WO2012123661A1

WO2012123661A1 - Prosthetic device comprising a dental implant, and related positioning method

Info

Publication number: WO2012123661A1
Application number: PCT/FR2012/050457
Authority: WO
Inventors: Eric GUEZ
Original assignee: Guez Eric
Priority date: 2011-03-11
Filing date: 2012-03-06
Publication date: 2012-09-20
Also published as: EP2683321A1; FR2972343B1; FR2972343A1

Abstract

The technical field of the invention is that of means to be attached to the jawbone so as to brace the natural teeth or secure prostheses and/or dental implants. Specifically, the invention relates to a prosthetic device comprising a dental implant and to a related positioning method. According to a first aspect, the invention relates to a prosthetic device (1) comprising a dental implant (2), characterized in that said implant (2) comprises a threaded anchoring body (3) extending about a reference axis (x) and secured to a supporting head (4) of a prosthetic element (5), said anchoring body (3) being frusto-conical and comprising a dual taper as well as a median section (10) and an apical section (1) that are continuous with each other in a two-by-two manner. Said median section (10) comprises a base (12) having a nominal diameter (D_n) of between 3 mm and 6 mm, and threading, the threads (8a) of which form an angle (β) of between 55º and 59º. Said apical section comprises an apex having a nominal diameter (d_n) of between 1 mm and 4 mm, and a threading, the threads (8b) of which form an angle (γ) of between 50° and 54°.

Description

PROTHETIC DEVICE COMPRISING A DENTAL IMPLANT AND METHOD OF PLACING THE SAME

TECHNICAL FIELD OF THE INVENTION

The technical field of the invention is that means intended to be attached to the jaw bone to consolidate the natural teeth or to attach prostheses and / or dental implants, and more particularly to a subject prosthetic device comprising a dental implant and a method of putting it in place.

STATE OF THE PRIOR ART

The problem of the means intended to be attached to the jawbone for securing prostheses and / or dental implants already knows several solutions, including that consisting of the establishment of a prosthetic implant comprising a body of frustoconical shape and having a thread adapted to insert and fix the implant in the bone volume.

As such, it is known the patent FR 2 9432 420 which describes a dental implant 40 and more generally an assembly comprising such an implant and a prosthetic element. Said implant comprises a self-tapping threaded anchor body 41 elongated about an axis 42 secured to a support head 43 of a prosthetic element, the head comprising a neck 44 having an annular groove 45 surmounted by an end connecting member comprising a tapered frustoconical tenon converging towards the top of said head. In addition, the anchoring body 41 comprises a cylindrical apical end section 48 connected to a frustoconical cervical section 49 of connection with the head. The neck 44 comprises a first convex portion 50 of junction with the body, in the form of an O-shaped portion and a second concave portion 57 forming said annular groove.

Such devices have the particular disadvantages of requiring a significant exposure time and to present many difficulties during the pose as the anchoring of said implant made difficult by the size of the bone volume and the quality of the bone. In addition, these implementation difficulties promote heating of the bone and also affect the stability of the implant and the quality of healing. In addition, the risk of fractures of the bone are important in the case where it is weakened. In other words, a large exposure time and a large number of forests involve increased heating of the bone and thus more difficult healing. Likewise, the dimensions of the bone volume, in particular the width of the bone ridge, which is sometimes too thin, may necessitate transverse bone expansion by bone grafting and, therefore, lengthen the exposure time.

SUMMARY OF THE INVENTION

The invention aims to overcome the disadvantages of the state of the art, by providing a prosthetic device comprising a dental implant capable of ensuring a reduced exposure time and improved implant quality for all bone qualities in freeing at best of bone grafts and allowing increased stability of the implant.

For this purpose and according to a first aspect, the invention relates to a prosthetic device comprising a dental implant characterized in that said implant comprises an elongate threaded anchor body about a reference axis and integral with a head. for supporting a prosthetic element, said anchoring body being of frustoconical shape and comprising: a double conicity:

a first nominal conicity relative to the frustoconical shape of the anchoring body, said first nominal conicity having a lateral surface defined as a frustoconical envelope delimited by the tops of the threads and whose angle of first conicity is between 1 ° and 15 ° ;

a second conicity relative to the frustoconical shape of the anchoring body, said second conicity exhibiting a lateral surface defined as a frustoconical envelope delimited by the troughs of the threads, and whose angle of second conicity is between 5 ° and 20 °;

a medial section and an apical section that are continuous two by two,

said median section having a base of nominal diameter between 3mm and 6mm, and a thread whose threads have an angle between 55 ° and 59 °; said apical section having an apex with a nominal diameter of between 1 mm and 3 mm, and a thread whose threads have an angulation of between 50 ° and 54 °.

[0007] As a result, such a device has the advantage of being both self-tapping and expander. Indeed, the self-tapping effect is due in particular to the double taper of the anchor body and the expander effect is allowed in part by the variation of the angulation of the threads as well as by the large conicity important. This also allows a much easier installation of the implant on the bone and therefore reduce the time and improve healing.

It is specified that the angles are indicated in "degrees" symbolized

"°".

In addition, according to a second particular characteristic, the thread on the anchor body has a variable pitch, between 1, 10mm and 1, 20mm on the median section and between 1, 30mm and 1, 50mm on the apical section. This feature brings another important advantage that is to allow the implant to have a self-condensing effect of the bone as the implant is anchored in the bone. This induces a very good anchoring of the implant.

Therefore, such an implant provides a substantially instantaneous stability during its implementation. It is also possible to correct the direction of an implant during its insertion into the bone to guide it more favorably in the bone volume, that is to say in the volume of the bone able to receive the implant, or even parallelize it to other implants. In the latter case, a sleeve known in the state of the art can be used to assist the establishment of said implant to parallelize it.

Advantageously, the thread on the anchoring body has an increasing thread depth over the entire anchoring body as the thread moves away from the support head and is between 0.6mm and 0.7mm at the apical section. This depth of thread is defined more precisely as the distance between the troughs of the threads and the tops of said threads. In other words, this increasing depth of the threads is verified by the conicity angle of the first conicity which is strictly greater. at the taper angle of the second taper.

Furthermore, according to another feature, said support head is substantially cylindrical in shape and comprises a substantially circular upper surface and a lateral surface, said lateral surface being provided with a stabilizing thread capable of stabilizing an expansion of the bone after blocking the implant and the threads being spaced from 0.10mm to 0.50mm.

Advantageously, the apex of the apical trunk comprises at least three tapping notches distributed radially substantially uniformly about the reference axis, the notches being constituted by longitudinal recesses formed from the apical apex and delimited by two faces. substantially perpendicular.

In addition, the implant preferably comprises a substantially cylindrical threaded recess symmetrical with respect to the reference axis opening on the upper surface of the support head and adapted to allow the fastening of the implant with the prosthetic element.

According to a particular characteristic, the implant has a length of 13 mm and / or the material which constitutes it is a grade V titanium alloy. Furthermore, the invention also relates to a method of setting up such a dental implant comprising all or part of the aforementioned characteristics, said method of setting up a dental implant comprising the following steps: - realization of a first hole of a first diameter by milling along a reference axis; at least one drilling of a bone volume of a second diameter strictly greater than the first diameter along the same reference axis; insertion of the dental implant whose nominal diameter of the base is strictly greater than the second diameter and placement of a prosthetic element.

Owing to its characteristics, its ease of insertion into the bone allows such a dental implant to be adaptable to all simple or complex clinical situations. It is possible to correct the direction of the implant during its insertion into the bone to guide more favorably in the bone volume, or parallel to other implants. In addition, the placement of the implant in patients with severe resorptions in the presence of an insufficient bone width allows a gradual expansion of the vestibular bone table by acting on the elasticity of the bone. The implant then plays the role of expander by leverage.

Finally, another advantage is the time saving, thanks to a reduced forest sequence. Drilling at least 2mm below the diameter of the implant allows the implant to be placed in the maxilla with a very good primary anchorage. Less bone heating and improved bone healing quickly stabilize the implant site and promote rapid loading.

BRIEF DESCRIPTION OF THE FIGURES Other features and advantages of the invention will become apparent from reading the description which follows, with reference to the accompanying figures, which illustrate: Figure 1, a diagram of a dental implant according to a first embodiment; Figure 2 is a sectional sectional view diagram AA of a dental implant according to this first embodiment; Figure 3 is a left-side diagram of a dental implant according to this first embodiment; Figure 4 is a schematic view to the right of a dental implant according to this first embodiment; Figure 5 is a diagram of a dental implant according to a second embodiment; Figure 6 is a cross-sectional sectional view diagram AA of a dental implant according to this second embodiment; Figure 7 is a left-side diagram of a dental implant according to this second embodiment; Figure 8 is a perspective diagram of a dental implant according to this second embodiment; Figure 9 is a diagram of a dental implant according to a third embodiment; Figure 10 is a sectional sectional view diagram AA of a dental implant according to this third embodiment; Figure 11, a schematic left view of a dental implant according to this third embodiment; Figure 12 is a schematic view to the right of a dental implant according to this third embodiment; Figures 13, 14, 15, diagrams of a prosthetic element according to one embodiment; FIGS. 16, 17, two diagrams of a prosthetic device comprising a dental implant and a prosthetic element according to one embodiment, FIG. 16 presenting them separately and FIG. 17 showing them fitted into one another.

For clarity, identical or similar elements are identified by identical reference signs throughout the figures.

DETAILED DESCRIPTION OF AN EMBODIMENT

Figures 1, 2, 3 and 4 show diagrams of a dental implant according to a first embodiment in different views.

More specifically, is shown in these Figures 1 to 4, a dental implant 2 measuring 13mm and whose constituent material is a grade V titanium alloy, ti-6al-4v, ie a titanium alloy comprising 6% aluminum and 4% vanadium

In addition, said dental implant 2 more precisely comprises an elongate threaded anchoring body 3 about a reference axis (x) and secured to a support head 4 of a prosthetic element 5, the head 4 support measuring 2.4mm.

Furthermore, said anchoring body 3 is of frustoconical shape and more precisely comprises: a double conicity, that is to say:

a first nominal conicity relative to the frustoconical shape of the anchoring body 3, said first nominal conicity having a lateral surface 6a defined as a frustoconical envelope delimited by the vertices 7 of the threads 8 and whose angle of first conicity o ₁ is equal to about 3.2 °;

and

a second conicity relative to the frustoconical shape of the anchoring body, said second conicity having a lateral surface 6b defined as a frustoconical envelope delimited by the recesses of the threads 9, this second conicity being characterized by an angle of second conicity a ₂ is equal at about 8.6 °;

and

a median section 10 and an apical section 1 1 continuous two by two, in particular:

said median section 10 comprises a base 12 of nominal diameter D _n equal to 3.8 mm, and a thread whose threads 8a have a β angulation equal to 56.3 °;

said apical section comprises an apex 16 of nominal diameter d _n equal to 3.2 mm, and a thread whose threads 8b have an angulation equal to 52 °. In addition, in this illustrated embodiment, the thread 8 located on the anchoring body 3 has a variable pitch p equal to 1, 15mm at the median section 10 and equal to 1, 45mm at the section apical 1 1.

In addition, the same thread 8 located on the anchor body has a thread depth d _f , defined as the distance between the recesses 9 of the threads and the tops 7 of said threads, which is increasing over the entire body of anchoring 3 as the thread 8 moves away from the support head 4 and is equal to 0.65 mm at the apical section 1 1. This is also illustrated by the fact that the angle of first conicity cr? the first taper is strictly greater than the second taper angle a ₂ of the second taper. Furthermore, said support head 4 is of substantially cylindrical shape and comprises a substantially circular upper surface 13 and a lateral surface 14, said lateral surface 14 being provided with a stabilizing thread 15 capable of stabilizing an expansion of the bone after locking of the implant 2, the stabilizing threads having a pitch equal to 0.35 mm.

Is further shown in these figures the apex 16 of the apical trunk 1 1 having three tapping slots 17 distributed radially substantially uniformly about the reference axis (x), the notches 17 being formed of recesses longitudinal formed from the apical apex and delimited by two faces 18, 19 substantially perpendicular. The homogeneous distribution deduces notches 17 is characterized by an angle of 120 degrees formed by each of the same faces 18 or 19.

In addition, the implant 2 comprises a cylindrical threaded recess 18 symmetrical with respect to the reference axis (x) opening on the substantially circular upper surface 13 of the support head 4 and adapted to allow the fastening of the implant 2 with the prosthetic element 5. [0031] Figures 5, 6, 7 and 8 show diagrams of a dental implant according to a second embodiment in different views.

This second embodiment differs mainly from the first embodiment at least in that:

- its angle of first conicity cr? is equal to about 7.0 °; its angle of second conicity at ₂ is equal to about 13.0 °;

its nominal diameter D _n equal to 3.9 mm;

its nominal diameter d _n equal to 2.6 mm;

- Its thread depth d _f is equal to 0.61 mm at the apical section 1 1;

its stabilizing threads have a pitch equal to 0.30 mm Figures 9, 10, 11 and 12 show diagrams of a dental implant according to a third embodiment in different views.

This third embodiment differs mainly from the first and second embodiments at least in that: - the implant has a length of 1 1, 5mm

- its angle of first conicity cr? is equal to about 6.5 °;

its angle of second conicity at ₂ is equal to about 10.1 °;

its nominal diameter D _n equal to 3.75 mm;

its nominal diameter d _n equal to 2.8 mm; stabilizing threads 15 have a pitch p equal to 0.40 mm

Figures 13, 14, 15 show, for their part, diagrams of a prosthetic element according to one embodiment, FIGS. 16 and 17 showing diagrams of an assembly of this same prosthetic element with an implant according to a method. 16, showing them separately and FIG. 17 presenting them fitted one inside the other.

Indeed, this prosthetic element 5 comprises a first end 20 and a second end 21, said second end 21 being adapted to engage in the recess 18 opening on the upper surface 13 substantially circular head 4 of the dental implant 2, the fitting being along the reference axis (x).

Furthermore, the establishment of such implants may, for example, be performed as follows: in a first step, the use of a ball mill diameter of 0.5mm allows for a pre-hole according to a desired axis; a first forest with a diameter of 1.5 mm is set up according to the length of the predefined implant, then a second forest with a nominal diameter of 2 mm makes it possible to complete the implant osteotomy, that is to say to complete the drilling of the implant. bone, for the establishment of an implant. Minimal drilling is sufficient even in a highly corticalized bone because the diameter of the apex is only 1.5mm for a 3.3mm implant. the implant and its titanium implant holder are taken from their sterile capsule and placed in the implant site. The use of a sleeve may possibly be used to help its implementation, especially when the implant must respect a certain parallelism.

During the insertion of the implant in the implant site, it easily penetrates into the implant site thanks to its large conicity and allows condensation but especially bone expansion without risk of fracture of the external cortex, that is to say, the bone bark.

In this embodiment of such a method, the implant site is prepared only with the first and second forests of respective diameters 1, 5mm and 2mm for the establishment of an implant whose base has a nominal diameter. 3.3mm or 3.75mm. Nevertheless, other forests can be used, for example, for the establishment of an implant whose base has a nominal diameter of 4.2mm the use of a first forest of 2.8mm and a second 3.2mm forest can be preferred.

Furthermore, the implant as described can be inserted with insertion forces greater than 70N / cm without apical bone constraint. This results from the fact that its apex has a large conicity which also allows to minimize bone warming. In particular, the apical osteotomy is reduced by 30%, in other words, bone shrinkage is reduced by 30%. It is also noted that, during its insertion, a curvature and expansion of the cortex with a bone gain in the horizontal direction of 1, 5mm to 2mm is necessary for the establishment in complete safety of a implant, in the case where it has a base of nominal diameter equal to 3.3 mm, this expansion being stable in the long term even after a start.

If the cortical bone around the implant is less than 1, 5mm or a crack is present, bone management may be necessary by apposition, for example, of synthetic biomaterials or xenografts or autogenous bone chips covered with a collagen membrane or platelet derivatives after a blood test of the patient beforehand.

The bone healing time after the placement of such an implant is about 6 weeks, without filling because it has a very high primary stability to insertion, immobility without micromotion facilitating osteoblastic adhesion at the level of the bone / implant interface, osteoblast being the young bone-cell form that participates in ossification and is transformed into an osteocyte.

Many modifications can be made to the embodiments described above without departing from the scope of the invention. Thus, the general shapes are shown here for illustrative purposes only.

Claims

Prosthetic device (1) comprising a dental implant (2) characterized in that said implant (2) comprises an anchoring body (3) elongated threaded about a reference axis (x) and secured to a head (4). ) for supporting a prosthetic element (5), said anchoring body (3) being of frustoconical shape and comprising:

a double taper:

a first nominal conicity relative to the frustoconical shape of the anchoring body (3), said first nominal conicity having a lateral surface (6a) defined as a frustoconical envelope delimited by the vertices (7) of the threads (8) and of which the angle of first taper (cr _? ) is between 1 ° and 15 °;

a second conicity relative to the frustoconical shape of the anchoring body, said second conicity having a lateral surface (6b) defined as a frustoconical envelope delimited by the troughs of the threads (9) and whose angle of second conicity (cr ₂ ) is between 5 ° and 20 °;

- a median section (10) and an apical section (1 1) continuous two by two,

said median section (10) having a base (12) of nominal diameter (D _n ) between 3mm and 6mm, and a thread whose threads (8a) have an angulation (β) between 55 ° and 59 °;

said apical section comprising an apex 16 of nominal diameter (d _n ) between 1 mm and 4 mm, and a thread whose threads (8b) have an angulation (y) of between 50 ° and 54 °. Prosthetic device according to claim 1, characterized in that the thread (8) on the anchoring body (3) has a variable pitch (p) of between 1.10 mm and 1.20 mm on the median section (10) and between 1, 30mm and 1, 50mm on the apical section (1 1).

Prosthetic device according to any one of claims 1 or 2, characterized in that the thread (8) on the anchoring body has a thread depth (d _f ), defined as the distance between the recesses (9) of the threads and the tops (7) of said threads, increasing over the entire anchoring body (3) as the thread (8) moves away from the support head (4) and is between 0.6mm and 0.7mm at the apical section (1 1).

Prosthetic device according to any one of claims 1 to 3, characterized in that said support head (4) is substantially cylindrical in shape and comprises a substantially circular upper surface (13) and a lateral surface (14), said lateral surface (14) being provided with a stabilizing thread (15) capable of stabilizing an expansion of the bone after locking of the implant (2), the stabilizing threads (15) having a pitch (ρ ') of between 0.10 mm and 0.50mm;

Prosthetic device according to any one of claims 1 to 4, characterized in that the apex (16) of the apical trunk (1 1) comprises at least three notches (17) tapping distributed radially substantially uniformly around the reference axis (x), the notches (17) consisting of longitudinal recesses formed from the apical apex and delimited by two substantially perpendicular faces (18, 19).

Prosthetic device according to any one of claims 1 to 5, characterized in that the implant (2) has a recess (18) substantially cylindrical threaded symmetrical with respect to the reference axis (x) opening on the substantially circular upper surface (13) of the head (4) of support and adapted to allow the attachment of the implant (2) with the prosthetic element (5).

Prosthetic device according to any one of claims 1 to 6, characterized in that the implant (2) has a length (L) of 13mm.

Prosthetic device according to any one of claims 1 to 6, characterized in that the implant (2) is a grade V titanium alloy.