RU2284791C1 - Jaw bone implant - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has bearing member having head part. The bearing member is manufactured from porous titanium nickelide and has half-cylinder shape having threaded hole for receiving temporary closure substituted with permanent head. Grooves are produced on both sides from threaded hole in the middle distance from threaded hole edge to rest member end. U-shaped metal clamps possessing shape memory properties are mounted in the grooves. Clamp pedicles have sharp ends bent at an angle of 90° to meet each other.

EFFECT: high stability; reduced penetration into bone tissue.

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Description

The invention relates to medicine, in particular maxillofacial surgery and orthopedic dentistry, and can be used to treat adentia of the jaw.

According to statistics, of the total number of patients who turn to the dentist for lack of teeth, approximately 35% have end-defects in the dentition. Due to the anatomical and topographic features of the alveolar processes of the upper and lower jaws, in most cases it is possible to use only plate implants. However, these implants have one significant drawback - low stability in the buccal-lingual direction. To address these shortcomings, the designs of metal implants used for the manufacture of endoprostheses were developed.

Known dental endocostal implant (GB, application No. 212906, publication 01/25/84 No. 4952, Mcl A 61 C 8/00) made of metal with shape memory effect, consisting of a head, neck, plastic body with legs, deformable in the lateral directions from the plane of the body after insertion into the appendix of the jaw.

This device has insufficient stability in the vestibulo-oral direction due to the arising lever of forces, causing micro-movements of the fixing elements relative to the bone in a vertical plane.

A device for eliminating bone defects of the maxillary sinus and fixing dental implants according to the invention patent No. 2187281, Mcl, 7 A 61 C 8/00, BIMP No. 23, 08/20/2002. The device contains a titanium mesh plate and cylindrical implants made of porous titanium nickelide. At one end, the implants have a threaded hole for fastening the denture, and at the other end they have titanium nickelide petals with shape memory effects that diverge at 90 ° for attachment to the titanium mesh plate.

The titanium nickelide plate does not have sufficient rigidity, therefore, at the beginning of treatment, before integration, the vertical fixation is insufficient, which does not allow early use of the support under the denture.

A known design of the applied subperiosteal implant, which is a carrier plate, congruent to the surface of the alveolar ridge, perforated with holes or made in the form of an openwork tape design with one or more heads. Surov O.N. Dental prosthetics on implants, M., Medicine, 1993

The disadvantages of the design are that it is strictly individual, requires a lot of time for manufacturing, since laboratory steps are needed.

Insufficient fastening strength, as it is held only by germinating soft tissues.

The presence of a head protruding from the surgical wound requires careful hygiene in the postoperative period and leads to an increased risk of infection.

The objective of the invention is to increase the stability of the implant due to combined fixation, expansion of indications for use, by reducing the immersion of the structure in the bone.

This task is achieved by the fact that the jaw implant consists of a supporting element with a head. The support element is made of porous titanium nickelide in the form of a half cylinder with a threaded hole in the center to accommodate a temporary plug in it, which is subsequently replaced with a permanent head. On the cylindrical surface of the support element, grooves are made on both sides of the threaded hole, located at the middle of the distance from the edge of the threaded hole to the end of the support element, metal brackets with a shape memory effect of U shape are installed in the grooves. The ends of the legs of the brackets are bent at an angle of 90 ° towards each other and are pointed.

Novelty of the jaw implant:

- The support element is made of porous titanium nickelide in the form of a half cylinder with a threaded hole in the center to accommodate a temporary plug in it, which is subsequently replaced with a permanent head;

- On the cylindrical surface of the support element, grooves are made on both sides of the threaded hole, located at the middle of the distance from the edge of the threaded hole to the end of the support element, under the brackets;

- Brackets U shape made of metal with shape memory effect;

- The ends of the legs of the brackets are bent at an angle of 90 ° towards each other and are pointed.

The set of essential features of the invention allows to obtain the following new result:

1. The use of a rigid supporting element in the form of a half-cylinder allows you to evenly distribute the pressure on the body of the jaw, its shape is similar to the crest of the alveolar process of the jaw.

2. The small introduction of the support element of the implant and the fixing brackets allows it to be used with a close arrangement of the maxillary sinus and the mandibular canal.

3. The use of porous titanium nickelide after integration provides secondary fixation of the support element due to its germination by tissues.

4. Placing the brackets in the grooves avoids protruding parts above the alveolar ridge.

5. The supporting element in the form of a half-cylinder has a wide base with ends serving as thrust pads for fixing the implant in the mesiodistal direction.

6. Fixing brackets fix the implant in the buccal and vertical direction.

All this increases the reliability of fixation of the implant in various directions.

7. Grooves are placed on both sides of the threaded hole at the middle of the distance from the edge of the threaded hole to the end of the support element, which allows you to evenly distribute the forces from the brackets to the support element.

The design of the jaw implant is presented in Fig.1-8.

Figure 1 shows a top view of the support element.

Figure 2 shows the end view of the support element.

Figure 3 shows a side view of the support element.

Figure 4 is a bracket.

Figure 5 is a constant head.

6 is a stub.

Figure 7 - implant assembly.

On Fig - implant mounted on the crest of the alveolar process of the lower jaw.

The jaw implant consists of a support element 1, which is a half-cylinder made of porous titanium nickelide with a threaded hole 2 for the plug 3, installed in the first stage and subsequently replaced with a permanent head 4 in the second stage. On the surface of the support element 1 there are grooves 5 for installing fixing brackets 6 made of titanium nickelide with a shape memory effect. The grooves 5 are located in the middle of the distance from the edge of the threaded hole 2 to the end 7. The brackets 6 have a U shape. The ends of the legs of the brackets 6 are pointed and bent at an angle of 90 ° towards each other. The supporting element has ends 7.

The manufacture of the support element 1 of porous titanium nickelide ensures its integration, and its shape in the form of a half cylinder provides an even distribution of the masticatory load. The use of titanium nickelide locking brackets with shape memory effect simplifies and enhances implant fixation.

The implant is used as follows.

After anesthesia, a patient with an adentia is made an incision along the crest of the jaw body to expose the alveolar ridge, trapezoidal mucoperiosteal flaps are formed, vertical cuts are made with a saline cooling disc in accordance with the size of the implant support element. Then, a flat prosthetic bed corresponding to the dimensions of the implant supporting element is formed with a milling cutter, then the bone wound is washed and the supporting element 1 is imposed with a width of 6 mm, a length of 12 mm, a radius of 6 mm and a plug 3 screwed into the hole 2 with a diameter of 3. The supporting element has a wide the base, which rests on the bone and ends 7 rests on the end walls of the bed formed in the bone, which provides primary fixation of the implant in the mesiodistal direction. Fixing brackets 6 with a diameter of 1.0 mm secure the supporting element of the implant in the buccal-lingual and vertical directions. Thus, primary fixation is carried out in three directions.

The fixing brackets 6 are treated with refrigerant and their legs are expanded to an angle of 90 °, then they are successively inserted into the grooves 5 of the support element 1 of the implant and held. Under the influence of the temperature of surrounding tissues and contact heating up to 36 ° С, the brackets are compressed due to the shape memory effect and the cortical layer is pierced with pointed ends. The legs of the brackets are pressed against the surface of the jaw bone and securely fix the supporting element. Mucous - periosteal flaps are put in place, the wound is sutured. Two months later, after the integration of the support element from porous titanium nickelide, the mucous membrane above the plug is perforated, the plug is unscrewed and replaced with a permanent head, the wound around the head is sutured.

Example.

Patient B., 38 years old. Appealed about the terminal defect of the lower jaw on the right. Under local torusal and infiltration anesthesia with Scandonest solution 2% -5.0 ml, a mucosal incision was made along the alveolar ridge of the lower jaw to the right 1 cm longer than the supporting element. Vestibular and oral trapezoidal mucoperiosteal flaps are formed. On the exposed ridge of the alveolar ridge, a disk with cooling by saline solution made two vertical cuts to a distance of the length of the supporting element. Further, a support platform is formed by a milling cutter according to the dimensions of the base of the support element. The bone wound is washed, a support element with a screwed-in plug is applied. After bracing, the legs of the brackets are bred to an angle of 90 ° and sequentially installed in the grooves of the supporting element and held until the legs are fixed in the bone. Mucoperiosteal flaps laid in place. The wound is sutured. The postoperative period was uneventful. After 2 months, under local anesthesia, a mucosal incision was made over the plug. The cap is removed by screwing it out with a screwdriver and replaced with a permanent head, which is screwed into place. The wound around the head is sutured. After a week, prosthetics were performed based on the implant head and 44 and 43. After 6 and 9 months, the patient did not complain. The position of the implant is stable, the bite is not broken.

Thus, the jaw implant to eliminate end defects allows you to restore the integrity of the dentition, and therefore, the chewing function with minimal trauma and high efficiency. The combined fixation of the implant in several directions improves the stability of the implant.

Claims (1)

A maxillary implant consisting of a support element and a head, characterized in that the support element is made of porous titanium nickelide in the form of a half cylinder with a threaded hole for placement of a temporary plug in it, which is subsequently replaced by a permanent head, grooves are made on the cylindrical surface of the support element on both the sides of the threaded hole located in the middle of the distance from the edge of the threaded hole to the end of the support element, metal brackets with memory effect f rmy, brackets have a U-shape, the ends of the legs are bent at an angle brackets 90 ° towards each other and pointed.

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