WO2009060415A2 - Dental implant adaptor - Google Patents

Dental implant adaptor Download PDF

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Publication number
WO2009060415A2
WO2009060415A2 PCT/IB2008/054668 IB2008054668W WO2009060415A2 WO 2009060415 A2 WO2009060415 A2 WO 2009060415A2 IB 2008054668 W IB2008054668 W IB 2008054668W WO 2009060415 A2 WO2009060415 A2 WO 2009060415A2
Authority
WO
WIPO (PCT)
Prior art keywords
adaptor
crown
implant
dental implant
receiving portion
Prior art date
Application number
PCT/IB2008/054668
Other languages
French (fr)
Other versions
WO2009060415A3 (en
Inventor
Dana Galgut
Giuseppe Geldenhuys
Graham Alan Blackbeard
Original Assignee
Southern Implants (Pty) Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Southern Implants (Pty) Ltd filed Critical Southern Implants (Pty) Ltd
Priority to US12/734,527 priority Critical patent/US9055988B2/en
Publication of WO2009060415A2 publication Critical patent/WO2009060415A2/en
Publication of WO2009060415A3 publication Critical patent/WO2009060415A3/en

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Classifications

    • 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
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • 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
    • A61C8/0001Impression means for implants, e.g. impression coping
    • 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
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0066Connecting devices for joining an upper structure with an implant member, e.g. spacers with positioning means
    • 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
    • A61C2008/0084Provisional implants or abutments
    • 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
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/006Connecting devices for joining an upper structure with an implant member, e.g. spacers with polygonal positional means, e.g. hexagonal or octagonal
    • 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
    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0068Connecting devices for joining an upper structure with an implant member, e.g. spacers with an additional screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • A61C9/004Means or methods for taking digitized impressions
    • A61C9/0046Data acquisition means or methods
    • A61C9/0053Optical means or methods, e.g. scanning the teeth by a laser or light beam

Definitions

  • THIS invention relates to a dental implant adaptor.
  • a conventional dental implant assemby consists of an implant, an abutment and a crown.
  • the implant has a threaded shank which is screwed into the bone, the abutment is then fastened to the implant and the crown, which has the appearance of the original tooth and which is visible in the mouth after implantation, is fastened to the abutment.
  • the crown must be individually manufactured in a dental laboratory.
  • a digital camera is placed in the patient's mouth or over a model thereof and optical scanning is used to register the position and shape of the implant and abutment, and the corresponding part of the crown is shaped according to the scanned data.
  • the shapes of the current implant/abutment components are however not ideal for optical scanning in situations where a "screw retained" protocol, in which the crown is held in position by a screw, is used.
  • a "closed crown cemented” protocol is used, the relevant components are more suited to optical scanning but the protocol is not universally popular. This is because it is difficult to retrieve the crown in the event of, for instance, excess wear or fracture.
  • the protocol leads to formation of a cement junction line just beneath the soft tissue of the gum and this line can be visible and unsightly if soft tissue recession takes place.
  • a dental implant adaptor comprising a hollow body mountable on a dental implant and including:
  • crown-receiving portion on which a dental crown is mountable, the crown-receiving portion having a distal end and a proximal end and including a first anti-rotation formation to prevent rotation between the adaptor and a dental crown mounted on the crown-receiving portion,
  • the crown-receiving portion and collar together having an overall axial length in the range 3.5mm to 7mm and the collar having an axial thickness of 1.5mm or less.
  • the crown-receiving portion is at least partially of tapered shape.
  • the tapered part may for example be generally conical with a cone angle in the range 1.5° to 5°, preferably about 3°.
  • the axial thickness of the collar is in the range 0.2mm to 0.7mm, possibly of the order of 0.3mm, and the overall axial length of the tapered portion and crown together is in the range 4mm to 5mm, typically 4.3mm.
  • a dental implant assembly comprising:
  • an implant having a proximal end which can be anchored in a bone, an opposite, distal end and a threaded passage in the implant, an implant adaptor as summarised above which is engagable non- rotatably on the distal end of the implant through non-rotational engagement between the second anti-rotation formation and the implant, and a screw designed to extend through the adaptor and to be screwed into the threaded passage in the implant, thereby to anchor on the implant a crown which is, in use, fixed non-rotatably on the crown- receiving portion of the adaptor through non-rotational engagement of the first anti-rotation formation and the crown.
  • a dental implant apparatus comprising:
  • the crown- receiving portion of the dental implant adaptor including at least a part which is of tapered shape
  • a scanning and locating insert made of plastics material and having a tapered distal end and a threaded proximal end, the insert being shaped for its proximal end to be screwed into the threaded passage in the implant with its distal end bearing on the adaptor, thereby to secure the adaptor to the implant for scanning of the adaptor and implant in the mouth of a patient.
  • a further aspect of the invention provides a method of installing a dental crown in a patient's mouth, the method comprising the steps of providing a dental implant assembly according to claim 19,
  • a crown mountable non-rotatably on the crown-receiving portion of the adaptor the crown including a passage therethrough for the screw; fixing the crown non-rotatably on the crown-receiving portion of the adaptor, outside the patient's mouth, and locating the assembled crown and adaptor non-rotatably on the implant in the patient's mouth and anchoring them to the implant by passing the screw through the passage in the crown and screwing it into the threaded passage in the implant.
  • Figure 1 shows a perspective view of a dental implant adaptor according to the invention
  • FIGS. 2 to 4 show perspective views of dental implant adaptors according other embodiments of the invention.
  • Figure 5 shows a perspective view from the opposite end of an implant adaptor as shown in Figures 1 to 4;
  • Figure 6 shows a perspective view from the opposite end of another embodiment of dental implant adaptor
  • Figure 7 illustrates a step in a dental implantation method
  • Figure 8 shows a perspective view of a crown used in a dental implant assembly according to the invention
  • Figure 9 shows a perspective view of a dental implant assembly according to the invention
  • Figure 10 shows a perspective view of the dental implant assembly of Figure 9, after implantation
  • Figure 11 shows a cross-sectional view of the implant assembly of Figure 9;
  • Figure 12 shows a side view of a scanning and locating insert
  • Figure 13 shows a perspective view of another embodiment of dental implant adaptor according to the invention
  • Figure 14 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 15 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 16 shows a side view of the dental implant adaptor seen in Figure 15;
  • Figure 17 shows a cross-section at the line 17-17 in Figure 15;
  • Figure 18 shows a plan view of the dental implant adaptor seen in Figure 15;
  • Figure 19 shows a bottom view of the dental implant adaptor seen in Figure 15;
  • Figure 20 shows a perspective view of a further embodiment of dental implant adaptor according to the invention
  • Figure 21 shows a perspective view of a further embodiment of dental implant adaptor according to the invention
  • Figure 22 shows a side view of the dental implant adaptor seen in Figure 21 ;
  • Figure 23 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 24 shows a side view of the dental implant adaptor seen in Figure 23;
  • Figure 25 shows a plan view of the dental implant adaptor seen in Figure 23;
  • Figure 26 shows another side view of the dental implant adaptor seen in Figure 23;
  • Figure 27 shows a bottom view of the dental implant adaptor seen in Figure 23;
  • Figure 28 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 29 shows a side view of the dental implant adaptor seen in Figure 28;
  • Figure 30 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 31 shows a perspective view of a further embodiment of dental implant adaptor according to the invention
  • Figure 32 shows a side view of the dental implant adaptor seen in Figure 31 ;
  • Figure 33 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 34 shows a side view of the dental implant adaptor seen in Figure 33;
  • Figure 35 shows a perspective view of a further embodiment of dental implant adaptor according to the invention.
  • Figure 36 shows a side view of the dental implant adaptor seen in Figure 35;
  • Figure 37 shows a bottom view of the dental implant adaptor seen in Figure 35.
  • Figure 38 shows a perspective view of an assembled insert and dental implant adaptor.
  • Figure 1 shows a first embodiment of dental implant adaptor 10 according to the invention. The view in this Figure is taken from the coronal end of the adaptor.
  • the adaptor 10 is made of a suitable non-corrosive and bio-compatible material, typically a suitable grade of titanium.
  • the adaptor 10 includes a hollow body 12 including a generally conically tapered, crown-receiving or abutment portion 14 extending from a relatively narrow, distal or coronal end 16 to a relatively wide, opposite, proximal end 18.
  • the hollow body 12 also includes a collar 20 which projects laterally at the relatively wide, proximal end.
  • the overall axial length of the crown-receiving portion and collar together is in the range 3.5mm to 7mm, preferably 4mm to 6mm.
  • the axial thickness of the collar is preferably 1.5mm or less, most preferably in the range 0.2mm to 0.7mm.
  • the collar has an axial thickness of the order of 0.3mm and the crown-receiving portion has an axial length of 4mm, giving the crown- receiving portion and collar together an overall axial length of 4.3mm.
  • the cone or taper angle 26 is preferably in the range 1.5° to 5°, and in this example is 3°.
  • the numeral 28 indicates a first anti-rotation formation in the form of an outwardly extending, lateral protrusion or bulge on the external surface of the tapered crown-receiving portion 14. In the region of this protrusion the tapered crown-receiving portion 14 is non-circular in cross-section.
  • the crown-receiving portion 14 includes a conically tapered part 14.1 and a first anti-rotation formation 30 located between the tapered part and the collar 20. While the tapered part 14.1 has a circular cross-section throughout in this embodiment, the anti-rotation formation 30 has three equiangularly spaced apart projections in the form of lobes 32 defining a non-circular cross-sectional shape.
  • the crown-receiving portion 14 has a non-circular, elliptical cross-section throughout. This is demonstrated by the fact that, while the central axis of the crown-receiving portion coincides with that of the collar and the collar is circular in shape, the indicated dimensions x and y are different from one another. In this case the entire length of the crown- receiving portion between the distal end 16 and the collar at the proximal end serves as an anti-rotation formation.
  • the crown-receiving portion 14 has anti-rotation formations in the form of channels or recesses 34 in its external, generally conical surface, giving it a non-circular cross-sectional shape throughout.
  • the generally conical crown-receiving formation 14 includes an anti-rotation formation in the form of an outwardly extending protrusion or abutment 90. More is said below about the nature of the protrusion 90.
  • the body 12 is hollow, the numeral 36 indicating the central hollow or bore of the body.
  • the anti-rotation formations i.e. the bulge 28 in Figure 1 , the lobes 32 in Figure 2, the elliptical cross-section in Figure 3, the channels or recesses 34 in Figure 4 and the protrusion 90 in Figures 13 to 37, serve to prevent relative rotation between a crown mounted on the crown-receiving portion 14 and the adaptor 10 when these components are fixed to one another as described in more detail below.
  • the dental implant adaptor 10 includes a second anti-rotation formation, at its proximal end, to prevent rotation between the adaptor and a dental implant on which the adaptor is mounted in use, as described below.
  • the second anti- rotation formation 38 includes a socket of non-round, in this case hexagonal, shape.
  • the anti-rotation formation 38 extends axially from the collar in a direction opposite to the crown-receiving portion 14.
  • the formation 38 in this case includes a part 40, adjacent the collar 20, which has three equi-angularly spaced lobes 42 defining a non-circular cross-sectional shape and a hollow, round cylindrical part 44 arranged coaxially with the portion 14.
  • the adaptors seen in Figure 2 to 4 could include formations 38 as seen in Figure 6 or Figures 22, 33 and 34 or the formation 38 seen in Figure 6 could be replaced by a formation 38 as seen in Figure 5 or as seen in Figures 22, 33 and 34, and so on.
  • the selection of the appropriate type of anti-rotation formation will be dictated by the particular implant which is used.
  • FIGs 7 to 11 illustrate components of a dental implant assembly which includes a dental implant adaptor 10 of the type described above with reference to Figures 2 and 6.
  • the assembly also includes an implant 50 which has a tapered, threaded shank 52 extending to a narrow, proximal end, a multi-lobed socket 54 complemental in shape to the formation 38 of the implant adaptor 10, a threaded passage 56 extending axially into the shank from the base of the socket 54 and a distal or coronal end 58.
  • the assembly further includes a crown 60, about which more is said below, and a prosthetic retaining screw 62.
  • a hole is formed by drilling, reaming or other suitable procedure in a jaw bone 64 of the patient and the threaded shank 52 of the implant 50 is screwed into the hole such that the end of the implant is accessible above the bone.
  • the implant may then be left, after closing up the wound site, for a period of time suitable for integration and stabilisation of the implant to take place.
  • a temporary abutment may be engaged with the coronal implant.
  • the implant adaptor 10 is located on the coronal end of the implant, as shown in Figure 7, with the multi-lobed formation 38 of the adaptor received complementally and non-rotationally in the socket 54 of the implant.
  • the shank of a plastic scanning and locating insert or pin 64 is passed through the central bore 36 of the adaptor 10 and is screwed into the threaded passage 56 of the implant 50, as shown in Figure 7.
  • the insert 64 has a tapered head 66 terminating at a shoulder 67.
  • the shoulder 67 of the insert bears on the coronal end 16 of the adaptor 10 with the result that the insert holds the adaptor in place on the implant 50.
  • the head 66 of the insert 64 has a conical taper matching that of the tapered part 14.1 of the crown-receiving portion 14 of the abutment 10. Thus, when the insert has been screwed into position, the head 66 effectively forms a conical extension of the part 14.1 , as shown in Figure 7.
  • a camera is inserted into the patient's mouth and is used to conduct a scan of the components described above and of the surrounding teeth, as indicated by the arrows 68 in Figure 7.
  • the insert 64 is unscrewed and the adaptor 10 is detached from the implant 50 and is removed from the patient's mouth.
  • a suitable contrast spray may be applied to the assembly of adaptor 10 and insert 64.
  • the insert 64 holds the adaptor 10 in position and provides an accurate indication of the position, shape and size of the adaptor 10 and passage 36.
  • the scanning camera is of a type providing simply a two- dimensional, axial image of the components, as indicated by the arrows 68 in Figure 7, the tapered shapes of the part 14.1 of the crown-receiving portion 14 of the adaptor and of the head 66 of the insert 64 provide depth perception in the image.
  • the image captured by the camera is used in the manufacture of the crown 60, typically of ceramic. In some cases other information such as physical bite impressions of the patient's mouth may also be obtained to assist in accurate manufacture of the crown.
  • the camera captures one or more digital images which are fed to a computer controlled manufacturing apparatus, typically including a CNC milling machine, programmed to manufacture the crown from the input information.
  • a computer controlled manufacturing apparatus typically including a CNC milling machine, programmed to manufacture the crown from the input information.
  • the head 66 of the insert 64 has a length corresponding to the height of the crown which is to be manufactured. If necessary, the head 66 may be cut down as necessary to suit the crown height before scanning takes place.
  • the tapered shapes of the part 14.1 of the portion 14 of the adaptor 10 allow for depth perception even in a two-dimensional, axial scanning mode.
  • This facilitates the formation of an axial passage 74 through the crown, as shown in Figure 8, during crown manufacture.
  • the axial passage 74 which is formed is complemental in shape to the portion 14 of the abutment 10 and includes a socket 72, adjacent the proximal end of the crown, which is complemental in shape to the anti-rotation formation 30, and extends to the occlusal or coronal end 70 of the crown.
  • the manufactured crown is accordingly shaped for proper conformity and location in the mouth and for complemental location on the abutment 10.
  • the manufactured crown is then fixed to the implant adaptor 10 by cementing the portion 14 of the adaptor in the axial passage in the crown, thereby creating a unitary assembly consisting of the crown and adaptor.
  • a suitable cement may, for instance, be PanaviaTM or similar.
  • the crown and portion 14 may be etched to improve cementation and SilaneTM or a suitable porcelain activator may be applied to the portion 14.
  • the assembly of crown and adaptor is then taken to the patient's mouth and the adaptor 10 is mounted on the implant 50 with the collar 20 resting on the end of the implant and the multi-lobed formation 38 locating non- rotatably in the socket 54 of the implant.
  • the shank of the retaining screw 62 is passed through the screw-receiving passage in the crown and through the bore 36 of the adaptor 10 as shown in Figures 9 to 11 , and the threaded end of the shank is screwed into the passage 56 in the implant with a predetermined torque.
  • the head of the screw bears on an internal shoulder 100 in the adaptor (see, for example, Figure 17) and fastens the adaptor, and hence the crown, relative to the implant.
  • the screw will be inserted through the passage 36, so that its head locates on the shoulder 100, before the crown is cemented in place.
  • the passage 74 will then provide access to the screw head, by means of a narrow screw-driver or other tool, for the purposes of fastening the screw to the implant.
  • the head of the screw has a socket formation 80 which has a hexagonal cross-section and which can be engaged by the appropriate tool.
  • the head of the screw may have a different tool-engaging formation, for example a slot or so-called “torx" or “unigrip” socket formation.
  • FIG 38 illustrates an assembly of insert 64 and adaptor 10, in this case an adaptor 10 of the kind seen in Figure 13, in which the insert is formed with a socket 102.
  • This socket can be engaged by a suitable tool for the purposes of screwing the insert 64 to the implant prior to scanning.
  • the socket is designed as a "unigrip" socket but it will be understood that the socket could have other designs, for example a hexagonal or "torx" design.
  • inserts such as that seen in Figure 38 can be screwed in using a suitable spanner or other tool. This may be particularly advantageous in cases in which the implantation is carried out at the back of the mouth and manual access is difficult.
  • the socket 102 on the insert will usually match the socket on the screw 62, so the same tool can be used to screw both the insert and the screw 62.
  • FIG. 6 The formation 38 of Figure 6 type has three lobes 42 and from the above description persons skilled in the art will recognise that implant adaptors 10 employing this type of anti-rotation formation will be particularly suitable for use with so-called "tri-lobe internal connection" implants 50.
  • adaptors 10 which employ different anti-rotation formations 38 will be suitable for use with other types of implant 50 where, in each case, the formation will engage complementally and non-rotationally with the implant.
  • an implant adaptor of the type seen in Figure 5 will be suitable for mounting on a so-called “external hex" implant, with the hexagonal mouth 38 of the bore in the adaptor serving as an anti-rotation formation that mates non-rotationally with the corresponding formation on the implant.
  • the protrusion 90 has a cylindrical, radially outer surface 92 flush with the outer edge of the collar 20.
  • the protrusion has an axial end surface 94 lying in a plane normal to the axis of the crown-receiving formation 14 and radially oriented circumferential end surfaces 96 which meet the end surface 94 at curved corners 98.
  • the embodiment seen in Figures 15 to 19 differs from that of Figures 13 and 14 in that the outer surface 92 of the protrusion 90 is generally conical, not cylindrical.
  • the angle 104 is typically of the order of 10°.
  • the crown may be manufactured so as to meet the collar at the edge 108 thereof on the side of the portion 14, and extends outwardly from that edge, completely encapsulating the portion 14 including the lobes 32.
  • the crown may again meet the collar at the edge 108, and may also meet the protrusion 90 at the edge 106. In this case the surface 92 of the protrusion is exposed.
  • the adaptor 10 will normally be oriented on the implant 50 such that the protrusion 90 faces in a palatal direction, i.e. into the mouth, and so will not be readily visible.
  • the protrusion 90 is located at a circumferential position midway between two of the lobes 42 of the anti- rotation formation 38.
  • the adaptor 10 on the implant 50 such that the third lobe 42 (not visible in Figure 13) is oriented to the outside, i.e opposite to the palatal direction, thereby ensuring that the protrusion 90 is palatally oriented.
  • the dental surgeon can orientate the adaptor 10 properly merely by facing the relevant lobe 42 to the outside.
  • the protrusion 90 in Figure 14 has a greater circumferential extent than the corresponding protrusion 90 in Figure 13.
  • the protrusion extends circumferentially through an angle 100 of about 90° while in Figure 13 the corresponding protrusion has a smaller circumferential extent.
  • the adaptor 10 seen in Figure 20 differs from the adaptors described above in that the collar 20 has an increased radial dimension.
  • the radial size of the collar will be determined with reference to the implant 50 which is selected, the latter selection in turn inter alia depending on the size of the space available to receive the implant and crown.
  • the adaptor 10 seen in Figures 21 and 22 has an anti-rotation formation 38 which is hexagonal in cross-section and the collar has a conical outer surface 110.
  • the inner surface 112 of the collar is shaped to mate with a conical surface on the implant 50.
  • the surface 92 of the protrusion 90 is conical in shape.
  • the protrusion 90 has a somewhat more rounded shape than, for instance, the protrusions 90 seen in Figures 13, 14 and 15 to 19.
  • the outer surface 92 of the protrusion has a generally conical shape.
  • the adaptor has an anti-rotation formation 38 including a hexagonal section socket but, as explained previously, this could in appropriate cases be replaced by a projecting anti-rotation formation generally of Figure 6 type or of the type seen in Figures 21 and 22.
  • the adaptor 10 seen in Figures 28 and 29 again has a protrusion 90 with a somewhat rounded shape and a conical outer surface.
  • the collar 20 includes an outwardly flaring portion 20.1 and the portion 14 has an outwardly curved, transitional end region 14.2 extending to the edge 106 of the collar.
  • Figure 30 shows an adaptor 10 with, again, a somewhat rounded protrusion 90, a collar 20 with a greater radial extent and a transitional end region 14.2 similar to that seen in Figures 28 and 29.
  • Figures 31 and 32 show an embodiment in which the outer edge 112 of the collar 20 is markedly tapered.
  • Figures 33 and 34 show an embodiment in which the corresponding taper is less pronounced and in which the anti- rotation formation 38 is, once again, provided as a hexagonal section projection.
  • Figures 35 to 37 show an embodiment, similar to that described with reference to Figure 5, but in this case including a protrusion 90 somewhat similar to that of Figures 13 and other embodiments described above.
  • the anti-rotation formation 38 includes a hexagonal section socket.
  • the adaptor designs embodying the more rounded protrusion 90 are suitable for use with LavaTM- type scanning and crown manufacturing systems where the crown is machined from the appropriate ceramic in a "green" state.
  • the protrusions 90 seen in Figures 13 to 37 are effective anti-rotation formations. Where the surfaces 96 are at right angles to any applied rotational force as, for example, in Figures 13, 14 and 15 to 19, such surfaces provide substantial resistance to any applied rotation forces. Also the fact that the protrusions extend to the periphery of the collar 20 means that they have a substantial radial extent to resist rotation.
  • the crown may meet the abutment at the edge 106 of the collar. However this may not always be so, since the exact the shape of the crown in each case will be determined by the shape and size of the space available for implantation and desire for an aesthetic match with adjacent teeth.
  • the crown material may extend to the opposite edge of the collar. It has been found that those embodiments in which the surface 92 of the protrusion 90 is conically tapered can be particular advantageous in providing a smooth transition from the material of the adaptor to the crown material, as indicated by the crown surface 114 depicted diagrammatically in Figure 34. The preferred taper angle of 10° has been found to suit a variety of crown shapes.
  • a major advantage of the invention as exemplified above is the fact that the crown is cemented to the adaptor outside the mouth. This means that it is possible, outside the mouth, to blend and polish the cement line 82 which is formed.
  • the cement line is typically below the soft tissue margin, making it difficult to blend and/or polish the line.
  • the collar Being very thin, i.e. 1.5mm or less, preferably 0.2mm to 0.7mm, most preferably about 0.3mm, the collar itself does not detract meaningfully from the desired aesthetics of the crown, even if the collar is not itself covered by crown material, i.e. is exposed.
  • the tapered shapes of the portion 14 and insert head 66 are particularly advantageous where two-dimensional scanning is used, because such shapes provide depth perception in the scanned images. In more sophisticated cases where scanning is carried out three-dimensionally, the tapered shapes may not be necessary.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Prosthetics (AREA)

Abstract

One aspect of the invention concerns a dental implant adaptor (10) which is particularly suitable for dental crown implantation using a screw-retained protocol. The adaptor has a hollow body (12) that can be mounted on a dental implant (50). The body includes a crown-receiving portion (14) on which a dental crown (60) can be mounted. The portion (14) has a distal end and a proximal end and includes a first anti-rotation formation (28, 30, 34, 90) to prevent rotation between the adaptor and the crown. The body also has a laterally projecting collar (20) at the proximal end of the crown- receiving portion which, in use, locates on the implant. There is also a second anti-rotation formation (38) shaped for non-rotational engagement with the implant. The crown-receiving portion and collar together have an overall axial length in the range 3.5mm to 7mm and the collar has an axial thickness of 1.5mm or less. Another aspect of the invention is concerned with an implant assembly incorporating the adaptor

Description

"DENTAL IMPLANT ADAPTOR"
BACKGROUND TO THE INVENTION
THIS invention relates to a dental implant adaptor.
A conventional dental implant assemby consists of an implant, an abutment and a crown. The implant has a threaded shank which is screwed into the bone, the abutment is then fastened to the implant and the crown, which has the appearance of the original tooth and which is visible in the mouth after implantation, is fastened to the abutment.
While the implant and abutment may have standard designs, the crown must be individually manufactured in a dental laboratory. In modern practice a digital camera is placed in the patient's mouth or over a model thereof and optical scanning is used to register the position and shape of the implant and abutment, and the corresponding part of the crown is shaped according to the scanned data.
The shapes of the current implant/abutment components are however not ideal for optical scanning in situations where a "screw retained" protocol, in which the crown is held in position by a screw, is used. Where a "closed crown cemented" protocol is used, the relevant components are more suited to optical scanning but the protocol is not universally popular. This is because it is difficult to retrieve the crown in the event of, for instance, excess wear or fracture. Also, the protocol leads to formation of a cement junction line just beneath the soft tissue of the gum and this line can be visible and unsightly if soft tissue recession takes place. SUMMARY OF THE INVENTION
According to one aspect of the present invention there is provided a dental implant adaptor comprising a hollow body mountable on a dental implant and including:
- a crown-receiving portion on which a dental crown is mountable, the crown-receiving portion having a distal end and a proximal end and including a first anti-rotation formation to prevent rotation between the adaptor and a dental crown mounted on the crown-receiving portion,
- a laterally projecting collar at the proximal end of the crown- receiving portion, and
- a second anti-rotation formation shaped for non-rotational engagement with a dental implant, the crown-receiving portion and collar together having an overall axial length in the range 3.5mm to 7mm and the collar having an axial thickness of 1.5mm or less.
In the preferred embodiments, the crown-receiving portion is at least partially of tapered shape. The tapered part may for example be generally conical with a cone angle in the range 1.5° to 5°, preferably about 3°. Preferably also the axial thickness of the collar is in the range 0.2mm to 0.7mm, possibly of the order of 0.3mm, and the overall axial length of the tapered portion and crown together is in the range 4mm to 5mm, typically 4.3mm.
The stated dimensions and conicity render the adaptor suitable for scanning and for use in a screw-retained protocol.
According to another aspect of the invention there is provided a dental implant assembly comprising:
- an implant having a proximal end which can be anchored in a bone, an opposite, distal end and a threaded passage in the implant, an implant adaptor as summarised above which is engagable non- rotatably on the distal end of the implant through non-rotational engagement between the second anti-rotation formation and the implant, and a screw designed to extend through the adaptor and to be screwed into the threaded passage in the implant, thereby to anchor on the implant a crown which is, in use, fixed non-rotatably on the crown- receiving portion of the adaptor through non-rotational engagement of the first anti-rotation formation and the crown.
Yet another aspect of the invention provides a dental implant apparatus comprising:
- a dental implant assembly as summarised above, the crown- receiving portion of the dental implant adaptor including at least a part which is of tapered shape, and
- a scanning and locating insert made of plastics material and having a tapered distal end and a threaded proximal end, the insert being shaped for its proximal end to be screwed into the threaded passage in the implant with its distal end bearing on the adaptor, thereby to secure the adaptor to the implant for scanning of the adaptor and implant in the mouth of a patient.
A further aspect of the invention provides a method of installing a dental crown in a patient's mouth, the method comprising the steps of providing a dental implant assembly according to claim 19,
- anchoring the implant in a patient's jaw, temporarily locating the implant adaptor on the implant in the patient's mouth,
- obtaining a scan of the adaptor and its surroundings in the patient;s mouth,
- using the scan to manufacture a crown mountable non-rotatably on the crown-receiving portion of the adaptor, the crown including a passage therethrough for the screw; fixing the crown non-rotatably on the crown-receiving portion of the adaptor, outside the patient's mouth, and locating the assembled crown and adaptor non-rotatably on the implant in the patient's mouth and anchoring them to the implant by passing the screw through the passage in the crown and screwing it into the threaded passage in the implant.
Other features of the dental implant adaptor, assembly, apparatus and method are set forth in the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention will now be described in more detail, by way of example only, with reference to the accompanying drawings in which:
Figure 1 shows a perspective view of a dental implant adaptor according to the invention;
Figures 2 to 4 show perspective views of dental implant adaptors according other embodiments of the invention;
Figure 5 shows a perspective view from the opposite end of an implant adaptor as shown in Figures 1 to 4;
Figure 6 shows a perspective view from the opposite end of another embodiment of dental implant adaptor;
Figure 7 illustrates a step in a dental implantation method;
Figure 8 shows a perspective view of a crown used in a dental implant assembly according to the invention; Figure 9 shows a perspective view of a dental implant assembly according to the invention;
Figure 10 shows a perspective view of the dental implant assembly of Figure 9, after implantation;
Figure 11 shows a cross-sectional view of the implant assembly of Figure 9;
Figure 12 shows a side view of a scanning and locating insert; Figure 13 shows a perspective view of another embodiment of dental implant adaptor according to the invention;
Figure 14 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 15 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 16 shows a side view of the dental implant adaptor seen in Figure 15;
Figure 17 shows a cross-section at the line 17-17 in Figure 15; Figure 18 shows a plan view of the dental implant adaptor seen in Figure 15;
Figure 19 shows a bottom view of the dental implant adaptor seen in Figure 15;
Figure 20 shows a perspective view of a further embodiment of dental implant adaptor according to the invention; Figure 21 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 22 shows a side view of the dental implant adaptor seen in Figure 21 ;
Figure 23 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 24 shows a side view of the dental implant adaptor seen in Figure 23;
Figure 25 shows a plan view of the dental implant adaptor seen in Figure 23;
Figure 26 shows another side view of the dental implant adaptor seen in Figure 23;
Figure 27 shows a bottom view of the dental implant adaptor seen in Figure 23;
Figure 28 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 29 shows a side view of the dental implant adaptor seen in Figure 28;
Figure 30 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 31 shows a perspective view of a further embodiment of dental implant adaptor according to the invention; Figure 32 shows a side view of the dental implant adaptor seen in Figure 31 ;
Figure 33 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 34 shows a side view of the dental implant adaptor seen in Figure 33;
Figure 35 shows a perspective view of a further embodiment of dental implant adaptor according to the invention;
Figure 36 shows a side view of the dental implant adaptor seen in Figure 35;
Figure 37 shows a bottom view of the dental implant adaptor seen in Figure 35; and
Figure 38 shows a perspective view of an assembled insert and dental implant adaptor.
DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
Figure 1 shows a first embodiment of dental implant adaptor 10 according to the invention. The view in this Figure is taken from the coronal end of the adaptor.
The adaptor 10 is made of a suitable non-corrosive and bio-compatible material, typically a suitable grade of titanium. The adaptor 10 includes a hollow body 12 including a generally conically tapered, crown-receiving or abutment portion 14 extending from a relatively narrow, distal or coronal end 16 to a relatively wide, opposite, proximal end 18. The hollow body 12 also includes a collar 20 which projects laterally at the relatively wide, proximal end. In general it is preferred that the overall axial length of the crown-receiving portion and collar together is in the range 3.5mm to 7mm, preferably 4mm to 6mm. The axial thickness of the collar is preferably 1.5mm or less, most preferably in the range 0.2mm to 0.7mm. In this example the collar has an axial thickness of the order of 0.3mm and the crown-receiving portion has an axial length of 4mm, giving the crown- receiving portion and collar together an overall axial length of 4.3mm. The cone or taper angle 26 is preferably in the range 1.5° to 5°, and in this example is 3°.
The numeral 28 indicates a first anti-rotation formation in the form of an outwardly extending, lateral protrusion or bulge on the external surface of the tapered crown-receiving portion 14. In the region of this protrusion the tapered crown-receiving portion 14 is non-circular in cross-section.
In other Figures of the drawings which illustrate dental implant adaptors according to the invention, features corresponding to those in Figure 1 are designated by the same reference numerals.
In the embodiment of Figure 2, the crown-receiving portion 14 includes a conically tapered part 14.1 and a first anti-rotation formation 30 located between the tapered part and the collar 20. While the tapered part 14.1 has a circular cross-section throughout in this embodiment, the anti-rotation formation 30 has three equiangularly spaced apart projections in the form of lobes 32 defining a non-circular cross-sectional shape.
In Figure 3, the crown-receiving portion 14 has a non-circular, elliptical cross-section throughout. This is demonstrated by the fact that, while the central axis of the crown-receiving portion coincides with that of the collar and the collar is circular in shape, the indicated dimensions x and y are different from one another. In this case the entire length of the crown- receiving portion between the distal end 16 and the collar at the proximal end serves as an anti-rotation formation. In Figure 4, the crown-receiving portion 14 has anti-rotation formations in the form of channels or recesses 34 in its external, generally conical surface, giving it a non-circular cross-sectional shape throughout.
In Figures 13 to 37, the generally conical crown-receiving formation 14 includes an anti-rotation formation in the form of an outwardly extending protrusion or abutment 90. More is said below about the nature of the protrusion 90.
In each of Figures 1 to 4 and 13 to 37 the body 12 is hollow, the numeral 36 indicating the central hollow or bore of the body.
In use the anti-rotation formations, i.e. the bulge 28 in Figure 1 , the lobes 32 in Figure 2, the elliptical cross-section in Figure 3, the channels or recesses 34 in Figure 4 and the protrusion 90 in Figures 13 to 37, serve to prevent relative rotation between a crown mounted on the crown-receiving portion 14 and the adaptor 10 when these components are fixed to one another as described in more detail below.
The dental implant adaptor 10 includes a second anti-rotation formation, at its proximal end, to prevent rotation between the adaptor and a dental implant on which the adaptor is mounted in use, as described below. Referring by way of example to Figure 5, which shows a perspective view of the adaptor 10 of Figure 1 taken from the proximal end, the second anti- rotation formation 38 includes a socket of non-round, in this case hexagonal, shape. Referring also to Figure 6, again by way of example, the anti-rotation formation 38 extends axially from the collar in a direction opposite to the crown-receiving portion 14. The formation 38 in this case includes a part 40, adjacent the collar 20, which has three equi-angularly spaced lobes 42 defining a non-circular cross-sectional shape and a hollow, round cylindrical part 44 arranged coaxially with the portion 14.
From the descriptions of various embodiments of dental implant adaptor which follow in this specification, it will be understood that either one of the anti-rotation formations 38 such as those seen in Figures 5 and 6, or any other suitable type of anti-rotation formation, for example the formation 38 seen in Figure 22 or Figures 33 and 34, can be provided on any of the described adaptors. So, for example, the adaptors seen in Figure 2 to 4 could include formations 38 as seen in Figure 6 or Figures 22, 33 and 34 or the formation 38 seen in Figure 6 could be replaced by a formation 38 as seen in Figure 5 or as seen in Figures 22, 33 and 34, and so on. In each case, the selection of the appropriate type of anti-rotation formation will be dictated by the particular implant which is used.
Figures 7 to 11 illustrate components of a dental implant assembly which includes a dental implant adaptor 10 of the type described above with reference to Figures 2 and 6. The assembly also includes an implant 50 which has a tapered, threaded shank 52 extending to a narrow, proximal end, a multi-lobed socket 54 complemental in shape to the formation 38 of the implant adaptor 10, a threaded passage 56 extending axially into the shank from the base of the socket 54 and a distal or coronal end 58.
The assembly further includes a crown 60, about which more is said below, and a prosthetic retaining screw 62.
In the implantation procedure, a hole is formed by drilling, reaming or other suitable procedure in a jaw bone 64 of the patient and the threaded shank 52 of the implant 50 is screwed into the hole such that the end of the implant is accessible above the bone. The implant may then be left, after closing up the wound site, for a period of time suitable for integration and stabilisation of the implant to take place. During healing of the soft tissue surrounding the implant site, a temporary abutment may be engaged with the coronal implant. After implant integration and stabilisation and removal of the temporary abutment, the implant adaptor 10 is located on the coronal end of the implant, as shown in Figure 7, with the multi-lobed formation 38 of the adaptor received complementally and non-rotationally in the socket 54 of the implant. Next the shank of a plastic scanning and locating insert or pin 64 is passed through the central bore 36 of the adaptor 10 and is screwed into the threaded passage 56 of the implant 50, as shown in Figure 7. As shown in Figure 12, the insert 64 has a tapered head 66 terminating at a shoulder 67. When the insert is installed in the manner seen in Figure 7, the shoulder 67 of the insert bears on the coronal end 16 of the adaptor 10 with the result that the insert holds the adaptor in place on the implant 50.
The head 66 of the insert 64 has a conical taper matching that of the tapered part 14.1 of the crown-receiving portion 14 of the abutment 10. Thus, when the insert has been screwed into position, the head 66 effectively forms a conical extension of the part 14.1 , as shown in Figure 7.
In the next step, a camera is inserted into the patient's mouth and is used to conduct a scan of the components described above and of the surrounding teeth, as indicated by the arrows 68 in Figure 7. After completion of the scan, the insert 64 is unscrewed and the adaptor 10 is detached from the implant 50 and is removed from the patient's mouth. Prior to scanning a suitable contrast spray may be applied to the assembly of adaptor 10 and insert 64.
In the scan which is conducted, the insert 64 holds the adaptor 10 in position and provides an accurate indication of the position, shape and size of the adaptor 10 and passage 36.
Where the scanning camera is of a type providing simply a two- dimensional, axial image of the components, as indicated by the arrows 68 in Figure 7, the tapered shapes of the part 14.1 of the crown-receiving portion 14 of the adaptor and of the head 66 of the insert 64 provide depth perception in the image.
The image captured by the camera is used in the manufacture of the crown 60, typically of ceramic. In some cases other information such as physical bite impressions of the patient's mouth may also be obtained to assist in accurate manufacture of the crown.
In the preferred technique, the camera captures one or more digital images which are fed to a computer controlled manufacturing apparatus, typically including a CNC milling machine, programmed to manufacture the crown from the input information.
The head 66 of the insert 64 has a length corresponding to the height of the crown which is to be manufactured. If necessary, the head 66 may be cut down as necessary to suit the crown height before scanning takes place.
As indicated above, the tapered shapes of the part 14.1 of the portion 14 of the adaptor 10 allow for depth perception even in a two-dimensional, axial scanning mode. This facilitates the formation of an axial passage 74 through the crown, as shown in Figure 8, during crown manufacture. The axial passage 74 which is formed is complemental in shape to the portion 14 of the abutment 10 and includes a socket 72, adjacent the proximal end of the crown, which is complemental in shape to the anti-rotation formation 30, and extends to the occlusal or coronal end 70 of the crown. The manufactured crown is accordingly shaped for proper conformity and location in the mouth and for complemental location on the abutment 10.
The manufactured crown is then fixed to the implant adaptor 10 by cementing the portion 14 of the adaptor in the axial passage in the crown, thereby creating a unitary assembly consisting of the crown and adaptor. A suitable cement may, for instance, be Panavia™ or similar. Prior to cementing, the crown and portion 14 may be etched to improve cementation and Silane™ or a suitable porcelain activator may be applied to the portion 14.
These procedures are carried out outside the patient's mouth. The cooperation between the socket 72 and the anti-rotation formation 32, together with the cement, prevents rotation between the crown and adaptor.
The assembly of crown and adaptor is then taken to the patient's mouth and the adaptor 10 is mounted on the implant 50 with the collar 20 resting on the end of the implant and the multi-lobed formation 38 locating non- rotatably in the socket 54 of the implant. The shank of the retaining screw 62 is passed through the screw-receiving passage in the crown and through the bore 36 of the adaptor 10 as shown in Figures 9 to 11 , and the threaded end of the shank is screwed into the passage 56 in the implant with a predetermined torque. The head of the screw bears on an internal shoulder 100 in the adaptor (see, for example, Figure 17) and fastens the adaptor, and hence the crown, relative to the implant.
In practice, where the end of the tapered passage 74 is too narrow to allow the head of the screw 62 to pass through, the screw will be inserted through the passage 36, so that its head locates on the shoulder 100, before the crown is cemented in place. The passage 74 will then provide access to the screw head, by means of a narrow screw-driver or other tool, for the purposes of fastening the screw to the implant.
To facilitate the screwing operation the head of the screw has a socket formation 80 which has a hexagonal cross-section and which can be engaged by the appropriate tool. In other embodiments, the head of the screw may have a different tool-engaging formation, for example a slot or so-called "torx" or "unigrip" socket formation.
Figure 38 illustrates an assembly of insert 64 and adaptor 10, in this case an adaptor 10 of the kind seen in Figure 13, in which the insert is formed with a socket 102. This socket can be engaged by a suitable tool for the purposes of screwing the insert 64 to the implant prior to scanning. In Figure 38 the socket is designed as a "unigrip" socket but it will be understood that the socket could have other designs, for example a hexagonal or "torx" design. Whereas the insert 64 seen in Figure 7 is designed to be screwed in by hand, inserts such as that seen in Figure 38 can be screwed in using a suitable spanner or other tool. This may be particularly advantageous in cases in which the implantation is carried out at the back of the mouth and manual access is difficult.
In practice, the socket 102 on the insert will usually match the socket on the screw 62, so the same tool can be used to screw both the insert and the screw 62.
The formation 38 of Figure 6 type has three lobes 42 and from the above description persons skilled in the art will recognise that implant adaptors 10 employing this type of anti-rotation formation will be particularly suitable for use with so-called "tri-lobe internal connection" implants 50. As indicated above, adaptors 10 which employ different anti-rotation formations 38 will be suitable for use with other types of implant 50 where, in each case, the formation will engage complementally and non-rotationally with the implant. For example, an implant adaptor of the type seen in Figure 5 will be suitable for mounting on a so-called "external hex" implant, with the hexagonal mouth 38 of the bore in the adaptor serving as an anti-rotation formation that mates non-rotationally with the corresponding formation on the implant.
An advantage of dental implantation as described above is the fact that the screw-retained protocol allows the crown to be retrieved relatively easily for repair in the event of excessive wear or fracture. In comparison the conventional closed crown protocol makes crown retrieval extremely difficult and frequently results in destruction of the crown.
Referring again to Figures 13 and 14, the protrusion 90 has a cylindrical, radially outer surface 92 flush with the outer edge of the collar 20. The protrusion has an axial end surface 94 lying in a plane normal to the axis of the crown-receiving formation 14 and radially oriented circumferential end surfaces 96 which meet the end surface 94 at curved corners 98. The embodiment seen in Figures 15 to 19 differs from that of Figures 13 and 14 in that the outer surface 92 of the protrusion 90 is generally conical, not cylindrical. As is particularly clear from Figures 16, 18 and 19 the distal edge 106 of the protrusion projects radially beyond periphery of the collar 20. In a practical embodiment, the angle 104 is typically of the order of 10°.
As shown in Figure 11 the crown may be manufactured so as to meet the collar at the edge 108 thereof on the side of the portion 14, and extends outwardly from that edge, completely encapsulating the portion 14 including the lobes 32. In the embodiments of Figures 13 and 14, the crown may again meet the collar at the edge 108, and may also meet the protrusion 90 at the edge 106. In this case the surface 92 of the protrusion is exposed. For this reason, the adaptor 10 will normally be oriented on the implant 50 such that the protrusion 90 faces in a palatal direction, i.e. into the mouth, and so will not be readily visible.
Referring to Figure 13 it will be noted that the protrusion 90 is located at a circumferential position midway between two of the lobes 42 of the anti- rotation formation 38. With this feature it is possible to align the adaptor 10 on the implant 50 such that the third lobe 42 (not visible in Figure 13) is oriented to the outside, i.e opposite to the palatal direction, thereby ensuring that the protrusion 90 is palatally oriented. Thus the dental surgeon can orientate the adaptor 10 properly merely by facing the relevant lobe 42 to the outside.
It will be noted that the protrusion 90 in Figure 14 has a greater circumferential extent than the corresponding protrusion 90 in Figure 13. In Figure 14 the protrusion extends circumferentially through an angle 100 of about 90° while in Figure 13 the corresponding protrusion has a smaller circumferential extent.
The adaptor 10 seen in Figure 20 differs from the adaptors described above in that the collar 20 has an increased radial dimension. In each case the radial size of the collar will be determined with reference to the implant 50 which is selected, the latter selection in turn inter alia depending on the size of the space available to receive the implant and crown.
The adaptor 10 seen in Figures 21 and 22 has an anti-rotation formation 38 which is hexagonal in cross-section and the collar has a conical outer surface 110. The inner surface 112 of the collar is shaped to mate with a conical surface on the implant 50. As in Figures 15 to 19, the surface 92 of the protrusion 90 is conical in shape.
In the adaptor 10 seen in Figures 23 to 27, the protrusion 90 has a somewhat more rounded shape than, for instance, the protrusions 90 seen in Figures 13, 14 and 15 to 19. Once again, the outer surface 92 of the protrusion has a generally conical shape. As illustrated the adaptor has an anti-rotation formation 38 including a hexagonal section socket but, as explained previously, this could in appropriate cases be replaced by a projecting anti-rotation formation generally of Figure 6 type or of the type seen in Figures 21 and 22.
The adaptor 10 seen in Figures 28 and 29 again has a protrusion 90 with a somewhat rounded shape and a conical outer surface. However in this case, the collar 20 includes an outwardly flaring portion 20.1 and the portion 14 has an outwardly curved, transitional end region 14.2 extending to the edge 106 of the collar.
Figure 30 shows an adaptor 10 with, again, a somewhat rounded protrusion 90, a collar 20 with a greater radial extent and a transitional end region 14.2 similar to that seen in Figures 28 and 29.
Figures 31 and 32 show an embodiment in which the outer edge 112 of the collar 20 is markedly tapered. Figures 33 and 34 show an embodiment in which the corresponding taper is less pronounced and in which the anti- rotation formation 38 is, once again, provided as a hexagonal section projection. Figures 35 to 37 show an embodiment, similar to that described with reference to Figure 5, but in this case including a protrusion 90 somewhat similar to that of Figures 13 and other embodiments described above. The anti-rotation formation 38 includes a hexagonal section socket.
The adaptor designs embodying the more rounded protrusion 90 are suitable for use with Lava™- type scanning and crown manufacturing systems where the crown is machined from the appropriate ceramic in a "green" state.
The protrusions 90 seen in Figures 13 to 37 are effective anti-rotation formations. Where the surfaces 96 are at right angles to any applied rotational force as, for example, in Figures 13, 14 and 15 to 19, such surfaces provide substantial resistance to any applied rotation forces. Also the fact that the protrusions extend to the periphery of the collar 20 means that they have a substantial radial extent to resist rotation.
It was mentioned above that the crown may meet the abutment at the edge 106 of the collar. However this may not always be so, since the exact the shape of the crown in each case will be determined by the shape and size of the space available for implantation and desire for an aesthetic match with adjacent teeth. In some cases, the crown material may extend to the opposite edge of the collar. It has been found that those embodiments in which the surface 92 of the protrusion 90 is conically tapered can be particular advantageous in providing a smooth transition from the material of the adaptor to the crown material, as indicated by the crown surface 114 depicted diagrammatically in Figure 34. The preferred taper angle of 10° has been found to suit a variety of crown shapes.
When compared to conventional practice, a major advantage of the invention as exemplified above is the fact that the crown is cemented to the adaptor outside the mouth. This means that it is possible, outside the mouth, to blend and polish the cement line 82 which is formed. In conventional practice in which the crown is cemented to the abutment inside the mouth, the cement line is typically below the soft tissue margin, making it difficult to blend and/or polish the line. Being very thin, i.e. 1.5mm or less, preferably 0.2mm to 0.7mm, most preferably about 0.3mm, the collar itself does not detract meaningfully from the desired aesthetics of the crown, even if the collar is not itself covered by crown material, i.e. is exposed.
The small thickness of the collar together with other, above-described dimensions for the adaptor 10, which are preferably present in all embodiments of the invention, make it possible for the cement line to be below the soft tissue margin and so unlikely to be exposed in an unsightly manner even if there is some tissue recession. In combination these factors lead to a dental implant which is aesthetically pleasing, particularly in the context of a screw-retained protocol which has the additional advantage of crown recovery if necessary.
The tapered shapes of the portion 14 and insert head 66 are particularly advantageous where two-dimensional scanning is used, because such shapes provide depth perception in the scanned images. In more sophisticated cases where scanning is carried out three-dimensionally, the tapered shapes may not be necessary.

Claims

1.
A dental implant adaptor comprising a hollow body mountable on a dental implant and including:
- a crown-receiving portion on which a dental crown is mountable, the crown-receiving portion having a distal end and a proximal end and including a first anti-rotation formation to prevent rotation between the adaptor and a dental crown mounted on the crown-receiving portion,
- a laterally projecting collar at the proximal end of the crown- receiving portion, and
- a second anti-rotation formation shaped for non-rotational engagement with a dental implant, the crown-receiving portion and collar together having an overall axial length in the range 3.5mm to 7mm and the collar having an axial thickness of 1.5mm or less.
2.
A dental implant adaptor according to claim 1 wherein at least a part of the crown-receiving portion is of tapered shape.
3.
A dental implant adaptor according to claim 2 wherein the tapered part is generally conical.
4.
A dental implant adaptor according to claim 3 wherein the conical part has a cone angle in the range 1.5° to 5°.
5.
A dental implant adaptor according to claim 4 wherein the cone angle is about 3°.
6.
A dental implant adaptor according to any one of the preceding calms wherein the axial thickness of the collar is in the range 0.2mm to 0.7mm.
7.
A dental implant adaptor according to claim 6 wherein the axial thickness of the collar is of the order of 0.3mm.
8.
A dental implant adaptor according to any one of the preceding claims wherein the overall axial length of the crown-receiving portion and collar together is in the range 4mm to 5mm.
9.
A dental implant adaptor according to claim 8 wherein the overall axial length of the crown-receiving portion and collar together is about 4.3mm.
10.
A dental implant adaptor according to any one of the preceding claims wherein the first anti-rotation formation comprises a protrusion extending outwardly from the crown-receiving portion and distally from the collar.
11.
A dental implant adaptor according to claim 10 wherein the protrusion extends to the periphery of the collar.
12.
A dental implant adaptor according to claim 10 or claim 11 wherein the protrusion has an outer surface which is curved in cross-section and which is inclined with respect to a central axis of the adaptor such that the outer surface tapers in a proximal direction.
13.
A dental implant adaptor according to claim 12 wherein the outer surface of the protrusion is inclined at an angle of about 10° with respect to the central axis of the adaptor.
14.
A dental implant adaptor according to any one of the preceding claims wherein the body has a bore extending through it, the bore including a shoulder therein positioned to support the head of a screw which, in use, serves to secure the adaptor to a dental implant.
15.
A dental implant adaptor according to any one of the preceding claims wherein the second anti-rotation formation comprises a non-circular socket or a projection at least a part of which has a non-circular cross-section, the socket or projection being complementally and non-rotationally engagable with a dental implant.
16.
A dental implant adaptor according to claim 15 wherein the socket is adjacent the collar and has a hexagonal shape.
17.
A dental implant adaptor according to claim 15 wherein the projection includes a multi-lobed part adjacent the collar and a round cylindrical part extending in a proximal direction from the multi-lobed part.
18.
A dental implant adaptor according to claim 15 wherein the projection is adjacent the collar and is hexagonal in cross-section.
19.
A dental implant assembly comprising:
- an implant having a proximal end which can be anchored in a bone, an opposite, distal end and a threaded passage in the implant,
- an implant adaptor according to any one of the preceding claims which is engagable non-rotatably on the distal end of the implant through non-rotational engagement between the second anti- rotation formation and the implant, and
- a screw designed to extend through the adaptor and to be screwed into the threaded passage in the implant, thereby to anchor on the implant a crown which is, in use, fixed non-rotatably on the crown- receiving portion of the adaptor through non-rotational engagement of the first anti-rotation formation and the crown.
20.
An assembled dental implant comprising a dental implant assembly according to claim 19 and a crown fixed non-rotatably on the crown- receiving portion of the dental implant adaptor through non-rotational engagement and cement between the first anti-rotation formation and the crown.
21.
A dental implant apparatus comprising:
- a dental implant assembly according to claim 19, the crown- receiving portion of the dental implant adaptor including at least a part which is of tapered shape, and a scanning and locating insert made of plastics material and having a tapered distal end and a threaded proximal end, the insert being shaped for its proximal end to be screwed into the threaded passage in the implant with its distal end bearing on the adaptor, thereby to secure the adaptor to the implant for scanning of the adaptor and implant in the mouth of a patient.
22.
A dental implant apparatus according to claim 21 wherein the taper of the distal end of the insert matches the taper of the tapered part of the crown- receiving portion of the adaptor.
23.
A method of installing a dental crown in a patient's mouth, the method comprising the steps of
- providing a dental implant assembly according to claim 19,
- anchoring the implant in a patient's jaw,
- temporarily locating the implant adaptor on the implant in the patient's mouth, obtaining a scan of the adaptor and its surroundings in the patient's mouth, using the scan to manufacture a crown mountable non-rotatably on the crown-receiving portion of the adaptor, the crown including a passage therethrough for the screw; with the implant adaptor removed from the implant, fixing the crown non-rotatably on the crown-receiving portion of the adaptor, outside the patient's mouth, and locating the assembled crown and adaptor non-rotatably on the implant in the patient's mouth and anchoring them to the implant by passing the screw through the passage in the crown and screwing it into the threaded passage in the implant.
24.
A method according to claim 23 wherein a locating and scanning insert is in inserted temporarily through the adaptor into the implant passage in order to provide an indication, in the scan, of the required position of the passage through the crown.
PCT/IB2008/054668 2007-11-09 2008-11-07 Dental implant adaptor WO2009060415A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US12/734,527 US9055988B2 (en) 2007-11-09 2008-11-07 Dental implant adaptor

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
ZA2007/09679 2007-11-09
ZA200709679 2007-11-09
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EP2130514A1 (en) * 2008-06-06 2009-12-09 Wieland Dental Implants GmbH Abutment with optically detectable elements defining its position and orientation
US11042979B2 (en) 2009-05-27 2021-06-22 James R. Glidewell Dental Ceramics, Inc. Method of designing and fabricating patient-specific restorations from intra-oral scanning of a digital impression coping
EP2434981B2 (en) 2009-05-27 2023-11-15 James R. Glidewell Dental Ceramics, Inc. A method of designing and fabricating patient-specific restorations from intra-oral scanning of a digital impression coping
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WO2011056452A3 (en) * 2009-10-28 2011-10-13 3M Innovative Properties Company Dental implant mill blank articles and methods of making those
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