Dentistry – Prosthodontics – Holding or positioning denture in mouth
Reexamination Certificate
1999-10-08
2001-05-15
Lewis, Ralph A. (Department: 3732)
Dentistry
Prosthodontics
Holding or positioning denture in mouth
C433S223000
Reexamination Certificate
active
06231342
ABSTRACT:
FIELD OF THE INVENTION
The invention relates to customized dental abutments and methods of preparing or selecting such abutments. More specifically, the invention relates to customized dental abutments fabricated through the use of a computer algorithm into which a series of measurements taken of the site for tooth replacement are entered.
BACKGROUND OF THE INVENTION
Dental restorative systems seek to provide cosmetic and functional replacements for missing teeth. A dental restorative system that replaces a single tooth typically includes three components. These are the dental implant fixture, the abutment, and the crown. The dental implant fixture anchors the restorative system to the jawbone. The crown replicates the contour and appearance of the visible portion of the restorative system to match that of the natural dentition. Finally, the abutment connects the crown to the dental implant fixture. The abutment also holds the crown in proper alignment relative to the implant fixture, and absorbs the stress of chewing. A customized abutment should also match the size, shape and contour of the original tooth in order to provide the best possible appearance.
Standard methods for preparing dental restorative systems require considerable time, labor, and expense. Methods typically require that the patient make between six and ten visits to the dentist's office to complete installation of the restorative system. An oral surgeon or periodontist is required to surgically implant the dental implant fixture into the patient's jawbone. A general dentist or prosthodontist typically performs the measurement and fitting of the abutment and crown, and a technician typically sculpts the abutment and crown.
During the first office visit, an impression of the patient's existing teeth is made. During the second visit, the dental implant fixture is installed in the patient's jawbone. At the third visit, a temporary healing abutment is installed in the implant fixture. After healing, a fourth visit is necessary to make an impression of the patient's mouth showing the position of the implant fixture relative to the natural dentition. From this impression, a customized abutment is fabricated. At a fifth visit, the abutment is installed along with a temporary crown. At the sixth visit, the progress of gum healing is examined and a final impression of the patient's mouth is made in order to determine if the abutment needs to be further modified. At the seventh visit, the crown is installed. The number of office visits required increases if the abutment or crown needs to be modified before installation of the final crown.
The standard procedure therefore requires a considerable number of visits to the dentist's office for the patient and the labor of up to three different dental professionals. This time and labor adds to the high cost of undergoing a tooth replacement by this method. Accordingly, there remains a need in the art for a methods and materials that will aid in reducing the time, labor and cost of dental implant restorations. The present invention addresses this need by presenting customized dental abutments and methods of preparing or selecting such abutments in a manner which is quicker and less costly than standard techniques.
SUMMARY OF THE INVENTION
Dental abutments of the present invention are customized to replicate a tooth being replaced. A series of measurements of the tooth site is taken, including measurements of the mesial-distal angle, the facial-lingual angle, the rotational axis of a dental implant fixture implanted at the site of desired tooth replacement, the width, the facial-lingual offset, the mesial-distal offset, and the height from the gumline to the top of a dental implant fixture. In addition to these measurements, a determination of the tooth type (e.g., lateral incisor, first bicuspid, etc.) is made. Additional measurements may include the height to the occlusal plane and the gingival profile of the tooth being replaced. The dimensions, including the size, position,.orientation and inclination, of the adjacent and opposing teeth may also be made.
According to the invention, an abutment is customized by entering measurements into an algorithm that modifies a standard tooth shape for the type of tooth being replaced. The result is a customized abutment that regulates characteristics of the tooth being replaced.
Methods of the present invention provide for the preparation of a customized dental abutment in a manner that reduces the amount of time, labor and cost involved in dental restorative system installation. It has now been realized that taking a series of measurements of the site of tooth replacement allows for the quicker and easier development of a customized dental abutment. Accordingly, methods of the present invention allow for the design and construction of a customized dental abutment based on such measurements.
A method of the invention comprises implanting a dental fixture into a study cast that was previously made of the patient's mouth. This study cast works as a model of the patient's mouth and shows the site of desired tooth replacement as well as its relation to the surrounding teeth. The dental fixture is preferably placed in the study cast using an impression coping device as described in co-owned, co-pending U.S. Ser. No. 08/851,836, incorporated by reference herein.
Once the dental implant fixture is placed in the correct position in the study cast, a preferred method of the invention provides for taking a series of measurements. The measurements include the mesial-distal angle of the site of tooth replacement, the facial-lingual angle of the site, the rotational axis of the fixture, the width of the site, the facial-lingual offset of the site, the mesial-distal offset of the site and the height from the gumline to the top of a dental implant fixture implanted in a patient's mouth. The specific tooth being replaced (e.g., lateral incisor, first bicuspid, etc.) is also determined from its position in the mouth. Based on these measurements a customized dental abutment is fabricated. Other measurements may be used to guide the manufacture of a customized dental abutment These measurements include the height of the occlusal plane, the gingival profile, and the dimensions (e.g., height, width, etc.) of the adjacent and opposing teeth.
In a particularly preferred method of the invention, a computer program is used to generate a model of the customized abutment based on these measurements. The computer is programmed to generate a model of the customized abutment based on the particular tooth being replaced and on the measurements and tooth and fixture positions. The computer is pre-programmed to contain a series of standard tooth shapes for each type of tooth. The standard shape for the particular type of tooth being replaced is then modified to conform to the measurements taken. From this customized model, the computer program generates a file from which a wax prototype of the abutment is generated. From the wax prototype, the abutment is built. The technician need only polish and sterilize the abutment before it can be permanently implanted in the patient's jaw.
Another method of the invention relates to selection of a customized dental abutment from an inventory of such abutments. The inventory is preferably a computer inventory. Measurements such as the mesial-distal angle, the facial-lingual angle, the rotational axis of the dental implant fixture, the width, the facial-lingual offset, the mesial-distal offset, and the height from the gumline to the top of a dental implant fixture implanted in a patient's mouth are taken and compared to the inventory to select a model that most closely replicates the actual tooth being replaced. In addition to these measurements, a determination of the type of tooth (e.g., lateral incisor, first bicuspid, etc.) being replaced is made. Additional measurements may include the height to the occlusal plane and the gingival profile of the tooth being replac
Osorio Julian
Ziegler Andrew
Atlantis Components, Inc.
Lewis Ralph A.
Testa Hurwitz & Thibeault LLP
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