WO2023121576A1

WO2023121576A1 - Ud-smarthybrid denture prosthesis

Info

Publication number: WO2023121576A1
Application number: PCT/TR2021/051481
Authority: WO
Inventors: Mahmut AKAY
Original assignee: Akay Mahmut
Priority date: 2021-12-24
Filing date: 2021-12-24
Publication date: 2023-06-29

Abstract

Completely different from existing denture prostheses and techniques, UD-Smarthybrid is a new denture prosthesis, which is produced without the use of filling materials, but instead contains a light and durable octet-truss lattice structure produced from materials such as Cobalt Chrome, Titanium and Zirconium by applying different design softwares and production machines. UD-Smarthybrid is lighter than all known denture prostheses. By eliminating the filling materials and replacing it with the light lattice structure, the weight on the implant and jawbone are reduced. This is achieved through distributing the vertical and lateral loads to the axles. In this way, UD-Smarthybrid prevents the corrosion, bending and breakage of the implants while allowing them to be used for a long time without dental problems.

Description

UD-SMARTHYBRID DENTURE PROSTHESIS

DESCRIPTION

UD-SMARTHYBRID is a unique denture prosthesis product and design, which is produced without the use of conventional filling materials, but instead contains a light and durable octet-truss lattice structure made of various lattice cell geometric forms.

CURRENT TECHNIQUE

A dental implant (Figure 5, Image 17) (also known as an endosseous implant or fixture) is a medical product that is surgically placed into the jawbone or skull bones to support dental prostheses such as crowns, bridges, removable dental prostheses, facial prostheses, or to use as a fixed support in orthodontic treatments. A biological process called osseointegration is essential on the basis of modern dental implants (Figure 5, Image 19), in which materials such as titanium or zirconia form a tight bond to the bone.

First, the implant is placed so that there is osseointegration (Figure 5, Image 19), and then a dental prosthesis is added (Figure 2, Image 5). Before a dental prosthesis (a tooth, bridge or prosthesis) is attached to the implant or to the abutment (Figure 5, Image 15) that will support the dental prosthesis/crown (Figure 5, Image 14), recovery time is required for osseointegration (Figure 5, Image 19), which may vary according to the patient.

The success or failure of dental implants is directly related to the patient’s general health, the patient’s use of drugs that affect chances of bone integration (Figure 5, Image 19) and the health of the mouth tissues (Figure 5, Image 11) (Figure 5, Image 16). The stress on the implant and prosthesis placed on the implant should also be evaluated in terms of the success of integration with the bone. When determining the location and number of implants that will be placed in the bone, the biomechanical forces generated during chewing can be significant for the long-term health of the prosthesis. The locations and angles of the implants, the locations and angles of the adjacent teeth are determined by computerized tomography studies applied with laboratory models or CAD/CAM models and surgical implant application guidelines called stents. The prerequisites for the long-term success of dental implants are healthy bones and gingiva (Figure 5, Image 11) (Figure 5, Image 16). Since atrophy may occur after tooth extraction, pre-prosthetic procedures such as sinus lifts or gingival grafts are sometimes required in order to obtain ideal bone and gingiva.

The final version of the prosthesis can be fixed in such a way that the person cannot remove the prosthesis or teeth from the patient’s mouth, or it can be made movable so that the patient can remove it when necessary. In each case an abutment is placed on the implant fixture. In fixed prostheses, the crown, bridge or prosthesis is fixed to the abutment with lag screws or dental cement. When the prosthetic is movable, the two parts are secured together with a piece (adapter, locator, etc.) suitable for the prosthesis.

The risks and difficulties in implant treatment can be divided into those that occur during surgery (such as excessive bleeding or nerve injury), those that occur in the first six months (such as infection or failure to osseointegrate) and those that occur in the long-term (such as peri-implantitis or mechanical failures).

In the presence of healthy soft tissues, a well-integrated implant with appropriate biomechanical loads will have a lifespan of 5-years and more in 93-98% of cases and a lifespan of 10-15 years for prosthetic teeth. Long-term studies show that the 16-to-20-year success rate (if implants remain without problems or corrections) is 52-76%, with complications occurring up to 48% of the time.

An implant supported bridge (or fixed denture) is formed by fixing a group of teeth to the implants and the denture cannot be removed by the patient. They are similar to conventional bridges, except that the prosthesis is supported and retained by one or more implants instead of natural teeth. Bridges are generally attached to more than one implant and can also about the teeth on the anchor points. Typically, the number of teeth will outnumber the anchor points with the teeth, while the abutments (Figure 5, Image 15) on the implants act as cut teeth, bodies called pontics come into the spaces. Implant supported bridges are attached to the implant abutments in the same way as a single tooth implant replacement. A fixed bridge may replace as few as two teeth (also known as a fixed partial denture) and may extend to replace an entire arch of teeth (also known as a fixed full denture). In both cases, the prosthesis is said to be fixed because the denture wearer cannot remove it.

Developed in the 1990s, the AII-on-Four procedure quickly became recognized as one of the biggest breakthroughs in modern dentistry. Created by the famous dentist, inventor, and businessman Paulo Malo, in collaboration with a Swiss prosthetics company called Nobel Biocare, this procedure allows the teeth arches to be attached to the entire jaw in one implant procedure. The full arc could be installed with four titanium screws faster, cheaper and less deformation, than the traditional method where a separate implant process was required for each tooth.

Since developing the AII-on-Four method, Malo has become synonymous with innovations in the world of dentistry. His inventions have concentrated on dental bridges and implants, and he has co-authored numerous published books and scientific papers. Today he is the president of the Malo Clinic in Lisbon and travels the world to lecture on clinical topics. Beyond his personal accomplishments, his All-On-Four method is an internationally recognized brand.

In current practices, since the inside of the prosthesis is filled (Figure 1 , Image 2), it’s weight is quite high (Figure 1 , Image 1). This heaviness causes an increase in the number of implants placed in the jawbone area. Additionally, the heaviness can lead to the attrition of the jawbone and the placed implants, as well as the loss of such implants and damage to the jawbone. Therefore, these implants cannot be used in the medium and long term.

Due to the heaviness of the prosthesis, a passive stance/fit on the jaw cannot be achieved. This causes the implants to have additional weight placed on them. This creates stress on the neck area and on the screws attached to the prosthesis. Therefore, ruptures may occur.

Since the interior of the prosthesis is monolithic (Figure 1 , Image 2), it has a heavy structure. Therefore, as a result of the corrosion caused by pressure, excessive use and impacts; the resistance of the prosthesis may decrease and the prosthesis may rupture. They may be endurable to the pressure from the central and oblique loads (Figure 2, Image 3 and 4).

Company Products

Nobel Biocare All-on-x prosthesis, custom abutments, bar systems

Panthera All-on-x prosthesis, custom abutments, bar systems

THE OBJECTIVE OF THE INVENTION

- Lighter Prosthesis (Figure 1, Image 1)

The inside of our prosthesis invention is not monolithic. Since the inside of the prosthesis is not filled, our invention is much lighter compared to today’s standard prostheses.

- Prevention of excessive central and oblique loads (Figure 1, Image 2)

As a result of this lightness, the stress that may occur on the jawbone or the implant due to high weight is prevented.

In order to prevent buckling due to central loads (Figure 2, Image 3) and contortion caused by oblique loads (Figure 2, Image 4); a structure formed as lattice structure (Figure 3, Image 9) (e.g., consisting of octahedral cells, tetrahedral cells, equilateral triangles, etc.) is placed, while taking into account the patient’s potential bone loss (osteolysis).

Thus, these prostheses are produced with different scales and parameters for each case. Consequently, the load on the implants is reduced/relieved by the lightness and passive stance/fit of the prosthesis. Additionally, this prevents the stress and destruction that may be caused by fractures on the implant’s neck area and on the fractures, screws attached to the prosthesis, as well as reducing the loads on the jawbone. - Durability (Figure 1 and 2)

Due to the implant’s fixed support in the jawbone (Figure 2, Image 4), in order to increase the endurance against vertical and horizontal forces, and to ensure the long-term use of the patient; the lattice structures placed inside the prosthesis (Figure 2, Image 4) increase resistance to loads and improve resistance to corrosion that may occur over time, compared to the prostheses that are filled. As a result, this ensures the long-term usage of the prosthesis. (Figure 1 , Image 2) (Figure 2, Image 3)

Since the prosthesis is emptied and the placement of the lattice structures increases its durability (Figure 3, Image 6 and 7); the prosthesis is light and durable.

- Passive Fit

By increasing the sensitivity between the prosthesis and the implant spacers, it is aimed to not put a load on the screw used for fixing the prosthesis. This situation both reduces the probability of failure of the implant and prolongs the life of the prosthesis.

- Adaptation of Porcelain

Although light materials such as titanium or peek may be used for similar purposes, they are not compatible to be applied porcelain, it's only possible to work with composite on them, which highly increases the costs.

DESCRIPTION OF FIGURES

Figure 1 (Weights of the same cases): Includes sectional views of the UD- SMARTHYBRID and Conventional prostheses displaying the difference in weight of prostheses.

Figure 2 (Distribution of forces): Includes sectional views of the various rods making the lattice structure inside the prosthesis, displaying the distribution of forces independently from the direction of the rods with geometric forms (triangles, squares, pentagons etc.)

Figure 3 (Prosthesis): Sectional view of the octet truss lattice cell, XY plane section and outer wall, displaying the unique structure and design of the prosthesis with examples of lattice cell geometries.

Figure 4 (Jawbone): Sectional view of the placement of the prosthesis inside the jawbone.

Figure 5 (Cross sectional view of the natural tooth and the implant inside the jawbone): Sectional views of the natural tooth and implant bone, displaying the structure of the prosthesis and implant inside the jawbone. REFERENCES

1. UD SmartHybrid denture prosthesis

2. Conventional denture prosthesis

3. Osseo integrated implant with excess central load and flambage strain

4. Osseo integrated implant with oblique loads and contortion effect

5. Distribution of forces with lattice structure

6. Octet truss lattice cell details

7. View from XY plane section of lattice cell

8. Outer wall of prosthesis

9. Examples of lattice cell geometries

10. Natural tooth crown

11. Gum tissue

12. Fibers that attach the tooth to the gum

13. Fibers that attach the tooth to the bone (periodontal fiber)

14. Artificial tooth crown

15. Implant abutment

16. Gum tissue

17. Screw type implant

18. Base

19. Direct relationship of the base to the implant (osseointegration)

EXPLANATATION OF THE INVENTION

UD-SMARTHYBRID DENTURE PROSTHESIS

By replacing the filling structure in dental prostheses with the lattice structure (Figure 3), which is formed by combining various geometric forms, UD- Smarthybrid Denture Prosthesis both reduces the weight of the prosthesis and minimizes the loads on the implant with its lattice structure. The UD- Smarthybrid Denture Prosthesis is three times lighter compared to conventional prostheses. By providing passive fit and screw centering with the hybrid manufacturing method, it is a design and production method that prevents; fractures of the implant neck region, screw fractures and osteolysis on the implant neck area. The natural tooth is wrapped by the periodontal ligament (Figure 5, Image 13) in the tooth socket and is a mobile structure. However, the implant is osseointegred into the jawbone and is therefore an immobile abutment (Figure 2, Image 5). For this reason, while the loads on the natural tooth are distributed within the periodontal ligament, the loads on the implant are transferred directly to jawbone. This situation may lead to bone loss and screw fractures in the neck implant.

Thanks to its lattice structure, UD-Smarthybrid Denture Prosthesis ensures the distribution of stress regardless of the direction of the load (Figure 2, Image 5), thus increasing the strength of the prosthesis and preventing excessive load on the implant.

In addition, during the production phase, with the hybrid manufacturing method, passive fit is achieved by increasing the sensitivity of the sitting between the implant spacers and the prosthesis, enabling very high adaptation precision, and it is aimed to prevent implant losses and prosthesis fractures.

MANUFACTURING METHOD

1 . The product is able to be produced through the data received from oral and intraoral scanning devices coming from the jaw of the patient or by the measurements taken by the conventional (traditional) methods. Firstly, the measurements taken with the conventional method are first drawn on the plaster model to convert them to the physical structure; the model to be studied is created and digitized with scanner (digital scanning) devices.

2. Or the measurement is digitized directly through scanner devices and with the use of 3-D printers, the model which will be worked upon is thus created.

3. In order to make a digitalized impression of the design, dental design programmes such as 3Shape, Exocad, Dentalwings etc. are used.

4. The lattice structure is designed and controlled in respective programs and will be monitored.

5. The data received after the design will be transferred to Materialize, Sap2000, Bodycad and other related engineering and/or medical softwares.

6. Within these softwares, first the inside of the product will be emptied and then the lattice structure composed of octet truss cells will be constructed and placed inside of it.

7. These equilateral triangles (Figure 3, Image 6) and the thickness of the product’s outer wall (Figure 3, Image 8) can change within 100 to 1000 microns, based on the measurements of the patient’s vertical and horizontal bone loss.

8. In order to remove the dust and gas inside the prosthesis that will remain inside after manufacturing, holes with a diameter of 0.2-2 mm between the two implant interfaces that connect the prosthesis to the jawbone.

9. After this process, the product will be transferred to the program called ANSYS in order perform an endurance test of the product of each person and the necessary tests are made and reported.

10. After all these steps, the ready product will be transferred to the relevant CAM software for production. Its optimization will be checked.

11. Production is made with 3D metal printers or 3D resin printers.

12. After the production process, the production residue is evacuated from the holes drilled by using ultrasonic cleaner device, using compressed air and vacuum.

13. The process of closing the said holes before the porcelain stage and removing the gases accumulated in the prosthesis is done by the means of the hydrozone welding flame machine.

14. Starting from the posterior part of the prosthesis, the hydrozone flame and gas will be injected into the drilled hole from the posterior region. The hydrozone fire is applied until fire and dust come out of the eye of the nearest other hole. The holes are then enclosed with CoCr wire. This process continues until there is no hole, dust and gas left.

15. In a 980 degrees Celsius casting furnace, the prosthesis will be preheated for 25 minutes and will then be left for free cooling.

16. The part of the product, which rests on top of the implant, will be engraved with the hex or non-hex structure in CNCs through the use of the CAM software. Likewise, the part, which rests on the tooth, is engraved in CNCs through the use of CAM software.

THE INDUSTRIAL APPLICATION OF THE INVENTION

1 . Area of Utilization

Just as the material can be applied to a single toothless jaw, it can also be simultaneously applied to the lower and upper jaws, or in one of them afterwards. In addition, it can be used in a single jaw with teeth, in both the lower and upper jaws at the same time, or in one of them, which can be applied later. Areas with partial edentulism, the teeth and implant can be operated on together simultaneously, or in cases with full jaws that fit this description can be operated on as well. Just as this can be done for an area with partial tooth, it can also be done for an area with partial implant. In the same manner, this material can be done on 2 implants, or it can be applied without any restriction on the number of implants. Similar to how the material can be cemented on the implant through the use of adhesive, it can also be used without the help of an adhesive by being screwed on the implant. The product can also be cemented in cases of partial edentulism. Just as material can be cemented on the tooth through the use of adhesive, it can also be cemented on the implant together with the teeth on the same jaw through the help of the adhesive. On the other hand, the product can be used together with the teeth and implant in the same jaw by attaching it to the same axis with cement (with an adhesive) or screwing.

2. Materials

It can be made from all biocompatible materials such as CoCr, Ti, Zi, Composite, Composite Resin or Au, for medium and long-term use.

3. Upper Structure

After the foundation is produced; direct porcelain, porcelain crown with direct metal infrastructure, zircon-based porcelain, monolithic zirconium with or without porcelain, composite, composite crown, manufactured tooth, composite gingiva, porcelain gingiva can be applied.

4. Product Benefits

Some of the advantages of the product are; the lightness of the product, its lattice structure (Figure 3), the fact that it distributes the stress originating from central and lateral loads that may cause distortion-contortion and bending to the axes, thereby increasing the strength.

Claims

9

Claim-1. The invention is a denture prosthesis design and manufacturing method, the design process must include the following steps:

• After the jaw model is digitalized, it is transferred to dental design programmes 3Shape, Exocad, Dentalwings etc, in order to design the denture prosthesis.

• In the respective programs, to design the octet-truss lattice structure, various cell geometric forms such as triangular, square, hexagonal will be used and controlled (Figure 3, Image 9).

• The data received from the finalized design will be transferred to Materialize, Sap2000, Bodycad and other related engineering and/or medical softwares.

• Within these softwares, first the inside of the product will be emptied and later the lattice structure composed of octahedral cells, tetrahedral cells will be constructed and placed inside of it.

• These geometric cells and the thickness of the product’s outer wall (Figure 3, Image 8) can change between 100 to 1000 microns, based on the measurements of the patient’s vertical and horizontal bone loss.

• In order to remove the dust and gas that remains inside of the prosthesis after manufacturing, holes with a diameter of 0.2 - 2mm will be left between the two implant interfaces that connect the prosthesis to the jawbone.

• Once this process is done, the product will be transferred to the program called ANSYS which will perform an endurance test and other necessary tests for each patient and will then be reported.

Claim-2. According to Claim-1 the invention is a denture prothesis design and manufacturing method. DMP (Direct Metal Printing) process and its production must include the following steps:

• The finalized design of the lattice structure will transfer to the CAM software to be manufactured and its optimization will be monitored.

• Manufacturing will be made with 3D printers or 3D resin printers.

Claim-3. According to Claim-1 the invention is a denture prothesis design and manufacturing method. The steps after DMP’s production must include the following steps:

• After the manufacturing process, the production residue dust and gas are evacuated from the drilled holes by using an ultrasonic cleaner device which applies compressed air and vacuum.

• Starting from the posterior region of the prosthesis, the hydrozone flame and gas are injected into the drilled hole and come out of the eye of the nearest other hole, the holes are then enclosed with CoCr wire. This process will be continued until the gas has left and the hole is closed.

• In a 980 degrees Celsius casting furnace, the prosthesis will be preheated for 25 minutes and will then be left for free cooling.

• The part of the product which rests on top of the implant will be engraved with the hex or non-hex structure in CNCs through the use of the CAM software. Likewise, the part, which rests on the tooth, is engraved in CNCs through the use of CAM software.