RU177272U1 - Implant placement surgical template - Google Patents

Implant placement surgical template Download PDF

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Publication number
RU177272U1
RU177272U1 RU2017131154U RU2017131154U RU177272U1 RU 177272 U1 RU177272 U1 RU 177272U1 RU 2017131154 U RU2017131154 U RU 2017131154U RU 2017131154 U RU2017131154 U RU 2017131154U RU 177272 U1 RU177272 U1 RU 177272U1
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Russia
Prior art keywords
patient
tire
made
implant
guide
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RU2017131154U
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Russian (ru)
Inventor
Павел Александрович Коледа
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Павел Александрович Коледа
Жолудев Сергей Егорович
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Priority to RU2017131154U priority Critical patent/RU177272U1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003Not used, see subgroups

Abstract

Field of use: the utility model relates to medicine, namely to surgical dentistry and can be used for prosthetics on implants when creating access through the mucous membrane of the oral cavity and periosteum to the bone tissue in the area of implant administration. The essence of the utility model: a surgical template 1 for implant placement contains a splint 2, the inner surface of which is congruent to the surface of the teeth 3 of the corresponding jaw of the patient and the adjacent mucous membrane of the alveolar process. Bus 2 is made by 3D prototyping. In the tire 2 holes are made in accordance with the plan for the installation of implants. The guide metal bushings are installed in the holes 4. The tire 2 is equipped with interchangeable bushings 5 drilling restrictions. On the vestibular side, in each guide sleeve 4 and in the corresponding part of the tire 2, a common vertical recess 6 is made, passing through the diameter of the guide sleeve 4. The recess 6 is bounded below by a half cylinder 7 with a generatrix length of 1 mm. The problem of reducing the requirement for the width of the patient’s opening of the mouth is solved, while simultaneously securing the position of the cutting tool and ensuring the individuality of the positioning of the cutting tool when making holes in the patient’s bone for the implant. Achievable technical result: increased physiology, reduced likelihood of a gag reflex, the ability to use a surgical template for patients with maxillofacial joint problems when installing implants, increased patient comfort during implant placement. 2 ill.

Description

The utility model relates to medicine, namely to surgical dentistry and can be used for prosthetics on implants when creating access through the mucous membrane of the oral cavity and periosteum to the bone tissue in the area of implant administration.

Known surgical template for positioning implants in the jaw bones, which is a plate with holes made on gypsum models, usually made of quick-hardening plastic. The plate is fixed on the teeth or on the gingival mucosa. On the oral side in the holes, a recess is made in the form of a sector of a circle for the possibility of visual installation of the drill in a vertical position. Through the holes, the jaw bone is drilled, then the device is removed, the holes made are expanded and implants are installed in them. The device does not solve the problem of orientation and fixing the position of the cutting tool when performing bone drilling. The device sets only the entry point of the implant into the bone and does not automatically set the required depth and direction of implant placement for a particular patient, which leads to low accuracy of implant placement, leads to impaired comfort in the future when chewing, and, therefore, reduces the physiology of the known device (Stefan Wolfart "Prosthetics based on an implant. Planning on the result." M., S.-P., Kiev, Almaty, Vilnius: Alphabet, 2016, Chapter 10, p. 143, Fig. 10-19).

The problem of fixing the position of the cutting tool when drilling under the implant in the jaw bone is solved in the well-known surgical template for positioning implants in the jaw bones, which is a plate with holes made on gypsum models, usually made of quick-hardening plastic (Ryakhovsky A.N., Mikhaskov S.V. Variants of the use of guide patterns at the surgical stage of dental implantation // Panorama of Orthopedic Dentistry, 2007, No. 1. - P. 9-11). Metal tubes are inserted into the holes. The plate is made with the possibility of fixation on the teeth, on the gingival mucosa or directly on the bone. Bone is drilled through metal bushings, then the device is removed, the holes made are expanded and implants are inserted into them. Since the template is a plate with holes made on gypsum models, despite the fact that the guide bushings for drilling the bone are installed in the plate, which allows you to fix the position of the cutting tool when drilling the bone, the problem of the orientation of the cutting tool in accordance with the anatomical features of the jaw of the patient when performing the channel under the implant. The device sets only the entry point of the implant into the bone; it does not automatically set the required depth and direction of implant placement for a particular patient. In addition, fixing the position of the cutting tool by installing guide sleeves requires a wide opening of the mouth, since it causes the drill to enter only from above, which increases the likelihood of a gag reflex and is not acceptable for patients with a problem in the maxillofacial joint. The foregoing, together with the low accuracy of implant placement, which further leads to a violation of comfort when chewing, reduces the physiology of the known surgical template.

In another known device for orienting a cutting tool when installing a cylindrical dental implant, the cutting tool guide is made in the form of a sleeve with a central through channel. In this case, the sleeve is built into the bottom of the glass, which is equipped with a saddle groove and has an elastic clamp with support on the jaw. (RF patent No. 2262905, A61C 8/00, 10.27.2005). The proposed fixation of the cutting tool allows to ensure equal thickness of the bone tissue between the lateral surface of the implant and the outer surfaces of the jaw. However, the device itself is cumbersome, takes up a lot of space in the mouth, which is not comfortable for the patient, and requires wide opening of the mouth, since it causes the drill to enter only from above, which increases the likelihood of a gag reflex and is not acceptable for patients with a problem in the maxillofacial joint. At the same time, the device retains all the disadvantages of the two previous analogues.

In the following technical solutions, the physiologicality of the surgical template is increased by performing it in accordance with the anatomical features of the patient’s teeth by 3D prototyping based on preliminary computer planning of implant placement according to computed tomography and their positioning in the patient’s bones.

Known guide template, which is a three-dimensional monolithic or collapsible part of complex shape, including a supporting part with an inner surface that repeats the relief of the prosthetic bed, designed for the smooth installation of a template on it, and connected to the supporting part, at least one guide shaft with a through hole having the shape and dimensions to accommodate the head of the dental handpiece with a drill with the possibility of reciprocating movement, providing direction Noah drilling the jawbone of the patient to the desired depth. The guide shaft is placed on the supporting part to ensure the coaxial position of the guide shaft with the design position of the dental implant in the jaw bone. (RF patent No. 2574575, A61C 8/00, 06/10/2015).

Known guide template for the installation of dental implants (RF patent No. 2400178, A61C 8/00, 09/27/2010), based on the results of computed tomography (CT) of the jaw of the patient on which the implantation will be performed, and optical scanning of the dentition or its gypsum models: design the position in the bone of the implant, and then, taking into account the designed position, design the details of the guide template, which consists of guide shafts connecting their beams and supporting elements. The guide template is an all-metal construction in which the guide shafts are tubes of a given diameter. The tubes in the template are positioned in accordance with the anatomical features of the patient's jaw. The beam connecting the guide shafts can follow the contour of the alveolar ridge (variant of the osseous template), or rely on the mucous membrane (variant of the supragingival template). In the presence of natural teeth, the guide template can rest on the teeth, for which it can additionally be equipped with caps that repeat the shape of the teeth connected to the beam.

Known surgical templates for the installation of implants in the form of a plastic plate, the inner surface of which is congruent to the surface of the teeth of the corresponding jaw of the patient. The plate has holes for the guiding metallic bushings. The plate was made by 3D prototyping based on preliminary computer planning of implant placement according to computed tomography. The axial direction and the height of the metal bushings are calculated, which ensures accurate positioning of the cutting tool when installing implants in the bone, and, consequently, the exact installation of implants. (Zhusev A.I., Remov A.Yu. Dental implantation. Success criteria. - M., 2004. - 223 p .; Stefan Wolfart “Prosthetics based on an implant. Planning on the result.” M., S.-P ., Kiev, Almaty, Vilnius: Alphabet, 2016, Chapter 10, p. 163, Fig. 10-73.)

Known surgical template made on the basis of computer simulation. The template contains a tire resting on the patient’s teeth and is equipped with one or more dental guide bushings for the implant and one or more interchangeable drill restriction bushings for the cutting tool inserted into the guide bushings during drilling. (WO 99/26540, publ. 06/03/1999; US 19970977324, priority 24.11.1997, A61B 6/03, A61B 6/14, A61C 1/08, A61C 1/084, A61C 2201/005, A61C 8/0089)

Closest to the proposed surgical template for implant placement according to the application US 2005/0170311 A1 contains a tire for installation in place of the implant (s), the inner surface of which is congruent to the surface of the patient’s teeth. The tire is made on the basis of data obtained using a computed tomography (CT) scan, an X-ray machine, or other device providing an image of the bone, in particular the jaw bone, in order to be able to plan and accurately set the desired position of the implant, taking into account the anatomical, surgical, as well as aesthetic present conditions. The tire corresponds to the relevant situation and the existing conditions and has at least a drilled through hole for receiving a guide sleeve with a drilled through hole, in accordance with which you can set the exact orientation and installation in place of the drilled channel for the implant. In addition, the screw sleeve (interchangeable bore restriction sleeve), inserted into the guide sleeve of the tire, has a through hole, the inner diameter of which is consistent with the outer diameter of the corresponding drill to accommodate the channel in the bone.

Thus, templates made in accordance with the anatomical features of the patient’s teeth by 3D prototyping based on preliminary computer planning of the placement of implants according to computed tomography and their positioning in the patient’s jaw bone provide fixation of the position of the cutting tool and positioning of the cutting tool corresponding to the anatomical features of the jaw the patient, which ensures their physiology. However, the need for the patient to wide open his mouth reduces the physiological nature of the known surgical templates described above. This is because the position fixation and positioning of the cutting tool is carried out by means of the guide bushings, which causes the introduction of the cutting tool into the guide bush from above. As a result, there remains the problem of creating a surgical template for implant placement, which allows to reduce the requirements for the width of the patient’s opening of the mouth while ensuring the fixation of the position of the cutting tool and ensuring the individuality of positioning of the cutting tool when making holes in the jaw bone of the patient under the implant.

The proposed surgical template for implant placement during implementation solves the problem of reducing the requirement for the patient to open the mouth while fixing the position of the cutting tool and ensuring the individuality of the positioning of the cutting tool when making holes in the patient’s jaw bone for the implant.

When implementing the claimed surgical template for implant placement, the technical result is achieved:

- increase in physiology;

- reduction in the likelihood of a gag reflex;

- the ability to use when installing implants surgical template for patients with problems of the maxillofacial joint;

- increasing the comfort of the patient's condition during the operation of the implant installation.

The essence of the claimed utility model lies in the fact that the surgical template for implant placement contains a splint, the inner surface of which is congruent to the teeth surface of the corresponding jaw of the patient and the mucous membrane of the alveolar bone adjacent to them, while the splint is made in accordance with the anatomical features of the patient’s teeth using 3D prototyping based on preliminary computer planning of implant placement according to computed tomography, and with the possibility of hard f iksatsii on the patient’s teeth, the holes are made in the tire, the number of which and the location corresponds to the implant installation plan, while the holes are equipped with metal guide bushes positioned in accordance with the results of computer planning, in addition, the tire is equipped with interchangeable drilling restriction bushes (hereinafter referred to as interchangeable bushes ), inserted into the guide sleeve of the tire and made with the possibility of support on the edges of the guide sleeve with the fully inserted position, while the inner di the meter of the replaceable sleeve corresponds to the diameter of the drill for making the channel in the bones of the jaw of the patient and provides the possibility of its reciprocating movement, new is that the tire is made on the entire dentition, in addition, from the vestibular side of the tire in each guide sleeve and in its corresponding part the tire has a common vertical recess passing through the diameter of the guide sleeve, the recess being bounded below by a half-cylinder with a generatrix length of 1 mm, while the replaceable bushes have an outer diameter of and which ensures their placement in the guide sleeve with effort.

The technical result is achieved as follows.

Salient features of the utility model formula: “A surgical template for implant placement containing a splint, the inner surface of which is congruent to the tooth surface of the corresponding jaw of the patient and the adjacent mucous membrane of the alveolar bone, and the splint is made in accordance with the anatomical features of the patient’s teeth by 3D prototyping using based on preliminary computer planning of implant placement according to computed tomography, and with the possibility of hard fixation on patient, the holes are made in the tire, the number of which and the location correspond to the implant installation plan, while the holes are equipped with guide metal bushings positioned in accordance with the results of computer planning, in addition, the tire is equipped with replaceable drilling restriction bushings (hereinafter referred to as replaceable bushings), inserted into the guide sleeve of the tire and made with the possibility of support on the edges of the guide sleeve with the fully inserted position, while the inner diameter is replaceable minutes bushing corresponds to the diameter of the drill to perform channel in a patient's jaw bone and enables its reciprocation, ... "- are an integral part of the claimed surgical template and ensure its feasibility, and therefore, provide the achievement of the claimed technical result.

The claimed template is made in accordance with the anatomical features of the patient’s teeth by 3D prototyping based on preliminary computer planning of the placement of the implants according to computed tomography and their positioning in the patient’s bone, which ensures fixation of the position of the cutting tool and positioning of the cutting tool in accordance with the anatomical features of the patient’s jaw, and, therefore, provides the physiological pattern. In this case, to fix the position and positioning of the cutting tool, guide metal bushings are installed in the template tire, for which holes are made in the tire, the number of which and the location of them corresponds to the implant installation plan. However, unlike the prototype, on the vestibular side of the tire in each guide sleeve and in the corresponding part of the tire, a common vertical recess is made, passing through the diameter of the guide sleeve, which allows the cutting tool to be inserted into the guide sleeve not from above, but from the side from the oral side. In this case, the patient needs to open his mouth only to the height of the sleeve, plus, drilling depth, plus, the vertical size of the tip to secure the drill. While in the prototype, the patient needs to open his mouth to the height of the sleeve, plus, to the full length of the drill, plus, to the vertical size of the tip to secure the drill. Thus, in the claimed template, the execution from the vestibular side of the tire in each guide sleeve and in the corresponding part of the tire of a common vertical recess allows to reduce the requirements for the width of the opening of the mouth of the patient. As a result, the physiological nature of the claimed surgical template is increased compared with the prototype, the likelihood of a gag reflex is reduced, the surgical template can be used for patients with maxillofacial joint problems that limit the opening width of the mouth, and the patient’s condition is more comfortable during implant placement.

The implementation of the recess passing through the diameter of the guide sleeve, and the restriction of the recess from the bottom with a semicylinder with a generatrix length equal to 1 mm, ensure unhindered passage through the recess of the drill, fixed in the tip. Moreover, the implementation of the tire on the entire dentition and with the possibility of rigid fixation on the patient’s teeth ensures the tight fit of the inner surface of the tire to the teeth and the mucous membrane of the alveolar process in the region of the notch, which together with the restriction of the notch from the bottom by a half-cylinder with a generatrix length of 1 mm , allows you to reliably save the positioning of the guide bushings corresponding to the results of computer planning. As a result, the implementation of the proposed recess in the surgical template does not affect the accuracy of implant placement, and, therefore, does not reduce the physiological nature of the claimed surgical template.

Moreover, in the claimed surgical template, the possibility of fixing the position and positioning of the cutting tool in the presence of a recess from the vestibular side of the tire in each guide sleeve and in the corresponding part of the tire is provided, in addition to the guide bushings, by the presence of a set of replaceable bushings for drilling restrictions (hereinafter referred to as replaceable bushings) inserted into the guide sleeve of the tire. Moreover, the internal diameter of the replaceable sleeve corresponds to the diameter of the drill for making the channel in the bone of the jaw of the patient and provides the possibility of its reciprocating movement. In this case, the movement of the removable sleeve in the vertical direction is excluded due to the fact that the replaceable bushings have an outer diameter at which they are placed in the guide sleeve with force, as well as their implementation with the possibility of support on the edges of the guide sleeve with the fully inserted position. In this case, the restriction of the recess from the bottom with a half-cylinder with a generatrix length equal to 1 mm excludes the possibility of moving the replaceable sleeve in the horizontal direction. In addition, when drilling, the interchangeable sleeve is held in by the muscular effort of a doctor or assistant who presses it orally against the inner surface of the guide sleeve.

The length of the half-cylinder generatrix, equal to 1 mm, was obtained experimentally and is optimal, ensuring a stable position of the replaceable sleeve in the recess of the guide sleeve.

Thus, it follows from the foregoing that the proposed surgical template for implant placement during implementation solves the problem of reducing the requirement for the width of the patient’s mouth opening while ensuring that the position of the cutting tool is fixed and that the positioning of the cutting tool is individual when the hole in the patient’s jaw bone is made for the implant. When implementing the claimed surgical template for implant placement, a technical result is achieved, which consists in increasing physiology, in reducing the likelihood of a gag reflex, in using the surgical template for patients with maxillofacial joint problems when installing implants, in increasing the patient's condition comfort during the operation implant placement.

In FIG. 1 shows a schematically declared surgical template for implant placement and a process for using the claimed surgical template; in FIG. 2 - guide sleeve view from the vestibular side.

The claimed surgical template 1 for implant placement contains a splint 2, the inner surface of which is congruent with the surface of the teeth 3 of the corresponding jaw of the patient and the adjacent mucous membrane of the alveolar bone. Bus 2 was made in accordance with the anatomical features of the patient’s teeth by 3D prototyping based on preliminary computer planning of implant placement according to computed tomography, and with the possibility of rigid fixation on the patient’s teeth. Holes (not shown) are made in the tire 2, the number of which and the location correspond to the implant installation plan (in the example, one implant is installed). A guide metal sleeve 4, vertically positioned, is installed in the hole in accordance with the results of computer planning. In addition, the tire is equipped with interchangeable drilling restriction bushings 5 (hereinafter - shift bushings) inserted into the guide sleeve 4 of the tire 2 and made with the possibility of support on the edges of the guide sleeve 4 with the fully inserted position. The internal diameter of the replaceable sleeve 5 corresponds to the diameter of the drill for the channel in the bone of the jaw of the patient and provides the possibility of its reciprocating movement. The tire 2 is made on the entire dentition. In addition, on the vestibular side of the tire 2, in each guide sleeve 4 and in the corresponding part of the tire 2, a common vertical recess 6 is made, passing through the diameter of the guide sleeve 4. The recess 6 is bounded below by a half-cylinder 7 with a generatrix length of 1 mm. Replaceable sleeves 5 have an outer diameter at which they are placed in the guide sleeve 4 with effort.

The claimed surgical template for implant placement is used as follows. Template 1 is applied to the problem area of the jaw of the patient. Insert the drill into the tip. Then, a replaceable sleeve 5 with an appropriate diameter is put on the drill. Through the recess 6, on the side of the vestibular side, the replaceable sleeve 5 together with the drill is inserted into the guide sleeve 4 and lower it down to the stop of its shoulders in the upper end of the guide sleeve 4. The lower end of the replaceable sleeve 5 is at or below the lower end of the guide bushings. Thus, the replaceable sleeve on the oral side fixes the half-cylinder of the inner surface of the guide sleeve 4 along its entire height, and on the vestibular side, the lower end of the replaceable sleeve 5 fixes the half-cylinder 7 1 mm high remaining from the side surface of the guide sleeve 4 after the recess 6. When when drilling, the replaceable sleeve 5 is additionally held by the muscular effort of a doctor or assistant, who presses it orally throughout the height to the inner wall of the half-cylinder of the guide sleeve 4. By at the end of drilling, the tool together with the replaceable sleeve 5 is removed from the oral cavity through the recess 6 in the reverse sequence.

Claims (1)

  1. A surgical template for implant placement containing a splint, the inner surface of which is congruent to the tooth surface of the corresponding jaw of the patient and the adjacent mucous membrane of the alveolar bone, the splint is made in accordance with the anatomical features of the patient’s teeth by 3D prototyping based on preliminary computer planning of implant placement according to computed tomography data and with the possibility of hard fixation on the patient’s teeth, holes are made in the tire, The location of which corresponds to the implant installation plan, with guide metal bushings installed in the holes, positioned in accordance with the results of computer planning, characterized in that the tire is made over the entire dentition, in addition, from the vestibular side of the tire in each guide bush and the corresponding part of the tire has a common vertical recess, the recess being bounded below by a half cylinder with a generatrix length equal to 1 mm, the guide bushings are made with the possibility of displacements of replaceable bushings in them.
RU2017131154U 2017-09-04 2017-09-04 Implant placement surgical template RU177272U1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2698296C1 (en) * 2018-12-29 2019-08-23 Общество с ограниченной ответственностью "Мегадента Клиник" Method of fixing a surgical template for mounting dental implants in an edentulous upper jaw

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5613852A (en) * 1995-01-06 1997-03-25 Board Of Regents Univ Of Ne At Lincoln Dental implant drill guide system
US20050170311A1 (en) * 2002-02-28 2005-08-04 Philippe Tardieu Method and device for placing dental implants
US20150173870A1 (en) * 2013-12-20 2015-06-25 Biomet 3I, Llc Dental system for developing custom prostheses through scanning of coded members
RU2574575C2 (en) * 2013-12-04 2016-02-10 Александр Николаевич Ряховский Implant guide and method for manufacturing it

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5613852A (en) * 1995-01-06 1997-03-25 Board Of Regents Univ Of Ne At Lincoln Dental implant drill guide system
US20050170311A1 (en) * 2002-02-28 2005-08-04 Philippe Tardieu Method and device for placing dental implants
RU2574575C2 (en) * 2013-12-04 2016-02-10 Александр Николаевич Ряховский Implant guide and method for manufacturing it
US20150173870A1 (en) * 2013-12-20 2015-06-25 Biomet 3I, Llc Dental system for developing custom prostheses through scanning of coded members

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2698296C1 (en) * 2018-12-29 2019-08-23 Общество с ограниченной ответственностью "Мегадента Клиник" Method of fixing a surgical template for mounting dental implants in an edentulous upper jaw

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