PROSTHETIC ARRANGEMENT WITH AT LEAST ONE ALL-CERAMIC DENTAL IMPLANT

Description

[0001] The invention relates to a dental prosthetic arrangement with at least one all-ceramic dental implant, in particular with an all-ceramic dental implant made of zirconia ceramic.

[0002] Ceramic implants, for example those made of zirconium ceramic, are a well-established technology. However, the use of such implants is still associated with difficulties, which is why this type of implant has not yet gained widespread acceptance. The potential advantages, however, would be considerable. Many patients react to titanium particles, with tests having observed an excessive immune response in approximately 30% of patients. Therefore, ceramic implants would offer an alternative to avoid the risk of non-integration. Likewise, peri-implantitis and mucositis, with their associated chronic inflammation and strain on the body, could be avoided in the long term. Consequently, the proportion of patients who desire metal-free or nearly metal-free restorations is increasing.Furthermore, ceramic implants also offer aesthetic advantages, which are particularly important in the front tooth area, since metallic implants are visible from the outside through the gingiva due to their color, which is often exacerbated by the associated gum loss in the case of existing periodontitis, which was the cause of the tooth loss.

[0003] Several solutions to this problem are known from the state of the art.

[0004] A dental implant system is known from EP 2 436 336 A1, comprising a dental implant, a dental restoration, a connector with a central through-hole, a circumferential, radially projecting collar, and a screw passing through the through-hole, with which at least the connector can be firmly connected to the dental implant. The collar has a first stop surface interacting with the dental implant and a second stop surface interacting with an abutment or a dental restoration. The color of the collar, in particular the color of the connector, corresponds to at least one tooth or gum color. The connector extends at least partially into the dental implant and / or the abutment and consists essentially of the same material as the abutment or of zirconium dioxide.

[0005] From DE 101 59 683 A1, a dental implant is known with an anchoring part for anchoring in the bone and with an abutment for receiving a prosthetic superstructure, wherein the anchoring part and the abutment are formed in one piece from a zirconia-based material and wherein at least the anchoring part is pretreated at least partially on its outer surface by a subtractive, abrasive process or is provided with a coating that supports ossification.

[0006] German patent DE 10 2012 024 596 A1 discloses a dental implant that is manufactured as a single piece and whose outer surface is structured for anchorage in the jawbone. The dental implant has an internal threaded sleeve into which a superstructure can be attached by means of a screw. Furthermore, the implant is provided at its occlusal end with a conical anchoring area for receiving a prefabricated conical cap.

[0007] From US 2004 / 029075 A1, a one-piece implant made of a ceramic material is known, which has a conical section on its upper side, which is provided with an internal thread into which a cemented screw is inserted to fix a dental prosthesis on a cushioning material, or onto which a dental prosthesis is directly attached with cement without a screw.

[0008] DE 10 2018 120 901 A1 shows an implant which may be made of zirconium oxide and on which a superstructure is held by means of a screw.

[0009] US 2010 / 009316 A1 shows an implant which may be made of a ceramic material and which has a conical rim at the gingival junction at its upper end.

[0010] US 2013 / 0273500 A1 also shows an implant made of a ceramic material.

[0011] Based on this state of the art, the inventor has now set himself the task of creating a dental prosthetic arrangement with at least one all-ceramic dental implant that enables secure cementless attachment of a superstructure, particularly without intermediate parts such as abutments or the like.

[0012] This problem is solved by the features of claim 1. Further advantageous embodiments of the invention are the subject of the dependent claims. These can be combined with one another in a technologically meaningful manner. The description, particularly in conjunction with the drawing, further characterizes and specifies the invention.

[0013] According to the invention, a dental prosthetic arrangement is provided comprising at least one all-ceramic dental implant, in particular made of zirconium dioxide, a dental prosthetic abutment, and a screw, wherein the dental prosthetic abutment, which is made of a thermoplastic polymer material, in particular from the group of polyetherketones such as PEEK, can be attached to the dental implant without cement, and wherein the dental implant is formed in one piece, has structural elements suitable for insertion into a jawbone in a region tapering towards the lower end, and has a frustoconical outer cone on its upper surface, which adjoins directly at the tapering region and which is provided with an internal thread extending from its top surface and at least partially penetrating the outer cone.to create a detachable fastening of a dental prosthesis to an internal cone corresponding to the external cone by means of a screw inserted into the internal thread.

[0014] Accordingly, a prosthetic dental arrangement is created using an all-ceramic dental implant. In addition to the well-known aesthetic advantages, particularly evident in the anterior region, this also ensures the long-term health of the soft tissue. This is because all-ceramic implants, especially those made of zirconium dioxide, exhibit high biocompatibility, thus largely preventing peri-implantitis with this type of implant. Furthermore, the one-piece design eliminates any gap in the subgingival area, preventing the infiltration of bacteria into the soft tissue and vice versa.Due to the one-piece design of the all-ceramic dental implant, greater stability and a reduced risk of fracture are achieved, as thicker walls are possible, particularly compared to a two-piece implant. Furthermore, the elimination of an abutment also results in cost savings. A detachable connection to a prosthetic restoration is created by means of the external cone located on the upper surface and the internal thread extending from the capping surface. The prosthetic restoration (often also called superstructure or suprastructure) can be a crown, a bridge, or a complete denture. The dental implant according to the invention is suitable for immediate loading, as the prosthetic restoration (suprastructure) is attached by means of screws.If immediate loading is not desired or possible, the dental implant according to the invention protrudes only minimally into the oral cavity, resulting in lower stress, as less force is transmitted to the jawbone during chewing or with the tongue or cheek during the healing phase. Likewise, the dental implant according to the invention requires no bonding or cementation, which significantly simplifies further treatment, particularly during the transition from a temporary to a permanent restoration. This prevents inflammation caused by excess cement into the peri-implant soft tissue, thus preventing cementitis and the potential for peri-implantitis and ultimately implant loss.

[0015] According to one embodiment of the invention, the internal thread is designed as a round thread. The transition between the top surface and the thread pitch of the internal thread can be rounded.

[0016] This approach avoids potential microcracks during the occlusal screw fixation of the prosthetic restoration, as it prevents abrupt changes in force transmission. For secure retention, the internal thread can be designed to allow tightening torques of up to 20 Ncm. Typically, the internal thread has a diameter of approximately 2 mm, ensuring stable fixation of the prosthetic restoration. Additional bonding or cementation is unnecessary, which facilitates removal and reattachment for follow-up examinations or repairs. This is not possible with permanently cemented superstructures.

[0017] According to a further embodiment of the invention, the outer cone is provided with a rotational restraint on its outer surface, wherein the rotational restraint can be formed with at least one flank in the outer surface. One or more flanks can be arranged substantially parallel to a longitudinal axis running between the upper surface and the lower end.

[0018] Accordingly, anti-rotation is achieved by a lateral flattening on the outer cone, creating a flank with a flat surface that breaks the frustoconical outer contour of the outer cone. It is also possible to incorporate several such flanks. Anti-rotation is particularly advantageous for single-tooth restorations using a single crown. These flanks can also be used to screw in the implant.

[0019] According to a further embodiment of the invention, the all-ceramic dental implant is shaped in such a way that a transition between the implant and the dental prosthetic structure lies at least partially above a gum area.

[0020] Accordingly, the transition between the dental implant and the prosthetic abutment is not located within the gingival area, so that, due to the paramarginal design, bacterial colonization through infiltration into the peri-implant soft tissue is not possible. Ideally, the transition between the dental implant and the prosthetic abutment would run precisely along the gingival margin. However, since this margin is typically not completely flat, in practice the majority of the transition often lies above the gingival margin, with some sections only slightly below it. This is described in the context of the invention by the term "at least partially above".

[0021] According to a further embodiment of the invention, the outer cone is formed rotationally symmetrical about the longitudinal axis. The outer cone can be shaped in such a way that axial divergences of up to 40° can be compensated for.

[0022] Axial divergences of up to approximately 40° can be compensated for with an abutment geometry where the outer cone has an angle of up to 20°. Therefore, it is possible to compensate for such divergences even with multiple implants, allowing a bridge or prosthesis to be restored with a common insertion path. Previously known one-piece zirconia implants were severely limited in their applications in this respect, as the small cone angles, often only 4° to 8°, precluded a common insertion path. Consequently, the zirconia implants known from the prior art were ground down, which, however, is associated with material weakening and an increased occurrence of microcracks in all-ceramic zirconia dental implants. Furthermore, good retention of cemented superstructures cannot be achieved on heavily ground abutments, which again leads to difficulties, particularly during cement removal.Compared to individually milled abutments in two-piece implant systems, the connection geometry according to the invention offers particularly cost-effective implementation. Two-piece implant systems can only compensate for minimal axial divergences, as they have an internal connection geometry that geometrically allows only limited compensation.

[0023] According to a further embodiment of the invention, the outer cone is formed at an angle to the longitudinal axis.

[0024] Alternatively, an angled design of the outer cone can also be chosen in the invention, so that the prosthetic alignment of the dental implants according to the invention can be adjusted in different ways by matching the implant axis to the given bone anatomy.

[0025] Furthermore, a dental prosthetic arrangement with at least one implant as described above is created, in which the dental prosthetic structure is a crown or a bridge.

[0026] The dental implant according to the invention proves particularly advantageous in combination with a prosthetic restoration, thus creating a prosthetic arrangement that can be, for example, a crown, a bridge, or a complete denture. Dental implants according to the invention can be placed at one or more positions in the jaw. A previously completed provisional prosthetic restoration (superstructure) can be screwed onto the implant after the surgical procedure, without the need for bonding, passivation, or similar processes. Since dental implants made of zirconium dioxide have a less active surface, utilizing all of the remaining bone in the jaw is necessary to achieve primary stability.The occlusal screw connection creates a removable dental prosthesis, which patients typically prefer to a removable partial denture as a temporary replacement. The implants according to the invention can also be used for large implant restorations, for example, in the form of screw-retained Toronto bridges. The screw connection of the superstructure primarily splints the implants to one another. This distributes the masticatory forces and protects against overloading in cases of differing primary stability of the implants after immediate loading. This also makes it possible to immediately restore implants that are not primarily stable in conjunction with other stable implants.

[0027] According to the invention, the dental prosthesis is made of a thermoplastic polymer material, in particular from the group of polyetherketones such as PEEK. The dental prosthesis can be sealed by means of an internal cone via the screw on the external cone of the implant.

[0028] A superstructure made of thermoplastic material can be screwed directly onto the dental implant. No intermediate abutments or other components are required, which contributes to cost reduction. In addition to the sealing effect of the external cone of the dental implant against the internal cone of the prosthetic restoration, the minimal deformation of the thermoplastic material during screwing creates a clamping effect, which also protects against loosening of the occlusal screws.

[0029] According to a further embodiment of the invention, the screw has a round thread. The screw can be constructed without metallic components, in particular from a carbon fiber material.

[0030] Both metal screws and carbon fiber screws can be used if a completely metal-free solution is desired. The round thread on the screw and the correspondingly rounded transitions on the screw shank allow for fastening without the risk of microcracks.

[0031] Furthermore, the use of at least one implant as described above, together with a surgical guide, is described. This proves advantageous for the immediate loading of a patient. However, its use with the surgical guide can also be employed for testing or practice purposes, or in treatment planning.

[0032] Here, a fully navigated and template-guided treatment is performed, in which the statically navigated preparation of the implant site in the bone and the insertion of the implant through the guide sleeves of the surgical template to a defined height are carried out. This makes it possible to place one or more dental implants according to the invention without extensive flap elevation of the soft tissue, since their position has already been planned in the surgical surgical template. In many cases, the implants can then be placed using the so-called flapless technique, in which only a small gingival opening needs to be created by punching or microincision, thus significantly preserving the soft tissue. Complete elevation of the gingiva from the bone is no longer necessary. The prosthetic alignment of the implants can be taken into account in the planning software during the planning phase.

[0033] Some exemplary embodiments are explained in more detail below with reference to the drawing. The drawing shows: Figure 1 is a perspective side view of a first embodiment of an all-ceramic dental implant according to the invention; Figure 2 is a sectional view of the embodiment according to the invention. Figure 1 Figure 3 shows a sectional view of a dental prosthetic arrangement with the all-ceramic dental implant according to Figure 1 , and Figure 4 a perspective side view of a second embodiment of an all-ceramic dental implant according to the invention with an angled abutment cone.

[0034] In the figures, identical or functionally equivalent components are provided with the same reference symbols.

[0035] In Figure 1Figure 1 shows a perspective side view of an all-ceramic dental implant 2 according to a first embodiment of the invention. The all-ceramic dental implant 2 is made entirely of a ceramic material, in particular zirconium dioxide. The dental implant 2 tapers towards its lower end 4 and has 6 structural elements 10 in this tapered area, which allow the implant 2 to be inserted into a patient's jawbone. The structural elements 10 can be formed in a known manner in the form of a screw thread. Above the structural elements 10, an area with a helical microthread 12 can be provided. On the upper surface 14, the dental implant is provided with a frustoconical outer cone 16, which adjoins the tapered area 6.

[0036] The dental implant 2 is provided with an internal thread 20 on the top surface 18 of the outer cone 16, which engages in the interior of the outer cone 16. The outer cone 16 can have a rotational restraint 24 on its outer surface 22, for example, in the form of a flank 26 that cuts into the outer surface 22 of the outer cone 16. The flank 26 can be arranged parallel to a longitudinal axis 28. Furthermore, it is possible to provide additional rotational restraints at other positions on the outer surface 22, for example, opposite the existing one.

[0037] The outer surface 22 of the outer cone 16 has a smooth surface; therefore, no grooves, depressions, or projections are provided on the outer surface 22. The rotational restraint 24 in the form of the flank 26 is enclosed by the outer surface 22 of the outer cone 16.

[0038] With reference to Figure 2 Is the dental implant 2 made of Figure 1The diagram is shown again in a sectional view along the longitudinal axis 28. It can be seen that the internal thread 20 is designed as a round thread and that the area between the top surface 14 and the thread of the internal thread 20 is rounded as a radius 30 in order to minimize the risk of microcracking during the attachment of a dental prosthetic restoration.

[0039] With reference to Figure 3 Is the dental implant made of Figure 2shown together with a dental prosthetic assembly 32. The dental prosthetic assembly 32 comprises, in addition to the dental implant 2, a dental prosthetic abutment 34, which in this example is designed as a dental crown and can be made, for example, of a thermoplastic material such as PEEK. An internal cone 36 on the dental prosthetic abutment 34, corresponding to the external cone 16, is separated from an occlusal screw channel 38 by a bridge 40. A screw 42 can be inserted into the occlusal screw channel 38, and its shank 44 can engage in the internal thread 20. The screw 42 can be made of metal or carbon fiber. The shank 44 can also have a round thread.

[0040] After the dental prosthesis 34 is attached to the implant 2 by means of the screw 42, the transition 46 between the dental prosthesis 34 and the implant 2 is located approximately at the position of the dashed line in Figure 3 with the same reference numeral 46. The dimensions of the dental implant 2 are chosen such that the transition 46 lies just above a gum area or in sections above a gum area.

[0041] In Figure 3A dental prosthetic abutment 34 in the form of a single-tooth restoration using a dental crown was explained in more detail. It goes without saying that the concept according to the invention can also be extended to a bridge. However, the anti-rotation feature 24 is advantageous when restoring a single tooth. The corresponding design of the inner cone 36 and outer cone 16 results in a seal between the dental prosthetic abutment 34 and the implant 2, which is further improved by the compressibility of the thermoplastic material. In addition to the sealing effect of the outer cone 16 of the dental implant 2 against the inner cone 36 of the dental prosthetic abutment 34, the minimal deformation of the thermoplastic material during screwing creates a clamping effect, which also protects against loosening of the screw 42 used for occlusal screw retention.The smooth surface of the casing 22 improves the sealing effect between the outer cone 16 of the dental implant 2 and the inner cone 36 of the prosthetic abutment 34, or even makes it possible in the first place compared to designs with one or more grooves. Therefore, no sealing material in the form of an intermediate layer or even cement needs to be introduced between the outer cone 16 of the dental implant 2 and the inner cone 36 of the prosthetic abutment 34; the prosthetic abutment 34 sits directly on the outer cone 16 of the dental implant 2.

[0042] In the embodiments shown so far according to Figures 1 to 3 The outer cone is rotationally symmetrical to the longitudinal axis 28. Due to the cone angle of up to 20°, axial divergences of up to 40° can be compensated, so that a common insertion direction for a bridge or prosthesis can still be created in a multi-part structure.

[0043] However, if an angled design is necessary in certain applications, the outer cone 16 can also be inclined with respect to its axis of symmetry 48 relative to the longitudinal axis 28, as shown in Figure 4 The dental implant 2 is shown. Figure 4 It also features an optional rotational locking device 24, while otherwise, apart from the angulation, there are no differences compared to previous embodiments. The internal thread 20 is aligned along the axis of symmetry 48. List of reference symbols:

[0044] 2 Dental implant 4 Lower end 6 Area 10 Structural elements 12 Helical microthread 14 Top surface 16 External cone 18 Cover surface 20 Internal thread 22 Casing surface 24 Rotational restraint 26 Flank 28 Longitudinal axis 30 Rounding 32 Prosthetic arrangement 34 Prosthetic superstructure 36 Internal cone 38 Screw channel 40 Bar 42 Screw 44 Screw shaft 46 Transition 48 Axis of symmetry

Claims

1. Dental prosthetic arrangement (32) comprising at least one all-ceramic dental implant (2), in particular made of zirconium dioxide, a dental prosthetic structure (34), and a screw (42), wherein the dental prosthetic structure (34), which is made of a thermoplastic plastics material, in particular from the group of polyetherketones such as PEEK, is attached to the dental implant without cement, and wherein the dental implant (2) is formed in one piece, and has, in a region (6) which tapers toward the lower end (4), structural elements (10) suitable for insertion into a jawbone and, on its upper side (14), a frustoconical external cone (16) which connects directly to the tapered region (6) and which, starting from its top surface (18), is provided with an internal thread (20) which at least partially penetrates the external cone (16) in order to create a releasable attachment of the dental prosthetic structure (34) on an inner cone (36) corresponding to the outer cone (16) by means of the screw (42) inserted into the internal thread (20).

2. Dental prosthetic arrangement (32) according to claim 1, wherein the internal thread (20) is designed as a round thread.

3. Dental prosthetic arrangement (32) according to claim 1 or 2, wherein a transition between the upper side (14) and a thread of the internal thread (20) is designed with a rounding (30).

4. Dental prosthetic arrangement (32) according to any of claims 1 to 4, wherein the outer cone (16) is provided with a rotational restraint (24) on its outer side (22), which restraint is preferably formed having at least one flank (26) in the outer side (22), wherein the flank(s) (26) are arranged substantially parallel to a longitudinal axis (28) extending between the upper side (14) and the lower end (4).

5. Dental prosthetic arrangement (32) according to any of claims 1 to 4, wherein a coiled microthread (12) is formed in the tapered region (6), between the structural elements (10) and the outer cone (16).

6. Dental prosthetic arrangement (32) according to any of claims 1 to 5, wherein the outer cone (16) is formed rotationally symmetrically to the longitudinal axis (28).

7. Dental prosthetic arrangement (32) according to claim 6, wherein the outer cone (16) is shaped such that axial divergences of up to 40° can be compensated for.

8. Dental prosthetic arrangement (32) according to any of claims 1 to 5, wherein the outer cone (16) is formed at an angle to the longitudinal axis (28).

9. Dental prosthetic arrangement (32) according to any of claims 1 to 8, wherein the dental prosthetic structure (34) is a crown or a bridge.

10. Dental prosthetic arrangement (32) according to claim 9, wherein the dental prosthetic structure (34) is provided with an inner cone (36) which is sealed on the outer cone (16) of the implant (2) by means of the screw (42).

11. Dental prosthetic arrangement (32) according to claim 9, wherein the dental prosthetic structure (34) sits with its inner cone (36) directly on the outer cone (16) of the implant (2).

12. Dental prosthetic arrangement (32) according to any of claims 9 to 11, wherein the screw (42) has a round thread.

13. Dental prosthetic arrangement (32) according to any of claims 9 to 11, wherein the screw (42) is constructed without metal components, in particular from a material made of carbon fiber.