RU2438618C2 - Method of setting bone implant - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine. A method of setting a bone implant involves making a bone bed, introducing a frame portion of the implant therein, forming a porous layer in between and closing an operative wound The porous layer is initially formed of the rings made of metallic rubber introduced into the bone bed with the help of fixture with filling. Then the frame portion of the implant with a threaded surface is screwed in the porous layer.

EFFECT: invention provides higher strength of the connection and union rate, and also accuracy of implant positioning.

3 cl, 3 dwg

Description

The invention relates to medicine and can be used in surgical and orthopedic dentistry for prosthetics using implants.

Recently, in orthopedic dentistry, the obvious advantage of the installation of porous implants when introducing the jaw bone into the bone part of the alveolar process as a separate tooth, as well as as a support for partial or complete prosthetics, is more and more confirmed. The study of a porous metal material based on titanium wire - metal rubber used as bone implants shows that all pores of this material are through, which facilitates the process of filling them with bone tissue and accelerates healing. The elasticity of the material, which can be set during manufacture within the required limits, will allow in a number of operations to avoid dystrophic changes in the surrounding tissues. Due to the smooth, rounded edges of the pores, there are no local mechanical overstresses during the germination of biological tissues into the prosthesis, which reduces the likelihood of their delamination. The pore structure is such that complete preoperative cleaning of the implant volume and its disinfection is guaranteed, which also ensures high quality of healing. The production technology guarantees the constancy of the chemical composition of the implant at all stages of manufacture and, as a result, ensures the maximum biological compatibility inherent in the selection of the starting material.

From the prior art patent RU No. 2172620 known "Intraosseous dental implant", the authors of Revyakin and others, publ. 08/27/2001, the Method of installation of such a bone implant includes the implementation of the bone bed, the introduction of an implant into it, which in its design contains an outer porous layer of metal rubber with a threaded surface. They screw a porous layer with a thread that is almost impossible to perform into the bone bed, also with a threaded surface. At the same time, stratification and destruction of the porous layer of metal rubber occurs. Since this material practically does not tolerate tensile and shear loads, and can withstand only compressive loads, the disadvantage is the practically impractical operation of screwing a part from metal rubber. When this part is rubbed against the walls of the bone bed, stratification and destruction of the metal rubber will occur.

Closest to the claimed is a method of installing a bone implant according to patent RU No. 2180197 Bogatov A.I. and others. "Method of direct dental implantation", cl. IPC A61C 8/00, publ. 03/10/2002, the Method of installing a bone implant according to the prototype includes the implementation of the bone bed, the introduction of the skeleton of the implant into it, the formation of a porous layer between them and closing the wound. The procedure of insertion and fixation of the implant in the bone bed is carried out by installing the screw frame part of the implant 1/3 of the length of its intraosseous part in a preformed base in the bottom of the bone bed, followed by filling the free space between the implant and the walls of the bed with a porous layer in the form of a granular biocomposite material or crushed demineralized allocation. Thus, in this method, the skeleton of the implant is initially introduced into the bone bed, and then a porous layer is formed. The disadvantages of this method of implant placement are the unwarranted filling of the free space between the implant and the walls of the bone bed with a biocomposite material and the insufficient strength of the resulting joint.

When creating this invention, the problem was solved by creating a method of installing the implant in a cylindrical porous layer previously formed in the bone bed.

The technical result in solving this problem is to increase the strength of the connection and the rate of growth, as well as the accuracy of the positioning of the implant.

The specified technical result is achieved in that, in comparison with the prototype, including the implementation of the bone bed, the introduction of the skeleton of the implant into it, the formation of the porous layer between them and the closure of the wound, in the inventive method, the porous layer is initially formed from rings made of metal rubber inserted into bed with mandrels as the bed is filled, and then the frame part with a threaded surface is screwed into the porous layer. The porous layer is formed from rings made of metal rubber with different porosity, and the bone bed can be made with a threaded surface.

Figure 1 shows the introduction of a porous layer using mandrels.

Figure 2 shows the location of the frame part in the porous layer.

Figure 3 shows the installation of the implant after osseointegration.

Figure 1-3 indicated:

1 - a bone bed;

2 - a porous layer made of rings;

3 - the first mandrel in the form of a rod;

4 - the second tubular mandrel;

5 - frame part;

6 - a stub;

7 - abutment;

8 - fixing screw.

In an example implementation of the proposed installation method, the implant is installed as follows. After local anesthesia is performed, an incision is made, the alveolar bone is exposed and, successively, with two or three drills (reamers), a bone implant bed 1 is formed. The bone bed can have a smooth inner surface, or a thread is cut with a tap, depending on the bone density, to half or the entire length of the formed bone bed. Then, with the help of two mandrels 3 and 4, a porous layer 2 is formed, introducing successively the rings from metal rubber to the level of the cortical bone layer, both mandrels are removed, the frame part 5 of the implant is screwed, the plug 6 is inserted and the surgical wound is sutured. After completion of the osseointegration process (for the lower jaw 3-4 months, for the upper 5-6 months), the intraosseous part of the implant is exposed through a small incision, the plug 6 is removed, the abutment 7 is installed and it is fixed with the fixing screw 8.

The operation to install the frame part of the implant takes place in two stages: first, the formation of the porous layer, the introduction of porous ring elements, and then screwing in the frame part, which allows for more flexible implantation operations, i.e. to regulate the force during installation, to change the size of the porous layer, and if necessary, after the time of ingrowth, to replace the frame part without destroying the already grown porous layer. In the inventive method, when introducing rings of metal rubber using mandrels and when introducing the frame part, the porous layer experiences only compressive loads, which allows to preserve its integrity (porous layer). The use of rings made of metal rubber with different porosity allows them to more accurately correspond to areas of bone with a variable structure, which also increases the strength of the joint and the rate of fusion. The implementation of the bone bed with a threaded surface increases the specific surface contact with the porous material and also increases the strength of the connection and the rate of fusion.

Changing the sequence of operations: the formation of the porous layer, and then the installation of the frame part, in comparison with the prototype, allows you to:

but. to form a uniform porous layer over the entire surface of the bone bed with a guaranteed thickness;

b. ensure clear fixation in a predetermined direction of the implant;

at. ensure uniform pressure between the porous layer and bone tissue to create optimal conditions for osseointegration.

Thus, in comparison with the prototype, the inventive method for installing a bone implant allowed to achieve a technical result: to increase the rate of growth and joint strength while providing gentle installation of the implant by separating the operations of introducing the porous part and screwing the frame part of the implant. In this case, it is possible to adjust the height of the porous layer by changing the number of installed rings of metal rubber, change their porosity at various depths of the bone bed, depending on the structure of the bone, and adjust the screwing force of the frame part.

Claims (3)

1. A method of installing a bone implant, including performing a bone bed, introducing a skeleton of the implant into it, forming a porous layer between them and closing the surgical wound, characterized in that the porous layer is initially formed from rings made of metal rubber inserted into the bone bed using mandrels as they are filled, and then the frame part of the implant with a threaded surface is screwed into the porous layer. 2. The method according to claim 1, characterized in that the porous layer is formed from rings made of metal rubber with different porosity. 3. The method according to claim 1, characterized in that the bone bed is performed with a threaded surface.

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