ONE-PIECE HEALING ELEMENT

Description

Technical field of the invention

[0001] The present invention relates to a healing element intended to be attached to a dental implant. It also relates to a dental restoration assembly comprising such a healing element and an implant. Finally, it also relates to a dental restoration method. State of the art

[0002] Dental restoration allows for the creation of artificial teeth for a partially or completely edentulous patient. It relies on the integration of one or more implants into the bone structure, achieved through an incision in the gum to access and drill into the bone. Next, a healing element is generally attached to an implant, and this assembly remains untouched 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 to the implant, onto which the dental prosthesis is fixed. The abutment and the dental prosthesis are customized, adapted to the patient's anatomy and the tooth to be replaced, to achieve a result as close as possible to an ideal natural dentition.For this, the precise volume of the space to be restored is generally taken into account by taking an impression, which allows for the personalized manufacture of the dental prosthesis.

[0003] US patent 2016 / 206408 A1 describes a one-piece temporary gingival healing element adapted for fixation to a dental implant, the gingival contact portion of which extends along an axis different from the implant axis. WO patents 2014 / 200404 A1 and 2014 / 012973 A2 describe other healing elements in which the gingival contact portion extends along an axis different from the implant axis.

[0004] In the current state of the art, existing methods of dental restoration encounter some or all of the following technical problems: In many existing procedures, a new intervention on the gum is carried out after it has healed following the placement of the implant, in order to take the impression, material or digital, of the space to be restored, while having a view of the implant and the gum in order to take into account precisely the whole of this geometry, in order to manufacture an abutment and a prosthesis of precise shapes: this approach is naturally traumatic;Other existing procedures limit this trauma by using healing components that are not removed during impression taking, so as not to damage the gum. However, these procedures use specific healing elements, generally of a roughly cylindrical and standard shape, sometimes incorporating indicators and / or several additional components to allow for consideration of all or part of the geometry above the implant without fully accessing it through an impression. These less traumatic methods then present other drawbacks, such as increased complexity and / or less effective optimization of the healing phase.Existing dental restorations offer limited flexibility in appearance, positioning, and / or orientation relative to adjacent teeth. During the transitional period preceding the final restoration with an implant-supported prosthesis, aesthetics are often neglected. Furthermore, poor positioning and / or orientation can induce significant mechanical stress in the bone structure and healing gum tissue. Such stress can be painful and slow healing; the abutment and dental prosthesis are aligned with the implant.The implant must therefore be positioned along the axis defined by the dentition to be restored, i.e., the axis of the dental prosthesis. This approach has the disadvantage of a lack of flexibility in the positioning of the implant within the bone structure. If the bone is insufficient at the location required for the implant, a prior bone graft is necessary, which entails additional surgical complexity, detrimental to the patient. Object of the invention

[0005] Thus, a general object of the invention consists of a healing element 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 dental restoration solution that minimizes patient trauma during the restoration process.

[0007] A second object of the invention is a dental restoration solution that allows for a restoration that is as adapted as possible to the patient's anatomy.

[0008] A third object of the invention is a solution for dental restoration that is as simple as possible.

[0009] A fourth object of the invention is a dental restoration solution enabling an optimal aesthetic appearance to be achieved.

[0010] A fifth object of the invention is a dental restoration solution limiting the use of bone grafts.

[0011] To this end, the invention relates to a one-piece healing element, characterized in that it comprises: an implant part adapted for fixation on a dental implant, at least a lower part of which is oriented along a first axis, a coronal part intended for integration within a gum to shape the gum during its healing, at least an upper part of which extends overall along a second axis, and characterized in that the first axis and the second axis form a first non-zero angle.

[0012] The coronal portion may include a lateral surface intended for integration within a gingiva to shape the gingiva during its healing, and a terminal surface at its upper end, a portion of the lateral surface and the terminal surface forming an emergent surface, intended to remain outside the gingiva, which is asymmetrical with respect to at least one median plane to present an anatomical shape, and / or this emergent surface comprising a single plane of symmetry to present an anatomical shape.

[0013] Parts of the emerging surface of the healing element intended for positioning facing inwards and outwards from the mouth respectively may have a different shape.

[0014] A cross-section perpendicular to the second axis of the lateral surface of the coronary portion, or a projection onto a plane parallel to a transverse plane perpendicular to the second axis of the emergent surface of the coronary portion, may exhibit: a substantially trapezoidal shape or a substantially polygonal shape, or triangular, or square, or rectangular, or ovoid, or a substantially polygonal shape with rounded corners; and / or a part intended for outward positioning of the mouth that is larger than a part intended for inward positioning.

[0015] The emergent surface of the healing element can present an identifiable three-dimensional shape, forming a part of digital impression taking, allowing automatically its recognition, positioning, and / or orientation and indirectly the positioning and orientation of an implant (60), without a marker.

[0016] The healing element may have the following characteristics: at least a part of the lateral surface of the coronary part, in particular at the level of a superior part as an emergent surface, is formed by a set of parallel generators, and the second axis is parallel to this set of generators; or at least a part of the lateral surface of the coronary part, in particular at the level of a superior part as an emergent surface, is inscribed in a cylinder with a circular cross-section closest to said part, and the second axis corresponds to the axis of this cylinder.

[0017] The healing element may include a conical bearing surface suitable for cooperating with a conical portion of a screw head to seal an interface between a screw and the healing element, and / or may include a frustoconical portion suitable for cooperating with a conical bearing surface of the implant to seal an interface between the implant and the healing element and to reduce to zero any translational play between the healing element and the implant.

[0018] The healing element may include an anti-rotational element, including a portion with a hexagonal cross-section, to cooperate with an anti-rotational element of an implant, including an opening with a hexagonal cross-section, and ensure fixation of the healing element without rotation around the implant.

[0019] The healing element can be made from a polymer material, including "PEEK" material, or from metal, zirconia or titanium and / or be manufactured by machining and / or molding and / or by adding material.

[0020] The central opening may locally include an enlargement dimensioned to allow the pivoting of a screw towards an orientation parallel to the first axis and / or to receive a male connecting element of a prosthetic element, in particular an abutment, a provisional prosthesis support, a cap, or an impression-taking element.

[0021] The healing element may include a linking device arranged in the second segment of the central opening in the coronal portion suitable for receiving removable attachment of an abutment, a provisional prosthesis support, a cap, or an impression element.

[0022] The angle formed between the first axis and the second axis can be between 5 and 30 degrees or is greater than or equal to 10 degrees.

[0023] The healing element may include a central opening extending along its entire length, adapted for the passage of a screw and / or a tool such as a screwdriver for screwing a screw into an implant, the central opening including an outlet at the lower end of the implant part, intended for cooperation with an implant, and the first axis being oriented parallel to the axis of the outlet.

[0024] The central opening may include an entrance at the upper end of the coronary portion, the entrance being substantially oriented along a third axis, and the second axis may be parallel to the third axis, or the second axis and the third axis may have a second non-zero angle.

[0025] The invention also relates to a dental restoration assembly comprising a healing element as described above, an implant, a screw, and a cap, suitable for sealing the central opening to form a continuous and smooth terminal surface of the healing element.

[0026] The invention also relates to a dental restoration system, characterized in that it comprises a healing element as described above, a digital impression taking element, in particular a scanner, and at least one computer which uses the images from the digital impression taking for automatic recognition, based on the anatomical shape of the healing element and / or by the recognition of at least one marker, of the type of healing element used, from images of an emergent part of the healing element.

[0027] The invention also relates to a dental restoration method, characterized in that it includes a step of screwing a healing element as described above into the mouth using a screw, by passing a tool, in particular a screwdriver, through the central opening of the healing element, so as to reach the screw and allow it to be screwed into an implant.

[0028] The dental restoration procedure may include a step of determining the positioning of a dental implant, integrated into an individual's bone structure, from the identification and positioning of a healing element as described previously, the healing element being fixed at one of its ends in the implant, the healing element comprising a lateral surface intended for integration within a gingiva to shape the gingiva during its healing, and a terminal surface, a part of the lateral surface and the terminal surface forming an emergent surface, intended to remain outside the gingiva, which is asymmetrical with respect to at least one median plane to present an anatomical shape. Brief description of the drawings

[0029] These objects, features and advantages of the present invention will be described in detail in the following description of two particular embodiments, given by way of non-limiting example, in relation to the accompanying figures, among which: There figure 1 is a cross-sectional view of a dental restoration assembly according to a first embodiment of the invention. figures 2A, 2B, 2C and 2D These are respectively views of a right lateral side, a lingual side, a left lateral side, and a vestibular side of the entire dental restoration according to the first embodiment. figure 2E is a perspective view of the entire dental restoration according to the first embodiment. figures 3A, 3B, 3C and 3D These are respectively views of the right lateral, lingual, left lateral, and vestibular sides of a healing element of the dental restoration assembly according to the first embodiment. Figures 4A , 4B, 4C, 4D and 4E These are respectively views from a right lateral side, a lingual side, a left lateral side, a vestibular side, and a perspective view of the entire dental restoration according to a second embodiment. figures 5A, 5B, 5C and 5D These are respectively views of the right lateral, lingual, left lateral, and vestibular sides of a healing element of the dental restoration assembly according to the second embodiment. figures 6A, 6B, 6C and 6D are respectively a side view, a cross-sectional side view, a cross-sectional and exploded side view, and an exploded side view of the dental restoration assembly according to the second embodiment. figures 7A to 7D These are schematic views of steps in a dental restoration procedure. figures 8A to 8LThese are radiographs of teeth superimposed with dental restoration sets to illustrate the advantages of a dental restoration set according to the invention compared to a standard dental restoration set. figures 9A, 9B, 9C and 9D are respectively a side view, a cross-sectional side view, a cross-sectional and exploded side view, and an exploded side view of the dental restoration assembly according to the second embodiment equipped with an impression transfer tray. figure 9E is a perspective view of a wound healing element according to an alternative embodiment of the invention. Figure 10A This is a side view of an implant fitted with a dental abutment and a crown. figure 10Bis a side view of the implant equipped with the dental restoration abutment and the apex prosthesis superimposed on a view of the implant equipped with a healing element according to an embodiment. Description of a method of implementation

[0030] In the description that follows, the same references will be used for all variants of implementations to designate the same components, or even their equivalents, in order not to burden the text and to facilitate its reading.

[0031] Furthermore, we will conventionally choose a reference point along an axis defined in relation to the longitudinal axis of an implant, with the adjective "superior" designating the side of the implant intended to face the gum and the adjective "inferior" designating the opposite side. The same adjectives "inferior" and "superior" will be used for all components forming a dental restoration, in reference to the position they are intended to occupy when connected to an implant.

[0032] There figure 1 illustrates a dental restoration assembly 1 comprising a healing element 10 according to a first embodiment of the invention, as well as a screw 50 and an implant 60, the latter being integrated into a bone structure 2 of a patient, the bone structure being covered with gingiva 3.

[0033] Such a dental restoration kit is part of the implementation of a dental restoration process which may include a first phase and then a second phase.

[0034] During the first phase, known as the healing phase, one or more implants are integrated into the patient's bone structure through osseointegration. During this initial phase, a specific healing element is used, as will be detailed later. This healing element, also called a "healing cap," can be attached to the implant for the time necessary for gum healing and implant osseointegration. The healing element is therefore a temporary component. It covers the implant while allowing the gum to heal. It can prevent the implant from being covered by the gum during the healing process. In addition to its healing function, it can also serve an aesthetic purpose by filling the gap left by the extracted tooth while the implant heals.The healing element may not be designed to form a prosthesis useful for chewing, so as not to transmit stress to the implant during osseointegration. For this reason, it may, for example, be designed to be shorter than the adjacent teeth. The design of the healing element can be adapted for temporary use, generally for a few months. The healing element can then be easily detached from the implant to which it is attached.

[0035] The second phase is a restoration phase in itself. During this phase, a definitive prosthesis is placed on the implant(s) using a restorative abutment. The definitive prosthesis thus replaces the healing element.

[0036] The final prosthesis can be custom-made to perfectly fit the patient's teeth. In contrast, the healing element can be a standard component or at least readily available. In particular, the healing element does not necessarily have to be custom-made by a dental technician.

[0037] With reference to Figures 1 , 2A, 2B, 2C, 2D and 2EThe implant 60 comprises an overall cylindrical or frustoconical shell and a longitudinal axis L. It advantageously exhibits rotational symmetry about this longitudinal axis, which forms an axis of revolution. The implant 60 includes an anchoring means 61 for the patient's bone structure. The implant includes an opening on the side of its upper end, inside which is a connecting device 64 for the healing element 10. The connecting device 64 includes a threaded opening 65, a hexagonal opening 66 extending from the threaded opening 65, and a conical bearing surface 67 opening onto a superior face of the implant.The threaded opening 65, the hexagonal section opening 66 and the conical bearing 67 are adjacent, coaxial with the longitudinal axis L and arranged so that the threaded opening 65 is on the lower side of the implant 60, the conical bearing 67 is on the upper side of the implant 60 and the hexagonal section opening 66 is in an intermediate position between the threaded opening 65 and the conical bearing 67.

[0038] THE figures 3A, 3B, 3C and 3D illustrate a healing element 10 according to a first embodiment. The healing element 10 is monobloc, that is to say, it is made of a single piece and preferably from a single material. As illustrated on the figure 3AThe healing element 10 comprises an upper portion, referred to as the coronal portion 11, intended to be in contact with the patient's gingiva 3, in other words, intended to integrate with the gingiva to shape it during healing. The healing element 10 also comprises a lower portion, referred to as the implant portion 12, intended to be inserted into the implant opening to cooperate with the connecting device 64 and allow the healing element 10 to be fixed to the implant 60.

[0039] The healing element includes a central opening 13, which passes through and is designed to receive the screw 50 screwed into the threaded opening 65 of the implant. The central opening thus forms a well for the screw 50. The healing element is intended to be fixed to the implant by means of the screw 50. The central opening 13 includes an outlet 14 at the level of the implant portion 12, substantially oriented in the direction of a first axis A1. In other words, the outlet 14 corresponds to the lower opening of the central opening 13, the lower part of which is substantially cylindrical and oriented along the first axis A1. Since the implant portion 12 is intended for connection with an implant 60, this first axis A1 is intended for alignment with the longitudinal axis L of an implant. Thus, the implant part 12 of the healing element, in particular at least its lower part, is generally oriented along the first axis A1.The central opening 13 further includes an entry 15 in the upper part of the healing element, intended for the insertion of the screw 50.

[0040] The coronal part 11 extends globally in the direction of a second axis A2. In other words, the external shape of the coronal part 11 develops, or unfolds, from a boundary between the implant part and the coronal part, in the direction of the second axis A2. Depending on the particular geometry of the coronal part, the second axis A2 can be defined in different ways.

[0041] First, all or part of the lateral surface 22 of the coronal portion 11, particularly its upper part, is advantageously defined by a set of parallel generators G. The second axis A2 is defined in this case with reference to the orientation of this set of generators G, that is, as an axis parallel to these generators G. Indeed, as appears, for example, on the figures 2A to 3D , the coronal part 11 comprises a lateral surface defined by a set of parallel generatrices G.

[0042] Alternatively, in the case of a more complex lateral surface 22 of the coronary portion 11, not defined by parallel generatrices, it is possible to refer to the nearest circular cylinder of the coronary portion, particularly the upper part of the coronary portion, in which it is inscribed. The second axis A2 thus corresponds to the axis of this nearest cylinder.

[0043] According to another approach, in the case where the cross sections, perpendicular to the second axis A2, of the coronary part, at least in its upper part, have a center, this second axis A2 includes these different centers.

[0044] According to the invention, the first axis A1 and the second axis A2 are not aligned, that is, they are not parallel. In other words, the first axis A1 and the second axis A2 form a first non-zero angle α. Thus, the healing element is angled, its two implant and coronal parts having a different orientation.

[0045] Advantageously, the angle α between the first axis A1 and the second axis A2 is between 5 and 30 degrees. In the first embodiment illustrated on the figures 1 to 3DThe angle α is equal to 10 degrees. This value allows for easy insertion and pivoting of the screw 50 within the central opening 13. When the healing element is fixed to the implant 60, the first axis A1 coincides with the longitudinal axis L of the implant. This assembly is illustrated in particular in the figure 1 and on the figure 2A This assembly is obtained by screwing the screw 50 into the implant 60, through the central opening 13 of the healing element 10, for example using a screwdriver.

[0046] As a point of note, in this first embodiment, the second axis A2 also corresponds to the orientation of the inlet 15 of the central opening 13, which is substantially arranged in the central part of the terminal surface 21 that forms the upper surface of the healing element. The inlet 15 corresponds to the upper opening of the central opening 13, the upper part of which is substantially cylindrical and oriented along a third axis A3. In this first embodiment, the second axis A2 can be defined as an axis parallel to this third axis A3. In other words, in this particular configuration of the inlet 15, the two axes A2 and A3 are parallel, and the second axis A2 can be defined from the third axis A3 of the inlet 15 of the central opening.

[0047] On the figure 1It can be observed that the central opening 13 of the healing element 10 comprises a first section 16 at the level of the implant portion 12, oriented along the first axis A1, and a second section 17 at the level of the coronal portion 11, oriented along the third axis A3. The first section extends from the outlet 14 to the second section, with which it communicates. Similarly, the second section extends from the inlet 15 to the first section. The central opening forms a bend 18, or a curved portion, at the interface between the first and second sections. The bend 18 is positioned approximately at the level of the boundary between the implant portion 12 and the coronal portion 11 of the healing element.

[0048] The second section 17 comprises a set of circular sections centered on the third axis A3. Tracing the second section 17 from the inlet 15 towards the elbow 18, it is found to consist of a first frustoconical section 17A, followed by a second cylindrical section 17B, followed by an expansion 17C, and then a third cylindrical section 17D. This third section 17D connects to the elbow 18. The expansion 17C is a section of the second portion whose diameter is larger than the diameters of the sections positioned on either side of it. This allows the screw 50 to pivot within the healing element during its installation. The screw 50 can therefore pivot from an orientation parallel to the third axis A3 to an orientation parallel to the first axis A1.As a reminder, in this first embodiment, the second axis A2 and the third axis A3 are aligned, which will not be the case in the second embodiment described below.

[0049] Similarly, the first section 16 comprises a set of circular sections centered on the first axis A1. Tracing the first section 16 from the bend 18 towards the outlet 14, it is observed that it consists of a conical bearing surface 16A forming a first frustoconical section, followed by a second cylindrical section 16B. The conical bearing surface 16A is designed to cooperate with a conical (i.e., frustoconical) portion of a screw head 51 of the screw 50, which has a complementary shape, so as to form a watertight interface.

[0050] The screw 50 comprises a screw head 51, a threaded portion 52, and a cylindrical portion 53. The unthreaded cylindrical portion 53 is positioned between the threaded portion 52 and the screw head 51. The threaded portion 52 is designed to engage with the threaded opening 65 of the implant to lock the healing element in position. The cylindrical portion 43 of the screw is designed to be positioned at the second section 16B of the first segment 16 of the central opening 13 of the healing element. The healing element and the screw can be supplied pre-assembled, which reduces the amount of handling required by the dentist.

[0051] The healing element 10 includes, at its lower end and along its outer perimeter, a hexagonal section 19, designed to cooperate with the hexagonal opening 66 of the implant. The interface thus formed ensures that the healing element 10 is fixed in a fixed orientation, without rotation of the healing element around the implant 60. It should be noted that the cooperation of the hexagonal sections allows for six distinct positions of the same healing element relative to the implant. These positions are distinguished by 60-degree rotations of the healing element around the first axis A1. The dentist can identify the orientation that best suits the patient's anatomy. The hexagonal section 19 and the hexagonal opening 66 are anti-rotational elements that could be replaced by any other equivalent anti-rotational elements.As an alternative to a hexagonal section, the healing element could include any other pattern capable of cooperating with an implant having a complementary pattern to achieve an anti-rotation function. This pattern could, for example, include a polygon with more than six sides so as to offer orientation choices for the healing element distinguished from one another by a rotation angle of less than 60 degrees. This pattern could also include a set of notches capable of cooperating with complementary notches arranged on the implant.

[0052] The healing element thus includes an implant fixation device at its lower end. Furthermore, the healing element also includes, on the outer periphery of its implant portion 12, a frustoconical or substantially frustoconical section 20, adapted to cooperate with the conical bearing surface 67 of the implant to form a watertight interface between the implant and the healing element. The conical bearing surface 67 and the frustoconical section 20 function as a sealing cone and also serve a unique positioning function for the healing element relative to the implant. Indeed, the assembly of the conical bearing surface 67 with the frustoconical section 20 eliminates any translational play between the healing element and the implant after the screw 40 is tightened.Furthermore, as rotation of the healing element relative to the implant is impossible thanks to the interface formed by the hexagonal section portion 19 and the hexagonal section opening 66, the connection between the healing element 10 and the implant 60 is a particularly rigid connection.

[0053] With reference to the figure 2E The dental restoration kit 1 includes a cap 80 suitable for sealing the opening 15. This cap is also visible on the figures 6B, 6C and 6Dillustrating a second embodiment of the invention. The cap 80 comprises a frustoconical head 81, a cylindrical body 82, and a male connecting element 83. The frustoconical head 81 cooperates with the first frustoconical section 17A of the healing element to form a watertight interface between the cap 80 and the healing element at its upper surface. The cylindrical body extends along the second section 17B of the healing element when the cap is in place. The male connecting element 83 cooperates with the enlargement 17C to form a clip-type connection. The cap 80 also includes a blind, threaded opening 84 on its upper face. This opening 84 provides a grip for a tool specifically adapted for removing the cap by pulling. Notably, this opening 84 is small, so that a limited volume of foreign matter could become lodged within it.This opening 84 can also be plugged with a suitable sealing paste, or closed with a second cap during the healing period to form a continuous, smooth upper surface of the healing element.

[0054] Existing implants can have different shapes and, in particular, different connection devices for dental restorations. There can be as many different dental restorations as there are different connection devices, so that each existing implant can be matched with a healing element equipped with a suitable connection device.

[0055] The healing element 10 is designed to be housed within the incised gingiva after the implant has been fixed. In this configuration, the implant 60 is secured to the bone structure 2. It does not protrude, or only very slightly protrudes, from the bone within the gingiva 3. The healing element 10 is fixed to the implant 60 in such a way that the gingiva 63 is almost exclusively in contact with the healing element 10. The healing element may include at least one plane substantially perpendicular to the second axis A2, defining a 360° contour of the healing element, which is entirely in contact with the gingiva. More generally, the healing element may include a line extending 360° around the healing element, on the lateral surface 22 of the coronal part 11, which is fully in contact with the gingiva.A significant portion of the healing element's height, particularly its lateral surface 22, is advantageously in contact with the gingiva. At least half of its height can thus be advantageously in contact with the gingiva, along at least one axis substantially parallel to the second axis A2 along the lateral surface of the healing element. The healing element temporarily participates in the restoration process by fulfilling the function of healing the gingiva. It can also contribute to the smooth fabrication of the final prosthesis, as will be detailed later.

[0056] As previously mentioned, the coronal portion 11 of the healing element comprises an end surface 21 through which the inlet 15 of the central opening 13 opens, and a lateral surface 22 around which the gingiva 3 is intended to heal. The lateral surface 22 is chosen to best match the patient's oral environment. The end surface 21 of the healing element is designed to remain visible above the gingival surface 4 of the gingiva 3, since the gingiva remains in full contact with the lateral surface 22 of the healing element. The end surface 21 is oriented substantially perpendicular to the second axis A2. Thus, when the healing element is fixed to the implant in the patient's mouth, the end surface 21 is inclined relative to the implant axis.Advantageously, the dentist can orient the healing element so that the terminal surface 21 faces inwards towards the mouth at an angle corresponding to angle α. Such an inclination makes it possible to conceal, or at least make less easily visible, the central opening 13 or the screw head 51. The upper part of the lateral surface 22 and the terminal surface 21 thus form an emergent surface 23 of the healing element. This emergent surface is illustrated in particular in Figure 1. figure 1 .

[0057] With reference to the figure 2EIt is observed that the shape of the terminal surface 21 of the healing element is asymmetrical. The lingual side (CL) is the portion of the lateral surface 22 facing the inside of the mouth, that is, towards the patient's tongue. Similarly, the vestibular side (CV) is the portion of the lateral surface 22 facing the outside of the mouth, that is, towards the patient's lip. The vestibular side of the healing element is wider than the lingual side. The terminal surface 21 can be roughly trapezoidal in shape. Consequently, the inner (lingual CL) and outer (vestibular CV) portions of the healing element have different shapes.

[0058] The healing element's shape features rounded corners and curved sides to ensure it does not impinge on the gums. Furthermore, the terminal surface 21 of each healing element, with the exception of the central opening 13, is a continuous surface, free of ridges, hollows, grooves, edges, and / or roughness. This surface is convex. This smooth geometry promotes oral hygiene, reduces food accumulation, and minimizes plaque buildup.

[0059] Thanks to the use of the cap 80, the terminal surface 21 is essentially continuous, even at the entrance 15. Thus, this terminal surface, closed by the cap 80, essentially exhibits the property of a continuous surface, without raised areas, hollows, grooves, edges, or asperities. Such a cap helps ensure good oral hygiene, since the healing element is intended to remain in the mouth during the healing phase, being the only part in contact with the gum and unprotected from oral aggressions.

[0060] In addition, the cross-section of a healing element at its lateral surface 22, that is, the section along a plane substantially perpendicular to the second axis A2, could take any other anatomical shape; in particular, it could approximate any polygon, such as a three-, four-, five-, or six-sided polygon. Alternatively, the angles of these polygons could be so rounded that the overall shape would approach an oblong shape, or even an ovoid cross-section, or any other shape further removed from a polygon. This lateral surface 22 and the terminal surface 21 (and / or its projection onto a plane perpendicular to the second axis A2) ultimately have an identical or similar shape, since they are continuous with each other.

[0061] Depending on the embodiment, the geometry of the visible emergent surface of the healing element on the inside of the mouth differs from the geometry on the outside, to account for the curvature of the gingiva and / or the natural shape of the teeth. A justogingival plane (PJ) can be defined as the plane in which the gingiva extends at the level of tooth emergence. The justogingival plane is notably shown as an example in the... figures 8A to 8L The shape of the emergent surface of the healing element is asymmetric with respect to at least one median plane, perpendicular to the justogingival plane and passing through a center C of the terminal surface 21. In particular, the healing element is asymmetric with respect to the median plane PM illustrated in the figures 2E And 4E The median plane PM mentioned above delimits the lingual side from the vestibular side of the healing element.

[0062] On the one hand, asymmetry can be characterized by a height along the second axis A2 of the coronal portion of the healing element on the lingual side, greater than the height of the healing element on the vestibular side. Such a height difference Δh is particularly visible on the figure 3C or the figure 5C Furthermore, considering the projection of the coronal portion, particularly its terminal and / or emergent part, of the healing element onto a transverse plane P, perpendicular to the second axis A2, the asymmetry can be characterized by a non-circular shape of the contour of this projection. In other words, this section presents at least one axis passing through the center of the section and defining an axis of asymmetry of the section.

[0063] According to the embodiments presented, the coronal portion of the healing element comprises a single plane of symmetry PS (see figures 2E And 4EThus, each healing element is equally well-suited for integration into either the left or right side of a patient's dentition. Alternatively, a healing element could have no plane of symmetry and be specifically adapted to either the right or left side of the patient's dentition.

[0064] Finally, the emergent surface of a healing element can take any identifiable three-dimensional shape, allowing recognition of the healing element used and possibly knowing its orientation, to fulfill a second function which will be detailed later in addition to allowing the healing of the gum according to an anatomical shape.

[0065] The healing element can be made of a medical-grade plastic material and is available in pink, white, or cream. Specifically, it can be made from a polymer material, such as PEEK. Alternatively, it can be made of metal, for example, titanium, or zirconia. Indeed, this healing element can be made of titanium with a zirconia nitride surface treatment, notably to improve its visibility on oral scanners, while remaining biocompatible. The healing element can be manufactured by machining, molding, and / or additive manufacturing, in other words, by 3D printing.

[0066] The use of dental restoration elements promotes optimal gum healing during a dental restoration procedure due to their geometry, which is designed to conform to oral anatomy. It should be noted that this healing element can, alternatively, be completely subgingival and invisible, then made visible through a procedure on the gum. In this case, the outermost part of the healing element is still often referred to, somewhat inaccurately, as the emergent portion.

[0067] The shape of the coronal part of the healing element is specifically chosen to promote gum healing, according to an anatomical shape that best corresponds to the tooth to be replaced and consequently also to the future summit prosthesis intended to occupy this oral space.

[0068] Advantageously, the dentist has access to a range of ready-to-use dental restorations. These restorations vary in size and have different α angles. Preferably, the α angle is 10° or greater. The dentist can then select the healing element best suited to the patient's oral geometry. Color markings on the screw or cap allow for quick identification of the size and / or α angle of a given healing element. This simplifies communication between dentists and dental technicians.

[0069] We will now describe the second embodiment of the dental restoration assembly with reference to figures 4A to 4E And 5A at 5E, detailing the differences with the first embodiment.

[0070] According to the second embodiment, the second axis A2, corresponding in particular to the set of generators G in this embodiment, the first axis A1, along which the output 14 is oriented, and the third axis A3, along which the input 15 is oriented, are all three distinct, that is to say, they are not parallel to each other. The angle α denotes the angle formed between the second axis A2 and the first axis A1. A second angle β is defined as the angle formed between the second axis A2 and the third axis A3. The angle β can be, for example, between 0 degrees and 30 degrees. As a remark, the first embodiment corresponds to a healing element in which the angle β is zero. According to the second embodiment, the angle β is approximately 10 degrees and the angle α is approximately 20 degrees.Advantageously, angle β can be formed in the same direction as angle α, that is, in the same plane as angle α, so that the angle formed between the first axis A1 and the third axis A3 can be obtained from the two angles α and β. Thus, the second embodiment of the healing element includes an angle formed between the first axis A1 and the third axis A3 equal to 10 degrees. Advantageously, the range of ready-to-use dental restorative elements is complemented by dental restorative elements with different angle values.

[0071] THE figures 7A to 7C schematically illustrate a step in choosing a particular healing element during a dental restoration procedure. Initially, as illustrated on the figure 7AThe implant 60 is fixed to the patient's bone structure 2. Then, the dentist chooses from the range of dental restoration elements available the healing element best suited to the shape of the tooth to be replaced. He may use a healing element according to the invention as illustrated in the figure 7B or to a healing element according to the state of the art as illustrated on the figure 7C We observe that for a healing element according to the state of the art, as illustrated on the figure 7C The central opening is oriented towards the vestibular side. That is to say, the central opening opens onto a surface of the tooth facing outwards from the mouth. The central opening is therefore easily visible. On the other hand, for a healing element according to the invention, as illustrated in the figure 7BThe central opening 13 is oriented towards the lingual side. Since the central opening leads to a tooth surface facing the inside of the mouth, it is less easily visible. Therefore, it is preferable to choose a healing element according to the invention to optimize the aesthetics of the patient's dentition. figure 7D This illustrates the final prosthesis after the dental restoration procedure. The final prosthesis can be fixed to the implant using a screw that passes through a screw hole in the final prosthesis. This screw hole can be oriented parallel to the second axis A2.

[0072] THE figures 8A to 8L illustrate, by way of example, twelve practical cases in which a wound-healing element according to the invention is advantageously used. More particularly, in the cases illustrated in the Figures 8B , 8C , 8E , 8G , And 8JA healing element according to the first embodiment of the invention was used. In the cases illustrated in the Figures 8A , 8D , 8F , 8H , 8I , 8K and 8LA healing element according to the second embodiment of the invention was used. Each figure illustrates, with a superimposed radiographic image, the replacement of a standard healing element (visible on the left in each figure) by a healing element according to the invention (visible on the right in each figure). It can be seen that the terminal surface 21 and the inlet 15 are oriented towards the inside of the mouth. This prevents the cap 80 from being visible externally, thus improving the patient's aesthetics. Furthermore, the use of a healing element according to the invention promotes the formation or healing of the gingiva in an anatomical shape, which further improves aesthetics. In particular, it is noted that the volume of gingiva on the buccal side is greater when a healing element according to the invention is used.Furthermore, the emergence axis of the coronal portion, that is, the orientation of the second axis A2, corresponds more closely to the future tooth. Indeed, as can be seen by observing the position of the original tooth, an inward inclination of the coronal portion allows for a more accurate reproduction of the natural inclination of a tooth. The definitive prosthesis, which replaces the healing element after the healing phase, includes a screw hole designed to accommodate a screw for its fixation to the implant. The screw hole of the definitive prosthesis is also oriented parallel to the second axis A2 to replicate the natural inclination of the tooth.

[0073] In addition to the advantages described above, the healing element allows for a beneficial restorative procedure and a manufacturing process for a dental prosthesis and abutment with minimal trauma to the gums. Indeed, it is possible to obtain a digital or physical impression of the area to be restored without removing the healing element from the mouth, thus avoiding any impact on the gums. Therefore, in addition to its primary healing function, detailed previously, the healing element fulfills a second function during the restorative procedure by allowing for the advantageous definition of the shape of the restorative abutment and / or prosthesis before its removal. This function complements its primary healing function, as it prevents further trauma to the gums after healing, ensuring a chosen, anatomically advantageous shape.

[0074] To achieve this, at the end of the healing phase of the dental restoration procedure, a practitioner can take a digital impression of the patient's mouth without removing the healing element. The scan data, obtained using any device such as an oral scanner, is automatically transmitted to a computer equipped with dental restoration software. This software has a user interface through which an operator can specify the model of healing element used, or more generally, the reference number of the healing element, and possibly the implant used.

[0075] To identify the healing element pattern used, a first approach may be to form dental restoration elements or screws or caps of different colors for different healing element patterns.

[0076] A second approach consists of placing any indicator on the emergent surface of the healing element to indicate the healing element model, this indicator being able to consist of numbers and / or letters and / or any symbol and / or colors and / or laser markings and / or one or more barcodes and / or datamatrix codes and / or any identification code.

[0077] According to a third approach, the healing element model may have been previously recorded in a database associated with the patient. The dentist then simply consults this database to identify the model used.

[0078] Finally, according to a fourth approach, the software can automatically identify the healing element model used by comparing a scan of the emerging surface obtained with an oral scanner with a database containing scans of the various dental restoration models that the dentist is likely to have attached to the patient's implant. The software then determines which healing element model has a shape that matches the impression of the emerging surface captured by the oral scanner. The asymmetrical anatomical shape of the emerging portion and the terminal surface of the healing element makes it automatically identifiable in this digital process. The approaches described above as examples can also be combined to improve the reliability of healing element identification.

[0079] From the scan data, software automatically determines the position of the healing element. The anatomical shape of the emerging surface 23 is recognizable and forms part of the digital impression. More precisely, the software matches the emerging surface of the dental element, as obtained from the oral scanner, with a previously identified scan of the complete healing element. This scan is available in a database stored electronically, accessible via the software.The dentist or an operator can assist the software in correctly superimposing the scan of the emerging surface obtained by the oral scanner with the scan of the identified healing element model. This is achieved by capturing one or more points on the emerging surface of an image obtained during the aforementioned scanning step and presented to the operator on a human-machine interface screen. Then, through geometric construction, the software automatically determines the position of the implant, fixed at a unique location relative to the healing element. With such software, the dentist can thus determine the position, and in particular the axis of the implant, without having to directly visualize it.

[0080] Once the restoration software has accurately repositioned the hidden implant, it uses this information to determine the final geometry of a definitive prosthesis that must be attached to the implant and occupy the entire gingival volume defined by the healing element. This definitive prosthesis can then be attached to the implant either directly or via a dental abutment fixed to the implant, using a known method.

[0081] As a side note, this restoration process can be done entirely digitally, therefore virtually, or it can involve phases of constructing a model in plastic or plaster. In the latter case, a physical impression, for example in silicone, can be taken, and a plaster cast can be poured into the impression to create the master model, that is to say, a replica of the dental arch to be restored, which is then scanned in the laboratory to reconstruct a digital image.

[0082] 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 of the restoration process 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, as explained above. 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 device for manufacturing a restoration and / or prosthesis abutment. Furthermore, it can be linked via a second communication device to a manufacturing device such as a machine tool.

[0083] As illustrated on the figures 9A to 9DThe healing element can also be used for the temporary or permanent fixation of a prosthetic component or a dental restoration tool. As shown in the specific example in these figures, the prosthetic component could be, for example, a temporary abutment or support 30 around which a crown prosthesis, preferably temporary and optionally permanent, can be fixed to improve aesthetics and / or patient comfort. The dental restoration tool could be, for example, a traditional impression tray, which allows for a traditional impression to be taken in an impression material such as a suitable paste, capturing an impression of the oral space at the implant site. This is thus an alternative to the digital impression described previously.The prosthesis support 30 is generally cylindrical in shape and can be locally truncated to be compatible with the angled shape of the healing element 10. Advantageously, the support 30 includes a male connecting element 31 adapted to cooperate with the expansion 17C arranged inside the central opening 13. The expansion 17C thus also functions as a prosthesis support 30, temporary or otherwise, and / or as an impression transfer element. These connecting elements can allow for a clip-type connection, or any other mechanical connection. In addition, the support 30 can be equipped with circumferential grooves 32 improving the adhesion of the apex prosthesis to the support 30. To ensure a unique orientation of the support 30 relative to the healing element 10, an anti-rotational device 24, visible on the figure, is used. figure 9E, can be arranged in the second section 17 of the central opening 13. The anti-rotational element 24 can be in the form of a groove parallel to the third axis A3 and made over all or part of the height of the second portion 17 of the central opening 13. Naturally, alternatively, any other removable connecting device can be arranged at the level of the second section 17 of the central opening 13 within the coronal part 11.

[0084] After healing, a 40 angled dental restoration abutment is fixed to the implant to support a 70 abutment, thus completing the dental restoration, illustrated by the Figure 10A As a point of note, this elbow advantageously presents an angulation identical or close to the angulation of the healing element used for wound healing. As illustrated by the figure 10BThe lower shape of the apex prosthesis 70 within the gingiva corresponds to that of the healing element 10 used for healing: thanks to this approach, the prosthesis fits smoothly and ideally into the anatomically shaped cavity prepared by the healing phase. The prosthesis can be easily fixed to the implant using a screw that passes through a screw hole oriented on the lingual side. The final prosthesis is therefore particularly aesthetic since the screw hole is invisible from outside the mouth.

[0085] Thanks to this invention, a healing element is available that minimizes patient trauma during the restoration process because it does not need to be removed to take an impression of the underlying implant for the fabrication of the final prosthesis. The healing element can even be left in place during the final prosthesis placement phase, further reducing trauma for the patient. Thanks to its anatomical shape, the gum heals in its natural form. The gum is not deformed during the placement of the final prosthesis. Furthermore, the installation of a healing element is particularly simple because it consists of a single piece screwed into the implant. Finally, the patient's aesthetic appearance is optimized from the healing phase onward because the healing element has a coronal portion whose orientation respects the natural alignment and shape of the teeth.Furthermore, this orientation helps to conceal the screw hole used for fixing.

[0086] This specific curvature of the restorative element, and subsequently of the eventual final abutment, allows for the formation of a prosthesis 70 arranged around a lower opening that acts as a connecting means to cooperate with said abutment, since it is fixed in the correct final orientation thanks to the prior arrangement of the invention. This avoids, for example, attempting to compensate for an angle by using an asymmetrical shape of a prosthesis, to the detriment of the mechanical rigidity and aesthetic appearance of that prosthesis. In other words, the invention makes it possible to use a prosthesis of optimal shape, which automatically extends at the end of the restoration overall along the direction defined by the second axis A2, which is not aligned with the longitudinal axis L of the implant.

Claims

1. One-piece healing element (10) which comprises: - an implant part (12) intended to be fixed to a dental implant (60), of which at least a lower part is oriented along a first axis (A1), - a coronal part (11) intended to be integrated into a gum (3) in order to shape the gum (3) as it heals, of which at least an upper part extends overall along a second axis (A2), the coronal part (11) having a terminal surface (21) and a lateral surface (22), the terminal surface being intended to remain visible above a gum surface (4) of the gum (3), the gum being intended to be wholly in contact with the lateral surface (22) and which is such that the first axis (A1) and the second axis (A2) form a non-zero first angle (α).

2. Healing element (10) according to the preceding claim, characterized in that the coronal part (11) comprises a lateral surface (22) intended to be integrated into a gum (3) in order to shape the gum (3) as it heals, and a terminal surface (21) at its upper end, a part of the lateral surface (22) and of the terminal surface (21) forming an emergent surface (23), intended to remain out of the gum (3), which is asymmetric with respect to at least a median plane (PM) so as to exhibit an anatomical shape, and / or in that this emergent surface (23) comprises a single plane of symmetry (PS) so as to exhibit an anatomical shape.

3. Healing element (10) according to Claim 2, characterized in that parts of the emergent surface (23) of the healing element (10), which are respectively intended to be positioned facing towards the inside and towards the outside of the mouth, have different shapes.

4. Healing element (10) according to either of Claims 2 and 3, characterized in that a cross section perpendicular to the second axis (A2) of the lateral surface (22) of the coronal part (11) or a projection onto a plane parallel to a transverse plane perpendicular to the second axis (A2) of the emergent surface (23) of the coronal part (11) exhibits: - a substantially trapezoidal shape or a substantially polygonal or triangular or square or rectangular or ovoid shape or a substantially polygonal shape with rounded corners; and / or - a part intended to be positioned facing towards the outside of the mouth that is larger in dimension than a part intended to be positioned facing towards the inside.

5. Healing element (10) according to one of Claims 2 to 4, characterized in that the emergent surface (23) of the healing element (10) exhibits an identifiable three-dimensional shape forming a part for the taking of a digital impression, allowing automatic recognition, positioning and / or orientation thereof and indirectly allowing an implant (60) to be positioned and oriented without a marker.

6. Healing element (10) according to one of the preceding claims, characterized in that: - at least a part of the lateral surface (22) of the coronal part (11), notably at an upper part such as an emergent surface (23), is formed by a set of parallel generatrices (G), and in that the second axis (A2) is parallel to this set of generatrices; or - at least a part of the lateral surface (22) of the coronal part (11), notably at an upper part such as an emergent surface (23), is inscribed inside a cylinder of circular cross section closest to said part, and in that the second axis (A2) corresponds to the axis of this cylinder.

7. Healing element (10) according to one of the preceding claims, characterized in that it comprises a conical bearing surface (16A) able to collaborate with a conical portion of a screw head (51) so as to seal tight an interface between a screw (50) and the healing element (10), and / or in that it comprises a frustoconical portion (20) able to collaborate with a conical bearing surface (67) of the implant (60) so as to seal tight an interface between the implant (60) and the healing element (10) and reduce to zero any translational play between the healing element (10) and the implant (60).

8. Healing element (10) according to one of the preceding claims, characterized in that it comprises a rotation-proofing element, notably a hexagonal-section portion (19), to collaborate with a rotation-proofing element of an implant (60), notably a hexagonal-section opening (66), and ensure that the healing element (10) is fixed without the ability to rotate around the implant (60), and / or in that the healing element (10) is made from a polymer material, notably from a PEEK material, or from metal, zirconia or titanium, and / or in that it is manufactured by machining and / or by moulding and / or by additive manufacturing.

9. Healing element (10) according to one of the preceding claims, characterized in that the central opening (13) locally comprises a widening (17C) dimensioned so as to allow a screw (50) to pivot into an orientation parallel to the first axis (A1) and / or to accept a male connection element (31, 83) of a prosthetic element, notably of an abutment, of a support (30) for a temporary prosthesis, of a cap (80) or of an impression-taking element, and / or in that the healing element (10) comprises a connecting device arranged in the second portion (17) of the central opening (13) in the coronal part (11) able to accept the removable attachment of an abutment, of a support (30) for a temporary prosthesis, of a cap (80) or of an impression-taking element, and / or in that the angle (α) formed between the first axis (A1) and the second axis (A2) is comprised between 5 and 30 degrees or is greater than or equal to 10 degrees.

10. Healing element (10) according to one of the preceding claims, characterized in that it comprises a central opening (13) extending over its entire length, suitable for the passage of a screw (50) and / or of a tool such as a screwdriver for screwing a screw (50) into an implant (60), the central opening (13) comprising an exit (14) at the lower end of the implant part (12), intended for collaboration with an implant (60), and in that the first axis (A1) is oriented parallel to the axis of the exit (14).

11. Healing element (10) according to the preceding claim, characterized in that the central opening (13) has an entrance (15) at the upper end of the coronal part (11), the entrance (15) being oriented substantially along a third axis (A3), and in that the second axis (A2) is parallel to the third axis (A3), or the second axis (A2) and the third axis (A3) exhibit a non-zero second angle (β).

12. Dental restoration assembly (1), characterized in that it comprises a healing element (10) according to one of the preceding claims, an implant (60), a screw (50) and a cap (80) able to occlude the central opening (13) so as to form for the healing element a terminal surface (21) that is continuous and free of roughness.

13. Dental restoration system, characterized in that it comprises a healing element (10) according to one of Claims 1 to 11, a digital impression-taking element, notably a scanner, and at least a computer that exploits the images from the digital impression taken for the purpose of automatic recognition, on the basis of the anatomical shape of the healing element and / or by the recognition of at least one marker, of the type of healing element used, from images of an emergent part (23) of the healing element (10).

14. Method for manufacturing a definitive dental prosthesis comprising a step of determining the positioning of a dental implant (60), which is integrated into a bony structure (62) of an individual, from the identification and the positioning of a healing element (10) according to one of Claims 1 to 11, the healing element (10) being fixed at one of its ends into the implant (60), the healing element (10) comprising a lateral surface (22) intended for integration into a gum (3) in order to shape the gum (3) as it heals, and a terminal surface (21), a part of the lateral surface (22) and of the terminal surface (21) forming an emergent surface (23), intended to remain out of the gum (3), which is asymmetric with respect to at least a median plane (PM) so as to exhibit an anatomical shape.