WO2012168835A1 - Expanseur d'os de la mâchoire et kit le comprenant - Google Patents

Expanseur d'os de la mâchoire et kit le comprenant Download PDF

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Publication number
WO2012168835A1
WO2012168835A1 PCT/IB2012/052708 IB2012052708W WO2012168835A1 WO 2012168835 A1 WO2012168835 A1 WO 2012168835A1 IB 2012052708 W IB2012052708 W IB 2012052708W WO 2012168835 A1 WO2012168835 A1 WO 2012168835A1
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WO
WIPO (PCT)
Prior art keywords
bone
bone expander
expander
connection
holes
Prior art date
Application number
PCT/IB2012/052708
Other languages
English (en)
Inventor
Mauro Bonino
Michele PERELLI
Original Assignee
Mauro Bonino
Perelli Michele
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Mauro Bonino, Perelli Michele filed Critical Mauro Bonino
Publication of WO2012168835A1 publication Critical patent/WO2012168835A1/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
    • A61C8/0089—Implanting tools or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated screw

Definitions

  • the present disclosure regards a dental bone expander for expansion and regeneration of tissue of dental implant sites and a corresponding kit.
  • a fundamental requisite for the success of implant-prosthetic therapy is the availability of an adequate volume and good quality of bone for proper insertion and osteo-integrat ion of the implants.
  • osteotomes were developed that enable compacting of the bone and expansion of the narrow ridges through their insertion in the implantation site.
  • Osteotomes basically consist of a rigid metal structure, which is tapered to facilitate its insertion in the implantation site, where said insertion is performed manually using a surgical hammer. Osteotomes e made with different diameters for generation in the ne of the volume necessary for insertion of the osthetic implant. These instruments, however, present me disadvantages: they cannot be used in the ndible, since the strokes of the- surgical hammer uld cause fracture thereof; they are rigid struments that can cause fracture of the vestibular rtex; and in some cases they are intolerable for the tient on account of the method of insertion in the ne .
  • ntury bone expanders that are nical or frustoconical in shape and are provided with progressive thread, which can be used both in the ndible and in the maxilla, such as the ones described the patent applications Nos . WO-A-2004/019807 and -A-2007/105063.
  • the use of said threaded bone panders - which are inserted in the alveolar ridge rely by screwing - enables creation of an adequate lume for housing the dental implant and enables a od bone density to be obtained for the subsequent ntal implant, preserving the existing walls of the ne ridge.
  • the volume and good bone density are tained by progression of the instrument into the bone ee, for example, Figure 1), i.e., by means of a ogressive widening of the implantation site and by ans of a compacting of the bone adjacent to the plantation site.
  • the aforesaid mechanical expanders do not enable timization of the activation of a physiological ocess of bone regeneration, i.e., the synthesis of w bone tissue through living bone cells contained in e implantation site (osteoblasts or mesenchymal stem lis) in so far as the bone cells adjacent to the implantation site are compacted in a sort of monolithic structure that prevents neoformation of vascular structures, moreover preventing the contribution of mesenchymal stem cells of the systemic blood circulation .
  • One embodiment of the present invention regards a dental bone expander having a rigid structure including a base part and an axially extended and at least partially tapered head part, where the head part has a surface helical groove and an apical end that is opposite to the base part.
  • the rigid structure of the dental bone expander has an internal cavity that develops through the base part and the head part, where the latter is provided with a plurality of holes communicating with the internal cavity.
  • a second embodiment of the present invention regards a kit for facilitating osteo-integration of a dental implant comprising: at least one bone expander as described above; at least one closing means designed to be inserted into the internal cavity of the at least one bone expander for occluding at least part of the holes of the plurality; and means for connection of the bone expander to actuation means, where the actuation means are selected between an aspirator and a rotary dri e .
  • FIG. 1 illustrates the phenomenon ' of compacting of bone caused by insertion in the implantation site of an ostetome or of a bone expander known in the art
  • FIG. 2 is a front cross-sectional view of a first embodiment of the bone ⁇ expander forming the subject of the present disclosure
  • FIG. 3 is a front cross-sectional view of a second embodiment of the bone expander forming the subject of the present disclosure.
  • FIG. 4 illustrates the phenomenon of inhomogeneous compacting and the creation of fractures in the bone walls of the implantation site caused by the use a bone expander according to the present invention.
  • references to "an embodiment” or “one embodiment” means that a particular peculiarity, structure, or characteristic described in connection with the embodiment is included in at least one embodiment.
  • phrases such as “in a certain embodiment” or “in one embodiment” or the like that may appear in various points of the present specification do not necessarily always refer to one and the same embodiment.
  • the particular peculiarities, structures, or characteristics may be combined in any suitable way in one or more embodiments .
  • the purpose of the present invention is to develop a dental bone expander that will enable an osteogenic regeneration of the bone adjacent to the grafting site of a dental implant.
  • the expander forming the subject of the present disclosure enables, by virtue of its own structural characteristics , stimulation, by optimizing it, of the formation of bone through activation of biological stimuli that induce local cells, cells coming from the systemic blood circulation, or possibly transplanted cells to tart a process of proliferation and differentiation, which leads to formation of mature osteoblasts, thanks to the neoformation of vascular structures .
  • the dental bone expander described herein enables the necessary broadening of the alveolar ridge of an implantation site, whether maxillar or mandibular.
  • the dental bone expander designated as a whole by 1, has a rigid structure 10 that comprises a base part 2 and an axially extended and at least partially tapered head part 3.
  • the head part 3 has a surface helical groove 35 and an apical end 4 that is opposite to the base part 2.
  • the rigid structure 10 has an internal cavity 5, which develops through the base part 2 and the head part 3, where the latter is provided -with a plurality of holes 6 communicating with the internal cavity 5.
  • the base part 2 and the head part 3 can be made of a single piece or of two distinct, preferably coaxial, pieces subsequently coupled together.
  • the surface helical groove 35 is constituted by a part in relief, having an appropriate profile, which limits a helical bottom made in the head part 3.
  • the head part 3 has a proximal portion with a cylindrical section 31 and a distal portion with a substantially conical or frustoconical section 32, which includes the apical end 4.
  • the head part 3 moreover has at least one marker 7 on its outer surface .
  • the bone expander 1 is moreover made in different dimensions, i.e., different diameters, according to the degree of expansion of the implantation site that it is desired to obtain.
  • the holes of the plurality 6 are formed at the bottom of the helical groove 35, and are substantially distributed along at least one substantial part of the development of the helical groove 35.
  • the presence of said plurality of holes 6 enables a inhomogeneous compacting of the bone to be obtained, simultaneously with expansion of the implantation site, in so far as at the holes the compacted bone layer undergoes structural fractures (micro- fractures or macro-fractures) .
  • the bone expander 1 further comprises closing means 9, which can be inserted into the internal cavity 5 to obstruct at least some holes of the plurality 6.
  • the closing means 9 comprise an axially hollow jacket element.
  • the closing means 9 comprise an axially hollow jacket element presenting an outer thread (not illustrated) , which can be coupled to a thread of the cavity 5 (which is not illustrated either) , at the base part 2 and head part 3, for a better retention of the closing means 9 to the cavity 5 when the closing means 9 itself is inserted into the expander 1.
  • the base part 2 of the expander 1 is provided at one end thereof generally opposite to the head part 3, with a hollow connection element 21 designed for connection with actuation means, preferably selected between an aspirator and a manual rotary drive (manual jack) or motorized rotary drive (surgical motor) .
  • the hollow connection element 21 generally has a polygonal, more preferably hexagonal, cross section for connection to standard aspirators and rotary drives available in dentists' surgeries.
  • connection element 21 can be made of a single piece with the base part 2, in which case its cavity is represented by a portion of the cavity of the rigid structure 10. In the case where the connection element 21 and the base part 2 are constituted by distinct pieces, the cavity of the connection element 21 is in communication with the cavity 5 of the base part 2 and head part 3.
  • the connection element 21 is preferably coaxial to the base part 2 and head part 3.
  • the bone expander 1 is, then, initially connected to a rotary drive, such as, for example, a surgical motor or else a manual jack, for insertion of the expander 1 in the alveolar ridge of the implantation site so as to obtain an expansion and a inhomogeneous compacting of the bone surrounding the implantation site. Subsequently, the bone expander 1 is connected to an aspirator for application of a negative pressure in the implantation site for stimulating osteogenic regeneration .
  • a rotary drive such as, for example, a surgical motor or else a manual jack
  • the apical end 4 has a substantially conical configuration (Figure 2) or frustoconical configuration ( Figure 3) according to the desired degree of expansion of the implantation site.
  • a further embodiment of the present invention regards a kit for facilitating osteo-integration of a dental implant that comprises: at least one bone expander 1 as described above; at least one closing means 9 designed to be inserted into the internal cavity 5 of the at least one bone expander 1 for occluding at least part of the holes of the plurality 6; and means for connection 8 of the bone expander 1 to actuation means.
  • connection means 8 comprise a flexible tube having a first end configured for connection to the internal cavity 5 or to the connection element 21 of the bone expander 1 and a second end configured for connection to the aspirator.
  • the closing means 9, preferably in the form of an axially hollow jacket element, inserted into the bone expander 1 enables exertion of a negative pressure on the implantation site even when the bone expander 1 is not altogether inserted into the implantation site, i.e., when a part of the holes of the plurality 6 is not located in a position adjacent to the bone of the implantation site, given that the depth of the implantation site is smaller than the length of the cross section of the head part 3 of the bone expander 1.
  • By occluding at least the part of the holes of the plurality 6 not adjacent to the bone of the implantation site it is possible to exert in any case a negative pressure on the implantation site.
  • connection means 8 comprise a mechanical transmission member having a first end configured for connection to the rigid structure 10 of the bone expander 1 and a second end configured for connection to the manual or motorized rotary drive.
  • the dental bone expander described herein favours osteogenic regeneration of the bone adjacent to the implantation site (i.e., of the bone adjacent to the cavity obtained using the expander itself) in so far as it determines formation of fractures (preferably microfractures) in the compacted bone layers that are located at the holes 6. of the head part 3 of the expander ( Figure 4) .
  • Said fractures induce an irrigation of blood that enables the implantation site to be reached by osteoinducti e growth factors (for example, PDGF - Platelet-Derived Growth Factor; TGF-b - Transforming Growth Factor-b ; IGF I and II - Insulin- Like Growth Factor I and II) , proteins with morphogenetic activity (BPMs - Bone Morphogenetic Proteins) , osteoprogenitor cells (fibroblasts, osteoblasts, and chondrocytes) that stimulate regeneration of the bone tissue, as well as mesenchymal stem cells coming from the blood flow. Moreover stimulated is the formation of new capillaries within the new bone tissue generated through the presence of angiogenic factors (for example, PDGF) brought to the implantation site by the blood flow.
  • osteoinducti e growth factors for example, PDGF - Platelet-Derived Growth Factor; TGF-b - Transforming Growth Factor-b ; IGF I and II - Insulin-
  • Said regenerative phenomenon is further induced by the application of a negative pressure (vacuum) obtained by connection of the expander to an aspirator.
  • the treatment with negative pressure enables a controlled and localized application of a sub- atmospheric pressure at the implantation site, of the VAC-therapy type.
  • the negative pressure determines a mechanical stress on the bone tissue adjacent to the expander and enables creation of further micro-deformations in the bone cells, with consequent production of cell messengers responsible for increase in " the proliferation of the bone cells around the expander.
  • the negative pressure increases local microvascular blood flow and controls vascularization, determines an increase in the rate of formation of the granulation tissue, and can moreover reduce the bacterial charge that may be present at the implantation site in addition to removing substances that inhibit healing (for example, exudate).
  • the exudate that accumulates can, in fact, mechanically compress the local capillaries and restrict the blood flow in the implantation site: its removal enables a normal flow of blood to be obtained in the area, which is fundamental for osteogenic regeneration.
  • the negative pressure is applied by means of a vacuum pump (aspirator) that supplies continuous and/or intermittent negative pressure, regulated according to the osteogenic regeneration required.
  • the negative pressure is generally applied with values in the 5-125- mmHg range .

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Prosthetics (AREA)
  • Medicines Containing Plant Substances (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

La présente invention concerne un expanseur d'os de la mâchoire (1) ayant une structure rigide (10) comprenant une partie base (2) et une partie tête (3) s'étendant axialement et étant au moins partiellement conique, la partie tête (3) ayant un sillon hélicoïdal de surface (35) et une extrémité apicale (4) opposée à la partie base (2) ; la structure rigide (10) a une cavité interne (5) qui se développe dans la partie base (2) et la partie tête (3) ; cette dernière étant dotée d'une pluralité de trous (6) communiquant avec la cavité interne (5).
PCT/IB2012/052708 2011-06-08 2012-05-30 Expanseur d'os de la mâchoire et kit le comprenant WO2012168835A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITTO2011A000500 2011-06-08
IT000500A ITTO20110500A1 (it) 2011-06-08 2011-06-08 Espansore osseo odontoiatrico e relativo kit

Publications (1)

Publication Number Publication Date
WO2012168835A1 true WO2012168835A1 (fr) 2012-12-13

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PCT/IB2012/052708 WO2012168835A1 (fr) 2011-06-08 2012-05-30 Expanseur d'os de la mâchoire et kit le comprenant

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IT (1) ITTO20110500A1 (fr)
WO (1) WO2012168835A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004019807A1 (fr) 2002-09-02 2004-03-11 Eduardo Anitua Aldecoa Jeu d'instruments a moteur facilitant la fixation d'implants dentaires
DE102004006930A1 (de) * 2003-02-27 2004-11-18 C.G.M. S.P.A., Correggio Werkzeug zur Erweiterung eines in einem Knochen ausgebildeten Loches, insbesondere zum Einsetzen eines intraossären Zahnimplantates
EP1488745A1 (fr) * 2003-06-20 2004-12-22 Massimo Corigliano Structure d'ostéotome
US20070105068A1 (en) * 1997-07-02 2007-05-10 Stucki-Mccormick Suzanne Combination distraction dental implant and method of use
WO2007105063A2 (fr) 2006-03-10 2007-09-20 Biotechnology Institute, I Mas D, S.L. Dispositif d'expansion-compaction de crête osseuse et outils associés
ES2288437A1 (es) * 2007-04-27 2008-01-01 Antonio Juan Flichy Fernandez Sistema de implante dental.

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070105068A1 (en) * 1997-07-02 2007-05-10 Stucki-Mccormick Suzanne Combination distraction dental implant and method of use
WO2004019807A1 (fr) 2002-09-02 2004-03-11 Eduardo Anitua Aldecoa Jeu d'instruments a moteur facilitant la fixation d'implants dentaires
DE102004006930A1 (de) * 2003-02-27 2004-11-18 C.G.M. S.P.A., Correggio Werkzeug zur Erweiterung eines in einem Knochen ausgebildeten Loches, insbesondere zum Einsetzen eines intraossären Zahnimplantates
EP1488745A1 (fr) * 2003-06-20 2004-12-22 Massimo Corigliano Structure d'ostéotome
WO2007105063A2 (fr) 2006-03-10 2007-09-20 Biotechnology Institute, I Mas D, S.L. Dispositif d'expansion-compaction de crête osseuse et outils associés
ES2288437A1 (es) * 2007-04-27 2008-01-01 Antonio Juan Flichy Fernandez Sistema de implante dental.

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Publication number Publication date
ITTO20110500A1 (it) 2012-12-09

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