DE19949055A1 - Constructing implanted crown at low cost from ceramic blank employs plastic model, light-hardening composition, image recording, matching and computer programs finishing crown - Google Patents

Abstract

A process for crown production is elaborated. It covers use of a preformed plastic blank (1), a screw (2) fixation system and impression-taking with light-hardening composition (7). Form matching is described. A video camera or other device is used in the mouth to produce a record. Contact points, edges and inter-dental contacts are assessed and marked on the blank. Equipment used is further detailed. Data recorded is introduced into the preferred construction program CORRELATION. In a second stage, an optimally-prepared ceramic crown blank is fixed using the same screw casing and screw as in the first stage. Further programs EXTRAPOLATION and CORRELATION are employed in the 3D shaping unit (e.g. CEREC 2). Following cutting of the precontoured blank, is finished and subjected to a preferred polishing firing.

Description

The applicant has now made registrations in short order, some present extensive complex and ultimately from the basic idea to one "Volksimplantat" with appropriate pricing should lead. Therefore it will aspired to a comprehensive PCT patent application with all essential parameters create.

The last registrations, like this one now, dealt with prefabricated ones Ceramic crown blanks, with plastics of appropriate material properties and mouth-friendly in a reasonable manner, also compared to the preferred ceramic Could find application.

The purpose of the invention is in the premolar and molar area, but ultimately Canini and Incisiven also offer a milling blank, the walls of which are primarily parallel are designed and which is suitable with the corresponding modifications in a 3-D Milling unit like CEREC 2 to be converted into a crown, the gnathological Aspects are enough. This is a high-resolution video camera with monitor and Interface to the milling unit required, but this can also be done via data carriers.

It is essential to take a look at the starting position from several angles.

Furthermore, it is proposed with the registration, about a previous one on the Implant body fixed plastic implant with fixable, light-curing composite cap perform the bite registration and then allow the composites to harden. After digitization and evaluation of the contact point relationships or the Interdental contacts possible via a more or less careful grinding of the Plastic implant as a kind of model of the actual crown, the prerequisite for it To create construction and milling.

The option is used via the high-resolution video camera Image sequences in the memory of a preferred PC or the processor unit / s Milling unit to transmit as data with which on the monitor and a so-called EXTRAPOLATIONS or CORRELATIONS program at CEREC 2  A crown milling program is to be created which allows milling in the manner of an interpolation the crown should preferably be carried out using a modified "CEREC 2".

As I said, the contact points with the antagonist and the interdental contacts to the neighboring teeth from a static and cosmetic point of view increased importance donated.

In a practical procedure, a suitable ceramic blank is used for a single implant after construction and taking into account the color preferred in CEREC 2 stable and fixed unbreakable so that a suitable chip removal is possible.

The utmost attention must be paid to tool life. With the final Finishing or the final glaze, if necessary after the application of stains is the Crown quasi chairside prepared for integration.

The summary results in the following individual components, which in turn are largely composed of different elements:

• 1. The implant blank made of preferred ceramic in all common colors with integrated Screw sleeve and an implant-side circulation,
• 2. The plastic blank with integrated screw sleeve and an implant side Circulation on which a preferably light-curing structure is placed for the construction of the crown in which the patient bites to bite and in this position by means of light is cured,
• 3. CEREC 2, modified for the blank recording, with digital video camera and one Monitor that the construction on the current programs EXTRAPOLATION and CORRELATION enables, especially if the plastic blank after gnathological aspects are precontoured and the ceramic blank with a modified receiving device can be clamped exactly,
• 4.Constructed, precisely fitting shaft screws,
• 5. standard drills or individual drills and grinding wheels or grinding wheels,
• 6. Taps for the bone,  
• 7. Laboratory transmission elements and parts that are cheaper to buy.

The invention will now be explained in more detail with reference to claims 1-36 and FIGS. 1-12.

It shows

Fig. 1 in a schematic and largely hand drawing the necessary hard plastics blank, in its combination with the light-curing composites

Fig. 2 in a schematic, partly perspective view of the preferred ceramic blank later in a more understandable sectional plane A,

Fig. 3 in a schematic representation the plastic blank between two natural teeth on the implanted implant body in the phase of the bite record,

Fig. 4 in a schematic representation the occlusal view of a molar with its ideal contact points,

Fig. 5, in a schematic representation the interdental relationship between two molars

Fig. 6 in a schematic representation a possible impression of the antagonist with the ideal contact points,

Fig. 7 in a schematic representation the building hand processed on this information plastic blank,

Fig. 8 in a schematic representation the necessary digitization steps through the video camera,

Fig. 9 in a schematic view of a possible modified chuck of CEREC 2,

Fig. 10 in a schematic representation of the screw sleeve, which is necessary for tilted abutments,

Fig. 11 in a schematic representation a replaceable spacer sleeve,

Fig. 12 shows a schematic representation of the antagonist contact of two molars with contact points and a possible extension to a bridge.

Fig. 1 shows a schematic and largely hand drawing of the required hard plastic blank ( 1 ) in its combination with the light-curing composite ( 7 ). Plastic blank ( 1 ) is shown in an indicated connection to the implant body ( 3 ) or to the gingival transition ( 55 , 22 ) and has integrated screw sleeve ( 5 ) so that the light-curing composite ( 7 ) in its through hole ( 4 ) by extension ( 25 ) introduced and fixed by polymerisation after the bite. The bite registration is necessary in order to be able to determine the contact points ( 12 ) later after digitization via the preferred video camera ( 21 ). This is the prerequisite for the subsequent manual rough contouring from a gnathological point of view. ( 25 ) is colored over ( 24 ) in order to either get rid of the shank screw ( 20 ,...) Used or to mill away portion ( 7 ).

Fig. 2 shows a schematic, partial perspective representation of the later preferred ceramic blank ( 18 ) in a better understandable cutting plane A. It also integrates a modified screw sleeve ( 5 '), which differs from ( 5 ) in that ( 4 ) on the screw receptacle ( 26 ) has a stepped bore ( 68 ) with which the preferred shaft screw ( 20 ,...) Is sunk so far that the milling model is not affected. The screw head receptacle ( 68 ) is preferably bolted beforehand by a ceramic element. These details are not shown. It is striking that the blank ( 18 ) is preferably not designed to be circular and thus on the one hand facilitates interdental contact, on the other hand z. B. in premolars their rough lingual shape.

Fig. 3 shows a schematic representation of the combined plastic blank ( 1 , 7 ) between two natural teeth ( 11 ), here molars ( 27 ) on the implanted implant body ( 3 ) in the bite registration phase. This results in ( 7 ) a negative of the antagonist (s) ( 27 ) and opens up the possibility of specifying the contact points ( 12 ) as precisely as possible after hardening and renewed digitization.

At the same time we recognize the tooth equator ( 10 ) and the interdental contacts ( 16 ).

Plastic blank ( 1 ) is fixed via the screw sleeve ( 5 ) and by means of a socket screw ( 20 ,...) On the implant body ( 3 ) with a screw sleeve ( 5 ) in a recess ( 50 ) from ( 3 ) via the circulation ( 2 , 49 ) .

Fig. 4 shows a schematic representation of the occlusal view of a milled molar ( 38 ) with its ideal contact points ( 12 ). In general, the molar is marked here with ( 27 ).

Fig. 5 shows a schematic representation of the interdental relationship ( 16 ) between two molars ( 27 ). It is an occlusal view ( 29 ), particular attention being paid to the marginal ridges ( 15 ) in the indicated form.

Fig. 6 shows a schematic representation of a possible impression of the antagonist with the ideal contact points ( 12 ), which were determined after digitization.

Fig. 7 shows a schematic representation based on this information, the hand-processed plastic blank ( 1 , 7 ), in which essentially the cusps ( 13 ), the fissures ( 14 ) and the indicated edge strip are to be pointed out. The shaft screw ( 20 ,...), As illustrated here with head ( 20 '), is accommodated in a stepped bore of ( 4 ) and is divided into a precisely fitting shaft portion ( 63 ) and a preferred fine thread portion ( 64 ).

Fig. 8 shows a schematic representation of the necessary digitization steps via the video camera ( 21 ).

A shows the initial position, which is preferably digitized from vertical and from orthograd-buccal, where there is a gap between a molar ( 27 ) and a premolar ( 28 ) with their indicated occlusal surfaces ( 29 ).

B shows, among other things, the occlusal impression after the bite registration, a contact point ( 12 ) which was obtained after evaluation, preferably after vertical and orthograd buccal digitization. The rest of the presentation details have not been named.

C symbolizes the roughly contoured blank ( 1 , 7 ), here on the separated implant structure ( 22 ) and the digitization directions "vertical", "orthograd-buccal" and "orthograd-lingual".

D ultimately symbolizes the preferred digital video camera ( 21 ).

Fig. 9 shows in schematic representation a possible modified chuck of CEREC. 2

Ceramic blank ( 18 ) was included according to the design, although screw sleeve ( 5 ) was omitted for drawing reasons. Attention is again set screw (20,...) That fits with the screw head (20 ') in register (67) in the screw head receptacle (68), pass-shaft portion (63) and threaded portion (64). Since the fixation is arranged eccentrically, the blank ( 18 ) is secured in a rotationally stable manner on the base portions ( 69 , 70 ) by means of a circulation ( 60 ).

Fig. 10 shows a schematic representation of the screw sleeve ( 5 ), which is necessary for tilted structures. Through hole ( 4 ) can be clearly seen, which is deliberately fitted eccentrically. In the illustration, a stepped bore has been dispensed with, especially since the screw head ( 67 ) is normally supported in the crown ( 38 ,...) In a different way.

Fig. 11 shows in a schematic representation a replaceable spacer sleeve (55, 22) jumps directly here to the implant (3) in the width screws sleeve (5) and perfectly without any gap (57) via corresponding rounds (56, 56 ') is ultimately connected to the finished ceramic crown by means of a socket head screw ( 20 ,...).

Fig. 12 shows a schematic representation of the antagonist contact of two molars ( 27 , ( 38 )) with contact points ( 12 ) and a possible extension to a bridge over the pre-milled attachment matrix ( 48 ). All other display details have already been discussed, but here the transition to milled bridge is emerging.

Last but not least, the bridge, whose individual pontices are preferred, will be discussed be supported after loading with your own implant, but preferably one individual spacer sleeve for passage through the mucous membrane to avoid irritation and To prevent inflammation. A separate registration will follow.

Claims (36)

1. Method for creating an implant crown from a ceramic blank in preferably digital 3-D milling technology, whereby already through design programs such as EXTRAPOLATION and CORRELATION z. B. the milling system "CEREC 2" is able to manufacture crowns by the standard design program EXTRAPOLATION, possibly refined by the CORRELATION in the posterior region, characterized in that a preformed suitable and preferred plastic blank in a straight or kinked design with the precontoured transition to the implant body and with optimized, preferably eccentric screw sleeve that can be inserted into a preformed, precisely fitting through-perforation, which is reduced in length to the washer, after screw fixation is covered with a preferred shank screw, with a light-curing composite, which, after biting and light-curing, is the counterpart of the opposing tooth with cusp, fissure and marginal bar impressions up to the respective equator of the neighboring tooth shows that after intraoral video recording or the like, the contact points in the area of the later cusps, fissures and marginal bars or the interdental contacts of the missing tooth are fixed and marked or are marked on the blank as well as the screw access, that the blank is intraorally pre-contoured palatal and buccal while maintaining the contact points as opposing teeth at least in the area of the occlusal surface or in incisives and canini and that ultimately with a Further, possibly incisal video recording or the like, the recording / s preferably go into the preferred design program CORRELATION, that in the second step an optimally prefabricated crown blank made of ceramic is available, which has an identical implant fixation form, with the same screw sleeve and the same Is equipped with standard or individualized construction in the sense of the preferred construction programs EXTRAPOLATION with CORRELATION digital in a corresponding 3-D unit such as "CEREC 2", the initial position, but especially the pre-contoured Enter the blank in the image memory into the milling program and then finishing and a preferred glaze finish the crown design. 2. The method according to claim 1, characterized, that before beginning vertically, orthograd laterally from extra and / or intraorally and / or likewise incisal, preferably by means of a preferred digital one High-performance camera a recording sequence of the exit position is taken and after the rough milling process of a preferred plastic blank with its Image values of the construction programs the recorded unprocessed preferred ceramic blank for its final design using the appropriate tools to lead. 3. The method according to at least one of claims 1, 2, characterized, that then the preferred plastic blank is selected and with the described Provide screw sleeve or washer, like an implant abutment preferred shaft screw is fixed. 4. The method according to at least one of claims 1-3, characterized, that then preferably the plastic blank preferably with a same, preferably light-curing and preferably prefabricated composite material so covered and is preferably fixed on the blank that after biting and light curing the Composite preferably extends to the neighboring tooth equators and then the negative, particularly in the area of the occlusal surface, using a preferred video camera is detected, preferably the preformed composite in a different color and preferably marked the screw access as a corresponding extension. 5. The method according to at least one of claims 1-4, characterized,  that the named inclusion in relation to the contact points in the area of the cusps, Fissures and marginal ridges and especially in the area of interdental contacts were analyzed which are preferably marked by means of laser or paint or the like and which Form the basis according to which the preferred plastic blank is ground intraorally and preferably connect again with the preferred one from optimal viewing angles Video camera is recorded. 6. The method according to at least one of claims 1-5, characterized, that the actual preferred ceramic blank in the 3-D unit it is clamped that all the desired coordinates are traversed, with what about suitable tools and machining spindles a crown and / or a bridge arises. 7. The method according to at least one of claims 1-6, characterized, that the preferred ceramic blanks preferred according to the natural Tooth colors and selected according to patient preferences, which are preferred almost all be available. 8. The method according to at least one of claims 1-7, characterized, that as a programming requirement preferably an intraoral video camera higher Resolution with direct image access is used, the obtained Recordings made directly visible on a monitor and on a preferred one PC saved and can be called up at any time. 9. The method according to at least one of claims 1-8, characterized, that prefers the EXTRAPOLATION and CORRELATION can be used according to the CEREC 2 method.   10. The method according to at least one of claims 1-9, characterized, that preferably a separate tool changer is used and the Tool life is either specified or preferably measured. 11. Kit for carrying out the method 1, characterized in that for creating an implant crown from a ceramic blank in preferably digital 3-D milling technology, already through design programs such as EXTRAPOLATION and CORRELATION z. B. the milling system "CEREC 2" is able to manufacture crowns by the standard design program EXTRAPOLATION, possibly refined by the CORRELATION in the posterior region, characterized in that a preformed suitable and preferred plastic blank ( 1 ) in a straight or kinked design with the preferably precontoured transition ( 2 ) to the implant body ( 3 ) and with optimized, preferably eccentric screw sleeve ( 5 ) that can be inserted into a preformed, precisely fitting through-perforation ( 71 ), which is reduced in length to the washer ( 6 ), after screw fixing via a preferred shaft screw ( 20 ,...), is coated with a preferably light-curing composite ( 7 ), which, after biting and light-curing, causes the counterpart of the opposing tooth ( 8 ) with cusp, fissure and marginal bar impressions and up to the respective equator ( 10 ) of the neighboring tooth ( 11 ) represents that after intraoral Vi deodorant or the like. The contact points ( 12 ) in the area of the cusps ( 13 ), fissures ( 14 ) and marginal ridges ( 15 ) or the interdental contacts ( 16 ) are suitable for being fixed and marked on the blank ( 1 ), that the blank ( 1 ) intraorally while maintaining the contact points ( 12 ) is suitable as a missing opposing tooth, at least in the area of the chewing surface ( 17 ) or in incisives and canini, to be pre-contoured palatally and buccally and that ultimately with a further possibly buccal video recording o. Like. The recordings are preferably able to go into the preferred design program CORRELATION, that in the second step an optimally prefabricated ceramic crown blank ( 18 ) is available, which has an identical implant fixation shape ( 2 ) and the same screw sleeve ( 5 , 6 ) and a preferred shaft screw ( 20 ,. , .) is equipped for fixation and is suitable to be milled digitally in a corresponding 3-D unit such as "CEREC 2" using standard or individualized construction in the sense of the preferred construction programs EXTRAPOLATION with CORRELATION, whereby the starting position, but especially the pre-contoured blank ( 1 ) are able to enter the milling program in the image memory and that finishing and a preferred glaze are suitable for completing the crown design. 12. Kit according to claim 11, characterized in that a high-performance video camera ( 21 ) is suitable to take orthograd laterally from extra and / or intraoral and / or equally incisal at least one digital recording sequence of the initial position. 13. Kit according to at least one of claims 11, 12, characterized in that thereupon the suitable plastic blank ( 1 ), optionally provided with the modified eccentric screw sleeve ( 5 ') or washer ( 6 ), is suitable as an implant structure ( 22 ), preferably fixed by means of a socket head screw ( 20 ,...) and provided with a preferred, optimized, light-curing composite structure ( 7 ), the preformed composite material ( 7 ) preferably having a different color ( 24 ) and preferably with the corresponding extension ( 25 ) is suitable to mark the screw access ( 26 ) and to fix ( 7 ), whereby ultimately the cap screw ( 20 ,...) is accessible again by caps of ( 7 ). 14. Kit according to at least one of claims 11-13, characterized in that the initial blank ( 1 , 7 ) created later by biting is suitable for roughly working out the crown relief to be created in the implant position. 15. Kit according to at least one of claims 12-14, characterized in that the preferred plastic blank ( 1 , 7 ) is primarily suitable intraorally, after bite registration and fixing light curing, preferred video recording and definition of the contact points ( 12 ) for molars ( 27 ) and premolars ( 28 ), preferably primarily occlusal ( 29 ), before the preferably additional buccal and lingual sequence of steps are contoured, which in a similar sequence is suitable for canini and incisives. 16. Kit according to at least one of claims 12-15, characterized in that after the intraoral grinding again preferably digital video recordings are suitable and can be used with the programs EXTRAPOLATION and CORRELATION at "CEREC 2", preferably a full ceramic crown ( 38 ) to create. 17. Kit according to at least one of claims 12-16, characterized in that the preferred ceramic blank ( 18 ) with preferably parallel circumferential walls ( 39 ) is suitable in a suitable shape ( 65 ), optimally pre-shaped and color-machined stable in the 3-D -Unit modified ( 59 ) to be clamped ( 60 , 20 ',...), Whereby the tools used are preferably suitable with the two programs Extrapolation and CORRELATION to create an implant crown ( 38 ) after construction with "CEREC 2" . 18. Kit according to at least one of claims 12-17, characterized in that the blank ( 18 ) is / are preferably suitable according to the natural tooth shades, which are preferably almost all available and are possibly suitable, can also be individualized with stains. 19. Kit according to at least one of claims 12-18, characterized in that a video high-performance camera ( 21 ) with direct image access can preferably be used as a programming requirement, the recordings obtained being suitable via a monitor, made directly visible and stored via a preferred processor unit and are available at any time. 20. Kit according to at least one of claims 12-19, characterized, that prefers the construction program EXTRAPOLATION and CORRELATION are suitable to be used. 21. Kit according to at least one of claims 12-20, characterized, that preferably a separate tool changer can be used and the Tool life is either predetermined or suitable, preferably by measuring to be determined. 22. Kit according to at least one of claims 12-21, characterized in that the through-perforation ( 4 ) with its inlet ( 26 ) at ( 1 ) can preferably be closed with a composite before the start of grinding and / or preferably at ( 18 ) can be bolted with a ceramic pin is. 23. Kit according to at least one of claims 12-22, characterized in that the screw sleeve ( 5 , 6 ), the through hole ( 4 ), the socket head screws ( 20 , 20 ') and the implant recess ( 50 ) for ( 5 , 6 ) and the implant circulation ( 2 ) as well as the circulation ( 56 , 56 ') of a possible spacer element ( 55 , 22 ) and the corresponding crown circulation ( 49 ) have the minimum tolerance values that are technically feasible. 24. Kit according to at least one of claims 12-23, characterized in that the shaft screws ( 20 ,...), Which are anchored in the implant body ( 3 ), in the shaft region ( 63 ) and in the upper implant body region, where no threads ( 64 ) are present, have the minimum tolerance values in the tolerance field "bore-shaft". 25. Kit according to at least one of claims 12-24, characterized in that for the preferred ceramic crown ( 38 ) the programs used are suitable for integrating a bed load recess ( 48 ) for a divided bridge at an optimal or constructed location. 26. Kit according to at least one of claims 12-25, characterized, that preferably every loaded pontix is suitable, via a suitable implant to be supported. 27. Kit according to at least one of claims 12-26, characterized in that preferably all pontices are three-dimensionally millable and can be connected to one another and to at least one implant crown ( 38 ) and / or the preferably conventional crown, gnathological aspects being taken into account. 28. Kit according to at least one of claims 12-27, characterized, that also for the pontices preferably plastic and preferably ceramic blanks for To be available. 29. implant body, characterized, that this has no external thread and one with otherwise identical parameters Healing phase with closure of the inner bore required.   30. implant body, characterized, that with screw implants, the external thread is preferably suitable by means of preferred to be pre-cut to individual taps. 31. implant body, characterized, that with screw implants, the core drilling in the bone is preferred Thread tap is adjusted. 32. implant body, characterized, that preferably two implant diameters both in the cylinder implants as also available with defined lengths for the screw implants. 33. Implant body, characterized in that, in addition to the surface enlargement according to the prior art, a preferred alloy with an optimized pure gold content is used, which is suitable with appropriate treatment with preferably hot hydrochloric and sulfuric acid in an optimal composition, in the preferred passivated titanium implant body ( 3rd ) To produce micro lacunae. 34. implant body, characterized, that the surface roughness in the gingival area is suitable, e.g. B. by polishing to be brought to an optimized minimum. 35. Implant body according to at least one of claims 28-33, characterized in that the gingival transition ( 55 , 22 ) with corresponding circumferences ( 56 , 56 ') or the like with the implant body ( 3 ) almost eccentrically preferred with almost no marginal gap ( 57 ) can be connected by a socket screw ( 20 ,...) and that this ( 55 , 22 ) is available at different heights. 36. Milling unit, characterized in that the preferred ceramic blank ( 18 ) is suitable to be clamped ( 20 ,..., 60 ) analogously to the implant fixation, which makes the integration of an additional clamping device ( 59 ) necessary.