JPH10155813A - Fixing of implant by regeneration of alveolar bone having defect part and implant holder - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to exactly fix an implant to a desired position of the alveolar bone. SOLUTION: The gingiva 11 covering the defect part of the alveolar bone 10 is incised to expose the defect part and its peripheral part and to accelerate the bleeding by a wound in the cortical bone of the defect part of the alveolar bone 10. A frame material which is formed of a rigid material to the shape meeting the external shape of the part planned to be regenerated and is held with the implant 20 to be fixed to a prescribed position is mounted at the alveolar bone 10 near the defect part by a fixation method, such as screwing. An osteoanagenesis material 22 is packed in the defect part of the alveolar bone enclosed by the frame material. The packed osteoanagenesis material 22 and the frame are covered by a film material, by which the osteocytes are isolated from the other cells and the gingiva 11 subjected to incision and necessary working is sutured. The implant is made to remain in the regenerated bone after lapse of the time for osteoanagenesis.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for fixing artificial roots or other implants to alveolar bone having a defect, and more particularly to a method for fixing an implant by regenerating alveolar bone.

[0002]

2. Description of the Related Art In order to carry out treatment with an artificial root, that is, an implant, it is required that the patient's alveolar bone condition is good and the general health condition is good. On the contrary,
Although there is no problem with the health condition, there are often cases where the condition of the alveolar bone is poor and implant implantation is difficult or impossible. In cases where implant placement is difficult,
This refers to a denture in which the alveolar bone at the target site is lost and the denture is considered unusable even if the implant is surgically implanted. If the lost area of the alveolar bone is large, implant placement is not possible on its own.

In such a case, the GBR method (Gui
ded Bone Generation) can be applied.
eous approach (one-time method) and staged
Approach (two-time method) can be selected. The one-time method is limited to relatively small cases because initial fixation must be obtained, while the two-time method withstands larger cases. However, the number of operations has increased and the treatment period has been prolonged.
Pace making becomes more difficult and requires more invasive surgery, such as harvesting and using autologous bone for increased reliability.

In order to implant an implant at an ideal position, it is necessary to control an ideal bone morphology.
Is what has been said in recent years. However, the current situation is as described above, and it is expected that it is difficult to implement an ideal implant by conventional techniques as far as it is judged.

[0005]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has as its object to properly fix the above-mentioned implant, that is, an artificial tooth root or other implant at a target position of alveolar bone. Is to be able to do it.

[0006] Another object of the present invention is to realize a surgical procedure that requires less burden on a patient.

[0007]

In order to solve the above-mentioned problems and achieve the object, the present invention provides: B. Incising the gingiva covering the alveolar bone defect to expose the defect and its surroundings; B. Promote bleeding from the wound on the cortical bone at the alveolar bone defect; A frame material, which is formed of a rigid material in a shape that matches the external shape of the part to be regenerated, and holds the implant to be fixed in place, is attached to the alveolar bone near the defect by a fastening method such as screwing D. E. filling the alveolar bone defect surrounded by the frame with a bone regeneration material; B. Isolating bone cells from other cells by covering the filled bone regenerating material and frame material with a membrane material, and suturing the incised and processed gingiva; After the bone regeneration time has elapsed, a measure is taken to allow the implant to remain in the regenerated bone.

In order to carry out this fixing method, a plurality of holes are opened in a frame member made of a band-like material which can be shaped in accordance with the regenerated shape of the alveolar bone. It is desirable to use an implant holding device that attaches the material itself to the alveolar bone.

[0009]

DESCRIPTION OF THE PREFERRED EMBODIMENTS As described above, the present invention relates to a process for regenerating a defective portion of an alveolar bone in fixing an artificial root or another implant to an alveolar bone having a defective portion. The implanted body is incorporated into the regenerated bone to be integrated.

According to the first aspect of the present invention, in the step A, in order to enable an operation on the alveolar bone 10 covered with the gingiva 11, the gingiva is incised and the defect 12 and the It is a stage to expose the peripheral part,
That is one purpose. See FIG. 1 and FIG. However, in this process, it is necessary to insert a scalpel M into the gingiva so that the suturing that covers the entire operation field can be performed after the fact, not just an incision.

The step B is a means for creating a wound 13 in the cortical bone, promoting bleeding, and giving a start for bone regeneration. See FIG.

Process C is a stage for space making, in which a frame material 21 having a shape conforming to the outer shape of the part to be reproduced is attached to the alveolar bone 10 near the defect. The frame member 21 is provided to give the external shape of the bone to be regenerated to the defect part and at the same time hold the implant 20 to be incorporated into the regenerated bone at the target position.

The frame 21 is made of a material which is not embedded in the living body and causes no adverse effects during the period of bone regeneration. The frame 21 may be a non-absorbable material that needs to be removed after bone regeneration, or may be an absorbent material that does not need to be removed. Examples of the non-absorbable material include titanium, and examples of the absorptive material include polylactic acid resin, cellulose, and collagen.

It is expected that the implant 20 will most likely be an artificial root. However, the method for fixing an implanted body according to the present invention is not limited to a means for so-called implants, and can be applied to, for example, tooth replanting. The invention is not limited to the method of fixing artificial dental roots because the above is possible.

Process D is a step of filling the alveolar bone defect surrounded by the frame material 21 with the bone regeneration material 22. Representative bone regeneration materials include, for example, clots, collagen, and cancellous bone collected from the iliac bone.

In the step E, the filled bone regenerating material 22 is formed into a frame material 21 for shaping for space making.
And the step of covering with the film material 23. Bone regeneration material 2
2 is completely isolated from other cells such as gingival cells by the membrane material 23. Thus, the ideal space maki
The wound is completely closed by suturing the gingiva 11 so that ng is achieved. Reference numeral 14 denotes a suture. This closure needs to be done completely, which requires the scalpel M to be inserted in the process A so that a flap or the like for proper suturing can be obtained.

The process F is a stage where several months have passed since the completion of the above processes A to E. When an absorptive material is used for the frame material and the film material, the work performed at this stage is X
Confirmation that bone is regenerated by means such as a line image,
And when the implant is an implant, mounting a denture on the implant. When a non-absorbable material is used for the frame material and the film material, the gingiva is cut again to remove the frame material and the film material (in some cases, only one of them). When the implant is an implant, a denture can be attached to it at the same time, but it goes without saying that the gingiva is sutured.

Next, an implant holding device used directly for carrying out the method for fixing an implant according to the present invention will be described. The main body of the holding device is a frame member 21. It has already been described that it can be made of non-absorbable or absorbent material.
To explain this apparatus with reference to FIG. 7, several holes 25 are opened in the frame material 21 in the longitudinal direction of the band. In the hole 25, a screw as a means 26 for stopping the implant 20 (an implant in the example of FIG. 7) and a self-tapping screw as a means 27 for attaching the frame material 21 to the alveolar bone 10 are passed. The shape of the frame material is not limited to a linear shape, but may be any shape such as a Y-shape.

Means 26, 2 for stopping implants and frame material
The smaller the amount of the screw 7 protruding onto the frame body 21 after fastening, the better. Therefore, for example, it is preferable that the edge of the hole 25 is counterbored so that the screw head is in a recessed state. Assuming that the frame material 21 shown in FIG. 7 is formed as the regenerated shape 15, the frame material 21
At the position indicated by the mark 24 at 0, it is screwed, and after filling the bone regenerating material, it is covered with a film material 23 from the outside of the frame material 21, and the film material 23 is fixed to the bone surface by pins 28 or the like.

The above-described holding device according to the present invention assumes that each constituent member is made of a non-absorbable material. However, it is of course also possible to make all the components from the frame material 21 to the pin 28 with an absorbent material, so that the device shown in FIG. 7 may be made of either non-absorbent or absorbent material. Means for stopping the member 2
6, 27 and 28 include screws, pins and other examples of clamping,
Alternatively, means such as sewing and bonding are also included.

An embodiment will be described below.

[Example] Case, patient: 51-year-old man, chief complaint: esthetic disorder, medical history: no special remarks, presenting history: L23 missing.

The first incision was made mesio-distally on the palatal tangent of the adjacent tooth. Make an incision in the gingival sulcus on both adjacent missing teeth,
On the buccal side, make an incision on the extension of the nipple including the interdental nipple,
-Make an incision beyond the Junction and further into the surgical field,
A trapezoidal flap (trapezoid valve) was made. Figure 1,
FIG. Coronally Position on the palate side
The ed Palatal Sliding Flap was used (indicated by reference numeral 16).

A dummy implant (IMZ Hex cylinder) was placed in the fourth hole from the cheek side of a six-hole titanium frame.
It was fixed by the healing cap of the MZ Hex cylinder, and an ideal bone form could be given by a pliers, and it was bent to a form that slightly inserted the bone. Cortical bone was perforated with a round bar to promote bleeding. Implant (I
MZ Hex cylinder) is fixed to a titanium frame material,
L2 is the 2nd hole on the labial side, 1st hole on the palate side, and L3 is the 1st hole on the lip side with the plate body on the bone with a fixing screw (self-tapping screw) of φ2 mm x 4 mm manufactured by LEIBINGER (registered trademark). The eyes and palate were fixed buccolingually in the second hole. FIG.

The sterilized paper was placed on a membrane, trimmed so as to sufficiently cover the operative field, and GORE-TEX membrane oval 9 manufactured by Gore was shaped accordingly. First fix the lip side with Fria-Tech Frio Spin,
The defect site was filled with a clot of collagen and separately collected venous blood. On the palatal side, the membrane was only inserted under the periosteum. FIG. Flap on the labial side is incised by decompression (indicated by reference numeral 17), and Palatal Slide on the palate side.
ig Flap was used to completely cover the surgical field. The labial and palatal Flaps were completely closed with mattress sutures and simple sutures. FIG.

Solcoseryl was applied over the entire wound surface to promote wound healing.

After 3 months, the membrane was removed, and after 9 months, the low profile plate manufactured by LEIBINGER was removed. At this point, sufficient fixation of the implant body and labial gingival morphology were obtained. FIG.

[0028]

The present invention is constructed and operates as described above. By performing space making by floating an implant in a space where regeneration is to be performed, integration by integration into regenerated bone is enabled. It has the effect of becoming. Therefore, for a case in which initial fixation was not obtained and surgery had to be performed a plurality of times, bone formation and fixation of the implant to an ideal three-dimensional position are realized at once. Therefore, the present invention can be applied to sinus lift method, GBR method, simultaneous tooth extraction implant, tooth replanting, and the like.

[Brief description of the drawings]

The drawings relate to a method for fixing an implant by regeneration of alveolar bone having a defect according to the present invention,

FIG. 1 is a sectional view showing a process A,

FIG. 2 is a sectional view showing a process A,

FIG. 3 is a sectional view showing steps B and C,

FIG. 4 is a longitudinal sectional view showing a process D,

FIG. 5 is a longitudinal sectional view showing a process E,

FIG. 6 is a longitudinal sectional view showing a process F,

FIG. 7 is an exploded perspective view of an implant holding device used directly in the practice of the present invention.

Claims (8)

[Claims] 1. A method for fixing an artificial root or other implant to an alveolar bone having a defect, comprising the steps of: B. Incising the gingiva covering the alveolar bone defect to expose the defect and its surroundings; B. Promote bleeding from the wound on the cortical bone at the alveolar bone defect; A frame material, which is formed of a rigid material in a shape that matches the external shape of the part to be regenerated, and holds the implant to be fixed in place, is attached to the alveolar bone near the defect by a fastening method such as screwing D. E. filling the alveolar bone defect surrounded by the frame with a bone regeneration material; B. Isolating bone cells from other cells by covering the filled bone regenerating material and frame material with a membrane material, and suturing the incised and processed gingiva; A method for fixing an implant by regenerating an alveolar bone having a defect, wherein the implant is left in the regenerated bone after a period of bone regeneration. 2. One or both of the frame material and the membrane material are made of a non-absorbable material, and after a period of time for bone regeneration in step F, the gingiva is incised to remove the material and the membrane material. The method for fixing an implant by regenerating an alveolar bone having a defective part according to claim 1, wherein only the implant retained in the bone is left in the regenerated bone. 3. The method according to claim 1, wherein the frame member and the set screw thereof are made of titanium. 4. The alveolar bone having a defective portion according to claim 1, wherein the membrane material is made of Gore-Tex (registered trademark), and is fixed to the cortical bone with a pin or is pinched under the periosteum. How to fix the plant by regeneration. 5. The method for fixing an implant according to claim 1, wherein the implant is an artificial tooth root. 6. The method for fixing an implant according to claim 1, wherein the implant is a denture. 7. The method according to claim 1, wherein one or both of the frame material and the membrane material are made of an absorbable material. 8. An implant holding device for use in a method of fixing an implant by regenerating an alveolar bone having a defect, wherein the frame member is formed of a band-shaped material that can be shaped according to the regenerated shape of the alveolar bone. A method for fixing an implant by regenerating an alveolar bone having a defect, characterized by opening a plurality of holes and holding the implant using the holes and attaching the frame material to the alveolar bone. The implant holding device to be used.