Note: Descriptions are shown in the official language in which they were submitted.
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SPLINT ABUTMENT OVER OSSEOINTEGRATED IMPLANT AND
COMPENSATORY SLANTED COPING
The present invention is related to a splint abutment
for dental a prosthesis that can be made of titanium, gold,
carbon, chromium-cobalt, tilite, zirconium, niobium,
alumina, and other similar materials, without restriction.
It is a splint abutment for implant-supported prosthesis
that makes it possible to place two prosthetic crowns over
a single implant, thus providing better biomechanics,
normal dental function, good aesthetics and hygienic
.cleaning of prostheses. This invention offers superior
resistance of the abutment, lasting aesthetics and a
reduction in clinical time, assuring more predictable
results.
The aesthetic and functional necessities of lost teeth
replacement have been the primary focus in oral
rehabilitation. The introduction of the osseointegrated
implants increased the possibility of supplying fixed,
predictable and functional restorations, mainly in
extensive edentulous sites.
The objective of teeth replacement treatment initially
concentrated its function and success on the medium and
long-term, but new necessities have brought about
discussions and more appropriate treatment planning,
providing greater predictability in the final results.
Innovations in technique are necessary so that it has
greater functional, aesthetic and biomechanical suitability
to the patient's needs, a factor for which the new features
introduced by the present invention are so important and
justify the protection of the herein described creation.
Currently, the dental osseointegrated implants offered
by the technology available in the market receive a single
abutment on which a single crown element is placed. In the
majority of cases, an inlay splint prosthetic bar is made,
and/or a metallic infra structure fused and welded, joining
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two or more osseointegrated implant abutments, according to
the planning of the edentulous site. This inlay splint
procedure presents some disadvantages, such as the
difficulty in cleaning, the aesthetic problems due to the
absence of the prefabricated "abutment" with sinuous
format, that follows gingival contour and that provides a
more flattened in the mesiodistal direction and lengthened
in the buccolingual direction and presents greater
similarity to the form of a natural tooth, unlike those
currently in the market.
Another disadvantage in the current technique is the
difficulty in attaining total passivity of the metallic
structure, whose welding points do not always provide total
precision in the meeting of the inlay splint blocks,
perhaps causing tension that will be transmitted to the
implants. Such tension concentrates in the neck of the
implant, and it could cause bone loss increase in the
periimplant region in the medium or long-term, and, as a
consequence, the possible loss of the implant itself or of
the implant abutment screw, either by breaking, unscrewing
or becoming damaged.
The existence of a' similar technology to the one
presented by the invention described herein was not
verified in searches made in patent databases. The state of
the art does not possess similar solutions to the present
invention for the use in prosthesis on osseointegrated
implants.
The modalities offered currently present single pins
with cylindrical formats that bring biomechanical and
aesthetic limitations, since they do not follow
multidimensionally the contour of the profile of the
gingival emergency, which causes a concentration of stress
on the implant neck, which could cause greater bone loss in
the surrounding area, due to the fact that the pins are
single.
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The cylindrical format of the available abutment in
the state of the technique provides less nesting stability
and retention of the prosthetic crown, compared to the
innovation described herein. This hinders a uniform motion
of the normal dental function forces in the longitudinal
direction of the implant, as occurs in the resulting forces
of a natural tooth, which could also cause stress
concentration in the neck of the implant and bring about
bone loss the surrounding area.
All the disadvantages identified above have serious
consequences in the effectiveness of the treatment, in the
medium and long-term.
In biomechanical terms, the divergences of forces from
the normal dental function, resulting from the cylindrical
shape of the abutment, could limit the success of clinical
solutions, as well as presenting a shape that favors the
accumulation of bacterial plaque due to great difficulty of
hygienic cleaning.
The existing patents in this technological area,
identified in the search carried through in the patents
databases, do not solve the existing problems.
The invention patent BR P19602881-5, for example,
presents a thin profile dedicated to very sensitive bone
structures, in order to keep the temporary prosthesis
attached throughout the process of osseointegration of the
definitive implants. The patent of utility model MU7801874-
9 is designed to make it easier to implant the prosthesis
with a fast and safe attachment to the bone. Its object
consists of a cylindrical piece of pure titanium, with a
highly polished external ring band at one end, thus better
adapting to the gum, and a threaded blind bore, centered in
the longitudinal direction, which is larger and hexagonal
in the apical third, facilitating the fitting of proper
tools for threading the implant in the bone. This
arrangement allows greater stability in applying and
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There are, however, circumstances when the edentulous
site is located between 9.7 mm and 13.8 mm, or there are
anatomical defects or prosthetic or surgical planning
errors, and as a result there is not space or the necessary
conditions for two implants. The alternative commonly used
is to make a larger prosthesis implant, or to leave an
element hanging (cantilever), which presents functional,
biomechanical and aesthetic problems. Another alternative
is to adopt a fixed prosthesis, using tooth-implant union.
However, it is very controversial. Using the cantilever, as,
.with the state of the technique, the prominent bone
overload is clear and the probable future perimplantitis
caused by the bone overload, which could expose the inter-
bone part of the implant in contact with the subgingival
microbiota, possibly causing future implant loss.
It is therefore clear that the existing technologies
still provide no solution for some problems related to the
dental implant, as indicated.
The great spacial difference that exists between the
perimeter of the normal dental function plane of the
prosthetic crown and the diameter of the implant or of its
neck, has always caused problems in the aesthetic as well
as in the hygienic cleaning because it does not provide an
appropriate emergency profile, one that has a shape that
makes it possible to format or to follow the triangular
contour of papillas and of the interproximal crenas. The
rose aesthetic of the gum should hug the prosthetic white
crown to achieve the best result of aesthetic excellence in
implant-supported work.
To solve such problems, the invention described here
presents a splint abutment that makes it possible to place
two dental elements in a single implant, thus providing
better normal dental function, aesthetic stability and oral
hygienic maintenance.
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The innovation described here provides greater nesting
stability and retention of the prosthetic crown, bringing
about better directing of normal dental function forces in
the axial of the implant, as it occurs with natural tooth
5 forces, where the tensions are equally distributed,
diminishing the concentration of tensions on the neck of
the implant.
The new design presented by the invention described
here allows greater stability, retention and directing of
prosthesis forces for the axial forces of the implant,.
.since the adaptation of the prosthetic crown occurs in the
divergent girdle and not in the neck of the implant, thus
presenting more favorable and appropriate biomechanical
properties by allowing an emergency profile more similar to
the natural tooth.
The present invention provides better marginal
sealing, as well as better hygienic cleaning, since the
nesting of the prosthetic crown occurs above of the implant
neck, in the divergent girdle of the pre-manufactured
abutment, which can still be re-preparable, adjusting the
prosthetic emergency profile according to the contour shape
of the gingival architecture.
The splint abutment has parallel, slightly flared pins
for the normal dental function, with convergence degree of
6 to 9 , and they form angles between 30 and 60 with the
insertion axis of the implant, conforming with the
emergency profile of the gingival papilla.
It presents a milling area of 1.0 mm to 5.0 mm in the
longitudinal direction, to guide the insertion axis of the
prosthetic crown, as well as to confer greater stability
and retention, more naturally characterizing the contact
point of the inlay splint crown.
There is also a chanfer area or shoulder with a
rounded axio-cervical angle in all the perimeter of the
cervical edge, determined by sustaining periodontium.
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The biomechanical possibilities of the invention allow
better occlusal stability, since the shape and contour of
the abutment partially distribute and absorb the occlusal
load for the axial forces.
The abutment possesses a neck or divergent marginal
girdle of adjustable height of 1.0 mm to 8.0 mm, and
changeable perimeter between 4.5 mm and 14.0 mm, in the
mesiodistal direction and buccolingual perimeter of 4.0 mm
to 9.0 mm, from where two pins protrude with height, also
adjustable, of between 2.0 mm and 13.5 mm, and changeable
.diameter of 1.0 mm to 8.0 mm, according to the edentulous
site. These pins are parallel to themselves, slightly
flared for normal dental function, with a chanfered area in
all its cervical ending, that is, bevel deep chanfer or
shoulder with rounded axio-pulpar angle, which can be pre-
manufactured and repreparable for individualization of the
piece according to the architecture of the gingival
contour. Between the pins there is a narrow channel or
milling area that can be located either in the vestibular
or in the lingual position, to confer greater retention and
stability to the splint abutment.
In the central portion of the abutment there is an
open area where the screw of the abutment is fixed for
cases of internal hexagon implant, external hexagon, or
internal octagons, and a totally compacted area for a Morse
cone and cold welding implants.
The splint abutment, object of the present invention,
can, when necessary, be separated into two parts,
separating the pins from the marginal girdle and then
fitting them together to assemble them.
The dismemberment of this abutment can also occur in
the splint abutment coupling base, in cases of inclination
correction of the implant in the mesio-distal or
buccolingual directions, rotationally, where the use of a
connected cylindrical part is necessary, that is, a
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compensating slanted cap that provides an inclined plane,
varying from between 0 to 35 , to adjust the "abutment"
position according to each case, providing greater
possibility for correction of the rotational angles. In
specific buccolingual bone defects, for example, where
there is the need of angle correction, such defects can be
corrected through the slanted coping.
The compensatory slanted coping, which will be fitted
between the implant and the splint abutment, is
characterized by being a specific piece made of the same
.material as the abutment, with a perforation where the
fixation screw of the "abutment" will pass. The height of
the inclination slant can vary in accordance with the angle
from between 0 and 35 , rotational, which will determine
the compensatory and corrective slant. In the case of the
present invention, the screw of the splint abutment must be
sufficiently large, in height, to compensate the height of
the compensatory slanted coping. The splint abutmerit
provides an opening between the bolts of 2.1 mm to 5.5 mm,
designed to make it possible to insert the axis of the
abutment screw, when the coupling part is needed, that is,
the compensatory slanted coping. Besides the functional,
operational and aesthetic advantages of these alternatives,
they also speed up, facilitate and simplify the process of
industrial production of the parts, as to reduce its final
cost.
For the Morse cone and cold welding cases, the
compensatory slanted coping will be connected in the
vertical direction, with the same inclination compensation
varying from between 0 to 35 .
The splint abutment, object of the present invention,
also presents the inclination compensation of the implants
set on the bone ridge, with a single part, with a variation
between 10 and 35 with the implantation insertion axis.
The multidimensional angled splint abutment still offers
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the alternative of being repreparable, accordance to the
availability of the gingival architecture, and offers a
flexibility of shape for greater effectiveness of the of
the implant result, as well as for greater comfort and
patient adaptation.
The pins are parallel, slightly flared for the
occlusal and form angles between 30 and 60 with the neck,
in accordance with the emergency profile of gingival
papilla. They possess a chanfer area, or deep chanfer, or
shoulder with axio-cervical angle rounded in its entire,
,perimeter, following the edge of the profile of natural
emergency provided by periodontium support.
The peripheral and internal gingival contour is
obtained by means of making a prefabricated coping for
splint abutment, or by making moldings, for cases of
repreparable splint abutments, providing an anatomical
contour similar to natural teeth.
The splint abutment can present a narrowing at the
base of the cervical divergent brace, in all its perimeter
of 0.7 mm to 2.0 mm for gingival biological space between
the platform of the implant and the splint abutment.
T'he present invention innovates the state of the art,
since it offers a product that makes it possible, in a
single osseointegrated implant, whether of external
hexagon, internal hexagon, internal octagon, Morse cone and
cold welding, to place two dental elements conjugated or
inlay splint, with the option for cemented or screwed
prosthesis in cases of edentulous sites up to 15.0 mm, for
cases that present anatomical or surgical variations that
prevent placing two implants.
The invention described here, for its different
variations of shape, height and diameter, offers better
aesthetic, marginal sealing, oral hygiene maintenance,
greater normal dental function stability, total passivity
for being free of welding points, as well as a reduction in
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treatment time and a simplification of the clinical and
prosthetic procedures. These advantages lead to an
optimization of the surgical and rehabilitation planning,
besides obtaining an aesthetic proof, in the way of models,
perfect to provide predictability for future prosthetic
rehabilitation reconstruction and, above all, to improve
the final result, reflected in lower operational costs, as
well as better execution of the procedure.
The present innovation also aims to present
individualized splint abutments solutions, for the.
.posterior or anterior region, besides corrective abutments
according to the positioning or topography of periodontium.
The splint abutments, described here, straight and
angled, since they are prefabricated, offer the advantage
of eliminating the laboratorial phase of dieing, waxing and
scanning that still occurs with the existing products in
the state of the technique.
The splint abutment also offers a solution for placing
a single element, with wide or small diameter, whose
edentulous site is up to 10.0 mm, the mesiodistal or
buccolingual, since it provides a much more natural
emergency profile, that is, more similar to the original
tooth. It also favors proper oral hygiene maintenance and
offers much more suitable and satisfactory biomechanical
properties. There is, moreover, the possibility of varied
positioning of the splint abutment to naturally follow the
individualized emergency profile, since it presents
adjustable dimensions and chanfers that follow the convex /
concavous profile of the gingival tissue.
The new exclusive design of the product, object of the
present invention, furthermore offers clinical benefits,
since, by means of the marginal sealing, it provides better
bacterial protection, besides providing to higher
periodontal health for ensuring a more suitable hygienic
cleaning, following the gingival architecture.
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A further embodiment of the present invention is
related to small variations, mainly in relation to the
dimensions, and greater detailing of splint abutment and
compensatory slanted coping. The product of this
5 additional embodiment makes it possible to place two inlay
splint prosthetic elements in a single osseointegrated
implant, in edentulous sites of up to 16.0 mm, for cases in
which anatomical or surgical variations occur that prevent
the insertion of two implants.
10 The splint abutment provides better marginal sealing,
.as well as better oral hygiene maintenance; therefore the
passive nesting of the splint abutment occurs in the
platform of the implant. The adaptation of the prosthetic
crown is done above this platform, that is, in the
divergent girdle of the prefabricated splint abutment,
repreparable. Moreover, it can be adjusted and
individualized in accordance with the contour shape and the
gingival architecture, adjusting itself to the height of
its sinuosity, to the sizes and height of the divergent
cervical, buccal and lingual girdle, of 0.5 mm to 10.0 mm,
and of the divergent interproximal cervical girdle, from
1.0 mm to 12.0 mm, adjusting the emergency profile of the
prosthetic.
The splint abutment has two parallel pins, slightly
flared for the normal dental function, with a convergence
degree of 4 to 30 with the insertion axis of the
prosthetic crown and forming angles of 8 and 60 between
themselves, and it is possible to merge them in cases where
the edentulous site is less than 10 mm. They have a chanfer
area, or deep chanfer, or shoulder with axio-cervical angle
rounded along its entire perimeter, following the border of
the natural emergency profile presented by periodontal.
The divergent girdle forms angles between 30 and 80
with the axial forces of implant setting, determined by the
anatomical contour of the gingival papilla, with the option
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of using a cemented prosthesis, individuali2ed or not. For
cases of screwed prostheses, the splint abutment could be
reprepared to directly receive the selected restoring
material or even to receive fused ceramics directly in the
splint abutment.
There is a milled area between the bolts of 1.0 mm to
5.0 mm in the longitudinal direction, both in the
vestibular or in the lingual or both, to guide the
insertion axis of the prosthetic crown, as well as to
confer greater stability and retention of the crown,.
.rendering the point of contact between the crown more
naturally.
The splint abutment possesses a neck or divergent
marginal girdle of adjustable height from 1.0 mm to 8.0 mm,
and a variable length between 3.0 mm and 14.0 mm both in
the mesiodistal and in the buccolingual direction, from
where two pins protrude, also with adjustable heights,
between 2.0 mm and 13.5 mm, and variable diameter of 1.0 mm
to 8.0 mm, determined by the edentulous site.
There is, also in the divergent girdle, a milling area
that can be placed either in the buccal or in the lingual
or both, to confer greater retention and stability to the
splint abutment.
In the central portion of the splint abutment there is
an open area where the splint abutment screw is fixed, for
cases of internal hexagon implant, external hexagon,
internal octagon, internal duodecagonous, non-restrictive,
and completely compacted for implant area of the Morse cone
type and cold welding or, even, a single body implant, also
non-restrictive.
In some cases, the open area could be differentiated
by being lingualized in relation to the parallel pins in
the anterior elements, and in the posterior elements, for
overlap cases.
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The open area, where the splint abutment screw is
fixed, can also be differentiated, because it coincides
with the positioning place of one of the parallel pins,
allowing an extension of up to 55 mm of the divergent
girdle, both for mesial and for distal.
In some cases, as buccolingual bone defects, setting
inclined implants, for example, where there is the need for
angle correction, these can be corrected through the angled
compensatory slanted coping.
The compensatory slanted coping, which will be fit
.between the implant and the splint abutment, is
characterized for being a specifically made piece with the
same material of the abutment, non-restrictive, with a
perforation through which the screw of the "abutment"
setting will pass. The height of the compensatory slanted
coping can vary in accordance to the angle between 0 and
501, rotational, which will determine the compensatory and
corrective slant. In the case of the present invention, the
screw of the splint abutment must be large enough, in
height, to compensate the height of the compensatory
slanted coping. The splint abutment presents an opening
between the bolts of 2.1 mm to 5.5 mm, designed to make it
possible to insert the axis of the abutment screw, when the
coupling piece is needed, that is, of the inclination
plane. Besides the functional, operational and aesthetic
advantages of these alternatives, they not only speed up,
facilitate and simplify the process of industrial
production of the pieces, but they also reduce the final
cost.
For the Morse cone and cold welding cases, the
compensatory slanted coping will be connected in the
vertical direction, with the same compensation of
inclinations varying from 0 to 50 .
The splint abutment, object of the present invention,
also presents the inclination compensation of the implants
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set on the bone ridge, in a single piece, with variation
between 100 and 60 with the implant insertion axis. The
multidimensional angled splint abutment furthermore
provides the alternative of being repreparable, offering a
shape flexibility to allow greater effectiveness of the
implantation result, as well as greater comfort and
adaptation for the patient.
The peripheral and internal gum contour of the
prosthetic crown is obtained by making the pre-manufactured
coping for splint abutment, or by making moldings. For the
.cases of repreparable splint abutments, it provides
anatomical contour, similar to natural teeth or even by
means of sculpture and fused ceramics directly on the
splint abutment, eliminating molding, casting and welding
stages, reducing the laboratorial clinical time as well as
final cost.
The present invention can be better understood by
means of the presented figures, where:
Figure 1 shows the plant or view from above the
implant where: (1) is the mesiodistal distance that varies
from 4.5 mm to 14.0 mm; (2) is the buccolingual distance
that varies from 4.0 mm to 9.0 mm; (3) is the diameter of
the base of the pins that varies from 2.5 mm to 6.0 mm; (4)
is the diameter of the top of the pins that varies from 2.0
mm to 4.0 mm; (5) is the space between the two the pins
that varies from 2.1 mm to 5.5 mm.
Figure 2 shows the front view of the implant where:
(6) is the mesiodistal distance that varies from 4.5 mm to
14.0 mm; (7) is the height oi the pins from 2.0 mm to 13.5
mm; (8) is the height of the cervical interproximal
divergent girdle that varies from 1.0 mm to 6.0 mm; (9) is
the abutment height that varies from 4.0 mm to 14.5 mm;
(10) is the height of the buccal and/or lingual divergent
cervical girdle that varies from 1.0 mm to 5.0 mm.
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Figure 3 shows the lateral view of the implant where:
(2) is the buccalingual distance that varies form 4.1 mm to
9.0 mm; (8) is the height of the divergent cervical girdle
that varies from 1.0 mm to 6.0 mm; (10) is the height of
the buccal and/or lingual divergent cervical girdle that
varies from 1.0 mm to 5.0 mm.
Figure 4 shows all items that make up the splint
abutment where: (11) are the prosthetic crowns; (12) are
the parallel pins; (13) is the divergent girdle; (14) is
the compensatory slanted coping; (15) is the implant; (16)
-is the splint abutment and (17) are the splint abutments on
the implant with and without the compensatory slanted
coping; (17) is the splint abutment, and the prosthetic
crown, on the implant in the correct position (a), and
without the inclination slant (b).
Therefore, with broad and immediate application in the
implant-support area, the invention presented here
justifies its protection for both its innovative character
and for the great contribution to the technological
development in the medical-odontologic sector, since this
invention can also be used for osseointegrated implants in
other medical areas.