Arrangement and device for using a template to form holes for implants in jaw bone

Installation and device to use a template to form holes for implants in a jaw

The present invention relates, among other things, to an installation for using a template to form holes for implants in a bone, preferably a maxilla, without any negative effect due to the elasticity of the tissues surrounding the bone, for example the gum . The template in question is adapted to the shape or shapes of the bone and gum, and has guide holes for a hole forming unit that may consist of drilling equipment known to itself.

Likewise, the invention relates to a device, according to the above, in which a perforated template to be applied to an implantation point is arranged. In this case, the device comprises one or several first devices arranged to explore the implantation point and cause electronic signals, preferably digital, related to the implantation point and send them to a computer application. The latter is arranged to simulate the implantation point and the perforated template that is adapted to it. The computer application is arranged to provide information on the whole, or part of the simulated situation and is arranged to send or transmit the information to a second device designed for, or cooperating with, the manufacturing equipment to manufacture the simulated perforated template.

The use of templates to form holes is well known, for example, in the jaw. It is also known that it may be difficult to achieve the necessarily accurate formation of the hole unless the gum is bent back and the jaw is therefore exposed, because the gum or the like is a soft elastic mass with elastic properties that can interfere with the application of the template and the formation of the hole.

It is a great inconvenience to carry out surgical interventions to expose the maxilla, that is, folding the gum backwards. This causes discomfort to the patient, and the implantation work is also painful because, due to the formation of the hole and the implant insertion, a healing process that can last a considerable time must follow. There are currently specific needs to substantially shorten the time required for implementation work. It is also convenient to use modern technology with computerized exploration and manufacturing for the templates in question. The main objective of the present invention is to solve this problem.

WO97 / 49351 discloses a dental prosthesis system that incorporates a superstructure, a positioning device and fixed parts.

WO01 / 54609 discloses a superstructure comprised together with other components in a dental prosthesis system.

US5697777 discloses a surgical template and a method for perforating osteotomies.

The article & quot; Édentement complet maxillaire avec atrophie osseuse terminle: prise en charge thérapeutique à propos d'un cas -Partie 2, Réalisation implantaire et prothétique: l'implantologie assistée par ordinateur, Implants -volume 7 -Number 3, 2000 & quot ;, da to know a template supported on a bone.

The invention is defined in independent claims 1 and 10. According to an installation, a template is designed for application to the bone (maxillary) with the gum (of the maxillary) located in the middle, and the template is provided with two or more anchoring elements provided to extend along the gum and parts considerable of the whole bone, and preferably through it, the hole formation unit being arranged to penetrate through the gum during the formation of the hole in the bone (maxillary).

In other embodiments, the template is arranged to form holes for implants for anchoring a dental bridge with various implant arrangements. The anchoring elements can have long and narrow or needle-shaped designs, and can be arranged extending through lateral holes or lateral recesses in the side walls of the template. The anchoring elements for dental bridges are at least three, two of the anchoring elements being arranged at a certain distance from the ends of the bridge, and one or more anchoring elements being arranged in the central parts of the dental bridge. Each anchoring element is arranged to extend substantially horizontally through the gum and maxilla.

According to a device, the computer application mentioned initially is arranged to indicate a perforated template shape for application to the bone, the gum being in the middle. The computer application is also arranged, with the help of information obtained from the first device and / or user information sent to the computer equipment (in the so-called interactive mode between the user and the computer application) and / or empirical information which can be obtained in a library, in a data container element, etc., to perform a determination function in order to determine areas of the nerve (maxillary) rich in nerves. Other features are that, in relation to the information sent to the second device, the computer application is arranged to provide, in addition to the data on the shape of the perforated template, also data relating to positions and extensions for the fixing elements that are intended pass through the gum and into the bone (maxillary), and preferably through it, taking into account the trajectories of these nerve pathways.

Other device developments according to the invention are presented in the dependent claims relating to the device.

A currently proposed embodiment of an installation and a device, according to the invention, will be described below with reference to the accompanying drawings, in which

Figure 1 shows, in a block diagram, a computerized function for the manufacture of a perforated template relative to a patient, where an exploration function is included and the exploration function is connected to a computerized apparatus which, in turn , is willing to distribute information to the manufacturing team for the template in question,

Figure 2 shows, in a horizontal view, a template applied to a jaw with the gum located in the middle, and where the fixing elements are indicated to fix the template to the jaw,

Figure 3 shows the template, gum and maxilla in a vertical view,

Figure 4 shows in perspective, obliquely from the upper right and from the front, the application of a template to a lower jaw,

Figure 5 shows a rear view of the template and the jaw, according to Figure 4,

Figure 6 shows, in perspective, the application of the template to the upper jaw, and

Figure 7 shows the application of the template, according to Figure 6, from above.

In Figure 1, it is schematically indicated as -1-an implant point in the form of a jaw or located thereon. The maxilla is shown in a vertical view -1a-, and in a horizontal view -1b-. The implant point in the jaw is to be provided with a dental bridge, and in the present case all the teeth of the jaw in question are going to be replaced by a dental bridge. The implant can be explored with an exploration function, which can be an X-ray function, for example, computerized tomography. Alternatively, the implant point scan can be performed with a scanner (which can be known by itself), a camera, etc. The scanning function in question is indicated schematically with the numeral -2-and the scanning function of the scanning equipment is arranged to generate signals -i1-based on the scanning, in a manner known per se. The equipment comprises an apparatus -3- that receives said signals -i1-. The apparatus -3-is arranged to generate signals -i1'-, depending on said signals -i1-, and send them to a computerized application that is symbolized as -4-. The computer application can be of a type known to itself and can be, for example, in the form of a PC. In this case, the term computer application should be considered in its broadest sense, in which the computer application has a screen -4a-and -4b-and is provided with memory and software elements that can be of known type. The computer application can operate with software known to itself, which is added or arranged in one or more memory devices -5-, for example in said memory elements. Likewise, the computer application may comprise, or be connected to, other information that can be used in relation to the manufacture of the template, for example applications in the form of library functions and / or empirical functions. This connection function is indicated as -6-in Figure 1.

The computer application is arranged to simulate, preferably visually, the present implant situation as a function of said software known to itself. Also, the application is arranged to use the known software in order to generate a template design that can be used for the implant situation in question. The generation takes place in interaction with a user -7-who, in said interaction, uses a visual screen -4a-computer and a keyboard -4b-, voice control, etc.

The simulation of the implant point and the suitable template made for the formation of holes are transmitted in the form of digital signals -i2-to a manufacturing point -8-for the manufacture of the model. The manufacturing point -8-can be arranged locally or in a remote place, and the transfer of information can be done by means of the computer and / or telecommunications network indicated with the number -9-. Therefore, the manufacturing point -8-produces a template -10-corresponding to the simulated template in the computer application. The template is provided with recesses or holes -12-guiding the device (hole) -11-hole formation, with positions corresponding to the planned positions for implants in the jaw. The template -10-is prepared to be placed in a jaw or equivalent -13-which is covered by the gum -14-. According to the concept of the invention, the template will be applied to the jaw -13-with the gum -14-placed in the middle.

Therefore, said information -i2-contains information related to the design of the template. In addition, the information -i2-contains data on the positions and extensions for fasteners that are intended to pass through the gum and into and preferably through the bone (maxillary). Furthermore, said information -i2 contains data on the trajectories of nerve pathways related to the bone / maxilla.

In Figure 2, the template -10-is applied on the gum and maxilla. The information on the applications of the implants from the computer application -4- (see figure 1) results in drilling hole positions that have been established in the template -10-. In the illustrative embodiment according to Figure 2, the drilling holes -15-, -16-, -17-, -18-and -19- have been created. The application of said fixing elements is arranged as a function of said positions of the holes and of the implants. In a template -10-, for a given dental bridge, the external fixation elements -20-, -21-are arranged to cross the gum and maxilla at the ends -10a-and -10b-of the dental bridge and / or between the outermost and adjacent fixed parts in the dental bridge. Alternative or supplementary positions are indicated by dashed lines -20a-and -21a-, respectively. Additional fasteners -22-, -23-extend through the gum and bone in central parts -10c-of the dental bridge. According to the planning carried out with the help of the computer application -4- (see figure 1), the trajectories for the fixation elements are arranged according to the nerve pathways, or to avoid them, which have been symbolized by -24-, -25-in Figure 2. The fixing elements extend through the jaw in its main horizontal direction. The fasteners are indicated schematically in Figure 2 and have a long and narrow or needle-shaped design. The purpose of the fixation elements is that they will be firmly anchored to the bone / maxilla and that the elasticity of the gum, which is located in the middle, should not affect the position of the template when the template has been anchored to the bone / maxillary through anchoring elements. The formation of the holes in the bone / maxilla means that the gum must be penetrated by the hole-forming equipment (see -11-in Figure 1). The number of fasteners may vary from case to case. In an illustrative preferred embodiment that applies to the example of dental bridges, at least three fixing elements are used, two of the fixing elements being arranged at the ends of said bridge and / or between the outermost fixed parts and the following more exterior, in the dental bridge. Alternative or supplementary positions are indicated by dashed lines -20a-and -21, respectively, and one or more fixing elements are arranged in the central parts.

In Figure 3, the template is indicated with the numeral -10- and the maxillary bone with the numeral -13-, and the gum located in the middle is indicated with the numeral -14-. The template is provided with lateral recesses, showing the numerals -26-and -27-two lateral recesses towards the front, in figure 3.

In Figures 4 and 5, it is indicated with the numeral -28-a lower jaw, and the main nerve path of the lower jaw (lower dental foramen) is indicated with the numeral -29-. The surgical template is shown in -30- and its guiding sleeves in -31-. According to the above, each fixing element -32-can be inserted in a hole or in a hole -33-formation that extends totally or partially in the horizontal direction through the template and the maxilla. The elements have pieces -32a-shaped head, which determine the position of the insert.

In figures 6 and 7, the upper jaw -34- with the template -35-applied and its guiding parts -36- for the fixing elements -37- are shown from below, which are provided with a head -37a- . As is known, each jaw -28-, -34-has underlying bone, and, according to the invention, it is not necessary to open the gum -28a-located on the latter in the embodiment according to Figures 4 and 5. With regard to the structure of the bone and gum, reference is made to the known literature.

The invention is not limited to the embodiment described above by way of example, but can be modified within the scope of the appended patent claims and the inventive concept. Likewise, reference is made to the Swedish patent application filed by the same applicant on the same date, and entitled "Implant arrangement and device". ("Installation and implant device").