Automated alignment multi-unit abutment system for dental prosthetics

Abstract

Disclosed is a multi-unit abutment for coping and aligning dental implants and screw-mounted prostheses. The multi-unit abutment has a threaded base post for attachment to the implant and ball portion. A one-piece swivel shell surrounds the ball and can be fixed in place without a locking screw. A screw-driver function on the ball allows a tool that penetrates the swivel shell to screw the base post into the implant when the multi-unit assembly is in a linear form. The swivel shell is then positioned and fixed at the desired inclination and azimuth angle. The swivel shell has a mating surface for coping. The multi-unit abutment may be used with full-arch dental prostheses. The multi-unit abutment is capable of passively changing the alignment of the swivel shell relative to the ball in response to natural forces or changes over time.

Description

[Technical Field]

[0001] Cross-reference of related applications This disclosure claims priority to U.S. Provisional Patent Application No. 63 / 509,529, filed on 22 June 2023, which is incorporated herein by reference in its entirety.

[0002] This invention relates to a dental implant system. [Background technology]

[0003] Various systems have been described for attaching dental prostheses to dental implants to replace one or more natural teeth. To simplify future modification or replacement needs, it is desirable to use a mechanical system to provide a reversible attachment between the implant and the prosthesis, rather than directly bonding the implant and the prosthesis. Such systems may include features that allow for both proper alignment and retention for use within the patient's tolerance. Intermediate components such as titanium bases (also called copings) and detachable abutments are often used to ensure proper alignment between the dental prosthesis, one or more implants embedded in the patient's jawbone, the soft tissues, and all remaining natural teeth. These intermediate components may be attached to each other by screws, ball joints, snap-on mounts, cement, or other mechanical means.

[0004] The simplicity of screw-mount systems offers advantages that outweigh the manufacturing cost compared to snap-on systems. The mounting pressure between the coping and abutment is easily controlled by the torque applied to tighten the screw. This axial tension control and auto-alignment characteristic of the engaged threads improves the reliability of the engagement force and relative orientation between components. Even if a screw breaks, techniques are known to remove the fragments without damaging surrounding components. Screws also offer the advantage of independent removal, as each coping can be loosened individually. Tilting the prosthesis after removing a screw to disengage one coping does not likely cause re-engagement of another coping. Potential damage to the prosthesis or implant due to installation and removal stresses, which is present in snap-on systems, is also avoided. Unlike screw-mount systems, snap-on systems do not require access holes for engaging the screw heads of the prosthesis and can absorb minor misalignments between parts through variable compression force. Therefore, both types of systems are expected to be used in the near future. Both systems offer the advantage of optimal alignment between interface components.

[0005] In the case of single-tooth crown mounting, the surfaces of the titanium base and abutment preferably include a function to eliminate rotational symmetry about the azimuth axis when the surfaces of the abutment and coping are mated together. These single-mount systems may also include a rotational locking function. As shown in this disclosure, when the prosthesis includes multiple copings for mounting to multiple abutments, this rotational locking is generally not essential. For example, for achieving perfect alignment, it is sufficient for the mating surfaces to be tapered at 30 degrees to accommodate multiple interface positions. This form is shown in the drawings of this disclosure for convenience, but this is not intended to be limiting. While such symmetry simplifies the modeling of mechanical stresses, many of the inventive concepts disclosed herein are applicable to axially asymmetric systems. These are considered to be part of the scope of the inventive concepts described herein.

[0006] The goal of all prostheses attached to implants is for the prosthesis to passively fit to the implant without causing stress on the prosthesis or on the osseointegration process of the implant. Such stresses can cause problems during initial loading or appear suddenly much later. Poor fit can result in both mechanical and biological problems in single-implant and multi-implant procedures. Mechanical problems may include loosening of prosthesis retaining screws or abutment screws, or breakage of components including screws. Biological problems may include discomfort, progressive marginal bone loss, bacterial infection, accumulation of microbial plaque, and implant loosening.

[0007] For prostheses to function properly and last, it is crucial that they achieve a passive fit from the outset, or that their components can be readjusted or reworked later to adapt to changes. Achieving a passive fit remains challenging due to the accumulation of tolerances, misalignment, and distortion during the fabrication of prostheses. While there are advantages to taking direct impressions, improvements are still needed. The challenges of passive fit are discussed in 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), pp. 16-23, and in Katsoulis et al. (2017), "Misfit of implant prostheses and its impact on clinical outcomes. Definition, assessment and a systematic review of the literature," European Journal of Oral. This is discussed in *European Journal of Oral Implantology*, 10 (Appendix 1), pp. 121-138. While the acceptable amount of misfit for a successful outcome remains uncertain, a gap limit of 10-150 microns has been proposed for mechanical tolerances. To prevent harmful periodontal bacteria from entering, a gap of less than 2 microns would likely be necessary.Although there are no quantitative metrics for passive fit, clinicians agree that efforts should be made to minimize poor fit.

[0008] A growing treatment option for edentulous patients involves placing 4 to 8 implants in the edentulous jaw and mounting a prosthetic arch. Transmucosal abutments are fixed to the implants, intended to remain in place permanently. While it would be desirable for all implant axes to be parallel to each other, due to the underlying bone structure, implants are often positioned at an angle to this ideal orientation. "Multi-unit abutment" is a well-known descriptive term for a specific type of transmucosal abutment used to restore edentulous jaws with a single prosthesis (i.e., a full arch prosthesis).

[0009] Multi-unit abutments (commonly known as "MUAs") are a very simple way to improve the bifurcation angle of an implant, with options for 0-degree, 17-degree, and 30-degree angle corrections. Generally, 0-degree MUAs are easier to position because the abutment is positioned along the linear axis of the implant. 17-degree and 30-degree MUAs typically include a "screw access" indicator, which is difficult to handle in confined spaces such as the posterior jaw due to its relatively long length, and these abutments are usually positioned to compensate for the centrifugal tilt of posterior implants, a technique popularized by Dr. Paolo Maolo in 2004.

[0010] Several alternative abutment designs have been developed for restoring edentulous arches. While most implant companies have settled on the MUA geometry adopted by Nobel Biocare, several attempts have been made to improve upon its shortcomings. For example, Dentsply Implants' Astra EV system uses a "mulTi base" abutment to improve the insufficient coverage of prosthetic screws in multi-unit abutments. Neoss uses a type of MUA that "lowers the abutment" by using a female connector instead of the standard male connector of the MUA. Regardless of the merits of these improved designs, clinicians must order a certain stock for each angle correction and height for each design. One example of the complexity of inventory management is when an implant system offers multiple implant / abutment connections (e.g., narrow platform and standard platform), multiple heights for the MUA (e.g., 1.5 mm, 2.5 mm, 3.5 mm, 4.5 mm, etc.), and various angles or inclination angles (e.g., 0 degrees, 17 degrees, and 30 degrees). To maintain a sufficient stock for immediate loading procedures fixed with full arch implants, the number of options needed would be the number of inclination angle choices (3), the number of platform choices, and the number of reasonable tissue heights multiplied by the number of implants expected to be placed (at least 4 according to Paolo Malo's protocol).

[0011] The resulting inventory formula is as follows: 3 (number of angle options) × 2 (number of platform connections) × 2 (number of different tissue heights) × 4 (number of implants) = 48 (number of multi-unit abutments)

[0012] This inventory problem is exacerbated when multi-unit abutment systems require even more specific implants, titanium bases, and prosthetic fasteners. The complexity of this inventory management is further amplified when practitioners select different vendor systems for different patient situations, or when different practitioners within a single practice select different vendor offerings.

[0013] In addition to the complexity of inventory management, there are limitations such as the discrete nature of "angle corrections" (e.g., being limited to specific angles of 0, 17, and 30 degrees), as well as limitations on the internal connections of the implant around its longitudinal axis, sometimes called the azimuth angle. Often, the possibilities are limited by the internal hex to six azimuth positions, varying by 60 degrees from one position to the next. In some cases, 0 degrees may be too small for tilt angle correction, while 17 degrees may be too large. The same would be true for 17 to 30 degrees. Alternatively, 17 degrees might be the appropriate tilt correction, but due to the limitation of six positions in the internal hex, the required 17-degree correction cannot be applied to the ideal azimuth direction of the required correction. The same is true for 30-degree corrections. Clinicians inexperienced in full-arch implant procedures struggle with the selection and positioning of multi-unit abutments. This prolongs procedure time, which can lead to a worsening of the patient's pathological condition.

[0014] A 2020 paper by Omori et al., "Biological and mechanical complications of angulated abutments connected to fixed dental prostheses: A systematic review with meta-analysis" (Journal of Oral Rehabilitation, 47(1):101-111), found a statistically significant increase in marginal bone loss with angled abutments, but did not claim this was clinically significant. Mechanical problems, particularly screw loosening and other mechanical effects, are found in both angled and straight abutments. It is uncertain whether angled implants are more prone to osseointegration deficiencies than straight abutments, but it is certain that all implants impose higher mechanical stress and strain on bone structures than natural teeth. Natural teeth are 10 times more mobile within a socket than implants embedded in bone. This natural shock absorber helps to buffer the magnitude and direction of forces applied from the bone to the tooth. Screw loosening has been associated with screw joint bending and sag effects (where initial surface micro-roughness keeps the joint parts separated, but raised spots gradually wear down). Micro-gaps due to initial mechanical misfit between elements of a prosthetic superstructure may be too small to be detected by inspection equipment, but may be large enough to concentrate mechanical forces applied from various directions and of varying magnitudes during chewing. Such micro-gaps may be larger than bacteria that can enter and grow within the internal cavities of the entire placed dental prosthetic superstructure.

[0015] Due to the wide range of variables, varying specifications for different applications, and the difficulty of on-site measurement, there is no acceptable passive fit threshold for long-term success. Fit quality may be tested in the dental laboratory using approximations or in a patient-placed state, but this is not a rigorous science. For example, a "one-screw test" for fit involves tightening only one screw at one end of the prosthesis to see if the other end lifts. A variation of this, a "screw resistance test," involves inserting and seating multiple screws in sequence to see if it is necessary to rotate them more than 180 degrees to achieve a torque of (e.g.) 10 N-cm. Failure to meet the prescribed GO / NO-GO test criteria means that the prosthesis needs to be reworked or replaced. Since the same process is used to manufacture replacements, there is uncertainty as to whether these replacements will be properly aligned.

[0016] Consider a case where a screw-mounted dental prosthesis is attached to implants in the patient's jawbone using four multi-unit abutments. Three of these implants are perfectly aligned perpendicular to the jaw plane and use 0-degree multi-unit abutments, but the fourth implant is not oriented perpendicular to the jaw plane. That is, its linear axis is not parallel to the other three linear axes. This is schematically shown in Figure 1. In this figure, four titanium bases (also called "copings") 5 are shown as being incorporated into the prosthesis 68. These are shown as an ideal configuration in which all the linear axes of the titanium bases are parallel to each other and the distal end seating surface 22 of each titanium base is located in a single horizontal plane perpendicular to the linear axis. Three of the implants 16 in the jaw 70 have 0-degree fixed multi-unit abutments 220 for the three corresponding titanium bases, and these multi-unit abutments 220 are located in a common horizontal plane that is perfectly aligned with three of the titanium bases 5. The last implant, 216, has its linear axis offset by an angle a from the orientation of the other implants, but is in the same plane as the corresponding titanium base, and its vertical midpoint is aligned with the other three implants. A 0-degree fixed multi-unit abutment 220 is installed. Let's assume the angle a is 8 degrees. In the case of the fixed-angle multi-unit abutment described above, the practitioner must choose between a 0-degree and a 17-degree fixed-angle abutment, both of which produce a similar angle offset. This angle offset is small enough that the prosthesis 68 can be installed with the coping 5 of the prosthesis 68 engaged with the multi-unit abutment 220. Figure 2 is a cross-sectional view of the angled implant 216, one of the other implants 16, and the corresponding 0-degree multi-unit abutment 220. In this figure, the prosthetic screw 6 is not fully tightened. As shown in the diagram, the seating of the two titanium bases on the multi-unit abutment is angular due to the fact that the longitudinal axes of the two implant abutments are not parallel to the axes of the titanium bases.The gap provided by the aperture 23 on the proximal end of the titanium base 5 allows the prosthetic screw threads to freely engage with the threads of the 0-degree multi-unit abutment. Specifically, in the misaligned system mounted on the left implant 216, the prosthetic screw 6 is positioned so that its threads just begin to engage with the threads of the implant abutment. The misalignment between the titanium base 5 and the abutment 220 may improve as the prosthetic screw 6 is tightened in this example. Specifically, the titanium base 5 responds by pivoting around the contact points at the seating surfaces 22 and 222. The gap between the titanium base 5 and the implant abutment 220 on the implant 216 may decrease, but this comes at the cost of stress due to the misalignment throughout the entire system. Depending on the degree of this angular misalignment, applying further torque to the prosthetic screw may draw the seating surfaces 22 of the two titanium bases 5 into aligned contact with the seating surface 222 of the 0-degree fixed multi-unit abutment. This will depend on the angular displacement, material strength, and flexibility of everything depicted in the diagram.

[0017] In general, as the four prosthetic screws 6 are tightened, any misalignment of the fourth multi-unit abutment attached to the implant 216 inevitably leads to direct mechanical stress on the prosthesis 68 between each of the three aligned multi-unit abutments 220 and the angled implant 216, and, in some cases, to direct mechanical stress on the prosthetic screws 6 and the multi-unit abutments 220. By strengthening the attachment of the titanium base 5 to the implant, these stresses can further spread within the implant and reach the attachment interface between the implant and the jawbone 70. If the angled implant 216 and its associated 0-degree implant abutment 220 were removed, the remaining system consisting of the three aligned and positioned titanium bases and multi-unit implant abutments would be a necessary and sufficient configuration for passively aligning and holding the prosthesis in the desired location on the remaining implant. That is, the relative position of the dental prosthesis to the jawbone would be constrained to be precisely positioned in the desired location at the time of placement. Even if more than three elements in this example are perfectly aligned and positioned relative to each other from the perspective of ideal geometry, positioning can be considered theoretically over-constrained. Of course, in actual installation, as the number of implants increases, the difficulty of ideal alignment increases, and the likelihood of misaligned elements causing stress on each other also increases. As the number of implants with associated angular misalignments increases, these stresses become more complex. This angular misalignment stress, resulting from selecting from a discrete set of fixed-angle abutments, can be reduced by using omnidirectional multi-unit abutments that can be directed and fixed by applying torque to a locking screw at any angle within a certain range, as described, for example, in shared U.S. Patent Application No. 17 / 832,143, filed 3 June 2022, which is incorporated herein by reference as if fully described herein.

[0018] One advantage of snap-on systems is that a compressible liner with reversible retention can absorb minor angular misalignments between implant abutments. A snap-on system typically includes implant abutments and a snap-on coping that includes a rigid cap and a compressible retaining liner or retaining insert. The cap typically includes an external structure that improves the bond with the prosthesis and an internal structure that holds the compressible retaining insert within the cap. The compressible retaining insert generally includes some mechanical shape internally, which engages with the complementary shape of the implant abutment. The compressible retaining insert or retaining liner compresses between the abutment and the cap to achieve a snap-on connection. The geometric and material properties of the liner may be selected to provide varying levels of retention, depending on the degree of angular misalignment between multiple abutments, or the expected frequency or ease of prosthesis removal. More recently, retaining liners with improved retention capabilities, designed to be as permanent as screw-mounted prostheses, have become commercially available. These systems, like screw-mounted prostheses, require a dental professional and specialized tools for installation and removal. Of course, increasing the retention force can increase the risk of damage due to stress imbalances within the prosthesis, which are caused by the fixed position and rigidity of the multi-unit abutment attached to the implant.

[0019] While retaining inserts absorb some degree of misalignment, misalignment of the abutment and the resulting asymmetrical forces can increase stress on the implant abutment attached to the implant, the prosthesis, and / or the patient's bone housing the implant. Therefore, an improved passive fit of the prosthesis to the implant abutment system is equally desirable in these snap-on systems. The stock formula for fixed-angle abutments, as described above, also applies to using angled snap-on abutments to reduce the possibility of damage or difficulty during mounting or removal of the prosthesis. The consumable nature of adding relatively inexpensive retaining liners to the assortment adds a slight further drawback.

[0020] Even if all multi-unit abutments are initially perfectly aligned and fixed to the implant and prosthesis, changes can occur over time. For example, the prosthesis may deform, or the bone structure may change, or, more likely, the fasteners may loosen or break, altering the static stress relationships between anchor points. The latest summary of reported complications is given by Goodacre et al., "Prosthetic complications with implant prostheses (2001-2017)" (European J Oral Implantology, 2018; 11 Supplement 1: S27-S36). In many prior art systems, adjusting the orientation, tightening multi-unit abutment fasteners, replacing components, or, in some cases, fabricating and fitting a new entire prosthesis, requires the complete removal of the prosthesis. The inefficient and repeated trial-and-error fitting process to improve alignment is frustrating for both patients and dental practitioners. Replacing a faulty multiunit abutment among several and correctly aligning the replacement with the existing prosthesis can be significantly more difficult than the initial alignment. For example, a recent paper by Hess et al., "A technique to guide replacement of multiunit abutments supporting an existing implant-supported fixed complete denture" (Journal of Prosthetic Dentistry, September 2020; 124(3): 270-273), describes the difficulty of correctly orientedly replacing one angled multiunit abutment in a system.This process involves fabricating a specialized tool using a final model with an abutment analogue that is attached to an adjacent abutment. It has also been reported that the impression technique used substantially affects the accuracy of the final model, and that the deformable force and resulting distortion increase with the implant angle. See, for example, Elshenawy et al., "Cast accuracy obtained from different impression techniques at different implant angulations (in vitro study)," International J of Implant Dentistry 4,9 (2018), and Lee et al., "Accuracy of five implant impression technique: effect of splinting materials and methods," J Advanced Prosthodontics 2011; 3:177-1785.

[0021] There is a general need for improved passive fit of implant-supported prostheses. There is a need for a way to adjust the orientation of multi-unit abutments while the prosthesis is in place, not only during the initial mounting but also during the repair or readjustment of complications to compensate for errors in prosthesis fabrication. It would be advantageous to have some kind of auto-adjustment function that does not require intervention by a dental professional to remove material to access the screw heads of the prosthesis or to determine what adjustments are needed to improve the passive fit.

[0022] Some commercially available systems require the on-site sequential assembly of elements of a multi-unit abutment while installing the multi-unit abutment in a patient's oral cavity. Some systems require the use of multiple tools, which can also increase the complexity of the procedure and potentially lengthen the treatment time. Materials and methods that eliminate chairside assembly steps or adjustments can enhance clinician efficiency and patient satisfaction.

[0023] To address one or more of the above problems and limitations of currently available multi-unit abutments in the market, embodiments of a novel multi-unit abutment are disclosed herein. Such units are considered to be omni-directional and self-aligning in the sense that they can be positioned over a continuous range of orientations sufficient to correct for angular differences over time in implants typically found in general practice installations and re-alignment shifts to improve passive fit without the intervention of a dental professional. Embodiments of an omni-directional multi-unit abutment are provided that are advantageous in inventory management, installation procedures, angle correction options, and flexibility, improve passive fit, and solve problems related to angle correction limitations or other existing multi-unit abutment systems in the attachment of multiple implant prostheses. SUMMARY OF THE INVENTION MEANS FOR SOLVING THE PROBLEM

[0024] Some embodiments of the present invention include a multi-unit abutment for screw attachment to a dental implant, which enables a titanium base to seat at an angle of rotation and inclination relative to the implant selected by the user. This selected seating orientation is maintained by the multi-unit abutment until the titanium base is coupled to the prosthesis during processing. This feature can correct or reduce misalignment resulting from the accumulation of positioning errors at each step of prosthesis fabrication relative to the initial position of the abutment during installation. After installation, the multi-unit abutment has the function of maintaining or improving a passive fit in response to mechanical stresses transmitted through the prosthesis, thus adapting to mechanical changes. Thus, the final relative orientation of the adjustable abutment can be directly affected by the position of the titanium base within the prosthesis or the position of the implant during the service life of the installation.

[0025] Some embodiments of the present invention include a multi-unit abutment, which is assembled outside the patient's oral cavity, mounted on a screwdriver tool in a linear arrangement for attachment to the implant, and reoriented for processing to interface the abutment portion with a titanium base that is not aligned with the axis of the implant. Thereafter, the titanium base may be attached to the multi-unit abutment with a prosthetic screw.

[0026] Assembling a swivel shell to an abutment base having a ball may be performed at a factory or OEM site, thereby providing a factory preset orientation holding force, whereby the swivel shell is held in a desired orientation relative to the ball, and the preset orientation holding force is provided solely by the ball contact surface with the swivel shell.

[0027] Some embodiments of the present invention include a ball portion and a swivel portion, which are capable of tilting or rotating relative to each other but are constrained not to separate from each other. Some embodiments allow a desired force threshold for changing the orientation of the ball and swivel to be fixed at the time of manufacture. In some embodiments, the installation of the multi-unit abutment to the implant may be performed by passing a screwdriver tool through the aperture of the swivel. In some embodiments of the present invention, this aperture includes threads for a prosthetic screw to attach the titanium base. In some implementations, the swivel includes a function for snap-locking onto the titanium base.

[0028] One embodiment illustrates a system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw. The prosthetic screw has a head and a threaded shaft. The system includes an abutment base having a longitudinal axis, the abutment base having a proximal end including a ball portion and an abutment base screwdriver interface, and a distal end having threads for attachment to the implant. The system also includes a swivel shell having an inner and outer surface. The swivel shell includes a swivel aperture near the distal end and a threaded aperture at the proximal end. These threads are sized to engage with the prosthetic screw shaft. The swivel shell is sized and molded to resist (tilting / rotational) movement of the ball portion below a predetermined torque threshold.

[0029] One embodiment illustrates a method for using an omnidirectional multi-unit abutment, and this method is The steps include inserting the tip of the abutment screwdriver tool through the swivel shell aperture and engaging it with the abutment base screwdriver interface, Steps include applying the abutment base screwdriver tool and the multi-unit abutment assembly to the implant, The abutment base screwdriver tool is used to attach the abutment base to the implant to the first torque, and The steps include: disengaging the abutment base screwdriver tool from the abutment base screwdriver interface, Steps to move the swivel shell to a different direction, The steps include: applying a prosthesis containing a titanium base to the implant abutment system, The steps include: attaching the prosthesis to the implant abutment with a prosthetic screw, Includes.

[0030] Several embodiments demonstrate a system for aligning and attaching dental prostheses to implants using a multi-unit implant abutment, where the multi-unit implant abutment is, Ball and shell assembly This assembly includes, A base including an abutment screwdriver interface for screw attachment to an implant, the base comprising a first end having a ball and a second end having a threaded post having a longitudinal axis, the threaded post being designed to be screwed into a dental implant to a predetermined torque, and the base A shell having an inner and outer surface, the shell having a first end having an aperture and a second end having a threaded portion for a prosthetic screw, wherein the ball is trapped within the shell when the threaded portion of the base post extends through the aperture, A titanium base comprising a proximal end containing an aperture and a distal end containing an interface designed to be mounted on the outer surface of a shell portion at a known location, A screwdriver tool designed to engage with an abutment screwdriver interface, and which can be inserted into the threaded portion of a shell, Includes.

[0031] One embodiment illustrates a method of holding a swivel in place on a ball by rotary swaging, which deforms a portion of a one-piece swivel shell toward a ball, thereby restricting the swivel's movement, increasing the contact area with the ball, and applying a pressure below a predetermined slip torque to the ball from the opposite side.

[0032] One embodiment illustrates a method for fabricating an omnidirectional multi-unit abutment, and this method is: The steps include inserting the ball portion of the abutment base into the swivel shell, The steps include applying axial pressure to the ball to bring the proximal side of the ball into close contact with the inner surface of the swivel shell, The steps include: deforming the wall at the opening of the swivel shell by metal forming (optionally rotary swaging) to capture the swivel shell on the ball portion; Includes.

[0033] This metal forming process (e.g., rotary waging) achieves inelastic deformation of the swivel shell by reducing the aperture at its distal end against the ball. This inelastic deformation of the interface between the swivel shell and the ball generates a static frictional force that maintains the relative orientation of the two parts. This frictional force can only be overcome by a slip torque exceeding a design threshold determined by the material selection, geometry, surface finish, and rotary waging process variables. For example, maintaining a minimal wall thickness at the distal aperture of the swivel shell after reducing the aperture size by rotary waging is useful in maintaining stable reorientation resistance. This also improves the sealing of the swivel shell against the ball in this area when placed in the patient's oral cavity.

[0034] Some embodiments include adjusting the alignment of the abutments relative to the coping as a response to the forces applied by the coping of the prosthesis during placement or removal of the prosthesis. In the case of screw-mounted prostheses, the prosthesis may be manually pressed down onto abutments that are not fully aligned to orient them toward sufficient seating for engagement with the prosthetic screw. Since torque is applied to the prosthetic screw without the use of any tools to hold the multi-unit abutment, fine adjustment of passive alignment is possible. In the case of snap-on systems, it is possible to more easily attach or detach one or more elements by intentionally moving the prosthesis. After all snap connections have been made, the system may be designed so that local compressive forces exceeding a desired threshold on each abutment are naturally redistributed without human intervention.

[0035] Embodiments of the present invention provide a system for aligning and attaching a dental prosthesis to an implant. The system includes an abutment base having a longitudinal axis, a proximal end having a ball with an abutment base screw-driver interface, and a distal end having threads for attachment to an implant. The ball has an equator. The system also includes a swivel shell, which has a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis. The swivel shell further includes an open internal channel extending along the longitudinal axis between the proximal and distal ends. The swivel shell interlocks with the ball and contacts the ball at the ball's equator, or above and below the ball's equator, when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, thereby allowing the swivel shell to tilt and rotate in response to a force greater than a specified force applied to the swivel shell. The swivel shell is configured to press the ball with enough force to maintain the desired tilt angle.

[0036] The swivel shell may have a deformable wall at its distal end, thereby configured to have a first form for assembly onto a ball, the first form deforms into a second form for trapping the ball within the swivel shell, so that the swivel shell contacts the ball above and below the ball's equator when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell.

[0037] The swivel shell may have a single-piece monolithic metal body with all ball contact surfaces. In a second embodiment, the swivel shell may have a minimum wall thickness at its distal end, which ranges from approximately 0.1 mm to approximately 0.25 mm.

[0038] When the specified value is exceeded, the force applied distally to the dental prosthesis, including the dental coping, can generate a force sufficient to change the orientation of the swivel shell relative to the ball, which is then applied to the interface with the swivel shell.

[0039] The swivel shell may be configured to passively tilt and / or rotate relative to the ball when an applied torque of 1 N-cm or more is applied to the swivel shell.

[0040] The inner surface of the swivel shell may define the contact surface with the ball above its equator when the longitudinal axes are aligned, and this contact surface is approximately 3 mm in diameter. 2 ~about 6mm 2 It is within the range, and can be optionally selected as approximately 4mm. 2 ~about 6mm 2 It is within the range.

[0041] The system may further include a prosthetic screw. The open channel of the swivel shell may have threads sized and configured to engage with the prosthetic screw. The prosthetic screw screw engages with the threads of the open channel of the swivel shell.

[0042] The open channel of the swivel shell does not need to have threads.

[0043] The system may further include a snap-on cap, which is sized and configured to engage with the proximal end of a swivel shell for attaching a dental prosthesis to an abutment base. The snap-on cap may be fixed to a titanium base bonded to the inner surface of the dental prosthesis.

[0044] The system may include a snap-on cap, which is sized and configured to engage with the proximal end of the swivel shell. At least a portion of the proximal end of the swivel shell may be inside the snap-on cap.

[0045] The swivel shell may be configured to be used without a locking screw for coupling with the ball. The prosthetic screw may be rotatable within the swivel shell to be tightened to a specified torque and may work in cooperation with the swivel shell so that the swivel shell alone provides a force to hold the ball at a desired angle relative to the ball. The swivel shell may hold the ball with enough force to allow the prosthetic screw to be tightened within the swivel shell when the abutment base is attached to the implant.

[0046] The distal end of the swivel shell may be rotary swaged to form a second form so as to capture the ball while an axial load is applied to the swivel shell with the ball held within the swivel shell, thereby causing the swivel shell to capture the ball by deforming the distal end of the swivel shell.

[0047] The system may further include a titanium base. The titanium base may have a proximal aperture that is larger than the shaft of the prosthetic screw and smaller than the head of the prosthetic screw, and a distal end that may be shaped to seat on a seating surface on the outer surface of the swivel shell.

[0048] The system may further include an orientation tool having an orientation post that extends within an open channel of the swivel shell and engages with the swivel shell using threads within the open channel, which are configured to screw-engage with a prosthetic screw to apply sufficient force / torque to slide the swivel shell in a selected orientation relative to the ball.

[0049] The system may further include an elastic member located between the proximal end of the ball and the distal end of the swivel shell, which promotes slip resistance and / or maintains the seal between the ball and the swivel shell.

[0050] The swivel shell and ball may be sized and configured to enable attachment to implants and dental prostheses without the need for locking screws.

[0051] The open channel of the swivel shell may have threads sized and configured to directly engage with a prosthetic screw, or the open channel of the swivel shell may be threadless.

[0052] The swivel shell may be supplied as a single-piece monolithic metal body, which has a molded inner surface extending around an internal cavity for holding and trapping the ball, and may have contact surfaces that strike the ball above and below the ball's equator when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell.

[0053] The swivel shell and ball are configured to slidably cooperate to allow for passive internal changes in the alignment between the implant and / or dental prosthesis at that location after placement, unless there is direct, intentional manipulation of the swivel shell from the outside.

[0054] Another embodiment of the present invention relates to a dental system for aligning and mounting a full arch dental prosthesis to multiple dental implants. The system includes multiple abutment bases, each having a longitudinal axis, the abutment base having a proximal end containing a ball having an abutment base screwdriver interface, and a distal end having threads for attachment to an implant. The ball has an equator. The system also includes multiple swivel shells, each having a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis. The swivel shell further includes an open channel extending along the longitudinal axis between the proximal and distal ends. The open channel of the swivel shell has threads sized and configured to engage with a prosthetic screw, or the open channel of the swivel shell is threadless. The swivel shell has a single-piece monolithic metal body, which has a molded inner surface extending around an internal cavity that holds and captures the ball, and has contact surfaces that strike the ball above and below its equator when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell. At least some of the swivel shells cooperate to rotate relative to each other and relative to the coupled abutment base, defining the proper alignment of the target implant at installation.

[0055] The system may be configured to allow passive changes in the alignment between the implant and / or full arch dental prosthesis at that location after placement, unless the swivel shell is directly and intentionally manipulated from the outside.

[0056] The swivel shell may have a deformable distal end, which deforms to capture the ball post assembly into the corresponding swivel shell, allowing the factory preset orientation holding force to be set for the desired orientation.

[0057] Another embodiment relates to a system for aligning and attaching a dental prosthesis to a dental implant. The system includes an abutment base having a longitudinal axis, a proximal end having a ball with an abutment base screw-driver interface, and a distal end having threads for attachment to an implant. The ball has an equator. The system also includes a swivel shell, which has a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis. The swivel shell further includes an open internal channel extending along the longitudinal axis between the proximal and distal ends. The swivel shell is configured to capture the ball and prevent it from moving axially relative to the longitudinal axis of the abutment base, and to give a desired tilt orientation in the range of about 0 to about 30 degrees. During assembly, when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, the swivel shell captures the ball as a result of the upper and lower hemisphere forces on the ball caused by contact with the ball above and below the ball's equator, and frictional engagement occurs between them, thereby factory-presetting the minimum orientation holding force of the swivel shell.

[0058] The swivel shell may have a distal end wall segment, which deforms inelastically to contact the ball at that location.

[0059] The distal end wall segment may seal the ball.

[0060] The swivel shell is a single-piece monolithic body that makes full contact with the ball, thereby interfering with the ball and making contact with the ball at the ball's equator, or both above and below the ball's equator, when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, thereby allowing the swivel shell to tilt and rotate in response to a force greater than a specified force applied to the swivel shell, and the swivel shell may be configured to push the ball with a force sufficient to maintain a desired (preset) tilt angle.

[0061] The swivel shell may have a deformable wall at its distal end, so that the deformable wall has a first form for being assembled to a ball, which deforms into a second form for trapping the ball within the swivel shell, and when the longitudinal axis of the swivel shell is aligned with the longitudinal axis of the post, the swivel shell may provide contact forces that strike the ball above and below its equator.

[0062] The swivel shell may have a single-piece monolithic metal body, and in a second embodiment, the swivel shell may have a minimum wall thickness at its distal end, which is at least about 0.1 mm.

[0063] The system may further include a dental coping. The dental coping may be sized and configured to enclose a portion of the swivel shell. The dental coping may have a mounting interface, the mounting interface configured such that its distal end is mounted to a seating surface on the outer surface of the swivel. One or more screwdriver tools can be inserted through the aperture of the dental coping and engage with the abutment screwdriver interface or threads in the open channel of the swivel shell.

[0064] The swivel shell may have a proximal end configured to engage with a snap-on coping, the snap-on coping may include a compressible structure.

[0065] Forces applied distally to a dental prosthesis, including an embedded coping, can generate enough force at the interface with the swivel shell to alter the orientation of the swivel shell relative to the ball.

[0066] The system may further include a coping having a tapered outer surface. A force applied distally may be applied to the tapered outer surface, which applies a force to the swivel shell that changes the orientation of the swivel shell relative to the ball.

[0067] Another embodiment relates to a system for aligning and attaching a dental prosthesis to a dental implant, the system comprising an abutment base having a longitudinal axis, the abutment base comprising a proximal end having a ball having an abutment base screwdriver interface, and a distal end having threads for attachment to an implant. The ball may have or be defined an equator. The system also comprises a swivel shell, the swivel shell having a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis. The swivel shell may also have an open internal channel extending along the longitudinal axis between the proximal and distal ends. The open internal channel has threads sized and configured to engage with the male threads of a prosthetic screw. The swivel shell slidably holds the ball and contacts the ball above and below the equator of the ball when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell. The swivel shell is configured to capture the ball and prevent it from moving axially relative to the longitudinal axis of the abutment base, and to provide a desired tilt angle in the range of approximately 0 to 30 degrees.

[0068] The swivel shell, as a result of the upper and lower hemispherical forces on the ball, captures the ball before assembly, thereby allowing the minimum orientation holding force of the swivel shell to be factory preset, with or without locking screws.

[0069] The swivel shell may have a distal end wall segment, which deforms inelastically to contact the ball at that location and form a seal.

[0070] The distal end wall segment may seal the ball.

[0071] Some embodiments of the present invention include a multi-unit abutment for screw attachment to a dental implant, which allows a titanium base to seat at a user-selected angle of rotation and inclination relative to the implant. This seating orientation may be fixed before the titanium base is bonded to the prosthesis, and in some implementations, it may be adjusted while the titanium base is otherwise held on the abutment. Thus, the final relative orientation of the adjustable abutment can be directly influenced by the fixed position of the titanium base within the prosthesis. This makes it possible to correct or reduce misalignments resulting from the accumulation of positioning errors at each stage of prosthesis fabrication relative to the initial position of the abutment.

[0072] Some embodiments of the present invention include a multi-unit abutment, which is assembled outside the patient's oral cavity and mounted on a screwdriver tool in a linear configuration for attachment to an implant, with the abutment portion being reoriented to interface with the implant axis and an unaligned titanium base. The titanium base may then be attached to the multi-unit abutment with a prosthetic screw.

[0073] Some embodiments of the present invention include a ball portion and a swivel portion, which are capable of tilting or rotating 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 the opposite side of the equator of the ball portion in the absence of a locking screw. Some embodiments maintain pressure on the opposite side of the ball in the absence of a locking screw. In some embodiments, the installation of the multi-unit abutment to the implant may be performed by passing a screwdriver tool through the aperture of the swivel shell.

[0074] While screw-mounted prostheses are preferred, some embodiments of the present invention provide multi-unit abutments with angle adjustment capabilities that use snap-on connections as an alternative to prosthetic screws.

[0075] One embodiment describes a system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw, the prosthetic screw comprising a head and a threaded shaft, the system comprising an abutment base having a longitudinal axis and a proximal end having a ball portion and an abutment base screwdriver interface, and a distal end having threads for attachment to an implant, and a swivel shell having an inner and outer surface. The swivel shell includes a swivel aperture near the distal end and a threaded aperture at the proximal end.

[0076] Embodiments of the present disclosure provide a swivel shell having a portion that is deformable toward a ball (optionally by rotary swaging), which, by deformation, captures the swivel shell, increases the contact area with the ball, and applies pressure from the swivel shell to the ball from both sides of the equator, thereby holding the swivel shell in place. In this case, no locking screws are tightened to restrict axial movement and / or maintain a relative tilt angle.

[0077] One embodiment illustrates a method for manufacturing an omnidirectional multi-unit abutment, which includes the step of inserting the ball portion of the abutment base into the swivel shell, The method includes the steps of applying axial pressure to the ball to bring the proximal side of the ball into close contact with the inner surface of the swivel shell, and deforming the opening of the swivel shell to capture the swivel shell on the ball portion.

[0078] This deformation can be achieved by rotary waging, which reduces the aperture at the distal end of the swivel shell, allowing for inelastic deformation of the swivel shell as it contacts the ball. The interference fit between the swivel shell and the ball provides a static frictional force that maintains the relative orientation of the two parts without tightening the locking screw. This frictional force can be overcome by a slip torque that exceeds a design threshold determined by the variables of material selection, geometry, surface finish, and rotary waging process. For example, maintaining a minimal wall thickness at the distal aperture of the swivel shell after reducing the aperture size by rotary waging is necessary to maintain stable reorientation resistance. This also improves the sealing of the swivel shell to the ball in this area when placed in the patient's oral cavity.

[0079] Several embodiments demonstrate a system for aligning and mounting dental prostheses to implants using a multi-unit implant abutment, the multi-unit implant abutment comprising a ball-and-shell assembly having a base including an abutment screwdriver interface for screwing into the implant. The base has a first end having a ball and a second end having a threaded post having a longitudinal axis. The threaded post is designed to be screwed into the dental implant to a predetermined torque. The ball-and-shell assembly also has a shell portion having an inner and outer surface. The shell portion has a first end having an aperture and a second end having threads for a prosthetic screw. When the threaded portion of the base post extends through the aperture, the ball is trapped within the shell portion by metal forming (optionally rotary swaging) near the aperture of the shell portion. The system also includes a titanium base having an aperture at its proximal end and an interface at its distal end designed to be mounted on the outer surface of a shell portion at a known position, and one or more screwdriver tools designed to engage the abutment screwdriver interface with a prosthetic screw.

[0080] Some embodiments of the present invention illustrate a multi-unit implant abutment system for aligning and mounting dental copings to dental implants, the multi-unit implant abutment comprising a ball-and-shell assembly having a base, the base having a proximal end including a ball portion and an abutment screwdriver interface for rotating the base for screwing onto an implant, and a distal end having a shell having a distal portion including a threaded portion for mating with the threads of the implant and a distal shell aperture. The distal shell aperture is sized and molded around the ball portion of the base to prevent the ball portion from passing through the distal shell aperture. The abutment screwdriver interface is accessible by a screwdriver tool inserted through the shell aperture.

[0081] Some embodiments involve fine-tuning the alignment of the abutments relative to the coping of the prosthesis. In the case of screw-mounted prostheses, the prosthesis is manually pushed down onto the abutments, which are not fully fixed in place, to orient them toward a more passive seating position before inserting the prosthetic screws. In the case of snap-on systems, the prosthesis can be used to reorient the abutments at the coping without compression fixation, which is done using zero-retention machined inserts before mounting with the final retention inserts, or without using any retention inserts applied to the initial alignment. In this case, local compressive forces exceeding a predetermined force threshold for each abutment of the system are naturally redistributed without external / intentional human intervention. That is, after the final coping is snapped into place, the redistributed multi-unit abutment orientation redistributes unbalanced forces exceeding the slip torque.

[0082] For the purposes of this disclosure, “dental prosthesis” is broadly defined as something incorporating multiple dental copings or titanium bases that are mountable to and removable from at least three implant abutments. Various titanium base designs are known in the dental industry, and the systems and methods disclosed herein may be adapted to work with a number of commercially available types of titanium bases, such as pickup copings, temporary cylinders, inserts, and impression copings. Implant abutments with compatible interfaces to these titanium bases are known in the dental industry. Since the mechanical interfaces are identical, for the purposes of this disclosure, implant abutment is considered a general term encompassing abutment analogues. The description of abutment alignment systems and fabrication methods using titanium bases and implants, which are placed in the patient’s jaw, should also be considered to describe equivalent inventive concepts that may be used in a dental laboratory with titanium bases and implant analogues. A common geometry is a conical titanium base seating on a conical implant abutment. While this configuration of the system is used in the following figures and description, the concept of the present invention is applicable to other types of titanium bases and abutments. The concept of the present invention is not limited to titanium bases or copings attached to abutments with prosthetic screws. Each feature may also be applicable to various snap-on systems, including systems that include copings having deformable retaining inserts that are reversibly held in place by compressive forces on multi-unit abutments. While this type will be described, the concept of the present invention can also be adapted to other snap-on systems that do not include discrete retaining inserts. For the purposes of this disclosure, the terms “coping” and “titanium base” are used generally and without distinction to refer to all of these structures used to align and seat prostheses to implant abutments.

[0083] The inventive concepts disclosed herein may be used with various types of dental prostheses. These prostheses may be impressions of any form used in a dental laboratory to assist in the fabrication and testing of dental prostheses. The dental prostheses may also be dental prostheses fabricated in a dental laboratory using a physical model made from an impression, newly fabricated dental prostheses, or existing prostheses modified for screw mounting. Dental prostheses are defined to include any multi-tooth bridge or denture. These prostheses may incorporate a titanium base, which provides a separable interface that gives orientation to a suitable abutment attached to the patient's jaw or gingiva. The multi-unit abutments used by the inventive concepts disclosed herein include threads for mounting a prosthesis having a titanium base onto an abutment and for mounting the abutment onto an implant. While the concept states that a typical male thread within the multi-unit abutment mates with a female thread on the implant, this is for convenience of disclosure. Unless otherwise specified or specifically limited by functional necessity, some inventive concepts may also apply to systems in which female threads within a multi-unit abutment engage with male threads within an implant. These are considered simple variations of the inventive concepts. One advantage of preferring typical female threads on implants for abutment attachment is standardization and implementation flexibility. For the same reason, prosthetic screws with male threads and commercially available titanium bases are also preferred, but this is not necessarily required to obtain any advantage from the inventive concepts of this disclosure. These types of variations are considered to be within the scope of this disclosure.

[0084] The systems and methods disclosed herein may be used with prostheses attached to implants in both the maxilla and mandible. As a result, the portion of the system oriented downward toward the mandible can also be oriented upward toward the maxilla, and vice versa. For convenience, a disclosure of an embodiment of the inventive concept limited to one jaw orientation is considered to disclose an embodiment for the opposite jaw orientation. From the clinician's perspective, the proximal portion is closer to the clinician than the distal portion. Terms such as "supra" are the opposite of the term "bottom," and "proximal" is the opposite of "distal," but their actual relative orientations depend on the context in which they are used. The term "tissue side" is used without distinction from "intaglio" to indicate the opposite side of the occlusal or cameo surface of a prosthesis.

[0085] The systems of the disclosed invention are advantageously applicable to screw-mounted prostheses and abutments. Key advantages of screw-mounted prostheses are their variable torque and reversibility. The terms permanent, semi-permanent, definitive, and final are used interchangeably in this disclosure when referring to screw-mounted prostheses. Conventional screws, even if definitively mounted, can be removed by accessing the screw and turning it in the reverse direction of mounting. For the purposes of screw-mounted prostheses in this disclosure, mounting is semi-permanent, permanent, or definitive in the sense that frequent mounting and removal in normal use is not expected. In contrast, temporary screw mounting is applied within a planned process time or at another anticipated interval. Positioning of the titanium base within a dental prosthesis can be effectively carried out by a lift-off process using a temporary screw, disclosed in the shared U.S. Patent No. 11,311,354, which is incorporated fully herein by reference. However, the usefulness of the inventive concepts of this disclosure does not depend on the use of the systems or methods disclosed in the referenced patents.

[0086] The screw attachment of the abutment to the implant is also described in the embodiments. However, some of the concepts of the present disclosure can be readily adapted to other systems that do not utilize screw attachment of dental components to other elements (e.g., implants including snap-on, magnetic, and even adhesive attachment systems). Less flexible, the implant and abutment may be assembled before placement in the patient, or the function of the abutment may be directly incorporated into the implant. Nevertheless, the benefits of the angle-adjustable concept disclosed with the abutment and implant as separate can be obtained. These modifications are considered obvious variations of the inventive concepts disclosed in the present disclosure.

[0087] The impetus for semi-permanent or definitive removal of screws is generally a problem or the possibility of improvement. Accessing the screws to apply removal tools may require removing material covering the screws, which may have been added for aesthetic reasons. Some embodiments allow for realignment of the orientation of multi-unit abutments when the prosthesis is placed on multi-unit abutments and semi-permanent or definitive screws are in place. This makes it possible to improve the passive fit of the prosthesis to the implant at the time of initial placement or after the system has been used for a long period of time. Implant abutments are generally used initially to position the titanium bases within the prosthesis, but individual alignment errors inevitably accumulate during subsequent machining or over time. The apparatus and methods disclosed herein allow a series of titanium bases within a prosthesis to be aligned with a series of multi-unit abutments without the intervention of a dental professional, thereby improving and maintaining the overall passive fit.

[0088] Each element disclosed herein may be characterized to have an axis or longitudinal axis. In the case of a long cylindrical object such as a pencil, the longitudinal axis obviously passes through the center of the cylinder from the tip of the pencil lead to the eraser end. Traditionally, the longitudinal axis is considered to be along the length or longest dimension of the object, characterized by length, width, and thickness from the largest dimension to the smallest. Considering a threaded bolt instead of a pencil, the axis, and furthermore the longitudinal axis, may be considered to pass through the center from the engaging end of the thread to the center of the bolt head. In this case, the axis of rotation and the longitudinal axis are the same even for a short, thick bolt. In this disclosure, the axis or longitudinal axis of an object having a thread is the same as the axis of rotation of the thread. The width is measured perpendicular to this axis of rotation. Thus, a traditional nut with a female thread is considered to have a longitudinal axis passing through the center of the central aperture (i.e., where the axis of the bolt would be located when the corresponding bolt is engaged). Extending this idea, a threadless washer, which is trapped between a bolt and a nut, can also be considered to have a longitudinal axis, or simply an axis located at the center of the aperture and perpendicular to the plane of the washer. For the purposes of this disclosure, the assembly of components is linear because the axes of each component of the assembly are roughly aligned on the same straight line. Therefore, an assembly including a bolt with a washer and a nut is a linear assembly even if the washer's axis can move around the common axis of the bolt and nut because the washer's aperture is larger than the width of the threaded portion of the bolt. Male threads are generally characterized to have a root diameter measured at the base of the thread and an outer diameter measured at the crest of the thread. Female threads are generally characterized to have an inner diameter measured at the crest and a root diameter measured at the base. Unless otherwise specified, the width of the male threads on the stem of a bolt is specified as the outer diameter or the maximum deviation from the bolt axis (i.e., as measured with calipers). The width of the female threads on a nut is specified as the inner diameter of the female threads or the minimum deviation from the nut axis (i.e., as measured with a pin gauge or plug gauge).

[0089] In this disclosure, several threaded elements that are tightened by relative rotation may have some characteristics that can be considered nut-like, such as elements having both male and female threads, and other characteristics that are thread-like. In this disclosure, the term "screw" is used collectively with respect to these threaded elements when discussing the concepts of the present invention. However, male threads on a screw are considered to be on the male side, and female threads are considered to be on the female side. The phrases "screwing into" and "threading into" are used for male and female parts, respectively. That is, screwing a first piece into a second piece does not require the first piece to have male threads. Unless otherwise explicitly stated, when conventional bolt and nut threads engage in this disclosure, it may generally be described as a conventional bolt being screwed into a conventional nut.

[0090] For the purposes of this disclosure, the term “ball” means a mechanical structure that includes several geometric attributes of a sphere. This is a more general term that allows for cases where only some parts of the ball’s surface are essentially spherical, while other parts may deviate significantly from being spherical. Sphericity is preferred with respect to some degree of flexibility in the orientation of the contact surfaces between the ball and a structure that may be repositioned and locked in place relative to the ball (possibly by swiveling) and to sealing. The term “shell” (used without distinction as “swivel” and “swivel shell”) is something that at least partially surrounds the ball. The contact surfaces between the outer surface of the ball and the inner surface of the shell are preferably spherical segments of approximately the same diameter, which is to increase frictional grip at the start of the locking process or to provide a sealing surface that blocks the inner surface of the assembly from biological contamination. The inclusion of structures or deviations typically smaller in size than the spherical radius may be included to improve sealing or to adjust resistance to movement between the ball and the shell, compared to a smooth spherical mating surface. While it would be preferable to have flexibility in positioning the prosthetic screw and titanium base axis, with no limitation of a maximum angle of 30 degrees relative to the implant axis, and with any rotational angle around either axis, the mating of the implant, ball, shell, or titanium base elements may be designed to limit this omnidirectional angular flexibility. Such restrictive modifications are known in the art and may be used in conjunction with some of the inventive concepts disclosed herein. Structures having a spherical portion in this disclosure are generally characterized by linear axes through their respective threaded interfaces. Similar to the planet Earth, a ball structure may be thought to have a northern and southern hemisphere separated at the center of the ball by an equator perpendicular to the linear axis. In this disclosure, a hemisphere does not need to be an ideal geometric structure that is exactly half of an ideal geometric sphere; a hemisphere may simply mean the smaller portion of a theoretical sphere. In the drawings, the northern or upper hemisphere is roughly shown as the proximal hemisphere, and the southern or lower hemisphere is roughly shown as the distal hemisphere.A shell structure having an inner spherical portion surrounding a ball may be shown to have a proximal and distal hemisphere, similar to how the Earth's atmosphere surrounding the Earth's crust can be divided into a northern hemisphere and a southern hemisphere. The equator of the shell would be located in a plane between the two hemispheres, perpendicular to the shell's longitudinal axis. Some shell structures of this disclosure have an internal space containing a hemispherical hollow compartment, which is merged in the equatorial crust with a cylindrical void of at least the same diameter. This cylindrical void allows this type of shell to be moved axially across the ball portion of the abutment base to bring a portion of the ball's hemisphere into contact with the hemispherical hollow portion of the shell.

[0091] For the purposes of this disclosure, the term “one piece” as applied to a component should be interpreted as having no parts that form a functional shape that is not integrally molded. That is, a one-piece component has no mechanical joints or seams in any part with respect to the specific function that the component is intended to perform, for which being one piece is an advantage. In this disclosure, a one-piece shell provides a one-piece monolithic body having a spherical clamp section and having no seams between parts within the contact areas on both sides of the ball's equator (no seams at all), or forming a continuous seal as the term is used in this disclosure by forming the entire ball contact surface. Therefore, for clarity, the term “one piece” with respect to the shell does not exclude a monolithic structure with additional components that are not essential to the interface characteristics of the spherical clamp interface. A one-piece part may have an interface for joining with another part in a higher-level assembly, but that higher-level assembly will not be a one-piece part when assembled. A one-piece part is a monolithic structure of a single continuous piece of material, but its shape can be changed without modifying the characteristics of that one piece. This disclosure includes a description of a one-piece shell that includes spherical clamping surfaces on both sides of the equator of a ball to form a continuous annular seal on both the spherical surfaces above and below the equator of the ball. The one-piece shell remains a single, continuous piece of material throughout this process, although its shape is inevitably modified to form these interface parts with the ball. The shell remains a single piece, but is also part of a multi-piece assembly having a ball. In contrast, if the shell is formed around a ball by mechanically joining or welding two shell parts, the assembly does not become a one-piece shell with one-piece spherical clamping surfaces on both sides of the equator of a ball to form a continuous annular seal, as the term is used in this disclosure.

[0092] For the purposes of this disclosure, the term “fixing one part in place” means maintaining the relative position of that part in relation to another part in a manner that is sufficiently satisfactory for the purpose. That is, the degree of fixation may vary depending on the resistance to movement required during manufacturing or use. Fixation does not necessarily have to be interpreted as a permanent state of relative position unless it is explicitly shown as being performed by a typically permanent manufacturing process (e.g., welding). For many of the parts in this disclosure, directional fixation is achieved by mechanical force and frictional resistance to movement. A part that was fixed for one step of the process may be reoriented by the application of sufficient force for the next step. The context of the discussion should be considered when interpreting the desired degree of fixation. Furthermore, parts may be constructed in such a way that they do not allow to translate or separate relative to each other unless their relative angular orientations are permanently fixed in place.

[0093] It is common in prosthodontics to fasten threaded elements with a desired torque, or to fasten several elements with a higher or lower torque than some combination of elements. For example, when three elements are screwed in sequentially, it is often preferable to fasten the first two with a high torque so that the attachment or removal of the third element does not affect the attachment of the first two. In some cases, the torque is quantified with a torque wrench, and in other cases, whether the torque is sufficient to perform the desired function is determined by the practitioner's experience. For the purposes of this disclosure, it should be assumed that such torques are predetermined to be assessed either quantitatively or qualitatively. If a quantitative minimum torque value or tolerance is specified as essential, measurement by a tool or by some indicator structure incorporated into the part is required. In some implementations, it may be desirable to prevent excessive torque that could cause structural or biological stress on the implant base or prosthesis through controlled mechanical failure of a sacrificial element. This controlled mechanical failure may be due to both intentionally weakened structures or the characterization of the inherent failure characteristics of uniform structures. In other cases, the practical minimum torque is obtained by limiting the thread length so that relative rotation stops due to the bottoming out of the threads. Various desired or predetermined torque levels may be used quantitatively or qualitatively to achieve various levels of relative orientation fixing between parts. For example, the desired torque may represent any torque in the range between the minimum torque at which the parts do not change orientation due to gravity and the maximum torque that still allows the parts to move relative to a force applied by contact with another part (e.g., a seating force applied to a prosthetic coping in contact with a multi-unit abutment). The actual magnitude of the desired torque is determined by the physical properties and the environment in which it is applied. The desired level of resulting retention or fixing is, of course, derived from the context of why and how that torque is applied.

[0094] For the purposes of this disclosure, "contact surface area" should be interpreted in a macroscopic view unless otherwise specified. An example may be helpful in understanding this term. If a small metal plate is placed on the middle of a much larger plate, the contact surface area of ​​these two elements would, in this specification, simply be the area of ​​the bottom surface of the smaller plate. Naturally, if the contact between these plates is not tight due to small variations in flatness, machining tolerances, or surface roughness, there will be several places where air is trapped between the plates. Some of this air can be removed by applying sufficient pressure with a hydraulic press, but in a macroscopic view, this surface area will not increase. This is how the term is generally interpreted in this disclosure.

[0095] Other terms in the specification and claims of this application should be interpreted as having the commonly accepted ordinary meaning, as applicable in any contextual language in which they are used. The words "a" or "an" are defined herein as one or more. The word "plurality" is defined herein as two or more. The word "another" is defined herein as at least two or more. The words "including" and / or "having" are defined herein as "comprising" (i.e., open language). The term "coupled" is defined herein as connected, but this does not necessarily mean direct connection or mechanical connection. The terms "about" and "essentially" mean ±10 percent. In this specification, phrases such as "between X and Y" and "between about X and Y" should be interpreted as including X and Y. In this specification, phrases such as "between about X and Y" mean "between about X and about Y." In this specification, phrases such as "from about X to Y" mean "from about X to about Y." Throughout this specification, references to "one embodiment," "certain embodiments," and "an embodiment," or similar terms, mean that certain features, structures, or characteristics described in relation to that embodiment are encompassed in at least one embodiment of this specification. Therefore, occurrences of such phrases throughout this specification, or in various places, do not necessarily all refer to the same embodiment. Furthermore, certain features, structures, or characteristics may be combined without limitation in any suitable manner in one or more embodiments.The term "or" in this specification should be interpreted as inclusive, or as meaning any one or any combination. Thus, "A, B, or C" means any of "A," "B," "C," "A and B," "A and C," "B and C," or "A, B, and C." Exceptions to this definition occur only when combinations of elements, functions, steps, or actions are in some way inherently mutually exclusive.

[0096] Each figure shown in the drawings is intended to illustrate a particular convenient embodiment of the present invention and should not be considered a limitation to that embodiment. The term “means” preceding the present participle of an action indicates a desired function represented by one or more embodiments (i.e., one or more methods, devices, or apparatus for achieving the desired function) and refers to a desired means that a person skilled in the art could select from those embodiments or their respective equivalents in light of the disclosure herein; the use of the term “means” is not intended to be limiting. Other objects, features, embodiments, and / or advantages of the present invention will become apparent by reading the following specification in conjunction with the following drawings. [Brief explanation of the drawing]

[0097] [Figure 1] This is a schematic perspective view of the application environment for a prior art dental prosthesis incorporating four aligned titanium bases, and a jawbone with three aligned implants and one misaligned implant. [Figure 2] Figure 1 is a partial side cross-sectional view showing a pair of one aligned titanium-based implant abutment and one misaligned titanium-based implant abutment, including a prior art fixed-angle multi-unit implant abutment. [Figure 3]This is a side cross-sectional view of one embodiment of an automatically adjusting omnidirectional multi-unit abutment according to the inventive concept of the present disclosure. [Figure 4] This is a top exploded isometric view of an automatically adjusting omnidirectional multi-unit abutment assembly for attaching prosthetic screw copings according to an embodiment of the present invention. [Figure 5] Figure 4 is a bottom exploded isometric view of one embodiment of an auto-adjusting omnidirectional multi-unit abutment assembly for the attachment of a prosthetic screw coping, as shown in Figure 4. [Figure 6] Figure 4 is an isometric top view of an automatically adjusting omnidirectional multi-unit abutment assembly for the installation of a prosthetic screw coping. [Figure 7] Figure 4 is a bottom isometric assembly view of an embodiment of an auto-adjusting omnidirectional multi-unit abutment assembly for the attachment of a prosthetic screw coping. [Figure 8A] Figure 4 is a cross-sectional view of the auto-adjusting omnidirectional multi-unit abutment assembly before the formation / assembly of the ball capture. [Figure 8B] Figure 4 is a cross-sectional view of the self-adjusting omnidirectional multi-unit abutment assembly after ball capture formation / assembly. [Figure 9] Figure 8A is a magnified view of the lower part of the self-adjusting omnidirectional multi-unit abutment assembly before assembly. [Figure 10] Figure 8B is a magnified view of the lower part of the self-adjusting omnidirectional multi-unit abutment assembly after the formation / assembly of the ball capture. [Figure 11] Figure 4 is a cross-sectional view of an auto-adjusting omnidirectional multi-unit abutment assembly for prosthetic screw coping attachment according to an embodiment of the present invention, shown in a linear arrangement mounted on an implant screwdriver tool for attachment to an implant. [Figure 12] Figure 11 is a cross-sectional view of an auto-adjusting omnidirectional multi-unit abutment assembly for prosthetic screw coping attachment, showing the assembly with a titanium base attached by prosthetic screws. [Figure 13A] This is the first in a sequence of cross-sectional views showing the reorientation of the swivel in response to the attachment of a prosthesis with an embedded titanium base. [Figure 13B] This is the second in a sequence of cross-sectional views showing the reorientation of the swivel in response to the attachment of a prosthesis with an embedded titanium base. [Figure 13C] This is the third in a sequence of cross-sectional views showing the reorientation of the swivel in response to the attachment of a prosthesis with an embedded titanium base. [Figure 13D] This is the fourth in a sequence of cross-sectional views showing the reorientation of the swivel in response to the attachment of a prosthesis with an embedded titanium base. [Figure 14] This is a cross-sectional view of an auto-adjusting omnidirectional multi-unit abutment assembly for mounting prosthetic screw copings, incorporating a spring washer, according to an embodiment of the present invention. [Figure 15] This is a top exploded isometric view of an example of an automatically adjusting omnidirectional multi-unit abutment using snap-on coping according to an embodiment of the present invention. [Figure 16] Figure 15 shows a top-view equiangled assembly diagram of an auto-adjusting omnidirectional multi-unit abutment using snap-on coping. [Figure 17] Figure 16 shows a bottom isometric assembly diagram of an auto-adjustable omnidirectional multi-unit abutment using snap-on coping. [Figure 18] Figure 16 is a side view of an auto-adjustable omnidirectional multi-unit abutment using snap-on coping. [Figure 18] Figure 17 is a cross-sectional view of an auto-adjustable omnidirectional multi-unit abutment using a snap-on coping, along line AA, passing through the longitudinal axis. [Figure 20] Figure 16 shows a cross-sectional view of the application environment of a typical embodiment of an auto-adjustable omnidirectional multi-unit abutment having a snap-on coping including a prosthesis, coupled to a dental implant, according to an embodiment of the present invention. [Figure 21] This is a cross-sectional view of an azimuth post attached to the swivel shell of an automatically adjusting omnidirectional multi-unit abutment according to an embodiment of the present invention. [Modes for carrying out the invention]

[0098] This disclosure includes several embodiments that demonstrate options for realizing the benefits of an auto-aligning omnidirectional multi-unit abutment. Figure 3 shows an application environment for a first embodiment of the auto-aligning omnidirectional multi-unit abutment 100 ("SA-MUA"). Figure 3 shows an SA-MUA system including at least two SA-MUAs, the orientation of which is substantially the same as that of the fixed 0-degree multi-unit abutment 220 located at the site of the angled implant 216 in Figure 2. During use, the seating surface 22 of the titanium base 5 does not need to be aligned with the seating surface 122 of the auto-aligning omnidirectional multi-unit abutment 100. However, as shown in Figure 3, further tightening of the prosthetic screw 6 applies torque to the auto-aligning omnidirectional multi-unit abutment 100, and the resulting pivoting motion aligns the conical surface 94 with the corresponding taper of the titanium base 5. This angle adjustment is a result of the auto-aligning omnidirectional multi-unit abutment 100 responding to the orientation of the titanium base 5 embedded in the dental prosthesis 68. The structure of the auto-aligning omnidirectional multi-unit abutment 100, which causes pivot and swivel rotations resulting in this controlled response, will be described in detail later. While both fixed and auto-aligning multi-unit abutments can be used, it is preferable to replace all conventional fixed-angle multi-unit abutments with the auto-aligning omnidirectional multi-unit abutment 100. This is because Figures 1 and 2 make the unrealistic assumption that in a perfectly aligned dental prosthesis, all but one multi-unit abutment are perfectly aligned with all titanium bases.

[0099] Figures 4 and 5 show the auto-aligning multi-unit abutment 100 before assembly of its two components. This includes a swivel shell 190 and an abutment base 81, the swivel shell 190 having a prosthetic thread 8 at its proximal end and an aperture 193 at its distal end. The abutment base 81 has a ball (also referred to as the “ball” portion) 82 at its proximal end and a thread 14 at its distal end for attachment to the implant 16. The ball 82 also includes a screwdriver function 60 that engages with a tool for screwing the abutment base 81 into the implant thread. As shown in Figures 6 and 7, the size of the aperture 193 is determined to allow the ball portion 82 of the abutment base 81 to be inserted into the swivel shell 190. Figures 8A and 8B show the internal structure of the swivel shell 190 and the abutment base 81 and the interface between them more clearly than the perspective views in Figures 6 and 7.

[0100] Referring to Figures 8A, 8B, 9, and 10, the swivel shell 190 in Figure 8A, in its pre-assembly state, includes a distal wall end 190D, an initial distal aperture shape 193, and an internal curved portion 96, the internal curved portion 96 being sized and shaped substantially to match the curvature 89 of the ball portion 82 of the abutment base 81. The illustrated swivel 190 includes a female thread 8 to which the male thread 87 of the prosthetic screw 6 is attached. The swivel 190 also includes a titanium base seating function 122 that supports and orients the titanium base 5 when the titanium base 5 is mounted on the omnidirectional multi-unit abutment 100 (a combined assembly in which the ball 82 of the abutment base 81 is captured by the shell 190) with the prosthetic screw 6. The average outer diameter of the seating function 122 is typically in the range of about 4 mm to about 6 mm.

[0101] Figure 8A shows a dotted line labeled "eq," which represents the equator of the ball 82 and the equator of the spherical surface that coincides with the ball 82, extending toward the proximal end of the swivel shell 190. The equator lies in a plane perpendicular to the longitudinal axis of each part, passing through the center of the sphere. The illustrated ball 82 is spherical up to the edge of the screwdriver function 60, above the equator. The illustrated ball 82 is spherical down to the waist 95, below the equator in its lower hemisphere. At the waist 95, the ball 82 connects to the lower part of the abutment base 81. The waist 95 can restrict the movement of the swivel shell 190 relative to the longitudinal axis of the abutment base 81.

[0102] These figures and cross-sectional views illustrate embodiments in which the swivel shell 190 may be positioned and rotated at any location within a cone of ±30 degrees. The magnitude and orientation of the adjustable tilt are design choices, but a 30-degree tilt is generally sufficient for most clinical applications. In Figure 8A, there is a hemispherical surface 96 inside the swivel shell, which corresponds to / matches the curvature 89 of the ball 82 and extends above the equator to reach the female thread 8 for the prosthetic screw. The thread 8 is illustrated as extending across the entire swivel shell 190 in the aperture region proximal to the ball 82, but may be limited to a portion of this distance. Of course, the length of the thread 8 must be longer than the maximum thread engagement of the prosthetic screw 6 required to secure the titanium base 5. If a prosthetic screw 6 is used, the distal end of the shaft of the prosthetic screw 6 must not extend to interfere with the movement of the swivel 190 relative to the ball 82.

[0103] Referring to Figures 8A and 89, the diameter of the initial distal aperture shape 193 of the swivel shell 190 is sufficient to allow the ball portion 82 of the abutment base 81 to be inserted into the initial distal aperture shape 193 of the swivel shell 190 until it contacts the internal spherical surface 96 of the swivel shell 190 near the distal end of the thread 8, as shown in the cross-sectional view of Figure 8A. In this case, there is no constraint on the width of the abutment base below the ball 82, nor on the small diameter of the female thread 8 of the swivel 190, as is the case with some prior art multi-unit abutments. As shown in Figure 8B, after insertion, the initial distal aperture 193 becomes smaller in size, trapping the ball 82 inside the swivel shell 190 to form the multi-unit abutment 100.

[0104] Figures 9 and 10 illustrate how the initial distal end wall segment 90W (Figure 9) of the swivel shell 190 deforms inelastically to form a smaller final distal aperture shape with the deformed distal end wall segment 91W (Figure 10).

[0105] Figure 12 is a cross-sectional view showing the final assembly of the parts in this embodiment, including the coping 5 and the prosthetic screw 6. The curvature of the inner outer shape 96 of the shell 190 matches the curvature 89 of the ball portion 82 of the base 81. In this configuration example, the spherical contact surfaces are opposite each other. Contact between the swivel shell 190 and the ball 82 occurs above and below the equator of the ball 82 (shown by a dotted line in Figures 8A and 8B). Referring to Figure 8B, when the longitudinal axes are aligned, the swivel shell 190 is pressed against both the upper and lower hemispheres of the ball portion 82. As a result, the swivel shell 190 is constrained to tilt and rotate freely over a certain angular range, but not to move along the longitudinal axis of the implant abutment base 81. This curved outer shape 96 of the swivel shell 190 may also have a larger contact surface area to adjust the frictional characteristics of the swivel shell 190 with respect to the ball 82.

[0106] Using a multi-unit abutment offers several advantages in controlling the slip torque of the swivel shell 190 relative to the ball 82, independently of any locking screw. The threshold force (i.e., minimum slip torque) required for the swivel shell 190 to move relative to the ball 82 can be predetermined during the design and manufacture of the SA-MUA (assembly) 100. A slip torque in the range of 1 to 10 N-cm allows for stable maintenance of the relative position of the swivel shell 190 relative to the ball 82 during subsequent assembly and machining processes. These steps may include assisting in sealing the interface between the ball 82 and the shell 190 at the distal end 190D of the shell 190 to help prevent bacterial contamination during placement in the patient; individually aligning the multiple swivels 190 within the jaw 70 to engage with the multiple titanium bases 5 fixedly positioned within the prosthesis 68; holding the swivel shells 190 in place for a lift-off process as detailed with reference to U.S. Patent No. 11,311,354; and engaging and torqueing the prosthetic screws 6 without holding the swivels 190. The retaining capacity (retaining force) of the swivel shell 190 in its original orientation, which originates solely from the force emanating from the swivel shell 190 (e.g., the friction / interference fit of the swivel shell 190 gripping the ball 82 above and below its equator), is thus found to provide predictable slip torque for other machining processes, as well as assisting the assembly process of adding the prosthetic screw 6 (or a temporary screw as described in U.S. Patent No. 11,311,354 for the lift-off process) and the titanium base 5. The prosthetic screw 6 may be torqued to a higher desired permanent locking value without retaining the swivel shell 190 to facilitate final assembly after final alignment with the coping.

[0107] The swivel shell 190 may be a single-piece metal swivel shell body that can be used with only the ball 82 without requiring a locking screw like conventional devices. The compressive force required to deform the ball so that it is captured by the reduced final distal aperture wall 91W may be applied by any technique known in the field of metalworking. Reducing the aperture by inelastic deformation can be done by cold working, warm working, or hot working and / or forging processes. Cold working is preferred because it improves the controllability of mechanical tolerance and increases tensile strength due to work hardening of the swivel shell 190 just before deformation. Cold working may also have the advantage of maintaining the external shape of the swivel shell 190 interface with the inside of the coping 97 (e.g., the guide surface 94 and the base 122). The mechanical properties of the ball portion 82 may be selected to be suitable for use as a backing support in the forging process.

[0108] One advantage of this approach is that, in the process of manufacturing the multi-unit abutment assembly, the friction clamping characteristics of the swivel shell 190 and the ball portion 82 can be controlled entirely independently of the locking screw. The magnitude of the threshold force in the swivel-restricted state, which is required to change the relative angle between the assembly and the initial linear configuration for installation, may be given by the OEM or supplier, entirely independently of the dental practitioner's field work. Furthermore, the proximal contact surface at 96P and the distal contact surface at 96D, which are along and in contact with the ball curve 89 as shown in Figures 9 and 10, help prevent bacteria or other pathogens from entering the inside of the assembly during installation. By using the ball portion 82 as a backing support in this way, a spherical annular contact surface is formed in both the proximal and distal portions of the swivel shell 190, separated by its equator.

[0109] Rotary waging is a preferred cold working process for forming an aperture reduced to 91W. Rotary waging may be performed during the assembly of the multi-unit abutment 100, by holding the abutment base 81 with its longitudinal axes aligned and simultaneously rotating the swivel shell 190, pressing a tool against the distal end wall 90W of the swivel shell 190 at point 98, and sequentially moving the material near the distal end 190D toward the axis of rotation, thereby modifying the distal end wall 90W into the distal end wall 91W. However, other metal forming processes (preferably cold working processes) may be used in the deformation region, provided that the process can stably produce the desired shape / deformation without causing significant defects and maintain the minimum wall thickness Tm. The specifications of the process depend on the material properties and individual geometry, but several process parameters have been shown to be important for the performance of rotary waging of the swivel shell. Tests show that by applying an axial preload force Fp (Figure 9) to press the spherical surface 89 of the ball 82 against the swivel shell 190 along the spherical interface 96 shown in Figure 9, and then deforming the wall 90W (Figure 9) to generate wall 91W, the shape of the initial aperture 193 (Figure 9) effectively changes to the final aperture shape 193 (Figure 10), which is useful for stably fixing the swivel shell 190 to the ball 82. This axial preload force Fp may be approximately 4 to 110 N, which is less than the maximum force that can exceed 300 N when clenching teeth. The relative rotational motion between the swivel shell 190 and the ball during the rotary swaging process makes it possible to polish the contact surfaces. The swaging tool contacts the distal end 190D of the swivel shell at point 98 and pushes the distal end wall 90W with a force F toward the longitudinal axis to generate the distal end wall 91W. As shown in Figure 10, the swaging tool path and the direction of force F are not strictly perpendicular to the axis of rotation. This includes an axial component (i.e., a component in a more angular direction toward the center of the ball), which can be used to increase the radial clamping force of the swivel shell 190 relative to the ball 82.The dominant deformation is the inelastic deformation of wall 90W, forming a smaller aperture wall 91W, although some elastic deformation oriented radially at the spherical contact surface may contribute to the frictional force resisting relative angular motion. Depending on the applied force, the tool design, and the geometry of the swivel shell 190, material displacement may occur that reduces the wall thickness of 90W from the original wall thickness T (Figure 9) to the wall thickness Tm (Figure 10) of 91W, accompanied by some elongation due to material displacement.

[0110] In Figure 10, the swivel shell 190 is held on the ball 82, and the ball 82 is held at any angle within the range of relative motion by contact above and below the equator (eq), however, the requirements regarding the degree of contact during use in a patient are asymmetrical. This asymmetry stems, to some extent, from the large directional differences of the forces applied by the jaw muscles. While clenching the teeth can push the swivel shell 190 down against the ball 82 with forces in the range of 300-350 N, the maximum separation force attempting to pull the swivel shell 190 away from the ball 82, which can be used to separate fused teeth (e.g., by a toffee), is considerably smaller and less frequently exposed. In the cross-sectional view of Figure 12, when the multi-unit abutment 100 is used over a long period, the downward strength is more important than the upward strength. The resistance of the swivel shell 190 to movement depends on the surface area that interfaces primarily with the proximal surface of the ball portion 82. With respect to proximal forces, the pull-out resistance to proximal forces is determined by the amount of inelastic deformation caused by moving the distal end 190D of the swivel shell 190 toward the axis, and the thickness Tm of the distal wall 91W (Figure 10). Such characteristic distances also affect the static torque value that enables the positioning of the swivel shell, and the ability to apply torque to the prosthetic screw 6 without holding the swivel shell 190.

[0111] The contact between the swivel shell 190 and the ball 82 is examined in the enlarged view of Figure 9. Due to a force applied in the proximal axial direction, the ball 82 contacts the internal curvature 96 of the swivel shell 190. The most proximal contact point 96P is necessarily above the equator "eq" and located at a radial distance R1 from the longitudinal axis of the abutment base 81. In Figure 9, this contact point 96P is associated with the threads 8 for the prosthetic screw 6. From this point, the surface contact extends radially outward and downward toward the equator eq, extending to a maximum outer radial distance R2 at point 96E. In an ideal part, R2 is equal to the radius RB of the ball portion 82. Due to part tolerances, R2 may be slightly shorter than RB, depending on the precision capabilities of the individual design and manufacturing processes, in order to allow the ball 82 to slip within the swivel shell 190. Differences of a few percent in these dimensions are not important in this discussion. The difference between the radial distances R2 and R1, i.e., X, affects the mechanical strength of the swivel shell 190 and ball 82 assembly to withstand distal forces. This also determines the contact surface area of ​​the upper hemisphere, which affects the static torque resisting the swivel motion. How large X can be is limited by the thread size for the prosthetic screw 6 and the seating shape of the titanium base 5. There is a design trade-off between the ability of the swivel shell 190 to withstand downward forces on its own, the overall height of the abutment 100, and the mating characteristics of the titanium base 5 along the surface 94. It has been found that a minimum X distance of approximately 0.04 mm is sufficient for titanium parts to withstand distal compressive forces. In the configuration shown in Figure 10, X is approximately 0.5 mm for a standard-sized system. In the basic design shown in Figures 10 and 12, the multi-unit abutment, sized to fit a widely used titanium base, has a contact surface area of ​​approximately 6.1 mm² above the equator of the ball relative to the swivel shell. 2 That is the case.

[0112] In some implementation configurations, the contact surface area of ​​the ball 82 above the equator with respect to the swivel shell 190 is approximately 3 mm². 2 ~about 6mm 2may be in the range of. In some implementations, this may be from about 4 mm 2 to about 6 mm 2 may be in the range of.

[0113] The inelastic deformation of the distal portion of the swivel shell 190 provides resistance to separation of the swivel shell 190 from the ball 82 when a force is applied in the proximal direction. The reduced aperture wall 91W seals the swivel shell 190 against the ball 98, affecting the slip torque that resists the swivel motion. As shown in Figure 10, the deformed distal wall 91W near the distal end 190D of the swivel shell contacts the ball along the outer surface shape of the ball over a distance to the most distal contact point 96D. This most distal contact point 96D determines the radial distance R3 from the longitudinal axis. The difference between R3 and RB is shown by X1. This dimension X1 and the minimum wall thickness Tm of wall 91W are important parameters for the function of the swivel 190. This distance X1, depending on the material, helps determine the retention characteristics of the shell during machining, both when allowing relative movement as needed for the uniformity and reliability of swivel motion and alignment with the prosthetic titanium base 5, and when it is not moved when torque is applied to the prosthetic screw 6. Maintaining a minimum shell thickness Tm (Figure 10) in the inelastic deformation region after the rotary swaging process is also an important consideration for maintaining stable slip torque characteristics. In the case of titanium, a typical minimum thickness Tm of approximately 0.1 mm for the distal wall 91W is sufficient, but stable results were obtained by starting with an initial wall thickness T of approximately 0.25 mm for the distal wall segment 90W (Figure 9) and reducing it by less than approximately 5% as a result of the deformation process in the deformation region to the thickness Tm shown as the distal wall segment 91W in Figure 10. Therefore, an example of the minimum wall thickness Tm may be in the range of approximately 0.1 mm to approximately 0.25 mm, including 0.2 mm, 0.3 mm, 0.4 mm, 0.5 mm, 0.6 mm, 0.7 mm, 0.8 mm, 0.9 mm, 0.10 mm, 0.11 mm, 0.12 mm, 0.13 mm, 0.14 mm, 0.15 mm, 0.16 mm, 0.17 mm, 0.18 mm, 0.19 mm, 0.20 mm, 0.21 mm, 0.22 mm, 0.23 mm, 0.24 mm, and 0.25 mm. Depending on the metal or metal alloy used, other minimum wall thicknesses may be appropriate.Work hardening from cold working is often seen as an undesirable consequence that can be mitigated by annealing, but this is not the case for the omnidirectional multi-unit abutment based on prototype testing. As long as the minimum thickness of 91W is maintained in the inelastic deformation region, the benefits of increased tensile strength do not appear to come with any undesirable consequences. X1 and wall thickness Tm in the deformation region also affect sealing the reduced aperture of 91W at 190D, helping to prevent the intrusion of bacterial contamination. These two parameters also determine the force required to pull the ball 82 out of the swivel shell 190. As long as there is no interference with the neck 95 of the abutment base 81, the constraints on these dimensions, which are mostly related to the range of inclination of the swivel 190, are minimal. A distance X1 of approximately 0.13 mm provides stable performance in titanium parts. The axial force required to separate the ball 82 from the swivel shell 190 by restoring the inelastic deformation through rotary swaging of the actual part was measured to be in the range of 400-650 N. This is considerably higher than required.

[0114] Typical prosthetic screw sizes include M1.4 x 0.3 thread, M1.6 x 0.35, UNF 1-72, etc. The screwdriver function 60 may be a socket compatible with a general dental screwdriver, such as a Torx T5 or T6, 0.035"~0.050" hex screwdriver or square screwdriver, or a straight screwdriver and star screwdriver of similar size (having various numbers of lobes and geometries and a ball with a diameter of approximately 3.25 mm). Tightening the abutment base 81 to the implant may be advanced until the desired seating pressure is obtained on the abutment base 21. A typical torque value is approximately 30 N-cm, but this value may be greater or less than approximately 30 N-cm depending on the implant system used. When the prosthesis is directly attached, the torque value must be less than the torque value used when the implant 16 is placed in the jawbone.

[0115] Near wall 91W in Figure 10, excellent sealing by the sample part is demonstrated, with an anti-swivel threshold torque of several N-cm.

[0116] The tool 17 shown in Figure 11 extends through the prosthetic thread 8 of the swivel shell 190 and drives the multi-unit abutment 190 onto the implant 16. The screw-driving function 60 of the ball shown in the figure has a width smaller than the smallest diameter of the prosthetic screw that matches the thread 8. This allows the tool to be inserted into and pass through the thread 8 when the longitudinal axes are aligned, and to engage with the screw-driving function.

[0117] Figure 12 shows how the coping 5 is mounted with the prosthetic screw 6. Note that even when the prosthetic screw 6 is fully engaged and the titanium base 5 is held in place, the distal end of the prosthetic screw 6 is not long enough to contact the ball portion 82. Applying torque to the prosthetic screw provides the force to seat the titanium base 5 on the swivel shell 190, but does not restrict the swivel's movement around the ball 82. Since the parts are pre-assembled, only the tool 17 is needed to apply torque to the prosthetic screw 6. Of course, access holes must be provided through the prosthesis for the prosthetic screw 6 and the tool 17. This is common in the process of standard screw-mounted prostheses.

[0118] As mentioned in the background technology section above, we referred to the paper by Goodacre et al., which concerns how trial-and-error alignment problems can make the restoration of implant abutment assemblies more difficult than the initial placement. As previously stated, Hess et al. have proposed a process to overcome the difficulty of replacing one angled multi-unit abutment in a system in the correct orientation. The process proposed in that paper involves fabricating a specialized tool using a final model having an abutment analogue to be attached to an adjacent abutment. One important advantage of the present invention is that this orientation problem is completely avoided when replacing a damaged angled multi-unit abutment to match the coping group in the prosthesis.

[0119] Figures 13A–13D show a sequence of steps illustrating how a pair of titanium bases 5 embedded in the prosthesis 68 can orient the auto-aligning multi-unit abutment 100 during the prosthesis installation process. These figures are cross-sectional views showing the change in orientation of the swivel shells in response to contact with the embedded titanium bases. Figure 13A shows the prosthesis 68, with its pair of embedded titanium bases 5, moving away from the target pair of auto-aligning multi-unit abutments 100. The longitudinal axes of the pair of titanium bases 5 are in the plane of the figure. Similarly, the longitudinal axes of the pair of swivel shells 190 are also in the same plane and converge to a point outside the figure. Their angles are close to the limit of the tilt range of the swivel shells 190 on the ball 82. Some initial alignment may be required to position the proximal ends of the swivel shells 190 so that they can enter the distal ends of the embedded titanium bases 5 as shown. This orientation can be achieved by a dental professional simply moving the swivel shell with their finger or a tool. This orientation is maintained when the finger is released. This alignment is not critical.

[0120] In Figure 13B, the longitudinal axis of the swivel shell 190 in this embodiment is oriented vertically, completely overcoming the friction torque threshold provided by the swivel interference fit between the swivel 190 and the ball 82 as a result of the downward movement of the prosthesis 68.

[0121] As shown in Figure 13C, when a dental professional applies a downward force to the prosthesis 68, the inner conical surface of the coping applies a lateral force to the swivel shell along surface 94, thereby moving the swivel shell toward the convergent longitudinal axis of the titanium base. Here, contact is made along the conical outer shape 94, and this continues until it also makes contact with one point of the seating surface 122. As shown in Figure 13D, further pressure aligns the swivel shell 190 with the embedded titanium base 5. Once the prosthetic screw 6 is inserted and torque is applied to the specified torque, the swivel shell 190 is held firmly in place and finalized.

[0122] In this sequence, replacing a fixed-angle multi-unit abutment with an existing prosthesis does not require the extensive trial-and-error fitting of Goodacre, etc., nor the fabrication of any alignment fixtures detailed by Hess et al. The illustrated sequence of steps is reversible, so after mounting as shown in Figure 13D, the prosthetic screw 6 can be removed and the prosthesis 68 pulled up and separated from the auto-aligning multi-unit abutment 190, returning it to the separated form shown in Figure 13A. After the prosthesis has been completely removed, it is clear that the illustrated auto-aligning multi-unit abutment 100 can be removed from its implant 16, or a new auto-aligning multi-unit abutment 100 can be attached to its implant 16. The prosthesis can be reattached by simply reorienting the swivel shell 190 as shown in Figure 13A and repeating the sequence in Figures 13B-13D. The fixed implant position serves as a reference point for the replacement multi-unit abutment, allowing the titanium base 5 to realign the angle of the replacement multi-unit abutment.

[0123] The sequence described above demonstrates adaptation to misaligned components. This is educational in that it shows how the replacement of a faulty component can be accomplished by the inventive concept of the disclosure. Another advantage over fixed-angle abutments obtained by this angle adaptability of the self-adjusting multi-unit abutment during machining is the ease of removing the impression tray from the misaligned implant abutment. As described in the literature by Buzayan et al. and Hanif et al., the improvement in passive fit reduces static load and tension, thereby reducing delayed mechanical failure of parts throughout the prosthetic superstructure, and thus reducing the need for replacement in the first place. This sequence shows the large movements that can occur during installation. After torque is applied to the prosthetic screw to pull the swivel shell, which is aligned with the coping, smaller movements of the swivel shell may occur as a response to the movement due to osseointegration of the implant or to changes in the mechanical properties of non-biological elements. Visual inspection of Figure 13D reveals that the assembly is already constrained to some extent by two auto-aligning multi-unit abutments, and as the number increases, more secure positioning of the prosthesis is achieved. Since natural teeth are 10 times more mobile than the proposed tolerances for passive fit, fine-tuning to reduce mechanical stress and tension during or over time is not expected to have any practical impact on occlusion. Various prosthetic screw tightening sequences may be used to find analogues that best fit other thread patterns common in mechanical maintenance.

[0124] Figure 14 includes an elastic member 191 positioned between the swivel shell 190 and the proximal end of the ball 82. The inclusion of the elastic member 191 may be done to vary the anti-swivel force or to add sealing. The elastic member 191 varies the frictional force of the swivel shell 190 against the ball 82, and can therefore be useful for pulling the distal end of the swivel 190 toward the prosthetic screw for sealing, particularly when different slip torques are required depending on the application. It may be appropriate to modify the motion threshold for different prosthetic structures and mechanical strain characteristics. The elastic member 191 may be one or a combination thereof, such as a hemispherical annular spring washer, an elastically deformable hydrogel, polymer or copolymer, a dome washer, or a Belleville washer.

[0125] Referring to Figures 15-19, many of the functions described above, which are not specific to prosthetic screws and screw-mount copings, can be adapted as alternatives to screw mounting of prostheses. Figure 15 is an exploded view of an automated alignment omnidirectional multi-unit abutment system 180 incorporating a coping embedded in the prosthesis or a titanium-based snap-on connector. The specific differences of this modified form will be discussed.

[0126] One embodiment of a snap-on auto-aligning omnidirectional abutment includes an abutment base 81 as described above, a snap-on swivel shell 83, a retaining liner 106, and a coping 105 in the form of a cap. The swivel shell 83 is modified to have a snap connection, but its connection to the ball portion 82 of the abutment base is the same as described above. That is, the ball 82 is captured by inelastically deforming the distal portion of the swivel shell 83, as described above with respect to the swivel shell 190. The outer shape of the swivel shell 83 is adapted so that a snap-on fit occurs when the cap 105 and retaining liner 106 are pressed down from above on the proximal side of the multi-unit abutment. Since there is no prosthetic screw, the aforementioned thread 8 is neither essential nor necessary. However, an aperture 108 sized to allow a screwdriver tool 17 to engage with the screwdriver function 60 of the implant base is required at the proximal end of the swivel shell 83. The cap 105 and retaining insert 106 may be considered to provide the same functionality with respect to orientation and attachment as the coping 5 and prosthetic screw 6 described above. The cap 105 is generally made of metal, but may be made of various engineering materials used in dentistry. As an alternative to the illustrated two-piece system, a cap or swivel shell with an integrated snap function (not shown) may be used, but commercially available snap abutment systems generally package a single metal cap with various elastomer retaining inserts for processing and temporary or semi-permanent attachment. Generally, when the prosthesis is snapped onto multiple abutments (especially when the axes of the abutments are not all parallel), a lower retaining insert is selected. Since this disclosure provides a method that allows for flexible orientation of multi-unit abutments, a smaller range of retaining insert forces may be used for individual patients. The cap 105 and retaining insert 106 have no apertures, as this eliminates the need for tools extending through these elements. These are not in their designated positions when the screwdriver function 60 is in use.

[0127] Figure 19 is a cross-sectional view of these four elements as a linear assembly. As in the first embodiment, the distal end wall of the swivel shell 83 may be inelastically deformed by the ball portion 82 to serve as backing for reducing the aperture in the wall segment 192. When the means of coping attachment is a snap fit, shape memory material shift, or other dentally known mechanical attachment means, the interaction between the swivel shell and the ball may apply when coping attachment is prosthetic screw torque application. The processing and merits of deformation of a one-piece swivel are irrelevant to the means of attaching the coping to the implant abutment, so it is unnecessary to repeat their shared details here. As in the previous embodiment, rotary swaging is a preferred method for generating a radially inward force to frictionally hold the swivel shell 83 on the ball portion 82. Figure 19 shows the tight contact between the one-piece swivel shell 83 and the ball 82 along the surface 196, both extending axially above and below the dotted line of the formed equator. Comparing this to the cross-section of Figure 11 beyond the implant 81, and to the distal portion of the swivel shell 83 and the distal portion of the swivel shell 190, the external shape of the contact surfaces of these mating parts from the lower wall portion to a point considerably above the equator of the ball portion 82 is identical. The rotary swaging characteristics and advantages of this one-piece swivel shell configuration are as previously discussed. Therefore, the cold working to reduce the lower aperture after ball insertion, swivel motion, slip torque performance, radial force components above and below the equator, and the options for the compression washer option 191 all apply here and will not be repeated. Clearly, the swivel shell 83 shown in the cross-sectional view of Figure 19 is only free to rotate and tilt due to the cold forming (preferably by rotary swaging) of a one-piece swivel. Because there are no prosthetic threads, the contact surface area between the spherical surfaces of the ball and the swivel is potentially larger, and if it is necessary to increase the slip torque threshold with this parameter, this can be done by snap fitting.The outer surface of the swivel shell 83 has been modified from the conical interface / connection surface 94 of the first embodiment to have a snap interface.

[0128] The retaining insert 106 is shown to line the distal surface of the cap 105, but it may be in the form of a ring with a flat or domed outer shape, or even an O-ring (not shown). In particular, if it is in the form of a ring, it would be preferable to attach the ring to the swivel shell 83 before snapping the cap 105 onto it. Unlike the previous embodiments, the proximal surface of the swivel shell 83 has a larger diameter than the proximal surface of the swivel shell 190. A surface shape 187 on the swivel shell 83, having a ridge similar to the recessed outer shape 188 on the cap 105, is not essential but may be useful for achieving stable snap-holding operation. An O-ring or other shape as an alternative to the retaining member 106, conforming to the shape of the cap 105, is also an obvious modification of the illustrated system. Whatever the actual shape, it is desirable that the retaining member include a sealant to prevent bacteria from passing between the cap 105 and the swivel shell 83 into the aperture 108. A two-piece swivel shell or a two-piece ball-base assembly can also have a snap system, but this is not preferred.

[0129] As in previous embodiments, the implant screwdriver tool 17 may be inserted through the uppermost aperture 108 of the swivel shell 83 and engage with the screwdriver function 60 of the base 81 to tighten the base 81 within the implant 16 to a desired torque. The retaining liner 106 is typically repositioned to a desired angle to align with the cap 105 already embedded in the prosthesis, and then, possibly by a lift-off process, is attached to the cap 105 within the prosthesis. Due to downward pressure on the prosthesis, the cap 105 and the retaining liner 106 are compressed and partially loosened to hold each element together, as shown in Figure 20.

[0130] Generally, the greater the angular divergence to be compensated for in the snap-on abutment axis, the more difficult it is to use a retaining insert with greater angular displacement tolerance and lower force. Improved relative parallelism of multiple snap-on abutments is desirable because it results in more uniform force distribution on the retaining insert. This force redistribution makes the process of snapping the prosthesis and abutment together easier, potentially reducing stress on both the prosthesis and the implant.

[0131] Furthermore, variations of the process described above may be used in the snap-on system 180 with respect to screw-mounted prostheses.

[0132] As described above, the deformation of the retaining insert 106 helps to address some of the angular misalignments between multiple multi-unit abutments 180 associated with a single prosthesis 68. Even if all multi-unit abutments are perfectly aligned initially, the passive fit may deteriorate over time as the shape of the prosthesis or the patient's jaw changes. Since an overly rigid system would not mimic the movement of natural teeth, this embodiment allows for the redistribution of forces within the snap system without the intervention of a dental professional, thereby maintaining or improving the passive fit, by enabling unbalanced forces within the retaining insert to move the swivel shell and balance the stresses to improve the passive fit. If the geometry of the prosthesis or jaw changes over time, the swivel shell will readjust its orientation and redistribute the forces to improve the passive fit in this new geometry. The force required to reorient the swivel shell for automatic adjustment will depend on the geometry and mechanical properties of the part.

[0133] The discussion so far has described how swivel shells of various embodiments hold themselves in a particular orientation until an applied force is applied to shift them to a different angular orientation. This reorientation can be done by hand, but given the small size of the assemblies, it may be useful to have a tool to move the swivels more easily in the patient's oral cavity, and further, an indicator to show the angle at which the swivels are positioned. Figure 21 shows an orientation post 300 for an embodiment for mounting a prosthetic screw. The one-piece orientation post 300 can be made inexpensively from a plastic such as thermoplastic or other polymer, but may be made from any material that is rigid enough to be useful. It includes a proximal shaft portion 306, a threaded portion 301 of the swivel shell 190 that engages with the threads 8 used by the prosthetic screw 6, a distal seating surface 322, and an internal outer shape 394 complementary to the outer shape 94. The orientation post is rotated and engaged with the thread 301 to apply torque until the surface 322 seats. This aligns the linear axis of the orientation post with the linear axis of the swivel shell 190, providing an axial indicator. The length of the shaft provides a mechanical lever that overcomes the slip torque threshold. The axial indicator function is useful for aligning multiple swivels in several machining functions. Of course, similar functionality can be achieved by snap-on orientation posts and snap-on swivel shells 83, which offer similar benefits, simply by replacing the mounting thread and seat surface geometry in Figure 21 with their correspondings in Figure 19. Other tools for moving the swivel shell are also possible, which are as simple as a rod, having an aperture perpendicular to the axis of the rod, and sliding over the swivel shell, but they do not offer the two advantages of visual indication and mechanical benefits.

[0134] Various embodiments have been described that illustrate the inventive concept of this disclosure and do not limit the invention. Whether the prosthetic screw or snap system is used to stably hold the prosthesis to the multi-unit abutment, the orientation of the swivel shell of the multi-unit abutment is not individually fixed in place. They can be positioned as needed for the installation or removal of the prosthesis. During initial installation and throughout the life of the dental restoration, the swivel shell responds freely to unbalanced forces. The prosthesis generally constrains the initial orientation of the set of omnidirectional multi-unit abutments, but the swivel shell can change orientation to maintain maximum passive fit over time.

[0135] The embodiments of the omnidirectional multi-unit abutment 100 described above are preferably adapted to be compatible with already licensed and commercially successful titanium bases 5 and threaded implants 16. Threading and seating to widely available implants improves stockability, as the same implant can be used for the same patient with both conventional linear abutments and the embodiments described above. Less important, but compatibility with widely available threaded titanium bases 5 is also considered an advantage. However, the inventive features of the described embodiments may be incorporated into, or adapted to work with, newly designed implants that employ the inventive concepts for the passive fit improvements or installation efficiency and restoration described above. As described above with respect to snap retention systems, these inventive concepts may be adapted to work with non-threaded prostheses. These adaptations are not excluded and are considered to be within the scope of the claims disclosed herein and can be broadly interpreted to apply to them. U.S. Patent No. 11,311,354 includes various approaches to aligning the titanium base and abutment for integration into a prosthesis using temporary fasteners in a lift-off process. The basic design of the temporary fastener shown in the shared patent may be used in conjunction with the omnidirectional multi-unit abutment and titanium base described above.

Claims

1. A system for aligning and attaching dental prostheses to implants, An abutment base having a longitudinal axis, the abutment base comprising a proximal end including a ball having an abutment base screwdriver interface, and a distal end including threads for attachment to the implant, wherein the ball includes an equator, A swivel shell comprising a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis, wherein the swivel shell further comprises an open internal channel extending along the longitudinal axis between the proximal end and the distal end, Includes, The swivel shell intercepts and engages with the ball, and when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, it contacts the ball at the equator of the ball, or above and below the equator of the ball, thereby enabling the swivel shell to tilt and rotate in response to a force greater than a specified force applied to the swivel shell, and the swivel shell is configured to push the ball with a force sufficient to maintain a desired tilt angle. system.

2. The system according to claim 1, wherein the swivel shell has a deformable wall at its distal end, the deformable wall is configured to have a first form for being assembled to the ball, the first form deforms into a second form for capturing the ball within the swivel shell, the swivel shell contacting the ball above and below the equator of the ball when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell.

3. The system according to claim 2, wherein the swivel shell has a single-piece monolithic metal body with all ball contact surfaces, and in the second embodiment, the swivel shell has a minimum wall thickness at the distal end, the minimum wall thickness is in the range of about 0.1 mm to about 0.25 mm.

4. The system according to claim 1, further comprising a dental coping, the dental coping being sized and configured to overlap the upper outer portion of the swivel shell, and exceeding a specified value, such that a force applied distally to the dental prosthesis including the dental coping results in a force sufficient to change the orientation of the swivel shell relative to the ball, applied at the interface with the swivel shell.

5. The system according to claim 1, wherein the swivel shell is configured to tilt and / or rotate with respect to the ball when an applied torque greater than 1 N-cm is applied to the swivel shell.

6. The inner surface of the swivel shell defines the contact surface with the ball above the equator when the longitudinal axes are aligned, and the contact surface is approximately 3 mm in diameter. ２ ~about 6mm ２ It is within the range, and can be optionally selected as approximately 4 mm. ２ ~about 6mm ２ The system according to claim 1, which is within the range.

7. The system further includes a prosthetic screw, the open channel of the swivel shell includes threads sized and configured to engage with the prosthetic screw, and the prosthetic screw screw engages with the threads of the open channel of the swivel shell, according to claim 1.

8. The system further includes a snap-on cap, the snap-on cap being sized and configured to engage with the proximal end of the swivel shell for attaching the dental prosthesis to the abutment base, and the snap-on cap being fixed to a titanium base bonded to the inner surface of the dental prosthesis, according to claim 1.

9. The system according to claim 1, further comprising a snap-on cap, the snap-on cap being sized and configured to engage with the proximal end of the swivel shell, with at least a portion of the proximal end of the swivel shell being inside the snap-on cap.

10. The system according to claim 1, wherein the swivel shell is configured to be used without a locking screw for coupling with the ball, the prosthetic screw is rotatable within the swivel shell to be tightened to a specified torque, and cooperates with the swivel shell so that the swivel shell alone provides a force that holds the ball at a desired angle to the ball, and the swivel shell holds the ball with a force sufficient to allow the prosthetic screw to be tightened within the swivel shell when the abutment base is attached to the implant.

11. The system according to claim 2, wherein the distal end of the swivel shell is rotary swaged to form the second form so as to capture the ball while an axial load is applied to the swivel shell with the ball held within the swivel shell, thereby deforming the distal end of the swivel shell and causing the swivel shell to capture the ball.

12. The system according to claim 1, further comprising a titanium base, the titanium base having a proximal end aperture larger than the shaft of the prosthetic screw and smaller than the head of the prosthetic screw, and a distal end formed to seat on a seating surface on the outer surface of the swivel shell.

13. The system according to claim 1, further comprising an orientation tool, the orientation tool comprising an orientation post, the orientation post extending within the open channel of the swivel shell and engaging with the swivel shell using threads within the open channel, the threads being configured to screw-engage with a prosthetic screw to apply sufficient force / torque to slide the swivel shell in a selected orientation relative to the ball.

14. The system according to claim 1, further comprising an elastic member, the elastic member being located between the proximal end of the ball and the distal end of the swivel shell, to promote slip resistance and / or maintain a seal between the ball and the swivel shell.

15. The system according to claim 1, wherein the swivel shell and the ball are sized and configured to enable attachment to the implant and the dental prosthesis without the need for locking screws.

16. The system according to any one of claims 1 to 15, wherein the open channel of the swivel shell includes threads sized and configured to directly engage with a prosthetic screw, or the open channel of the swivel shell is threadless.

17. The system according to any one of claims 1 to 15, wherein the swivel shell comprises a single-piece monolithic metal body, the body having a molded inner surface extending around an internal cavity for holding and capturing the ball, and having contact surfaces that strike the ball above and below the equator of the ball when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell.

18. The system according to any one of claims 1 to 15, wherein the swivel shell and the ball are configured to slidably cooperate to allow passive internal changes in the alignment between the implant and / or the dental prosthesis at that location after placement, unless there is intentional external manipulation of the swivel shell.

19. A dental system for aligning and attaching a full arch dental prosthesis to multiple dental implants, A plurality of abutment bases, each abutment base having a longitudinal axis, the abutment base comprising a proximal end including a ball having an abutment base screwdriver interface, and a distal end including threads for attachment to the implant, the ball including an equator, the plurality of abutment bases, A plurality of swivel shells, each swivel shell including a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis, Includes, Each swivel shell further includes an open channel extending along the longitudinal axis between the proximal end and the distal end, The swivel shell comprises a single-piece monolithic metal body, the body having a molded inner surface extending around an internal cavity for holding and capturing the ball, and having contact surfaces that strike the ball above and below the equator of the ball when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell. At least some of the swivel shells cooperate to rotate relative to each other and with respect to the coupled abutment base, so that the target implant can be properly aligned during installation. system.

20. The system according to claim 19, wherein the system is configured to allow passive changes in the alignment between the implant and / or the full arch dental prosthesis after placement, unless there is direct, intentional manipulation of the swivel shell from the outside.

21. The system according to any one of claims 19 to 20, wherein the swivel shell has a deformable second end, the second end deforms to capture the ball, thereby forming the assembly into the corresponding swivel shell and providing a factory preset orientation-holding force to hold the swivel shell in a desired orientation using only the swivel shell and the ball.

22. A system for aligning and attaching dental prostheses to dental implants, An abutment base having a longitudinal axis, the abutment base comprising a proximal end including a ball having an abutment base screwdriver interface, and a distal end including threads for attachment to the implant, wherein the ball includes an equator, A swivel shell comprising a proximal end and an opposite distal end, an inner surface, an outer surface, and a longitudinal axis, wherein the swivel shell further comprises an open internal channel extending along the longitudinal axis between the proximal end and the distal end, Includes, The swivel shell is configured to capture the ball and prevent it from moving axially relative to the longitudinal axis of the abutment base, and to provide a desired tilt orientation in the range of about 0 to about 30 degrees. During assembly, when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, the swivel shell captures the ball as a result of the upper and lower hemisphere forces on the ball due to contact with the ball above and below the equator, and frictional engagement occurs between them, thereby factory-presetting the minimum orientation holding force of the swivel shell. system.

23. The system according to claim 22, wherein the swivel shell has a distal end wall segment, the distal end wall segment deforms inelastically to contact the ball and its location.

24. The system according to claim 23, wherein the distal end wall segment seals the ball.

25. The system according to any one of claims 22 to 24, wherein the swivel shell is a single-piece monolithic body that makes full contact with the ball, thereby interferentially fitting with the ball and making contact with the ball at the equator of the ball, or above and below the equator of the ball, when the longitudinal axis of the abutment base is aligned with the longitudinal axis of the swivel shell, thereby enabling the swivel shell to tilt and rotate in response to a force greater than a specified force applied to the swivel shell, and the swivel shell is configured to push the ball with a force sufficient to maintain a desired tilt angle.

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