WO2023057673A1 - Implants hexagonaux externes et internes appliqués au maxillaire supérieur et au maxillaire inférieur pour une hauteur d'os de 3 à 7 mm et pour des secteurs postérieurs atrophiques ayant 2-3 mm d'os au plancher du sinus maxillaire, qui intègrent un élément de fixation auxiliaire ou un ajout prothétique pour l'ancrage initial ou la stabilité et protocole chirurgical associé - Google Patents

Implants hexagonaux externes et internes appliqués au maxillaire supérieur et au maxillaire inférieur pour une hauteur d'os de 3 à 7 mm et pour des secteurs postérieurs atrophiques ayant 2-3 mm d'os au plancher du sinus maxillaire, qui intègrent un élément de fixation auxiliaire ou un ajout prothétique pour l'ancrage initial ou la stabilité et protocole chirurgical associé Download PDF

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Publication number
WO2023057673A1
WO2023057673A1 PCT/ES2022/070626 ES2022070626W WO2023057673A1 WO 2023057673 A1 WO2023057673 A1 WO 2023057673A1 ES 2022070626 W ES2022070626 W ES 2022070626W WO 2023057673 A1 WO2023057673 A1 WO 2023057673A1
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WIPO (PCT)
Prior art keywords
implant
bone
holes
hexagonal
implants
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PCT/ES2022/070626
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English (en)
Spanish (es)
Inventor
Gonzalo Manuel VALLE
Original Assignee
ZARAZAGA MASSETTI, Sebastián
PÉREZ, Gustavo Fernando
DÍAZ, Martiniano Ezequiel
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from ES202130924A external-priority patent/ES2938069A1/es
Priority claimed from ES202230282A external-priority patent/ES2953361A1/es
Application filed by ZARAZAGA MASSETTI, Sebastián, PÉREZ, Gustavo Fernando, DÍAZ, Martiniano Ezequiel filed Critical ZARAZAGA MASSETTI, Sebastián
Publication of WO2023057673A1 publication Critical patent/WO2023057673A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools

Definitions

  • the present invention reveals the development of external and internal hexagonal implants applied to both the upper and lower jaw, also allowing alveolar reconstruction without sinus floor lift for bone height from 3 to 7 mm within the implant framework, furthermore in the invention
  • External and internal hexagonal implants are proposed for atrophic posterior sectors with 2-3 mm of bone to the floor of the maxillary sinus, where said implants incorporate an auxiliary element or prosthetic attachment that allows to improve the initial anchorage or primary or mechanical stability based on traumatological principles. increasing the speed at which bone integration occurs.
  • the invention also shows a surgical protocol for the placement of the implants.
  • a dental implant is a "root” device used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.
  • Dental implants, abutments, and dentures are collectively referred to as dental restorations or implant systems that resemble a tooth or group of teeth (referred to as a "restoration” or “implant system”) as replacements for missing teeth.
  • a dental implant usually looks similar to a real tooth root and is placed inside the jaw bone to replace the missing tooth root. After implantation the surface is fused with the surrounding jaw bone (osseointegration), dental abutments and dental prostheses such as crowns, bridges or implant-supported dentures can be installed.
  • Dental abutments and dentures allow the patient to use the restorations for chewing (also called chewing load).
  • SUBSTITUTE SHEET (RULE 26) The process of placing dental implants into a patient's jaw bone is called dental implantation and is a very strenuous surgical procedure, resulting in bone damage at the bone-implant interface. A relatively long healing period follows this dental implantation process, which lasts at least around two to three months and can extend to six months. During the healing period, bone damage is repaired and replaced with new bone tissue (active biological bone remodeling) and direct bone. Growth or fusion between the surface of the implant and the bone tissue surrounding the implant (osseo-integration) is also achieved.
  • the implant could fail due to bone damage in the pre-existing interstitial bone, weak new bone tissues, and an unstable bone-implant interface with partial osseointegration.
  • the masticatory force applied on an insufficiently healed implant creates excessive micro-motion between the bone and the implant surface, resulting in the development of fibrous tissue at the interface, which could block further osseointegration and cause a eventual failure of the implant system.
  • Bone tissue constantly undergoes a remodeling process, that is, it is reabsorbed by osteoclasts and replaced by new bone formed by osteoblasts.
  • This process of remodeling substitution which begins at six weeks of intrauterine life, and continues until the death of the individual, constitutes the biological basis responsible for the fact that, under certain circumstances, bone tissue can be regenerated with tissue identical to the original, without repair. with fibrous tissue, which represents the biological foundation that allows the osseo-integration of dental implants, regardless of their loading moment.
  • the SLA process (Sandblasted Large Grain Acid Etched Implant Surface) is the best known surface treatment process as it creates surface roughness
  • SUBSTITUTE SHEET (RULE 26) with the aim of improving bone-integration through greater bone-implant contact.
  • the SLA process increases the rate at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface a higher roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseointegration, SLA can help provide greater implant stability that will ultimately extend its longevity.
  • Korean patent application KR2014-0143295 which describes a dental implant that includes an antimicrobial coating layer and a surface treatment method thereof.
  • the invention describes implants made of titanium and coated on the surface of the implant with titanium nanotubes in order to prevent peri-implantitis, where a drug is adsorbed on the coating layer nanotube in order to prevent peri-implantitis with the help of the drug eluted after the implant procedure.
  • the above-described invention has a drawback that the amount of eluted drug is small so as to decrease the antimicrobial effects and degradation of the adhesion between the implants and the alveolar bone may be caused by the nanotube coating.
  • US20120141955 patent application describes a hybrid dental implant having a screw body including a middle part having an interior cavity and one or more lateral openings.
  • the invention further describes that a drug is delivered through the side openings to promote bone regeneration around the implant.
  • the side openings have a rectilinear shape so as to degrade the strength of the implant, and the adhesion between the implant and the alveolar bone is weakened so as to deteriorate the mechanical stability of the implant.
  • US patent application US20150230889 describes a hybrid dental implant comprising a screw body having one or more lateral openings that extend while rotating in the form of a helix.
  • the invention states that a drug is injected through an open space in the upper part, being delivered through the side openings, in such a way that it allows thus accelerating bone regeneration around the implant.
  • the invention described above has a disadvantage that a connecting part of the teeth and the body part of the screw are separated from each other and the implant is manufactured with
  • SUBSTITUTE SHEET (RULE 26) a type of separation to decrease mechanical stability.
  • the injected drug spreads in a short period of time together with the injection, and as a result, sufficient time required to induce activation of bone cells is not guaranteed.
  • One of the objectives of the present invention is the development of exclusive external and internal hexagonal implants for maxillary sinuses without raising the sinus floor (bone height 3 to 7 mm) in atrophic maxillae, thus producing alveolar reconstruction within the framework of the implant, where These implants are treated using an SLA (Sandblasted Large Grain Acid Etched Implant Surface) process that increases the speed at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface roughness at multiple levels, this allows osteoblasts to proliferate and adhere to the implant surface, through osseointegration, SLA treatment helps provide greater implant stability which will ultimately lengthen its longevity.
  • SLA Sandblasted Large Grain Acid Etched Implant Surface
  • Another of the objectives of the present invention is the development of external and internal hexagonal implants, applied both to the upper jaw (posterior atrophic sectors with 2-3 mm of bone at the floor of the maxillary sinus), and to the lower jaw where said implants allow the incorporation of an auxiliary element formed by a through screw with a central hollow part in the shape of a hexagon for external hexagonal implants or with a central hollow part in a circular shape for internal hexagonal implants.
  • This allows for greater primary stability, avoiding fractures, since the auxiliary element is solidly attached to a lateral connection element with at least four holes for fixing the implant in the bone by means of self-tapping and self-drilling screws, all of which increases speed.
  • osseo-integration occurs, since the initial anchorage or primary or mechanical stability is achieved from traumatological principles such as fracture reduction.
  • Figure 1. Shows a view of the external hexagon implant element (1) of the first embodiment for maxillary sinuses without raising the sinus floor, bone height 3 to 7 mm in atrophic maxillae, where the different elements are shown.
  • Figure 2.- shows a view of the outer capsule (8) for the external hexagon implant, of the first embodiment with its elements.
  • Figure 3.- Shows a view of the external hexagon implant element (1) of the first embodiment assembled in the capsule (8).
  • Figure 4.- Shows a top view of the base (11) that incorporates two holes (12) for the introduction of screws in the external hexagon implants of the first embodiment.
  • Figure 5. Shows a view of the internal hexagon implant element (T) of the first embodiment, where the different elements are shown.
  • Figure 6.- shows a view of the outer capsule (8') for the internal hexagon implant, of the first embodiment with its elements.
  • Figure 7.- Shows a view of the internal hexagon implant element (T) of the first embodiment, assembled in the capsule (8').
  • Figure 8. Shows a top view of the base (11') that incorporates two holes (12') for the introduction of screws in the internal hexagon implants of the first embodiment.
  • Figure 10.- Shows a view of the outer capsule (8) for the external hexagon implant, of the second embodiment with its elements.
  • Figure 11.- Shows a view of the external hexagon implant element (1) of the second embodiment assembled in the capsule (8).
  • Figure 12 - shows a view of the auxiliary element with the through screw (14), where the auxiliary element is solidly attached to a lateral connection element (12), in this case a mesh with mini holes (11) and four holes ( 13) in the vertices for fixation of the implant in the bone by means of self-tapping and self-drilling screws.
  • Figure 13a.- shows a view of the external hexagon implant element of the second embodiment and the position that allows coupling the auxiliary element by means of the through screw.
  • Figure 13b.- shows a view of the external hexagon implant element of the second embodiment coupled to the auxiliary element by means of the through screw.
  • Figure 14.- Shows a view of the external hexagon implant element (T) of the second embodiment, where the different elements are shown.
  • Figure 15.- Shows a view of the outer capsule (8') for the internal hexagon implant of the second embodiment with its elements.
  • Figure 16.- Shows a view of the internal hexagon implant element (T) of the second embodiment assembled in the capsule (8').
  • Figure 17.- shows a view of the auxiliary element with the through screw (14'), where the auxiliary element is solidly attached to a lateral connection element (12'), in this case a mesh with micro holes (11'). and with four holes (13') in the corners for
  • SUBSTITUTE SHEET (RULE 26) fixation of the implant in the bone by means of self-tapping and self-drilling screws.
  • Figure 18a.- shows a view of the internal hexagon implant element of the second embodiment and the position that allows coupling the auxiliary element by means of the through screw.
  • Figure 18b.- shows a view of the internal hexagon implant element of the second embodiment coupled to the auxiliary element by means of the through screw.
  • Figure 19.- shows a view of an alternative for the auxiliary element, where the lateral connection element (12') is a rectangular mesh-shaped structure made up of mini holes (11') and with at least four holes (13' ).
  • Figure 20.- shows a view of an alternative for the auxiliary element, where the lateral connection element (12') is an "II"-shaped structure, where the sides of said "II"-shaped structure incorporate at least four holes (13') for fixing the implant in the bone with self-tapping and self-drilling screws.
  • connection implants were designed with the sole purpose of assisting in the placement of the implant in the patient's mouth, but they were never designed to resist forces other than in mandibular sectors in edentulous patients and in fixed screw-retained rehabilitation.
  • this type of implant was later used for partial or single-unit restorations, the hexagon came to be used to prevent rotation of the intermediate and crown.
  • scientific evidence and daily practice in the implantology industry observed the drawbacks of this type of implant; deficiencies that produced great failures in the rehabilitations and, consequently, dissatisfaction of the patient carrying them.
  • the external hexagon is used in many cases when making splints (where many implants are used for full arch rehabilitations), because some non-ideal position in the placement can be corrected in the prosthetic part either with angular abutments or the so-called UCLAS that They are given the desired shape and cast into metal.
  • the implant is designed with a shape that allows the pillar that joins the implant and the prosthesis to be introduced a few millimeters inside the implant itself.
  • Internal connection implants provide great stability and sealing to the union of the implant and the prosthesis. This type of solution minimizes external connection problems: loosening and bacterial filtration. In addition, it transmits the forces directly from the pillar to the internal hexagon and its stabilizing area.
  • the present invention shows the development of exclusive implants for maxillary sinuses without sinus floor elevation (bone height of 3 to 7 mm) in atrophic maxillae thus producing alveolar reconstruction and for atrophic posterior sectors with 2-3 mm of bone to floor of maxillary sinus, where the implants present unique characteristics with a frame that allows bone tissue to regenerate within it and also allows vascularization and the passage of all the growth factors necessary for development and subsequent formation in situ.
  • the implants of the invention make it possible to isolate the environment where the cells that have the capacity to fibro-integrate it are, so the capsule is manufactured in a biocompatible material, such as titanium (grade IV), the external and internal part of the implants have characteristics special for bone development where the SLA process is carried out (acid-etched, large-grained and sandblasted implant surface) and that increases the speed at which bone-integration occurs, giving the surface a greater roughness in multiple levels, so that osteoblasts proliferate and adhere to the implant surface.
  • the SLA process can help provide greater implant stability that will ultimately extend its longevity
  • the implant features an internal structure with space and holes for bone filler materials to produce the scaffolding for development bone, and space for them.
  • auxiliary element or prosthetic attachment made of titanium (or biocompatible material)
  • This auxiliary element is formed by a through screw with a central hollow part in Hexagon shaped for external hexagonal implants or with a circular hollow central part for internal hexagonal implants. This allows greater primary stability, avoiding fractures, since the auxiliary element is solidly attached to a lateral connection element with at least four holes for fixing the implant in the bone by means of self-tapping screws and
  • a titanium mesh or sheet extends horizontally, which can be bent or not, that is, toward the vestibular but also palatal (if the clinical case allows it).
  • fixation holes that will also depend on the clinical case due to the remaining bone in each case, then this horizontal portion continues upwards in upper jaws or downwards in lower jaws, which will have lateral fixation holes to give it stability primary to the implants (more in the maxillary sinuses since it is a pneumatic cavity) can have different shapes and even make it in the form of a mesh in those cases that there is also little bone remnant both vestibular or palatal and thus regenerate these deficiencies, these elements Auxiliaries can be standardized or that the dentist, through the tomography of the patient, requests the manufacture of a customized or personalized design, both in shape, size, holes, etc.
  • auxiliary element or prosthetic attachment is solidly attached, providing great fixation to the implant in the bone by means of self-tapping and self-drilling screws, all of this increases the speed at which the implantation occurs.
  • bone-integration since the initial anchorage or primary or mechanical stability is achieved from traumatological principles such as fracture reduction.
  • This auxiliary element does not receive surface treatment since once the osseointegration period is over, it is removed to begin the final part, which is the placement of the fixed prosthesis on the implant(s).
  • implants are going to receive surface treatments to create roughness on the surface with the aim of improving bone-integration through greater bone-implant contact.
  • the aim is to improve osseointegration and achieve higher long-term implant survival rates.
  • Mechanical treatments include grinding, blasting and machining to generate smoother or rougher surfaces, among other methods.
  • Chemical treatments they are carried out with acids, alkalis or through anodization among other methods. Chemical treatments modify the roughness and composition of the implant surface.
  • the invention also makes it possible to show a simple protocol that can be used by any implantologist for the placement of implants in atrophic maxillary sinuses, without the need for sophisticated equipment or having such advanced training to perform the surgical act.
  • the protocol is accompanied by a special implant design for these cases, since the implant has unique characteristics to avoid adhesions of unwanted tissues for osseointegration, internally it has characteristics for bone development (SLA treatment), space for the bone fillings, a barrier to the environment where the filling materials will be found and protected, and the regeneration of the sinus membrane, which achieves primary anchorage in an atrophic area where it is difficult to achieve due to atrophy.
  • the first preferred embodiment of the invention is the development of exclusive implants for maxillary sinuses without lifting the sinus floor for a bone height of 3 to 7 mm in atrophic maxillae, thus producing alveolar reconstruction, where the implants have unique characteristics with a framework that allows the bone tissue to regenerate within it and that also allows vascularization and the passage of all the growth factors necessary for development and subsequent formation in situ.
  • external hexagon implants have an implant element (1), where a perforation (2') has been made internally along it, where said perforation is made up of a hexagonal structure (2) at the top, leaving the rest of the grooved perforation for housing a screw that, when inserted, allows the tooth to be fixed to the implant element (1).
  • the exterior of the hexagonal structure (2) is located above the implant element (1), protruding from the upper cross section of the implant element (1); a neck arranged in the upper part of the body of the implant (1) with a surface (3) of titanium, smooth and polished to facilitate the adhesion of the gum cells; an implant body (4) arranged in the central part of the implant element (1) that makes it possible to give stability to the whole assembly; and an apex (5) arranged at the lower end of the implant element (1) and which allows it to be anchored in the bone.
  • the anchoring system does not protrude from the support surface of the implant element (1) or the upper cross section of the implant element (1), that is, the hexagonal structure is placed inside the perforation made in the implant element.
  • the external and internal hexagon implants of the first embodiment also present a series of characteristics that allow increasing the speed at which osseointegration occurs through the use of a combination of sandblasting and acid etching to give the surface increased roughness at multiple levels.
  • Sandblasted Large Grain Acid Etched (SLA) implant surface is a type of surface treatment that creates surface roughness with the goal of improving osseointegration through increased bone-implant contact.
  • the external hexagon implant of the present embodiment is made up of an implant element (1), where a perforation (2') has been made internally along its length and topped at the top by a hexagonal structure (2) that is above the implant element (1), overhanging the upper cross section of said implant element (1); a neck arranged below the hexagonal structure (2) with a first surface (3) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3') inferior to the first that presents micro- threads to be treated with the SLA process (acid-etched, sandblasted, large-grain implant surface), which allows creating roughness on the surface with the aim of improving osseointegration, through greater bone-implant contact; an implant body (4) arranged in the central part of the implant element (1), where a plurality of slots (6) have been made at the lower, middle and upper level and which has a plurality of holes (7) between the grooves (6) in at least four directions that cross its entire length.
  • the SLA process increases the rate at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface a higher roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseointegration, SLA treatment helps provide greater implant stability that will ultimately extend its longevity.
  • the implant body (4) is finished off at the bottom by an apex (5) that allows the implant element (1) to be anchored in the bone.
  • the external hexagonal implant also has a capsule (8) where the body of the implant (1) is inserted and threaded by means of a connection element (9).
  • the capsule (8) is made up of a plurality of holes (10) to be treated equally as the internal surface, by means of an SLA treatment.
  • the capsule (8) can have a cylindrical shape and small tabs to hook a collagen membrane inside.
  • the hexagonal implant has a base (11) that incorporates two holes (12) for the introduction of two screws of approximately 1.5mm x 3mm that allow its fixation to the alveolar bone.
  • the internal hexagonal implant of the present embodiment is formed by an implant element (1'), where a perforation (2") has been made internally along the body of the implant (1'). ') and topped at the top by a hexagonal structure (2a) that is located internally and arranged below the upper cross section (3a) of the neck of the implant element (T); a neck with an upper cross section (3a) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3b) inferior to the first and with a greater longitudinal section that presents micro-threads to be treated with SLA process (acid-etched, sandblasted, large-grain implant surface), which allows for the creation of roughness on the surface with the aim of improving bone-integration, through greater bone-implant contact; an implant body (4') arranged in the central part of the implant element (1'), where a plurality of slots (6') have been made at the lower, middle and upper level and which has a
  • the slots (6') and holes (7') also allow the application of an S.L.A. treatment. (acid-etched, sandblasted, large-grain implant surface) with the aim of improving osseointegration through greater bone-implant contact.
  • the internal hexagonal implant also has a capsule (8') where the body of the implant (T) is inserted and threaded through a connection element (9').
  • the capsule (8') is made up of a plurality of holes (10') to be treated equally as the internal surface, by means of an SLA treatment.
  • the capsule (8') can have a cylindrical shape and small tabs to hook a collagen membrane inside.
  • the surgical protocol associated with the placement of external and internal hexagonal dental implants for maxillary sinuses in atrophic maxillae of the present invention requires several stages that start first of all from a clinical and radiographic analysis (Orthopantomography and CT), addition silicone impressions of both jaws, bite registration, Surgery, rinse with chlorhexidine digluconate (0.12%), anesthetize the area to be treated, incision made with a number 15 scalpel that allows a wide flap to be made, where
  • each implant is made of type IV titanium, inside the implant body (4) or (4') arranged in the central part of the implant element (1 ) or (T), an S.L.A. with the aim of improving bone-integration through greater bone-implant contact in the plurality of slots (6) or (6') at the lower, middle and upper level and in the plurality of holes (7) or (7') between the grooves (6) or (6') in at least four directions that cross their entire length for the purpose of injecting filler materials or else the 3D superimposition of the bone apposition.
  • the capsule (8) or (8') is incorporated externally and treated in the holes (10) or (10') in the same way as the implant body (4) or (4'), by means of an SLA treatment, and the union with the rest of the body of the implant is screwed through the connection element (9) or (9'), previously filled with powdered bone regeneration materials of large and small granules mixed with the patient's blood.
  • the capsule (8) or (8'), any of the aforementioned options (it has a cylindrical shape and small tabs to hook a collagen membrane), so that the entire implant is covered with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant and protecting the dispersion of bone filler material in that pneumatic cavity.
  • the implant is covered from the upper part, the membrane protruding from the base of the implant, the implant is inserted slowly and when bone level is reached, two titanium screws of approximately 1.5mm x 3mm are inserted into the holes of the base and They are screwed together with the membrane and overlaid with a barrier of fibrin-rich plasma to achieve initial anchorage or primary stability. Once the implant is screwed and fixed, a suture is made.
  • SUBSTITUTE SHEET implants in maxillary sinuses in atrophic jaws, because it is a simple technique, since osseo-integration occurs inside the implant, which will be able to be nourished and serve as scaffolding for new bone formation due to the holes (10) or (10') left on the outside of the implant. All this is thanks to the specific and unique anatomy of the implant that allows vascularization.
  • the membranes or barriers used are also a primordial factor because we have fibrin-rich plasma that is autogenous and below it the collagen membrane that offers biocompatibility, that is, it does not cause an immune response or chronic inflammation that interferes with the healing of the area. excludes the formation of cells adjacent to the implant, creates and maintains the space for new bone formation, gives stability to the placed filler, thus forming a guide for bone development and preventing the filler material from dispersing through the maxillary sinus along with the feature that the implant itself offers us as well.
  • the initial anchorage or primary or mechanical stability is achieved through the placement of screws that secure it, to then wait for secondary or biological stability, where new areas of direct contact with the implant surface are formed.
  • secondary or biological stability where new areas of direct contact with the implant surface are formed.
  • the implants of the invention are prepared, either external or internal hexagon, inside the implant body (4) or (4') arranged in the central part of the implant element (1) or (1'), where an S.L.A. treatment was carried out in its initial phase.
  • SUBSTITUTE SHEET (RULE 26) the objective of improving bone-integration through greater bone-implant contact in the plurality of grooves (6) or (6') at the lower, middle and upper level and in the plurality of holes (7) or (7') between the grooves (6) or (6') in at least four directions that cross its entire length,
  • the capsule (8) or (8') is incorporated and treated in the holes (10) or (10'), injecting and filling with bone filler materials mixed with the patient's blood, and the union is made with the rest of the body of the implant (1) or (T) screwing it through the connection element (9).
  • the second preferred embodiment is the development of external and internal hexagonal implants, applied in particular to atrophic posterior sectors with 2-3 mm of bone at the floor of the maxillary sinus as well as for the lower jaw, where said implants allow the incorporation of an auxiliary element formed through a through screw with a central hollow part in the shape of a hexagon for external hexagonal implants or with a central hollow part in a circular shape for internal hexagonal implants
  • the external hexagon implant of the second embodiment is formed by an implant element (1) topped at the top by a hexagonal structure (2) that is located above the implant element (1), protruding to the upper cross section of said implant element (1); a neck arranged below the hexagonal structure (2) with a first surface (3) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3') inferior to the first that presents micro- spirals to be treated superficially, which allows creating roughness on the surface with the aim of improving bone-integration, through greater bone-implant contact; an implant body (4) arranged in the central part of the implant element (1), where a plurality of slots (6) have been made at the lower, middle and upper level and which has a plurality of holes (7) between the grooves (6) in at least four directions that cross its entire length. These slots (6) and holes (7) allow a surface treatment to be applied also with the aim of improving bone-integration through greater bone-implant contact.
  • the surface treatment process increases the speed at which osseointegration occurs to give the surface a greater roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseo-integration, the surface treatment helps to provide greater implant stability that will ultimately extend its longevity.
  • the implant body (4) is finished off at the bottom by an apex (5) that allows the implant element (1) to be anchored in the bone.
  • the external hexagonal implant of the second embodiment also has a capsule (8) where the body of the implant (1) is inserted and threaded by means of an element of
  • the capsule (8) is made up of a plurality of holes (10) to be treated equally as the internal surface, by means of a surface treatment.
  • the capsule (8) can have a cylindrical shape and small tabs to hook a collagen membrane inside.
  • the capsule (8) can present coils around its cylindrical structure, which allows a possibility of greater bone retention, since the coils are fixed more firmly to the bone tissue. It should be noted that internally and externally the capsule undergoes a surface treatment to increase roughness and attract beneficial nutrients for osseointegration.
  • the implant of the second embodiment allows incorporating a prosthetic attachment or auxiliary element formed by a through screw (14) with a central hollow part in the shape of a hexagon to introduce the hexagonal element (2) inside said central hollow part to fix this auxiliary element.
  • the hexagonal element (2) is inserted into the central hexagonal hollow part of the auxiliary element as if it were a male-female connection.
  • the auxiliary element is solidly attached to a lateral connection element (12) with at least four holes (13) for fixing the implant in the bone by means of self-tapping and self-drilling screws.
  • the prosthetic attachment or auxiliary element allows the initial anchorage or primary or mechanical stability based on traumatological principles such as fracture reduction, in such a way that they ensure the immobility of the implant (especially in the maxillary sinus, which is a pneumatic cavity and it is difficult to achieve that anchorage in atrophic upper jaws), to then wait for secondary or biological stability, where new areas of direct contact with the implant surface are formed. When the healing process is complete the primary stability is completely replaced with secondary or biological stability.
  • the lateral connection element (12) can be a rectangular structure, that is, as a solid sheet or with a sheet with holes to form a mesh, which does not have a surface treatment because after the osseointegration period it is removed from there to give way to the final stage of fixed prosthesis on the implant, the mesh is made up of mini holes (11) for the passage of nutrients and with at least four holes (13) at the vertices for fixation of the implant in the bone by means of self-tapping and self-drilling screws.
  • SUBSTITUTE SHEET (RULE 26) Mesh allows vestibular and palatal bone augmentation according to the clinical case.
  • the lateral connection element (12) can be a "U"-shaped structure, where the sides of said "II"-shaped structure incorporate at least four holes (13) for fixing the implant in the bone with screws. self-tapping and self-drilling.
  • the internal hexagonal implant of the present embodiment is formed by an implant element (1') topped at the top by a hexagonal structure (2a) that is located internally and arranged below the upper cross section (3a) of the neck of the implant element (1'); a neck with an upper cross section (3a) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3b) inferior to the first and with a greater longitudinal section that presents micro-threads to be treated with surface treatment which allows creating roughness on the surface in order to improve bone-integration, through greater bone-implant contact; an implant body (4') arranged in the central part of the implant element (1'), where a plurality of slots (6') have been made at the bottom, middle and top and which has a plurality of holes ( 7') between the grooves (6') in at least four directions that traverse their entire length; and an apex (5') in the lower part of the body of the implant (4') that allows the implant element (1') to be anchored in
  • the slots (6') and holes (7') also allow the application of a surface treatment with the aim of improving bone-integration through greater bone-implant contact.
  • the internal hexagonal implant also has a capsule (8') where the body of the implant (T) is inserted and threaded through a connection element (9').
  • the capsule (8') is made up of a plurality of holes (10') to be treated equally as the internal surface, by means of a surface treatment.
  • the capsule (8') can have a cylindrical shape and small tabs to hook a collagen membrane inside.
  • the capsule (8') can present coils around its cylindrical structure, which allows a possibility of greater bone retention, since the coils are fixed more firmly to the bone structure.
  • the internal hexagonal implant like the external one, also incorporates an abutment
  • SUBSTITUTE SHEET (RULE 26) prosthetic or auxiliary element formed by a hexagonal through screw (14') with a circular central hollow part, for the incorporation of the prosthetic abutment.
  • the hexagonal through bolt (14') allows its introduction into the hole (2”), since it has a hexagonal shape with appropriate clearance, therefore it acts as a male-female connection between the hexagonal through bolt (14') and the perforation (2”).
  • the prosthetic attachment or auxiliary element incorporates a lateral connection (12') with at least four holes (13') for fixing the implant in the bone by means of self-tapping and self-drilling screws.
  • the lateral connection element (12') can be a rectangular structure, that is, as a solid sheet or with a sheet with holes to form a mesh or different shapes according to the clinical case in a personalized or standardized way, it can serve to carry out a vestibular or palatal or lingual bone regeneration if the case requires it, in the case of a mesh it is made up of mini holes (11') for the passage of nutrients and with at least four holes (13') in the vertices for fixation of the implant in the bone by means of self-tapping and self-drilling screws.
  • the lateral connection element (12') can be a "U"-shaped structure, where the sides of said "II"-shaped structure incorporate at least four holes (13') for fixing the implant in the bone with some self-tapping and self-drilling screws.
  • each implant is made of a compatible biomaterial, inside the implant body (4)
  • SUBSTITUTE SHEET (RULE 26) or (4') arranged in the central part of the implant element (1) or (1'), a surface treatment is performed with the aim of improving bone-integration through greater bone-implant contact in the plurality of grooves (6) or (6') at the lower, middle and upper level and in the plurality of holes (7) or (7') between the slots (6) or (6') in at least four directions that traverse their entire length with the purpose of injecting filler materials or the 3D superimposition of the bone apposition.
  • the capsule (8) or (8') is incorporated externally and treated in the holes (10) or (10') in the same way as the implant body (4) or (4'), by means of a surface treatment, and the union with the rest of the body of the implant is screwed through the connection element (9) or (9'), previously filled with bone regeneration materials mixed with the patient's blood or the clot only as a vehicle for osseointegration.
  • the capsule (8) or (8') has a cylindrical shape, so the entire implant is covered with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant and protecting the dispersion of bone filler material in that pneumatic cavity.
  • the prosthetic abutment or auxiliary element described above is incorporated, either external hexagon or internal hexagon, choosing depending on the clinical situation if the lateral connection element (12) or (12') is the structure is rectangular in the form of a mesh, or structure in the form of "II", as previously described that the shape is variable depending on the case and the standardized or customized production.
  • the membranes or barriers used are also an essential factor because they must have biocompatibility, that is, they do not cause an immune response or chronic inflammation that interferes with the healing of the area, it excludes the formation of cells adjacent to the implant, it creates and maintains the space for the neo-bone formation, gives stability to the filler placed, thus forming a guide for the development of bone and preventing the filler material from dispersing through the maxillary sinus together with the characteristic that the implant itself also offers us.
  • the initial anchorage or primary or mechanical stability is achieved by first anchoring those 2 or 3 mm of bone to the floor of the maxillary sinuses of these
  • SUBSTITUTE SHEET (RULE 26) microthreads completed with the placement of a prosthetic attachment or auxiliary element, to then wait for secondary or biological stability, where new areas of direct contact with the implant surface are formed. When the healing process is complete the primary stability is completely replaced with secondary or biological stability.
  • the membranes or barriers used are a primary factor that offer biocompatibility, that is, they do not provoke an immune response or chronic inflammation that interferes with the healing of the area, excludes the formation of cells adjacent to the implant, creates and maintains the space for neoformation bone, gives stability to the bone filler placed inside the capsule, thus forming a guide for bone development and preventing the filler material from dispersing through the maxillary sinus along with the characteristic offered by the implant itself.
  • all the techniques applied to increase the vertical component in the maxillary sinuses can be performed.
  • the lateral access sinus floor lift technique due to the external fixation achieved, added to the internal characteristics of the implant, times are considerably reduced by about 6 months, since they are going to perform the rehabilitation prosthetics in less time and without having to perform another surgery for the placement of the implant with all that this implies for the professional and the patient.

Landscapes

  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention est un développement dans une première réalisation d'implants hexagonaux externe et interne appliqués au maxillaire supérieur et inférieur pour une hauteur d'os de 3 à 7 mm et dans une deuxième réalisation pour des secteurs postérieurs atrophiques ayant de 2 à 3 mm d'os au plancher du sinus maxillaire, qui intègrent un élément de fixation auxiliaire ou un ajout prothétique pour l'ancrage initial ou la stabilité primaire à partir de principes traumatologiques comme la réduction de fractures et un protocole associé. L'ajout prothétique ou auxiliaire est formé par une vis traversante (14) avec une partie creuse centrale en forme d'hexagone pour introduire l'élément hexagonal (2) dans ladite partie creuse ou bien un élément auxiliaire formé par une vis traversante hexagonale (14'), lequel élément auxiliaire se trouve relié solidement à un élément de connexion latéral (12) ou (12') avec au moins quatre orifices (13) ou (13') pour la fixation de l'implant dans l'os au moyen de vis autotaraudeuses et autoperceuses.
PCT/ES2022/070626 2021-10-04 2022-10-03 Implants hexagonaux externes et internes appliqués au maxillaire supérieur et au maxillaire inférieur pour une hauteur d'os de 3 à 7 mm et pour des secteurs postérieurs atrophiques ayant 2-3 mm d'os au plancher du sinus maxillaire, qui intègrent un élément de fixation auxiliaire ou un ajout prothétique pour l'ancrage initial ou la stabilité et protocole chirurgical associé WO2023057673A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
ES202130924A ES2938069A1 (es) 2021-10-04 2021-10-04 Implantes hexagonales externos e internos para senos maxilares en maxilares atroficos con altura osea de 3 a 7 mm y protocolo quirurgico asociado
ESP202130924 2021-10-04
ES202230282A ES2953361A1 (es) 2022-03-28 2022-03-28 Implantes hexagonales externos e internos aplicados al maxilar superior como al inferior que incorporan un elemento de fijacion auxiliar o aditamento protetico para el anclaje inicial o estabilidad primaria a partir de principios traumatologicos como la reduccion de fracturas
ESP202230282 2022-03-28

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PCT/ES2022/070626 WO2023057673A1 (fr) 2021-10-04 2022-10-03 Implants hexagonaux externes et internes appliqués au maxillaire supérieur et au maxillaire inférieur pour une hauteur d'os de 3 à 7 mm et pour des secteurs postérieurs atrophiques ayant 2-3 mm d'os au plancher du sinus maxillaire, qui intègrent un élément de fixation auxiliaire ou un ajout prothétique pour l'ancrage initial ou la stabilité et protocole chirurgical associé

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4122605A (en) * 1976-09-22 1978-10-31 Kyoto Ceramic Kabushiki Kaisha Somatic element of single crystalline sapphire ceramics
US20110123951A1 (en) * 2009-11-24 2011-05-26 Zimmer Dental, Inc. Porous Implant Device With Improved Core
US8684734B1 (en) * 2003-02-27 2014-04-01 Philip Scott Lyren Dental implant with porous body
ES2738402T3 (es) * 2013-07-17 2020-01-22 Bruno Spindler Soporte de supraestructura y un procedimiento para su fabricación

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4122605A (en) * 1976-09-22 1978-10-31 Kyoto Ceramic Kabushiki Kaisha Somatic element of single crystalline sapphire ceramics
US8684734B1 (en) * 2003-02-27 2014-04-01 Philip Scott Lyren Dental implant with porous body
US20110123951A1 (en) * 2009-11-24 2011-05-26 Zimmer Dental, Inc. Porous Implant Device With Improved Core
ES2738402T3 (es) * 2013-07-17 2020-01-22 Bruno Spindler Soporte de supraestructura y un procedimiento para su fabricación

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