WO2009115617A1

WO2009115617A1 - Support tool for oral implantology

Info

Publication number: WO2009115617A1
Application number: PCT/EP2009/053400
Authority: WO
Inventors: Pio Domenico Gallo; Antonio Mancuso; Nicola Mauceri; Vincenzo Calunniato; Giancarlo Dolce
Original assignee: Universita' Degli Studi Di Palermo
Priority date: 2008-03-21
Filing date: 2009-03-23
Publication date: 2009-09-24
Also published as: ITRM20080160A1

Abstract

A tool in support of oral implantology, which allows drills to run on the jaw, reducing associated problems such as perforation of the bony wall, with the ability to orient the instrument in two directions and secure it to the jaw structure by defining the correct position of the drill-axis and maintaining them during the drilling itself, the tool including: a support member, which provides a driving help for implantology; a locking system to link to the bone site, presenting the various elements of the block at the opposite ends of the support, which is able to rotate relative to at least one respective axis A, B and can be locked in a desired position, and a system to scan the location of a bone site, associated with that support member, instead of a fixed axis.

Description

SUPPORT TOOL FOR ORAL IMPLANTOLOGY DESCRIPTION

The object of this invention is to create a tool to support the oral implantology which can be used as an aid to its user during the execution of implants, for example when drilling holes (pilot and following) for the subsequent installation of an oral implant. This device can be applied in the context of surgery where the so-called "Flap-less" technique is used, and it is less invasive and less traumatic for the patient than the classic method.

The U.S. patent No. 6,626,667 describes a device that provides a guide for the drill to make holes for oral implantology, thanks to a tongs system that allows a portion of soft tissue to be held. However, this device cannot be used to check the consistency of the portion of the jaw bone where holes have to be made and, in addition, it cannot offer sufficient guarantees of stability to its user during drilling operations.

The patent application No. U.S. 2005/0069835 describes a device to help the drilling of a jaw bone. More precisely, the device has a positioning element which can be arranged in the alveolar bone through screws. The device also includes a pipe for positioning, which works as guide for the surgeon during the drilling of the bone. The use of this device is remarkably invasive.

Moreover, none of the above devices are appropriate for use with the Flapless technique.

Several systems have currently been developed to support the above mentioned technique and the positioning of oral implants.

However, they are based either on acquisition systems and image processing, and are therefore very expensive, or they consist of guide-masks suitable for drilling in a single patient, and therefore need to be replaced periodically due to the inevitable changes of the bone structures.

The technical problem underlying the present invention is to provide a support tool for oral implantology in order to overcome the drawbacks mentioned with reference to the prior art. This problem is solved by a tool as defined in attached claim 1.

The main advantage of the tool according to the present invention lies in allowing a correct positioning of an oral implantology, e.g. guide for carrying out a drilling in a jaw bone and particularly with respect to the side walls thereof.

In this way, operations of implantology will be properly executed according to the Flap- less technique directly on the bone site, with a precise knowledge of the position of the bone site. The present invention will be described below in accordance with a possible example of its preferred implementation, together with some forms of application and in some of its variants, provided for example purposes and not limited by reference to the attached drawings in which:

• Figure 1 shows a perspective view of an instrument to support oral implantology in accordance with the invention;

• Figure 2 shows an exploded perspective view of the device of Figure 1 ;

• Figures 3A, 3B and 3C respectively show a front view, a side view and a top view of the device of Figure 1 ;

• Figure 4 shows a perspective view of a first detail of the device of Figure 1 ; • Figure 5 shows a further perspective view of the detail of figure 4;

• Figure 6 shows a perspective view of a second detail of the device of Figure 1 ;

• Figure 7 shows a perspective view of a device to support oral implantology with a variant of the device of Figure 1 ; and

• Figures 8, 9 and 10 show perspective views illustrating various stages of implementation of an instrument according to the invention in oral implantology.

With reference to the drawings, a support tool for oral implantology is indicated as a whole by 1 . It includes a support member 2, substantially bridge-shaped, having opposite ends 3, 4 where respective clamping members 5 are linked.

Centrally, the support member includes a guide hole that, as it will be explained later, embodies guide means for implantology instruments.

The clamping members 5, together constituting locking means of the support member 2 to a bone site, such as a piece of jaw bone, are pliers shaped, and each of them includes an upper transverse member 6 that is linked to the ends 3, 4 of the support member 2 by a hinge made by a screw 7 engaged in a bushing 8, both inserted in a respective hole 9 at the end of the support member 2 and at a first hinge seat 10, formed at the center of the upper transverse member 6. The support member 2 and the upper transverse member 6 have a substantially double T configuration. The upper transverse member 6 and clamping members 5, are then linked to the support member 2 and they are free to rotate with respect to the latter, particularly around axes A and B identified by the hinge. At the ends on each side of the support, the upper transverse members 6 have leg members 1 1. They are connected to first hinge members 12, then they are inserted in a second hinge seat 13, in the middle of leg member 1 1 itself.

Each leg member 1 1 is L-shaped, with the lower ends 14 corresponding to the upper transverse member 6 facing towards each other and conformed to form a sharp tip, fixed or mobile.

The top ends 15 of each leg member each has a seat receiving a respective first threaded bushing with transverse threaded hole 16, where a micrometric screw is engaged, indicated as a whole with 17.

At each end, the upper transverse members 6 include a second bushing with threaded hole 18 where the micrometric screw 17 is engaged.

In particular, the micrometric screw 17 includes an adjustment wheel 19 and two threaded portions aligned on the screw shaft: a first portion 20 with a larger diameter and adjacent to the wheel 19, is engaged in said second bushing by a threaded hole 18 and a second portion 21 , with a smaller diameter, engaged into the first bushing with a transverse threaded hole 16.

The two portions 20 and 21 have opposite threads and the second bushing with transverse hole 18 is located, compared to the support member 2, in the most external position in connection with the first bushing with threaded transverse bore 16 and the first elements of hinge 12 of the leg member 1 1 . In this way, rotating the hand-wheel 19 in the direction of the screw of the first portion 20, the traction of the top end 15 of a leg member 1 1 is obtained, and then the first bushing with the threaded hole transverse 16, compared to the respective first hinge member 12, and the approach of the tip 14 of the leg member 1 1 to the middle of the support member 2. Each screw can be provided with adjustment systems, such as resistance to torque, not represented, to prevent an excessive plunging of the tip 14 in the bone sites. These adjustment systems may include a helical coaxial spring coaxial in the first portion 20, located between wheel 19 and the second bushing with transverse threaded hole 18. The support member 2 has, in a central position, a calibrated hole 22 defining a reference axis C, perpendicular to the support member 2. In this embodiment, the calibrated hole 22 defines guide means for implantology aids.

Also in central position, the support member 2 has a transversal extension 23 shaped by two joined parallel arms that extend perpendicularly and horizontally to the support member itself, to the portion where a calibrated hole 22 is located.

Two bar members 24 are connected to the transversal extension 23 to form a quadrilateral structure. Bar members 24 extends downward to the support member 2 and they present, at its upper end, seats for hinge members 25 which are locked to these arms, the upper end of the bar members 24 is linked between them. In the intermediate portion, each bar member 24 presents a third bushing with threaded hole 26. The third bushings 26 are facing each other and they are engaged by a second micrometer screw 27, all similar to previous ones, with a respective hand-wheel 28, a first portion with a larger diameter 29 and a second one with a smaller diameter portion 30, the first and the second portion 29, 30 with opposite threads, engaged in separate third bushings 26.

In this way, the rotation of the hand wheel 28 will determine the approach or the moving away of the third bushing 26, and thus the inclination of bar members 24 is defined.

The lower edge of the articulated quadrilateral is composed of a probe member 31 which is equipped with a probe-tip 32 facing the C axis of reference and linked into the lower ends of the bar members 24 with their third hinges 33.

On the top, a bar member 24 extends with a pointer 34 which should rotate to a graduated scale 35 joined to the support member 2.

The position of the pointer 34 on the scale 35 may provide the distance between the probe-tip 32 and the reference axis C, which can be varied using the hand-wheel 28 of the second micrometer screw 27.

From the description above it can be immediately understood that each clamping member 5 can be controlled by acting independently on each first screw 17 ,to rotate the support member according to a horizontal axis, parallel to its development. In addition, each clamping member can be located among the others at different height levels, allowing the support 2 to be rotated around a horizontal axis perpendicular to it.

Finally, unscrewing each screw 7 in its respective site 8, 9, the opposite ends 3, 4 of support member 2 can be rotated to each clamping member 5, independently of each other, and then be blocked once a desired position is found.

With reference to Figures 8 to 10, the positioning of the device 1 can be achieved by enlarging the leg member 1 1 and fixing them in the required position, in the mandibular bone site, covered with a gum layer, which has been highlighted to obtain a correct positioning of the tool, e.g. for drilling a pilot hole for a prosthetic implant.

To facilitate the positioning, a punch-tip 36 can be applied into the hole 22 (Figure 5), equipped with a tip 37 which will be rested on the highlighted point on the soft tissue until the crest bone.

Referring to previous inspections, for example those of ultrasound or radiography, and/or with reference to the shape of the site, the tool will be positioned with the desired angle, with the maximum freedom allowed by the four leg members 1 1 and by the joints between the support member 2 and upper transversal member 6.

Once a satisfactory position is obtained, acting on the first screw 17 the device 1 will be locked in that position. At this point, by acting the second screw 27, the bone-wall thickness among to C axis, which may be the central axis of the pilot hole can be verified. This thickness will be the distance between the probe-tip 32, which will be penetrated through the gum layer, and the axis, showed in the graduated scale 35.

To take measurements across the width of the C axis, you can reposition the tool or mount the probe member 31 to guide it along the bar member 24, controlled by a third micrometric screw, not represented, or by a similar aid.

Once it has been verified that the thickness of the bone wall is satisfactory, the punch member 36 can be taken away and inserted into the bur-pilot cable within the cylinder body 2, which serves as a guide. It can be noted that the hole may be made using a Flap-less technique without discovering the bone, even by a dentist who is not particularly specialized, by guiding the drill-tip through the guide for a predetermined depth.

The articulated quadrilateral described above, commanded by the second micrometer screw 27, is used for the relief of the support member 2 position, instead of a fixed axis that, in this example is the axis C.

With reference to Figure 7, a simplified embodiment of the tool 1 provides that the leg members 1 1 , extend with their tops ends 15 above the respective upper transverse member 6. The upper ends 15 of the leg members 1 1 of the upper transverse member 6 are connected by a threaded shaft 40 on the respective opposite-thread portions, driven by a single hand-wheel 41. By rotating the hand-wheel 41 in one direction or another, the mirror-rotation of the facing leg members 1 1 is caused. This variant with the above described legs provided with a suitable adjustment system allowing simultaneous movement, can be more quickly fixed to the bone of the lower jaw or the upper jaw. It is understood that to the instrument described here several modifications may be introduced.

For example, the micrometric screws can be operated in a servo mode. Furthermore, the probe-tip can be used as an ultrasound sensor, connected to an echography system to get a clear image of the bone site, which is shown on a monitor in real time.

Moreover, the guide means embodied by said hole 22 may be otherwise achieved, and it can be used not only as a guide but also to position various elements connected to oral implantology, such as X-ray plates.

Therefore, it is possible to replace the body-guide with a module that allows the insertion of X-ray film / a sensor for digital radiography during the procedure of radiography in order to exempt the patient from further exposure to X-rays which would otherwise needed. This application is useful for the purpose of preventing and/or to avoiding the distortion of radiographic images.

Hence, the above described support tool is distinguished by the fact that it can be anchored to the bone in a stable manner, so as to provide high security for the user during osteotomy surgery. Despite the size that can be contained, the screws that allow adjustment and recording of movements of the parts are easily accessible and operable regardless of where the instrument is located. It follows a simple use that could lead the surgeon to use the device during the ordinary practice of technical assistance with Flap-less technique.

It can be made of titanium or an aluminum alloy, thus ensuring the criteria of high mechanical resistance and also enabling it to be subjected to sterilization cycles, which are essential in surgery applications.

The availability for use on different patients and of being equipped by a kit for use in applications other than with the Flap-less technique gives this device appropriate conditions for standardization and large mass production, making it possible as a widespread device to be included in the equipment of surgical dentists.

The instrument described above is thus able to perform drilling on the jaw whilst limiting relevant problems as much as possible, e.g. drilling through the bone wall. Its capacity for orientation in two directions and of being fixed to the mandibular structure in fact allows the correct position of the axis to be defined and this position to be maintained during the drilling itself.

With regard to the above described oral implantology support tool, in order to satisfy further and contingent needs, a man skilled in the art will make several changes and variants, all of these however included within the protection scope of this invention as defined by the attached claims.

Claims

CLAIMS 1. Support tool (1 ) for oral implantology, comprising:

• a support member (2) having guide means (22) for implant aids;

• clamping means of the support member to a bone site, having respective clamping members (5) at the opposite ends (3, 4) thereof, the latter being linked to each clamping member (5) so as to rotate with respect to at least one respective axis (A, B) and which can be locked in a desired position; and

• means for the bony wall position scanning, associated with that support member (2) with respect to a fixed axis (C) thereof.

2. Tool (1 ) according to claim 1 wherein support member (2) is substantially bridge shaped, having a central guide hole (22).

3. Tool (1 ) according to claims 1 or 2, wherein the clamping members (5) are pliers shaped.

4. Tool (1 ) according to claim 3, wherein each clamping member (5) includes an upper transversal element (6) which is linked to the respective ends (3, 4) of the support (2) at a hinge.

5. Tool (1 ) according to claim 3 or 4, wherein the clamping members (5) have a leg member (1 1 ) connected at the respective hinge members (12) at the center of the leg member (1 1 ), substantially L-shaped, with the lower ends (14) shaped so as to provide a sharp tip.

6. Tool (1 ) according to claim 5, wherein each leg member (1 1 ) is driven by a respective first micrometer screw (17).

7. Tool (1 ) according to claim 6, wherein each micrometer screw (17) is provided with an adjustment system, such as resistance to torque, to prevent excessive plunging of the tip (14).

8. Tool (1 ) according to any of the preceding claims, wherein the means for the bony wall position scanning includes an articulated quadrilateral structure (23, 24, 31 ) whose bottom side is composed by a probe member (31 ), equipped with a touching probe tip (32) facing the reference axis (C).

9. Tool (1 ) according to claim 8, wherein said articulated quadrilateral (23, 24, 31 ) is driven by a respective micrometric screw (27).

10. Tool (1 ) according to claim 8 or 9, wherein the articulated quadrilateral (23, 24, 31 ) is extended with a pointer (34) that can rotate relatively to a graduated scale (35) joined to the support (2 ), providing the distance between the probe-tip (32) and the reference axis (C).

1 1. Tool (1 ) according to any one of claims 8 to 10, wherein the probe member (31 can be vertically moved.

12. Tool (1 ) according to any one of claims 8 to 1 1 , wherein the probe tip consists of an ultrasound sensor.

13. Tool (1 ) according to any of the preceding claims, wherein to the support member (2) a module allowing the introduction of a magnetic film is associated for the carrying out of a tomographic scan.