U.S. patent application number 11/702259 was filed with the patent office on 2007-06-14 for device for regenerating, repairing, and modeling human and animal bone, especially in the jaw area for dental applications.
Invention is credited to Holger K. Essiger.
Application Number | 20070134623 11/702259 |
Document ID | / |
Family ID | 26038120 |
Filed Date | 2007-06-14 |
United States Patent
Application |
20070134623 |
Kind Code |
A1 |
Essiger; Holger K. |
June 14, 2007 |
Device for regenerating, repairing, and modeling human and animal
bone, especially in the jaw area for dental applications
Abstract
A device for reshaping human or animal bone with bone
replacement material includes at least two spaced apart implants
and a bar connected to the at least two spaced apart implants and
bridging at least one reshaping location. The bar has notches at
the longitudinal sides and transverse grooves at the underside. The
bar has slotted holes extending in the longitudinal direction of
the bar for receiving the implants, respectively, fasteners of the
implants.
Inventors: |
Essiger; Holger K.;
(Wedemark, DE) |
Correspondence
Address: |
Gudrun E. Huckett;ROBERT W. BECKER & ASSOCIATES
Suite B
11896 N. Highway 14
Tijeras
NM
87059
US
|
Family ID: |
26038120 |
Appl. No.: |
11/702259 |
Filed: |
February 5, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09394135 |
Sep 10, 1999 |
7172422 |
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11702259 |
Feb 5, 2007 |
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09113031 |
Jul 9, 1998 |
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09394135 |
Sep 10, 1999 |
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Current U.S.
Class: |
433/173 |
Current CPC
Class: |
A61F 2002/2835 20130101;
A61F 2002/30535 20130101; A61F 2/2846 20130101; A61B 17/8085
20130101; A61C 8/0006 20130101; A61B 2090/037 20160201; A61F
2250/0058 20130101; A61F 2002/285 20130101; A61C 8/0068 20130101;
A61F 2220/0041 20130101; A61B 17/8071 20130101; A61F 2002/30777
20130101; A61B 17/8605 20130101; A61F 2/2803 20130101; A61F
2002/30433 20130101; A61F 2002/30785 20130101; A61F 2310/00023
20130101; A61B 17/8038 20130101; A61C 8/005 20130101 |
Class at
Publication: |
433/173 |
International
Class: |
A61C 8/00 20060101
A61C008/00 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 9, 1997 |
DE |
197 29 222.4 |
Feb 1, 1998 |
DE |
198 03 628.0 |
Claims
1-7. (canceled)
8. A device for reshaping human or animal bone with bone
replacement material, said device comprising: at least two spaced
apart implants adapted to be implanted in the bone so as to project
by a projecting height from the bone and having a support surface
facing away from the bone; a bending-resistant bar placed onto said
support surfaces to bridge at least one reshaping location filled
with bone replacement material during bone regeneration; fasteners
penetration said bar and engaging said implants to clamp said bar a
t said supporting surface of said implants.
9. A device according to claim 8, wherein said bar has at least two
penetrations distributed in a longitudinal direction of said bar
and wherein said at least two spaced apart implants engage said
penetrations.
10. A device according to claim 8, wherein said at least two spaced
apart implants consist of titanium.
11. A device according to claim 8, wherein said penetrations are
slotted holes extending lengthwise in said longitudinal
direction.
12. A device according to claim 8, wherein said bar has a flat
cross-section.
13. A device according to claim 8, wherein an upper side of said
bar is convex.
14. A device according to claim 8, wherein said bar has areas of
reduced cross-sectional size defining bending locations for bending
said bar.
15. A device according to claim 14, wherein said bending locations
are located at lateral edges of said bar remote from said
penetrations or at an underside of said bar.
16. A device according to claim 14, wherein said bending locations
are break-off locations.
17. A device according to claim 8, wherein said implants are
pin-shaped and have a smooth mantle surface so that said implants
are rotatable about a longitudinal axis when implanted.
18. A device according to claim 8, wherein said implants have an
outer thread for position-adjustment in the bone.
19. A device according to claim 8, wherein said fasteners are
located at a head portion of said implants.
20. A device according to claim 19, wherein said fasteners are
nail-shaped or screw-shaped elements and wherein said implants have
receiving bores into which said fasteners are inserted.
21. A device according to claim 19, wherein said fasteners secure a
membrane on said bar.
22. A device according to claim 8, wherein said implants are
adapted to secure dental replacements thereat.
23. A device according to claim 8, wherein said fasteners have a
head countersunk into an outer cross-sectional area of said
bar.
24. A device according to claim 8, wherein said bar is designed to
support a membrane or the periosteum of the bone, wherein the
membrane or the periosteum retain the connective tissue and cover
the reshaping location.
25. A device according to claim 8, wherein an underside of said bar
is concave.
26. A device according to claim 8, wherein said fasteners are
adapted to secure permanently or temporarily at least one of a
dental prosthesis, a cosmetic device and a reconstructive device
positioned external to the skin.
27. A device according to claim 26, wherein said fasteners are
screws or pins having longitudinal bores accessible from a head
portion of said fasteners.
28. A device according to claim 27, wherein said wherein said
longitudinal bores have an inner thread.
29. A device according to claim 27, wherein said longitudinal bores
are blind bores.
30. A pin-shaped implant for securing a bar, said implant adapted
to be implanted in the bone so as to project by a projecting height
from the bone and having a support surface facing away from the
bone when said 8implant is implanted, said support surface adapted
to support the bar, said implant having a smooth mantle surface so
that said implant can be rotated about a longitudinal axis when
implanted in order to allow height adjustment of said implant
relative to the bone.
31. An implant according to claim 30, wherein said mantle surface
has an outer thread for height-adjustment relative to the bone.
32. An implant according to claim 31, comprising a fastener
penetrating the bar for fastening the bar to said implant and
optionally a membrane placed on the bar.
33. An implant according to claim 32, wherein said fastener is a
nail-shaped or screw-shaped element and wherein said implant has a
receiving opening into which said fastener is inserted.
34. An implant according to claim 33, wherein said fastener has a
head countersunk into an outer cross-sectional area of the bar.
35. An implant according to claim 33, wherein said fastener serves
to secure permanently or temporarily at least one of a dental
prosthesis, a cosmetic device and a reconstructive device after
completion of reshaping.
36. An implant according to claim 33, wherein said fastener is a
crew or a pin having a longitudinal bore accessible from a head
portion of said fastener.
37. An implant according to claim 36, wherein said longitudinal
bore has an inner thread.
38. An implant according to claim 37, wherein said longitudinal
bore is a blind bore.
39. An implant according to claim 36 for securing dental
replacements thereat.
40. canceled
Description
[0001] This is a divisional application of Ser. No. 09/394,135
filed Sep. 10, 1999 and now allowed. Ser. No. 09/394,135 is a CIP
application of Ser. No. 09/113,031 filed Jul. 9, 1998.
BACKGROUND OF THE INVENTION
[0002] The present inventions relates to a device for reshaping
(regenerating, reconstructing, repairing, and modeling) human and
animal bones with any type of bone material, for example, synthetic
bone material and bone modeling proteins (BMP), especially in the
jaw area for dental applications. Accordingly, the device can be
used in all areas of a human or animal skeleton, for repairing and
modeling bone portions, for example, also complicated fractions
with defective bone areas, whereby the device is not limited to a
certain bone shape.
[0003] The invention is based on the knowledge that the different
materials employed for the regeneration of bone material, for
example, a patient's own ground bone material and/or, for example
Bio-Oss (trademark), is comparatively pressure-sensitive and can
thus atrophy or be resorbed during the healing and building phase.
Accordingly, in the known regeneration methods, for example, of the
human jaw, atrophies and constrictions as well as bone loss cannot
be avoided. The desired effect of a regeneration or reconstruction
as complete as possible, especially in the vertical dimension, can
thus practically not be achieved.
[0004] The aforementioned and other known substances which serve
for regenerating and reconstructing bone, including bone blocks,
are in the following referred to as bone replacement materials.
[0005] The invention has the object to avoid the aforementioned
disadvantages of atrophy, i.e., constrictions between the implant
and all other bone deposits and repair locations as well as
respective contour changes.
SUMMARY OF THE INVENTION
[0006] The present invention suggests a device which is
characterized by a bending-resistance bar or strip for bridging
reshaping locations, i.e., regenerating, repair, and modeling
locations, at the bone and which can be supported by two spaced
apart implants. This bar or strip receives pressure forces and thus
reduces substantially a pressure loading of the bone replacement
materials. Furthermore, the bar distributes locally occurring
forces onto larger areas in order to thus reduce specific pressure
forces. At the same time, the bar also protects and stabilizes the
correlated implants. Also, the bar has the advantage to secure and
optionally fasten the membranes which are employed during such
regeneration processes, for example, for retaining connective
tissue. The membranes can be fastened by guiding the membrane
across the bar so that the membrane is supported on the bar.
[0007] Expediently, the bar has two or more penetrations
distributed over its length, for example, in the form of slotted
holes, through which fasteners, for example, pins or screws, are
guided which are secured or screwed into the implant. The slotted
holes have the advantage that the bar can be secured at implants
having non-uniform spacing between them.
[0008] While known implants for the dental jaw area are provided
with roughened surfaces, depressions, or penetrations, the present
invention suggests pin-shaped, for example, cylindrical, implants
which are polished at their exterior surface and are thus so smooth
that in the implanted state they can be rotated, when applying a
force, about its longitudinal axis even after having been implanted
for an extended time period. Also, it is especially advantageous in
this context when the implants are provided with an outer thread.
These implants are height-adjustable by rotation and, in the case
of bone reconstruction to be carried out step-wise, can be adjusted
with respect to their relative vertical position by sequential
steps of approximately 4 mm after an initial a build-up phase of
approximately nine months. The bar connected thereto is then also
raised accordingly.
[0009] After regeneration, the implants can be removed or support
elements for dental replacements or prostheses (crowns, bridges,
etc.) or other utilitarian elements can be provided.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] The object and advantages of the present invention will
appear more clearly from the following specification in conjunction
with the accompanying drawings, in which:
[0011] FIG. 1 shows a plan view onto a longitudinal section of a
bar which is suitable for regeneration of the jaw bone;
[0012] FIG. 2 shows the bar section according to FIG. 1 in a side
view;
[0013] FIG. 3 shows a bar in a plan view which is slightly
differently embodied as the one shown in FIG. 1;
[0014] FIG. 4 shows the bar section according to FIG. 3 in a side
view;
[0015] FIG. 5 shows an implant in an end view which can be used in
connection with the bar of FIGS. 1-4;
[0016] FIG. 6 shows a section along the line VI-VI of FIG. 3
together with an implant according to FIG. 5;
[0017] FIG. 7 shows a schematically represented longitudinal
section of the regeneration area of a jaw bone to be
reconstructed;
[0018] FIG. 8 shows a part sectional view of the fastening element
for a bar;
[0019] FIG. 9 shows a schematically represented longitudinal
section of the regeneration area of a jaw bone to be reconstructed
with a bar according to FIGS. 3 and 4 bent into a bridge
structure;
[0020] FIG. 10 illustrates schematically a bar according to FIGS. 3
and 4 in a differently bent bridge structure; and
[0021] FIG. 11 illustrates schematically a bar according to FIGS. 3
and 4 in a differently bent bridge structure.
DESCRIPTION OF PREFERRED EMBODIMENTS
[0022] The present invention will now be described in detail with
the aid of several specific embodiments utilizing FIGS. 1 through
11.
[0023] The bar 1, which is manufactured of titanium or any other
suitable material, has a substantially flat design of great length
extension and, when viewed in cross-section, has centrally arranged
penetrations in the form of round holes 2, preferably however
slotted holes 3 (see FIG. 3) extending in the longitudinal
direction of the bar and distributed over its length. The slotted
holes 3 provide for an improved adaptation to imprecisely
positioned implants 4, i.e., the bar 1 can be easily positioned
even if the position of the implants 4 deviates from the preset,
desired location.
[0024] The bar or strip 1 has at both edges recesses 5 and at the
underside it is provided with transverse grooves 6. Such reductions
5, 6 in the cross-sectional shape allow for cutting to length and
deformation of the bar 1 which is produced as a member of great
length. The transverse grooves 6 allow easy cutting to length of
the bar 1 as well as bending of the bar 1 out of the plane of the
bar 1 (indicated by arrow B in FIG. 4). The notches 5 allow bending
deformation in the plane of the bar 1 (indicated by arrow A in FIG.
3) in order to adapt the bar 1 to the jaw curvature of the patient.
The notches 5 and the grooves 6 are thus predetermined bending
locations. These predetermined bending locations allow a reshaping
of the bar 1 according to the patient's specification, but also
allow bending of the bar 1 during oral surgery and during
implantation in order to properly adjust the fit of the bar 1 to
the patient's jaw. The arrangement of the grooves 6 at the bottom
side of the bar 1 is advantageous because the upper side is thus
relatively smooth and will not bother the patient.
[0025] The notches 5 and the transverse grooves 6 can also be
designed as rated break points so that a required length of the bar
1 can be simply broken off and no cutting tools are required. It is
also possible to provide rated break points in addition to the
notches 5 and the transverse grooves 6.
[0026] The pin-shaped implants are comprised of, for example,
titanium or any other suitable material. Within the entire central
shaft area an outer thread 7 is provided. Otherwise, they are
embodied so as to be very smooth or polished in order to be able to
rotate the implant 4 in its operative position, i.e., when
implanted about its longitudinal axis so that the implant 4 can be
threaded in and out of the bone, as needed. For this purpose, the
implant 4 can be designed at the upper end or head portion such
that it has a hexagon socket head in order to facilitate rotation.
The implant 4 has also a longitudinal receiving bore 8 embodied as
a blind bore open at the upper end. The bore 8 is provided for
receiving a fastener 10 with lens-shaped head 9, for example,
shaped like a screw or pin. The fastener 10, after removal of the
bar 1, may optionally provide in the area of the implant 4 a cover
for the implant 4, respectively, a closure element.
[0027] The diameter of the bores 2, respectively, the width of the
slotted holes 3 is designed to match the diameter of the fastener
10, while the diameter of the implant 4 is slightly greater than
the aforementioned diameter, respectively, the aforementioned
width. Accordingly, the bar 1, after having been cut to length, can
be placed according to FIG. 6 onto the implants 4 and can be
secured thereat with the aid of the fasteners 10. Since the bores
2, respectively, slotted holes 3 widen at the upper side of the bar
1, the lens-shaped head 9 according to FIG. 6 is countersunk in
order to prevent it from projecting.
[0028] As can be seen in FIG. 6, the upper side 11 of the bar is
curved, respectively, convexly designed in order to prevent in its
operative position perforations of the soft tissue, respectively,
of the synthetic material possibly positioned there. The underside
22 of the bar 1 is designed substantially planar, but optionally
can also be concave.
[0029] In FIG. 7, the bone to be regenerated or reshaped is
indicated by reference numeral 13 and the reconstructed layer is
indicated by reference numeral 14. The initial bone contour is
indicated by reference numeral 15.
[0030] When it is assumed that a plurality of implants 4 is
arranged in the reconstructed area 14, but without the bar 1 and
without the special design of the implants according to FIG. 5, and
when employing a conventional free comb-shaped bone transplant, the
resulting atrophy produces a contour according to the dashed line
16. When, instead, according to FIG. 7, a bar 1 is provided at a
spacing to the area to be reconstructed, pressure loading of the
reconstructed layer 14 is avoided and the reconstructed layer
remains intact. The bar 1 is spaced from the contour 15 by the
implants 4 and not only bridges the reconstructed material between
the implants 4, but also stabilizes the implants 4.
[0031] The presence of the bar 1 also allows possibilities for
other applications in that a membrane 17, especially for protecting
the reconstructed layer 14 and for separating and retaining the
connective tissue, can be provided. The membrane 17 covers the bar
1 and can be attached thereto by the lens-shaped head 9 whereby the
fasteners 10 penetrate the membrane 17 and clamp the membrane 17
between the bar 1 and the lens-shaped head 9.
[0032] After completion of the desired reshaping (regeneration
and/or apposition), the membrane 17 and the bar 1 are removed.
[0033] It should be noted that the notches 5 must be positioned
remote from the slotted holes 3, as can be seen in FIG. 3, in order
to prevent a width reduction (denting) of the slotted holes 3
during deformation of the straight bar 1 into the substantially
U-shaped jaw-shape, respectively, a curved shape of another
bone.
[0034] It should also be noted that the represented mechanical
connection between the bar 1 and the implant 4 is advantageous,
that, however, other connecting means can be used. It is important
in this context that the implanted bar 1 in the area of its upper
side 11 has a curvature, i.e., is rounded and thus prevents
perforations of the mucus membranes or other tissues or materials,
and thus also of the membrane 17.
[0035] It should further be noted that the invention includes such
bars 1 which already during manufacture (instead of being produced
as a straight endless bar to be cut to length) have been shaped to
the typical design of the bone to be treated, for example, for a
jaw bone the bar has a substantially U-shaped contour in a top
view.
[0036] Even though the disclosed invention, respectively, the
inventive bar is primarily designed for bone reconstruction or
regeneration of the human jaw, it can also be used at any other
location within the skeleton of a human or animal, for example, for
reshaping and reconstructing fractures.
[0037] After treatment the bar 1 is removed. However, it is within
the gist of the present invention to leave the bar 1 at the
treatment location, if so desired.
[0038] The embodiment of FIG. 8 has a special feature in comparison
to the one of FIG. 5. In FIG. 8 there is also shown a fastener 10
for the bar 1 with outer thread 20, but the fastener 10 has an
upwardly open blind bore 21 with inner thread 22, penetrating the
head and a portion of the shaft of the fastener. The blind bore 21,
after mounting of the bar 1 and providing penetrations in
optionally present covers (mucous membrane), receives preferably
threadable fastening devices for prostheses, bridges or other
dental chewing aids and/or cosmetic devices and/or reconstructive
devices positioned external to or above the skin. The attachment
may be temporary or permanent. This additional attachment function
of the fastener 10 has the advantage that, for example, in
reconstructive oral (jaw) surgery the patient who is generally
without teeth will be able to chew again. In any case, it is at
least possible to realize cosmetic purposes. The fastening devices,
which are not disclosed in any detail, can be of any desired kind
and, for example, may be conical pins. A threaded embodiment is not
a requirement.
[0039] FIG. 9 shows a shaped bar 1 that is bent into a bridge
structure with a raised bridge portion 23, 24 and fastened to the
jaw by fastening means, such as screws 26 or implants or bone
nails, extending through penetrations provided at the end portions
25 of the shaped bar 1 resting on the bone 13. In the shown
embodiment, the fastening means are screws 26 penetrating a
penetration in the form of a respective slotted hole 3. The spacing
to the bone 13 is thus provided by the slanted lateral portions 24
of the raised bridge portion of the bent bar 1, whereby the central
area 23 of the raised bridge portion of the bar 1 extends
substantially parallel to the bone 13. In the shown embodiment, the
portions 23, 24, 25 are straight. However, it is also possible to
curve each portion 23, 24, 25 slightly or to angle the individual
portions 23, 24, 25. The bending locations are the grooves 6 at the
underside of the bar 1.
[0040] FIG. 9 shows a bar according to FIGS. 3, 4. However, the bar
1 can also be designed without notches, grooves or slotted holes
and can be preshaped into the desired bridge structure. Since the
raised bridge potion must be connected to implants 4, slotted holes
3 are not required.
[0041] FIGS. 10 and 11 show variations of the embodiment of FIG. 9.
FIG. 10 shows a reduced angel between the portions 25 and 24,
respectively, 24 and 23 in comparison to FIG. 9. FIG. 11 shows a
substantially continuous bending of the bar from one end portion 25
to the other end portion 25 so that the lateral portions 24 and the
central portion 23 are no longer discernable.
[0042] The specification incorporates by reference the disclosure
of German priority document 197 29 222.4 of 9 Jul. 1997 and 198 03
628.0 of February 1998.
[0043] The present invention is, of course, in no way restricted to
the specific disclosure of the specification and drawings, but also
encompasses any modifications within the scope of the appended
claims.
* * * * *