WO2007073743A1

WO2007073743A1 - Implant for fixing in bone

Info

Publication number: WO2007073743A1
Application number: PCT/EP2005/013471
Authority: WO
Inventors: Jürgen Siemonsmeier
Original assignee: Tissuedent Gmbh & Co. Kg
Priority date: 2005-12-15
Filing date: 2005-12-15
Publication date: 2007-07-05

Abstract

The invention relates to an implant (20) with at least one shaft region (21) for fixing in a bony structure with at least one opening (24) at the distal end (25) of the shaft region (21), the shaft region (21) having a through drilling (23) running from the opening (24) to at least one outlet (26) at the apical end (27) such as to permit a targeted introduction of material at least into the periapical region after implantation on a stable fixing in the bony structure.

Description

Implant for anchoring in bone

Background of the invention

The invention relates to an implant having at least one shaft region for anchoring in a bony structure and having at least one opening at the distal end of the shaft region.

Implants of the type mentioned above are known from various fields of surgery or maxillofacial surgery and generally consist of a shaft region and a head region integrally formed or attached thereto. While the shaft region is introduced into the bone tissue with its apical end and serves to anchor the implant in the bone, a prosthesis or a dental crown replacement is attached to the head region, for example. The shaft region often consists of a porous material or a solid material, which is roughened on its surface, so that the bone tissue can grow into the pores to improve the fixation of the implant. The head region often has at its distal end an opening or attachment means in which or to which the prosthesis or an adapter provided therefor can be attached. In the distal opening of the head area, for example, there may be an internal thread into which a corresponding screw can be screwed. In daily dental or orthopedic surgery, the implant is placed as an anchoring module in the bone, i. H. For example, screwed by means of a self-tapping external thread, and then awaited the endosseous integration. To improve the integration into the bone tissue, the most varied surface structures or material structures for the shaft area have already been investigated.

When anchoring the implants in the bone, there is often the problem that a stable integration of the implant due to the structure or strength the corresponding bone section is not possible or only with great effort. Thus, for example, when anchoring dental implants in the upper jaw below the antrum (maxillary sinus), only a very small number of bones are available for fixing the implant, since the jawbone has only a relatively small thickness at the locations below the antrum. Therefore, the jawbone often has to be "widened" into the maxillary sinus to achieve sufficient bone strength to anchor an implant, but this procedure called "sinus lift" is very cumbersome and very stressful for the patients. Another problem with the anchoring of implants in a bony structure is that in the periapical or peri-paraimplantar area, after insertion of the implant, inflammatory processes can occur which can not be adequately treated due to the already integrated implant and therefore to follow-up operations or even removal of the implant.

State of the art

From DE 41 05 165 A1 a tooth root implant is known, which consists of a arranged at the distal end of the implant head and an integrally connected to this shaft. The head has inclined abutment surfaces with respect to the longitudinal axis of the shaft, which contact the jawbone and have an open-cell structure into which bone tissue can grow, so that the implant is anchored in the jaw. The head also has an opening distally connected to the shaft via a bore. The stem consists of an open network through which an antiseptic can be introduced into the bone stock. However, this known implant has the disadvantage that the shaft does not contribute anything to anchoring in the bone, but the stability of the implant depends solely on the contact surfaces of the head and thus is relatively low. In addition, a targeted application of the antiseptic in certain areas of the jaw is not possible due to the open network structure. A tooth root implant is also known from US Pat. No. 6,939,135 B2, which likewise consists of a head arranged at the distal end of the implant and a shaft connected in one piece therewith. The cylindrical shaft has an external thread for screwing into the jawbone and vertically extending rows of radially outwardly extending outlet openings. These outlet openings are connected via a channel running centrally in the shaft to an opening at the distal end of the shaft, so that growth factors introduced through the opening can be introduced via the outlet openings into the bone structure surrounding the implant radially. However, this known implant has the disadvantage that no material can be introduced into the periapical region in order to avoid, for example, the elaborate sinus lift.

Summary of the invention

It is therefore an object of the invention to provide an implant of the type mentioned above, which, with stable anchoring in the bone structure, enables targeted introduction of material, at least into the periapical region, even after implantation.

According to the invention the object is achieved by an implant of the type mentioned, in which the shaft portion has a through hole extending from the opening to at least one outlet at the apical end. The implant according to the invention allows the targeted application of substances or the introduction of material into the periapical (tip) or peri-paraimplantären area after implantation of the implant via the apical outlet arranged to postimplantarily possible tissue regeneration control, for example, a complex external or internal sinus lift to avoid. The implant according to the invention thus makes it possible, for example, to apply various agents, medicaments, cells or other substances via the shaft area directly intraoperatively and / or subsequently over a prolonged period in one or more further sessions as inductive and / or adjuvant and / or therapeutic measures. me. The targeted application of any substances, medicaments and / or cells into the periapical or paraimplantar area is thus made possible, whereby the implant itself persists in its capacity as a "carrier or anchor of old standards." That is, a postimplantary delivery treatment of the surrounding Tissue, especially at the tip of the implant, by drug application, such as antibiotics or growth promoters, remains possible.A complication treatment in otherwise hitherto inaccessible area is thus still possible for many years post implantationem when using the implant according to the invention It also makes possible a post- or peri-implant tissue regeneration by applying stem cells of any kind to the periapical area.

In an advantageous embodiment of the invention, it is provided that the shank region has at least one fastening element in the bore at the apical end. For example, a conduit, an access tube, a screw, a mandrel or a plug can be attached to the fastening element. The fastening element may be an internal thread and / or a part of a plug-in or latching connection. If a conduit, which may for example be a cannula or a tube, or an access tube attached to the fastener, so the safe and targeted introduction or introduction of substances, cells or other material through the outlet into the periapical area is possible in an advantageous manner. In addition, the outlet can be closed by means of a screw or plug placed in the fastening element, thus preventing the penetration of foreign bodies or microorganisms into the periapical operating area between the individual treatments.

If the shaft region has an external thread, preferably a self-tapping, at least at the apical end, the implant according to the invention can advantageously be screwed into the bone without previous measures. In a particularly advantageous embodiment of the invention, it is provided that the shaft region has at least one laterally arranged perforation, which can preferably be connected to the bore via at least one channel. The shaft preferably has several perforations distributed uniformly over its circumference. In this embodiment, the possibility of the application of substances, cells or other material through the distal opening directly into different level areas of the bone stock, ie any bone tissue and, for example, alveolar ridge, sinus, cyst lumen, osteomyelitic zone or fracture gap, over the entire or a portion of the Implant or beyond. If the perforations are arranged in different compartments of the shaft area, targeted application into the different levels of the bone bed is advantageously possible, in particular if the different compartments of the shaft area can be sealed off from one another. This can be done, for example, by means of a screw which can be screwed into the transition region between the compartments or a plug which can be attached here.

Preferably, the shank region has at least one fastening means at its distal end in the bore. The fastening means may for example be an internal thread and / or a part of a plug-in or latching connection. For example, a conduit, an access tube, a screw, a mandrel or a plug may be attachable to the attachment means. If a conduit, which can be, for example, a cannula or a tube, or an access tube attached to the attachment means, so the safe and targeted introduction or introduction of substances, cells or other material through the distal opening into the bore is possible in an advantageous manner. By means of an attached in the fastener screw or a corresponding plug the outlet can be closed and thus between the individual treatments penetration of foreign bodies or microorganisms into the bore and possibly the surgical area can be prevented. In particular embodiments, a spacer or healing sleeve, a prosthesis, a denture may be attached to the attachment means and / or an adapter for attaching the prosthesis or the denture be attached.

In an advantageous embodiment of the invention is further provided that the shaft portion is at least partially cylindrical and / or stepped.

The invention will be explained in more detail below with reference to the figures.

Brief description of the illustrations

It shows

Figure 1 is a perspective view of an embodiment of the implant according to the invention with screwed healing sleeve after implantation in a jawbone and

Figure 2 is a schematic representation of a longitudinal section through a further embodiment of the implant according to the invention.

Description of various embodiments of the invention

FIG. 1 shows by way of example a perspective view of an implant 1 according to the invention after implantation in a jawbone 2. The implant 1 is substantially cylindrical and mainly consists of a shaft region 3 which on the outside of its apical half has a self-tapping external thread 4 for screwing into the Jawbone 2 has. At its distal end 5, a spacer or healing sleeve 12 is screwed into a not visible here opening, which is closed by means of a screw 6, of which only the screw head is visible in this illustration. At its apical end 7, the shaft region 3 has an outlet 8, which has a bore extending along the longitudinal axis within the shaft region 3 with the opening at the distal end 5 which is closed here. is bound. If the screw 6 is removed, various substances, cells or other material can be introduced through the opening of the healing sleeve 12 via the outlet 8 into the periapical space 9. For example, stem cells and / or growth factors could be introduced into the periapical space 9 to facilitate or assist in the formation of bone tissue. In this way, for example, a sinus lift could be avoided.

The implant 1 also has perforations 10 in the shaft region 3, via which therapeutic substances, cells or similar material can likewise be introduced into the bone tissue 11 surrounding the implant 1. The perforations 10 are in each case connected via a channel to the through-bore, so that the material only has to be introduced into the distal opening or the healing sleeve 12 in order to pass through the perforations 10 into the bone tissue 11. The perforations 10 are distributed uniformly over the circumference of the shaft region 3 of the implant 1, so that the surrounding bone tissue 11 can also be supplied uniformly with the substances and / or cells.

The implant 1 according to the invention thus makes it possible to administer medicaments, stem cells or other material via the shaft region 3 directly intraoperatively and / or subsequently over a prolonged period in one or more further sessions as an inductive and / or adjuvant and / or therapeutic measure. The targeted application of the substances and / or cells into the periapical space 9 is thus made possible, the shaft region 3 remaining in its capacity as anchor in the bone tissue 11. A postimplant conveying treatment of the surrounding tissue, especially at the apical end 7 of the implant, by drug application, such as antibiotics or growth factors, remains possible even after the endosseous integration of the implant 1. Depending on the type of use, the implant 1 can be adapted to the implantation into various bones, for example jaw, hip or thigh bones. FIG. 2 shows by way of example a schematic representation of a longitudinal section through an implant 20 according to the invention, which consists essentially of a cylindrical shaft region 21. The shank region 21 is formed by a hollow, step-shaped cylinder 22, which has a through bore 23 in its interior. The bore 23 extends from the opening 24 at the distal end 25 to an outlet 26 at the apical end 27 of the shaft portion 21. The cylinder 22 has at its periphery perforations 28 which communicate with the bore 23 via a channel 29 in each case , The cylinder 22 may be provided on its outer surface completely or partially with an external thread, not shown here for screwing into a bony structure.

At the apical end 27 of the shaft region 21, which forms the tip of the implant 20, an internal thread 30 is arranged as a fastening element 31 in the bore 23. For example, a conduit, an access tube, a screw, a mandrel and / or a plug may be attached to the fastener 31. In the present exemplary embodiment, a screw or a screw mandrel can be screwed into the internal thread 30, so that the apical end 27 can either be closed or provided, for example, with an access line for introducing substances and / or cells into the periapical space. The inner cone of the distal end 25 of the shaft portion 21 is also provided with an internal thread 32 as a fastener 33, so that the opening 24 can be closed with a screw so that, for example, when healing the implant 20 into the bone tissue no unwanted foreign matter or germs in the operating area can reach. During healing in the bone, a spacer or healing sleeve may be attached to the fastener 33 to facilitate attachment of a prosthesis after complete healing of the surrounding tissue. If the implant 20 healed into the bone or fused with it, for example, a spacer sleeve, a prosthesis, a denture or a corresponding adapter can be screwed into the internal thread 32. The implant 20 then serves as an anchor for the prosthesis or the dentures in the bone. The surrounding remains Bone tissue also postimplantationem via the opening 24 (after removal of the prosthesis, the denture or the adapter), the perforations 28 and especially the outlet 26 for the application of therapeutic substances accessible. Furthermore, a hose or a cannula or the like can also be connected to the fastening means 33 in order to facilitate the introduction of material into the bore 23.

The bore 23 has in the vicinity of the apical end 27 as an additional fastening element 31, a further internal thread 34 on which also a conduit, an access tube, a screw, a mandrel and / or a plug can be attached. With the aid of the fastening elements 31, the shaft region 21 or the bore 23 can be subdivided into different compartments 35, 36, 37. By selectively closing the bore 23 by means of attaching a screw or a plug to one or more fasteners 31, the individual Compartimen- te 35, 36, 37 are sealed against each other such that a targeted application to different levels of the surrounding tissue on the respective Perforations 28 is possible. If, for example, the compartment 35 is closed by means of a screw screwed into the internal thread 30 and a stylet is screwed into the internal thread 34 with an access line, then therapeutic substances and / or cells can be introduced via the perforations 28 of the compartment 36 into the corresponding plane of the surrounding tissue become. Of course, the same applies to the compartment 37, in which case the compartment 36 must be sealed by closing the bore 23 on the internal thread 34.

Of course, further fastening elements and perforations can also be arranged in the shaft region 21. The implant 20 according to the invention can therefore be used very flexibly due to the variety of design possibilities and can be adapted to different requirements or applications in the (orthodontic) surgical and orthopedic area. LIST OF REFERENCE NUMBERS

1 implant

2 jaw bones

3 shaft area

4 external threads

5 Distal end

6 screw

7 Apikales end

8 outlet

9 Periapical space

10 perforations

11 bone tissue

12 cure pod

20 implant

21 shaft area

22 cylinders

23 hole

24 opening

25 Distal end

26 outlet

27 Apical end

28 perforations

29 channel

30 internal thread

31 fixing element

32 internal thread

33 fasteners

34 internal thread

35 compatibility

36 compartment

37 compartment

Claims

claims

1. implant (1, 20) with at least one shaft region (3, 21) for anchoring in a bony structure and with at least one opening (24) at the distal end (5, 25) of the shaft region (3, 21), characterized in that the shaft region (3, 21) has a through bore (23) which extends from the opening (24) to at least one outlet (8, 26) at the apical end (7, 27).

2. Implant according to claim 1, characterized in that the shank region (3, 21) at the apical end (7, 27) in the bore (23) has at least one fastening element (31).

3. Implant according to claim 2, characterized in that on the fastening element (31) a conduit, an access tube, a screw, a mandrel or a plug is attachable.

4. Implant according to claim 2 or 3, characterized in that the fastening element (31) is an internal thread (30, 34) and / or part of a plug-in or latching connection.

5. Implant according to claim 3 or 4, characterized in that the conduit is a cannula or a hose.

6. Implant according to one of claims 1 to 5, characterized in that the shank region (3, 21) at least at the apical end (7, 27) has a, preferably self-tapping, external thread (4).

7. Implant according to one of claims 1 to 6, characterized in that the shank region (3, 21) at least one laterally arranged perforation (10, 28), which preferably via at least one channel (29) connected to the bore (23) is.

8. Implant according to claim 7, characterized in that perforations (28) in different compartments (35, 36, 37) of the shaft portion (21) are arranged.

9. Implant according to claim 8, characterized in that the different compartments (35, 36, 37) of the shaft region (21) are mutually sealable.

10. Implant according to one of claims 1 to 9, characterized in that the shank region (3, 21) at the distal end (5, 25) in the bore (23) has at least one fastening means (33).

11. An implant according to claim 10, characterized in that on the fastening means (33) a conduit, an access tube, a screw (6), a mandrel or a plug is attachable.

12. Implant according to claim 11, characterized in that the conduit is a cannula or a hose.

13. Implant according to claim 10, 11 or 12, characterized in that on the fastening means (33) a spacer or healing sleeve, a prosthesis, a dental prosthesis and / or an adapter for attaching the prosthesis or the denture is attachable.

14. Implant according to one of claims 1 to 13, characterized in that the shank region (3, 21) is at least partially cylindrical and / or stepped.