WO1998009581A2 - Implant system, method and tools for implantation in a toothless jaw - Google Patents

Abstract

An implant system (43) for anchoring a tooth replacement in a toothless jaw (3,4) or a toothless jaw section, comprising a first implant (45) with expandable side areas (46) for anchoring in the jaw bone and a second part (65) that can be screwed into the first implant (45) interacting with the tooth replacement and through which the side areas (46) of the first implant (45) can be expanded. Said system is so designed that the second part is intended as a secondary implant (65,65a) which can be implanted in the jaw bone and which on the one side hermetically seals the primary implant (45) with the expandable side areas (46) in the jaw bone (3,4) against the oral cavity and to which a third part (85) can be joined on the other side towards the oral cavity in order to fix the tooth replacement. The invention also comprises an implantation system and tools for the preparation of the bed of the implant. The expandable side areas (46) are only required during immediate strain on the implant system. These side areas and the second implant by virtue of its design are not subjected to a strainless inward growth of the implant system.

Description

Implant systems as well as methods and tools for implanting in the edentulous jaw

The invention relates to implant systems for anchoring dental prostheses in a toothless jaw or a toothless jaw section, consisting of a primary implant for anchoring in the jaw bone and a secondary part 1 which can be connected to the primary implant and to which the dental prosthesis is connected e.g. Bridges or the like can be connected. The invention also relates to a method and tools for implanting the implant systems.

Implant systems for anchoring dentures in the jawbone usually consist of an endosseous part that heals in the bone bed and often, not always, a second part that has no contact with the bone.

Titanium, for example, has proven to be a suitable material for implants. It has become known to use various measures to condition the surface of the implant by means of various measures in order to require healing and growth, particularly of the Pπ implant, in the jawbone, ie to enable the tightest possible bond between the implant and the bone. In one case, the surfaces of lm plants made of aluminum that do not work themselves are sprayed with a liquid titanium plasma. It has also become known to sandblast and roughen the titanium surface with aluminum oxide in a grain size of 100-150 μm in order to enable better bone contact. Various coatings of the implants are also known as surface treatment.

A method for producing titanium implants with wire-shaped surface structures has also become known. First, the basic body of the implant is made of titanium. A dense network of titanium and Fe wires is then produced so that the Fe wires essentially take up the later open spaces of the wire-shaped surface structure. This braid is then applied to the base body and welded to its surface. Finally, the Fe wires are dissolved by an oxidizing acid to which titanium is resistant (European patent application 262 354 AI).

This treatment is intended to encourage the ingrowth of the bone tissue into the open spaces of the surface structure, so that there is close bone contact of the implant.

However, it has been shown that such implants made of titanium with wire-shaped surface structures are not only extremely complex to manufacture, but also that smooth surfaces still have enough smoothness, ie porosity, to allow bone cells to grow into them. A further disadvantage is that this surface treatment cannot prevent, in particular, the formation of gaps between the implant and the bone and the oral cavity or the oral mucosa, which create a connection between the implant, the bone and the oral cavity. Since the mucous membrane cells grow much faster than bone cells, the mucosal cells penetrate into the cleft space and block the way for the bone cells to the implant body. This creates a connective tissue distinction of the implant, which is very susceptible to chronic inflammation processes and can lead to the loss of the implant. The shaping of the implant system is of great importance in order to enable the primary implant to be as stable as possible in the bone, in addition to surface structures. Any movement of the implant after insertion into the bone leads to undesirable gaps.

In order to avoid movements of the implant in the bone bed through shaping, implants have become known which consist of a primary implant into which a secondary part can be screwed, areas of the primary implant being spread outwards by screwing in the secondary part in order to increase the anchoring in the bone.

For example, a dental root implant with a positive bioreactive ceramic coating and an internal thread for attaching a superstructure has become known. The implant consists of a metal core which has an expansion cone at its front end and an internal thread in the region of the cylindrical section. A sleeve which is partially slotted from its front end is slipped over the metal core and is drivable through the slot on the expansion cone of the metal core. On the outer surface of the expansion cone of the metal core, longitudinal ribs engaging in the slots of the sleeve are arranged, the height of the wall thickness and the width of which can be adapted to the slots of the sleeve which are widened after the anchoring toward the front side of the expansion cone. (DE 3326710 A1).

The disadvantage is that the implant neck is exposed, so that germs have access to the implant body or to the bone via the part of the implant facing the oral cavity. This promotes the undesired formation of gaps and can lead to the loss of the implant through infection of the gaps. Another disadvantage is the shape of the implant.

An implantable fastening means for dental prostheses with one intended for healing in the bone tissue has also become known according to the apical conical tapering fastening pin, the apical end of which can be inserted into the jaw has an external thread, the fastening pin is tubular and the apical end of the fastening pin has longitudinal slots in the area of the external thread, in particular in the direction of the generatrix of the conical, apical end ( EP-PS 0207211).

The implant should be filled with a plastic, tissue-friendly mass, which should also support the tooth crown. This implantable fastener is intended to facilitate the insertion of a dental implant and to improve healing while at the same time producing the required elasticity.

The disadvantage is that it is not taken into account here that a bone reacts to pressure with degradation. Therefore, the pressure that the implant exerts on the bone should be kept as low as possible. Pressure and voltage peaks must be avoided at all costs. The threads of the implant that can be screwed into the jawbone do not meet this requirement. Main loads always occur at the implant tip of the implant and on the implant neck. i.e. at the transition from the bone to the mucous membrane.

Finally, a coated cylinder implant with an integrated fixation system as a carrier of various intraoral structures has also become known. The implant consists of a hollow cylinder with longitudinal slits at the top and bottom with an inner shoulder tapering at the top and bottom. The screwed-in screw expands the hollow cylinder at the top and bottom through an outer cone and conical tips on the screw. This is intended to fix the implant inserted into the bone hole. (DE 4000112 AI).

Slits, especially in the implant neck area, mean cavities into which the mucous membrane grows and bacteria penetrate. The consequence of this is a progressive connective tissue change with the resulting risk of infection and implant loss. Slots in the implant tip area indicate sharp edges and pressure peaks in the edge area under load. This causes bone loss over time, which increases the mobility of the implant in the bone.

In contrast, the invention is based on the object of improving implant systems from a primary implant and a secondary part which can be connected to it in such a way that they offer the least possible attack for bacteria and also enable seamless healing and permanent and firm growth in the jawbone . Another task then is to develop an implantation method and tools for carrying out this method.

This task is solved on the one hand by the fact that the secondary part is designed as a secondary implant that can be impregnated into the jawbone with an outer diameter that is equal to or in sections larger than the outer diameter of the surface of the pneumatic implant facing the secondary implant, that the secondary implant is close to the implant in the implanted state Primary implant and on the Kompakta, and that the end of the secondary mouth pointing towards the oral cavity is designed as a coupling point for a turning tool and, on the other hand, in that after predrilling an entry point in the toothless jaw or a toothless jaw section with a pilot drill to a depth that the long and the combined Pπmar- Sekundanmplan- tate corresponds, with a dressing tool prepared the final implant bed for the primary graft, and thereafter the primary ^¬ implant in this recycled bed is implanted, whereupon with a Aufbereitungswerkz The bed was prepared for the secondary implant and then the secondary implant was connected to the primary implant in the jaw, whereupon the tertiary part was connected to the secondary implant.

Significant further developments of the implant systems can be found in claims 2 to 50.

In the claims 2 to 4 possibilities are characterized, how the Pπmar- and second-ante plants according to the invention with each other can be connected. In any case, when assembled, the secondary implant sits tightly on the primary implant and in the compact. Without changing anything at the core of the invention, both implants can also be combined with one another by gluing or by a correspondingly close fitting connection.

In claims 5 to 11 different design options of the primary and secondary implants are characterized. In the simplest case, both implants have the shape of circular cylinders with the same outside diameter.

According to claim 6, the primary implant has the shape of a circular cylinder, the secondary implant, on the other hand, has a shape in the manner of a rotational paraboloid. The outer jacket of the primary implant merges into the outer jacket of the secondary implant without a shoulder.

According to claim 7, the primary implant has the shape of a cone and the secondary implant has the shape of a truncated cone.

According to claim 8, at least one intermediate implant can also be arranged between the two implants in order, if necessary, to bring about a length adjustment to the prepared implant bed.

In the claims 9 to 33, a preferred embodiment of the invention is characterized, the special features of which can be changed without changing the essence of the invention, and can also be used in connection with the implants according to claims 1 to 8.

With all of the exemplary embodiments of the invention, a three-part implant with two endosseous implant parts, ie with a primary implant that can be anchored in the bone and a secondary implant, has been created. As a result of the guiding of the tool for the purification of Sekundanmpl antatbettes within the implanted in the jaw already Primaπ plantates it is possible to prepare an exact circle in cross-section ^¬ secondary round hole for storing the secondary implant in the Kcrπpakta. The Sekundanmplantat is congruent to but slightly k le ⁱ e - re secondary bore trained so that in addition to a good anchoring of the primary implant in the jaw, a safe healing of the secondary implant in the jaw is possible, as well as a reliably tight seal to the oral cavity. The fixed healing of the primary implant into the jawbone is supported by the spreadable areas in the primary ^¬ implant, which also guarantee an optimal primary stability. The expansion slots are sealed against the oral cavity by the secondary nipi antat. They will grow through the bone over time, which also contributes to the rotational stability of the implant. The twisting especially of the primary implant can also be increased to claim 26 characterized in accordance with that additional longitudinal beads are provided on the abspreiz ^¬ cash areas.

What is important is that all the implants in the zusammengefugten state have a smooth surface and that the transmission of the oral cavity wegwei ^¬ cone end of the primary implant is spherical. The implants consist of titanium or niobium or common alloys of these metals or of other tissue-friendly materials. The surfaces can also be roughened in a manner known per se, for example by blowing with aluminum dioxide, in order to promote the ingrowth of the jawbone. The surface roughness should be 100 to 150 µm.

Another advantage of the implant systems according to the invention can be seen in the fact that the primary implant can be loaded immediately after being embedded in the jaw.

It is important that a flat implant neck is provided at the end of the secondary implant pointing towards the oral cavity, to which the mucous membrane can grow. This prevents germs from reaching the areas where the bone grows into the implants.

The implant systems e according to the invention offer only a very slight possibility of attack for bacteria. It follows that the implant systems form a tight bond with the jawbone from the start. There are no gaps that allow bacteria to penetrate the mucous membrane. All of these advantages result from the clever outer shape of the implant systems with a smooth surface and a rounded end. The form according to the invention of the expansion of the areas provided for this purpose in the primary implant by means of a corresponding expansion cone step in the screw-in secondary implant leads to a maximum stability of theparam. The fact that it is possible according to the invention to make an absolutely circular compact bore for the secondary implant in the jaw results in a tight connection of the secondary implant with the jaw, thereby preventing the attack surface for bacteria, but also for ingrowth of the mucous membrane.

The implant system according to the invention also allows salting in anatomically difficult conditions of the jaw. According to claims 24-25, the secondary implant can be implanted vertically in the jaw even if the primary implant only has to be inserted obliquely into the jaw. In both cases, spreadable areas can be provided in the load-neutral area of the implant systems.

For the first implant system, in which the primary implant and also the secondary implant are designed as circular cylinders with the same outside diameter, the implant bed is prepared for both implants after predrilling with a predrill by a further drill. Given ^¬ if light hammer hitting - - then the primary implant is first transferred into the prepared bed is ^¬. The long beads on the outer skin of the primary implant ensure good torsional stability.

The secondary implant is then connected to the primary implant, implant whereby a tight seal between the Pπmar- and the secondary ^¬, but also takes place between the secondary implant and the cortical bone.

In all cases in which the secondary implant is designed as a truncated cone or in the manner of a paraboloid of revolution, a Special tools to prepare the secondary implant bed. For implant systems of this type, the bed is first prepared in accordance with the shape using a tool for preparing the implant bed for the primary implant, after pre-drilling through a pre-drill. The primary implant is then inserted, which immediately has a secure seat in the cancellous bone.

Thereupon, with a further tool for the preparation of the secondary implant bed, the latter is prepared, the tool having a guide pin which is guided by a corresponding guide section in the primary implant. This makes it possible to prepare the secondary implant bed with an absolutely circular cross section.

After the secondary implant has been inserted into the primary implant, the implant system consisting of the endosseous primary implant and the secondary implant is firmly implanted in the jaw.

The tools for preparing the implant beds are characterized in claims 36 to 50.

Exemplary embodiments of the invention are explained below with reference to the drawing.

It shows:

1 schematically shows a first implant system,

La is a plan view of the secondary rim implant along the line la, la in Fig. 1,

1b shows a plan view of the primary implant along the line 1b, 1b in FIG. 1,

2 schematically shows a second implant system in partial section,

3 shows schematically in section a third implant system,

4 is a view of a preferred embodiment of an implant system,

Fig. 5 shows the preferred implant system according to Fig. 4 in

Partial longitudinal cut,

6 shows an angled implant system in partial section, 7 shows a representation of successive stages of the anti-intrusion process,

8 a pilot drill,

Fig. 9 a preparation tool for a primary implant bed,

Fig. 10 is a preparation tool for a secondary implant bed and

Fig. 1 1 shows a section through the tool according to FIG. 10 along the line XI / XI.

In Fig. 3 the oral cavity 1, the mucous membrane 2, the compact 3 and the cancellous bone 4 are indicated schematically. These suggestions apply to all implant systems of the present invention.

A first implant system 5 is shown schematically in FIG. 1, the circular-cylindrical primary implant 6 and the circular-cylindrical secondary implant 8 being shown in the non-assembled state. The primary implant has a spherically curved end 7. Both implants have the same outer diameter 9. They therefore merge into one another without a shoulder in the assembled state.

A bayonet connection is used for the assembly, one part 10 of which is arranged on the circular-cylindrical secondary implant 8, and the other part 11 of which is incorporated into the upper region of the primary implant 6.

The secondary rim implant 8 ends towards the oral cavity 1 in an implant neck 12 for ingrowth of the mucous membrane 2. The implant neck 12 is followed by an edge bevel 13, the meaning of which will be explained later.

In the secondary rim implant 8, an internal thread 14 is provided, into which a screw for fastening a tertiary part for attaching the denture can be screwed. In the upper region of the secondary ^¬ implant 8 is a hexagon socket 15 is provided which can be used in which a tool for rotating the secondary implant. 8 Long beads 16 are provided on the outer jacket of the primary implant 6, which, in the implanted state, ensure that the primary implant is prevented from rotating in the jaw.

Fig. La shows a plan view of the side facing away from the oral cavity 1 part of the secondary implant 8 with the attached hawks of Ba ^¬ jonettverbindung 10. Fig. Lb shows a top view of the pointing toward the oral cavity 1 area of the primary implant 6 with the attached there ßajonett- Connection part 11.

Fig. 2 shows a second embodiment of the invention. The implant system 18 has a circular-cylindrical primary implant 19 with a spherically curved end 7 and an outer diameter 20. In the primary implant 19 there is an internal thread 21 for a screw attachment 24 on the secondary rim implant 23, which is designed like a paraboloid of revolution.

At least one intermediate implant 22 can be provided between the primary implant 19 and the secondary implant 23, which may make it possible to adapt the length of an implant system to the prepared implant bed. Intermediate implants can be used on all implant systems.

An internal thread 25 is arranged in the secondary implant 23, into which a screw for fastening a tertiary part, not shown, can be screwed.

The Sekundärtei 1 23 has a smaller, facing away from the oral cavity 1 ^¬ outer diameter 26 and a larger outer diameter 26a, the implant neck 12 adjoined by the edge bevel. 13

Unlike the implant system 5, the pointing toward the mouth end of the Sekundari 1 pl antäte 23 on a screw head 27 to which a tool for screwing the implant 23 into the secondary primary ^¬ implant can be attached 19th 3 shows an implant system 29 with a conical primary implant 30 and a truncated conical secondary implant 34. The implant system 29 is shown in section in order to explain the internal structure.

The conical primary implant 30 ends in a spherically curved end 7. The wall inclinations of the primary implant 30 and the secondary implant 34 can be the same. Both parts of the implant merge into one another in the assembled state without attachment. The wall inclination of the Seundar implant can also be greater than that of the primary implant.

In the primary implant there is a frustoconical fitting insert 31 into which a frustoconical fitting shoulder 35 on the secondary implant 34 fits. The primary implant has a larger diameter 32, which corresponds to the smallest outer diameter 36 of the secondary implant. Towards the oral cavity 1, the secondary implant 34 has a larger outer diameter 36a, to which the implant neck 12 with the bevel 13 can be connected. The fitting insert 31 and the fitting projection 35 can also be designed in the shape of a circular cylinder.

Following the fitting insert 31, a longitudinal bore 37 with an internal thread 33 is provided in the primary implant 30, into which a screw thread 39 of a screw 38 can be screwed, which holds the secondary and primary implant together. The screw 38 has a screw head 40 which lies against the bottom of a blind hole in the secondary implant. The blind hole is provided with an internal thread 41 into which a screw for fastening a tertiary part to the secondary implant can be screwed.

On the region of the secondary implant 34 pointing towards the oral cavity 1 there is in turn a screw head 27, with the aid of which the secondary implant 34 can be inserted into the primary implant 30.

4 shows the side view of a preferred implant system 43. The oral cavity 1, the mucous membrane 2, the Ko pakta 3 and the cancellous bone 4 are indicated schematically. The implant system, generally designated 43, with a longitudinal axis 44 is composed of a primary implant 45, a secondary implant 65 and one Tertiary part 85 together, of which the primary implant 45 with the cancellous bone 4 and the secondary implant 65 with the compact 3 have grown together. The tertiary part 85 protrudes into the oral cavity 1. If necessary, the secondary implant 65 can also be partially overgrown with the cancellous bone.

The primary implant 45 consists of an end cone 53 with a spherical cone end 54. The imaginary base area is designated 55. The wall inclinations 63 of the end cone 53 and of a first truncated cone 57. Into which the end cone 53 merges via a rounded first retentions 56 depend on the different sizes of the implant systems 43. The imaginary larger base area of the first truncated cone 57 is designated 58 .

A second, shorter truncated cone 61 with an imaginary larger base area 62 adjoins the first truncated cone 57 via a second rounded retention pin 59. The wall inclination 63 of the second truncated cone 61 also depends on the size of the implant system. Usual wall inclinations 63 can be between 6 and 10 °.

The surface 64 of the primary implant 45 is smooth or treated in a manner known per se, for example roughened.

The truncated cones 57 and 61 can form expandable side regions 46 which are separated from one another by expansion slots 47 and which end in a relief bore 50 in addition to the base surface 55 of the end cone 53. The number of spreadable side areas 46 is arbitrary. In preferred exemplary embodiments, the primary implant 45 has three spreadable side areas 46.

In a manner explained later, a secondary implant 65 is screwed together with the primary implant. Fig. Shows that the secondary implant 65 consists, inter alia, of an ingrowth area 72 χ of an imaginary larger base area 73. The wall inclination 63 of the ingrowth area 72 can be 6 ° to 7 °. The implant neck 12 adjoins the base surface 7 of the lip waxing area 72 and ends at the mouth 1 along its circumference with a bevel 13. The implant neck 12 is designed as an annular groove rounded toward the longitudinal axis 4, the surface of which can be smooth or post-treated in a manner known per se. The mucous membrane 2 can grow into the implant neck 12 when the implant system 43 is embedded or waxed in the jaw 3, 4. The edge of the implant neck 12 pointing towards the oral cavity 1, when the primary implant 45 is correctly implanted in the cancellous bone 4 and the secondary implant 65 screwed to the primary implant 45 in the compact 3, is flush with the surface of the mucous membrane 2.

The upper area of the secondary implant 65 closes off as a screw head 78, which in preferred exemplary embodiments is designed as a hexagonal screw head and with the aid of which the secondary implant 65 is screwed into the primary implant 45.

The tertiary part 85 of the three-part implant system 43 is seated on the secondary implant 65. The lower edge region of the tertiary part 85 pointing towards the secondary implant 65 is designed as a bevelled inner edge 86 which fits onto the beveled edge 13 of the secondary implant 65. The tertiary part 85 is penetrated by a channel 87 which is designed as an inner cone 88. Dental replacement parts, which are not shown, can be attached to the tertiary part 85 in a manner known per se.

5 shows the previously described exemplary embodiment of the invention on the left as a view and on the right as a longitudinal section. The positions used in FIG. 5 correspond to those which have been illustrated in FIG. 4 and explained in connection with it.

An internal thread 52 is provided in the end cone 53 of the primary implant 45, into which a screw attachment 66 can be screwed at the end of the secondary implant 65 pointing towards the end cone 53; adjoining the screw shoulder 66 is a truncated cone 69 formed as a connecting piece with an imaginary larger base area 70. The wall slope 71 of the expansion truncated cone 69 is 3 ° to 6 °. When the screw attachment 66 is screwed into the internal thread 52, the expandable edge regions 46 of the primary implant 45 are expanded. In the non-splayed state, the side portions 46 form a Führungsab ^¬ section 48 for a not shown on ereitungswerkzeug 120 to the after the implantation of the primary implant 45, an exact compact secondary bore 67 is drilled, into which the waxing area 72 of the secondary implant 65 fits when the secondary implant 65 is screwed into the primary implant 45. The compact secondary bore 67 and the ingrowth area 72 are matched to one another in such a way that the secondary implant 65 fits tightly into the bore 67. Fig. 4 shows that the primary implant 45 in the cancellous bone

4 and the secondary implant 65 are embedded in the compact 3 and partially in the cancellous bone.

In the secondary implant 65, an internal thread 75 is provided for a screw 89 with which the tert 85 part is screwed to the secondary rim 65. The head portion 90 of the screw 89 is formed as a cone 91, of the tertiary part 85 is firmly connected with the secondary part 65 ver ^¬ in the screwed-in state by means of the inner cone 88 in the channel 87, wherein the bevelled inner edge 86 abuts against the edge bevel. 13 The head region 90 of the screw 89 can be equipped with a cross recess 92 or an internal hexagon 93.

6 shows an angled implant system 43a as a modified exemplary embodiment of the invention. Essential individual parts correspond to those of the implant system 43 and are labeled with the same positions. If a clear allocation between the positions of Figs. 6 and those of FIGS. 4 and 5 is possible, this Po ^¬ sitions will not be explained again.

Referring to FIG. 6 have the tertiary part 85 and the screw 89 a center ^¬ line 68 and the primary graft 45 and the secondary rimplantat 65a a center line 79 which may form depending on the anatomical conditions in the jaw, an inclination angle 82 with each other, between 180 ° - as in the implant system 43 according to FIGS. 4 and

5 - and about 125 "in the implant system 43a according to FIG. 6.

The ingrowth area 72a has a correspondingly designed larger base area 73, to which the implant neck 12 connects. In the waxing area 72a there is an internal thread 80 for the screw 89. The surface 83 is smooth or post-treated in accordance with the surface 64 of the primary implant 45.

In order to enable correct positioning of the ingrowth areas 72 and 72a with the imaginary base surface 73 relative to the primary implant 45 already implanted at an angle, opposing marking grooves 94 can be provided in the primary implant 45 and 95 in the secondary implant 65, 65a in the desired position. Expansion markers 47 can also be used as marking aids.

The implantation of the implant system 43 according to FIGS. 4, 5 and 6 is explained with reference to FIGS. 7a to f.

The oral cavity 1, the mucous membrane 2, the compact 3 and the cancellous bone 4 are again indicated.

According to FIG. 7a, a pre-drilling is made in the toothless jaw at the desired location with the aid of a pre-drill 97. The pre-drill 97 consists of a shaft 98 for clamping in the drill chuck of a drill and a drill body 99 which ends in a tip 102.

After predrilling, the bed is prepared for the primary implant 45 with the aid of a preparation tool 106. The preparation tool 106 also consists of a shaft 107 for clamping in the drill chuck of a drilling machine and a processing section 109, which ends in an arcuate tip 117 according to FIG. 7b.

Fig. 7c shows that the primary graft 45 with the spherical formation from ^¬ is embedded in the implant bed 54th The areas 46 not yet spread apart in this state form a guide part 48 (FIG. 5) for a guide pin 130 on a preparation tool 120 designed as a truncated cone for the secondary implant bore. By guiding the guide pin 130, it is possible to prepare an exact compact secondary bore 67 for the secondary implant 65. When the secondary implant 65 is screwed into the primary implant 45, the expansion cone 69a manages to spread out the expandable side regions 46 so that the primary implant 45 assumes the shape shown in FIG. 7f, in which a smooth transition from the primary implant 45 to the secondary implant 65 is possible . When the secondary implant 65 is screwed into the primary implant, a twisting tool engages the screw head 78.

8 shows the pilot drill 97 in an enlarged view. A shaft 98 for clamping in the drill chuck of a drilling machine is adjoined by a drilling body 99 which is equipped with working strips 100 which, according to FIG. The work ^strips 100 have an essentially rectangular cross section.

The entire pre-drill 97 is penetrated by a channel 103, through which coolant reaches an outlet opening 104, which exits between the cutting edges 100 at the tip 102 of the drill body 99.

The drill body 99 ends flat and the cutting edge 100 merges into the tip 102.

The drilling body 99 is provided with a depth marking 105, by means of which it is possible to determine the drilling depth.

8b shows a view of the pilot drill 97 from the tip. The cutting edges 100 that emerge from the drill body 99 at an angular distance 101 can be clearly seen.

FIG. 9 shows a preparation tool 106 for the primary implant 45. 9a three-edged, acc. Fig. 9b but also be four-edged.

A preparation section 109 adjoins a shaft 107. Coaxial to the longitudinal axis 110, the tool is penetrated by a channel 114 for the passage of coolant. Wings 111 are attached to the preparation section and have cutting edges 112 at their outer ends. Troughs 113 are arranged between the wings 111. The angular distance 116 between the cutting ^¬ edge is 120 ° or 90 °. The channel 114 ends in a cooling water ^outlet 115, from which the wings 111 are brought together in arches 117 to the tip.

The tool 106 also has a depth marking 118, with the aid of which the surgeon can recognize the depth of penetration of the tool into the pilot hole.

The Figs. 10 and 11 show a dresser 120 for the seconding ^¬ därimplantatbohrung 67. On a shaft 121 is coaxial with the longitudinal axis

122 is connected to a preparation section 123 designed as a truncated cone, which has a large base area 124 and a smaller base area 125. The contour of the processing section

123 is bluntly modeled according to FIG. 10. But it can also have any other suitable shape that corresponds to the secondary rim implant.

On the shell 126 cutting edges 127 are provided on the cutting edge ^¬ carriers 128 (Fig. 11) sit. The angle 129 which the cutting edge to the longitudinal axis 122 ^¬ occupy, is usually 70 to 75 °. Depending on the application, other angles can also be preferred.

The tool 120 is also penetrated by a channel 132, which ends in outlet openings 133 within the cutting edges 127.

te of the terms used

Oral cavity mucous membrane Compact cancellous bone Implant system Circular cylindrical primary implant Spherical curved end Circular cylindrical secondary implant Outside diameter Bayonet lock Bayonet lock Implant neck Edge bevel Internal thread Hexagon socket, longitudinal bead

Implant system circular cylindrical primary implant outer diameter inner thread intermediate piece 3 rotat i onsparabol i dart i ges Secondary mpl antat 4 screw attachment 5 internal threads 6 smallest external diameter a largest external diameter 7 screw head 8 9 implant system 0 conical primary implant 1 fitting insert 2 largest external diameter primary implant 3 internal thread 4 conical truncated secondary implant 5 conical truncated 6 small fitting fitting a largest outside diameter 7 longitudinal bore 8 screw 9 screw thread 0 screw head 1 internal thread 2 3 impl antatsystem a angled implant system 4 longitudinal axis 5 primary implant 6 expandable side area 7 expansion slot 8 guide section for preparation tool 9 0 relief bore 1 2 internal thread 3 end cone 4 cone end 5 base 6 first leeleisirisri 7 first truncated cone 90 head area 8 base 91 cone 9 second retention groove 92 cross recess 0 93 hexagon socket 1 second truncated cone 94 marking groove (primary implant) 2 base 95 marking groove (secondary implant) 3 wall inclination 96 4 surface 97 pilot drill 5 secondary implant 98 shaft and secondary implant 99 drill body 6 screw attachment 100 work bar 7 compact secondary bore 101 angular spacing 8 center line 102 tip 9 connecting piece 103 channel a expansion cone blunt 104 opening 0 base 105 depth marking 1 wall slope 106 preparation tool for primary implant 2 waxing area 107 shaft a waxing area 108 3 base area 109 preparation section 4 110 longitudinal axis 5 internal thread 111 Fly! 6 112 cutting edge 7 113 groove screw head 114 channel 9 center line 115 outlet opening 0 internal thread 116 angular distance 1 long bore 117 bend 2 inclination angle 118 depth marking 3 surface 119 4 120 preparation tool for the 5 tertiary part secondary implant bore 6 chamfered inner edge 121 shaft 7 channel 122 longitudinal axis 8 inner cone 123 9 screw preparation section formed as a truncated cone 124 large footprint

125 small footprints

126 coat

127 cutting edge

128 cutting edge supports

129 angles

130 guide pins

131 angular distance

132 channel

133 outlet opening

Claims

claims 1.Implant system (5, 18, 29, 43, 43a) for anchoring dentures in a toothless jaw (3, 4) or a toothless jaw section, consisting of a primary implant (6, 19, 30, 45) for anchoring in the jawbone ( 4) and a tat with the Primärimplan ^¬ (6, 19, 30, 45) connectable secondary part to which the dental prosthesis as bridges or the like. can be connected, characterized in that the secondary part is designed as a secondary implant (8, 23, 34, 65, 65a) implantable in the jawbone with an outer diameter (9, 26, 26a, 36, 36a) which is the same or larger in sections than that The outside diameter of the surface of the primary implant (6, 19, 30, 45) facing the secondary implant (8, 23, 34, 65, 65a) is that the secondary implant (8, 23, 34, 65, 65a) is attached to one another in the implanted state the primary implant (6, 19, 30, 45) and against the compact (3) and that the end of the secondary implant (8, 23, 34, 65, 65a) pointing towards the oral cavity (1) as a coupling part (15, 27) for one Turning tool is formed. 2. Implant system according to claim 1, characterized in that a bayonet connection (10, 11) is provided as the connection between the primary implant (6) and the secondary rim implant (8). 3. Implant system according to claim 1, characterized in that as a connection between the primary implant (19) and the secondary ^¬ implant (23), a screw connection (24, 25) with a screw ^¬ approach (24) on the secondary implant (23) and an internal thread (25) is provided in the primary implant (19). 4. Implant system according to claim 1, characterized in that as a connection between the primary implant (30) and de secondary ^¬ implant (34) through the secondary implant (34) screw (38) and an internal thread (33) arranged in the primary implant (30) ) are provided. 5. Implant system according to claims 1 to 4, characterized in that the primary implant (6) and the secondary implant (8) are designed as circular cylinders with the same outer diameter (9). 6. Implant system according to claims 1 to 4, characterized in that the primary implant as a circular cylinder (19) and the secondary implant ^{¬ are} designed in the manner of a paraboloid of revolution (23), the surface adjacent to the primary implant (19) having the same smallest outer diameter ( 26) as the primary implant (19) and its end pointing towards the oral cavity (1) have a larger outer diameter. 7. Implant system according to claims 1 to 4, characterized in that the primary implant as a cone (30) and the secondary implant as a truncated cone (34) are formed, the outer walls of which merge into each other without Ab from. 8. Implant system according to claims 1 to 7, characterized in that between the primary implant (19) and the secondary implant (23) at least one intermediate implant (22) is provided, the outer ^¬ sheath without heel both in the outer jacket of the primary implant (19) as also passes over to the secondary implant (23). 9. Implant system according to one or more of the preceding claims, characterized in that the oral cavity (1) in the primary implant (19, 30, 45) on the internal thread (52) has a cylindrical, to the longitudinal axis (44) coaxial guide section (48) for a guide pin (130) to a tool (120) for preparing an exact compact secondary bore (67). 10. Implant system according to claim 9, characterized in that an elongated connecting piece (69) is provided between the waxing-in area of the secondary implant (65) and the screw attachment (66). 11. Implant system according to one or more of claims 1 to 10, characterized in that an internal thread (75) for a screw (89) for screwing the tertiary part (47) is provided in the secondary implant (65). 12. Implant system according to one or more of the preceding claims, characterized in that the end region of the primary implant (45) is designed as an end cone (53) surrounding the internal thread (52) with a spherical cone end (54) on which, to the oral cavity ( 1) out, with the interposition of a rounded first retention groove (56), a first truncated cone (57) adjoins, which merges into a second truncated cone (61) via a second rounded retention groove (59). 13. Implant system according to claim 12, characterized in that the base surface (55) of the end cone (53) and the larger base surfaces (58, 62, 73) of the wax cone blunt (72) of the secondary implant (65) and the first and second cones blunt (57, 61) of the primary implant (45) are directed towards the oral cavity (1). 14. Implant system according to claims 12 and 13, characterized in that the second truncated cone (61) of the primary implant (45) and the ingrowth region (72) of the secondary implant (65) have wall inclinations (71), and that the sheath of both cones are blunt ( 61, 72) merge into one another when the implant system (43) is screwed together without a shoulder. 15. Implant system according to claims 1 to 14, characterized in that the surfaces (64, 83) of the primary implant (45) and the secondary implant (65, 65a) are smooth or roughened by surface processing. 16. Implant system according to one or more of the preceding claims 1 to 15, characterized in that the internal thread (52, 80) in the primary implant (45) and in the secondary implant (65, 65a) and the corresponding thread of the screws (66, 89) as Fine threads are formed. 17. Implant system according to one or more of the preceding claims, characterized in that the secondary implant (65, 65a) has an implant ^¬ neck (12) for the growth of the mucous membrane (2) on the region pointing towards the oral cavity (1). 18. Implant system according to one or more of the preceding claims, characterized in that the implant neck (12) for ingrowth of the mucous membrane (2) merges into an edge bevel (13) for applying a correspondingly bevelled inner edge (86) of the tertiary part (85). 19. Implant system according to one or more of the preceding claims, characterized in that the wall inclinations of the end cone, the first and second truncated cone (57, 61) of the primary implant (45) and the ingrowth area (72) of the secondary implant (65, 65a) at least 6 ° amounts. 20. The implant system according to one or more of the preceding An ^¬ claims, characterized in that the secondary implant (65, 65a) is designed for oral cavity (1) toward the screw head (78). 21. I implant system according to one or more of the preceding claims 1 to 20, characterized in that the secondary implant (8, 23, 34, 65, 65a) to the oral cavity is designed as an internal hexagon (15). 22. Implant system according to claims 12 and 13, characterized in that the secondary rim implant (34, 65, 65a) is penetrated by a longitudinal bore (37, 81) for the screw (38, 89) for fastening the tertiary implant (85). 23. Implant system according to claim 22, characterized in that the screw (38, 89) for fastening the tertiary part (85) to the secondary implant (65, 65a) is a Phillips screw or a screw with a hexagon socket, and in that the head region (90) the screw (89) is designed as a cone and the channel (87) in the tertiary part (85) as an inner cone (88). 24. The implant system according to one or more of the preceding claims, characterized in that the center line (68) implant by the implant neck (12) and the screw head (78) relative to the center line (79) through the secondary implant (65a) and the primary ^¬ ( 45) run inclined to each other. 25. Implant system according to claim 24, characterized in that the angle of inclination (82) between the center lines (68, 79) is between 120 ° and 180 ° in accordance with the anatomical relationships in the jaw (3, 4). 26. The implant system according to claims one or more of the preceding An ^¬, characterized in that there are provided on the outer wall of the primary ^¬ implant (6, 19, 30, 45), longitudinal beads (16). 27. The implant system claims to one or more of the preceding An ^¬, characterized in that the primary graft (6, 19, 30, 45), the secondary rimplantat (8, 23, 34, 65, 65a) and the Tertiary Advantage (85) made of titanium or titanium alloys. 28. The implant system according to one or more of the preceding claims An ^¬ 1 to 26, characterized in that the primary graft (6, 19, 30, 45), the secondary rimplantat (8, 23, 34, 65, 65a) and the tertiary part (85) consist of niobium. 29. Implant system according to one or more of the preceding claims, characterized in that the primary implant (45) has expandable side areas (46), and in that the connecting piece (69) between the screw attachment (66) and the ingrowth area (72) of the secondary implant (65 , 65a) is designed as an expanding truncated cone (69a). 30. Implant system according to claim 29, characterized in that the expandable side areas (46) of the primary implant (45) in the non-expanded state, the cylindrical guide section (48) for the guide pin (130) of the preparation tool (120) for a compact secondary bore ( 67) form. 31. Implant system according to claims 29 and 30, characterized in that the larger base of the expanding cone is blunt (69a) towards the oral cavity (1). 32. Implant system according to claims 29 and 30, characterized in that the spreadable side regions (46) of the primary implant (45) are formed by expansion slots (47) running in the longitudinal direction of the primary implant. 33. Implant system according to claim 32, characterized in that the expansion slots (47) of the primary implant (45) end in a relief bore (50). 34. A method for implanting a three-part implant with a combined primary-secondary implant according to one or more of the preceding claims 1 to 4 and 6 to 33, characterized in that after predrilling an entry point in the toothless jaw or a toothless jaw section with a pre-drill (97 ) to a depth that corresponds to the length of the combined primary and secondary ^implants with a preparation tool (106) the final implant bed is prepared for the primary implant and the primary implant is then implanted in this prepared bed, whereupon the bed is prepared for the secondary implant with a preparation tool (120) and then the secondary implant is connected to the primary implant located in the jaw, whereupon the tertiary part (85) is connected is connected to the secondary implant. 35. The method according to claim 34, characterized in that during the preparation of the secondary implant bed, the preparation tool (120) is guided through the primary implant. 36. pre-drill for drilling the entry point for an implant according to claim 34 with a shaft for clamping in the chuck of a drilling machine, characterized in that on the shaft (98) a drill body (99) with four arranged parallel to the longitudinal axis of the pre-drill (97) , adjoining work strips (100) at an angular distance of 90 °, which run out together with the drill body (99) to a tip (102) and which can be guided by a guide sleeve. 37. Pre-drill according to claim 36, characterized in that the shank (98) and the drill body (99), parallel to the longitudinal axis (110) of a channel (114) ending in outlet openings (104) between the cutting edges or tips of the work strips (100) ) are interspersed with coolant. 38. With a shaft (107) for clamping in the chuck of a drilling machine, preparation tool (106) for the final implant bed for an elongated primary implant (45) after drilling an entry point in a toothless jaw or jaw section, characterized in that on the shaft (107) is connected to a processing section (109) with flights (111) arranged in the same direction as the longitudinal axis (110) of the processing tool (106), the ends of which point outward Edges are designed as cutting edges (112), and between which channels (113) which are lowered towards the longitudinal axis (110) and are rounded in cross section are arranged. 39. Preparation tool according to claim 38, characterized in that the wings (111) with the cutting edges (112) have an outer contour adapted to the shape of the primary implant. 40. Preparation tool according to claims 38 and 39, characterized in that the shaft (107) and the preparation section (109) are traversed parallel to the longitudinal axis (110) by a channel (114) for the passage of cooling liquid. 41. Preparation tool according to claim 40, characterized in that outlet openings (115) are connected to the channel (114) for the throughput of the cooling liquid and end in the grooves (113) between the cutting edges (112). 42. Processing tool according to claims 39 to 41, characterized in that three wings (111) with cutting edges (112) are provided, which are arranged in a star shape with an angular distance (116) of 120 ° to each other. 43. Processing tool according to one or more of the preceding claims 38 to 42, characterized in that the ends of the cutting edges (112) opposite the shaft (107) are brought together in the form of arches (117) to form a tip. 44. Processing tool according to one or more of the preceding claims 38 to 43, characterized by a depth marking (118) on the processing section (104). 45. A preparation tool (120) provided with a shaft (121) for clamping in the chuck of a drilling machine for preparing the final implant bed for a secondary implant (65, 65a), which fits into a toothless jaw or jaw section implanted primary implant (45) can be used, characterized in that the shaft (121) is followed by a preparation section (123) adapted to the shape of the secondary implant (65, 65a) with a large base area (124) pointing towards the oral cavity, on the jacket ( 126) are arranged at angles (129) or parallel to the longitudinal axis (122) of the preparation tool (120) cutting edges (127), and from its small base area (125) a guide pin (130) for a corresponding guide section (48) in the primary implant (45 ) protrudes. 46. Processing tool according to claim 45, characterized in that the cutting edges (127) are straight and run at an angle (129) of 0 -40 ° to the longitudinal axis (122) of the processing tool (120). 47. A tool according to claims 45 and 46, characterized in that the shaft (121) and formed stor dull as a cone ^¬ reitungsabschnitt (127) are interspersed concurrently to the longitudinal axis (122) of ewinem channel (132) for enforcing Coolant Expansiontank. 48. Preparation tool according to claim 47, characterized in that after the channel (132) for the throughput of cooling liquid, outlet openings (133) are connected which end within the cutting edges (127) of the preparation section (123). 49. Processing tool according to one or more of the preceding claims, characterized in that the angular distance (131) between the cutting edges (127) is 5 -20 °. 50. Processing tool according to one or more of the preceding claims 45 to 49, characterized in that each cutting edge (127) is part of a triangular-shaped cutting edge support (128).