WO2017021010A1

WO2017021010A1 - Osseointegrated alveolar implant prosthesis

Info

Publication number: WO2017021010A1
Application number: PCT/EP2016/025081
Authority: WO
Inventors: Giovanni IOANNONI FIORE
Original assignee: Ioannoni Fiore Giovanni
Priority date: 2015-07-31
Filing date: 2016-07-28
Publication date: 2017-02-09
Also published as: ITUB20152693A1

Abstract

The present invention relates to the field of restorative implant prosthetics dentistry and more specifically concerns an osseointegrated alveolar implant prosthesis able to prosthetically increase missing bone volume and allow the insertion of endosseous implants, said prosthesis being composed of: a polished titanium plate provided with one or more threaded holes running through it vertically all along its height and which an implant prosthesis fits into which fixes the plate to an alveolar crest, a titanium grill soldered to said plate and a screw system with a double class of diameters.

Description

Osseointegrated alveolar implant prosthesis

Description Field of the invention

Background of the invention

Implant prosthetics is a branch of dentistry which aims to treat edentulism, namely the partial or total lack of teeth, through insertion in the jaw bones of artificial dental roots called endosseous "implants", onto which dental prostheses are then cemented or screwed.

Prosthetically guided implantology presupposes the insertion of the implants in an ideal position from a functional point of view and with an arrangement as similar as possible to that of natural teeth, thereby permitting the creation of an aesthetically and functionally adequate prosthesis.

The reconstruction of atrophic maxilla allows implant-prosthetic rehabilitation even in patients with severe bone deficiency. Having little bone tissue available, the aim is to increase the volume of the maxillary or mandibular alveolar process in order to insert implants which are both functional and aesthetic at the same time. Pn the field of implant prosthetics various methods are known for raising the maxillary or mandibular bone tissue, among which:

- the grafting of fragments of autologous blocks of bone (belonging to the same person) has the drawback that the patient must be operated on a first time to harvest the bone, this must then be shaped and lastly reinserted; the patient thus undergoes surgery involving two surgical sites which must be performed in a hospital or suitably equipped facilities, and subsequently a second surgery for the insertion of the implants with a long interval between the first and the second.

- The grafting of fragments of heterologous blocks of bone (from a different person) has the drawback that the bone must be deantigenated and thus loses all its active part and biological characteristics which are difficult to regenerate at the moment of regrafting, so that the patient must rely solely on his/her own regenerative capacities.

- Vertical bone expansion, which is usually practised in the elderly as the jaw thins and a greater depth is needed to insert the implant, consists of the lateral translation of the inferior alveolar nerve to make space for the implant to be inserted, after which the nerve is made to lie against the implant; a difficult technique in that it involves an operation on the jaw.

- Horizontal bone expansion, also known as split crest, consists of dividing the crest, with the use of osteotomes, into two parts so as to insert the implant, after which, with the clot of blood, the division of the bone crest closes again. This method only permits minor horizontal expansions and, if a vertical expansion is simultaneously needed, there is no solution to this problem. - Mixed techniques or Guided Bone Regeneration which permit the new formation of bone in those anatomical sites with vertical, horizontal or combined defects or atrophies, restoring a bone volume suitable for positioning osseomtegrated implants. This technique can be practised only where bone conditions permit and which are:

- the presence of a blood clot in the defect to be regenerated;

- the presence of bone peaks;

- adequate release of growth factors from the bone injury in order to increase the influx of osteoblasts.

On many occasions, therefore, the patient's clinical situation is such as not to allow one of the known techniques described above to be practised, thereby entailing an incorrect insertion of implants at the expense of the functionality of the prosthesis.

Disclosure of the invention

The purpose of the present invention is to make an osseomtegrated alveolar implant prosthesis which increases the missing bone volume and at the same time permits the insertion of endosseous implants.

Another purpose of the present invention is to make an osseomtegrated alveolar implant prosthesis able to simultaneously increase the bone volume horizontally and vertically.

Another purpose of the present invention is to make an osseomtegrated alveolar implant prosthesis which no longer requires surgery in hospital for the graft.

A further purpose of the present invention is to make an osseomtegrated alveolar implant prosthesis which can be constructed in various formats in relation to the breadth of bone volume to restore. Another no less important purpose of the present invention is to make an osseointegrated alveolar implant prosthesis which is functional, but at the same time aesthetically pleasing.

Further characteristics and advantages of the invention will be evident from the description of a preferred but not exclusive embodiment of an osseointegrated alveolar implant prosthesis, made by way of a non-limiting example with reference to the appended drawings, wherein:

- Fig. 1 is a three-dimensional view of an osseointegrated alveolar implant prosthesis (1) composed of:

- a plate (2);

- one or more holes (4) depending on the number of implants to be inserted;

- a grill (5) in titanium welded all around the perimeter of the plate

(2);

- a screw implant (6) in titanium for connection to the mesostructure;

- titanium screws (7).

- Fig. 2 shows, from a different angle, a three-dimensional view of the osseointegrated alveolar implant prosthesis (1) shown in Fig. 1.

- Fig. 3 shows in cross-section a three-dimensional view of an osseointegrated alveolar implant prosthesis (1) in which a threaded cavity (9) can be seen made inside the screw implant (6) and suitable to receive an attachment screw (not shown) for the planned prosthetic mesostructure.

- Fig. 4 shows, in a cross-section view, the osseointegrated alveolar implant prosthesis (1) in Fig. 3.

- Fig. 5 shows, in a three-dimensional view, a titanium grill (5). - Fig. 6 shows, in a three-dimensional view, the titanium grill (5) with titanium screws (7) inserted at the four corners.

- Fig. 7 shows, in a three-dimensional view, a preferred embodiment of a plate (2) with a flat base (3) with a single hole (4) made to insert a screw implant (6).

- Fig. 8 shows, in a three-dimensional view, the plate (2) in Fig. 7 in which a narrowing (8) of the hole (4) made at 0.5 mm from the flat base (3) of said plate (2) can be seen.

- Fig. 9 shows, in a cross-section view, the plate (2) in Fig. 8, where in its apical portion a groove (10) can be seen of 0.1 mm in depth and 1 mm in height, needed to weld it to the titanium grill (5).

- Fig. 10 shows the front plate (2) in a cross-section view and according to a further cross-section line.

- Fig. 11 shows, in a front view, a screw implant (6) fitted, in the part between the smooth coronal part and the rough, coiled, apical part, with a flat collar (1 1).

- Fig. 12 shows, in a three-dimensional view, a screw implant (6) in which a threaded cavity (9) suitable to receive an attachment screw for the intended prosthetic mesostructure, may be seen.

- Fig. 13 shows, in a three-dimensional view, an alternative embodiment of the plate (2) in Fig. 7 with two holes (4) instead of just one.

- Fig. 14 shows, in a three-dimensional cross-section view, the osseointegrated alveolar implant prosthesis (1) in Fig. 13.

- Fig. 15 shows, in a cross-section view, the osseointegrated alveolar implant prosthesis (1) in Fig. 14.

Detailed description of the invention: According to a preferred but non-limiting embodiment, the present invention relates to an osseointegrated alveolar implant prosthesis (1) for prosthetically increasing missing bone volume and, at the same time, allowing the insertion of endosseous implants more in keeping with the aesthetics and function of the teeth.

Said prosthesis (1) is composed of:

- A titanium plate (2) ranging in height, width and length depending on the size of the bone defect to be corrected and the number of implants to be inserted; said plate (2) has a flat base (3) which lies on the surface of the bone site to be reconstructed. The flat base (3) of the plate (2) has a micro -roughened surface in order to encourage broader and more extensive contact between the bone tissue and said plate (2). All the other surfaces: mesial, distal, vestibular, lingual and coronal, which instead come into contact with soft tissue, are in smooth, polished titanium, with rounded corners and tapered profile.

- One or more holes (4), depending on the number of implants to be inserted, centrally located with respect to the plate (2) and axial in the coronal-apical direction, i.e. vertically crossing the plate (2) throughout its height from the apex to the base.

- A grill (5) in titanium welded all around the perimeter of the plate (2) i.e. welded to the vestibular, lingual, mesial and distal surfaces. Said grill (5) has three functions:

^■ to stabilise the plate (2) to the recipient bone site;

^■ to serve as a guide for the correct preparation of the implant cavity;

^■ to hold and guide the biocompatible filler material. - A screw implant (6) in titanium with an internal or external anti- rotation system for connection to the mesostructure and having two classes of diameters:

^■ one wide and smooth in the coronal portion and corresponding to the diameter of the through hole (4) situated in the body of the plate (2);

^■ one narrower in the apical portion, provided with a system of coils in roughened, micro-treated titanium which will be screwed and osseointegrated in the basal bone.

- Titanium screws (7).

The screw implant (6) has the following functions:

- to integrate into the bone in its apical portion;

- to attach the plate (2) to the recipient bone site;

- to permit the construction of a dental prosthesis.

The holes (4) may be one or more in number and are made on the plate (2) depending on the number of screw implants (6) to be inserted. These holes (4) have a constant diameter which however narrows (8) at 0.5 mm from the base of the plate (2).

Around the entire apical perimeter of the plate (2) is a groove (10) of 0.1 mm in depth and 1 mm in height needed to weld it to the titanium grill (5).

The grill (5) has different dimensions in the two vestibular-palatal and distal- mesial interproximal portions, being longer in the first portion and shorter in the second in proportion to the space available in the mouth.

The grill (5) in its vestibular and palatal portions is fixed to the bone site using titanium screws (7).

The screw implant (6) is suitable to be placed in the patient's dental arch. Said implant (6) has a dual mo hological-structural system: in its coronal portion it has a diameter and length corresponding to those of the first part of the through hole (4) in the body of the plate (2) and is in polished titanium, while in its apical portion it has the diameter and length corresponding to those of the second part of the hole (4). Said apical portion has a plurality of coils and the titanium surface of said portion is micro roughened to promote greater integration in the bone.

hi the point between the smooth coronal part and the rough and coiled apical part of the screw implant (6) there is a flat collar (11) in polished titanium which corresponds to the narrowing at 0.5 mm from the base of the plate (2). hi the body of the screw implant (6) a threaded cavity (9) is made suitable to accommodate an attachment screw (not shown) for the intended prosthetic mesostructure.

On the head of the screw implant (6) there is a multi-angle, anti-rotation system for connection with the mesostructure which may be indifferently inside or outside the neck of the screw implant (6).

An alternative embodiment of the plate (2) provides that it has greater dimensions (length, width and height) than that of a plate (2) with a single screw implant (6). These increased dimensions are needed for the simultaneous insertion of a number of screw implants (6).

The osseointe grated alveolar implant prosthesis (1) may be customized to the patient by changing hits dimensions depending on the extent of the bone defect to be corrected and the number of implants to be inserted or because of clinical variables; said prosthesis (1) can be produced industrially in various formats which may vary in height and extension in relation to the three- dimensional reabsorption dimensions, the number of screw implants (6) to be inserted and the type of prosthetic rehabilitation planned, hi addition, at the industrial level, the same prosthesis (1) may be made customizing it to the clinical case by means of CAD / CAM techniques.

The osseointe grated alveolar implant prosthesis (1) is positioned using the following method:

- ample exposure of the recipient bone site through a full thickness mucoperiosteal flap;

- levelling and remodelling of the recipient bone crest;

- decortication of the bone surface corresponding to the contact surface with the plate (2) promoting good blood flow;

- storage of residual bone particles possibly mixed with osteoconductive - osteoinductive substitutes;

- positioning of the prosthesis (1) on the bone site and attachment thereof by means of the lingual flap of the grill (5);

- preparation of the surgical implant alveoli through the through holes (4) of the plate (2);

- screwing of the screw implant (6) into the basal bone through the hole (4) of the plate (2) in turn adequately adapted to the bone site including by use of the previously stored particles;

- definitive attachment with the buccal flap of the grill (5);

- closing of the mucoperiosteal flap properly passivated according to common relaxation techniques.

The materials and dimensions of the invention as described above, shown in the appended drawings and claimed below, may be any as needed. Moreover all the details can be replaced with others, technically equivalent, while remaining within the scope of the present patent application.

Claims

An osseointegrated alveolar implant prosthesis (1) for increasing missing bone volume and permitting the insertion of endosseous implants, characterised in that it comprises:

- a plate (2) in titanium having:

- a flat base (3) with a micro-roughened surface to promote contact between bone tissue and plate (2);

- a groove (10) all around the apical perimeter;

- one or more holes (4) centrally located and axial in a coronal- apical direction, having a constant diameter which narrows (8) from the base of the plate (2);

- a grill (5) in titanium welded all around the perimeter of the plate (2) having different dimensions in the two vestibular-palatal and distal- mesial interproximal portions, being longer in the first portion and shorter in the second in proportion to the space available in the mouth;

- a screw implant (6) in titanium:

- positioned in the hole (4);

- provided with an internal or external anti-rotation system for connection to the mesostructure having two classes of diameters:

^■ one narrower in the apical portion, provided with a system of coils in rough, micro-treated titanium which is screwed and osseointegrated in the basal bone. - having a threaded cavity (9) suitable to receive an attachment screw (not shown);

- having in the part between the smooth coronal part and the rough, coiled, apical part, a flat collar (1 1);

- titanium screws (7) to attach the grill (5) to the bone site.