RU2496444C2 - Method of increasing durability of dental prosthesis with application of implants and micro-shock-absorbing elements and device for its realisation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, in particular to dentistry and can be applied for installation of dental on implant. Device contains implants with cylindrical external part with screw thread, internal fitting cone, fitting cylinder and thread, and elements of suprastructure (ES). ES contains case, hexahedron, groove, cylindrical base, fitting cone, fitting cylinder and fixing thread. Fixing thread of each ES is screwed into respective implant to tight contact of fitting cone and cylinder of ES and implant. Outside ES case in its upper part there is a hexahedron for screwing ES into implant, and in its lower part there is a groove for fixation of detachable dental prosthesis. Es contains micro-shock-absorbing element (ME) inside initially separable cylindrical base and hollow ES case in form of spring, located vertically and coaxially with implant and ES to rest without compression between cylindrical base of ME and dome inside ME case cavity, and medical sealing material. ME spring has cone-like shape with apex inside under dome of ES case. Before filling with sealing material spring apex is stably fixed by means of cone-like shape of cavity inside ES case, spring cone base being fixed on cylindrical base of ES. Case and cylindrical base of ES are tightly connected to each other, and after installation of spring, pouring sealing material into ES case cavity and its hardening ES become integral whole.

EFFECT: durability of dental prosthesis.

3 dwg

Description

The invention relates to dental implantology and can be used to increase the life of the denture.

A known method and device for two-stage prosthetics of teeth on implants (patent No. 2007141 for the invention of “Dental implant” according to IPC A61C 8/00, BI No. 3 for 1994).

The known method is characterized by the installation of implants at the surgical stage in the patient’s jaw bone, and after their implantation, by installing superstructural elements in them, onto which a removable denture is then installed.

The device contains implants with a cylindrical outer part with an external screw thread for screwing into the jaw bone of the patient and an internal thread for screwing into each implant a suprastructure element of the so-called supporting head on which the denture is fixed.

A disadvantage of the known method and device is that the implant, in contrast to a living tooth, does not have a micro-depreciation effect (a living tooth moves by 20 microns under the influence of load and smoothing it), which leads to stress in the material of the prosthesis and its faster than we would like wear and tear.

The closest method and device to the claimed invention are the method and device described in the invention "Method of prosthetics of teeth on implants using a fiberglass support head and its device" (application No. 2007144275 according to IPC A61C 8/00 from 11/30/2007).

The known method includes the installation of implants at the surgical stage in the jaw bone of a patient, screwing screw plugs through their outer ends and suturing gum tissue over them, and after implant engraftment, the number of which from one or more corresponds to the specific task of prosthetics of this patient, at the orthopedic stage - opening gingival tissue over the implants, unscrewing of screw plugs from them, screwing in instead of screw plugs of suprastructure elements and making a cast of the patient's jaw with projections and elements of suprastructure and healthy teeth of the patient, on the basis of which a removable denture of this patient is made.

Moreover, in the known device containing implants with a cylindrical outer part, external screw thread, an internal landing cone, a landing cylinder and thread and elements of the superstructure corresponding to the number of implants, each of which contains a housing, a hexagon, a groove, a cylindrical base, a landing cone, and a landing cylinder and fixing thread, the external screw thread of each implant is screwed into the jaw bone of the patient in an appropriate place, and the fixing thread of the superstructure element (ES ) is screwed into the implant through its internal thread until the landing cone and the ES cylinder are firmly in contact with the internal landing cone and the implant cylinder, the hexagon is located on the outside of the ES housing for screwing the ES into the implant, and in its lower part there is a groove for fixing the removable tooth prosthesis.

The disadvantages of these methods and devices also consist in the absence of the microamortization effect of the implants used, in contrast to the presence of such an effect in living teeth.

In comparison with natural teeth, implants implanted in the bone exhibit a significantly smaller and also exclusively linear deviation, since they do not have a periodontal ligament of natural teeth, whose collagen structures play a special role in the reception and distribution of masticatory forces.

The elastic connective tissue of the Charpei desmodont fibers is a kind of shock absorber in natural teeth when exposed to any mechanical force. Thus, the intrinsic mobility of a natural tooth under vertical load will be up to 20 microns.

However, due to the ankylotic fixation of the implants in the surrounding bone tissue, the implants are inferior to the masticatory forces arising under a vertical load of only 2 μm. Therefore, mechanical overload of implants can lead to fractures and cracks both in it and in the frozen abutment of the denture. It is also sometimes considered as an additional factor explaining the occurrence of peri-implantitis. In addition, the installation of bridge joints between natural teeth and fixed abutments fixed on implants entails the risk of uneven distribution of masticatory force on bridge supports that are significantly different from each other. This limits the physiological mobility of natural teeth. Clinical studies have revealed a particularly negative effect of this factor on natural teeth, but its negative effect on implants has also been noted.

The technical result and the purpose of the claimed invention is to increase the durability of a denture using implants by incorporating a microamortization element into the superstructure element. This allows according to preliminary data to extend the life of the denture by an average of 3-5 years longer compared with the prototype.

The specified technical result is achieved by the fact that the method of increasing the durability of the denture using implants and microamortization elements, which is a two-stage procedure, consisting first of the surgical and then orthopedic stages, involves installing implants at the surgical stage in the patient’s jaw bone, screwing them through their outer ends screw plugs and suturing of gingival tissue over them, and after engraftment of implants, the number of which from one or more corresponds specifically the task of prosthetics for this patient, at the orthopedic stage, opening the gingival tissue over the implants, unscrewing the screw plugs from them, screwing in the screw plugs instead of screw plugs, and making a cast of the patient’s jaw with projections of the patient’s suprastructure and healthy teeth of the patient, on the basis of which a removable denture of this patient is made , which after manufacture is installed on the elements of the superstructure, as elements of the superstructure, prepared for the beginning of the orthopedic About the stage, microamortization elements (MEs) are used with their initially detachable bodies and cylindrical bases, and each ME during its assembly includes the installation of a micro shock absorber in the form of a spring made of medical stainless steel in its upper supragingival part inside the cavity of the ME body coaxially with the implant and with focusing on the cylindrical base of the gingival part of the ME, while the first end of each spring is fixed under the dome of the cavity of the body of the ME, and the second on the basis of the gingival part of the ME, then fill the medical With the sealant, the cavity of the ME body together with the spring joint the ME body with its cylindrical base, providing, after the sealant hardens, the whole ME structure with the shock absorption of force effects on its body up to 20 μm.

The technical result is also achieved by the fact that the device for increasing the durability of the denture using implants and microamortization elements contains implants with a cylindrical outer part, an external screw thread, an internal seating cone, a landing cylinder and thread, and elements of the superstructure corresponding to the number of implants, each of which contains a housing, hexagon, groove, cylindrical base, seat cone, seat cylinder and locking thread, with screw out The threaded section of each implant is screwed into the jaw bone of the patient at an appropriate place, and the fixing thread of the suprastructure element (ES) is screwed into the implant by its internal thread until the landing cone and the ES cylinder are in tight contact with the internal landing cone and the implant cylinder, outside the ES case in its upper part there is a hexagon for screwing the ES into the implant, and in its lower part there is a groove for fixing a removable denture, each ES additionally contains a micro shock absorber in the form of a spring from a medical stainless steel placed vertically and coaxially with the implant and ES, which in this case is a micro-depreciation element (ME), at point-blank range without compression between the cylindrical base of the ME and the dome inside the cavity of the ME case, and a medical sealant that fills all the voids inside the cavity of the ME after installation of the spring without mechanical fixing of its ends in the ME case, inside the upper part of the ME cylindrical base there is a circular recess, where the liquid sealant flows when pouring, as a result of which after hardening I sealant body ME firmly articulated with a cylindrical base ME.

The above technical result is somewhat improved if the ends of the springs in the microamortization element are mechanically fixed in the device.

Figures 1, 2 and 3 respectively show sketches of an implant with a micro-depreciation element assembly and sections of enlarged fragments at the junction of the cylindrical base and the ME body for the case of mechanical fixing of the spring ends and the recesses in the cylindrical base and for the case without it.

The device contains a micro-damping element (ME) 1 with a housing 1.1, a hexagon 1.2, a groove 1.3, a cylindrical base 1.4, a seating cone 1.5, a seating cylinder 1.6 and a locking thread 1.7, a micro-shock absorber 1.8, a sealant 1.9 and a recess 1.10 of a cylindrical base, an implant 2 with a cylindrical surface 2.1, screw external thread 2.2, internal landing cone 2.3, internal landing cylinder 2.4 and internal thread 2.5.

The bone 3 of the patient is shown for explanation.

A method of increasing the durability of a denture using implants 2 and microamortization elements 1, which is a two-stage procedure, consisting first of the surgical and then orthopedic stages, involves installing implants 2 at the surgical stage in the bone 3 of the patient’s jaw, screwing screw plugs through their outer ends and suturing of gingival tissue over them, and after implant implantation 2, the number of which from one or more corresponds to the specific task of prosthetics of this patient, on pedic stage - opening the gingival tissue over the implants 2, unscrewing screw plugs from them, screwing in the superstructure elements instead of screw plugs and making a cast of the patient’s jaw with projections of the patient’s suprastructure and healthy teeth, on the basis of which a removable denture of this patient is made, which is installed after manufacture on the elements of the suprastructure, as elements of the suprastructure, prepared for the beginning of the orthopedic stage, micro-depreciation elements are used nti (ME) 1 with their initially detachable bodies 1.1 and cylindrical bases 1.4, while each ME 1 during its assembly includes the installation of a micro shock absorber 1.8 in the form of a medical stainless steel spring in its upper supragingival part inside the cavity of the body 1.1 ME coaxially with the implant 2 and with emphasis on the cylindrical base 1.4 of the gingival part of the ME, the first end of each spring 1.8 is fixed under the dome of the cavity of the body 1.1 ME, and the second on the cylindrical base 1.4 of the gingival part of ME, then the medical seal is filled ICOM 1.9 1.1 ME body cavity together with the spring and the mating housing 1.8 1.1 ME with its cylindrical base 1.4, providing a sealant after curing 1.9 ME-piece construction with shock absorption.

A device for increasing the durability of a denture using implants 2 and microamortization elements 1 contains implants 2 with a cylindrical outer part, an external screw thread 2.2, an internal seating cone 2.3, a seating cylinder 2.4 and a thread 2.5, and the elements of superstructure 1 corresponding to the number of implants 2, each of which contains case 1.1, hexagon 1.2, groove 1.3, cylindrical base 1.4, seat cone 1.5, seat cylinder 1.6 and securing thread 1.7, with external thread 2.2 each the implant is screwed into the bone 3 of the jaw of the patient at the appropriate place, and the fixing thread 1.7 of the suprastructure element (ES) 1 is screwed into the implant 2 by its internal thread 2.5 until the landing cone 1.5 and cylinder 1.6 of the ES are tightly connected with the inner landing cone 2.3 and the implant cylinder 2.4 2, outside the body 1.1 of the ES, in its upper part there is a hexagon 1.2 for screwing the ES 1 into the implant 2, and in its lower part there is a groove 1.3 for fixing the removable denture, each ES 1 additionally contains a micro shock absorber 1.8 in the form of a spring made of medical stainless steel placed vertically and coaxially with the implant 2 and ES 1, which in this case is a micro-depreciation element (ME) 1, point blank without compression between the cylindrical base 1.4 ME 1 and the dome inside the body cavity 1.1 ME, and medical sealant 1.9, filling all voids inside the cavity of the housing 1.1 ME after installing the spring 1.8 without mechanical fixing of its ends in the housing 1.1 ME, inside the upper part of the cylindrical base 1.4 ME there is a circular recess 1.10, where the liquid sealant 1.9 flows when pouring, in As a result, after the sealant has hardened, the casing 1.1 and the cylindrical base 1.4 are firmly connected.

As materials of the device, materials widely used in medical technology are used.

Parts 1.1 and 1.4 of microamortization element 1 and implant 2 are made of titanium of grades VT1-0 or VT1-00 OR GRADE 4.

Micro shock absorber 1.8 is made of medical steel.

The method is as follows. At the first surgical stage, a titanium implant 2 is installed in the bone 3 of the patient’s jaw. To do this, a hole is drilled in the bone 3 at the site of the doctor, a thread is cut in it and the implant 2 is screwed. Then, a screw plug is screwed on the internal thread 2.5 of the implant 2 (Fig. 1 the plug is not shown, and instead of it the microamortization element 1) is screwed in the same place and the gum tissue is sutured. There can be several implants 2, and their number is determined by the specific task of prosthetics for this client. In this case, implants 2, as a rule, are installed simultaneously. At the second orthopedic stage, after the implant 2 has been engrafted, the gingival tissue is opened, the screw plug is unscrewed and a micro-depreciation element (ME) is screwed into its place using a special key and hexagon 1.2. 1. If the number of implants is more than 1, the same is done for others, forming as a whole necessary of this patient, sometimes quite complex, the superstructure of the 2 elements of the superstructure screwed into the implants, which in the framework of the present task, being endowed with 1.8 micro-shock absorbers, are called microamo Rectification elements (ME) 1.

The most important task of the orthopedic stage, in contrast to the known methods, is the assembly of ME 1 before screwing them into implants 2.

Currently, the ME1 assembly is carried out in special laboratory conditions by the authors and applicants of this application, if they have the relevant permissions from the Ministry of Health.

Moreover, with initially detachable 1.1 ME cases and a 1.4 ME cylindrical base, they are installed inside the cavity of the 1.1 ME case in its upper supragingival part (for example, conditionally for the lower jaw of the patient) micro shock absorber 1.8 in the form of a spring made of medical stainless steel. Moreover, the spring 1.8 is installed without compression coaxially (when the axes coincide) with the implant 2 (see figure 1), but with the emphasis of its first upper end under the dome of the body cavity 1.1 ME, and the second lower end on the cylindrical base 1.4 of the gingival part ME 1. Then they fill the body cavity 1.9 with a medical sealant 1.9 along with a micro-shock absorber - a spring 1.8 and joint the ME body 1.1 with a cylindrical base 1.4, providing a solid ME 1 structure after hardening of the sealant 1.9, which under force (when chewing food by the patient ) absorbs, smoothes, dampens, softens these effects due to the oscillation (compression and decompression) of the spring 1.8 together with sealant 1.9 within 20 microns, as well as live teeth.

For greater strength, the ends of the spring 1.8 are mechanically fixed. The dentist receiving the finished ME 1s, screw them into the implants 2 with the help of a special key, and then makes a cast of the patient’s jaw with projections of all installed ME 1s and adjacent living teeth. Based on this cast, a removable denture of this patient is made.

Using the shock absorber 1.8 installed in the implant 2, the synchronous mobility of the periodontal ligament of natural teeth and fixed implants 2 in the bridge connection is ensured. The result of this is the achievement of a constant uniformity in the distribution of masticatory force on various bridge supports. In certain cases, you can reduce the number of implants 2 and limit the cost of the operation.

Optimization of biomechanics has a positive effect on the ratio of costs and effectiveness for both the patient and the doctor involved in its treatment.

The device operates as follows.

Increasing the durability of the entire structure of the assembled denture using implants 2 (Fig. 1; for simplicity, one implant 2 with its ME 1 is shown) depends to a large extent on, among other things, the technologies used to ensure strong engraftment of implants 2 in the bone 3 of the jaw of the patient and to ensure reduce the harmful effects of stress (when chewing food) on the supra-gingival suprastructure.

The implants 2 installed in the patient’s bones 3 take root stronger and more durable due to the increase of its cylindrical surface 2.1 and, mainly, of the external screw thread 2.2.

All the already assembled ME 1s used in the superstructure are firmly connected to the corresponding implants 2 after screwing their fixing thread 1.7 into the internal thread 2.5 with the help of a special key and a hexagon 1.2 ME due to the exact fit of the landing cone 1.5 and cylinder 1.6 ME to the corresponding surfaces of the inner landing cone 2.3 and cylinder 2.4 of implant 2.

At the final stage of the orthopedic stage, from the supragingival elements of the superstructure in the form of a set of installed ME 1 and adjacent living teeth of the patient, a cast is made using which a denture is made with metal caps mounted on it from the side of ME 1, which are snapped onto the corresponding grooves when the denture is installed to the patient 1.3 ME 1 (the indicated caps and denture are not shown in the application since they are beyond its scope).

The main subject of the application is a micro-depreciation element (ME) 1 with a micro-shock absorber 1.8 in the form of a spring made of medical stainless steel. On the inner side of the cylindrical base 1.4 ME 1 there is a recess 1.10 (FIG. 2), into which the sealant 1.9 flows when it is poured after installing the spring 1.8 and the joint of the housing 1.1 and the cylindrical base 1.4 ME 1. Thanks to the circular recess 1.10 after the sealant hardens, the ME 1 becomes non-separable.

Use two options ME 1:

- without mechanical fastening of the orthogonal annular ends of the spring 1.8 (for light load structures having a relatively small diameter of the implant 2 and a cylindrical base 1.4 ME 1; children's, temporary, etc.);

- with mechanical fastening of the ends of the spring 1.8 (for large loads with a relatively large diameter of the implant 2 and the cylindrical base 1.4 ME 1).

The mechanical fastening of the ends of the spring 1.8 inside the dome of the housing 1.1 and to the center of the base 1.4 is carried out before filling the sealant 1.9 by hooking, screwing or inserting into the groove.

The most widely used are 1.8 coil springs. For special designs, cone-shaped springs 1.8 with a peak under the dome of the housing 1.1 ME are used.

Claims (1)

A dental prosthesis device using dental implants, comprising implants with a cylindrical outer part, an external screw thread, an internal seating cone, a landing cylinder and thread, and superstructure elements (ES) corresponding to the number of implants, each of which contains a body, a hexagon, a groove, a cylindrical base, the landing cone, the landing cylinder and the fixing thread, while the screw external thread of each implant is screwed into the jaw bone at the appropriate place cantilever, and the fixing thread of each ES is screwed into the corresponding implant through its internal thread until the landing cone and the cylinder of the ES are in tight contact with the inner landing cone and the implant cylinder, the hexagon for screwing the ES into the implant is located in the upper part of the body of the ES, and in its the lower part - a groove for fixing a removable denture, and each ES contains a microamortization element (ME) inside the originally detachable cylindrical base and hollow body of the ES in the form of a spring made of honey Itsinskiy stainless steel placed vertically and coaxially with the implant and the ES in an emphasis without compression between the cylindrical base of the ME and the dome inside the cavity of the ME body, and medical sealant that fills all the voids inside the cavity of the ES body after installing the spring in the ES body, characterized in that the spring The ME has a conical shape with a vertex inside under the dome of the ES housing; in this case, until the housing cavity is filled with sealant, the top of the spring is stably fixed by the conical shape of the cavity inside the ES housing, and the base is cone and the springs are fixed on the cylindrical base of the ES, the body and the cylindrical base of the ES tightly articulating with each other, preventing leakage of sealant between them, and after installing the spring, pouring the sealant into the cavity of the ES housing and hardening the ES, it becomes one.

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