Pillar base for dental restoration

Description

[0001] The present invention relates to an abutment base for a dental restoration. A dental restoration provides an artificial denture for a partially or totally edentulous patient. A prior art method involves integrating one or more implants into the bone structure, achieved by making an incision in the gum to access and drill through the bone. A healing element is then typically attached to an implant, and this assembly remains undisturbed until the implant integrates with the bone through osseointegration and the gum heals around the healing element. The dental restoration can be completed by attaching a restorative abutment base to the implant, onto which a dental prosthesis is then fixed.

[0002] There figure 1 This represents a dental restoration assembly used according to current best practices. An implant 1 is secured to the bone portion 2, and an abutment base 3 is fixed to the implant 1, so that its flange 4 is positioned at the boundary between the bone portion 2 and the gingiva 5. Finally, a prosthesis 6 is fixed to the abutment base 3. It should be noted that, according to current best practices, in this assembly, the abutment base 3 and the prosthesis 6 are aligned with the implant 1; the latter must therefore be positioned along the axis 7 defined by the dentition to be restored, that is, the axis of the prosthesis 6. This approach has the disadvantage of a lack of flexibility in the implant's positioning within the bone structure. If the bone is insufficient at the location required for the implant, a bone graft must be performed beforehand, which introduces additional surgical complexity, detrimental to the patient.

[0003] Other state-of-the-art solutions require fixing a prosthesis in the mouth, that is, bonding it directly in the mouth to an abutment base that has been previously screwed onto an implant. This approach has the drawback of handling the adhesive used for this purpose directly in the mouth, which carries the risk of harmful adhesive being expelled into the patient's mouth and makes it difficult to remove excess adhesive from under the gum.

[0004] Document WO 2014 / 012973 A2 describes a pillar base according to the preamble of claim 1.

[0005] Thus, a general object of the invention consists of a dental restoration solution that does not include all or part of the disadvantages of the prior art.

[0006] More specifically, a first object of the invention is a simpler and less traumatic dental restoration solution for the patient, limiting in particular the use of bone grafts and bonding performed directly in the patient's mouth.

[0007] A second object of the invention is a dental restoration solution enabling an optimal aesthetic appearance to be achieved.

[0008] To this end, the invention is based on an abutment base comprising an implant portion oriented around a first axis, adapted for fixing to a dental implant, and a coronal portion oriented around a second axis, adapted for fixing a dental prosthesis, and a collar separating said implant portion and coronal portion, the two axes respectively of the implant portion and the coronal portion not being aligned and forming an angle of the angled base, the abutment base comprising a central opening extending along its entire length, adapted for the passage of a tool such as a screwdriver, the entry of which is substantially oriented in the direction of the second axis at the level of one end of the coronal portion and the partial exit substantially oriented in the direction of the first axis at the level of the implant portion, for screwing into an implant, the abutment base comprising a truncation made in the wall of the coronal portion,to allow the passage of a screw at the level of a non-straight portion of the central opening of the abutment base, the truncation increasing the dimension of the entry into the central opening or the truncation extending from the end of the coronal part over approximately half the height of the coronal part, this truncation being arranged at the level of the open side of the angle of the angled base, characterized in that this open side is located at the level of the greatest thickness of said collar,

[0009] The pillar base may include a lug-type guide and positioning element arranged on the outer surface of the coronal portion.

[0010] The abutment base may include a clipping element, such as a groove, arranged on the outer surface of the coronal portion, for clipping a healing cap.

[0011] The abutment base may include at least one glue retention groove on the outer surface of the coronal portion.

[0012] The coronal portion may have at least one part in a truncated cone and / or cylindrical shape arranged around the second axis.

[0013] The angle α formed between the two axes of the implant part and the coronal part can be between 5 and 30 degrees.

[0014] The central opening can be substantially symmetrically arranged around the second axis of the coronal part, at least at the level of the end of the coronal part, and substantially symmetrically arranged around the first axis of the implant part at the level of a connection device with an implant, arranged at the end of the implant part of the abutment base.

[0015] The pillar base can be in a one-piece form.

[0016] According to one embodiment of the invention, a restoration assembly comprising a prosthesis, optionally a healing cap, is fixed to an abutment base as described above.

[0017] The abutment base of the invention is used in a dental restoration procedure, comprising the following steps: fixing a prosthesis on an angled abutment base as described above; then screwing the assembly obtained into the mouth onto an implant using a screw, by passing a tool, in particular a screwdriver, through an opening in the prosthesis and a central opening in the abutment base, so as to reach the screw housed in the central opening of the abutment base and to allow its screwing into the implant, the opening of the prosthesis being positioned on a non-visible lingual face.

[0018] The dental restoration procedure may include a preliminary step of inserting a screw into the central opening of the abutment base before bonding the prosthesis to the abutment base.

[0019] The scope of the present invention is defined by the claims.

[0020] These objects, features and advantages of the present invention will be described in detail in the following description of a particular embodiment, given by way of non-limiting example, with reference to the accompanying figures, among which: There figure 1 represents a set of dental restorations according to the current state of the art. figures 2 et 3 represent perspective views of a pillar base according to one embodiment of the invention. figure 4 represents a side view of the pillar base according to the embodiment of the invention. figure 5 represents a dental restoration assembly using an abutment base according to the embodiment of the invention. figure 6 illustrates a variant of a dental restoration assembly using an abutment base according to the embodiment of the invention. figure 7 illustrates the fact that a state-of-the-art dental restoration kit would not be suitable for dental restoration as envisaged by the figures 5 et 6 . There figure 8 represents a step in a dental restoration procedure using an abutment base according to the embodiment of the invention. figure 9 represents a detail of the assembly for dental restoration using an abutment base according to the embodiment of the invention.

[0021] According to the embodiment of the invention that will be described, a dental restoration uses an intermediate component that we will call the abutment base 10, which is sometimes simply called an abutment or T-base or Esthétibase. The abutment base 10, particularly represented on the figures 2 à 4 , comprises two main parts, separated by a collar 14.

[0022] A first implantable part 11 includes a connection device 12 with an implant, arranged towards the first end of the abutment base 10. This connection device 12 is oriented along a first axis 13, highlighted on the figure 4 , intended for alignment with the axis of an implant when connecting the abutment base 10 to that implant, as can be seen on the figure 9 for example. In the described embodiment, the connecting device 12 is in the form of a hexagonal cross-section arranged symmetrically around the first axis 13. Alternatively, any other shape, standardized or not, could be used for this connecting device 12.

[0023] The abutment base 10 further includes a second coronal portion 21, intended to receive a dental prosthesis. According to the embodiment, this coronal portion 21 comprises first a sub-portion of substantially frustoconical shape and then a substantially cylindrical sub-portion, extending to the collar 14. These two sub-portions are aligned coaxially. They are arranged around a second axis 23, visible on the figure 4 .

[0024] The outer surface of the coronal portion 21 is designed to receive the bonding of a dental prosthesis, as will be detailed later. For this purpose, this outer surface includes, at least over a portion of its surface, grooves 22 for adhesive retention. It also includes a first groove which serves as a clipping element 28 for a component such as a healing cap, which will be described with reference to the figure 6 It also includes a lug 24 for positioning a dental prosthesis, preventing its misalignment around this coronal portion 21. This lug 24 thus serves as a guide for proper positioning and for maintaining the position, as well as an anti-rotational element for a cap and / or a dental prosthesis. Alternatively, the lug 24 may be in any other form fulfilling the same functions. Finally, this second coronal portion 21 has a central opening 25, extending continuously to the end of the connection device 12 of the implant portion 11, intended for the passage of a screw for fixing the abutment base 10 to an implant. This opening 25 therefore extends along the entire length of the abutment base 10.

[0025] The coronal portion 21 extends along a second axis 23. This second axis 23 is not aligned with the first axis 13 of the implant portion 11. Indeed, the two axes have an angle α; this characteristic makes the abutment base 10 angled. Preferably, the angle α is between 5 and 30 degrees inclusive. Thus, the central opening 25 extends along the entire length of the abutment base 10, along the direction of the first axis 13 in the implant portion 11 and along the direction of the second axis 23 in the coronal portion 21. It therefore has a non-straight portion, for example, a bend or a curved portion, at the level of the collar 14, to form a change of direction with an angle α corresponding to the angle between the two axes 13 and 23 mentioned above. Preferably, the central opening 25 is arranged symmetrically around the second axis 23 at the level of the coronal part 21.Preferably, this same central opening 25 is arranged symmetrically around the first axis 13 at the level of the implant part 11.

[0026] The outer surface of the coronal portion 21 further has a truncation 26, allowing the passage of such a fixation screw on an implant, particularly its head, at the level of the non-straight portion of the abutment base. To this end, and according to the present invention, this truncation 26 is arranged on the outer side of the bend to be made by the screw, that is to say, at the level of the open side 27 of the angle of the angled base, as is particularly visible on the figure 4 , this side is located at the level of the greatest thickness of the collar 14 which separates the two implant parts 11 and coronal part 21 from the abutment base 10. The truncation 26 extends from the end of the coronal part 21, over about half the height of the coronal part 21. Its dimension is adapted to the passage of the head of a fixing screw.

[0027] The abutment base 10 is preferably universal and has a symmetrical, or more precisely, nearly symmetrical shape (the lug 24, for example, is an exception to the symmetry) around the two axes 13 and 23 mentioned above, which form axes of revolution. The abutment base 10 is advantageously monobloc, made in one piece. It is advantageously made of a metallic material. For example, it can be made of titanium or a titanium alloy. Furthermore, the outer surface of the coronal portion 21 can be wholly or partially sandblasted to promote adhesive adhesion and prosthesis fixation. It can also be coated with a layer of titanium nitride, for example, by PVD deposition, to give it a yellow appearance and prevent dark areas under the gingiva.

[0028] There are as many different abutment bases as there are different connection devices for existing implants, so that for each existing implant, there is an abutment base with a connection device 12 that is adapted to it. The advantage of this approach is that it allows the entire second coronal portion 21 of the abutment bases 10, from the flange 14 onwards, to remain unchanged, regardless of the implant corresponding to the abutment base. Naturally, it is also possible to provide different second coronal portions 21 for different abutment bases 10, depending on their intended use. In all cases, the second coronal portion 21 of the abutment base is independent of the implant, uncorrelated with the implant fixation device. It maintains a standard shape, compatible with receiving a prosthesis manufactured using existing prosthesis manufacturing techniques, such as block milling.The collar 14 can be of varying heights to accommodate different gum thicknesses. Specifically, its maximum height (h) is advantageously between 0.5 and 7 mm inclusive.

[0029] Ultimately, by abutment base we mean any base intended to support a prosthetic construction, by fixing it to at least one implant, such as a prosthesis, a framework, a healing cap, an impression...

[0030] Furthermore, the invention applies to any dental prosthesis, which may be a final prosthesis, such as a crown or bridge, or a temporary prosthesis. In addition, the term "dental prosthesis" also includes an incomplete prosthesis, in particular an intermediate sub-part comprising a hollow internal volume for its attachment to an abutment base, sometimes called a coping.

[0031] There figure 5 represents a dental restoration assembly, based on an implant 1 integrated into a bone fragment 2. An abutment base 10, as described above, is fixed to the implant 1 by its connecting device 12, and by means of a screw, which will be shown in the diagram. figures 8 et 9 The flange 14 of the abutment base 10 is located at the justogingival surface, and its upper surface forms a receiving and abutment surface for a prosthesis 30. The latter is fixed to the coronal portion 21 of the abutment base 10. In this design, the coronal portion 21 is oriented in a direction (along axis 23) approximately equal to that of the prosthesis 30, plus or minus 10 degrees. This geometry allows for ideal fixation of the prosthesis 30 to the abutment base 10. Furthermore, since the abutment base 10 is angled, it also allows for fixation to an implant oriented in a different direction (axis 13). The final configuration thus combines the first advantage of positioning the implant 1 in the most favorable bone area, regardless of the induced orientation, while also orienting the prosthesis in the ideal direction to allow it to achieve optimal functional positioning and aesthetic appearance.This solution also allows for ideal gingival healing.

[0032] The embodiment has been described above in the context of a pillar base 10 having a substantially frustoconical, and at least partially cylindrical, coronal portion 21, onto which a prosthesis 30 is directly fixed. Such an approach has the advantage of simplicity. However, the invention is not limited to such an approach. In particular, the figure 6 represents an alternative embodiment in which a healing cap 29 is fixed to the coronal portion 21 of the same abutment base 10. In this embodiment, the healing cap is clipped onto the coronal portion 21, notably by means of a groove forming a clipping element 28, as described previously. This healing cap has an anatomical shape, enabling it to perform an optimized healing function for the gingiva, which is shaped by the outer lateral surface of the healing cap 29. This gingival shape corresponds as closely as possible to the shape of the prosthesis 30 and is also formed in the correct orientation, that of the prosthesis 30. This lateral surface of the healing cap 29 may have a substantially trapezoidal or rectangular cross-section in a plane perpendicular to the axis 23 of the abutment base.The lug 24 allows the correct angular orientation of said healing cap around the axis 23 of the coronal part 21 of the pillar base 10.

[0033] There figure 7 illustrates the result that would be obtained if implant 1 of the embodiment were combined with a state-of-the-art restoration kit, as illustrated with reference to the figure 1 , as a replacement for the entire dental restoration assembly with the abutment base according to the present invention.

[0034] It appears here that bonding prosthesis 30 to abutment base 3 would not be ideal, or even impossible, due to the significant difference in orientation between axis 7 of implant 1 and abutment base 3, and axis 9 of the prosthesis. Furthermore, screwing abutment base 3 onto implant 1 would be impossible here, except by drilling an opening 31 through prosthesis 30, on its visible vestibular side, at its intersection with axis 7, to the detriment of the aesthetic appearance of the dental restoration.

[0035] This description also outlines a dental restoration procedure using an abutment base as described previously. Depending on the embodiment, this dental restoration procedure involves the following steps: Fixing a prosthesis 30 onto an angled abutment base 10, as described previously; then screwing the assembly obtained into the mouth onto an implant 1 using a screw 35, by passing a tool 40, in particular a screwdriver, through an opening 31 of the prosthesis 30 and a central opening 25 of the abutment base 10, so as to reach the screw 35 housed in the central opening 25 of the abutment base 10 and to allow its screwing into the implant 1, the opening 31 of the prosthesis 30 being positioned on a non-visible lingual face.

[0036] There figure 8 Figure 10, on which the prosthesis 30 is bonded to the abutment base 10, illustrates this screwing operation. The connection device 12 of the abutment base 10 has been positioned to connect with the corresponding connection device of the implant 1. The active part of a tool 40, such as a ball-jointed screwdriver, is inserted into an opening 31 of the prosthesis 30 and into the central opening 25 of the abutment base until it reaches the head of a screw 35 positioned in the central opening 25 of the abutment base 10, to proceed with screwing it into the implant 1, resulting in the simultaneous joining of the abutment base 10 and the prosthesis 30 to the implant 1, in the final position illustrated in Figure 10. figure 9(in which the prosthesis 30 is not shown). In this final position, the screw 35 therefore partially exits the central opening 25 of the abutment base, beyond the connection device 12, within the implant 1. In addition, the head of the screw 35 comes to rest against a stop adapted within the central opening 25, preventing it from continuing its progression and guaranteeing the maintenance of the entire restoration.

[0037] Note that the insertion of tool 40 into the abutment base 10 is performed along the axis 23 of the coronal portion 21 of the abutment base 10. This insertion, through an opening 31 in the prosthesis 30, superimposed on the central opening 25 of the abutment base 10, in the aforementioned direction 23, offers the aesthetic advantage that this opening 31 is positioned on the lingual side of the mouth, therefore on the non-visible side. At the end of the screwing process, the opening 31 of the prosthesis 30 is sealed with a dental composite; since this area is not visible from outside the mouth, it has no negative effect on the aesthetic appearance of the dental restoration. The visible portion of the prosthesis 30, on the buccal side, remains intact.

[0038] Note that the fixing screw 35 is first inserted into the central opening 25 of the abutment base 10. This screw is then driven into its final position, engaging with a threaded portion within the implant 1. Note that as the screw 35 passes through the center of the abutment base at the non-straight section, for example, a bend, formed by the angled shape of the abutment base, its head is slightly offset through the truncation 26, which allows it to move off-center and pass beyond this non-straight section. In other words, the truncation 26 prevents the head of the screw 35 from abutting the inner surface of the central opening 25 of the abutment base, thus preventing its progression in a non-straight direction within an opening of minimal diameter, due to the small dimensions of an abutment base.This truncation 26 thus allows the final orientation of the screw 35 according to the axis 13 of the implant part 11 of the abutment base 10.

[0039] As a note, the insertion of screw 35 can be carried out before the prosthesis 30 is bonded to the abutment base, in which case its introduction into the abutment base is facilitated by the truncation 26, which increases the size of the entry into the central opening 25. Alternatively, the insertion of screw 35 can be carried out after the prosthesis has been bonded, in which case its introduction into the abutment base 10 is made along the axis 23 of the coronal portion 21 of the abutment base 10. This insertion is achieved through the opening 31 of the prosthesis 30, which is superimposed on the central opening 25 of the abutment base 10.

[0040] According to the embodiment of the invention, the central opening 25 includes a threaded hole in the implant portion 11, and the screw 35 has a threaded surface under its head, adapted for engagement with this threaded hole. Thus, when the screw 35 is inserted into the central opening 25, once it reaches its position oriented along the axis 13 of the implant portion 11, it must be screwed into the aforementioned threaded hole to continue its travel. This feature allows it to occupy a stable temporary position within the central opening 25 of the abutment base, which thus fulfills a captive function. This feature provides the significant advantage of allowing the abutment base 10 to be brought into the mouth, with or without the prosthesis, with the screw already inserted, without risk of losing it in the mouth.

[0041] The dental restoration process can be combined with the following complementary steps of a manufacturing process for a dental restoration kit.

[0042] First, a practitioner can take a digital impression of the patient's mouth. The scan data, obtained by any device such as an oral scanner, is automatically transmitted to a computer equipped with dental restoration software. From this scan data, the software automatically determines the most suitable bone area for the dental restoration, in order to position the appropriate implant(s) in the most optimal way possible.

[0043] The same software determines the shape, position, and orientation of the prosthesis(es) to be manufactured. It then determines the necessary abutment base(s), constructing at least one angled abutment base with an angle adapted to the difference in orientation between a specific implant and the superimposed prosthesis. It then initiates the automatic manufacturing of the predefined angled abutment base, as described previously.

[0044] As a side note, this manufacturing process for a dental restoration can be entirely digital, starting with a virtual phase, or it can involve constructing a model in plastic or plaster. In the latter case, a physical impression, for example in silicone, can be taken, and plaster can be poured into the impression to create the master model—that is, a replica of the dental arch to be restored—which is then scanned in a laboratory to create a digital image.

[0045] As can be seen from the description above, the final phase of the restoration process relies on a restoration device, which includes a central processing and control unit. This unit comprises at least one microprocessor connected to electronic memory, on which software is run to implement all or part of the steps in the manufacturing process for a dental restoration unit described above. This central unit is connected via a communication device to a module for acquiring digital data representing all or part of a patient's dentition, which may consist of a device such as an oral scanner. It is also connected to a human-machine interface, including, for example, a screen and / or a keyboard, to allow interaction with an operator. The central unit then performs all the necessary processing, calculations, and other operations using software.It is finally capable of generating and transmitting manufacturing commands to a manufacturing device, such as a machine tool, for a pillar base, a possible healing cap and an associated prosthesis.

[0046] The invention therefore makes it possible to combine the desired advantages, by allowing the bonding of a prosthesis to an abutment base outside the mouth of a patient, the implementation of a dental restoration in which an implant is oriented according to the bone structure present at the level of the restoration, and not according to the final orientation of the prosthesis, and in which the prosthesis has an optimized final aesthetic appearance.

Claims

1. Abutment base (10) comprising an implant part (11) oriented about a first axis (13), suitable for fixing to a dental implant, and a crown part (21) oriented about a second axis (23), suitable for fixing a dental prosthesis, and a collar (14) separating said implant part (11) and said crown part (21), which two axes (13, 23), respectively of the implant part (11) and of the crown part (21), are not aligned and form an angle of the angled base, the abutment base (10) comprising a central opening (25) extending over the entire length thereof, suitable for the passage of a tool such as a screwdriver, the inlet of which opening is substantially oriented in the direction of the second axis (23) at one end of the crown part (21), and the partial outlet of which opening is substantially oriented in the direction of the first axis (13) at the implant part (11), for screwing into an implant, the abutment base (10) comprising a truncation (26) made in the wall of the crown part (21), to allow the passage of a screw at the level of a non-rectilinear portion of the central opening (25) of the abutment base (10), the truncation (26) increasing the size of the inlet of the central opening (25), or the truncation (26) extending from the end of the crown part (21) over about half the height of the crown part (21), this truncation (26) being arranged at the open side (27) of the angle of the angled base, characterized in that this open side is situated at the level of the greatest thickness of said collar (14).

2. Abutment base (10) according to the preceding claim, characterized in that the central opening (25) comprises an internal thread at the level of the implant part (11), suitable for temporarily keeping a screw stable within the central opening (25), thereby fulfilling a captive securing function.

3. Abutment base (10) according to Claim 1 or 2, characterized in that it comprises a guiding and position-holding element, of the lug type (24), arranged on the outer surface of the crown part (21) .

4. Abutment base (10) according to one of the preceding claims, characterized in that it comprises a clip element (28), like a groove, arranged on the outer surface of the crown part (21), for the clipping-on of a healing cap (29).

5. Abutment base (10) according to one of the preceding claims, characterized in that it comprises at least one groove (22) for retaining glue on the outer surface of the crown part (21).

6. Abutment base (10) according to one of the preceding claims, characterized in that the crown part (21) has at least one part of frustoconical and / or cylindrical shape arranged about the second axis (23) .

7. Abutment base (10) according to one of the preceding claims, characterized in that the angle α formed between the two axes (13, 23), respectively of the implant part (11) and of the crown part (21), is between 5 and 30 degrees.

8. Abutment base (10) according to one of the preceding claims, characterized in that the central opening (25) is substantially symmetrically arranged about the second axis (23) of the crown part (21), at least at the end of the crown part (21), and substantially symmetrically arranged about the first axis (13) of the implant part (11) at the level of a device (12) for connection to an implant, arranged at the end of the implant part (11) of the abutment base (10).

9. Abutment base (10) according to one of the preceding claims, characterized in that it is in one piece.

10. Restoration assembly comprising a prosthesis (30), optionally a healing cap (29), fixed to an abutment base (10) according to one of the preceding claims.