Omnidirectional multi-unit abutment system for threaded attached dental prostheses

Abstract

A multi-unit abutment for aligning a dental implant and a screw-attached prosthesis with a coping is disclosed. The multi-unit abutment has a threaded base post and a ball for attachment to the implant. A rotating shell surrounds the ball and can be secured in place with a locking screw. A drive feature on the ball allows a tool to pass through the locking screw to drive the base post into the implant while the multi-unit assembly is in a linear configuration. The rotating shell is then positioned and secured at a desired inclination and azimuth. The rotating shell has a mating surface for the coping. When the prosthesis is positioned on the implant abutment, the locking screw can still be accessed through the hole in the coping. Different embodiments for capturing the rotating shell on the ball are disclosed. A method for improving passive alignment of a prosthesis with an implant is described.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This disclosure claims priority to U.S. Provisional Patent Application No. 63 / 196,227, filed on June 3, 2021, the entire contents of which are incorporated herein by reference. Background Art

[0003] Different systems have been introduced to attach dental prostheses to dental implants to replace one or more natural teeth. In order to simplify future modifications or replacement needs, it is desirable to use a mechanical system to have a reversible attachment between implant and prosthesis, rather than directly bonding these components together. These systems may include the following features, which provide both appropriate alignment and maintenance for acceptable use by patients. Usually intermediate components such as titanium bases (also referred to as copings) and detachable abutments are used to provide a dental prosthesis, one or more implants embedded in the patient's jaws, and appropriate alignment between soft tissue and any remaining natural teeth. These intermediate elements can be attached to each other with screws, ball joints, snap-fit ​​mountings, adhesives or other mechanical devices.

[0004] In addition to manufacturing costs, the simplicity of the screw-attached system also provides some benefits over the snap-fit ​​system. The installation pressure between the coping and the abutment is easily controlled by the torque applied to the screw to tighten the screw. This axial tension control and the self-aligning nature of the engaged threads provide greater certainty in the engagement force and relative orientation of the components. Even if the screw breaks, techniques are known for removing the fragments without damaging surrounding components. The screw also has the benefit of independent removal because each coping can be loosened individually. Tilting the prosthesis after screw removal to disengage one coping does not cause reengagement of the other coping.

[0005] In the case of single tooth crown attachment, the titanium base and abutment surfaces preferably include features that remove rotational symmetry about the azimuth axis in the mating of the abutment and coping surfaces. A rotational locking feature may also be included in these single mount systems. Such rotational fixation is generally not required when the prosthesis includes multiple copings for attachment to multiple abutments. For example, a 30 degree tapered mating surface for multiple interface locations is sufficient to provide complete registration. For convenience, this form is shown in the drawings of the present disclosure, but this is not meant to be limiting.

[0006] The goal of the prosthesis to which all implants are attached is to passively match the prosthesis superstructure to the implant, to avoid stress on the prosthesis or stress on the osseointegration process of the implant. These stresses may cause problems during initial loading or long-term cutting (cropup). Mismatching may cause mechanical and biological problems in single implantation and multiple implantation treatments. Mechanical problems may include loosening of prosthesis fixing screws and abutment screws and the splitting of parts, including screws. Biological problems may include discomfort, progressive marginal bone loss, bacterial infection, microbial plaque accumulation and implant loosening.

[0007] Having a passive fit initially or being able to readjust or rework components later to accommodate changes is important for successful prosthesis functionality and survival. Obtaining a passive fit remains a challenge due to increased tolerances and the introduction of misalignment and distortion when manufacturing the prosthesis. Using a direct pick-up impression process has been beneficial, but improvements are still needed. Buzayan, MM, and Yunus NB, 2014, "Passive Fit in Screw Retained Multi-unit Implant Prosthesis Understanding and Achieving: A Review of the Literature", Journal of Indian Prosthodontic Society ,14(1),16–23(https: / / doi.org / 10.1007 / s13191-013-0343-x.) has provided a review of the challenges of passive coordination.

[0008] An increasingly popular treatment option for edentulous patients involves placing four to eight implants in the edentulous jaw and installing a prosthetic arch. Transmucosal abutments are fastened to the implants and are intended to remain in place indefinitely. While it is desirable that the axes of all implants be positioned parallel to one another, the underlying bone structure typically results in the implants being installed at an angle to this ideal mutual orientation. "Multi-unit abutment" is a popular descriptor for a specific type of transmucosal abutment used to repair an edentulous jaw using a single prosthesis (i.e., a full-arch prosthesis).

[0009] The Multi-Unit Abutment (commonly referred to as a "MUA") is a fairly easy way to improve the divergence angle of an implant with the option of 0, 17, and 30 degree angle correction. Typically, the 0 degree MUA is easier to position because the abutment is positioned in line with the linear axis of the implant. The 17 and 30 degree MUAs typically include a "screw entry" indicator that is relatively long and difficult to work in narrow spaces (such as the back of the jaw) where these abutments are typically positioned to compensate for the disto-angulation of posterior implants popularized by Dr. Paolo Maolo in 2004.

[0010] There are several alternative abutment designs for repairing edentulous arches. Although most implant companies have settled on the MUA geometry adopted by Nobel Biocare, there have been some attempts to improve the weaknesses of this geometry. For example, the Dentsply Implants Astra EV system uses a "mulTibase" abutment that improves the lack of coverage of prosthetic screws in multi-unit abutments. Neoss uses a form of MUA that "reduces the height of the abutment" by using a female connection that is opposite to the standard male connection of the MUA. Regardless of the benefits of these improved designs, each design requires the clinician to customize a specific inventory with a specific angular correction and height. An example of the complexity of inventory management is when an implant system provides the MUA with multiple implant / abutment connections (e.g., narrow platforms and conventional platforms) and multiple heights (e.g., 1.5mm, 2.5mm, 3.5mm, 4.5mm, etc.) and different angles or inclinations (e.g., 0 degrees, 17 degrees, and 30 degrees). In order to maintain sufficient inventory to be well prepared for full-arch implants, a fixed immediate loading process may need to have three tilt angle options times the number of platform options times the number of reasonable tissue heights for the number of implants expected to be placed (a minimum of four per the PaoloMaolo protocol).

[0011] The resulting inventory formula is as follows:

[0012] 3 (degree options) x 2 (platform connections) x 2 (different tissue heights) x 4 (implants) = 48 (multi-unit abutments).

[0013] This inventory problem increases when a multi-unit abutment system also requires unique implants, titanium bases, and prosthetic fasteners. This inventory management complexity is further exacerbated when practitioners prefer different vendor systems in different patient situations, or when different practitioners in a practice prefer different vendor supplies.

[0014] In addition to the complexity of inventory management, there are limitations on the discrete nature of "angle correction" (e.g., limited to three specific angles 0°, 17°, and 30°) and the internal connection of the implant around its longitudinal axis (which may be referred to as the azimuth). In many cases, the internal hexagon limits the possibilities to 6 azimuth positions, varying 60 degrees from one position to the next. In some cases, 0 degrees would be too small an inclination correction, but 17 degrees would be too large. The same applies to 17 to 30. Or 17 degrees may be an appropriate inclination correction, but due to the limitation of 6 positions in the internal hexagon, the desired 17 degree correction cannot be applied to the ideal azimuth direction of the desired correction. The same applies to the 30 degree correction. Clinicians novice to total arch implant treatments struggle with the selection and positioning of multi-unit abutments. Surgical times are prolonged, which can lead to increased patient morbidity.

[0015] Although there is uncertainty as to whether angled implants are more susceptible to loss of osseointegration than straight abutments, all implants do exert higher mechanical stresses and strains on the bone structure than natural teeth. The movement of a natural tooth in its socket can be an order of magnitude greater than that of an implant embedded in bone. This natural shock absorber helps to buffer the range of magnitudes and directions of forces applied from the bone to the tooth. Screw loosening is associated with the bending and settling effects of the screw joint, where initial surface micro-roughness keeps the joined components initially separated, but the high points gradually wear away. Micro-gaps of initial mechanical mismatch between elements in a prosthetic superstructure may be too small to be detected with a detector, but large enough to concentrate mechanical forces of varying magnitudes from different directions during chewing. These micro-gaps may still be large compared to bacteria that are able to penetrate and grow in the internal cavities throughout a dental prosthetic superstructure device.

[0016] Due to a wide range of variables, application details and the difficulty of in-situ measurement, there is no acceptable passive fit threshold for long-term success. The quality of fit can be tested in the dental laboratory with analogs and when installed in the patient, but this is not a strict science. For example, the "one screw test" for fit involves tightening only one screw at one end of the prosthesis and then looking for lift at the opposite end. The "screw resistance test" variation of this situation includes inserting and placing the screws in sequence, and then observing whether it is necessary to turn more than 180 degrees to obtain a torque of, for example, 10Ncm. Failure of the specified pass-fail inspection criteria means that the prosthesis needs to be reworked or replaced. Since the same process will be used to manufacture the replacement, it cannot be determined that the replacement will be correctly aligned.

[0017] Even if all multi-unit abutments are initially perfectly aligned and fixed with the implant and prosthesis, changes may occur over time. For example, the prosthesis may deform, or the bone structure may change, or the fasteners may become loose or break. In many prior art systems, the prosthesis must be completely removed in an attempt to adjust the orientation, re-tighten the multi-unit abutment fasteners, replace parts, or even possibly manufacture and match a completely new prosthesis. The ineffective trial and error matching cycle for improving alignment frustrates both the patient and the dentist. Replacing a single failed multi-unit abutment from several abutments and aligning it correctly with the existing prosthesis may be more difficult than the initial installation alignment. A method for adjusting the orientation of the multi-unit abutment orientation when the prosthesis is in place is needed.

[0018] Some commercial systems require that the multiple-unit abutment components be assembled sequentially into place during installation into the patient's mouth. This increases the chance that the patient will accidentally swallow the components. Some systems require the use of multiple tools, which can also increase the complexity and length of the procedure.

[0019] To address one or more of the above challenges and limitations of existing multi-unit abutments on the market, embodiments of new multi-unit abutments are disclosed herein. These units are designated as omnidirectional in the sense that they can be positioned over a continuous range of orientations sufficient to correct implant angle differences commonly found in general practice. Although the above discussion is based on structural reasons, angled implants may also be preferred simply for aesthetic reasons, for example, to redirect screw entry holes in a single crown. Embodiments of omnidirectional multi-unit abutments are provided that have advantages in inventory management, placement procedures, options for angle correction, and flexibility, improve passive fit, and eliminate limitations on angle correction or other issues of existing multi-unit abutment systems for single implant crowns and multiple implant prostheses. Summary of the invention

[0020] Some embodiments of the present invention include a multi-unit abutment for screw attachment to a dental implant that allows the titanium base to be positioned relative to the implant at a user-selected rotation and tilt angle. This positioning orientation can be fixed before the titanium base is bonded to the prosthesis, and in some embodiments can be adjusted or tightened by removing the prosthesis fixing screw when the titanium base is otherwise retained to the abutment. In this way, the final relative orientation of the adjustable abutment can be directly affected by the fixed position of the titanium base in the prosthesis. This can correct or reduce misalignment caused by the accumulation of positioning errors relative to the initial position of the abutment during the prosthesis manufacturing steps.

[0021] Certain embodiments of the present invention include a multi-unit abutment that is assembled outside of the patient's mouth, mounted to a drive tool in a linear arrangement to attach it to an implant, reorienting the portion of the abutment that interfaces with the titanium base (which is not aligned with the axis of the implant), and then fixing the orientation. Subsequently, the titanium base can be attached to the multi-unit abutment with a prosthetic screw.

[0022] Certain embodiments of the present invention allow a single drive tool to screw a multi-unit abutment into an implant and lock the orientation of the abutment surfaces. Other embodiments use different drive tools for these procedures.

[0023] Some embodiments of the present invention include a ball portion and a swivel portion that can tilt or rotate relative to each other but are constrained not to separate from each other. Some embodiments allow the relative orientation of the ball and swivel to be fixed by applying pressure on opposite sides of the ball portion. Some embodiments of the present invention include a locking screw attached to the swivel portion to apply pressure on opposite sides of the ball. In some embodiments, the multi-unit abutment can be installed in an implant by passing a drive tool through the hole of the locking screw. In some embodiments of the present invention, the locking screw includes threads for a prosthetic screw. In some embodiments, the locking screw can be accessed by fixing to the titanium base of the prosthesis.

[0024] One embodiment describes a system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw, wherein the prosthetic screw includes a head and a threaded shaft, the system comprising:

[0025] An abutment base having a longitudinal axis, the abutment base comprising:

[0026] a proximal end including a ball portion and an abutment base drive interface; and

[0027] a distal end comprising threads for attachment to the implant; and

[0028] a rotating housing having an inner surface and an outer surface, wherein the rotating housing includes a rotating hole near the distal end and a threaded hole at the proximal end; and

[0029] A locking screw having a longitudinal axis, wherein the locking screw comprises:

[0030] a portion having external threads compatible with the threaded hole of the rotating housing; and

[0031] an internally threaded portion sized to engage the prosthetic threaded shaft; and

[0032] a locking screw drive interface; and wherein rotating the locking screw is capable of fixing the orientation of the longitudinal axis of the locking screw in an orientation that is non-parallel to the longitudinal axis of the abutment base.

[0033] One embodiment describes how an omnidirectional multi-unit base station can be used in a method comprising:

[0034] attaching the locking screw to the rotation housing surrounding the abutment base, wherein the ball portion is loosely constrained within the rotation housing, wherein the abutment base threadably extends through the rotation aperture to form a multi-unit abutment assembly;

[0035] inserting an abutment drive tool tip through said locking screw to engage said abutment base drive interface;

[0036] presenting an abutment base drive tool and a multi-unit abutment assembly to the implant;

[0037] rotating the abutment base driving tool to attach the abutment base to the implant to a first torque;

[0038] disengaging the abutment base drive tool from the abutment base drive interface;

[0039] moving the rotating housing to a different orientation;

[0040] rotating the locking screw driving tool to fix the orientation of the rotating housing axis relative to the implant axis to a second torque;

[0041] presenting a prosthesis including a titanium base to the implant abutment system; and

[0042] The prosthesis is attached to the implant abutment with a prosthesis screw.

[0043] Some embodiments describe a system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment, the multi-unit implant abutment comprising:

[0044] A ball and housing assembly, the ball and housing assembly comprising:

[0045] a base comprising an abutment drive interface for threaded attachment to the implant; the base comprising a first end having a ball and a second end having a threaded post, the threaded post having a longitudinal axis; and wherein the threaded post is designed to be screwed into the dental implant at a predetermined torque;

[0046] a housing portion having an inner surface and an outer surface; wherein the housing portion has a first end with a hole and a second end with a locking screw; and wherein the ball is captured within the housing portion, wherein the threaded portion of the base post extends through the hole;

[0047] a titanium base including a hole at the proximal end and a port at the distal end, the distal end being designed to be mounted on an exterior of the housing portion in a known position; and

[0048] One or more drive tools designed to engage the abutment drive interface and the locking screw; wherein at least one drive tool is capable of being inserted through the titanium base hole to engage the locking screw; and wherein tightening the locking screw applies pressure on the ball to fix the orientation of the housing.

[0049] For the purpose of this disclosure, a dental prosthesis is broadly defined as anything including one or more dental copings or titanium bases that can be mounted to and removed from one or more implant abutments. Different titanium base designs are known in the dental industry, and the systems and methods disclosed herein can be adapted to work with many commercially available types of titanium bases, including pick-up copings, temporary cylinders, inserts, and impression copings. Implant abutments are known in the dental industry to have interfaces compatible with these titanium bases. Since the mechanical interface is the same, for the purpose of this disclosure, implant abutments are considered to be a general term that includes abutment analogs. The description of abutment alignment systems and process methods with titanium bases and implants mounted in the patient's jaws should also be considered to describe equivalent inventive concepts that can be used with titanium bases and implant analogs in dental laboratories. Common geometries include conical titanium bases placed on conical implant abutments. Although this form of system is used in the accompanying drawings and the following discussion, the concept of the present invention can also be applied to other types of titanium bases and abutments.

[0050] The inventive concepts disclosed herein can be used with different types of dental prostheses. A dental prosthesis can be any form of impression used in a dental laboratory to help create and test a dental prosthesis. A dental prosthesis can also be a dental prosthesis made in a dental laboratory using a physical model made from an impression, a newly manufactured dental prosthesis, or an existing prosthesis converted for screw attachment. A dental prosthesis is defined as including a single-tooth appliance (e.g., a crown), or any multi-tooth bridge or denture. These prostheses can include a titanium base to provide a detachable interface, thereby providing orientation with an appropriate abutment attached to the patient's jaw or gums. Although the name implies the application of multiple implants, a multi-unit abutment can also be used separately to provide installation to an implant for a single dental prosthesis. Therefore, whether it is a single implant or multiple implant applications, and any form of dental prosthesis, the term "multi-unit abutment" will be used herein. The multi-unit abutment for the inventive concepts disclosed herein includes a thread to mount a prosthesis with a titanium base onto the abutment, and the abutment is mounted into the implant. Although the concept describes typical male threads in a multi-unit abutment that mate with female threads on an implant, this is for ease of disclosure. Unless expressly stated or limited by functional necessity, certain inventive concepts may be applied to systems having female threads in a multi-unit abutment that engage with screws of male threads in an implant. These are considered to be direct variations of the inventive concept. One benefit of the typical female threads of implants preferably used for abutment connection is standardization and implementation flexibility. For the same reason, prosthetic screws having male threads and commercially available titanium bases are preferred, but this may not be necessary to obtain some of the benefits from the disclosed inventive concepts. These types of variations are considered to be within the scope of the present disclosure.

[0051] The systems and methods disclosed herein can be used with prostheses for attachment to implants in the maxilla and mandible. As a result, those portions of the system that are oriented downward for the mandible will be oriented upward for the maxilla, and vice versa. For convenience, the disclosure of embodiments of the inventive concepts limited to a single jaw orientation is considered to disclose embodiments for the opposite jaw orientation. When referring to the clinician's perspective, the proximal portion is closer to the clinician than the distal portion. Although terms such as top are opposite to the term bottom, and proximal is opposite to distal, their actual relative orientation will be determined by the context in which they are used. The term tissue side is used interchangeably with intaglio to refer to the side of the prosthesis opposite to the occlusal or relief surface.

[0052] The disclosed system of the present invention is advantageously applicable to screw-attached prostheses and abutments. The key benefits of screw attachment are variable tightening torque and reversibility. In the present disclosure, when it comes to screw attachment, the terms permanent, semi-permanent, final and finally are used interchangeably. The traditional screws attached finally can still be removed by approaching the screw and rotating the screw in the direction opposite to the direction used for attachment. For the purpose of the screw-attached prosthesis of the present disclosure, the attachment is semi-permanent, permanent or final, which means that for normal use, frequent attachment and removal are not expected. On the contrary, temporary screw attachment is applied to the planned process time period or other expected intervals. The temporary screw disclosed in the co-owned U.S. Patent 11,311,354 can be used to effectively perform the positioning of the titanium base in the dental prosthesis through the lift-off process, and the patent is incorporated herein by reference in its entirety. However, the utility of the inventive concept in the present disclosure does not rely on the use of the system or method disclosed in the cited patent.

[0053] The screw attachment of the abutment to the implant is also described in the embodiments. However, some of the disclosed concepts can be easily adapted to other systems that do not utilize screw attachment of the dental component to the implant, such as snap-on systems or magnetic systems. These modifications are considered obvious variations of the inventive concepts described in the current disclosure.

[0054] Removal of a semi-permanent or final screw is often prompted by a problem or an opportunity for improvement. Accessing the screw to apply the tool for removal may require removal of material covering the screw that was added for aesthetic reasons. Some embodiments provide for adjusting the orientation of a multi-unit abutment when a prosthesis is positioned on the multi-unit abutment without the semi-permanent or final screws in place. This can improve the passive fit of the prosthesis to the implant when initially installed or after the system has been in use for a long period of time. Although implant abutments are often initially used to position the titanium base in the prosthesis, individual alignment errors will inevitably accumulate during subsequent processing or over time. The apparatus and methods disclosed below allow a collection of titanium bases in a prosthesis to be used to fine-tune the alignment of a multi-unit abutment to the collection of titanium bases, thereby improving the overall passive fit.

[0055] The elements disclosed herein may be characterized by having an axis or longitudinal axis. In the case of a long cylindrical object like a pencil, the longitudinal axis clearly passes through the center of the cylinder from the writing end of the pencil to the eraser end. The longitudinal axis is traditionally considered to be along the length or longest dimension of an object, which is characterized by length, width and thickness of decreasing size. If instead of a pencil, a bolt is considered, the axis or even the longitudinal axis can be considered to pass through the center, from the engagement end of the thread through the center of the head of the bolt. In this case, even for short and thick bolts, the rotation axis and the longitudinal axis are the same. In the present disclosure, the axis or longitudinal axis of an object with threads will be the same as the rotation axis of the threads. The width will be measured perpendicular to the rotation axis. Therefore, a traditional nut with internal threads will be considered to have a longitudinal axis passing through the middle of the central hole, that is, when engaged, the axis of the matching bolt will be located. By extension, a washer without threads captured between a bolt and a nut will also be considered to have a longitudinal axis or simply an axis, which is centered in the hole and perpendicular to the plane of the washer. For the purposes of this disclosure, a linear assembly of components is produced by arranging the component axes of the assembly roughly in a colinear manner. Therefore, even if the axis of the washer can move about the common axis of the bolt and nut because the washer hole is larger than the width of the threaded portion of the bolt, the assembly including the bolt and nut with the washer will be a linear assembly. External threads are generally characterized by having a minor diameter measured at the root of the thread and a major diameter measured at the crest of the thread. Internal threads are generally characterized by having a minor diameter at the crest and a major diameter at the root. Unless otherwise specified, the width of the external thread on the bolt shank is defined as the major diameter or the maximum deviation from the axis of the bolt, i.e., the dimension that can be measured with a caliper. The width of the internal thread of a nut is defined as the minor diameter of the internal thread or the minimum deviation from the axis of the nut, i.e., the dimension that can be measured with a pin or plug gauge.

[0056] In the present disclosure, some threaded elements that are tightened by relative rotation may have some features that can be considered nut-like, while other threaded elements are screw-like, such as elements having both female and male threads. When discussing the concept of the present invention, the term screw will be generally used for these threaded elements in the present disclosure. However, the external threads on the screw will be considered male threads, and the internal threads will be considered female threads.

[0057] For the purpose of this disclosure, the term ball refers to a mechanical structure that includes some geometric properties of the ball. This is a more general term that allows only some parts of the surface of the ball to have a substantially spherical surface, while other parts can significantly deviate from having a spherical surface. Spherical surfaces are preferred for some directional flexibility and sealing of the contact surface between the ball and the structure that may be repositioned and locked in place relative to the ball by rotation. The shell is something that surrounds the ball at least partially. The contact surface between the outside of the ball and the inside of the shell is preferably a spherical surface segment of approximately the same diameter, so as to increase friction grip when starting the fixation process, or provide a sealing surface to prevent the interior of the component from being biocontaminated. Although it may be preferred to have flexibility to position the axis of the titanium base and the prosthetic screw without restriction at an angle of 30 degrees relative to the axis of the implant and at any rotation angle around any axis, the mating elements of the implant, ball, shell or titanium base can be designed to limit this omnidirectional angular flexibility. This restrictive modification is known in the art and can be used with some of the inventive concepts disclosed herein.

[0058] In prosthodontics, threaded elements are usually fixed to a desired torque, or some elements are fastened to a torque higher or lower than some other element combinations. For example, if three elements are screwed together in sequence, it is usually preferred that the first two elements are assembled with a higher torque so that the third element can be attached or removed without affecting the attachment of the first two elements. In some cases, the torque is quantified with a torque wrench, and sometimes the experience of the practitioner is used to determine when the torque is sufficient to work as desired. For the purpose of this disclosure, these torques will be considered to be predetermined, whether quantitatively or qualitatively evaluated. If a quantitative minimum torque value or an acceptable range is specified as necessary, it is expected to be measured using a tool or using some indicating structures built into the parts. In some embodiments, it may be expected to prevent excessive torsion, which may cause structural or biological stress on an implant seat or prosthesis by the controlled failure of a sacrificial element. This controlled mechanical failure may be due to both the characteristics of the inherent failure characteristics of a deliberately weakened structure or a uniform structure.

[0059] Other terms in the specification and claims of this application should be interpreted using the generally accepted, common meanings defined by any contextual language in which they are used. As used herein, the term "one" or "an" is defined as one or more than one. As used herein, the term "multiple" is defined as two or more than two herein. As used herein, the term "another (one)" is defined as at least the second or more. The terms "include" and / or "have" as used herein are defined as including (i.e., open language). The term "connection" used herein is defined as connection, although it is not necessarily directly connected or mechanically connected. The terms "about" and "substantially" refer to ±10%. Throughout the application document, references to "one embodiment", "certain embodiments" and "embodiment" or similar terms mean that the specific features, structures or characteristics described in conjunction with the embodiment are included in at least one embodiment of the present invention, and therefore, these phrases appearing in various places throughout the application document do not necessarily all refer to the same embodiment. In addition, these specific features, structures or characteristics can be combined in one or more embodiments in any suitable manner without limitation. The term "or" used herein is interpreted as inclusive or means any one or any combination. Thus, “A, B or C” means any of the following: “A; B; C; A and B; A and C; B and C; A, B and C. An exception to this definition occurs only when a combination of elements, functions, steps or actions are inherently mutually exclusive in some way.

[0060] The figures shown in the accompanying drawings are for the purpose of illustrating certain convenient embodiments of the present invention and should not be considered as limiting the present invention. The term "device" before the current participle of the operation indicates the desired function, for which there are one or more embodiments, i.e., one or more methods, devices or devices for implementing the desired function, and those skilled in the art can select from these or their equivalents in view of the disclosure herein, and the use of the term "device" is not intended to be limiting. Other objects, features, embodiments and / or advantages of the present invention will become apparent from the following description in conjunction with the following drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0061] Figure 1 is a bottom exploded isometric view of a first embodiment of an omni-directional multi-unit abutment assembly having a titanium base and prosthetic screws.

[0062] Figure 2 is a top exploded isometric view of a first embodiment of an omni-directional multi-unit abutment assembly having a titanium base and prosthetic screws.

[0063] Figure 3 yes Figure 1 and Figure 2Side plan view of the assembled system without the prosthetic screws and with the longitudinal axes of the components aligned.

[0064] Figure 4 yes Figure 3 A side cross-sectional view of the assembled system taken along the longitudinal axis.

[0065] Figure 5 yes Figure 4 Side plan view of the assembly after reorienting the rotating housing and titanium base.

[0066] Figure 6 yes Figure 1 and Figure 2 Top isometric assembly view of the omnidirectional multi-unit abutment.

[0067] Figure 7 yes Figure 3 and Figure 4 A side cross-sectional view of the assembly during attachment to an implant. Fig. 7A Includes the relative proportions of the implant driving tool.

[0068] Figure 8 yes Figure 3 and Figure 4 The components are as follows Figure 5 Side cross-sectional view after reorientation of the rotating housing and titanium base, showing the orientation secured with a locking screw. Fig. 8A Includes relative proportions of locking screw driving tools.

[0069] Fig. 9 yes Figure 8 A side cross-sectional view of the assembly after fixation of the titanium base with the prosthetic screw.

[0070] Fig.10 is a bottom assembled isometric view of a second embodiment of an omni-directional multi-unit abutment and titanium base in a linear configuration.

[0071] Fig.11 yes Fig.10 A side plan view of an embodiment of the present invention.

[0072] Fig.12 yes Fig.11 A cross-sectional view of an embodiment along the longitudinal axis.

[0073] Fig.13 yes Fig.11 A cross-sectional view of an embodiment after a prosthetic screw has been added.

[0074] Fig.14 is a top exploded isometric view of a third embodiment of an omni-directional multi-unit abutment with a titanium base and prosthetic screws.

[0075] Fig.15yes Fig.14 A top isometric view of an embodiment of the present invention is in a linear assembled configuration.

[0076] Fig.16 yes Fig.14 A cross-sectional view of an embodiment along the longitudinal axis.

[0077] Fig.17 is used for Fig.14 A top plan view of a locking screw of an embodiment of the present invention having a hexagonal internal (Torx) drive feature.

[0078] Fig.18 is used for Fig.14 A top plan view of a locking screw of an embodiment of the present invention having a four-lug internal drive feature.

[0079] Fig.19 is used for Fig.14 A top exploded isometric view of a four-lobe driver tip and abutment base with a locking screw of an embodiment of the present invention.

[0080] Fig. 20 is an exploded top isometric view of a two-part abutment base stem with a sleeve and a swivel mount for a fourth embodiment of an omni-directional abutment.

[0081] Fig.21 yes Fig. 20 Top isometric view of the assembled two-part abutment base bar with sleeve and swivel mount.

[0082] Fig. 22 yes Fig.21 A cross-sectional view of the assembled two-part abutment base stem with sleeve and swivel mount along the longitudinal axis.

[0083] Fig.23 is a cross-sectional view of an application environment of a representative embodiment of an omnidirectional multi-unit abutment including a prosthesis and an implant. DETAILED DESCRIPTION

[0084] Several embodiments are included in this disclosure to illustrate options for providing the benefits of a screw-attached omnidirectional multi-unit abutment. Figure 1 and Figure 2 An exploded view of one embodiment of an omnidirectional multi-unit abutment 100 is shown, which includes four parts: abutment base 1, swivel mount 2, swivel base 3 and locking screw 4. Figure 1 and Figure 2A representative titanium base 5 and prosthetic screw 6 are also shown in the exploded view of . This omnidirectional multi-unit abutment 100 can be made of titanium or any other suitable material for implant abutment systems, including precious and non-precious metals and alloys, ceramics and high-strength engineering polymers (e.g., PEEK, PEI), or combinations of the above materials. Treatments, coatings, or gels can be added to the surfaces or spaces between components to prevent unwanted biological growth or promote healing. Figure 3 Shown in a linear orientation Figure 1 and Figure 2 elements, except prosthetic screws 6. Figure 4 Shown along Figure 3 The longitudinal section is marked as AA. Figure 3 The internal features of the component. Note that Figure 4 The titanium base 5 is shown in the figure for the purpose of description. The titanium base 5 is finally retained in the prosthesis (not shown) and attached to the omnidirectional multi-unit abutment using the prosthetic screw 6, as shown in FIG. Figure 6 The prosthetic screw 6 may be a permanent screw, or may be a temporary fastener as described in commonly owned US Pat. No. 11,311,354 and other continuation-related applications. Figure 6 It is in a linear structure Figure 1 and Figure 2 A perspective view of the components. Figure 5 is a side view of an embodiment tilted at approximately 30 degrees. Figure 7-9 Different stages of installation and adjustment of the embodiment into an implant are shown.

[0085] The abutment base 1 includes a ball or spherical portion 13 which may be approximately 3.25 mm in diameter and has an abutment base drive feature 10 on the proximal end. As shown, the drive feature may be a T5 sized internal hexagonal (Torx) drive feature socket centered on the longitudinal axis at the top of the ball 13. Other types of drive tools may also be used. At the distal end of the abutment base 1 is a threaded portion 14 for attachment to a female thread of an implant 16, which is fixed into the patient's jaw. The implant 16 and its attachment to the mandible or maxilla are schematically described in the present disclosure because the inventive concept of the omnidirectional multi-unit abutment may be adapted to interface with different abutments. Figure 7 The generic implant 16 shown having female threads is of very common design, but the threaded portion 14 and abutment seating projection 21 may be adapted to conform to other implants.

[0086] The rotating base 3 includes a hole 19 and an internal curved portion 15, the size and shape of which are designed to substantially match the curvature of the ball portion 13 of the abutment base 1. The rotating mount 2 shown includes an internal thread 20 for attaching to the external thread 9 of the locking screw 4. It also includes a titanium base seat feature 22 for supporting and orienting the titanium base 5 when the titanium base 5 is mounted on the omnidirectional multi-unit abutment 100 with a prosthetic screw. The rotating mount may optionally include an engagement feature 11, which can be used to attach a tool such as a wrench to assist in assembly or limit the azimuthal orientation of the titanium base 5 (not shown). Limiting the orientation of the titanium base using matching engagement features of the titanium base and the implant abutment is a common technique for single-tooth crowns. By fixing the azimuthal orientation of a non-cylindrical symmetrical titanium base with a matching abutment mounting surface, the omnidirectional multi-unit abutment 100 embodiment herein can be easily adapted to single-tooth prostheses and will not be described in detail.

[0087] The ball 13 of the abutment base 1 can be captured between the rotating base 3 and the rotating mount 2, which includes a rotating shell around the ball 13, and the threaded portion 14 extends through the hole 19. For this insertion process, the hole 19 must be larger than the abutment seat protrusion 21. The rotating base 3 and the rotating mount 2 are preferably joined at the intersection joint 12, which is formed by continuous welding or spot welding (for example, with a laser) after positioning around the ball 13 to form the base assembly 101. This joining technique provides a strong assembly with a thin shell over a short distance, but other joining techniques can also be used to capture the ball 13 within the shell. As Figure 4 As shown in the cross-sectional view of FIG, after being combined, the mechanical design of the internal curved portion 15 and the hole 19 of the assembled rotating base 3 and rotating mount 2 can be designed to prevent the ball portion 13 of the abutment base from being dislodged from the rotating housing. The relative size and shape of the hole 19 and the size and shape of the abutment base 1 at the abutment seat protrusion 21 determine the possible tilt range. Generally, if the minor diameter or width of the hole 19 and the internal thread 20 of the rotating mount are both smaller than the width of the ball portion 13, the ball portion 13 is captured in the housing without the locking screw 4.

[0088] The locking screw 4 shown has an external thread 9 to engage with the internal thread 20 of the rotating mount 2. These threads can be, for example, m3×0.35 size. The locking screw 4 also has an internal thread 7 for attaching a prosthetic screw 6 and a drive interface 8 for tool attachment to tighten the locking screw 4 in the rotating mount 2. Representative prosthetic screw sizes include m1.4×0.3 threads, m1.6×0.35, UNF 1-72, etc. The drive interface 8 can be a socket that accommodates a common dental driver, including Torx T5 or T6, 0.035" to 0.050" hexagonal or square drivers, or straight and star drivers of similar sizes. As shown, the internal thread 7 and the drive interface 8 have a partial overlap along the longitudinal axis of the locking screw. This is a design choice. Complete axial overlap or no axial overlap is another design option.

[0089] The rotating base 3 is configured to engage a section of the ball 13 when the locking screw 4 is tightened. The drawings and cross-sections shown illustrate an embodiment in which the rotating base and mount can be positioned and rotated anywhere within a 30 degree cone, such as Figure 5 and Figure 8 As shown. The amount of tilt allowed and the orientation of the adjustment are design choices, although 30 degrees of tilt are generally sufficient for most clinical applications. As shown in this embodiment, the hole 19 and the hole with internal thread 20 in the rotating mount 2 are smaller than the diameter of the ball 13. In this case, when the rotating base 3 and the rotating mount 2 are attached to each other, the ball 13 of the abutment base 1 can be loosely captured by these two components. That is, the locking screw 4 does not have to be attached to the rotating mount 2 to form a housing that captures the ball 13 of the illustrated embodiment. This is a design option, but is not necessary to benefit from the inventive concepts of the present disclosure.

[0090] Figure 4 The cross-sectional view of the omnidirectional multi-unit abutment embodiment with titanium base 5 in FIG. 1 can be used to illustrate some of the advantages of the preferred geometric relationship between the elements. As shown, the ball 13 is spherical throughout the range of motion of the housing formed by the rotating base 3, rotating mount 2 and locking screw 4. The range of tilt caused by the interference of the rotating base 3 near the hole and the abutment base 1 surface 61 near the abutment seat protrusion 21 is limited to Figure 5 and Fig. 9, marked as angle b. The inner curvature of the rotating mount 2 is substantially the same as the curvature of the ball portion 13. The locking screw 4 also has substantially the same curvature as the ball portion 13 in the contact area. The inner curvature 15 of the rotating mount 2 is preferably slightly larger than the curvature of the ball portion 13. As a result, when the locking screw 4 is tightened, the ball portion 13 contacts the inner curvature 15 of the rotating base 3 and the corresponding inner curvature of the locking screw 4. Because the inner curvature of the rotating mount 2 is larger, the rotating mount does not contact the ball when the locking screw 4 is fully tightened. This provides a more consistent, continuous circular seal of the rotating base with the ball to help prevent biological contaminants from entering the interior of the omni-directional, multi-unit abutment assembly. Figure 4 In the linear configuration, the locking screw 4 also provides an equivalent circular seal with the ball 13. Fig. 9 As shown in the maximum tilt state of FIG. 1 , the continuous sealing of the rotating base 3 to the ball is maintained. However, due to the abutment base drive feature 10, the sealing of the locking screw 4 to the ball 13 is not continuous. However, when the titanium base 5 and the prosthetic screw 6 are applied to the omnidirectional multi-unit abutment, the abutment base drive feature 10 is effectively sealed.

[0091] The relatively large annular contact of the (hollow) locking screw 4 with the ball 13 distributes the clamping force over a larger area than the concentrated contact of a solid set screw. The extended contact of the rotating base 3 with the ball 13 and the matching internal curved portion 15 have been determined to have sufficient friction grip when the components are made of titanium to allow tightening of the locking screw 4 to exceed 25Ncm without holding the rotating base 3 or rotating the mount 2. The relatively large contact area also minimizes deformation of the ball 13 due to clamping compared to densely marketed set screws, which makes it easy to reposition the inclination or azimuth without interference from deformation of the ball 13 geometry. The relatively large outer diameter of the locking screw 4 also provides sufficient wall thickness between the internal thread 7 and the external thread 9 to obtain mechanical strength so that torque can be applied to the locking screw 4 with a drive tool size comparable to the thread width of the prosthetic screw 6.

[0092] The relatively large locking screw 4 provides a sufficient number of external threads 9 to engage with the internal threads 20 of the rotating mount to provide a stable clamping force on the ball 13. Although threads (not shown) may also be used at the interface 12 between the rotating mount 2 and the rotating base 3, the diameter of the omnidirectional multi-unit abutment may need to be increased to have sufficient wall thickness and engaging thread depth to have a stable grip with the ball 13. Figure 4. However, if it is desired to prevent over-torque of the locking screw 4, limited engagement of the threads between the rotating mount 2 and the rotating base 3 can be used to cause separation when a threshold torque is reached. Other options for torque limitation include adjusting the preferred weld joint strength described above, increasing the size of the hole 19 in the rotating mount, and / or introducing an intentionally thinner wall portion with lower torque resistance near the hole 19 in the rotating base. Although the intentional failure design will likely result in the loss of the omnidirectional multi-unit abutment, this may be preferred over excessive stresses that may result in future failure of prosthesis or implant retention.

[0093] Figure 4 The hollow type locking screw 4 and driving geometry shown provide benefits in dental system installation and maintenance. After the rotating base 3 is attached to the rotating mount 2 to form the base assembly 101, the ball portion 13 of the abutment base 1 is captured by the housing formed by the rotating mount 2 and the rotating base 3. The locking screw 4 can be initially entered into the rotating mount 2 and rotated sufficiently to secure it but not contact the ball portion 13 to form the omnidirectional multi-unit abutment assembly 100. The titanium base 5 can optionally be placed on top of the omnidirectional multi-unit abutment assembly and the components aligned along a common axis, such as Figure 3 and Figure 4 During installation and orientation of the abutment base 1, rotating base 3, rotating mount 2 and locking screw 4, the titanium base 5 does not need to be in place. Once so aligned, the drive tool 17 can be inserted through the titanium base 5 and locking screw 4 to engage with the drive feature 10 of the abutment base 1, as shown. Figure 7 As shown. Note that it may be necessary to rotate the drive tool 17 slightly after passing the locking screw 4 in order to engage the abutment base drive interface 10. Preferably, the engagement of the drive tool 17 with the abutment base drive feature 10 has sufficient friction to retain the omni-directional multi-unit abutment 100 on the drive tool 17, thereby presenting the omni-directional multi-unit abutment assembly to the implant 16, as shown. Figure 7 As shown. A slight twisting of the locking screw 4 in the loosening direction can help with this retention. When the drive tool 17 is rotated, the threaded portion 14 engages the implant 16, and the omnidirectional multi-unit abutment assembly can be screwed down to obtain the ideal placement of the abutment seat protrusion 21 to the implant 16. Since the drive tool engages both the abutment base 1 and the locking screw 4, these components rotate simultaneously. Since the position of the locking screw 4 does not change relative to the abutment base 1, the ball 13 is not grasped between the rotating base 3 and the locking screw 4. The rotational force from the drive tool 17 drives the threaded portion 14 deeper into the implant 16.

[0094] The abutment seat protrusion 21 of the abutment base that contacts the implant can be modified to match the seat geometry of the fixed angle abutment. The abutment base drive feature 10 allows the threaded portion 14 of the abutment base 1 to be fixed to the implant 16. The tightening of the abutment base 1 to the implant can continue until the desired placement pressure is obtained at the abutment seat protrusion 21. A representative torque value is about 30Ncm, although this value will depend on the implant system used and can be higher or lower than this value. In order to load the prosthesis immediately, the torque value should be less than the torque value used to install the implant into the jawbone.

[0095] like Figure 8 As shown, once the abutment base 1 is fixed to the implant 16, it is no longer necessary Figure 7 linear configuration. By movement of a drive tool 18 inserted into the locking screw 4, the desired inclination and azimuth of the rotational mount 2 receiving the titanium base 5 for prosthesis attachment can be selected. Turning the drive tool 18 causes the locking screw 4 and the rotational base 3 to clamp the ball portion 13 and lock the angle of the omnidirectional multi-unit abutment 100. An engagement feature 11 may be included to prevent the locking screw and the rotational base from rotating when the locking screw 4 is tightened. Other engagement features, such as small holes or splines, may also be used for this purpose as anti-rotation or azimuth selection features. In the case of a single-tooth prosthesis, the selection feature of the rotational fixation feature on the engagement titanium base on the rotational mount 2 allows the azimuth of the titanium base to be selected and maintained while tightening the locking screw 4. A coaxial two-piece tool that engages the anti-rotation feature and includes a drive tool similar to 18 can be used to orient and tighten the rotational mount 2 and locking screw 4 in the appropriate position on the ball portion 13 of the abutment base 1. Having a tool included in Figure 5 The arrangement of the titanium base 5 can facilitate azimuth angle selection.

[0096] The drive interface 8 of the locking screw 4 is preferably accessible through the titanium base 5 in both the temporary and final prostheses. This allows for moving and re-torquing the locking screw 4 in the proper orientation if it loosens over time, making fine adjustments to improve the passive fit, and replacing and realigning one omnidirectional multi-unit abutment 100 within a plurality of omnidirectional multi-unit abutments 100. By placing the inset Figure 7 The drive tool dimension d1 shown in a is different from that in the inset. Figure 8 Compared with the drive tool dimension d2 shown in a, Figure 8 The drive tool 18 shown in FIG. Figure 7The drive tool 17 in the abutment base 1 is not required. The benefit of using two different sized drive tools (e.g., a T5 drive tool 17 for driving the abutment base 1 and a T6 drive tool 18 for securing the locking screw 4) is to provide additional clearance in the locking screw 4 when driving the abutment base. Since the torque used to drive the abutment base 1 can be selected to be higher than the torque used to secure the locking screw 4, a first torque wrench with the drive tool 17 and a second torque wrench with the drive tool 18 can help ensure that the desired torque is obtained. Of course, in order to allow the assembled omnidirectional multi-unit abutment 100 to be as Figure 7 To be installed into the implant 16 as shown, the drive tool 17 must be sized and shaped to pass through the locking screw 4. Figure 8 The drive tool 18 in FIG. 4 is prevented from fully penetrating the locking screw 4 because the drive interface 8 shown does not extend all the way to the distal side of the locking screw 4. This is a design choice.

[0097] Some practitioners may choose to use their muscle memory experience rather than a calibrated objective tool to determine when the predetermined desired torque is applied to the abutment base 1 and locking screw 4. If the abutment base drive interface 10 and drive interface 8 are the same size and shape, then the drive tools 17 and 18 can use one tool. In this case, in the case of Figure 7 After driving the abutment base 1 into the implant 16 as shown, the drive tool 17 will only need to be withdrawn just enough to disengage from the abutment base drive interface 10 before repositioning the drive tool 17 to lock the position of the omnidirectional multi-unit abutment 100 by rotating the locking screw 4. If different calibration torques are desired, two different wrenches with the same drive tool tip size can be used. Some practitioners may prefer to have the drive tip inserted into the omnidirectional multi-unit abutment for two torsion process steps and switch torque wrenches set to different values. Since the axis of rotation of the drive tool 17 is usually different from that of the drive tool 18, it may be acceptable to use the same torque amplitude for the abutment base 1 and the locking screw 4. A torque wrench with a button or other selector to switch between two different torque settings may be useful. The automatic selection can be based on the difference between the deeper drive tool depth required to engage the abutment base drive interface 10 and the drive interface 8, such as by requiring a force along the axis of the drive tool tip to engage the spring-loaded sheath with a higher torque mechanism. In this case, if desired, the lower torque device can remain engaged, although it will slip.

[0098] Fig. 9A cross-sectional view of an omnidirectional multi-unit abutment assembly 100 is shown, including a prosthetic screw 6 holding a titanium base 5. The prosthetic screw 6 may be replaced with a detachable fastener (not shown) as described in reference U.S. Pat. No. 11,311,354 to facilitate positioning of the titanium base 5 into the prosthesis by a lift-off process. Note that the drive interface 8 may be accessed by removing the prosthetic screw 6 even after the titanium base 5 is incorporated into the prosthesis. This essentially changes the construction from Fig. 9 Change to Figure 8 This benefit will be described in more detail after further examples are given.

[0099] Figures 1 to 9 A variation of the illustrated embodiment is shown in Figures 10 to 13 From a practical design point of view, given the constraints of conventional abutment diameter, seat height (in the first embodiment, the distance between the titanium base seat feature 22 of the titanium base 5 and the abutment seat protrusion 21), and other dimensional constraints, the omnidirectional multi-unit abutment design may also include embodiments in which the abutment base 30 and the ball or spherical feature 31 are initially separate components. Figure 1-9 In the embodiment of the present invention, the diameter of the ball is about 3 mm. A nominal seat height of about 2.5 mm is shown in the figure.

[0100] like Figure 1-9 The omnidirectional multi-unit base assembly 100 shown, Figure 10-13 The second embodiment shown is shown to have approximately the same dimensions to work with the same implant 16 and titanium base 5. The seat height between the abutment seat 42 and the titanium base seat 41 is also comparable. The main difference is that the rotational member 32 is captured between the parts of the two-part abutment base 30. Fig.12 The abutment base 30 in includes a separate ball 31 attached to a stem portion 34. For example, a discrete ball 31 may be useful in situations where the rotating base will not fit through a desired abutment diameter without interference. Figures 10 to 13 The embodiment includes a ball 31 having a drive feature 45 with a distal mounting hole 46 attached to the stem portion 34 of the abutment stem portion 34. After the ball 31 is inserted into the swivel 32, the ball 31 is assembled to the stem portion 34 by any form of mechanical engagement, such as press fit, heat shrink, laser welding, adhesive, or a combination thereof. For example, the ball 31 may have a slight press fit on the stem portion 34 and a small radial laser weld at the interface 35. This method reliably bonds the ball to the base while minimizing mechanical precision, providing a radius at the interface 35, and sealing the joint to prevent liquid ingress.

[0101] In the illustrated embodiment, the minor diameter of the internal threads 38 of the rotating member 32 is large enough to allow the ball 31 to be inserted through the internal threads 40 of the rotating member 32. The drive feature 45 can be used to orient the ball for assembly. After the rotating member 32 is captured and the locking screw 33 is installed and tightened, the ball 31 contacts the rotating member 32 along the seat surface 47. Figure 12-13 The seat / interference surface is shown at approximately 17.5 degrees in FIG. 4 . The locking screw 33 also contacts the ball 31 along the seat surface 48. Various surface finishes and mechanical features may be employed to enhance the locking ability of the seat surfaces 48 and 47 to the ball 31, such as surface textures, ridges, or ribs. Note that this method of capturing the rotating member 32 to the ball prevents the rotating member 32 from falling off the ball 31. Similar to Figure 1-9 In the rotating base 3 of the first embodiment, the rotating member 32 contacts the distal surface of the ball, but also provides a titanium base seat 41 to support the titanium base 5 in a known orientation similar to that provided by the aforementioned titanium base seat feature 22 of the rotating mount 2.

[0102] The locking screw 33 is similar to the locking screw 4 in the first embodiment. The locking screw 33 includes an internal thread 7 for the prosthetic screw thread 36, a drive feature 37, a seat surface 48, and an external thread 39. The proximal end of the ball 31 includes a drive feature 45, which can be accessed by the locking screw 33, similar to the locking screw 4 described above. When the locking screw 33 is tightened using the drive feature 37, the rotating member 32 engages the seat surface 47 of the ball 31, which allows the locking screw 33 to fix the rotating member 32 in an ideal omnidirectional orientation up to thirty degrees from the implant axis and at a desired azimuth. Likewise, during the installation and orientation of the omnidirectional multi-unit abutment, the titanium base 5 does not need to be present. By appropriately selecting the dimensions of the prosthetic screw thread 36 and the drive features 45, 37, and 44, a single drive tool can be used for the following three steps: tightening the abutment base 30 into the implant (not shown), locking the orientation of the rotating member 32 with the locking screw 33, and tightening the drive feature 44. For example, a typical single T5 drive tool with an M1.6×0.35 prosthetic screw 6 having prosthetic screw threads 36 may be used if the drive features 37, 44, and 45 also have T5 socket characteristics. Of course, in this case, the locking screw drive feature 37 needs to extend through the locking screw 33 (not shown) in order to engage the abutment base drive feature 45. The portion of the M1.6 prosthetic screw thread that is removed for the T5 driver has been determined to provide sufficient thread integrity to properly retain the prosthetic screw. Other combinations of standard and custom thread and drive geometries may also be used to allow the use of a single drive tool.

[0103] By assembling the ball 31 to the abutment base 30, the width of the abutment base 30 at the abutment seat portion 42 can be greater than that in the first embodiment. In the first embodiment, the threaded portion 14 of the abutment base 1 is inserted into the hole 19 to contact the ball portion 13. The ball portion 13 is captured by coupling the swivel mount 2 to the swivel base 3. By combining the features of the swivel base 3 and the swivel mount 2 into a single-piece swivel 32 in this embodiment, the size of the distal end of the abutment base is not limited by the hole at the distal end of the swivel 32 hole. Figure 10-13 In the embodiment of FIG. 3 , the minor diameter of the locking screw outer thread 39 must be larger than the diameter of the ball 31 to allow the ball to be inserted through the swivel 32 to be coupled to the abutment base 30 . Fig.12 and Figure 4 A comparison of 30 and 31 shows that this results in a shorter depth for the engagement thread between the rotation member 32 and the locking screw 33 .

[0104] Figure 14-16 Another method of capturing a rotating housing component to an abutment base with a ball feature is shown. In this embodiment, an abutment base assembly 101 is made of a rotating member 32 and a ball with a tapered stem 50, the ball having a ball portion 13, a drive feature 45 at the proximal end, and a tapered stem 51 at the distal end. The tapered stem 51 is coupled to a base 52, which has a tapered socket 53 at the proximal end and a threaded portion 14 at the distal end. The widest part of the ball with the tapered stem 50 is the diameter of the ball portion 13. The rotating member 32 is captured by inserting the tapered stem 51 into the proximal side of the rotating member 32 and then inserting the tapered stem 51 into the tapered socket 53.

[0105] Fig.15 and 16 The abutment base assembly 101 is shown. As previously mentioned, the tapered stem 51 and base 52 can be joined using different techniques. However, it is preferred that welding at the interface 63 be included. Fig.16 and Fig.14 A comparison of shows that the ball portion 13 of the ball having the tapered stem 50 may have improved structural stability compared to the ball 31. This may be important in view of the small size of the components and the desire to have a smooth rotational action and a tight seal of the components when locked in place.

[0106] Fig.14The locking screw 49 shown differs from the locking screws 4 and 33 in the aforementioned embodiments in that a hexagonal drive feature 64 is included on its outer surface near its proximal end. The hexagonal drive feature 64 is configured to facilitate the removal of a failed device. For example, if the prosthesis screw 25 breaks in the locking screw 4, the drive interface 8 may be blocked, so that the drive tool 18 for installing the omnidirectional multi-unit abutment cannot be inserted. As an alternative to removing the broken prosthesis screw 25, a wrench (not shown) can be applied to the hexagonal drive feature 64 to remove the locking screw 49. Of course, these hexagonal drive features 64 will generally be inaccessible when the titanium base 5 is in position on the omnidirectional multi-unit abutment. As a result, for the use of a titanium base embedded in the prosthesis, the locking screw drive feature 37 is preferred to help align and lock the omnidirectional multi-unit abutment orientation, thereby improving the passive fit. If necessary, a wrench can also be applied to the engagement feature 11 on the side of the rotating member 32 to help remove the blocked locking screw 49 because the titanium base 5 will not cover it.

[0107] Fig.17 is a top plan view of a locking screw 49. At the outer edge are the locking screw external threads 39, and at the center is the drive interface 8, which is shown as a Torx type. The major diameter 66 (dashed line) and the minor diameter 65 of the internal thread 7 are shown. The minor diameter 65 is not a continuous circle, but a series of discontinuous arc segments, which is due to the drive interface 8 axially overlapping the internal thread 7. Note that the locking screw 49 has the drive interface 8 and the internal thread 7 extending all the way through the locking screw 49. In other words, they are substantially completely axially overlapped through the thickness of the locking screw 49, so that both the prosthesis screw 25 and the drive tool 18 of sufficient length can pass through the thickness of the locking screw 49. The amount of material in the locking screw 49 available for the drive tool 18 to apply torque to lock the orientation of the omni-directional multi-unit abutment 100 corresponds to the volume defined by the major diameter 66 and the minor diameter 65 of the internal thread 7 minus the material removed to provide a drive interface 8 socket for the drive tool 18 (not shown). The size and shape of the drive interface 8 may be modified to change the strength of the remaining internal threads 7 used to retain the prosthetic screw 6 and the maximum torque applied to the locking screw 49 to fix the orientation before damaging the internal threads 7 .

[0108] Fig.18 FIG. 4 is a top plan view of a locking screw 49 having an alternative locking screw internal drive interface 54. The internal drive interface 54 has four lobes instead of the six lobes of the Torx drive tool interface shown previously. With fewer lobes and a more distinct lobe transition, the locking screw 49 is more easily accessible than the conventional locking screw 49. Fig.17 A visual comparison is sufficient to show that Fig.17Thus, there is a compromise of materials and geometry that can be used to compensate for any degradation in mechanical strength caused by the axial overlap of the internal threads 7 and the internal drive interface 54, which allows for final alignment and locking of the omnidirectional multi-unit abutment 100 with the prosthesis in place.

[0109] Fig.19 A 4-lobe drive tip 62 is shown with Fig.18 The present invention also provides a locking screw 49 and an abutment base 59 with a matching 4-lobed drive interface 60. For clarity, other components of the omnidirectional multi-unit abutment 100 are not shown. Since the drive tip 62 is sized to pass through the locking screw 49, it can be used to drive the abutment base 59 into the implant 16 (not shown). Since the drive tip is sized to pass through the hole 23 (not shown) of the titanium base, it can also rotate the locking screw 49 to fix the position of the omnidirectional multi-unit abutment through the prosthesis (not shown) embedded in the titanium base 5 (not shown).

[0110] Fig. 20 Another embodiment of a two-part abutment base 55 is shown, which is assembled to capture the rotation member 32. In this embodiment, the ball portion 13 and the threaded portion 14 are included in the abutment base rod 56. The distal end of the abutment ball base rod is inserted into the rotation member 32 and then inserted into a hollow sleeve 57 that matches the interface requirements of the abutment of the implant 16 to be used. The sleeve 57 has a maximum width that is greater than the diameter of the ball portion 13. As a result, when the sleeve 57 is coupled to the abutment base rod 56, the rotation member 32 is captured. Any of the various coupling operations described above can be used, although it is preferred to include such as Fig. 22 Welding at interface 58 is shown. Fig. 22 Also shown are two critical dimensions for the above assembly process. The minimum diameter "d" of the through hole of the rotating member 32 must be greater than the maximum width "c" of the abutment base rod 56 below the ball portion. Due to the similarity of this embodiment to the previous embodiment, other components and features will not be described.

[0111] Many other methods of capturing the swivel on the ball with an attached abutment connection assembly are possible, such as differently shaped male pins on the ball, female sockets on the base of the abutment, threaded rods on the ball or abutment. Although a substantially spherical ball has been shown to demonstrate the concepts of the invention and provide maximum orientation flexibility, other shapes may be used to intentionally restrict orientation. The mating interface may be adjusted to meet the purpose in embodiments not presented that still use one or more of the illustrated inventive concepts.

[0112] Fig.23A cross-sectional view of an application environment of an installed omnidirectional multi-unit abutment 100 of the first embodiment is shown. An implant 16 has been installed in the bone and soft tissue of a patient, schematically indicated at 70. The abutment base 1 has been screwed into the implant 16 to the desired torque level. In this case, the swivel mount 2 has been tilted to substantially align with the implant 16. Figure 8 The titanium base 5 is embedded in the prosthesis 68. The occlusal surface 72 of the prosthesis 68 is schematically shown as 72. The titanium base 5 is placed on the rotating mount 2, but the prosthesis screw 6 has been removed to allow the drive interface 8 ( Figure 1 ) is accessible by a drive tool 71 through the prosthesis screw access hole 69. Note that while a 4-lobe drive tool 71 is shown, a smaller drive tool (not shown) may be required to drive the abutment base 1 into the implant 16, as previously described for the first embodiment. As described in the first embodiment, it may be advantageous to be able to make changes in the omnidirectional multi-unit abutment orientation when the prosthesis is in place. Fig.23 will be used to describe this in more detail.

[0113] although Fig.23 Only one implant is shown in the figure, but the benefits of in situ adjustment are magnified when the prosthesis includes multiple titanium bases that mate with multiple implants. During the manufacture or modification of a prosthesis for implant installation, uncertainties in the positions of the titanium bases can accumulate. Due to the random nature of these shifts, the orientation and position of the titanium bases can deviate from each other and from the position of the abutment set that was originally used to orient the titanium bases with the prosthesis. Even if the titanium bases were perfectly positioned initially, the shape of the patient's jaw or prosthesis can change over time. As Fig.23 As shown, removing the prosthesis screw 6 allows the locking screw 4 to be accessed and loosened by the driving tool 71. Applying a relocation force to the prosthesis 68 from the occlusal side 72 will push the embedded titanium base 5 against the titanium base seat feature 22, thereby redirecting the orientation of the omnidirectional multi-unit abutment. Tightening the locking screw 4 with the driving tool 71 while maintaining the relocation force on the prosthesis 68 will lock the orientation. The prosthesis screw 6 can then be reinserted and torqued to secure the titanium base 5 and prosthesis 68 in place. If it is desired to check the torque on the locking screws 4 to see if they have loosened over time, this can also be done with the titanium base 5 embedded in the prosthesis 68.

[0114] Similarly, if one omnidirectional multi-unit abutment 100 in a set fails and needs to be replaced, the prosthesis 68 with its embedded titanium base 5 can be removed after all of the prosthetic screws 6 have been removed. Figure 8 and Figure 7 The angulation and implant attachment process shown in will remove a failed omnidirectional multi-unit abutment assembly 100. Repeat Figure 7The process of attaching the new omni-directional multi-unit abutment 100 to the implant 16 will result in the abutment base 1 being fixed within the implant 16, but the housing consisting of the rotating base 3, rotating mount 2 and locking screw 4 will be loose. Minimal pressure on the locking screw 4 is sufficient to maintain the orientation of the omni-directional multi-unit abutment so that gravity does not cause it to move, but only minimal force needs to be applied to change its orientation. Rough positioning of the rotating mount 2 is sufficient to engage the titanium base 5 in the prosthesis 68 and manually apply pressure to the prosthesis from the occlusal side 72, which will re-orient the newly installed omni-directional multi-unit abutment to align with the titanium base 5 already installed in the prosthesis. The titanium base 5 can then be inserted through the hole 23 ( Figure 4 ) Tighten the locking screw 4 in the appropriate position, such as Fig.23 Before tightening the locking screw 4, whether to use the prosthetic screw 6 from the original omnidirectional multi-unit abutment 100 to maintain the alignment pressure on the newly installed omnidirectional multi-unit abutment 100 is optional.

[0115] Since the drive interface 8 can be approached through the titanium base 5 and the prosthesis 68, a variation of the screw passive fit test scheme can be used to fine-tune the orientation of the omnidirectional multi-unit abutment to improve the passive fit when originally installed. There are different options to develop the ability to reorient the omnidirectional multi-unit abutment 100 through the hole 23 of the titanium base 5 installed in the prosthesis 68. In one method, all prosthetic screws 6 are removed. When the prosthesis 68 is kept in place, all omnidirectional multi-unit abutment locking screws 4 are loosened and then tightened with fingers to provide a certain friction resistance, but not to prevent rotational slip. The actual torque value for proper finger tightening will depend on the construction and surface finishing of the omnidirectional multi-unit abutment, but will generally be less than a few Ncm. Then, all prosthetic screws 6 are reinstalled and torqued to the recommended value. In this way, the orientation of each omnidirectional multi-unit abutment will more closely match the dental prosthesis 68. Then, a single prosthetic screw 6 is removed to provide access to the locking screw 4 of the omnidirectional multi-unit abutment in that position. The locking screw 4 is torqued to its predetermined value. The prosthetic screw 6 is reinserted and torqued to the predetermined value. The process is repeated until all omnidirectional multi-unit abutment locking screws 4 have been tightened and all prosthetic screws 6 have been tightened.

[0116] The above fine-tuning process may be modified depending on the details of the initial level of passive fit. For example, it may be desirable to loosen only certain of the omni-directional multi-unit abutment locking screws 4, while leaving other omni-directional multi-unit abutment locking screws fixed to serve as anchor points for the original prosthesis fit. This may be due to compromising the requirements of passive fit to some extent for better occlusion or other reasons. Alternatively, the results of a conventional one screw or screw resistance test may suggest directional adjustment of only a subset of the omni-directional multi-unit abutments or a different order of adjustments. In any case, these improvements in passive fit derive directly from the ability to orient and fix the omni-directional multi-unit abutments when the prosthesis is in place.

[0117] Preferably, the above embodiment of the omnidirectional multi-unit abutment 100 is adapted to be compatible with the already qualified and commercially successful titanium base 5 and implant 16. Since the same implant can be used with the conventional straight abutment and the above embodiment in the same patient, the threaded connection and placement of the widely available implants improves the inventory formula. Although less critical, the compatibility with the widely available screw-attached titanium base 5 is also seen as an advantage. However, the inventive features of the embodiments can be integrated into or adapted to work with newly designed implants that adopt the inventive concepts for passive fit improvement or installation efficiency and the above repair. These inventive concepts can also be adapted to work with prostheses that are not attached with screws. These adaptability is not excluded and is considered to be disclosed herein and within the scope of the claims that can be broadly interpreted to apply to them. U.S. Patent No. 11,311,354 includes different methods of using temporary fasteners to align the titanium base with the abutment to be incorporated into the prosthesis during the lift-off process. The basic design of the temporary fastener shown in this commonly owned patent can be used with the above-mentioned omnidirectional multi-unit abutment and titanium base.

[0118] Various embodiments have been described to illustrate the disclosed inventive concepts, not to limit the invention. Combining inventive elements of one or more embodiments with known materials, components and techniques in dental science to create further embodiments using the inventive concepts is considered part of the present disclosure.

Claims

1. A system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw, wherein: The prosthetic screw comprises a head and a threaded shaft, and the system comprises: An abutment base having a longitudinal axis, the abutment base comprising: a proximal end including a ball portion and an abutment base drive interface; and a distal end comprising threads for attachment to the implant; and a rotating housing having an inner surface and an outer surface, wherein the rotating housing includes a rotating hole near the distal end and a threaded hole at the proximal end; and A locking screw having a longitudinal axis, wherein the locking screw comprises: a portion having external threads compatible with the threaded hole of the rotating housing; and a portion having an internal thread sized to engage a threaded shaft of the prosthetic screw; and locking screw drive interface; and Titanium base, wherein the titanium base has a hole at a proximal end that is larger than the threaded shaft of the prosthetic screw and smaller than the head of the prosthetic screw, and the titanium base has a distal end that is shaped to be supported by the rotating housing in a known orientation, wherein rotating the locking screw is capable of fixing the orientation of the longitudinal axis of the locking screw in an orientation that is not parallel to the longitudinal axis of the abutment base, wherein the ball portion of the abutment base is squeezed between a portion of the inner surface of the rotating housing and the locking screw, wherein the locking screw drive interface is a through socket for receiving a locking screw drive tool, and Wherein a portion of the locking screw driving tool is sized to pass through the hole of the titanium base without interference.

2. The system of claim 1, wherein: The rotating housing includes a rotating base and a rotating mount that are mechanically assembled to capture the ball portion of the abutment base.

3. The system of claim 1, wherein: The abutment base drive interface is a socket for receiving an abutment base drive tool, and wherein the abutment base drive tool has a longitudinal axis and an abutment base drive tip shaped to engage the abutment base drive interface.

4. The system of claim 1, wherein: The locking screw driving tool has a longitudinal axis and a maximum width that is less than a maximum width of the threaded shaft of the prosthetic screw.

5. The system of claim 3, wherein: The abutment base drive tip is sized to pass through the locking screw.

6. The system of claim 5, wherein: The abutment base driving tip is designed to tighten the abutment base into the implant to a first torque without simultaneously tightening the locking screw to fix the orientation of the rotational housing.

7. The system of claim 3, wherein: The orientation of the rotating housing is selected by tilting the locking screw driving tool away from the linear axis of the abutment base and tightening the locking screw to a second torque.

8. The system of claim 7, wherein: The abutment base driving tool and the locking screw driving tool are provided as a single tool, whereby the abutment base driving tip is also used to tighten the locking screw.

9. A method of aligning and attaching a dental prosthesis to an implant using a prosthetic screw using the system of claim 1, the method comprising: attaching the locking screw to the rotation housing surrounding the abutment base, wherein the ball portion is loosely constrained within the rotation housing, wherein the abutment base threadably extends through the rotation aperture to form a multi-unit abutment assembly; inserting a tip of an abutment base drive tool through said locking screw to engage said abutment base drive interface; presenting the abutment base drive tool and multi-unit abutment assembly to the implant; rotating the abutment base driving tool to attach the abutment base to the implant to a first torque; disengaging the abutment base drive tool from the abutment base drive interface; moving the rotating housing to a different orientation; rotating the locking screw driving tool to fix the orientation of the rotating housing axis relative to the implant axis to a second torque; presenting a prosthesis including the titanium base to the implant abutment system; and The prosthesis is attached to the implant abutment with a prosthesis screw.

10. The method of claim 9, further comprising applying a force to the prosthesis to move the rotating shell into alignment with the titanium base.

11. The method of claim 9, wherein: The titanium base is incorporated into the prosthesis using a lift-off process with a temporary fastener comprising: a post having an axis, a first post end, and a second post end, wherein the first post end is threaded for threaded attachment to the locking screw; and a cap, wherein the cap is attached to the second column end; And wherein the temporary fastener is configured to hold the titanium base against the rotating housing by applying a rotational force to the cap to thread the first post end into the locking screw, and wherein the cap is separable from the post by a release force directed away from the first post end.

12. A system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment, the multi-unit implant abutment comprising: A ball and housing assembly, the ball and housing assembly comprising: a base comprising an abutment drive interface for threaded attachment to the implant; the base comprising a first end having a ball and a second end having a threaded post, the threaded post having a longitudinal axis; and wherein the threaded post is designed to be screwed into the dental implant at a predetermined torque; a housing portion having an inner surface and an outer surface; wherein the housing portion has a first end with a hole and a second end with a locking screw; and wherein the ball is captured within the housing portion, wherein the threaded post of the base extends through the hole; a titanium base including a hole on a proximal end and a port on a distal end, the distal end being designed to fit onto an exterior surface of the housing portion at a known location; and one or more drive tools designed to engage the abutment drive interface and the locking screw; wherein at least one of the one or more drive tools is insertable through the titanium base hole to engage the locking screw; and wherein tightening the locking screw applies pressure on the ball to fix the orientation of the housing portion, Wherein the locking screw has a longitudinal bore, and wherein the longitudinal bore is sized to allow the abutment driving tool to extend through the locking screw.

13. The system of claim 12, wherein: The titanium base is incorporated into a prosthesis, and wherein, when the locking screw is tightened, a force is applied to the prosthesis to align the multi-unit implant abutment with the titanium base.

14. The system of claim 12, further comprising a prosthetic screw, wherein: The prosthetic screw comprises: a head having a width greater than the titanium base bore; and a threaded shaft portion having a width smaller than the titanium base bore; and Wherein, the locking screw comprises threads for receiving threads of the prosthetic screw.

15. The system of claim 14, wherein: The locking screw includes a longitudinal hole, and the longitudinal hole includes: internal threads for engaging the prosthetic threaded shaft; and A drive interface is provided for receiving a tool for tightening the locking screw.

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