EP3151780A1 - Implant de distraction à mécanisme amélioré - Google Patents

Implant de distraction à mécanisme amélioré

Info

Publication number
EP3151780A1
EP3151780A1 EP15726167.8A EP15726167A EP3151780A1 EP 3151780 A1 EP3151780 A1 EP 3151780A1 EP 15726167 A EP15726167 A EP 15726167A EP 3151780 A1 EP3151780 A1 EP 3151780A1
Authority
EP
European Patent Office
Prior art keywords
implant
distraction
membrane
bone
implant body
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.)
Withdrawn
Application number
EP15726167.8A
Other languages
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
Publication of EP3151780A1 publication Critical patent/EP3151780A1/fr
Withdrawn legal-status Critical Current

Links

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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • A61B17/663—Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access
    • A61B17/666—Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access for alveolar distraction

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, wherein the implant has a connection mechanism for connecting and moving the distraction membrane along the implant body comprising a lifting mechanism located at least predominantly inside 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.
  • jawbone structure If not enough bone is available for the secure anchoring of a sufficiently large or long implant, a so-called jawbone structure must be made. In particular, the recovery of bone height is considered problematic.
  • different methods are used. With little bone deficiency in width, 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. Further procedures These include bone spread, bone cleavage, bone-block transplantation, sinus lift, cavity techniques, sometimes using bone replacement matehales and protective membranes, and socket preservation. From a biological point of view, the best substitute for a bone is an autologous cancellous graft. However, such grafts are available only limited and show a high absorption rate after transplantation.
  • 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 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, wherein the distraction membrane along a portion of the longitudinal axis of the implant body by means of a coronal 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 Tooth implantation and bone distraction, which make it possible to perform implantation procedures and bone regeneration procedures in the jaw area, which overcome the disadvantages of the prior art.
  • the technical problem underlying the present invention is the provision of means and methods that allow to perform a safe dental implantation when the jawbone has to be built up.
  • the technical problem underlying the present invention is also the provision of distraction devices 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 on which it is based in particular by providing an implant comprising an implant body and a distraction membrane, wherein the distraction membrane is connected to the implant body via a connection mechanism such that the distraction membrane is displaceable along the longitudinal axis of the implant body, and wherein the connection mechanism comprises a lift mechanism located at least predominantly inside the implant body.
  • 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. wherein the distraction membrane is connected via a connecting mechanism with the implant body such that the distraction membrane is displaceable along the longitudinal axis of the implant body, and wherein the connection mechanism has a lifting mechanism which is at least predominantly apical to the distraction membrane.
  • the lifting 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 advantageously makes it possible that no additional, in particular complicated, surgical steps are required for bone formation by distraction osteogenesis than for the actual placement of the implant itself.
  • the procedural steps in setting a conventional dental implant necessarily include the two operative ones Steps a) Make a threaded hole using a tap or temporary implant and then b) insert and wax the final implant. Before that, the optional steps of "setting a pilot hole in the bone” and “extending the pilot hole” can be performed. After healing the final implant, a crown is usually placed on the final implant. But this can also be the case with temporary implants.
  • step a When using 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 for building up the bone surrounding the implant can take place.
  • 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, the membrane can then be inserted without great effort and connected to the implant body by the connection mechanism.
  • the membrane is slowly pulled away from the jawbone so that a dissection osteogenesis occurs between the actual steps a) and b ) he follows.
  • the gradual displacement of the lifting mechanism by the patient or a non-trained helper can take place, as is also customary, for example, when adjusting a toothed clip, since the point of application for a tool on the lifting mechanism lies outside the mucous membrane and is thus easy to reach.
  • the connection mechanism can be removed from the implant base by the dentist without any operational effort. be removed.
  • the membrane of the implant is resorbable, then no further operative step for removing the membrane is necessary because it can remain between mucous membrane and bone and is degraded there.
  • step b) can then be carried out in the usual way, ie the implant body can be removed 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 the case of 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 a major surgical outlay, whereby the individual distraction steps are not necessarily performed by a dentist a dental practice.
  • the implant according to the invention has the additional advantage that the implant body does not have to be rotated for distraction but remains rigid 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 link mechanism with the lift mechanism serves to attach the distraction membrane to the implant body and to controllably move the distraction membrane 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.
  • connection mechanism in which the lifting mechanism is located at least predominantly inside the implant body and / or apical of the distraction membrane, additionally has the surprising advantage that the main part of the connecting mechanism and the lifting mechanism is located on the apical side of the distraction membrane during distraction and thus not from the mucous membrane that covers the bone, looks out.
  • the counter surface of the distraction membrane and the screw a surface and shape that protects the connective tissue lying above the bone and in which the connective tissue and the mucous membrane can fit close to the implant body. This reduces the risk of infection and results in better trachoma comfort during bone distraction.
  • 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 made of titanium or a titanium alloy, in particular the material TIAI4V, 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 this, 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.
  • an implant in particular an implant described above, comprising an implant body and a distraction membrane, the implant body having an outer member with a bone screw thread, wherein the outer member as a sleeve with a coronal opening wherein the sleeve inner wall has an internal thread, wherein the implant body has a central element with an outer surface, wherein at least a portion of the central element is slidably but not rotatably mounted in the sleeve of the outer member, wherein the central element formed as a sleeve with a coronal opening wherein the central element has a lateral opening, wherein the implant body has an inner element, wherein at least a portion of the inner element rotatably but not displaceably in the sleeve of the central element gelage rt, the inner member having an external thread passing through the lateral opening of the central member and being in operative engagement with the internal thread of the outer member, the distraction membrane being connected to the central member.
  • the outer element is thus the basic element of the implant body.
  • the sleeve inner wall of the outer element form with the internal thread, the middle element and the inner element the connection mechanism with lifting mechanism.
  • the preferred construction of the outer member, middle member and inner member implant also has the surprising advantage that the majority of the linkage mechanism and lifting 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 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 counter surface of the distraction membrane and the nut form a surface and shape which protects the connective tissue lying above the bone and in which the connective tissue and the mucous membrane can lie close to the implant body.
  • this implant structure is very compact.
  • the engagement of the external thread of the inner member in the internal thread of the sleeve inner wall of the outer member prevents unwanted displacement of the central element in the outer member while the non-rotatable mounting of the central element in the outer member prevents rotation of the central element and thus the Dis- traction membrane.
  • the membrane is moved advantageously not by tensile forces but by compressive forces in an advantageous manner.
  • the central element projects beyond the coronal end of the outer element.
  • the central element and the inner element project beyond the coronal end of the outer element.
  • the coronal end of the central element has a point of application for a tool for screwing in or unscrewing the bone screw thread of the outer element into or out of a bone.
  • the distraction membrane is reversibly connected to the central element by a nut.
  • the middle element at the coronal end of the outer element preferably has a holding element, preferably a bead, which has a slightly larger diameter than the hole of the distraction membrane, so that the distraction membrane can be placed on the holding element and then the nut on the coronal end of the central element is screwed so that the nut presses the distraction membrane against the retaining element. Also, removal of the distraction membrane by unscrewing the nut is easily possible.
  • the nut is designed as a conical spacer sleeve.
  • a spacer sleeve is a metallic body used in implants.
  • a spacer sleeve is designed to bridge the gap between bone and mucous membrane. The spacer sleeve is usually used during the healing phase of an implant.
  • the spacer sleeve can fulfill two tasks in an advantageous manner.
  • the spacer sleeve can reversibly fix the distraction membrane to the middle element
  • the spacer sleeve in this embodiment is in a position in which it passes through the oral mucosa, especially when used in the jaw region and thus the border between under the mucous membrane lying membrane and the overlying the mucous membrane attack point for the tool for rotating the inner element forms. This can be generated by the membrane and the spacer sleeve, a smooth, not sharp-edged surface with which the mucous membrane in contact.
  • the coronal 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 member, its outer thread rotates in the inner thread of the outer member, so that the inner member displaces the non-rotatable but displaceable center member in the sleeve of the outer member, and thus also the distraction membrane attached to the central member along the longitudinal axis of the implant body in the coronal region of the implant body shifts.
  • the portion of the middle element mounted in the sleeve of the outer element has a three-part angular, quadrangular, pentagonal, hexagonal or polygonal cross section.
  • the inner sleeve wall of the outer element is then preferably also triangular, square, pentagonal, hexagonal or polygonal designed so that the sleeve inner wall gives a negative of the portion of the central element as a positive and the Mittelele- ment slidably but not rotatably mounted in the sleeve of the outer member.
  • an implant according to the invention is preferred, the implant body, in particular the bone screw thread of the outer element, being designed as a thread cutter, in particular a thread cutter cutting forward and backward.
  • the bone screw thread of the outer member is formed as a forward and backward cutting tap.
  • 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 that must Implant according to the invention are 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.
  • 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 thread mount, for example by at least one corresponding cutting groove between the thread flanks, that is to say a notch which connects at least two thread valleys to one another. det, 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 of the thread
  • the implant has a cutting edge in the apical region for forward cutting Cutting edge formed by the apical end of the threaded mountain.
  • the implant body or the outer element has a bone screw thread with an apically directed end and with a cervically directed end.
  • the bone screw thread on the cervical end preferably has a cutting edge for cutting backwards.
  • the cutting edge is formed by a recess in the threaded mountain formed by the thread flanks 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 at the apical end has a cutting edge for forward cutting and at the cervical end a cutting edge for cutting backwards.
  • the external thread of the tap can be catchy or multi-threaded. For a multi-start thread know prefers each turn on the cervical end has a cutting edge for backward cutting.
  • the thread has no recesses or cutting grooves which extend along more than two thread valleys and serve, for example, for receiving bone chips when screwing in a tap.
  • forward cutting or “forward cutting” is understood to mean that an internal thread is cut into the bone as the implant is being 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.
  • a person skilled in suitable implant body forms are known.
  • 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 be removed from the prior art.
  • 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 bone distraction or callus distraction. Such a membrane is preferably rigid and resistant to fracture, in particular dimensionally stable.
  • a distraction membrane is preferably designed such that it can be attached to a distraction device and can be removed from the bone in a controlled manner at a desired speed in a controlled manner at a desired rate, for example pulled away or pushed away from the bone, and in the process Forces acting on them do not lead to a deformation of the distraction membrane.
  • a distraction membrane is thus a specific subgroup of medical membranes, which can be easily distinguished by a person skilled in the art from other medical membranes which serve, for example, for easy covering of a bone defect.
  • 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.
  • bone distraction or “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 the callus arising between the bone defect and the element located cells, in particular osteoblasts, an artificial biomechanical pulse, in particular Buchimpuls is exercised.
  • the element may be, for example, a bone, a bone fragment or an artificial body act.
  • the element may be a distraction meshbranch.
  • 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 middle element, preferably also the inner element, extends. In a preferred embodiment, the hole is not positioned at the midpoint of the distraction membrane.
  • the distraction membrane has a hole through which the middle member passes, and preferably wherein the hole is not positioned at the midpoint of the distraction membrane.
  • the distraction membrane has a first side surface, a second side surface, a third side surface, and a fourth side surface, the first side surface facing the second side surface, and wherein the distance of the distraction membrane hole from the first side surface is less than that Distance of the hole to the second side surface.
  • This asymmetric positioning of the distraction membrane on the implant body axis of the implant has the advantage that a jaw ridge can be covered particularly well by the distraction membrane, since a ridge usually does not have any sympathetic has metric cross section.
  • a suitable distraction membrane may thus be selected, the hole of which is either only slightly removed from the center of the distraction membrane or whose hole is more remote from the center of the distraction membrane.
  • the dentist may stock different distraction membranes and, depending on the shape of the alveolar ridge, select the appropriate distraction membrane. It is of course also possible to individually adapt a distraction membrane to a ridge.
  • the distraction membrane has a four-sided base.
  • the third side surface opposes the fourth side surface, wherein the distance of the hole of the distraction membrane to the third side surface is approximately equal to the distance of the hole to the fourth side surface.
  • 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 Dis Dimensionionsmembran made of titanium, wherein the contact surface is coated, wherein the layer preferably consists of a mineral see material or predominantly a mineral material contains.
  • the contact surface may, for example, be coated with hydroxyapatite.
  • the distraction membrane consists 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 Magnesi- umlegtechnik, 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.
  • a distraction membrane leads in particular to a good vascularization of the newly forming bone tissue when the distraction membrane is used according to the invention. having preferred pores, which extend through the distraction membrane from the mating surface to the contact surface interconnecting therethrough.
  • the distraction membrane according to the invention is a distraction membrane for periodontal regeneration by means of distraction.
  • 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 tissue, the gingiva and the papillae, for example by guided tissue regeneration (GTR)
  • GTR guided tissue regeneration
  • the distraction membrane is In a preferred embodiment, 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.
  • an implant according to the invention is preferred, wherein the implant is a dental implant, in particular a provisional or permanent dental implant.
  • a dental implant in particular a provisional or permanent dental implant.
  • an implant according to the invention for use in a bone distraction, in particular jaw bone distraction.
  • a "dental implant” is understood to be an alloplastic fabrication part inserted into the jawbone, whose main body is preferably a pencil or helical shape.
  • 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.
  • the implant is intended for use in a medical procedure, in particular in a surgical procedure.
  • 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 is used 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 for periodontal regeneration by distraction.
  • the implant according to the invention is a dental implant with a membrane for periodontal regeneration.
  • Periodontal regeneration is understood as 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 a kit containing an implant according to the invention.
  • the present invention also relates to a kit containing the implant body of an implant according to the invention, and at least one distraction membrane, in particular a plurality of different membranes.
  • the kit preferably contains an instruction manual.
  • the instructions for use preferably contain information on how the kit can be used for setting the implant and performing a callus distraction.
  • a preferred embodiment is a kit according to the invention for use in medical procedures, in particular surgical procedures, preferably in bone distraction, especially in the jaw area.
  • a further preferred embodiment is the use of a kit according to the invention for producing an implant according to the invention.
  • 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 so with a certain speed removed by the lifting mechanism of the connection mechanism of the bone defect.
  • the speed is preferably 0.2 mm to 2.5 mm per day, in particular 0.5 mm to 2 mm per day.
  • the speed is particularly preferably about 1 mm per day.
  • 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 is a provisional implant 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. Before and / or after step c), 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) carrying out 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 bioabsorbable membrane is used which does not have to 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 a) of the methods according to the invention comprises the following substeps: a1) implanting the implant body in the bone; a2) attaching the distraction mesh to the implant body and applying the membrane to the bone defect; and a3) screwing the nut onto the implant body.
  • step a the optional steps "setting a pilot hole in the bone” and “extending the pilot hole” can be performed. After healing the final implant, a crown is usually placed on the final implant. But this can also be the case with temporary implants.
  • 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. 1 a shows a cross-section of an implant according to the invention
  • FIG. 1 b shows a cross-section of an implant according to the invention
  • FIG. 2 a shows a view of an implant according to the invention
  • FIG. 2b shows a further view of an implant according to the invention
  • FIG. 3 shows the individual elements of a device according to the invention
  • Implant as an exploded view. 1 shows in FIGS. 1 a and 1 b 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 (10, 20, 30) such that the distraction membrane (2) along a longitudinal axis (L) of the implant body (1) is displaceable.
  • the connecting mechanism (10, 20, 30) has a lifting mechanism, which is located at least predominantly inside the implant body (1) and apically of the distraction membrane (2).
  • the outer element (10) is the basic element of the implant body (1).
  • the sleeve inner wall (12) of the outer element (10) with the internal thread (12a), the central element (20) and the inner element (30) form here the connection mechanism with lifting mechanism.
  • the implant body (1) thus has an outer element (10) with a bone screw thread (40), wherein the outer element (10) as a sleeve (10a) with a coronal opening (1 1) is formed.
  • the sleeve inner wall (12) has an internal thread (12a).
  • the implant body (1) has a central element (20) with an outer surface (23).
  • the middle element (20) is designed as a sleeve (20a) with a coronal opening (21), wherein the middle element (20) has a has lateral opening (22).
  • the implant body (1) has an inner element (30), wherein at least a portion of the inner element (30) is rotatably but not displaceably mounted in the sleeve (20a) of the middle element (20).
  • the inner member (30) has an external thread (31) which extends through the lateral opening (22) of the central member (20) and is in operative engagement with the internal thread (12a) of the outer member (10).
  • the distraction membrane (2) is connected to the central element (20).
  • the portion of the middle element (20) mounted in the sleeve (10a) of the outer element (10) is polygonal with its outer surface (23) as well as the sleeve inner wall (12), so that this portion of the middle element (20) is displaceable but not rotatable in the Sleeve (10 a) of the outer member (10) is mounted.
  • the middle element (20) and the inner element (30) protrude beyond the coronal end of the outer element.
  • the distraction membrane (2) has a hole (3) through which the middle element (20) passes.
  • the distraction membrane (2) on a bead (26) of the central element (20) and is reversibly connected to the central element (20) by a nut (25), since the nut (25) is screwed onto the thread (27) and so presses the membrane (2) on the bead (26).
  • the nut (25) is designed here as a spacer sleeve. In Figure 1 a, the distraction membrane is only indicated.
  • the coronal end (33) of the inner element (30) has an engagement point (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).
  • FIG. 2 shows in FIGS. 2a and 2b the embodiment of the dental implant (100) from FIG. 1 in external views.
  • the outer element (10) of the implant body (1) and the distraction membrane (2) and the nut (25) can be seen.
  • FIG. 2b shows the point of application (34) for a tool for rotating the inner element (30).
  • 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 outer member (10) advantageously has a forward and backward cutting bone screw thread (40).
  • the primary forward cutting external thread (40) has valleys (41) and threads (42) and an apical end portion (44) and a cervical end portion (45).
  • the apical end portion (44) of the thread (40) has a forward cutting cutting element (46).
  • the cervical end region (45) of the thread (40) has a cutting element (43) with a cutting edge (43a) which is backward-divergent, ie when the implant body (10) is unscrewed from the bone, an internal thread is cut into the bone.
  • the cutting edge (43a) is formed by means of a notch (43b) in the uppermost passage of the threaded mountain (42).
  • FIG. 3 shows the embodiment of the dental implant (100) from FIG. 1 as an exploded view.
  • the outer element (10) with the bone screw thread (40) of the coronal opening (11) and the polygonal sleeve inner wall (12) with internal thread (12a) can be seen.
  • the middle element (20) has a partial area with a polygonal outer surface (23) for insertion into the outer element (10).
  • Another portion (24) is designed as a hexagon and serves as a point of attack for a tool for screwing or unscrewing the outer element (10) in or out of a bone.
  • Through the coronal opening (21) of the engagement point (34) for a tool for rotating the inner member (30) can be seen.
  • the inner element (30) is rotatably but not displaceably mounted in the middle element.
  • the external thread (31) of the inner element (30) extends through a lateral opening (22).
  • the membrane (2) has a hole (3) for attaching the membrane to the central part (20) and placed on the bead (26). Thereafter, the membrane (2) with the nut (25) over the thread (27) are reversibly fixed.
  • the distraction membrane (2) has pores (4), which allow a mass transfer.

Landscapes

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

Abstract

La présente invention concerne un implant, de préférence un implant dentaire, comprenant un corps d'implant et une membrane de distraction, ainsi que l'utilisation dudit implant dans la distraction du cal et des procédés de pose d'implants, ledit implant présentant un mécanisme de liaison pour relier et déplacer la membrane de distraction le long du corps d'implant, ledit mécanisme de liaison comportant un mécanisme de levage qui se situe au moins principalement à l'intérieur du corps d'implant.
EP15726167.8A 2014-06-04 2015-06-03 Implant de distraction à mécanisme amélioré Withdrawn EP3151780A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102014008503.1A DE102014008503A1 (de) 2014-06-04 2014-06-04 Distraktionsimplantat mit verbessertem Mechanismus
PCT/EP2015/062341 WO2015185603A1 (fr) 2014-06-04 2015-06-03 Implant de distraction à mécanisme amélioré

Publications (1)

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EP3151780A1 true EP3151780A1 (fr) 2017-04-12

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EP15726167.8A Withdrawn EP3151780A1 (fr) 2014-06-04 2015-06-03 Implant de distraction à mécanisme amélioré

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EP (1) EP3151780A1 (fr)
DE (1) DE102014008503A1 (fr)
WO (1) WO2015185603A1 (fr)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015009932A1 (de) * 2015-07-28 2017-02-02 Celgen Ag Implantat mit Distraktionsmembran zur Kallusdistraktion
US10321979B2 (en) * 2017-10-04 2019-06-18 Dietmar SONNLEITNER Dental implant system

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US5129901A (en) * 1991-06-10 1992-07-14 Decoste Vern X Cannulated orthopedic screw
EP2845561A1 (fr) * 2012-04-19 2015-03-11 Jeong Bin Hwang Implant dentaire

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Publication number Priority date Publication date Assignee Title
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
US7396232B2 (en) * 2001-12-05 2008-07-08 Ophir Fromovich Periosteal distraction
DE10295781D2 (de) 2001-12-15 2004-11-04 Richard Blankenhorn Gmbh Vorrichtung und Verfahren zum Knochenaufbau durch Distraktion von Knochensegmenten
DE102010017023A1 (de) * 2010-05-19 2011-11-24 Dieter Derichs Vorrichtung zur Distraktion von Knochensegmenten
DE202010018144U1 (de) 2010-12-10 2014-05-06 Celgen Ag Universaldistraktor zur Knochenregeneration
CA2748750A1 (fr) * 2011-08-11 2013-02-11 John David FRENCH Dispositif de greffe osseuse utilisant un clou a tete large
KR101301694B1 (ko) * 2012-02-28 2013-08-30 오스템임플란트 주식회사 치과용 멤브레인 고정용 어버트먼트
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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US5129901A (en) * 1991-06-10 1992-07-14 Decoste Vern X Cannulated orthopedic screw
EP2845561A1 (fr) * 2012-04-19 2015-03-11 Jeong Bin Hwang Implant dentaire

Non-Patent Citations (1)

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Title
See also references of WO2015185603A1 *

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WO2015185603A1 (fr) 2015-12-10
DE102014008503A1 (de) 2015-12-31

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