• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    The present invention relates to a method of producing a grid of a juxta-osseous implant comprising the steps of acquiring a 3D image via a CT scan of a bone structure, the grid being adapted to be implanted on. this, making a three-dimensional resin model of the bone structure as a function of the 3D digital image acquired, and making a drawing of the grid on the produced three-dimensional model of the bone structure. The method further comprises the steps of modifying one or more parts of the realized three-dimensional model of the bone structure according to the drawing made in the previous step and the conformation of the three-dimensional model, acquiring a 3D digital image of the modified three-dimensional model during the previous step, produce a 3D digital model of the grid as a function of the 3D digital image acquired during the previous step, and produce the grid as a function of the 3D digital model produced.
    公开号:BE1027582B1
    申请号:E20205677
    申请日:2020-10-01
    公开日:2021-08-27
    发明作者:Mauro Cerea
    申请人:Eaglegrid S R L；
    IPC主号:
    专利说明:

    Method for producing a grid of a juxta-osseous implant DESCRIPTION
    TECHNICAL FIELD The present invention relates to a method for the production of a juxta-osseous implant.
    BACKGROUND ART As is known, severe maxillomandibular atrophy can often be corrected only by the application of implant techniques.
    A juxta-osseous implant is a medical device belonging to the category of dental implants. A juxta-osseous implant consists of a main structure, a framework or grid, which presses tightly on the patient's residual bone, precisely in the juxta-osseous seat.
    The implant is anchored to a patient's bone, by synthetic self-tapping screws, in predetermined anatomical areas, but different depending on the patient's mandibular or jawbone structure and / or specific pathology.
    The grid consists of support arms and reinforcement arms. In addition, support points are connected to the grid for the tines. The support points for the teeth can be monophasic, i.e. created as a single piece with the grid, for example by means of a laser fusion technique, or biphasic, that is, engaged with the grid using a screw connection which allows the type of fulcrum or type of locking with the teeth to be selected after surgery.
    The number of fulcrums, their shape, and the ratios of fulcrums with opposing teeth are selected and determined during the implant design and implementation stage and may also vary, depending on the bone structure and / or the specific pathology of the patient.
    To enable the production of juxta-osseous implants that are less invasive to the patient, and above all, to allow the compatibility of the implant with a juxta-osseous seat of the structure to be improved, the same applicant has provided a process for the production of a grid of a juxta-osseous implant according to Italian patent 102016000118979. After three years of research and development activity carried out on the grid production process and various feedback obtained from a point of Clinically, there has been a need to improve the production process to further improve the compatibility of the implant with the juxta-bony seat of the bone structure.
    An objective of the present invention is therefore to provide a response to this need in the context of a simple, rational and economical solution.
    Such objects are accomplished by the features of the invention given in the independent claim.
    The dependent claims outline preferred and / or particularly advantageous aspects of the invention.
    DESCRIPTION OF THE INVENTION According to the objects mentioned above, the present invention provides a method for producing a grid of a juxta-osseous implant which comprises the steps of: - acquiring a 3D digital image by computed tomography of a bone structure, the grid being adapted to be implanted on it, - make a three-dimensional model of the bone structure according to the 3D digital image acquired, - make a drawing of the grid on the three-dimensional model produced of the bone structure ,
    - modify one or more parts of the three-dimensional model of the bone structure, depending on the drawing made during the previous step and the conformation of the three-dimensional model, - acquire a 3D image of the three-dimensional model modified during the previous step, - producing a 3D digital model of the grid as a function of the 3D digital image acquired during the previous step, and - producing the grid as a function of the 3D digital image produced. Thanks to such a solution, it is possible to produce a grid of a juxta-osseous implant which significantly reduces the impact on the patient's bone structure and promotes its correct healing.
    Another aspect of the present invention provides that the step consisting in producing a 3D digital model of the grid provides for the steps consisting in: processing the 3D image of the modified three-dimensional model by means of CAD / CAM software , and - compare it with the 3D image of the patient's unmodified bone structure, and - transfer to the 3D digital image of the patient's unmodified bone structure the modifications and the drawing made on the three-dimensional model of the bone structure in the 3D digital image of the modified model.
    Thanks to this solution, the modifications and the drawing made on the three-dimensional model are reproduced in the digital environment so as to allow the activities carried out to be modified and / or validated with extreme precision.
    Another aspect of the present invention provides that the step of modifying one or more parts of the three-dimensional model of the bone structure provides for making a second design of the grid on the resin model of the bone structure according to the requirements. modifications made before acquiring a 3D image of the modified three-dimensional model.
    Thanks to this solution, it is possible to optimize the design and consequently the conformation, the dimensions and the thicknesses of one or more parts of the grid so as to further improve the adhesion to the patient's bone structure and to accelerate healing times.
    Another aspect of the present invention provides that the step of producing a three-dimensional model of the bone structure provides for its production from a thermoplastic or thermosetting resin, by means of rapid prototyping techniques.
    Another aspect of the present invention provides that the step of modifying one or more parts of the three-dimensional model of the bone structure provides for making one or more notches in the resin model, corresponding to transverse osteotomies carried out in one. bone structure.
    Another aspect of the present invention provides that the tomodensitometry is performed with a section less than or equal to 0.5 mm.
    Another aspect of the present invention provides that the grid is produced by the sintering of metal powders.
    Another aspect of the present invention provides that the grid is made of titanium or a titanium alloy.
    The present invention provides a resin model for producing a grid of a juxta-bone implant produced according to any one of the preceding steps, configured to reproduce a three-dimensional conformation of a bone structure of a patient.
    BRIEF DESCRIPTION OF THE DRAWINGS Additional features and advantages of the present invention will become more apparent on reading the following description provided by way of non-limiting example, with reference to the accompanying drawings, in which:
    FIG. 1 is a flowchart of one of the embodiments of a production method according to the present invention; FIG. 2 is a schematic perspective view of an overlap arm arranged on a part of a bone structure modified according to the method of the present invention.
    It should be understood that elements and features of one embodiment may be conveniently incorporated into other embodiments without any additional specifications.
    BEST MODE FOR CARRYING OUT THE PRESENT INVENTION Reference will now be made in detail to the various embodiments of the present invention, one or more examples of which are illustrated in the accompanying drawings. Each example is provided merely by way of illustration of the present invention, and is not intended as a limitation thereof. For example, the technical features illustrated or described as part of one embodiment may be adopted on, or in combination with, other embodiments to produce a further embodiment. It should be understood that the present invention is to include such modifications and variations.
    It should also be emphasized that the present description is not limited to its application to the construction details and the arrangement of the components as described in the following using the accompanying drawings. The present description can envisage that other embodiments are implemented or in practice with other technically equivalent characteristics. The terms used in the following are intended for descriptive purposes only, and should not be construed as limiting.
    The most delicate part of a grid of a juxta-bone implant is a support arm, known as an overlap arm which, when the grid is applied to a patient, passes over the alveolar bone ridge on the palatal side toward the buccal side in the upper jaw and on the lingual side of the buccal direction in the patient's jaw.
    In this part of bone, that is to say at a ridge level, is annexed a gingiva, a type of very strong keratinized gingiva with an often large and inextensible connecting coating, and which is in close contact with the underlying bone.
    The attached gingiva is such that, by healing around the collar of the point of support, it determines the clinical and prosthetic success thereof. Most grid exposures take place in the attached gingiva because the overlapping arm of the grid is always a foreign body of some thickness and the attached gingiva must incorporate it while maintaining contact with the grid. 'bone.
    In typical implants, the attached gingiva surrounds the cylindrical collar of the implant circumferentially, and adheres to the bone surrounding the implant. In juxta-osseous grids, it adheres circumferentially to the monophasic or biphasic fulcrum and must also adhere to the overlap arm, which reduces adhesion and stability with the sub-bone. jacent.
    Testing has shown how the shape of the straddle arm can determine grid exposures near the fulcrum collar. Sharp angles of the overlap arm can determine the presence of sharp cutting edges, causing said exposures.
    A first step of the production process provides for acquiring a 3D digital image of a bone structure, a grid of a juxta-osseous implant being adapted to be implanted thereon. The 3D digital image can be acquired by computed tomography (CT), for example via TAC-Cone Beam or dental scanning.
    This step allows a 3D digital image of the bone structure and the soft tissues attached to it to be acquired non-invasively. The resulting 3D digital image also contains information about the bone thicknesses of the bone structure, useful for the design of the implant grid and in particular for the correct positioning of the grid adjustment screws. For this purpose, to correct any distortions of the test, the patient must wear a radiopaque resin reproduction of the prosthesis, having known measurements, adapted to his mouth, and allowing the device and the software to acquire the image. 3D to achieve higher levels of precision and resolution in terms of final device design. A second step of the production process provides for the creation of a three-dimensional model of the bone structure as a function of the digital image of the bone structure acquired during the previous step. The model is preferably made of thermoplastic or thermosetting resin, by means of rapid prototyping techniques, for example 3D printing, laser stereolithography or drop-on-demand.
    A third step of the production method according to the present invention provides for making a first drawing of the implant grid based on the 3D model, digital or resin model, of the bone structure.
    In particular, thanks to the information on bone thicknesses contained in the 3D image of the bone structure, it is possible to determine the appropriate position and / or length (s) of the adjustment screws of the implant grid. The design of this grid is made according to the positioning of the adjustment screws. The adjustment screws are, for example, titanium osteosynthesis screws having a diameter of 2 mm and a variable length.
    In the preferred embodiment, the third step comprises a process which provides for making a first design of the grid directly on the resin model of the bone structure, for example, by means of a felt-tip pen. The drawing is based on clinical parameters such as the position of the teeth which must rest on the grid, and anatomical parameters deduced from the degree of bone atrophy.
    A fourth step of the production process provides for the modification of the resin model of the bone structure.
    Based on the drawing made in the previous step and the conformation of the resin model of the bone structure, it is possible to modify one or more parts of the resin model, so that the implant grid, which must be performed in a consecutive step, has dimensional and morphological characteristics that significantly reduce the impact on the patient's bone structure and promote proper healing.
    By way of non-limiting example and as illustrated in Figure 2, an overlap arm 10 of an implant grid is usually arranged "overlapping" an alveolar bone ridge 20. The overlap arm drawn on the resin model is. naturally two-dimensional, while the overlapping arm of the implant grid, which must follow the morphology of the alveolar bone ridge will include sharp edges, often with a "knife-edge" shape, which can damage the surrounding gum tissue and / or otherwise complicate the healing process.
    The fourth step of the production method according to the present invention contemplates the modification of the model, by way of non-limiting example, through the realization of one or more notches 30 in the resin model, corresponding to transverse osteotomies. performed in a bone structure of a patient.
    The notches 30 are made near the alveolar bone ridge 20 of the resin model 1, that is to say the part of the resin model corresponding to the alveolar bone ridge of the bone structure.
    The resin model 1, corresponding to the alveolar bone ridge 20 where the notches 30 are made, coincides with the part of the resin model where a drawing of an overlapping arm is made.
    In one of the preferred embodiments, the fourth step includes a process which involves making a first drawing of the grid directly on the resin model of the bone structure based on the modifications made. The second drawing is therefore different from the first, due to the modifications and notches previously made on the resin model.
    The purpose of these notches and the second grid design and therefore to design, and then produce, an overlapping arm of a grid of a juxta-osseous implant that has dimensions - length, width and thicknesses - and a shape, for example, curved and without sharp edges, which improves the correspondence between the implant grid and the bone structure of a patient. For example, tests carried out by the applicant have brought to light how the modification of the model allowed an overlap arm to be made with a greater thickness compared to grids of the known type, and this allowed the grid, and in particular the overlap arm, to tolerate even better the non-axial loads of the prosthetic support points.
    In addition, it has been observed that bone points adjacent to the osteotomy guarantee healing of the attached gingiva around the prosthetic fulcrum and allow the bone to be able to heal to cover the overlapping arm in the intra- part. bone. Finally, the attached gingiva has the possibility of better tolerating the foreign body of the grid, also by its realization with a thickness greater than one millimeter, which does not extend the dimensions above the bone.
    The final result of this fourth step is a resin model modified from the resin model made at the end of the second step, on which a second grid design is made, modified from the design made at the end of the second stage. third step.
    A fifth step of the production method according to the present invention provides for an acquisition of a three-dimensional image in digital format of the modified resin model, comprising the second drawing. The 3D digital image can be acquired by a high resolution scanner, computed tomography (CT) or other similar techniques.
    A sixth step of the production method according to the present invention provides for processing of the 3D image of the modified resin model, acquired during the previous step, using CAD / CAM software (for example the same software used for the '3D image of the bone structure), comparing it with the 3D digital image of the unmodified bone structure of the patient acquired during the first step of the production method according to the present invention. By computer mapping and mitigation techniques, the modifications, drawings and anchor points made on the resin model and contained in the 3D digital image of the modified model acquired during the previous step, are transferred to the 3D digital model of the patient's bone structure obtained at the end of the first step of the present process. By doing so, it is possible to apply all the modifications made in an analog way, that is to say on the resin model, directly in a digital way and on the virtual model of the patient's bone structure. A seventh step of the production method of the present invention provides for the realization, again by means of computer techniques, for example CAD / CAM software, of a 3D digital model of the grid.
    The 3D digital model of the grid is made on the basis of the second grid drawing made on the model modified and acquired during the previous step. In addition, the 3D digital model of the grid can be modified concerning its structure, thus being able to differentiate, for example, the thicknesses thereof according to the critical structural zones. In this way, the implant grid is adapted to the virtual model of a patient's bone structure, being able to use the maximum precision and mounting. By way of non-limiting example, the collar of the support points and the length thereof are adapted according to the depth of the notches made on the resin model and corresponding to the osteotomies, and according to the thickness of the overlapping arm which support it. Tests carried out by the applicant have brought to light, for example, how the neck of the fulcrum should have a height of 2-3 mm in the gingiva annexed around the bony crest to ensure that the gum can again annex.
    After finishing the sixth step and obtaining the final 3D model of the grid, the production method according to the present invention comprises a seventh step which provides for production of the grid of the juxta-osseous implant according to the definitive 3D digital model mentioned. above.
    According to the preferred embodiment, the seventh grid production step provides for a first formation step by means of sintering of metal powders, for example, titanium or titanium alloys.
    For example, the grid can be produced by SLM (selective laser melting), SLS (selective laser sintering), EBM (electron beam melting).
    The seventh grid production step comprises a second step which provides for subjecting the formed grid to one or more finishing operations, such as cleaning and / or polishing, for example electro-erosion polishing.
    The seventh grid production step provides for a third process in which the grid is cleaned and decontaminated in a clean room and packaged in suitable sterilized packaging, for example by means of gamma sterilization.
    Using this new production process, it is not necessary to make a prototype resin sample of the implant grid, such as the step of transferring modifications, drawings and anchor points made on the model. in resin, using computer techniques, acquired in the 3D digital model, on the 3D digital model of the patient's bone structure obtained at the end of the first step of the present process, guarantees a high degree of accuracy and excellent compatibility with the patient of the grid obtained by means of the method of the present invention.
    The prototyped resin model, however, is easy to produce if requested by the end user.
    According to an alternate embodiment of the present invention, however, a prototyped resin sample of the implant grid is made for further verification, but only for design requirements.
    All details may be replaced by other technically equivalent elements.
    Likewise, the materials used, and the inherent shapes and sizes, may be any, according to the requirements but without departing from the protective scope of the appended claims.
    权利要求:
    Claims (9)
    [1]
    1. A method for producing a grid of a juxta-osseous implant comprising the steps of: - acquiring a 3D digital image by computed tomography of a bone structure, the grid being adapted to be implanted thereon, - producing a model three-dimensional resin model of the bone structure according to the 3D digital image acquired, - draw a grid drawing on the three-dimensional resin model of the bone structure produced, - modify one or more parts of the three-dimensional resin model of the structure bone, according to the drawing made during the previous step and the conformation of the three-dimensional model, - acquire a 3D image of the three-dimensional resin model modified in the previous step, - produce a 3D digital model of the grid according to the 3D digital image acquired during the previous step, and - producing the grid as a function of the 3D digital image produced.
    [2]
    2. Method according to claim 1, characterized in that the step of producing the 3D digital model of the grid comprises the steps of: - processing the 3D image of the three-dimensional model modified by CAD / CAM software, and - compare it with the 3D image of the patient's unmodified bone structure, and - transfer to the 3D digital image of the patient's unmodified bone structure the modifications and drawing made on the three-dimensional model of the bone structure in the 3D digital image of the modified model.
    [3]
    3. Method according to claim 2, characterized in that the step of modifying one or more parts of the three-dimensional model of the bone structure provides for the production of a second design of the grid on the resin model of the bone structure. depending on the modifications made before acquiring a digital 3D image of the modified three-dimensional model.
    [4]
    4. Method according to any one of the preceding claims, characterized in that the step of producing a three-dimensional model of the bone structure provides for its production from a thermoplastic or thermosetting resin, by means of techniques of fast prototype.
    [5]
    5. Method according to any one of the preceding claims, characterized in that the step of modifying one or more parts of the three-dimensional model of the bone structure provides for the production of one or more notches in the resin model, corresponding transverse osteotomies performed in a bone structure.
    [6]
    6. The method of claim 1, wherein the computed tomography is performed with a section less than or equal to 0.5 mm.
    [7]
    7. The method of claim 1, wherein the grid is produced by sintering metal powders.
    [8]
    8. The method of claim 7, wherein the grid is made of titanium or a titanium alloy.
    [9]
    9. A resin model for producing a grid of a juxta-bone implant produced according to any one of the preceding claims, configured to reproduce a three-dimensional conformation of a bone structure of a patient.
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    同族专利:
    公开号 | 公开日
    BE1027582A1|2021-04-08|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US20180289454A1|2015-06-18|2018-10-11|Panthera Dental Inc.|Method and system for generating a model of a subperiosteal dental implant device and customized implant head|
    US20170312057A1|2016-04-29|2017-11-02|Jung-Chuan CHENG|Tooth implantation technique and a subperiosteal implant manufacturing method for the solution of extreme atrophy of a tooth bone|
    IT201600118979A1|2016-11-24|2018-05-24|Eaglegrid S R L Via Rossini 19 24129 Bergamo Bg|Method of production of a grid of a Juxtaoxian implant|
    法律状态:
    2021-09-30| FG| Patent granted|Effective date: 20210827 |
    优先权:
    申请号 | 申请日 | 专利标题
    IT201900017978|2019-10-04|
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