WO2014142769A1

WO2014142769A1 - Early loading system for dental implants

Info

Publication number: WO2014142769A1
Application number: PCT/TR2014/000060
Authority: WO
Inventors: Akman Serhan
Original assignee: Akman Serhan
Priority date: 2013-03-12
Filing date: 2014-02-28
Publication date: 2014-09-18

Abstract

The invention is about the early loading(installation) system that makes it possible to achieve early loading dental implants to be used in the fields of surgical dentistry, prosthetic dental treatment, periodontics, maxillofacial surgery, maxillofacial prosthetics and orthopedics, plastic surgery areas of medicine and in the treatment of tissue deficiencies.

Description

DESCRIPTION

EARLY LOADING SYSTEM FOR DENTAL IMPLANTS

TECHNICAL FIELD

The invention is about the early loading system that makes it possible to achieve early loading dental implants to be used in the fields of surgical dentistry, prosthetic dental treatment, periodontics, maxillofacial surgery, maxillofacial prosthetics and orthopedics, plastic surgery areas of medicine and in the treatment of tissue deficiencies.

PRIOR ART

Dental implant is a treatment choice that should be considered primarily by the patients who have problems with chewing, speech, and aesthetic particularly because of missing teeth.

Today, dental implants are implemented within the protocol published in the 1960s by Branemark. According to the protocol osseointegration period must be completed without any installation after the implants surgically placed in the jaw bone.

Osseointegration means direct and continuous contact between the living bone tissue and the implant surface made of pure titanium. Branemark stated the time required for the completion of this process as3-4 months for the lower jaw and 6-8 months for the upper jaw.

The rationale behind this approach is the fact that micro-movement of the implant that may be caused by the functional forces on the bone-implant interface during wound healing may lead to the formation of fibrous tissue, which could lead to clinical failure, rather than, bone contact.

Bone healing is one of the most complex processes enabling the continuation of the original skeletal structures and functions. In addition. bone healing with the biomaterial makes this complex healing process even more difficult to understand. Bone healing mechanism occurs in two different ways; secondary healing as in the epiphysis plates of long bones and lower jaw condylar neck, and primary bone healing that occurs with the direct differentiation and mineralization of mesenchymal cells as seen in the face and skull bones. Osseointegration is a description that means the relation of bone with implant in addition to the running of this mechanism. Implant-bone healing follows the stages of bone healing except some important differences in. In this healing model, osseointegration, which is a result of hemostasis, is a functional and structural connection of the living bone and implant surface. Thus, this creates the most important difference.

While this definition of osseointegration explains the clinical observations on the stability of the implant properly, it does not explain the bone formation and the biological processes that control the continuity on the implant surface. Complex cellular and molecular chain of reactions occur during the preparation of implant site and subsequent to implant placement. These events are the primary bone healing and deposition of bone around the implant. This process depends on both time and dynamics. Maximum bone deposition was reported to occur in 3-4 months. After this time, the interface continuity is provided with the cycle of lifelong fixed resorption and new bone formation.

The first 72 hours : Blood clot formation and platelet activity

The first 4 weeks : The formation of granulation tissue; angiogenesis and

fibroplasia

3 weeks-2 months : Woven bone formation

2 months- 4 months : Lamellar bone replacement

4 months later : Ongoing bone remodeling

Woven bone gradually turns to lamellar structure of the bone with bone marrow and Havers structure from the second month.

Collagen fibrils packed in layers parallel with the changing course strengthens the lamellar bone. The newly formed lamellar bone has both the primary and secondary osteons in close contact with the implant surface to provide rigid fixation for loading the implant.

1. Primary implant stability; Of all the factors, primary implant stability is the most important determinant factors related to the instant installation. Functional load on a non-mobile implant is an inevitable requirement of obtaining osseointegration. Insufficient initial stability significantly increases the risk of implant failure. An extreme micro-motion or a move in the early stage of the recovery prevents the adhesion of fibrin clot to the surface of the implant and the bone-implant interface, so it can damage the healing phase by causing the formation of fibrous connective tissue on the bone-implant interface. Movements more than lOOprn, is sufficient enough to cause damage the improvement on the bone-implant interface. The movements over 150μιη have been reported to lead to the formation of fibrous capsule instead of osseointegration. A micro- movement over 150μιη due to the installation can be considered as harmful to the osseointegration in the instantly installed implants.

Some researchers hypothesized that immediately loaded implants to ensure extra stability confronted dense cortical bone in the apical and crest area. Biomechanicaly, the hypothesis that the bicortical placement concept is more valuable because the surface of the implant is in contact with more compact bone is still open to debate.

Factors Related to Patients

2.1. The Quality and Quantity of Bone; Clinically, the patient's bone density, plays an important role in determining the predictability of the success of the installing of the implant immediately. Load-carrying capacity of the cortical bone is higher than that of cancellous bone. Therefore, if immediately installed implant is thought, close trabecular structure in the cortical bone in the region where implant is planned should be preferred. Lekholm and Zarb divided jaw bone into four groups basing on the quality in their classification.

a) Almost all jawbone consists of homogeneous cortical bone.

b) There is thick cortical bone around the inner dense trabecular bone. c) There is thin layer of cortical bone around the inner dense trabecular bone.

d) There is thin layer of cortical bone around the inner low dense trabecular bone.

Thus, this type of uniform dense bone provides many advantages.for immediate or early installing of dental implants. While cortical lamellar bone recover near endosteal implant, it can recover ensuring good bone support with a small amount of woven bone formation. Moreover, when compared with thin, soft cancellous bone, it provides better mechanical locking. In fact, studies have shown that less dense bone can cause more failure of the implant even if late installing protocol is applied. ealing

ctors Related to the implant;

1. Implant Design / Configuration; The configuration of the implant is known to be an important factor for the success of the implant. In general, the screw-type implant design also provides greater mechanical retention as well as having more ability of transferring the pressure forces. Screw design not only minimizes micro-movement of the implant but also increases the primary stability, the essential requirement for the success of the installation. Also, the grooves contributes to the primary stabilization increasing the surface area. Studies have shown that fibrous tissue do not occur on the interface of the screw-shaped implants installed immediately.

. Implant Surface Coating; Rough surfaces are thought to stimulate osteo conduction and this is associated with new bone formation on the surface of the implant. The 3^rd phase of osseointegration, is the phase of the bone remodeling which is critical for the long-term stability. Installation of implants in this phase, creates a micro-motion. This may prevent adhesion of fibrin clot to the surface of the implant during early recovery period. Davis stated that the roughness of the implant surface will positively affect adhesion.

. Length of implant; The surface area of a cylindrical implant is increased by 20-30% on average with the increase in length in each 3 mm. 50% failure rate of immediately loaded short implants less than 10 mm have been reported in studies. In most studies, the length of the implant greater than 10 mm is recommended to ensure a high success rate.

tors Related to Occlusion

. Quality and Quantity of the Force

. Prosthetic Design BRIEF DESCRIPTION OF THE INVENTION

The invention is about the early installing system consisting of the apparatus which groove in the bone and enable graft to be located in the groove set and implant that make it possible to achieve early loading dental implants to be used without the need to wait for the required osseointegration period in the fields of surgical dentistry, prosthetic dental treatment, periodontics, maxillofacial surgery, maxillofacial prosthetics and orthopedics, plastic surgery areas of medicine and in the treatment of tooth and tissue deficiencies. A socket in which implants will be placed is prepared using drills in the bone where implants will be installed. Groove forming apparatus are used to create spiral graft groove in the apical, middle part and coronal of the implant socket. Spiral designed graft material is placed into the prepared graft groove using the graft placement apparatus. While the graft material is stable in the groove, implant is placed into the implant socket. When there is bone graft prepared spirally around the implant in the bone, the period of the prosthesis can be reduced safely. In order to apply the implant, early installment can be performed by placing the implant in the middle of the graft material which is in the form of a hollow flake and is odiametric to the socket bottom and will be placed close fit implant at the bottom of the implant socket drilled in the bone. However, such a stabilization system is disadvantageous in terms of implant design as regards to the structure that surrounds the implant spirally.

THE PROVISIONS OF THE FIGURES Figure 1 Perspective View of the Spiral Groove Preparation Apparatus

Figure 2 Perspective View of the Graft Placement Apparatus

Figure 3 Perspective View of the Graft

Figure 4 The View of Graft Placement into the Graft Placement Apparatus

Figure 5 Cross-section View Taken During the Implantation of the Graft Placed in the Graft Placement Apparatus and was being Placed into the Bone

Figure 6 Cross-section View Taken After the Implant was Placed in the Bone Provisions to as the part numbers are given below;

1. Spiral Groove Preparation Apparatus

1.1. Spiral Groove Kit

2. Graft Placement Apparatus

2.1. Graft Channels

2.2. Set

3. Implant

4. Bone

5. Graft

DETAILED DESCRIPTION OF THE INVENTION

The invention is composed of a spiral groove preparation apparatus (1 ) containing a groove set (1 ) that grooves spiral slots where spiral shaped graft (5) prepared for the implant (3) will be placed in the bone (4), graft conduit (2.1 ) for the placement of the graft (5) into the prepared spiral grooves and graft insertion apparatus(2) containing a set (2.2) that provides easy positioning the graft (5). A graft (5) that is thicker than the depth of the groove and compatible with the shape of the groove is placed by using the graft placement apparatus (2) into the groove formed with the help of the spiral groove preparation apparatus (1 ) in the slot where implant (3) will be installed in the bone (4).

In this way, early installment of the implant (3) can be performed safely placing the graft (5) into the socket surrounded with graft material.

The side of the graft(5) facing the graft canal on the graft placement apparatus (2) is compatible with the shape of the graft canal (2.1 ) and the side in the grooves of the socket in the bone(4) prepared for the implant(3) complies with the grooves and is thicker.

This extra thickness reduces of micro movement contacting the implant. Thanks to the set at the end point of graft canal (2.1 ) on the graft placement apparatus (2), spiral graft (5) material can be mounted easily onto the spiral placement apparatus.

The implant (3) slot is drilled with the help of surgical drills and physiodispenser. Spiral grooves are formed on the wall of the slot with the help of the spiral groove preparation apparatus(l ) including spiral diestock set (1.1 ). Spiral groove preparation apparatus(l ) forms the grooves compatible with the apical, middle part and spiral shaped graft material in the slot where implant(3) will be placed. The groove formed is a little thinner than the previously prepared graft (5) and conforms with its length.

The graft (5) placed in the graft canals (2.1 ) on the graft placement apparatus(2) is placed in the groove of the slot prepared for implant (3) installation. Thus, the graft (5) is positioned in the slot prepared to accommodate the implant (3) so that it can embrace circular all slot from apex to coronal. In this way, a structure, which surrounds the implant (3) all around with a graft (5) material in correct thickness and superior physical and biological properties is formed to enhance the stability of the implant(3). Implant (3) is placed tightly together with this structure into the insertion slot prepared for the implant. For this application, the implant (3) being cylindrical in shape and having no groove increases its stability.

Claims

C L A I M S

1. It is the early installation system for the dental implants and contains a spiral groove preparation apparatus (1 ) that opens the grooves in which graft will be placed in the slot where implant(3) will be positioned in the bone (4), and a graft placement apparatus(2) to place the graft into the prepared spiral grooves.

2. It is the graft placement apparatus (2) mentioned in claim 1 , and its property is characterized by the fact that it contains graft canals(2.1 ) that conveys graft to place it into the spiral grooves of the prepared implant slot.

3. It is the graft placement apparatus (2) mentioned in claim 1 , and its property is characterized by the fact that it is the part thick enough to screw down the implant into the spiral grooves of the prepared implant slot.

4. It is the graft (5) material mentioned in claim 1 , and its property is characterized by the fact that it is the material located spirally in the graft canals (2.1 ).

5. It is the graft (5) material mentioned in claim 1 , and its property is characterized by the fact that it is the material that surrounds all around the apical, middle part and coronal area of the implant.

6. It is the graft (5) material mentioned in claim 1 , and its property is characterized by the fact that it is the compatible with the shape of the prepared groove and is thicker than its depth.