WO2019069112A1 - Device for mounting guide sleeves in a 3d surgical template according to the orientation of virtual dental implants - Google Patents

Abstract

The invention relates to the field of medicine, and more particularly to orthopaedic dental devices for tooth implantation. A device for performing a transgingival implant, more particularly for preparing a 3D surgical guide, in the form of a structure comprising an oral plate and a vestibular plate, and a supporting base having a wedge-shaped cross section with a downwardly oriented apex and a measuring scale on its front and rear surfaces, said base having a slot-like aperture at the top, in the centre of which a tube is vertically mounted such as to be capable of deviating from its vertical axis, wherein the tube is fastened to holders which are arranged at the front and rear of the base and which form projections above the surface thereof, wherein the end face of the rear holder of the tube is provided with two small indentations arranged diagonally relative to each other which are intended for setting, by means of the plates, the required distance from the centre with the aid of electronic calipers, wherein the tube is fastened in a holder by means of screws in the lower part of the holders, the tube is fastened in accordance with a given angle by means of two lateral screws oriented inward from two sides toward the centre of the base and arranged in the lower part of said base, wherein in the upper part of the rear surface of the base there is a textured strip for fastening the plates using screws, and a circular recess on the left-hand side below the textured strip for fastening a protractor in a set position with the aid of a screw. The technical result of the invention is more effective and accurate functioning of the device, enabling the efficient chairside creation of a highly accurate 3D surgical template without the need for adjustment on the jaw of the patient, thus saving operating time and improving the quality of the operation.

Description

 DEVICE FOR INSTALLING GUIDES OF SLEEVES IN 3D SURGICAL PATTERN ACCORDING TO THE DIRECTION OF VIRTUAL DENTAL IMPLANTS TECHNICAL AREA

 The invention relates to the field of medicine, in particular to orthopedic dental devices for dental implants.

 BACKGROUND

 A prior art device for producing a 3D surgical template for planning a transgingival dental implantation, taken as a prototype (patent for the invention of the Russian Federation No. 2522379), is a device that contains a carrier part and means of fixation in an X-ray pattern device. in the form of a base with a hole in which the tube is vertically installed with the possibility of deviation from its vertical axis, and with protrusions on both sides of the specified hole in which the screws are installed with the possibility of interaction with the specified tube, as well as with two horizontal arms, and the said means of fixation are made in the form of plates with fasteners for an X-ray pattern installed on both of these horizontal arms, and the device is additionally equipped with an arrow installed in said tube with the possibility of extraction from it, and a plate-scale mounted on one of the horizontal arms and in this position which is in interaction with The indicated arrow in the tube, and the indicated base and horizontal shoulders are provided with a measuring scale.

 The device is used as follows.

First, conduct the planning phase. Make a radiological template of plastic in the form of a removable denture. On this template, in the area of each planning implant, 3 small holes are drilled along the axial plane: the vestibular, oral and apical. The apical opening is performed on the occlusal surface of the template, and the vestibular and oral openings - as far as possible from the apical opening. Then the model is installed in the patient's mouth and axial sections are performed using computed tomography. On an axial slice that passes through three points, an implant is virtually inserted with the optimal direction and size. Spend a "reference line" connecting the vestibular and oral edges of the template. Then find the angle between the axis of the implant and the "orientation line", as well as the distance from the edge of the "orientation line" to the point of intersection of the axis of the implant.

After that, the device with the tops of the shoulders and with plates mounted on the shoulders is mounted on the radiological pattern, taking into account the distance from the edge of the orienting line to the point of intersection of the implant axis defined above, using a scale on the surfaces of the base and shoulders. Then the plates are moved along the shoulders close to the X-ray pattern, fixed in this position on the shoulders with fixing screws and screwed into the X-ray pattern and thus fasten the device with the pattern. Then an arrow is inserted into the tube, and an arcuate scale is placed on the shoulder. The lower end of the plate-scale is made in the form of a triangular shaped yoke, with which the plate-scale is placed on the shoulder. Then the screws deflect the tube to the position in which the arrow indicates on the scale of the plate the angle corresponding to the previously determined angle between the implant and the reference line. Then the tube is fixed in this position with screws. After fixing the tube, the arrow and the scale plate are removed and in the x-ray model at the desired angle, a through hole is drilled on the occlusal surface with a drill, directing the drill through the tube, which allows the channel to be drilled at the desired angle. Then in the specified through-hole fix the guide sleeve. The last operation with the installation of the tube at the desired angle and drilling in the radiological template of the through channel using the tube as a guide and then inserting the guide sleeve into this channel is repeated for each implant. Upon completion of all operations, a ready-made 3D surgical template for transgingival dental implantation is obtained. The finished AOR-surgical template with guide sleeves is put on the patient's alveolar ridge and a step-by-step drilling of the bone is carried out through the sleeves for subsequent installation of implants into the channels drilled in this way at the right angle.

 DISCLOSURE OF INVENTION

 As a result of use, it was found that the device known from the prior art has several disadvantages.

 The disadvantages of this device are:

 - the device is not adapted to electronic devices for measuring angle and distance (electronic inclinometer and electronic calipers), the use of which can significantly increase the accuracy of the device;

 - the inclination of the tube occurs within the base of the device, the shoulders prevent a large tilt of the tube, therefore, at large angles between the virtual implant and the orientation line, the device’s capabilities are limited;

 - protrusions on the base, carrying screws in their threaded holes prevent maximum movement of the plates to the center, which prevents the plate from setting a place from the center for a short distance.

 The present invention is to eliminate the disadvantages of the prior art, namely the possibility of increasing the range of inclination of the tube and the movement of the plates with maximum accuracy by adapting the device to electronic devices.

 The technical result of the invention is a more effective and accurate operation of the device, allowing you to quickly create an ultra-precise 3D surgical template in the presence of the patient, eliminating the need for adjusting it in the patient's jaw, which reduces the time it takes to perform the operation and improves its quality.

The claimed technical result is achieved due to the fact that the device for the manufacture of an AOR-surgical template when planning a transgingival dental implantation is a design that includes oral and vestibular plates, the supporting base of the wedge-shaped cross-section with a downward pointing and measuring scale on the front and rear surfaces, having a slit-like opening at the top, in the center of which a tube is vertically mounted with the possibility of deviation from its vertical axis, where the tube is attached to the holders located in front and behind the base and forming protrusions above its surface, where on the end surface of the back tube holder there are two small grooves diagonally arranged relative to each other, intended for exposing the plates with the required distance from the center using an electronic rod calipers, while fixing the tube in the holder is made by screws in the lower part of the holders, fixing the tube in accordance with a given angle is achieved by means of two side screws directed from two sides inward to the center of the base, located in the pointed part of the wedge-shaped base body, while on the upper parts of the back surface of the base have a rough strip for fixing with screws of the plates, and a round notch on the left side under the rough strip for fixing with a screw of the protractor position.

 BRIEF DESCRIPTION OF THE DRAWINGS

 The above and other features, advantages of the present invention and its essence will be clearer after reading the accompanying figures.

 Figure 1A is a front view of the device;

 1B is a rear view of the device;

 1 C shows a top view of the device;

 2A shows a view of the protractor with an arrow in front;

 2B is a view of the protractor with an arrow at the back;

 on the figure FOR presents a table for electronic devices;

 Figure 3 shows a table for an electronic device with the device shown;

 4 A shows plates: oral (left) and vestibular (right);

4B is a view of the oral plate from the inside (left) and outside (right); 4C is a view of the vestibular plate from the inside (left) and outside (right);

 4D is a top view of the device with a vestibular plate to the left of the center of the device and an oral plate to the right of the center of the device, where the plates are as close as possible to the tube holders;

 4E shows a top view of the device with a vestibular plate to the left of the center of the device and an oral plate to the right of the center of the device, where the plates are separated from each other;

 5 shows a tripod.

 IMPLEMENTATION OF THE INVENTION

 The device (Fig. 1A, Fig., Fig. L C) for the manufacture of a BZ-surgical template when planning a transgingival dental implantation is a design that includes a support base (1) of a wedge-shaped cross-section with a downward pointing apex and a measuring scale on the front and rear surfaces having a slit-like opening at the top (2), in the center of which a tube is vertically mounted (3, FIG. 1 C) with the possibility of deviation from its vertical axis, where the tube is attached to the holders (4) located in front and behind Base and forming protrusions above its surface, where on the end surface of the rear tube holder there are two small depressions (5, Fig 1C), diagonally arranged relative to each other, designed to set the plates with the required distance from the center using electronic calipers, while fixing the tube in the holder is made by means of screws (6) in the lower part of the holders, the fixation of the tube in accordance with a given angle is achieved by means of two side screws (7), directed from two sides inside The center of the base located in the lower part of the wedge-shaped base body, while on the upper part of the back surface of the base there is a rough strip (8, FIG. 1B) for fixing with screws of plates, and a round notch (9, fig. 1B) on the left side under a rough strip for fixing with a screw of a protractor in a predetermined position.

Plates for adjusting the distance from the center of the device are shown in figures 4A, 4B, 4C, 4D, 4E. Plates are designed to adjust the distance from the center of the device (Fig. 4E), developed in two types: oral (23) (in contact with the oral side of the template) and vestibular (24) (in contact with the vestibular side of the template). Plates are solid-molded parts of complex shape and have two main functions: they clamp the edges of the template in the device and fix the distance that corresponds to the length of the “orientation line”. The “orientation line” is a conditional line that connects the edges of the vestibular and oral sides of the radiological template during virtual planning of implantation based on the jaw cross section along with the radiological template using computed tomography. With the help of an “orientation line”, the position of the virtual implant is determined. In this case, the oral plate is installed from the center of the device at a distance that is equal to the distance from the intersection point of the central axis of the virtual implant to the oral point of the “orientation line”. The vestibular plate is established according to the same principle.

 Both plates (23, 24) in the lateral projection (Fig. 4, 4C) are U-shaped with inward-curved free ends, with which they grip the base of the device. The cutouts in the plates due to this coincide with the slit-like hole (2, Fig. 1A) of the base, which allows them to move freely along the base of the device, without interfering with the inclination of the tube (3, Fig. 1C). In the front projection (Fig. 4D, 4E), the back of both plates is wider than the front side, with the wide side provided with threaded holes (25, Fig. 4B, 4C), which are intended for fixing the plate on a rough strip (8, Fig. 1B) device bases. Oral plates (23, 24) conditionally consist of two zones: a rectangular frame (26), which directly contacts the device, and a trapezoid plate (27), which touches the template.

Plates (23, 24) on the inner side closer to the center have the same protrusion (28) in the form of a triangular prism, while the face of the protrusion (28) is an indication of the distance on the scale of the device. Inside, the plates (23, 24) have a longitudinal groove (29) of a triangular shape in cross section, which serves as guide for precise movement of the plates along the base of the device, having a wedge-shaped shape with a downward pointing apex.

 The vestibular plate (24) differs from the oral plate (23) only in height and in that it contains threaded holes (30, Fig. 4C), which help to fix the plate to the template with screws, while the oral plate (23), unlike vestibular plate (24) rests on the template without fixing screws.

 On the wide side of the vestibular (24) and oral plates (23) there are corresponding recesses (31, Fig. 4D), which, when cooperated with the recesses on the holders (5, Fig. 4D), help to install the plates at the right distance from the center using electronic calipers.

 In various embodiments, the implementation of the present invention, the device in accordance with the present invention is made with the possibility of supplying it with additional elements, such as:

 - means for adjusting the angle of the tube in the device: a mechanical protractor with an arrow, shown in figure 2, fixed with a screw in the place of a circular recess (7 of Fig. 1B) located on the left side under a rough strip, and electronic devices (for example, inclinometer , caliper), for fixing which a special table is provided, shown in figure 3;

 - tripod, which is designed to optimize ergonomics when working with the device, shown in figure 5.

 Means for adjusting the angle of the tube in the device can be used both independently and in conjunction with the claimed device.

A protractor (Fig. 2A, Fig. 2B) conventionally consists of 3 parts: a graduated part, a retainer, a connecting part. The graduated part (10) has a scale on the surface for measuring the angle with the arrow (11). The clamp (12) in the form of a clamp is designed to secure the protractor on the device. Inside the shape of the retainer (12) corresponds to the shape of the base of the device, while the end surface of the retainer has a wedge-shaped notch for free access to the screw (7, Fig. 1). The clamp (12) has a threaded hole on the back surface (13 of Fig. 2 B), which corresponds in position to a circular recess (9, Fig. 1 B) on the back surface of the device and is intended to fix the protractor in a predetermined position. On top of the latch has a slit (14), the width of which corresponds to the width of the slit-like opening (2, Fig. 1A) of the device. This cut allows the needle to bend from a high angle. The connecting part (15) connects the upper surface of the retainer with the graduated part (10). The connecting part (15) at its junction with the latch is shifted to the edge of the latch and has a T-shape, with the angle directed towards the inside of the protractor, which allows increasing the radius of the arrow and the number of strokes on the scale of the graduated part for more accurate angle measurement.

 The table (fig.ZA, fig. 3B) is intended for an electronic device, for example, an inclinometer, and conventionally consists of 3 parts: a bar, a horizontal plate and a protrusion. A rod (16) of circular section with a longitudinal protrusion (17), which coincides with a longitudinal groove on the inner wall of the tube (3, Fig. 1C) of the device, while the outer diameter of the rod (16) corresponds to the inner diameter of the tube (3, Fig. 1C; horizontal plate (18) with side cuts in the center (19), which correspond in shape to the upper protrusions of the device holders (4, Fig. 1A); a protrusion (20) located in the center of the plate (18) for fixing the inclinometer (21) with help screw (22).

 The tripod (figure 5) is designed to optimize ergonomics when working with the device, consists of two parts: a stand (32) and a pipe (33). The stand with the U-shaped end (34) covers the edge of the table cover, and is fixed to it with a screw (35). The stand has grooves (36) for fixing the pipe (33) at different levels using a ring (37) with threaded holes and a screw (38) and grooves (39) when the lower edge of the pipe (33) coincides with the groove (39) and grooves (36) with screws on the pipe, which helps to quickly find the right grooves inside the pipe for fixing. At the upper end of the tube is a retainer (40) with two threaded screw holes that secure the device to it with the aid of a vestibular plate (24, Fig. 4A).

 The device is used as follows.

First, conduct the planning phase. Then make a radiopaque template from plastic. On this template in the area of each Three small holes are drilled along the axial plane of the planned implant: vestibular, oral and apical. The apical opening is performed on the occlusal surface of the template, and the vestibular and oral openings are as far as possible from the apical opening. Then the template is installed in the patient's mouth and axial sections (cross section) are performed using computed tomography. On an axial slice that passes through three points, an implant is virtually installed with the optimal direction and size. Spend a "reference line" connecting the vestibular and oral edges of the template. Then find the angle between the axis of the implant and the "orientation line", as well as the distance from the edge of the "orientation line" to the point of intersection of the axis of the implant.

 After virtual planning, the device is attached to the tripod using the vestibular plate. Then, using either an electronic inclinometer or a conventional protractor, the tube specifies the angle that formed between the “orientation line” and the virtual implant. After setting the desired angle of the tube, it is fixed on both sides with longitudinal screws. Next, the vestibular and oral plates using an electronic caliper are installed from the center of the device at a distance equal to the distance from the intersection point of the central axis of the virtual implant and the orienting line to the corresponding edge of the orienting line.

 Then the device is removed from the tripod and using plates, is attached to the template and then through the tube the guide sleeve is installed in the right direction in the through hole of the template.

Claims

■ hey MV 2017 2019/069112 PCT / IB2017 / 001339 Formula of the INVENTION 1. A device for performing transgingival implantation, in particular for manufacturing a BZ-surgical template, characterized in that it is a structure comprising an oral and vestibular plates, a support base of a wedge-shaped cross-section with a downward pointing apex and a measuring scale on the front and rear surfaces, having a slit-like opening at the top, in the center of which a tube is vertically mounted with the possibility of deviation from its vertical axis, where the tube is attached to the holders, is located on the front and rear of the base and forming protrusions above its surface, where on the end surface of the rear tube holder there are two small depressions diagonally arranged relative to each other, designed to set the plates with the required distance from the center using electronic calipers, while fixing the tube in the holder by means of screws in the lower part of the holders, fixation of the tube in accordance with a given angle is achieved by means of two side screws directed from two seconds Thoron inward to the center of the base, located in the lower part of the support base, while on the upper part of the back surface of the base there is a rough strip for fixing with screws of the plates, and a round notch on the left side under the rough strip for fixing with a screw of the protractor in a predetermined position.  2. The device according to claim 1, characterized in that it is additionally equipped with a protractor with an arrow or a table for installing an electronic device for adjusting the angle.  3. The device according to PP.1 -2, characterized in that it is additionally equipped with a tripod. ten  SUBSTITUTE SHEET (RULE 26)