MXPA06009350A - Implant that can be implanted in osseous tissue, method for producing said implant and corresponding implant - Google Patents

Abstract

The invention relates to an osseous implant (10) that is implanted in a predetermined cavity or cavity that has been specifically produced, parallel to an implant axis (1) without a significant degree of rotation. Said implant has cutting edges (14), which do not lie on a common plane with the implant axis and are oriented towards the distal end of the implant. In addition, the implant comprises surface areas (16) consisting of a material that can be liquefied by means of mechanical vibrations. The cutting edges (14) are dimensioned in such a way that once implanted, they cut into the cavity wall. To carry out the implantation, said implant is subjected to mechanical vibrations, causing the thermoplastic material to liquefy at least partially and be pressed into uneven areas and pores of the cavity wall, where it hardens to form a connection between the implant (10) and the cavity wall by means of a positive fit and/or a union of materials. The cutting edges (14) provide anchoragefor the implant in the cavity wall, in a similar manner to a screw-type implant. As the implant requires no rotation, the implant can have a form that is neither cylindrical nor conical and can thus be stabilised against rotative stresses more effectively than a screw-type implant. The implant is also more stable with regard to tensile forces as a result of the anchorage by means of the liquefiable material and can, in particular, be subjected to stress immediately after implantation. The implant is, for example, a dental implant.

Description

IMPLANT TO BE IMPLANTED IN BONE TISSUE AND PRODUCTION METHOD AND IMPLEMENTATION OF THIS DESCRIPTION OF THE INVENTION The invention is located in the field of medicinal technology and is related to an implant to be implanted in a bone tissue that can be a standardized implant that is implanted in a cavity prepared specifically for it or adapted for it, or an individual implant that is implanted in an individual bone cavity (eg, a dental implant, an articulation implant, or an implant to fill a -defect in a bone). The invention also relates to methods for the production and implantation of the implant. Implants implanted in bone tissues are usually implanted in cavities. bony, being that such a bone cavity is a cavity specially produced (for example perforation or stepped perforation) or a cavity arising from other circumstances, for example a trauma or a degenerative disease. The implant is inserted with adjustment, according to the state of the art, either with the help of a cement arranged around the implant, or has a shape that adapts with the necessary precision to the cavity in such a way that it is in direct contact with the implant. a proportion as large as possible, functionally essential of its surface with the bone tissue. In the case of an individual implant, the latter means that the shape of the implant is irregular, in particular an irregular cone which does not have a round cross section and / or a straight axis in its entirety. Dental implants that are implanted in the maxillary bone as replacement of a natural root to support, for example, artificial crowns, abutments, bridges or dental prostheses after extraction of the natural root of the tooth are known as standardized implants that must be implanted in cavities -produced specifically for this or at least adapted, as well as individual implants in a form adapted to a tooth root or individual alveolus. Normed dental implants that must be implanted in perforations specially produced for this purpose are cylindrical or slightly conical pins, essentially with rotating symmetry, almost always screws, which are offered in the market in different sizes and shapes and among which the dental surgeon selects the implant more appropriate for a specific case. The implantation of such a dental implant is generally possible only until the cavity, generated with the extraction of the natural dental root that must be replaced, has been filled with regenerated bone tissue, that is, close to a waiting time of 3 to 6. months after the referred extraction. The screwed-in implant is usually not exposed to load immediately after implantation, since the risk is great that, due to the load, the implant moves excessively relative to the bone tissue, so that a good integration of the implant is prevented. bone tissue (bone integration). For this reason, in a large • majority of cases an element is built on the implant that projects beyond the mandible (crown, pillar, etc.) only after a second period of waiting again about 3 a 6 months, specifically until the implant has completely integrated with the bone tissue and relative movements, due to normal loads, between the implant and the bone tissue, do not exceed a physiologically compatible quantity. It turns out that dental implants in the form of screws, when fully integrated into the jaw bone, have a stability that is sufficient for a normal load and that does not vary even in the long term. This is explained among other reasons also because the implant is well anchored, thanks to the thread, also laterally in the bone tissue, which reduces the pushing forces on the bone tissue and avoids an overload of the alveoli bottom due to the force of Pressure. It is known that the bone tissue has the tendency to suffer undesirable degeneration during the waiting times when the dental implant respectively the maxillary bone does not receive a local load. It is also known that the relative movement between the implant and the bone tissue, which does not exceed a physiologically compatible magnitude, would stimulate bone regeneration and with this the bone integration of the implant. For this reason, the most diverse ways are to reduce the waiting times referred to or eliminate them completely. In order to avoid the first waiting period, specifically the time that passes until the cavity generated by the extraction of the natural dental root. has been filled with bone tissue, and also to be in a position to take advantage of the bony layer (alveolar bone) compacted that surrounds the natural cavity (alveolus) as a support element, it is proposed to give the implant a shape that does not essentially have a Rotary symmetry as a screw, but essentially corresponds to the shape of the natural dental root that must be replaced (individual implant). Such an individual implant can be implanted immediately or shortly after the extraction of the natural dental root in the existing cavity (natural alveolus). But as in the natural state a fibrous holding device (dental epithelium) is disposed between the dental root and the alveolar wall, an implant representing an exact copy of the natural dental root (for example by a negative-positive molding method). ), does not have a firm seat in the alveolus. This has a negative effect on the bone integration during the second waiting period, since a tissue of the conjunctive type can be formed in a gap between the alveolar wall and the implant that prevents bone integration at least locally, but can not provide the implant with sufficient stability. In order to lend to the dental implants formed by copying a natural dental root an improved stability for the second phase of bone integration (second waiting period) and with this a better starting point for a successful bone integration, is formed according to the document US-5562450 (Gieloff et al.) And W0-88 / 03391 (Lundgren) the implant with excessive dimensions relative to the natural dental root, that is, with slightly larger cross sections, and the implant surface that makes contact with the bone it is provided with structures, in particular depressions (alveoli structures, undermined structures). The aforementioned implants are produced, for example, since the natural tooth root is measured after the extraction without making contact, being that the measurement data are processed with a CAD system and that the implant with a CAM system is produced. Starting from a corresponding blank based on the measured data processed by milling, grinding, electro-erosion etc. The above mentioned "super-sized" individual dental implants have, after implantation, a much firmer seat in the alveolus, thanks to the seat under pressure, than the exact copies of the natural dental root. It turns out, however, that the alveolus wall is relaxed in a short time by reconstructive processes and mechanical relaxation before the forces introduced and that the implant is no longer stabilized by a 'pressurized seat' but is again settled relatively loose in the alveolus, so that, notwithstanding the improved primary stability immediately after implantation, the best conditions for bone integration are not given. It also turns out that these implants have a tendency, even after the bone integration phase (second waiting period) to lose their grip on bone bone once they are exposed to load. Such as E.-J. Kohal et al. have reported in a speech during the fifty-second annual conference of the German Society for prosthetics of medical dentists and knowledge of materials (DGZPW, for its acronym in German) in May 2003 (published in DentSci (2) 7: 11), the maxillary bone degenerates strongly in the region of such implants during the bone integration phase and in the exposure to subsequent loading, and it is possible for the implants to completely detach from the bone tissue. The findings referred to above can be explained not only for dental implants, but in general for implants that must be implanted in bone activity among other causes because the implant has contact by large areas with a bone tissue that is under intense reconstruction due to an intervention (tooth extraction), so that the stresses induced in the bone are very low. Although superficial geometries can locally increase stresses by pressure seating, but the volume occupied is apparently too low to effectively achieve stimulation of bone neoformation, mechanically induced. The pressure forces generated by the load (chewing movements) on the implant cause thrust forces on the wall of the cavity. Due to the positive adjustment with the wall of the cavity is achieved, in addition, just a stabilization against the rotating forces. As a consequence of the above, displacements can occur in relation to newly formed bone, which prevents bone integration due to lack of adequate rotational stability. This problem has also been discussed in detail in hip prosthetics. For the particular case of the dental implant, a transfer of the axial load is possible only to a small degree due to the steepness of the alveolus wall. Due to this, the charges of the originally proximal part move strongly distally and can consequently cause an overload of the alveolus fundus, which is not completely ossified as an exit point for blood vessels and nerves at the time of extraction. The consequences can be pressure necrosis and other problems induced by undue burdens. In the design of conventional screw implants, however, this problem receives the maximum attention, although in this case the alveolus has normally been ossified completely. In summary it can be said that of the bone implants applicable without cement, the screw-shaped implants are to be preferred to all implants of different formation, but in many cases they can not be applied due to the inevitable geometric conditions that must be fulfilled in their application, or that can be applied only in exchange for other disadvantages. Something similar applies to many other implants that must be implanted in bone tissue. The object of the invention is now to create an implant to be implanted in a bone tissue (individual implant or normed implant), as well as some methods for its production and implantation. The inventive implant must have a stability at least as good as an implant in the form of a screw screwed in a corresponding perforation, but have a primary stability (immediately after implantation) of an inventive implant clearly better particularly in the case of loads. rotational that of the implant in the form of a screw mentioned. But above all, the inventive implant must be substantially less limited in terms of its geometric conditions than the implant in the form of a screw mentioned. The implantation of the inventive implant must be able to be performed in this with the known implantation methods and the implant must be able to be produced by the known production steps. The objective is achieved by the implant and the methods, as defined in the claims. The inventive implant is implanted essentially parallel to an implant axis (ie, without essential rotation) and has a region of the leading distal end and a region of the proximal end opposite the region of the distal end on the axis of the implant that is locates after implantation in the region of the bone surface or eventually protruding from the bone. The implant has in the surface regions that are located between the region of the distal and proximal end and which come into contact at least in part with the bone tissue due to the implantation, cutting edges that form shavings that do not extend into the bone. a plane common with the axis of the implant, that is to say, which do not move in the bone tissue during implantation in the direction of its length but essentially in a transverse direction with respect to it, and which are oriented towards the region of the distal end. The implant additionally has a fluidizable material by mechanical vibration, for example thermoplastic, which is disposed in the surface regions without sharp edges or which is applied or can be applied in an implant cavity, the cavity being connected through openings with the surface regions without sharp edges. The inventive implant is inserted into the cavity in the bone in the direction of the implant axis without essential rotation, with the cutting edges cutting the surface of the bone forming a chip. Simultaneously with the introduction of the implant into the bone cavity, the implant is exposed to mechanical vibrations. Due to this, the fluidizable material, which in this case is preferably a thermoplastic material, is fluidized at the points of contact with the bone material and enters under pressure into irregularities and pores or also into structures produced in the wall of the cavity specifically with This purpose, being that it is placed in intimate contact with the surface of the bone. After the fluidizable material solidifies again, it forms a positive and possibly material bond between the implant and the bone tissue. If the fluidizable material is located in a cavity of the implant, then mechanical vibration is advantageously applied only after the implant is inserted into the cavity, and namely only on the fluidizable material. For an implant with such a configuration, a thermoplastic material or also a thixotropic particulate, hydraulic or polymer cements can also be used as the fluidizable material, such as is used in orthopedics also for the anchoring of implants or, for example, also for infiltration of collapsed osteoporotic vertebral bodies. The inventive implant is stabilized immediately after implantation in the cavity thanks to its connection with the bone tissue by fluidizable material, this stabilization acting against pressure and traction load (ie, parallel to the axis of the implant), but also against rotary action loads. Also the cutting edges, who make cuts in the bone tissue during implantation, anchor the implant. Both the anchoring by the fluidizable material, and also by the cutting edges, act in particular on the side walls of the cavity, so that the bottom of the cavity receives little or no load, which is important in particular for dental implants . All the mentioned effects lend primary stability to the inventive implant which is sufficient, in most cases, for a load immediately after implantation. The connection structures of the thermoplastic material have a lower modulus of elasticity than the bone matrix and in particular as the implant itself and have no drainage capacity, which makes them particularly suitable for sudden loads and for the reduction of excessive stresses. Thanks to their elasticity, these joints allow small relative movements and - thanks to this - favorable for the bone integration between the implant and the bone tissue, which act mainly in the region of the cutting edges in a stimulating way on the bone tissue. These joints simultaneously prevent greater displacements between the implant and the bone tissue that would cause the interruption of the bone integration process. As the inventive implant is implanted essentially without rotation (in particular without rotation that is greater than 360 °), it is possible and advantageous to form the implant in such a way that it is stabilized in the cavity, thanks to its shape, against rotationally acting loads. As will be shown below, it is possible - however - to configure the inventive implant in such a way that it can be implanted in a cavity with a round cross-section (perforation or stepped perforation) When the inventive implant is an individual implant, then it will have the majority of the cases the shape of an irregular cone (which does not have rotational symmetry), that is, it will decrease towards its distal end and will have in the case of a dental implant a shape essentially adapted to a natural tooth root. the invention can be implanted, as well as known dental implants that copy a natural tooth root, immediately after extraction of the natural tooth root, but has long-term stability - in contrast to the known individual dental implants, also designated as replicas teeth, during the bone integration phase and after this, as is the case with dental implants in the form of a screw. The same is also true for individual joint implants and implants for the repair of individual bone defects, according to the invention. The cutting edges of an implant that decreases towards its distal end according to the invention, for example of a single dental implant, are shaped as external edges of reductions of cross-section in stepped form, and must also be dimensioned in this case in such a way as to the cavity, which are placed by sectioning the wall of the cavity at least in part. The cutting edges or stepped cross-section reductions, equipped with cutting edges, extend completely or partially at the periphery of the implant, essentially vertical or inclined relative to the axis of the implant and have a wedge angle that is less than 90 °. (see Fig. 5). In addition to the cutting edges, an implant of conical configuration can also have stepped cross section reductions without shearing action (wedge angle 90 ° or greater). When the aforementioned stepped cross-sectional reductions do not have sharp edges and / or are relatively deep, then it is advantageous to produce corresponding beadings in the cavity before implantation, for example with the help of a tool adjusted in shape to the implant. The procedure to be selected, with or without previous production of heels in the cavity, depends in particular on the nature of the bone tissue present, but also on the surgeon and the patient. By previously producing heels, the bone tissue receives less mechanical load during implantation (with the same depth of cross-sectional reductions), so that this procedure is particularly appropriate for application in elderly patients with poor quality of life. the bones. In the implanted state, the cutting edges of the inventive implant, inserted by sectioning the bone tissue of the wall of the cavity, form, in a manner similar to the screw threads of a screw-shaped implant, lateral supports in the bone tissue, ie sites , where the pressure forces are coupled laterally of the implant to the bone tissue, and more specifically in orthogonal sense is what can happen through a conical implant surface, essentially smooth without sharp edges and steps, and in particular more than what happens in the case of a cylindrical implant surface. These supports generate deliberate load absorption sites in which bone generation is stimulated. In addition to the structures described above, the inventive implant can also produce structures that produce grooves or self-cutting in a plane common to the axis of the implant, that is, they extend essentially in the direction of implantation, penetrating during implantation into the implant. the wall of the cavity and that lend a particular primary stability in relation to torsional forces. Similarly, it is possible for the inventive implant to have cutting collars in the proximal region that stabilizes the implant further on the surface of the cortical bone. The surface regions of the cutting edges In an inventive implant they consist of a material suitable for a cutting action in the bone material, which does not fluidize under the conditions of implantation.

They consist, for example, of titanium, of a titanium alloy, of zirconium oxide or of other suitable metallic or ceramic material or of an appropriately reinforced synthetic material. The fluidizable material to be applied in the inventive implant is advantageously biologically re-absorbable. It does not extend over the regions of. surface with cutting edges, which have biocompatible surface regions, that is, beneficial for bones and advantageously having bone integration characteristics. In these surface regions, bone integration of the implant can start immediately after implantation and successively replace the anchor with the re-absorbable thermoplastic material. It is possible, however, also to use a non-re-absorbable thermoplastic material, in such a way that its anchoring in bone tissue can complement or even replace the anchor by bone integration. In this case, a broad coating of the surface with the polymer can also make sense for the maximization of stability. Suitable materials for the individual inventive implant that are biologically re-absorbable and fluidizable are thermoplastic polymers based on lactic acid and / or glycolic acid (PLA, PLLA, PGA, PLGA etc.) or polyhydroxyalkanoates (PHA), polycaprolactones (PCL), polysaccharides, polydioxanones (PD), polya-nhydrides, polypeptides, trimethyl carbonate (TMC) or corresponding copolymers or polymers mixed or composite materials containing the aforementioned polymers. Suitable thermoplastic materials which are not re-absorbable are, for example: polyolefins (for example polyethylene), polyacrylates, polymethacrylates, polycarbonates, polyamides, polyesters, polyurethanes, polysulfones, polyphenylsulfides or polymers of liquid crystal (liquid crystal polymers or LCP), polyacetals , halogenated polymers, in particular halogenated polyolefins, polyphenylsulfides, polysulfones, polyethers or the corresponding mixed polymers or polymers or composite materials containing said polymers. Particularly suitable as re-absorbable fluidizable materials are: poly-LDL-lactide (obtainable, for example, from Bhringer under the trade name Resomer R208); as non-resorbable fluidizable material: polyamide 11 or polyamide 12. The most important advantages of the inventive implant are the following: * As the inventive implant can be implanted essentially without rotation by the axis of the implant, it can be adopted in its form to an existing cavity , for example an alveolus, in which it is possible to implant it in essence immediately after the extraction of the natural tooth root. This means for the patient that a waiting period between extraction and implantation is suppressed. In addition, complex measures of precise alignment of the dental implant and other components that must be placed on the implant (abutment, crown, etc.) are suppressed. * In the case of a dental implant that is adopted in terms of its shape to a tooth root natural, the wall of the alveolus is preserved to a good extent during implantation as a region of compacted bone structure and can support the implant better than what happens in the case of a more remote and less dense bone tissue. * As the implant is stabilized immediately after implantation, sufficiently for a load exposure, thanks to its anchorage by the fluidizable material and by the insertion of the sharp edges in the bone material and thanks to its. As it prevents rotation in the cavity, it is possible to expose it to load immediately after implantation. * As an inventive dental implant can be exposed to load essentially immediately after implantation, it can represent as an essentially one-piece implant an entire tooth with root region and crown region. Other work steps that must be performed in the patient's mouth for the construction of the implant are suppressed. * Thanks to the lateral support of the implant through the cutting edges in the wall of the cavity, the forces of pressure on the implant are coupled locally into the bone tissue., so that the implant receives long-term stability which is equivalent to the long-term stability of a screw-shaped implant. * As the lateral support of the implant in the bone tissue of the wall of the cavity prevents a support at the bottom of the cavity or at least reduces it significantly, complications at the bottom of the cavity are avoided, which is important especially for dental implants, since the alveolus phone is not prepared to receive a strong load. * Due to the loading of the implant immediately after implantation, bone degeneration due to lack of load is avoided. * The anchoring of the implant with the help of fluidizable material reduces the relative movements due to the load between the implant and the bone tissue to a physiological magnitude and this not only stops inhibiting bone integration, but on the contrary favors * Due to the use of a non-decomposable fluidizable material, a long lasting anchorage of the implant is allowed even in weak bone tissue due to disease or degeneration due to old age or with a low regenerative capacity. Various modalities are described by way of example of the inventive implant, as well as its production and implantation in relation to the following figures. In these they show: Figure 1 a natural tooth in cross section in relation to the maxillary crest; Figure 2 an inventive individual dental implant replacing the tooth according to Figure 1; Figure 3 a side view of a preferred embodiment of the individual dental implant according to the invention; Figure 4 three cross sections projected one on top of the other through a single dental implant (approximately the section lines A-A, B-B and C-C in Fig. 3); Figures 5A and 5B axial sections through the region of a cutting edge of an inventive implant; 6 shows an axial section through a series of cutting edges of an inventive implant, arranged one after the other in the direction of implantation; 7 is an axial section through a stepless cross section reduction without cutting edge of an inventive implant; FIG. 8 is an axial section through a stepped cross section reduction with fluidizable material extending above it; Figure 9 Partial axial section through an embodiment of an inventive implant with fluidizable material positioned in an internal cavity; Figures 10 to 12 three dental implants according to the invention; Figures 13 and 14 an inventive implant that is suitable for implantation in a perforation as a side view (Fig. 13) and sectioned e? transverse direction in relation to the axis of the implant (Fig. 14, section line XIV-XIV in Fig. 13); Figures 15, 16A and 16B another inventive implant that is suitable for implantation in a perforation and in which the fluidizable material is positioned in an internal cavity, in axial section (Fig. 15), sectioned transverse to the implant axis (FIG. Fig. 16A, section line XVI-XVI in Fig. 15) and as side view (Fig. 16B); Figures 17 and 18 details of implants, according to figures 15 and 16. Figure 19 an implant according to figures 13 and 14 with a transition element; FIG. 20 shows an exemplary embodiment for a play adjustment as a connection between the implant and the transition element or between the transition element and the sonotrode (axial section); Figure 21 a diagram to illustrate the production of an individual dental implant according to the invention; FIGURE 22 a diagram to illustrate the implantation of a dental implant according to the invention; Figure 23A to 23C a schematic illustration of the implantation of a joint implant according to the invention; Figures 24A to 24C are a schematic illustration of the repair of a defective site produced by a bone tumor with the help of an inventive implant. In all the figures, the same elements are designated with the same reference numbers. Figure 1 shows in a cross-sectional section in relation to the maxillary crest a natural tooth 1 whose root 2 is integrated into a maxillary bone 3. The maxillary bone 3 is covered by gums 4 (connective tissue and epithelium). The tooth crown 5 projects beyond the maxillary bone and gums 4 and is covered with an enamel layer 6, while the inside of the tooth crown 5 and the tooth root 2 consist of dentine. The maxillary bone 3 has an alveolus (dental pouch) for the reception of the tooth root 2, the bone tissue of the alveolus wall 7 (alveolar bone) usually having a higher density - in comparison with the bone tissue that is further away from the root 2, and has, therefore, greater mechanical stability. Between the alveolus wall 7 and the tooth root 2 is located the tooth epithelium 8 containing collagen fibers (fibrous Scharp apparatus) with the help of which the tooth root 2 is connected to the alveolus wall 7, ie , they support the tooth and couple the forces acting on the tooth laterally towards the bone tissue. In an extraction, the dental epithelium is destroyed. It can not be regenerated. FIG. 2 shows, in identical section to FIG. 1, an individual dental implant 10 according to the invention which replaces the tooth 1 shown in FIG. 1, that is, it is implanted in the location of this tooth 1 in the maxillary bone 3 (direction of implantation, respectively, implant axis I). And dental implant 10 has in the case represented not only a region 11 of root adapted tooth 1 respectively wall 7 alveolus, but also a crown region 12 adapted to the dental crown. The dental implant 10 is, for example, in a single piece and consists of titanium, the crown region being covered with a ceramic layer not shown and the surface of the root region 11 may be equipped at least part for a Bone integration action, but which is at least biocompatible and favorable for bone. Instead of the crown region 11 it is possible that the dental implant also has a pillar or a means for fixing a pillar, a crown, a bridge or a dental prosthesis. Region 11 root decreases toward the distal end of the implant 10 dental has cuts 13 • cross section whose outer edges are formed as cutting edges 14 cutting oriented distal end region and have cut during implantation in the alveolar wall. Among the stepped cross section reductions 13, the cross section of the implant remains essentially constant towards the distal end of the implant or decreases continuously. Among the stepped cross section reductions, the implant is connected in the regions 15 by the thermoplastic material to the bone tissue of the alveolar wall 7. As already mentioned in the foregoing, these unions occur during implantation. The thermoplastic material liquefies in it by mechanical vibrations acting on the implant and is pressed into the irregularities and pores of the alveolar wall, where it solidifies again anchored after positive locking and / or material. Figure 3 shows a similar individual dental implant 10 as Figure 2, but not yet implanted. In the region 11 of the root of this implant, the cutting edges 14 respectively the stepped cross-section reductions 13 as well as the surface regions 16 located between them of the thermoplastic material protruding from the surface regions 17 between them are appreciated. . The surface regions 17 are biocompatible and advantageously equipped for bone integration. If the thermoplastic material is re-absorbable, advantageously the entire surface of the root region 11 is equipped for bone integration. The shape of the root region 11 is adapted at least in part to the shape of the natural tooth root that must be replaced or to a mechanically relevant part of this tooth root, respectively to the corresponding alveolar wall shape, i.e. has in general terms the same conical shape with cross sections at least partly non-round and / or without a straight cone axis. The root region 11 has, however, in contrast to the natural tooth root respectively the alveolar wall the cross-sectional reductions 13 whose edges are formed at least in part as cutting edges 14, and the surface regions 16 of thermoplastic material which they project above the regions 17 of bone integration surface. The surface regions 16 of the thermoplastic material are arranged and dimensioned in such a way that the fluidized material moves during the implantation as little as possible over the bone integration regions 17, so that they can develop their bone integration activity immediately after the implantation. implantation. Figure 4 shows three cross sections (approximately the section lines AA, BB and CC in Figure 3) by an inventive implant corresponding, for example, to approximately the dental implant according to Figure 3. From section BB it can clearly be seen how the surface regions 16 project beyond the thermoplastic matter above the regions 17 of bone integration surface. As mentioned initially and as shown in FIG. 4 by a line of dashes and dots, the inventive implant can also have structures 21 that form essentially axial extension grooves or cuts that are dimensioned in such a way that they penetrate during the process. implantation in the wall of the cavity. Such structures lend the implant an additional component of primary stability, in particular in relation to torsional stresses, and also couple, after bone integration, the torsional forces acting on the implant towards the bone tissue. It is shown that it is possible to achieve good results if the root region 11 of a dental implant is dimensioned according to the invention as follows: * The cross sections in the root region 11 are approximately the same size as the cross sections through the corresponding alveoli (FIG. tooth root with dental epithelium). The cutting edges 14 and possibly the stepped cross section reductions 13 and the groove structures 21 and having axial extension, as well as the surface regions 16 with the thermoplastic material project beyond these cross sections. * The axial distances between the contiguous stepped cross section reductions 13 are determined on the one hand by the depth of the steps as well as by the local inclination of the root region, but it may be advantageous, on the other, to partly reinforce the steps proximally, respectively reduce the distances and shape the cutting edges eventually slightly protruding, so that they fit more deeply into the alveolar wall and thus anchor the implant optimally. * The stepped cross-section reductions 13 have, predetermined by the space available between two teeth, a maximum depth of 1 mm, advantageously from 0.1 to 0.5 mm. If they protrude by more than approximately 0.3 mm from the measurement of the alveolar wall, it is advisable to produce corresponding heels < in the alveolar wall before implantation. * The surface regions 16 with the thermoplastic material are projected by 0.05 to 2 mm (advantageously 0. 2 to 1 mm) beyond the adjoining surface regions 17. * The surface regions 16 of the thermoplastic material advantageously occupy 10 to 50% of the total area of the root region 11 and are advantageously arranged axially between the surface regions 17. Depending on the load group, it is possible to transfer the previous indications to other implants as well. The depth of the stepped cross-section reductions can surely be increased by having bone mass, on the one hand to correspond to the inclination of the cavity and on the other to optimally induce stresses in the sense that the bone is stimulated appropriately without generating a local overload. This means that the loads transferred by cross-sectional reductions stepped on average after achieving bone integration in the bone tissue should not induce expansions greater than 0, .5%, but greater than 0.05%.

These different implants are, for example, joints of joint prostheses (articulation implants for example for hip, knee or finger joint prostheses) adapted to an epi, meta or diaphyseal geometry or to the geometry of a producible or existing cavity which is implant in the tubular bones prepared accordingly, or are implants that are intended for the repair of defective sites (for example, defective sites in the region of the skull or maxilla or defective sites generated by tumor diseases in another bone region). It is also conceivable to apply the invention to copies of existing implants, where an existing implant with only minimal loss of vital bone tissue is replaced in an intervention by an individual implant adapted to the existing implant respectively to a cavity arising from the root canal. of the removal of an existing implant. The surface regions 16 of the thermoplastic material advantageously have directional elements for the energy, that is, these regions decrease outwardly forming edges or points or have a hump of frets. These directional elements produce stress concentrations when the implant positioned in the bone tissue is excited by mechanical vibrations, and ensure that the thermoplastic material initiates its fluidization in the boundary areas with the bone material and that a thermoplastic material can fluidize in the first place. The thermoplastic material is advantageously selected and disposed in the implant in such a way that when the mechanical vibration is applied the implant as a whole is acoustically excitable, that is to say, it functions as a resonance box, ie the mechanical oscillations are not essentially damped inside the implant, that is, in particular in the contact areas between the non-thermoplastic material and the thermoplastic material or in the inner e-1 of the thermoplastic material. In this way, the thermoplastic material is fluidized on the surfaces of the implant, in particular in the region of the directional elements that contact the bone tissue. For a light damping inside the thermoplastic material, a material with a modulus of elasticity of at least 0.5 GPa is advantageously selected. To prevent energy losses in the boundary areas between the two materials, the thermoplastic material is advantageously joined rigidly and over an area as large as possible with the non-thermoplastic material. It turns out that the thermoplastic material can be inserted under pressure into the bone tissue during implantation by ultrasound to a depth of two trabecular chambers, ie, to a depth in the magnitude of approximately 0.2 to 1 mm. To achieve such a depth of penetration, the thermoplastic material must be available in an appropriate volume and a corresponding pressure force, produced by the oversize, must govern between the surface regions of the thermoplastic material and the wall of the cavity. As can be seen from figures 2, 3 and 4, the dental implant can have in addition to the region Root 11, for example, a corona region 12 (FIG. • 2) or a cone 18 to mount one. 19 artificial crown (figure 3) or means (for example a blind hole 20 with internal thread, figure 4) for holding a pillar or a clamping device for a bridge or a dental prosthesis. Such superstructures are known from the state of the art. Figures 5A and 5B show in each case a cutting edge 14 in partial axial section of an inventive implant on a larger scale, the implant being represented with its proximal end region upward and the distal end region downward. The cutting edge 14 facing the region of the distal end (in the figures below) has a wedge angle ß that is less than 90 ° (advantageously 45 ° to 80 °) and is configured relative to the axis of the implant so that it protrudes slightly, which gives it - depending on the configuration of the projection relative to a cavity wall K (perforation) of extension parallel to an implant axis I a free angle a (FIG. 5A) or a free space (FIG. 5B) that is reduced by the friction in the wall of the cavity and the heat generated due to it. The free angle a is advantageously small (for example 1 ° to 15 °) and the free space has, by way of example, a depth of 0.1 to 0.3 mm). For the cutting edge 14 to have cutting action and chip formation, the cutting angle, which amounts to a + ß, is less than 90 °, or the angle? between the chip removal area 22 and the implant axis I is less than 90 °. The chip S torn off by the cutting edge of the wall of the cavity is pushed into an undercut that serves as a chip chamber 23 that forms the chip removal area 22. Depending on the size of the chip chamber 23, the cutting edge 14 acts not only in shear form but also compacting the bone tissue. If an implant with a cutting edge 14 similar to the cutting edges 14 shown in FIGS. 5A and 5B is implanted in a slightly conical cavity (the perforation wall K is not parallel to the implant axis), then the projection can be dispensed with out from cutting edge 14; the free angle is then equal, for example, to the angle between the cavity wall K and the implant axis I. Fig. 6 again shows in a partial axial section a series of cutting edges 14, 14 'and 14"arranged one after the other in sequence which are configured similarly as the cutting edge shown in Fig. 5A. and the axis I of the implant decreases in the direction of implantation, so that the cutting edges can present forming shavings one after ortho on a wall K (K 'before the action of the cutting edges) cavity extending parallel to the implant axis I. Obviously, also in such a case the edges 14, 14 'and 14"are therefore associated with minimal cross-sectional reductions.The depths (d) of these cross-sectional reductions do not depend, unlike a conical implant ( for example according to figures 2 and 3) of the general shape of the cavity respectively of the implant, otherwise a good anchoring of the implant can be optically designed for a good chip formation respectively For a dental implant to be implanted in a corresponding perforation, the depths d referred to do not exceed, advantageously, 0.3 mm When the chip chambers 23 are not large enough for all the chip material, then the chip material in them is compacted.In order to avoid excessive compaction it can also be compacted. removing at least a part of the chip material from the chip chambers, for example by suction or by rinsing, since by means of a shaping of the implant for a rinsing, the rinsed material (chip material and rinsing medium) can exit the cavity between the wall of the cavity and the implant. Figure 7 shows again as a partial axial section a reduction 13 of stepped cross section which in this case does not have a cutting edge (cutting angle + ß in a perforation with a parallel cavity wall implant axis I equal to 90 °, in a conical cavity with wall K of cavity greater than 90 °; angle? equal to or greater than 09 °) and its edge can act, therefore, when much scraping on the wall of the cavity. Such cross-sectional reductions 13 can be provided in addition to the cross-section reductions with cutting edges. In figure 7 the surface regions 16 with the fluidizable material M can also be seen, the fluidizable material being arranged in depressions and projecting beyond the adjacent surface regions. When a cross-section reduction 13 has a cutting edge, then the fluidizable material, or a depression provided therefor, can also extend beyond it, as shown in FIG. 8 in an additional axial section through such reduction 13 of cross section. 9 shows again an axial section part an inventive implant having 26 internal cavity in which is positioned or positions the subject M flowable before implantation, and openings 27 through which the flowable material is pressed during the implantation in fluidized state (M ') to the surface of the implant, where it until then forms the surface regions of the implant and immediately or after its new solidification also an anchorage between the bone tissue and the implant. The internal cavity 26 is advantageously provided with directional elements 28 for energy, for example in the form of sharp steps to minimize the energy requirement for optimal fluidization of the fluidizable material prepared and achieve low as possible viscosity so.

Figure 10 shows as an example of an additional inventive implant an individual dental implant having a root region 11 consisting of several parts, such as a grindstone. This root region 11 does not necessarily replace the entire natural root region, but may be limited to its mechanically relevant and / or extractable parts. In this case too, it is possible to implant the implant immediately after removal of the tooth by replacing it and exposing it to load immediately after implantation. The implant can therefore have a crown region 12 which is, for example, a copy of the crown of the extracted wheel. Figure 11 shows another individual dental implant according to the invention, again having a root region 11 with stepped cross-section reductions 13 which are equipped at least in part with cutting edges 14. These cross-sectional reductions 13 are irregularly distributed over the root region 11 and do not extend completely over the entire periphery thereof and rather with an inclination relative to the axis I of the implant. Correspondingly irregular, the surface regions 16 of thermoplastic material and the regions 17 of bone integration surface are also arranged. The implant also has a proximal portion 30 in the manner of a pillar, which projects after implantation beyond the maxillary bone to the region of the gums and which is equipped, for example, with a blind bore 20 with internal thread for holding of other superstructures. The pillar part 30 has a collar 31 with a lower edge undercut in the form of a blade. With this lower edge, the pillar part "30 rests after the implant on the surface of the maxillary bone by cutting it lightly Immediately below the collar 31 is arranged a ring 32 of thermoplastic material which is intended to anchor the implant In the outer layer of the maxillary bone by fluidization during implantation, this ring 32 consists above all for a larger patient advantageously of a non-absorbable thermoplastic material, so that an additional function of sealing between its anchoring function can be entrusted to the bony tissue and gums which are located above and abutting the implant eventually do not in a very tight manner.The collar 31 and the ring 32 can also be used in a functionally independent manner, and can also be applied individually or in a combination also for standardized dental implants and also for different implants ai dental implants in general for an anchoring on a bone surface and for a filling of the cavity with respect to the interior of the bone. The orientation of the implant in the cavity is precisely defined thanks to the non-cylindrical circular and non-conical circular shape and - in the case of an individual implant - flat not with rotational symmetry of the inventive implant. For this reason it is also possible to configure the collar 31 not, as shown in FIG. 11, in a transverse direction relative to the implant axis, in a flat and round shape (rotational invariant), but adapted to the natural tooth, for example approximately oval and adapted the naturally curved course of a maxillary ridge, in the so-called scalloped shape (shell-shaped). Figure 12 shows another implant according to the invention which is again designed as an example dental implant and which has a root region 11 with stepped cross-section reductions 13 disposed therein, which are formed at least in part as sharp edges. cutting and which are limited in this case to parts of the circumference of the implant, so that they stand out from the remaining surface of the implant as flakes. These flake-like structures may have an essentially rectangular or square shape, as shown in the root region 11, and the edges (lower edges) that extend along the periphery can be shaped as described in the preceding (Figures 5 to 7) without or cutting edge. The same is true for the edges that extend essentially axially of the structures in the form of scales, which, if equipped sharply, function as structures of acial extension that produce grooves or cuts. To the right of the root region 11, other shapes are shown in FIG. 12, as an example, of cross-sectional reductions 13, stepped in the form of scales. These may also have concave lower edges in the axial direction (decreasing laterally, or in the center in the form of a tip) or convex (not shown) or axial edges that decrease obliquely towards the lower edge. It is also possible that the lower edges and regions above the lower edges are curved in a convex or concave manner in the radial or planar direction, ie the "scale" may have the shape of a cone or a hollow cone, or it can be essentially flat. It is also possible to provide the root region 11 of the individual dental implant in a manner known per se with one or more through openings 33. Similar openings are penetrated by bone tissue during the bone integration phase. Figures 13 and 14 show other embodiments of an inventive implant that can be applied, for example, as a dental implant. Figure 13 shows the implant in a side view, figure 14 sectioned transversely with respect to implant axis I (section line XIV-XIV in figure 13). The implant is essentially cylindrical and is designed. for the implantation in a cylindrical perforation. The implant has mutually opposite faces relative to the axis of the implant regions 16 of surface area of thermoplastic material M, the thermoplastic material being arranged in depressions 40 (here as grooves closed in the axial direction) and protruding from the adjacent surface regions 17. At the periphery of the implant between the surface regions 16 with the thermoplastic material, the implant has towards its proximal end additives 41 carrying cutting edges 14. These extend essentially transversely with respect to the axis of the implant and have, as shown in Fig. 6, distances to implant axis I that decrease in the direction of implantation.These distances vary from cutting edge to cutting edge by approximately 0.3 mm (for a dental implant) so that the implant can be implanted without previous formation of the cavity.This means in other words that the cutting edges are designed ed so that the respective cutting edge front wall modifies the cavity by starter • chip so that the following cutting edge can act on this optimally and again forming chips. The distances measured in transverse direction relative to the axis of the implant between cutting edges aligned with one another in the axial direction can also be greater than 0.3 mm for larger implants than dental implants. The implant according to FIGS. 13 and 14 is, therefore, implanted in a rotationally invariable cavity (perforation in the form of a circular cylinder) and still stabilized against rotational load thanks to its non-rotating shape. In comparison with a screw-shaped implant, the present implant has the advantage that it can be implanted in a precisely predetermined rotational position and that it can also carry, for this reason, superstructures that are not rotationally invariant, for example slanted collars, a crown , etc. It is not a condition for the implant according to FIGS. 13 and 14 that the depressions 40 provided for the thermoplastic material are grooves of axial extension. In particular, they can also be slightly helical extension slots that have a better capacity for absorbing torsional forces. The implant according to figures 13 and 14 can also have, for the implantation in a stepped perforation or in a cavity with internal end that decreases conically, in addition to the cutting edges also reductions of stepped cross section (not shown) that facilitate the extension of the depressions and of the fluidizable material M arranged therein, as shown in figure 8. Figures 15, 16A and 16B show another inventive implant (Fig. 15: axial section; Fig. 16A: section transversely with respect to the axis of the implant with the section line XVI-XVI; . Fig. 16B: side view), for example a dental implant that corresponds essentially in its shape to the implant according to figures 13 and 14, but having an internal cavity 26 and openings 27 connecting the internal cavity 26-- the external surface of the implant and which are, for example, essentially round or in the form of slits. The openings 27 open into depressions 40 whose bottom is, for example, rough for the best adhesion of the fluidizable material. The fluidizable material M, which can be, in this case, a thermoplastic or thixotropic material, is placed before or during implantation in the internal cavity 26 and is at least partially fluidized with the help of mechanical vibrations and pressed through the openings 27 to the depressions 40 forming between the implant and the cavity wall bags in which the fluidized material is introduced under pressure guided by the shape of the depression and which in this way makes intensive contact with the wall of the cavity. As shown in FIG. 16A, the depressions 40 can be formed, in particular for the case of the implant with the cavity 26, as slots that extend spirally around the implant, which allows the implant to stabilize even better against rotation in the cavity, thanks to the fluidizable material. The implant according to FIGS. 15, 16A and 16B is advantageously implanted without fluidisation of the fluidizable material M, that is to say, it is placed in its definitive position in the cavity, so that it is driven to impacts with a conventional tool or with an element that it oscillates mechanically (for example, a sonotrode of an ultrasound apparatus). Then the position of the implant is checked and it is still adjusted slightly in terms of its depth and rotational position and only then mechanical vibrations are applied on the fluidizable material and pressed against the distal end of the implant, so it is fluidized and leaves through the openings 27, it fills the depressions 40 and penetrates the adjoining bone tissue. So that the implant is seated in the cavity with sufficient stability for the verification and the eventual adjustment of its position, it is eventually advantageous to design the implant with a slight oversize in relation to the cavity, so that not only the edges Cutting penetrates cutting into the bone tissue, otherwise the implant is clamped in the cavity also with a press fit. For the fluidisation of the fluidizable material, a sonotrode fitted to the cross section of the cavity 26 or a piston 42 which is component of the implant can be used. A sonotrode is placed on the proximal end 43 of the piston 42 for the application of mechanical vibrations. The piston 42 is designed such that it penetrates, as the fluidization and displacement of the fluidizable material of the cavity 26 advances therein, until its proximal end 43 reaches the region of the opening of the cavity 26. The piston in this, for example, of titanium and is equipped in the region of its proximal end 43 with a thin thread 44 which is cold welded when pushed into the interior of the cavity 26 with the wall of the cavity also consisting of titanium. In this way, the proximal opening of the cavity 26 is closed in a sealed manner, which ensures the necessary sealing for a dental implant between the buccal cavity and the bone tissue. When the fluidizable material is re-absorbable, then the bone tissue will replace this material successively after implantation, that is to say, penetrate by growth in the opening 27 and the cavity 26, being in this case more important than the cavity 26. be completely sealed in relation to the oral cavity. Fig. 17 shows, like Fig. 15, in a partial axial section a piston 42 which is positioned for displacement of the fluidizable material of the cavity 26 in its proximal opening and which is designed such that its proximal end 43 reaches the proximal area 45 of the implant when sufficient fluidizable material has been expelled from the cavity 26 through the opening 27 provided therefor against the external face of the implant. The proximal end 43 of the piston is widened conically and-, the piston consists, in the present case, of thermoplastic material, for example, PEEK. When the edge around the proximal opening of the cavity 26 makes contact with the piston end 43 enlarged in oscillation, it serves as a directional element of energy and causes voltage concentrations that fluidize the thermoplastic material. The fluidized material penetrates between the wall of the cavity 26 and the piston 42, where a sealing groove 47 is advantageously provided, and thus closes together with the piston 42 the proximal opening of the cavity 26 in a watertight manner. From Figure 18, different embodiments of openings 27 and their outlets 40 are also seen. The openings 27 have, for example, a round cross section (top in the figure) or a slit (bottom in the figure) and the depressions can to be separated from the openings by a sharp edge (to the left in the figure) or as enlargements of the openings of the openings (to the right in the figure). Also combinations of the mentioned characteristics are imaginable. Figure 19 shows using the example of an implant according to Figures 13 and 14 a transition element 52 which is suitable for implantation by mechanical oscillations, in particular by means of ultrasound oscillations. The transition element 52 is adopted on the implant side in the region of the proximal end of a specific implant 10, optionally individual and on the exciter side in a sonotrode 53, advantageously standardized, which is part of an ultrasound apparatus. The connection of the transition element 52 is advantageously designed on the side of the implant and / or on the side of the exciter as an adjustment with play, that is, as an adjustment having play in the axial direction and a guide function in the radial direction. The respective other connection can be a rigid connection, for example a snap fit with friction connection or a threaded connection. The element 52 consists of a material (e.g. PEEK) with little acoustic damping (high modulus of elasticity) and can cause an acoustic adaptation between the sonotrode 53 and the implant 10 by means of a corresponding shaping or selection of material. The transition element 52 can have in addition to its interface function between the standardized sonotrode geometry and a specific implant geometry also an acoustic adaptation function, it can carry marks for orientation and measurement purposes, it can serve as a component that can be grasped easily by the surgeon who does not belong directly to the implant that allows to better manage the implant, in particular, when it is a relatively small dental implant. The transition element 52 is advantageously placed, on the part of the manufacturer, on the implant 10 and is discarded after implantation. In this function it is also possible that it forms part of the packaging of the implant. When the transition element 52 consists of a transparent material, it can also be responsible for light-conducting functions, whereby. the light is coupled from the sonotrode side to the serving element on the side of the implant eventually to illuminate the cavity and implantation. A connection with play adjustment between the implant 10 and the transition element 52 and / or between the transition element 52 and the sonotrode 53 (or between the sonotrode and the implant, when no transition element is used) can transmit only components of axial oscillation oriented against the implant, that is to say, that drive the implant into the cavity. Oscillation components that remove the implant from the cavity are not transmitted. It has been shown that the implantation by semi-waves thus produced is an advantage. One reason for this is probably the fact that the return movements of the implant in the cavity are suppressed and therefore less friction heat is produced between the cavity wall and the implant. Another advantage of the play adjustment is that the implant acoustically separates the sonotrode and eventually the transition element and that therefore the exact acoustic adjustment between the components of the exciter and the implant becomes less important. The adjustment with play is performed, for example, by means of an adjustment between the implant and the transition element acting as a capillary connection and in which a liquid is introduced immediately before implantation. That is, the implant - inserted in the transition element - is mounted on the sonotrode while it is oriented upwards and unpacked and then a liquid, for example water, is applied between the region of the proximal end of the implant and the transition element. which is distributed thanks to the capillary effect between the two components and holds them together with sufficient force so that the implant can be oriented downwards without falling off the adjustment. Fig. 20 shows an axial section through another embodiment of an adjustment with play between an inventive implant 10 and a transition element 52 (or between the transition element and the sonotrode or between the implant and the sonotrode). This consists essentially of a tension ring 54 which is positioned in slots 55 of implant 10 and transition element 52 aligned with one another and axially oversized and consisting of a material that can support the weight of the implant but which allows destruction of the ring, respectively, a separation of the implant from the fit with little application of force. Other variations of games with adjustment are part of the state of the art and can be applied analogously in the present case. As shown in Figure 20, the transition element 52 does not necessarily have to be without interruption.

You can have openings in this intermediate region without problems or have another appropriate structure. Figure 21 shows the method for the production of a dental implant 10 according to the invention. This method consists essentially of three stages that are all based on methods that are known per se. These steps are: * Measurement: a tooth 1 that must be replaced and / or the corresponding alveole 57 respectively the alveolus wall 7 are measured to produce a figure, for example three-dimensional. The measurement data that represents the figure are prepared for the. next processing. * Processing of the measured data: The measurement data that represent the figure are modified in particular by the addition of cutting edges and structures of fluidizable material, possibly by addition of an oversize or structures that produce grooves and cuts of axial orientation. If the figure is not a complete, three-dimensional figure, it is previously complemented with empirical values in relation to the shape of the implant. The processed measurement data is prepared for the production of an implant. * Production of the implant: the implant is produced based on the measurement data processed eventually in a multiplicity of productive stages. Different methods are appropriate for the measurement stage, in particular the computed tomography (CT) method or a MRl (magnetic resonance imaging) method, these methods allow, for example, simultaneously produce a figure of tooth 1 for a tooth not yet extracted and alveolus 57. Such method allows the implant to be produced before the extraction of the natural tooth that must be replaced and extract, in only one session, the tooth that must be replaced and implant in place the implant. However, it is also possible without any problem to measure the extracted tooth and / or the socket 57 after the extraction, which allows in particular to include in the measurement the deformations of the alveolus due to the extraction. Instead of a three-dimensional figure whose taking requires a complex apparatus, it is also possible to measure a two-dimensional X-ray image or a multiplicity of such images, being that the images are complemented with corresponding experience values for the production of a three-dimensional model. For the processing stage of the measured data, a CAD system (computer-supported design) is advantageously used, which is fed with the measured data of the measurement stage. When the measured data of the alveolus 57 are taken, the region of the root of the implant is advantageously modeled by means of this data. If only the measured data of the tooth to be replaced is available, an experience thickness for the dental epithelium is eventually added. For an implant with a cavity, an oversize can be added for a pressurized seat. The lateral surfaces of the root region are also modified by the addition of the cutting edges and the ... surface regions of thermoplastic material and possibly by structures that favor bone integration. For the surface regions of thermoplastic material, depressions are provided in a prior implant 10 ', whereby the components of thermoplastic material can advantageously be positively connected. For the bone integration surface regions, for example, the corresponding surface structures are provided. In the stage of the processing of the measured data, data allowing the production of a transition element can also be generated, being that it is adapted as accurately as possible to a region of the proximal end of the implant, for example its crown region 12. Just the same type of data can be produced for the production of a machining tool 58 or a set of machining tools, being that these tools are adapted to the root region of the implant (with a slightly smaller measurement for a machining tool, respectively a smaller measure increased in stepped form for a multiplicity of machining tools). The machining tool 58 serves for the preparation of the alveolar wall before implantation of the implant. For the stage of the production of the implant, a CAM (computer aided machining) system is advantageously used, which is fed with the data of the stage of the processing of the measured data. In this step, a prior 10 'implant is produced, for example, from a titanium raw part, for example by milling, grinding or electro-erosion. The surface regions for bone integration are then produced by an appropriate surface treatment and the components of thermoplastic material are applied (under pressure, by gluing, molding, ultrasound, etc.), which gives rise to the implant 10 finished. In essentially the same way as the previous implant 10 ', the transition element 52 and the machining tool (s) 57 are also produced for the preparation of the honeycomb wall. Figure 22 illustrates the method for implanting a dental implant according to the invention, wherein the implant 10 shown additionally has a root region 11 also inventively equipped with a crown region 12, these two regions being adapted to the shape of a natural tooth that must be replaced. The root region 11 of the implant 10 shown has stepped cross-section reductions 13 with cutting edges 14 and surface regions 16 of a thermoplastic material and optionally axial orientation geometries that produce grooves and cuts (not shown). The alveolus, before implantation, is cleaned and subjected to curettage, for which, for example, a tool operated with ultrasound is used (not shown). When the load on the bone tissue generated by direct implantation is tolerable, the implant is implanted directly into the socket 57 prepared in this manner (variant shown in the left part of FIG. 22). When it is sought to keep the load on the bone tissue low, then the socket 57 is prepared with a machining tool 58 producing the corresponding beads 13 'in the honeycomb wall 7 corresponding to the stepped cross-section reductions 13 (variant shown in FIG. right part of figure 22 with alveolus 57 'machined). For this pre-machining, a machining tool 58 adapted to the root region 11 in the alveolus is introduced. The cross-sectional dimensions of the machining tool 58 should for this be slightly smaller than the corresponding dimensions of the implant. If necessary, several machining tools of this type can also be used, each tool being somewhat thicker compared to the previously used tool. The alveolus is prepared eventually. also with the corresponding tools when an implant adapted to the alveolus is not used, but an appropriate but standardized implant must be used. The machining tools 58 can be inserted into the alveolus by corresponding strokes. Advantageously, however, they are excited with mechanical oscillations, preferably ultrasound, and guided simultaneously into the interior of the alveolus. A machining tool 58 can optionally be rinsed by a slightly abrasive medium, this medium being introduced under pressure through an opening in the distal end of the tool between the tool and the honeycomb wall and this means also serves to output the removed bone material. In the alveolus (57 or 57 ') cleaned or machined correspondingly, the implant 10 is inserted. Mechanical oscillations are applied to this., in particular ultrasound, which happens advantageously during the insertion of the implant in the alveolus. Of course it is also possible to insert the implant first with a blow tool in the alveolus and apply the ultrasound only afterwards. In particular, if the implant has a crown region 12, the transition element 52 adapted to this crown region is advantageously used. . When the implant has only one root region with an essentially flat proximal front face or a normed superstructure it is possible to use for the implantation also a transition element 52 or a corresponding standard sonotrode. By adapting the length and geometry of the sonotrode and possibly the transition element, it is possible to optimize the acoustic excitation of the implant. The sonotrode or transition element 52 can be equipped by appropriate measures as a positive or material connection or also by applying a vacuum that supports the coupling with the implant and to improve handling (see also Figures 19 and 20 and the corresponding parts). of the description).

When in the root region of the dental implant only the mechanically relevant parts of the corresponding natural tooth root have been copied, but this has been completely removed, then parts of the alveolus should be filled advantageously, before implantation. occupied by the implant, with a substitute bone material, for example with a calcium phosphate granulate, as used for the augmentations. Advantageously, the implant is implanted as quickly as possible immediately after the extraction of the tooth to be replaced. Of course it is also possible to produce a cavity for the implantation of the inventive implant in a site of the maxillary bone that does not have an alveolus or only one already closed, and prepare it in the manner previously described for implantation. The shape of such cavity and the corresponding implant can be adapted in this to bone structures that can be measured equally as a socket by a computerized tomogram. Figures 23A to 23C illustrate the implantation of an articulation implant according to the invention. Figure 23A shows a section through a bone 60 with an epiphyseal region 60.1, a metaphyseal region 60.2 or the diaphyseal region 60.3, wherein in this bone the joint implant may be implanted which may be in an individual implant produced particularly for the bone, or an opriate standardized implant. Figure 23B shows the machining tool 58 (also in section) whose shape essentially coincides with the shape of the implant and with which help the cavity 62 is produced or terminated in the bone 60. Figure 23C shows the articulation implant 10 implanted in the the cavity 62 as a side view. This has the shape of an irregular cone and has stepped cross-section reductions 13 with sharp edges 14, surface regions 16 disposed between those consisting of a thermoplastic material and structures 21 (ribs) of axial extension, which produce grooves and cuts . From the bone geometry captured with the aid of CT or MRl, the joint implant 10 and the machining tool 58 are selected or produced, essentially in the same manner and manner as described in connection with FIG. dental implant. The implant 10 and the cavity 62 are designed in such a way that the anchoring with the help of the cutting edges 14 and the ribs 21 is located in the epi and metaphyseal region. The surface regions 16 of the thermoplastic material are disposed at sites that are exposed to higher tensile and pressure stresses. In this way, the displacements or rotations that reduce the bone integration in the border area between the implant and the bone to a dimension that is no longer critical are reduced in focus. When producing the cavity the first opening can be produced with standard instruments. At least for the last emptying stage, however, the machining tool 58 adapted to the implant is used in terms of its shape, so as to adapt the shape of the cavity 62 sufficiently close to the shape of the implant 10. FIGS. 24A a 24C illustrate the repair of a bone defect generated by the removal of a bone tumor with an inventive implant 10 which creates a bridge over the defect. Figure 24A shows the bone 65 sectioned with the tumor 66. Figure 24B shows in section the region 66 'of bone to be removed (excision) and the machining tool 58 to be used at least for the finishing of the cavity 62. Figure 24C shows in section the cavity 62 already finished and the implant 10 to be implanted in the cavity, which in turn has, for example, the shape of an irregular cone and comprises reductions 13 of cross-section stepped with cutting edge 14 and surface regions 16 of a thermoplastic material. The tumor 66 of bone is previously delimited geometrically by means of X-ray, CT or MRl images.

Based on the measurement data, the surgeon determines the magnitude of the excision. The implant 10 and the machining tool 58 are selected or produced especially according to the geometry of the excision. The machining tool 58 further has suction channels 58.1 which open onto the surface of the tool in the region of the edges formed in the form of knives of the cross section reductions. Through these 58.1 aspiration channels, bone material, bone marrow and tumor cells are sucked out of the cavity, thereby increasing the volume that the tool 58 can extract and avoiding the accumulation of high local pressures that could produce lipid emboli. . The aspiration of the tumor cells also prevents them from being transferred to healthy tissue, which considerably reduces the risk of leaving cells in metastasis. The figures described above and the corresponding parts of the description refer in most cases to specific implants (dental implant, joint implant, individual implant, standard implant, etc.) and to specific characteristics of these implants. Of course it is also possible to apply the described features to other implants and to combine them in another way, as is the case in the present description. In this way, implants arise that are not specifically described, but can be subsumed, however, to the present invention.

Claims (9)

1. Implant for bone that is suitable for implantation in a direction of implantation parallel to the axis of the implant in a cavity surrounded by a cavity wall of bone tissue, wherein the implant has in a region to be implanted surface regions of a fluidizable material by mechanical oscillations or similar surface regions can be produced by squeezing the fluidisable matter from a cavity through openings, characterized in that the region to be implanted also has outside edges of predicted or producible surfaces of the fluidizable material edges. Cutters that are not located in a common plane with the implant axis, which are oriented against a region of the distal end of the implant and which extend at least partially around the circumference of the implant.

2. Implant for bone according to claim 1, characterized in that the cutting edges have a wedge angle of less than 90 °.

3. Implant for bone according to claim 1 or 2, characterized in that the cutting edges are shaped in a slightly projecting manner. Bone implant according to one of claims 1 to 3, characterized in that the cutting edges are undercut to form a chip chamber. 5. Bone implant according to one of claims 1 to 4, characterized in that the fluidizable material is arranged in depressions and the surface regions of the fluidizable material protrude from the surface regions adjacent to the depressions. Bone implant according to one of claims 1 to 4, characterized in that the openings open into the depressions. Implant for bone according to one of claims 5 or 6, characterized in that the depressions are grooves extending axially or spirally on the region to be implanted. Bone implant according to one of claims 1 to 7, characterized in that regions of the bone integration surface are disposed between the surface regions of the fluidizable material. Bone implant according to one of claims 1 to 8, characterized in that axially extending structures producing grooves or cuts are also provided in the region to be implanted. Implant for bone according to one of claims 1 to 9, characterized in that the cutting edges extending • partially around the circumference of the implant form lower edges of scaled structures. Bone implant according to one of claims 1 to 10, characterized in that the region of the proximal end has a collar with a lower edge formed in the manner of a blade. Bone implant according to one of claims 1 to 11, characterized in that the region of the proximal end has a ring of a thermoplastic material. Implant for bone according to one of claims 1 to 12, characterized in that the region to be implanted has a shape that decreases in the distal direction. 1

4. Implant for bone according to the claim 13, characterized in that it has stepped cross-sectional reductions that extend totally or partially around the implant and that have edges at least in part that are shaped as cutting edges. 1

5. Implant for bone according to the claim 14, characterized in that a part of the stepped cross section reductions has non-cutting edges with a wedge angle of 90 ° or more. Implant for bone according to one of the claims 1 to 12, characterized in that the region to be implanted is essentially cylindrical and has cutting edges that protrude from the cylindrical shape that have distances from the axis of the implant that decrease in the direction of implantation. 17. Implant for bone according to the claim 16, characterized in that the cutting edges protruding from the cylindrical shape extend over a part of the circumference of the implant and are aligned with one another in series in the axial direction. 18. Implant for bone according to the claim 17, characterized in that it has at least two series of cutting edges opposite each other and that the surface regions of the fluidizable material or the openings of the openings are arranged on the circumference of the implant between the series. 19. Implant for bone according to one of claims 1 to 18, characterized in that it has an internal cavity and a piston that can be pushed into a proximal opening of the cavity. 20. Implant for bone according to claim 19, characterized in that at a proximal end of the piston and / or around the proximal opening of the cavity means are provided for a sealed connection of piston and implant. 21. Implant for bone according to one of claims 1 to 20, characterized in that it carries a transition element in a proximal end region. 22. Implant for bone according to claim 21, characterized in that the transition element is connected through an adjustment with play with the implant and / or is prepared for an adjustment connection with -play to a sonotrode. 23. Implant for bone according to one of claims 1 to 22, characterized in that it is a dental implant. 24. Implant for bone according to claim 23, characterized in that it has in addition to the root region a crown region, a pillar part or means for holding a pillar, a crown, a bridge or a dental prosthesis. 25. Implant for bone according to one of claims 1 to 22, characterized in that it is the rod of a joint prosthesis. 2

6. Implant for bone according to one of claims 1 to 22, characterized in that it is designed to create a bridge over a bone defect. 2

7. Set of implantation consisting of a bone implant according to one of claims 1 to 26, and at least one machining tool that is adopted in terms of its shape to the region to be implanted of the implant and / or a transition element that it is adopted in terms of its shape to the region of the proximal end of the implant. 2

8. Method for the production of a bone implant according to one of claims 1 to 26, wherein the bone implant referred to is implanted as a replacement for a bone part or a tooth in a predetermined cavity or for producing with a wall of bone. bony cavity, wherein the method comprises a method step in which the bone part or tooth to be replaced is measured and / or the predetermined cavity or a predetermined bone structure in the region of the cavity to be produced to determine measurement data that they allow the formation of a figure of the bony part, of the tooth, of the cavity or of the bone structure, a stage of processing of measurement data in which the measurement data are processed, and a stage of production in which the implant for bone based on the processed measurement data, characterized in that in the measurement data processing stage the region to be implanted is provided with cutting edges that they are dimensioned in such a way that after implantation they are at least partially inserted by means of a section in the cavity wall and with structures - for housing components of the fluidizable material. 2

9. Method according to claim 28, characterized in that a three-dimensional image or one or more two-dimensional images are captured in the measurement step. 30. Method according to claim 28 or 29, characterized in that in the step of processing measurement data are built in the region by implanting an internal cavity and openings connecting the surface of the region to be implanted with the internal cavity. , 31. Method according to one of claims 28 to 30, characterized in that in the step of processing measurement data are constructed in the region by implanting structures of axial extension that produce grooves or cuts and that are sized such that they extend after implantation at least in part to the interior of the cavity wall. 32. Method according to one of claims 28 to 31, characterized in that data for the production of a measuring tool adapted to the region by implantation of the implant are additionally established in the measurement data processing stage. Method according to one of claims 28 to 32, characterized in that data for the production of a transition element adapted to the region of the proximal end of the implant are additionally established in the step of processing measurement data. 34. Method according to one of claims 28 to 33, characterized in that structures with bone integration activity are constructed in the step of processing measurement data. 35. Method according to one of claims 28 to 34, characterized in that the implant for bone is a dental implant and that the tooth to be replaced and / or the socket before the removal of the tooth to be replaced is measured. 36. Method for implanting a bone implant according to one of claims 1 to 26, wherein the implant for bone is inserted in a predetermined cavity or to be produced with a bone cavity wall, characterized in that when the implant is inserted the cutting edges penetrate by cutting into the wall of the cavity and because by application of mechanical oscillations at least a part of the fluidizable material is fluidized and introduced under pressure in the wall of the cavity. 37. Method according to claim 36, characterized in that for the application of mechanical oscillations to the implant, the implant is coupled to an excitation element in such a way that of the oscillations only the component that pushes the implant in the cavity is transferred to the implant. 38. Method according to claim 37, characterized in that the excitation element is a sonotrode of an ultrasound apparatus or a transition element that can be coupled to the sonotrode. 39. Method according to one of claims 36 to 38, characterized in that the implant comprises surface regions of the fluidizable material and because the implant is positioned in the cavity by mechanical oscillations. 40. Method according to one of claims 36 to 38, characterized in that the implant comprises an internal cavity in which the fluidizable material is positioned or positioned, because the implant is inserted into the cavity without applying mechanical oscillations or are mechanical application without including the fluidizable material, and that subsequently the fluidizable material positioned in the cavity receives a load of mechanical oscillations and is pressed against the distal end of the implant. 41. Method according to claim 40, characterized in that before the application of mechanical oscillations to the fluidizable material and after inserting the implant in the cavity, the position of the implant is verified and eventually adjusted. 42. Method according to claim 40 or 41, characterized in that a piston is used to load and press? A fluidizable material and the piston is subsequently connected in a sealed manner to the implant due to the effect of the mechanical oscillations. 43. Method according to one of claims 36 to 42, characterized in that the implant is coniferous and comprises stepped cross-sectional reductions and that before inserting the implant, heels adapted to the stepped cross-section reductions are prepared. 44. Method according to claim 43, characterized in that for the preparation of the beads a machining tool is used which is adapted to the implant region of the implant. 45. Method according to one of claims 36 to 44, characterized in that the implant for bone is a dental implant and because the implantation is performed immediately after the extraction of the tooth to be replaced. SUMMARY The invention relates to an implant (10) for bone that is implanted in a predetermined cavity or a cavity that has been specifically produced, parallel to an implant axis (1) without a significant degree of rotation. The implant has cutting edges (14) that are not located in a common plane with the implant axis and that are oriented towards the distal end of the implant. Additionally, the implant comprises surface areas (16) consisting of a material that can be fluidized by mechanical vibrations. The cutting edges (14) are dimensioned in such a way that - once they are implanted - they cut into the wall of the cavity. To perform the implantation, the referred implant is subjected to mechanical vibrations which cause the thermoplastic material to be fluidized at least in part and to be pressurized into the irregular areas and pores of the cavity wall where it hardens to form a connection between the implant (10) and the wall of the cavity through a positive union and / or material union. The cutting edges (14) provide an anchorage for the implant in the wall of the cavity in a manner similar to a screw-type implant. Since the implant does not require rotation, the implant can have a shape that is neither cylindrical nor conical and thus can be stabilized against rotational stress more effectively than a screw type implant. The implant is also more stable in terms of tensile forces as a result of anchoring by the fluidizable material and can, in particular, be subjected to stress immediately after implantation. The implant is, for example, a dental implant.