PH12018050179A1

PH12018050179A1 - Dental plate and surgical procedure thereof

Info

Publication number: PH12018050179A1
Application number: PH12018050179A
Authority: PH
Inventors: Parakram Parajuli; Iv Macario Antonio Fadrigalan
Original assignee: Parakram Parajuli; Iv Macario Antonio Fadrigalan
Priority date: 2018-04-20
Filing date: 2018-04-20
Publication date: 2019-11-11
Also published as: WO2019203666A1

Abstract

The present invention is directed to a dental plate and the surgical procedure thereof. Said dental plate has a base which is completely cemented with high adhesive material like Polymethylmethacrylate (PMMA) cement within the alveolar bone after preparing a box with modified bur and disposable scale. Said base, is covered with bone graft and sutured, while the abutment exposed to oral cavity for temporary or permanent prosthesis. The gum (gingival) heals and surrounds the gum gutter. Permanent prosthesis is achieved by cementing it directly to the abutment. Temporary prosthesis is achieved through cementing accessories like ball cap, magnet cap and screw cap for ball and socket, magnetic and screw retention respectively.

Description

DENTAL PLATE AND SURGICAL PROCEDURE THEREOF AC

FIELD OF THE INVENTION o

The present invention relates to a dental plate which would restore - missing tooth or teeth through a surgical procedure in maxilla or mandible. -

BACKGROUND OF THE INVENTION -

Due to several reasons, the natural teeth are lost leading to partial - or complete edentulous condition in the oral cavity. The treatment of such condition is accomplished through several means. Most preferred is fixed crown or bridge. The fixed crown or bridge are achieved through a conventional method, a natural tooth retained bridge, or intraosseous surgical method wherein dental implant (screws) retained tooth or bridge.

To avoid the process of compromising healthy tooth structure, which occurs in conventional method, the trend is concentrated more on dental implants. However, dental implants have their own drawbacks such as requiring acceptable bone density, height and width. Additional sensitive surgical procedure of bone graft is indicated if bone height and width is deficient, which requires additional time and expense. Aside from that, dentist and surgeon needs to develop a special skill to conduct the sensitive and multiple surgical procedures that requires specialized surgical kit and equipment, which are expensive. Apart from being expensive, the procedure for setting up a dental implants takes time, spanning from six months to one year.

SUMMARY OF THE INVENTION -

The present invention is a dental plate and surgical procedures o thereof. It utilizes low cost dental plate and provides faster surgical i procedure from the point of a dentist or surgeon while also giving patient " an additional option for fixed tooth or bridge.

The object of the present invention is to provide a dental plate = intended to copy the natural way of load transformation. Natural teeth have © roots, that are divergent and covers larger surface area than the trunk, and ; natural molar teeth also have multiple and divergent roots, that cover equal or more surface area than the crown of the teeth. Load receiving area is narrower than the load distributing component. Dental plate is designed in similar fashion.

Another object of the present invention is to provide a dental plate designed to achieve its retention mainly from bio-compatible cements through adhesion, and a very minimal through anchorage or mechanical means, but not through osseointegration.

Other objects, features and advantages of the present invention will become readily apparent from the following detailed description of the preferred embodiment when considered with the attached drawings and the appended claims.

BRIEF DESCRIPTION OF DRAWINGS -

Fig. 1 shows a front view of the dental plate displaying the length of = the base. i.

Fig. 2 shows a side view of the dental plate displaying the width of - the base. -

Fig. 3 shows a front view of the bevel dental plate displaying the = length of the base. =

Fig. 4 shows a front view of flush dental plate displaying the length o of the base. -

Fig. 5 shows a top view of titanium dental plate displaying both the length and the width of the base.

Fig. 6(a) shows a cross-sectional view of ball cap.

Fig. 6(b) shows a cross-sectional view of magnet cap.

Fig. 6(c) shows a cross-sectional view of screw cap.

Fig. 7 shows a modified bone bur.

Fig. 8 shows a disposable scale.

Fig. 9 shows a diagram of the surgical procedure.

Fig. 10 shows the cross-sectional view of surgical site with dental plate in place.

Fig. 11(a) shows a photograph of the actual sample of a dental plate showing the front view that had the base height of 2mm.

Fig. 11(b) shows a photograph of the actual sample of a dental plate showing the front view that had the base height of 3.5mm.

Fig. 11(c) shows a photograph of the actual sample of a dental plate showing the front view that had the base height of 4mm.

Fig. 11(d) shows a photograph of the actual sample of a dental = plate showing the front view that is circular in shape with base height of ”

Fig. 12 shows a photograph of the actual samples of the dental - plates showing their front views tied with orthodontic wire and marked with - individual names. -

Fig. 13 is a photograph showing the front view of a goat's mandible = with proper incision to fit each dental plate samples. -

Fig. 14 is a photograph showing the perspective view of the - samples attached to the mandible with PMMA bone cement and then was " tied with the copper wire.

Fig. 14 is a photograph showing the perspective view of the goat's mandible loaded on tensile testing machine.

DETAILED DESCRIPTION

A dental plate is made of zirconia, titanium or any other biocompatible material, which is considered strong and load bearing.

Manufactured product comprises of kit with dental plate made of zirconia, a protective cap, a lab coping and a disposable scale.

Fig. 1 shows a front view of a regular dental plate 100A as embodied in the present invention. Said dental plate 100A is a single unit comprising of a base 101 and a section 102.

Said base 101 have different height of 2mm, 3mm and 4mm. The width (bucco-lingual) determines the manufacturing size code of said

CL ———————— ES — dental plate 100A with at least five different sizes, 7mm, 6mm, 5mm, 4mm < and 3mm. While the length (mesio-distal) is 2mm longer than the width, for = e.g. dental plate 100A with the base 101 of 5mm width will have a length = of 7mm. > »

The bottom surface of the base 101 that meets the bone with ~ cement is manufactured with porosities, straight grooves or multiple “S” = shaped grooves to increase the adhesive strength with the cement. Said 5 base 101 adopted and securely cemented on the alveolar bone. This = portion lies under the soft tissue and is not exposed in the oral cavity.

Said section 102 is the abutment, which is exposed in the oral cavity and is also the receiver of the fabricated crown or bridge. It is overall a circular section.

The size of said section 102 is the diameter at the highest convexity of 7mm, 6mm, 5mm, 4mm and 3mm. Since it is same as the width of the base 101, it also determines the manufacturing size code. For e.g., 6mm dental plate 100A means that the width of the dental plate 100A and the diameter of the abutment is same, which is 6mm. Said section 102 comprised of: i. Lower member 103, the gum gutter, is 2mm in height. The gingiva (gums) heals and surrounds this section after surgery. It consists of the highest convexity of the abutment (also determining the size of the abutment) and provides room for middle member 104. It is narrower as it approaches the base 101;

ee ———————————— —— ii. Middle member 104, the prosthetic margin, is 2mm wide and - it is the portion where the crown is seated. It runs around the ” abutment along the highest convexity; and = iii. Upper member 105, the body, where the crown is cemented ow for final restoration, and is 5mm. Since it is made of zirconia, - it can be reduced to desired height as needed. It is broader - at the middle portion 104 margin and lower portion 103, while = gets narrower as it approaches the end. It also has = rectangular depressions 106 prepared on buccal or © lingual/palatal side or on both sides. This rectangular - depression discontinues the circular body and avoids the rotational dislodgment of the crown.

Fig. 2 shows a side view of a regular dental plate 100A as embodied in the present invention. Said dental plate 100A is intended for cases having enough supportive bone. Used in cases where at least 2mm bone can be reduced without any complications.

Fig. 3 shows a front view of dental plate 100B with a bevel base as embodied in the present invention. The corners of the base 101 of the said dental plate 100A are beveled in an angle reducing the height of base 101 to 1mm. It is used, if only 1mm of bone reduction is intended.

Fig. 4 shows a front view of dental plate 100C with full bevel base or a flush dental plate as embodied in the present invention. The corners of the base 101 of this type are completely beveled, reducing the height of the base 101 to almost Omm. It is used when reduction of bone is very

Co —————————————————— EE — minimal or impossible or not intended. The complete bevel creates a - flushed relation with the underlying bone after cementation. If the flush ~ dental plate do not seat properly above the bone and displays rocking or - “sea-saw” effects, minimum preparation is indicated only. o ;

Fig. 5 show another embodiment of a dental plate manufactured i. with other biocompatible materials like titanium. The titanium dental plates = will not consist of abutments. Instead of abutments, it will have a female = screw section 107 to receive a male screw of external metal abutments. =

This will also have holes on the corner 108 for better retention with the ” cement. The height of the base can be that of only 1mm.

To broaden the options for final restoration, dental plates have the following accessories made of cobalt chromium, gold or any other metal that is accepted by the oral cavity: a) ball cap, b) magnet cap and c) screw cap as shown in Fig. 6(a), 6(b) and 6(c).

The ball cap as shown in Fig. 6(a) consists of a ball 109 on the top.

It is used, if over-dentures or removable dentures are preferred, which is meant for ball and socket retention where the socket is prepared on the dentures. Next Fig. 6(b) shows a magnet cap that consists of a magnet 110 on the top. It is used, if magnet retentive removable dentures are preferred. Lastly, a screw cap as shown in Fig. 6(c) consists of screw portion (female) 111 that embeds inside the abutments. It is intended for screw-retained crowns.

Accessories as shown in Fig. 6(a), 6(b) and 6(c) can be used if oo desired. Since it exactly fits on the body of the abutment, it can just be ~ cemented on the abutment using any luting cement. For placing a screw o cap, the body of the abutments needs a preparation of a hole, where the = screw portion (female) can fit in. i»

Modified bone bur =

Referring to Fig. 7, the procedure to fix the dental plate on maxilla = or mandible includes reduction of bone. The diameter of the bone burs depends on the size cutting surface 112 from the edge of the shaft 113 of the bur. For so reason, four (4) different sizes of plate bur ranging from 1mm, 2mm, 3mm and 4mm of a non-tapering bone burs are developed. All the while, the bone bur also comes in five sizes, 7mm, 6mm, 5mm, 4mm and 3mm where the said size represents the length (cutting portion) 114 of the bur. Another factor is considered in producing the modified bone bur wherein the size of the bur resembles the size of the dental plate. It also serves as a guide in surgical procedure that determines the width of the surgical preparation that will receive the dental plate.

Disposable Scale

Fig. 8 shows the disposable scale that resembles the length of the dental plate. Said disposable scale is also a guide during surgical procedure that will identify the starting point and the end point of surgical procedure for width wise reduction. A dental plate with 7mm length is provided with a 7mm scale in the kit.

Surgical procedure -

Fig. 9 shows the method for implanting a dental plate. First of all, ke the impression should be secured so that a model cast can be a guide for o determining the actual location to fix the dental plate and to anticipate the - width of the alveolar crest. A panoramic (OPG) x-ray is also acquired to ~ know the condition and bulk of the bone (length wise). Cone Beam ©

Computer Tomography (CB/CT) scan can also be acquired to know the = details of the residual ridge, but is not mandatory, since model cast and panoramic x-ray will be sufficient as guide tools.

Once the exact location for the placement of dental plate is finalized, the soft tissue is anesthetized, and incisions are made to achieve triangular or trapezoidal flaps 115. According to the size of the dental plate, correct bone bur 116 is chosen, which will also be the guide for width (bucco-lingual) reduction. The bone is reduced to prepare a rectangular depressed box 117. This box should have good bulk of bone 118 all around it. Exact length (mesio-distal) reduction can be achieved with the help of disposable scale 119 provided in the kit. Initial guiding depressions with the bur along mesio-distal length is highly recommended.

The dental plate is then placed 120 on the box to check for its exact fit. It is considered an exact fit if the dental plate properly seats inside the box and the corners of the base is completely submerged within the bone and no sharp edges protrude outside the box, as shown in Fig. 10. While the base is checked for the fitting in the box, the abutment is checked to see if it is in right angle (90 degree) relation to the opposing ridge/tooth from mesial, distal and buccal/labial aspects. If it is not, or if it also presents rocking or “sea-saw” effect then the bur is used to make necessary - reduction on the floor of the box so that the abutment is in correct relation = to the opposing ridge/tooth and firmly seated. Right angle relation of the Lh abutment to the opposing ridge/tooth from mesial, distal and buccal/labial aspects ensures the accurate parallelism and path of insertion of crown or bridge. -

If the alveolar ridge consists of very narrow ridge, reduction of = 2mm-3mm of such ridge is recommended, until a flat bony surface is accomplished.

The prepared box is then cleaned with normal saline and dried.

Once dried, a bone bonding agent (if available) is applied within the box (on the floor, as well as on the walls of the box) and the ceramic bonding agent is applied on bottom surface of the base of the dental plate, which increases the adhesive strength between zirconia base and cement.

Polymethylmethacrylate (PMMA) is used as a cement to adhere the dental plate to the bone. It is smoothly and thoroughly distributed on all the surfaces of the base of the dental plate, or the surgical box is filled with

PMMA cement. After which the dental plate is cemented inside the surgical box. For faster and effective working time, an ultra violet light can be used to polymerize the bonding agents and the PMMA cement, if the bonding agent and PMMA cement consist of photoinitiator. Aside from

PMMA cement, any cement can be used, which is developed with a very high adhesive strength, and which is biocompatible and do not have toxic effect to soft and hard tissues. However, use of cements like PMMA also - provides cushion effect, which will mimic the natural periodontal ligament. ~

Once the dental plate is secured in desired location, excess cement “ should be removed. The base should then be covered with resorbable w bone graft material, and a protective membrane is then placed above it. ~

The reason to place the bone graft material is to facilitate bone growth - above the base, so that the soft tissue (gingiva) will attached to the newly = formed bone and do not have to lay on a foreign material. The flap is then = sutured back in such a way that the base is completely closed with the gingiva while resting around the gum gutter. Protective cap, which is also a gum former is placed on the abutment. Suture is removed in a week time, and final restoration with crown or bridge can be accomplished in two weeks’ time since the retention and adhesive strength is already achieved with bonding agent and cement within this time.

The dental plates made that of titanium can be cemented similarly.

In both cases, resorbable bone graft material and protective membrane should be place above the base.

Test and Results

Both materials, Zirconia and PMMA cement used in the present invention has proven biocompatibility and safe to use through several researches and clinical uses since more than decades. Zirconia disc that are used to prepare dental crowns were used in this study. Zirconia disc were marked with desired dimension and then were cut using hand instruments to come up with the dental plates. For this invention, the base - of the dental plate was focused properly while preparing the sample since ” the retainability test is supposed to take place in base, once it is attached = to the mandible with bone cement. And the abutment part of the dental . plate was prepared focused only to hold wire for the tensile test. Ten - samples of dental plates were cut and prepared with the following - dimensions as shown in Figs. 11(a) -11(d): = e Fig. 11(a) shows a photograph of the actual sample that had the 5 base height of 2mm. Total of 4 samples (A1, A2, A3 and A4) were = prepared with 6mm of length and 5mm of width. - ¢ Fig. 11(b) shows a photograph of the actual sample that had the base height of 3.5mm. Total of 3 samples (B1, B2 and B3) were prepared with 6mm of length and 5mm of width. e Fig. 11(c) shows a photograph of the actual sample that had the base height of 4mm. Only 1 sample (C1) was prepared with 8mm of length and 5mm of width. ¢ Fig. 11(d) shows a photograph of the actual sample that is circular in shape with base height of 2mm. Total of 2 samples (D1 and D2) were prepared with the diameter of 5mm.

Once the samples were cut and prepared, they were then sent to dental lab for heat treatment. After the treatment was completed the abutment of each sample were tied with orthodontic wire. This wire will be secured in the tensile machine so that the machine could pull it out from the goat's mandible. Each sample were then marked with individual names as shown in Fig. 12.

After the dental plate samples were prepared, a goat's mandible was - purchased from the local market. All remaining soft tissues were properly ~ removed and was thoroughly cleaned. Pencil marking were placed to - incise the bone on exact desired measurements as shown in Fig. 13 to i properly fit each sample and then the incision were made using dental - burs on high-speed handpiece. -

Fig. 14 is a photograph showing the perspective view of the samples = which were then attached to goat's mandible with PMMA bone cement. -

The mandible was then tied with copper wire so that tensile machine could - hold it while conducting the test.

After one hour of cementation time, the mandible was loaded in the tensile testing machine as shown in Fig. 15. Machine would hold the orthodontic wire tied to dental plates in one end and would hold the copper wire tied to the mandible on the other end. The machine would then pull the sample in opposite direction until the sample would detach from the mandible. The reading was then recorded for each sample in Newton force, and later were calculated for Megapascal (MPa). To calculate MPa of rectangular samples, MPa = N/Length X Width (Area) was used while to calculate MPa of circular samples, first area was calculated with the formula A = 1 r2, and then MPa was calculate with the formula MPa = N/Area.

Based on the test conducted Sample C1 showed the best results of 332 N (8.3 MPa), while sample D1 and D2 showed the least retainability with 54

N (2.75 MPa) and 60 N (3 MPa). Table 1, Graph 1 shows the result of each sample in newton and Table 2, Graph 2 shows the result of each ~ sample in megapascals. - Sampl | Newton(N) | ~

B33 | 20 = cr a3 - op2 | = e0

Table 1 - Reading of each sample in newton force.

Chart Title

BE) ee——— nt AA AAPA

AL a2 AZ a4 BL 82 83 1 B51 oz £1 ewton

Graph 1 - Reading of each sample in newton force. _Sampl | Megapascals (MPa

Aa | 56

A | a8

A300 | 0 40 "

Bt | 55 ~

B33 | er = bt} 0 27 2 b2 | 30 | -

Table 2 - Reading of each sample in MPa

Chart Title - ee — 8 | ho

AL AZ AZ Ad B81 B82 83 C1 3 o2 on

Graph 2 - Reading of each sample in MPa.

While the foregoing detailed description has discussed the details of a dental plate, the same should not be construed as a limitation of this invention the scope of which should be determined by interpreting the attached claims.

Claims

; CT Tg a CLAIMS Cm z Cn 0 Za

1. A dental plate comprising: = a base: on an abutment mounted on the base which receives a C fabricated crown or bridge said abutment comprises: — a gum gutter located at the bottom section of the = abutment, and provides room for middle member: = a prosthetic margin located at the middle section of - the abutment, and where the crown is seated: and a body where the crown is cemented for final restoration, having a rectangular depression and used to prevent the rotational dislodgement of the crown on the central portion related to the vertical wall; whereby said dental plate is adapted to be cemented to the alveolar bone with high adhesive material.

2. A dental plate according to claim 1, wherein the high adhesive material used is a polymethylmethacrylate (PMMA) cement.

3. A dental plate according to claim 1, wherein the material used is made of zirconia or titanium, or any other biocompatible material.

4. A dental plate according to claim 1, wherein said base has a no beveled base, 1mm beveled base or full beveled base.

5. A dental plate according to claim 1, wherein the middle member of — said abutment has a recess outer portion. <

6. A dental plate according to claim 1, wherein the upper member of Le said abutment has a wider bottom and ends with a tapered portion. oO

7. A dental plate according to claim 1, wherein said base has a female - screw section which receives and holds the male screw of an © external abutment.

8. A dental plate according to claim 1, wherein said base has a ball protrusion section which receives and holds socket for retention.

9. A dental plate according to claim 1, wherein said base has a magnet to hold the external abutment.

10. A dental plate according to claim 1, wherein a kit for surgical procedure which also comprises the modified bone bur has: a non-tapering cutting part with cutting depth of 1mm and 2mm or length of 7mm, 6mm, 5mm, 4mm and 3mm.

11. A method for implanting a dental plate according to claim 1, wherein said method comprising the steps of:

a. determining the location to fix the dental plate;

b. choosing a preferred dental plate;

c. choosing modified bone bur to create the incision and bone graft for covering the base;

d. making an incision around the determined location: <

. e. reducing bone within the incised portion to form a depressed ~ box; = f. placing and fitting the dental plate in the depression box; o g. using Polymethylmethacrylate (PMMA) as a cement to adhere the dental plate to the bone; -

h. securing the dental plate; and = i. closing the incision. = -

ve - * oe; a eines CLAIMS ” ho Mm IN rea Jott elt In Css

1. A dental plate comprising: = a base; on a-seetionn_abutment mounted on the base which receives a I fabricated crown or bridge—wherein-said—section—comprises_said abutment comprises: re ——a lower—membergum gutter located at the . bottom section of the abutment, and provides room for Bh middle member; ——a_rniddle—memberprosthetic margin located at the middle section of the abutment, and where the crown is 16 seated; and

———a_—upper—memberbody where the crown is = cemented for final restoration, having a rectangular ” depression and used to prevent the rotational dislodgement = of the crown on the central portion related to the vertical wall; o whereby said dental plate is adapted to be cemented to the - alveolar bone with high adhesive material. -

2. A dental plate according to claim 1, wherein the high adhesive = material used is a polymethylmethacrylate (PMMA) cement. .

0

4. A dental plate according to claim 1, wherein said base having-has a no beveled base, 1mm beveled base and-or full beveled base.

SSS [a

5. A dental plate according to claim 1, wherein the middle member of = said section-abutment having-has a recess outer portion. ~

6. A dental plate according to claim 1, wherein the upper member of 0 said section-abutment having-has a wider bottom and ends with a tapered portion. =o

7. A dental plate according to claim 1, wherein said base having-has a = female screw section which receives and holds the male screw of . an external abutment. -

8. A dental plate according to claim 1, wherein said base having-has a ball protrusion section which receives and holds socket for retention.

9. A dental plate according to claim 1, wherein said base having-has a magnet to hold the external abutment.

10. A dental plate according to claim 1, wherein ;-having-a-medified ” bone-bur-for-surgical-procedure-a kit for surgical procedure which oO also comprises the modified bone bur haseemprising-of. Ny 4 o a non-tapering cutting part with cutting depth of 1 im and 2mm_; - andor length of 7mm, 6mm, 5mm, 4mm and 3mm. T - re

11. A-method-A method for implanting a dental plate according to claim = 1, wherein said method comprising the steps of: ’

a. determining the location to fix the dental plate; -

b. choosing a preferred dental plate;

d. making an incision around the determined location;

e. reducing bone within the incised portion to form a depressed box;

f. placing and fitting the dental plate in the depression box;

g. using Polymethylmethacrylate (PMMA) as a cement to ~ adhere the dental plate to the bone; ”

h. securing the dental plate; and 5 i. closing the incision. oo 44—for-implanting—a—dental-plate—according-to—eclaim—t—wherein—said method-comprising-the steps-of: - 16 plac { fitting the dental plate. in the-d ion-box: 8 losina-the. incision. 19: