U.S. patent application number 12/237004 was filed with the patent office on 2009-01-15 for dental implant surgical guide.
Invention is credited to Glenn L. GITTELSON.
Application Number | 20090017418 12/237004 |
Document ID | / |
Family ID | 38041275 |
Filed Date | 2009-01-15 |
United States Patent
Application |
20090017418 |
Kind Code |
A1 |
GITTELSON; Glenn L. |
January 15, 2009 |
DENTAL IMPLANT SURGICAL GUIDE
Abstract
A prefabricated dental implant surgical guide. The implant
surgical guide comprises a tooth shaped contour which simulates a
natural tooth and the final prosthesis. The tooth shaped contours
can be shaped to match any tooth found in the mouth. The system
further comprises apical posts which protrude from the apical
aspect of the tooth contour of the surgical guide. These apical
posts are capable of marking an initial osteotomy site. The apical
posts are further able to be placed in to an initial and developing
osteotomy site to verify proper implant location, angulation and
rotational position prior to implant placement. Significantly the
apical post can be attached to the surgical guide and of a fixed
length. The apical post can also be adjustable allowing continuous
osteotomy site verification and removable allowing an implant
surgical drill to pass thru it thereby allowing continuous
osteotomy site development and verification. The system further
comprises a coronal post aspect to position the surgical guide. The
posts can be removed, the tooth contour aspect of the guide
hollowed out and then relined and secured to the abutment aspect of
an implant thereby functioning as a provisional crown or crowns.
The prefabricated dental implant surgical guide can be used to
place single implants or multiple side by side implants in a
continuous fashion allowing verification of implant location,
angulation and rotational position prior to implant placement
leading to a more aesthetic, functional and stable prosthesis.
Inventors: |
GITTELSON; Glenn L.;
(Merrick, NY) |
Correspondence
Address: |
ROBERTS, MARDULA & WERTHEIM, LLC
11800 SUNRISE VALLEY DRIVE, SUITE 1000
RESTON
VA
20191
US
|
Family ID: |
38041275 |
Appl. No.: |
12/237004 |
Filed: |
September 24, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11594400 |
Nov 8, 2006 |
7429175 |
|
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12237004 |
|
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|
60737789 |
Nov 17, 2005 |
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Current U.S.
Class: |
433/75 ;
433/174 |
Current CPC
Class: |
A61C 1/084 20130101 |
Class at
Publication: |
433/75 ;
433/174 |
International
Class: |
A61C 3/00 20060101
A61C003/00; A61C 8/00 20060101 A61C008/00 |
Claims
1. A prefabricated dental implant surgical guide consisting
essentially of: a single tooth-shaped contour having an apical end
and coronal end; a post affixed to the coronal end of the
tooth-shaped contour; a post affixed to the apical end of the
tooth-shaped contour; and wherein the coronal post is used for
positioning the tooth-shaped contour and the apical post of the
implant surgical guide into the implant osteotomy site and wherein
the apical end post is dimensioned to fit within a hole created by
a surgical drill during an implant osteotomy site preparation
procedure; and whereupon insertion of the apical end post into the
implant osteotomy site, a proper positional, rotational and angular
alignment of the implant to the osteotomy site is verified.
2. The prefabricated dental implant surgical guide of claim 1,
wherein the apical end post comprises a length approximating a
finished depth of the osteotomy site.
3. The prefabricated dental implant surgical guide of claim 1,
wherein the shape of the tooth-shaped contour is selected from the
group consisting of a central incisor shape, a lateral incisor
shape, a cuspid shape, a premolar shape, and a molar shape of both
upper and lower jaws.
4. The prefabricated dental implant surgical guide of claim 1,
wherein the apical end post and coronal end post posts are
removable from the tooth-shaped contour of the surgical guide,
thereby allowing the tooth-shaped contour to be attached to an
abutment aspect of a dental implant, thereby serving as a
provisional crown.
5. The prefabricated dental implant surgical guide of claim 1,
wherein the apical end post comprises a bottom face, the bottom
face further comprising a marking agent for marking and locating an
initial implant osteotomy site, prior to drilling the osteotomy
site.
6. A prefabricated dental implant surgical guide consisting
essentially of: a single tooth-shaped contour having an apical end
and a coronal end, wherein the tooth-shaped contour comprises a
central bore along an axis extending from a center of the apical
end through a center of the coronal end; and an adjustable
removable post located in the bore, wherein the adjustable
removable post comprises a post apical end extending beyond the
apical end of the tooth-shaped contour, and a post coronal end
extending beyond the coronal end of the tooth-shaped contour and
wherein the adjustable removable post is adjustable by moving the
post along the axis of the central bore; and wherein the post
apical end is adjusted thereby extending the post apical end into a
hole created by a surgical drill during an osteotomy site
preparation procedure; and whereupon insertion of the post apical
end in to the osteotomy site, a proper positional, rotational and
angular alignment of the implant to the osteotomy site is
verified.
7. The prefabricated dental implant surgical guide of claim 6,
wherein the post coronal end is used for positioning the
tooth-shaped contour and apical post end of the surgical guide into
the osteotomy site.
8. The prefabricated dental implant surgical guide of claim 6,
wherein the adjustable removable post is removable and wherein an
implant osteotomy drill can be placed within the central bore to
initiate an osteotomy site preparation.
9. The prefabricated dental implant surgical guide of claim 6
further comprising a handle on the tooth-shaped contour used to
stabilize the tooth-shaped contour during osteotomy site
preparation through the central bore.
10. The prefabricated dental implant surgical guide of claim 8
wherein the adjustable removable post can be interchanged with the
osteotomy drill to continuously verify implant osteotomy site
location and angulation during the osteotomy preparation
process.
11. The prefabricated dental implant surgical guide of claim 6,
wherein the adjustable removable post is removable from the
tooth-shaped contour of the surgical guide, allowing the
tooth-shaped contour to be attached to the abutment aspect of a
dental implant and thereby serve as a provisional crown.
12. The prefabricated dental implant surgical guide of claim 6,
wherein the shape of the tooth-shaped body contour is selected from
the group consisting of a central incisor shape, a lateral incisor
shape, a cuspid shape, a premolar shape, and a molar shape of both
upper and lower jaws.
13. The prefabricated dental implant surgical guide of claim 6,
wherein the apical end post comprises a bottom face comprising a
marking agent for marking and locating an initial osteotomy drill
site prior to drilling the osteotomy site.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. utility
application Ser. No. 11/594,400, filed Nov. 8, 2006. Priority is
claimed to application Ser. No. 11/594,400, which claims priority
to U.S. provisional application No. 60/737,789, filed Nov. 17,
2005. Priority is also claimed to U.S. utility application Ser. No.
11/933,815, filed Nov. 1, 2007, which claims priority to U.S.
utility application Ser. No. 11/594,400, which claims priority to
U.S. provisional application No. 60/737,789. The Ser. Nos.
11/933,815, 11/594,400 and 60/737,789 applications are incorporated
by reference herein, in their entirety, for all purposes.
BACKGROUND
[0002] This application relates generally to oral implant surgery.
More particularly the present invention relates to a surgical guide
to be used during dental implant surgery which is used to effect
correct placement of a dental implant.
[0003] In the healthy non-diseased mouth with natural teeth
present, there exists a biologic relationship between the root of a
tooth, the crown of a tooth, the bone surrounding the root and the
gingiva (soft tissue) surrounding the bone, root and crown of a
tooth. In nature, the shape and contour that the gingiva or soft
tissue assumes and follows is dictated by the underlying presence
and shape of bone. The bone contours around a natural tooth are
actually scalloped, with the bone more apical on the facial and
lingual aspects of the tooth and more coronal in the inter-proximal
area (between the teeth). In a healthy mouth, this scalloping
effect is dictated by the cemento-enamel junction (CEJ) of the
tooth which itself is also scalloped. It is this scalloping of the
bony architecture which lends itself to the formation and
maintenance of proper gingival contours including the inter-dental
papilla (the small triangular flesh portion adjacent the gum line
and located between the teeth).
[0004] However, despite best efforts of a person, or because of
lack of proper dental care, it may become necessary to replace
teeth completely. In these cases, dental implant procedures have
proven to be an effective method of restoring both form and
function in patients having missing teeth. Implants provide a
structure upon which a prosthetic tooth or teeth can be attached
and secured in an otherwise edentulous (non-tooth) area. In
contrast to using dentures or other tooth born fixed or removable
dental bridge systems, implants have the advantage of maintaining
bone and not being subject to decay.
[0005] Bone support is necessary for proper placement, securement
and maintenance of a dental implant. Proper bone support around an
implant is also necessary for the development and maintenance of
healthy gingival contours, including papilla. Bone growth around an
implant follows the shape of the bone-integrating part of the
implant. A primary concern in implant dentistry is the precise
placement of an implant in its proper location, with appropriate
and accurate angulation and rotational position at the time of
implant placement surgery. Even the slightest error in implant
placement can result in significant complications and or
compromises in the stability of the implant, the maintenance of
bone, the contours of the gingival tissues, placement of the final
prosthesis, stability of the final prosthesis and the overall
appearance of the patient's mouth.
[0006] Accordingly, it is desirable to provide a prefabricated
dental implant surgical guide which ensures the proper placement of
a dental implant or implants and its corresponding prosthesis
(crown or crowns). One exemplary embodiment of the present
invention allows it to be converted from a surgical guide to a
dental provisional crown which can then be used to help maintain
the hard (bone) and soft (gingival) tissue architecture of the
mouth during the healing phase of treatment, with the end result
being a final prosthesis that is stable, functional, natural
looking and aesthetically pleasing in the patient's mouth.
[0007] For such applications, the prefabricated dental implant
surgical guide of the present invention may be configured as a
surgical guide with a tooth-shaped configuration contour (also
referred to as a "tooth contour") with a post affixed to its apical
end, or with a post as an integral part of the entire guide. This
embodiment of a dental implant surgical guide is placed into an
initial osteotomy site (a surgical procedure in which bone is cut
or prepared for the placement of a dental implant) at the time of
dental implant placement surgery, but prior to final implant body
placement, to ensure and or to correct proper location, angulation,
and rotational position of an implant body prior to its
placement.
[0008] The present invention in various embodiments is a
prefabricated dental implant placement surgical guide which, in one
exemplary embodiment, has a post affixed to the apical end of an
anatomically correct tooth form. This tooth form can be made to
represent any tooth in the mouth in order to have accurate implant
placement regarding the tooth to be replaced.
[0009] At the time of initial osteotomy site preparation, a small
hole is prepared into the jaw bone using conventional dental
implant surgical drills. The apical post of the surgical implant
guide is inserted into the osteotomy site allowing verification of
proper implant placement in location, angulation, and rotational
position prior to implant body placement. This is accomplished by
viewing the surgical guide in place, then comparing the
tooth-contoured part of the surgical guide with some facial and/or
intra-oral guideline such as the adjacent teeth, gingiva, shape of
the arch and lips etc. This allows for proper implant location and
ultimately placement to be verified or corrected prior to implant
body placement lending to a more stable, functional and esthetic
prosthetic outcome. The apical post of the surgical guide can
repeatedly be inserted into the osteotomy site, as the site is
further developed and deepened to continuously verify proper
position and location of the implant body prior to its placement.
This process of trying in the surgical guide with further osteotomy
site preparation is repeated until the appropriate final depth of
the osteotomy site is achieved. Thus the process of the present
invention provides for a verified correct position, location and
angulation of the osteotomy site, all prior to final implant body
placement. If improper alignment is detected during this
verification process, the osteotomy site location, angulation and
position can be corrected with minimal damage to the bone.
[0010] In another embodiment of the present invention, the
prefabricated dental implant surgical guide can be converted into a
provisional crown, a plurality of crowns, or a bridge. This is
accomplished by removing the finger grip and apical post, or guide
post, hollowing out the tooth contour aspect of the guide, and
relining the tooth contour aspect of the surgical guide, then
reversibly fastening via screw or cement, the tooth contour aspect
of the surgical guide to the abutment of an implant body.
[0011] In yet another embodiment, the surgical guide comprises a
set of anatomically correct tooth forms each having an apical post
and finger grip. The apical posts are graduated in length thus
constituting a set of surgical guides that are sequentially used as
an osteotomy site is created and deepened. In this way the surgical
guide set can sequentially provide guidance that the osteotomy site
is being correctly prepared.
[0012] In yet another exemplary embodiment, the prefabricated
dental implant surgical guide comprises an anatomically correct
tooth form having a bore through the tooth form into which an
adjustable and removable post is placed or threaded. The apical end
of the post protrudes through the tooth form and can be lengthened
by pushing or screwing the post through the bore. In this way the
apical end is lengthened and can be placed into the gradually
deepening osteotomy site to insure that the site is correctly
prepared. The post can also be removed and an osteotomy drill
passed thru the bore to allow for further preparation of the
osteotomy site with the guide in place. In another embodiment of
the present invention, a bottom face of the apical end of the
movable post comprises a marking agent. In this embodiment, the
surgical guide is placed in a desired position on the jaw bone at a
proposed osteotomy site. Once the correct position of the surgical
guide is established, the movable post is pressed downward to
engage the bottom face of the apical end with the jaw bone thereby
marking the location of the osteotomy site.
[0013] In still another exemplary embodiment, the prefabricated
dental implant surgical guide comprises a number of anatomically
correct tooth forms as a unitary surgical guide. In this case, for
example and without limitation, a number of tooth forms can be
connected and tried into a series of side by side osteotomy sites
as a unit. This allows multiple dental implants to be placed side
by side with verification of proper location, angulation, and
rotational position.
[0014] Thus various embodiments improve the dental implant
placement process and allow for proper placement of a dental
implant subsequent to osteotomy site preparation. Embodiments act
as a prefabricated surgical guide and improve the placement of a
dental implant. Embodiments further allow sequential placement of
individual prefabricated implant surgical guides to develop
sequential osteotomy sites for subsequent multiple side by side
implant placement during dental implant placement surgery.
Additional embodiments use unitary multi-tooth prefabricated
implant surgical guides during dental implant placement surgery
where more than one tooth is to be replaced with a dental implant.
Other embodiments use a prefabricated dental implant surgical guide
having adjustable apical posts for use with deepening osteotomy
sites.
[0015] These and other embodiments will become apparent to those
skilled in the art upon review of the detailed description that
follows.
DESCRIPTION OF THE FIGURES
[0016] FIGS. 1a, 1b, and 1c illustrate a prefabricated dental
implant surgical guide configured as a tooth with a static
post.
[0017] FIGS. 2a and 2b illustrate another embodiment of a
prefabricated dental implant surgical guide converted to and also
used as an interim crown with posts that are removable.
[0018] FIGS. 3a, 3b, 3c and 3d illustrate a prefabricated dental
implant surgical guide as a series of tooth shapes having graduated
post lengths.
[0019] FIGS. 4a, 4b and 4c and 4d illustrate another embodiment as
a prefabricated dental implant surgical guide having a central bore
with an adjustable, removable post.
[0020] FIG. 5 illustrates an embodiment, as illustrated in FIGS.
1a-c, 2a-b, 3a-d and 4a-d being used in a multiple side by side
format.
[0021] FIG. 6 illustrates another embodiment as a one piece
multiple unit surgical guide.
[0022] FIGS. 7a-c illustrate an embodiment for the purpose of
marking and identifying an osteotomy site.
[0023] FIGS. 8a-c illustrate another embodiment for the purpose of
marking and identifying an osteotomy site.
[0024] FIGS. 9a-c illustrate another embodiment for the purpose of
marking and identifying an osteotomy site.
[0025] FIGS. 10a-c illustrate another embodiment for the purpose of
marking and identifying an osteotomy site.
[0026] FIGS. 11a-c illustrate another embodiment for the purpose of
marking and identifying an osteotomy site.
DETAILED DESCRIPTION
[0027] As noted above, the present invention comprises a method and
apparatus for insuring correct placement of dental implants during
the surgical placement process. Referring now to FIGS. 1a, 1b, and
1c, the prefabricated dental implant surgical guide configured as a
surgical guide with a tooth-shaped contour with a post affixed to
its apical end is illustrated. The guide can be made of metal,
plastic, acrylic, porcelain or some other material known to those
of skill in the dental arts. Such materials will be collectively
referred to herein as "dental material." This exemplary embodiment
is placed into an initial osteotomy site at the time of implant
placement surgery, prior to implant body placement to ensure and or
to correct the proper location, angulation, and rotational position
of the implant body.
[0028] FIGS. 1a, 1b, and 1c illustrate the dental implant aid in an
exemplary alternative embodiment. As illustrated in FIG. 1a, the
dental implant aid, generally referred to as 40 in this figure, is
configured as a one piece surgical guide with a tooth-shaped
contour 42. The tooth shaped contour 42 is further defined by its
anatomical components, i.e. the incisal edge (for an anterior
tooth) or occlusal table (for a posterior tooth) 30, facial contour
31, lingual contour 32, interproximal aspect 33 and apical aspect
34. Affixed to the apical end of tooth-shaped contour 42 is collar
45 which has apical post 44 extending above it. Affixed to the
coronal end of tooth-shaped contour 42 is a protruding post which
acts as finger grip 43. Thus the surgical guide 40 can be held in
the mouth and the tooth-shaped component contour 42 of guide 40 can
be seen clearly by the surgeon during the course of surgery with
out the surgeon's fingers obscuring the view.
[0029] This tooth-shaped contour 42 can be represented by any tooth
shape found in the mouth (central incisors, lateral incisors,
cuspids, premolars, and molars of both the upper and lower jaws)
and can therefore be used as a surgical guide to verify implant
body placement with respect to any tooth and its corresponding
position in the mouth prior to implant placement. For example, FIG.
1b represents a jaw bone 48 to which an osteotomy site 46 (a
surgical procedure in which bone is cut or prepared for the
placement of an implant) has been prepared in jaw bone 48. As
illustrated in FIGS. 1b and 1c, by holding finger grip 43, the
apical post 44 of implant surgical guide 40 is placed into the
osteotomy site 46 so that collar 45 of implant surgical 40 rests
against jaw bone 48 at the opening of osteotomy site 46. This is
done at the time of implant placement surgery, but prior to implant
body placement.
[0030] By using existing intra-oral guidelines as a reference (i.e.
adjacent teeth 50, lips, shape of the arch as but several
examples), the tooth contour 42 and its corresponding anatomic
components of implant surgical guide 40 with apical post 44 in
osteotomy site 46, can be used to verify and/or correct the proper
location, angulation, and rotational position of any implant body
and it's corresponding system prior to it's insertion. This is
accomplished by comparing the location, angulation, and position of
the tooth shape-contour 42 and its corresponding anatomic
components of the implant surgical guide 40 with some facial and/or
intra-oral guideline or reference such as the adjacent teeth,
gingiva, shape of the arch and lips, face etc., while apical post
44 of implant surgical guide 40 is engaged in osteotomy site
46.
[0031] Verification of osteotomy site position, angulation,
location, subsequent proper implant location and placement and
proper prosthesis location, requires the tooth contour aspect 42 of
implant surgical guide 40 be in proper alignment with the facial
and or intra-oral guide lines or references previously noted. This
alignment is verified by comparing the position of the anatomic
components of tooth contour 42, for example, the incisal edge (for
an anterior tooth) or occlusal table (for a posterior tooth) 30,
facial contour 31, lingual contour 32, interproximal aspect 33 and
apical aspect 34 of tooth contour 42 of the surgical guide 40 while
engaged in the mouth with facial and or intra-oral references
previously noted.
[0032] If the alignment of the anatomic components of tooth contour
42 of surgical guide 40 is in harmony with and is symmetrical to
the facial and or intra-oral references previously noted, osteotomy
site location, position and angulation are verified, and osteotomy
site and subsequent implant placement can be completed.
[0033] If there is disharmony and/or an asymmetrical position of
the anatomic components of tooth contour 42 of the implant surgical
guide 40 is noted with respect to the facial and or intra-oral
references previously noted, a correction as to position and
location can be made and verified prior to final implant
placement.
[0034] It will be apparent to those skilled in the art that, not
only can different tooth shapes be represented, but also different
sizes of tooth contour 42 of the prefabricated dental implant
surgical guide 40 can be used to conform to the size teeth and arch
form of the dental implant patient.
[0035] Referring now to FIGS. 2a and 2b, another alternate
embodiment generally referred to as 51 is illustrated. In this
embodiment, the prefabricated implant surgical guide is made of a
dental material so that once implant placement has been verified
and the implant body has been placed, either at the time of surgery
or at a later date subsequent to healing, the surgical guide can be
converted to a provisional crown as illustrated in FIGS. 2a and
2b.
[0036] Referring again to FIG. 2a, apical post 24 of implant guide
51 having a collar 25 is placed into osteotomy site 46 of jaw bone
48 to verify proper implant location and angulation prior to
implant body placement as previously described in FIGS. 1a-c.
[0037] Referring now to FIG. 2b, implant body 52 is shown having
been placed into jaw bone 48. At the time of surgery or subsequent
to surgical healing, the finger grip 23 and apical post 24 of
implant surgical guide 51 are removed via a cutting procedure known
in the art. The tooth contour 22 of implant surgical guide 51 is
then hollowed out so that a concavity 26 is formed on the internal
aspect 27 of tooth contour 22 of implant guide 51. At the time of
surgery or subsequent to surgical healing utilizing either a
2-stage, 2-piece implant system, a one-stage, 2-piece implant
system or a one piece, one-stage implant system, the concavity 26
of internal aspect 27 of tooth contour 22 of implant guide 51 is
relined with a dental provisional material, known to those in the
art (for example and without limitation, acrylic) to the abutment
aspect 54 of implant body 52 to create a custom fitting, retentive
provisional crown which can then be either cemented into place with
some provisional dental cement (for example and without limitation
zinc oxide-eugenol) or screw retained.
[0038] Referring now to FIGS. 3a, 3b, 3c and 3d, another embodiment
of the prefabricated implant surgical guide, herein referred to as
53 having separate graduated apical post lengths is illustrated. In
this embodiment, implant guide 53 exists in a multiple set format
with apical posts 13, 15, and 17, connected to tooth contours 12,
14, and 16 respectively via collars 7, 9, and 11 respectively.
Tooth contours 12, 14 and 16 are further defined by their
anatomical components, that is, the incisal edge (for an anterior
tooth) or occlusal table (for a posterior tooth) 1a, 1b and 1c
respectively, facial contours 2a, 2b and 2c respectively, lingual
contours 3a, 3b, and 3c respectively, interproximal aspects 4a, 4b
and 4c respectively and apical aspects 5a, 5b and 5c
respectively.
[0039] The tooth-shaped contours 12, 14 and 16 can be represented
in the form of any tooth shape found in the mouth (central
incisors, lateral incisors, cuspids, premolars, and molars of both
the upper and lower jaws) and can therefore be used as a surgical
guide to verify implant body placement with respect to any tooth
and its corresponding position in the mouth prior to implant
placement.
[0040] Apical posts 13, 15, and 17 increase in length to be used as
described in FIGS. 3a, 3b, 3c and 3d. Finger grips 6, 8, and 10,
respectively allow for manipulation of the surgical guide during
the surgical implant placement procedure.
[0041] Referring now to FIG. 3b, the use of the embodiment of FIG.
3a is illustrated. An initial osteotomy site 46 of minimum depth is
prepared into jaw bone 48. By placing implant guide 53 with the
shortest apical post 13 first into initial osteotomy site 46, an
initial and preliminary evaluation as to proper implant position,
location and angulation can be done. At this time, verification and
or correction to the initial osteotomy site 46 can be done with
minimal trauma to jaw bone 48. This is accomplished by comparing
the location, angulation and position of the tooth shape-contour 12
of the surgical guide 53 with some facial and/or intra-oral
guideline or reference such as the adjacent teeth, gingiva, shape
of the arch and lips, face etc. with apical post 13 of surgical
guide 53 engaged in osteotomy site 46.
[0042] To verify osteotomy site position, angulation, location,
subsequent proper implant location, angulation and placement and
ultimately proper prosthesis location, requires the tooth contour
aspect 12 of implant surgical guide 53 be in proper alignment with
the facial and or intra-oral guide lines or references previously
stated. This alignment is verified by comparing the anatomic
components of tooth contour 12, that being the incisal edge or
occlusal table 1a, facial contour 2a, lingual contour 3a,
interproximal aspect 4a and apical aspect 5a of tooth contour 12 of
surgical guide 53 while engaged in the mouth with facial and or
intra-oral references previously noted.
[0043] If the alignment of the anatomic components of tooth contour
aspect 12 of surgical guide 53 is in harmony with and is
symmetrical to the facial and or intra-oral references previously
noted, osteotomy site location, position and angulation are
verified and osteotomy site and subsequent implant placement can be
completed.
[0044] If there is disharmony and or an asymmetrical position of
the anatomic components of tooth contour aspect 12 of implant
surgical guide 53 is noted with respect to the facial and or
intra-oral references previously noted, a correction as to
position, angulation and location of the osteotomy site can be made
and verified prior to final implant placement.
[0045] As illustrated in FIGS. 3e and 3d, as the osteotomy site 46
is deepened and developed, the implant guide 53 with the increasing
apical post lengths 15 and 17 can be tried into deepening osteotomy
site 46 to further verify and or to correct the position and or
angulation of osteotomy site 46 prior to final implant body
placement. This is accomplished by comparing the position of tooth
contours 12, 14, and 16 (as the osteotomy site is deepened) of
guide 53 with some other facial or intra-oral reference point (i.e.
other teeth, gingiva, shape of the arch, lips, face, etc.) with
posts 13, 15, and 17 of guide 53 sequentially engaged in osteotomy
site 46. This verification process is accomplished as previously
described in FIG. 3b. In this fashion, osteotomy site 46 is
gradually prepared (deepened) and continuously verified during the
preparation process to ensure accuracy in final location,
angulation and position of the implant body and final prosthesis
prior to its placement.
[0046] Referring now to FIGS. 4a, 4b, 4c and 4d, yet another
embodiment of the prefabricated dental implant surgical guide
generally referred to as 70 is illustrated. Implant surgical guide
70 comprises a tooth contour 62, collar 65, finger grip 63 and
apical post 64. The tooth shaped contour 62 is further defined by
its anatomical components: the incisal edge (for an anterior tooth)
or occlusal table (for a posterior tooth) 61, facial contour 58,
lingual contour 66, interproximal aspect 69 and apical aspect
71.
[0047] The tooth-shaped contour 62 can be represented by any tooth
shape found in the mouth (central incisors, lateral incisors,
cuspids, premolars, and molars of both the upper and lower jaws)
and can therefore be used as a surgical guide to verify implant
body placement with respect to any tooth and its corresponding
position in the mouth prior to implant placement.
[0048] In this embodiment, the surgical guide 70 has a central bore
60 which extends the entire length of guide 70 (through tooth
contour 62 and collar 65). This central bore 60 can be either
smooth or threaded. An adjustable and removable post generally
referred to as 67, comprises a central portion 68 which is located
in central bore 60, finger grip portion 63 that extends beyond the
coronal end of guide 70 and apical post portion 64 that extends
beyond the apical end of guide 70. The central post portion 68 of
post 67 remains in the central bore 60. Central post portion 68 and
central bore 60 can be either smooth or threaded. If smooth,
central post portion 68 of post 67 may be pushed through the
central bore 60 thereby adjusting the length of apical post 64. If
threaded, central post portion 68 of post 67 may be turned through
central bore 60 thereby adjusting the length of apical post 64. In
this fashion apical post portion 64 of adjustable removable post 67
can be adjusted and made shorter or longer to fit into a developing
osteotomy site 46 to verify or correct final implant body location,
position and angulation in jaw bone 48 prior to implant body
placement.
[0049] During this process, as in other embodiments described
above, proper implant location and position can be verified by
comparing the position of tooth contour 62 of guide 70 with some
other facial or intra-oral reference point (i.e. other teeth,
gingiva, shape of the arch, lips, face, etc.) with apical post 64
of guide 70 engaged in osteotomy site 46.
[0050] Referring now to FIG. 4b, an osteotomy site is identified,
and an initial osteotomy site 46 of minimum depth is prepared in
jaw bone 48. Surgical guide 70 is placed over osteotomy site 46.
Finger grip portion 63 of adjustable, removable post 67 is pushed
or turned so that central post portion 68 of adjustable, removable
post 67 moves through central bore 60 increasing the length of
apical post portion 64 of adjustable, removable post 67 until it
engages the base 49 of osteotomy site 46. By comparing the position
of tooth contour 62 of guide 70 with some other facial or
intra-oral reference point (i.e. other teeth 50, gingiva, shape of
the arch, lips, face, etc.), with apical post portion 64 of
adjustable, removable post 67 of guide 70 engaged in osteotomy site
46, an initial verification or correction of position and or
angulation of osteotomy site 46 can be done with minimal trauma to
jaw bone 48.
[0051] This is accomplished by comparing the location, angulation
and position of the tooth shape-contour 62 of the surgical guide 70
with some facial and/or intra-oral guidelines or references such as
the adjacent teeth, gingiva, shape of the arch and lips etc. with
apical post 64 of surgical guide 70 engaged in osteotomy site
46.
[0052] To verify osteotomy site position, angulation, location,
subsequent proper implant location, angulation and placement and
ultimately proper prosthesis location, requires tooth contour 62 of
prefabricated dental implant surgical guide 70 be in proper
alignment with the facial and or intra-oral guide lines or
references previously stated. This alignment is verified by
comparing the anatomic components of tooth contour 62, that being
the incisal edge or occlusal table 61, facial contour 58, lingual
contour 66, interproximal aspect 69 and apical aspect 71 of tooth
contour 62 of surgical guide 70 while engaged in the mouth, with
facial and or intra-oral references previously stated.
[0053] If the alignment of the anatomic components of tooth contour
aspect 62 of surgical guide 70 is in harmony with and is
symmetrical to the facial and or intra-oral references previously
noted, osteotomy site location, position and angulation are
verified and osteotomy site and subsequent implant placement can be
completed.
[0054] If there is disharmony and or an asymmetrical position of
the anatomic components of tooth contour 62 of implant surgical
guide 70 is noted with respect to the facial and or intra-oral
references previously noted, a correction as to position and
location can be made and verified prior to final implant
placement.
[0055] Referring now to FIG. 4c, as osteotomy site 46 is further
deepened, guide 70 can repeatedly be placed over osteotomy site 46,
with apical post portion 64 of adjustable, removable post 67
further lengthened into osteotomy site 46 by turning or pushing
finger grip portion 63 of adjustable, removable post 67 (See FIG.
4a) to move central post portion 68 of adjustable, removable post
67 thru central bore 60, thus providing a means of continuous
verification and or correction of position and or angulation of
osteotomy site 46 prior to final implant body placement. Again,
this is accomplished by comparing the position of tooth contour 62
of guide 70 with some other facial and or intra-oral reference
point (i.e. other teeth 50, gingiva, shape of the arch, lips, face,
etc.) with apical post portion 64 of adjustable, removable post 67
of guide 70 engaged in osteotomy site 46. This verification process
is accomplished as previously described in FIG. 4b.
[0056] Referring now to FIG. 4d, adjustable, removable post 67 can
be removed from surgical guide 70. Surgical guide 70 can be held in
place in the mouth at osteotomy site 46 with a buccal and or
lingual finger grip 45. By stabilizing guide 70 with buccal and or
lingual finger grip 45, osteotomy bur 47 attached to surgical drill
59 can be placed thru central bore 60 of tooth contour 62 of
implant guide 70 and activated allowing further preparation and
continuous verification of osteotomy site 46 with surgical guide 70
in place in the mouth.
[0057] This verification process is accomplished as previously
described in FIG. 4b.
[0058] As more fully explained below, in another embodiment, a
bottom face of the apical end of the movable post comprises a
marking agent. In this embodiment, the prefabricated dental implant
surgical guide is placed in a desired position on the jaw bone at a
proposed osteotomy site before a hole is drilled. Once the correct
position and location of the osteotomy site is established, the
movable post is pressed downward to engage the bottom face of the
apical end with the jaw bone thereby marking the location of the
osteotomy site.
[0059] Referring now to FIG. 5, embodiments as illustrated in FIGS.
1-4 is described when placing multiple implants in a side by side
format. Initial osteotomy sites 46a-c are identified, made and
verified into jaw bone 48 as previously described. As an example,
the most mesial osteotomy site 46a could be prepared and verified
or corrected as previously described. Leaving the implant guide 40a
in place, the next implant osteotomy site 46b can be prepared and
verified or corrected as previously described. Now, leaving that
implant guide 40b in place, another osteotomy site 46c can be
prepared with implant guide 40c put in its place and verified or
corrected as previously described. This type of verification
process can be used to place implants side by side in a partially
edentulous arch and or in a continuous fashion all the way around a
completely edentulous arch. Thus all potential multi-unit side by
side implant sites can be properly and accurately prepared,
verified and or corrected prior to implant body placement.
[0060] FIG. 6 illustrates another embodiment of the present
invention generally referred to as 72. In this embodiment, the
surgical guide is formatted as a one piece, multi-unit surgical
guide having tooth contours 72a, 72b, and 72c. Affixed to these
tooth contours are collars 75a, 75b, and 75c, apical posts 74a,
74b, and 74c respectively, and corresponding finger grips 73a, 73b,
and 73c respectively. The purpose of this embodiment is to guide
the placement of multiple, side by side implants in a multi tooth
edentulous site. Although formatted as such, guide 72 can be
fabricated and used as described in FIGS. 1-4. In this embodiment,
a proper guide size 72 and corresponding contour would be chosen
that corresponds to the size and location of the edentulous site.
Multiple initial osteotomy sites 46a-c would be made in jaw bone 48
with apical posts 74a, 74b, and 74c tried in osteotomy sites 46a-c
to verify and or correct position, angulation and location of
osteotomy sites 46a-c prior to implant body placement as previously
described in FIGS. 1-4.
[0061] As will be appreciated by those skilled in the art, the
multi-unit surgical guide may use movable (adjustable) posts as
previously described in place of the fixed posts illustrated in
FIG. 6.
[0062] Thus the embodiments as described may be used to guide the
placement of dental implants in a single tooth format, multi tooth
format and fully edentulous format.
[0063] Referring now to FIG. 7a, another embodiment of the
prefabricated dental implant surgical guide 40 is illustrated.
Surgical guide 40 as depicted in FIG. 1a, has fixed apical post 44
with bottom end face 75 and marking agent 77 on it for the purpose
of marking and identifying an osteotomy site 46.
[0064] Referring now to FIGS. 7b and 7c use of the embodiment of
FIG. 7a is illustrated. By holding coronal post 43 and by using
tooth shaped contour 42 as a guide as previously described,
osteotomy site 46 in jaw bone 48 can be located and demarcated by
pressing end face 75 with marking agent 77 of fixed apical post 44
on top of jaw bone 48 leaving a mark denoting the osteotomy site
46. Osteotomy bur 47 of surgical drill 59 can then be used to
initiate osteotomy site preparation. Further preparation,
verification and completion of the osteotomy site 46 via drill 59
can then be accomplished as previously described in FIGS. 1b and
1c.
[0065] Referring now to FIG. 8a, another embodiment of the
prefabricated dental implant surgical guide 51 is illustrated. In
this embodiment, surgical guide 51, comprises a fixed apical post
24 with bottom end face 85 and marking agent 87 on it for the
purpose of marking and identifying an osteotomy site 46.
[0066] Referring now to FIGS. 8b and 8c, by holding coronal post 23
and by using tooth shaped contour 22 as a guide as previously
described, osteotomy site 46 in jaw bone 48 can be located and
demarcated by pressing bottom end face 85 with marking agent 87 of
fixed apical post 24 on top of jaw bone 48 leaving a mark denoting
the osteotomy site 46. Osteotomy bur 47 of surgical drill 59 can
then be used to initiate osteotomy site preparation. Subsequent to
osteotomy site preparation and implant placement, the tooth shaped
contour 22 of guide 51 can be converted to a provisional crown
(immediate or delayed) as previously described in FIG. 2b.
[0067] Referring now to FIG. 9a, yet another embodiment of the
prefabricated dental implant surgical guide 53 is illustrated.
Surgical guide 53 comprises a fixed apical post 13 with bottom end
face 95 and marking agent 97 on it for the purpose of marking and
identifying an osteotomy site 46.
[0068] Referring now to FIGS. 9b and 9c, use of the surgical guide
53 is illustrated. By holding coronal post 6 and by using tooth
shaped contour 12 as a guide as previously described, osteotomy
site 46 in jaw bone 48 can be located and demarcated by pressing
end face 95 with marking agent 97 of fixed apical post 13 on top of
jaw bone 48 leaving a mark denoting the osteotomy site 46.
Osteotomy bur 47 of surgical drill 59 can then be used to initiate
osteotomy site preparation. Further preparation, verification and
completion of the osteotomy site 46 can then be accomplished as
previously described in FIGS. 3b, 3c and 3d.
[0069] Referring now to FIG. 10a, another embodiment of
prefabricated dental implant surgical guide 70 is illustrated.
Surgical guide 70 comprises an adjustable removable post 67 with
apical post aspect 64 with a bottom end face 102, and marking agent
104 on it for the purpose of marking and identifying an osteotomy
site 46.
[0070] Referring to FIGS. 10b and 10c, use of the prefabricated
dental implant surgical guide is illustrated. By pushing or turning
coronal post 63 of adjustable removable post 67 so that central
post portion 68 moves through central bore 60, thereby lengthening
apical post portion 64 and by using tooth shaped contour 62 as a
guide as previously described, osteotomy site 46 in jaw bone 48 can
be located and demarcated by pressing end face 102 with marking
agent 104 of apical post aspect 64 of adjustable removable post 67
on top of jaw bone 48 leaving a mark denoting the osteotomy site
46. Osteotomy bur 47 of surgical drill 59 can then be used to
initiate osteotomy site preparation. Further preparation,
verification and completion of the osteotomy site can then be
accomplished as previously described in FIGS. 4b, 4c and 4d.
[0071] Referring now to FIG. 11a, still another embodiment of
prefabricated dental implant surgical guide 72 is illustrated. The
multi unit one piece surgical guide 72 comprises fixed apical posts
74a, 74b, and 74c with bottom end faces 109a, 109b and 109c and
with marking agents 110A, 110b, and 110c on them for the purpose of
marking and identifying an osteotomy sites 46a, 46b and 46c.
[0072] Referring now to FIGS. 11b and 11c, use of the prefabricated
dental implant surgical guide is illustrated. By holding coronal
posts 73a, 73b and or 73c and by using tooth shaped contour 72a,
72b and 72c as a guide as previously described, osteotomy sites
46a, 46b and 46c in jaw bone 48 can be located and demarcated by
pressing end faces 109a, 109b and 109c with marking agents 110a,
110b and 110c of fixed apical posts 74a, 74b and 74c on top of jaw
bone 48 leaving marks denoting the osteotomy sites 46a, 46b and
46c. Osteotomy bur 47 of surgical drill 59 can then be used to
initiate osteotomy site preparations. Further preparation,
verification and completion of the osteotomy sites can then be
accomplished as previously described in FIGS. 1-4.
[0073] A method and apparatus for using a prefabricated implant
surgical guide during dental implant placement surgery has now been
illustrated. It will also be understood that the invention may be
embodied in other specific forms without departing from the scope
of the invention disclosed and that the examples and embodiments
described herein are in all respects illustrative and not
restrictive. Those skilled in the art of the present invention will
recognize that other embodiments using the concepts described
herein are also possible. Further, any reference to claim elements
in the singular, for example, using the articles "a," "an," or
"the" is not to be construed as limiting the element to the
singular.
* * * * *