Implant driver that controls both implant depth and rotation according to digital planning

Abstract

An implant driver assembly for placing an implant according to a digital virtual planning implant and an implant position in a patient's jaw, wherein the implant driver assembly includes at least an implant driver and at least a surgical template, wherein the implant driver has one or more first marks and is suitable for alignment with the surgical template, the surgical template has a guide element and has one or more second marks, so that when connected to the implant, the alignment of the one or more first marks on the implant driver with the one or more second marks on the surgical template defines the spiral movement of the implant when it is inserted into the jawbone, the implant driver and the surgical template also include at least one of the one or more first marks and at least one of the one or more second marks for indicating the rotational or rotationally symmetrical position of the implant driver defined by the digital virtual planning implant position, wherein the guide element is a bushing with a smooth hole; wherein the one or more first marks include a thread in or on the outer surface of the implant driver; wherein the one or more second marks include a thread follower for following the thread in or on the outer surface of the implant driver; wherein the thread follower includes one or more pins that can be removed or retracted from the guide element of the surgical template.

Description

Technical Field

[0001] The present invention relates to methods, systems and apparatus for placing an implant in a patient's mouth and for preparing a tool suitable for placing an implant in a patient's mouth. Background Art

[0002] Using implant driver in conjunction with patient-specific surgical template to place dental implant in predetermined position is common method in dental implant treatment.But, there is no commercially available guided surgical instrument kit on the market, which allows implant to be placed in its predetermined virtual planning position, while controlling vertical position and rotation around its longitudinal axis.In most commercial guided surgical systems, implant is either placed in the vertical position of its predetermined virtual planning, or is placed in the rotation position of its predetermined virtual planning, but can not be placed in the vertical position of its predetermined virtual planning and is placed in the rotation position of its predetermined virtual planning.The reason is that the commercial instruments currently used for guided surgery can not force implant to follow the spiral path of predetermined virtual planning.In the process of implant placement with current commercial system, the spiral path followed by implant is determined by implant position and the thread design of implant when the thread of implant is "stuck" into bone. Reference prior art, not currently commercialized, describes implant drivers that allow helical controlled placement of an implant with repeatable depth and rotation guided to the implant's final position, however without a helix predefined in a virtually planned manner.

[0003] WO2010 / 125593 discloses a guided dental implant positioning system, which utilizes a surgical guide device provided with one or more holes or sleeves corresponding to the implant insertion point and used to control the insertion orientation of the implant, and the system includes a device for simultaneously controlling the position, final insertion depth, insertion axis direction and rotation angle around the axis of each implant by setting the rotation angle of each implant around its own axis when each implant is initially inserted into the osteotomy seat. A device for simultaneously controlling the depth and axis direction of the osteotomy seat is also disclosed.

[0004] EP2153797 discloses an accessory made as a positioning fixture, wherein the accessory is provided with channels (25) for screws (22) which can be screwed into the implant (7), these channels (25) and the attached screws (22) having such a shape that they can be pressed into a specific position when the screws (22) are tightened, and an accessory in the shape of a drill fixture (6), in which one or more guide tubes (9) for drilling are formed, which are arranged in the drill fixture (6) in a computer-planned function.

[0005] WO2007 / 129955 relates to a device and method for fixing a dental implant in a patient's bone tissue. The device includes an internally threaded guide sleeve having an interlocking portion that can engage an interlocking portion on a tubular mounting guide. A retainer includes a screw that is complementary to the thread of the guide sleeve. The retainer is arranged to fix the implant at one end of the retainer. The tubular mounting guide is placed in a hole in a surgical template and bonded in the hole at a desired angular position. The template is placed in the patient's mouth. Through the hole in the template, a hole is drilled into the bone. The dental implant is fixed to the retainer, and the guide sleeve is placed in the hole in the template so that the corresponding interlocking portions interlock. The retainer is screwed in through the guide sleeve until the implant is screwed into the bone. The application also relates to a method for manufacturing a surgical template. Summary of the invention

[0006] Embodiments of the present invention provide a design of a surgical template and / or a set of instruments and methods of creating and using the template or the instruments to place a dental implant into a position that is a predetermined virtual planned position. The position can be achieved by digitally planning a virtual implant position relative to digital clinical data of the patient's jaw, resulting in actual definition of the implant position in the jaw.

[0007] It is an object of embodiments of the present invention to simultaneously control the position, final insertion depth and rotation angle about its axis of each implant as it is installed in the patient's jaw.

[0008] Another object of an embodiment of the present invention is to be able to place an implant with an implant driver, and after reaching the correct vertical position (i.e., the correct insertion depth in the jaw), there is a mark to show that the implant driver should not be further screwed in to cause damage to the jawbone. On the contrary, the implant and the driver not only reach the correct vertical position, but also reach the correct rotational position at the same time, thus not requiring further vertical movement. This prevents possible damage to the jawbone. The various parts of the system cooperate to achieve the correct positioning of the implant in the operation.

[0009] For example, embodiments of the present invention are directed to an implant driver assembly, as described below, with optional features in logical dependencies.

[0010] 1. An implant driver assembly for placing an implant according to a digitally virtual planned implant and implant position in a patient's jaw, wherein the implant driver assembly includes at least an implant driver and at least a surgical template, wherein the implant driver has one or more first marks and is suitable for alignment with the surgical template, the surgical template has a guide element and has one or more second marks, so that when connected to the implant, the alignment of the one or more first marks on the implant driver with the one or more second marks on the surgical template defines the spiral movement of the implant when it is inserted into the jawbone, the implant driver and the surgical template also include at least one of the one or more first marks and at least one of the one or more second marks for indicating the rotational or rotationally symmetrical position of the implant driver defined by the digitally virtual planned implant position, wherein the guide element is a bushing with a smooth hole; wherein the one or more first marks include threads in or on the outer surface of the implant driver; wherein the one or more second marks include a thread follower for following the threads in or on the outer surface of the implant driver; wherein the thread follower includes one or more pins that can be removed or retracted from the guide element of the surgical template.

[0011] 2. An implant driver assembly according to item 1, wherein at least one of the one or more first marks and at least one of the one or more second marks are used to indicate a final vertical position of the implant driver.

[0012] 3. An implant driver assembly according to item 1 or 2, wherein the digital virtual planned implant and / or the implant position in the patient's jaw is stored on a signal storage device.

[0013] 4. An implant driver assembly according to any of the preceding claims, wherein one of the one or more first markers is a distributed marker.

[0014] 5. An implant driver assembly according to any preceding claim, wherein the thread has a thread start and a thread entry.

[0015] 6. An implant driver assembly according to any of the preceding claims, wherein the implant driver narrows at one end so that the thread follower disengages from the threads.

[0016] 7. An implant driver according to any preceding claim, wherein the implant driver is adapted to pass through a smooth perforated bushing.

[0017] For example, embodiments of the present invention relate to a method for determining allowable positions of a first marking on an implant driver and a second marking on a guide element of a surgical template, as described below, with optional features in logical dependencies.

[0018] 8. A method for determining the permitted positions of a first marking on an implant driver and a second marking on a guide element of a surgical template, comprising the steps of:

[0019] Prior to manufacturing the surgical template, the rotational position of the implant is virtually planned relative to the patient's digital clinical data, and a second marker is positioned on a guide element of the surgical template such that cooperation of the second marker on the guide element and the first marker on the implant driver allows the implant to be placed in the patient's jaw using the implant driver, such that the implant driver is moved into a rotational position wherein the guide element has a smooth hole suitable for receiving the implant driver.

[0020] 9. A method according to item 10, wherein the coordination of the second mark on the guide element and the first mark on the implant driver allows the implant to be placed in the patient's jaw using the implant driver, so that before manufacturing the surgical template, the implant driver is moved to a vertical position of the implant in the patient's jaw, and the vertical position is virtually planned relative to the patient's digital clinical data.

[0021] 10. A method according to item 10 or 11, wherein the digital virtual planned implant and / or the implant position in the patient's jaw is stored on a signal storage device.

[0022] 11. A method according to any one of items 10 to 12, wherein the first and / or second marker is a distributed marker.

[0023] 12. A method according to item 11, wherein the second marking comprises threads in or on an outer surface of the implant driver.

[0024] 13. The method according to item 12, wherein the thread has a thread start and a thread entry.

[0025] 14. A method according to item 12 or 13, wherein the first marking comprises a thread follower for following, and the first marking is a thread in or on the outer surface of the implant driver.

[0026] 15. The method of claim 14, wherein the thread follower is one or more pins that are removable or retractable from a guide element of the surgical template.

[0027] 16. A method according to any one of items 13 to 15, wherein the implant driver is narrowed at one end so that the thread follower disengages from the threads.

[0028] 17. The method according to any one of items 8 to 16, wherein the guide element is a bushing.

[0029] 18. The method of item 17, wherein the bushing has a smooth bore.

[0030] 19. The method of item 18, wherein the implant driver is passed through a bushing having a smooth bore.

[0031] For example, embodiments of the present invention are directed to a method of programming in a setting of a dental handpiece, as described below, with optional features in logical dependencies.

[0032] 20. A method for programming in a dental handpiece setting the rotation required to place an implant into a digital predetermined position in a patient's jaw, comprising the steps of:

[0033] Manufacturing an implant driver including one or more first markings defining a helix, wherein:

[0034] The longitudinal axis of the helix coincides with the longitudinal axis of the implant driver,

[0035] The pitch of the helix is ​​consistent with the thread pitch of the implant that the implant driver is compatible with.

[0036] The one or more first markings on the implant driver facilitate alignment with the one or more second markings on the surgical template to allow a predetermined initial position of the implant driver to be established, and the surgical template has a smooth perforated bushing through which the implant driver passes.

[0037] 21. The method of item 20, wherein the thread entry and the thread start allow for establishing a predetermined initial position of the implant driver.

[0038] 22. A method according to item 21, wherein the implant position in the patient's jaw is determined based on digital clinical data obtained from the patient.

[0039] 23. A method according to item 22, wherein, based on the virtual implant position and the implant driver, the virtual spiral path is defined by the position of one or more first markers of the implant driver in the virtual final position when connected to the virtual planned implant.

[0040] 24. The method according to item 23 also includes identifying the position of a thread start on the implant driver, which thread start is virtually connected to the virtually planned implant position.

[0041] 25. A method according to item 23 or 24, wherein the spiral path is a groove and the position of a thread follower / guide pin is selected which is located in the surgical template and follows the spiral.

[0042] 26. The method according to any one of items 21 to 25, further comprising calculating the polar rotation required to move an initial position of the start of the thread to a final position of the start of the thread following the helical path.

[0043] 27. The method according to item 26, further comprising calculating

[0044]

[0045] (where pitch is the thread pitch)

[0046] Wherein α is the polar rotation and h is the vertical height measured along the longitudinal axis of the virtually planned implant between the initial position of the thread start and the final position of the thread start.

[0047] 28. The method of item 27, further comprising programming a polar rotation α into the dental handpiece system so that the rotation can be applied to the implant driver after the thread start has been moved into its initial position.

[0048] For example, embodiments of the present invention are directed to a method of setting up a surgical template to place an implant into a digitally predetermined position in a patient's jaw, as described below, with optional features in logical dependencies.

[0049] 29. A method of setting up a surgical template to place an implant into a digitally predetermined position in a patient's jaw, comprising the steps of:

[0050] The surgical template is manufactured so that a predetermined set of surgical instruments can be guided by a guide element that is part of the surgical template, the surgical template is suitable for use in creating an osteotomy, which is positioned according to a virtual position of an implant planned before surgery, wherein the virtual implant position is planned relative to digital clinical data obtained from a patient, wherein the guide element of the surgical template is a bushing that is smooth and has holes, and the bushing includes a retractable or embedded thread follower so that the thread follower follows a spiral groove on the implant driver.

[0051] 30. The method of item 29, wherein the thread follower has a retractable pin / screw or an apex of an embedded pin.

[0052] 31. A method according to item 29 or 30, wherein the implant driver 2 is connected or can be connected to the implant which is suitable for moving and for moving into a guide element of a surgical template.

[0053] 32. A method according to item 30 or 31, wherein the threaded entry on the implant driver is aligned with the apex of the pin / screw, and the implant driver is moved into the smooth perforated bushing until the thread start coincides with the apex of the pin / screw.

[0054] 33. A method according to item 32, wherein, because the apex of the pin / screw follows the threads of the implant driver, the implant driver and implant in the assembly move downward in a spiral motion driven by the threads of the implant driver and the thread follower of the bushing.

[0055] 34. The method according to item 33, wherein the movement continues until the start of the thread and the implant driver / implant assembly is moved into its final position.

[0056] 36. A method according to item 34, wherein the final position is indicated by aligning a first final position mark on the implant driver with a second final position mark on the surgical template.

[0057] For example, an embodiment of the present invention relates to a set of components, including a digital virtual planning implant stored on a signal storage device, an implant driver having one or more first markers, an implant to be placed, and a guide element of a surgical template including one or more second markers, so that when the implant driver is connected to the implant, the alignment of the one or more first markers on the implant driver with the one or more second markers on the surgical template defines the spiral movement of the implant when the implant is inserted into the jaw using the implant driver, the implant driver and the surgical template also include at least one of the one or more first markers and at least one of the one or more second markers for indicating the final vertical position of the implant driver, so that the final vertical position of the implant driver is such that the implant is in the same vertical and rotational or rotationally symmetrical position as defined in the digital virtual planning implant when placed.

[0058] By the combination and predetermined position of the mark on the implant driver and the surgical template, especially the guide element (such as the sleeve in the bushing or the bushing), when these marks are aligned, embodiments of the present invention can limit the spiral insertion path of the implant driver, and this path can bring the implant to the position corresponding to the rotation or rotationally symmetrical position. This can be relevant with the implant position of the predetermined virtual planning. Except the rotationally symmetrical position, optionally, the vertical position or the depth of the implant can also be realized. The guide element can have a smooth hole, such as the smooth hole sleeve in the smooth hole bushing or the bushing, and it has a smooth inner surface, for example, there is no thread. The sleeve can be assembled in the bushing, in which case the sleeve has a smooth hole, but in this case, the bushing does not need a smooth inner surface.

[0059] In embodiments of the invention, the hole of a guide element (such as a bushing) on ​​a surgical template can have one, two, three, four, or up to five pins or screws that enter the hole and serve as a second marker on the guide element. The pins or screws can be disposable or can be embedded in the guide element (such as a bushing). The pins or screws can be thread followers.

[0060] The embodiments of the present invention have the following advantages:

[0061] (i) No internal threads are required on the inner surface of the guide element of the surgical guide, such as a smooth bore of a bushing or cannula in the surgical guide.

[0062] (ii) easier retrieval of the implant driver after the implant has been placed,

[0063] (iii) the possibility to use other tools through the sleeve without risk of damaging these tools, and (iv) direct integration into surgical planning and potential programming of the dental handpiece.

[0064] In one aspect of the present invention, an implant driver is provided with a group of implants or implants to be placed in the patient's jaw, and the outer surface of the implant driver has a rotation mark. Optionally, there can be a depth mark for indicating the insertion depth of the implant in the patient's jaw. The rotation mark can be distributed on the surface of the implant driver, for example in the form of a spiral. The advantage of using distributed rotation marks is that at least a portion of it can be seen by a dentist or dental surgeon at any time. Distributed marks can include various marking elements, such as ribbons, lines, segmented linear marks, such as dotted lines or dot-dash lines. The rotation mark can be placed in or on the implant driver by any suitable process (such as printing, painting, milling, laser ablation, engraving, etching). For example, the rotation mark can be scored, scraped, milled into the surface of the implant driver, for example, it can be a thread. The position of the mark on the implant driver relative to the mark on the guide element is determined by the design specifications of the implant driver, the design specifications of the surgical template, and the position of the virtual planning implant, and the guide element is such as a sleeve with an optional sleeve. The latter is patient-specific, and therefore determines the patient-specific features of the mark position.

[0065] The implant depth mark can be provided by a local marking element, for example any suitable design, such as one or more lines, such as a segmented linear mark of a dotted line, one or more local engravings, one or more local etchings, one or more local printings or paintings, one or more local millings or the like. When the implant is in final and correct rotation and depth position, the mark on the implant driver is preferably aligned with at least one mark on the surgical template, for example the mark on a guide element (such as a bushing). The first mark on the implant driver and the second mark on the guide element of the template limit spiral motion. The first and second marks can interact, cooperate or coordinate with each other, to limit the rotation start and end point and for example all points therebetween.

[0066] The vertical stop position does not necessarily need to be matched between the first mark on the implant driver and the second mark on the guide element (such as a bushing). For example, another embodiment of the present invention provides an implant driver having a thread that stops at a specific position along its length. This can be used to determine the final vertical position of the implant without the need for the second mark on the surgical template.

[0067] The marking on the sleeve of the surgical template can include one or more retractable or embedded thread followers at a patient-specific position. The thread follower cooperates with a rotation mark on the implant driver, which is also, for example, a thread or a spiral groove. The thread can be formed in or on the surface of the implant driver. The position of the thread follower relative to the guide element (such as a sleeve) is determined by the design specifications of the implant driver, the design specifications of the guide element (such as a sleeve) and the position of the virtual planning implant. The latter is patient-specific, and therefore determines the patient-specific characteristics of the thread follower position. The thread follower is a mark that can facilitate or even strengthen the alignment with the rotation mark on the implant driver (such as the implant driver thread). When the thread follower is inserted into the thread on the implant driver or the thread on the implant driver is inserted into the thread follower on the implant driver, the movement of the implant driver relative to the surgical template is controlled by the position of the thread follower and the sliding movement of the thread follower in the thread or on the thread of the implant driver inserted into the implant driver.

[0068] In some embodiments of the present invention, the thread of the implant driver can correspond to the thread of the implant, i.e., have the same thread pitch. In addition, the implant driver can also include a mark for indicating the correct final position of the implant driver, such as rotationally and / or vertically. When the implant and the implant driver are placed in this specific final position, the implant has reached the same vertical and rotational or rotationally symmetrical position as defined for the virtual planning implant. For this reason, this position is referred to as the final position. Note that the implant connector has x-fold rotational symmetry, such as, when the implant connector has a hexagonal shape, it has six-fold symmetry. The final implant rotational position around its vertical axis can be allowed to be a multiple of the virtual planning rotational position. For example, for a hexagonal connector, the final implant can rotate an angle around its longitudinal axis relative to the virtual planning rotational orientation around its longitudinal axis, such as 60 °, 120 ° ... The implant driver and the bushing design can be changed to achieve similar or identical results. For example, a thread follower can be provided on the implant driver, and a thread can be provided on the bushing.

[0069] Embodiments of the present invention provide a method for designing, and / or manufacturing and / or using a surgical template with patient-specific markings and / or an implant driver with markings so that an implant can be placed according to a predetermined virtual planned position.

[0070] In another aspect of the present invention, a specific mathematical calculation is proposed as a way to determine the position of the mark. Other methods that do not use mathematical calculations to determine the position of the mark are also included in the scope of the present invention.

[0071] Embodiments of the present invention include a method for determining the number of implant driver rotations or turns required to reach a final implant position that matches a virtual planned implant position. This number can then be programmed into a motorized handpiece used to drive in the implant driver so that reaching the final position no longer requires the use of a marker indicating the final implant driver position.

[0072] Embodiments of the present invention can solve one or two major problems existing in the referenced prior art. For example, implant drivers and surgical templates according to embodiments of the present invention do not require two threaded interacting components. The first problem is related to the fact that known methods require tapping both the sleeve of the surgical template (or an additional threaded sleeve mounted to the surgical template, such as within the sleeve) and the implant driver. This combination of two threaded interacting components has several disadvantages. First, it does not allow the implant driver to be easily separated from the implant when the final position of the implant is reached. In fact, the implant driver can usually only be separated from the implant by translating away from the implant along its longitudinal axis. This movement is impossible when the threaded implant driver is also connected to the thread of the surgical template sleeve. One aspect of some embodiments of the present invention includes one or more (capable of) retractable thread followers. The thread follower can be a simple pin. Such a pin has a local penetration or point contact in the thread groove on the implant driver. Retraction allows translational movement of the implant driver, which is necessary to separate it from the implant. Second, the threaded sleeve or threaded additional sleeve in the surgical template is not optimal for guiding other surgical instruments (such as drills) that usually rotate faster. To guide these instruments, a smooth inner surface of the bushing (i.e., a smooth perforated bushing) or a smooth bore of the cannula (when the cannula is within the bushing) is preferred. In short, the introduction of one or more discrete markings (such as guide pins from a thread follower) in the bushing of the surgical template rather than a fully threaded bushing is considered a superior concept compared to the referenced prior art.

[0073] In embodiments of the invention, the hole of a guide element (such as a bushing) on ​​a surgical template can have one, two, three, four, or up to five pins or screws that enter the hole and serve as a second marker on the guide element. The pins or screws can be disposable or can be embedded in the guide element (such as a bushing). The pins or screws can be thread followers.

[0074] The second problem with the referenced prior art is that it does not include a method for determining the position of a marker based on virtual implant planning. As a result, the prior art disclosure does not provide a device for placing an implant that matches the implant position of the virtual plan in both vertical depth and rotational or rotationally symmetrical positions. Embodiments of the present invention allow implants to be placed at positions that match the virtual planning position rotationally or rotationally symmetrically and in an orientation that matches it. The matching of the virtual planning position can be performed in both depth and rotational position. This is in contrast to the referenced prior art, and embodiments of the present invention allow more accurate placement of virtually planned and virtually designed patient-specific prosthetic components, such as abutments and crowns, in the same treatment process for placing implants. Because the vertical (or depth) and rotational positions of the implants to be placed are controlled, the positions of the patient-specific prosthetic components placed will more accurately match their virtual planning positions. In the referenced prior art, the implant position is predetermined and is repeatable only after the surgical template is manufactured. Therefore, the referenced prior art only allows the preparation of prosthetic components manually (e.g., by implant (simulation) placement in a physical model using the same surgical template), and cannot be prepared digitally. For this reason, a method for determining the patient-specific position of discrete markings in a surgical template guide element (such as a smooth perforated bushing) based on a virtual implant position and based on predetermined markings on an implant driver is considered a superior concept.

[0075] In one aspect, an embodiment of the present invention provides a set of components, including a digital virtual planning implant stored on a signal storage device, an implant driver having one or more first marks, an implant to be placed, and a guide element of a surgical template including one or more second marks, so that the alignment of one or more first marks on the implant driver (which is connected to the implant when the implant is driven) and one or more second marks on the surgical template limits the spiral movement of the implant when it is inserted into the jawbone, and the implant driver and the surgical template also include at least one of the one or more first marks and at least one of the one or more second marks, for indicating the final vertical position of the implant driver, so that the final vertical position of the implant driver and the implant is in the same vertical and rotational or rotationally symmetrical position as the digital virtual planning implant when placed. The above is preferably only a mark of the final position, because this is insufficient, because the limitation will include such a situation, where the implant with the implant driver can be placed in a normal manner, and then after first reaching the correct vertical position, the implant driver is further screwed into the correct rotational position, while preventing further vertical movement. This is likely to damage the bone.

[0076] The guide element can have a hole, which is smooth. This provides the advantage that it is easier to remove the implant driver from the implant after the implant has been placed in the patient's jaw. In an embodiment of the present invention, the hole of the guide element (such as a bushing) on ​​the surgical template can have one, two, three, four or up to five pins or screws, which enter the hole and serve as a second mark on the guide element. The pin or screw can be disposable, or can be embedded in the guide element (such as a bushing). The pin or screw can be a thread follower.

[0077] The one or more first marks may be one or more distributed marks. This makes it easier for a dentist or dentist to see the marks.

[0078] The one or more first markings may include threads in or on the outer surface of the implant driver. The threads may have a thread start and a thread entry. The threads are easy to manufacture.

[0079] The one or more second markings may include a thread follower for following a thread in or on an outer surface of the implant driver.The thread follower provides positional stability.

[0080] The thread follower may be one or more pins, some or each of which are or can be removed from a guide element of the surgical template.

[0081] The guide element may be a smooth perforated bushing. This makes it easier to remove the implant driver from the implant after the implant has been inserted into the jawbone.

[0082] The implant driver can be narrowed at one end so that the thread follower disengages the threads. This makes it easier to remove the implant driver from the implant after the implant has been inserted into the jawbone. BRIEF DESCRIPTION OF THE DRAWINGS

[0083] Figure 1A A combination of an implant driver, a virtual planning implant, a surgical template with a guide element in the form of a smooth perforated bushing and a thread follower according to an embodiment of the invention is schematically shown.

[0084] Figure 1B Shows Figure 1A details.

[0085] Figure 2A Shown is a combination of an implant driver and an implant placed in the final position and a guide element in the form of a smooth perforated bushing of a surgical template according to an embodiment of the invention.

[0086] Figure 2B Shows Figure 2A details.

[0087] Figure 3 Shown is a portion of an implant driver having a thread, a thread entry and a thread start, a portion of an implant, and a guide element in the form of a smooth perforated bushing having a thread follower in the form of a guide pin according to an embodiment of the present invention.

[0088] Figure 4 An implant driver with a thread, a thread entry and a thread start, an implant and a guide element with a thread follower in the form of a guide pin according to an embodiment of the invention are shown.

[0089] Figure 5 An implant driver with a thread, a thread entry and a thread start, a portion of an implant, and a guide element with different thread followers in the form of guide pins according to embodiments of the invention are shown.

[0090] Figure 6 An implant narrowing near the top, a portion of a driver implant, and a guide element with an embedded thread follower are shown according to an embodiment of the present invention, the implant driver having threads, a thread entry, and a thread start.

[0091] Figure 7 A portion of an implant driver according to an embodiment of the present invention is shown in a virtual final position (ie connected to a virtually planned implant).

[0092] Figure 8 A portion of an implant driver according to an embodiment of the present invention is shown, the implant driver having a spiral defining mark, such as a spiral line and a set of points separated by a spiral pitch and a final position mark, and a guide element having a mark to be aligned with the spiral mark on the implant driver and a final position mark to be aligned with the final position mark of the implant driver.

[0093] definition

[0094] "Spiral insertion path": When a dental implant is inserted into the jawbone, the implant driver is rotated, which screws the implant into the jawbone. A point on the implant driver will thus rotate and move linearly in a direction parallel to the axis of rotation, whereby the combined movement creates a spiral path for that point.

[0095] "Smoothly perforated" means that all embodiments of the present invention do not have threads or other surface irregularities on the inside of the guide element on the surgical template (such as a bushing). In embodiments of the present invention, the hole of the guide element (such as a bushing) on ​​the surgical template can have one, two, three, four, or up to five pins or screws that enter the hole and serve as a second mark on the guide element. The pin or screw can be disposable or can be embedded in the guide element (such as a bushing). The pin or screw can be a thread follower.

[0096] "Distributed markings" means markings that are dispersed on the surface of, for example, an implant driver, such that a portion of the markings can be seen by a dentist or dental practitioner independently of the rotational position of the implant driver. Such markings can be present at any position around the surface of, for example, an implant driver, such as a thread traversing 360° of the surface of, for example, an implant driver.

[0097] "Local marking" means a marking whose area is small so that the marking is located at a specific location rather than scattered on the surface. A typical local marking will be a dot or a line. DETAILED DESCRIPTION

[0098] Embodiments of the present invention can utilize virtual planning software to plan the position of implants via computer simulation, i.e., formulate preoperative planning. The input of preoperative planning is preferably one or more images obtained from one or more volume scans, such as MRI scans, conventional or cone beam (CB) computed tomography (CT) scans of the patient's anatomical structure (e.g., jaws and dentition). Optionally, other types of scans (such as optical scans of in vitro models or intraoral optical scans of the patient's oral cavity) can be used alone or in combination with other scans. From one or more scans, for example, by using software and conventional techniques known to technicians, digitization of the patient's anatomical structure (e.g., dentition) is obtained. In preoperative planning, digitization of the patient's anatomical structure (e.g., bones and dentition) is combined, and the dentist or practitioner can virtually plan the position and orientation of the implant in their best or best possible clinical and aesthetic position.

[0099] Embodiments of the present invention may include the generation and use of a digital preoperative plan, the design of a surgical template or set of instruments, and methods of creating and using the surgical template or these instruments to place dental implants into predetermined virtually planned digitally defined locations.

[0100] The predetermined virtually planned digitally defined position of the implant may be digitally stored in a random access memory or on a signal storage medium such as a compact disc, magnetic tape, hard drive, semiconductor solid state memory such as a flash drive, or the like.

[0101] By for example on implant driver and surgical template or in one of them, there is the mark of predetermined position, embodiments of the present invention can limit the spiral insertion path of implant driver, and this path can bring implant in the position corresponding to predetermined virtual planning implant position in rotation or rotationally symmetric position.Optionally, this position can correspond to predetermined virtual planning implant position on both vertical and rotation or rotationally symmetric position.A rear position is called final position, and can indicate by any one, each or both additional (one group) marks in the implant driver and the guide element that are aligned when arriving at final position.

[0102] Figure 1A and 1B An implant driver 2 with a handle 18 is shown according to an embodiment of the present invention and the connection of the implant driver to a virtual implant location 16 is schematically shown. Figure 2A and 2B An implant driver 2 with a handle 18 and a connection of the implant driver to an actual implant 24 according to this embodiment of the invention is shown. According to this embodiment, when the implant driver 2 is used to install the implant 24, the installation is accomplished using a first mark such as a thread 4, for example as at least one distributed rotational mark, which allows the implant 24 to be positioned in the jaw when the thread 4 is used to determine the final position. Thus, as the driver 2 rotates, the implant 24 moves further into the jaw. As the driver 2 rotates and moves downward toward the jaw or into the jaw, any point on the implant driver 2 will follow a spiral path. The connection of the implant driver to achieve a correctly terminated spiral path that is consistent with a predetermined virtual implant position in rotation and, optionally, in both depth and rotation, can be indicated by aligning a combination of the two marks on the implant driver (e.g., a first mark, such as a thread 4 (see Figure 1A ), or the drawn line 26 (see Figure 1B ) or 55 (see Figure 8 )) or line 56A to N (see Figure 8 ) a set of points, the thread start 6 or the thread entry 8 (see Figure 1B ) ...) and on the guide element of the surgical template 12 (for example, on the smooth perforated bushing 14 (see Figure 1A )) with a local marking specific to the patient's position (e.g., a second marking, such as a thread follower 10, or a drawn line 27 or 28 (see Figure 1B ) or 57, 58, 59 (see Figure 8 ……)). The first and second markings may be aligned with each other, or may cooperate with each other, interact with each other, coordinate with each other, or operate with each other to bring the implant 24 into the correct final position. Thus, the markings on the implant driver 2 (such as the thread 4 (see Figure 1A), or the drawn line 26 (see Figure 1B ), helical line 55 (see Figure 8 ), or a set of points in line 56 (see Figure 8 ) or the thread start 6 or the thread entry 8, etc.) defines the pitch 29 of the helical path of the implant driver 2 (see Figure 3 ). The pitch of the helical path is 29 (see Figure 3 ) can optionally be adjusted to the pitch 30 of the lead screw thread of the implant (see Figure 3 ) are the same to avoid damaging the implant 2 or the jawbone when placing the implant 24. The alignment of these distributed spiral defining marks on the implant driver 2 and the local markings on the surgical template 12, such as a smooth perforated bushing, optionally with an inserted sleeve, defines the spiral movement of the implant driver 2 and its final position, and therefore defines the implant 24 connected thereto. This places the implant 24 according to the predetermined and virtually planned digitally defined implant position, including its predetermined virtually planned final rotational position around its longitudinal axis and / or its depth within the jaw.

[0103] The surgical template 12 is assembled to the patient's oral anatomy, such as teeth 13. Methods for achieving this are known to the skilled person. The surgical template 12 has a guide element, such as a smooth perforated bushing 14. The guide element, such as a smooth perforated bushing 14, will be located over the position of the patient's missing teeth and, therefore, at the virtual implant position 16 where the implant 24 will be placed. In an embodiment of the present invention, the helix defining the first mark on the implant driver 2 is a thread 4 having a thread start 6 and a thread entry 8 (at the Figure 1B The function of the thread entry 8 and the thread start 6 is to facilitate alignment of such a mark on the implant driver 2 (e.g., the thread 4) with a local second mark on the guide element (such as on a preferably smooth perforated bushing 14). This can be provided by the guide pin / screw 10 or 15 (see Figure 4 or Figure 6) is defined by the apex 11 of the pin / screw, which is assembled to the smooth perforated bushing 14 by means of a hole in the smooth perforated bushing 14 (e.g., threaded in the case of a screw). The position of the apex 11 of the pin / screw is patient-specific and depends on the position of the virtually planned implant 16, the design specifications of the implant driver 2 including its markings 4, 6, 8, 26, 27, 28, 55, 56, 57, 58, 59, and the design specifications (e.g., vertical position) of the guiding element of the surgical template 12 (e.g., smooth perforated bushing 14). The depth of penetration of the thread follower 10 into the guiding element (e.g., smooth perforated bushing 14) is preferably adjustable so that the apex 11 of the thread follower 10 enters the thread 4 and slides therein, while still allowing the implant driver 2 to rotate and drive the implant 24 through the gums 20 into the patient's jawbone 22 (see Figure 2A ). When the first and second marks on both the implant driver 2 and the smooth perforated bushing 14 are aligned, for example when the apex 11 of the thread follower follows the thread 4, the helical path of the implant driver is such that it drives the implant 24 into the bone so that the implant 24 can be placed in a rotational position around its longitudinal axis or optionally in both a depth and a rotational position according to the virtually planned position. This is the so-called final position.

[0104] like Figure 5 As shown, more than one vertex 11 or guide pin / screw 10 - 10A, 10B, 10 - may be used. However, in order to prevent these guide pins / screws 10A and 10B from initially obstructing the rotation, they may be made retractable so that they are normally in a retracted position and move into a position to engage with the groove 4 only after the guide pin / screw 10 has entered the spiral groove 4.

[0105] In embodiments of the invention, the hole of a guide element (such as a bushing) on ​​a surgical template can have one, two, three, four, or up to five pins or screws that enter the hole and serve as a second marker on the guide element. The pins or screws can be disposable or can be embedded in the guide element (such as a bushing). The pins or screws can be thread followers.

[0106] The final implant position is achieved, for example, by aligning the final position markings 4, 6, 8, 26 and / or the rotation markings 27 on the implant driver 2 with the final position markings 28 (top surface) 60 on the surgical template 12. For example, the local vertical position indicator line 26 (see FIG. 2 ) on the implant driver 2 Figure 1B ) can be aligned with the top 60 of the smooth perforated bushing 14, or the local rotational final position indicator lines 27, 58 on the implant driver 2 (see Figure 8) can be aligned with the local rotation final position indicator lines 28, 59 on the smooth perforated bushing 14 of the surgical template 12 (see Figure 8 The final position marks on the implant driver 2 and the surgical template 12 can exist in a variety of forms that can be created in different ways, such as lines, dots, ridges, valleys, ribbons, physical stops, physical shape changes, etc. They can be drawn, engraved, milled, painted, printed, etched, laser ablated, or added to the marking elements in any other way, etc.

[0107] Alternative embodiments include implant drivers 2 that narrow near the top so that the thread follower 10 is disengaged from the implant driver 2 before reaching the final position. The final position can be indicated by a final position mark 26. When this occurs, the spiral movement is no longer determined by the cooperation of the implant driver 2 and the thread 4 with the thread follower 10, but by the cooperation of the implant 24 (thread) with the bone. The latter embodiment allows, after reaching the final position, for example, when using an embedded (i.e., non-retractable) thread follower 10, the implant driver 2 is easily separated from the implant 24.

[0108] Alternative embodiments of the present invention may include an implant driver 2 in which the threads 4 may be replaced by different kinds of distributed markings that also define a helix, the pitch 29 of the helical path optionally being the same as the lead screw pitch 30 of the implant (see Figure 3 ) to avoid damaging the implant 24 or the jawbone when placing the implant 24. These implant driver markings 4, 6, 8, 26, 27, 55, 56 can take a variety of forms, such as spirals, dots, lines, ... that can be drawn, engraved, etched, painted, printed, laser ablated, milled, or added to the element or added by any other means. Examples are physical screw threads 4 (e.g., engraved spirals), laser marked spirals, vertically spaced dashed lines 56A...56N that all define the pitch 29 (see Figure 8) etc. Preferably, the thread marker 4 cooperates with a thread follower 10, which is located on the surgical template 20 and passes through a guide member, such as a smooth perforated bushing 14. The patient-specific markings 28, 57, 59, 60 on the guiding element of the surgical template (such as the smooth perforated bushing 14) can also take a variety of forms, such as any of lines, dots, grooves, holes, etc., which are drawn, engraved, painted, printed, laser ablated, milled, added by any other means, etc. on the guiding element of the surgical template 12 (such as the smooth perforated bushing 14). When aligned with the markings 4, 6, 8, 26, 27, 55, 56 on the implant driver 2, this type of marking 28, 57, 59, 60 allows visual reinforcement and feedback of the position of the implant driver 2, and therefore allows visual reinforcement and feedback of the position of the implant 24 connected thereto along the insertion path, which accurately places the implant 24 according to the predetermined virtually planned implant position. The final position may be indicated by the alignment of final position markings 4, 6, 8, 26, 27 on both the implant driver 2 (such as lines 27, 58) and the guide element (such as lines 28, 60).

[0109] Embodiments of the invention including a method

[0110] Embodiments of the present invention provide a method for designing, and / or manufacturing and / or utilizing a surgical template 12 and a smooth perforated guide 14 having patient-specific local markings 28, 57, 59 or 60 and / or an implant driver 2 having markings 4, 6, 8, 26, 27, some of which may be distributed markings. The distributed markings may exist around the entire circumference of the implant driver. The use of markings allows the implant 24 to be placed according to a predetermined virtual planning position. The predetermined virtual planning position can be achieved by digitally planning the implant position relative to digital clinical data, which can be obtained by any suitable scanning technology, such as CAT scans, X-rays, MRI, CBCT, optical or intraoral scans or any combination thereof.

[0111] A method for determining the allowable positions of a marking of a surgical template guide element, such as the apex 11 of a pin-shaped thread follower 10, has the following steps.

[0112] - Step 1: Fabricate an implant driver 2 having one, some or all of the markings 4, 6, 8, 26, 27, 55, 56, 58 in the design specifications of the implant driver 2. One or more of these markings may be distributed markings, for example, defining a spiral including the following specifications:

[0113] o The longitudinal axis of the helix coincides with the longitudinal axis of the implant driver 2.

[0114] o The pitch 27 of the helix is ​​optionally consistent with the thread pitch 30 of an implant with which the implant driver 2 is compatible.

[0115] o Optionally, the markings 4, 6, 8, 26, 27, 55, 56, 58 on the implant driver 2 are conveniently aligned with the markings 28, 57, 59, 60 on the surgical template 12 (e.g., on the smooth perforated bushing 14). For example, the threaded entry 8 and the thread start 6 are conveniently aligned with the thread follower 10 on the surgical template 12 (e.g., on the bushing 14) to establish a predetermined initial position of the thread start 6, and therefore a predetermined initial position of the implant driver / implant assembly.

[0116] - Step 2 (before or after step 1): Virtually plan the implant position for the patient's jaw relative to the digital clinical data obtained from the patient.

[0117] - Step 3: Based on the virtual implant position and the design specifications of the implant driver 2, a virtual spiral is defined by the positions of the implant driver markings 4, 6, 8, 26, 27, 55, 56 on the implant driver 2 in their virtual final positions (i.e. connected to the virtually planned implant).

[0118] - Step 4: Define the position of the markings 28, 57, 59, 60 in the design of the guiding element of the surgical template (eg the smooth perforated bushing 14) so ​​that it can be aligned with the spiral path defined in step 3.

[0119] - Step 5: Manufacturing the surgical template 12 including the markings.

[0120] - Step 6: Mount the surgical template 12 on the patient's anatomy, create the osteotomy, connect the implant driver 2 to the implant, insert the implant driver / implant combination into the guide element 14 of the surgical template 12, align the markings 28, 57, 59, 60 on the guide element 14 of the surgical template 12 with the markings 4, 6, 8, 26, 27, 55, 56 of the implant driver 2, drive the implant 24 into the bone while maintaining the alignment of the markings 4, 6, 8, 26, 27, 26 on both the implant driver and the guide element. Stop placing the implant 24 when the final position is reached, which is indicated by the final position markings on both the implant driver and the guide element 4, 6, 8, 26, 27, 28.

[0121] Embodiments of the present invention provide a method for programming the rotation required to place an implant into a digitally predetermined position in a dental handpiece setting:

[0122] - Step 1: Manufacturing an implant driver 2 comprising one, some or all of the markings 4, 6, 8, 26, 27, 55, 56 in the design specifications of the implant driver 2, which define a spiral comprising the following specifications:

[0123] o The longitudinal axis of the helix coincides with the longitudinal axis of the implant driver 2.

[0124] o The pitch 29 of the helix is ​​optionally consistent with the thread pitch 30 of an implant with which the implant driver is compatible.

[0125] o The markings 4, 6, 8, 26, 27, 57, 56, 58 on the implant driver 2 facilitate alignment with the markings 28, 57, 59, 60 (such as the thread entry 8 and the thread start 6) on the surgical template 12 to allow establishment of a predetermined initial position of the thread start 6, and thereby a predetermined initial position of the implant driver / implant assembly.

[0126] - Step 2: (before or after step 1) virtually planning the implant position for the patient's jaw relative to the digital clinical data obtained from the patient.

[0127] - Step 3: Based on the virtual implant position and the design specifications of the implant driver, define a virtual spiral defined by the positions of the implant driver markings 4, 6, 8, 26, 27, 55, 56 of the implant driver 2 in its virtual final position (i.e. connected to the virtually planned implant 24). In addition, identify the position of the thread start 6 of the implant driver 2, which is virtually connected to the virtually planned implant position. This is the final position of the thread start (see Figure 7 ).

[0128] - Step 4: Select the position of the thread follower / guide pin 10 in the design of the surgical template 12, such as the position of the guide pin apex 11, as a point located on the spiral path as defined in step 3. By definition, when the implant is placed, the initial position of the thread start will coincide with the position of the thread follower 10. See the "Principle of Operation" section below for more details.

[0129] - Step 5: Calculate the polar rotation required to move the initial position of the thread start to the final position of the thread start (determined in step 3) following the spiral defined by the markings 4, 6, 8, 26, 27, 55, 56 of the implant driver 2. This can be done using the following formula, where α is the polar rotation and h is the vertical height between the initial position of the thread start and the final position of the thread start (measured along the longitudinal axis of the virtually planned implant):

[0130]

[0131] (where pitch is the thread pitch)

[0132] - Step 6: Program this polar rotation into the dental handpiece system so that it can be applied to the implant driver 2 after the thread start 6 has moved into its initial position, i.e. the thread start 6 coincides with the position of the thread follower 10 (e.g. the apex position 11 of the guide pin).

[0133] Principle of Operation

[0134] For clarity, an embodiment of a surgical template 12 is disclosed having a guide element (preferably smooth and perforated) in the form of a bushing 14 having a single guide thread follower, such as a pin 10 .

[0135] - First, a surgical template 12 is designed and manufactured so that a predetermined set of surgical instruments can be guided by a guide element, such as a bushing 14 (preferably smooth with holes) that is part of the template 12. The surgical template 12 is used to create an osteotomy that is positioned according to the preoperatively planned virtual position of the implant 24. The virtual implant position is planned relative to the digital clinical data obtained from the patient.

[0136] - The guiding element or bushing 14 (preferably smooth with holes) of the surgical template 12 is designed and manufactured so that it includes a retractable or embedded thread follower 10, such as a retractable pin / screw 10 or an apex 11 of an embedded pin 15 (see Figure 6 ) so that the apex 11 of the pin / screw will be positioned on the spiral defined by this method.

[0137] - After the osteotomy has been created, the implant driver 2 is connected or can be connected to the implant 24, the assembly being adapted to be moved or then moved into a guide element, such as a bushing 14 (preferably smooth with holes) of the surgical template 12. The driver threaded entry 8 is aligned with the apex 11 of the pin / screw 10, 15, and the driver 2 is then moved downwards into the bushing 14 (preferably smooth with holes) until the thread start 6 coincides with the apex 11 of the pin / screw. This is the initial position of the thread start.

[0138] -Then, because the apex 11 of pin / screw follows the thread 4 of implant driver 2, implant driver / implant assembly moves downward with spiral motion under the promotion of the thread 4 of implant driver and the thread follower 10 of liner.This movement continues until the thread start 6 and therefore implant driver / implant assembly moves in its final position.By aligning the final position mark 4,6,8,26,27,58 on the implant driver 2 with the final position mark (such as the top 60 of line 28, surgical template 12 and line 59 (preferably smooth with holes) on liner 14) on the surgical template respectively, this final position can be further indicated.

Claims

1. An implant driver assembly for placing an implant according to a digitally virtually planned implant and an implant position in a patient's jaw, wherein: The implant driver assembly includes at least an implant driver and at least a surgical template, wherein the implant driver has one or more first marks and is suitable for alignment with the surgical template, the surgical template has a guide element and has one or more second marks, so that when connected to the implant, the alignment of the one or more first marks on the implant driver with the one or more second marks on the surgical template defines the spiral movement of the implant when it is inserted into the jawbone, the implant driver and the surgical template also include at least one of the one or more first marks and at least one of the one or more second marks for indicating the rotational or rotationally symmetrical position of the implant driver defined by the implant position of the digital virtual plan, whereby the guide element is a bushing with a smooth hole; wherein the one or more first marks include threads in or on the outer surface of the implant driver; wherein the one or more second marks include a thread follower for following the threads in or on the outer surface of the implant driver; wherein the thread follower includes one or more pins that can be removed or retracted from the guide element of the surgical template.

2. The implant driver assembly of claim 1, wherein: At least one of the one or more first markings and at least one of the one or more second markings are used to indicate a final vertical position of the implant driver.

3. The implant driver assembly according to claim 1 or 2, wherein: The digitally virtually planned implant and / or the implant position in the patient's jaw is stored in a signal storage device.

4. The implant driver assembly according to claim 1 or 2, wherein: One of the one or more first markers is a distributed marker.

5. The implant driver assembly according to claim 1 or 2, wherein: The thread has a thread start and a thread entry.

6. The implant driver assembly according to claim 1 or 2, wherein: The implant driver is adapted to pass through a smooth perforated bushing.

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