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WO2016045958A1 - Implant de distraction avec mécanisme amélioré - Google Patents

Implant de distraction avec mécanisme amélioré Download PDF

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Publication number
WO2016045958A1
WO2016045958A1 PCT/EP2015/070454 EP2015070454W WO2016045958A1 WO 2016045958 A1 WO2016045958 A1 WO 2016045958A1 EP 2015070454 W EP2015070454 W EP 2015070454W WO 2016045958 A1 WO2016045958 A1 WO 2016045958A1
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WO
WIPO (PCT)
Prior art keywords
implant
implant body
distraction
bone
membrane
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2015/070454
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German (de)
English (en)
Inventor
Domonkos Horvath
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Celgen AG
Original Assignee
Celgen AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Celgen AG filed Critical Celgen AG
Priority to EP15760181.6A priority Critical patent/EP3197387A1/fr
Publication of WO2016045958A1 publication Critical patent/WO2016045958A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003—Not used, see subgroups
    • A61C8/0004—Consolidating natural teeth
    • A61C8/0006—Periodontal tissue or bone regeneration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0022—Self-screwing

Definitions

  • the present invention relates to an implant, preferably a dental implant comprising an implant body and a distraction membrane, the use of the implant for callus distraction and methods of implantation, the implant having a connection mechanism for connecting and moving the distraction membrane along the implant body.
  • the jawbone at the appropriate place must be both thick enough and strong enough. So there must be bone in sufficient quantity as well as quality.
  • the bone needed for jawbone augmentation can be gained during surgery. It can also be used bone substitute material or the addition amount can be stretched by mixing bone and substitute material. This augmentation area is often protected with a flexible membrane, so that an undisturbed healing of the bone can take place.
  • Other procedures include bone spreading, bone splitting, bone-block transplantation, sinus lift, cavity techniques, partial also using bone substitute materials and protective membranes and socket preservation.
  • WO 03/051220 A2 describes a method for distraction of a jaw bone by means of bone segments.
  • DE 10 2010 055 431 A1, WO 01/91663 A1 and US Pat. No. 5,980,252 describe devices and methods for callus distraction by means of artificial interfaces, for example membranes.
  • US Pat. No. 6,537,070 B1 discloses a multipart implant which is intended to produce a distraction osteogenesis by unscrewing the individual parts. However, this is limited at most to the direct area of the implant thread.
  • the present Applicant proposes in the two unpublished applications DE 10 2012 024 205.0 and DE 10 2014 001 377.4 implants, comprising an implant body and a distraction membrane, the distraction membrane along a portion of the longitudinal axis of the implant body by means of a coronal of the membrane located mechanism can be moved.
  • this mechanism is outside the epithelial mucosa.
  • the technical problem underlying the present invention is to provide improved means and methods for dental implantation and bone distraction that enable implantation procedures and jaw bone regeneration procedures to be overcome that overcome the disadvantages of the prior art.
  • the technical problem underlying the present invention is the provision of means and methods that allow a secure To perform tooth implantation when the jawbone has to be built up.
  • the technical problem underlying the present invention is also the provision of Dis
  • vomchtept which have a simple and safe construction.
  • the present invention solves the underlying technical problem in particular by the provision of implants, methods and uses according to the claims.
  • the present invention solves the technical problem underlying it, in particular by providing an implant comprising an implant body having a distal end and an apical end and a distraction membrane, the distraction membrane being connected to the implant body via a linkage mechanism such that the distraction membrane is distal to the implant Implant body is positioned and away from the distal end of the implant body by the connection mechanism, wherein the implant body has at the distal end a first opening from which a recess extends into the implant body in the direction of the apical end and wherein the connection mechanism in the recess of the implant body displaceable is stored.
  • the apical end of the implant body has a second opening which is connected to the recess.
  • the implant body preferably has a bone screw thread on the outside.
  • the bone screw thread of the implant body is designed as a forward and backward cutting tap.
  • the recess has an internal thread, at least in the apical region, wherein the connection mechanism has a sleeve element, wherein at least a portion of the sleeve member is slidably but not rotatably mounted in the recess of the implant body, wherein the connection mechanism has an inner member, wherein at least a portion of the inner member is rotatably but not slidably mounted in the sleeve member, wherein a portion of the inner member protrudes from the sleeve member and having an external thread which is in operative engagement with the internal thread of the implant body, wherein the distraction membrane is connected to the sleeve member.
  • the apical end portion of the inner member protrudes from the sleeve member and has an external thread which is in operative engagement with the internal thread of the implant body.
  • the internal thread in the recess is not continuous.
  • the recess is not formed circular.
  • the recess and the partial region of the sleeve element mounted in the recess of the implant body preferably have a polygonal, in particular triangular, quadrangular, pentagonal, hexagonal, octagonal or polygonal cross section. This ensures that the sleeve element and thus the diaphragm can not rotate.
  • the distal end of the inner element preferably has a point of application for a tool for rotating the inner element.
  • the implant is a dental implant.
  • a provisional dental implant is preferred.
  • the present invention solves the technical problem on which it is based in particular by providing an implant comprising an implant body and a distraction membrane, the distraction membrane being connected to the implant body via a connection mechanism so that the distraction membrane can be displaced along the longitudinal axis of the implant body , and wherein the linkage mechanism is predominantly apical to the distraction membrane.
  • connection mechanism is located at least predominantly in the interior of the implant body and apically of the distraction membrane.
  • the connection mechanism is thus arranged so that it itself and thus also the membrane connected to it can be moved along at least a partial region of the longitudinal axis of the implant body or coronal of the implant body.
  • the implant body has a bone screw thread.
  • An implant with this preferred construction makes it possible advantageously for bone formation by distraction osteogenesis not to require additional, in particular costly, surgical steps than for the actual placement of the implant itself.
  • the procedural steps in setting a conventional dental implant necessarily include the two operative steps a ) Make a threaded hole using a tap or temporary implant and then b) insert and wax the final implant.
  • the optional steps of "setting a pilot hole in the bone” and “extending the pilot hole” can be performed. After healing the final implant is usually a crown on the final implant set. But this can also be the case with temporary implants.
  • an implant according to the invention in step a) no further, in particular costly, operational steps are necessary, although with the implant according to the invention between the steps a) and b) a bone distraction can take place for the construction of the bone surrounding the implant.
  • the placement of the implant body of an implant can advantageously take place in a conventional manner, so that the dentist does not have to learn a new technique. After setting the implant body can then be used without much effort, the membrane and connected by the connection mechanism with the implant body.
  • the membrane Due to the continuous or, in particular, stepwise movement of the lifting mechanism of the connecting mechanism along the implant body away from the bone with a typical distraction speed, the membrane is slowly pulled away from the jawbone so that a distraction osteogenesis occurs between the actual steps a) and b) for a desired period of time.
  • the gradual displacement of the lifting mechanism by the patient or a non-trained helper can be done, as is also common for example when adjusting a brace, since the point of application for a tool on the lifting mechanism is outside the mucosa and thus easy to reach.
  • the connection mechanism can be removed by the dentist without any operational effort from the implant base body.
  • the membrane of the implant can be resorbed, no further operative step is necessary for removal of the membrane since it can remain between the mucous membrane and bone and is degraded there.
  • a nonabsorbable membrane only a small surgical step is needed to remove the membrane.
  • step b) can take place, that is to say the implant body. be removed by and the final implant set.
  • the implant according to the invention may also be a permanent implant and the implant body remain in the bone and provided with a permanent crown, for example, in a dental implant.
  • the present invention also provides an implant which allows the conventional steps a) and b) to be carried out in the usual way, but in between to carry out a bone distraction to build up the bone without major operational effort, with the individual disparaging steps not necessarily being accompanied by a Dentist in a dental office.
  • the implant according to the invention also has the advantage that the implant body does not have to be rotated for distraction but remains rigidly in the bone, so that ingrowth in the bone is improved and irritation of the mucous membrane is avoided by rotating the implant body.
  • the basic structure and the basic function of an implant for bone distraction can also be found in the two not yet published applications DE 10 2012 024 205.0 and DE 10 2014 001 377.4, whose contents are included in the present application.
  • the connecting mechanism serves to fasten the distraction membrane to the implant body and to move the distraction membrane in a controlled manner along the implant body.
  • the connecting mechanism preferably connects the distraction membrane and the implant body in such a way that the contact surface of the membrane, that is to say the surface which bears against the bone defect, is directed in the direction of the tip of the implant body.
  • a suitable connection mechanism are readily known to the person skilled in the art, which permit the inventive connection of the distraction membrane with the implant body and permit a movement, in particular controlled movement of the distraction membrane along the implant body.
  • connection mechanism in which the connection mechanism is located at least predominantly in the interior of the implant body and / or apical of the distraction membrane, additionally has the surprising advantage that the main part of the connection mechanism is located on the apical side of the distraction membrane during the dissection and thus not from the mucous membrane covering the bone.
  • This allows a structure in which only one nut protrudes in the coronal region of the distraction membrane, which can be advantageously formed as a conical spacer sleeve, at the coronal end of a point of application for a tool for moving the distraction membrane can be achieved.
  • the Gegenfiambae the distraction membrane and the nut form a surface and shape that protects the connective tissue located above the bone and in which the connective tissue and the mucous membrane can abut close to the implant body. This reduces the risk of infection and results in better comfort during bone distraction.
  • the distal portion of the membrane lying portion of the sleeve member and the inner member is well suited for receiving a temporary or a crown.
  • the provisional is not in the range of the mechanism of the implant.
  • the mechanics of the implant according to the invention is particularly stable.
  • the implant according to the invention allows maximum utilization of the distraction section.
  • connection mechanism has a first point of application for a tool so that the connection mechanism can be moved or moved along the implant body in a controlled manner with the aid of the tool.
  • the point of application of the tool is at the coronal end of the connection mechanism.
  • connection mechanism or the implant body has a second point of application for a tool so that the bone screw thread of the implant body can be screwed into a bone or out of a bone with the aid of the tool.
  • connection mechanism and the implant body of titanium or a titanium alloy in particular the material TIA14V, zirconium or stainless steel or may contain this, in particular predominantly contain.
  • connection mechanism and / or the implant body may consist of a biodegradable material, in particular of a biodegradable plastic such as polylactide or polycaprolactone, or may contain it, in particular predominantly contain it.
  • the implant body preferably consists of a biogenic and non-biodegradable material.
  • the implant body preferably consists of a metal, in particular titanium or of zirconium, in particular if the implant according to the invention is a dental implant.
  • the person skilled in the art is familiar with suitable materials for a dental implant body.
  • the present invention also solves the technical problem on which it is based by providing an implant, in particular an implant described above, comprising an implant body and a distraction membrane, wherein the implant body is an outer element with a bone screw thread, the outer element being a sleeve having a first distal Opening and preferably formed with a second apical opening, wherein at least a portion of the inner wall of the implant body has an internal thread, wherein the connection mechanism comprises a sleeve member having an outer surface, wherein at least a portion of the sleeve member is slidably but not rotatably mounted in the sleeve of the outer member wherein the sleeve member is formed as a sleeve having a distal opening and an apical opening, wherein the connecting mechanism comprises an inner member, wherein at least a portion of the inner member navb but not slidably mounted in the sleeve of the central member, the inner member having an external thread passing through the apical opening
  • the preferred construction of the outer member, sleeve member, and inner member implant also has the surprising advantage that the major part of the linkage mechanism is located on the apical side of the distraction membrane during distraction and thus does not stick out of the mucosal lining covering the bone. This allows one Structure in which only a portion of the sleeve member and a portion of the central element protrudes in the coronal region of the distraction membrane, at the distal end of a point of application for a tool for displacing the distraction membrane is reached.
  • the opposing surface of the distraction membrane and the sleeve member form a surface and shape which protects the connective tissue located above the bone and in which the connective tissue and the mucosa can abut close to the implant body. This reduces the risk of infection and results in better comfort during bone distraction.
  • this implant structure is very compact. The engagement of the external thread of the inner element in the internal thread of the implant body inner wall prevents unwanted displacement of the central element in the implant body while the non-rotatable mounting of the sleeve member in the implant body prevents rotation of the sleeve member and thus the dis- traction membrane.
  • the sleeve member and the inner member protrude beyond the distal end of the outer member.
  • the distal end of the sleeve element has a point of application for a tool for screwing in or loosening the bone screw thread of the implant body into or out of a bone.
  • a tool for screwing in or loosening the bone screw thread of the implant body into or out of a bone.
  • the central element in the sleeve of the implant body although displaceable, but not rotatably mounted, so that the force acting on the tool transmits directly to the outer member.
  • the distraction membrane is connected to the sleeve member.
  • the membrane can be attached to the sleeve element be clipped, glued or welded.
  • Membrane and sleeve member may also be integrally formed.
  • the distal end of the inner element has a point of application for a tool for rotating the inner element.
  • a tool for rotating the inner element By turning the inner element, its external thread rotates in the internal thread of the implant body, so that the inner element displaces the non-rotatable but displaceable sleeve element in the sleeve of the implant body, and thus also the distraction membrane attached to the sleeve element along the longitudinal axis of the implant body in the coronal region of the implant body shifts.
  • the portion of the sleeve element mounted in the sleeve of the implant body has a triangular, quadrangular, pentagonal, hexagonal or polygonal cross section.
  • the sleeve inner wall of the implant body is then preferably also triangular, quadrangular, pentagonal, hexagonal or polygonal designed so that the sleeve inner wall gives a negative of the portion of the sleeve member as a positive and the sleeve member is slidably but not rotatably mounted in the sleeve of the implant body.
  • an implant according to the invention is preferred, wherein the implant body, in particular the bone screw thread of the outer element, is designed as a thread cutter, in particular a thread cutter cutting forward and backward.
  • the bone screw thread of the implant body is designed as a forward and backward cutting thread cutter.
  • the preferred implant is characterized in particular by the fact that it has an end, in particular a tip for screwing into a bone, wherein the end, in particular the tip is designed as a forward and backward cutting tap. It is particularly advantageous if the implant body has a forward and backward cutting tap. It is possible with this embodiment of the invention that the implant according to the invention in step a) when screwing into the bone in the forward direction in a known manner cuts a thread in the borehole, through which the implant is held in the bone. Thereafter, the bone is formed by the distraction of the membrane.
  • step b) After completion of the bone structure implant of the invention must be removed again so that the final implant in step b) can be set.
  • the implant is removed by unscrewing.
  • the implant is also unscrewed through the newly formed bone. Due to the additional backward cutting function of the tap, a thread is advantageously also cut in the newly formed bone, in particular in a largely atraumatic and compression-free manner. This prevents unnecessary damage to the newly formed bone and allows the final implant to be screwed in without a thread having to be introduced into the newly formed bone in a further intermediate step or without the final implant also having to have a tap.
  • forward and backward cutting tap is advantageous since, after setting and healing of the implant, even smaller corrections in the positioning of the implant are possible by minimizing the turning back of the implant.
  • a person skilled in suitable embodiments of forward and backward cutting taps are known.
  • such a thread cutter are designed as an external thread having at least one corresponding cutting element.
  • Suitable cutting elements are in particular cutting edges or cutting grooves. These can in particular be formed on the threaded mount, for example by at least one corresponding cutting groove between the thread flanks, ie a notch connecting at least two thread valleys, so that at least one threaded mountain has an edge to the notch.
  • the implant is self-tapping.
  • self-tapping is understood to mean that the implant can be inserted immediately after a predrilling of the threaded hole and without pre-cutting the thread
  • the implant has a cutting edge in the apical region for forward cutting be formed the apical end of the threaded mountain.
  • the implant body has a bone screw thread with an apically directed end and a cervical end.
  • the bone screw thread on the cervical end has a cutting edge for cutting backwards.
  • the cutting edge is formed by a recess from the thread mountain formed by the thread mountain in the region of the cervical end of the thread.
  • the cutting edge is in the thread closest to the cervical end.
  • the bone screw thread on the apical end has a cutting edge for forward cutting and cervical forward cutting directed end at least one cutting edge for cutting backwards.
  • the external thread of the tap can be catchy or polygonal.
  • each thread on the cervical end preferably has a cutting edge for cutting backwards.
  • the thread has no recesses or cutting grooves extending along more than two thread valleys and serve, for example, for receiving bone chips when screwing a tap.
  • forward cutting or “forward cutting” is understood to mean that an internal thread is cut into the bone when the implant is screwed into the bone.
  • backward cutting or “backward cutting” is understood to mean that an internal thread is cut into the bone when the implant is being turned out of the bone.
  • the second portion of the implant body having the tap may be based on a threaded portion of a prior art implant except for the feature that it is cutting forward and backward.
  • the length of the tap can also be taken from the prior art.
  • the implant body may widen distally in diameter. Alternatively, it may also be preferred that the implant body has the same diameter, in particular in the apical and distal regions of the external thread, so that the implant body does not taper or widen in the region of the external thread.
  • the distraction membrane is curved.
  • a “distraction membrane” is understood to be a medical membrane which can serve or serve as an artificial interface in a bone distraction or callus distraction.
  • This membrane is preferably rigid and fracture-stable, in particular dimensionally stable such that it can be fastened to a distraction device and can be removed from the bone continuously or in individual steps with the aid of the distraction device at a desired speed, for example pulled away from the bone or pushed away, and the forces acting on it can not be increased
  • a distraction membrane is a specific subset of medical membranes readily available to one skilled in the art from other medical membranes, for example, for ease of covering a K serve still defectively, can be distinguished.
  • a distraction membrane has a contact surface which abuts the bone defect during distraction, and a counter surface which rests against the bone tissue, in particular connective tissue, during distraction.
  • a "bone distraction” or a “callus distraction” is understood to mean a medical procedure for bone regeneration in which an element is slowly removed from a bone defect, so that cells located in a callus formed between the bone defect and the element , in particular osteoblasts, an artificial biomechanical pulse, in particular Bachimpuls is exercised.
  • the element may be, for example, a bone, a bone fragment or an artificial body.
  • the element may be a distraction membrane.
  • a “biomechanical pulse” is understood to mean a mechanical force transmission, in particular the transmission of a tensile force, to a cell, in particular osteoblasts, and the biological processes in the cell triggered thereby.
  • the distraction membrane has a hole through which the connection mechanism or the sleeve element, preferably also the inner element, extends.
  • the distraction membrane has a four-sided base.
  • the edges of the distraction membrane are rounded.
  • the distraction membrane is made of a metal or a metal alloy.
  • the membrane, in particular distraction membrane consists of titanium.
  • the membrane, in particular Disreteionsmembran made of titanium wherein the contact surface is coated, wherein the layer preferably consists of a mineral material or predominantly contains a mineral material.
  • the contact surface may, for example, be coated with hydroxyapatite.
  • the distraction membrane is made of a resorbable material.
  • the membrane can remain between mucous membrane and bone, where it degrades into harmless substances and decomposed.
  • the distraction membrane according to the invention is resorbable, in particular bioresorbable.
  • the distraction membrane is a bioresorbable distraction membrane.
  • Suitable resorbable materials are, for example, magnesium and magnesium alloys, polylactitol or polycaprolactone.
  • the membrane in particular distraction membrane made of magnesium or a magnesium alloy, wherein the contact surface is coated, wherein the layer preferably consists of a mineral material or contains predominantly a mineral material.
  • the contact surface may, for example, be coated with hydroxyapatite.
  • the distraction membrane of the present invention is a distraction membrane for periodontal regeneration by distraction.
  • Periodontal regeneration is understood to mean regeneration of the periodontium, ie not only of the bone but also of the periodontal ligament, the periodontal tissue, the gingiva and the papillae, for example by guided tissue regeneration (GTR)
  • GTR guided tissue regeneration
  • the distraction membrane is
  • the periodontal regeneration distraction membrane is very thin
  • the periodontal regeneration membrane is shaped to have at least one lobe or segment, which or which can be inserted into a tooth space.
  • the membrane preferably has three sections, wherein the middle section is horizontal to the vertical implant body and the two outer sections are curved in the direction of the implant body.
  • This membrane shape surprisingly leads to a particularly gentle distraction. In particular, this does not disturb the blood circulation in the fine vessels of the mucous membrane.
  • the present invention also relates to such a distraction membrane with three sections.
  • an implant according to the invention is preferred, wherein the implant is a dental implant, in particular a provisional or permanent dental implant.
  • implant is.
  • a "dental implant” is understood to mean an alloplastic confectionery part inserted into the jawbone, whose main body is preferably pen-shaped or helical.
  • the implant is a dental implant, in particular a provisional dental implant.
  • the present teaching therefore covers, in particular, dental implants and methods for bone regeneration, wherein bones in the jaw area and / or in the periodontal area are to be regenerated.
  • the implant is for use in bone distraction.
  • the present invention also relates to an implant according to the invention for use for callus distraction, in particular for the construction of a bone, in particular jaw bone, by distraction.
  • the implant is suitable for callus distraction. In a preferred embodiment, the implant is suitable for bone regeneration. In a preferred embodiment, the dental implant is suitable for callus distraction in the jaw region. In a preferred embodiment, the dental implant is suitable for bone regeneration in the jaw area. In a preferred embodiment, the dental implant is suitable for periodontal regeneration in the jaw area. In a preferred embodiment, the implant is intended for use in a medical procedure, in particular in a surgical procedure. In a preferred embodiment, the implant is intended for use in bone regeneration by distraction, especially in the jaw region.
  • the implant according to the invention is suitable for use for bone distraction, in particular of a jawbone.
  • the implant according to the invention serves for use for bone distraction, in particular of a jawbone.
  • Distraction is preferably carried out with the implant according to the invention at a distraction rate of at least 0.2 mm per day to at most 2.5 mm per day, in particular from at least 0.5 mm per day to at most 2 mm per day. More preferably, the distraction rate is about 1 mm per day.
  • the present invention also relates to an implant according to the invention for use for callus distraction, in particular for the construction of a jaw bone by distraction.
  • the present invention also relates to an implant according to the invention for use in periodontal regeneration by distraction.
  • the implant according to the invention is a dental implant with a membrane for periodontal regeneration.
  • Periodontal regeneration is understood to mean a regeneration of the periodontium, ie not only of the bone but also of the periodontal ligament, the periodontal skin, the gingiva and the papillae, for example by guided tissue regeneration (GTR).
  • GTR guided tissue regeneration
  • the present invention also relates to the use of an implant according to the invention in a medical procedure, in particular in a surgical procedure.
  • the present invention also relates to the use of an implant according to the invention for callus distraction, in particular in the jaw region, in particular for the construction of a jaw bone by distraction.
  • the present invention also relates to methods for callus distraction, in particular for the construction of a jaw bone by distraction, wherein a distraction membrane of an implant according to the invention is applied to a bone defect to be regenerated and pressure is applied to this membrane via the connecting element.
  • the distraction membrane is thus removed from the bone defect at a certain speed by the lifting mechanism of the connection mechanism.
  • the speed is preferably 0.2 mm to 2.5 mm per day, in particular 0.5 mm to 2 mm per day. Most preferably, the speed is about 1 mm per day.
  • a distraction method at the beginning of the process in particular a distance of about 1.5 mm between distraction membrane and bone is advantageous.
  • the slow removal of the distraction membrane from the bone defect can be continuous or discontinuous, for example daily or half-daily.
  • the present invention also relates to methods for callus distraction, in particular for the construction of a jaw bone by distraction, comprising the following steps: a) implanting the implant body of an implant according to the invention into a bone, preferably a jawbone, wherein the implant body a temporary implant is and wherein the implant body is at least partially screwed into the bone or a predrilled hole in the bone; b) performing a distraction osteogenesis with the distraction membrane of the implant according to the invention; in particular as described above; c) Unscrewing the provisional implant body from the bone.
  • the attachment mechanism can be removed from the implant body or from the outer element;
  • step d) preferably follows the insertion and ingrowth of your permanent implant into the drilled hole of the removed implant according to the invention.
  • the present invention also relates to a method for implanting a permanent dental implant according to the invention, comprising the following steps: a) implanting the implant body of an implant according to the invention into a bone, preferably a jawbone, wherein the implant is a permanent implant; b) performing a distraction osteogenesis with the distraction membrane of the implant according to the invention; in particular as described above; c) removing the attachment mechanism from the implant body;
  • a bioresorbable membrane is used in the method according to the invention, which need not be removed.
  • a non-biodegradable membrane for example of titanium, may be used. This is preferably also removed after removal of the fastener from the implant body.
  • step b in particular the stepwise displacement of the connecting element by the patient or a non-trained helper, for example by means of a tool, which are attached to a point of application for the tool to the connecting mechanism, preferably at the coronal end of the connecting mechanism can.
  • FIG. 1A shows a view of an implant according to the invention
  • Figure 1B shows a view of the connecting element with membrane
  • Figure IC shows a view of the implant body
  • FIG. 2A shows a further view of an implant according to the invention
  • FIG. 2B shows the top view of the implant of FIG
  • FIG. 3 shows a cross-section of an implant according to the invention
  • FIG. 4 shows a further cross-section of a device according to the invention
  • FIG. 5 shows a cross section of a further embodiment of the implant according to the invention.
  • An implant (100) comprising an implant body (1) with a distal end (1a) and an apical end (1b) and a distraction membrane (2), wherein the distraction membrane (2) via a connecting mechanism (20, 30) with so the implant body (1) is connected such that the distraction membrane (2) is positioned distally of the implant body (1) and can be moved away from the distal end (1a) of the implant body (1) by the connecting mechanism (20, 30), the implant body (1 ) at the distal end (la) has a first opening (11) from which a recess (13) extends into the implant body (1) in the direction of the apical end (1b) and wherein the connecting mechanism (20, 30) in the recess of the implant body (1) is displaceably mounted.
  • the apical end (1b) of the implant body (1) has a second opening (12) which is connected to the recess (13).
  • the implant body (1) has on the outside a bone screw thread (40), wherein preferably the bone screw thread (40) of the implant body (1) is designed as a forward and backward cutting tap (40).
  • the recess (13) has an internal thread (13a) at least in the apical region (14), wherein the connecting mechanism (20, 30) has a sleeve element (20), wherein at least a partial region of the sleeve element (20) is displaceable but not rotatable in the recess (13) of the implant body (1) is mounted, wherein the connecting mechanism (20, 30) has an inner element (30), wherein at least a partial region (30a) of the inner element (30) is mounted rotatably but not displaceably in the sleeve element (20), wherein a partial region (30b) of the inner element (30) consists of the sleeve element (20 protrudes and has an external thread (31) which is in operative engagement with the internal thread (13a) of the implant body (1), wherein the distraction membrane (2) with the sleeve member (20) is connected.
  • the apical end region (30b) of the inner element (30) projects out of the sleeve element (20) and has an outer thread (31) which is in operative engagement with the inner thread (13a) of the implant body (1).
  • the internal thread (13a) in the recess (13) is not continuous.
  • the recess (13) is not circular but hexagonal shaped.
  • the recess (13) and in the recess (13) of the implant body (1) mounted portion of the sleeve member (20) thus have a hexagonal cross-section (Q 1, Q2).
  • the distal end (33) of the inner element (30) has a point of engagement (34) for a tool for rotating the inner element (30).
  • FIG. 1 shows in an outer view in FIGS. 1A, 1B and 1C an embodiment of an implant (100) according to the invention as a dental implant, in particular a provisional dental implant for use in a bone distraction. You can see the implant body (1) and the distraction membrane (2).
  • FIG. 1A shows the entire implant, in FIG. 1B the connection mechanism with the membrane of the implant from FIG. 1A and FIG. 1C the implant body of the implant of FIG. 1A.
  • the distraction membrane (2) has pores (4), which allow a mass transfer between the callus and bone tissue on the side of the contact surface (5) and the connective tissue on the side of the mating surface (6).
  • the dental implant (100) comprises an implant body (1) and a distraction membrane (2), wherein the distraction membrane (2) is connected to the implant body (1) via a connection mechanism (20, 30) such that the distraction membrane (2) runs along the Longitudinal axis of the implant body (1) is displaceable.
  • the connection mechanism (20, 30) is located at least predominantly in the interior of the implant body (1) and apically of the distraction membrane (2).
  • the implant body (1) has a distal end (1a) and an apical end (1b).
  • the implant body (1) has a recess (13) which extends as a tube from a first, distal opening (11) to a second apical opening (12).
  • the implant body (1) is apically open.
  • the recess (13) has a hexagonal cross section (Ql).
  • the recess (13) has an internal thread.
  • the implant (100) has a sleeve element (20) with a hexagonal cross-section (Q2).
  • the sleeve element (20) is designed as a sleeve with a coronal opening. det, wherein the sleeve member (20) also has an apical opening (22).
  • the implant (100) has an inner element (30), wherein at least a portion of the inner element (30) is mounted rotatably but not displaceably in the sleeve element (20).
  • the inner member (30) has an apical portion (30b) extending from the apical opening of the sleeve member and protruding and having an external thread (31) which is in operative engagement with the internal thread (13a) of the implant body (1).
  • the internal thread (13a) stops short of the distal end of the implant body (1), so that thereby further rotation of the apical portion (30b) is prevented with its thread (31) beyond this point.
  • the apical portion (30b) of the inner element (30) forms the apical bottom of the implant body (1).
  • the distraction membrane (2) is connected to the sleeve element (20).
  • the sleeve member (20) has several tasks. It serves as a boring and boring post for the implant body (1). As a central element it carries the membrane (2), which can be connected, for example, latching.
  • a provisional crown can be attached to the sleeve element.
  • the sleeve member (20) slides out of the implant body (1) and moves with the membrane (2) in a coronal or distal direction. Similarly, this approaching the provisional crown of the occlusal plane.
  • the occlusal surface of the provisional crown may be pierced so that a screwdriver may be placed in the recess (34) to rotate the innermost member (30).
  • the sleeve member (20) and the inner member (30) protrude beyond the distal end of the outer member.
  • the distraction membrane (2) has a Hole (3) through which passes through the central element (20).
  • the distraction membrane (2) for example, by a click connection or a groove with the sleeve member (20) fixedly connected or reversibly connected.
  • the diameter of the sleeve member (20) may change minimally, creating a fixed contact point for the membrane (2).
  • the membrane 829 snaps into a micro groove, so that it is also secured against pulling off forces.
  • the distal end (33) of the inner element (30) has a point of engagement (34) for a tool for rotating the inner element (30).
  • the bone screw thread (40) of the outer member (10) is formed as a forward and backward cutting tap (40).
  • the outer member (10) advantageously has a forward and backward cutting bone screw thread (40).
  • the primary forward cutting external thread (40) has troughs (41) and threads (42) and an apical end portion (44) and a cervical end portion.
  • the apical end portion (44) of the thread (40) has a forward cutting cutting element (46).
  • the cervical end portion of the thread (40) has a cutting element (43) with a cutting edge (43 a), which is gur tonescheidend, so when unscrewing the implant body (10) from the bone cuts an internal thread into the bone.
  • the cutting edge (43a) is formed by means of a notch (43b) in the uppermost passage of the threaded mountain (42).
  • the backward cutting cutting element (43) is formed by three threaded peaks (42), which leads to better cutting results in an advantageous manner.
  • the erfindunlice structure has the advantage that the connecting mechanism is positioned apically of the membrane plane and thus distal to the membrane plane only for a temporary or a crown place.
  • the connecting element (20, 30) can be inserted at the apical end of the implant body (1) so that the apical region (30b) of the inner element (30) terminates apically as the base of the implant body 81). So the dentist gets only a mounted medical device, which greatly simplifies the handling.
  • the membrane (2) is placed on the sleeve member (20) and moved to the latching point and so firmly connected to the sleeve member (20).
  • the membrane (2) can be made of titanium. It can be used to layer an angiogenic collagen membrane, to reposition and suture the mucosa, and to use a provisional supragingival device. But it can also be provided that no temporary is used, so that the tongue can not press on the implant or this move.
  • FIG. 2 shows in FIG. 2A a further illustration of the implant according to the invention from the side.
  • Figure 2B shows a view of the implant from distal.
  • the individual elements shown and their reference numerals can be taken from the description of FIG.
  • FIG. 3 shows an embodiment of an implant (100) according to the invention as a dental implant, in particular a provisional dental implant for use in a bone distraction, in cross-section.
  • the dental implant (100) comprises an implant body (1) and a distraction membrane (2), wherein the distraction membrane (2) is connected to the implant body (1) via a connection mechanism (20, 30) such that the dissection Traction membrane (2) along a longitudinal axis (L) of the implant body (1) is displaceable.
  • the inner member (30) includes a portion (30a) located inside the sleeve member (20) and a portion (30b) located apically of the sleeve member (20).
  • This section (30b) and a short section of the inner element which lies distally of the sleeve element (20) are wider in diameter than the openings of the sleeve element, so that the inner element is rotatably but not displaceably mounted in the sleeve element by these sections.
  • the other individual elements shown and their reference numerals can be taken from the description of Figures 1 and 2.
  • FIG. 4 shows a further illustration of the implant (100) according to the invention in cross section.
  • a membrane (2) is shown, which has three sections, wherein the middle section is aligned horizontally with respect to the implant body (1) and the two lateral sections are bent in the apical direction.
  • the other individual elements shown and their reference numerals can be found in the description of Figures 1, 2 and 3.
  • FIG. 5 shows a further embodiment of the implant (100) according to the invention.
  • the basic structure is shown in FIG. 4.
  • the sleeve member (20) is truncated distally of the diaphragm (2) and the inner member has a longer portion (30c) distal to the sleeve member (20) and having a diameter like the sleeve member (20).
  • the other individual elements shown and their reference numerals can be found in the description of Figures 1, 2 and 3.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Developmental Biology & Embryology (AREA)
  • Engineering & Computer Science (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un implant, de préférence un implant dentaire, comprenant un corps d'implant et une membrane de distraction, l'utilisation de l'implant pour la distraction osseuse et un procédé de mise en place de l'implant. L'implant possède un mécanisme de liaison servant à la liaison et au déplacement de la membrane de distraction le long du corps d'implant. Le corps d'implant possède à son extrémité distale une ouverture depuis laquelle s'étend une cavité dans le corps d'implant en direction de l'extrémité apicale et le mécanisme de liaison est monté coulissant dans le corps d'implant.
PCT/EP2015/070454 2014-09-23 2015-09-08 Implant de distraction avec mécanisme amélioré Ceased WO2016045958A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP15760181.6A EP3197387A1 (fr) 2014-09-23 2015-09-08 Implant de distraction avec mécanisme amélioré

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102014014096.2A DE102014014096A1 (de) 2014-09-23 2014-09-23 Distraktionsimplantat mit verbessertem Mechanismus
DE102014014096.2 2014-09-23

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WO2016045958A1 true WO2016045958A1 (fr) 2016-03-31

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DE (1) DE102014014096A1 (fr)
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WO2017017079A1 (fr) * 2015-07-28 2017-02-02 Celgen Ag Implant à membrane de distraction pour la distraction osseuse

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US20020156485A1 (en) * 2000-10-04 2002-10-24 Sellers Timothy M. Compact maxillary distractor
WO2005074831A2 (fr) * 2004-02-04 2005-08-18 Yosef Gross Dispositif dentaire
KR101301694B1 (ko) * 2012-02-28 2013-08-30 오스템임플란트 주식회사 치과용 멤브레인 고정용 어버트먼트

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US5980252A (en) 1995-05-08 1999-11-09 Samchukov; Mikhail L. Device and method for enhancing the shape, mass, and strength of alveolar and intramembranous bone
US5961329A (en) 1997-07-02 1999-10-05 Stucki-Mccormick; Suzanne U. Combination distraction dental implant and method of use
EP1745759B1 (fr) 2000-05-29 2009-05-06 CelGen AG Membranes médicales pour la régénération osseuse
DE10258977A1 (de) 2001-12-15 2003-07-17 Richard Blankenhorn Gmbh Vorrichtung und Verfahren zum Knochenaufbau durch Distraktion von Knochensegmenten
DE202010018144U1 (de) 2010-12-10 2014-05-06 Celgen Ag Universaldistraktor zur Knochenregeneration
DE102012024205B4 (de) 2012-12-05 2016-09-15 Celgen Ag Implantat zur Knochendistraktion
DE102014001377A1 (de) 2014-01-29 2015-08-13 Celgen Ag Distraktionsimplantat mit verbessertem Verbindungselement

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US20020156485A1 (en) * 2000-10-04 2002-10-24 Sellers Timothy M. Compact maxillary distractor
WO2005074831A2 (fr) * 2004-02-04 2005-08-18 Yosef Gross Dispositif dentaire
KR101301694B1 (ko) * 2012-02-28 2013-08-30 오스템임플란트 주식회사 치과용 멤브레인 고정용 어버트먼트

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017017079A1 (fr) * 2015-07-28 2017-02-02 Celgen Ag Implant à membrane de distraction pour la distraction osseuse

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EP3197387A1 (fr) 2017-08-02

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