CN102551901B - Oral implantation method for improving jaw bearing mode and screw implant - Google Patents

Abstract

The invention discloses a screw sleeve type oral implant for improving the bearing mode of the jaw. The implant is composed of a screw sleeve and a base body. The shape of the screw sleeve is a helix similar to a spring, and the inner and outer surfaces of the sleeve are threaded structures respectively. It is divided into a cortical bone segment and a cancellous bone segment from top to bottom, and the cross-sections of the two segments are rhomboid or quasi-rhombic. The shape of the base body is designed as a cylindrical external thread body, including a gingival segment, a fine segment, a coarse segment and an introduction segment, and a composite cavity in the center. After the internal thread of the screw sleeve is assembled with the matrix, the cortical bone segment and the cancellous bone segment form a stable thread connection with the fine tooth segment and the coarse tooth segment respectively, and the height of the cortical bone segment of the screw sleeve is 0.1~ 0.5mm. In the present invention, the implant is optimized into a composite structure composed of a screw sleeve and a base body, which can generate pre-tension stress in the jaw after surgery, thereby changing the load transmission mode of the traditional implant and alleviating the stress concentration of the jaw. Reduced risk of bone resorption due to overload.

Description

A screw-type oral implant that improves the load-bearing mode of the jaw

technical field

The invention relates to a screw sleeve type oral implant for improving the bearing mode of the jaw, which belongs to the field of intraosseous implants.

Background technique

my country is a country with a large population, but there is a lack of awareness about oral hygiene knowledge, and the awareness of oral health care is not strong. At present, my country has become a high-incidence area for oral diseases. According to the third national oral health epidemiological survey completed in 2006, the middle-aged and elderly people have severe tooth loss. of the elderly are edentulous. At present, there are three common methods of restoring missing teeth in oral clinic: removable dentures, fixed dentures and dental implants. Removable dentures are attached to the adjacent teeth of the missing tooth by using a retention mechanism, which has the characteristics of free removal and easy cleaning; however, the retention and aesthetics are poor, affecting chewing, foreign body sensation, and easy to cause dysphonia. Fixed dentures use the adjacent teeth as the abutment teeth, and the dentures are fixed on it with the help of adhesives. The patient does not need to take and wear them by himself. It has the characteristics of small size, comfort, beauty, and no foreign body sensation; Normal tissue is healthy and the bottom of the denture is not easy to clean.

In the 1960s, an orthopedic expert in the Swedish Nobel Laboratory The research team led by the professor put forward the theory of osseointegration, and successfully developed a modern oral implant system for clinical application. In 1965, the world's first oral implant surgery was completed. Since then, this bionic denture has been clinically obtained. Rapid development and application. At the same time, with the rapid development of clinical application, the connotation of modern oral implant has been greatly enriched and matured, forming a complete set of scientific and practical systems on the basic theory, histopathology, surgery, and implant restoration of modern oral implant, which has become the standard of oral science in this century. The fastest growing profession. As a supporting device for dentures, implants are often divided into four types clinically: intraosseous implants, subperiosteal implants, root canal implants, and perforated bone implants. At present, intraosseous implants are the most widely used. Branemark, ITI, IMZ, BLB, etc. are well-known brands of implants at home and abroad. Although there are many brands of implants, their structure and clinical operation process are basically similar: the implant has a cylindrical or conical base with external threads, and the base is generally made of metal or bioceramics. A hole with a size similar to the shape of the implant is prepared with a drill in the jaw area of the tooth, and then the implant is placed in the hole to simulate the function of the autogenous tooth root. Finally, the abutment and denture are placed on the base body, and finally the missing tooth in the oral cavity is completed. repair. This implant-made denture has an incomparable restoration effect compared to traditional dentures, and is known as the third set of human teeth.

At present, although oral implant has become a form of restoration that is easily accepted by doctors and patients, and has been widely promoted in clinic, there are still many problems in terms of implant itself, which affect the clinical efficacy and success rate. As we all know, the oral cavity is a very complex environment. After the implant is planted in the jaw, it will bear chewing forces of varying intensity and frequency. The classic implant theory proposes that after implant placement, it needs to go through a period of unloaded healing (3-6 months) before the restoration can be installed. In recent years, experts in the implant field have proposed the concept of early loading or even immediate loading, and achieved relatively recognized success rate. However, due to the limitations of the integrated structure of the existing implants, a high-stress zone will be formed near the crest of the alveolar bone when bearing loads. In particular, literature has proved that the stress of the bone around the implant will increase with the osseointegration. The degree of increase is greatly reduced. In the early stage of implant healing, the bone around the implant is undergoing bone remodeling, the integration between the implant and the bone tissue has not yet occurred or the degree of integration is very low, and the strength of the interface is very poor. Therefore, when bearing functional loads in the early stage, Existing implants will form stress concentration on the alveolar ridge, resulting in overload, resulting in bone resorption; at the same time, because the integration between the implant and the bone has not yet formed in a real sense, the stability of the implant is very poor, and the When the chewing force is strong, the micro-movement of the implant will be triggered, and the micro-movement of the implant at the interface will directly affect the healing of the bone; in addition, once the existing implant has clinical problems, it will cause damage to the surrounding bone tissue. Serious injury will cause many complications, and will greatly increase the difficulty of secondary repair. Based on the above statements, it can be seen that the existing implants not only have practical problems affecting aesthetics and functional recovery, but will directly lead to loosening and falling off of clinical implants.

Contents of the invention

In order to overcome the phenomenon of stress concentration on the crest of the alveolar bone caused by the existing implants under the masticatory force, and to improve the stability of the implants during the healing process and the replaceability of the damaged implants, this paper invented a An oral implant method that can effectively improve the stress distribution in the jawbone after the oral implant is loaded, and a screw-type implant. The invention optimizes the structural composition of the implant, which is completely different from the design concept of the existing products, can ensure the initial stability and excellent replaceability of the implant, and the most important thing is that it can significantly reduce the alveolar bone crest around the implant The phenomenon of stress concentration, so that the chewing load can be more evenly dispersed, so as to effectively reduce the bone resorption caused by stress concentration, and effectively ensure the normal reconstruction and integration of surrounding bone tissue, so as to improve the success rate of mid-term and long-term implantation and The purpose of improving the aesthetics of implant restoration.

The method adopted by the present invention to pre-solve the existing problems is to change the structure of the existing implant body through its own external thread to achieve intraosseous retention into a two-piece structure of indirect retention, that is, the screw sleeve (1) and the base body ( 2) A combined intraosseous retention structure. The implant of the present invention is characterized in that: the implant is composed of two parts, a screw sleeve (1) and a base body (2), the shape of the screw sleeve (1) is a helix similar to a spring, and its cross section is rhombus or quasi-rhombic, and the screw sleeve (1) The external and internal surfaces of ) are respectively external thread and internal thread structure, which are divided into cortical bone segment (10) and cancellous bone segment (20) from top to bottom, while the base body shape includes the transgingival segment (30 ), fine tooth segment (40), coarse tooth segment (50) and import fixation segment (60). The center of the matrix is a compound cavity (70), which is used to install the superstructure of the implant abutment.

The cortical bone segment (10) of the screw sleeve (1) adopts a thinner thread, and the thread of the cancellous bone segment (20) adopts a thicker profile, and the profile of the thread can be a triangular thread, a rectangular thread, or a trapezoidal thread. Or arc thread, the outer side of described thread sleeve (1) is used for connecting bone tissue, and the outer side (101) of corresponding cortical bone segment (10) and the outer side (201) of cancellous bone segment (20) and jawbone respectively The cortical bone (4) and cancellous bone (5) form a thread fit.

The gingival section (30) of the base body (2) is a circular frustum (301) with a large top and a small bottom, and the top of the circular frustum is a conical chamfer (302);

The fine tooth segment (40) of the base body (2) is a cylindrical external thread structure (401), and its external thread (401) is used in conjunction with the internal thread (102) of the cortical bone segment (10) of the screw sleeve (1). The same number of thread turns;

The coarse tooth segment (50) of the base body (2) is a cylindrical external thread structure (501), and its external thread (501) is used in conjunction with the internal thread (202) of the cancellous bone segment (20) of the screw sleeve (1), Both threads have the same number of turns.

The introduction and fixing section (60) of the base body (2) is a one-third spherical segment, and a cross groove (601) is provided on the outer surface of the spherical segment.

The composite cavity (70) is a conical hole (701) with a Morse taper and a cylindrical internal threaded hole (702) from top to bottom.

The screw sleeve type implant in the present invention is characterized in that: the height of the screw sleeve (1) cortical bone segment (10) is higher than the height of the fine tooth segment (40) of the matrix (2), and the difference between the two is 0.1 to 0.5 mm.

The screw sleeve type implant in the present invention is characterized in that: the height of the screw sleeve (1) cancellous bone segment (20) is higher than the height of the coarse tooth segment (50) of the matrix (2), and the difference between the two is 0.5- 5mm.

The screw sleeve type implant in the present invention is characterized in that: the outer diameter of the cylindrical thread of the base (2) is denoted as D, and the heights of the fine tooth segment (40) and the coarse tooth segment (50) are respectively denoted as d ₁ , d ₂ , the overall height of the matrix (2) in the bone is recorded as H, then H=d ₁ +d ₂ +D/3, and the matrix (2) is divided into 6 series according to the height of d ₁ , the heights of d ₁ of the six series are 1mm, 1.5mm, 2mm, 2.5mm, 3mm and 3.5mm respectively, the total height H can be set to 8-22mm, and D can be set to 3-5mm; at the same time, the screw sleeve (1 ) is also divided into 6 series that match the base body ( ₁ ) according to the height a1 of the cortical bone segment.

The advantages of the oral implantation method and the screw sleeve type implant for improving the bearing mode of the jaw after oral implantation of the present invention are:

[1] Conducive to the uniform distribution of masticatory force in the alveolar bone: Both animal experiments and clinical experiments have proved that under the action of masticatory force, the existing implants will cause a high-intensity concentrated load on the crest of the alveolar bone. This load will further cause the alveolar bone to absorb, and once the alveolar bone is absorbed, the metal part of the implant will be exposed, seriously affecting the aesthetics of the implant restoration. The implant of the present invention adds a screw sleeve structure, and adopts a threaded connection with small screw teeth in the dense cortical bone area, which can effectively relieve the stress level of the first few threads of the alveolar bone crest area, and make the chewing force along the implant The distribution of the body axis is more uniform, which can effectively avoid or reduce the absorption of the jaw.

[2] It is conducive to improving the initial stability of the implant: the screw sleeve is shaped like a spring. After screwing into the prepared hole in the alveolar bone, its outer surface will closely fit on the internal threaded hole of the bone wall by elastic force, while Its inner surface forms an internal thread connection matched with the base body. On the one hand, this structure can obviously improve the initial stability of the screw sleeve relative to the bone tissue. On the other hand, after the base body is screwed in, it can obviously Improve the connection strength and wear resistance of the matrix, which can effectively prevent the matrix from loosening and falling off.

[3] Facilitate the secondary replacement of the implant: once the existing implant is damaged, it needs to be uprooted during the removal process, which will cause serious trauma to the surrounding bone tissue, but in the present invention, an additional implant is added between the matrix and the bone tissue. The screw sleeve structure makes it possible for the base body to have problems in clinical application, only need to loosen the threaded connection between the base body and the screw sleeve, and only take out the base body, while the original matching relationship between the bone tissue and the screw sleeve is maintained, thus Damage to bone tissue due to damage to the matrix can be avoided.

[4] Contribute to the formation of an initial stress environment in the alveolar bone that is conducive to bone reconstruction: the screw sleeve designed in the present invention is different from the wire screw sleeve commonly used in mechanical structures. The tensioned state is screwed into the matching part, while the use process of the screw sleeve in the present invention is similar to that of the compression spring, which is screwed into the jawbone in a compressed state, so the screw sleeve will produce an initial pull on the matching jawbone stress. Experiments have confirmed that a certain intensity of tensile stress is helpful to the reconstruction of bone tissue and the prevention of bone resorption. In addition, masticatory force will form compressive stress in the bone tissue, and the tensile stress formed in the bone by the screw sleeve in the present invention can just relieve this compressive stress to a certain extent, thereby further reducing the adverse effect of masticatory force on the bone.

Description of drawings

Fig. 1 is a schematic diagram of the structure and composition of the screw-type implant of the present invention.

Fig. 2 is a front view external view of the screw sleeve of the present invention.

Fig. 2A is a side perspective view of the screw insert of the present invention.

Fig. 2B is another side perspective view of the screw insert of the present invention.

Fig. 3 is a side perspective view of the substrate of the present invention.

Fig. 3A is a front perspective view of the substrate of the present invention.

Fig. 3B is another side perspective view of the substrate of the present invention.

Fig. 3C is a half-sectional outline view of the substrate of the present invention from a front view.

Fig. 4 is a schematic diagram of the assembly of the implant and alveolar bone of the present invention.

Detailed ways:

The present invention will be further described in detail below in conjunction with the drawings and implementation process.

Referring to Fig. 1, the present invention shows a screw-type oral implant that improves the load-bearing mode of the jaw, which transforms the existing method of relying on cylindrical or conical external threads in the jaw bone into a screw-type implant. Mode of indirect retention. The oral implant of the present invention comprises two parts, a screw sleeve (1) and a base body (2), wherein the outer side of the screw sleeve is screwed into the bone tissue to play the role of intraosseous retention, while the inner side of the screw sleeve (1) is connected to the base body (2). ) to form a stable internal thread connection.

Referring to Fig. 2, 2A, 2B, and 4, among the present invention, screw sleeve (1) external shape is the spiral body similar to spring, and its height is greater than the height H of the intraosseous part of base body that is used with it, is divided into from top to bottom Cortical bone segment (10) and cancellous bone segment (20). During the implant operation, the gingiva (4) is processed and a hole is prepared on the jaw, and then the screw sleeve (1) is screwed into the jaw hole in a compressed state, wherein the external thread (101) of the cortical bone segment (10) ) is in contact with the cortical bone region (4) of the jawbone, while the external thread (201) of the cancellous bone segment (20) is in contact with the cancellous bone region (5) of the alveolar bone. Simultaneously in order to make the implant of the present invention applicable to the implantation of clinical different thickness cortical bone regions, the present invention designs the cortical bone segment (10) and the fine tooth segment (30) of the screw sleeve (1) and the matrix (2) to be different respectively. height, forming 6 series. Therefore, in clinical use, it is necessary to select a screw sleeve (1) and a matrix (2) that can better match it according to the bone quality of the patient, especially the thickness of the compact bone.

Referring to Fig. 3, 3A, 3B, shown in 3C, in the present invention, the outer surface of matrix (2) comprises gingival section (30), fine tooth section (40), coarse tooth section (50) and Import fixed section (60). During the implant operation, the gingival section (30) must be located below the high point of the gingiva (3), and should not be higher than the gingival surface. It is the transgingival part of implant surgery. The external thread (401) of the fine tooth section (40) of the base body (2) and the external thread (501) of the coarse tooth section (50) are respectively connected with the internal thread (102) and the loose thread of the screw sleeve (1) cortical bone section (10). The internal thread (202) of the bone segment (20) forms a threaded internal connection, so that the matrix is indirectly fixed in the jawbone through the screw sleeve (1). The shape of the base body (2) leading into the fixing section (60) is a one-third spherical segment, and a cross groove (601) is provided on the end surface of the spherical segment, and the cross groove (601) is conducive to the ingrowth of new cancellous bone, It can further improve the stability of the bottom of the implant and help relieve the impact of vertical chewing force.

As shown in FIG. 3C , in the present invention, the composite cavity ( 70 ) is used for installing a healing abutment or a formal abutment in clinical implantation.

Referring to Fig. 1, compared with existing products, the implant of the present invention can significantly reduce the stress concentration on the crest of the alveolar bone, relieve the impact of external load on the bone tissue during mastication, and facilitate the development of masticatory force on the alveolar bone. The uniform distribution in the center can effectively avoid the trauma to the bone tissue caused by the removal of the implant when there is a problem with the implant, which is convenient for secondary repair. The specific process of the implant of the present invention in clinical use is as follows:

1) Preliminary preparation: For conventional implantation, preparatory work such as incision, flap flap and alveolar ridge trimming is performed on the surgical area; it is also possible to only sterilize the surgical area and adopt the implantation form without flap.

2) Drill positioning holes: Use a drill bit with a diameter of 1.6-2.0 mm to prepare in the jawbone through the surgical guide, and use the detection rod to detect the direction and depth of the hole. If there is an error, it needs to be adjusted in time.

3) Forming of the implant hole in the cancellous bone area: the diameter of the forming drill in the cancellous bone area is 0.7-1.1 mm different from the diameter of the corresponding part of the implant. According to the different bone quality of the patient, use different sizes of drill bits, such as those with better bone quality patients, can be molded with a relatively small diameter. After molding, detection and adjustment are performed with the detection rod as described above.

4) Cortical bone implant hole formation: use the cortical bone area forming drill to further form internal thread holes in the cortical bone area on the basis of the previous hole preparation, and accurately control the depth of the hole forming through the surgical guide plate and the stop device of the implanting handpiece

5) Implanting the screw sleeve: use a special wrench for the screw sleeve to screw the screw sleeve in, and the external thread (101) of the cortical bone segment (10) of the screw sleeve to be screwed in should match the cortical bone screw hole of the jaw. After the screw set is installed, it should be slightly compressed.

6) Installing the base body: use a mobile phone to screw into the base body (2), and then use a torque wrench to precisely control the size of the retaining torque to complete the threaded connection between the base body (2) and the screw sleeve (1).

7) Post-implantation treatment: As in conventional post-implantation treatment, a healing abutment or formal abutment is placed for the implant, and soft tissue is sutured.

Claims (4)

1. a screw implant, it is characterized in that: implantation body is comprised of swivel nut (1) and matrix (2) two parts, the spirillum that swivel nut (1) profile is spring-like, its cross section is rhombus or class rhombus, outer surface and the inner surface of swivel nut (1) are respectively external screw thread and female thread structure, be divided into from top to bottom cortical bone section (10) and spongy bone section (20), and matrix profile comprises from top to bottom and wears gum section (30), closely-pitched section (40), coarse thread section (50) and import canned paragraph (60) four parts, the center of described matrix is a compound cavity (70);

The cortical bone section (10) of described swivel nut (1) adopts thinner thread, the screw thread of spongy bone section (20) adopts thicker tooth form, the tooth form of screw thread is triangle thread, rectangular thread, trapezoidal thread or circular thread, the outside of described swivel nut (1) is used for connecting osseous tissue, and the corresponding outside (101) of cortical bone section (10) and the outside (201) of spongy bone section (20) form threaded engagement with cortical bone (4) and the spongy bone (5) of jawbone respectively;

The gum section (30) of wearing of described matrix (2) is up big and down small round platform (301), and the top of round platform is a taper chamfering (302);

The closely-pitched section (40) of described matrix (2) is cylinder external thread structure (401), and its external screw thread (401) is used in conjunction with the female thread (102) of swivel nut (1) cortical bone section (10), and both thread turns are identical;

The coarse thread section (50) of described matrix (2) is cylinder external thread structure (501), and its external screw thread (501) is used in conjunction with the female thread (202) of swivel nut (1) spongy bone section (20), and both thread turns are identical;

The segment that the importing canned paragraph (60) of described matrix (2) is 1/3rd, the outer surface of this segment is provided with cross recess (601);

Described compound cavity (70) is from top to bottom for having conical bore (701) and the cylinder internal thread hole (702) of Morse's taper.

2. screw implant according to claim 1, is characterized in that: the height of swivel nut (1) cortical bone section (10) will be higher than the height of the closely-pitched section (40) of matrix (2), and both differ 0.1～0.5mm.

3. screw implant according to claim 1, is characterized in that: the height of swivel nut (1) spongy bone section (20) will be higher than the height of the coarse thread section (50) of matrix (2), and both differ 0.5～5mm.

4. screw implant according to claim 1, it is characterized in that: the external diameter of the cylindrical thread of described matrix (2) is designated as D, the height of its closely-pitched section (40) and coarse thread section (50) is designated as respectively d1, d2, the overall height of matrix (2) in bone is designated as H, there is H=d1+d2+D/3, by matrix (2), according to the different demarcation of d1 height, be 6 series, 6 serial d1 are highly respectively 1mm, 1.5mm, 2mm, 2.5mm, 3mm and 3.5mm, overall height H is set to 8～22mm, and D is set to 3～5mm; Simultaneously by swivel nut (1) according to the difference of cortical bone section height a1, be also divided into 6 series that match with matrix (1).