Dentistry – Apparatus – Having gauge or guide
Patent
1995-12-14
1998-09-01
O'Connor, Cary E.
Dentistry
Apparatus
Having gauge or guide
A61C 1338
Patent
active
058001689
DESCRIPTION:
BRIEF SUMMARY
The present invention relates to the insertion of dental implants in the jaw bones. More particularly, the invention concerns an adjustable guiding device for properly positioning dental implants, an implantation system comprising said device and a method employing the same.
It is well known that fixed dental prostheses such as artificial crowns can be provided by osteointegrated implants, obtained by inserting in the jaw bone tissue an elongated shaft of a suitable material. Said shaft, once implanted, undergoes a process of integration within the bone tissue, and can thus provide a firm support projecting from the gum surface, suitable for connection with a prosthetic element such as an artificial crown.
After having uncovered the bone by removing the gum layer from upon the interested zone the surgical alveolus, i.e. the implant cavity adapted to receive said shaft, is normally obtained in the jaw bone by means of a drilling device. It is extremely important that the hole drilled in the bone tissue has a correct location and inclination with respect to the thickness and morphology of the bone. Care is to be taken to avoid any imperfect fit of the implant, and, most critically, to avoid any perforation of the nearest teeth roots, of the exterior surface of the jaw bone, of the mandibular canal and of the accessory nasal sinuses.
In order to properly direct the drill when making the surgical alveolus, implantologists generally use as a template an acrylic resin mask obtained from a model of the patient's dental arch, adapted to exactly fit over the patient's morsal plane (i.e. the plane lying over the biting surfaces of the teeth). Said mask is provided with a guiding hole in the exact position of the hole to be made or, more preferably, it is provided with a metallic hollow cylinder plunged in the resin in the desired location.
The correct position of the guiding hole or cylinder is determined by the implantologist on the basis of his knowledge and practice, and with the help of a radiographic evaluation of the patient's jaw bone. Once the template is made, however, its configuration cannot be further adjusted. Thus, if the position of the guide in the template, as ascertained by means of X-rays is not correct, a further trial must be made with a new template and further X-rays. In order to avoid further trials or reduce their number, the operator might decide to rely on his skill and experience and empirically modify the direction of the drill forgoing the use of the template.
U.S. Pat. No. 5,015,183 discloses a method for correctly positioning the guiding cylinders or sleeves within a template or stent fitting over the patient's dental arch, which method is carried out with the help of a radio-opaque reference device, comprising a series of regularly spaced radio-opaque wires. Said device is placed in the patients mouth in the site of the missing tooth (or teeth), together with a first stent obtained from a model of the patient's dental arch, bearing another radio-opaque reference wire and X-rays of the patient's jaw bone are taken, thus obtaining a grid of reference points on the resulting radiographic image of the jaw bone section. The optimal direction of the implant seat is determined on the X-ray picture with reference to said radio-opaque grid. After having transversely cut the reference device at a point corresponding to the desired location of the implant, the device is placed on the patient's mouth model and a hole is drilled adjacent to the cut surface of the guiding device, giving to the drill the same inclination as the optimal one determined on the X-ray picture. No guiding means are provided for drilling the pilot hole in the model with the desired inclination, and the latter is obtained by placing the model on a surveying table suitably oriented. After drilling the said hole, a post is inserted therein and a guide cylinder is placed over the post, so that a second stent or template produced on the model will incorporate the guide cylinder in the proper inclination. Any further adjustment
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English language International Search Report for PCT/IT94/00059.
Cascione Antonio
Relandini Luca
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