WO2013138308A1 - Procédé et trousse pour guides de fraisage d'implant dentaire - Google Patents

Procédé et trousse pour guides de fraisage d'implant dentaire Download PDF

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Publication number
WO2013138308A1
WO2013138308A1 PCT/US2013/030453 US2013030453W WO2013138308A1 WO 2013138308 A1 WO2013138308 A1 WO 2013138308A1 US 2013030453 W US2013030453 W US 2013030453W WO 2013138308 A1 WO2013138308 A1 WO 2013138308A1
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WO
WIPO (PCT)
Prior art keywords
socket
drilling
probe
axis
tooth
Prior art date
Application number
PCT/US2013/030453
Other languages
English (en)
Inventor
Howard Ian KATZ
Original Assignee
Katz Howard Ian
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
Priority claimed from US13/420,536 external-priority patent/US8858228B2/en
Application filed by Katz Howard Ian filed Critical Katz Howard Ian
Publication of WO2013138308A1 publication Critical patent/WO2013138308A1/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
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • 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
    • A61C8/0001—Impression means for implants, e.g. impression coping

Definitions

  • This invention is in the field of dental implants and methods and kits to assist the dental implant process.
  • Dental implants have become popular in recent years as a way to provide permanent artificial teeth to patients who have lost their original teeth and teeth roots.
  • the basic concept is fairly simple.
  • the dentist drills into the patient's jaw bone and implants an artificial tooth root, often made of titanium or other strong biocompatible material, which essentially resembles a small threaded screw.
  • Natural bone by a process called osseointegration, then fuses with this screw like artificial root.
  • An artificial crown can then in turn be screwed into the artificial root, and to all intents and purposes, the dental implant then performs like a natural tooth.
  • the implant process can commence soon after tooth extraction.
  • the empty tooth socket may have to be first filled with artificial bone material. Over the course of a few months, the artificial bone filled empty socket will gradually fill in with new natural bone. The implant can then be drilled into this new natural bone.
  • the present practice is to use computerized tomography and 3D materials fabrication technology (e.g. computer controlled steriolithography, CNC machining, and the like) to create a custom implant drilling guide.
  • computerized tomography and 3D materials fabrication technology e.g. computer controlled steriolithography, CNC machining, and the like
  • 3D image information on the structure of the patient's jaw is used to determine the optimum drilling angle, and the computer controlled fabrication technology is then use to create a custom drilling guide.
  • Such computerized tomography devices and 3D fabrication methods are very expensive, and as a result, implant guides alone can often cost around $1000 or more.
  • the dentist, oral surgeon, or peridontist can attempt to drill guided only by professional judgment and standard dental X-rays, and assume the risk of problems and complications that may result. However this is not a risk that most general dentists, or their insurance providers, usually wish to assume.
  • the present invention is based, in part, on the insight that the patient's natural tooth socket, and in particular the hole in the bone (root socket, extraction socket) left over when the patient's natural tooth root has been extracted, either itself a good location to subsequently locate an implant screw (at least once this natural root socket has filled in with new bone) or is at least an excellent reference point by which to locate the subsequent implant screw.
  • natural tooth root originally avoided any critical structures such as nerves, and was usually well positioned with respect to the other surrounding bone.
  • an excellent implant screw location can be found by a simple angle or distance offset from the original natural tooth socket.
  • the present invention is also based, in part, on the insight that present practice, which typically determines the optimum angle for implant screw insertion days, weeks, or months after the natural tooth has been extracted, is suboptimum. Rather, the optimum time to determine the angle, depth, and location of the natural root socket is immediately after the natural tooth has been extracted.
  • the invention is a method and kit for determining the angle, depth, and location of the natural root socket immediately after (or at least relatively soon after) extraction of the natural tooth. Once this angle, depth, and location information has been determined, the invention further provides a means to quickly produce an implant drilling guide or position fixation device that captures this information, and makes it available to guide subsequent implant drilling up to months and even years later.
  • the record of the position and depth of the original tooth socket is well suited for providing a convenient reference for the subsequent implant drilling procedure
  • the invention's method and kit is designed to function using equipment typically available in general dentistry offices, such as standard X-ray equipment, and the like, and does not require use of sophisticated and expensive computerized tomography and computer controlled plastics fabrication equipment.
  • the invention's method and kit is also designed to be simple enough to be operated by general dentists, although of course it may also be used by oral surgeons, peridontists, and other specialists as well.
  • the invention may be a method and kit for drilling a dental implant socket for a dental implant screw in the mouth of a patient.
  • This method will generally comprise extracting a tooth from patient's lower or upper jaw, thereby forming an extraction socket with at least one tooth root socket.
  • This tooth root socket will correspond to the position of at least one root of the extracted tooth.
  • the practitioner will place a specially designed post device into the appropriate tooth root socket.
  • the invention's post device is configured to determine the depth and angle of the tooth root socket (relative to the patient's jaw and teeth). This post device will often also be configured to help generate a template for guiding a drill bit for drilling a dental implant socket at an optimal angle and depth for a dental implant screw.
  • the optimal angle and depth for the dental implant screw need not always be the same angle and depth of the tooth root socket.
  • the present invention teaches an alternative approach, in which instead a plurality of different post devices may be devised with built-in different angle and orientation offsets for this purpose. The method will then use a position fixation device or guide to preserve the position and orientation of this post device relative to the patient's jaw and teeth. After this is done, the post device may be removed from the patient's mouth. The position fixation device may then be subsequently used by a practitioner to guide a drill bit to the optimal angle and depth to drill a socket in the jaw for a dental implant screw.
  • the post device may comprise a bottom probe portion and a top drilling orientation portion.
  • the bottom probe portion may comprise an elongated probe with a probe axis. This bottom probe will generally have at least one radius small enough to penetrate substantially to the bottom of the tooth root socket.
  • the top portion (top drilling orientation portion) of the post device may comprise a larger radius or diameter portion with its own unique drilling axis. This drilling axis need not be collinear or even parallel with the probe axis on the bottom of the post device (which lines up according to the tooth root socket).
  • the drilling axis may be offset from the probe axis and/or additionally may be set at a different angle from the probe axis.
  • This top drilling orientation portion is generally configured to protrude outside of the tooth root socket, so that the various position fixation devices can use and preserve the direction and orientation of the top drilling orientation portion of the post device for subsequent use in drilling sockets for the various dental implant screws.
  • a family of such post devices may be produced and sold in kit form, along with ancillary equipment.
  • this family of post devices may, for example, be configured for at least some of the various positions that different human teeth occupy in human jaws, wherein for the individual post device in the plurality of post devices, the extent to which the drilling axis is offset from with the probe axis and the extent to which the drilling axis is not at the same angle as the probe axis, may be pre-determined based on either considerations of typical human jaw and tooth anatomy, considerations of atypical human jaw and tooth anatomy, or considerations of the patient's individual jaw and tooth anatomy.
  • the post device may have x- ray visible depth markers, at least on the probe portion, so that the depth of the post device may be X-ray visualized in the root of the patient's tooth immediately after tooth extraction.
  • This post device along with guideblocks, optional washers, reduction or expansion guides, and optional rapidly hardening position fixation devices or guide materials (such as acrylics or thermosetting materials) may be used to construct a removable position fixation device or guide that anchors to the patient's adjacent teeth, and preserves the location and orientation of the extracted tooth root. Often the tooth root and socket is then filled in with new bone and allowed to heal.
  • the guide When the practitioner then desires to drill the dental implant socket, the guide, often in conjunction with the X-ray post depth information, can be used to direct drilling along the same route as the old tooth root, thus avoiding critical structures.
  • the position fixation device or guide may be used to direct drilling to certain regions of the jaw bone, such as the interradicular bone, where implants may be safely implanted before the roots of the extracted tooth are filled in with new bone.
  • Figure 1 shows the method in operation on a lower first molar tooth socket, using an offset post device where the direction of the drilling axis, formed by the top drilling orientation portion of the post device is offset, relative to the probe axis (of the bottom probe portion), in a lingual direction so that the drill can drill into the anatomically safe region formed by the jaw bone between the two molar tooth root sockets.
  • Figure 2 shows the method in operation on an upper lateral incisor tooth socket, using an angled post device where the angle of the drilling axis formed by the top drilling orientation portion of the post device is offset, relative to the probe axis (of the bottom probe portion), in a lingual direction to avoid having the drill accidentally drill outside of the jaw bone in the facial direction, as well as to avoid subsequent facial bone resorption.
  • Figure 3 shows a schematic cross section of an upper molar tooth, illustrating the very narrow distance between the end of the tooth root and the beginning of the patient's open sinus region.
  • the angle of the top orientation portion of the post device is offset from the angle of the post device's probe axis.
  • Figure 4 shows a schematic drawing of the teeth in a normal adult human jaw, showing the typical offset considerations between the drilling axis of the top orientation portion of the post device, and the angle of the post device's probe axis (of the bottom probe portion), needed for various post devices optimized for drilling implant sockets for the various typical tooth positions.
  • Such considerations can be used to provide kits consisting of a plurality of various different post devices, with structures optimized for various tooth positions.
  • Figure 5 shows a detailed engineering drawing of a first type of post device where the drilling axis of the top orientation portion of the post device is not offset in either angle or direction from the device's bottom probe portion probe axis.
  • Figure 6 shows a detailed engineering drawing of a second type of post device where the drilling axis of the top orientation portion of the post device forms an angle that is offset from the angle of the device's bottom probe portion probe axis.
  • This post device can also accept an open U-shaped drill guide sleeve which allows drill entry from the open side, as compared to a closed ring drill guide where the drill has to enter from the top.
  • Figure 7 shows a detailed engineering drawing of a third type of post device where the drilling axis of the top orientation portion of the post device is offset (i.e., not collinear with) by some distance from the device's bottom probe portion probe axis.
  • Figure 8 shows an example where a circular O-shaped guide sleeve, which can be used as part of the position fixation device to preserve the position and orientation of the post device relative to the jaw bone, additionally comprises some surface appendages or attachments to help further stabilize the position and orientation of the sleeve and post device relative to adjacent teeth.
  • Figure 9 shows an example of a drill reduction guide tool, useful for the method, that both centers multiple drill sizes in various guide sleeves for implant socket drilling, while also at the same time has a unique branched wheel type design with multiple arms where some of the arms can also be also used to help reposition the soft tissues of the patient's mouth (i.e. inner cheeks, tongue, and the like) during the procedure.
  • Figure 10 shows an example of a parallel wishbone guide that facilitates drilling of adjacent parallel implant sockets for bridge type implants spanning more than one tooth.
  • the wishbone guide may be used to drill a parallel implant socket in the next tooth, while in other embodiments; the wishbone guide may have a wider separation to enable parallel implant bridges to skip over a missing tooth.
  • the invention may be a method of aligning a dental implant based upon the position and depth of the natural tooth socket at the time of tooth extraction.
  • the invention may also be a kit of components to accomplish this method.
  • the method will generally comprise or at least start by extracting a tooth from the jaw of a human patient. This patient will generally have a fair number of other teeth, usually including other teeth reasonably adjacent to the empty tooth socket left in the patient's jaw, after the tooth has been extracted.
  • this extraction socket will in turn typically contain at least one tooth root socket in the jaw bone corresponding to the position of at least one root of the extracted tooth.
  • a post device is placed into this at least one tooth root socket. This post device is generally configured to determine the depth and angle of this tooth root socket relative to the patient's jaw bone (e.g. relative to the position of nearby remaining teeth adjacent to the extraction socket and tooth root socket, which in turn are anchored firmly to the patient's jaw bone).
  • the post device used for this method is typically configured to also serve as a template for guiding a drill bit for drilling a dental implant socket at an optimal angle and depth for a dental implant screw for that particular tooth socket.
  • the optimal angle and depth will generally be one that will both avoid vital structures (i.e. nerves, sinus cavities, blood vessels) and which will also remain inside the bone (i.e. not accidentally penetrate outside the jaw bone).
  • the dental implant socket should also serve as a good foundation for the dental implant screw that will be later placed in the dental implant socket. Thus the surrounding bone should ideally not be too thin.
  • the optimal angle and depth for the dental implant screw need not be exactly the same as the angle and depth of the original tooth root socket. That is, although tooth root socket locations are often excellent choices (generally after they have been filled in with bone or artificial bone), for drilling subsequent dental implant sockets, this is not always the case. Often other anatomical considerations require that the dental implant socket be displaced from the location or the angle of the original tooth root socket by some precise and defined amount.
  • the position and orientation of this post device, relative to the patient's jaw bone and adjacent teeth can then be preserved by a position fixation device or guide device.
  • the post device can then be removed from the patient's mouth.
  • the position fixation device will also usually be removed from the patient's mouth as well, and then preserved for later use.
  • the position fixation device may then be reapplied to the patient's mouth, and this position fixation device can then be used to guide a drill bit (for drilling the dental implant socket) to the optimal angle and depth for a dental implant screw.
  • the post device may be a linear pole-like device that tends to fix the drilling angle of the guide drill bit at the same angle as the original root socket of the extracted tooth, other post device configurations are also possible.
  • a post device comprising a bottom probe portion that in turn is affixed to a top drilling orientation portion.
  • the bottom probe portion of the post device can comprise an elongated probe with a probe axis. This probe portion will generally have at least one radius small enough to penetrate substantially to the bottom of the empty tooth root socket.
  • the post device can additionally comprise a top drilling orientation portion with a larger radius or diameter portion.
  • the top drilling orientation portion of the post device can have its own drilling axis that is distinct from the probe axis, and this top drilling orientation portion will typically be configured to protrude outside of the tooth root socket.
  • This drilling axis may be (although it need not be) offset from the probe axis, and further this drilling axis need not be at the same angle as the probe axis.
  • the extent to which the drilling axis is offset from the probe axis, and wherein the extent to which the drilling axis is not at the same angle as the probe axis can be determined by the optimal displacement, angle and depth for a dental implant screw relative to the position of the tooth root socket.
  • the practitioner will typically determine the patient's particular tooth and jaw anatomy, and select an appropriate post device with the space offsets and angle offsets appropriate for the situation (i.e. offsets that will give the best results for drilling the dental implant screw later).
  • the practitioner can then place the appropriate post device into the empty tooth root socket, record the position of the post device, as well as the space offsets and angle offsets provided by the top orientation portion of the post device, and later use this to determine the extent to which the drilling axis (for the dental implant socket for the dental implant screw) is not at the same location and angle as the probe axis.
  • Figure 1 shows the method in operation on a lower first molar tooth socket, using an offset post device.
  • the direction of the drilling axis formed by the top drilling orientation portion of the post device is offset, relative to the probe axis (of the bottom probe portion), in a lingual direction so that the drill can drill into the anatomically safe region formed by the jaw bone between the two molar tooth root sockets.
  • FIG 1 the lower first molar tooth has been extracted, resulting in an empty tooth socket (102).
  • An offset type probe device here consisting of a bottom probe portion (104) and a top drilling orientation portion (106), and often some smaller "O" rings (114) around the bottom probe portion (104) is lowered into a suitable root socket in the empty tooth socket (102).
  • This is shown in a somewhat magnified view in (110).
  • the location of the two empty root sockets is shown by dotted lines (1 12).
  • the axis of the top drilling orientation portion (106) of the probe device is clearly offset from the axis of the bottom probe portion (104).
  • This type of offset probe device generally corresponds to the lateral placement probe device shown in more detail in figure 7.
  • O-rings (1 14) help center the post in the socket and also help protect the empty tooth socket bony walls (112) from damage due to the bottom probe portion of the post device (104).
  • These O-rings will often be made from somewhat flexible material such as elastic-or semi-elastic material.
  • a guide sleeve (122) is then lowered into position over the top drilling orientation portion of the probe device. This guide sleeve in position is then shown in (130) as (132).
  • This position fixation device (142) stabilizes the position of the guide sleeve (132), and therefore also the top orientation portion of the probe device (106) relative to the position of at least some of the patient's other teeth adjacent to the empty tooth socket (102).
  • this position fixation device or guide (142) may be constructed using a flexible but rapidly hardening material, such as an acrylic or thermoplastic guide material, to construct a position fixation device or guide that contacts at least some of the outer surface of the guide sleeve (132) as well as the outer surface of at least some of the teeth adjacent to tooth socket (102).
  • the position fixation device (142) After it has hardened and is rigid, locks the guide sleeve (132) into position relative to the patient's adjacent teeth, and the hole the guide sleeve (132) in turn preserves the position and orientation top drilling orientation portion of the probe device (106) which in turn is determined by the position and orientation of the patient's natural tooth root socket (112).
  • the position fixation device generally comprises a deformable plastic material configured to adhere to the patient's teeth proximate to the extraction socket in the patient's jaw bone.
  • the position fixation device generally grips the guide sleeve (132), so that the guide sleeve itself may become part of the position fixation device as well.
  • This guide sleeve in turn holds both the top drilling orientation portion of the post device, and the deformable plastic material.
  • the practitioner may also take standard dental X-rays, or other X-rays as desired, to determine the depth of the post device in the empty tooth socket (112). This can be used later to determine a safe drilling depth for the dental implant.
  • X-ray film or a solid state X-ray detector can be placed inside the patients mouth near the post, exposed with X-rays from outside the mouth (not shown), and the film or X-ray detector, when analyzed will show the relative depth of the post in the root socket. This information will often be preserved for the subsequent drilling step.
  • the post device will often made of a radio opaque material such as aluminum, or plastic doped with a radio opaque material.
  • the post may have a number of X-ray visible markers, such as detents or grooves positioned along the length of the post.
  • the dentist or other practitioner can, after inserting the post, take standard dental X-ray images of the post, and by counting grooves, detents or other X-ray visible markers determine the depth of the natural root socket, and this information in turn can be used later to guide the implant drilling process.
  • the position fixation device (142) Once the position fixation device (142) is fully formed, it then may be removed from the patient's mouth, along with the probe device. Often the tooth extraction socket will then be filled in (e.g. with bone or other material intended to encourage bone regrowth and healing), and allowed to heal. This healed tooth extraction socket is shown in figure 1 (150) as (152).
  • the position fixation device (142) may then be reapplied to the patient's mouth, and usually anchored relative to the teeth adjacent the tooth extraction socket, as shown in Figure 1 (160).
  • a drill reduction guide tool (162) may be placed into the hole in the guide sleeve (132), as is shown in (160) and (170).
  • Figure 2 shows the method in operation on an upper canine lateral incisor tooth socket, using an angled post device where the angle of the drilling axis formed by the top drilling orientation portion of the post device is offset, relative to the probe axis (of the bottom probe portion), in a lingual direction to avoid having the drill accidentally drill outside of the jaw bone in the facial direction, as well as to avoid subsequent facial bone resorption.
  • Dental implants are seldom placed in the center of teeth sockets when the facial bony wall is thin. This is because the facial bony wall usually has inadequate support strength, and, the facial bone usually resorbs after implant placement, exposing the outer surfaces of the implant to the oral environment. Thin facial bone walls are typical of most teeth especially incisors, cuspids and bicuspids. All of these teeth require that the implant to be angled or positioned away from the facial bony wall. Therefore this type post device would be used to offset the angle of the drill guide in the desired orientation.
  • the method shown in figure 2 is generally similar to those previously shown in figure 1, with the exceptions that in figure 2, here the method is optimized to allow the practitioner to drill a dental implant socket for an upper lateral incisor top canine tooth.
  • an alternate type of probe device generally similar to the angled probe device shown in figure 6, is often more appropriate. This is because due to the different anatomy of the jaw in the canine tooth region, it is usually preferable to angle the direction of the drill for the dental implant screw somewhat inward towards the lingual direction (i.e. back of the patient's throat) to avoid inadvertently drilling through the front of the patients jaw.
  • the direction of the drill for the dental implant screw somewhat inward towards the lingual direction (i.e. back of the patient's throat) to avoid inadvertently drilling through the front of the patients jaw.
  • the lingual direction i.e. back of the patient's throat
  • a probe device in which the drilling axis of the top drilling orientation portion of the probe device is not at the same angle as the angle of the bottom probe axis of the device is used.
  • the drilling axis of the top drilling orientation portion of the probe device will (once the location is preserved by the position fixation device) guide the drill for the dental implant screw somewhat away from the front of the patient's mouth, gently angled towards the back lingual portion of the mouth, thus ensuring that the drill will not go through the front of the patient's jaw and mouth.
  • the other steps (220-270) are otherwise similar to those previously shown in figure 1.
  • Figure 3 shows a schematic cross section of an upper molar tooth (300), illustrating the very narrow distance between the end of the tooth root (302) and the beginning of the patient's hollow sinus region (304). Note that accidentally drilling into the sinus region is highly undesirable.
  • the patient's jaw bone is shown in cross section as (306).
  • the angle of the drilling axis of the top orientation portion of the post device is offset (308) from the angle of the post device's probe axis (310).
  • Figure 3 shows the approximate position and scale of a suitable probe device, generally designed according to the angled probe device shown in figure 6, and the corresponding positions of the probe axis (310) and drilling axis (308).
  • This probe device (312) will fit into the extraction socket and root socket that is formed when tooth (300) is removed.
  • a guide sleeve (314) will cover the top drilling orientation portion (316) of probe device (312), and the position and orientation of this guide sleeve will be preserved by the position fixation device (318) (shown in cross section) that will anchor the guide sleeve relative to adjacent teeth (not shown).
  • the practitioner will often insert a drill reduction guide tool (320) into the center hold in the guide sleeve.
  • the net result is to position the center hole of the guide sleeve and drill reduction tool as to effectively guide a drill bit (322) down the same drilling axis (308) originally determined by probe device (312).
  • the kit may also contain various washers, guide sleeves, open guide sleeves (for side drilling, to be discussed), position location device materials, and other materials.
  • Figure 4 shows a schematic drawing of the teeth in a normal adult human jaw, showing the typical offsets between the drilling axis of the top orientation portion of the post device and the angle of the post device's probe axis (of the bottom probe portion) needed for various post devices optimized for various typical tooth positions.
  • Such considerations can be used to provide kits consisting of a plurality of various different post devices, with structures optimized for various tooth positions.
  • the post device used for a particular tooth implant may be selected from a kit of various different standard post devices configured for at least some of the various positions that different human teeth occupy in human jaws.
  • the extent to which the post device's drilling axis is offset from the post device's probe axis and the extent to which the post device drilling axis is not at the same angle as the post device's probe axis may often be pre-determined based on either considerations of typical human jaw and tooth anatomy, considerations of atypical human jaw and tooth anatomy, or considerations of that particular patient's individual jaw and tooth anatomy.
  • Figure 5 shows a detailed engineering drawing of a first type of post device where the drilling axis of the top orientation portion of the post device is not offset in either angle or direction from the device's bottom probe portion probe axis.
  • This drawing shows the device from the bottom (500), three various sides (502), (504), (506), the top (508) and in perspective (510).
  • the top drilling orientation portion is shown as (512), and the bottom probe portion is shown as (514).
  • the bottom probe portion may have optional indentations or indicia every few millimeters (516), such as every three millimeters, to help determine the distance to the bottom of the tooth root socket.
  • the top orientation portion of the device may additionally have various indicia and features (518) to help the dentist determine the orientation of the probe portion and probe axis relative to the orientation of the top drilling orientation portion and the drilling axis.
  • the indicia or features can also help remind the dentist what type of probe device is in use.
  • a triangular indicia or feature is shown (518).
  • the drilling axis is at the same orientation and angle as the probe axis.
  • figure 6 shows a detailed engineering drawing of a second type of post device where the drilling axis of the top orientation portion of the post device forms an angle that is offset from the angle of the device's bottom probe portion probe axis.
  • This type of device although not identical in all aspects, was previously shown in figure 2.
  • This drawing shows the device from the bottom (600), three various sides (602), (604), (606), the top (608) and in perspective (610).
  • the top drilling orientation portion is shown as (612), and the bottom probe portion is shown as (614). Note that the top drilling orientation portion has a different angle from the bottom probe portion, and thus the drilling axis of this portion is different from the probe axis of the bottom probe portion (614).
  • the bottom probe portion may have optional indentations or indicia every few millimeters, such as every three millimeters, to help determine the distance to the bottom of the tooth root socket.
  • the top orientation portion of the device may additionally have various indicia and features (618) to help the dentist determine the orientation of the probe portion and probe axis relative to the orientation of the top drilling orientation portion and the drilling axis.
  • the indicia or features can also help remind the dentist what type of probe device is in use.
  • a square indicia with various markings or features is shown (618).
  • the drilling axis is at a different orientation and angle from the probe axis, it is important for the dentist to clearly see which way the angle goes. This is done by the protruding square feature (620), positioned opposite the angle bend. This feature (620) also helps prevent the post device from rotating when the position fixation device is used to preserve the position and orientation of the post device relative to the patient's teeth and jaw bone.
  • an asymmetric top drilling orientation portion (612) such as this is used, often the guide sleeve will also have a similarly asymmetric hole to fit closely over the asymmetric top drilling orientation portion.
  • the post device when the post device is in the socket and the metal sleeve is attached to the position fixation device, all that is visible is the protruding square feature with the orientation markings. These markings indicate the exact spatial positioning of the post and guide relative to the jawbone. The dentist does not have to remove the entire assembly from the socket to confirm that the angulation of the post probe is correct.
  • Figure 7 shows a detailed engineering drawing of a third type of post device where the drilling axis of the top orientation of the post device is offset (i.e., not collinear with) by some distance from the device's bottom probe portion probe axis.
  • This type of offset device (although not identical in all aspects) was previously shown in figure 1.
  • This drawing again shows the device from the bottom (700), three various sides (702), (704), (706), the top (708) and in perspective (710).
  • the top drilling orientation portion is shown as (712)
  • the bottom probe portion is shown as (714). Note that the top drilling orientation portion is displaced from the bottom probe portion, and thus the drilling axis of this portion is displaced from the probe axis of the bottom probe portion (714).
  • the bottom probe portion may have optional indentations or indicia every few millimeters, such as every three millimeters, to help determine the distance to the bottom of the tooth root socket.
  • the top orientation portion of the device may additionally have various indicia and features (718) to help the dentist determine the orientation of the probe portion and probe axis relative to the orientation of the top drilling orientation portion and the drilling axis.
  • the indicia or features can also help remind the dentist what type of probe device is in use.
  • a square indicia with various markings or features different from those shown previously is shown (718).
  • the drilling axis is offset from the probe axis, it is again important for the dentist to clearly see which way the offset goes.
  • This feature (720) also helps prevent the post device from rotating when the position fixation device is used to preserve the position and orientation of the post device relative to the patient's teeth and jaw bone.
  • an asymmetric top drilling orientation portion (712) such as this is used, often the guide sleeve will also have a similarly asymmetric hole to fit closely over the asymmetric top drilling orientation portion.
  • Figure 8 shows an example of an alternate guide sleeve (800) configuration.
  • this guide sleeve may later also be used as part of the position fixation device to preserve the position and orientation of the post device relative to the patient's jaw and teeth.
  • this alternate device additionally comprises various surface appendages or attachments (802), such as bendable plastic or metal wires or other protruding fixtures, to help further stabilize the position and orientation of the guide sleeve and the inside post device relative to the patient's adjacent teeth.
  • attachments can also block out undercut surfaces on the adjacent teeth so that the position fixation device can be easily removed after fabrication.
  • guide sleeves can be made of a variety of materials, such as stainless steel, plastic, or other materials.
  • one side of the guide sleeve may be open, thus allowing the dentist to apply an angled drill from the side of the guide sleeve, rather than from the top.
  • This side opening type guide sleeve is particularly useful for working in tight spaces in the mouth, where there may not be enough room to work to apply the drill from the top of the guide sleeve opening.
  • Figure 9 shows an example of a drill reduction guide tool, useful for the invention's method, that both centers multiple drill sizes in various guide sleeves for implant socket drilling, and also at the same time has a unique branched-wheel type design with multiple arms where some of the arms can also be also used to help reposition the soft tissues of the patient's mouth during the procedure.
  • the diameter of the various drill bit openings (901) is shown in millimeters (902).
  • the protruding drill guides, which fit inside the guide sleeves, are also shown (906).
  • the drill guide has an overall diameter of about 90 millimeters (908), and the distance between the various "Y" branching is about 16.5 millimeters (910).
  • Other dimensions and configurations may also be used.
  • the dental implant screws may be used to support bridges spanning multiple teeth. In this sort of situation, often two dental implant screws are used, and it is important that the sockets for the two dental implant screws be precisely parallel. To assist in this process, it may additionally be useful to use another type of guide to insure that parallel holes are drilled, such as the "wishbone" shape guide shown in Figure 10.
  • Figure 10 shows an example of a parallel wishbone guide that facilitates drilling of adjacent parallel implant sockets.
  • the wishbone guide may be used to drill a parallel implant socket in the next tooth, while in other embodiments; the wishbone guide may have a wider separation to enable parallel implant bridges to skip over a missing tooth.

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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

L'invention concerne un procédé et une trousse pour produire des guides de fraisage d'implant positionnés à l'orientation appropriée pour éviter des dommages involontaires à des régions importantes de la mâchoire du patient lors du fraisage pour placer des vis d'implant dentaire. Un petit dispositif de tenon ayant des marqueurs de profondeur visibles aux rayons X est placé dans l'alvéole de la racine de la dent du patient immédiatement après l'extraction de la dent. Le dispositif de tenon peut être configuré pour guider le fraisage à des positions et à des angles qui sont différents de ceux de l'alvéole de la dent d'origine. Ce dispositif de tenon est utilisé pour construire un guide amovible qui se fixe aux dents adjacentes du patient et conserve l'emplacement et l'orientation de la racine de la dent extraite. Une fois que l'alvéole de la racine est remplie avec un nouvel os, le guide, conjointement avec les informations de profondeur de tenon à rayons X, peut être utilisé pour diriger le fraisage le long de la même trajectoire que la racine de l'ancienne dent, évitant ainsi des structures importantes.
PCT/US2013/030453 2012-03-14 2013-03-12 Procédé et trousse pour guides de fraisage d'implant dentaire WO2013138308A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/420,536 2012-03-14
US13/420,536 US8858228B2 (en) 2011-03-28 2012-03-14 Method and kit for dental implant drilling guides

Publications (1)

Publication Number Publication Date
WO2013138308A1 true WO2013138308A1 (fr) 2013-09-19

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113876428A (zh) * 2021-12-08 2022-01-04 极限人工智能有限公司 一种种植手术过程可视化方法、装置及手术机器人

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0694292A1 (fr) * 1994-07-27 1996-01-31 David A. Gelb Guide radiographique pour déterminer la profondeur et le positionnement d'une prothèse
US6319006B1 (en) * 1999-11-03 2001-11-20 Sirona Dental Systems Gmbh Method for producing a drill assistance device for a tooth implant
WO2009001007A2 (fr) * 2007-06-11 2008-12-31 Bousquet Frederic Procede de fabrication d'un gabarit de forage pour la pose d'implant dentaire, et dispositif de tuteur pour sa mise en oeuvre
US20100035201A1 (en) * 2008-08-10 2010-02-11 Israel Beck Universal Template Enabling Drilling and Placing a Dental Implant Into A Patient's Jaw
DE102010013411A1 (de) * 2010-03-30 2011-12-15 Karsten Baumann Verfahren zur Anfertigung einer Bohrschablone

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0694292A1 (fr) * 1994-07-27 1996-01-31 David A. Gelb Guide radiographique pour déterminer la profondeur et le positionnement d'une prothèse
US6319006B1 (en) * 1999-11-03 2001-11-20 Sirona Dental Systems Gmbh Method for producing a drill assistance device for a tooth implant
WO2009001007A2 (fr) * 2007-06-11 2008-12-31 Bousquet Frederic Procede de fabrication d'un gabarit de forage pour la pose d'implant dentaire, et dispositif de tuteur pour sa mise en oeuvre
US20100035201A1 (en) * 2008-08-10 2010-02-11 Israel Beck Universal Template Enabling Drilling and Placing a Dental Implant Into A Patient's Jaw
DE102010013411A1 (de) * 2010-03-30 2011-12-15 Karsten Baumann Verfahren zur Anfertigung einer Bohrschablone

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113876428A (zh) * 2021-12-08 2022-01-04 极限人工智能有限公司 一种种植手术过程可视化方法、装置及手术机器人

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