Dental prosthetic system with a bridge structure that can be removed from a base structure
20220387149 · 2022-12-08
Inventors
Cpc classification
A61C8/0012
HUMAN NECESSITIES
A61C13/0004
HUMAN NECESSITIES
A61C8/0075
HUMAN NECESSITIES
A61C9/0053
HUMAN NECESSITIES
A61C8/0001
HUMAN NECESSITIES
A61C8/0048
HUMAN NECESSITIES
International classification
A61C8/00
HUMAN NECESSITIES
Abstract
Method and prosthetic system for producing a substitution bridge structure with prosthetic teeth (6), for replacing an existing bridge structure (2) which is mounted on a base structure (1), wherein the base structure (1) is fixed to implants (10) by means of base screws (11) and the head (15) of the base screws (11) has a screw hole. A scan body is fixed to the head (15) of the base screws (11) and an intraoral scan of the oral cavity is executed and the scan data is related to a 3D digital model of the base structure (1) and/or of the existing bridge structure (2), wherein subsequently a 3D digital model of said substitution bridge structure is designed.
Claims
1. A method for producing a substitution bridge structure with one or more prosthetic teeth to replace an existing bridge structure that is mounted on a base structure, wherein the base structure is present in an oral cavity of a person and is fixed on multiple implants provided in the bone of a jaw, wherein the base structure has a bore for each implant through which the base structure is fixed with base screws to the corresponding implant or to an abutment provided on this implant, wherein said existing bridge structure is fixed to said base structure by means of bridge screws extending through corresponding bores the existing bridge structure and being coaxial with said bores in the base structure, wherein said base screws have a head provided with an internally threaded screw hole in which the bridge screws are secured, wherein at least one of said bridge screws is removed from the corresponding bore and from the head of the respective base screw and a scan body is fixed in this bore or in the head of said respective base screw present in the screw hole such that the position of the scan body is unambiguously determined relative to the base structure, wherein subsequently an intra-oral scan is performed of relevant parts of the oral cavity together with said scan body and scan data from this intra-oral scan is related to a digital 3D model of the base structure and/or of the existing bridge structure such that the position of said relevant parts of the oral cavity is determined unambiguously with respect to this digital 3D model, wherein subsequently a 3D digital model of said substitution bridge structure is designed starting from the 3D digital model of the base structure and/or of the existing bridge structure and the related scan data of the performed intraoral scan, such that the substitution bridge structure can be fitted to the base structure, while bores for bridge screws in this 3D model are provided which are coaxial with said bores in the base structure when the substitution bridge structure would be fitted to the base structure, wherein the substitution bridge structure is then manufactured starting from said 3D digital model thereof.
2. The method according to claim 1, wherein the 3D digital model of the substitution bridge structure is generated by modifying the 3D digital model of the existing bridge structure taking into account the scan data of said intra-oral scan.
3. The method according to claim 1, wherein said intra-oral scan is performed by applying an optical scan, in particular a three-dimensional laser scan.
4. A dental prosthetic system to be mounted on at least two implants fixed in the bone of a jaw, having a base structure that can be mounted on a free end of said implants, wherein bores are provided in the base structure that allow the base structure to be attached to the implants with screws, a bridge structure with one or more prosthetic teeth which can be fixed on said base structure in a fitting and detachable manner, wherein this bridge structure has bores for guiding screws to fix the bridge structure to the base structure, at least one scan body that can be detachably attached to said base structure, wherein said bores of the base structure cooperate with a corresponding bore of the bridge structure, wherein the bores of the base structure are coaxial with corresponding bores of the bridge structure when the bridge structure is placed in a fitting manner on the base structure, wherein this system includes base screws for attaching said base structure, via said bores of the base structure, to said implants or to an abutment provided on these implants, the base screws have a head provided with an internally threaded screw hole for mounting the bridge structure on the base structure via said bores of the bridge structure by means of bridge screws provided to that end which can be fixed in said screw hole of the base screws, wherein said scan body is provided with a attachment with which it is fixable in said head of the base screws.
5. The dental prosthetic system of claim 4, wherein said attachment of said scan body is threaded to be able to be fixed in said head of the base screws.
6. The dental prosthetic system according to claim 4, wherein said base structure has at least two bores that allow to attach the base structure to at least two implants, wherein for each said bore in the base structure a corresponding bore is provided in the bridge structure, wherein the bores in the bridge structure are coaxial to the bores in the base structure when the bridge structure is placed in a fitting manner on the base structure.
7. The dental prosthetic system according to claim 4, comprising a release screw, wherein said bores of the bridge structure have an internal thread that can cooperate with this release screw, such that when the release screw is screwed in the bores of the bridge structure, this bridge structure is detached from the base structure as a result of a pushing force exerted by the release screw on a corresponding base screw or on said base structure.
8. The dental prosthetic system according to claim 7, wherein an end of said release screw, opposite its head, extends opposite the head of said base screw when the release screw is screwed in said bore of the bridge structure while this bridge structure is placed on the base structure.
9. The dental prosthetic system according to claim 7, wherein said bore of the bridge structure is provided with a sleeve extending over the length of the bore, wherein this sleeve is provided with said internal thread for said release screw.
10. The dental prosthetic system according to claim 9, wherein one end of said sleeve has a collar, while its opposite end has an external thread and cooperates with a nut, such that the bridge structure is clamped between said collar and said nut.
11. The dental prosthetic system according to claim 9, wherein said bridge structure is mainly made of plastic, while said sleeve is made of metal.
12. The dental prosthetic system according to claim 7, wherein said bores of the bridge structure have a diameter which is larger than the diameter of the shaft of said bridge screws, wherein said release screw can be screwed in these bores-.
13. The dental prosthetic system according to claim 12, wherein the diameter of the shaft of said bridge screws is smaller than the diameter of said release screw.
14. The dental prosthetic system according to claim 7, wherein the end of said release screw opposite its head has a diameter which is smaller than the diameter of the shaft of said bridge screws at the level of its corresponding end, such that this end of the release screw, in the screw hole in the head of said base screws, can exert a pressure on the latter in order to remove the bridge structure from the base structure when the release screws are screwed in the bores in the bridge structure.
15. The dental prosthetic system according to claim 5, wherein said attachment is formed by a screw.
Description
[0013] Other particularities and advantages of the dental prosthetic system according to the invention will become apparent from the following description of some particular embodiments of the invention; this description is given as an example only and does not limit the scope of the claimed protection in any way; the reference figures used below relate to the accompanying figures.
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[0030] In the various figures, the same reference figures refer to the same elements.
[0031] The invention generally relates to dental prostheses, in particular fixed dental prostheses attached to implants in the jaw in the oral cavity. In particular, a dental prosthesis system including a base structure and a bridge structure. The base structure is to be attached to implants placed in the jaw, while the bridge structure is to be attached to the base structure.
[0032] In order to make a fixed prosthesis mounted on implants screwed in the jaw for a patient who, for example, has a toothless lower or upper jaw, a preliminary planning and design phase is required. A digital model is thus generated of the relevant jaw. This can be done, for example, by making a three-dimensional X-ray of the jaw by performing a so-called CT scan. If necessary, these data can be supplemented with data from the gums on the jaw based on an optical scan of the jaw concerned, made using a laser scanner.
[0033] In this way, a digital three-dimensional model of the jaw is composed. Using this model, a planned position and orientation are then selected for implants to be placed in the jaw. In addition, a dental prosthesis is also digitally designed, which is to be attached to the implants and which contains prosthetic teeth. This dental prosthesis, according to the invention, is composed of a base structure 1 and a bridge structure 2. A schematic view in perspective of such a base structure 1 and a bridge structure 2 to be attached to the latter for a mandible is shown, by way of example, in
[0034] After the base structure 1 and the bridge structure 2 have thus been digitally designed, they are manufactured in a manner well known as such from the digital design by milling, for example, or by applying an additive manufacturing technique such as stereo lithography, selective laser melting, etc.
[0035] In order to place the implants in a position and according to an orientation in the jaw that corresponds to the planned position and orientation of the implants, a drilling template is produced that allows to drill holes in the jaw at the pre-planned positions for placing the implants. Such a drill template for precisely placing implants in the jaw is already described, for example, in document WO 2008/009080. The thus placed implants extend with a free end above the bone of the jaw.
[0036] When the implants are thus secured in the jaw with the required accuracy as planned, the base structure 1 can be attached to the latter.
[0037] By generating a digital model of the jaw and planning the placement of implants based on the latter, and by digitally designing the dental prosthesis, as well as a corresponding drilling template for placing the implants, and then producing them very accurately, it is possible to place implants in the jaw with high precision, as planned. This high precision in the placement of implants in the jaw and in the manufacture of the base structure and the bridge structure of the dental prosthesis ensures that the latter can be precisely fitted to the implants in the jaw as was previously digitally planned.
[0038] This precise placement of implants according to a planned position and orientation and a corresponding manufacture of the base structure and bridge structure with very small tolerances ensures, in particular, that the base structure can be fitted almost perfectly to two or more independent implants and that the bridge structure can then be placed fitting almost perfectly on the base structure.
[0039] An example of a base structure 1 according to the invention is shown in
[0040] The side of the base structure 1 opposite to the bone side has recesses 5 in its surface for the head 15 of the screws 11 used to attach the base structure 1 to the implants. Thus, these recesses 5 allow the heads of these screws to be countersunk in the surface of the base structure 1 when the latter is mounted on the implants. However, it is not necessary for the heads 15 of the screws 11 to be countersunk in the surface of the base structure 1.
[0041] For the purposes of this description, the term implant or implants also includes an implant or implants to which an abutment is attached. The free end of the implants may then be formed by the end of an abutment opposite to the implant to which it is attached.
[0042] A bridge structure 2 is represented in
[0043] Furthermore, the bridge structure has 2 bores 8 for guiding screws to attach the bridge structure 2 to the base structure 1. To this end, the position and orientation of these bores 8 are selected such that the bores 8 in the bridge structure 2 are coaxial with the bores 3 in the base structure 1 when both structures 1 and 2 are placed fittingly on top of one another.
[0044] The screws that allow the base structure 1 to be attached to the implants through bores 3 are referred to as base screws 11 in this description, while the screws that allow the bridge structure 2 to be mounted through the bores 8 against the base structure 1 are referred to as bridge screws 12.
[0045] In the design of the base structure 1 and the bridge structure 2, it is ensured that the surface of the bridge structure 1, opposite to its bone side, can practically fit to the underside of the bridge structure 2. Recesses may be provided in which the heads 15 of said base screws fit. Thus, said gutter 7 of the bridge structure fits very closely to the surface of the base structure 1 when both are mounted on top of each other. It is particularly important here that the upright sides of the base structure 1 can match the upright walls of said gutter 7 of the bridge structure 2 in order to obtain a very tight seal between the base structure 1 and the bridge structure 2 in order to prevent seepage or migration of, for example, bacteria between these structures 1 and 2.
[0046] Preferably, the upright sides of the base structure 1 are tapered towards the crest 9. When the bridge structure 2 is then attached to the base structure 1 by means of said bridge screws, the compressive force between these upright sides and the walls of said gutter 7 increases when the bridge screws are tightened, so that a virtually hermetic seal can be obtained between the bridge structure 2 and the base structure 1.
[0047] In general, for example, for said upright sides of the base structure and for the corresponding walls of said gutter 7, a so-called conicity of 6° or of about 6° is selected in order to obtain a good seal between the base structure 1 and the bridge structure 2. This means that the inclination of these upright sides or of said walls, in a plane perpendicular to a central axis of the base structure and the bridge structure, forms an angle with an axis of symmetry in this plane of 6° or about 6°. Such a plane is represented, for example, as plane II-II in
[0048]
[0049] In this system, according to the invention, the base structure 1 is thus attached to the free end of the implant 10 by means of a base screw 11 through the aforementioned bore 3. The head 15 of the base screw 11 has an internally threaded screw hole. This screw hole in the head of the base screw 11 is coaxial to the axis of the screw and thus opens into the top surface of the screw head 15.
[0050] In addition, this screw head 15 also includes drive means for driving the screw 11 around its axis. These drive means are formed, for example, by a recess 23 which extends above the aforementioned screw hole in the head 15. The diameter of this recess 23 is slightly larger than the diameter of this screw hole here. For example, the recess 23 has a hexagonal cross-section in a direction perpendicular to the screw axis, such that the screw 11 can be driven using a so-called Allen key. It goes without saying that the recess 23 can also take other forms, such as a star-shaped recess that is suitable for working with a torx key.
[0051] The bridge structure 2 is placed on the base structure 1 and fastened by means of a bridge screw 12 which extends through a corresponding bore 8 of the bridge structure 2. The bridge screw 12 is screwed into the screw hole provided to that end in the head 15 of the base screw 11.
[0052] In this way, it is ensured that the bridge structure 2 can be fixed firmly and without any play to the base structure 1 with screws 11 and 12 in a spatially very compact manner.
[0053] Thanks to the digital design of the base structure 1 and the bridge structure 2 and their precise manufacture, said bores 3 and 8 extend almost perfectly coaxially so that the bridge screws 12 can be screwed in a fitting manner with their threaded ends into the heads 15 of the corresponding base screws 11 so as to fix the bridge structure 2 to the base structure 1.
[0054] Because the bridge screws 12 are screwed into the corresponding heads 15 of base screws 11, the bridge structure 2 can be removed from base structure 1 while the latter remains fixed with the implants 10. In addition, this design also ensures that it is not required to thread the base structure 1 for the bridge screws 12, which simplifies the manufacture of the base structure 1. In addition, it is possible to manufacture standardised bridge screws 12 and/or base screws 11 in an inexpensive way. During the digital planning of the design for the dental prosthesis, in particular the base structure 1 and the bridge structure 2, the dimensions of standardised bridge screws 12 and/or base screws 11 are then taken into account, such that they can be used.
[0055] In order to remove the bridge structure 2 from the base structure 1, the bridge screws 12 are loosened in a first step. Subsequently, moving the bridge structure 2 in relation to the base structure 1 without damaging these structures often proves to be very difficult or almost impossible due to the almost perfectly fitting connection of the structures 1 and 2 to each other.
[0056] As shown in
[0057] Thus, in order to detach and remove the bridge structure 2 from the base structure 1, the release screw 17 is screwed into the bore 8 of the bridge structure 2. When this release screw 17 reaches the end of the bore 8, it makes contact with the head 15 of the underlying base structure 11. As shown in
[0058] Preferably, the diameter of the shaft of the release screw 17 is greater than the diameter of the screw hole or of the recess 23 in the head 15. However, this diameter of the shaft of the release screw 17 may also be smaller.
[0059] According to an interesting embodiment of the invention, the bores 8 of the bridge structure 2 are provided with a sleeve 18. This sleeve 18 is more specifically cylindrical and preferably stretches over the entire length of the bores 8 in the bridge structure 2. The inside of this sleeve 18 thus shows the internal thread 16 for the release screw 17.
[0060] The presence of such a sleeve 18 is particularly interesting when the bridge structure 2, for example, is made of plastic. Providing such a sleeve 18, which is usually made of metal, allows a relatively large force to be exerted with the release screw 17 between the base structure 1 and the bridge structure 2 without damaging the latter. Thus, for example, both the sleeve 18 and the release screw 17 can be made of titanium or stainless steel, for example.
[0061] The sleeve 18 can be attached to the bridge structure 2 in various ways, such as, for example, by gluing, clamping, screwing, etc. According to an interesting embodiment of the invention, as shown in
[0062] Furthermore, in the embodiment of the prosthetic system according to the invention, shown in
[0063] Thus, in the embodiment shown in
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[0065] However, the release screw 17 has at its end, opposite its head, a coaxial rod 22 with a diameter smaller than the diameter of the shaft of the bridge-screw 12 at the level of the corresponding end. When the release screw 17 is thus screwed into the bore 8 to remove the bridge structure 2 from the base structure 1, the end with the rod 22 will fit into the screw hole in the head 15 of the base screw 11. Consequently, a pressure can be exerted on the base screw 11 by the release screw 17 when it is screwed into the bore 8 so to remove the bridge structure 2 from the base structure 1.
[0066] The above-described invention thus makes it possible to remove a bridge structure 2 from a base structure 1 in a simple and efficient manner in a prosthetic system. This offers as a major advantage that, when gums 14 have adhered to the prosthesis, it is not necessary to destroy the adhesion of these gums in order to replace or repair a prosthesis, for example. A major advantage of the invention is that the bridge structure 2 with the prosthetic teeth can be removed and replaced, while the adhesion between gums and the base structure is maintained.
[0067] Thus, according to the invention, the prosthetic system can be modified in a relatively simple manner by replacing the bridge structure 1. This may be required, for example, in case of fracture of teeth 6 of the bridge structure 1, aesthetic problems, functional changes in shape in the oral cavity, wear of the existing bridge structure 1, the addition of extra teeth to the bridge structure 1, etc. In addition, it is possible, when designing a substitution bridge structure, which is to replace an existing bridge structure 2, to use the digital 3D models generated to design and to manufacture the base structure 1 and the bridge structure 2.
[0068] In order to replace an existing bridge structure 2 by a substitution bridge structure, at least one of the bridge screws 12 is removed from the corresponding bore 8 and from the head 15 of the concerned base screw 11 in the oral cavity. Subsequently, a scan body is mounted in this bore 8, in particular in the screw hole present in the head 15 of the base screw 11 extending below this bore 8. It goes without saying that it is also possible to remove two or more bridge screws 12 and to replace these with scan bodies 24.
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[0070] It is not required that said attachment 25 of the scan body 24 is formed by a screw. The attachment 25 may also consist of a cylindrical pin or comprise some other element that allows the scanning body 24 to be fixed in an unambiguous manner relative to the base structure 1 or the bridge structure 2.
[0071] The position of the scan body 24 is thus unambiguously determined with respect to the basic structure 1 and the bridge structure 2 present thereon. Subsequently, an intra-oral scan is performed of relevant parts of the oral cavity together with the scan body 24. Such an intra-oral scan is, preferably, an optical scan in which a digital 3D image is generated of the scan body along with the relevant parts of the oral cavity. For example, a laser scan is used to perform the intraoral scan.
[0072] By means of this intra-oral scan, relevant parts of the oral cavity are thus registered and related to the scan bodies 24. Such relevant parts have an influence on the shape and dimensions of the replacement prosthesis to be manufactured and include, for example, gums, in particular receding gums, a change in bite height, changes in shape of the teeth or of the jaw, etc.
[0073] The scan data from this intra-oral scan, more specifically said 3D digital image, is then related to the 3D digital model of the base structure 1 and/or of the existing bridge structure 2 that was generated during the design and the manufacture of base structure 1 or of the existing bridge structure 2. In this way, the position of said relevant parts of the oral cavity is unambiguously determined with respect to this digital 3D model of the basic structure 1 and/or of the existing bridge structure 2.
[0074] Next, a substitution bridge structure 2 is designed taking into account the situation of the oral cavity that was registered by performing said intraoral scan of said relevant parts. Hereby, a digital 3D model of the substitution bridge structure 2 is designed starting from the digital 3D model of the base structure 1 and/or from the existing bridge structure 2 and the related scan data of the performed intra-oral scan.
[0075] In this way, a model for a substitution bridge structure 2 is generated that can be fitted to the base structure 1, wherein bores 8 for bridge screws 12 are provided in this 3D model which are coaxial with the bores 3 in the base structure 1 when the substitution bridge structure 2 would be positioned fittingly on the base structure 1.
[0076] For convenience, it is usually possible, when designing the substitution bridge structure, to use the 3D digital model of the existing bridge structure 2 which was generated for the manufacture of the latter. Thus, this 3D model of the existing bridge structure 2 can be modified taking into account the scan data of said intra-oral scan.
[0077] Starting from this thus generated digital 3D model for the substitution bridge structure, it is then manufactured by, for example, milling or by an additive manufacturing method such as selective laser melting or sintering, or by stereolithography.
[0078] After the substitution bridge structure is manufactured, the existing bridge structure 2 is removed from the base structure 1 as described above. The substitution bridge structure can then be fitted to the base structure 1. This method for manufacturing a substitution bridge structure thus has the additional advantage that a patient experiences virtually no hindrance when replacing an existing dental prosthesis and that an existing prosthesis can be removed and replaced by a new dental prosthesis during the same dental visit.
[0079] The invention is of course not limited to the embodiments of the dental prosthetic system described above and shown in the accompanying figures. Several variants or alternatives may be considered within the framework of the invention.
[0080] Thus, it goes without saying that the invention is not limited to a prosthesis to replace a complete dental arch, but that it can also relate to a prosthetic system in which only one or two teeth or prosthetic teeth are provided. The invention can of course be used for both the upper and lower jaws.
[0081] Furthermore, the bridge structure 2 may consist of different materials that are used for manufacturing a dental prosthesis. Thus, the bridge structure 2 may consist, for example, of synthetic resin, composite material, zirconium, polycarbonate, ceramics, etc., or a combination of these materials.
[0082] Although the base structure 1 and/or the bridge structure 2 are manufactured in an interesting way by milling, it goes without saying that other production techniques can also be used. For example, they can be manufactured by applying an additive manufacturing technique such as selective laser melting or sintering, or by stereo lithography.
[0083] It is also possible for the bridge structure 2 to be attached to the base structure 1 with a so-called cement or another bonding agent. In that case, the use of bridge screws 12 is not required and it is sufficient to provide the aforementioned bores 8 in the bridge structure 2, which can work in conjunction with a release screw 17.
[0084] In certain cases it is not required either to provide a bore 8 for a bridge screw 12 opposite each bore 3 in the base structure 1, but it may be sufficient to provide a smaller number of bores 8 in the bridge structure than the number of bores 3 with base screws 11 provided in the base structure 1.
[0085] The screws 12 are slightly recessed in the surface of the bridge structure 2 in an interesting way, so that the recessed side of the screws 12 can be filled in such a way that the presence of the bridge screws is no longer visible in the surface of the bridge structure 2.
[0086] When one of the implants 10 on which the base structure 1 is mounted has to be removed because, for example, the bone or gum around this implant is inflamed, it is not required to produce a new bridge structure 2. Thus, the bridge structure 2 is removed from the base structure and a new base structure 1 is manufactured which takes into account the changed situation of the implants. After this new base structure has been fixed in the oral cavity, the existing bridge structure 2 can then be mounted on the latter.