Note: Descriptions are shown in the official language in which they were submitted.
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NHK-lC
DENTAL IMPLANT SYSTEM
Field of the invention
A dental implant system for securing an artificial
tooth or dental prosthesis to the bone of a patient.
Backqround of the invention
Dental implants have been known, and used, since at
least the 1930's; see, e.g., United States patent 5,312,254 of
Joel L. Rosenlicht. See also United States patent 5,145,371
of Lars Jorneus which discusses the osseointegration method of
integrating a dental implant into a patient's jaw. The
disclosure of each of these patents is hereby incorporated by
reference into this specification.
In applicant's United States patent 5,338,197, a dental
implant having a cutting means is described and claimed;
the disclosure of this patent is hereby incorporated by
reference into this specification.
Another dental implant assembly is described in appli-
cant's copending patent application U.S.S.N. 08/391,662,
filed February 21, 1995, which discloses a "HEXAGONAL ABUT-
MENT IMPLANT SYSTEM".
Dental implants are moderately expensive. It often
costs from about three to four thousand dollars to implant a
tooth into a patient's mouth.
One of the reasons for this substantial cost is the
multiplicity of steps required by the implant procedure.
These prior art steps will be described below with reference
to Nobelpharma catalog PRI 385 94.03 2nd edition (published by
the Nobelpharma AB, Box 5190, S-402 26 Goteborg, Sweden).
In the first step of the prior art procedure, an
implant or "fixture" is purchased; see, e.g., page 7 of the
Nobelpharma catalog and the reference to the 3.75 mm and 4.0
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mm titanium fixtures illustrated on such page.
The fixture so purchases must then be placed into an
instrument set for fixture placement', which is shown on page
22 of the Nobelpharma catalog.
Once the fixture is disposed in the "instrument
set...", a "fixture mount" is then attached to the fixture by
means of a wrench and a screwdriver. The ~fixture mount" de-
vices are shown on page 22 of the Nobelpharma catalog. The
instruments for fixture placement of the fixture are also
shown on page 22 of the Nobelpharma catalog (see wrench part
17 and screwdriver part 19).
Thereafter, a "connection to contra-angle handpiece"
(see part 11 on page 22 of the Nobelpharma catalog) is at-
tached to a handpiece (see page 31 of the Nobelpharma
catalog); and the implant assembly may then be driven into
the jawbone of a patient.
Thereafter, the fixture mount is removed from the fix-
ture. Thereafter, a cover screw (see page 9 of the Nobelphar-
ma catalog) is inserted into the fixture. Thereafter, the
surgical site is allowed to heal for from about 3 to about 6
months. See, e.g., Branemark/ZarbtAlberektsson: "Tissue In-
tegrated Prostheses" (Quintessence Books, 1985).
After the healing period, the implant is exposed by
surgical procedures, and the cover screw is removed. There-
after, a healing abutment (see page 39 of the Nobelpharma cat-
alog) is attached to the fixture. It generally is left in
place for from about two to about three weeks, depending upon
how the patient's tissue has healed.
Thereafter, the healing abutment is then removed, and a
implant abutment is then attached to the fixture. The type of
implant abutment to be used will depend on the requirements of
the patient. Thus, e.g., and referring to pages 38 and 39 of
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the Nobelpharama catalog, one may standard abutment, and "Es-
thetiCone" abutment, a "CeraOne~' abutment, a "Ball
Attachment", an Angulated Abutment", and the like.
Thereafter, the desired prosthesis is formulated by
conventional means. Once the prosthesis has been prepared, it
is fitted to the patient's mouth secured to the implant.
It will be apparent that this prior art procedure re-
quires a myriad number of prosthetic instruments and parts,
many trips by the patient to the dentist, and a several surgi-
cal procedures. Not only is the process tedious and expen-
sive, but each surgical procedure introduces a certain ele-
ment of risk, pain, and suffering.
It is an object of this invention to provide an implant
assembly for implanting a prosthesis in a patient's mouth
which is substantially less expensive, stronger, safer to
use, and less-time consuming to use than the prior art
implant assemblies.
It is another object of this invention to provide an
implant assembly which, after it is secured to the patient,
is less likely to become disengaged therefrom.
It is yet another object of this invention to provide
an implant assembly which, after it is secured to the pa-
tient, provides substantially no opportunity for bacterial
ingress within the assembly.
Summary of the invention
In accordance wlth this invention, there is provided a
novel implant assembly comprised of an abutment integrally
joined to a dental implant fixture and, optionally, a coping
removably attached to the abutment. The abutment is prefer-
ably an integrally-formed, sleeve-shaped element containing a
lower portion and an upper portion. The exterior of the
lower portion of the abutment contains an annular groove
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disposed between its base and the main, substantially poly-
gonal portion of the abutment body. The sleeve of the abut-
ment preferably contains rounded corners which are compatible
with the oral tissue and its functions in the patient's
mouth.
Brief description of the drawinqs
The present invention will be more fully understood
by reference to the following detailed description thereof,
when read in conjunction with the attached drawings, wherein
like reference numerals refer to like elements, and wherein:
Figure 1 is a perspective view of one preferred abut-
ment of this invention;
Figure lA is a top view of an abutment with a substan-
tially hexagonal exterior shape;
Figure lB is a top view of an abutment with a substan-
tially square exterior shape;
Figure lC is a top view of an abutment with a substan-
tially octagonal exterior shape;
Figure 2 is a sectional view of the abutment of Figure
l;
Figure 3 is a top view of the abutment of Figure l;
Figure 4 is a bottom view of the abutment of Figure l;
Figure S is a perspective view of a carrier adapted to
be used with the abutment of Figure 1;
Figure 6 is a sectional view of the carrier of Figure S
connected to the abutment of Figure 1, which in turn i~ con-
nected to an implant fixture, the whole assembly being dis-
posed within a vial;
Figure 6A is a perspective view of an abutment retain-
ing screw which can be used with the abutment of this inven-
tion;
Figure 6B is an exploded perspective view illustrating
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how the retaining screw of Figure 6A may be attached to an
abutment and an implant fixture.
Figure 7 is an exploded view an abutment implant assem-
bly being driven into bone;
Figure 8 is view of a healing abutment which is adapted
to fit over the hexagonal abutment of Figure l;
Figure 9 is a sectional view of the healing abutment
connected to applicant's abutment/implant system;
Figure 9A is a sectional view illustrating another em-
bodiment of the healing abutment connected to applicant's
abutment/implant system;
Figure 10 is a perspective view of a denture connected
to the healing abutment/abutment/implant system of Figure 9 by
means of 0-rings;
Figure 11 is a sectional view of a the abutment/implant
system being connected to a standard gold cylinder; and
Figure 12 is a perspective view of the assembly of Fig-
ure 11 connected via a bar and clip to a denture in a pa-
tient's mouth;
Figure 13 is a perspective view of a fixed detachable
implant supported bridge which utilizes applicant's abutment
system.
Figure 14 is a perspective view of a gold coping device
which may be used with applicant's abutment system;
Figure 15 is a sectional view of the gold coping device
of Figure 14;
Figure 16 is a top view of the gold coping device of
Figure 14;
Figure 17 is a an exploded perspective view illustrat-
ing how the gold coping device may be attached within a tooth
and secured to the abutment;
Figure 18 a flow diagram illustrated certain preferred
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processes of the invention;
Figure 19 is a perspective view of one embodiment of an
implant assembly comprised of the abutment similar to the one
depicted in Figure 1 integraIly joined to a dental implant
having cutting means;
Figure 20 is a perspective view of another embodiment
of an implant assembly comprised of the abutment of Figure 19
integrally joined to a dental implant having cutting means;
Figure 21 is a perspective view of another embodiment
of an implant assembly comprised of the abutment of Figure 19
integrally joined to a dental implant having cutting means;
Figure 22 is a sectional view of the preferred abutment
depicted in Figures 19, 20, and 21; and
Figure 23 is an exploded view illustrating the connec-
tion of the healing ball of this invention to the integral
dental implant of Figure 19.
Description of the Dreferred embodiments
Referring to Figure 1, a perspective view of one pre-
ferred abutment 10 is shown. This abutment 10 is preferably
an integral structure which consists or consists essentially
of titanium or titanium alloy. Alternatively, the abutment 10
may consist of gold, silver, palladium, vanadium, cobalt al-
loy, stainless steel, and the like.
Any of the titanium or titanium alloy materials used in
implants may be used to make abutment 10. Thus, by way of
illustration and not limitation, one may use one or more of
the materials disclosed in United States patents 5,373,621 (a
titanium/aluminum/vanadium alloy), 5,372,660 (a titanium/zir-
conium alloy), 5,358,529, 5,354,390 (a titanium-base microal-
loy containing at least 98 weight percent of titanium),
5,334,264 (a nitrided titanium material), 5,326,362 (a titani-
um/aluminum/vanadium alloy), 5,205,921 (a coated titanium im-
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plant), 5,192,323 (a titanium/aluminum/vanadium alloy), and
the like. The disclosure of each of these United States pat-
ents is hereby incorporated by reference into this specifica-
tion.
In one preferred embodiment, abutment 10 is machined
from pure titanium which, preferably, is originally in the
form of a rod. It is preferred that the titanium used meet
the standards set forth in A.S.T.M. Standard F 67-88, "Speci-
fication for Unalloyed T~tanium for Surgical Implant Applica-
tions. In general, it is also preferred that the material
used, regardless of whether it is titanium, titanium alloy,
and/or other material, meet the requirements set forth in
A.S.T.M. Standard Test F 981-87 ~Practice for Assessment of
Compatibility of Bio Materials (Non-Porous) for Surgical Im-
plants n ~
Referring again to Figure 1, it will be seen that abut-
ment 10 is comprised of a hollow core 12 which extends from
the top 14 of abutment 10 to its bottom (not shown in Figure
1, but see bottom 16 in Figure 2). The hollow core 12 is in-
dicated in Figure 1 by dotted line 18.
Referring again to Figure 1, it will be seen that abut-
ment 10 is comprised of a base 20 is extends upwardly and out-
wardly from its bottom 16 to form an intermediate ledge 22.
Figure 2 better illustrates the preferred structure
near ledge 22. It will be seen that, in the preferred embodi-
ment illustrated, ledge 22 is disposed beneath substantially
hexagonal portion 24 of abutment 10. Disposed between ~ub-
stantially hexagonal portion 24 and ledge 22 is annular
groove. Without wishing to be bound to any particular theory,
applicant believes that this structure provides a more secure
attachment to devices attachable to abutment 10.
Referring again to Figure 1, and in the preferred em-
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bodiment depicted therein, it seen that the substantially hex-
agonal portion preferably has rounded corners. This is also
illustrated in Figure lA, which is a partial top view of the
structure of Figure 1.
Referring to Figure lA, it will be seen that hexagonal
portion 24 is comprised of exterior surface which contains al-
ternating linear portions 28 and arcuate portions 30. Without
wishing to be bound to any particular theory, it is believed
that the rounded corners (arcuate portions 30) in this struc-
ture are substantially compatible with the patient's mouth.
Thus, e.g., these rounded corners do not irritate the pa-
tient-s tongue during eating as much as the sharp corners
present on normal hexagonal structures.
It is preferred that the length of each linear portion
28 be substantially equal to the length of each of the other
linear portions 28. In one embodiment, the substantially hex-
agonal shape depicted in Figure 1 is substantially symmetri-
cal.
It is also preferred that the length of each linear
portion 28 be at least about 1.2 times as long as the length
of each curved portion 30. In one preferred embodiment, the
length of each linear portion 28 is at least about 3.0 times
as great as the length of each curved portion 30.
As will be apparent to those skilled in the art, the
abutment 10 may have an exterior shape which need not be sub-
stantially hexagonal but may assume the shape of other poly-
gons. Thus, Figure lB depicts a substantially ~hare cross-
sectional shape. Thus, Figure lC depicts a substantially oc-
tagonal cross-sectional shape.
As will be apparent to those skilled in the art, sub-
stantially any polygonal shape can be used which is capable of
being mechanically engaged. Thus, by way of further illustra-
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tion, one may use substantially triangular shapes, substan-
tially pentagonal shapes, substantially heptagonal shapes,
substantially nonagonal shapes, and the like. What is re-
quired of any such shape, however, is that contain alternating
linear and non-linear sections (the latter preferably being
arcuate) and that, preferably, they define a shape which is
symmetrical along at least one axis of symmetry.
Figure 2 is a sectional view of the abutment 10 of Fig-
ure 1. Referring to Figure 2, it will be seen that the base
of abutment 10 preferably has a width 42 at its bottom
which is substantially less than its width 44 at its top. In
general, width 44 is at least about 1.1 times as great as
width 42. In one preferred, with 44 is 4.7 millimeters, and
width 42 is 4.0 millimeters.
Referring again to Figure 2, it will be seen that base
has a depth 46 which, preferably, is from about 0.5 to
about 7.0 millimeters and, more preferably, is from about 0.5
to about 1.5 millimeters. In the preferred embodiment il-
lustrated in Figure 2, depth 46 is 1.0 millimeter.
Referring again to Figure 2, it will be seen that, near
base 20, hollow core 12 is comprised of stepped bores 48, 50,
and 52.
Stepped bore 52 has a diameter 54 sufficient for a
screw (not shown) to pass through it. In the preferred em-
bodiment illustrated in Figure 2, stepped bore 52 has a dia-
meter 54 of 2.2 millimeters.
Referring again to Figure 2, it will be seen that sub-
stantially hexagonal portion 24 extends from the top 14 of
abutment 10 to annular groove 26. It i~ preferred that the
distance 56 between top 14 and annular groove 26 of abutment
extend at least about 55 percent of the entire height of
abutment 10. In one preferred embodiment, distance 56 is
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about 3.0 millimeters.
It is preferred that annular groove 26 have a substan-
tially circular shape and, more preferably, have a radius of
curvature 58 of from about 0.1 to about 0.2 millimeters. In
one preferred embodiment, the radius of curvature of groove 26
is about 0.15 millimeters.
Referring again to Figure 1, and in the preferred em-
bodiment depicted therein, bore 48 has a diameter 58 of about
3.5 millimeters, bore 60 has a diameter 62 of about 3.0 milli-
meters, bore 64 has a diameter 66 at its top most point of
about 3.5 millimeters, the distance 70 between point 68 and
the end of bore 60 is 2.0 millimeters, and the distance bet-
ween surface 68 and ledge 22 is 3.0 millimeters.
Figure 3 is a top view of abutment 10. In the pre-
ferred embodiment depicted in Figure 3, the distance 74 bet-
ween opposite linear surfaces on the exterior of the hexagonal
sleeve preferably is about 3.9 millimeters; and the distance
76 between opposite arcuate surfaces on the exterior of the
hexagonal sleeve is about 4.1 millimeters.
Figure 4 is a bottom view of abutment 10. Referring to
Figure 4, and in the preferred embodiment depicted therein, it
will be seen that bore preferably has a substantially hexagon-
al cross-sectional shape 78 which is adapted to mate with the
external hexagonal shape of the upper portion of an implant
fixture (not shown). In the preferred embodiment shown, the
distance 80 between opposing linear walls of said hexagonal
shape is preferably 2.7 millimeters.
Referring again to Figure 2, it will be seen that bore
63 is disposed between bore 60 and bore 52 and has diameter
which continually decreases from bore 60 to bore 52, thereby
forming a chamfered surface. It is preferred that said cham-
fered surface form an obtuse angle (as measured with respect
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to the interior wall 65 of bore 60) of from about 120 to about
150 degrees.
Figure 5 is a perspective view of carrier 90 which is
adapted to be removably connected to abutment 10 and to manu-
ally deliver it into the jaw of a patient.
Referring to Figure 5, it will be seen that carrier 90
is preferably an integral assembly which, preferably, consists
essentially of plastic material which, preferably, is non-
toxic and thus is "medical grade".
One may use any of the -~ic~l grade" material known
to those skilled in the art such as, e.g., the plastics de-
scribed in United States patents 5,356,709 (polypropylene co-
polymyer; styrene/ethylene/butylene/styrene copolymer),
5,312,251 (medical grade ceramic material), 5,326,364 (medical
grade ceramic), and the like. The disclosure of each of these
United States patents is hereby incorporated by reference into
this specification.
In one preferred embodiment, carrier 90 consists essen-
tially of high density polypropylene which is extruded into
the desired shape.
Referring again to Figure 5, it will be seen that car-
rier 90 is comprised of a fin 92, grip 94, and removable cover
96. The fin 92 is comprised of external annular ridges 98
which are adapted to fit within and be contiguous with a ship-
ping vial(not show in Figure 5). The grip 94 is preferably
comprised of a multiplicity of vertically-extending ridges 100
which facilitate the h~n~ling of grip 94; and will be appar-
ent to those skilled in the art, other means of facilitating
the handling of grip 94 (such as, e.g., roughened surfaces)
may also be used.
Within grip 94 is a compartment 101 in which an acces-
sory part (not shown) may be stored. Removable cover 96 is
- CA 02206163 1997-0~-2~
adapted to snap into place within such compartment 101.
In one embodiment, removable cover 96 is color coded to
indicate which part it is to be used in connection with.
A bore 102 (shown in outline by dotted line 104) ex-
tends from the top 106 of fin 92 to the bottom 108 of fin 92.
That portion of bore 102 extending through fin 92 has a sub-
stantially hexagonal cross-sectional shape and, thus, is
adapted to fit over and engage with the substantially hexagon-
al portion 24 of abutment 10.
In one preferred embodiment, illustrated in Figure 5,
the width 110 of fin 92 is about 9.9 millimeters, and =xi
dimensional of the hexagonally shaped bore 102 as it exits fin
92 is about 4 millimeters.
In the preferred ; 'o~i -nt illustrated Figure 5, the
bottom surface 112 of the carrier 90 is preferably a flat sur-
face adapted to mesh with the flat surface of ledge 22 (see
Figures 1, 2, and 6) so that the carrier 90 is properly
aligned with abutment 10 when it is removably connected there-
to.
Figure 6 is a sectional view of carrier 90 connected to
abutment 10 which, in turn, is connected to implant fixture
114, the abutment and implant being disposed within a vial
116.
Referring to Figure 6, and in the preferred embodiment
illustrated therein, it will be seen that carrier 90 is remov-
able connected to both cover 96, vial 116, and abutment 10,
all by a friction fit. The entire assembly may be disposed
in another vial (not shown). In this embodiment, the depth
120 of compartment 101 is preferably from about 5 to about 10
millimeters, the distance 121 between the top lip 122 and the
bottom surface 124 of the grip 90 is from about 6 to about 12
millimeters, and the distance 123 from the top of carrier 90
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to its bottom is from about 10 to 20 millimeters.
Referring again to Figure 6, it will be seen that the
carrier 90/abutment 10/vial 16 assembly may be used in con-
junction with an implant fixture 114. This assembly is quite
adaptable and may be used with substantially any of the im-
plant fixtures known to those skilled in the art.
Thus, by way of illustration and not limitation, one
may use one or more of the implant fixtures disclosed in Unit-
ed Statespatents 5,338,197, 5,061,181, 5,030,095,
4,960,381, 4,932,868, 4,871,313, 4,854,873, 4,854,872,
4,713,004, 4,468,200, 4,330,891, 4,016,651, 3,672,058,
3,579,831, 2,609,6045,376,004, 5,364,268,5,362,235,
5,302,125, and the like. The disclosure of each of these
United States patents is hereby incorporated by reference into
this specification.
By way of further illustration, and referring to theNobelpharma catalog referred to elsewhere in this specifica-
tion, one may use any of the implant fixtures disclosed on
page 7 of such catalog.
Referring again to Figure 6, it will be seen that im-
plant fixture 114 is preferably connected to abutment 10 by
means of retaining screw 130. The retaining screw 130 is
shown in more detail in Figure 6A.
Referring to Figure 6A, it will be seen that retaining
screw 130 is comprised of an internal bore 132 with internal
threads 134 adapted to receive and engage with the external
threads on a multiplicity of dental prostheses (not shown).
The retaining screw 130 is comprised of tapered section
136 which is adapted to fit within bore 63 (see Figure 2) and
mesh with the tapered section therein.
The retaining screw 130 is also comprised of external
threads which, after they pass through abutment 10, may be se-
~ CA 02206l63 l997-0~-2~
cured to internal threads (not shown) in the implant fixture
(not shown in Figure 6A).
Figure 6B is an exploded perspective view illustrating
that, after retaining screw 130 is passed through abutment 10,
it may be screwed into orifice 140 of implant fixture 114 and
become screwably engaged with the internal threads located
within orifice 140.
In the preferred embodiment illustrated in Figure 6B,
implant fixture 114 is comprised of external threads 142 which
can be used to secure implant assembly within the jawbone of a
patient.
Figure 7 is an exploded view showing the abutment
10/retaining screw 130/implant fixture 114 assembly 150 dis-
posed beneath a socket wrench 152 with a hexagonal bore 154.
As will be apparent to those skilled in the art, socket wrench
152 may be removably attached to the substantially hexagonal
portion 24 of abutment 10 and used to insert assembly 150 into
a hole in the patient's jaw. Alternatively, or additionally,
depending upon the amount of force needed, carrier 90 may be
used for this purpose or, alternatively, to start the inser-
tion of the assembly 150 in said hole.
In the embodiment illustrated in Figure 7, the implant
fixture has an exterior hexagonal shape; and thus it is
adapted to be screwed into the hole in the patient's jaw by a
socket wrench with a matching hexagonal bore. It will be ap-
parent, however, that the means of inserting the assembly 150
into the hole in the patient's jaw will vary with the type of
implant 114 u~ed. ThuR, for example, when the exterior shape
of impIant 114 is substantially cylindrical, a seating tool
(such as a maliet) may be used. These procedures are well
known to those skilled in the art.
Figure 8 is a perspective view of a healing ball 160
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which may be used in connection with abutment 10. Referring
to Figure 8, it will be seen that healing ball 160 is com-
prised of a removable cover 162.
Healing ball 160 preferably consists essentially of
medical grade material such as, e.g., medical grade polyethy-
lene. In one preferred embodiment, healing ball 160 consists
essentially of high density polyethylene.
Referring again to Figure 8, it will be seen that heal-
ing ball 160 is comprised of an internal bore 164 which has a
substantially hexagonal shape and is adapted to fit snugly
over the substantially hexagonal portion 24 of abutment 10
(see Figure 9).
Referring to Figure 9, and in the preferred embodiment
illustrated therein, it will be seen that healing ball 160
preferably is comprised of an inwardly-extending annular pro-
tuberance 166 which is adapted to fit within and removably se-
cured to annular groove 26. There thus is a strong fit bet-
ween the mating hexagonal portions and the mating annular por-
tions of healing ball 160 and abutment 10.
In many cases, the healing abutment ball 160 is removed
from abutment 10 prior to the time any dental device is at-
tached. In some instances, however, it is desired to attach
the dental device directly to the healing ball 160. In this
latter case, it is sometimes desirable to more securely attach
the healing ball 160 to the abutment 10.
One means of more securely making such attachment is
illustrated in Figure 9A. Referring to Figure 9A, it will be
seen that a screw 170 may be inserted through healing ball 160
into abutment retaining screw 130.
Figure 10 illustrates a denture 180 into which two
metal rings 182 and 184 with O-rings 186 and 188 have been
cured into the denture chairside. Such dentures are well
CA 02206163 1997-0~-2~
known to those skilled in the art and are illustrated on page
21 of the aforementioned Nobelpharma catalog. Furthermore,
Nobelpharma also sells an ~Overdenture Rit for ~all Attach-
ment" (see page 21 of the catalog) which contains a plastic
cap with a rubber O-ring, ball attachment replicas, and spac-
ers for the ball attachment.
~ eferring again to Figure 10, it will be seen that the
metal ring/O-ring assemblies are friction fit over the healing
balls 160 to firmly and securely removably attach the denture
180 to the implant assembly.
Figure 11 illustrates how the implant assembly 150 may
be used in a similar manner with a gold cylinder 190. Such a
gold cylinder is well known to those skilled in the art. See,
for example, United States patents 5,209,659 (gold cylinder
126), 5,108,288 (coping 50 having a bore 52 passing axially
therethrough and opening into a polygonal opening at its lower
end), 5,145,371, and the like. The disclosure of each of
these United States patents is hereby incorporated by refer-
ence into this specification.
It is known that gold cylinders are available for the
fabrication of bar/clip overdentures, for they are designed to
fit accurately on the hex abutments and can be incorporated
into the bar/clip framework; see Figure 12, and the bar clip
assembly 192 illustrated therein. As will be apparent to
those skilled in the art, this type of over-denture bar system
may be readily connected to implant assemblies 150 attached to
gold cylinders 190 (see Figure 11).
Thus, as will be apparent to those skilled in the art,
applicant's abutment 10, because of the relative universality
of its design, may be used in conjunction with many different
types of prosthetic applications. It thus affords the dental
practitioner substantially more flexibility than does the pri-
16
CA 02206163 1997-0~-2~
or art systems, which utilize a substantial number of parts
which are adapted for specific applications.
Thus, by way of further illustration, and referring to
Figure 13, the gold cylinder devices 190 may be incorporated
into a fixed detachable implant supported bridge 200. See,
e.g., United States patent 5,174,954, the entire disclosure
of which is hereby incorporated by reference into this speci-
fication.
Referring again to Figure 13, it will be seen that
screws 202 may be used to secure the bridgework through the
gold cylinders to the abutments 10.
Figure 14 is a perspective view of a gold coping 210
which may be utilized to restore a tooth to a patient's mouth.
Referring to Figure 14, it will be seen that gold coping 210
is comprised of an internal hexagonal bore 212 adapted to fit
over and engage with hexagonal portion 24 of abutment 10 (see
Figure 15). As will be apparent to those skilled in the art,
when gold coping 210 is placed on abutment 10, there are only
six positions it can be in. By comparison, with prior art
abutments which have cylindrical outer surfaces, there are an
infinite number of such positions.
This system thus has several advantages. Because the
gold coping 210/abutment 10 connection is locked into place by
the interaction of the hexagonally-shaped parts, a patient
cannot cause the tooth attached to abutment 10 to rotate upon
application of pressure to the tooth. In the second place,
the gold coping 210 can be utilized as a transfer coping dur-
ing impression taking and, when so used, because of the inter-
action of the hexagonal shapes, accurately reproduces the po-
sition of abutment 10 in the working model.
Referring again to Figure 14, it will be seen that, in
the preferred embodiment illustrated therein, gold coping 210
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has a substantially rectilinear top shape 214 with rounded
corners 216. In one embodiment, the top of gold coping 210
is substantially square-shaped with rounded corners.
Referring again to Figure 14, it is preferred that gold
coping 210 comprise a multiplicity of annular grooves 218.
Gold coping 210 also is comprised of stepped bores 220 and
222.
The gold copying 210 preferably consist essentially of
a palladium alloy such as, e.g., the alloy disclosed in United
States patent 5,174,954, the entire disclosure of which is
hereby incorporated by reference into this specification.
Thus, e.g., one may use a palladium alloy containing from
about 50 to about 90 weight percent of palladium, from about 0
to about 37 weight percent of gold, from about 0 to about 3
weight percent of platinum, from about 0 to about 35 welght
percent of silver, from about 0.5 to about 8 weight percent of
gallium, from about 0 to about 8 weight percent of tin, and up
to about 0.2 weight percent of a material selected from the
group consisting of iridium, rhenium, ruthenium, and mixtures
thereof.
Referring again to Figure 14, it is preferred that the
bottom portion 224 of gold coping 210 be adapted to mesh with
a fit onto ledge 22 of abutment 10 (see Figure 1).
Figure 15 is a sectional view of the gold coping device
of Figure 14. Referring to Figure 15, and also to Figure 14,
it will be seen that gold coping 210 is comprised of a curved
neck portion with a radius of curvature of about 1.5 millimet-
ers.
In the preferred embodiment illustrated in Figure 15,
it will be seen that distance 230 is preferably 4.7 millimet-
ers, distance 232 is preferably 4.2 millimeters, distance 234
is preferably 5.2 millimeters, distance 236 is 4.6 millimet-
CA 02206163 1997-0~-2~
ers, distance 238 is 2.7 millimeters, distance 240 is 4.1 mil-
limeters, distance 242 is 3.1 millimeters, distance 244 is 1.5
millimeters, distance 246 is 2.5 millimeters, distance 248 is
2 millimeters, distance 250 is 1.5 millimeters, and distance
252 is 1.5 millimeters, and distance 254 is 2.8 millimeters.
Figure 16 is a top view of the gold coping of Figure
14. Referring to Figure 16, it will be seen that the distance
256 from opposing flat surfaces 214 is 4.0 millimeters.
Figure 17 is an exploded perspective view illustrating how
a tooth to which a gold coping 210 has been bonded may be at-
tached to a patient's jawbone (not shown) by means of the
abutment system of this invention.
Referring to Figure 17, and in the preferred embodiment
depicted, it will be seen that tooth 270 may be secured to
abutment 10 by at least two separate means.
In the first place, a screw 272 may be inserted through
orifice 22 and secured to retaining screw 130 by engagement
with internal threads 134 lnot shown in Figure 17, but see
Figure 6A).
In the second place, dental cement may be charged into
the interior of gold coping 210 prior to the time the gold
coping 210 is placed over the hexagonal portion 24 of abutment
10. Thus, in addition to the mechanical bond created by screw
272, there also is an adhesive bond.
Furthermore, there is yet another bond tending to main-
tain gold coping 210 in position vis-a-vis abutment 10, and
that is the interaction of their respective hexagonal shapes.
The system depicted in Figure 17 has the unique advan-
tage that allows the removal of the tooth 270 from the
abutment I0 even after the cement has hardened. In order to
do this, screw 272 may be removed by turning it counter-
clockwise, and thereafter, utilizing a three-pronged crown-
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remover to pull tooth 270 out of the abutment 10 by leverage
between the top of retaining screw 130 against the smaller
taper of 270.
A preferred Process of the invention
Figure 18 is a flow diagram of one preferred process of
applicant's invention.
In the first step of this process, step 300, abutment
10 is connected to implant fixture 114.
In this step, it is preferred to apply a torque no
greater than about 20 Newton/centimeter.
Thereafter, in step 302 of the process, a hole is
drilled in the jawbone of the patient sufficiently deep to re-
ceive only the length of the implant fixture. In general,
this hole is usually from about 8 to about 18 millimeters.
Thereafter, in step 304 of the process, the hole thus
drilled is preferably tapped with a tapping tool such as,
e.g., the screw taps illustrated on page 11 of the Nobelpharma
catalog.
Thereafter, in step 306 of the process, the
abutment/implant fixture assembly is delivered to the hole by
means of the carrier 90. The carrier 90 may also be used to
start screwing the assembly into the hole, applying downward
pressure while turning the assembly.
Generally, the carrier 90 will only enable one to drive
the abutment/implant fixture assembly a portion of the re-
quired distance. The job may be finished by a power-driven
socket wrench in ~tep 308 of the process
In the next step of this preferred process, step 310,
the healing ball 160 is preferably snapped onto the abutment
(see Figures 9 and 9A). In one preferred embodiment, the
healing ball 160 is disposed within compartment 101 of carrier
CA 02206l63 l997-0~-2
90 prior to its use.
Thereafter, in step 312, the gum tissue where the hole
had been drilled is sutured around the healing ball 160.
In the next step of process, step 314, the surgical
site is allowed to heal before the abutment 10 is directly or
indirectly connected to a denture. In general, a healing pe-
riod of from about 3 to about 6 months is desirable.
After the desired time of healing, no additional surgi-
cal procedure is required, unlike the prior art process (which
necessitated second stage surgery to remove the cover screw
used in the process and to attach the prosthetic abutment).
By comparison with prior art processes, applicant's prosthetic
abutment is already attached.
At this stage of applicant's process, several options
are available.
In one embodiment, illustrated in step 316 (also see
Figure 10), the healing ball is attached directly to a denture
into which metal caps with an O-ring have been cured.
In another embodiment, illustrated in step 318, the
healing ball 160 is removed from the abutment 10. At this
stage, several additional options are available.
One such option is to attach the gold cylinder 190 on
the abutment 10 (see Figures ll and 12) in step 320. Once the
gold cylinder 190 has been so attached, one may prepare a bar
clip overdenture (see Figure 12) and attach such denture to
the superstructure (see step 322). Alternatively, in step
324, the gold cylinders 190 can be incorporated into a fixed
detachable implant supported bridge and thereafter secured to
multiple implants in place in the jawbone (see Figure 13).
Alternatively, in step 326, after the healing ball 160
has been removed a gold coping 210 may be attached to a tooth
(see,e.g., Figure 17 where such a gold coping is imbedded in
CA 02206163 1997-0~-2~
the tooth). Thereafter, in step 328, such tooth is attached
to the abutment 10.
An integral implant assembly
Figure 19 is a perspective view of a preferred embodi-
ment of an implant device 350 which is comprised of an abut-
ment 352 integrally connected to an implant 354.
Referring to Figure 19, it will be seen that implant
device 350 is comprised of several cutting means. One such
cutting means is integrally formed drill bit 356.
Drill bit 356 is preferably integrally joined to im-
plant section 354 and is adapted to drill bone. Any of the
drill bit configurations known to those skilled in the art to
useful in drilling bone may be used as drill bit 356. Thus,
by means of illustration and not limitation, one may use one
or more of the drill bit configurations depicted in United
States patents 5,443,468, 5,437,677 (drilling in the glenoid
neck), 5,413,579, 5,409,489 (drilling in a femur), 5,403,322
(drilling in the bone of a human limb), 5,366,457,
5,354,299, 5,306,278 (corticotomy drill guide), 5,257,809,
5,055,105, D332492, D273326, and the like. The disclosure
of each of these United States patents is hereby incorporated
by reference into this specification.
- Referring again to Figure 19, and in the preferred
embodiment depicted therein, it will be seen that drill bit
356 is comprised of a tip 358, a first blade 360, and a
second blade 362, and a clearance channel 364. In one em-
bodiment, not shown, drilling bit 356 is comprised of three
blades.
In addition to the drill bit 356, implant assembly 350
also is comprised of raised external helical threads 364
which are disposed on a substantially cylindrical body por-
tion 366.
CA 02206163 1997-0~-2~
In one preferred embodiment, threads 364 and body
portion 366 are similar to or identical to the threads 53 and
body portion 52 of applicant's United States patent
5,338,197; the disclosure of this patent is hereby incorpo-
rated by reference into this specification.
In addition to the drill bit 356 and the threads 364,
applicant-s implant assembly also is comprised of a multi-
plicity of cutting means 368 such as, e.g., cutting flutes in
the form of indented notches. In one preferred embodiment,
illustrated in Figure 19 (also see elements 70 and 70' of
United States patent 5,358,197), each of the indented notches
368 has a radially outwardly-extending cutting surface 370 at
substantially a right angle to the circumerferential direc-
tion of rotation of the implant assembly 350 (see, e.g., axis
372).
Referring again to Figure 19, and in the preferred
embodiment depicted therein, it will be seen that implant
assembly 350 is comprised of a longitudinal channel 372 which
is similar in function and structure to the longitudinal
channel 84 depicted in applicant's United States patent
5,338,197.
As will be apparent to those skilled in the art, the
device of Figure 19 is comprised of abutment 352 joined to
implant 354. However, other implants may also be integrally
joined to abutment 352.
Thus, by way of further illustration, the implant
device 380 depicted in Figure 20 is very similar to the
device 350 depicted in Figure 19 but it omits the use of the
longitudinal channel 372 and the cutting flutes 368. In
another embodiment, not shown, the device incorporates the
longitudinal channel 372 but not the cutting flutes 368. In
another embodiment, not shown, the device incorporates the
CA 02206163 1997-0~-2~
Il cutting flutes 368 but not the longitudinal channel 372. In
another embodiment, not shown, the device omits the raised
helical threads 364 and incorporates either both the cutting
flutes 368 and/or the longitudinal channel 372 and/or the
drill bit 356. Other variations and combinations will be
apparent to those skilled in the art.
One preferred embodiment is disclosed in Figure 21 as
implant assembly 390. This implant assembly 390 is substan-
tially identical to the implant assembly 350 (see Figure 20)
with the exception that the drill bit 356 is replaced by a
bottom tapered portion 392 which is very similar to the
cutting assembly depicted in United States patent 5,338,197.
Thus, referring to Figure 21, it will be seen that
tapered portion 392 is comprised of cutting surfaces 394 and
396 disposed at opposite ends of through-hole 398 and prefer-
ably perpendicularly disposed to the axis of rotation 372
such that the cutting surfaces 394 and 396 will both cut and
direct all or a substantial portion of bone fragments into
through-hole 398.
Figure 22 is a sectional view of abutment 352. As will
be apparent to those skilled in the art, this abutment 352 is
very similar to abutment 10 (see Figure 1), but it differs
therefrom in that does not contain a passageway with six
stepped bores (see Figure 2 for a depiction of these passage-
ways in abutment 10).
By comparison, and referring to Figure 22, it will be
seen that abutment 352 is comprised is preferably comprised
of a threaded orifice 400 which, preferably, has a substan-
tially circular cross-sectional shape. As will be apparent
to those skilled in the art, threaded orifice 400 is adapted
to receive and retain a dental prosthesis (not shown).
Referring again to Figure 22, it is seen that base 20
24
CA 02206163 1997-0~-2~
of abutment 352 is tapered. This-is advantageous in the
retention of the implant assembly within the bone.
Referring again to Figures 19-22, the implant devices
depicted therein preferably consist essentially of titanium,
titanium alloy, and/or other material which is biocompatible
with human bone.
The integral implant assemblies of this invention may
be used in a manner similar to the multi-piece assemblies.
However, because of their integral structure, they are
stronger than the multi-piece assemblies, less likely to
disengage, and less likely to present opportunity for bacte-
rial ingress from the oral cavity into the bone tissue.
Elsewhere in this specification, the use of healing
ball 160 is disclosed in connection with its attachment to
abutment 10. As will be apparent to those skilled in the
art, healing ball 160 may also be remvoably attached to
abutment 352 and, when such abutment is integrally connected
to implant fixutre 354, to implant devices 350, 380, and 390.
Figure 23 illustrates one such attachment in which, for
the sake of simplicity of representation, the means by which
annular protuberance 166 fits within annular groove 26 have
been omitted (but see Figures 8, 9, and 10).
One substantial advantage of the system depicted in
Figure 23 is that, after coping 160 has been removably
attached to removable dental implant 350, the entire assembly
can be removed from the patient's mouth and transferred to a
working model to fabricate the dental prosthesis.
In one preferred embodiment, not shown, coping 160 has
a substantially hexagonal shape and preferably consists
essentially of plastic. This embodiment is especially advan-
tageous for allowing direct pick up of the assembly and
accurate timed transfer to a working model. Thus, the ex-
CA 02206163 1997-0~-2~
pesnsive prior art cast-on technique can be avoided, as can
the painful and time-consuming process of gingival retraction
for impression taking.
It is to be understood that the aforementioned descrip-
tion is illustrative only and that changes can be made in the
apparatus, in the ingredients and their proportions, and in
the sequence of combinations and process steps, as well as in
other aspects of the invention discussed herein, without
departing from the scope of the invention as defined in the
following claims.
