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

(54)

PATENT INVENTOR INVENTOR'S OFFICE NAME

Nobel Biocare AB (publ), Box 5190 402 26 Gothenburg SE Izidor Brajnovic, Partille SE

Gunnar Olsson

Device and arrangement for drawing up to bone implants, preferably jaw bone holes (56) (57)

CALLED PUBLICATIONS: - - SUMMARY:

A template (30, 35) is utilized to take up holes for bone implants (28, 34), preferably jawbones, without adversely affecting the resilient effect of bone / gum surrounding bone. The template is adapted to the shape or shapes of the bone and bone meat and exhibits guiding holes for the hole receiving unit (drill) (II). The template is designed for application to the bone with the bone meat intermediate and the template is provided cooperatively with two or more anchoring elements (20, 21). 22, 23) intended to extend through the bone meat and into and preferably through substantial portions of the entire bone. The hole receiving unit is thus arranged to penetrate the bone meat at the hole opening in the bone. The invention benefits from the fact that the bone or gum does not need to be folded up for the bone / jaw release, which significantly reduces the installation time for the dental application and spares the patient from a major surgical procedure which involves bone removal.

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The numbers in brackets indicate international identification code, INID code. Letters in clamps indicate international document code.

SUMMARY

A template (30, 35) is utilized to take up holes for bone implants (28, 34), preferably jawbones, without adversely affecting the resilient effect of bone / gum surrounding bone. The template is adapted to the shape or shapes of the bone and the bone meat and exhibits guiding holes for the hole receiving unit (drill) (11). The template is designed for application to the bone with the bone meat intermediate and the template is provided cooperatively with two or more anchoring elements (20, 21, 22, 23) intended to extend through the bone meat and into and preferably through substantial portions of the entire bone. The hole receiving unit is thus arranged to penetrate the bone meat at the hole uptake in the bone. The invention benefits from the fact that the bone or gum does not need to be folded up for the bone / jaw release, which significantly reduces the installation time for the dental application and spares the patient from a major surgical procedure which involves bone removal.

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The present invention relates, inter alia, to a device for removing holes for bone implants, preferably dental bones, by means of a template, without adversely affecting the existing spring effect in the bone surrounding meat, e.g. gums (gingiva). The template in question is adapted to the shape or shapes of the bone and the bone meat and exhibits guiding holes for the hole receiving unit which may consist of a drilling equipment known per se.

The invention also relates to an arrangement according to the above where a hollow template is arranged applicable to an implantation site. The arrangement then comprises one or more first equipment arranged to read the implant site and initiate electronic, preferably digital, signals regarding the implant site to a computer equipment. This is arranged to simulate the implant site and hollow template adapted to the same. The computer equipment is arranged to provide information on all or part of the simulated situation and is arranged to transmit or transmit the information to other equipment which is arranged or cooperates with a manufacturing equipment for or of the simulated hole template.

It is then known in the past to utilize templates in connection with hole making in e.g. jawbone. It is also known that there may be difficulties in obtaining the necessary precise hole apertures unless the bone meat, ie. the gums, are raised and the jaw bone is thus exposed, this being because the gums or the corresponding constitute a soft elastic mass with resilient properties that can interfere with the template application and the hole opening.

There is a major disadvantage in performing surgical procedures in connection with the expulsion of the jaw bone, ie. with the folding of the gums. This causes inconvenience to the patient and the installation work also suffers because the hole removal and implantation must be followed by a healing process that can extend over time. There are now special requests that the time for installation work can be significantly reduced. It is also important that modem technology with computer-based reading and production technology for the templates in question can be utilized. The main object of the present invention is to solve this problem.

What can primarily be considered a characteristic of a device according to the invention is that the template is designed for application to the bone (jaw bone) with the bone meat (gum bone) intermediate and that the template is provided with two or more anchoring elements intended to extend through the bone meat and into and preferably through substantial portions of the entire bone, the hole receiving unit being arranged to penetrate the bone meat (the gums) at the hole reception in the bone (jaw bone).

In further developments of the inventive idea, the template is provided for receiving holes for implants for anchoring a dental bridge with multiple implant connections. The anchoring elements may be of narrow or needle-shaped configurations and may be arranged to extend through lateral holes or lateral recesses in the template sidewalls. The anchor members are adjacent to dental bridges at least three in number, two of the anchor members being arranged at or away from the ends of the tooth bronze and one or more anchor members being arranged at the middle parts of the dental bridge. Each anchoring member is arranged to extend substantially horizontally through the gums and jawbone. Alternatively or in addition, the anchoring elements may extend only partially into the gums.

What can essentially be considered a characteristic of an arrangement according to the invention is, inter alia, that the computer equipment initially mentioned is arranged to indicate a hollow template shape arranged for application to the bone with its bone-meat intermediate. The computer equipment is further arranged to use user information provided by the first equipment and / or to the computer equipment (in so-called interactive interaction between the user and the computer equipment) and / or experience information that can be obtained from libraries, fact-giving bodies, etc. in a determination function determine nerve-rich areas of the leg (jawbone). Further features are that the computer equipment is arranged to indicate, in or in connection with the information to the other equipment, in addition to information about the hollow mold form, information on positions and stretches of retaining elements intended to extend through the bone meat and into and preferably throughout the bone (jawbone). taking into account stretches for said nerve pathways.

Further developments of the arrangement according to the invention can be seen in the subsequent subclaims of the arrangement.

A presently proposed embodiment of a device and arrangement according to the invention will be described in the following with reference to the accompanying drawing, in which Figure 1 shows in block diagram form and in principle a computer-based function for the development of a hole template in connection with a patient, said reading function is included and the scan function is connected to a computer-based equipment, which in turn is adapted to deliver information to a manufacturing equipment for the relevant template, Figure 2 in plan view shows a model applied to a jaw bone with the gum intermediate and where the holding element of the template to a jaw bone is In principle, Figure 3 in vertical view shows template, gums and jawbones in vertical view, Figure 4 in perspective, obliquely from top right and front shows a template's application to a lower jaw bone; Figure 5 from behind shows between and the jaw bone of Figure 4; Figure 6 shows a perspective application of template to an upper jaw; and Figure 7 from above shows the template application of Figure 6.

In Figure 1, an implant site in the form of or at a jaw bone is in principle indicated by 1. The jaw bone is shown partly in a vertical view 1a and partly in a horizontal view 1b. The implant site or jaw bone should be provided with a dental bridge and the present case assumes that all teeth in the jaw bone in question must be replaced with a dental bridge. The implant is readable with a readout function which may be an X-ray function, e.g. computer tomography. Alternatively, the scan of the implant site can be done in an alternate way with scanner (which may be known per se), camera, etc. The sensing function is in principle indicated by 2 and the sensing function or sensing equipment is arranged to generate the sensing in a known manner dependent signals il. The equipment comprises said signals in receiving equipment 3. This equipment 3 is arranged to generate signals il 'in response to said signals il' to a computer-based equipment which is symbolized by 4. The computer equipment may be of a kind known per se and may e.g. have the shape of a PC. The concept of computer equipment is hereby viewed in its broadest sense where the computer equipment has a screen 4a and 4b and is provided with memory means and software (s) which may be of known type. The computer equipment can thereby work with software known per se which is supplied or arranged in memory equipment or memory equipment 5, e.g. said memory means. The computer equipment may also include or be connected to external information useful in connection with the template creation, e.g. equipment in the form of library and / or experience functions. Said connection function is indicated in Figure 1 by 6.

The computer equipment is arranged to simulate, preferably visually, the present implant situation, depending on the software known per se. The equipment is also arranged to be able, with the help of the known software, to generate a template design that is useful for the implant situation in question. The generation takes place in interactive collaboration with a user 7 who in collaboration uses a visual data screen 4a and an operable keyboard 4b, voice control, etc.

The simulation of the implant site and the appropriate template for the drill pick-up obtained in this way is transmitted in the form of digital signals i2 to a manufacturing site 8 for the production of the model. The manufacturing site 8 can be arranged locally or remotely and the information transfer can thus be done via telephone and / or data networks, which are in principle indicated by 9. The manufacturing site 8 thus produces a template 10 corresponding to the template simulated in the computer equipment. The template is provided with hole retrieval device (drill) 11 guiding recesses or holes 12 with positions corresponding to the positions planned in the jaw bone for the implants. The template 10 is intended to be applied to a jawbone or equivalent 13 coated with gum 14.1 In accordance with the idea of ​​the invention, the template shall be applied to the jawbone 13 with the gum 14 intermediate.

Said information i2 thus contains information about the template design. In addition, information i2 contains information on the positions and stretches of retaining elements which are intended to extend through the bone meat and into and preferably through the entire bone (jaw bone). In addition, the said information i2 contains information about stretches for nerve paths in connection with the leg / jaw bone.

In Figure 2, the template 10 is applied to the gums and jawbone. Information on the applications of the implants from the computer equipment 4 (compare Figure 1) has resulted in the borehole positions of the template 10 being determined. In the embodiment according to Figure 2, the boreholes 15, 16, 17, 18 and 19. have been determined. The application of said retaining element is arranged in dependence on said hole and implant locations. In a template 10 for a current tooth bridge, outer retaining members 20, 21 are arranged to extend through the gums and jawbone at the ends 10a and 10b of the dental bronze and / or between the outermost and second outermost fixtures of the bridge (dental bridge). The alternate or complementary dashed positions are indicated by 20a and 21a, respectively. Additional retaining members 22, 23 extend through the bone meat and bone at the middle portions 10c of the dental bronze. In accordance with the planning by means of the computer equipment 4 (compare Figure 1), the stretches of the retaining elements are arranged in dependence on or avoidance of the determined nerve paths which in Figure 2 are symbolized by 24, 25. The retaining elements preferably extend through the jawbone in its main horizontal direction. The retaining elements are shown in principle in Figure 2 and have a long narrow or needle-shaped configuration. The purpose of the retaining element is that they should be securely anchored to the bone / jaw bone and that intermediate bone meat or gums should not affect the position of the template with its resilient property when the template has been anchored to the bone / jaw bone by means of the anchoring elements. The uptake of the holes in the bone / jawbone causes the bone meat / gums to be penetrated by the hole receiving equipment (compare 11 in figure 1). The number of retaining elements can vary from case to case. In a preferred embodiment which applies to e.g. at least three retaining elements shall be utilized, two of the retaining elements being arranged at said bridge ends and / or between the outermost and second outermost fixtures of the bridge (dental bridge). The alternate or complementary dashed positions are indicated by 20a and 21a, respectively, and one or more retaining elements are provided at the middle portions.

In Figure 3, the template is indicated by 10 and the bone or jaw bone by 13 and the intermediate bone or gum by 14. The template is provided with lateral recesses, two front side recesses are shown with 26 and 27 in Figure 3.

In Figures 4 and 5, a lower jaw is indicated by 28 and the main jaw (Foramen Mentalis) by 29. The surgical template is shown by 30 and its guide sleeves by 31. Each holding member 32 is slidably arranged in a hole or hole aperture as above. 33 extending completely or partially through the template and jawbone in a preferably horizontal direction. The elements exhibit insertion position determining means 32a in the form of skull or head.

Figures 6 and 7 show, inter alia, from below the upper jaw bone 34 with applied template 35 and its control means 36 for retaining elements 37 provided with skull or head 37a. Respective jaws 28, 34, in a known manner, have underlying bones and on this existing bone meat 28a in the embodiment according to Figures 4 and 5 thus need not be disclosed in accordance with the invention. Regarding the structure of bone and bone meat, reference is made to the known literature.

The invention is not limited to the embodiment shown by way of example, but may be subject to modifications within the scope of the following claims and the inventive idea. Reference is also made to the Swedish patent application filed on the same day "Device and arrangement for implants".