WO2011034780A1 - Points d'appui d'implant dentaire et procédés d'utilisation - Google Patents

Points d'appui d'implant dentaire et procédés d'utilisation Download PDF

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Publication number
WO2011034780A1
WO2011034780A1 PCT/US2010/048358 US2010048358W WO2011034780A1 WO 2011034780 A1 WO2011034780 A1 WO 2011034780A1 US 2010048358 W US2010048358 W US 2010048358W WO 2011034780 A1 WO2011034780 A1 WO 2011034780A1
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WIPO (PCT)
Prior art keywords
dental implant
abutment
implant abutment
restoration
dental
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PCT/US2010/048358
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English (en)
Inventor
Ryan E. Johnson
Kevin W. Wenzel
Howard P. Wanless, Iii
William A. Goodwin
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3M Innovative Properties Company
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Publication of WO2011034780A1 publication Critical patent/WO2011034780A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods

Definitions

  • Dental implants are available in a variety of styles.
  • One style is designed to install the implant substantially entirely within the patient's jawbone, accessible subgingivally at the crest of the jawbone.
  • Another style of implant incorporates a transgingival section and is installed with that section extending through the gingiva overlying the site of the implant installation. This later style often referred to as a "single-stage" implant.
  • a permanent implant abutment having a permanent restoration is attached to the underlying implant (e.g. anchor).
  • the permanent implant abutment can be a preformed one piece metal article having a base suitable for attachment to a tooth implant (e.g. anchor) and an opposing end suitable for receipt of a (e.g. permanent) restoration, such as a crown or bridge.
  • the permanent implant abutment can have a two piece design including an "abutment interface", i.e. a preformed metal article having a base suitable for attachment to a tooth implant (e.g.
  • a custom abutment such as a ceramic custom abutment as can be prepared from LavaTM Zirconia available from 3M ESPE.
  • the process of fashioning a restoration often begins with the step of attaching an impression coping to the implant. After the coping is attached to the implant and a (e.g. silicone) impression is taken, this "negative" impression is removed from the patient's mouth and used to make a "positive” stone (e.g. gypsum) model of the patient's case.
  • a "positive" stone e.g. gypsum
  • a scanning device can scan the region in the patient's mouth where the prosthesis is to be placed without the need to use impression materials or to construct a mold.
  • the impression material that is removed from the healing abutment and surrounding area can be scanned to produce the permanent (e.g. crown) restoration.
  • a dentist or a dental lab can scan the stone model of the dental region that was formed from the impression material.
  • the present invention concerns methods of fabricating a permanent restoration for a dental implant and dental implant abutment articles.
  • a method of making a dental restoration comprises attaching a dental implant abutment to a dental implant in a patient's mouth; scanning at least a portion of the patient's mouth comprising the dental implant abutment to acquire a digital surface representation; creating a three-dimensional digital model from the digital surface representation; and forming a restoration from the three- dimensional digital model.
  • the dental implant abutment has been adapted to be suitable for use as an orientation tool, also known as a "scan locator".
  • the supragingival end of the dental implant abutment is optically scannable and comprises at least one orientation feature.
  • the same dental implant abutment is also suitable for use as a permanent or temporary abutment that receives a dental restoration.
  • the (i.e. same) dental implant abutment can serve multiple purposes, thereby reducing the number of different parts needed during the processes of scanning a patient's mouth, fabricating a restoration for the implant abutment, and seating such restoration in the patient's mouth.
  • a dental implant abutment comprising a gingival end for mating with a dental implant and a supragingival end for mating with a dental restoration.
  • the supragingival end is optically scannable and comprises at least one orientation feature.
  • a dental implant abutment comprising a gingival end for mating with a dental implant and a supragingival end for mating with a dental restoration
  • the dental implant abutment comprises a metal base article comprising an opaque polymeric coating on at least the surpagingival end.
  • the inclusion of the opaque polymeric coating can improve the aesthetic appearance of the (e.g. crown or bridge) restoration attached to the abutment.
  • the dental abutment article further comprises at least one (e.g. optically scannable) supragingival orientation feature.
  • the optically scannable orientation feature may comprise digital information, at least one visual feature, at least one mechanical feature, or a combination thereof.
  • the optically scannable orientation feature is preferably a (e.g. single) mechanical feature such as a vertical groove, protrusion, or flat, that mates with a cooperating orientation feature of a custom abutment or dental restoration, such as a crown or bridge.
  • Fig. 1 is a block diagram of a method of making a restorative for a dental implant
  • Fig. 2 depicts a three dimensional scanning system
  • FIG. 3 is an illustrative dental implant abutment
  • Fig. 4 depicts a three-dimensional cross-sectional representation of the intraoral surfaces of an implant abutment attached to a dental implant
  • Fig. 5 is a graph of the total reflection of a metal dental implant abutment in comparison to an abutment comprising a permanently bonded opaque coating
  • Fig. 6 is an optical micrograph of an illustrative dental implant abutment
  • Fig. 7 is an optical micrograph of another illustrative dental implant abutment.
  • image generally refers to a two- dimensional set of pixels forming a two-dimensional view of a subject within an image plane.
  • image set generally refers to a set of related two dimensional images that might be resolved into three-dimensional data.
  • point cloud generally refers to a three-dimensional set of points forming a three-dimensional view of the subject reconstructed from a number of two-dimensional views. In a three-dimensional image capture system, a number of such point clouds may also be registered and combined into an aggregate point cloud constructed from images captured by a moving camera.
  • pixels generally refer to two-dimensional data and points generally refer to three-dimensional data, unless another meaning is specifically indicated or clear from the context.
  • three-dimensional surface map and the like, as used herein, are intended to refer to any three-dimensional surface map of an object, such as a point cloud of surface data, a set of two-dimensional polygons, or any other data representing all or some of the surface of an object, as might be obtained through the capture and/or processing of three-dimensional scan data, unless a different meaning is explicitly provided or otherwise clear from the context.
  • a "three-dimensional representation” may include any of the three-dimensional surface representations described above, as well as volumetric and other representations, unless a different meaning is explicitly provided or otherwise clear from the context.
  • implant abutment refers to a preformed (e.g. one piece) metal article having a base suitable for attachment to a tooth implant (e.g. anchor) and an opposing end suitable for receipt of a permanent restoration, such as a crown or bridge.
  • the implant abutment is an abutment interface having a base suitable for attachment to a tooth implant (e.g. anchor) and an opposing end suitable for receipt of a (e.g. custom) abutment such as ceramic custom abutment as can be prepared from LavaTM Zirconia available from 3M ESPE.
  • a permanent restoration is then attached to the custom abutment.
  • the term "implant abutment” as used herein also encompasses implant abutment interfaces having an abutment as well.
  • a method of making a dental restoration comprises attaching a dental implant abutment to a dental implant in a patient's mouth 101; scanning at least a portion of the patient's mouth at a location of the dental implant abutment to acquire a digital surface representation 103; creating a three-dimensional digital model from the digital surface representation 110; and fabricating a restoration from the three-dimensional digital model 114.
  • the dental implant abutment has been adapted to be suitable for use as an orientation tool, also known as a "scan locator". To serve this purpose, the supragingival end of the dental implant is optically scannable and comprises at least one orientation feature.
  • US 7,698,014 describes a method of acquiring a digital surface representation of one or more intraoral surfaces and processing the digital surface representation to obtain a three-dimensional model.
  • FIG. 2 shows an image capture system 200 that may include a scanner 202 that captures images from a surface 206 of a subject 204, such as a dental patient, and forwards the images to a computer 208, which may include a display 210 and one or more user input devices such as a mouse 212 or a keyboard 214.
  • the scanner 202 may also include an input or output device 216 such as a control input (e.g., button, touchpad, thumbwheel, etc.) or a display (e.g., LCD or LED display) to provide status information.
  • a control input e.g., button, touchpad, thumbwheel, etc.
  • a display e.g., LCD or LED display
  • the scanner 202 may include any camera or camera system suitable for capturing images from which a three-dimensional point cloud may be recovered.
  • the scanner 202 may employ a multi-aperture system as disclosed, for example, in U.S. Pat. Pub. No. 2004/0155975 to Hart et al. While Hart discloses one multi-aperture system, it will be appreciated that any multi-aperture system suitable for reconstructing a three- dimensional point cloud from a number of two-dimensional images may similarly be employed.
  • the scanner 202 may include a plurality of apertures including a center aperture positioned along a center optical axis of a lens and any associated imaging hardware.
  • the scanner 202 may also, or instead, include a stereoscopic, triscopic or other multi-camera or other configuration in which a number of cameras or optical paths are maintained in fixed relation to one another to obtain two- dimensional images of an object from a number of slightly different perspectives.
  • the scanner 202 may include suitable processing for deriving a three-dimensional point cloud from an image set or a number of image sets, or each two-dimensional image set may be transmitted to an external processor such as contained in the computer 208 described below.
  • the scanner 202 may employ structured light, laser scanning, direct ranging, or any other technology suitable for acquiring three-dimensional data, or two-dimensional data that can be resolved into three-dimensional data.
  • the scanner 202 is a handheld, freely positionable probe having at least one user input device 216, such as a button, lever, dial, thumb wheel, switch, or the like, for user control of the image capture system 200 such as starting and stopping scans.
  • the scanner 202 may be shaped and sized for dental scanning. More particularly, the scanner may be shaped and sized for intraoral scanning and data capture, such as by insertion into a mouth of an imaging subject and passing over an intraoral surface 206 at a suitable distance to acquire surface data from teeth, gums, and so forth.
  • the scanner 202 may, through such a continuous acquisition process, capture a point cloud of surface data having sufficient spatial resolution and accuracy to prepare a dental model, either directly or through a variety of intermediate processing steps.
  • supplemental lighting systems may be usefully employed during image capture.
  • environmental illumination may be enhanced with one or more spotlights illuminating the subject 204 to speed image acquisition and improve depth of field (or spatial resolution depth).
  • the scanner 202 may also, or instead, include a strobe, flash, or other light source to supplement illumination of the subject 204 during image acquisition.
  • the computer 208 may be, for example, a personal computer or other processing device.
  • the computer 208 includes a personal computer with a dual 2.8 GHz Opteron central processing unit, 2 gigabytes of random access memory, a TYAN Thunder K8WE motherboard, and a 250 gigabyte, 10,000 rpm hard drive.
  • This system may be operated to capture approximately 1,500 points per image set in real time using the techniques described herein, and store an aggregated point cloud of over one million points.
  • real time means generally with no observable latency between processing and display. In a video-based scanning system, real time more specifically refers to processing within the time between frames of video data, which may vary according to specific video technologies between about fifteen frames per second and about thirty frames per second.
  • processing capabilities of the computer 208 may vary according to the size of the subject 204, the speed of image acquisition, and the desired spatial resolution of three-dimensional points.
  • the computer 208 may also include peripheral devices such as a keyboard 214, display 210, and mouse 212 for user interaction with the camera system 200.
  • the display 210 may be a touch screen display capable of receiving user input through direct, physical interaction with the display 210.
  • Communications between the computer 208 and the scanner 202 may use any suitable communications link including, for example, a wired connection or a wireless connection based upon, for example, IEEE 802.11 (also known as wireless Ethernet), BlueTooth, or any other suitable wireless standard using, e.g., a radio frequency, infrared, or other wireless communication medium.
  • IEEE 802.11 also known as wireless Ethernet
  • BlueTooth or any other suitable wireless standard using, e.g., a radio frequency, infrared, or other wireless communication medium.
  • wireless image transmission from the scanner 202 to the computer 208 may be secured.
  • the computer 208 may generate control signals to the scanner 202 which, in addition to image acquisition commands, may include conventional camera controls such as focus or zoom.
  • the scanner 202 may acquire two-dimensional image sets at a video rate while the scanner 202 is passed over a surface of the subject.
  • the two-dimensional image sets may be forwarded to the computer 208 for derivation of three-dimensional point clouds.
  • the three-dimensional data for each newly acquired two-dimensional image set may be derived and fitted or "stitched" to existing three-dimensional data using a number of different techniques.
  • Such a system employs camera motion estimation to avoid the need for independent tracking of the position of the scanner 202.
  • One useful example of such a technique is described in commonly-owned U.S. Patent No. 7,605,817, incorporated herein by reference. However, it will be appreciated that this example is not limiting, and that the principles described herein may be applied to a wide range of three-dimensional image capture systems.
  • the display 210 may include any display suitable for video or other rate rendering at a level of detail corresponding to the acquired data. Suitable displays include cathode ray tube displays, liquid crystal displays, light emitting diode displays and the like. In some embodiments, the display may include a touch screen interface using, for example capacitive, resistive, or surface acoustic wave (also referred to as dispersive signal) touch screen technologies, or any other suitable technology for sensing physical interaction with the display 210.
  • Suitable displays include cathode ray tube displays, liquid crystal displays, light emitting diode displays and the like.
  • the display may include a touch screen interface using, for example capacitive, resistive, or surface acoustic wave (also referred to as dispersive signal) touch screen technologies, or any other suitable technology for sensing physical interaction with the display 210.
  • the digital surface representation may be processed with one or more postprocessing steps. This may include a variety of data enhancement processes, quality control processes, visual inspection, and so forth. Post-processing steps may be performed at a remote post-processing center or other computer facility capable of post-processing the imaging file, which may be, for example a dental laboratory. In some cases, this postprocessing may be performed by the image capture system 200. Post-processing may involve any number of clean-up steps, including the filling of holes, removing of outliers, etc.
  • Data enhancement may include, for example, smoothing, truncation, extrapolation, interpolation, and any other suitable processes for improving the quality of the digital surface representation or improving its suitability for an intended purpose.
  • spatial resolution may be enhanced using various post-processing techniques.
  • Other enhancements may include modifications to the data, such as forming the digital surface representation into a closed surface by virtually providing a base for each arch, or otherwise preparing the digital surface representation for subsequent fabrication steps.
  • the three-dimensional representation of a patient's intraoral surfaces at the location of a dental implant will vary depending of the type of dental implant procedure utilized.
  • a cover screw, healing abutment, or a temporary abutment typically extend through the gingivia overlying the site of the implant.
  • the retaining screw and healing abutment is removed to expose the internal bore of the underlying implant (e.g. anchor).
  • the method further comprises removing (healed) dental tissue above the tooth implant (e.g. anchor) such that the tooth implant (e.g. anchor) is exposed.
  • the first digital surface representation is acquired by attaching a dental implant abutment to the dental implant (e.g. anchor) 101.
  • the implant abutment conveys information about the position and orientation of the underlying dental implant.
  • the implant abutment comprises at least one orientation feature that is capable of being detected by the image capture system (e.g. by optically scanning).
  • Fig. 4 depicts a three-dimensional cross-sectional representation of the intraoral surfaces of a patient's mouth at the location of a dental implant after attaching a scannable implant abutment 350 of Fig. 3 to the dental implant (e.g. anchor) 400.
  • the dental implant (e.g. anchor) 400 is generally a threaded cylindrical body which is implanted in a cylindrical bore made in the patient's jawbone (i.e., an endosseous implant) at the site of an edentulous ridge or tooth extraction socket.
  • the dental implant (e.g. anchor) 400 also typically includes an internally-threaded cylindrical socket (e.g. having a hex-shaped opening) in which to fasten a cover screw, healing cap, or implant abutments.
  • Various implant systems are known, such as commercially available from Straumanns, 31, Astra tech, Zimmer, and Nobel.
  • the width of the dental implant at the gingival aspect is typically slightly wider than the mating end of the implant abutment.
  • the abutment can typically attach to the dental implant (e.g. anchor) 400 in more than one orientation such as in the case when the socket of the implant is a regular hexagon. It is preferred to attach the scannable implant abutment 350 of Fig. 3 to the dental implant (e.g. anchor) 400 such that the mechanical orientation feature is also highly visible to the dental practitioner. For example, if the abutment has a single orientation feature such as a single vertical flat, it is preferred to position the vertical flat such that it is not facing the adjacent teeth.
  • the (e.g. permanent) implant abutment is a preformed (e.g. one piece) metal abutment having a base suitable for attachment to a tooth implant (e.g. anchor) and an opposing end suitable for receipt of a (e.g. permanent) restoration, such as a crown or bridge.
  • the (e.g. permanent) implant abutment may comprise a preformed metal abutment that is an abutment interface having a base suitable for attachment to a tooth implant (e.g. anchor) and an opposing end suitable for receipt of a custom abutment such as ceramic custom abutment as can be prepared from LavaTM
  • implant abutment as used herein also encompasses implant abutment interfaces having an abutment as well.
  • a (i.e. temporary) surface treatment is generally applied to the intraoral (e.g. tooth) surfaces prior to three-dimensional scanning, such as described for example in
  • the surface treatment typically comprises a particulate opacifying agent, such as titanium dioxide, to reduce the specular reflectivity, translucency and the like of the intraoral surfaces.
  • the particles typically create a micron-scale roughness contributing to diffuse, Lambertian surface reflection characteristics.
  • the intraoral surface coating may include particles having a size ranging from about 15-30 microns.
  • the surface treatment may also include an active light sensitive layer or particles that can be excited by proper illumination (e.g. induced fluorescence).
  • particles may be applied to form an incomplete coating of the surface such as less than 95% of the surface, less than 90%> of the surface, less than 75 % of the surface, or less than 50%> of the surface.
  • Dental abutments and abutment interfaces are preformed articles comprised of a metal such as palladium-silver alloy, stainless steel, aluminum, and most commonly titanium or a titanium alloy.
  • a metal such as palladium-silver alloy, stainless steel, aluminum, and most commonly titanium or a titanium alloy.
  • the reflection properties of such metal surfaces are problematic to optical scanning.
  • Specular reflection is the mirror-like reflection of light from a surface, in which light from a single incoming direction (a ray) is reflected into a single outgoing direction. Such behavior is described by the law of reflection, which states that the direction of incoming light (the incident ray), and the direction of outgoing light reflected (the reflected ray) make the same angle with respect to the surface normal, thus the angle of incidence equals the angle of reflection. This is in contrast to diffuse reflection, where incoming light is reflected in a broad range of directions.
  • Lambertian reflectance When a surface exhibits Lambertian reflectance, light falling on it is scattered such that the apparent brightness of the surface to an observer is the same regardless of the observer's angle of view.
  • the surface luminance is considered isotropic.
  • Lambertian reflection is often used as a model for diffuse reflection. The effect this has from the viewer's perspective is that rotating or scaling the object does not change the apparent brightness of its surface.
  • One way to increase the diffuse reflection in favor of specular reflection and thereby increase the total reflection of a metal implant abutment is to apply the same opacifying (e.g. powdered) surface treatment as is typically applied to the patent's oral surfaces.
  • the implant abutment comprises an orientation feature (such as a visual marking)
  • the opacifying (e.g. powdered) surface treatment can alter or mask the orientation feature(s) from being detected by the image capture system.
  • the abutment is preferably a preformed metal abutment wherein at least the supragingival end is optically scannable without application of a (i.e. temporary) surface treatment.
  • the supragingival end of the dental implant abutment i.e. the portion underlying the subsequently seated restoration (e.g. crown or bridge)
  • a permanently bonded opaque coating can also mask the appearance of the preformed metal abutment, thereby improving the aesthetic appearance of the subsequently seated (e.g. crown or bridge) restoration.
  • the coating can increase the total reflection of the metal abutment such that the total reflection is at least 25%, 30%, 40%, 45%, 50%, or 55% at the wavelength(s) of light utilized by the scanner.
  • the scanner employs blue light having a wavelength ranging from about 450 nm to 495 nm.
  • a predominant amount of the light emitted form the scanner has a
  • the scanner employs a red light, having wavelengths ranging from 620 to 750 nm. In other embodiments, the scanner employs white light, emitting wavelength of light that span the entire visible light spectrum, i.e. from about 380 nm to 750 nm.
  • the coating also increases the roughness of the coated abutment.
  • the scannable (e.g. supragingival) surface of the abutment may have a surface roughness, Ra, of at least 3 and more preferably at least 4, 5, or 6. In some embodiments, the surface roughness is at least 10, 15, or 20.
  • the surface roughness of the uncoated abutment may be about 1 for a metal abutment that has not been subjected to surface roughening.
  • a sandblasted metal abutment may have a surface roughness of about 2 to 3.
  • the scan captures a three-dimensional representation of some or all of the dentition of a patient's intraoral surfaces at least at the location of a dental implant, i.e. typically the tooth structures directly adjacent to and those that will come in contact with the tooth- shaped surfaces of the restoration that will be affixed to the dental implant abutment.
  • the digital surface representations may be acquired by transmitting such information to a rapid fabrication facility such as a dental laboratory, an in-house dental laboratory at a dentist's office, or any other facility with machinery to fabricate physical models from digital models.
  • a rapid fabrication facility such as a dental laboratory, an in-house dental laboratory at a dentist's office, or any other facility with machinery to fabricate physical models from digital models.
  • representations may be downloaded from an internet site.
  • a permanent restoration can be fabricated without making a physical model.
  • a physical model of the patient's mouth at the location of the dental implant as known in the art, to verify the fit.
  • a dental model could be made by traditional dental impression techniques such as by covering the dental implant abutment with an impression coping 120, forming a negative (e.g. silicone) impression of the patient's mouth 121 (that comprises the impression copings cured therein), and forming a positive (e.g. stone) model from the negative impression 122.
  • a physical model is desired, it is preferably formed by use of a (e.g. additive) rapid prototyping 111 as described in copending Provisional Patent Application Serial No. 61/242543, filed September 15, 2009; incorporated herein by reference.
  • a permanent restoration such as a crown or bridge, can be fabricated, as known in the art, and seated on the restorative-receiving (i.e. top) supragingival end of the implant abutment.
  • a (e.g. custom) abutment is first formed and then a permanent restorative is fabricated to (e.g. custom) fit the abutment.
  • the permanent (e.g. crown) restoration is preferably fabricated such that the restoration has a cavity having a cooperating mechanical feature to mate with the supragingival end of the implant abutment.
  • the cavity of the restoration comprises a vertical protrusion that mates with such groove.
  • the cavity of the restoration comprises a vertical groove that mates with such protrusion.
  • the cavity of the restoration comprises a vertical flat that mates with such protrusion.
  • the mating orientation feature is preferably designed such that the restoration can be seated on the abutment in only one possible orientation.
  • This can be accomplished when the abutment and restoration each comprise a single mechanical feature, such as a single mating vertical flat.
  • this can be accomplished by use of an abutment that comprises more that one vertical mechanical orientation features provided that these mechanical features are not evenly spaced about the circumference of the abutment. This results in the abutment having an asymmetrical cross-section.
  • the asymmetry of the supragingival end of the abutment and restoration cavity permits these pieces to fit together in only one possible orientation.
  • the custom abutment is designed to have an asymmetrical cross section. It is appreciated that the abutment may comprises other, relatively smaller mechanical features such as shallow groove anti-pull features that need not be replicated in the restoration to insure proper placement.
  • Temporary restorative typically comprise a plastic; whereas permanent restorative generally comprise a ceramic material.
  • the restoration may also comprise a malleable material such as described in US 7,674,850; incorporated herein by reference.
  • the method generally comprises shaping at least a portion of the preformed restoration and hardening the restoration either prior to or after affixing the restoration to the supragingival end of the implant abutment.
  • the (e.g. permanent) restoration can be affixed to the implant abutment with a dental cement as known in the art.
  • a dental cement as known in the art.
  • the cavity of the dental restoration is partially filled with a dental cement and then placed over the implant abutment such that the base of the dental article contacts the abutment platform (352 of FIG. 3).
  • Suitable dental cements are commercially available from 3M ESPE under the trade designation "RelyX Unicem Self Adhesive Universal Resin Cement".
  • Various coatings have been described in the art that are suitable for coating metal dental articles.
  • U.S. Patent No. 5,454,716 describes an orthodontic arch wire coated with an opaque coating.
  • Such coatings are also suitable for increasing the total reflection of the metal implant abutment.
  • Such coatings generally comprise a polymeric binder and at least one opaque filler and/or pigment.
  • Suitable polymeric materials include thermoplastic, thermosetting, and
  • polymerizable materials such as acrylics, epoxies, liquid crystal polymers, acetals, nylons, polysulfones, polyamides, polyimides, polyacetates, phenolics, polyesters, and amino type resins such as melamine formaldehyde, and urea formaldehyde.
  • Polymerizable materials that crosslink upon heat or radiation curing are generally preferred.
  • Particularly preferred resins include monomeric and polymeric acrylates and in particular methacrylates which are ultraviolet, electron beam, or heat curable.
  • monomeric and polymeric acrylates and in particular methacrylates which are ultraviolet, electron beam, or heat curable.
  • methacrylates which are ultraviolet, electron beam, or heat curable.
  • 3,066,112 on the basis of bisphenol -A and glycidyl methacrylate, or their derivatives obtained by adding isocyanates, are often used in particular.
  • the diacrylic and dimethacrylic acid esters of bishydroxymethyltricyclo-[5.2.1.0.sup.2.6 ]-decane named in DE-A-2 816 823 are also particularly suitable.
  • the reaction products from diisocyanates and hydroxyalkyl(meth)acrylates, as described for example in DE-A-2 312 559, can also be used.
  • the fillers typically have an average particle size of ⁇ 50 microns and more typically less than ⁇ 25 microns, and more typically less than 10 microns. In some embodiments, the fillers have a primary particle size of less than 5, 4, 3, 2, or 1 micron.
  • Inorganic fillers can be for example quartz, ground glasses powder (e.g. which contain strontium, barium or lanthanum), and silica. For better incorporation in the polymer matrix, it is of advantage to hydrophobize the inorganic fillers. Customary
  • hydrophobization agents are organosilanes such as trimethoxymethacryloyloxypropyl silane.
  • the quantity of silane used is customarily 0.5 to 10 wt.-%, relative to inorganic fillers, and preferably 2 to 5 wt.-%.
  • the filler is typcially present in the polymeric coating at a concentration of at least 10%, 15% or 20% up to 40%, 50%, or 60% by weight.
  • the particle size of the filler is small for embodiments wherein the coating is quite thin. .
  • the kind and amount of filler and/or pigment is chosen such that a tooth-colored coating is achieved.
  • the underlying metal can change the appearance of the (e.g. crown) restorative affixed to such supragingival surface.
  • the kind and amount of filler and/or pigment renders the supragingival surface sufficiently opaque or tooth colored.
  • the polymeric coatings can be made by using a mixture of titanium dioxide and iron oxide pigments.
  • the titanium dioxide and iron oxide pigments can be used in varying amounts depending on the shade of tooth enamel desired to be reproduced. For example, about 20 wt-% to about 40 wt-% titanium dioxide, and about 0.01 wt-%) to about 0.10 wt-% iron oxide, based on the total weight of the polymeric coating material, give a natural tooth enamel appearance to the coating. Additional pigments or colorants can be optionally added to the starting coating powders to color- match the polymeric coating to a desired tooth color.
  • At least the supragingival surfaces of the metal abutment are covered by the coating at least at a thickness such that the exposed surfaces of the abutment (e.g. when in the patient's mouth) are optically scanneable.
  • the coating may be applied at thickness of as little as 10 microns.
  • the coating is of sufficient thickness to opacify at least the supragingival surfaces of the metal implant abutment. Since some restoratives, such as temporary crowns prepared from plastic materials, have some transparency, the underlying metal abutment can alter the color of such restoratives. Hence, opacifying the supragingival portion of the preformed metal abutment can improve the aesthetics of the restorative.
  • the (e.g. polymeric) coating typically has a thickness of at least about 25 micrometers, and more preferably a thickness of least about 50
  • the (e.g. polymeric) coating typically has a thickness of no more than about 100 micrometers thick, and more typically a thickness of no more than about 75 micrometer.
  • the polymeric coating is a powder coating.
  • conventional powder coating techniques typically includes electrostatic spraying processes, followed by thermally treating the powder to melt the powder coating and bond the resulting molten material to the crown surface.
  • powder coating techniques are well known to one of skill in the art.
  • Powder coatings typically have an average particle size (i.e., the largest dimension of a particle, such as the diameter of a spherical powder) of at least about 20 microns, and more preferably at least about 40 microns.
  • the average particle size is typically no more than about 100 microns, and more preferably no more than about 60 microns.
  • One suitable powder coating that comprises a polyester/epoxy hybrid compositions as described in U.S. 7,008,229; incorporated herein be reference.
  • Such powder coating preferably includes about 20 percent by weight (wt-%) to about 40 wt-% polyester, and about 20 wt-% to about 40 wt-% epoxy, based on the total weight of the coating powder.
  • At least the supragingival surfaces of the implant abutment comprises a ceramic coating.
  • a coated implant prepared by depositing in electrophoresis at least one ceramic layer one a body potion of an implant and sintering the ceramic layer using optical radiation.
  • An organo-metallic coupling agent may be either precoated onto at least the supragingival surfaces of the metal abutment or added to the polymeric coating to improve adhesion between the metal implant abutment and the polymeric coating.
  • Various organo- metallic coupling agents are known such as described in U.S. Patent No. 5,454,716.
  • At least the supragingival surfaces of the implant abutment can be prepared to remove oil or other surface contaminants by vapor degreasing, alkaline cleaning, acetone cleaning, or ultra-sonic cleaning, for example.
  • Surface oxides may be removed and surface activation can be accomplished by acid treatment or abrasive (e.g. sand) blasting, for example.
  • an exploded view of an illustrative preformed implant abutment (e.g. interface) 350 the implant abutment may take the form of an elongated tubular body generally comprising a (e.g. hex shaped) base end 355 that is designed to mate with the gingival aspect of the implant (e.g.
  • the abutment comprises a shoulder (not shown) within the cavity 354 for cooperation with a screw 370 to fasten the abutment to the implant (e.g. anchor).
  • Implant abutments typically comprise one or more anti-rotation features as known in the art.
  • the base portion of the abutment that mates with the implant are typically hexagonal 355 in shape.
  • Other anti-rotation features include for example vertical flat(s), vertical groove(s), or vertical protrusion(s).
  • the implant abutment may comprise a platform 352.
  • Abutments that include a platform are commercially available from Nobel Biocare under the trade designation
  • the abutment may lack a platform.
  • the base of the dental article may rest directly on the implant anchor.
  • Exemplary abutments that lack a platform are commercially available from Straumann ITI.
  • the supragingival end of the implant abutment comprises at least one orientation feature.
  • the orientation feature may comprise digital information, at least one visual feature, at least one mechanical feature, or a combination thereof.
  • the orientation feature preferably comprises a (e.g. single) mechanical feature such as a vertical groove, vertical protrusion, vertical flat (e.g. 356 of FIG. 3), or a combination thereof.
  • the abutment comprises more that one (e.g. 2, 3, or 4) vertical groove, vertical protrusion, vertical flat (e.g. 356 of FIG. 3), or a combination thereof.
  • these features are not evenly spaced about the circumference of the abutment. This results in the abutment having an asymmetrical cross-section.
  • the orientation feature is the asymmetry of the supragingival end of the abutment, rather than the presence of a single mechanical feature.
  • the exterior geometry of the abutment and mechanical orientation feature are preferably chosen to facilitate intraoral scanning and the fabrication of the subsequently seated restoration.
  • the supragingival exterior surfaces of the abutment are generally free of any structural features that would detract from the fit between the exterior surface of the abutment and the restorative.
  • the supragingival exterior surfaces of the abutment, as well as the restoration that receives such are generally free of undercuts, as well as deep (e.g. horizontal) grooves or protrusions (e.g. having a difference in depth of about 0.1 mm or greater).
  • the dental implant abutment comprises a mechanical orientation feature and the restoration comprises a cooperating mechanical orientation feature that mates with the mechanical orientation feature of the dental implant abutment.
  • an impression coping rather than a restoration may have a cooperation mechanical component that mates with the mechanical orientation feature of the dental implant abutment.
  • the mechanical feature insures that the restoration and/or impression coping are properly placed with respect to rotation.
  • the supragingival end of the implant abutment may comprise anti-pull feature such as shallow grooves 305 that hinder removal of the restoration from the abutment.
  • anti-pull features have a depth no greater than about 0.1 mm.
  • Other anti-pull features include for example shallow horizontal flat(s), horizontal groove(s), or horizontal protrusion(s). In the case of attachment with an adhesive, such shallow mechanical features or other surface roughening can increase the surface area, thereby improving the bond strength.
  • a prototype dental implant abutment interface was fabricated to the final shape from CP Titanium Grade 5 (purity specification: max . IO C, .5 Fe, .015 H, 0.05 N, and .50 O, Perryman Co., Houston, PA).
  • An optical micrograph of the dental implant abutment having a length of about 7 mm is depicted in Fig. 6.
  • the uncoated interface was sandblasted at 2 bars of pressure with 50 um aluminum oxide using a Vaniman Sandstorm XL (Vaniman Co., Fallbrook, CA), the nozzle being positioned 1 ⁇ 2" from the interface.
  • the sandblasted interface was coated per manufacturer's instructions with SinfonyTM Indirect Lab Composite (Part #49000, 3M ESPE, St. Paul, MN).
  • the Opaquer Liquid (Item No. 049860) was applied and light cured (3M LED curing light, Part #XL 3000, 3M ESPE, St. Paul, MN).
  • the opaque powder (shade A2, Item No. 049610) was mixed with the opaque liquid in a 1 : 1 ratio with the addition of one drop of the Activating Liquid (Item No. 049870).
  • the opaque mixture was applied to the treated surface of the interface with a brush and light cured.
  • the surface of the coated interface was lightly sandblasted as described above, but using 1 bar of pressure at 6" nozzle distance for a sufficient time to remove the gloss (by visual inspection), being careful not to sandblast through the coating.
  • Example 2 (coated without sandblasting)
  • a prototype implant interface was prepared according to the method of Example 1 , omitting the final, light sandblasting of the coated and cured interface.
  • Example 3 (coated without sandblasting)
  • Example 2 was repeated except that coating was vacuum cured to render a more uniform coating.
  • Control A sandblasted w/o coating
  • the prototype implant interface with no coating was sandblasted as described in Example 1.
  • Control B was a prototype implant interface with no coating or sandblasting, having a somewhat glossy surface after the fabrication process.
  • the coated implant abutment prepared in Examples 1-2 were scanned according to manufacturer's instructions in a Lava COS (Chairside Oral Scanner, 3M ESPE, St. Paul, MN), producing an acceptable image. Attempts to scan Control A and B resulted in an error message.
  • Lava COS Crossside Oral Scanner, 3M ESPE, St. Paul, MN
  • the coated interface prepared in Examples 1-3, Control A and Control B were also scanned according to manufacturer's instructions in a Lava Scan ST scanner with Lava Design 4.2 software (3M ESPE, St. Paul, MN) using an exposure setting of 35.
  • Examples 1-3 produced an acceptable image, while Control A and B produced error messages.
  • the surface roughness was measured on each of the flats of each of the abutments of Examples 1-3 and Control A and Control B. Topographic data was obtained from the nominally flat regions using the Keyence VK-9710 color 3D laser scanning confocal microscope with 20x/0.46 objective and VK Viewer observation software. Measurements were take use the VK Analyzer shape and particle analysis software program. The surface roughness measurement analysis was executed according to JIS B0601 :2001 (ISO
  • Example 3 coated with SinfonyTM and vacuum cured
  • Control A sandblasted titanium
  • TR Total Reflectance
  • Spectrophotometer fitted with a PELA 1000 Integrating Sphere Accessory. This sphere is 150 mm (6 inches) in diameter and complies with ASTM methods E903, D1003, E308, et al. as published in "ASTM Standards on Color and Appearance Measurement", Third Edition, ASTM, 1991.
  • a Perkin Elmer quartz optics small spot accessory was used in tandem with the PELA 1000 iris to focus and mask the beam to a size of about 1.2 mm diameter on the white plate at the back sample position of the sphere. After zeroing the instrument, the sample to be measured was suspended in the focal plane centered in the beam. The beam illuminated ca. half the diameter of the sample and the back enclosure served as a light trap behind the sample.
  • Prototype sandblasted titanium abutments were prepared as described in Example 1 , except the horizontal groove anti-pull features were omitted in order to evaluate the effect of the coating alone on adhesion.
  • An optical micrograph of the dental implant abutment having a length of about 7 mm is depicted in Fig. 7.
  • Titanium abutments were coated as described in Example 3. Uncoated titanium abutments were used as control samples. Lava Zirconia custom abutments were manufactured to a size and shape for mating with the titanium abutments as described in EP1992302A1. A Lava Scan ST, Lava Form CNC Milling System, and Lava Therm Furnace were used to form the abutment from a Lava Frame Zirconia Mill Blank. Onto each coated or control abutment, a Lava Zirconia custom abutment was cemented using RelyX Unicem Self Adhesive Universal Resin Cement (3M ESPE, St. Paul, MN) per manufacturer's instructions.
  • RelyX Unicem Self Adhesive Universal Resin Cement (3M ESPE, St. Paul, MN) per manufacturer's instructions.
  • the cemented assemblies were autoclaved by holding for 10 minutes at 135 deg. C.
  • the autoclaved samples were further prepared for Instron testing (Model 5500R, Instron Corp., Canton, Mass.) by attaching each to an implant analog (TERMINOLOGY AGAIN) using a screw.
  • the implant analog was clamped in the jaws of the Instron.
  • a custom steel plate having a circular hole was used to encircle the base of the zirconia abutment near the titanium abutment, to avoid crushing the ceramic abutment in the jaws.
  • the steel plate was gripped in the pulling jaws of the Instron and the jaws were pulled apart at a crosshead speed of 0.5mm/min.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial 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)
  • Orthopedic Medicine & Surgery (AREA)
  • Dental Prosthetics (AREA)

Abstract

La présente invention concerne des procédés de fabrication d'une restauration permanente pour un implant dentaire et des articles de point d'appui d'implant dentaire.
PCT/US2010/048358 2009-09-15 2010-09-10 Points d'appui d'implant dentaire et procédés d'utilisation WO2011034780A1 (fr)

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EP2468211A1 (fr) * 2010-12-27 2012-06-27 Terrats Mecanizados S.L. Fixation de prothèse améliorée
WO2014111413A1 (fr) * 2013-01-18 2014-07-24 Bredent Gmbh & Co. Kg Élément d'ancrage et procédé de fabrication dudit élément
FR3012736A1 (fr) * 2013-11-05 2015-05-08 Gacd Fabrication d'un pilier implantaire par impression 3d
WO2017029670A1 (fr) * 2015-08-17 2017-02-23 Optical Metrology Ltd. Cartographie intrabuccale de cavités buccales édentées ou partiellement édentées
US9993312B2 (en) 2013-08-30 2018-06-12 Zfx Gmbh Intraoral reference body
US20210000573A1 (en) * 2017-11-28 2021-01-07 Dentsply Sirona Inc. Dental prosthesis molding block and method for producing a dental prosthesis part from the dental prosthesis molding block
US11045286B2 (en) 2014-04-22 2021-06-29 Noga Medical Products Ltd. Dental implants
EP4248907A1 (fr) * 2022-03-24 2023-09-27 Implant Protesis Dental 2004 S.L. Pilier de scannage pour implants dentaires, procede de creation d'un modele, et utilisation du pilier de scannage

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Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2468211A1 (fr) * 2010-12-27 2012-06-27 Terrats Mecanizados S.L. Fixation de prothèse améliorée
EP2945563B1 (fr) * 2013-01-18 2018-10-17 bredent GmbH & Co. KG Procédé de fabrication d'un élément d'ancrage
WO2014111413A1 (fr) * 2013-01-18 2014-07-24 Bredent Gmbh & Co. Kg Élément d'ancrage et procédé de fabrication dudit élément
KR102260327B1 (ko) 2013-01-18 2021-06-04 브레덴트 게엠베하 앤드 코. 카게 고정 요소 및 그 제조 방법
KR20150109382A (ko) * 2013-01-18 2015-10-01 브레덴트 게엠베하 앤드 코. 카게 고정 요소 및 그 제조 방법
CN104968296A (zh) * 2013-01-18 2015-10-07 布莱登特有限两合公司 锚固元件及制造方法
CN104968296B (zh) * 2013-01-18 2019-04-09 布莱登特有限两合公司 锚固元件及制造方法
US9993312B2 (en) 2013-08-30 2018-06-12 Zfx Gmbh Intraoral reference body
FR3012736A1 (fr) * 2013-11-05 2015-05-08 Gacd Fabrication d'un pilier implantaire par impression 3d
US11045286B2 (en) 2014-04-22 2021-06-29 Noga Medical Products Ltd. Dental implants
WO2017029670A1 (fr) * 2015-08-17 2017-02-23 Optical Metrology Ltd. Cartographie intrabuccale de cavités buccales édentées ou partiellement édentées
US20210000573A1 (en) * 2017-11-28 2021-01-07 Dentsply Sirona Inc. Dental prosthesis molding block and method for producing a dental prosthesis part from the dental prosthesis molding block
EP4248907A1 (fr) * 2022-03-24 2023-09-27 Implant Protesis Dental 2004 S.L. Pilier de scannage pour implants dentaires, procede de creation d'un modele, et utilisation du pilier de scannage
WO2023180413A1 (fr) * 2022-03-24 2023-09-28 Implant Protesis Dental 2004 S.L. Butée de balayage pour implants dentaires, procédé de création d'un modèle et utilisation de la butée de balayage

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