WO2006056442A1

WO2006056442A1 - Device supporting the formation of a bone substance on the jaw bone

Info

Publication number: WO2006056442A1
Application number: PCT/EP2005/012574
Authority: WO
Inventors: Thomas Hess
Original assignee: Thomas Hess
Priority date: 2004-11-24
Filing date: 2005-11-24
Publication date: 2006-06-01
Also published as: DE112005002957A5; DE112005002957B4; DE202004018461U1; DE102005056398A1

Abstract

The invention relates to a device for supporting the formation of an additional bone substance on an atrophic jaw bone, which is used to anchor root-like implants. The aim of the invention is to further develop said type of device, such that the root-like implants can be anchored in a more secure manner in the jaw bone, and also if the atrophying of the jaw bone is relatively advanced. In order to achieve said aim, a lateral or lingual cassette (1), which can be secured to the jaw bone, is provided. Said cassette is used in order to receive the bone material and/or a bone-forming matrix which is open on the side oriented towards the jaw bone and on the side oriented away from the jaw bone, and is closed, to a large extent on the crestal and apical level.

Description

Device for supporting the formation of bone substance at

jawbone

The invention relates to a device for supporting the formation of additional bone substance on the jawbone, which serves for anchoring root-like implants.

When anchoring dental-like implants in the jawbone, complications often occur, especially in older patients, in that the jawbone is atrophied to a greater or lesser extent in the area of the alveolar processes, so that sufficient bone substance is no longer available for anchoring the implants. There has therefore been no lack of attempts in the past to feed the jawbone with supplementary bone substance in order to achieve a better anchoring of the root-like implant.

In the known methods, it has usually been attempted to feed the alveolar ridge of the jaw, which has become pointed in cross-section through the atrophy, by crestally applied bone material. However, experience has shown that this method is inadequate, especially for atrophic jaw bones. For this reason, in these cases (see, for example, DE 199 48 910 A1 or EP 0 935 949 A1), implants that are constructed in a complicated manner and otherwise anchored can lead to considerable defect states, especially in the case of implant losses, and have therefore found only a cautious acceptance , It is an object of the invention to develop the device of the type mentioned in that the root-like implants are better anchored to the jawbone, even if the atrophy of the jawbone is relatively far advanced.

To achieve this object, the invention proposes starting from a Vorrich¬ device of the type mentioned a laterally or lingually fixable on the jaw bone, bone material and / or a bone-forming matrix aufneh¬ mende cassette on the jaw bone facing the side open and on the Jawbone side facing away and crestal and apical is largely closed.

With the cassettes according to the invention succeeds, the pine comb from the side, d. H. so lateral or lingual, to feed with bone substance. The fed with the cassettes according to the invention bone substance is therefore no longer crestal, but applied as it were parakrestal. This ensures that the root-like implant is surrounded around its entire length and sufficiently thick with bone substance. As a result, a much better anchorage of the root-like implant succeeds even in largely atrophied jawbone.

A particularly preferred embodiment of the invention is characterized by a fixable on the cassette, krestal projecting into the cassette root-like implant, which is arranged at a distance from the walls of the cassette. In this way, it is achieved that the root-like implant grows from the outset into the forming bone substance, and indeed in the respectively correct position. By maintaining a sufficient distance of the implant relative to the walls of the cassette it is achieved that the bone substance forming the implant surrounds the implant sufficiently thick after removal of the cassette. Instead of the final root-like implant, a suitable placeholder can also be arranged in the cassette, which is later replaced after removal of the cassette by the final implant. This placeholder may be, for example, a thin, more or less long marker pen, in place of which the implant will later be inserted. Finally, it is also possible to use the interior of the First, completely fill the cassette with bone substance and subsequently introduce the implant.

The fixed in the cassette implant is suitably attached to a cassette krestal covering lid. In this way, it is automatically achieved that the ingrown implant after removal of the cassette for attachment z. B. of crowns or the like is easily accessible.

The attachment of the implant on the lid is expediently carried out by a lid crestal penetrating screw. As a result, the lid can be easily released from the remaining implant in the jaw bone after completion of the treatment. The screw hole of the screw can then be used for attaching crowns or the like.

To ensure that the ingrowing implant also has a sufficiently large distance to the walls of the cartridge in its length region, it is provided that the implant is spaced from the walls of the cartridge by spacers arranged on the walls of the cartridge is held.

In an alternative embodiment of the device according to the invention, the implant can also be fastened to the cassette by means of screws, which are screwed into the wall of the cassette and engage in a form-fitting manner in receiving openings of the implant. This makes it possible to easily detach the cartridge from the implant or, if necessary, to slightly adjust the position of the implant relative to the walls of the cartridge.

For attachment to the jawbone, the cassette is provided with lateral fastening tabs. These fastening tabs are thin and easily bendable and can therefore be adapted well to the course of the surface of the jawbone. In order to be able to align the position of the cassette relative to the pine comb transversely and, if necessary, saggittally, if necessary, the lateral fastening tabs are provided with a multiplicity of fastening holes or oblong holes, which permit a corresponding adjustment.

It is further provided that the crestal arranged lid of the cassette, which - as stated above - carries the projecting into the cassette implant is provided with attachment tabs for crestal attachment to the jawbone. In this way it is ensured that the implant attached to the lid assumes the crestal correct position relative to the cassette.

Again, it is provided for fine adjustment that the krestal arranged mounting tabs of the lid are flexible and / or provided with a plurality of Befestigungslöchem or slots.

Furthermore, the invention provides that, if required, a plurality of parallel zueinan¬ arranged cassettes are interconnected. In this way, it is possible to position two or three implants in the correct position along the pine comb and to surround it with sufficient bone substance.

The cassette expediently consists of biocompatible materials such as titanium and ceramic, resorbable plastics (polymers) or stable, resorbable matrices which may be carriers of bone-forming cells. In order not to obstruct the bone growth inside the cassette, the cassette may moreover be provided with holes or slits in suitable places.

Exemplary embodiments of the invention will be explained in more detail below with reference to the drawing. Show it:

Fig. 1: A first embodiment of a cassette according to the invention in plan view A, in Sei¬ tenansicht S and in a view O from above; Fig. 2 is a top view O of a cassette according to the invention in a second embodiment;

3 shows a third embodiment of a cassette according to the invention in plan view A, side view S and in view O from above;

4 shows a fourth embodiment of a cassette according to the invention in plan view A, in side view S and in view O of FIG

10 above;

5 shows a fifth embodiment of a Kas¬ sette according to the invention in plan view A, side view S, in view O from above and in a detail section V-A in the area

15 of the lateral fixing screw;

6 shows a sixth embodiment of a cassette according to the invention in plan view A, side view S, in view O from above and in view U from below;

FIG. 7 shows a seventh embodiment of cassettes according to the invention in plan view A, side view S, top view O and a detail view V-A of the super restraint frame; FIG.

FIG. 8 shows an eighth embodiment of cassettes according to the invention in plan view A; FIG.

9 shows a new embodiment of cassettes according to the invention in plan view A;

10 shows a tenth embodiment of Kasset¬

30 th according to the invention in supervision A;

Fig. 1 1: in side view S two cassettes according to the invention in situ. In the drawing, the laterally or lingually on the jaw bone fixable cassettes are each designated by the reference numeral 1. They are each open on their side facing the pine bone and on the side facing away from the jawbone as well as crestal and aplikal largely closed. The dimensionally stable walls of the cassettes 1 may be provided at appropriate locations with perforations in the form of holes or slots in order to be able to feed the introduced bone matrix sufficiently. The cassettes and their components are made of biocompatible materials, such. As titanium, ceramics, resorbable plastics (polymers) or stable, resorbable Matritzen, which may be carriers of bone-forming cells.

The open towards the jaw bone, cup-shaped cassette 1 is closed at the top by a lid construction having an integrally connected to the walls of the cassette 1 upper cover 2. This upper lid 2 is provided centrally with an opening which is covered from below, by a lower lid 3. This lower lid 3 is connected from below via point connections 4 with the upper lid, such that above the lower lid 3 in the region of the opening of the upper lid 2 remains a receiving space, which for receiving the screw head of a Befestigungs¬ screw 15 for an implant 6 to be fixed in the cassette 1 serves.

To attach the cassette to the jawbone fastening tabs 7 and

8 provided. The lateral fastening straps 7 are fastened laterally to the cassette 1 and are designed to be flexible in order to adapt to the anatomy of the jawbone. In order to make the mounting options as variable as possible, 7 differently shaped and arranged mounting holes are provided in the side fastening tabs, z. B. in the form of slots or in a variety of circular Befestigungs¬ holes. The various possibilities are shown in FIG.

The fastening straps 8 serving for crestal fastening are connected to the lower cover 3. They are also designed to be flexible, as indicated in Figure 1 by an arrow. The fastening straps 8 serving for the crestal fastening can also be fitted with differently shaped attachment holes for adaptation to the anatomical conditions be provided, for. B. in the form of a plurality of circular holes or in the form of slots (see, eg., Figures 1 and 2).

The root-like implant 6, which is located in the cassettes and fastened to the lower lid 3, is additionally held at a sufficient distance from the wraps of the cassette 1 by means of spacers 9 arranged internally on the walls of the cassette.

For the different embodiments of the cassettes according to the invention according to FIGS. 1 to 10, the following should be noted:

FIG. 1 illustrates the above-explained basic structure of the cassette 1 according to the invention, illustrating the different design possibilities for the fastening openings in the fastening slings 7.

FIG. 2 shows an embodiment of the cassette according to the invention with two attachment lugs 7 on the lower lid 3.

FIG. 3 shows an embodiment of the cassette according to the invention, in which the cross section of the cassette tapers from top to bottom.

Figure 4 illustrates the placement of different length implants 6 inside a cassette according to the invention.

FIG. 5 illustrates an embodiment of the cassette according to the invention, in which the fixation of the implant 6 in the interior of the cassette 1 is effected by means of screws 10 which are screwed into the wall of the cassette 1 and have respectively pin-shaped pins in the distal direction, which form-fittingly engage in FIG ¬ speaking formed recesses in the implant 6 engage.

FIG. 6 shows a cassette 1 extended in the apical region, which is closed apically by a complete dome-shaped dome. This coupling region is penetrated by separations 11. At the base of this calotte Ten-shaped dome are nubs 12, which serve as auxiliary elements for Kasset¬ tenentfernung. The nubs 12 are provided with small holes for attachment of tools, so that you can bend the calotte. This embodiment of the cassette 1 is intended for lingual attachment to the jaw (molar area). After successful osteointegration there is no defined deduction direction. Therefore, there must be the possibility of separating or bending the cassette.

Figure 7 shows a juxtaposition of three parallel arranged cassettes according to the invention. The individual cassettes 1 are interconnected by material bridges, between which slots 13 and 14 are located. Through these slots 13 and 14 ensures that the juxtaposed cassettes 1 of the anatomy of the jawbone can be better adapted. In the area of material bridges, the individual cassettes 1 can also be separated from one another, if necessary. FIG. 7 further shows, in the detailed illustration V-A, a supracrestal screw assembly 15 which can be mounted on the end face of the crestal fastening screw 5. It provides information about the angulation of the implants in the cassettes 1 and the positioning of the abutments for the opposing toothing. At the same time, this supracrestal screw assembly 15 may be part of a transmission system.

Figure 8 shows a specific embodiment of three juxtaposed Kas¬ setten 1 with mutually inclined course. The cassettes 1 imitate here the inclination of tooth axes. Figure 9 shows two juxtaposed cassettes 1 with mutually inclined axes and a modified trained lateral slot 13 between the adjacent mounting tabs 7 of the two cassettes 1. In this embodiment, the cassettes 1 according to the invention, the inclination angle between the axes can be subsequently changed.

Figure 10 shows a further embodiment of two interconnected cassettes 1, the axes here, however, have a lasting tendency gegeneinan¬. FIG. 11 shows two embodiments of implant cassettes 1 according to the invention in situ in the upper jaw a in a side view (section). In both depictions, the cassette 1 is already filled with matrix pM or bone chips and placed vestibularly (v) in a prepared bone cavity. The supracrestal structure 15 is used for holding and provides information about the position of the implant body for Gegenbezahnung.

The lower illustration shows a fixed cassette 1 according to the invention with lateral fastening screws 10, as shown in Figure 5, immediately before the seam closure.

- Claims -

Claims

claims

1. Device for supporting the formation of supplementary bone substance on the jawbone, which is used to anchor root-like bone

5 lent implants is used, characterized by a laterally or lingually fixable on the jaw bone, bone material and / or bone-forming matrix receiving cassette (1), which is open on the side facing the jawbone and on the side facing away from the jawbone lo and largely closed crestally and apically ,

2. Apparatus according to claim 1, characterized by a on the cassette (1) fixable, crestal in the cassette (1) projecting root-like implant (6), which at a distance to the walls of the cassette (1) is arranged ange¬.

i5 3. Apparatus according to claim 2, characterized in that the

Implant (6) on a the cassette (1) krestal covering lid (3) is fastened.

4. The device according to claim 3, characterized in that the attachment of the implant (11) on the cover (3) by a cover (3)

20 crestal penetrating screw (5) takes place.

5. Device according to claims 3 or 4, characterized gekennzeich¬ net, that the implant (6) by on the walls of the cassette (1) ange¬ arranged spacer (9) is kept at a distance from the walls of the cassette (1).

6. The device according to claim 2, characterized in that the implant (6) on the cassette (1) by screws (10) is fixed, which are screwed into the wall of the cassette (1) and positively in Aufnah¬ meöffnungen of the implant ( 6) intervene.

5 7. Apparatus according to claim 1, characterized in that the

Cassette (1) is provided with lateral fastening straps (7) for fastening to the jawbone.

8. The device according to claim 7, characterized in that the lateral fastening tabs (7) are provided with a plurality of mounting holes lo or oblong holes.

9. Apparatus according to claim 7, characterized in that the crestal arranged lid (3) of the cassette (1) is provided with fastening straps (8) for crestal attachment to the jawbone.

10. The device according to claim 9, characterized in that the i5 crestal arranged fastening straps (7) are flexible and / or with a

Variety of mounting holes or slots are provided.

1 1. A device according to one of claims 1 to 10, characterized gekenn¬ characterized in that a plurality of parallel arranged cassettes (1) mitein¬ other are connected.

20 12. The device according to one or more of claims 1 to 11, characterized in that the cassette (1) of biocompatible materials such as titanium and ceramics, resorbable plastics (polymers) or of stable, resorbable Matritzen, which may be carriers of bone-forming cells , consist.

25 - Summary -