Implantation help assembly

p0001The invention relates to a Implantierungshilfsanordnung for implanting a jaw implant in a patient's jaw, wherein the jaw implant implanted serves for fixing a dental prosthesis to the patient's jaw.

p0002In the whole process, which precedes the actual implantation of the jaw implant, the spatially exact bore of the implant bore is in particular in the patient's jaw is of great importance. For drilling the implant bore, therefore, templates are used which are placed onto the patient jaw, and having a guide bore for drilling the implant hole in the patient's jaw. Known Implantierungshilfsanordnungen and method for producing a template for drilling an implant hole in the patient's jaw are relatively complex, imprecise, error-prone and difficult to handle.

p0003Object of the invention is in contrast to provide an easy to use Implantierungshilfsanordnung and an easy to use method for manufacturing a template for drilling the implant hole in the patient's jaw.

p0004This object is achieved by an Imp! Antierungshilfsanordnung according to claim 1 or by a method of drilling a bore implant of claim. 7

p0005The Implantierungshiffsanordnung invention comprises at least three parts, namely a jaw adapter, a separate template and a separate marker plate.

p0006The jaw adapter has a preferred radiologically-visible individual molding which is to the patient pine adaptable or adapted. The patch on the patient's jaw Individual molding provides the relevant portion of the patient's jaw forth a positive fit, so that the jaw adapter rests reproducible and always in the same position and orientation on the patient's jaw. The jaw adapter establishes a spatially explicit reference to the patient's jaw.

p0007The jaw adapter has a preferred radiologically invisible coupling connector, which also enables the coupling sleeve of the surgical or the marker plate spatially reproducible form-fitting coupling. Under a Kupplungsbuchse all components are understood to enable a spatially reproducible coupling of the drilling template to the jaw adapter or the marker plate on the jaw adapter. The coupling plug or said complementary coupling sleeve may each be a single complex component which fulfills this task, but may be each of several components, together fulfill this function.

p0008The marker plate has a radiologically visible three-dimensional 3-D marker of a spatially unique position and orientation determination of the 3-D marker and with it rigidly and clearly connected parts allowed in its three-dimensional radiological detection. The 3-D markers may be a single complex component that allows a spatially unique position and orientation determination. However, it may also be provided a plurality of individual 3-D markers, which are formed for example as a radiologically visible small spheres each having a diameter of 0.5 to about 3 mm. If the marker plate coupled to the jaw adapter and the jaw adapter is placed on the patient's jaw, is a clear spatial relationship between the patient's jaw and the jaw adapter produced in this way or made radiographically visible. The marker plate has a preferred radiologically nonvisible coupling sleeve which is spatial clearly zusammenkuppelbar with the coupling plug of the jaw adapter.

p0009According to a first preferred embodiment of the Impfantierungshiffsanordnung a prosthesis plate is provided, which comprises at least one radiographically visible prosthetic tooth and a coupling bush which is uniquely oriented zusammenkuppelbar with the coupling connector of the jaw adapter. The prosthetic tooth is radiologically visible and constitutes a planning aid during the virtual planning and construction of the dental prosthesis.

p0010The prosthesis plate may be formed integrally with the marker plate so that the denture plate and the marker plate one and the same component. Preferably, the prosthesis plate is, however, designed as a separate component.

p0011More preferably, the jaw adapter in the region of the patient's jaw where the denture is planned or in which the prosthetic tooth of the prosthesis plate is arranged on a recess. This Ausnehmungs area coincides with the area of ​​Bohrschabionen guide bore which immediately forms in this embodiment, the template for drilling the implant hole in the patient's jaw. Therefore, the jaw adapter preferably has no prosthetic tooth. By jaw adapter recess, it is possible to use the template directly as an implant bore Schalone. Particularly preferably, the template projects in particular with her the guide hole having the area into the recess of the prosthesis plate, so that the overall height of the thus prepared implant bore mask is extremely low.

p0012In a second embodiment, an alternative to the first illustrating embodiment, the jaw adapter at least one prosthetic tooth, which is radiologically visible, and represents a Pianungshilfe in the virtual computer-aided planning and design of the denture.

p0013Preferably, the jaw adapter can have in both embodiments a standardized coupling plate with the coupling plug, the clutch plate is mounted on the individual molding. Also, the drilling template is a standardized Bohrschablonenplatte having the coupling bush. The property "standardized" in this context means that the clutch plate and the Bohrschablonenplatte are mutually zusammenkuppelbar in only one and known location and orientation. Because they are linked to each other and set is known, the individual molding, the clutch plate and the Bohrschablonenplatte can be radiologically-visible formed. Further, it is thereby possible to produce the guide bore by means of generated in the virtual denture planning implant bore location information the guide bore by a machine tool at a location remote from the patient's jaw and the jaw adapter place, and to send only after the production to the treatment site.

p0014According to the method of claim 7, the jaw adapter Individual molding is first molded by the patient's jaw or a real patient jaw model, for example by means of a quick-hardening plastic. Then the coupling plug is attached to the individual molding, for example, by a standard coupling plate including the coupling plug is connected to the individual molding, for example, glued, is. The individual molding with the coupling plug or with the clutch plate forms the jaw adapter.

p0015Subsequently, the marker plate is mounted to the jaw adapter by plugging the marker plate coupling sleeve with the jaw adapter Kuppfungsstecker, and placed the jaw adapter provided with the marker plate to the patient's jaw. This situation is then detected radiographically in three dimensions in the form of a corresponding digital three-dimensional jaw image three-dimensionally, in the jaw image substantially the patient's jaw, and in this case substantially the jaw bone, and the 3-D markers and, where appropriate, of the prosthetic tooth are visible. The quality, accuracy and resolution of the pine image can be further improved by additional optical recording and procedures.

p0016Using the thus obtained three-dimensional image jaw the jaw implant and where the necessary Impfantatbohrung is planned and specified in the form of implant bore location information to a computer.

p0017Subsequently, the guide hole is drilled in the template using the implant bore location information. Here, the dimensions are taken into account with respect to the position of the guide hole, if the dimensions are either an auxiliary drilling template for drilling a pilot hole in the jaw adapter, or else placed on the jaw adapter, already directly represents the implant bore template.

p0018Subsequently, the drill guide is mounted on the jaw adapter by plugging the surgical guide Kupplungsbuchse with the jaw adapter coupling connector.

p0019According to a first embodiment of the further process, which refers to the Implantierungshilfsanordnung according to claims 2, 4 or 5, is used according to the above-mentioned mounting of the jaw adapter including the mounted surgical template in the patient's jaw, and then the implant hole in the patient's jaw in alignment with the Bohrschablane-guide hole drilled. Here, the product bearing the drilling template jaw adapter already directly the implant bore template. As an intermediate step before planning the denture, the placement of a prosthesis plate in the patient's jaw, the denture plate having a radiologically visible denture tooth, and the radiological dimensional detecting an additional pine image this be provided situation. The visible in the maxillary denture tooth image is a planning aid, particularly in planning the denture.

p0020According to a second alternative embodiment of another method, which refers to the Implantierungshilfsanordnung according to claim 3, is provided by the surgical guide assembly, initially using the drilling template in the jaw adapter has a guide bore to be drilled in alignment with the template-guide hole to check whether a drilling template of the jaw adapter removed and the jaw adapter is inserted into the patient's jaw alone. Finally, the implant hole is drilled in alignment with the jaw adapter guide hole in the patient's jaw. So Here, alone of the jaw adapter provided with the guide hole is the implant bore template.

p0021In the following two embodiments of the invention will be explained in more detail with reference to the drawings.

p0022Show it:<ul><li><figref idrefs="f0001">figure 1</figref> a sagittal plane section of a first embodiment of a Implantierungshilfsanordnung which is formed by a jaw adapter, a drill and a marker plate,</li><li><figref idrefs="f0002">figure 2</figref> a sagittal plane section of a second embodiment of a Implantierungshilfsanordnung which is formed by a jaw adapter, a drill, a marker board and a denture plate, and </li><li><figref idrefs="f0003">figure 3</figref> a plan view of the patch on the patient's jaw jaw adapter implantierungshilfsanordnung the <figref idrefs="f0002">figure 2</figref>,</li></ul>

p0023In the <figref idrefs="f0001">figure 1</figref> is a first embodiment of a Implantierungshilfsanordnung 10 which is essentially formed by a jaw adapter 22, a separate template 34 and a separate marker plate 32nd Further, in the<figref idrefs="f0001">figure 1</figref> a patient's jaw 12 shown having a jawbone 18, gum 20 and not be replaced, so "healthy" teeth 14,15,16.

p0024The jaw adapter 22 consists of a radiologically-visible individual molding 24, an attached, for example bonded, standardized and radiologically-visible hitch plate 26 with a plurality of coupling plugs 28 and optionally one or more radiologically visible denture teeth 61,62,63. The jaw adapter 22 is made by first the individual molding 24 of the patient's jaw 12 or a real model of the patient's jaw is 12 molded by means of a quick-hardening plastic. After curing of the plastic, the individual molded part can be removed 24 from the patient's jaw 12, and is the standard clutch plate 26 bonded to the individual molding 24th Furthermore, can be fixed on the 63 individual molding to facilitate the subsequent planning of jaw implants denture teeth 61,62. The denture teeth, however, are alone placeholder and facilitate by their radiological Visibility Zahnprothesen- and jaw implant planning.

p0025On the thus prepared jaw adapter 22, the marker plate 32 is placed through matchmaking the coupling plug 28 with the Markerpiatten-Kuppfungsbuchsen 30th Subsequently, this assembly is placed on the patient's jaw 12 and the patient's jaw, including the jaw 22 and the adapter plate 32 by means of a marker device DVT is detected radiographically in three dimensions. Optionally additional imaging techniques can be used in addition to create the resulting jaw image precisely. Subsequently, the marker plate is again taken 33 of the jaw adapter 22nd

p0026The marker plate 32 has a plurality of 3-D markers 36 in the form of radiographically visible metal balls, are poured into the plastic marker plate body 33 and have a diameter of about 1.0 mm.

p0027After acquiring the three-dimensional image jaw dentures and the associated jaw implants are planned virtually on a computer. In particular, in this case, the position and orientation of the jaw implants in relation to the patient's jaw 12 are each set, this will also be the location information of the associated implant holes 71,72, 73 defined or identified in the patient's jaw 12 respectively in the jawbone 18th

p0028The implant hole location information is then transmitted to the place to be drilled to the corresponding implant using the hole-position information management holes 41,42,43 in the drilling template 34 by a digitally controlled drill. The template 34 is essentially formed by a plastic body 35 having on one side of coupling bushes 30, by means of which a positive coupling with the coupling plugs 28 of the jaw adapter 42 can be produced.

p0029The guide holes 41,42, 43 are so drilled in the drilling template 34 that this would align with the planned implant holes 71,42, 73 when the surgical guide 34 mounted on the jaw adapter 22 and the jaw adapter would be placed on the patient's jaw 12, which so However, is not possible due to the limited space in the patient's mouth.

p0030Therefore, the template 34 is first coupled extraorally to the jaw adapter 22, and manually guide bores 51,52,53 drilled with a drill in the jaw adapter 22 in alignment with the Bohrschabionen-management holes 41,42,43. The drill shaft of the drill is guided by the template-management holes 41,42,43. Subsequently, the template is removed 34 from the jaw adapter 22nd can then, however, do not have to, metal guide sleeves are inserted into the jaw adapter guide holes 51,52,53.

p0031The thus processed pine adapter 22 is now a template to drill the implant holes 71,72,73. The jaw adapter 22 is this, again placed on the patient's jaw 12th Then the implant holes are drilled with a drill manually 71,72,73 in alignment with the jaw adapter guide holes 51,52,53 in the patient's jaw 12, and the jaw adapter 22 eventually removed from the patient's jaw 12th

p0032In the <figref idrefs="f0002">figures 2</figref> and <figref idrefs="f0003">3</figref> is a second embodiment of a Implantierungshilfsanordnung 10 ', which is essentially formed by a jaw adapter 90, a separate marker plate 32, a prosthesis plate 80 and a drilling template 88th

p0033In contrast to the Imptantierungshitfsanordnung 10 <figref idrefs="f0001">figure 1</figref> is at the Implantierungshilfsanordnung 10 'of the <figref idrefs="f0002">figure 2</figref> the jaw adapter 90 provided with a recess 94 in the area in which the dental prosthesis, and therefore the implant bores 71 ', 72', 73 'are provided in the patient's jaw 12, see <figref idrefs="f0003">figure 3</figref>, In this way, the template 88 can with the guide bores 41 ', 42', 'are finally placed in the Bohrschabionen body 89 on the jaw adapter 90, and in this combination already directly as a template for drilling the implant bore 71' 43, 72 ' , 73 'serve. This eliminates the in the embodiment of<figref idrefs="f0001">figure 1</figref> required drilling of pilot holes 51,52,53 in the jaw adapter 22 so that an entire processing step is eliminated and the handling is greatly simplified.

p0034The jaws 90 of the adapter <figref idrefs="f0002">figures 2</figref> and <figref idrefs="f0003">3</figref> in this case is shown as a single body 91, but may also be composed of an individual molding and a standardized coupling plate.

p0035Optionally can be provided an intermediate step, namely the use of the prosthesis plate 80, at the Prothesenplatten.Körper 81 more prosthetic teeth 61 ', 62', 63 'having as a planning aid that are radiologically visible. The prosthesis plate 80 is placed on the jaw adapter 90, and the combination of the prosthesis plate 80 and jaw adapter 90 is then placed on the patient's jaw 12th This arrangement is detected radiologically in three dimensions, and the thus obtained additional pine image superimposed on the Pine image that is taken from the patient's jaw, the jaw adapter 90 sits with the marker plate 32nd

p0036Basically, the use of the prosthesis plate 80 may be omitted, however, for example, and in particular if the to be replaced by the denture original teeth are still in the patient's jaw 12 in the radiological detection of pine image. On the Prothesenptatte 80 can also be dispensed with if the dentures are planned solely by means of the Pine image on the computer, and the denture is related example of a virtual library.

p0037Basically, the 3-D marker 36 can also be cast into the jaw adapter 90 and / or in the prosthesis plate 80 in this embodiment, so that then a separate marker plate 32 would be omitted.

p0038The template 88 may, in particular with their guide bores 41 ', 42', protrude 43 'having the area in the recess 94 of the jaw adapter 90 toward patient's jaw 12, so that together coupled combination of the jaw adapter 90 and the template 88 is very compact.