WO2013136309A1 - Système dentaire de réhabilitation implantaire comportant une prothèse fixe et son procédé d'application - Google Patents

Système dentaire de réhabilitation implantaire comportant une prothèse fixe et son procédé d'application Download PDF

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Publication number
WO2013136309A1
WO2013136309A1 PCT/IB2013/052082 IB2013052082W WO2013136309A1 WO 2013136309 A1 WO2013136309 A1 WO 2013136309A1 IB 2013052082 W IB2013052082 W IB 2013052082W WO 2013136309 A1 WO2013136309 A1 WO 2013136309A1
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WO
WIPO (PCT)
Prior art keywords
prosthesis
support
dental
dental prosthesis
engagement means
Prior art date
Application number
PCT/IB2013/052082
Other languages
English (en)
Inventor
Eriberto BRESSAN
Original Assignee
Bressan Eriberto
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 Bressan Eriberto filed Critical Bressan Eriberto
Publication of WO2013136309A1 publication Critical patent/WO2013136309A1/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
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • 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
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0027—Frames
    • 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
    • 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
    • A61C8/0093—Features of implants not otherwise provided for
    • A61C8/0095—Total denture implant

Definitions

  • the present invention regards a dental prosthetic system for implant rehabilitation with fixed prosthesis, particularly suitable for the application in case of total or partial edentulism, as well as a method for the application thereof. Specifically, the present invention regards the field of fixed dental rehabilitation with conometric retention and implant support.
  • implant rehabilitation is obtained according to various techniques and it allows treating cases of total and partial eduntalism, which could otherwise be treated by using moveable prosthesis which are usually not always comfortable for the users.
  • the techniques of implant rehabilitation provide for the use of dental prostheses anchorable to the mandible or maxilla of a patient by means of one or more supports or support pins previously implanted therein.
  • Such anchorable prostheses at the mandible or maxilla of a patient can be removable or fixed.
  • FIGs 1a and 1 b A typical example of implant rehabilitation dental system with removable prosthesis is constituted by the Ankylos SynCone ® system schematically illustrated in Figures 1a and 1 b.
  • the prosthesis employed in such system type is quickly removable by the patient wearing it.
  • Figures 1 a and 1 b particularly a removable, complete dental prosthesis with combined support is shown, which, besides the removable connection to the mandibular bone by means of four support pins (PD and PP) inserted in the interforaminal region of the mandible, provides for two rear flanged end appendices (FD and FS), i.e. which extend well beyond the zone affected by the presence of artificial teeth, for the support of the prosthesis on the mucous membrane of the mouth.
  • PD and PP support pins
  • FD and FS rear flanged end appendices
  • the removable systems for implant rehabilitation are negatively affected by several drawbacks. Firstly, they require a certain care and a rather frequent maintenance of the prosthesis by the patient wearing it.
  • the removable prostheses used with this type of system for implant rehabilitation have a flanging F which covers the mucous membrane of the mouth, and at such flanging (in the above-illustrated case, this regards the two rear flanged ends (FD and FS)), food is inevitably accumulated in the zone comprised between the mucous membrane and the prosthesis (PR). In order to prevent food from remaining in contact with the mucous membrane of the mouth for a long time, it is advisable that the patient removes the prosthesis each night for an extensive cleaning thereof.
  • Document DE 10 2008 058 305 teaches a removable dental prosthesis, engageable with the maxilla of a patient by means of engagement or anchorage means, each of which can be provided screwable, at a first end thereof, on a respective support or support pin implanted in the maxilla of a patient and it is provided, at the other end thereof, with a frustoconical head insertable/disconnectable in/from a respective housing seat obtained for this purpose, in the dental prosthesis.
  • the engagement means of such removable prosthesis are manufactured "ad hoc" for each patient.
  • a typical example of implant rehabilitation dental system with fixed prosthesis is represented by the so-called "AII-on-4" system, which in the case of total edentulism of the mandibular arch, provides for the insertion of four supports or support pins in the interforaminal region of the mandible.
  • the four supports or support pins are provided for permanently maintaining a prosthesis, which prosthesis is directly anchored thereto by means of connection screws.
  • the connection screws are provided engageable in suitable openings obtained in the prosthesis, at some teeth thereof, and each of these connection screw is directly screwed on a respective support or support pin previously implanted in the mandibular bone.
  • the openings are occluded with suitable ceramic material in order to conceal the heads of the connection screws in the through openings obtained in the teeth of the prosthesis.
  • Figures 2a, 2b and 2c Another example of a type of fixed prosthesis for implant rehabilitation with connection screws is illustrated in Figures 2a, 2b and 2c. More particularly, Figure 2a shows a bottom view of an impression of an upper dental arch of a patient, in which a prosthesis is inserted for the left incisor tooth. As observable, the dental prosthesis has a through opening for screwing a connection screw between the prosthesis itself and a support or support pin to be implanted in the maxilla of the patient.
  • Figure 2b shows a radiographic image of the support pin implanted in the maxillary bone of the patient at the left incisor tooth thereof.
  • Figure 2c shows the screwing of the screw in the support pin of Figure 2b, with which the engagement between the prosthesis and the support pin is attained.
  • This type of system for implant rehabilitation provides for the use of cement as an alternative to the connection screws between the supports or support pins and dental prosthesis.
  • the main object of the present invention is therefore to provide an implant rehabilitation dental system with fixed prosthesis that resolves the problems of the fixed dental systems of the prior art and which, in particular, does not require difficult maintenance procedures.
  • Another object of the present invention is to provide an implant rehabilitation dental system with fixed prosthesis which offers good comfort to the patient using it.
  • Another object of the present invention is to provide an implant rehabilitation dental system with fixed prosthesis that is easy to apply.
  • a further object of the present invention is to provide an implant rehabilitation dental system with fixed prosthesis that can be manufactured at competitive costs.
  • Another object of the present invention is to provide a method for applying an implant rehabilitation dental system with fixed prosthesis that can be implemented, by the dentist, in very short time intervals
  • an implant rehabilitation dental system with fixed prosthesis comprising:
  • At least one engagement means between such at least one support and such dental prosthesis, such at least one engagement means being permanently engageable with such at least one support and removably engageable with the dental prosthesis at such at least one receiving seat and comprising, for such purpose, a stem portion, screwable on one side on such at least one support and on the other side configured as a frustoconical head for the engagement with the dental prosthesis;
  • such frustoconical head of such at least one engagement means has size such to be fit insertable in a forced manner in such at least one receiving seat of the dental prosthesis, the dental prosthesis thereby obtained being a fixed prosthesis, that cannot be removed by the patient.
  • a method for applying an implant rehabilitation dental system with fixed prosthesis comprising the following operative steps of: - arranging at least one support, at least one engagement means and a dental prosthesis;
  • Figures 1a and 1 b illustrate an implant rehabilitation dental system with removable prosthesis according to the prior art
  • FIGS. 2a, 2b and 2c show an implant rehabilitation dental system with fixed prosthesis according to the prior art
  • Figure 3 illustrate a movable prosthetic system according to the prior art, affecting the left lower dental arch portion, inserted in the mouth of a patient;
  • Figure 4 is a radiographic image of the mouth of Figure 3 provided with three supports or support pins of an implant rehabilitation dental system with fixed prosthesis according to the present invention
  • Figure 5 shows a photograph of the mouth of Figure 4, in which the upper ends of the support pins are visible;
  • Figure 6 is a photograph of the mouth of Figures 4 and 5, in which engagement means are provided, each permanently connected to a respective support pin;
  • Figure 7 shows a plurality of cope elements, each cope element being fit inserted or forced onto a respective engagement means of figure 6;
  • Figure 8 illustrates a slightly top perspective view of the fixed dental prosthesis for the system for implant rehabilitation according to the present invention, engageable with the cope elements of Figure 7;
  • Figure 8a is a perspective view of the prosthesis of Fig. 8, overturned;
  • Figure 9 shows the fixed dental prosthesis of Fig. 8 inserted in the mouth of the patient.
  • an implant rehabilitation dental system with fixed prosthesis is marked with the reference number 1 and comprises at least one support or support pin 2 (referred to as "implant” in technical jargon), e.g. osteointegration pin of any suitable type, intended to be implanted in the mandibular or maxillary bone of a patient in order to act as support for a dental prosthesis (whether partial or complete) 3, the prosthesis being made of suitable, relatively inexpensive material, e.g. acrylic material.
  • suitable, relatively inexpensive material e.g. acrylic material.
  • acrylic material suitable for attaining the dental prosthesis is the "PalaXpress Ultra" resin sold by the German company Heraeus Holding GmbH.
  • the number of supports or support pins 2 of the implant rehabilitation dental system with fixed prosthesis according to the present invention is preferably variable and depends on the extension of the dental prosthesis to be supported. More particularly, if the fixed dental prosthesis regards only one tooth, only one support or support pin will be provided in the dental system according to the present invention. If, instead, the dental prosthesis 3 to be applied to a patient affects a plurality of contiguous teeth (e.g. a number comprised between 2 and 8) and hence constitutes a portion of dental arch (as illustrated in figure 8), the number of supports or support pins provided will be comprised between two and four, depending on the case.
  • a plurality of contiguous teeth e.g. a number comprised between 2 and 8
  • the number of supports or support pins provided will be comprised between two and four, depending on the case.
  • the implant rehabilitation dental system according to the present invention provides for a maximum or three support pins 2, for portions of dental arches comprising up to six contiguous teeth.
  • the dental system according to the present invention provides for a maximum of four supports or support pins 2.
  • the number of support pins will be equal to four or more.
  • the number of supports or support pins 2 of the system for implant rehabilitation with fixed prosthesis according to the present invention will preferably be equal to four. Two of such supports or pins 2 will be provided inserted in the mandible in a front region ZA thereof, more specifically in the interforaminal region, in a manner so as to support the front part of the dental prosthesis 3.
  • the remaining two supports or support pins 2 will be laterally inserted outside such region, each in a rear region ZP of the mandible roughly corresponding with the first molar, in a manner so as to support the dental prosthesis 3 also on the rear part in one portion, respectively right and left 3ps thereof.
  • only one support pin 2 will be inserted outside the interforaminal region of the mandible, on the right or left side thereof, depending on the least damaged side of the bone structures thus providing the dental prosthesis 3 with at least one stable support at a rear portion 3p thereof.
  • the fixed prosthesis of the implant rehabilitation dental system according to the present invention regards the entire dental arch, it is preferable to maintain the support pins 2 implanted in a symmetric manner (2 per side) with respect to the median line of the mandible itself.
  • the osteointegration supports or support pins 2 depending on the bone structure of the mandible or maxilla of the patient, will have suitable lengths typically comprised between 8 mm and 1 1 mm and diameter typically comprised between 3.5 and 4.5 mm and they can be implanted in the mandibular or maxillary bone both in a front zone ZA and in a receded or rear zone ZP thereof, in a manner so as to provide a stable support for the dental prosthesis 3.
  • the dental prosthesis 3 is connected to the support pin or pins 2 by means of one or more engagement or anchorage means 4 (referred to as "abutments" in technical jargon), each having a first stem-like end 4a (not illustrated in the figures) for connecting to a respective pin 2, preferably threaded and intended to be screwed into a corresponding threaded cavity provided in the respective support or support pin 2, and a second external end 4b for connecting to the dental prosthesis 3 typically shaped as a frustoconical head (with conicity usually comprised between 4° or 5°).
  • engagement or anchorage means 4 referred to as "abutments” in technical jargon
  • engagement or anchorage means is represented by the Ankylos Syncone system, commonly used for removable prostheses, in which engagement or anchorage means 4 are provided having different lengths and different angles between the longitudinal axis of the stem with respect to the frustoconical head portion thereof.
  • Ankylos Syncone system commonly used for removable prostheses, in which engagement or anchorage means 4 are provided having different lengths and different angles between the longitudinal axis of the stem with respect to the frustoconical head portion thereof.
  • all the engagement or anchorage means 4 provided in the same dental prosthesis must have the longitudinal axes of the frustoconical portions thereof substantially perpendicular to the lying plane of the prosthesis itself and they must all be parallel to each other. This in order to facilitate the insertion/disconnection of the fixed dental prosthesis by the dentist.
  • the dental prosthesis 3 of the system for implant rehabilitation with fixed prosthesis comprises a receiving seat 5 for each engagement means 4 provided therein.
  • Such receiving seat 5 is formed by a cope element 6 that in use is permanently fixed to the dental prosthesis and has the cavity 6a thereof directed, in use, towards the mandible or maxilla of the patient.
  • Each cope element 6 is permanently fixed to the dental prosthesis 3 by means of a suitable fixing element for dental use, typically a polymerizable resin, e.g. the "ProBase Cold” resin sold by the Italian company Ivoclar Vivadent S.r.l.
  • connection between the frustoconical head end 4b of each engagement means 4 and the respective receiving seat 5 provided in the dental prosthesis 3 is obtained through forced fit insertion of the first in the second, the cope elements 6 delimiting respective receiving seats 5 also with frustoconical conformation corresponding with that of the ends 4b of the engagement or anchorage means 4, i.e. with cross sections with diameter equal to or slightly greater than that of the corresponding cross sections of the respective frustoconical head ends 4b.
  • both the insertion and the disconnection of the end of each engagement or anchorage means 4b in the respective cavity 5 of the dental prosthesis 3 requires the application of a certain force; therefore, once applied to a patient, the dental prosthesis for all practical purposes is a fixed prosthesis (even if removable by the dentist).
  • the method for applying an implant rehabilitation dental system with fixed prosthesis according to the present invention requires a certain number of separate operative steps described hereinbelow.
  • the application of the system firstly provides for (step 100) the insertion of one or more supports or support pins 2 in the mandibular or maxillary bone of the patient.
  • the operation of inserting the aforesaid supports 2 occurs, according to the prior art, in a zone of the maxilla or mandible suitable for ensuring an adequate support for the prosthesis to be applied.
  • the insertion of the pin will occur at the missing tooth.
  • the method according to the present invention provides for the application of a respective engagement or anchorage means 4 to each support or support pin 2 thus implanted.
  • Each engagement or anchorage means is engaged with the respective support or support pin 2, e.g. by means of a threaded connection end 4a thereof, which makes it screwable in a respective pin 2.
  • step (210) in the case in which the prosthesis must be supported by more support pins and hence its engagement is provided for with more engagement means, there follows the mutual alignment of the engagement or anchorage means 4, in a manner such that the longitudinal axes of the frustoconical ends 4b thereof are aligned with each other in the above-described way.
  • the alignment between the engagement or anchorage means 4 can be obtained without intervening on the subject during the operation step, e.g. by using computer-assisted design techniques in a step before the application of the system, i.e. determining the position of the supports or support pins 2 and the insertion angle thereof in the mandibular bone upstream.
  • step 300 the fixing is obtained between each engagement or anchorage means 4 and the mandibular dental prosthesis 3.
  • step 310 a cope element 6 will be applied on the frustoconical head 4b of each engagement or anchorage means 4.
  • This step requires the application of a certain force by the dentist, since the configuration of each cope element 6 corresponds with that of the respective engagement or anchorage means 4 and the insertion of one in the other is a forced fit insertion.
  • a fixing means is applied on the external surface of each cope element 6, accordingly provided with retention flanging 6b; such fixing means is typically a polymerizable resin.
  • the dental prosthesis 3 is applied on each cope element 6; in such prosthesis, suitable openings are obtained allowing the fixing means to set and after a given time period (step 340), ensuring the permanent connection between the prosthesis and respective cope elements 6. Subsequently, the dental prosthesis 3, with the cope element(s) 6 inserted therein, is removed from the mouth of the patient and, if necessary, finished.
  • step 400 most of the material designed to coat or cover the mucous membrane of the mouth is removed, thereby obtaining - for practical purposes - a small fixed and finished dental prosthesis, designed to be entirely supported by the support pin or pins (2) and which does not require, as in the case of the removable prosthesis, daily cleaning for removing food accumulated between it and the mucous membrane of the mouth.
  • the dental prosthetic system for implant rehabilitation according to the present invention is, in every respect, a fixed system in which the dental prosthesis 3 is always small in size, easy to maintain and, with respect to the fixed prostheses of the prior art, can be advantageously obtained at relatively low costs.
  • the dental prosthesis of the system for implant rehabilitation with fixed prosthesis according to the present invention has the great advantage of being quickly and easily applicable/removable by the dentist in the/from the mouth of a patient, without having to subject the patient to uncomfortable, long sessions.
  • the engagement/disengagement of the prosthesis from the mouth of a subject occurs in a very fast and easy manner, since it is sufficient to apply a force such to cause the decoupling between the frustoconical heads of the engagement means 4 of the system and the respective receiving seat(s) 5 of the dental prosthesis 3; hence, it is unnecessary to use the drill or execute subsequent teeth reconstruction operations in ceramic material once the required maintenance operations have been carried out.
  • a system according to the present invention drastically reduces the discomfort of a patient related to the removal of the fixed prosthesis.
  • the time interval required for the removal of the fixed prosthesis for implant rehabilitation according to the system of the present invention is approximately one minute.
  • the time for removing the fixed prostheses of the prior art and subsequent reapplication thereof, e.g. according to the "All-on- 4" system mentioned above, is never less than 30 - 45 minutes.
  • the fixed implant rehabilitation dental system according to the present invention has the further advantage of being easily adaptable both in the case of loss of one of the supports inserted in the mandibular bone of a patient and in the case in which a patient already possesses his own moveable dental prosthesis.
  • a dental system according to the present invention allows maintaining the dental prosthesis of the patient, suitably processed (referred to as "rebased" in the technical jargon) at the surface thereof directed, in use, towards the support pins in order to adapt it, in the first case, to the new support pin inserted to replace the lost one, and in the second case, to the new support pin(s) 4 inserted in the moveable prosthesis.
  • the system for implant rehabilitation with fixed prosthesis according to the present invention is thus advantageous, due to the fact that it can be manufactured at very low costs with respect to those provided for the systems with fixed prosthesis according to the prior art, also due to the low number of operative steps that must be executed for the application of the system.
  • mandibular dental system according to the present invention can be used both with “immediate load” and with “delayed load” and it is therefore very practical to program and implement.

Abstract

La présente invention concerne un système dentaire de réhabilitation implantaire comportant une prothèse fixe comprenant au moins un support (2) destiné à être implanté dans la mandibule ou l'os maxillaire d'un patient ; une prothèse dentaire (3), destinée à être supportée par au moins un support (2) et comprenant au moins un renfoncement de réception (5) ; au moins un moyen d'entrée en prise (4) entre l'au moins un support (2) et l'au moins une prothèse dentaire (3), l'au moins un moyen d'entrée en prise (4) étant mis en prise de manière permanente avec l'au moins un support (2) et mis en prise amovible avec la prothèse dentaire (3) au niveau de l'au moins un renfoncement de réception (5) et comprenant une partie tige (4a), l'une de ses extrémités pouvant être vissée sur l'au moins un support (2) et l'autre extrémité ayant une forme de tête tronconique (4b) pour être mise en prise avec la prothèse dentaire (3). Étant donné que la tête tronconique (4b) de l'au moins un moyen d'entrée en prise (4) est d'une taille telle qu'elle peut être insérée de manière forcée dans l'au moins un renfoncement de réception (5) de ladite prothèse dentaire (3), ladite prothèse dentaire est ainsi une prothèse fixe, qui ne peut être retirée par le patient.
PCT/IB2013/052082 2012-03-16 2013-03-15 Système dentaire de réhabilitation implantaire comportant une prothèse fixe et son procédé d'application WO2013136309A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
IT000047A ITVR20120047A1 (it) 2012-03-16 2012-03-16 Impianto dentale mandibolare e metodo di applicazione dello stesso
ITVR2012A000047 2012-03-16
ITVR20120239 ITVR20120239A1 (it) 2012-03-16 2012-12-06 Sistema dentale per riabilitazione implantare a protesi fissa e metodo di applicazione dello stesso
ITVR2012A000239 2012-12-06

Publications (1)

Publication Number Publication Date
WO2013136309A1 true WO2013136309A1 (fr) 2013-09-19

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PCT/IB2013/052082 WO2013136309A1 (fr) 2012-03-16 2013-03-15 Système dentaire de réhabilitation implantaire comportant une prothèse fixe et son procédé d'application

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IT (2) ITVR20120047A1 (fr)
WO (1) WO2013136309A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3470011A4 (fr) * 2016-06-08 2020-02-19 Sunrise Associates Corporation Système de prothèse dentaire et prothèse utilisée dans le système de prothèse dentaire

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090325125A1 (en) 2007-10-19 2009-12-31 Cagenix, Inc. Dental Framework
EP2143398A1 (fr) * 2008-07-12 2010-01-13 Gerd Axel Dr. Walther Implant dentaire avec element intermédiaire élastique
DE102008058305A1 (de) 2008-11-17 2010-05-20 Übermuth, Tim, Dr. Verbindungsvorrichtung zur Befestigung einer dentalen Prothese an einem Kieferknochen und Verfahren zur Herstellung einer Verbindungsvorrichtung

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090263763A1 (en) * 2008-04-16 2009-10-22 Shepard John S Denture Abutment & Retention System

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090325125A1 (en) 2007-10-19 2009-12-31 Cagenix, Inc. Dental Framework
EP2143398A1 (fr) * 2008-07-12 2010-01-13 Gerd Axel Dr. Walther Implant dentaire avec element intermédiaire élastique
DE102008058305A1 (de) 2008-11-17 2010-05-20 Übermuth, Tim, Dr. Verbindungsvorrichtung zur Befestigung einer dentalen Prothese an einem Kieferknochen und Verfahren zur Herstellung einer Verbindungsvorrichtung

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3470011A4 (fr) * 2016-06-08 2020-02-19 Sunrise Associates Corporation Système de prothèse dentaire et prothèse utilisée dans le système de prothèse dentaire

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ITVR20120239A1 (it) 2013-09-17

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