RU2661019C1 - Teeth implant and set for dental implantation - Google Patents

Teeth implant and set for dental implantation Download PDF

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Publication number
RU2661019C1
RU2661019C1 RU2017101148A RU2017101148A RU2661019C1 RU 2661019 C1 RU2661019 C1 RU 2661019C1 RU 2017101148 A RU2017101148 A RU 2017101148A RU 2017101148 A RU2017101148 A RU 2017101148A RU 2661019 C1 RU2661019 C1 RU 2661019C1
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Russia
Prior art keywords
implant
abutment
part
distal
made
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RU2017101148A
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Russian (ru)
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Рамиль Михайлович Гизатуллин
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Общество С Ограниченной Ответственностью "Инновационный Стоматологический Центр "Нано-Дент"
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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
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • 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
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0033Expandable implants; Implants with extendable elements

Abstract

FIELD: medicine; dentistry.
SUBSTANCE: group of inventions includes a dental implant and a kit for permanent dental implantation, belongs to the field of dental implantology and can be used for dental prosthetics. Dental implant comprises a proximal portion provided with a means for the fixation of a detachable cap to form the patient's gingiva and/or abutment, and a distal part made of a shape memory material and at least one cut from the distal end of the distal portion, extending along the longitudinal axis of the distal portion to form at least two fixation implants in the patient's bones of the supports. On the external surfaces of the supports are made transverse grooves. Grooves of one support are shifted along the longitudinal axis of the implant relative to the location of the grooves of the other supports. In the martensitic state, the fixing supports form a generally cylindrical shape of the distal part, and in the austenitic state the fixing supports form a generally conical shape of the distal part with a large base of the cone at its distal end. Kit for permanent dental implantation comprising a dental implant according to any one of the preceding claims 1–6, a removable cap for forming the patient's gingiva and abutment. Removable cap and abutment have means for fixing them on the implant.
EFFECT: inventions make it possible to use implants and a set with a low or narrow jawbone.
15 cl, 27 dwg

Description

The invention relates to surgical and orthopedic dentistry, namely to dental implantology, and can be used in the construction of a dental implant and in a kit for permanent dental implantation, including a dental implant, a removable cap for forming a patient’s gums and an abutment.

Non-separable dental implants are widely known, containing the distal intraosseous part of the conical shape with screw thread (thread) for screwing the implant into the implantation bone bed and the proximal part with the abutment (see, for example, A. Ivanov. Fundamentals of dental implantology. - St. Petersburg: SpecLit , 2013, p. 9 (Fig. 1.1a) and 11, or a patent for utility model RU 146418 U1, IPC A61C 8/00, published on 10/10/2014).

One of the drawbacks of these known implants is associated with the features of the anatomical structure of the jaw bone, the thickness of which increases from a rather thin alveolar process of the jaw (which is limited by the contour of the cortical plates and in which the tooth root is normal) to the wide main jaw bone, represented by the spongy substance of the bone, therefore, in general, the jawbone (alveolar process with the main spongy bone of the jaw) is a cone. After tooth extraction, the alveolar process is shortened and thinned (tapering), while the conical shape of the jawbone is preserved.

Since the diameter of the conical part of the screw implant decreases towards its distal end, when the implant is screwed into the cone-shaped jawbone, two oppositely directed cones (the implant and the alveolar bone) practically interact, in which the widest part of the implant is screwed into the narrowest part of the cone-shaped alveolar process of the jaw, therefore, the bone of the alveolar process of the jaw cannot accommodate a screw implant if the width of the alveolar process is ka jaw under the gum is not greater than 3 mm. With such a narrow bone (3 mm) implantation with screw implants for permanent implantation is absolutely contraindicated, and with the width of the alveolar ridge of the jaw under the gum from 3 to 4 mm there is a high risk of fracture of one of the walls of the alveolar ridge of the jaw with a screw implant, which leads to traumatic overload and subsequent atrophy of the bone of the alveolar bone during the operation of the screw implant and therefore is the reason for the relative contraindication to implantation with screw dental implants.

In addition, normal in a person in the front (in the so-called frontal) section of the alveolar process of the jawbone (in the so-called alveoli) are the roots of single-root teeth (these are incisors, canines and part of the small molars), and in the lateral sections the jaws are the roots of multirooted teeth (this is part of the small molars and all large molars), in which the proximal parts of the roots of the teeth, like the front teeth, are in the alveoli, and the distal parts of the roots of the two- and three-root molars of the person are located in alveoli and in the main to spines of the jaw. Above the multi-rooted teeth of the upper jaw is the air-borne sinus sinus, and under the roots of the lower molars there is a mandibular canal with vessels and a nerve. With the loss of multirooted molars along with the bone tissue of the alveolar processes in the lateral parts of the jaws, only the main jaw bone remains, which at its height less than 6 mm is called a low bone. The height of the low bone can be less than the length of the shortest screw permanent implants (5 mm) and less than the length of the intraosseous part of the shortest known shape memory implants (8 mm), and in the absence of the alveolar bone of the jaw with a wide but low main jaw bone, when the height of the main jaw bone suitable for implantation does not exceed 4 mm; implantation with all known permanent implants (both screw and shape memory) is contraindicated.

In addition, when replacing the loss of a multi-rooted tooth with a screw implant, the area of the only support of the future orthopedic construction, represented by the conical intraosseous part of the screw implant, is limited by the area of the threaded part of the implant, while the supports of the multi-root tooth are two or three of its roots and the area of two or three supports clearly exceeds the area threaded parts of a screw implant. In addition, the roots of a multi-root tooth diverge at different angles to the vertical axis passing through the center of the tooth between its roots, which gives the tooth the necessary stability when chewing, while a single helical dental implant replacing the loss of a multi-root tooth is a lever of the first kind and when chewing creates stresses on the jaw bone, exceeding the physiological loads created by several roots of one tooth when eating.

All of the above does not contribute to the earliest possible primary stabilization of the screw implant in the jaw, nor accelerated osseointegration, and shortens the life of known screw implants.

Known collapsible dental implant containing a body (distal intraosseous part) with external thread for screwing the implant into the bone bed and neck (proximal part) with a threaded hole for mounting on it a removable shaper of the gingival cuff and / or abutment (AS Ivanov. Basics Dental Implantology. - St. Petersburg: SpetsLit, 2013, p. 9 (Fig. 1.1b) and 11). A kit for permanent dental implantology is also known, containing the aforementioned known dental implant, a temporary (removable) plug, a temporary (removable) gingival cuff former and abutment, the plug, gingival cuff former and abutment being made with threaded rods for screwing them into the threaded hole of the neck implant (A.S. Ivanov. Fundamentals of dental implantology. - St. Petersburg: SpecLit, 2013, p. 9 (Fig. 1.1b) and 11). One of the main disadvantages of the known collapsible implant and the kit containing it is excessive trauma to the gums and periosteum at the implantation site as a result of their technologically caused inevitable double injury. The first trauma of the gum and periosteum occurs when the mucosal-periosteal flap is detached, performed before the implant body is screwed into the implantation bed, then the temporary plug is screwed into the threaded hole of the implant neck and the edges of the mucous-periosteal flap are sutured, and the second gum and periosteum injury occurs removal of the mucosal-periosteal flap with the aim of unscrewing the stub and installing a gingival cuff former instead. As a result of this, gum regeneration takes place twice (after installing the plug and after installing the gingival cuff former), therefore, the formation of the gingival cuff after the osseointegration of the known collapsible threaded implant requires a long time, at least two to three weeks after the gingival cuff former.

In addition, all known screw implants cannot be used for bone atrophy, in particular, with periodontal disease and generalized periodontitis, in which the jaw bone becomes porous and, in principle, is unable to hold the known screw implants.

In addition, the use of known screw (threaded) implants is associated either with the need for preliminary tapping of the corresponding threaded hole in the implant bone bed, into which the screw implant is then screwed with force, or with the presence of aggressive threads on the screw implant itself. Both require a certain thickness of the cortical plates of the alveolar process of the jaw bone, therefore, the known screw implants do not allow implantation with a thin (from 3 mm) bone of the alveolar process of the jaw (which, with such dimensions, is not able to withstand damage to the side walls of the implantation bed in the alveolar process of the jaw thread of the implant) and do not allow implantation at a low (from 4 mm) main bone of the upper jaw under the maxillary sinus and at a low (from 4 mm) main bone bo ttom mandibular jaw over a channel, which houses the mandibular nerve and artery of the same name and Vienna.

In addition, all known implants with external thread for screwing them into the implant bone bed have the disadvantage that this thread (screw thread) is the reason for the creation of a line of increased tension in the bone, leading to the risk of a linear fracture of the front or rear wall of the implant bed in a relatively narrow (3-4 mm) bone of the alveolar process of the jaw. More clearly, this drawback of known screw implants is illustrated in FIG. 24.

A non-separable dental implant is also known, comprising a proximal part with a denture attachment means and a distal (intraosseous) part made of a material with shape memory and with a cut from the side of the distal end of the distal part passing through the longitudinal axis of the distal part with the formation of two supports (petals) fixing the implant in the patient’s bones, on the outer surfaces of which transverse grooves are made, and in the martensitic state, the fixing supports form a generally cylindrical shape the distal part, and in the austenitic state, the fixing supports form a generally conical shape of the distal part with a large cone base at its distal end (patent RU 48753 U1, IPC A61C 8/00, publ. 10.11.2005). The denture fastening means in the form of a support head performing the function of an abutment, the neck and cervical region have a common relatively large length. This known implant is adopted as the closest analogue (prototype) of the implant of the present invention.

Although the known prototype implant has an anatomical regular shape (since in the austenitic state, the fixing supports form a conical shape with a large cone base at its distal end, which corresponds to the anatomical structure of the jaw bone, which has a thinner alveolar process and a wider bone at the base of the jaw) , it generally has a relatively large length, forming a lever of the first kind, and therefore can only be used with a bone height of at least 8 mm (the minimum length of the intraosseous part mplantata prototype) and a width alveolar bone by 4 mm (the minimum diameter of the intraosseous portion of the implant prototype is 3.25 mm). This limitation is again associated with the risk of fracture of the bone walls (front or back) of the implant bed, in particular, when lateral chewing loads are applied to the prototype implant, especially in the case of jaw bone tissue weakened by periodontal disease or periodontitis.

Another disadvantage of the prototype is associated with a symmetrical arrangement of the transverse grooves in the supports (petals) relative to the longitudinal axis of the implant, when the grooves of one support are located across this axis at the same level with the grooves of the other support. Corresponding radial protrusions are formed between the grooves, which, like the external thread on known screw implants, are the reason for the creation of lines of increased tension in the bone during the transition of the implant supports from the martensitic to the austenitic state, which leads to the risk of a linear fracture of the anterior or posterior wall of the implant bed relatively narrow jawbone. This drawback is illustrated more clearly in FIG. 25.

In addition, direct osseointegration associated with the use of known non-separable implants, both with external thread and with shape memory, leads to increased bone load in the process of primary stabilization.

The main objective of the present invention is to provide a dental implant and kit with its use, in which the above-mentioned disadvantages of the known devices would be eliminated, i.e. the present invention should provide the possibility of implantation with thin and low jaw bones, as well as its atrophy. In addition, the claimed dental implant and kit with its use should be less traumatic, provide less time for osseointegration of the implant in the bone and the formation of the gingival cuff with the least possible load on the bone during the initial stabilization of the implant in the bone, have a longer life compared to known implants.

The solution to this main problem is achieved by the fact that according to the present invention, there is provided a dental implant comprising a proximal part made with a threaded fastening means on it of a removable cap for forming a patient’s gum and / or abutment, as well as a distal part made of material with shape memory and with at least one incision from the distal end of the distal part extending along the longitudinal axis of the distal part with the formation of at least two fixing implants in the patient’s bones OR, on the outer surfaces of which transverse grooves are made, and in the martensitic state, the locking supports form a generally cylindrical shape of the distal part, and in the austenitic state, the locking supports form a generally conical shape of the distal part with a large cone base at its distal end.

The presence of threaded fastening means for the removable cap and / or abutment on the proximal part of the implant, together with the fixation of the distal part from material with shape memory, makes it possible to manufacture the distal part of the implant of shorter length and smaller diameter compared to known screw (threaded) implants (as collapsible) non-separable), which in turn allows the use of the claimed implants for low or narrow jaw bones, when the use of all known implants Ntatov categorically contraindicated. In addition, the presence of the indicated means of threaded fastening expands the indications for the use of the claimed implant, since it allows you to use it in a set with both short and elongated abutments with a deep intraosseous location of the distal part of the abutment, mating with the proximal intraosseous part of the claimed implant, which cannot be realized when the use of all known implants due to their design features (in more detail the advantages and useful technical results, gender tea using elongate abutments complete with the implants of the present invention are disclosed below).

The grooves of one support in the implant of the present invention can be offset along the longitudinal axis of the implant relative to the location of the grooves of the other supports. The technical result of the displacement of the grooves of one support along the longitudinal axis of the implant relative to the location of the grooves of the other supports is the prevention of the formation of a line of increased tension in the bone and the distribution of the load on the bone in different directions, which prevents the possible fracture of the front or rear wall of the implant bed in a relatively narrow jaw bone in the process of returning the shape of the implant during its transition from the martensitic state to the austenitic state. Therefore, the claimed implant can be safely used in the narrow jawbone, when implantation with known implants is generally contraindicated.

In addition, in the implant of the present invention, the grooves in the supports can be made at an acute angle to the longitudinal axis of the distal part, the apex of which is directed towards the distal end of the distal part. This arrangement of the grooves complicates the violation (distortion) of the required position of the implant inside the bone (for example, as a result of lateral chewing loads) immediately after reaching its austenitic state and thereby accelerates the process of primary stabilization of the implant in the bone and its osseointegration.

In one of the two main embodiments of the implant of the present invention (hereinafter referred to as option 1), the threaded fastener is made in the form of a threaded rod on the proximal part, in the other main variant (hereinafter referred to as option 2) the threaded fastener is made in the form of a threaded hole in the proximal part .

In one embodiment of the present invention, the longitudinal axis of the proximal and distal parts of the implant is coaxial, and in another embodiment, the longitudinal axis of the proximal part is located at an angle of 15-25 ° to the longitudinal axis of the distal part. Such an inclined location of the proximal part on which the abutment is installed corresponds to the range of the anatomical angles of inclination of the supragingival crown of the tooth to its root and the angles of inclination of the alveolar process of the jaw bone to the main bone of the jaw in the absence of teeth and in violation of occlusal relationships in most patients with a long absence teeth (adentia). The jawbone of the patient in the area of the adentia is often a kind of bone tissue into which the introduction of a direct implant is possible only at a certain angle, determined by the volume of bone tissue retained by the patient), the alveolar bone of the jaw in this area (the bone under the gum, in which there were previously roots of the patient’s teeth) is either too thin, and then you need to approach the anatomy of the tooth, in which the crown of the gingival part of the tooth has an angle of inclination to the root of the tooth in the specified range, or atrophied (i.e. there is a bone for the introduction of the intraosseous part of the implant parallel to the roots of the existing and surrounding dentition), or has an angle of inclination to the main bone of the jaw within 15-25 °, because due to malocclusion that has developed in the patient over the years (or congenital), the patient’s teeth (both on the jaw into which the implantation is supposed to be and on the opposite) have become inclined (in particular, they come forward with bipognathia), and an implant is installed it is possible only in the thickness of the main bone of the jaw so as not to damage the nerves and blood vessels with a small volume (deficit) of bone.

The present invention also provides a kit for permanent dental implantation comprising the dental implant of the present invention, a removable cap for forming the patient’s gums and an abutment, the removable cap and the abutment having means for fixing them to the implant.

In a preferred embodiment of the kit of the present invention, the abutment has a proximal narrowed portion for fastening the denture to it and a distal expanded portion in the form of a truncated cone with a smaller base mating with the proximal end of the proximal part of the implant, the diameter of the smaller base of the cone of the expanded part of the abutment being equal to the diameter of the proximal end proximal part of the implant. In addition, the removable cap has the shape of a truncated cone with a smaller base mating with the proximal end of the proximal part of the implant, the diameter of the smaller base of the cap being equal to the diameter of the proximal end of the proximal part of the implant. In a particularly preferred embodiment of the invention, the lateral surface of the truncated cone of the removable cap is identical in shape and size to the lateral surface of the truncated cone of the distal expanded part of the abutment.

In an embodiment of the invention, when the means for screwing the removable cap and / or abutment on the proximal part of the dental implant are made in the form of a threaded rod on the proximal part (option 1), the means for fixing the removable cap and the abutment on the implant are made in the form of an internal thread in the removable cap and abutment, respectively, for screwing the latter onto a threaded rod. At the same time, a slotted groove for a screwdriver can be made at the proximal end of the abutment to facilitate screwing the abutment onto the threaded rod.

In an embodiment of the invention, when the means for screwing the removable cap and / or abutment on the proximal part of the dental implant are made in the form of a threaded hole in the proximal part (option 2), the means for fixing the removable cap on the implant is made in the form of a coaxial threaded rod at the distal end of the cap for ensuring screwing this threaded rod into the threaded hole of the proximal part of the implant, a coaxial hexagonal recess is made at the proximal end of the proximal part of the implant ii, the abutment is made with a corresponding hexagonal protrusion inserted into the hexagonal recess, and the means for fixing the abutment on the implant is made in the form of a clamping screw screwed into the threaded hole of the proximal part of the implant, and an axial through hole is made in the abutment for the threaded part of the clamp to pass through it freely screw. In this case, the narrowed part of the abutment can be located at an angle to its longitudinal axis.

Preferred in all variants of the claimed kit is to make a slotted slot for a screwdriver at the proximal end of the removable cap to facilitate screwing the cap onto the threaded rod of the proximal part of the implant.

The invention is illustrated by drawings.

FIG. 1 - the claimed implant according to the variant when the means of screw fastening of the removable cap and / or abutment on the proximal part of the implant is made in the form of a threaded rod (option 1), in a martensitic state, side view.

FIG. 2 - the same in the austenitic state.

FIG. 3 is an enlarged image of the claimed implant, showing the displacement of the grooves of one support of the implant along its longitudinal axis relative to the location of the grooves of the other support

FIG. 4 is a top view of the implant (from its proximal part) shown in FIG. 2.

FIG. 5 - the claimed implant according to option 1 with the longitudinal axis of the proximal part at an angle γ to the longitudinal axis of the distal part, side view.

FIG. 6 - short removable cap for the implant according to option 1, side view.

FIG. 7 is an elongated removable cap for the implant according to option 1, side view.

FIG. 8 - short abutment for the implant according to option 1, side view.

FIG. 9 is an elongated abutment for the implant according to option 1, side view.

FIG. 10 - the claimed implant according to the variant when the means of screw fastening the removable cap and / or abutment on the proximal part of the implant is made in the form of a threaded hole in the proximal part (option 2), in a martensitic state, side view.

FIG. 11 is the same, top view.

FIG. 12 is a removable cap for the implant according to option 2, side view.

FIG. 13 - abutment for an implant according to option 2 with a clamping screw, side view.

FIG. 14 - side view of an abutment for an implant according to option 2 with a clamping screw, when the narrowed part of the abutment is inclined to its longitudinal axis.

FIG. 15 - mounted in the implant bed of the implant according to option 1 with a short removable cap with a periosteal location of the threaded rod.

FIG. 16 - installed in the implant bed of the implant according to option 1 with an elongated removable cap with an intraosseous arrangement of the threaded rod.

FIG. 17 - installed in the implant bed of the implant according to option 1 with a short abutment with a periosteal location of the threaded rod.

FIG. 18 - installed in the implant bed of the implant according to option 1 with an elongated (intraosseous-periosteal) abutment with a periosteal location of the threaded rod.

FIG. 19 - an implant installed in the implant bed according to option 2 with an abutment, the narrowed part of which is located at an angle to its longitudinal axis.

FIG. 20 - the location of the known helical implant in the narrow bone of the alveolar process of the jaw.

FIG. 21 - the location of the claimed implant according to option 1 in a narrow bone of the alveolar process of the jaw.

FIG. 22 - the location of the known helical implant in the low bone (in the absence of the alveolar process of the jaw).

FIG. 23 - location of the claimed implant according to option 1 in the low bone (in the absence of the alveolar process of the jaw).

FIG. 24 - formation of fracture lines in the narrow bone of the alveolar bone of the jaw using a known helical implant.

FIG. 25 - the location of the lines of increased voltage in the narrow bone of the alveolar process of the jaw when using a known implant with shape memory (prototype).

FIG. 26 is a photograph illustrating an example embodiment of the present invention below (prosthetics of the claimed implant in the Popov-Gordon phenomenon).

FIG. 27 is a radiograph illustrating the following example implementation of the present invention (prosthetics of the claimed implant in the Popov-Gordon phenomenon).

The claimed dental implant 1 contains a proximal part 2 and a distal part 3 (Fig. 1, 2, 10). The entire implant 1 or at least its distal part 3 is made of a shape memory material, for example, titanium nickelide. From the side of the distal end 4 of the distal part 3 in the implant 1, at least one incision 5 is made, passing along the longitudinal axis 6 of the distal part. As a result of the incision 5, two supports 7 are formed, fixing the implant 1 in the patient’s bones. The number of such sections may be more than one. For example, two mutually perpendicular cuts 5 can be made along axis 6 to form four supports 7, respectively (not shown in the drawings). On the outer surfaces of the supports 7, for example, cutters are provided with transverse grooves 8, and in an advantageous embodiment, the grooves 8 of one support 6 are offset along the longitudinal axis 5 of the implant 1 relative to the grooves 8 of the other supports 6 by Δ (Fig. 3). The displacement Δ can be either constant throughout the length of the support 6, or vary along the length of the support 8. In the preferred embodiment, the grooves 8 are made at an acute angle α to the longitudinal axis 6, with the apex of the angle α facing toward the distal end 4 of the distal part 3.

In the martensitic state of the material with shape memory, the fixing supports 7 form a generally cylindrical shape of the distal part 3 (Figs. 1, 10), and in the austenitic state, they form a generally conical form of the distal part 3 with a large cone base at its distal end 4 (Fig. 2, 5), and in the austenitic state, the fixing supports 7 are inclined to the longitudinal axis 6 of the distal part 3 at an angle β equal to 15-20 ° (Fig. 2).

The proximal part 2 of the implant 1 is made with threaded fastening on it of a removable cap 9 (Fig. 6, 7, 12) to form the patient’s gums or abutment 10 (Fig. 8, 9, 13). In option 1, this threaded fastener is made in the form of a threaded rod 11 on the proximal part 2 (Fig. 1, 2, 5), and in option 2 - in the form of a threaded hole 12 in the proximal part 2 (Fig. 10).

The longitudinal axis of the proximal 2 and distal 3 parts can be coaxial and in this case these parts have a common longitudinal axis 6 (Fig. 1, 2, 10). In one embodiment, the longitudinal axis 13 of the proximal part 2 is located at an angle y equal to 15-25 ° to the longitudinal axis 6 of the distal part 3 (Fig. 5).

The claimed kit for dental implantation contains a dental implant 1 of the present invention (Fig. 1, 2, 5, 10), a removable cap 9 for forming the patient’s gums (Fig. 6, 7, 12) and an abutment 10 (Fig. 8, 9, 13). The cap 9 and the abutment 10 have means for fixing them on the implant 1. The abutment 10 has a proximal narrowed part 14 for fixing the denture on it and a distal expanded part 15 in the form of a truncated cone with a smaller base, which, after installing the abutment 10 on the implant 1, is associated with the proximal end of the proximal part 2 (Fig. 17-19). The diameter of the smaller base of the cone of the expanded part 15 of the abutment 10 is equal to the diameter of the proximal end of the proximal part 2.

The removable cap 9 has the shape of a truncated cone with a smaller base, which after installing the cap 9 on the implant 1 is associated with the proximal end of the proximal part 2 (Fig. 15, 16). The diameter of the smaller base of the cap is equal to the diameter of the proximal end of the proximal part 2. In a preferred embodiment, the lateral surface of the truncated cone of the removable cap 9 is identical in shape and size to the lateral surface of the truncated cone of the distal expanded portion 15 of the abutment 10, which ensures that the shape of the gingival cuff formed by the cap is fully consistent. 9, in the form of the expanded portion 15 of the abutment 10 mounted on the implant 1 after removing the cap 9 from it.

If the claimed implant is made according to option 1, then the means for fixing the removable cap 9 and the abutment 10 on the implant 1 are made in the form of an internal thread or, in other words, threaded holes (not shown in the drawings) in the cap 9 and the abutment 10. These threaded holes are located along the longitudinal axes 16 and 17 (Fig. 6-9) of the cap 9 and the abutment 10, respectively. When screwing the cap 9 and the abutment 10 onto the threaded rod 11 of the proximal part 2 of the implant 1, the threaded holes of the cap 9 and the abutment 10 are aligned with the longitudinal axis 13 of the proximal part 2, and the threaded rod 11 enters these threaded holes (Fig. 15-18).

The claimed implant can be installed in the implant bed with both an intraosseous and periosteal location of the threaded rod 11. Depending on these two options for the location of the threaded rod 11, the cap 9 and the abutment 10 of the claimed kit are made of the corresponding length (height), namely, the kit for the intraosseous location of the threaded rod 11 (Fig. 16, 18), the cap 9 and the abutment 10 are elongated (have an increased, i.e., relatively large length), and in the kit for the periosteal location of the threaded with rod 11 (Fig. 15, 17), the cap 9 and the abutment 10 are made short (have a relatively short length).

The intraosseous location of the threaded rod 11 allows implantation in the absence of an alveolar bone of the jaw (in the case of, for example, incorrect extraction of teeth with a large volume of bone adjacent to the diseased tooth or in cases of purulent fusion of bone around the diseased tooth) without the need for preliminary bone growth (without bone augmentation or osteoplasty) in the area of the intended implantation, as well as when bone building is impossible or inappropriate due to the high risk of rejection bone-plastic material being used for this purpose. In such cases, implantation with all known implants is contraindicated, because the bone volume is very small for the use of known screw implants, and the bone suitable for implantation is deep under the gum, and the use of an excessively long abutment on known implants with shape memory will lead to immediate rejection of the latter, and the use of a short abutment is excluded, because it is impossible to excessively extend the orthopedic structure due to the ceramic-metal crown (a lever is formed with dislocation of the implant when chewing).

The problems associated with the use of known implants are solved by the present invention when installing an implant with an intraosseous location of the threaded rod 11, when the distal portion of the expanded portion 15 of the elongated abutment 10 is located inside the bone 24 (Fig. 18), and the proximal portion of the expanded portion 15 is at the level of the gums 25. The elongated abutment 10 is characterized by the elongated (greater height) expanded part 15. The elongated abutment 10, used for the intraosseous arrangement of the threaded rod 11 of the proximal hour and 2 of the claimed implant, is also referred to in this description as an intraosseous-periosteal abutment, also used with an elongated cap 9. The use of an intraosseous-periosteal (elongated) abutment 10 in the kit of the present invention allows the claimed implant to be inserted deep into the jawbone in the absence of an alveolar ridge, protecting the threaded part 11 with cap 9. Then, after completion of the primary stabilization and osseointegration of the implant, instead of cap 9, an intraosseous-periosteal abutment is screwed onto the implant 1 10 to obtain the location of the distal portion intraosseous expanded portion 15 of the abutment 10.

In addition, the intraosseous location of the threaded rod 11 in combination with the intraosseous-periosteal abutment 10 allows prosthetics to be performed with the so-called Popov-Godon phenomenon, which is manifested in the fact that the removal of one or more teeth leads to the development of a compensatory reaction of the body, expressed in the displacement of adjacent teeth in lost side, which leads to deformation of the dental arch and the jaw itself. Dental prosthetics on known implants and abutments are not possible without prejudice to the intact teeth of the opposite jaw of the adentia located above or below the site of the adentia and having an elongated clinical crown, since neither the known screw implants nor their abutments are designed for deep immersion in the bone. In contrast to the known implants and abutments, the present invention allows to solve the problem of prosthetics with the Popov-Gordon phenomenon, since the distal portion of the abutment 10 immersed in the bone has the shape of an elongated inverse cone and its wide “shoulders” at the border with the narrowed part 14 are located in the bone, and then these wide “shoulders” allow, without damage to the bone, to position the edges of the ceramic-metal crown on them intraosseously. The possibility of prosthetics in the Popov-Gordon phenomenon using the claimed implant in combination with intraosseous-periosteal abutment is described in more detail in the example below with illustrations in FIG. 26, 27.

If the claimed implant is made according to option 2, then the means for fixing the removable cap 9 on the implant 1 is made in the form of a threaded rod 18 at the distal end of the cap 9 (Fig. 12). The threaded rod 18 is located along the longitudinal axis of the cap 9. When installing the cap 9 on the proximal part 2 of the implant 1 by screwing the threaded rod 18 into the threaded hole 12 of the proximal part 2, the threaded rod 18 is aligned with the longitudinal axis 13 of the proximal part 2. The combination of the cap 9 with the implant 1 according to option 2 may not differ in appearance from the combination of the cap 9 with the implant according to option 1 (Fig. 15, 16). For embodiment 2 of the claimed implant, a coaxial hexagonal recess 19 (Fig. 10) is made in the proximal end of the proximal part 2, and the abutment 10 is made with a corresponding hexagonal protrusion 20 (Fig. 13, 14) inserted into the hexagonal recess 19. In this case, the means for fixing the abutment 10 on the implant 1 is made in the form of a clamping screw 21, screwed into the threaded hole 12 of the proximal part 2, and in the abutment 10 there is an axial through hole 22, which allows the threaded hour to pass freely through it ty of the clamping screw 21. The narrowed part 14 of the abutment 10 can be inclined to its longitudinal axis 17 (Fig. 14), while one side of the narrowed part 14 is located at an angle δ 1 equal to 15 °, and the other side is at an angle δ 2 equal to 30 °.

In all variants of the claimed kit, a slotted slot 23 for a screwdriver is made at the proximal end of the removable cap 9 (Fig. 6, 7, 12). A similar slotted groove for the screwdriver 23 is made at the proximal end of the abutment 10, used in conjunction with the claimed implant according to option 1 (Fig. 8, 9).

The claimed implant is made as follows.

The cylindrical preform of the implant is obtained by casting. To obtain a threaded rod 11 (option 1), first a cylindrical blank of this rod is bored on a lathe, and then an external thread is cut using a die on this blank. When performing the implant according to option 2, an internal thread is cut in the proximal part of the implant with a tap to obtain a threaded hole 12. From the side of the distal end of the distal part 3 of the implant, a diametrical incision 5 is made with a cutter, thereby forming two supports 7, each of which in general has the shape of a half cylinder. Grooves are made on the outer lateral surfaces of the supports 7 with a milling cutter 8. Then, the free (distal) ends of the supports 7 are bent apart (for example, they are wedged when the manufactured implant is in the muffle furnace) so that the supports 7 are inclined to the longitudinal axis 6 at an angle β = 15- 20 °.

Before implantation, the implant is cooled with a refrigerant (for example, liquid nitrogen), and the distal ends of the supports 7 are brought closer to each other by external force to obtain a generally cylindrical shape of the distal part 3 in a cooled martensitic state. In this state, the implant is inserted into a cylindrical implantation bed previously prepared in the jawbone. After that, in the process of heating the implant at the temperature of the human body and due to the memory effect, the forms of the support 7 return to the austenitic state with their inclination to the longitudinal axis at an angle β, as a result of which the implant is fixed in the bone.

After installation of the implant, a cap 9 is installed on it, which serves as a temporary plug to prevent infection from entering the gums, as well as the function of the gum former (gingival cuff around the periosteum of the implant). After completion of the gingival cuff formation process, the temporary cap 9 is replaced with a permanent abutment 10 onto which the denture 26 is mounted (Figs. 17, 18), while the cone of the expanded part 15 of the abutment 10 precisely fits into the complementary inner cone of the gingival cuff formed by the cap 9.

When performing the implant according to option 2, the presence of the hexagonal recess 19 in the proximal part 2 of the implant 1 and the corresponding hexagonal protrusion 20 on the abutment 10 located along the longitudinal axis 6, allows the installation of the abutment with an inclined narrowed part 14 in six different positions around the longitudinal axis 6.

Preliminary (before installing the claimed implant in the patient’s bones) introduction into the implantation bed of a special material for implantation according to patent RU 2399387 or the gel composition described in patent RU 2441620, promotes the accelerated formation of a thin connective tissue ligament around the intraosseous part of the implant, the faster formation of bone between the implant supports, and also expands the possibilities of orthopedic treatment, as the introduction of the gel composition described in patent RU 2441620 into the implantation bed immediately before implantation of the claimed implant provides micromotion of the claimed implant, identical to micromotion of human teeth, ensures the creation of a connective tissue interface of the implant with a bone around the intraosseous part of the claimed implant, similar to the natural (native) connective tissue ligament (periodontal) tooth roots and performing during operation of the claimed implant damper and b aberrant functions inherent in periodontal teeth (due to which human teeth are normally micromobile and successfully cope with multidirectional increased loads). Such an analogue of the periodontal around the intraosseous part of the claimed implant reduces the load on the bone, extends the life of the implant due to its physiology and allows, in particular, then to use the claimed implant in a single orthopedic design with human teeth, which cannot be done with direct osseointegration of known implants devoid of the inherent teeth human micromobility, damping and buffer properties at the implant-bone border.

In addition to the above-described advantages of the implant and the kit of the present invention, the shape and location of the grooves 8 in the fixing supports 7 provide them with less bone aggressiveness compared to the continuous thread faces in known screw implants. There is also no need for preliminary threading in the bone bed, since drilling of a cylindrical implant bed with smooth walls is sufficient to install the implant of the present invention.

In addition, the present invention allows to accelerate the periods of primary stabilization and osseointegration of the implant and to extend the period of its functional use compared to the known screw implants due to the most accurate correspondence of the claimed implant to natural teeth and its more appropriate natural anatomical and functional interaction, which also reduces the morbidity of the patient when using claimed implant. The form of the claimed implant in the austenitic state is closest to the anatomical structure of the jaw bone. Due to the relatively small height of the threaded rod 11 of the proximal part 2 of the claimed implant, the effects on the implant of the teeth of the antagonists of the opposite jaw are reduced, as well as the impact on the implant of lateral chewing loads.

The present invention allows to accelerate prosthetics on the claimed implant due to the use of a removable cap 9 having a conical shape that is identical to the conical shape of the expanded part 15 of the abutment 10. This is because when installing the claimed implant it is not necessary to exfoliate the gum, and its edges resulting from drilling cylindrical implantation bed, tightly pressed by the cone of the cap 9, which prevents the infection from entering the gum and bone. At the same time, there is no need for a separate use of the plug, as cap 9 performs its function; therefore, gum injury is eliminated when it is sutured after the plug is inserted and repeated gum injury to remove the plug and replace it with a separate gum former. As a result of this, the present invention provides the formation of gums around the periosteal part of the implant for a week, i.e. during the initial regeneration of the gums immediately after its minor injury during the installation of the implant.

The present invention expands the indications for implantation, since it allows implantation in bone atrophy, in particular with periodontal disease and with generalized periodontitis, in which the jaw bone becomes porous. The claimed implant first integrates with a weakened bone and, at the same time, due to the shape memory effect, strengthens the bone, and only then, after osseointegration is completed, is extended by screwing the abutment onto it. Indications for implantation are also expanding due to the fact that the proposed design and shape memory effect of the claimed implants allows minimizing their size and pressure on the bone, therefore, implantation can be performed as in the case of a narrow (from 3 mm) jaw bone with a maximum diameter of the proximal part 2 of the implant in the martensitic state equal to 6 mm (Fig. 21), and in the case of a low (from 4 mm) jawbone (under the maxillary sinus) with a length of the proximal part 2 of the implant equal to 4 mm (Fig. 23), which is contraindicated for all famous dental implants.

As shown in FIG. 20, the use of a known screw implant 27 of even the smallest diameter in a narrow bone (3.3 mm) of the alveolar ridge of the jaw will lead to a fracture of its cortical plate 28 in zone 29, while the use of the claimed implant in a narrow bone does not lead to such damage (FIG. . 21).

As shown in FIG. 22, the use of the known screw implant 27 even of the smallest length in the low (4 mm) bone 24 of the upper jaw beneath the maxillary sinus 30 will lead to the perforation of the bottom of the sinus by the implant 27, while in such a low bone, the claimed implant with an intraosseous part length of 4 mm may be successfully used (Fig. 23).

The above-described displacement of the grooves 8 of one support 7 of the claimed implant 1 relative to the grooves 8 of the other support 7 (Fig. 3) is an additional factor in preventing fractures of the walls of the narrow bone of the alveolar bone of the jaw.

As shown in FIG. 24, there is a risk of such fractures 31 when using the known screw implant 27. When the latter is screwed into the narrow jawbone from the vestibule of the oral cavity and from the oral cavity, the cutting edges of the thread of the implant 27 form lines of increased tension in the bone of the alveolar process of the lower jaw, located in general diametrically relative to the longitudinal axis of the implant. These lines can cause linear fractures 31 of the anterior or posterior wall of the implant bed when exposed to lateral chewing loads on the screw implant after prosthetics.

There is also a risk of such fractures when using the known shape memory implant 32 (Fig. 25) if the protrusions (or, respectively, the grooves 8) of the intraosseous supports 7 are located symmetrically with respect to the longitudinal axis of the implant, i.e. without displacement of the grooves of one support along this axis relative to the grooves of the other support. Symmetrically located (at the same height) projections of the supports 7 create lines of increased tension 33 during the transition of the supports from the martensitic state to the austenitic state, which can cause linear fractures of the walls of the lower part of the alveolar process of the jaw from the side of the vestibule of the oral cavity and from the side of the oral cavity.

In contrast to the direct osseointegration of known non-separable implants, the use of the claimed implant provides a gradual formation of a load on the jawbone, similar to an increase in load during the process of natural eruption of human teeth. Moreover, the claimed implant is able to bear the same load that was carried on the implanted areas of the jaw of the patient’s teeth before they were removed.

The claimed implant in its intraosseous part is structurally closest to the roots of multirooted human teeth since due to the shape memory effect, the supports of the claimed implant are located similarly to the roots of human teeth in the largest amount of preserved bone tissue of both the alveolar process and the main jaw bone. Therefore, the distribution of the load on the claimed implant during chewing is similar to the distribution of the load on the roots of the molar roots located at an angle to the vertical axis passing through the center of the tooth and is a lever of the first kind, while the area of two or four intraosseous supports of the claimed implant replaces the roots missing teeth (single or multi-root) always exceeds the area of interaction of a known conical screw implant, whose area of interaction with the jaw bone limited area of its threaded intraosseous portion.

Example. Prosthetics with the Popov-Gordon phenomenon (Fig. 26, 27).

Patient I. Popov-Godon phenomenon at the level of 2.6; 2.7 and 3.6; 3.7 teeth. The teeth of the upper jaw (2.5; 2.6 and 2.7) are absolutely healthy (intact). The use of known implants (screw and with shape memory) in the tooth section 3.7 is excluded due to the lack of abutments for deep immersion in the bone in sets with known screw implants and too long periosteal superstructure (abutment) in known shape memory implants. An intraosseous-periosteal abutment with a conical expanded part deeply immersed in the bone on the claimed implant replacing the missing 3.7 tooth (in Fig. 26, bottom right), is indicated in Fig. 26, 27 arrow.

Claims (15)

1. A dental implant comprising a proximal part made with a threaded fastening means on it of a removable cap for forming a patient’s gum and / or abutment, as well as a distal part made of material with shape memory and at least one cut from the distal end of the distal end parts extending along the longitudinal axis of the distal part with the formation of at least two supports fixing the implant in the patient’s bones, on the outer surfaces of which transverse grooves are made, and the grooves of one support are displaced in along the longitudinal axis of the implant relative to the location of the grooves of the other supports, in the martensitic state, the fixing supports form a generally cylindrical shape of the distal part, and in the austenitic state, the fixing supports form a generally conical shape of the distal part with a large cone base at its distal end.
2. A dental implant according to claim 1, characterized in that the grooves in the supports are made at an acute angle to the longitudinal axis of the distal part, the apex of which is directed towards the distal end of the distal part.
3. A dental implant according to claim 1, characterized in that the threaded attachment is made in the form of a threaded rod on the proximal part.
4. A dental implant according to claim 1, characterized in that the threaded attachment is made in the form of a threaded hole in the proximal part.
5. A dental implant according to claim 1, characterized in that the longitudinal axis of the proximal and distal parts are coaxial.
6. A dental implant according to claim 1, characterized in that the longitudinal axis of the proximal part is located at an angle of 15-25 ° to the longitudinal axis of the distal part.
7. A kit for permanent dental implantation containing a dental implant according to any one of paragraphs. 1-6, a removable cap for forming the patient’s gums and the abutment, the removable cap and the abutment having means for fixing them on the implant.
8. The kit according to claim 7, characterized in that the abutment has a proximal narrowed part for fixing a denture on it and a distal expanded part in the form of a truncated cone with a smaller base, mating with the proximal end of the proximal part of the implant, the diameter of the smaller base of the cone of the expanded part the abutment is equal to the diameter of the proximal end of the proximal part of the implant.
9. A kit according to claim 7, characterized in that the removable cap has the shape of a truncated cone with a smaller base mating with the proximal end of the proximal part of the implant, the diameter of the smaller base of the cap being equal to the diameter of the proximal end of the proximal part of the implant.
10. The kit according to claim 8, characterized in that the removable cap has a truncated cone shape with a smaller base mating with the proximal end of the proximal part of the implant, the lateral surface of the truncated cone of the removable cap being identical in shape and size to the side surface of the truncated cone of the distal expanded abutment .
11. The kit according to claim 7, characterized in that the dental implant is made according to claim 3, and the means for fixing the removable cap and abutment to the implant are made as internal threads in the removable cap and abutment, respectively, for screwing the latter onto the threaded rod of the proximal part of the implant .
12. A kit according to claim 11, characterized in that a slotted groove for a screwdriver is made at the proximal end of the abutment to facilitate screwing the abutment onto the threaded rod.
13. The kit according to p. 7, characterized in that the dental implant is made according to p. 4, the means for fixing the removable cap on the implant is made in the form of a coaxial threaded rod at the distal end of the cap to ensure that this threaded rod is screwed into the threaded hole of the proximal part of the implant, at the proximal end of the proximal part of the implant, a coaxial hexagonal recess is made, the abutment is made with a corresponding hexagonal protrusion inserted into the hexagonal recess, and the means for fixing the abutment the implant is designed as a clamping screw is screwed into a threaded hole of the proximal part of the implant, wherein the abutment in an axial through hole for the unimpeded passage therethrough of the threaded portion of the pressing screw.
14. The kit according to p. 13, characterized in that the narrowed part of the abutment is located at an angle to its longitudinal axis.
15. A kit according to claim 11 or 13, characterized in that a slotted groove for a screwdriver is made at the proximal end of the removable cap to facilitate screwing the cap onto the threaded rod of the proximal part of the implant.
RU2017101148A 2017-01-13 2017-01-13 Teeth implant and set for dental implantation RU2661019C1 (en)

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Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994015544A1 (en) * 1993-01-06 1994-07-21 A. Bromberg & Co. Ltd. Device for fixing a prosthesis to a bone
RU2075307C1 (en) * 1993-11-09 1997-03-20 Самсонов Владимир Егорович Intraosteal tooth graft from material with thermomechanical memory of shape
RU2187282C2 (en) * 2001-04-16 2002-08-20 Никольский Вячеслав Юрьевич Dental implant
RU48754U1 (en) * 2005-06-21 2005-11-10 Раздорский Владимир Викторович jaw implant
RU48753U1 (en) * 2005-06-21 2005-11-10 Раздорский Владимир Викторович jaw implant
UA51741U (en) * 2010-02-26 2010-07-26 Оксана Владимировна Добровольськая Abutment for removable denture
RU2396922C2 (en) * 2008-09-04 2010-08-20 Александр Павлович Нестеров Set for dental implantation
EA016751B1 (en) * 2008-11-26 2012-07-30 Евгений Александрович Веранчик Split antirotatsionny dental implant
RU2593349C1 (en) * 2015-03-30 2016-08-10 Сергей Сергеевич Комлев Collapsible dental implant

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994015544A1 (en) * 1993-01-06 1994-07-21 A. Bromberg & Co. Ltd. Device for fixing a prosthesis to a bone
RU2075307C1 (en) * 1993-11-09 1997-03-20 Самсонов Владимир Егорович Intraosteal tooth graft from material with thermomechanical memory of shape
RU2187282C2 (en) * 2001-04-16 2002-08-20 Никольский Вячеслав Юрьевич Dental implant
RU48754U1 (en) * 2005-06-21 2005-11-10 Раздорский Владимир Викторович jaw implant
RU48753U1 (en) * 2005-06-21 2005-11-10 Раздорский Владимир Викторович jaw implant
RU2396922C2 (en) * 2008-09-04 2010-08-20 Александр Павлович Нестеров Set for dental implantation
EA016751B1 (en) * 2008-11-26 2012-07-30 Евгений Александрович Веранчик Split antirotatsionny dental implant
UA51741U (en) * 2010-02-26 2010-07-26 Оксана Владимировна Добровольськая Abutment for removable denture
RU2593349C1 (en) * 2015-03-30 2016-08-10 Сергей Сергеевич Комлев Collapsible dental implant

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