U.S. patent application number 14/670380 was filed with the patent office on 2015-10-01 for dental device comprising surgical template and false teeth set and related methods.
The applicant listed for this patent is Ron Tsai, Jason Watson. Invention is credited to Ron Tsai, Jason Watson.
Application Number | 20150272704 14/670380 |
Document ID | / |
Family ID | 54188752 |
Filed Date | 2015-10-01 |
United States Patent
Application |
20150272704 |
Kind Code |
A1 |
Watson; Jason ; et
al. |
October 1, 2015 |
DENTAL DEVICE COMPRISING SURGICAL TEMPLATE AND FALSE TEETH SET AND
RELATED METHODS
Abstract
A dental device is described. The dental device includes a
surgical template having one or more sites for drilling osteotomies
in the maxillary or mandibular jaw and a false teeth set. The
surgical template and false teeth set are configured to fit
together to form a denture prosthesis that can be implanted in a
patient. Also described are a method for creating a surgical dental
template, a method for implanting a dental prosthesis, and a method
for reducing jaw bone in a patient.
Inventors: |
Watson; Jason; (La
Crescenta, CA) ; Tsai; Ron; (Arcadia, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Watson; Jason
Tsai; Ron |
La Crescenta
Arcadia |
CA
CA |
US
US |
|
|
Family ID: |
54188752 |
Appl. No.: |
14/670380 |
Filed: |
March 26, 2015 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
61971804 |
Mar 28, 2014 |
|
|
|
61971810 |
Mar 28, 2014 |
|
|
|
62052988 |
Sep 19, 2014 |
|
|
|
Current U.S.
Class: |
433/76 |
Current CPC
Class: |
A61C 9/0046 20130101;
A61C 13/08 20130101; A61C 13/01 20130101; A61C 2201/005 20130101;
A61C 13/09 20130101; A61C 13/0004 20130101; A61B 6/14 20130101;
A61C 8/0009 20130101; A61C 8/0089 20130101; A61B 6/032 20130101;
A61C 1/084 20130101 |
International
Class: |
A61C 1/08 20060101
A61C001/08; A61C 13/01 20060101 A61C013/01; A61C 13/08 20060101
A61C013/08; A61C 8/00 20060101 A61C008/00 |
Claims
1. A dental device comprising: a surgical template having one or
more sites for drilling osteotomies in a maxillary or mandibular
jaw of a patient; and a false teeth set; wherein the surgical
template and false teeth set are configured to fit together to form
a denture prosthesis.
2. The dental device of claim 1, wherein the surgical template is
configured to fit over an edentulous patient's maxillary or
mandibular gum tissue.
3. The dental device of claim 1, wherein a portion of the surgical
template is configured as gum tissue.
4. The dental device of claim 1, wherein the one or more sites are
openings each providing a channel for drilling an osteotomy into
the maxillary or mandibular jaw.
5. The dental device of claim 4, wherein each opening comprises a
cylindrical wall having a height which is capable of limiting
drilling depth of the osteotomy.
6. The dental device of claim 1, wherein the surgical template and
false teeth set have male and female portions capable of
interlocking.
7. The dental device of claim 6, wherein the surgical template
comprises a male portion configured to interlock with a female
portion on one of the teeth of the false teeth set.
8. The dental device of claim 1, wherein the surgical template
comprises a ledge configured to fit the false teeth set.
9. The dental device of claim 1, wherein the surgical template
comprises one or more sets of drill holes configured to provide a
guide for reducing jaw bone when the surgical template is
positioned on the maxillary or mandibular jaw during use.
10. The dental device of claim 4, wherein the false teeth set
comprises one or more openings configured to overlap the one or
more openings of the surgical template when the template and false
teeth set are fit together.
11. The dental device of claim 1, wherein a wall of the surgical
template is configured to provide one or more pin holes.
12. The dental device of claim 11, wherein the one or more pin
holes are configured as projections extending outward from the wall
of the surgical template.
13. The dental device of claim 12, further comprising pins
configured to pass though each of the pin holes.
14. The dental device of claim 13, wherein each pin has a handle
portion extending outward from each projection and a tapered
portion extending inward through each projection.
15. The dental device of claim 1, wherein the surgical template
comprises one or more flanges extending outward from the
template.
16. A dental device comprising: a surgical template configured to
fit the interior of a maxillary or mandibular jaw over an
edentulous patient's maxillary or mandibular gum tissue; a false
teeth set; wherein the surgical template and false teeth set are
configured to fit together; wherein the surgical template comprises
one or more openings each providing a channel for drilling an
osteotomy into the maxillary or mandibular jaw; wherein the false
teeth set comprises one or more openings configured to overlap the
one or more openings of the surgical template when the template and
false teeth set are fit together; wherein a wall of the surgical
template is configured to provide one or more pin holes.
17. The dental device of claim 16, further comprising pins
configured to pass though each of the pin holes.
18. A dental device comprising: a surgical template configured to
fit over gum tissue of a partially edentulous jaw missing one or
more incisors, the surgical template having one or more openings
each providing a channel for drilling an osteotomy into a maxillary
or mandibular jaw of a patient at a site of the missing incisors;
and one or more removable false teeth configured to fit the
surgical template at each opening; wherein the surgical template
and one or more removable false teeth provide a partial or complete
bridge between left and right cuspids when implanted into a
patient's jaw.
19. The dental device of claim 18, wherein the surgical template is
configured to partially wrap around the left and right cuspids.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application relies on the disclosure of and
claims priority to and the benefit of the filing dates of U.S.
Provisional Application No. 61/971,804 and U.S. Provisional
Application No. 61/971,810, both filed on Mar. 28, 2014, and U.S.
Provisional Application No. 62/052,988, filed Sep. 19, 2014, the
disclosures of which are hereby incorporated by reference herein in
their entireties.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to the field of dental
surgery. More particularly, the present invention relates to a
combination surgical template and false teeth set that fit together
to form an implantable denture. The present invention also relates
to methods for manufacturing a surgical dental template, methods
for installing a denture prosthesis in a partially edentulous
patient, and method for reducing jaw bone in a patient.
[0004] 2. Description of Related Art
[0005] The use of dental prostheses with dental implants secured in
the upper or lower jawbone is well known in the art. Accurate
placement of the implants within the jawbone is a difficult task.
The dental surgeon typically has difficulty deciding on a drilling
axis for the implants since the ideal position for the implants
should be decided with knowledge of the jawbone structure into
which the implant is to be inserted, and with knowledge of the
position within the jawbone structure of the nerve tissue, the gum
surface and the required position and dimensions of the false teeth
or dentures to be supported by the dental implant.
[0006] The conventional surgical procedure for installing one,
implant-supported, prosthetic tooth includes drilling a properly
positioned hole in the jawbone of the patient, inserting the
implant in the hole, and attaching the prosthetic tooth to the
implant. Proper implant positioning is also extremely important to
ensure that the implant is anchored within sufficient bone
structure in the patient's jawbone.
[0007] The most common method for locating a dental implant hole is
to visually survey the area and drill the hole in a freehand
manner. However, this method can readily result in imperfect bores
due to space limitations associated with working inside a patient's
mouth. If the drilling axis is not properly chosen, the installed
implants might cause damage to the tissues and muscle surrounding
the area of implantation and subsequently cause temporary or
permanent paresthesia. Furthermore, other problems can result from
flawed or imperfect implant holes, such as uneven force
distribution, insufficient bone growth around the implant,
secondary infections, and ultimately, implant failure.
[0008] During a one-stage surgical procedure, a healing abutment
assists in the healing, formation, and maintenance of the soft
tissue over the implant while bone integration occurs. The healing
abutment is immediately placed into the implant well to ensure that
the gum line will heal properly and look natural once the final
abutment is tapped into the implant.
[0009] During a two-stage surgical procedure, a cover screw is
initially screwed into the implant well. The tissue surrounding the
cover screw is then sutured to protect the implant site while bone
integration occurs. Once the bone has integrated, an incision is
made in the tissue above the site, at which time integration is
checked. Once the bone has healed properly, the cover screw is then
removed, and a healing abutment is screwed into the implant well.
With the healing abutment securely in place the tissue surrounding
the area is sutured. Approximately 4-6 weeks later, the healing
abutment can be removed and a final abutment is then placed into
the implant. In some surgical cases, a final abutment is
immediately placed into the implant well rather than the healing
abutment and sutures are not required. In both the one-stage and
two-stage surgical procedure, the final abutment supports the final
crown or denture.
[0010] Many types of surgical guides are on the market today. They
can be tooth supported, gum supported, or bone supported. The
simplest guides are done in the laboratory. They consist of acrylic
templates (or stents), or teeth, both filled with radiopaque
markers that provide the position of the teeth in relation to the
bone on 2D radiographs. Holes are drilled through these surgical
guides at the selected implant sites and the surgeon uses them to
make bone perforations. Afterwards, the surgeon needs to raise a
flap in order to make the osteotomies. Examples of such guides are
shown in FIGS. 1 and FIGS. 2A-2B. More sophisticated guides use
computer tomography (CT)-scan data and special software in order to
place the implants according to three-dimensional (3D) data. The
guide is then fabricated using stereolithographic machines or
milling machines.
[0011] Each surgical stent commonly used is custom-built and these
devices are only useful for a single patient, are costly to
fabricate, and they require a number of intermediary office and
laboratory steps to take an impression of the patient's arch and
create a cast model from which the surgical stent is formed.
[0012] Superstructures are used as load-bearing elements that
interface prosthesis to implants. In the conventional method for
the construction of superstructures, a physical model of the
patient's gums and dental implant heads is prepared on which the
superstructure is built manually using molding and other techniques
known in the art. The craftsman or technician skilled at
manufacturing such dental superstructures takes into consideration
the size and shape of the desired dentures to be placed over the
superstructure when crafting the same. The procedure for
manufacturing dental implant superstructures as is conventionally
known in the art is time-consuming and sometimes results in
imperfect structures or defects in the visual appearance of the
dentures to be placed over the superstructure.
[0013] Therefore, in an effort to reduce costs and the number of
steps associated with fabricating a traditional surgical stent,
various forms of prefabricated surgical stents and positioning
guide systems have been developed to aid the dental surgeon. In
International patent application publication no. WO 94/26200, there
is described an adjustable guiding device for positioning dental
implants in which it is possible for the dental surgeon to adjust a
drilling axis for each implant before proceeding to use the guiding
device or drill template to guide the surgeon's drill for the
purposes of preparing the drill hole for the implant.
[0014] In U.S. Pat. No. 5,401,170, there is disclosed a method and
apparatus for measuring by camera image the implant heads of the
implants in the patient's mouth for the purposes of cutting a frame
on which the prosthetic teeth will be arranged and baked. In the
method disclosed, the construction of the frame or superstructure
is carried out in the absence of a reference to the shape and
position of the patient's ideal tooth position.
[0015] Thus, as the dentures or artificial teeth are crafted on the
frame or superstructure, care would be required during the manual
process to ensure that the position of the teeth on the frame will
match the opposed set of teeth in the patient's mouth.
[0016] It would thus be desirable to provide a drill guide system
comprising components fabricated prior to the actual surgery that
may be used more than once for the same patient, for any
restoration configuration, and that enables precise implant
spacing, and also ensures that the implant holes are drilled at the
proper angle and orientation.
SUMMARY OF THE INVENTION
[0017] One embodiment of the invention comprises a dental device
comprising a surgical template having one or more sites for
drilling osteotomies in the maxillary or mandibular jaw and a false
teeth set. For such dental device, the surgical template and false
teeth set may be configured to fit together to form a denture
prosthesis that may be implanted in a patient to provide for the
appearance of natural teeth.
[0018] In embodiments, the surgical template may be configured to
fit over an edentulous patient's maxillary or mandibular gum
tissue, and a portion of the surgical template may have the
appearance of gum tissue.
[0019] In embodiments, the one or more sites may be openings each
providing a channel for drilling an osteotomy into the maxillary or
mandibular jaw. Further, each opening may comprise a cylindrical
wall having a height which is capable of limiting the drilling
depth of the osteotomy. In additional embodiments, the false teeth
set comprises one or more openings configured to overlap the one or
more openings of the surgical template when the template and false
teeth set are fit together.
[0020] In embodiments, the surgical template and false teeth set
may have male and female portions capable of interlocking. In one
embodiment, the surgical template comprises a male portion
configured to interlock with a female portion on one of the teeth
of the false teeth set. In another embodiment, the surgical
template comprises a ledge configured to fit the false teeth
set.
[0021] In additional embodiments, the surgical template comprises
one or more sets of drill holes configured to provide a guide for
reducing jaw bone when the surgical template is positioned on the
maxillary or mandibular jaw during use.
[0022] In additional embodiments, a wall of the surgical template
is configured to form one or more pin holes. The one or more pin
holes may be configured as projections extending outward from a
wall of the surgical template. The device may further comprise pins
passing though each of the pin holes. Each pin may have a handle
portion extending outward from each projection and a tapered
portion extending inward through each projection. In additional
embodiments, the surgical template may comprise one or more flanges
extending outward from the template.
[0023] Another embodiment of the invention comprises a dental
device comprising a surgical template configured to fit the
interior of a maxillary or mandibular jaw over an edentulous
patient's maxillary or mandibular gum tissue and a false teeth set.
In embodiments the surgical template and false teeth set may be
configured to fit together. The surgical template may comprise one
or more openings each providing a channel for drilling an osteotomy
into the maxillary or mandibular jaw. Further, the false teeth set
may comprise one or more openings configured to overlap the one or
more openings of the surgical template when the template and false
teeth set are fit together. Further, a wall of the surgical
template may be configured to form one or more pin holes and the
device may further comprise pins passing though each of the pin
holes.
[0024] Another embodiment of the invention comprises a dental
device comprising a surgical template configured to fit over the
gum tissue of a partially edentulous jaw missing one or more
incisors, the surgical template having one or more openings each
providing a channel for drilling an osteotomy into the maxillary or
mandibular jaw at the site of the missing incisors and one or more
removable false teeth configured to fit the surgical template at
each opening. In embodiments, the surgical template and one or more
removable false teeth provide a partial or complete bridge between
the left and right cuspids when implanted into a patient's jaw. In
embodiments, the surgical template may be configured to partially
wrap around the left and right cuspids.
[0025] Another embodiment of the invention comprises a method for
creating a surgical dental template, comprising performing a CT
scan on a patient, transferring one or more CT scan images into
treatment planning software, virtually placing implants in one or
more positions on the CT scan using the treatment planning
software, and creating a surgical template based on the positions
on the CT scan that provide one or more sites for drilling
osteotomies in the maxillary or mandibular jaw for installing the
implants. In embodiments, the CT scan slices implant or anchor
sites by size and diameter per zone into the jaw bone.
[0026] Another embodiment of the invention comprises a method for
implanting a denture prosthesis in a patient, comprising creating a
treatment planning protocol according to the treatment planning
software and implanting the surgical template in the patient
according to the treatment planning protocol.
[0027] In embodiments, the surgical template is configured to fit
over an edentulous patient's maxillary or mandibular gum tissue. In
embodiments, a portion of the surgical template has the appearance
of gum tissue.
[0028] In embodiments, the one or more sites are openings each
providing a channel for drilling an osteotomy into the maxillary or
mandibular jaw. Each opening may comprise a cylindrical wall having
a height which is capable of limiting the drilling depth of the
osteotomy
[0029] In embodiments, the one or more CT scan images are in the
form of DICOM files.
[0030] In embodiments, the surgical template may be manufactured
from a nanoceramic composite.
[0031] In embodiments, the surgical template is manufactured
through CNC milling.
[0032] In embodiments the patient is fully edentulous, and the CT
scan is performed with the patient wearing a denture with
radio-opaque markers. In other embodiments, the patient is
partially edentulous, and the CT scan is performed with the patient
wearing a radiographic guide. In other embodiments, the patient is
partially edentulous, and the CT scan is performed with the patient
not wearing a radiographic guide.
[0033] In embodiments, the method further comprises making a set of
full arch impressions from the patient's jaw; performing a CT scan
on the arch impressions; and creating a surgical template based on
the CT scan of the arch impressions.
[0034] In embodiments, the surgical template is configured to fit
with a false teeth set to form a denture prosthesis.
[0035] In embodiments, the false teeth set comprises one or more
openings configured to overlap the one or more openings of the
surgical template when the template and false teeth set are fit
together.
[0036] Another embodiment of the invention comprises a method for
implanting or installing a denture prosthesis in a partially
edentulous patient. The method may first comprise providing a
surgical template and a false teeth set. The surgical template is
configured to fit over the gum tissue of an edentulous jaw of a
patient and has one or more sites for drilling osteotomies, and the
surgical template and false teeth set are configured to fit
together to form a denture prosthesis. The surgical template is
then positioned over the gum tissue of an edentulous jaw of a
patient at a first position and the false teeth may be inserted and
set into the surgical template. The false teeth set may be fixed
into the surgical template with a composite. The patient is then
instructed to bite down on the false teeth set with natural teeth
of the jaw opposite the edentulous jaw. The surgical template is
repositioned, and the steps are repeated until the patient confirms
occlusion between the natural teeth and false teeth set. The
surgical template is finally fixed over the gum tissue of the
patient's edentulous jaw at a second position.
[0037] In embodiments, a wall of the surgical template is
configured to form one or more pin holes, the surgical template
comprising pins passing though each of the pin holes, and the pins
are used to fix the surgical template over the gum tissue of the
patient's edentulous jaw.
[0038] In embodiments, the method further comprises drilling
osteotomies into the edentulous jaw based on the drilling sites and
installing implants at the osteotomies and securing the surgical
template through the implants. The implants can be secured with a
fastener.
[0039] In embodiments, the surgical template and false teeth can be
finished or converted to provide the appearance of a dental
prosthesis by removing one or more of a boundary line between the
surgical template and false teeth set, one or more pin holes in the
surgical template, and one or more flanges in the surgical
template. The boundary line and one or more pin holes can be
removed by filling with composite.
[0040] Another embodiment of the invention comprises a method for
reducing jaw bone. A surgical template configured to fit the
interior of a maxillary or mandibular jaw over an edentulous
patient's gum tissue is installed in a patient. The surgical
template has one or more sets of drill holes. Next, osteotomies may
be perforated through the drill holes in the surgical template to
define markings in the jaw bone forming a boundary for reducing
bone. The surgical template is removed and the jaw bone is exposed
though an incision to reveal the osteotomies. Finally, a surgical
instrument is used to remove jaw bone based on the boundary formed
by the markings.
[0041] The device of the invention when implanted and converted to
a denture prosthesis provides for the appearance of natural teeth
while being fixed in the jaw, providing aesthetic benefits for an
edentulous or partially edentulous patient. Further, the invention
may provide for shorter surgery times for implantation of the
device as well as greater precision in placement compared to
conventional devices. In addition, the device may be converted to a
temporary or final prosthesis. The device can be used with a
variety of implants for implantation into jaw bone.
BRIEF DESCRIPTION OF THE DRAWINGS
[0042] The accompanying drawings illustrate certain aspects of
embodiments of the present invention, and should not be used to
limit the invention. Together with the written description the
drawings serve to explain certain principles of the invention.
[0043] The patent or application file contains at least one drawing
executed in color. Copies of this patent or patent application
publication with color drawing(s) will be provided by the Office
upon request and payment of the necessary fee.
[0044] FIG. 1 is a photograph showing a prior art surgical guide
half prosthesis.
[0045] FIG. 2A is a photograph showing a prior art tooth-supported
poly(methyl methacrylate) (PMMA) Milled Split Surgical Guide.
[0046] FIG. 2B is a photograph showing a prior art tooth- and
pin-supported PMMA Milled Split Surgical Guide.
[0047] FIG. 3A is a photograph showing a front view of a fully
assembled combination surgical template and dental prosthesis
device according to an embodiment of the invention.
[0048] FIG. 3B is a photograph showing a front, oblique view of a
fully assembled combination surgical template and dental prosthesis
device according to an embodiment of the invention.
[0049] FIG. 3C is a photograph showing a top view of a maxillary
portion of a combination surgical template and dental prosthesis
device according to an embodiment of the invention.
[0050] FIG. 4 is a photograph showing a mandibular portion of a
combination surgical guide dental prosthesis device according to an
embodiment of the invention.
[0051] FIG. 5 is a photograph showing a surgical template converted
to dental prosthesis with pins, pin holes, and flanges removed
according to an embodiment of the invention.
[0052] FIG. 6A is a photograph showing a front view of an
embodiment of the surgical template converted to a temporary dental
prosthesis with pins, pin holes, and flanges removed according to
an embodiment of the invention.
[0053] FIG. 6B is a photograph showing a bottom view of an
embodiment of the surgical template converted to a final dental
prosthesis showing towers from multi-unit abutments.
[0054] FIG. 7 is a photograph showing a two-part design of a
combination surgical template and dental prosthesis device
according to an embodiment of the invention.
[0055] FIG. 8A is a photograph showing a front, oblique view of a
drilling sequence of a combination surgical template and dental
prosthesis device according to an embodiment of the invention.
[0056] FIG. 8B is a photograph showing a top view of a drilling
sequence of a combination surgical template and dental prosthesis
device according to an embodiment of the invention.
[0057] FIG. 8C is a photograph showing a front view of a drilling
sequence of a combination surgical template and dental prosthesis
device according to an embodiment of the invention.
[0058] FIGS. 9A-9D are photographs showing a chair-side adaptation
workflow according to an embodiment of the invention.
[0059] FIG. 10A is a photograph showing bars milled for final clone
prosthesis according to an embodiment of the invention.
[0060] FIG. 10B is a photograph showing bars embedded in a
nanoceramic prosthesis according to an embodiment of the
invention.
[0061] FIG. 11A is a photograph showing a front view of a patient
implanted with a converted surgical guide and dental prosthesis
device according to an embodiment of the invention.
[0062] FIG. 11B is a photograph showing a front view of a patient
implanted with a converted surgical template and dental prosthesis
device according to an embodiment of the invention with teeth in
occlusion.
[0063] FIG. 11C is a photograph showing a side view of a patient
implanted with a converted surgical template and dental prosthesis
device according to an embodiment of the invention with teeth in
occlusion.
[0064] FIG. 12 is a photograph showing a combination surgical
template and dental prosthesis device with bone reduction guide
according to an embodiment of the invention.
[0065] FIG. 13 is a photograph showing a partial surgical template
and dental prosthesis device according to an embodiment of the
invention.
[0066] FIG. 14 is a photograph showing a front view of a drilling
sequence of a partial surgical template and dental prosthesis
device according to an embodiment of the invention.
[0067] FIG. 15A-15B are photographs before (FIG. 15A) and after
(FIG. 15B) of a patient implanted with a partial surgical template
and dental prosthesis device according to an embodiment of the
invention.
[0068] FIGS. 16-17 are computer-aided design (CAD) drawings showing
the combination surgical template and dental prosthesis device of
the invention is fully compatible with the BIOHORIZONS.RTM. Guided
Surgery Kit according to an embodiment of the invention.
[0069] FIGS. 18A-F are CAD drawings showing a series of steps for
using a surgical template of the invention with the
TEETHXPRESS.RTM. immediate load solution according to an embodiment
of the invention.
[0070] FIG. 19A is a CAD drawing showing an example of
BIOHORIZONS.RTM. implants according to an embodiment of the
invention.
[0071] FIG. 19B is a CAD drawing showing an example of
BIOHORIZONS.RTM. multiunit abutments according to an embodiment of
the invention.
[0072] FIG. 20 is a screenshot showing an example of a scanning
protocol verification checklist according to an embodiment of the
invention.
[0073] FIG. 21 is a CAD drawing showing the placement of implants
according to an embodiment of the invention.
[0074] FIG. 22 is a screenshot of a Treatment Planning Report
Overview supplied for case analysis according to an embodiment of
the invention.
[0075] FIG. 23 is a screenshot of a Planning Report for an implant
site for critical evaluation according to an embodiment of the
invention.
[0076] FIG. 24 is a screenshot showing guided surgery information
for a patient according to an embodiment of the invention.
[0077] FIG. 25 is a screenshot showing a treatment planning
approval form according to an embodiment of the invention.
[0078] FIG. 26A is a photograph of a guided surgery kit according
to an embodiment of the invention.
[0079] FIG. 26B is a photograph showing fast healing using a guided
surgery method embodiment of the invention.
[0080] FIG. 27 is a flow chart of a decision tree to support the
appropriate scanning protocol according to an embodiment of the
invention.
[0081] FIGS. 28A-28D are screenshots showing a Single Scan Protocol
for Teeth-supported Surgical Guide according to an embodiment of
the invention.
[0082] FIGS. 29A-29E are screenshots showing a Dual Scan Protocol
for Teeth-supported Surgical Guide according to an embodiment of
the invention.
[0083] FIGS. 30A-30F are screenshots showing a Dual Scan Protocol
for Gum-Supported Surgical Guide according to an embodiment of the
invention.
[0084] FIGS. 31A-31D are screenshots showing file transfer
instructions according to an embodiment of the invention.
[0085] FIG. 32 is a flowchart illustrating a method for creating a
surgical dental template according to an embodiment of the
invention.
[0086] FIG. 33 is a flowchart illustrating a method for implanting
a denture prosthesis in a partially edentulous patient according to
an embodiment of the invention.
[0087] FIG. 34 is a flowchart illustrating a method for reducing
jaw bone in a patient according to an embodiment of the
invention.
DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS OF THE INVENTION
[0088] Reference will now be made in detail to various exemplary
embodiments of the invention. It is to be understood that the
following discussion of exemplary embodiments is not intended as a
limitation on the invention. Rather, the following discussion is
provided to give the reader a more detailed understanding of
certain aspects and features of the invention.
[0089] In one embodiment, the present invention is a two-part
denture prosthesis or device comprising a surgical template or
guide and removable false teeth set for both the mandibular and
maxillary jaw. The surgical template and false teeth set may be
configured to fit together in an interlocking configuration. The
surgical guide may exist as two components that are each configured
to fit the top (maxilla) or bottom (mandible) portion of a
patient's jaw when placed inside the mouth. The surgical guide may
have one or more holes that may serve as drilling sites. The holes
may be positioned so that osteotomies may be drilled downward in
the mandible or upward in the maxilla. The holes in the guide can
comprise a cylindrical wall (also known herein as a depth stop)
that is raised or lowered to accommodate a target depth of the
osteotomy. The surgical guide may have one or more pin holes for
securing or clamping the guide to the jaw during surgery. During
surgical placement of the guide, pins can be set through the pin
holes in the guide through the bone to secure the guide in place
until it is permanently fixed with the abutments or implants. In
embodiments, the pin holes are located laterally on the guide and
spaced apart to secure the sides and central portion of the
guide.
[0090] In embodiments, the surgical guide has a removable false
teeth set configured to interlock with the surgical guide. The
removable teeth may exist as two additional components (e.g., one
for the maxillary jaw and one for the mandibular jaw) each
configured to fit the top maxillary portion or bottom mandibular
portion of the surgical guide. The removable false teeth set allows
the oral surgical guide to be simultaneously used as a prosthesis.
In addition, the removable false teeth are useful in helping to
confirm the fit of the surgical guide through occlusion. The
removable teeth may fit on the surgical guide above or below the
drill holes and may have access holes that complementarily fit the
drill holes. Ultimately, the surgical guide and teeth component are
secured as one piece to the implant(s) placed in the jaw though a
fastener such as screws.
[0091] The surgical guide may be manufactured to fit the individual
patient's mouth based on a CT scan of the maxilla and mandible. The
surgical guide may be manufactured from a nanoceramic composite or
other suitable material through CNC milling or 3D printing.
[0092] In another embodiment, the invention is a method for
performing oral surgery. The method comprises placing a surgical
guide of the invention in a patient's mouth, setting one or more
pins through the holes of the guide to secure the guide to the jaw,
placing a set of teeth on the guide, instructing the patient to
bite down on the teeth to confirm the fit of the guide through
occlusion, if necessary, releasing the guide with the pins and
readjusting the fit of the guide based on the occlusive bite, and
securing the guide with the pins, drilling osteotomies through the
holes, and securing the guide to the jaw through implants or
abutments placed in the osteotomies. The methods may further
comprise using a pre-surgical bite registration index based on the
patient's bite. The methods may further comprise cutting off
insertion pin holes and flanges on the guide and filling the border
between the surgical guide and false teeth set with composite to
provide for a natural look.
[0093] In another embodiment, the invention is a method of placing
a dental prosthesis in the mouth of a patient. The method comprises
placing a surgical guide in the mouth of a patient, performing
guided surgery based on drill holes in the surgical guide,
inserting abutments through the surgical guide, retrieving the
surgical guide and reducing excess material, inserting a
complementary false teeth set into the surgical guide, drilling a
guided screw channel into the surgical guide, and finishing the
surgical guide.
[0094] Various embodiments of a device of the invention are shown
in FIGS. 3-18F. FIGS. 3A-3B show a manufactured/milled denture
prosthesis 100 according to an embodiment of the invention. The
denture prosthesis includes mandibular guide 105, mandibular false
teeth set 112, maxillary guide 125, and maxillary false teeth set
118. Guides 105 and 125 include insertion pin holes 130 and
insertion pins 128 as well as flanges 135A extending above the
guides. Guides 105, 125 may have portions with the color, shape,
and appearance of gum tissue. The insertion pins 128 may be used to
pin the guide in position into the jaw bone based on results of the
CT scan and holds the guide in place like a vise. The false teeth
sets 112 and 118 are used as a reference for orientating the guides
105 and 125 into the jaw during placement. The guide is first
preliminarily placed in the mouth based on the results of the CT
scan, the teeth are placed in the guide, and the patient's mouth is
closed to provide occlusion of the false teeth set with the natural
teeth set on the opposite jaw. This method is also called canine
guidance, in which occlusal contacts of the cuspids cause contacts
of posterior teeth to separate in excursive mandibular movements.
Occlusion confirms that the guide is in proper position. The false
teeth sets 112 and 125 may be glued to the guides 105 and 125
during final preparation of the dental prosthesis. FIG. 3C shows
that insertion pins 128 have a tapered portion 132 projecting
inward through and beyond insertion holes 130 for insertion into
the jaw.
[0095] As will be shown below, the false teeth sets 112, 118 and
guides 105, 125 may include features that allow corresponding
components to fit into place. These may include at least one male
component on the guides 105, 125 and at least one female component
on the teeth or vice versa. In one embodiment, the guides 105, 125
have a male component having an appearance of a molar tooth
structure that interlocks with a molar tooth structure of the
corresponding false teeth sets 112, 118. In other embodiments, the
guides 105, 125 have a ledge or gulley that is configured to accept
a protruding portion of the corresponding false teeth sets 112,
118. Once they are fit together, false teeth sets 112, 118 and
guides 105, 125 may be permanently fixed together through an
adhesive such as a composite.
[0096] FIG. 4 includes a surgical guide 105 and false teeth set 112
which includes line 110 at point of insertion of false teeth set
112 into surgical guide 105. Since the surgical guide 105 and false
teeth set 112 will serve as a prosthesis, unnatural features such
as insertion pin holes 130 and line 110 must be removed from the
device during a conversion process. FIGS. 5 and 6A shows a surgical
guide 105 and false teeth set 112 with line between them removed by
filling with composite and insertion pin holes removed. The
surgical guide 105 and false teeth set 112 shown in FIG. 5 is
processed according to how it would appear in a patient. FIG. 6A
shows the maxillary 118 and mandibular 112 false teeth sets
together in occlusion. FIG. 6B is a photograph showing a bottom
view of an embodiment of the surgical template converted to a final
dental prosthesis showing towers 119 from multi-unit abutments.
[0097] Turning now to FIG. 7, shown is a surgical guide 105 with
separated false teeth set 112, which reveals drilling sites 120 on
the surgical guide 105. The drilling sites 120 comprise a
cylindrical hole which may be provided at different depths to help
guide the depth of the drill hole. For example, a cylindrical hole
may include a wall 121 at a specified height to prevent drilling
too deep. These cylindrical hole configurations are also known as
depth stops. As shown in FIGS. 8A-8C, the drilling sites 120 may be
accessible through guided surgical drilling equipment 150, 155,
which may drill osteotomies in the jaw for fixing the surgical
guide 105 and false teeth set 112 into the jaw. Also shown in FIG.
8C are complementary holes 122 in the false teeth set which align
with the drilling sites 120 which serve as screw access holes.
[0098] Now referring to FIGS. 9A-9D, shown are a surgical guide and
dental prosthesis device of the invention at different stages of
assembly. FIG. 9A shows a mandibular surgical guide 105 with the
removable false teeth set 112 removed, while FIG. 9B shows the
mandibular surgical guide 105 with the removable false teeth set
112 attached. Also shown in FIGS. 7 and 9A are interlocking
structure 147 and horseshoe-shaped ledge 153 for connecting false
teeth set 112 to mandibular surgical guide 105. Such features may
be used to fit the two components in place. FIGS. 9C and 9D show
the surgical guide 105 with excess material removed, including the
interior drilling sites 120A, flange 135B, and insertion pin holes
130 shown in FIGS. 9A and 9B. In embodiments, the excessive
material reduction is a component of a Chair-Side Adaptation
Workflow, which includes the following steps:
[0099] 1. Guided surgery
[0100] 2. Abutment (not shown) insertion and bonding, through
surgical guide still installed
[0101] 3. Surgical guide retrieval and excess material
reduction
[0102] 4. Surgical guide parts assembly and bonding
[0103] 5. Guided screw channel drilling
[0104] 6. Finishing
[0105] In embodiments, the device of the invention may be used as a
temporary prosthesis until a more permanent prosthesis is put into
place. FIGS. 10A and 10B show the manufacture of a more permanent
prosthesis based on the device. FIG. 10A is a photograph showing
bars milled for final clone prosthesis according to an embodiment
of the invention. FIG. 10B is a photograph showing bars embedded
within a nanoceramic prosthesis according to an embodiment of the
invention. The more permanent prosthesis may be implanted in the
jaw through the implants installed through the surgical guide.
[0106] FIGS. 11A-11C show a patient implanted with a surgical guide
converted to a dental prosthesis according to an embodiment of the
invention. As shown in FIGS. 11B and 11C, the maxillary 118 and
mandibular 112 false teeth sets are positioned so that they are in
perfect occlusion with canine guidance.
[0107] In embodiments, the surgical guide may include one or more
retaining pins and drill holes located on the denture which serve
as a surgical guide for bone reduction. The bone reduction guide
assists the user to reduce bone to the necessary thickness in order
for the denture to be placed at the right height, and may be
determined from a CT scan of the patient's jaw. The retaining pins
and drill holes allow for a boundary on the jaw to be marked when
the surgical guide is placed in the jaw as the jaw may be marked by
drilling though the drill holes. When the guide is placed the jaw
may be exposed through an open flap incision, allowing the oral
surgeon to see the holes. The jaw may be reduced by sawing down the
jaw until the holes are no longer visible.
[0108] Now referring to FIG. 12, a partial denture prosthesis 200
comprising a surgical guide 205 with bone reduction guide according
to an embodiment of the invention is shown. FIG. 12 shows three
retaining pins 228 located in insertion pin holes 230 and two sets
of four bore holes 260 located on surgical guide 205, which like
previous embodiments has corresponding false teeth set 212. The
bore holes 260 are drilled into the surgical guide 205, which
provides a bone reduction guide for the device. It acts as a part
of the same medical device. The bone reduction guide assists the
user to reduce bone to the necessary thickness which may be 15-16
millimeters thick in order for the denture to be placed at the
right height. The surgical guide will be stacked on the bone much
like a LEGO toy set. The ridge width acts as a guide to remove the
bone. The user will push through the tissue and make holes in the
bone. Pins inserted into the tissue will be cut. The gum tissue
will be opened up and the bone will be exposed. When this happens
there will be holes in the bone. The bone will be grinded until the
holes disappear at which point the bone will be leveled down along
the peak of the mountain peak which is the front or anterior end of
the jaw. The surgeon will remove bone along the holes. There will
be depressions in the bone and the bone will be ground down until
there is a flat plane. The osteotomy is CT driven and will use a
denture wherein it will be filled with resin. A denture will be
used to get inside of bone. It acts as a surgical guide,
prosthesis, and denture guide.
[0109] FIGS. 13 and 14 show a partial denture prosthesis embodiment
300 according to the invention. Partial denture 300 includes
surgical guide 305 and removable false teeth set 312. When teeth
312 are removed they reveal drill holes 320 which are accessed by
drilling equipment. FIGS. 15A and 15B show before after photographs
of a patient surgically implanted with the partial denture 300. In
embodiments, the partial denture comprises a false teeth set having
anywhere from 2 to 8 teeth.
[0110] As shown in FIGS. 13 and 14, a surgical guide or template
305 is configured to fit over the gum tissue of a partially
edentulous jaw missing one or more incisors. The surgical template
305 has one or more openings 320 each providing a channel for
drilling an osteotomy into the maxillary or mandibular jaw at the
site of the missing incisors. Included are one or more removable
false teeth 312 configured to fit the surgical template at each
opening 320. As shown in FIGS. 14, 15A, and 15B, the surgical
template and one or more removable false teeth provide a partial or
complete bridge between the left and right cuspids when implanted
into a patient's jaw. In embodiments, the surgical template is
configured to partially wrap around the left and right cuspids to
secure it to the jaw.
[0111] FIGS. 16-17 are CAD drawings showing the surgical guide of
the invention is fully compatible with the BIOHORIZONS.RTM. Guided
Surgery Kit according to an embodiment of the invention. FIGS.
16-17 show guide 405 with insertion pins 428 and insertion pin
holes 430, and drilling holes 420 which are accessible by drilling
equipment 450, 455. Features of the surgical guide include
anchoring using the CGS-FP Fixation pins, secure tool assembly
using the embedded pilot drill sleeves or yellow, green and blue
Master Cylinders, site preparation using the GGS-YTP/GTP/BTP Tissue
Punches, guided osteotomy using BIOHORIZONS.RTM. Drill Guides and
Drills, all displayed during design to prevent interference with
adjacent geometry, guided insertion using the BIOHORIZONS.RTM.
Implant Drivers and Depth Stops. The four depth stop configurations
can be considered during treatment planning.
[0112] The following provides specifications of a Demo Case:
[0113] Master cylinder=Green
[0114] Drill guide=Green, 4.1 mm internal diameter (final)
[0115] Implant=4.6 mm.times.10.5 mm Tapered
[0116] Internal Implant=Drill 21 mm length, 4.1 mm diameter
(final)
[0117] Implant driver and depth position=Tapered Internal 4.6,
SP2
[0118] FIGS. 18A-F are CAD drawings showing a series of steps for
using the surgical guide of the invention with the TEETHXPRESS.RTM.
immediate load solution according to an embodiment of the
invention. Such steps are explained in Table 1 below.
TABLE-US-00001 TABLE 1 Compatibility with TEETHXPRESS .RTM.
TEETHXPRESS .RTM. + Corresponding Steps TEETHXPRESS .RTM. Surgical
Guide Figures A. Starting Implants with adequate Implants with FIG.
18A conditions: primary adequate primary stability and proper
stability and proper abutments abutments installed installed
Denture Surgical Guide B. Initial Preparation of a denture
Prefabricated holes FIG. 18B modifications: hole aligned drilling
template according to the Drilling and adjustment treatment plan of
the (with the implants on holes to accommodate the the baseplate,
abutments and with the angled (Steps 1 to 3) multiunit abutment on
the halfprosthesis) Slight adjustments of the holes to accommodate
the abutments and copings C. Occlusion Using the pre-surgical Using
the half- and bite prosthesis, and a passive fit registration index
pre-surgical bite verification: (Step 4) registration index for
cases with challenging prosthetic geometry D. Coping Coping
installation, Trim any protruding FIG. 18C reduction marking, drill
guide supporting and trimming, smoothing, cylinders from the
installation: polishing and baseplate installation with rubber
Coping installation, dam marking, (Steps 5 to 11) trimming,
smoothing, polishing and installation with rubber dam E. Occlusion
Using the pre-surgical Using the half- and bite prosthesis, and a
intercuspation registration index pre-surgical bite verification:
(Step 12) registration index for cases with challenging prosthetic
geometry F: Coping Using self curing acrylic Using chairside FIG.
18D pick-up: Using the pre-surgical flowable, bite lightcurable
registration index for composite stability Using the Surgical
during acrylic curing Guide anchor pins for (Steps 13 to 17)
accuracy and stability during composite curing G. Prosthesis
Retrieve the prosthesis Retrieve the prosthesis FIG. 18E
adaptation: Fill-in any void around Trim the lot number the and
guide abutments/copings with anchors acrylic Assemble the half-
Shorten flanges and any prosthesis to excessive the base-plate with
posterior cantilever composite Creation of a 2 mm Fill-in any void
with incision from the composite mucosa Shorten flanges and (Steps
18 to 20) any excessive posterior cantilever Creation of a 2 mm
incision from the mucosa H. Occlusion Using the pre-surgical Using
the half- FIG. 18F verification, bite prosthesis, and a polishing
and registration index pre-surgical bite delivery of Cotton filling
and registration index the sealing of the for cases with
prosthesis: screw access holes challenging Acquisition of a post-
prosthetic geometry delivery Cotton filling and panoramic x-ray to
sealing of the validate the screw access holes seating of the
prosthesis Acquisition of a post- (Steps 21 to 24) delivery
panoramic x-ray to validate the seating of the prosthesis.
[0119] FIG. 19A is a CAD drawing showing an example of
BIOHORIZONS.RTM. implants according to an embodiment of the
invention. FIG. 19B is a CAD drawing showing an example of
BIOHORIZONS.RTM. multiunit abutments according to an embodiment of
the invention. These are examples of implants and abutments that
can be used to secure the surgical template of the invention to the
jaw. However, the device of the invention is compatible with a
variety of implants such that the surgical template may be
considered a universal guide.
[0120] In another embodiment, the present invention is a method of
creating a two-part dental prosthesis comprising a surgical guide
and false teeth set. The method comprises performing a CT scan on a
patient, transferring the scan (such as in the form of a Digital
Imaging and Communications in Medicine (DICOM) file) into treatment
planning software. The CT scan slices implant or anchor sites by
size and diameter per zone into the jaw bone. From the CT scan, a
surgical guide is created based on one or more anchor or implant
sites to create a surgical template. The surgical guide may be
created by a trained biomedical engineer or oral surgeon who
virtually places the implants in position on the CT scan, taking
into account the bone quality and quantity and the presence of
nerves. The surgical guide is then milled based on the template
that provides one or more holes that may serve as drilling sites to
place the implants which secure the guide into the jawbone. The
drilling sites are created so that the implants are placed at
consistent angles to provide for an even pressure distribution on
the surgical guide when it is secured in the jaw. A treatment
protocol may also be produced from the treatment planning software
which instructs a dental surgeon how to place the surgical guide,
including the drilling depth. Based on the CT scan, sites in the
jaw bone may be identified that may be used to secure one or more
implants. The implants may provide a means for securing the device
in place with a fastener such as a screw. The device may be
attached to the jaw through the implants according to the implant
manufacturer's instructions.
[0121] In embodiments, the CT scan may be performed in a variety of
ways, depending on whether the jaw is fully or partially edentulous
and whether metal restorations or amalgams are present. For a
partially edentulous jaw, if there is good teeth support, and no
metal restorations or amalgams, then the CT scan may be performed
without a radiographic guide. If there is good teeth support and
amalgams or metal restorations are present, then the CT scan may be
performed with a radiographic guide. For a partially edentulous jaw
without good teeth support or for a fully edentulous jaw, the CT
scan may be performed with a gum-supported surgical guide (denture
with markers).
[0122] FIG. 20 is a screenshot showing an example of a scanning
protocol verification checklist according to an embodiment of the
invention, illustrating different scanning protocols that can be
used to create the surgical guides. The checklist includes the
following separate protocols: Single-Scan Protocol for
Teeth-Supported Surgical Guide, Dual Scan Protocol for
Teeth-Supported Surgical Guide, and Dual Scan Protocol for
Gum-Supported Surgical Guide. The Single Scan Protocol can be used
if there are no metal restorations or amalgams. The Dual Scan
Protocol for Teeth-Supported Surgical Guide can be used only if
there is good tooth support, and the Dual Scan Protocol for
Gum-Supported Surgical Guide can be used for the gum-supported
surgical guide. Further, the Single Scan protocol can be used
without any radiographic guide, the Dual Scan Protocol for
Teeth-Supported Surgical Guide is used with a radiographic guide,
and the Dual Scan Protocol for Gum-Supported Surgical Guide is used
with a denture with markers.
[0123] FIG. 21 is a CAD drawing showing the placement of implants
according to an embodiment of the invention.
[0124] FIG. 22 is a screenshot of a Treatment Planning Report
Overview supplied for case analysis according to an embodiment of
the invention. The Treatment Planning Report Overview includes
results of the CT scan of the whole jaw (top) as well as slices of
the individual anchor or implant sites (bottom). The CT scan slices
zones for each of the implant sites. If this step if not performed,
the implants may be placed at divergent angles, and too much
pressure may be placed on the implants and they may ultimately
fail. The guide must be oriented so that the implants are not
coming down through the teeth or the gums. They should be parallel
and in best position in concert with the bone such that everything
lines up. Based on the results of the Treatment Planning Report
Overview, a Planning Report for each implant site is provided, an
example of which is shown in FIG. 23.
[0125] FIG. 24 is a screenshot showing guided surgery information
for a patient according to an embodiment of the invention. The
surgical guide information may be developed from the CT scans shown
previously. The surgical guide information includes a Complete
Guided Surgery Protocol including drill selection and handles for
preplanned osteotomy position. The surgical guide information
includes general practitioner information, case information, and
implant information including sites, implant dimensions, surgical
kit, drill working length, and special notes.
[0126] FIG. 25 is a screenshot showing a treatment planning
approval form according to an embodiment of the invention. The
approval form includes information such as doctor information, case
information, and approval method.
[0127] FIG. 26A is a photograph of a guided surgery kit according
to an embodiment of the invention. It is an example of the type of
guided surgery tools that can be used to drill osteotomies through
the drill sites of the surgical guide.
[0128] FIG. 26B is a photograph showing fast healing using the
guided surgery method embodiments of the invention. The photographs
show the implants placed according to the methods of the
invention.
[0129] FIG. 27 is a decision tree to support the appropriate
scanning protocol according to an embodiment of the invention. The
decision tree determines which scanning protocol of FIG. 20 to use.
For a partially edentulous jaw, if there is good teeth support, and
no metal restorations or amalgams, then the CT scan may be
performed without a radiographic guide, and a single scan protocol
may be used. If there is good teeth support and amalgams or metal
restorations are present, then the CT scan may be performed with a
radiographic guide and a dual scan protocol may be used. For a
partially edentulous jaw without good teeth support or for a fully
edentulous jaw, the CT scan may be performed with a gum-supported
surgical guide (denture with markers), and a dual scan protocol for
a sum-supported surgical guide may be used.
[0130] FIGS. 28A-28D are screenshots showing a Single Scan Protocol
for Teeth-supported Surgical Guide according to an embodiment of
the invention. First, full arch impressions of the arch to be
treated and the opposite arch are taken as well as a bite
registration. The arch impressions are scanned and transformed into
3D computer images and used as the basis for design of the surgical
guide, as shown in FIG. 28A. Then, the patient is prepared
according to the instructions in FIG. 28B, and a scan of the
patient is performed. A CT scan is then performed according to the
scanning instructions and parameters shown in FIG. 28C. The
scanning data (DICOM files), impressions, and bite registrations
are then sent to a facility and used to create a surgical guide as
shown in FIG. 28D.
[0131] FIGS. 29A-29E are screenshots showing a Dual Scan Protocol
for Teeth-supported Surgical Guide according to an embodiment of
the invention. The arch impressions are scanned and transformed
into 3D computer images and used as the basis for design of the
surgical guide, as shown in FIG. 29A. Then, the patient is prepared
according to the instructions in FIG. 29B, and a scan of the
patient is performed with the radiographic guide in place according
to the instructions shown in FIG. 29C. Then, a CT scan of the
radiographic guide with the master model obtained from the arch
impressions is performed according to the instructions in FIG. 29D.
Finally, the scanning data (DICOM files), impressions, and bite
registrations are then sent to a facility and used to create a
surgical guide as shown in FIG. 29E.
[0132] FIGS. 30A-30F are screenshots showing a Dual Scan Protocol
for Gum-Supported Surgical Guide according to an embodiment of the
invention. Full arch impressions are obtained as shown in FIG. 30A,
while a denture with radiopaque markers on the outer surface of the
denture is created as shown in FIG. 30B. Then, the patient is
prepared for a CT scan wearing the denture according to the
instructions in FIG. 30C, and a scan of the patient is performed
with the denture in place according to the instructions shown in
FIG. 30D. A CT scan of the denture alone is performed according to
the instructions in FIG. 30E. Finally, the scanning data (DICOM
files) and impressions are then sent to a facility and used to
create a surgical guide as shown in FIG. 30F.
[0133] FIGS. 31A-31D are screenshots showing file transfer
instructions according to an embodiment of the invention. Such
instructions may be used to transfer the DICOM files to a facility
where a surgical guide can be created.
[0134] FIGS. 32-34 refer to flowcharts illustrating exemplary
methods of the invention. However, it is to be understood that the
following steps may be substituted or eliminated, or performed in a
different order, or additional steps may be added that fall within
the scope of the invention. FIG. 32 shows an embodiment of a method
1000 for creating a surgical dental template. The method comprises
performing a CT scan on a patient 1100, transferring one or more CT
scan images into treatment planning software 1200, virtually
placing implants in one or more positions on the CT scan using the
treatment planning software 1300, and creating a surgical template
based on positions on CT scan that provide one or more sites for
drilling osteotomies in the maxillary or mandibular jaw for
installing the implants 1400.
[0135] FIG. 33 shows an embodiment of a method 2000 for implanting
a denture prosthesis in a partially edentulous patient. The method
2000 comprises providing 2100 a surgical template and a false teeth
set of the invention, positioning 2200 the surgical template over
the gum tissue of an edentulous jaw of a patient at a first
position, inserting 2300 the false teeth set into the surgical
template; instructing 2400 the patient to bite down on the false
teeth set with natural teeth of the jaw opposite the edentulous
jaw, confirming occlusion 2500 with the patient, and if there is no
occlusion, repositioning 2600 the surgical template, and repeating
until the patient confirms occlusion between the natural teeth and
false teeth set; and when occlusion is confirmed, fixing 2700 the
surgical template over the gum tissue of the patient's edentulous
jaw at a second position.
[0136] FIG. 34 shows an embodiment of a method 3000 for reducing
jaw bone in a patient. The method 3000 comprises installing 3100 a
surgical template of the invention, wherein the surgical template
has one or more sets of drill holes, perforating osteotomies 3200
through the drill holes in the surgical template to define markings
in the jaw bone forming a boundary for reducing bone, removing the
surgical template 3300 and exposing the jaw bone though an incision
to reveal the osteotomies, and using a surgical instrument to
remove jaw bone 2400 based on the boundary formed by the
markings.
[0137] The present invention has been described with reference to
particular embodiments having various features. In light of the
disclosure provided above, it will be apparent to those skilled in
the art that various modifications and variations can be made in
the practice of the present invention without departing from the
scope or spirit of the invention. One skilled in the art will
recognize that the disclosed features may be used singularly, in
any combination, or omitted based on the requirements and
specifications of a given application or design. When an embodiment
refers to "comprising" certain features, it is to be understood
that the embodiments can alternatively "consist of" or "consist
essentially of" any one or more of the features. Other embodiments
of the invention will be apparent to those skilled in the art from
consideration of the specification and practice of the
invention.
[0138] It is noted in particular that where a range of values is
provided in this specification, each value between the upper and
lower limits of that range is also specifically disclosed. The
upper and lower limits of these smaller ranges may independently be
included or excluded in the range as well. The singular forms "a,"
"an," and "the" include plural referents unless the context clearly
dictates otherwise. It is intended that the specification and
examples be considered as exemplary in nature and that variations
that do not depart from the essence of the invention fall within
the scope of the invention. Further, all of the references cited in
this disclosure are each individually incorporated by reference
herein in their entireties and as such are intended to provide an
efficient way of supplementing the enabling disclosure of this
invention as well as provide background detailing the level of
ordinary skill in the art.
* * * * *