Surgical guide for dental implant placement
The surgical guide addresses the challenge of tooth loss by using a base, gutter, and drilling guide system to maintain accurate implant placement by memorizing pre-surgery anatomy, ensuring precise drilling and implant installation post-tooth extraction.
Patent Information
- Application Number
- FR2022012115
- Authority / Receiving Office
- FR · FR
- Patent Type
- Patents
- Current Assignee / Owner
- Filing Date
- 2022-11-21
- Publication Date
- 2025-04-18
- Estimated Expiration
- 2042-11-21
AI Technical Summary
Existing surgical guides for dental implants struggle to maintain accurate positioning during and after significant or complete tooth loss, as they rely on anatomical elements that disappear during surgery, such as teeth, and external anatomical references are cumbersome.
A surgical guide comprising a base fixed to the maxillary or mandibular bone, a gutter fixed to the base for initial positioning, and a drilling guide with removable sockets, all made of biocompatible materials, allowing precise implant placement by memorizing the pre-surgery anatomical repository.
Ensures accurate and stable implant placement by maintaining the guide's reference to the pre-surgery anatomy, enabling precise drilling and implant installation even after tooth extraction.
Smart Images
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Abstract
Description
Title of the invention: Surgical guide for the placement of dental implants Technical field
[0001] The invention relates to a surgical guide for the placement of dental implants. Prior art
[0002] It is known to use a surgical guide for the placement of dental implants. Such a guide has the function of guiding the practitioner, in particular when drilling the maxillary or mandibular bone, in order to place one or more implants.
[0003] To ensure its function, such a guide must be positioned relative to an anatomical reference frame.
[0004] For this purpose, such a guide relies on the remaining anatomical elements, typically the remaining teeth. This is not possible in the case of significant or complete toothlessness.
[0005] Also, such a guide can be based on anatomical elements outside the mouth, such as the facial bones. However, such an approach is very bulky.
[0006] The invention addresses the particular case of significant or complete toothlessness produced during or after surgery. In such a case, teeth initially present could constitute supports of an anatomical reference for a surgical guide for the placement of dental implants, however these supports disappear during surgery. Summary of the invention
[0007] Also, the guide according to the invention proposes to memorize the anatomical reference from the elements initially present.
[0008] For this purpose, the invention relates to a surgical guide for the placement of dental implants, comprising a base capable of being fixed to the maxillary or mandibular bone, a gutter capable of being fixed to the base and of being positioned in space relative to the tooth reference or anatomy remaining in the mouth, and a drilling guide capable of being fixed to the base and comprising at least one bore for guiding a drill.
[0009] Particular characteristics or embodiments, usable alone or in combination, are: - the base is fixed to the bone by means of screws and / or pins, - the base is substantially rigid and rests generously on the mucous membranes, - the drilling guide includes, for each bore, a removable and clip-on sleeve, - the guide also includes a prosthesis capable of being fixed on the base and having a hole at the right of each bore, - a hole has a diameter one clearance greater than the diameter of an abutment, capable of being fixed to an implant by one end and to the prosthesis by the other end, - the gutter is fixed to the base by means of screws, the drilling guide is fixed to the base by means of screws and the prosthesis is fixed to the base by means of screws, - the gutter, the drilling guide and the prosthesis are fixed alternately to the base, one at a time, substantially in place of each other and have a substantially identical fixing interface, capable of being fixed to a single interface of the base, - the base is made of titanium, chrome-cobalt alloy or class I or IIa biocompatible resin, the gutter is made of class I biocompatible resin, the drilling guide is made of titanium, chrome-cobalt alloy or class I or IIa biocompatible resin and the prosthesis is made of class IIa biocompatible resin.
[0010] According to a second aspect of the invention, a method of installing such a guide comprising the following steps: - assembly of the base and the gutter, - placement in the mouth of the assembly, the gutter ensuring the positioning in relation to the tooth reference or anatomy remaining in the mouth, of the assembly and therefore of the base.
[0011] Particular characteristics or embodiments, usable alone or in combination, are: - the method also includes the following steps: - fixing the base to the bone, - removing the gutter, - possible extraction of the teeth, - fixing the drilling guide to the base, - drilling the bone, - placing the implants in the bone, - removing the drilling guide, - fixing the prosthesis to the base, - placing the pillars in the implants, preferably by screwing, - fixing the prosthesis to the pillars, preferably by gluing. Brief description of the drawings
[0012] The invention will be better understood on reading the following description, given solely by way of example, and with reference to the appended figures in which:
[0013] [Fig-1] shows, in perspective view, a base,
[0014] [Fig.2] shows, in perspective view, a gutter,
[0015] [Fig.3] shows, in bottom view, the gutter of [Fig.2],
[0016] [Fig.4] shows, in perspective view, a drilling guide,
[0017] [Fig.5] shows, in perspective view, a drilling sleeve,
[0018] [Fig.6] shows, in perspective view, a prosthesis,
[0019] [Fig.7] shows, in top view, the prosthesis of [Fig.6],
[0020] [Fig.8] shows, in perspective view, the assembly of the gutter on the base,
[0021] [Fig.9] shows, in perspective view, the mounting of the drilling guide on the base,
[0022] [Fig. 10] shows, in perspective view, the mounting of the prosthesis on the base. Description of the embodiments
[0023] With reference to Figures 1-7, the invention relates to a surgical guide 1 for the placement of dental implants.
[0024] It goes without saying that, in the present, all the elements described are made to measure according to the particular measurements of the patient and his anatomical and pathological condition.
[0025] The guide 1 comprises a base 2, a gutter 3, a drilling guide 4, and possibly a prosthesis 7, components which are generically called stages.
[0026] The base 2, more particularly illustrated in [Fig. 1], substantially matches the shape of a maxilla or a mandible. It is widely openworked, with a day 11, along the maxillary or mandibular crest, in order to allow teeth still present at the start of the operation or implants to be installed during the operation to pass through.
[0027] The base 2 is capable of being fixed to the maxillary or mandibular bone, typically by means of a first fixing set 9 and screws and / or pins.
[0028] The base 2 is intended to serve as a foundation for the surgical guide 1 throughout the duration of the operation. The base 2 is also intended to remain in place on the patient's jaw. It is therefore appropriate that the base 2 be correctly positioned relative to an anatomical reference frame.
[0029] The positioning relative to an anatomical reference is due to the gutter 3. The gutter 3 is more particularly illustrated in figures 2 and 3. For this, the gutter 3 is able to be fixed to the base 2. This is typically achieved by means of a second set of fixings 10, declined 10a for the base 2, 10b for the gutter 3, 10c for the drilling guide 4 and 10d for the prosthesis 7.
[0030] The gutter 3 is still able to be positioned in space relative to the tooth or anatomy reference frame remaining in the mouth. For this purpose, the gutter 3 comprises at least one reverse molding 14 of the elements remaining in the mouth. These elements remaining in the mouth may be teeth of the treated jaw, teeth of the opposite jaw, or any other element present in the mouth. Advantageously, as illustrated in Figures 2, 3, the gutter 3 comprises at least one reverse molding 14 of teeth intended to be extracted to be replaced by the implant prosthesis.
[0031] As detailed further in the method for placing the surgical guide 1, the gutter 3 is used, assembled with the base 2, at the start of the operation, when the anatomical elements destined to disappear, such as the teeth to be extracted, are still present, to position the gutter 3 relative to these impermanent anatomical elements and thus correctly position the base 2 in a reference frame. anatomical. The base 2 thus positioned by the gutter 3, to which it is assembled by means of the second sets of respective fixings 10a and 10b, is then fixed to the treated maxillary or mandibular bone, by means of the first set of fixings 9. This bone fixing thus makes it possible to memorize the anatomical reference. The function of the gutter 3 is then completed. It can be removed and stored.
[0032] The removed gutter 3 can leave room for a drilling guide 4. The drilling guide 4, more particularly illustrated in [Fig. 4], is capable of being fixed to the base 2 by means of the second sets of respective fixings 10a and 10c. The drilling guide 4 is mounted substantially in place of the gutter 3. The drilling guide 4 is thus positioned relative to the base 2 and thus relative to the anatomical reference frame. The practitioner is thus sure to drill and place the implants in the right place and along the right axis. The drilling guide 4 comprises at least one bore 5. A bore 5 allows the guidance of a drill for drilling the bone underlying the base 2 and the placement of an implant. Also, the drilling guide 4 comprises as many bores 5 as there are implants to be placed.
[0033] It has been seen that the base 2 is capable of being fixed to the maxillary or mandibular bone. This is achieved by means of the first set of fixing means 9. These fixing means 9 are each designed to accommodate a screw or a pin. A screw is a surgical screw capable of being screwed into a bone. A pin is a surgical nail capable of being driven into a bone. According to another characteristic, the base 2 is thus fixed to the bone by means of screws, pins or a mixture of screws and pins.
[0034] Advantageously, the base 2 is fixed to the bone by at least three points / fixing means / screws or pins. Once thus fixed, the base 2 serves as a reference for the different stages of the guide 1 successively mounted: the drilling guide 4 and the prosthesis 7.
[0035] In order to correctly ensure its reference function, taking up the anatomical reference, the base 2 is preferably rigid. Thus, the base 2 has a design close to a chassis.
[0036] In addition, it rests in addition to the bone fixation points, as soon as possible, and as generously as possible, on the mucous membranes, in order to create a solid base for the successive stages 4, 7 of the guide 1. The central part 13, i.e. the entire V arranged on the internal face of the jaw, is more particularly intended to provide lingual or palatal support.
[0037] Furthermore, as far as possible the base 2 advantageously rests on teeth, to the extent that these remain. An example of such dental supports 12 is visible in [Fig.l].
[0038] It has been seen that the gutter 3 is assembled to the base 2. This is achieved by means of the fixing means 10a for the base and 10b for the gutter 3. According to another characteristic, in order to ensure a more secure hold of the floors together, the assembly is, at least for some of the fixing means, carried out by screws.
[0039] Thus, the fixing means 10a, 10b, 10c and 10d comprise facing plates capable of coming to bear against a homologous plate arranged facing each other on the other level. The fixing means 10a, 10b, 10c and 10d may be simple supports or may be supports coupled with an assembly element, such as a screw counter-piercing two facing fixing means.
[0040] Similarly, the drilling guide 4 is assembled to the base 2. This is achieved by means of the fixing means 10a for the base and 10c for the drilling guide 4. According to another characteristic, in order to ensure more secure holding of the stages together, the assembly is achieved, at least for some of the fixing means, by screws.
[0041] It has been seen that the drilling guide 4 comprises at least one bore 5 at the position where an implant is to be placed. A bore 5 is intended to guide the drill intended to dig the hole in the treated maxillary or mandibular bone receiving an implant.
[0042] According to another characteristic, the drilling guide 4 comprises, for each bore 5, a sleeve 6, more particularly illustrated in [Fig. 5], removable and clippable, housed in an orifice at the right of the implant. Thus, the bore 5 can be made of material with the drilling guide 4 or in a sleeve 6 in order to make it removable. The use of a sleeve 6 makes it possible to change, at will, the diameter of the bore 5, to locally change the material to, for example, choose a harder one in order to resist the abrasion of the drill or to carry out a local surface treatment.
[0043] The guide 1 as described above comprises a base 2, a gutter 3 and a drilling guide. Such a guide 1 has its use as such for the placement of implants.
[0044] Advantageously, the guide 1 can also comprise a prosthesis 7. Such a prosthesis 7 is more particularly illustrated in figures 6 and 7. This prosthesis 7 is capable of being fixed on the base 2. This is achieved by means of the second sets of respective fixings 10a for the base 2 and 10d for the prosthesis 7. In addition, the prosthesis 7 has a hole 8 at the right of each bore 5 or future implant.
[0045] Each hole 8 allows the passage through the prosthesis 7 of an implant abutment. A pillar (not shown) is a substantially elongated dowel, comprising, at one of its ends, an interface, conventionally screwed, intended to be assembled with an implant, and at the other of its ends, an interface glued or screwed with a prosthesis. Each hole 8 has the dimensions of the maximum section of a pillar in order to allow its passage.
[0046] According to another characteristic, a hole 8 has a diameter identical to the diameter of a pillar, increased by a clearance. This clearance allows, in addition to authorizing the passage of a pillar through the prosthesis 7, to have a slight latitude in positioning the prosthesis 7, allowing, among other things, to absorb any possible dispersion in the positioning of implant pillars, in order to avoid hyperstaticism of the prosthesis 7.
[0047] As can be deduced from the figures and the preceding description, each of the upper stages: the gutter 3, the drilling guide 4 and the prosthesis 7 are fixed alternately to the base 2, one at a time. This fixing is carried out, substantially in place of each other. Also, the base 2 has a single interface. This interface is materialized by the second set of fixing means 10a. The upper stages: the gutter 3, the drilling guide 4 and the prosthesis 7 have a fixing interface that is substantially identical from one stage to the other, complementary to the interface of the base 2. Thus the second set of means 10b of the gutter 3, the second set of means 10c of the drilling guide 4 and the second set of means 10d of the prosthesis 7 are substantially identical to each other: same positions and orientations.
[0048] In terms of materials, the base 2 is preferably made of titanium, chrome-cobalt alloy or class I or IIa biocompatible resin.
[0049] The gutter 3 is preferably made of class I biocompatible resin.
[0050] The drilling guide 4 is preferably made of titanium, chrome-alloy cobalt or biocompatible resin of class I or IIa. This includes any sockets 6.
[0051] The prosthesis 7 is preferably made of class IIa biocompatible resin.
[0052] These creations, substantially unique, due to the tailor-made nature adapted to the patient, are advantageously produced by 3D printing or by machining.
[0053] The invention also relates to a method for installing such a guide 1. This method comprises the following steps. In a first step, the base 2 is assembled with the gutter 3, as illustrated in [Fig.8]. This is achieved by means of the second sets of respective fixing means 10a and 10b. This assembly ensures precise relative positioning. Also, the two stages 2, 3 are in the same frame of reference.
[0054] During a second step, the previous assembly is placed in the mouth. The gutter 3 ensures, during this step, the positioning relative to the tooth reference or anatomy remaining in the mouth of the assembly and therefore of the base 2. This is achieved mainly by means of the tooth molds 14 formed in the gutter 3 and typically corresponding to the teeth intended to be subsequently extracted.
[0055] According to another characteristic, the method further comprises the following steps. During a third step, the base 2 is fixed to the bone. This is done by means of the first set of fasteners 9 and screws and / or pins passing through said fasteners 9.
[0056] Thanks to the gutter 3 which is taken up in relation to the dental reference, the base 2 is correctly placed. After its fixation to the bone, the base 2 serves as a reference for the rest of the operations.
[0057] Also, during a fourth step, the gutter 3 can be removed. A fifth step possibly involves the extraction of the teeth, if teeth need to be extracted. Thanks to day 11, these teeth are accessible through the base 2. In a sixth step, the drilling guide 4 replaces the gutter 3 and is fixed to the base 2, as illustrated in [Fig.9]. This is achieved by means of the second sets of respective fixing means 10a and 10c. This assembly ensures precise relative positioning. Also, the two stages 2, 4 are in the same reference frame. During a seventh step, the bone is drilled, the practitioner using the bores 5 of the drilling guide 4 to guide his drill. An eighth step sees the placement of implants in the bone. Then, in a ninth step, the drilling guide 4 can be removed. In the tenth step, the prosthesis 7 replaces the drilling guide 4 and is fixed to the base 2, as illustrated in [Fig. 10]. This is achieved by means of the second sets of respective fixing means 10a and 10d. This assembly ensures precise relative positioning. Also, the two stages 2, 7 are in the same frame of reference.
[0058] The eleventh step involves the installation of the pillars and their assembly with the implants. This is preferably done by screwing. The twelfth step involves fixing the prosthesis 7 to the pillars, preferably by gluing.
[0059] The prosthesis 7 is then securely fixed to the implants and to the base 2. The base 2 remains in place on the patient and can advantageously be at least partially concealed under the gum.
[0060] The invention has been illustrated and described in detail in the drawings and the preceding description. This should be considered as illustrative and given by way of example and not as limiting the invention to this description alone. Numerous alternative embodiments are possible. List of reference signs
[0061] 1: surgical guide, 2: base, 3: gutter, 4: drilling guide, 5: bore, 6: socket, 7: prosthesis, 8: hole, 9: first set of fixings, 10a: second set of base fixings, 10b: second set of gutter fixings, 10c: second set of drilling guide fixation, lOd: second set of prosthesis fixation, 11: day, 12: dental support, 13: lingual or palatal support, 14: tooth molding.
Claims
Claims
1. A surgical guide (1) for the placement of dental implants comprising a base (2) capable of being fixed to the maxillary or mandibular bone, a gutter (3) capable of being fixed to the base (2) and of being positioned in space relative to the tooth reference or anatomy remaining in the mouth, and a drilling guide (4) capable of being fixed to the base (2) and comprising at least one bore (5) for guiding a drill, characterized in that the base (2): - is rigid and is made of titanium, chrome-cobalt alloy or biocompatible resin of class I or IIa,; - rests on the mucous membranes by following the shape of a maxilla or a mandible and by having a central part (13) forming a V arranged on the internal face of the jaw and intended to provide lingual or palatal support;and - is widely open, with one day (11), along the maxillary or mandibular crest, in order to allow teeth still present at the start of the operation or implants to be installed during the operation to pass through.;
2. The guide (1) according to the preceding claim, wherein the base (2) is fixed to the bone by means of screws.
3. The guide (1) according to any one of the preceding claims, wherein the drilling guide (4) comprises, for each bore (5), a removable and clippable sleeve (6).
4. The guide (1) according to any one of the preceding claims, further comprising a prosthesis (7) capable of being fixed to the base (2) and having a hole (8) at the right of each bore (5).
5. The guide (1) according to the preceding claim, where a hole (8) has a diameter greater than one clearance than the diameter of a pillar, capable of being fixed to an implant by one end and to the prosthesis (7) by the other end.
6. The guide (1) according to any one of claims 4 or 5, wherein the gutter (3) is fixed to the base (2) by means of screws, the drilling guide (4) is fixed to the base (2) by means of screws and the prosthesis (7) is fixed to the base (2) by means of screws.
7. The guide (1) according to any one of claims 4 to 6, wherein the gutter (3), the drilling guide (4) and the prosthesis (7) are alternately fixed to the base (2), one at a time, substantially in place of each other and have a fixing interface (10b, 10c, lOd) substantially identical, capable of being fixed to an interface (10a) of the base (2).
8. The guide (1) according to any one of claims 4 to 7, wherein the base (2) is made of titanium, chrome-cobalt alloy or class I or IIa biocompatible resin, the gutter (3) is made of class Ia biocompatible resin, the drilling guide (4) is made of titanium, chrome-cobalt alloy or class I or IIa biocompatible resin and the prosthesis (7) is made of class IIa biocompatible resin.