US 3623226 A
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Description (OCR text may contain errors)
Nov. 30, 1971 A. E. EDELMAN 3,623,226
METHOD AND APPARATUS FOR INSERTING A DENTAL IMPLANT Filed Aug. 27, 1969 INVENTUR Alfred E. Edelmon ATTOR N I'IY United States Patent 3,623,226 METHOD AND APPARATUS FOR INSERTING A DENTAL IMPLANT Alfred E. Edelman, 2723 Federal St., Camden, NJ. 08105 Filed Aug. 27, 1969, Ser. No. 853,278 Int. Cl. A61c 13/00 U.S. CI. 3210 A 20 Claims ABSTRACT OF THE DISCLOSURE Fitting anchors called vents into the jaw bone of a person to support artificial tooth structure which includes a method of using a temporary gauge type implant to determine the proper location of the vent so that a vent for supporting a tooth will be in the most desirable position with a minimum of grinding and adjustment.
Heretofore supports for artificial teeth have been provided by bridging and other means including vents disclosed in the application Ser. No. 839,377 filed July 7, 1969 and now Pat. No. 3,562,912 issued Feb. 9, 1971, by the present applicant and the subject matter thereof is incorporated herein by reference.
Various means have been provided for supporting arti ficial teeth from the bone structure but it has not been possible to obtain correct positioning of a support by simply driving the support into the bone structure and to correct the positioning of such supports required substantial grinding with resultant heating and discomfort to the patient.
The present invention provides for correct positioning of the artificial tooth supporting structure by the use of a readily removable temporary gauge type implant hereafter referred to as a tryin.
An object of. the present invention is to provide a method for locating an artificial tooth supporting structure in accurate parallelism with respect to the anterior and posterior front teeth and the buccal-lingual parallelism of side teeth.
A further object is to provide a method of mounting a wide vent, blade type implant, sometimes called for supporting artificial teeth with a minimum of discomfort.
Other and further objects will be apparent on reference to the accompanying drawings wherein:
FIG. 1 is a section of a portion of the mouth showing a tryin plate being removed after inserting and forming a slit for a permanent anchor vent;
FIG. 2 is a similar view showing a wide vent being positioned in the previously cut slit;
FIG. 3 and HG. 4 are front and side elevations of the tryin showing the sharpened thin blade for making the original incision or slit;
FIGS. 5 and 6 are front and side elevations of one form of vent implant for permanent retention in the bone structure.
FIGS. 7 and 8 show a tryin post in elevation and in end view;
FIGS. 9 and 10 are elevational and end views of a vent which is screw-threaded into an opening made by the tryin of FIGS. 7 and 8;
FIG. 11 is a side elevation substantially on the lines 11 of FIG. 9.
The bone structure adjacent the upper gum of a patient is shown to include the tooth supporting bone structure 10 into which a tryin 11 has been inserted by the elongated impact receiving tool 16 disclosed in the prior application, the tryin being removed by the tool leaving a slit 12 in the bone structure 10, the blade portion 13 of the tryin 11 is made of very thin metal which is an ice extension of the shank 14 with a frustum of a cone 15 forming a lug providing for supporting the tryin from the tool 16 disclosed in the prior application.
After the slit 12 is formed by the tryin blade 11 and it is determined that the lug 15 is in the correct position for supporting the artificial tooth or teeth a vent plate 17 of wedge shape is inserted into the slit 12 by the tool 16 which is adapted to receive and support the vent plate 17. The vent plate 17 has a blade portion 18 of wedge shape and a plurality of apertures 19 therethrough so that when the vent plate 17 is inserted in the slit 12 in the bone structure 10 the bone structure 10 may grow into the apertures 19 to prevent displacement of the vent plate 17. A shank 20 extends downwardly from the vent plate 18 into an enlargement or lug of frustoconical shape 21., the front and back surfaces thereof being flattened at 22 and the side edges including flattened portions 23 with a shoulder 24 at the upper end of the flattened sides 23, 23.
The above description shows the method of implanting a vent 17 for supporting teeth. Frequently the vent must be reduced to a smaller size and the precise size and shape can be determined in advance by using the tryin 11 to form the slit 12 for receiving the permanent support in accurate position. The tryin 11 may be shaped by removring parts of the blade 13 and the blade 13 may be shaped by bending to correspond with the general shape of the bone structure 10 by cutting the sides of the blade and where an arch is required the blade 13 may be bent or curved to produce the correct arcuate shape for mounting of the vent 17 in the portion of the bone 10 into which the vent is to be inserted. Thus the blade 13- may have its corners cut off and the arcuate shape bent into the plate to correspond with the curvature or the arch in the bone structure 10 which normally supports teeth. After the tryin is properly shaped so as to locate the frustoconical end lug 15 in its correct position the vent 17 is cut and/ or bent to provide the precise same shape as the tryin 11. The correct fitting and the final position of the vent is determined by the tryin 11 whereby the initial insertion of the vent 17 into the slit 12 is the final position of the vent 17. Therefore the vent 17 is correctly mounted by a single insertion thereof into the slit 12 of the bone structure 10 and this is the correct position because the vent 17 was correctly shaped before its insertion into the slit 12.
Vents have been sharpened to serve as the cutting edge and such prior vents have been wedge shaped similar to that shown in FIGS. 5 and 6, so the bone structure 10 presses into the openings 19 When the vent was applied, preventing removal of the vent for shaping, or if the vent 17 is removed it damages the bone structre -10.
From the above description the advantages of the use of the tryin of the present invention should be evident. The blade 13 of tryin 11 is very thin and smooth on both surfaces and the ends with a sharpened leading edge 25 so that insertion thereof into the bone structure of the mouth does not injure the bone or the soft tissue and the contiguous teeth. The sizes shapes and dimensions required for the vent supporting plate 18 can be determined from the tryin 11 by the extent of embedment ofuthe tryin 11 into the bone structure 10. The wide vent of FIGS. 5 and 6 is shaped to correspond to the correctly shaped tryin 11. The vent 18 is then inserted into the properly shaped slit 12. A sharp cutting edge 25 is provided so there is no danger of injury with a sharp clean slit 12.
The blade 13 of the tryin can be formed to the proper curvature of the arch of the bone structure and the blade can be trimmed to have the correct dimensions for the bone structure into which it is inserted.
The bite relationship in all excursions can be determined with the tryin 11 in place. If the implant 17 would be made without the tryin first cutting the slit, the implant 17 would be in its permanent position and could only be altered by grinding with resultant discomfort to the patient. The implant 17 might become loosened by the grinding and/or shaping done.
Since the tryin 11 can be inserted and removed a number of times without damage to the bone structure it is possible to shape the blade 13 by reducing its dimensions and/or providing suitable curvature therein to correspond with the bone structure so that the most desirable shape is obtained without injury to the patients mouth.
The tryin allows determination of the undulations of the bone crest and the portions of the tryin which would protrude can be marked and transferred to the implant by actually removing the same portions of the implant as have been removed from the tryin. This will result in a physiological positioning and promote a far higher success ratio as the bone and tissue would grow over the correctly shaped implant.
After the precise shape is determined by use of the tryin 11, the vent 17 is shaped to correspond with the shape of the tryin and then inserted into its final position in a single insertion thereof thereby avoiding injury to the bone structure and discomfort to the patient. The tryins are designed to circumvent and avoid physiological or anatomical landmarks, to preclude injury to the patient since the shaping or design made in the blade 13 can be made in the plate 1 8 of the vent. Landmarks are the mandibular nerves and canal mental foramen and maxillary sinuses.
The tryins may have a single lug 15 or may have multiple lugs in the manner shown in the prior application and the tryin may be made of any rigid material such as plastic or metal which, if desired, may be bent to a desired shape and which will retain this shape while the vent 17 is made of the suitable material including noncorroding metals.
The tryin is very thin relative to the thickness of the vent so that when the wedge shaped vent is inserted in the slit the pressure on the bone structure and the frictional forces are increased to effectively retain the vent in place and the bone structure will grow into the apertures 19 to additionally secure the vent to the bone structure.
Another form of tryin and cooperating post vent are shown in FIGS .7 to 11. The tryin of FIG. 7 includes a square shank or lug 30 and a cylindrical portion 31 with a peripheral groove '32 being formed therein. Where a post type vent is desired a hole is drilled in the jawbone with a drill of the same size as the diameter of the tryin and the tryin is set in place to make sure the structures supported thereon will be in correct position.
After the position is finally determined by the tryin of FIGS. 7 and 8 the threaded vent shown in FIGS. 9 to 11 is screwed into the drilled opening corresponding to that which receives the tryin. The post vent includes a rectangular shank or lug 35 and a cylindrical mid portion 36 of the same length as the cylindrical portion 33 of the tryin between lug 30 and groove 32. Extending from the cylindrical portion 36 of the post vent implant is a screw threaded portion which includes a slot 37 extending radially through the threaded portion 38. A peripheral groove 39 is provided outwardly of the end adjacent the screw threads 38. It will also be noted that a bore 40 extends completely through the post vent so that when the post vent is in place in the jaw it is possible to treat the jaw without removing the post vent. Also cuttings formed by the threads 38 as the post vent is screwed into the jaw can be removed through the slot 37 and the axial bore 40.
It will therefore be seen that the present invention provides for accurately locating a tryin before using the permanent vent implant so the patient is not subject to the pain and discomfort which heretofore resulted from the conventional practice.
Since the present invention provides for the effective mounting of an implant with a minimum of discomfort to the patient and with a minimum of danger of contacting anatomical landmarks, a high quality implant serving for many years is assured.
What is claimed is:
1. A method of permanently anchoring a permanent dental implant having a tooth supporting lug comprising providing a temporary gauge type implant of substantially the shape as the permanent implant and inserting the shaped temporary implant into the bone structure to the desired depth, determining any portions of said temporary implant which vary from a desired permanent implant shape, removing the temporary implant leaving a shaped opening in the bone structure, conforming the final implant to the proper shape as determined from said temporary implant, and inserting the conformed permanent implant in said opening in the bone structure.
2. The invention according to claim 1 in which the temporary implant is a blade type implant of very thin material and the permanent implant is a blade type implant of relatively thick material and of wedge shape.
3. The invention according to claim 1 in which the temporary implant is a post of cylindrical shape and has a mounting lug on one end thereof.
4. The invention according to claim 3 in which the permanent dental implant is a post member having screw threads on one end and a supporting lug on the other end.
5. The method set forth in claim 1 wherein said permanent and temporary dental implants comprise a blade portion and a lug portion, the blade portion of said temporary implant being relatively thinner than the blade portion of said permanent implant and sharpened along one edge, and being free of any projections and apertures which would interlock with surrounding bone structure and prevent ready removal from a patients jaw.
6. A method of implanting dental implants of a type having a base portion adapted to be embedded in the bone structure of the jaw and a lug portion adapted to protrude externally from the jaw when the implant is properly positioned comprising providing a readily removable temporary gauge type implant which is of the same general configuration as a selected form of permanent implant, forming an opening in the jaw bone to receive said temporary implant in the same position in the bone as required to properly position said permanent implant, inserting said temporary implant in said opening in the same position in the bone as required to properly position said permanent implant, determining any portions of said temporary implant which vary from a desired implant shape, removing said temporary implant from the jaw, conforming the selected implant to the proper shape as determined from said temporary implant and positioning said conformed permanent implant in said opening in said jaw.
7. The method set forth in claim 6 wherein said temporary dental implant has a sharpened base portion for cutting an Opening in the bone and wherein the steps of forming at least a portion of said opening in the jaw bone and inserting said temporary implant in said opening are performed simultaneously.
8. The method set forth in claim 6 wherein the step of forming an opening in the bone and of inserting said temporary implant in said opening are performed in sequence, a cutting tool being used to form said opening prior to inserting said temporary implant.
9. The invention according to claim 6 in which base portions of the permanent implant and temporary implant are cylindrical in shape and the permanent implant is provided with a slot extending radially therethrough.
10. The invention according to claim 9 in which a bore extends longitudinally through the permanent implant, and the permanent implant base portion is provided with exterior threads having an outside diameter greater than the cylindrical base portion of the temporary implant.
11. The invention according to claim 9 in which a groove is provided in the base portion of the temporary implant and in the base portion of the permanent implant.
12. The method set forth in claim 6 including the steps of marking on said temporary implant any portions determined to vary from a desired implant shape, and after said temporary implant is removed, transferring said markings to said permanent implant as guides for conforming the permanent implant to the proper shape.
13. The method as set forth in claim 6 wherein certain marked portions of said permanent implant are trimmed to correct the shape of the permanent implant.
14. The method as set forth in claim 6 wherein the base portions of said temporary and permanent implants are thin blades having a shoulder edge portion from which said lug projects and an opposite free edge, the blade of said temporary implant being thinner than the blade of said permanent implant.
15. The method set forth in claim 14 wherein the base portion of said permanent implant has apertures formed therein for receiving interlocking bone growth from surrounding bone structure, said base portion of said temporary implant being free of interlocking apertures.
16. The method set forth in claim 14 wherein the base portion of said permanent implant has opposite longitudinal side surfaces which are divergent from said free edge toward said narrow shoulder edge portion, and the base portion of said temporary implant has parallel opposite longitudinal side surfaces, the thickness between the opposite longitudinal side surfaces of said base being substantially less than the maximum thickness between the divergent longitudinal side surfaces of said permanent implant.
17. The method set forth in claim 14 wherein the free edges of said base portions of the permanent implant and the temporary implant are sharpened.
18. The method set forth in claim 14 wherein said base portions of said temporary and permanent implants are formed of a material which may be shaped by bending forces and will retain the shape to which it is bent.
19. A method of implanting dental implants of a type comprising a blade like base portion adapted to be embedded in bone structure of the jaw and an integral lug portion adapted to protrude externally from the jaw bone when the implant is properly positioned comprising locating the proper site for the dental implant in the jaw, providing a temporary gauge type implant of a smaller overall shape as a selected permanent implant and having a sharpened base portion, forcing the blade like base portion of said temporary implant into the jaw bone in order to form an opening within the jaw bone for receiving the base portion of the permanent implant; the thickness of said base portion of said temporary implant being slightly less than the thickness of the base portion of the permanent implant in order that the opening formed by the temporary implant will be slightly less than the thickness of the base portion of the permanent implant, determining the proper position of the temporary implant in the jaw so as to circumvent and avoid injury to physiological and anatomical landmarks, marking any portions of the temporary implant which need to be removed for proper fit in the jaw with respect to the physiological and anatomical landmarks in the mouth, removing the temporary implant from the jaw, marking on the permanent implant similar portions to the portions marked on the permanent implant marked for removal, and removing any portions of the permanent implant marked for removal, and applying the base portion of the permanent implant into the opening in the bone structure from which the temporary implant has been removed.
20. The method set forth in claim 19 wherein the blade portion of said temporary implant has parallel, opposite side surfaces which are beveled adjacent to a sharpened free edge, and wherein said permanent implant is apertured and Wedge shaped with side walls diverging from a common free edge to a wide shoulder portion the thickness of which is greater than the thickness of said temporary implant between said parallel surfaces.
References Cited UNITED STATES PATENTS 693,884 2/1902 Nagy 32-10 A 1,216,683- 2/1917 Greenfield 32-10 A 3,435,526 4/1969 Brancato 32-10 A 3,465,441 9/1969 Linkow 32-10 A OTHER REFERENCES Implant Research Corporation publication 2 pages, copyright 1968.
ROBERT PESHOCK, Primary Examiner