WO2015185599A1

WO2015185599A1 - Permanent implant for bone regeneration

Info

Publication number: WO2015185599A1
Application number: PCT/EP2015/062335
Authority: WO
Inventors: Domonkos Horvath
Original assignee: Celgen Ag
Priority date: 2014-06-04
Filing date: 2015-06-03
Publication date: 2015-12-10
Also published as: EP3151779A1; DE102014008502A1

Abstract

The present invention relates to an implant for bone distraction, comprising an implant body and a distraction membrane. The implant body has a bone anchor element and an abutment, at least one portion of the surface of the bone anchor element being rough and/or coated and at least one portion of the surface of the abutment being smooth. The invention also relates to the use of such implants, in particular for bone distraction and/or as a permanent implant, and to methods for bone distraction using an implant according to the invention.

Description

Permanent implant for bone regeneration Description

The present invention relates to an implant for bone distraction, comprising an implant body and a Distraktionsmemb- ran, wherein the implant body comprises a bone anchoring element and a structure, wherein at least a portion of the surface of the bone anchoring element is rough and / or coated and wherein at least a portion of the surface of the Construction is smooth. Furthermore, the invention relates to the use of such implants, in particular for bone distraction and / or as a permanent implant and method for bone distraction by means of an implant according to the invention.

In order to be able to permanently and firmly fix implants in a jaw, the jawbone at the appropriate place must be both thick enough and strong enough. So there must be bones of sufficient quantity and quality.

If not enough bone is available for the secure anchoring of a sufficiently large or long implant, a so-called jawbone structure must be made. In particular, the extraction at bone height is considered problematic. For bone extraction different methods are used.

The callus distraction by means of an artificial membrane is becoming increasingly important.

The callus distraction itself has been known for over a hundred years. The most important biological stimulus for bone formation is the mechanical load. This releases piezoelectric forces that activate osteoblasts and osteoclasts. Distraction osteogenesis induces new bone formation by inducing biological growth stimuli through slow separation of bone segments. By this method, the direct formation of braid bones is achieved by distraction. The defined tension in the bone generation is essential. If such a defined tensile stress is applied to bone fragments, then the mesenchymal tissue in the gap and at the adjoining fragment ends exhibits an osteogenic potential. When there is sufficient vascular potency, progressive distraction results in metaplasia of the organized hematoma, also called blood coagulum, in a zone of longitudinally-arranged, fibrous tissue that can transform directly into cortical bone under optimal external and internal conditions. To make matters worse, however, that the bone tissue undergoes highly complex control during its regeneration. WO 03/051220 A2 describes by way of example a method for distraction of a jaw bone by means of bone segments. DE 10 2010 055 431 A1, WO 01/91663 A1 and US Pat. No. 5,980,252 describe devices and methods for callus traction by means of artificial interfaces, for example membranes. US Pat. No. 6,537,070 B1 discloses a multipart implant which is intended to generate a distraction osteogenesis by unscrewing the individual parts. However, this is limited at most to the direct area of the implant thread.

In addition, the present Applicant proposes an implant in an as yet unpublished state of the art, comprising Send an implant body and a Distraktionsmennbran, wherein the distraction membrane along a portion of the longitudinal axis of the implant body can be moved. The implant is intended primarily as a temporary, which is to be replaced by a later permanent implant.

The technical problem underlying the present invention is to provide improved means and methods for dental implantation and bone distraction that enable implantation procedures and jaw bone regeneration procedures to be overcome that overcome the disadvantages of the prior art.

The technical problem underlying the present invention is the provision of means and methods that allow to perform a simplified dental implantation when the jawbone has to be built up.

The technical problem underlying the present invention is also the provision of distraction devices which have a simple and safe construction.

Above all, the technical problem underlying the present invention can also be seen in providing devices and methods in which a bone structure necessary by implanting a dental implant can be achieved by means of distraction osteogenesis in such a way that a permanent implant can already be set during the distraction. The present invention solves the underlying technical problem in particular by the provision of implants, methods and uses according to the claims.

The present invention solves the technical problem on which it is based, in particular by providing a bone distraction implant comprising an implant body and a distraction mesh, the implant body comprising a bone anchoring element and a structure, wherein at least a portion of the surface of the bone anchoring element is rough and / or coated and wherein at least a portion of the surface of the construction is smooth.

In a preferred embodiment, the distraction membrane is reversibly connectable to the implant body.

In a preferred embodiment, the implant comprises an implant body and a distraction membrane, wherein the implant body comprises a bone anchoring element and a structure and wherein the distraction membrane is connected to the implant body via a connecting element, wherein the connecting element is movably arranged over a first portion of the longitudinal axis of the implant body and wherein the movable arrangement of the connecting element permits displacement of the distraction membrane along a longitudinal axis section of the implant body, wherein at least a portion of the surface of the bone anchoring element is rough and / or coated, and wherein at least a portion of the surface of the structure is smooth. In a preferred embodiment, it is a dental implant. In a preferred embodiment, it is a durable dental implant.

In the context of the present invention, a "dental implant" is understood to be an alloplastic fabrication part inserted into the jawbone, whose basic body is preferably pen-shaped or helical.

Since, in a preferred embodiment, the implant according to the invention is a dental implant, all embodiments of the implant according to the invention described here relate in particular also to a dental implant according to the invention.

In a preferred embodiment, the construction is a crown construction. In a preferred embodiment, the structure comprises a crown connecting element for a crown. In a preferred embodiment, the implant has a crown.

Roughness in the context of the present invention is preferably understood to mean the average roughness of a surface.

In a preferred embodiment, the rough and / or coated partial region of the surface of the bone anchoring element has a roughness of at least 15 μιτι. In a preferred embodiment, the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at least 20 μιτι on. In a preferred embodiment, the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at least 25 μιτι on. In a preferred embodiment, the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at most 300 μιτι on. In a preferred embodiment, the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at most 250 μιτι.

In a preferred embodiment, the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at least 25 μιτι and at most 250 μιτι on.

In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at most 5 μιτι on. In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at most 4 μιτι on. In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at most 3 μιτι on. In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at least 0.2 μιτι on. In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at least 0.5 μιτι on. In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of at least 0.7 μιτι on.

In a preferred embodiment, the smooth portion of the surface of the structure has a roughness of about 1, 1 μιτι on. In a preferred embodiment, the bone anchoring element has a rough surface. In a preferred embodiment, the structure has a smooth surface.

Those skilled in the art are aware of roughnesses suitable for implants, both for smooth surfaces and for rough and coated surfaces.

The roughness can be generated and adjusted either by working the base material or by coating the base material with a rough layer. An implant with a construction according to the invention advantageously makes it possible for bone formation by distraction osteogenesis not to require additional, particularly complicated, surgical steps than for actually setting the implant itself. The procedural steps in setting a conventional dental implant necessarily include the two operative steps a) Make a threaded hole using a tap or temporary implant and then b) insert and wax the final implant. Before that, the optional steps of "setting a pilot hole in the bone" and "extending the pilot hole" can be performed. After healing the final implant, a crown is usually placed on the final implant. When using an implant according to the invention in step b), no further, in particular costly, operational steps are necessary, although a bone distraction can take place for the construction of the bone surrounding the implant. In addition, even can to step a) are omitted, since the implant according to the invention may have a tap, so that the borehole can be created when setting the implant. Moreover, the placement of the implant body of an implant according to the invention can advantageously take place in a conventional manner, so that the dentist does not have to learn a new technique. After setting the implant body can then be used without much effort, the membrane and connected by the connecting element with the implant body. As a result of the continuous or, in particular, stepwise movement of the connecting element along the implant body away from the bone with a typical distraction speed, the membrane is slowly pulled away from the jawbone, so that a dissecting osteogenesis takes place over a desired period of time. In this case, the stepwise displacement of the connecting element can be effected by the patient or a non-trained helper, as is also customary, for example, when adjusting a brace, since the connecting element lies outside the mucous membrane and is therefore easy to reach. After the bone structure has been completed to the desired extent, the connector can be removed by the dentist without any operational effort from the implant body. If the membrane of the implant according to the invention is resorbable, then no further operative step for removing the membrane is necessary since it can remain between the mucous membrane and bone and is degraded there. When using a nonabsorbable membrane, only a small surgical step is needed to remove the membrane. Thereafter, the implant body can advantageously remain as a permanent implant in the jaw or alternatively be removed and replaced by a final implant. Before- However, the implant according to the invention is a permanent implant and the implant body remains in the bone and is provided, for example, with a permanent crown in the case of a dental implant. Thus, the present invention provides an implant which allows the conventional steps a) and / or b) to be carried out in the usual way, but in between without a major surgical effort to perform a bone distraction to build up the bone, whereby the individual distraction steps are not necessarily performed by a dentist must be performed in a dental office.

The present teaching therefore covers, in particular, dental implants and methods for bone regeneration, wherein bones in the jaw area and / or in the periodontal area are to be regenerated.

In this case, the construction according to the invention with at least one rough and / or coated partial area of the surface of the bone anchoring element and with at least one smooth partial area of the surface of the abutment makes it possible for the rough surface to provide good anchoring in the bone, in particular the jawbone, so that the implant is stably and firmly seated both in the existing bone and in the bone newly formed by the distraction, so that it can be used as a permanent implant. At the same time, the smooth part of the surface of the structure prevents colonization of the surface with bacteria so that infections can be prevented, especially in the area of the mucous membrane. Thus, in particular a peri-implantitis can be prevented or treated. Also, in the case of the implant according to the invention as a permanent implant, it is also possible to place a crown already during the bone construction, in particular even the final crown is placed on top. Bone building can then take place up to the desired height, also with regard to the already existing crown.

Due to the rough surface portion, the implant is well anchored in the residual bone, even in the case of rapid distraction, in which connective tissue is increasingly formed. Also, with the implant according to the invention, later occurring bone defects in the region of the implant can be subsequently treated by distraction, since the membrane can also be used for the first time or again at a later time.

In the context of the present invention, the region of the structure of the implant body is also referred to as the first partial region. In the context of the present invention, the region of the bone anchoring element of the implant body is also referred to as the second partial region.

In a preferred embodiment, the bone anchoring element is a bone screw element.

In a preferred embodiment, the bone anchoring element is designed as a tap.

In one embodiment, the bone anchoring element is designed as a forward and backward cutting tap. In a preferred embodiment, the connecting element is movably arranged over a first subregion of the structure of the implant body, whereby the movable arrangement of the connecting element makes it possible to displace the distraction membrane along a longitudinal axis section of the structure of the implant body.

In a preferred embodiment, the distraction membrane has a hole through which the implant body passes.

The present invention also relates to an implant according to the invention for use in bone distraction.

The present invention solves the underlying technical problem in particular by providing a dental implant according to the invention, comprising an implant body and a distraction membrane, wherein the distraction membrane is connected via a connecting element with the implant body, wherein the connecting element via a first, coronal portion of the longitudinal axis of Implant body is movably arranged and wherein on the movable arrangement of the connecting element, a displacement of the distraction membrane along the longitudinal axis of the implant body over the first portion of the longitudinal axis is made possible and wherein the implant body has a second, apical portion formed as a forward and backward cutting tap is.

It is particularly advantageous that the implant body has a second portion, which is designed as a forward and backward cutting tap. It is possible with this embodiment according to the invention that in the case of the invention If required, even smaller corrections in the positioning of the implant can be made by setting the implant to a minimum after turning the implant back after setting and healing.

One skilled in the art will recognize suitable embodiments of forward and reverse cutting taps. In particular, such a thread cutter are designed as an external thread having at least one corresponding cutting element. Suitable cutting elements are in particular cutting edges or cutting grooves. These can in particular be formed on the thread crest, for example by at least one corresponding cutting groove between the thread flanks, ie a notch connecting at least two thread valleys, so that at least one thread crest has an edge to the notch. Preferably, the implant is self-tapping. In the context of the present invention, "self-tapping" is understood to mean that the implant can be inserted immediately after a predrilling of the threaded hole and without pre-cutting of the thread Preferably, the implant has a cutting edge in the apical region for forward cutting Cutting edge formed by the apical end of the threaded mountain.

It is preferably provided that the thread has no recesses or cutting grooves which extend along more than two thread valleys and serve, for example, for receiving bone chips when screwing in a tap. In the context of the present invention, "forward cutting" or "forward cutting" is understood to mean that an internal thread is cut into the bone as the implant is being screwed into the bone. In the context of the present invention, "backward cutting" or "backward cutting" is understood to mean that an internal thread is cut into the bone when the implant is being turned out of the bone.

A person skilled in suitable implant body forms are known. In particular, the second portion of the implant body having the tap may be based on a threaded portion of a prior art implant except for the feature that it is cutting forward and backward.

The length of the tap can also be taken from the state of the art.

The implant according to the invention has the additional advantage that the implant body does not have to be rotated for distraction but remains rigid in the bone, so that ingrowth in the bone is improved and irritation of the mucous membrane is avoided by rotating the implant body. In an alternative embodiment, however, it can also be provided that the implant body is rotated to move the membrane.

However, the connecting element is preferably arranged such that it itself and thus also the diaphragm connected to the connecting element can be moved along at least a partial region of the longitudinal axis of the implant body. In a preferred embodiment, the distraction membrane has a hole through which the implant body passes. In a preferred embodiment, the hole is not positioned at the midpoint of the distraction membrane. In a preferred embodiment, the structure of the implant body is designed as a toothed rack. The rack is preferably a round rack.

In a preferred embodiment, the construction of the implant body is designed as a toothed rack and the connecting element has an internally threaded nut rotatable on the construction designed as a toothed rack, which is rotatably mounted in a sleeve, wherein the sleeve is connected to the distraction membrane.

In a preferred embodiment, the implant body along its longitudinal axis on a first portion and a second portion with a thread, wherein the first portion is formed as a rack.

In a preferred embodiment, the implant, in particular a dental implant, comprises an implant body and a distraction membrane, wherein the distraction membrane is connected to the implant body via a connecting element, wherein the connecting element is movably arranged over a first subregion of the longitudinal axis of the implant body, and wherein the movable one Arrangement of the connecting element a displacement of the distraction membrane along a longitudinal axis portion of the implant body is made possible, characterized in that the first portion is formed as a rack and the connecting element on the rack formed as a first Partial area has rotatable female thread nut, which is rotatably mounted in a sleeve, wherein the sleeve is connected to the membrane.

In a preferred embodiment, the connecting element has a sleeve counterpart, via which the sleeve is connected to the membrane. In a preferred embodiment, the sleeve counterpart is firmly connected to the distraction membrane. Preferably, the sleeve counterpart and the membrane is in one piece, so the sleeve counterpart part of the membrane. In particular, the sleeve counterpart is preferably designed as a shaping of the membrane counterface.

In a preferred embodiment, the internally threaded nut rests on the sleeve counterpart and is rotatably mounted there. Preferably, the sleeve and the sleeve counterpart are connected to one another, for example glued, welded, screwed, clamped or connected via a click connection.

The inventively preferred construction of the connecting element with sleeve, sleeve counterpart and internally threaded nut rotatably mounted in the sleeve has the additional technical advantage that so above the membrane by the connector a smooth shape is formed, at which bacteria can only be poorly set. The preferred one-piece design of the membrane and the sleeve counterpart further enhances this protection against bacterial infestation, as a groove or the like is avoided at the transition from membrane mating surface to sleeve counterpart in an advantageous manner. The implant according to the invention has the additional advantage that the implant body does not have to be rotated for distraction but remains rigid in the bone, so that ingrowth in the bone is improved and irritation of the mucous membrane is avoided by rotating the implant body.

The connecting element is thus arranged such that it itself and thus also the membrane connected to the connecting element can be moved along at least a partial region of the longitudinal axis of the implant body. In a preferred embodiment, the distraction membrane is curved.

In a preferred embodiment, the distraction membrane has a first side surface, a second side surface, a third side surface, and a fourth side surface, the first side surface facing the second side surface, and wherein the distance of the distraction membrane hole from the first side surface is less than that Distance of the hole to the second side surface.

This asymmetric positioning of the distraction membrane on the implant body axis of the implant according to the invention has the advantage that such a ridge can be particularly well covered by the distraction membrane, since a jaw comb usually has no symmetrical cross section. Depending on the curvature of the alveolar ridge, it is thus possible to select a suitable distraction membrane whose hole is either only slightly removed from the center of the distraction membrane or whose hole strength is removed from the center of the distraction membrane. For example, the dentist may choose different distraction membra- Keep in stock and select the appropriate distraction mesh according to the shape of the alveolar ridge. It is of course also possible to individually adapt a distraction membrane to a ridge.

In a preferred embodiment, the distraction membrane has a four-sided base.

In a preferred embodiment, the third side surface opposes the fourth side surface, wherein the distance of the hole of the distraction membrane to the third side surface is approximately equal to the distance of the hole to the fourth side surface. In a preferred embodiment, the connecting element comprises a gear, in particular a self-locking gear, for moving the distraction membrane along the longitudinal axis of the implant body.

In a preferred embodiment, the connecting element has a spacer sleeve.

In a preferred embodiment, the connecting element has a housing with a passage and a threaded body, wherein the rack is inserted in the longitudinal extent through the passage substantially free of play through the housing, and wherein the threaded body is rotatably mounted in the housing such that the threaded body and the rack are in operative engagement.

In a preferred embodiment, the implant is for use in bone distraction. In the context of the present invention, a "membrane" is understood to mean a medical membrane which is used in medical procedures for the regeneration of a bone or in the introduction of bone substitute materials in a bone defect, whereby the term "bone regeneration" encompasses both new bone formation, for example by natural o In the context of the present invention, a membrane is understood to mean a plate-shaped, ie plane or planar, body in the non-curved state or adhesion of osteoblasts in the region of a bone defect, and a mating surface opposite the contact surface, These two surfaces may have any shape, for example round, oval, quadrangular or polygonal e contact surface and the opposite surface of the membrane in the non-curved state rectangular or round. In the non-curved state, the size of these two surfaces of a rectangular membrane results from the length and the width of the membrane. The membrane also has at least one side surface, in particular four side surfaces, if it is a rectangular membrane. In the non-curved state, the size of two of the side surfaces of the height and the length of a rectangular membrane, the size of the other two side surfaces resulting from the height and the width of the membrane. According to the invention, the membrane is as thin as possible, that is to say the size of the side surfaces is many times smaller than the size of the contact surface and, in the case of a quadrilateral membrane is the height of the membrane is many times smaller than the length and the width of the membrane.

A membrane used according to the invention preferably serves for bone regeneration in the oral and maxillofacial region, ie in particular for bone regeneration in a jaw. The jaw can be an upper jaw or a lower jaw.

In a preferred embodiment, the membrane is a distraction membrane.

In the context of the present invention, a "distraction membrane" is understood to mean a medical membrane which can serve or serve as an artificial boundary surface in bone distraction it can be attached to a distraction device and controlled by the distraction device at a desired rate, can be removed continuously or in single steps from the bone, for example, pulled away or pushed away from the bone A distraction membrane is thus a specific subset of medical membranes, which can be readily distinguished by a person skilled in the art of other medical membranes, for example, for easy coverage of a bone defect.

In the context of the present invention, a "bone distraction" or a "callus distraction" is understood to mean a medical procedure for bone regeneration, in which an element is slowly removed from a bone defect, so that the cells located in a callus between the bone defect and the element, in particular osteoblasts, an artificial biomechanical pulse, in particular tensile pulse, is exerted. The element may be, for example, a bone, a bone fragment or an artificial body. In particular, the element may be a distraction meshbranch.

In the context of the present invention, a "biomechanical pulse" is understood to mean a mechanical force transmission, in particular the transmission of a tensile force, to a cell, in particular osteoblasts, and the biological processes in the cell triggered thereby.

In a preferred embodiment, the distraction membrane consists of a metal or a metal alloy. In a preferred embodiment, the distraction membrane, in particular distraction membrane, consists of titanium.

Alternatively, the membrane may also be formed from magnesium or a magnesium alloy or contain these materials predominantly. As a result, a bioresorbable membrane can advantageously be provided.

In a preferred embodiment, the membrane, in particular Distraktionsmembran made of titanium, wherein the contact surface is coated, wherein the layer preferably consists of a mineral material or predominantly contains a mineral material. The contact surface may, for example, be coated with hydroxyapatite. In a preferred embodiment, the membrane is made of a resorbable material. As a result, it is advantageously possible to dispense with removing the membrane after the bone has been built up. Rather, the membrane can remain between the mucous membrane and the bone, where it is broken down into harmless substances and decomposed.

In a preferred embodiment, the membrane according to the invention is resorbable, in particular bioresorbable. In a preferred embodiment, the membrane is a bioresorbable distraction membrane.

The membrane may also be formed of magnesium or a magnesium alloy or contain these materials predominantly. As a result, a bioresorbable membrane can advantageously be provided. Here, too, the contact surface can be coated, for example, with hydroxylapatite or another mineral material.

The person skilled in the art is familiar with further materials for resorbable, that is to say biodegradable, membranes and different resorbable membranes from the prior art. Suitable resorbable materials are, for example, polylactitol or polycaprolactone.

Preferably, both the contact surface and the counter surface of the membrane are rough. In a preferred embodiment, the membrane is sandblasted. In a preferred embodiment, the contact surface and / or the mating surface of the membrane are sandblasted. In a preferred embodiment, the contact surface and / or the mating surface of the membrane are coated.

The membrane may preferably be perforated. It can thus have pores which extend from the mating surface through the membrane to the contact surface. Through these pores, both the bone defect and the callus located there as well as the connective tissue separated by the membrane from the bone defect can be well supplied with nutrients and blood and thereby vascularize particularly well. In a preferred embodiment, the connecting element is located on the mating surface of the membrane or extends into the membrane as viewed from the mating surface. In a preferred embodiment, the edges of the membrane are rounded.

The membrane may be flat or curved. But especially when used in the jaw area, the membrane can also be arched alternatively. In a preferred embodiment, the membrane is curved. In an alternative embodiment, the membrane, especially if it is a membrane for use in the jaw region, curved in a U-shape. A U-shaped arched membrane can completely cover a bone defect, especially in the jaw area, ie cover it from above and from both sides. In cross-section like the letter "U" it includes more vestibular and lingual the jawbone. Thus, the area is also extended to the side walls of the jaw, where also artificial impulses are given by it. This can then serve to widen the comb, since the clinical task of a chamber increase combined with comb broadening very often occurs.

In an alternative embodiment, the implant according to the invention is an implant for periodontal regeneration by means of distraction. Periodontal regeneration is understood to mean regeneration of the periodontium, ie not only of the bone but also of the periodontal ligament, the periodontal tissue, the gingiva and the papillae, for example by guided tissue regeneration (GTR) In a preferred embodiment, the membrane of the implant is In a preferred embodiment, the periodontal regeneration membrane of the implant is very thin In a preferred embodiment, the periodontal regeneration implant membrane is shaped to have at least one lobe or segment which can be inserted into a tooth space.

A person skilled in the art will readily be able to determine a suitable size of the membrane. The minimum size of a preferred membrane with hole for passing the implant body results from the diameter of the implant body and the resulting diameter of the hole. Preferably, the membrane has a diameter of at least 3 mm, more preferably at least 4 mm, particularly preferably at least 5 mm, for example about 6 to 8 mm, in particular 7.15 mm. The diameter refers to round membranes. In the case of angular membranes, in particular rectangular membranes, the abovementioned minimum diameter values to the minimum length and minimum width of the membrane.

The size of the membrane can be adapted to the size of the bone surface on which bone formation is to take place.

In a preferred embodiment, the curvature has a radius which corresponds to the radius of a jawbone crest to be treated.

The membrane of the invention may be intended for repeated or single use. Preferably, the membrane is intended for single use, as this is common practice in medical membranes and the adhesiveness of the surface of the membrane decreases due to contact with body fluid.

The membranes can be made up in shape and size or individually adapted to the bone defect to be treated.

In a preferred embodiment, the connecting element comprises a gear, in particular a self-locking gear, for moving the membrane along the longitudinal axis of the implant body.

The connecting element is used to attach the membrane to the implant body and the controlled displacement of the membrane along the implant body.

In a preferred embodiment, the connecting element is attached to the opposite surface of the membrane or plugged into a hole in the membrane or preferably screwed. Preferably, the connecting element connects the membrane and the implant body in such a way that the contact surface of the membrane is directed towards the tip of the implant body and that the connecting element is directed towards the head of the implant body.

Various embodiments of a suitable connecting element are readily known to the person skilled in the art, which permit the connection of the membrane with the implant body according to the invention and permit a movement, in particular controlled movement of the membrane along the implant body.

Preferably, the connecting element has a point of application for a tool, so that the connecting element can be moved or moved in a controlled manner along the implant body with the aid of the tool. Preferably, the point of attack for the tool on the actuating body of the connecting element.

In a preferred embodiment, the point of application of the tool is on the side surface of the internally threaded nut. In this case, the sleeve in which the female thread nut is located has lateral openings through which the point of application on the internally threaded nut can be reached with the tool. This embodiment makes it possible that, for moving the connecting element and the diaphragm, a crown sitting on the implant body does not have to be removed. Alternatively, however, it may also be provided that the point of application is located on the upper side of the internally threaded nut. In a preferred embodiment, the connecting element has a spacer sleeve. In a preferred embodiment, the connecting element is designed as a spacer sleeve. Preferably, the spacer sleeve at least partially has a conical shape. In an alternative embodiment, the connecting element has a spacer sleeve and at least one further subelement. The at least one further subelement preferably serves for the displaceable connection of the connecting element to the implant body. In the prior art, a spacer sleeve is a metallic body used in implants. A spacer sleeve is designed to bridge the gap between bone and mucous membrane. The spacer sleeve is usually used during the healing phase of an implant. A spacer sleeve can be present in an advantageous manner in an implant according to the invention as part of the connecting element. Preferably, the spacer sleeve forms at least the part of the connecting element which is connected directly to the membrane. In this embodiment, the spacer sleeve can advantageously fulfill two tasks. On the one hand, the spacer sleeve as an intermediate element between the membrane and the sub-element of the connecting element, which is mounted on the implant body, allow a secure and simple connection, on the other hand, the spacer sleeve is in this embodiment at a position in which they especially in a use in Jaw area passes through the oral mucosa and thus they are the border between the underlying mucosa membrane and the over the mucous membrane lying further sub-elements of the connecting element forms. This can be generated by the membrane and the spacer sleeve, a smooth, not sharp-edged surface, with which the mucous membrane comes into contact, so that the mucosa during distraction not on the implant body, especially on sharp-edged parts of the implant body, such as the threaded portion or the optional Rack part, rubs.

In an alternative embodiment, the membrane is formed from a surface of the spacer sleeve. The spacer sleeve is configured in such a way that it has a surface which is directed in the direction of the tip of the implant body and either a membrane is applied to this surface or this surface is membrane-like, in particular coated, for example coated with hydroxyapatite. In a preferred embodiment, the connecting element has a housing with a passage and a threaded body, whereby the part of the implant body designed as a toothed rack is inserted through the passage at least substantially without clearance through the passage, and the threaded body is rotatably mounted in the housing in such a way is that the threaded body and the rack are in operative engagement.

In a preferred embodiment, the implant is based on the system of a connecting element with an adjusting nut with internal thread, which is rotatably mounted in the housing and is screwed onto the implant body. By turning this adjusting nut moves this and with it the housing and thus the connecting element with membrane along the implant body. Before- zugt is thereby also an embodiment in which the connecting element is designed as a spacer sleeve, wherein the membrane is attached to a surface of the spacer sleeve. Or the membrane is formed from a surface of the spacer sleeve, as described above.

In an alternative embodiment, the implant is based on the system of a connecting element with a worm gear, an implant body with a rack section and a membrane, wherein the rotational movement of a threaded body, in particular a screw translates into a translational movement of the connecting element and thus the diaphragm on the rack becomes. Preferably, the threaded body, in particular the screw, a thread with a pitch p = 0.1 to 0.5 mm, in particular about 0.3 mm, in particular 0.3 mm and the rack is toothed accordingly. By a pitch of 0.3 mm of the threaded body results, for example, per complete revolution of the threaded body, a stroke of 0.3 mm.

The implant body preferably consists of a metal, in particular titanium or of zirconium, in particular if the implant according to the invention is a dental implant. The person skilled in the art is familiar with suitable materials for a dental implant body.

In a preferred embodiment, the dental implant according to the invention serves for use in a bone distraction and at the same time as a permanent implant.

The implant according to the invention can preferably be designed as a permanent implant and in particular a permanent dental implant be. The dental implant may preferably have a crown. Alternatively, after the bone distraction has taken place, the connecting element can be removed and replaced by a crown.

The present invention also relates to an implant according to the invention for use for callus distraction, in particular for the construction of a bone, in particular a jaw bone, by distraction.

In a preferred embodiment, the implant is suitable for callus distraction. In a preferred embodiment, the implant is suitable for bone regeneration.

In a preferred embodiment, the dental implant is suitable for callus distraction in the jaw region. In a preferred embodiment, the dental implant is suitable for bone regeneration in the jaw area. In a preferred embodiment, the dental implant is suitable for periodontal regeneration in the jaw area.

In a preferred embodiment, the implant is intended for use in a medical procedure, in particular in a surgical procedure. In a preferred embodiment, the implant is intended for use in bone regeneration by distraction, especially in the jaw region.

In a preferred embodiment, the implant according to the invention is suitable for use for bone distraction, in particular of a jawbone. In a preferred embodiment Form is the implant according to the invention for use for bone distraction, in particular a jawbone.

Distraction is preferably carried out with the implant according to the invention at a distraction rate of at least 0.2 mm per day to at most 2.5 mm per day, in particular from at least 0.5 mm per day to at most 2 mm per day. More preferably, the distraction rate is about 1 mm per day.

The present invention also relates to an implant according to the invention for use in callus distraction, in particular for the construction of a jaw bone by distraction.

The present invention also relates to an implant according to the invention for use in periodontal regeneration by distraction. The present invention also relates to a kit containing an implant according to the invention. The present invention also relates to a kit containing the implant base body of an implant according to the invention, at least one connecting element and at least one membrane, in particular a plurality of different membranes. The kit preferably contains an instruction manual. The instructions for use preferably contain information on how the kit can be used for setting the implant and performing a callus distraction.

A preferred embodiment is a kit according to the invention for use in medical procedures, in particular surgery. see methods, preferably in the bone distraction, especially in the jaw area. A further preferred embodiment is the use of a kit according to the invention for producing an implant according to the invention. The present invention also relates to the use of an implant according to the invention in a medical procedure, in particular in a surgical procedure.

The present invention also relates to the use of an implant according to the invention for callus distraction, in particular in the jaw region, in particular for the construction of a jaw bone by distraction.

The present invention also relates to methods for callus distraction, in particular for the construction of a jaw bone by distraction, wherein a membrane of an implant according to the invention is applied to a bone defect to be regenerated and tension is exerted on this membrane via the connecting element. The membrane is thus removed at a certain speed with the rack from the bone defect. The speed is preferably 0.2 mm to 2.5 mm per day, in particular 0.5 mm to 2 mm per day. Most preferably, the speed is about 1 mm per day. Without being bound by theory, such a distraction process at the beginning of the process, in particular a distance of about 1, 5 mm between the membrane and bone advantageous. The slow removal of the membrane from the bone defect can be continuous or discontinuous, for example daily or half-daily. The present invention also relates to methods for callus distraction, in particular for the construction of a jaw bone by distraction, comprising the following steps: a) implanting the implant according to the invention in a bone, preferably a jawbone, wherein the implant is a provisional implant and wherein the second Part of the implant body is at least partially screwed into the bone or a predrilled hole in the bone; b) carrying out a distraction osteogenesis with the membrane of the implant according to the invention; in particular as described above; c) removing the fastener from the implant body; d) unscrewing the provisional implant body from the bone; In the case of a distraction in the area of the jaw, step e) is preferably followed by insertion and ingrowth of your permanent implant into the drilled hole of the removed implant according to the invention.

However, the present invention also preferably relates to a method for implanting a permanent tooth implant according to the invention, comprising the following steps: a) implanting the implant according to the invention in a bone, preferably a jawbone, wherein the implant is a permanent implant; b) carrying out a distraction osteogenesis with the membrane of the implant according to the invention; in particular as described above; c) removing the fastener from the implant body; Preferably, a crown is placed on a dental implant in the method according to the invention.

Preferably, in the method according to the invention, a bioabsorbable membrane is used which does not have to be removed. Alternatively, a non-biodegradable membrane, for example of titanium, may be used. This is preferably also removed after removal of the fastener from the implant body.

Preferably, step a) of the methods according to the invention comprises the following substeps: a1) implanting the implant body in the bone; a2) attaching the membrane to the implant body and applying the membrane to the bone defect; a3) attaching the connecting element to the implant body; and a4) attaching the connecting element to the membrane, for example by screwing, pinning, firmly locking, firmly clicking or gluing the connecting element, in particular the spacer sleeve of the connecting element, to the hole of the membrane.

Alternatively, the following sub-steps may be provided: a1) applying the membrane to the bone defect; a2) inserting the implant body into the hole of the membrane and implanting the implant body in the bone; a3) attaching the connecting element to the implant body; and a4) attaching the connecting element to the membrane, for example by screwing, pinning, locking, clipping or gluing the connecting element, in particular the spacer sleeve of the connecting element, to the hole of the membrane. Prior to step a), the optional steps of "setting a pilot hole in the bone" and "extending the pilot hole" may be performed. After healing the final implant, a crown is usually placed on the final implant. But this can also be the case with temporary implants. Advantageously, step b), in particular the stepwise displacement of the connecting element by the patient or a non-trained helper, for example by means of a tool attached to a point of application for the tool on the connecting element, preferably on the adjusting body of the connecting element can be.

Preferred embodiments of the invention will become apparent from the dependent claims.

The invention will be explained in more detail below with reference to FIGS. Show it: the cross section of an embodiment of an inventive implant; a further preferred embodiment of the implant according to the invention and a detailed view of the second portion with thread cutter; a further view of the preferred embodiment of the implant of Figure 2 and the corresponding implant body from three different directions of view; the membrane and the connector of the preferred embodiment of the implant of Figure 2; a further alternative embodiment of the implant (100) according to the invention during a use according to the invention for bone distraction in the jaw region (50). an implant according to the invention with a preferred embodiment of a tool for moving the membrane; further embodiments of the implant according to the invention with differently positioned membranes; a further embodiments of the implant according to the invention with a lateral points of attack for a tool for moving the membrane. Of course, preferred details of the embodiments shown in Figures 1 to 9 can be combined.

FIG. 1 shows the cross section of an embodiment of an implant (100) according to the invention. The implant (100) comprises an implant body (10), a distraction membrane (20) and a connecting element (30).

The coronal, first portion (1 1), so the structure of the implant body (10) is designed as a rack (13). The implant body (10) has a hole (14), which serves as a point of attack for a tool for screwing into a bone or unscrewing from a bone of the implant body (10).

The distraction membrane (20) has a contact surface (21) and a counter-surface (22). The contact surface (21) is preferably formed by a coating, for example of a mineral material.

The distraction membrane (20) is connected to the implant body (10) via the connecting element (30) such that the membrane (20) can be moved or displaced exactly along the implant body (10). The connecting element (30) has a partially conical spacer sleeve (32) as a sleeve. In this, the membrane (20) is engaged, screwed or glued. In the spacer sleeve (32) an adjusting nut (37) is rotatably mounted, which has an internal thread. By turning the adjusting nut (37), the spacer sleeve (32) and thus also the membrane (20) along the implant body (10) can be moved. The adjusting nut (37) is thus a rotatably mounted threaded body, which is connected to the rack (13) of the coronal portion (1 1) of the implant body (10) is in operative engagement.

The apical, second subregion (12) of the implant body (10), ie the bone anchoring element, has an external thread (40) for screwing or boring the implant body (10) into a bone. The thread (40) has threaded valleys (41) and threaded peaks (42) through which the thread flanks are formed. The thread (40) has an apical end portion (44) and a cervical end portion (45). The thread (40) is designed as a forward-cutting thread, so that it cuts an internal thread into the bone when the implant body (10) is screwed into a borehole in a bone or into a bone with a first cutting element (46). In addition, the cervical end region (45) of the thread (40) additionally has a second cutting element (43) with a cutting edge which is back-separating, ie when the implant body (10) is unscrewed from the bone, it can cut an internal thread into the bone.

A partial region (61) of the structure (1 1) according to the invention has a smooth surface, while a partial region (62) of the bone anchoring element (12) has a rough surface.

FIG. 2 shows an overview of a preferred embodiment of the implant (100) according to the invention in FIG. 2a. The implant (100) comprises an implant body (10), a curved distraction membrane (20) and a connecting element (30).

The coronal section (1 1) of the implant body (10) is again designed as a toothed rack (13). The apical region (12) of the implant body (10) again has an external thread (40) for screwing or boring the implant body (10) into a bone. The thread (40) has threaded valleys (41) and threaded peaks (42) through which the thread flanks are formed. The thread (40) has an apical end portion (44) and a cervical end portion (45). The thread (40) is designed as a forward cutting thread, so that when screwing the implant body (10) into a borehole in a bone or bone with a first cutting element (46) cuts an internal thread into the bone. In addition, the cervical end region (45) of the thread (40) has a second cutting element (43) with a cutting edge which is rearward-diverging.

The entire structure (1 1) according to the invention preferably has a smooth surface (61), while the entire bone anchoring element (12) has a rough surface (62).

FIG. 2b shows an enlarged section of the apical, second subregion (12) of the implant body (10) from FIG. 2a, whereby also the projections of the coronal, first subregion (11) with the toothed rod (13) can be seen in the form of a round toothed rod ,

The apical region (12) of the implant body (10) again has a forward cutting external thread (40) with thread valleys (41) and thread crests (42) and an apical end portion (44) and a cervical end portion (45). The apical end portion (44) of the thread (40) has a forward cutting cutting element (46). The cervical end region (45) of the thread (40) has a cutting element (43) a cutting edge (43a), which is rückwärtsscheidend. The cutting edge (43a) is formed by means of a notch (43b) in the uppermost passage of the threaded mountain (42).

The structure (1 1) according to the invention preferably again has a smooth surface (61), while the entire bone anchoring element (12) again has a rough surface (62).

FIG. 3 shows the implant (100) according to the invention from FIG. 2a in a somewhat different perspective in FIG. 3a. The implant (100) again comprises the implant body (10), the curved distraction membrane (20) and a connecting element (30). The implant body (10) is again subdivided into a first coronal section (11) with a rack (13) in the form of a round rack and into a second, apical area (12) with forward and backward cutting threads (40). The first, coronal end of the implant body (10) has a hole (14), here a hexagonal hole, which serves as a point of application for a tool for screwing in or unscrewing the implant body. The membrane (20) has a plurality of pores (23), which lead to improved perfusion of the underlying tissue under the membrane. The connecting element (30) has holes (34) as engagement points for a tool for rotating an adjusting nut of the connecting element (30), whereby the membrane (20) along the first, coronal part (1 1) of the implant body (10) are moved along can, since the adjusting nut as a rotatably mounted threaded body with the rack (13) of the coronal portion (1 1) of the implant body (10) is in operative engagement. The structure (1 1) according to the invention preferably again has a smooth surface (61), while the entire bone anchoring element (12) again has a rough surface (62).

In FIG. 3b, the implant body (10) of the implant from FIG. 3a without membrane and connecting element can be seen in three different perspectives. On the one hand, the design of the coronal first portion (11) as a rack (13) becomes clear. On the other hand, in the second, apical partial region (12), the thread (40) which cuts in both directions is aligned with the apically directed end region (44) and a cutting element there and with the cervically directed end region (45) with a second cutting element (43 ) clear to see. The second cutting element (43) with a cutting edge (43a), which is formed by a notch (43b) in the uppermost thread of the thread, makes it possible to cut a thread in the bone newly formed by the callus distraction by means of a membrane when unscrewing the bone Implant body (10) from the bone.

FIG. 4 shows in FIG. 4 a a preferred embodiment of the separation membrane (20) and of the connecting element (30).

The distraction membrane (20) has pores (23) for improved blood and nutrient delivery to the callus tissue. The connecting element (30) is in three parts. An adjusting nut (37) is held by a sleeve (31 a) and a sleeve counterpart (31 b). The adjusting nut (37) rests on the sleeve counterpart (31 b) and is in the Sleeve (31 a) rotatably mounted. In this case, the sleeve counterpart (31 b) is firmly connected to the distraction membrane (20) or part of the membrane (20). Preferably, the distraction membrane (20) and the sleeve counterpart (31 b) are in one piece. The adjusting nut (37) has an internal thread (38) which can engage in the rack (13) of the implant body (10) from FIG. 3b. Thus, the Distraktionsmembran (20) by rotation of the adjusting nut (37) along the first portion (1 1) of the implant body (10) are moved. The rotation of the adjusting nut (37) is made possible by three holes (34), which serve as points of attack for a turning tool.

FIG. 4b shows the three individual parts from FIG. 4a, that is to say the distraction membrane (20) with the sleeve counterpart (31b), the distraction membrane and the sleeve counterpart being integrally formed, the adjusting nut (37) with internal thread (38) and holes (34) and the sleeve (31a). When assembling the device, the sleeve (31 a) with the sleeve counterpart (31 b) can be connected in any suitable manner, for example, welded or glued or held by corresponding elements, such as clip elements.

FIG. 5 shows a further alternative embodiment of the implant (100) according to the invention during a use according to the invention for bone distraction in the region of the jaw (50).

Shown again are the implant body (10) with second apical region (12) and first coronal subregion (11) with rack (13), the distraction membrane (20) with contact surface (21), counter surface. che (22) and interconnecting perforations or pores (23) and the connecting element (30).

In this embodiment, a spacer sleeve (32) via an internal thread with an external thread (36) of the connecting element (30) screwed or screwed. The Distraktionsmennbran (20) is screwed via an internal thread in its hole (25) with an external thread (35) of the spacer sleeve (32) or screwed.

The connecting element (30) is designed here so that in the housing (31) a threaded body in the form of a worm (33) is rotatably mounted in the housing (31) such that the worm (33) and the rack (13) in Intervene. The rotational movement of the screw (33) can thus be translated into a translatory movement of the connecting element (30) and thus the distraction membrane (20) on the rack (13). The worm (33) has a point of engagement (34) for a tool, for example an Allen wrench, so that the worm (33) can easily be turned.

Furthermore, a jawbone (51) with two teeth (52) can be seen. The jawbone (51) has a bone defect into which the thread (40) of the second, apical part (12) of the implant body (10) is screwed.

With this structure, an inventive method for bone structure is possible. In this case, the distraction membrane (20) is connected via the connecting element (30) by turning the worm (33) on a daily or half-daily basis via an attachment point (34). cutting tool at a rate of 0.2 mm to 2.5 mm per day from the bone defect.

As a result, the tissue (54) resting on the contact surface (21), in particular the callus, becomes distraction pulses which trigger bone formation. Connective tissue (53) is located above the distraction membrane (20).

According to the invention, the distraction membrane (20) has a longer part (20a) and a shorter part, whereby only the longer part (20) with the second side (28) can be seen here. This has the advantage that the membrane can cover the asymmetrical structure of a jawbone particularly well.

Through the interconnecting perforations or pores (23) of the distraction membrane (20), it is possible to exchange substances and blood between the tissue (54) resting against the contact surface (21) and the tissue (53) resting against the counter surface (22).

Before and after this method of bone augmentation by callus distraction using the distraction membrane (20), the benefits of the preferred implant body (10) construction with a forward cutting and backward cutting thread (40) are borne in mind. When screwing the implant body (10) into the bone (51), a forward cutting cutting element (46) is used in the apical region (44) of the thread (40), which cuts a thread in the bone. This is well known from conventional implants and those skilled in the art will appreciate suitable embodiments. In the subsequent distraction osteogenesis, new bone forms in the cervically directed end region (45) of the thread (40), if this is not completely in the bone (51) is screwed in, but also above all in the region of the first, coronal partial region (11) of the implant body (10). The newly formed bone thus encloses partial regions of the implant body (10), in particular regions of the first partial region (11) which has no thread. However, if the implant (100) is a temporary implant, which is preferred according to the invention, then the implant body (10) must be screwed out of the bone again. This is unproblematic in the area of the original bone (51), since an internal thread has already been produced here by the forward-cutting elements of the thread (40). However, such an internal thread is not present in the newly formed bone (54). Therefore, in the cervical end region (45) of the thread (40), the implant (100) according to the invention has a second cutting element (43) with a cutting edge, wherein the cutting element (43) is back-cutting. As a result, when screwing out the implant body (10) after completion of the distraction, an internal thread can be cut into the newly formed bone (54), so that on the one hand the newly formed bone can be removed by unscrewing the implant body (10) and its protruding parts, for example the thread (40) is not damaged and so that a subsequent permanent implant can be screwed directly into the internal thread of not only the original bone (51) but also the newly formed bone (54). According to the invention, the first subregion (11) preferably again has a smooth surface (61), while the second subregion (12) again has a rough surface (62). As a result, the implant body (10) is anchored particularly well in the original bone (51) and in the newly formed bone (54), while at the first part of the implantation (10) rich (1 1) bacteria can settle particularly badly, so that infections, for example in the area of the adjacent tissue (53), are avoided. Of course, only a portion of the second portion (12) may be rough, in particular the apical portion of the bone anchoring element (12).

FIG. 6 shows the preferred embodiment of the implant according to the invention from FIGS. 2a and 3a (100) in combination with a tool (200) for displacing the distraction membrane (20). FIG. 6a again shows the implant (100) with implant body (10), distraction membrane (20) and connecting element (30). As can be seen from FIGS. 2 a and 3 a and 4, the connecting element (30) comprises an adjusting nut (37) with three holes (34) which is not visible in the present case. According to the invention, the first subregion (11) preferably again has a smooth surface (61), while the second subregion (12) again has a rough surface (62).

For turning the adjusting nut (37) and thus for displacing the distraction membrane (20) along the first, coronal area (11) of the implant body (10), the tool (200) shown in FIGS. 6b and c is suitable. This has a hole (210) through which the tool can be pushed onto the implant body (10). Furthermore, the tool (200) has three projections (234) which can engage in the holes (34) of the adjusting nut (37). Thus, by turning the grip part (21 1) over the three connections between the holes (34) and protrusions (234), the adjusting nut (37) can be turned so that it rests against the tooth surface. Shifts rod (13) of the implant body (10) in the direction of the coronal end of the implant body and the Distraktionsmembran (20) via the connecting element (30) entrains. FIG. 6 d shows the tool (200) in a state attached to the implant (100). FIG. 7 shows various embodiments of the preferred implant from FIGS. 2a and 3a. The implants (100) shown in FIGS. 7a, 7b and 7c all have an implant body (10), a distraction membrane (20) and a connecting element (30) with the details as shown in FIG. 3a. However, the positioning of the distraction membrane (20) with respect to the longitudinal axis of the implant body (10) and thus also of the connecting element (30) is different in each case. In FIG. 7a, the curved distraction membrane (20) is arranged centrally. The hole of the distraction membrane (20), through which the implant body (10) extends, is thus located in the middle of the distraction membrane (20). In contrast, according to the invention, this hole is preferably not located at the center of the distraction membrane (20) in FIGS. 7b and 7c. Thus, the distraction membrane protrudes farther on one side than on the opposite side. This preferred embodiment of the implant (100) according to the invention has the advantage that a jaw ridge, as shown in FIG. 7d, can be covered particularly well by the distraction membrane (20), since a jaw ridge (51) usually has no symmetrical cross section , Depending on the curvature of the alveolar ridge (51), a suitable distraction membrane (20) can thus be selected, whose hole is either only slightly removed from the center of the distraction membrane, as shown in FIG. 7b, or its hole, as shown in FIG. 7c, more strongly from the center the distraction membrane is removed. For example, the dentist may choose different distraction Keep membranes in stock and select the appropriate distraction membrane according to the shape of the alveolar ridge. It is of course also possible to individually adapt a distraction membrane to a ridge. According to the invention, the first subregion (11) preferably again has a smooth surface (61), while the second subregion (12) again has a rough surface (62). In this case, in FIG. 7 d, the second partial region (12) with the rough surface (62) extends far into the alveolar ridge (51), where it ensures good osseointegration. Also, a piece of the first portion (1 1) with the smooth surface (61) extends into the alveolar ridge (51). This effectively prevents infections, such as peri-implantitis.

FIG. 8 shows an alternative embodiment of the implant (100) according to the invention with lateral points of attack for a tool for displacing the distraction membrane (20).

FIG. 6a again shows the implant (100) with implant body (10), distraction membrane (20) and connecting element (30). The connecting element (30) comprises an adjusting nut (37) with holes (34).

According to the invention, the first subregion (11) preferably again has a smooth surface (61), while the second subregion (12) again has a rough surface (62).

To rotate the adjusting nut (37) and thus to move the distraction membrane (20) along the first, coronal area (11) of the implant body (10), a tool can engage in the laterally lying holes (34). This is made possible by openings in the connecting element (30). The lateral intervention is particularly Especially advantageous if on the implant body (10) is already attached a crown.

A tool can engage in the holes (34) of the adjusting nut (37), so that by turning the adjusting nut (37) with the tool, wherein the adjusting nut (37) on the rack (13) of the implant body (10 ) moves in the direction of the coronal end of the implant body and the Distraktionsmembran (20) pulls over the connecting element (30). FIG. 8b shows the implant (100) from FIG. 8a from a different perspective.

Claims

claims

1 . A bone distraction implant comprising an implant body and a distraction membrane, the implant body comprising a bone anchoring element and a structure characterized in that at least a portion of the surface of the bone anchoring element is rough and / or coated and at least a portion of the surface of the construction is smooth.

2. Implant according to claim 1, wherein the distraction membrane is reversibly connectable to the implant body.

3. Implant according to one of the preceding claims, comprising an implant body having a longitudinal axis and a distraction membrane, wherein the implant body comprises a bone anchoring element and a structure and wherein the distraction onsembran is connected via a connecting element with the implant body, wherein the connecting element over a first portion characterized in that the movable arrangement of the connecting element, a displacement of the distraction membrane along a longitudinal axis portion of the implant body is made possible, characterized in that at least a portion of the surface of the bone anchoring element is rough and / or coated, wherein at least a portion of the Surface of the construction is smooth.

4. Implant according to one of the preceding claims, wherein it is a dental implant.

5. Implant according to one of the preceding claims, wherein it is a durable dental implant.

6. Implant according to one of the preceding claims, wherein the rough and / or coated portion of the surface of the bone anchoring element has a roughness of at least 15 μιτι and wherein the smooth portion of the surface of the structure has a roughness of at most 5 μιτι.

7. An implant according to any one of the preceding claims, wherein the bone anchoring element is a bone screw element.

8. An implant according to any one of the preceding claims, wherein the bone anchoring element has a rough surface.

9. Implant according to one of the preceding claims, wherein the structure is a crown structure and has a crown connecting element for a crown.

10. Implant according to one of the preceding claims, wherein the bone anchoring element is designed as a forward and backward cutting tap.

1 1. An implant according to any one of the preceding claims, wherein the distraction membrane has a hole through which the implant body passes.

12. Implant according to one of the preceding claims for use in a bone distraction.