explained by comparison with the two-time method.

  FIG. 12 shows a state where the cover cap 32 and the healing cap 42 are attached to the dental implant 40 for the two-time method. In the dental implant 40 for the two-time method, the fixture portion 14-2 is embedded in the alveolar bone, and the connection with the living tissue, that is, osseointegration is promoted, and the dental implant 30 is fixed to the alveolar bone. The

  During the implant treatment period, first, the cover cap 32 is attached with screws from the upper part of the dental implant 40 for two-time operation, the osseointegration proceeds, and when the unloading period ends, the cover cap 32 is removed. A healing cap 42 is attached.

  FIG. 13 is a flowchart 44 of a two-time implant operation.

  First, in step S1, an alveolar bone in a portion where a dental implant is to be implanted is anesthetized, and an implant hole is formed with a drill in accordance with the length of the implant to be implanted. Next, in step 2, the dental implant is inserted into the formed planting hole up to the planned insertion position. The embedded dental implant has a cap attachment portion with an open upper surface of the collar portion. In step S3, a cover cap is attached to the opening, and in step S4, the gums are sutured and sealed. In step S5, the gingival is sutured and left for 2 to 6 months until osseointegration is promoted. The period of standing still varies slightly depending on the case, but is about 3 to 6 months for the upper jaw and about 2 to 4 months for the lower jaw.

  After osseointegration is promoted, move on to secondary surgery. In step S6, the gums, that is, the epithelial tissue, connective tissue, and periosteum are incised, and the cover cap attached to the dental implant is removed. Next, in step S7, a healing cap is attached to the dental implant. The healing cap sews the gum with the upper part of the healing cap protruding from the gum, and forms a gum when the upper structure (denture) is attached. In step S8, it is allowed to stand for 2 to 4 weeks until a gum is formed. After the gums are formed, in step 9 the healing cap is removed.

  Next, in step 10, an impression coping is attached to the dental implant and an impression is taken with a silicon impression material.

  In the final step 11, the impression coping is removed from the fixture, and the analog is attached to the removed impression coping and returned to the impression. Furthermore, silicon for gum model is poured into the impression, and an analog model is made by pouring gypsum over it. Remove the impression coping after setting the plaster. Further, an upper structure (denture) is prepared, and the upper structure is attached to the dental implant via an abutment, and the implant operation is completed.

  FIG. 14 shows an ideal state before the secondary operation. The fixture 14-2 of the dental implant embedded in the alveolar bone 50 is combined with the living body by osseointegration. After the cover cap 32 is attached, the incised portion of the gum is sutured, but the epithelial tissue proliferates to block traffic with the outside world, and the bone is absorbed while avoiding the downgrowth of the epithelial tissue. The periosteum 52, connective tissue 54 and epithelial tissue 56 cover the upper portion of the collar portion 12-2 and the cover cap 32 in a layered manner. The sutured portion 58 incised when the dental implant is placed is healed by tissue bonding.

  Bacteria may invade from the sutured portion 58 and become contaminated. In the second method, even if the sutured portion 58 is tissue-bonded and healed, the cover cap 32 is removed by incising the gums in the secondary operation. It must be replaced with a healing cap 42. At this time, the epithelial tissue 56, the connective tissue 54, and the periosteum 52 are removed, and the healing cap 42 is attached. For this reason, when an inflammatory reaction is caused by an invasion to the removal of the epithelial tissue 56, the connective tissue 54, and the periosteum 52 in the secondary operation, the periphery of the healing cap 42 is contaminated, and downgrowth appears.

  FIG. 15 shows a contamination state and a down-growth state at the end of the unloading period when the healing cap 42 is attached to the dental implant 40 in the secondary operation. Since the healing cap 42 communicates with the outside, the incision is not covered with gums, and the periphery of the healing cap 42 is simply in contact with epithelial tissue or connective tissue. When an inflammatory reaction is caused by an invasion to the removal of the epithelial tissue 56, the connective tissue 54, and the periosteum 52, the distance from the fixture 14-2 is short because the height of the collar portion 12-2 is low. As shown in Fig. 5, the fixture 14-2 is reached beyond the collar portion 12-2. In addition, when excessive contamination occurs and the downgrowth of the epithelial tissue 56 progresses, the dental implant is not fixed and another operation must be performed.

  On the other hand, in the one-time implant operation, the one-piece type dental implant corresponding to the one-time method is used in the flowchart of the two-time implant operation shown in FIG. It becomes. Therefore, because the incision of the gum is only once, the burden on the patient is light, the superstructure (denture) is directly attached to the dental implant, the treatment period can be shortened, and the integrated type has excellent strength, etc. There are benefits. On the other hand, as a disadvantage, there is a high risk of invasion of bacteria because the traffic to the outside is not blocked even during the period corresponding to the unloading period that promotes osseointegration where the fixture and biological tissue are combined as in the two-time method. Sometimes. In addition, when the amount of bone is small, a bone regeneration induction method or the like may be used together. However, when bone formation is used together, there is a higher risk of bacterial infection than the twice method.

  Even if it is a dental implant compatible with the one-time method, the two-piece type has a freedom of being able to change the angle etc. of the superstructure because the abutment is separated and the connecting portion is easy to clean. However, the risk of bacterial infection and downgrowth are the same for both 1-piece and 2-piece types.

  The progress of downgrowth is related to the shape of the collar part and is not clearly proved at present. However, the invasion of the removal of epithelial tissue, connective tissue and periosteum causes an inflammatory reaction, and downgrowth proceeds. From experience, it has been recognized that when the collar portion has a straight shape, it is easy to proceed without any resistance. The shape of the collar part, where downgrowing is difficult to proceed, is when there is an umbrella-shaped protrusion that tapers, which is essentially a function to reduce the surface area because the epithelial tissue is blocked from the outside world. It is thought to be because of having.

  Since the epithelial tissue works to reduce the surface area, it is difficult to downgrow beyond the tapered umbrella-shaped protrusion, and as a result, downgrowth is suppressed. In addition, bacteria are less likely to invade than the straight shape, and as a result of preventing contamination, the effect of suppressing downgrowth works.

  FIG. 16 shows an example of a conventional one-piece dental implant 52. Conventionally, the collar portion 12-1 is long and has a straight shape. In some cases, not only the fixture 14-1 but also the collar portion 12-1 is inserted into the alveolar bone as shown in FIG. It was sometimes buried. For this reason, there is no function of inhibiting downgrowth due to the invasion of bacteria, and there have been many cases of failure in implant treatment compared to the twice method.

  The dental implant according to the present invention has a shape utilizing the property of having a function of reducing the surface area in order to block the epithelial tissue from the outside.

  FIG. 17 shows a state where the dental implant 10 of the present invention is embedded. The upper portion of the collar portion 12 is exposed from the epithelial tissue 56 and is sealed with a cover cap 64. The collar portion 12 forms a protruding state with a taper angle of 30 degrees or less at a portion in contact with the fixture, and an upper portion thereof has a taper angle of 60 degrees or more to form a tapered shape in the epithelial tissue 58. For this reason, it is difficult for bacteria to enter, and downgrowth is also suppressed.

  FIG. 18 is a view showing a state in which a dental implant according to the present invention is implanted and downgrowth due to contamination occurs. Around the collar portion 12, a contaminated portion 60 is generated due to the invasion of bacteria, and the epithelial tissue 58 develops downgrowth to the middle of the collar portion 12. Downgrowth of epithelial tissue cannot be completely prevented and is more or less expressed. For this reason, the contaminated portion 60 is removed, an impression is taken, an upper structure is produced, attached to the abutment, and attached to the upper portion of the collar portion 12. At this time, if the height of the abutment cannot be adjusted, the surface of the epithelial tissue is lowered by the downgrowth, so that the collar portion 12 is exposed and the aesthetics are remarkably impaired.

  19 is adjusted in height by the abutment according to the present invention shown in FIG. 2, and an upper structure 66 to be a denture indicated by a broken line is prepared and attached to the abutment 16 adjusted in height. A fixed state is shown. The height of the abutment 1616 was adjusted by moving the sealing surface 20 shown in FIG. 4 to the fixture 14 side by widening the inner diameter. For this reason, the collar portion 12 is not exposed and the aesthetics are not impaired.

Various structures for adjusting the height of the abutment are conceivable. However, the method of cutting the sealing surface shown in FIG. 4 to widen the inner diameter is to place the sealing surface so that it is positioned at the uppermost portion of the side surface of the collar portion. It is a structure that lowers the abutment by setting and deleting. On the other hand, there is a structure in which the abutment is raised from the lowermost part of the side surface of the collar part.
FIG. 20 shows an adjustment ring 70 for adjusting the height of the abutment. The adjustment ring 70 is put in the sealing surface of the abutment to reduce the inner diameter, thereby adjusting the height of the abutment at the collar portion.

  FIG. 21 is a cross-sectional view of the abutment when the adjustment ring 70 is inserted into the abutment 16 and attached to the collar portion 12. Here, the fixture is omitted. When the adjustment ring 70 is not provided, the abutment 16 is designed such that the bottom surface of the abutment 16 is positioned at the lowermost portion indicated by the broken line of the collar portion 12 by the sealing surface. The adjustment ring 70 is inserted so as to be in the same position as the horizontal direction of the bottom side of the sealing surface. By changing the thickness of the adjustment ring 70, the inner diameter is narrowed, and the height of the abutment is adjusted. Therefore, a plurality of adjustment rings having different inner diameters are prepared.

  Next, another embodiment of the present invention will be described.

  FIG. 22 shows only the collar portion of the dental implant according to the present invention. The collar portion is a stepped collar portion 72 in which a flat portion 74 is provided in a step shape to realize a tapered shape of the collar portion. In the step-like side shape, the flat portion 74 serves as a sealing portion with the abutment, and the height of the abutment is adjusted. Further, the flat portions provided in multiple stages serve as receiving portions for invasion of bacteria at the time of dental implant placement, and also serve as protrusions for downgrowth of epithelial cells. Therefore, the structure is very effective against downgrowth.

  FIG. 23 is a cross-sectional view showing a state in which an adjustment ring 76 for height adjustment is inserted into the abutment 16. Sealing with the collar portion becomes the bottom surface of the adjustment ring.

  FIG. 24 is a view in which the abutment 16 in which the adjustment ring 76 is inserted as shown in FIG. 23 is attached to the stepped collar portion 72. When the adjustment ring 76 is not provided, the bottom of the abutment is sealed with the broken line portion shown in FIG. 24 as the lowest position. Depending on the level of downgrowth of the epithelial tissue, the adjustment ring determines which flat surface portion 74 of the stepped collar portion 72 is sealed. The adjustment ring 76 is provided with a plurality of adjustment rings corresponding to the flat surface portion 74 of the stepped collar portion 72.

  Further, the adjustment ring 76 may have an inner diameter cut so that the bottom surface of the adjustment ring 76 comes into contact with the uppermost portion of the stepped collar portion 72 (see FIG. 24). In this case, the sealing portion is the bottom surface portion of the adjustment ring 76 and can be easily adjusted at a medical site regardless of the roughness of the inner diameter due to cutting. Further, since the shape of the stepped collar portion 72 is determined, a marker may be attached to the bottom surface of the adjustment ring 76 to determine which flat portion 74 the inner diameter of the adjustment ring 76 corresponds to.

  The present invention does not depend on the fixture shape, and can hold any shape fixture. However, to maintain long-term stability during and after implant treatment, the fixture of an osseointegrated implant It is desirable to have a fixture shape that allows for initial fixation, facilitates osseointegration, and avoids excessive concentration on the load.

  FIG. 25 shows an example of a dental implant according to the present invention in which a fixture shape that can fix initial fixation and avoid excessive concentration with respect to a load is adopted as a fixture. The fixture 68 has already been proposed by the inventor and disclosed in Japanese Patent Application Laid-Open No. 2011-135975. It has a structure that can be stable for a long time, and has a neck part with a slight constricted part, a body part that forms a part of a conical shape whose outer shape is gradually reduced from the neck part, and a hemispherical or rounded apex part. I have. The neck of the neck may be constricted in an arc shape or may have a shape having a straight side surface with a small outer diameter.

  Thus, the dental implant according to the present invention can exhibit further effectiveness by combining a fixture that is stable over an initial period and a long period of time.

As mentioned above, although the Example of this invention was described, this invention contains the appropriate deformation | transformation which does not impair the objective and advantage, Furthermore, the limitation by said embodiment is not received.

DESCRIPTION OF SYMBOLS 10 Dental implant 12,12-1,12-2 Collar part 14,14-1,14-2 Fixture 16 Abutment 18 Mounting part 20 Sealing surface 22 Screwing part 24 Screw part 26 Cutting surface 28 Lost part 30 , 30-1, 30-2, 30-2 Opposite teeth upper surface position 31 Cutting surface 32, 32-1 Cover cap 34 Healing cap for temporary teeth 35 Maintenance part 36 Temporary teeth 38 Gingival surface 40 Dental for double-use method Implant 42 Healing cap 44 Two-time implant surgery flow chart 50 Alveolar bone 52 Periosteum 54 Connective tissue 56 Epithelial tissue 58 Suture 60 Contaminated part 62 One-piece dental implant 64 Cover cap 66 Superstructure 68 Loss site 70,76 Adjustment ring 72 Stepped collar part 74 Plane part 78 Fixture

Claims (13)

A fixture to be embedded in the alveolar bone,
A collar portion that extends to a position exposed on the surface of the epithelial tissue above the alveolar bone and has a side surface that tapers from the fixture toward the other end;
An abutment that is fitted in a state of covering the collar portion, with the side surface of the collar portion serving as a sealing portion,
With
The abutment has a structure in which the fitting position in the height direction of the collar part can be adjusted by a sealing part,
Dental implant characterized by
The dental implant according to claim 1,
The collar portion is a linear or curved tapered surface,
The abutment includes a sealing surface that tightly contacts a side surface of the collar portion so as to be positioned at an uppermost portion of the collar portion inside the collar portion,
The position of the abutment in the collar part is a structure that can be adjusted in height by removing the sealing surface of the abutment to increase the inner diameter and moving the abutment to the fixture side of the collar part,
Dental implant characterized by
The dental implant according to claim 2,
The removal of the sealing surface is made by CAM by changing CAD data,
Dental implant characterized by
The dental implant according to claim 1,
The upper part of the collar part is deleted, and the abutment that fits in a state of covering the collar part with the side surface of the collar part having the deleted shape as a sealing part,
Dental implant characterized by
The dental implant according to claim 1,
The collar portion is a linear or curved tapered surface,
The abutment includes a sealing surface that closely contacts a side surface of the collar portion so as to be positioned at a lowermost portion of the collar portion inside the collar portion.
The position of the abutment in the collar portion is adjusted by inserting an adjustment ring having a certain thickness into the sealing surface of the abutment to reduce the inner diameter and moving the abutment toward the tip side of the collar portion. Be a possible structure,
Dental implant characterized by
The dental implant according to claim 5,
In order to fix the abutment at different positions of the collar portion, it includes a plurality of adjustment rings having different thicknesses;
Dental implant characterized by
The dental implant according to claim 1,
The collar portion has a side surface that tapers in a step shape,
Dental implant characterized by
The dental implant according to claim 7,
Furthermore, it has an abutment that fits in a state of covering the collar part, with the flat part of the stepped side surface of the collar part as a sealing part,
Dental implant characterized by
The dental implant according to claim 8,
The abutment has a structure capable of adjusting the fitting position in the height direction depending on which plane of the stepped side surface in the collar portion is sealed.
Dental implant characterized by
The dental implant according to claim 9,
The abutment includes a sealing surface in close contact with a flat portion of the upper side surface of the collar portion so as to be positioned at the lowermost portion of the collar portion inside the collar portion.
Position in the collar portion of the abutment, to reduce the inner diameter to put adjustment ring having a constant thickness with a lower end of the sealing surface and the horizontal plane of the abutment in the same therein, the collar It is a structure that can be adjusted to the height by moving to the tip side,
Dental implant characterized by
The dental implant according to claim 9,
The abutment includes a sealing surface in close contact with a flat portion of the upper side surface of the collar portion so as to be positioned at the lowermost portion of the collar portion inside the collar portion.
The position of the abutment in the collar portion is such that an adjustment ring having a thickness located at the uppermost portion of the collar portion is inserted into the abutment, and the flat portion of the stepped side surface of the collar portion on the lower surface of the adjustment ring With a structure that closely adheres to
The inner diameter of the adjustment ring is removed and widened, and the abutment is moved to the fixture side so that the height can be adjusted.
Dental implant characterized by
The dental implant according to claim 1,
Furthermore, it has a cover cap that fits in a state of covering the collar part with the side surface of the collar part as a sealing part,
Dental implant characterized by
The dental implant according to claim 1,
Furthermore, it has a healing cap for temporary teeth that fits in a state of covering the collar part, with the side surface of the collar part as a sealing part,
Dental implant characterized by