CA2238016A1 - Dental implant systems and methods - Google Patents
Dental implant systems and methods Download PDFInfo
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- CA2238016A1 CA2238016A1 CA002238016A CA2238016A CA2238016A1 CA 2238016 A1 CA2238016 A1 CA 2238016A1 CA 002238016 A CA002238016 A CA 002238016A CA 2238016 A CA2238016 A CA 2238016A CA 2238016 A1 CA2238016 A1 CA 2238016A1
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- Prior art keywords
- prosthodontic
- impression
- implant
- temporary abutment
- temporary
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0001—Impression means for implants, e.g. impression coping
Abstract
This invention is a dental implant system having a temporary abutment (110) made of plastic. An impression coping (226), also made of plastic, is attached to the temporary abutment using a snap fit. This snap fit obviates the need to remove the temporary abutment during the process of taking an impression of the mouth in the area around an implant. The cap (218) may be provided for the temporary abutment that is attached thereto using the same snap fit mechanism.
The snap fit mechanism comprises projections (142) formed on one of the components and recesses (238) formed on the other of the components, where the projections engage the recesses to maintain the components in a desired position relative to each other against incidental force. However, these components may be separated by deliberate application of manual force when required.
The snap fit mechanism comprises projections (142) formed on one of the components and recesses (238) formed on the other of the components, where the projections engage the recesses to maintain the components in a desired position relative to each other against incidental force. However, these components may be separated by deliberate application of manual force when required.
Description
CA 022380l6 l998-05-l5 Wos7/17go7 PCT~S96J~8447 DENTAL IMPLANT SYSTE~S ~ND METHODS
~E~A~ED -APPLICATIO~S
This appli~ation claims prio~ity o~ U S~
Provisional Patent Applic~tion Serial No 60~006,955, ~hich was ~iled on Novem~er 17, ~995 ~E~D OF TH~ lNv~ ON
The present ~ventio~ relates to prostho~onti~ methods and apparatus and, ~ore ~peci~ically, to such methods and apparatus that simpli~y the making o~ dental impre~sion6 employed 15 to ~abrlcate a restoratlve tooth prosthesi~
BACKGROUND OF THE lN~lLO~
Many syste~s and method~ are c~rre~tly ~0 a~ailable ~or replacing lo~t ~eeth The~e systems and ~ethodY comprise the ~ollowing ba~ic steps, First, an implant is ~hreadcd i~to a cavity ~ormed in the patient's ~aw at ~he location o~ a los~
tooth The implant is then allowed to osseointegrate with ehe jaw bone. ~ technician will then ~abricate a pro~the~ic tooth on a permanent ab~tment member The p~n~t ab~tment me~ber is then attached to the implant to mo~nt the prosthetic too~h at its appropriate location In ~his context, the perm~n~n~ abutment membe~
~orms the s~ructural attachment between the prosthe~ic ~ooth and the implant, and the WO 9~ 90'7 PCT/US96~18~.~7 p~oythetic tooth ~unctio~ally and ae~the~ically ~eplac~S the exposed portion o~ the lo~t tooth It should be clear that this basic proce~s ca~ be e~ployed whe~ replacing a plu~ality o~
teeth as well as when replacing a ~ingle tooth I~ ~e ~ollowing disc~ss~on, the present i~vent~on is de~cribed in the contex~ of replacinq a si~gle to~t~; but one o~ ordinary skill i~ the art will recogni~e that the principles o~ the p~e~e~t 0 in~ention are equall~ applicable to the replacemenC o~ more than one Cooth at a time The step o~ ~abricating the prosthetic tooth varie3 with the particular patien~ but requires that the position o~ the implant ~e capt~ed ~o lS thac the resul~ing pro~thesis per~orm~ a8 required ~oth ~ctionally and aes~heticall~ the po~i~ion o~ ~he implant is no~ acc~rately captured, the resulting prosthesis may not ~nction properly and may not look nat~al when attached to the implan~
The pro~hesis ~abrication p~oc~ss comprises the steps Or taking an impressio~ o~ the area o~
the loYt tooth and, with the impression, ~orming a ~odel o~ the area o~ the lost ~oo~h The p~oces~
~5 o~ taki~g t~e impres~ion compri-~es the 8teps att~ ~g an impr~s~io~ coping to the implant, injecting ha~dena~le im~re~ion ma~erial into the area ~urrounding the impres8ion coping, and, when the impr~ssion material hardens, remo~in~ t~e impression ~aterial with the imp~ession coping e~cased ~herei~ ~o ~ab~icate the model, an analog o~ the implant is then at~ched to the imp~ession coping encased in the impression CA 022380l6 l998-05-l5 WO~7/17Yo7 ~cT~ss6/l8447 ~ardenable model material is then placed around the implant ~nalog ~d allo~ed to harden The model, with the imp~ant analog buried ~he~ei~, i~
then remo~ed ~rom ~he impres~ion The ~osition of ~he impla~t analog in ~he ~odel sho~ld, and in most ~y~tems will, re~lect the positio~ o~ the lmplant i~ the mo~th; that is, the model will contain ~ a~e~ correspondi~g to the surface~ o~ the teeth and so~t tis~ue, with t~ese ~odel ~ur~aces ~ei~g accuracely located ~elati~e to ~he i~plant analog. I~ the model acc~rately re~l~cts the po~i~ion o~ the implant in t~e m~uth, a techni~ian c~ ~ccu~atel~ ~abricate ~he p~os~hetic tooth in a labo~atory ~etting Whi~e most c~r~ently availahle ~ystems ~or replacing lo~t teet~ allow ~he ~abrication o~ a ~ model that acc~rately re~lects the poYition o~ th~
impla~t in ~he mouth, these sy~tem~ each have dr~wbacks ~hat, i~ general, re~lt in the proces3 o~ replaciny lost teeth ~eing ~airly compllcated ~d expensive To the Applica~t's knowledge, all o~ t~e c:~erLtly a~ailable ~stems and methods employ metal pa~t~ down to ~he i~plant during the proce~
25 of taki~ the impres~ion. Such metal partfi a~e precision machined and thus ~ela~i~ely expensive Although metal parts are in theory -eusable, they must ~e sterilized be~wee~ each use. ~nd even i~
~terilized, these me~al pa~ts are o~ten di~ic~lt ~o clean completely Acco~di~gly, in practice the~e parts are o~ten discarde~ a~ter ~eing ~sed once to eliminate the possibility o~ cros~-cont ~mi n~ tion.
CA 022380l6 l998-05-l5 Wos7/17sO1 PCT~Ss~/18~7 -~ he u~e o~ metal par~s al~o i~crea~e5 the complexity o~ previo~ly availabl~.gy~tems o~
methods ~or replacing lo~ teech ~ore speci~ically, during t~e proces~ o~ taking an lmp~es~ion a~d -~ubgeque~tly creatlng a model ~rom t~at impres~ion, it i9 necegg~ry ~o temporarily ~oin two component~ togecher ~i e., the lmp~es~ion coping is joined ~o the implant and ehe implan~
analog is joined to the impre~sion coping) Usi~g c~re~tly a~ailable ~y~tems, whene~e~ two metal compo~e~t~ are temporarily joined together, one o~
two methods must be used~ ~a) one o~ the co~ponents m~t ~e directl~ threaded onto the otherj or (b) one o~ the compone~t~ is in~ernally l~ threaded, the other component i~ ~threaded, and a separate screw enga~es the threade~ component to a~ac~ t~e unthreaded c~r~n~ to the threaded component I~ the ca~e whe~e both o~ the component~ a~e thr~, one component is ~eual1y ~ixed and the other is rotated relati~e ~o ~he ~ixed compone~t For one component to ~e direccly th~eaded on~o another, one o~ the~e component~ must be ~reely rotatable relati~e ~o ~he other Por ~x~mple, i~
certain s~e~s, healing abutmen~s are pro~ided with a threaded po~ ex~e~ding ~here~rom. To at~h the ~ealing abutme~ to the implant, ~he healing ab~tment is rota~ed relati~e to the implant such that ~he threaded poRt ~or~d thereon is received within the ~hreaded ca~ity dE~i~ed by the implant Rotati~g one component rela~lve to the other i~ ~ot po~ible in ma~y ~it~atio~s; ~or example, WO g7/l7gol rCTJtJS96~18~47 this is not possible when one o~ the componen~s is an impl~t ~lxed withi~ the mouth and the other i9 an impression coping ~xed within an impression Accordingly, with previou~ly available 5 systems, ~he ~arious co~po~ents employed a~e attached to each other ~sing threaded screws du~i~g the proce~s o~ taking an impression and making a model there~rom. A screw is ~qed to 3ecurely attach the impression coping to the 0 implant while the l~p~essio~ ~aterial is injected around the impression copi~g. And a screw is also ~sed to attach the implant ana~og to the i~p~ession coping d~ring the process o~ ma~ing the ~odel ~rom t~e impre~sion ~he use o~ screws to attach the impression copi~g onto the implant increa~es the complexity o~ the process o~ taking the imp~ession. The ~e~tis~ must thread the Ycrew into ~he impla~t ~e~oxe the impression is taken and remove the scre~ ~rom the imp~an~ to remove the impression ~rom the mo~th A~other i~porta~t drawback o~ p~io~ art sys~ems and methods o~ ~eplacing teeth is that ~hese s~ste~s c~m~ly employ 2~-30 components Z~ each ha~ing a speci~ic purpose Many o~ these co~pone~t~ ~ork o~ly with ~ ~peci~c sub~et o~
othe~ components In any case, all o~ the componentY o~ a ~iven ~ystem m~st kept i~ in~entory And accu~ate reco~ds be kept to e~sure that the oral surgeon, den~ist, a~d laboratory technicia~ all have the risht ~artq a~ ~he right time. Further, because these components a~e small and man~ di~er only i~
wos7rl7~o7 PCT~S9G/IX~47 si~e, the di~erence between one co~pon~nt ~nd anot~er i~compacible component may not be ob~io~
to the n~ked eye, pos~ibly result~ng in confuYio~
among various gi~i7~ looking parts.
The ~act ~hat certain components work only with certai~ other components reduces the ~lexibility o~ ~he ~em For example, in certain prior art sy~tem~, the pe~m~t ~butment member must be selected prior ~o ~he process o~
maki~g the i~pression because a parricular impressio~ coping mu~ be used ~or t~e selected permane~t abutment. I~, ~ubse~uently, the dentist or la~oratory technician dete~;~ that another type o~ permanene abutment is more appropriate, a lS ne~ imp~ession with a di~erent impression cOpi~g m~st be made.
REhATED ART
ZO Perhaps ~he mo~t co~mon comme~cially a~ailable dental lmplan~ system is ma~keted by Br~n~m~k~ The Branemark syste~ employ~ a la~ge num~er o~ metal componen~s that are relatively expensive. Additionally, as generally ~isc~ssed ~S a~ove, the denti~t mu~t decide at ~he time the impresslon is made what type o~ p~t abutmen~
~ill be ~sed ~o ~abricated the prosthetic tooth.
This red~ces the ~lexi~ility o~ the overall process, because a ~ew impres~ion must be ~ake~ lr i~ i~ later det~m~ n~ that a di~erent type o~
p~m~n~nc a~tment member is more appropriate ~ ra~emar~ also marke~s a specialized single tooth den~a~ implant system under the trade ~ame Wos7/l79o7 PCT~S96/lS447 ~7-CeraOne, The CeraOne p~oce~ employs a t~taniumabutment that is attached to an impla~ a~ter se~o~d ~tage ~urgery. This abutme~t has an elo~gate exposed portion that extend~
substantially above the gum line, a~d a ~lexi~le, synthe~ic polymer he~li~g cover i9 placed over the abutment while the tiss~e he~l~ a~ter s~cond s~age surgery To take an impression u~ing the Ceraone p~oduct, impression material is pl~ced aro~nd ~he hea~ing co~er ~nd allowed to har~en The impres~io~ i remo~ed ~rom the mouth, with the healing cover sliding o~ o~ the ex~osed elongate po~tion o~ the ~eali~g abutme~t.
The ~eraOne product may be used to replace only ~ single tooth; the cover that s~ip~ on and o~~ o~ the elongate proj~ction on the he~ling abutment pre~ent 5 a~ impreqsion bei~g taken o~
more than one impla~t ~ecause the implants a~e normall~ not parallel The cover~ wo~ld not ~e able ro slip o~ the non-parallel projections on the healing a~utmen~q r And in prac~ice, th~s co~er i~ typically not used while the g~m ti~sue is allowed to heal a~ter second staye qurgery Z5 becau~e the material ~rom which i~ is made ~ends to ~b~orb odors and become ~nc~ean even during thi~ rela~ively short pe~iod.
A third type o~ rele~ant dental implan~
~y~tem i~ marke~ed by 3~ under the trade name EPS
30 The EPS system i~ similar to the ~ranemark Qystem ln that it uses a large number o~ metal componen~s. ~he EPS sysLem is al so typical i~
tha~ membe~s such aQ heal~n~ abutwents or cap~ are WO~7/17gO7 PCT~Ss6/ts447 .
~hreaded to allow them to be directly attached to ~he implant And the EPS Cystem employs a separate ~crew to atta~h imp~e~sion copings a~d p~n~t ~b~ents onto t~e i~plant S ~he need thu~ exist~ ~or den~al implan~
system~ and method~ ~ha~ are simple to implement, allo~ che den~al pro~e~ional ~lexi~ility in th~
seleceion o~ per~anent ab~tment~, require ~ewe-step~ durin~ ~abrication o~ ~he prosthetic tooth, and are le8g expensi~e than those c~rrently ~vall~le on the mar~etplace OB~CTS O~ ~H~ I~v ~:N l'10~
From the ~oregoing, 1~ should be apparent ~hat one object o~ the present invention i~ to pro~ide an improved ~y5temS and me~hod~ ~or replac~ng los~ tee~h.
Another more speci~c o~ject o~ the pre~ent in~ention i5 to p~ovide s~ch me~hod~ and yys~çms ha~ing a ~avorable mix o~ the ~ollowing ch~racteristics:
mi~im;zes the ~e o~ expensive, precision mi~led components, reduces the ~um~er o~ pa~ts that must be kept on hand to implement such Sys~ems a~d mechods;
employs low pro~ile part~ that allow a f lapper Co be ~orn a~ter ~ir~t and second ~tage s~rger~ ~e~ore ~he prosthetic ~ooth is permanently attached to the implanti CA 022380l6 l998-05-l5 ~WO97/l7907 rcT~s96ll8~47 ~ simpli~ies the process o~ ~aking an impre~ion accurately captu~e~ the emergence pro~ile o~
one or more implan~s in a patie~t~q mouth.
delays the deci3ion on which type o~
permanent abutment will b~ ~sed to maintain ~or a~ long a~ po~ible ~lexibilit~ in ~he ~electibn o~ th~
permanent ab~tment member;
allo~s the ~se o~ techniq~es that are sui~able ~or ma8s production resnl~ing i~ co~pone~t~ th~ m~y be dlscarded a~cer a single use t~ prevent croxs-conr~ eio~; and can be used with i~plant~ and pe~ane~t ab~tment~ ~urrently availa~le on t~e mar~et SU~M~RY OF THE lNv~ O~
These and other obj ects are obtalned by the prese~t in~ention, which i~ a ~tem or method ~o~
replaci~g lost teeth The present in~entio~
employs a ~emporary abutment ~ha~ 19 atta~hed ~o an ~mp~ant membe~ d~ing seco~d stage 3~rgery Th~s temporary ab~tment member is le~t on the implane when ~he den~i~t ma~es an impre~sion o~
the area o~ the mouth su~ro~ndin~ t~e i~plant~ To capt-~re the loca~ion o~ the impla~, an impre-q~ion ~ea~her iq attached to the temporary abutment using a snap ~i~ The te~por~r~ abutmen~ and impression coping are ~oth m~ o~ pla~ic and one CA 022380l6 l998-05-l5 wo97/~7so7 PC~ss6t18 o~ t~ese is pro~ided ~ith the projec~ion and th~
o~he~ with an indenta~io~. ~he projection engages the inde~tation whe~ the i~pres~ion coping i~ in the appropriate position relative to the temporary abu~ment and maintains the impre~ion coping in this position throughout the process o~ in~ect~ng impre~ion materlal a~ou~d ~he impression coping.
When the imp~eqcion material hardens, the entire impre~sion may ~e ~imply li~ted away ~rom the implant The snap ~ hat ~ounts the impression coping on ~o the temporary ~butment i3 designed to allow ~nll~l remo~al o~ the ~mpression coping, and thus the impression i~s~l~, ~rom the implant.
F~o~ the ~oregoing description, i~ should be see~ that t~e dentist doe~ ~o~ need to remove the temporary ab~tment be~ore ~a~ing the lmpres~ion ~he dentist need only ~nap on the lmpression copins ~nd m~ke ~he impre~3io~ This signi~ica~tly ~educes the a~o~nt o~ time required to ta~e an impression.
When ~he impression is deli~ered to t~e la~o~atory ~or the pu~pose o~ manu~acturing a proqthetic tooth, a temporary abutment and ~nalog o~ the i~er~ are snap fiC onto the exposed portion o~ the impress~on coping. Model material 15 then placed around t~e implan~ analog a~d allowed to harden ~t this poi~t, the model may be simply li~ted away ~rom the impre~sion, with the snap ~it ~ormed between th~ temporary abutment ~ttached ~o the im~lant analog and the impression coping easily being ove~co~e ~y deliberate applicatio~ o~ o~ce CA 022380l6 l998-05-l5 s7/~7sn7 PCT~S96/lX447 The model ~hus con~ains an implant an~log that captures ~he position o~ the implant in ~he mouth The la~oratory-technicia~ ~ay ~h~n ~abricate the prosthetic tooth on the model using S conventional technique~.
Signi~icantly, the decision on the type o~
permanent abllt~ent that is to ~e ~sed ca~ ~e delayed until a~er the model has ~een made. This allows the laboratory technician ~lexi~ility in ~electi~g a~ appropriate pe~m~nt a~utment member e~en a~ter the i~pre~sion ha~ been ~aken Tn the abo~e ex~mple, the snap ~it ~as described in the prQcess o~ taki~g a~ impressio~
Q~ the locatio~ o~ a~ i~plant mem~er in a mou~h The sn~p ~it employed during this p~oceqs may also be ~sed ~or othe~ compo~çnts Fo~ example, a c~p may ~e attac~ed to th~ tempor~ry a~tme~ d~ri~g the h~aling p~riod a~ter the second stage ~rgery S~ch a cap wo~ld pre~en~ ~ood and o~e~ de~ris ~orm getting i~o ~he interio~ o~ the ~e~porary abutme~t, but i~ easily removed by the de~tis~
using readily available tools l~i~tely p~io~ to che attachme~t o~ the ~mpre~ion coping o~to the ~e~pora~y a~tme~t.
Formi~g a temporary abutment o~t o~ plastic as described herein pro~ides ~igni~icant .
~lexibili~y i~ the design o~ the temporary abu~ment member Thi~ abutment member may ~hu~ be adapted to match an existing implant or permanen~
~b~tme~t cur~ently on the market ~ 190, t~e ~emporary a~u~ment member may be mas~ prod~ced usin~ iAj ection ~oldi~g techni~ue~
Th~ pre~era~e ~aterial ~or ~he plas~ic compo~e~t~
CA 022380l6 l998-05-l5 ~O97/l7907 PCT~$96/1~4~7 -12~
u~ed in this sysrem is an acetyl copolymer. This material may be accurately injec~ion molded, has g~icien~ rigidit~ to ~unc~ion as set ~orth ~o~e, is d~ble, and is biocompati~le A den~al impl~nt system or method const~ucted in accorda~ce ~ith the pre~ent in~en~io~ gr~atly ~educes the number o~ part~ req~ired to provide a ~lex~ble de~tal implant ~ystem~ s~bYtantially r~-lce~c ~he ~o~t o~ many o~ the~e c~mp~nents, and pro~ide~ 6ig~i~icant ~lexi~ility not hereco~ore ~een ~ ~uch ~y~tem~ a~d ~ethod~, BRIEF D~s~RIp~IoN OF THE DRAWINGS
FIGS 1-16 depict a prosthodontic proced~e emplo~ing the principles o~ ~he present i~vention FIG 17 ~epicts an exemplary i~plant u~e~ in ~he p~ocedure dep~ct~d in ~IGS 1-16 FIG 18 ~epicts an exe~lary a~tmen~ screw 2~ a~embly as used in ~he procedure depicted i~
PIGS~ 1-16.
F~GS. l9A-D depict a~ exemplar~ tempo~ary abutmen~ as us~d in ~h~ procedu~e depic~ed in FIGS. 1-16.
FIG 20 depicts ~n exemplary abut~en~ cap ~sed in the procedu~e depicted i~ FIGS 1-16 FIG 21 depiCt~ an alrernati~e ab-~tmer~t screw assernbly ~h~t mi~y be used in many ~itua~cions in place o~ the ablltment screw a~;sembly shown in FIG.
18.
~?IGS 22A-B depict ~n exemplary impres:3ion i~eather used in the proced~re depict~ed in FIGS 1-7/179U7 Pc~ss6/l8~7 FIG. 23 de~ictq an exemplary pick up post that may be used to take an impressio~
FIG 24 depic~s a ~rgical impresqio~ coping tha~ may be u~ed to take an impre~qio~ d~rlng stage on~ ~rgery.
FIG 2S depictq a temporary cylinder thac may be used to take an impre~sion FIGS 26 and 27 depict ~embers th~c may ~e ~sed d~:~ing the rest~ratio~ p~oc~ss ~o~ ~eplaci~g a tooth with a temporary tooth to allow ~or ~urther maturation o~ the implant in the hone;
FI~S. 28 and 29 depict alternative screws that ma~ be employed to attach the temporary ~ menc o:E l~he pr~sent in~rentio~ to an imp~ant;
FIG 30 is a ~ront, ele~ational cut-a~ay ~ie~
depicting a another exemplary temporary a~utment, implanr member, and snap ~it sys~em;
~ G 31 is ~ cutaway ~riew takell along lines - 31--31 in FIG. 30:
FIG 32 is a ~ront eleva~io~al view depicting an impression ~eathe~ ha~in~ a ba3e portion that ~orm~ a part o~ the snap ~it sys~em shown in FIG
31;
FIG 33 is a bottom plan ~iew o~ che impre~sion coping ~how~ in FIG 32;
FIG 34 is an ele~ational c~t away ~iew depicting yet anoth~r exempla~y temporary abutment and implant: and FIG 3S i~ a ~ront, ele~a~ional, cut-away ~iew depicting a screw employed to mount the tempor~r~ cylinder o~ FIG. 26 onto a te~porary a~tment member.
~Og7/17901 PCT~S96/18447 D~TAI~E~ ~ESCR~P~O~
Re~errlng i~iti~lly ~o FIGS 1-16, deplcted therein is a pro~thodontic procedure ~or ~abric~tin~ and implanti~g a tooth ~ro~thesis This pr~cedure employg a ~y~tem ~or m~king impre~ions constructed in accorda~ce wit~, and embodying, che principles o~ the p~ese~t in~en~ ion.
0 A~ an o~erview, ~he prost~nAontic procedure shown in ~IGS 1-16 can be broke~ down into ~ive di~tinct phase~ each comprislng a number o~ ~teps-P~AS~ 1. FIGs 1-4 ~how what is re~e~red to as stage one ~yëry in which an lmplan~
i9 placed into the jaw ~one PXASE ~: FIGS. ~-7 depict what is ~e~e~red to as ~ta~e two ~rger~ in whioh a healing a~t~e~t i~ attached to the in~pl a~
PHAS~ 3~ ~IGS 8-11 depict the ~mpression ~tage ln whi~h a~ impre~sion is made o~
the patle~t's mo~th PHASE 1. FI~S. 12~15 depict the ~estor~tive phase in which the imp~ession is used co ~abrica~e a prosthetic tooth PHASE 5: FIG 16 deplcts the ~inal stage in which the pros~etic tooeh is mo~nted o~to th~ implant To provide some perspective, initial re~erence is made to FIG 5, which -~how~ a portion o~ a patie~t~ mo~th lO whe~e a gap 12 exis~
bet~een ~ir~t and second adjacent ~eet~ 14 and 16 Sho~n at 18 i~ FIG 5 is the ~i~e at which the ' ~09qll7907 PCT~S96/1~7 ~ prosthetic too~h i~ to be located FIG. l is a sligh'cly enlarged cut-away view o~ the patient ' g mout:h 10 ~t t}~e gap 12 ~ddl~ionally, du:ciny ~he p;~oces~3 depicced ir 5 FIG~ 16 ~he variou~ steps ~ill nonmal~y be per~ormed by a periodon~ist or oral surgeon, denti~t, and laboratory te~hniclan~ In particular, a ~urgeon will n~m~l ly per~orm the steps a~sociated wi~h Pha~es 1 and 2 descri~ed 10 abo~e, a dentist wil~ per~orm ~he steps as~ociated ~ith Phases 3 and S, and laborato~y technicianx will per~o~m ~he step~ aq~ociated with Phas~ 4 D~ring the ~ir~t pha~e o~ the prosthodo~tic procqd~re, o~ten ~e~er~ed to a~ st~ge one ~urgery, the ~urgeon makes an incision in the patient's gum 20 to expose ~he edentulous, or jaw, bone 22.
T~e s~rgeon t~en drill~ a ~ole 24 in the jaw bone 22 (FIG. l) The surgeon then taps the inner ~ur~ace 2 6 o~ t~e jaw bone 22 surrounding the hole 24 such that chis sur~ace 26 is ~hreade~
(FIG. 2) ~ me~allic ~ixture insert 28 ha~ing a threaded outer sur~ace 30 ma~ching the inner ~ur~ace 26 is then threaded in~o ~he ho}e 24 in the bone 22 ~FXG- 3)-The insert 28 also has a ~hreaded inner ~ur~ace 32 de~ining a ~crew chamber 34 A~ter ~he in~ert 28 has been threaded in~o the ~aw ~one 22, a ~o~er screw 36 is threaded into the screw c~amber 3 4 - The gum 20 ls then sut~red as sho~n at 38 s~ch that the gum 20 ~overs t~e entire ~mplant 28 and ~over scre~ 36 (FIG 4) At this point, sta~e one surgery i5 complece and the p~tie~ enters an osseointegration period CA 022380l6 l998-05-l5 ~097/17907 ~T~S9~l8447 o~ approximately ~-6 months The o~eoin~egration period allow~ the jaw bone to in~egrate the implant 28. During th~ o~eoin~egration period, ~rima~ily ~or cosmetic reaso~ the patie~ will ~s~ally wear wha~ i~ re~erred ~o as a ~lippe~ (~ot shown) over the imrl~nt si~e 18 A~er the impla~t 28 has been i~tegrated ~to the jaw ~o~e 22, ~he patien~ enter~ the seco~d phaqe o~ t~e procedure, commonly referred to as phase two surgery, in which,the s~rgeon attaches a temporary ab~m~nt 4Q onto ~he insert 28~ To ~ccqmp11sh this, the surgeon assembles an ab~t~ent screw 42 on~o the temporary a~u~ment 40 (FIGS. 5 and 6~ The abu~me~t ~cre~ ~2 passes ~hrough the lS temporary a~t~e~t 40 and into the ~rew c~vity 34 ~ormed in the i~sert 28. The abut~e~t screw 4~ i~
the~ tigh~ened to attach the temporary abutme~t 40 onto t~e i~sert 28 (FIG 7) ~n abutme~t c~p 44 is placed o~to t~e t~mpo~a~y abutme~t 40 over ~he screw 42 (FIGS 6 and 7) The gum tissue is then allowed 1-3 we~kq ~o heal The temporary abutment 40 and abutment cap 44 are m~de with a low prof~ile f3uch that:, when installed, they are approximately sa~e level as the gum li~e. Accordingly, while the gum ti~s~e i~ ~ealiAg around the temporary ab~me~t 4O, a ~lipper may be worn over location 12 witho~C
inter~e~ence by the temporary ab~tment 40 or a~utment cap 44.
~0 A~ter the g~m has healed ~rom the a ~e~ts o~
sta~e two s~rg~r~, ~he pa~ient goe~ to ehe dentist re~ponsible ~or the restoraci~e wor~ The dentist will initially remove the cap 44 a~d attach what Wog7/17go7 PC~S96/18~47 - will be re~er~d to ~erein as a~ i~pre~sion ~eather ~ 6 onto the ~empora~y a~utment 40 ~FIG.
8~. ~he dentist then positions an impression tray (not shown) ove~ ~he impregsion ~eat~er 46 and inserts impresslon mate~ial 48 in~o the imp~e~sion tray around the impressio~ :~ea~he~ 4~i ~a~ well ag the Y~rrounding gum and teeth).
The i~pression material 48 solidi~ies to ~orm an impression 50 comprising the solidif~ied impres~ion ma~erial ~8 and th~ impre~sion ~e~ther 4~ ~FIG. lO). The imp~ession 50 is remo~red :E~om the paeient ' s mouth and sent to the laboratory ~or the restorati~e ~ork Upon recei~ing the impression 50 ~rom the denti~t, the laboratory technician~ will ~o~m an a~alog assembly 52 ~omprising a~ i mr- ~nt 2~nalog 54, a tempora~y ablltme~t 56 iden~:ical ~o ~he a~u~ment 40 attached to the implan~ 28, and a screw 58 to hold the implant analog 54 and 20 t~mporary a~utment 56 together (F~GS lO and ll~
The temporary abutme~t 56 is ~hen a~tac~ed o~to the impression ~at~e~ ~6 ~eh that the implant analog 52 is ~paced a~d extends from the impression i~eather 46 in the ~ame nlFlnn~r as the 25 implant 28 (E':~:G 11) ~
Model ma~erial 60 is then pla~ed onto the impression 50 aro~nd the ~n~lo~ as~embl~ 52 (FIG
12). The model material 60 solidi~ies to ~orm a mo~el 62 and the impre~sion 50, incl~di~g ~he i~pression ~eather 46, is removed ~rom the model 62 At ~his point, the temporary ~utment 56 is still ~o~ed on ~he ~mplant a~alog 54 by ~he screw 58 (F~G 13).
CA 022380l6 l998-05-l5 Wo97/~79ol Pc~sY6/ls .
The next step is to remo~e the 3crew 58 and temporar~ abutment 56 from the model 62 (FIG. 14) The model ~o~ corresponds to the patie~t~s ~o~th, wi~h the implant analog 54 at a location corre3p~ to tha~ o~ the Implant 2~ in the patient ~FIG. 14).
~ t this poin~, a p~t abutment 64 may be selected and attached to the implant analos 54 to allow the ~abrication o~ a tooth prosthesis, or replacement tooth, 66 ~G 15~
once the replacement tooth 66 has ~een ~ab~icated, the patient goe~ ~ack to the de~tist ~here the t~mporary ab~t~ent 40 is removed and the permanent ab~tment 64 and ~eplacement tooth ~6 a~tached to thè implant 28 (FIG. 16).
The prosthodontic procedu~e desc~ibe~ above will vary depending upon s~ch ~actors as the desires o~ the patient, the te~igues employed by the s~geo~ and denti~t, a~d the type o~
~e~o~ati~e work invol~ed. Within this ove~all conte~r, howe~e~, the systems a~d methods o~ rhe present invention pro~ide a numbex o~ bene~its ~ o~ e~ample, ~he qyqtemq and method~ o~ the preqe~t inventio~ g~eatly gimplify the dentist's Z5 job d~ing Phase 3 when the denti~t makes the imp~e~q_ion The dentiqt need only remo~e the ab~tme~t cap a~d insert the impre~ion feather be~ore making th~ impre~sion. A~ter the imp~ession is removed, the denci~t simply replaces ~he ~butment cap The den~ist need not remove and reinsert ~he he~llng a~utm~nt when making the impresqion WO97~17~7 pcT~ss~/l8447 Additionally, the ~tyle O~ Rermanent abutment may be selected in the laboratory during Pha~e 4 and need not be known ~t the time the i~pre~sion is made The present invention thus ~reatly S gimpli~ies the denti3t~ job by reducing the ~umbe~
o~ i~plan~ parts that the dentist must ~eep in in~entory and ~rack ~or each patient A~other i~port~nt aspect of the pre~ent invention iq ~bat certain ~ey parts may be made cheaply ou~ o~ disposa~le pla~tic and ~ot out o~
surgical grade metals In particu~a~, the Cemporary ab~me~, abutment capJ ab~t~ent ~c~e~, and impres~io~ ~eather may be made wholly or i"
part o~t o~ plastic ~a~ing ~hese p~rts out o~
plastic allow~ them to made c~eaply enough to be di~posable and obviate~ the need to ~terilize them between each use Re~e~ri~g now to FIGS l~-35, a number o~
components that may be ~ed with the basic p~oçed~re descri~qd in relation to FIGS~ 1-16, or minor ~ari~tion~ thereo~ r wil 1 be descri~ed The proc~dure depicted in ~IGS l-l~ may be per~ormed with imp~ve~ res~lts over similar prio~ a~t methods witho~t the e~act component~ desc~i~ed in rela~ion to ~IGS. 17-35, ~ut these compone~ts opti~ize ~he per~ormance o~ thi~ procedure Be~ore desc~ibi~g the particular~ o~ the components depicted in FIGS l7-35t seve~al impor~ant concepts ~hould ~e expl At the hea~t o~ the proces~ d~picted ~n FIGS. l-16 a~e th~ temporary abut~ent~ 40 and 56 The~e abutments are intermediate members tha~ transition between the implant 28 (or implant analog 4~) and WOs7/~7901 PCT~S~/1s~47 one or more o~her components the positions o~
which need to be ~lxed rel~tive to ~he ~mplant The ab~tments 40 an~ SÇ thus per~onm two ba~ic ~u~ction~ they engage the implant ~8 and they ~o~m a snap ~it cha~ securely mounts ~other component rela~lve to t~e implant (or the analog thereo~) The physical ~ructure ne~e~ary to engage ~he implant ls depe~de~t ~pon the exact imp~ant selected Tempo~ary ~t~ents having structure necessary to engage th~ee ~mm~cially a~ailable implan~s are depic~ed in FIGS. l9A-D, 28, and 29 Othe~ st~uctures may be similarly ~ormed to engage othe~ impl~n~s not disc~ssed in thi~ applica~ion ~he ~ormation o~ th~ app~opri~te ~truc~ur~ ~or a glven implant type can be easily implemeneed d~ing ~he proce~s o~ ~abricating the mold ~sed to man~acture a gi~en t~mpo~ry abutment And typically, it will be ~ece~ary ~o m~nllfact~e and 2~ carry in inventory tempo~ary ab~tme~ts havi~g ~truceure adapted to engage a~y implant that is co~merciall~ a~ailable on a ~ig~i~i~ant le~el The snap ~it o~ the present invention can ~lso be formed in one o~ a number o~ di~erent Z5 ways A ~irst exemplary snap fit iS embodied in the components shown in FIGS l9A-D and 20, 22~-B, 26, 27, 28, and 29. A ~econd exemplary snap ~it ~ys~em is em~odied in the components ~hown ln FIGS 30-3~. =
The exace deta~ls o~ the ~nap ~it a~e not critical to implemen~ the principles o~ the presene inven~ion a~d o~her snap ~it systems may be e~p~oyed with 5~m;1~ ~ect To ~nc~ion ... . . . .
flexibly and reliably, the snap fit systems of the present invention have two characteristics: first, they are formed of projections and depressions that mate to positively hold one member onto another; and second they have a geometric shape that can be used to key one component relative to another. While both of these characteristics have advantages in the particular environment described, the present invention can be practiced with snap fit systems having either or neither of these characteristics and still obtain certain advantages over the prior art.
Once the details of the snap fit are determined, all components should be manufactured with the selected snap fit. Unlike the situation in which a number of different temporary abutments will normally be manufactured to match each style of commercially available implant, only one snap fit system needs to be and should be employed.
The various components used to implement the basic prosthodontic procedure described above with reference to FIGS. 1-16 will now be described. In the following discussion, the geometry of these components will first be described in detail, after which the function of the component geometry will be discussed.
Referring initially to FIGS. 19A-D, depicted therein at 110 is a temporary abutment identical to the abutments 40 and 56 described above. The temporary abutment 110 has a longitudinal axis A, an outer surface 112, and an inner surface 114 defining a centrally extending bore 116.
-CA 022380l6 l998-05-l5 WOs7t~7907 pcT~ss6/l8~7 ~ h~ o~er ~r~ace 112 comprises an ~pper por~ion 118, a ~ide portion 120, a~d a lower portio~ 122 The upper and lower sur~ace portions 118 and 122 are ~lat and generally arcua~e. The ~ide ~ac~ portion 20 comp~ise~ a gene~ally cylindrical upper area 124 adjace~ to ~e upper s~r~ace portion 118 and curved lower ~ea 126 ~ adjacent to the lower sur~ace portion 1~2 The low~r area ~26 is ~moothly and continuouqly c~rve~
~rom the upper area t 24 to ehe lower sur~ace por~ion 12~, The inner q~r~ace 114 de~i~e~ ~he shape o~
t~e ce~tral bore 116 such tha~ t~e ~or~ 116 comprises a lock portion 128, a ~crew receiving portion 130, and a he~ receiving portion 132 A~ perhaps ~e~t shown in FIG l9A, the loc~
portion 128 o~ the central bore 116 has ~ ~hape that ~ill be re~erred to ~ereln a~ ~coronal1', In pa~tic~l~r, ehe lock portion 128 is ~e~ined by a ZO generally cylindrical ~irst portlon 134 o~ the inner sur~ac~ 114 having a diameter dl Vertic~l groo~es 136 ~onmed in ~he inner sur~ace ~irst portion 134 ~urther de~ine the shap~ o~ the lock po~tion 128 ~dditionally, a locking groove 138 (FIG 19D) is ~ormed on the ~irst portion 134 o~ the inner ~ur~ace 114 ~he ~ertical grooves 136 extend t~ough the inner ~ur~ace ~irst ~ortion 134 and the lockiny groove 138 guch that ~he inner sur~ace portion 13g and ~he g~oo~e 138 are disconti~uo~
The screw recei~ing portion 130 o~ the central bore 116 is de~ined b~ a ~e~e~ally cylind~ical seco~d po~tion 140 o~ the i~er WOs7Jl7gO7 PCT~S96/18~47 sur~ace 114 having a diameter dZ This diameterd2 is less than ~he diameter dl o~ the inner ~ur~ace ~irs~ por~ion 134. A rounded, a~nular, horizontal re~aining projection 142 extends ~rom ~he inner ~ur~ace second portion 140 ad~acent to the central ~ore lock portion 12R.
The hex portion 132 o~ the centra~ bore is de~~ned by ~ six-sided hex por~io~ 144 o~ the inner ~ur~ace 114~ Th~s shape is pe~haps be~
~hown i~ FIG~ l9C
Fir-qt a~d seco~d conical port~ons 146 and 148 o~ the inner sur~ace 1~4 are ~o~med o~ a triangular, annular, horizontal projectio~ 150 arran~ed be~wee~ the i~ner surface ~eco~d portion l~O ~nd the ;nner sur~ace hex portion 144 The conical ~r~ace portio~s 14~ and 148 meet at an ann~lar tran~itio~ rid~e 15~ The conical e~r~ace po~io~ 146 and 148 an~ transicion ridge 152 de~ine a transition portion 154 o~ t~e cent~al bore 116 Re~erri~g now to F~G 18, depicted therein at 156 is an abutment screw asYembly ldeneical ~o the abutment screw as~emblie~ 4Z a~d 48 described a~ove~ The ~ut~ent screw assembly 156 co~prise~
a screw body 158 and an O-ring 160 The ~crew body lS8 has a ~hre~ded internal ~ace 16~ and an external s~rface 164. The e~te~al s~r~ace 164 comprises, ~rom bottom to top i~ FIG 18, a threaded portion 166, a ~ha~t portion 168, a conical portion 170, an i~creaYed diameter po~ion 172, an O-ri~g ~roo~e 174, and a hex body 176.
W O ~7/17~07 p ~ Au~s6/lS4~7 To obtain che as~en~bl~ 156, the O-ring 160 is seated in ~he 0-ri~g groove 174 When ~o ~eated, incidental movement bet~een the screw body 158 a~d the 0-~ing 160 i~ p~e~ented ~e~errin~ now ~o FIG 21, depict~d therein i3 a~ a~utment scrèw assembly 178 ~ed in a manner ~imlla~ to the a~utment ~crew assem~lies ~2 ~d 48 deqcribed above ~he abutmen~ ~crew assembly 178 çomprises a screw body 180 aud a sea~ing cap 18~ The ~crew ~o~y 180 is a simple cylinder with a~ externally th~eaded o~ter ~r~ace 184 The ~e~ting cap la2 has an outer ~ur~ace 186 having a ~yl~ndrical portio~ 1~8, a conical por~ion 190, ~nd a hex 1~ portio~ lgZ The seating ~ap 182 i~ ri~idly connected to ~he screw body 180 s~ch t~at axial rotation o~ the ~ap 182 is transmltted to the ~od~
Re~erring now to FIGS 28 and 29, t~e~e ~igures illus~rate how ~he abutment ~crew assemblies lS6 and 178 engage the te~porary ab~tment 110. In both cases, the annular re~i~;~g projection 142 o~ t~e inte~io~ sur~ace 114 o~ ~he a~tme~t 1lo engages a portion o~ the screw assembly such thae the ~crew assembly is cape~red within the central ~ore 116 More particularly, as ~how~ in FIG 28 the ~lexible 0-ring 160 hag ~ slightly larger diameeer than the annula~ retaining projection 142 The screw a~sem~ly 156 may be inser~ed into the cen~ral hore 116 such that t~e O-ring 160 is wi~hin the .~cre~ receiving por~ion 130 o~ the central b4~e 116, howe~r, because the o-ring 160 CA 022380l6 l998-05-l5 ~ W~97/17907 PCT~S96/1844 i co~preg~ible and de~l~c~s ~lightly to allow it ~o ente~ the screw receivi~g portion 130 Once the O-ring is within the bore por~ion 130, ~he O-ri~g ~o wil~ e~gage t~e retaining pro~ection 142 to p~e~e~t inadvertent ~emoval o~ the ~crew as~embly 156 But deliber~e applicatio~ o~ ~orce in a directio~ shown by a~row C will cause ~he O-ring l~O ~o compre~s and allow the screw as.qembly 1~6 to ~e removed ~rom the central bore 116.
Similarly, as show~ in FIG 29 the conical sur~ace l~O o~ the screw a~embly 178 ha~ a slig~tly la~gex diameter t~a~ t~e annular ret~;ng projec~ion 142. By manu~ac~ing at l~ast the sea~ing cap 1.82 o~ the screw assembly 178 o~t o~ pla~tic, the part~ m~y be ~abricated s~ch that ~he conic~l ~ur~ac~ l9O will pa~s by ~he re~n;~ projectio~ 142 such t~at ~he hex body 192 is within the scr~w recei~ing portion 130 o~
the cent~l bo~e 116 Onc~ the ~onical ~r~ace i~
withi~ the bore portion 130, the ~eati~g cap 182 will engage ~he retaining projection 142 to pre~ent inadvertent remo~al o~ the ~crew assembl~
1 178 B~t delibe~a~e applica~io~ o~ ~o~ce in a direc~io~ shown by arrow C will allow the screw assem~ly 15~ to be remo~ed from the ceneral ~ore 116 if de~ired ~ dditionally, i~ each o~ ~he si~uations sho~n in FIGS. 2~ and 2~, some movemen~ between the sc~ew ~s~emblies 1S6 and 17~ a~d the a~tment llO
3D ~long the ab~tment axi-~ A is allowed. As will be explained in ~urther detail below, ~his allows ~he ah~tment to ~e }i~ted sligh~ly and rotated CA 022380l6 l998-05-l5 W097n7907 PC~96/184~7 relati~e to th~ in~ert even a~ter the poqi~on o~ -the ~cr~w assembly i9 ~iXedA
~e~er~lng now ~o PIG 17, ~epicted therein i~
a~ i~pla~ 2iO identical to the i~plant Z8 descr~ed abo~e. The implan~ 210 i~ conve~tional and will be de~cribed herein only to the ~tent necessary ~or a complete understanding o~ the pre~ent invention The implan~ 2~0 ha~, in addltio~ to the threaded extern~1 ~urface 30, threaded inte~nal s~r~ace 32, and screw cavity 34 b~ie~ly descr~bed abo~e, an ~pper ~houlder 212, ~pper ~Ur~ace ~14, ~nd hex ~ody 216. ~he upper shoulder 212 is genera11y cyli~dri~al, The ~pper ~ur~ace 214 i9 ~la~, disc-shaped, and is bounded at its outer pe~iph~ry by the 3hould~r 212, The hex body 216 ex~end~ f~om ~he uppe~ ~r~ace ~O. The screw ca~ity 3~ p~.~3e~ th~o~gh the ~ppe~ ~r~ace 2~2 and t~e he~ body 21~. The e~ti~e implant 28 is ZO ge~erally ~ym~etrical abo~t its longi~udi~al axi~
D, with the exte~nal sur~ace 30, internal sur~ace 32, 3crew cavity ~4, Upper sho~lder ~12, upper sur~ace 21~, and hex body 216 all being coa~ially aligned wi~h the longit~l~;n~l axis D.
~e~erring ~ow tO FIG. 20, depic~ed therein i9 an abu~ment cap 218 ldentical to ehe a~tment cap 44 described abo~e. The abut~ent cap 21~
comprises a cylindrical ~ase po~tion 220, a dome-ghaped co~er po~tion 222, a~d a locking rin~ 224.
FIGS 22A and 22B ill~strate an impression ~ea~her ~26 l~entical to ehe impres~ion feather 4~
described abo~e The ~eather 226 comprises a base po~io~ 228 a~d an ~pper po~tio~ 2~9 T~e o~erall woy7/l7~07 PCT~S96/~8~7 shape o~ the base portion ~2B is pe~haps best shown in FIG 22B and is sized and con~igured to match the ~im~n~ions o~ ~he lock portion 128 o~
~he central bore 114 o~ ~he ~emporary ab~ment llO
In partic~lar, the base port1on 128 compri~e~
a wall 230 having a cylindrical ou~er ~ur~ace 232 and a hex-shaped inner sur~ace 234 Projecting at interva~s ~rom ~he ~rom the outer sur~ace 232 are ~ertlcal aliynment projection~ 236 The ~ase portion o~ter ~ace 232 iB ~im~ianed ~o ~it s~ugly wi~hin the cylindrical inner portion 134 o~
t~e ah~t~ent inner wa~ 114 The alignment projections 236 are s~milarly ~m~n~ioned to ~it s~ugly wi~hin the alig~ment g~oove~ 136 ~ormed in the ab~tment inner wall 11~ The ~ase portio~ 128 o~ the impression ~eat~e~ 226 may thus be ~eceive~
wit~in the lock portion 128 o~ the abut~ent centra~ bo~e ~1~ in a ~nn~ pre~ents relative axial rotation bet~ee~ the ~eather 226 and the ab~tment 110~
Additionally, locking pxojections ~3~ ex~end ~om the cylindrical outer ~r~ace 230 o~ t~e base wall 228 The ~pper po~tio~ 2:2g af~ the lmp:re:3~3io~
~eather 226 co~ri~e~ a se~ies of horizontal ~langes 240 ~hat extend ~rom a cen~ral post 242 The ~langes 240 are o~se~ ~om the flanges above and ~elow by 90 degrees The purpose o~ ~he 30 ~ an~es 240 is ~o crea~e a ~ec~re interco~ne~tion between the ~mp~ession ~eaeher 226 and the ~mpresqion in whi~ it is cap~ured ~0~7/~7~07 pcT~ss6Jl8~7 -2~-Wi~h an unde~ge~nAi ng o~ the s~a~e o~ tAe ~o~going compo~e~t llO, 156, 178, 210, 218, and Zz6, certain qteps in t~e pro3thodontic procedu~e illus~rated tn ~IGS 1-16 will be now deQcribed in ~rther detail Re~erring initially to the ~tep deplc~ed in FIG. 6, in that step the a~utment ~cre~ 42 is captured within the te~porary ~butment 4O a~
described above and may thus be transported to the patie~t~ mo~th as an as~embl~. Thi~ lesse~ the li~elihood that ~he ~urgeon will drop or ocherwi~e ¢h~n~l e ~he componen~ used d~ring stage two surger~r ~etween ~IGS 6 a~d 7, ~he abutment cap 4 ~as ~ee~ placed o~to the te~porary ~tment 40 T~e cap ~ is man~actu~ed ~l~ch that it engages the tempo~a~ ah~tment 40 wi~h a qimple snap ~t Mor~ speci~lcally, ~he locki~g ring 224 ~o~med bn the cap 44 is sized, ~m~n~ioned~ an~ ~paced ~rom the cover portio~ 222 thereo~ such that ~he ~ing 22~ enga~eq t~e locking groove 138 ~ormed on the inner surfac~ 114 o~ the a~tment 40 So engaged, the co~er portion 22Z o~ the cap 4~ ~est~ snugly against the upper s~r~ace 118 o~ the abutment 40 Z5 to p~e~ent material ~rom ente~ing the center bo~e Between the stepq depicte~ i~ FIGS 7 and 8, the abu~ment cap 44 is removed ~ro~ the temporary abu~me~t 40 To ~acilita~e this removal, a notch 242 ~FI~. l9B) is ~onmed on the abutme~t llO. A
dental pic~ may be inse~ted into this notch under the cap co~er po~tlon 222 to pop ~he cap 44 o~ ~~
the ~b~tment ~O
. ' W O 97/17907 PCT~US96/18447 ~ Prior to the ~tep shown in ~G 8, the impres~io~ ~ea~her 46 wa~ attached to the temporary abut~ent 40 Thi~ atta~hmen~ 1~ made by a snap ~it sl~ilar to that employed to at~ach th~
cap ~4 on~o the abutment 40. I~ p~ticula~, the locking projection~ 238 ~ormed on the base 228 o~
~he i~p~e~sio~ ~e~ther 46 e~gage t~e lock~g groo~e 138 ~ormed on the inne~ ~u~ace 114 o~ the ~b~tme~t 40. This engage~ent pre~ents inad~ertent ~e~oval o~ t~e ~mpre~ion ~eath~r 46 ~rom the ab~tment 40 but may ea-~ily be overcome ~y the app}lcation o~ deli~erate ~orce on the impressio~
~eather ~6 ~wa~ ~rom the abutment 40.
An identica~ aetachment is ~onmed bet~ee~ the imp:r:ession ~eather 46 in the impre~ion 50 aIld the second temporar~ a~utment 56 as sho~n i~ FIGS. lO
and 11 Many o~ ~he compone~ts descri~ed abo~e may ~e m~de o~t o~ any ~aterial t~at i~3 ~ic~logically ~e~t a~d ~trong enou~h to with5tand the loads enco~tered durlng i~ertio~ and whlle belng worn in the patie~t'~ mouth Certainly any s~rgical grade m~tal such as ~i~an:ium would work sa~is~actorily, although th~ pri~ary be~e~itR of the presen~ in~ention are ob~aine~ by ma~u~acturing the at least portion~ o~ the~
component~ ou~ o~ dental grade plasti~.
n particular, the temporary a~tment 1lo, ~eatin~ cap 182, ab~tment cap 224, and impre-~sion ~eather 22~ are a~1 pre~er~bly ~a~ricated o~t o~
pla~tic ~uch as an ace~yl copol~mer I~ any ~ituatio~ where a snap ~it i~ employed to attach two components toge~her, at lea~t one, and WO97/17907 P~T~s9fi/l 8~47 pre~era~ly both, o~ these components must be manu~actured o~t o~ plastic to allow ~h~
de~lec~ion nece~sary to achie~e ~he snap ~
. Re~erring now to FIGS ~-27, depicted the~ein are ce~ain addi~ional componenr~ that may be em~loyed using the sysCems and components o~ the present in~en~ion It ~ho~ld be noted that thes~
~dditional compo~ents will normally be used during ~ariation~ o~ the ~asic proced~re de~icted in F~GS l-16 a~ ~its a partic~lar c~rc~mst~nce.
FIG 23 depicts a pick ~p po~t zs4 tha~
passe~ thro~gh ~ central bore 246 ~or~ed in the impresqi~n ~eather 226 or in one o~ the ~em~ers depicted in FIGS. 24, 26, or ~7 ~ ~hreaded end ~48 o~ the post 244 allows ~he post 244 to ~ix the position the member thro~gh which it passes rel~ti~e to ~n implant.
FIG. 24 depicts a surgical impression ~e~ther 250 that may be ~sed during phase o~e s~rgery to ob~ain an imp~egsion indicating the locatio~ o~
the imp~ant. A lower post 252 o~ the ~rgical imp~ession ~eather 2~0 enters the screw chamber 34 de~i~ed by the implant to ~or~ a ~ric~io~ ~it that holds the ~eather 2SO in place while the impression i~ being taken. ~he pos~ 2S2 is not Chreaded, ho~ever, and may be withdraw~ when the impression is re~oved FIG 25 ~epict~ a temporary cyli~er ~54 adapted ~o ~e ~tt~ched to the ~emporary ab~tment 3Q llO by the pick-~p ~ost 244 ~he bottom end thereo~ has a corona type ~aste~er to ~ey the cylinder ~56 relative to the ~emporary ab~ment 110 _ -CA 022380l6 l998-05-l5 ~ ' WO97/17907 pcT~ss6/l8~7 - FIG5 ~ and 27 depict a cylinder 25~ a~d a preped abutment 258, respectively These me~bers - 256 and 258 may be attac~ed to the temporary a~utment llO and implant 210 and preped like a tooth to s~pport a temporary or permanent restoration Th~se members ~56 ~nd 258 ha~e bases 260 and 262 that allow them be snap ~it onto a temporary abutment s~ch as t~e t em~orary ab~tme~t 110, FIG 35 ~epicts the cylind~r 256 attaehed to the a~utment 40 and implant 28 by a screw 264.
~e ~ase 260 o~ the ~ylinder 256 eng~geY and ~o~m.
a snap-~it with the abutment 40 The sc~ew 264 has a ~ead portion 266, ~ sha~t por~ion 268, and a 1~ th~eaded portion 270 ~ hex recess 272 is ~ormed in the he~d portion 270. The cylinder 2~6 de~ines ~ ce~tral bore 274 havi~g a ~rst, lar~er diamecer portion Z76 and a second, ~maller diameter ~ortion 2~8 A shoulder s~r~ace 280 is ~or~ed at the Z0 j~ncture o~ the ~ore por~ions ~74 and 276 The sh~t portion 268 o~ the ~crew spaces the treaded por~ion 270 ~rom ~he head portion 266 such that, when the threaded portion 270 is rotated onto the threaded sur~ace 32 o~ the implant 28, the head portion 266 act~ on the sho~lder sur~ace 280 to ~old the cylinder 256 onto the ab~tmen~ ~o and the a~tment 40 onto the impla~t 28. The base 260 th~s keys the cylinder ~56 onto the a~tment 40, and ~he screw 264 holds the assembly o~ the cylinder 256, a~utme~e 40, and imp~an~ 28 to~ether The cylinder 256 can th~$ support, on a tempora~y basis, a temporary or perm~
res~or~tion.
~0g7/17907 P~r~ss6/lx447 Re~erring now to FIG. 30, depicted therei~ is prosthodontic assembly 310 comprising z temporary ~butment 312; implant 31~, and screw 31~. ~he tempora~y abutment 312 has a longitu~ 7.n~ 1 axis A, an outer ~r~ace 318, and an inner sur~ace 320 de~ini~g a c~ntrally ext~
bore 322. ~he implant 31~ h~s an externa~
sur~ace 324 having a threaded portion 326 and ~n internal Bur~ace 328 ha~i~g a threaded 10 portion 330 The screw 316 has a head po~tio~ 332 and a bha~t portion 334. A threaded s~r~ace 336 i5 ~ormed on the sha~t portion 334 In general, the scre~ 316 attaches the t~mporary abutment 312 to the implant 314. The speci~ic str~c~ure tha~ allows this a~tachment will be described in ~rther detail ~elow.
In ge~eral, the screw 316 passes thro~yh ~he cen~ral bore 322 such thae ~he thrèaded s~r~ace 336 on the ~c~ew engages the threaded portion 330 20 o~ the internal sur~ace 328 o~ the implant 314 The outer sur~ace 318 di~ers ~rom the o~ter sur~ace 312 o~ the temporary a~u~en~ llO
described abo~e in that it is adapted to mate with the implan~ 314. I~ pa~tic~lar, the exte~ior 25 sur~ace 324 o~ the implant 314 has a co~ical por~ion 338 that ~orms a ~ho~lder o~ t~e impla~t 314 ~he i~terior sur~ace 32 a 0~ the implant 314 de~ines, in addition to the threaded por~ion 330 ~escribed abo~e, a hex portion 340.
~e~erring to ~ 31, it ca~ be seen that the hex por~ion 340 ~e~ines a hex c~amber. To allow the temporary a~utm~nt 312 ~o securely e~gage ~h~
implant 314, a ~r~stoconic~l ~ace 3~2 and CA 022380l6 l998-05-l5 'WO97/I7907 PCT~S96/18~47 hexagonal projection 344 are ~onmed thereon. The ab~tment conical sur~ace 342 is angled ~ith re~pect to the longitl]~i~l axis A to abut ~he ~r~stoconical sur~ace 33~ ~ormed on the imp~ant 314. S~milarly, the hexagonal p~ojection 344 is sized and ~lm~n~ioned to ~e sn~gly recei~ed withi~
the cham~er de~ine~ by the hexagona~ sur~ace 3~0 on t~e implan~ mem~er 314 Th~s, when the temporary abutment 312 i~ attached to the imp~ant 314, t~e conical s~r~a~c~ 338 and 342 a~ut each other and the hexagonal projection 344 on the abutment llO is received ~ithin ~he he~agonal ca~ity de~ined ~y the hexagonal su~ace ~40 on ~he implant 31~.
~he ce~ral bore 322 comprise~ a lock portion 346 a~d a 5cre~ rec~i~ing portion 3~
The loc~ portion 346 is similar in operation to the lock ~ortion 128 o~ the cen~ral bore 116 described a~o~e The lock portion 3~6 is de~ined by a ~irst portio~ ~48 o~ the interior wall 320. Thi~ wall portio~ 348 is generally hexagonal in shape. In particular, this wall portion 3~8 comprises 5iX
iden~ical wall segments 350 each ha~ing an Z5 elliptical ~cesS 352 ~ormed the~ein.
~ e~erring now ~or a m~m~t to FIGS 32 and ~3, depicted therein is an impression coping 354 adapted to m~te with the temporary ab~tment 312 The impression coping 3~4 is i~
most ~espects the sa~e as ~he impression coping 226 described above. The primary di~erence ~etw~en these is that a base ~097/1790~ Pcr~96/18~47 por~ion 356 o~ the coping 354 is adapted to mat~
wi~h the tempora~y abutment llO.
In particular, ~he-bage portion ~S6 has a hexagonal ~ody 358 ha~ing six ~dentical s~r~aces 360, with a projection 362 fonm~d on each o~ the s~aces 360~ T~e hex me~ber 35~ i~ slzed and ~n~ioned to be sn~gly recei~ed wi~hin the locke~ por~io~ 346 o~ the cent~al bore 322, ~ith the projections 3~2 being recei~ed within the ~ecesses 352. The recesses 362 engage the proj ection~ 362 to ~os~ a snap pit that loc~s ~he i~pression copi~g 354 onto the tempor~r~
ab~ltme~t 31~ as desc~ibed a~ove The loc~ing system ~o~med ~y the base portion 3~6 o~ the impre~sion coping 3S~ and the ~irst portio~ 346 o~
the central bore 32~ malntains the impression coping in an appropriat~ relatio~hip to the temporary abutment 312 during the process o~
taking the impression But the impressio~ coping 354 can ~e removed ~y ~he applica~ion o~
deliberate manual ~orce o~ the impre5sion copin~
354 away ~ro~ the temporary ab~tme~t 31~
It sho~ld b~ recog~ized that ~he base po~ion ~56 o~ the impression coping 3S~ may be - 25 s~tit~ted on any o~ ~he co~ponents de~cribed ~ove ~hat a~e in~ended to be mo~n~ed o~ to the temporary ab~tment llO The impre~sio~ coping 35 i~ ~imply exemplary o~ these other ~ompone~ts.
~ e~errlng now to FIG 30, it can be seen that 30 ~he central bor~ 322 further comprises a seco~d, head receiving portion 364 ~hi~ hea~ r~c~i~ing po~tion 364 is de~ine~ by a cylindrical wall 366 and a ~r~s~QcQ~ical wall 368 The head po~tion CA 022380l6 l998-05-l5 ~ ' WO97/17907 PCT~Ss~/l84~7 332 o~ the screw 316 has a ~u~toconical wall 370 that is arra~ged ~t the same a~gle as the wall 36a Accordingly,-as the screw 316 i~
axiall~ rotated, its threaded s~rface 336 engages S the threaded portion 330 o~ the implant 314 to pull the conical s~r~ace ~70 on the head portion 332 against t~e c~nical s~r~ace 368 de~ining the head receivin~ portion 364 R~fer~ing now to FIG. 3~, depicted at ~lO
ther~in i~ yet another exemplary implant asse~ly constr~c~ed in accordance wi~, ~n~ em~odying, the principles o~ the present invention This a~sembly 410 comprises yet another exemplary temporary abutmen~ 412 that i~ attached to an impl~nt ~14 The i~plant 414 i5 a special type of i~plant re~erred to as ~ Morris taper. Th~
temporary abutment 412 has ~een modi~ied to the ~orris taper style implant 414 The implant 414 has an ex~erior ~rface ~16 Z0 and an interior s~lr~ace 4la- The exterior s~rface is adapted to be threaded into a pa~ient'e bone a~d be o~seointegrated thorewich An upper portion 420 o~ the e~terior s~r~ace 416 i~ ~ormed i~ a downwardly tape~in~ ~r~stoconical shape The inner sur~ace 418 has an upwardly taperin~
~r~stoconical s~r~ace 4~2 that extends at ~n angle o~ approximately 6 deg~ees relative to the longit~ n~l axis o~ the impla~t 414~ These two ~urraceq 420 and 422 ~e~ at an annular uppermo~
portion 424 o~ the implan~ 414-The in~e~ s~r~ace 418 o~ the i~pla~t 414 th~s de~ines a ~rustoc~nica} region 426 abo~e a threaded region 4Z8 de~ined ~y a ~hre~ded s~rface CA 02238016 1998-0~-15 WOs7/~7907 ~CT~ss6~l84~?
~E~A~ED -APPLICATIO~S
This appli~ation claims prio~ity o~ U S~
Provisional Patent Applic~tion Serial No 60~006,955, ~hich was ~iled on Novem~er 17, ~995 ~E~D OF TH~ lNv~ ON
The present ~ventio~ relates to prostho~onti~ methods and apparatus and, ~ore ~peci~ically, to such methods and apparatus that simpli~y the making o~ dental impre~sion6 employed 15 to ~abrlcate a restoratlve tooth prosthesi~
BACKGROUND OF THE lN~lLO~
Many syste~s and method~ are c~rre~tly ~0 a~ailable ~or replacing lo~t ~eeth The~e systems and ~ethodY comprise the ~ollowing ba~ic steps, First, an implant is ~hreadcd i~to a cavity ~ormed in the patient's ~aw at ~he location o~ a los~
tooth The implant is then allowed to osseointegrate with ehe jaw bone. ~ technician will then ~abricate a pro~the~ic tooth on a permanent ab~tment member The p~n~t ab~tment me~ber is then attached to the implant to mo~nt the prosthetic too~h at its appropriate location In ~his context, the perm~n~n~ abutment membe~
~orms the s~ructural attachment between the prosthe~ic ~ooth and the implant, and the WO 9~ 90'7 PCT/US96~18~.~7 p~oythetic tooth ~unctio~ally and ae~the~ically ~eplac~S the exposed portion o~ the lo~t tooth It should be clear that this basic proce~s ca~ be e~ployed whe~ replacing a plu~ality o~
teeth as well as when replacing a ~ingle tooth I~ ~e ~ollowing disc~ss~on, the present i~vent~on is de~cribed in the contex~ of replacinq a si~gle to~t~; but one o~ ordinary skill i~ the art will recogni~e that the principles o~ the p~e~e~t 0 in~ention are equall~ applicable to the replacemenC o~ more than one Cooth at a time The step o~ ~abricating the prosthetic tooth varie3 with the particular patien~ but requires that the position o~ the implant ~e capt~ed ~o lS thac the resul~ing pro~thesis per~orm~ a8 required ~oth ~ctionally and aes~heticall~ the po~i~ion o~ ~he implant is no~ acc~rately captured, the resulting prosthesis may not ~nction properly and may not look nat~al when attached to the implan~
The pro~hesis ~abrication p~oc~ss comprises the steps Or taking an impressio~ o~ the area o~
the loYt tooth and, with the impression, ~orming a ~odel o~ the area o~ the lost ~oo~h The p~oces~
~5 o~ taki~g t~e impres~ion compri-~es the 8teps att~ ~g an impr~s~io~ coping to the implant, injecting ha~dena~le im~re~ion ma~erial into the area ~urrounding the impres8ion coping, and, when the impr~ssion material hardens, remo~in~ t~e impression ~aterial with the imp~ession coping e~cased ~herei~ ~o ~ab~icate the model, an analog o~ the implant is then at~ched to the imp~ession coping encased in the impression CA 022380l6 l998-05-l5 WO~7/17Yo7 ~cT~ss6/l8447 ~ardenable model material is then placed around the implant ~nalog ~d allo~ed to harden The model, with the imp~ant analog buried ~he~ei~, i~
then remo~ed ~rom ~he impres~ion The ~osition of ~he impla~t analog in ~he ~odel sho~ld, and in most ~y~tems will, re~lect the positio~ o~ the lmplant i~ the mo~th; that is, the model will contain ~ a~e~ correspondi~g to the surface~ o~ the teeth and so~t tis~ue, with t~ese ~odel ~ur~aces ~ei~g accuracely located ~elati~e to ~he i~plant analog. I~ the model acc~rately re~l~cts the po~i~ion o~ the implant in t~e m~uth, a techni~ian c~ ~ccu~atel~ ~abricate ~he p~os~hetic tooth in a labo~atory ~etting Whi~e most c~r~ently availahle ~ystems ~or replacing lo~t teet~ allow ~he ~abrication o~ a ~ model that acc~rately re~lects the poYition o~ th~
impla~t in ~he mouth, these sy~tem~ each have dr~wbacks ~hat, i~ general, re~lt in the proces3 o~ replaciny lost teeth ~eing ~airly compllcated ~d expensive To the Applica~t's knowledge, all o~ t~e c:~erLtly a~ailable ~stems and methods employ metal pa~t~ down to ~he i~plant during the proce~
25 of taki~ the impres~ion. Such metal partfi a~e precision machined and thus ~ela~i~ely expensive Although metal parts are in theory -eusable, they must ~e sterilized be~wee~ each use. ~nd even i~
~terilized, these me~al pa~ts are o~ten di~ic~lt ~o clean completely Acco~di~gly, in practice the~e parts are o~ten discarde~ a~ter ~eing ~sed once to eliminate the possibility o~ cros~-cont ~mi n~ tion.
CA 022380l6 l998-05-l5 Wos7/17sO1 PCT~Ss~/18~7 -~ he u~e o~ metal par~s al~o i~crea~e5 the complexity o~ previo~ly availabl~.gy~tems o~
methods ~or replacing lo~ teech ~ore speci~ically, during t~e proces~ o~ taking an lmp~es~ion a~d -~ubgeque~tly creatlng a model ~rom t~at impres~ion, it i9 necegg~ry ~o temporarily ~oin two component~ togecher ~i e., the lmp~es~ion coping is joined ~o the implant and ehe implan~
analog is joined to the impre~sion coping) Usi~g c~re~tly a~ailable ~y~tems, whene~e~ two metal compo~e~t~ are temporarily joined together, one o~
two methods must be used~ ~a) one o~ the co~ponents m~t ~e directl~ threaded onto the otherj or (b) one o~ the compone~t~ is in~ernally l~ threaded, the other component i~ ~threaded, and a separate screw enga~es the threade~ component to a~ac~ t~e unthreaded c~r~n~ to the threaded component I~ the ca~e whe~e both o~ the component~ a~e thr~, one component is ~eual1y ~ixed and the other is rotated relati~e ~o ~he ~ixed compone~t For one component to ~e direccly th~eaded on~o another, one o~ the~e component~ must be ~reely rotatable relati~e ~o ~he other Por ~x~mple, i~
certain s~e~s, healing abutmen~s are pro~ided with a threaded po~ ex~e~ding ~here~rom. To at~h the ~ealing abutme~ to the implant, ~he healing ab~tment is rota~ed relati~e to the implant such that ~he threaded poRt ~or~d thereon is received within the ~hreaded ca~ity dE~i~ed by the implant Rotati~g one component rela~lve to the other i~ ~ot po~ible in ma~y ~it~atio~s; ~or example, WO g7/l7gol rCTJtJS96~18~47 this is not possible when one o~ the componen~s is an impl~t ~lxed withi~ the mouth and the other i9 an impression coping ~xed within an impression Accordingly, with previou~ly available 5 systems, ~he ~arious co~po~ents employed a~e attached to each other ~sing threaded screws du~i~g the proce~s o~ taking an impression and making a model there~rom. A screw is ~qed to 3ecurely attach the impression coping to the 0 implant while the l~p~essio~ ~aterial is injected around the impression copi~g. And a screw is also ~sed to attach the implant ana~og to the i~p~ession coping d~ring the process o~ ma~ing the ~odel ~rom t~e impre~sion ~he use o~ screws to attach the impression copi~g onto the implant increa~es the complexity o~ the process o~ taking the imp~ession. The ~e~tis~ must thread the Ycrew into ~he impla~t ~e~oxe the impression is taken and remove the scre~ ~rom the imp~an~ to remove the impression ~rom the mo~th A~other i~porta~t drawback o~ p~io~ art sys~ems and methods o~ ~eplacing teeth is that ~hese s~ste~s c~m~ly employ 2~-30 components Z~ each ha~ing a speci~ic purpose Many o~ these co~pone~t~ ~ork o~ly with ~ ~peci~c sub~et o~
othe~ components In any case, all o~ the componentY o~ a ~iven ~ystem m~st kept i~ in~entory And accu~ate reco~ds be kept to e~sure that the oral surgeon, den~ist, a~d laboratory technicia~ all have the risht ~artq a~ ~he right time. Further, because these components a~e small and man~ di~er only i~
wos7rl7~o7 PCT~S9G/IX~47 si~e, the di~erence between one co~pon~nt ~nd anot~er i~compacible component may not be ob~io~
to the n~ked eye, pos~ibly result~ng in confuYio~
among various gi~i7~ looking parts.
The ~act ~hat certain components work only with certai~ other components reduces the ~lexibility o~ ~he ~em For example, in certain prior art sy~tem~, the pe~m~t ~butment member must be selected prior ~o ~he process o~
maki~g the i~pression because a parricular impressio~ coping mu~ be used ~or t~e selected permane~t abutment. I~, ~ubse~uently, the dentist or la~oratory technician dete~;~ that another type o~ permanene abutment is more appropriate, a lS ne~ imp~ession with a di~erent impression cOpi~g m~st be made.
REhATED ART
ZO Perhaps ~he mo~t co~mon comme~cially a~ailable dental lmplan~ system is ma~keted by Br~n~m~k~ The Branemark syste~ employ~ a la~ge num~er o~ metal componen~s that are relatively expensive. Additionally, as generally ~isc~ssed ~S a~ove, the denti~t mu~t decide at ~he time the impresslon is made what type o~ p~t abutmen~
~ill be ~sed ~o ~abricated the prosthetic tooth.
This red~ces the ~lexi~ility o~ the overall process, because a ~ew impres~ion must be ~ake~ lr i~ i~ later det~m~ n~ that a di~erent type o~
p~m~n~nc a~tment member is more appropriate ~ ra~emar~ also marke~s a specialized single tooth den~a~ implant system under the trade ~ame Wos7/l79o7 PCT~S96/lS447 ~7-CeraOne, The CeraOne p~oce~ employs a t~taniumabutment that is attached to an impla~ a~ter se~o~d ~tage ~urgery. This abutme~t has an elo~gate exposed portion that extend~
substantially above the gum line, a~d a ~lexi~le, synthe~ic polymer he~li~g cover i9 placed over the abutment while the tiss~e he~l~ a~ter s~cond s~age surgery To take an impression u~ing the Ceraone p~oduct, impression material is pl~ced aro~nd ~he hea~ing co~er ~nd allowed to har~en The impres~io~ i remo~ed ~rom the mouth, with the healing cover sliding o~ o~ the ex~osed elongate po~tion o~ the ~eali~g abutme~t.
The ~eraOne product may be used to replace only ~ single tooth; the cover that s~ip~ on and o~~ o~ the elongate proj~ction on the he~ling abutment pre~ent 5 a~ impreqsion bei~g taken o~
more than one impla~t ~ecause the implants a~e normall~ not parallel The cover~ wo~ld not ~e able ro slip o~ the non-parallel projections on the healing a~utmen~q r And in prac~ice, th~s co~er i~ typically not used while the g~m ti~sue is allowed to heal a~ter second staye qurgery Z5 becau~e the material ~rom which i~ is made ~ends to ~b~orb odors and become ~nc~ean even during thi~ rela~ively short pe~iod.
A third type o~ rele~ant dental implan~
~y~tem i~ marke~ed by 3~ under the trade name EPS
30 The EPS system i~ similar to the ~ranemark Qystem ln that it uses a large number o~ metal componen~s. ~he EPS sysLem is al so typical i~
tha~ membe~s such aQ heal~n~ abutwents or cap~ are WO~7/17gO7 PCT~Ss6/ts447 .
~hreaded to allow them to be directly attached to ~he implant And the EPS Cystem employs a separate ~crew to atta~h imp~e~sion copings a~d p~n~t ~b~ents onto t~e i~plant S ~he need thu~ exist~ ~or den~al implan~
system~ and method~ ~ha~ are simple to implement, allo~ che den~al pro~e~ional ~lexi~ility in th~
seleceion o~ per~anent ab~tment~, require ~ewe-step~ durin~ ~abrication o~ ~he prosthetic tooth, and are le8g expensi~e than those c~rrently ~vall~le on the mar~etplace OB~CTS O~ ~H~ I~v ~:N l'10~
From the ~oregoing, 1~ should be apparent ~hat one object o~ the present invention i~ to pro~ide an improved ~y5temS and me~hod~ ~or replac~ng los~ tee~h.
Another more speci~c o~ject o~ the pre~ent in~ention i5 to p~ovide s~ch me~hod~ and yys~çms ha~ing a ~avorable mix o~ the ~ollowing ch~racteristics:
mi~im;zes the ~e o~ expensive, precision mi~led components, reduces the ~um~er o~ pa~ts that must be kept on hand to implement such Sys~ems a~d mechods;
employs low pro~ile part~ that allow a f lapper Co be ~orn a~ter ~ir~t and second ~tage s~rger~ ~e~ore ~he prosthetic ~ooth is permanently attached to the implanti CA 022380l6 l998-05-l5 ~WO97/l7907 rcT~s96ll8~47 ~ simpli~ies the process o~ ~aking an impre~ion accurately captu~e~ the emergence pro~ile o~
one or more implan~s in a patie~t~q mouth.
delays the deci3ion on which type o~
permanent abutment will b~ ~sed to maintain ~or a~ long a~ po~ible ~lexibilit~ in ~he ~electibn o~ th~
permanent ab~tment member;
allo~s the ~se o~ techniq~es that are sui~able ~or ma8s production resnl~ing i~ co~pone~t~ th~ m~y be dlscarded a~cer a single use t~ prevent croxs-conr~ eio~; and can be used with i~plant~ and pe~ane~t ab~tment~ ~urrently availa~le on t~e mar~et SU~M~RY OF THE lNv~ O~
These and other obj ects are obtalned by the prese~t in~ention, which i~ a ~tem or method ~o~
replaci~g lost teeth The present in~entio~
employs a ~emporary abutment ~ha~ 19 atta~hed ~o an ~mp~ant membe~ d~ing seco~d stage 3~rgery Th~s temporary ab~tment member is le~t on the implane when ~he den~i~t ma~es an impre~sion o~
the area o~ the mouth su~ro~ndin~ t~e i~plant~ To capt-~re the loca~ion o~ the impla~, an impre-q~ion ~ea~her iq attached to the temporary abutment using a snap ~i~ The te~por~r~ abutmen~ and impression coping are ~oth m~ o~ pla~ic and one CA 022380l6 l998-05-l5 wo97/~7so7 PC~ss6t18 o~ t~ese is pro~ided ~ith the projec~ion and th~
o~he~ with an indenta~io~. ~he projection engages the inde~tation whe~ the i~pres~ion coping i~ in the appropriate position relative to the temporary abu~ment and maintains the impre~ion coping in this position throughout the process o~ in~ect~ng impre~ion materlal a~ou~d ~he impression coping.
When the imp~eqcion material hardens, the entire impre~sion may ~e ~imply li~ted away ~rom the implant The snap ~ hat ~ounts the impression coping on ~o the temporary ~butment i3 designed to allow ~nll~l remo~al o~ the ~mpression coping, and thus the impression i~s~l~, ~rom the implant.
F~o~ the ~oregoing description, i~ should be see~ that t~e dentist doe~ ~o~ need to remove the temporary ab~tment be~ore ~a~ing the lmpres~ion ~he dentist need only ~nap on the lmpression copins ~nd m~ke ~he impre~3io~ This signi~ica~tly ~educes the a~o~nt o~ time required to ta~e an impression.
When ~he impression is deli~ered to t~e la~o~atory ~or the pu~pose o~ manu~acturing a proqthetic tooth, a temporary abutment and ~nalog o~ the i~er~ are snap fiC onto the exposed portion o~ the impress~on coping. Model material 15 then placed around t~e implan~ analog a~d allowed to harden ~t this poi~t, the model may be simply li~ted away ~rom the impre~sion, with the snap ~it ~ormed between th~ temporary abutment ~ttached ~o the im~lant analog and the impression coping easily being ove~co~e ~y deliberate applicatio~ o~ o~ce CA 022380l6 l998-05-l5 s7/~7sn7 PCT~S96/lX447 The model ~hus con~ains an implant an~log that captures ~he position o~ the implant in ~he mouth The la~oratory-technicia~ ~ay ~h~n ~abricate the prosthetic tooth on the model using S conventional technique~.
Signi~icantly, the decision on the type o~
permanent abllt~ent that is to ~e ~sed ca~ ~e delayed until a~er the model has ~een made. This allows the laboratory technician ~lexi~ility in ~electi~g a~ appropriate pe~m~nt a~utment member e~en a~ter the i~pre~sion ha~ been ~aken Tn the abo~e ex~mple, the snap ~it ~as described in the prQcess o~ taki~g a~ impressio~
Q~ the locatio~ o~ a~ i~plant mem~er in a mou~h The sn~p ~it employed during this p~oceqs may also be ~sed ~or othe~ compo~çnts Fo~ example, a c~p may ~e attac~ed to th~ tempor~ry a~tme~ d~ri~g the h~aling p~riod a~ter the second stage ~rgery S~ch a cap wo~ld pre~en~ ~ood and o~e~ de~ris ~orm getting i~o ~he interio~ o~ the ~e~porary abutme~t, but i~ easily removed by the de~tis~
using readily available tools l~i~tely p~io~ to che attachme~t o~ the ~mpre~ion coping o~to the ~e~pora~y a~tme~t.
Formi~g a temporary abutment o~t o~ plastic as described herein pro~ides ~igni~icant .
~lexibili~y i~ the design o~ the temporary abu~ment member Thi~ abutment member may ~hu~ be adapted to match an existing implant or permanen~
~b~tme~t cur~ently on the market ~ 190, t~e ~emporary a~u~ment member may be mas~ prod~ced usin~ iAj ection ~oldi~g techni~ue~
Th~ pre~era~e ~aterial ~or ~he plas~ic compo~e~t~
CA 022380l6 l998-05-l5 ~O97/l7907 PCT~$96/1~4~7 -12~
u~ed in this sysrem is an acetyl copolymer. This material may be accurately injec~ion molded, has g~icien~ rigidit~ to ~unc~ion as set ~orth ~o~e, is d~ble, and is biocompati~le A den~al impl~nt system or method const~ucted in accorda~ce ~ith the pre~ent in~en~io~ gr~atly ~educes the number o~ part~ req~ired to provide a ~lex~ble de~tal implant ~ystem~ s~bYtantially r~-lce~c ~he ~o~t o~ many o~ the~e c~mp~nents, and pro~ide~ 6ig~i~icant ~lexi~ility not hereco~ore ~een ~ ~uch ~y~tem~ a~d ~ethod~, BRIEF D~s~RIp~IoN OF THE DRAWINGS
FIGS 1-16 depict a prosthodontic proced~e emplo~ing the principles o~ ~he present i~vention FIG 17 ~epicts an exemplary i~plant u~e~ in ~he p~ocedure dep~ct~d in ~IGS 1-16 FIG 18 ~epicts an exe~lary a~tmen~ screw 2~ a~embly as used in ~he procedure depicted i~
PIGS~ 1-16.
F~GS. l9A-D depict a~ exemplar~ tempo~ary abutmen~ as us~d in ~h~ procedu~e depic~ed in FIGS. 1-16.
FIG 20 depicts ~n exemplary abut~en~ cap ~sed in the procedu~e depicted i~ FIGS 1-16 FIG 21 depiCt~ an alrernati~e ab-~tmer~t screw assernbly ~h~t mi~y be used in many ~itua~cions in place o~ the ablltment screw a~;sembly shown in FIG.
18.
~?IGS 22A-B depict ~n exemplary impres:3ion i~eather used in the proced~re depict~ed in FIGS 1-7/179U7 Pc~ss6/l8~7 FIG. 23 de~ictq an exemplary pick up post that may be used to take an impressio~
FIG 24 depic~s a ~rgical impresqio~ coping tha~ may be u~ed to take an impre~qio~ d~rlng stage on~ ~rgery.
FIG 2S depictq a temporary cylinder thac may be used to take an impre~sion FIGS 26 and 27 depict ~embers th~c may ~e ~sed d~:~ing the rest~ratio~ p~oc~ss ~o~ ~eplaci~g a tooth with a temporary tooth to allow ~or ~urther maturation o~ the implant in the hone;
FI~S. 28 and 29 depict alternative screws that ma~ be employed to attach the temporary ~ menc o:E l~he pr~sent in~rentio~ to an imp~ant;
FIG 30 is a ~ront, ele~ational cut-a~ay ~ie~
depicting a another exemplary temporary a~utment, implanr member, and snap ~it sys~em;
~ G 31 is ~ cutaway ~riew takell along lines - 31--31 in FIG. 30:
FIG 32 is a ~ront eleva~io~al view depicting an impression ~eathe~ ha~in~ a ba3e portion that ~orm~ a part o~ the snap ~it sys~em shown in FIG
31;
FIG 33 is a bottom plan ~iew o~ che impre~sion coping ~how~ in FIG 32;
FIG 34 is an ele~ational c~t away ~iew depicting yet anoth~r exempla~y temporary abutment and implant: and FIG 3S i~ a ~ront, ele~a~ional, cut-away ~iew depicting a screw employed to mount the tempor~r~ cylinder o~ FIG. 26 onto a te~porary a~tment member.
~Og7/17901 PCT~S96/18447 D~TAI~E~ ~ESCR~P~O~
Re~errlng i~iti~lly ~o FIGS 1-16, deplcted therein is a pro~thodontic procedure ~or ~abric~tin~ and implanti~g a tooth ~ro~thesis This pr~cedure employg a ~y~tem ~or m~king impre~ions constructed in accorda~ce wit~, and embodying, che principles o~ the p~ese~t in~en~ ion.
0 A~ an o~erview, ~he prost~nAontic procedure shown in ~IGS 1-16 can be broke~ down into ~ive di~tinct phase~ each comprislng a number o~ ~teps-P~AS~ 1. FIGs 1-4 ~how what is re~e~red to as stage one ~yëry in which an lmplan~
i9 placed into the jaw ~one PXASE ~: FIGS. ~-7 depict what is ~e~e~red to as ~ta~e two ~rger~ in whioh a healing a~t~e~t i~ attached to the in~pl a~
PHAS~ 3~ ~IGS 8-11 depict the ~mpression ~tage ln whi~h a~ impre~sion is made o~
the patle~t's mo~th PHASE 1. FI~S. 12~15 depict the ~estor~tive phase in which the imp~ession is used co ~abrica~e a prosthetic tooth PHASE 5: FIG 16 deplcts the ~inal stage in which the pros~etic tooeh is mo~nted o~to th~ implant To provide some perspective, initial re~erence is made to FIG 5, which -~how~ a portion o~ a patie~t~ mo~th lO whe~e a gap 12 exis~
bet~een ~ir~t and second adjacent ~eet~ 14 and 16 Sho~n at 18 i~ FIG 5 is the ~i~e at which the ' ~09qll7907 PCT~S96/1~7 ~ prosthetic too~h i~ to be located FIG. l is a sligh'cly enlarged cut-away view o~ the patient ' g mout:h 10 ~t t}~e gap 12 ~ddl~ionally, du:ciny ~he p;~oces~3 depicced ir 5 FIG~ 16 ~he variou~ steps ~ill nonmal~y be per~ormed by a periodon~ist or oral surgeon, denti~t, and laboratory te~hniclan~ In particular, a ~urgeon will n~m~l ly per~orm the steps a~sociated wi~h Pha~es 1 and 2 descri~ed 10 abo~e, a dentist wil~ per~orm ~he steps as~ociated ~ith Phases 3 and S, and laborato~y technicianx will per~o~m ~he step~ aq~ociated with Phas~ 4 D~ring the ~ir~t pha~e o~ the prosthodo~tic procqd~re, o~ten ~e~er~ed to a~ st~ge one ~urgery, the ~urgeon makes an incision in the patient's gum 20 to expose ~he edentulous, or jaw, bone 22.
T~e s~rgeon t~en drill~ a ~ole 24 in the jaw bone 22 (FIG. l) The surgeon then taps the inner ~ur~ace 2 6 o~ t~e jaw bone 22 surrounding the hole 24 such that chis sur~ace 26 is ~hreade~
(FIG. 2) ~ me~allic ~ixture insert 28 ha~ing a threaded outer sur~ace 30 ma~ching the inner ~ur~ace 26 is then threaded in~o ~he ho}e 24 in the bone 22 ~FXG- 3)-The insert 28 also has a ~hreaded inner ~ur~ace 32 de~ining a ~crew chamber 34 A~ter ~he in~ert 28 has been threaded in~o the ~aw ~one 22, a ~o~er screw 36 is threaded into the screw c~amber 3 4 - The gum 20 ls then sut~red as sho~n at 38 s~ch that the gum 20 ~overs t~e entire ~mplant 28 and ~over scre~ 36 (FIG 4) At this point, sta~e one surgery i5 complece and the p~tie~ enters an osseointegration period CA 022380l6 l998-05-l5 ~097/17907 ~T~S9~l8447 o~ approximately ~-6 months The o~eoin~egration period allow~ the jaw bone to in~egrate the implant 28. During th~ o~eoin~egration period, ~rima~ily ~or cosmetic reaso~ the patie~ will ~s~ally wear wha~ i~ re~erred ~o as a ~lippe~ (~ot shown) over the imrl~nt si~e 18 A~er the impla~t 28 has been i~tegrated ~to the jaw ~o~e 22, ~he patien~ enter~ the seco~d phaqe o~ t~e procedure, commonly referred to as phase two surgery, in which,the s~rgeon attaches a temporary ab~m~nt 4Q onto ~he insert 28~ To ~ccqmp11sh this, the surgeon assembles an ab~t~ent screw 42 on~o the temporary a~u~ment 40 (FIGS. 5 and 6~ The abu~me~t ~cre~ ~2 passes ~hrough the lS temporary a~t~e~t 40 and into the ~rew c~vity 34 ~ormed in the i~sert 28. The abut~e~t screw 4~ i~
the~ tigh~ened to attach the temporary abutme~t 40 onto t~e i~sert 28 (FIG 7) ~n abutme~t c~p 44 is placed o~to t~e t~mpo~a~y abutme~t 40 over ~he screw 42 (FIGS 6 and 7) The gum tissue is then allowed 1-3 we~kq ~o heal The temporary abutment 40 and abutment cap 44 are m~de with a low prof~ile f3uch that:, when installed, they are approximately sa~e level as the gum li~e. Accordingly, while the gum ti~s~e i~ ~ealiAg around the temporary ab~me~t 4O, a ~lipper may be worn over location 12 witho~C
inter~e~ence by the temporary ab~tment 40 or a~utment cap 44.
~0 A~ter the g~m has healed ~rom the a ~e~ts o~
sta~e two s~rg~r~, ~he pa~ient goe~ to ehe dentist re~ponsible ~or the restoraci~e wor~ The dentist will initially remove the cap 44 a~d attach what Wog7/17go7 PC~S96/18~47 - will be re~er~d to ~erein as a~ i~pre~sion ~eather ~ 6 onto the ~empora~y a~utment 40 ~FIG.
8~. ~he dentist then positions an impression tray (not shown) ove~ ~he impregsion ~eat~er 46 and inserts impresslon mate~ial 48 in~o the imp~e~sion tray around the impressio~ :~ea~he~ 4~i ~a~ well ag the Y~rrounding gum and teeth).
The i~pression material 48 solidi~ies to ~orm an impression 50 comprising the solidif~ied impres~ion ma~erial ~8 and th~ impre~sion ~e~ther 4~ ~FIG. lO). The imp~ession 50 is remo~red :E~om the paeient ' s mouth and sent to the laboratory ~or the restorati~e ~ork Upon recei~ing the impression 50 ~rom the denti~t, the laboratory technician~ will ~o~m an a~alog assembly 52 ~omprising a~ i mr- ~nt 2~nalog 54, a tempora~y ablltme~t 56 iden~:ical ~o ~he a~u~ment 40 attached to the implan~ 28, and a screw 58 to hold the implant analog 54 and 20 t~mporary a~utment 56 together (F~GS lO and ll~
The temporary abutme~t 56 is ~hen a~tac~ed o~to the impression ~at~e~ ~6 ~eh that the implant analog 52 is ~paced a~d extends from the impression i~eather 46 in the ~ame nlFlnn~r as the 25 implant 28 (E':~:G 11) ~
Model ma~erial 60 is then pla~ed onto the impression 50 aro~nd the ~n~lo~ as~embl~ 52 (FIG
12). The model material 60 solidi~ies to ~orm a mo~el 62 and the impre~sion 50, incl~di~g ~he i~pression ~eather 46, is removed ~rom the model 62 At ~his point, the temporary ~utment 56 is still ~o~ed on ~he ~mplant a~alog 54 by ~he screw 58 (F~G 13).
CA 022380l6 l998-05-l5 Wo97/~79ol Pc~sY6/ls .
The next step is to remo~e the 3crew 58 and temporar~ abutment 56 from the model 62 (FIG. 14) The model ~o~ corresponds to the patie~t~s ~o~th, wi~h the implant analog 54 at a location corre3p~ to tha~ o~ the Implant 2~ in the patient ~FIG. 14).
~ t this poin~, a p~t abutment 64 may be selected and attached to the implant analos 54 to allow the ~abrication o~ a tooth prosthesis, or replacement tooth, 66 ~G 15~
once the replacement tooth 66 has ~een ~ab~icated, the patient goe~ ~ack to the de~tist ~here the t~mporary ab~t~ent 40 is removed and the permanent ab~tment 64 and ~eplacement tooth ~6 a~tached to thè implant 28 (FIG. 16).
The prosthodontic procedu~e desc~ibe~ above will vary depending upon s~ch ~actors as the desires o~ the patient, the te~igues employed by the s~geo~ and denti~t, a~d the type o~
~e~o~ati~e work invol~ed. Within this ove~all conte~r, howe~e~, the systems a~d methods o~ rhe present invention pro~ide a numbex o~ bene~its ~ o~ e~ample, ~he qyqtemq and method~ o~ the preqe~t inventio~ g~eatly gimplify the dentist's Z5 job d~ing Phase 3 when the denti~t makes the imp~e~q_ion The dentiqt need only remo~e the ab~tme~t cap a~d insert the impre~ion feather be~ore making th~ impre~sion. A~ter the imp~ession is removed, the denci~t simply replaces ~he ~butment cap The den~ist need not remove and reinsert ~he he~llng a~utm~nt when making the impresqion WO97~17~7 pcT~ss~/l8447 Additionally, the ~tyle O~ Rermanent abutment may be selected in the laboratory during Pha~e 4 and need not be known ~t the time the i~pre~sion is made The present invention thus ~reatly S gimpli~ies the denti3t~ job by reducing the ~umbe~
o~ i~plan~ parts that the dentist must ~eep in in~entory and ~rack ~or each patient A~other i~port~nt aspect of the pre~ent invention iq ~bat certain ~ey parts may be made cheaply ou~ o~ disposa~le pla~tic and ~ot out o~
surgical grade metals In particu~a~, the Cemporary ab~me~, abutment capJ ab~t~ent ~c~e~, and impres~io~ ~eather may be made wholly or i"
part o~t o~ plastic ~a~ing ~hese p~rts out o~
plastic allow~ them to made c~eaply enough to be di~posable and obviate~ the need to ~terilize them between each use Re~e~ri~g now to FIGS l~-35, a number o~
components that may be ~ed with the basic p~oçed~re descri~qd in relation to FIGS~ 1-16, or minor ~ari~tion~ thereo~ r wil 1 be descri~ed The proc~dure depicted in ~IGS l-l~ may be per~ormed with imp~ve~ res~lts over similar prio~ a~t methods witho~t the e~act component~ desc~i~ed in rela~ion to ~IGS. 17-35, ~ut these compone~ts opti~ize ~he per~ormance o~ thi~ procedure Be~ore desc~ibi~g the particular~ o~ the components depicted in FIGS l7-35t seve~al impor~ant concepts ~hould ~e expl At the hea~t o~ the proces~ d~picted ~n FIGS. l-16 a~e th~ temporary abut~ent~ 40 and 56 The~e abutments are intermediate members tha~ transition between the implant 28 (or implant analog 4~) and WOs7/~7901 PCT~S~/1s~47 one or more o~her components the positions o~
which need to be ~lxed rel~tive to ~he ~mplant The ab~tments 40 an~ SÇ thus per~onm two ba~ic ~u~ction~ they engage the implant ~8 and they ~o~m a snap ~it cha~ securely mounts ~other component rela~lve to t~e implant (or the analog thereo~) The physical ~ructure ne~e~ary to engage ~he implant ls depe~de~t ~pon the exact imp~ant selected Tempo~ary ~t~ents having structure necessary to engage th~ee ~mm~cially a~ailable implan~s are depic~ed in FIGS. l9A-D, 28, and 29 Othe~ st~uctures may be similarly ~ormed to engage othe~ impl~n~s not disc~ssed in thi~ applica~ion ~he ~ormation o~ th~ app~opri~te ~truc~ur~ ~or a glven implant type can be easily implemeneed d~ing ~he proce~s o~ ~abricating the mold ~sed to man~acture a gi~en t~mpo~ry abutment And typically, it will be ~ece~ary ~o m~nllfact~e and 2~ carry in inventory tempo~ary ab~tme~ts havi~g ~truceure adapted to engage a~y implant that is co~merciall~ a~ailable on a ~ig~i~i~ant le~el The snap ~it o~ the present invention can ~lso be formed in one o~ a number o~ di~erent Z5 ways A ~irst exemplary snap fit iS embodied in the components shown in FIGS l9A-D and 20, 22~-B, 26, 27, 28, and 29. A ~econd exemplary snap ~it ~ys~em is em~odied in the components ~hown ln FIGS 30-3~. =
The exace deta~ls o~ the ~nap ~it a~e not critical to implemen~ the principles o~ the presene inven~ion a~d o~her snap ~it systems may be e~p~oyed with 5~m;1~ ~ect To ~nc~ion ... . . . .
flexibly and reliably, the snap fit systems of the present invention have two characteristics: first, they are formed of projections and depressions that mate to positively hold one member onto another; and second they have a geometric shape that can be used to key one component relative to another. While both of these characteristics have advantages in the particular environment described, the present invention can be practiced with snap fit systems having either or neither of these characteristics and still obtain certain advantages over the prior art.
Once the details of the snap fit are determined, all components should be manufactured with the selected snap fit. Unlike the situation in which a number of different temporary abutments will normally be manufactured to match each style of commercially available implant, only one snap fit system needs to be and should be employed.
The various components used to implement the basic prosthodontic procedure described above with reference to FIGS. 1-16 will now be described. In the following discussion, the geometry of these components will first be described in detail, after which the function of the component geometry will be discussed.
Referring initially to FIGS. 19A-D, depicted therein at 110 is a temporary abutment identical to the abutments 40 and 56 described above. The temporary abutment 110 has a longitudinal axis A, an outer surface 112, and an inner surface 114 defining a centrally extending bore 116.
-CA 022380l6 l998-05-l5 WOs7t~7907 pcT~ss6/l8~7 ~ h~ o~er ~r~ace 112 comprises an ~pper por~ion 118, a ~ide portion 120, a~d a lower portio~ 122 The upper and lower sur~ace portions 118 and 122 are ~lat and generally arcua~e. The ~ide ~ac~ portion 20 comp~ise~ a gene~ally cylindrical upper area 124 adjace~ to ~e upper s~r~ace portion 118 and curved lower ~ea 126 ~ adjacent to the lower sur~ace portion 1~2 The low~r area ~26 is ~moothly and continuouqly c~rve~
~rom the upper area t 24 to ehe lower sur~ace por~ion 12~, The inner q~r~ace 114 de~i~e~ ~he shape o~
t~e ce~tral bore 116 such tha~ t~e ~or~ 116 comprises a lock portion 128, a ~crew receiving portion 130, and a he~ receiving portion 132 A~ perhaps ~e~t shown in FIG l9A, the loc~
portion 128 o~ the central bore 116 has ~ ~hape that ~ill be re~erred to ~ereln a~ ~coronal1', In pa~tic~l~r, ehe lock portion 128 is ~e~ined by a ZO generally cylindrical ~irst portlon 134 o~ the inner sur~ac~ 114 having a diameter dl Vertic~l groo~es 136 ~onmed in ~he inner sur~ace ~irst portion 134 ~urther de~ine the shap~ o~ the lock po~tion 128 ~dditionally, a locking groove 138 (FIG 19D) is ~ormed on the ~irst portion 134 o~ the inner ~ur~ace 114 ~he ~ertical grooves 136 extend t~ough the inner ~ur~ace ~irst ~ortion 134 and the lockiny groove 138 guch that ~he inner sur~ace portion 13g and ~he g~oo~e 138 are disconti~uo~
The screw recei~ing portion 130 o~ the central bore 116 is de~ined b~ a ~e~e~ally cylind~ical seco~d po~tion 140 o~ the i~er WOs7Jl7gO7 PCT~S96/18~47 sur~ace 114 having a diameter dZ This diameterd2 is less than ~he diameter dl o~ the inner ~ur~ace ~irs~ por~ion 134. A rounded, a~nular, horizontal re~aining projection 142 extends ~rom ~he inner ~ur~ace second portion 140 ad~acent to the central ~ore lock portion 12R.
The hex portion 132 o~ the centra~ bore is de~~ned by ~ six-sided hex por~io~ 144 o~ the inner ~ur~ace 114~ Th~s shape is pe~haps be~
~hown i~ FIG~ l9C
Fir-qt a~d seco~d conical port~ons 146 and 148 o~ the inner sur~ace 1~4 are ~o~med o~ a triangular, annular, horizontal projectio~ 150 arran~ed be~wee~ the i~ner surface ~eco~d portion l~O ~nd the ;nner sur~ace hex portion 144 The conical ~r~ace portio~s 14~ and 148 meet at an ann~lar tran~itio~ rid~e 15~ The conical e~r~ace po~io~ 146 and 148 an~ transicion ridge 152 de~ine a transition portion 154 o~ t~e cent~al bore 116 Re~erri~g now to F~G 18, depicted therein at 156 is an abutment screw asYembly ldeneical ~o the abutment screw as~emblie~ 4Z a~d 48 described a~ove~ The ~ut~ent screw assembly 156 co~prise~
a screw body 158 and an O-ring 160 The ~crew body lS8 has a ~hre~ded internal ~ace 16~ and an external s~rface 164. The e~te~al s~r~ace 164 comprises, ~rom bottom to top i~ FIG 18, a threaded portion 166, a ~ha~t portion 168, a conical portion 170, an i~creaYed diameter po~ion 172, an O-ri~g ~roo~e 174, and a hex body 176.
W O ~7/17~07 p ~ Au~s6/lS4~7 To obtain che as~en~bl~ 156, the O-ring 160 is seated in ~he 0-ri~g groove 174 When ~o ~eated, incidental movement bet~een the screw body 158 a~d the 0-~ing 160 i~ p~e~ented ~e~errin~ now ~o FIG 21, depict~d therein i3 a~ a~utment scrèw assembly 178 ~ed in a manner ~imlla~ to the a~utment ~crew assem~lies ~2 ~d 48 deqcribed above ~he abutmen~ ~crew assembly 178 çomprises a screw body 180 aud a sea~ing cap 18~ The ~crew ~o~y 180 is a simple cylinder with a~ externally th~eaded o~ter ~r~ace 184 The ~e~ting cap la2 has an outer ~ur~ace 186 having a ~yl~ndrical portio~ 1~8, a conical por~ion 190, ~nd a hex 1~ portio~ lgZ The seating ~ap 182 i~ ri~idly connected to ~he screw body 180 s~ch t~at axial rotation o~ the ~ap 182 is transmltted to the ~od~
Re~erring now to FIGS 28 and 29, t~e~e ~igures illus~rate how ~he abutment ~crew assemblies lS6 and 178 engage the te~porary ab~tment 110. In both cases, the annular re~i~;~g projection 142 o~ t~e inte~io~ sur~ace 114 o~ ~he a~tme~t 1lo engages a portion o~ the screw assembly such thae the ~crew assembly is cape~red within the central ~ore 116 More particularly, as ~how~ in FIG 28 the ~lexible 0-ring 160 hag ~ slightly larger diameeer than the annula~ retaining projection 142 The screw a~sem~ly 156 may be inser~ed into the cen~ral hore 116 such that t~e O-ring 160 is wi~hin the .~cre~ receiving por~ion 130 o~ the central b4~e 116, howe~r, because the o-ring 160 CA 022380l6 l998-05-l5 ~ W~97/17907 PCT~S96/1844 i co~preg~ible and de~l~c~s ~lightly to allow it ~o ente~ the screw receivi~g portion 130 Once the O-ring is within the bore por~ion 130, ~he O-ri~g ~o wil~ e~gage t~e retaining pro~ection 142 to p~e~e~t inadvertent ~emoval o~ the ~crew as~embly 156 But deliber~e applicatio~ o~ ~orce in a directio~ shown by a~row C will cause ~he O-ring l~O ~o compre~s and allow the screw as.qembly 1~6 to ~e removed ~rom the central bore 116.
Similarly, as show~ in FIG 29 the conical sur~ace l~O o~ the screw a~embly 178 ha~ a slig~tly la~gex diameter t~a~ t~e annular ret~;ng projec~ion 142. By manu~ac~ing at l~ast the sea~ing cap 1.82 o~ the screw assembly 178 o~t o~ pla~tic, the part~ m~y be ~abricated s~ch that ~he conic~l ~ur~ac~ l9O will pa~s by ~he re~n;~ projectio~ 142 such t~at ~he hex body 192 is within the scr~w recei~ing portion 130 o~
the cent~l bo~e 116 Onc~ the ~onical ~r~ace i~
withi~ the bore portion 130, the ~eati~g cap 182 will engage ~he retaining projection 142 to pre~ent inadvertent remo~al o~ the ~crew assembl~
1 178 B~t delibe~a~e applica~io~ o~ ~o~ce in a direc~io~ shown by arrow C will allow the screw assem~ly 15~ to be remo~ed from the ceneral ~ore 116 if de~ired ~ dditionally, i~ each o~ ~he si~uations sho~n in FIGS. 2~ and 2~, some movemen~ between the sc~ew ~s~emblies 1S6 and 17~ a~d the a~tment llO
3D ~long the ab~tment axi-~ A is allowed. As will be explained in ~urther detail below, ~his allows ~he ah~tment to ~e }i~ted sligh~ly and rotated CA 022380l6 l998-05-l5 W097n7907 PC~96/184~7 relati~e to th~ in~ert even a~ter the poqi~on o~ -the ~cr~w assembly i9 ~iXedA
~e~er~lng now ~o PIG 17, ~epicted therein i~
a~ i~pla~ 2iO identical to the i~plant Z8 descr~ed abo~e. The implan~ 210 i~ conve~tional and will be de~cribed herein only to the ~tent necessary ~or a complete understanding o~ the pre~ent invention The implan~ 2~0 ha~, in addltio~ to the threaded extern~1 ~urface 30, threaded inte~nal s~r~ace 32, and screw cavity 34 b~ie~ly descr~bed abo~e, an ~pper ~houlder 212, ~pper ~Ur~ace ~14, ~nd hex ~ody 216. ~he upper shoulder 212 is genera11y cyli~dri~al, The ~pper ~ur~ace 214 i9 ~la~, disc-shaped, and is bounded at its outer pe~iph~ry by the 3hould~r 212, The hex body 216 ex~end~ f~om ~he uppe~ ~r~ace ~O. The screw ca~ity 3~ p~.~3e~ th~o~gh the ~ppe~ ~r~ace 2~2 and t~e he~ body 21~. The e~ti~e implant 28 is ZO ge~erally ~ym~etrical abo~t its longi~udi~al axi~
D, with the exte~nal sur~ace 30, internal sur~ace 32, 3crew cavity ~4, Upper sho~lder ~12, upper sur~ace 21~, and hex body 216 all being coa~ially aligned wi~h the longit~l~;n~l axis D.
~e~erring ~ow tO FIG. 20, depic~ed therein i9 an abu~ment cap 218 ldentical to ehe a~tment cap 44 described abo~e. The abut~ent cap 21~
comprises a cylindrical ~ase po~tion 220, a dome-ghaped co~er po~tion 222, a~d a locking rin~ 224.
FIGS 22A and 22B ill~strate an impression ~ea~her ~26 l~entical to ehe impres~ion feather 4~
described abo~e The ~eather 226 comprises a base po~io~ 228 a~d an ~pper po~tio~ 2~9 T~e o~erall woy7/l7~07 PCT~S96/~8~7 shape o~ the base portion ~2B is pe~haps best shown in FIG 22B and is sized and con~igured to match the ~im~n~ions o~ ~he lock portion 128 o~
~he central bore 114 o~ ~he ~emporary ab~ment llO
In partic~lar, the base port1on 128 compri~e~
a wall 230 having a cylindrical ou~er ~ur~ace 232 and a hex-shaped inner sur~ace 234 Projecting at interva~s ~rom ~he ~rom the outer sur~ace 232 are ~ertlcal aliynment projection~ 236 The ~ase portion o~ter ~ace 232 iB ~im~ianed ~o ~it s~ugly wi~hin the cylindrical inner portion 134 o~
t~e ah~t~ent inner wa~ 114 The alignment projections 236 are s~milarly ~m~n~ioned to ~it s~ugly wi~hin the alig~ment g~oove~ 136 ~ormed in the ab~tment inner wall 11~ The ~ase portio~ 128 o~ the impression ~eat~e~ 226 may thus be ~eceive~
wit~in the lock portion 128 o~ the abut~ent centra~ bo~e ~1~ in a ~nn~ pre~ents relative axial rotation bet~ee~ the ~eather 226 and the ab~tment 110~
Additionally, locking pxojections ~3~ ex~end ~om the cylindrical outer ~r~ace 230 o~ t~e base wall 228 The ~pper po~tio~ 2:2g af~ the lmp:re:3~3io~
~eather 226 co~ri~e~ a se~ies of horizontal ~langes 240 ~hat extend ~rom a cen~ral post 242 The ~langes 240 are o~se~ ~om the flanges above and ~elow by 90 degrees The purpose o~ ~he 30 ~ an~es 240 is ~o crea~e a ~ec~re interco~ne~tion between the ~mp~ession ~eaeher 226 and the ~mpresqion in whi~ it is cap~ured ~0~7/~7~07 pcT~ss6Jl8~7 -2~-Wi~h an unde~ge~nAi ng o~ the s~a~e o~ tAe ~o~going compo~e~t llO, 156, 178, 210, 218, and Zz6, certain qteps in t~e pro3thodontic procedu~e illus~rated tn ~IGS 1-16 will be now deQcribed in ~rther detail Re~erring initially to the ~tep deplc~ed in FIG. 6, in that step the a~utment ~cre~ 42 is captured within the te~porary ~butment 4O a~
described above and may thus be transported to the patie~t~ mo~th as an as~embl~. Thi~ lesse~ the li~elihood that ~he ~urgeon will drop or ocherwi~e ¢h~n~l e ~he componen~ used d~ring stage two surger~r ~etween ~IGS 6 a~d 7, ~he abutment cap 4 ~as ~ee~ placed o~to the te~porary ~tment 40 T~e cap ~ is man~actu~ed ~l~ch that it engages the tempo~a~ ah~tment 40 wi~h a qimple snap ~t Mor~ speci~lcally, ~he locki~g ring 224 ~o~med bn the cap 44 is sized, ~m~n~ioned~ an~ ~paced ~rom the cover portio~ 222 thereo~ such that ~he ~ing 22~ enga~eq t~e locking groove 138 ~ormed on the inner surfac~ 114 o~ the a~tment 40 So engaged, the co~er portion 22Z o~ the cap 4~ ~est~ snugly against the upper s~r~ace 118 o~ the abutment 40 Z5 to p~e~ent material ~rom ente~ing the center bo~e Between the stepq depicte~ i~ FIGS 7 and 8, the abu~ment cap 44 is removed ~ro~ the temporary abu~me~t 40 To ~acilita~e this removal, a notch 242 ~FI~. l9B) is ~onmed on the abutme~t llO. A
dental pic~ may be inse~ted into this notch under the cap co~er po~tlon 222 to pop ~he cap 44 o~ ~~
the ~b~tment ~O
. ' W O 97/17907 PCT~US96/18447 ~ Prior to the ~tep shown in ~G 8, the impres~io~ ~ea~her 46 wa~ attached to the temporary abut~ent 40 Thi~ atta~hmen~ 1~ made by a snap ~it sl~ilar to that employed to at~ach th~
cap ~4 on~o the abutment 40. I~ p~ticula~, the locking projection~ 238 ~ormed on the base 228 o~
~he i~p~e~sio~ ~e~ther 46 e~gage t~e lock~g groo~e 138 ~ormed on the inne~ ~u~ace 114 o~ the ~b~tme~t 40. This engage~ent pre~ents inad~ertent ~e~oval o~ t~e ~mpre~ion ~eath~r 46 ~rom the ab~tment 40 but may ea-~ily be overcome ~y the app}lcation o~ deli~erate ~orce on the impressio~
~eather ~6 ~wa~ ~rom the abutment 40.
An identica~ aetachment is ~onmed bet~ee~ the imp:r:ession ~eather 46 in the impre~ion 50 aIld the second temporar~ a~utment 56 as sho~n i~ FIGS. lO
and 11 Many o~ ~he compone~ts descri~ed abo~e may ~e m~de o~t o~ any ~aterial t~at i~3 ~ic~logically ~e~t a~d ~trong enou~h to with5tand the loads enco~tered durlng i~ertio~ and whlle belng worn in the patie~t'~ mouth Certainly any s~rgical grade m~tal such as ~i~an:ium would work sa~is~actorily, although th~ pri~ary be~e~itR of the presen~ in~ention are ob~aine~ by ma~u~acturing the at least portion~ o~ the~
component~ ou~ o~ dental grade plasti~.
n particular, the temporary a~tment 1lo, ~eatin~ cap 182, ab~tment cap 224, and impre-~sion ~eather 22~ are a~1 pre~er~bly ~a~ricated o~t o~
pla~tic ~uch as an ace~yl copol~mer I~ any ~ituatio~ where a snap ~it i~ employed to attach two components toge~her, at lea~t one, and WO97/17907 P~T~s9fi/l 8~47 pre~era~ly both, o~ these components must be manu~actured o~t o~ plastic to allow ~h~
de~lec~ion nece~sary to achie~e ~he snap ~
. Re~erring now to FIGS ~-27, depicted the~ein are ce~ain addi~ional componenr~ that may be em~loyed using the sysCems and components o~ the present in~en~ion It ~ho~ld be noted that thes~
~dditional compo~ents will normally be used during ~ariation~ o~ the ~asic proced~re de~icted in F~GS l-16 a~ ~its a partic~lar c~rc~mst~nce.
FIG 23 depicts a pick ~p po~t zs4 tha~
passe~ thro~gh ~ central bore 246 ~or~ed in the impresqi~n ~eather 226 or in one o~ the ~em~ers depicted in FIGS. 24, 26, or ~7 ~ ~hreaded end ~48 o~ the post 244 allows ~he post 244 to ~ix the position the member thro~gh which it passes rel~ti~e to ~n implant.
FIG. 24 depicts a surgical impression ~e~ther 250 that may be ~sed during phase o~e s~rgery to ob~ain an imp~egsion indicating the locatio~ o~
the imp~ant. A lower post 252 o~ the ~rgical imp~ession ~eather 2~0 enters the screw chamber 34 de~i~ed by the implant to ~or~ a ~ric~io~ ~it that holds the ~eather 2SO in place while the impression i~ being taken. ~he pos~ 2S2 is not Chreaded, ho~ever, and may be withdraw~ when the impression is re~oved FIG 25 ~epict~ a temporary cyli~er ~54 adapted ~o ~e ~tt~ched to the ~emporary ab~tment 3Q llO by the pick-~p ~ost 244 ~he bottom end thereo~ has a corona type ~aste~er to ~ey the cylinder ~56 relative to the ~emporary ab~ment 110 _ -CA 022380l6 l998-05-l5 ~ ' WO97/17907 pcT~ss6/l8~7 - FIG5 ~ and 27 depict a cylinder 25~ a~d a preped abutment 258, respectively These me~bers - 256 and 258 may be attac~ed to the temporary a~utment llO and implant 210 and preped like a tooth to s~pport a temporary or permanent restoration Th~se members ~56 ~nd 258 ha~e bases 260 and 262 that allow them be snap ~it onto a temporary abutment s~ch as t~e t em~orary ab~tme~t 110, FIG 35 ~epicts the cylind~r 256 attaehed to the a~utment 40 and implant 28 by a screw 264.
~e ~ase 260 o~ the ~ylinder 256 eng~geY and ~o~m.
a snap-~it with the abutment 40 The sc~ew 264 has a ~ead portion 266, ~ sha~t por~ion 268, and a 1~ th~eaded portion 270 ~ hex recess 272 is ~ormed in the he~d portion 270. The cylinder 2~6 de~ines ~ ce~tral bore 274 havi~g a ~rst, lar~er diamecer portion Z76 and a second, ~maller diameter ~ortion 2~8 A shoulder s~r~ace 280 is ~or~ed at the Z0 j~ncture o~ the ~ore por~ions ~74 and 276 The sh~t portion 268 o~ the ~crew spaces the treaded por~ion 270 ~rom ~he head portion 266 such that, when the threaded portion 270 is rotated onto the threaded sur~ace 32 o~ the implant 28, the head portion 266 act~ on the sho~lder sur~ace 280 to ~old the cylinder 256 onto the ab~tmen~ ~o and the a~tment 40 onto the impla~t 28. The base 260 th~s keys the cylinder ~56 onto the a~tment 40, and ~he screw 264 holds the assembly o~ the cylinder 256, a~utme~e 40, and imp~an~ 28 to~ether The cylinder 256 can th~$ support, on a tempora~y basis, a temporary or perm~
res~or~tion.
~0g7/17907 P~r~ss6/lx447 Re~erring now to FIG. 30, depicted therei~ is prosthodontic assembly 310 comprising z temporary ~butment 312; implant 31~, and screw 31~. ~he tempora~y abutment 312 has a longitu~ 7.n~ 1 axis A, an outer ~r~ace 318, and an inner sur~ace 320 de~ini~g a c~ntrally ext~
bore 322. ~he implant 31~ h~s an externa~
sur~ace 324 having a threaded portion 326 and ~n internal Bur~ace 328 ha~i~g a threaded 10 portion 330 The screw 316 has a head po~tio~ 332 and a bha~t portion 334. A threaded s~r~ace 336 i5 ~ormed on the sha~t portion 334 In general, the scre~ 316 attaches the t~mporary abutment 312 to the implant 314. The speci~ic str~c~ure tha~ allows this a~tachment will be described in ~rther detail ~elow.
In ge~eral, the screw 316 passes thro~yh ~he cen~ral bore 322 such thae ~he thrèaded s~r~ace 336 on the ~c~ew engages the threaded portion 330 20 o~ the internal sur~ace 328 o~ the implant 314 The outer sur~ace 318 di~ers ~rom the o~ter sur~ace 312 o~ the temporary a~u~en~ llO
described abo~e in that it is adapted to mate with the implan~ 314. I~ pa~tic~lar, the exte~ior 25 sur~ace 324 o~ the implant 314 has a co~ical por~ion 338 that ~orms a ~ho~lder o~ t~e impla~t 314 ~he i~terior sur~ace 32 a 0~ the implant 314 de~ines, in addition to the threaded por~ion 330 ~escribed abo~e, a hex portion 340.
~e~erring to ~ 31, it ca~ be seen that the hex por~ion 340 ~e~ines a hex c~amber. To allow the temporary a~utm~nt 312 ~o securely e~gage ~h~
implant 314, a ~r~stoconic~l ~ace 3~2 and CA 022380l6 l998-05-l5 'WO97/I7907 PCT~S96/18~47 hexagonal projection 344 are ~onmed thereon. The ab~tment conical sur~ace 342 is angled ~ith re~pect to the longitl]~i~l axis A to abut ~he ~r~stoconical sur~ace 33~ ~ormed on the imp~ant 314. S~milarly, the hexagonal p~ojection 344 is sized and ~lm~n~ioned to ~e sn~gly recei~ed withi~
the cham~er de~ine~ by the hexagona~ sur~ace 3~0 on t~e implan~ mem~er 314 Th~s, when the temporary abutment 312 i~ attached to the imp~ant 314, t~e conical s~r~a~c~ 338 and 342 a~ut each other and the hexagonal projection 344 on the abutment llO is received ~ithin ~he he~agonal ca~ity de~ined ~y the hexagonal su~ace ~40 on ~he implant 31~.
~he ce~ral bore 322 comprise~ a lock portion 346 a~d a 5cre~ rec~i~ing portion 3~
The loc~ portion 346 is similar in operation to the lock ~ortion 128 o~ the cen~ral bore 116 described a~o~e The lock portion 3~6 is de~ined by a ~irst portio~ ~48 o~ the interior wall 320. Thi~ wall portio~ 348 is generally hexagonal in shape. In particular, this wall portion 3~8 comprises 5iX
iden~ical wall segments 350 each ha~ing an Z5 elliptical ~cesS 352 ~ormed the~ein.
~ e~erring now ~or a m~m~t to FIGS 32 and ~3, depicted therein is an impression coping 354 adapted to m~te with the temporary ab~tment 312 The impression coping 3~4 is i~
most ~espects the sa~e as ~he impression coping 226 described above. The primary di~erence ~etw~en these is that a base ~097/1790~ Pcr~96/18~47 por~ion 356 o~ the coping 354 is adapted to mat~
wi~h the tempora~y abutment llO.
In particular, ~he-bage portion ~S6 has a hexagonal ~ody 358 ha~ing six ~dentical s~r~aces 360, with a projection 362 fonm~d on each o~ the s~aces 360~ T~e hex me~ber 35~ i~ slzed and ~n~ioned to be sn~gly recei~ed wi~hin the locke~ por~io~ 346 o~ the cent~al bore 322, ~ith the projections 3~2 being recei~ed within the ~ecesses 352. The recesses 362 engage the proj ection~ 362 to ~os~ a snap pit that loc~s ~he i~pression copi~g 354 onto the tempor~r~
ab~ltme~t 31~ as desc~ibed a~ove The loc~ing system ~o~med ~y the base portion 3~6 o~ the impre~sion coping 3S~ and the ~irst portio~ 346 o~
the central bore 32~ malntains the impression coping in an appropriat~ relatio~hip to the temporary abutment 312 during the process o~
taking the impression But the impressio~ coping 354 can ~e removed ~y ~he applica~ion o~
deliberate manual ~orce o~ the impre5sion copin~
354 away ~ro~ the temporary ab~tme~t 31~
It sho~ld b~ recog~ized that ~he base po~ion ~56 o~ the impression coping 3S~ may be - 25 s~tit~ted on any o~ ~he co~ponents de~cribed ~ove ~hat a~e in~ended to be mo~n~ed o~ to the temporary ab~tment llO The impre~sio~ coping 35 i~ ~imply exemplary o~ these other ~ompone~ts.
~ e~errlng now to FIG 30, it can be seen that 30 ~he central bor~ 322 further comprises a seco~d, head receiving portion 364 ~hi~ hea~ r~c~i~ing po~tion 364 is de~ine~ by a cylindrical wall 366 and a ~r~s~QcQ~ical wall 368 The head po~tion CA 022380l6 l998-05-l5 ~ ' WO97/17907 PCT~Ss~/l84~7 332 o~ the screw 316 has a ~u~toconical wall 370 that is arra~ged ~t the same a~gle as the wall 36a Accordingly,-as the screw 316 i~
axiall~ rotated, its threaded s~rface 336 engages S the threaded portion 330 o~ the implant 314 to pull the conical s~r~ace ~70 on the head portion 332 against t~e c~nical s~r~ace 368 de~ining the head receivin~ portion 364 R~fer~ing now to FIG. 3~, depicted at ~lO
ther~in i~ yet another exemplary implant asse~ly constr~c~ed in accordance wi~, ~n~ em~odying, the principles o~ the present invention This a~sembly 410 comprises yet another exemplary temporary abutmen~ 412 that i~ attached to an impl~nt ~14 The i~plant 414 i5 a special type of i~plant re~erred to as ~ Morris taper. Th~
temporary abutment 412 has ~een modi~ied to the ~orris taper style implant 414 The implant 414 has an ex~erior ~rface ~16 Z0 and an interior s~lr~ace 4la- The exterior s~rface is adapted to be threaded into a pa~ient'e bone a~d be o~seointegrated thorewich An upper portion 420 o~ the e~terior s~r~ace 416 i~ ~ormed i~ a downwardly tape~in~ ~r~stoconical shape The inner sur~ace 418 has an upwardly taperin~
~r~stoconical s~r~ace 4~2 that extends at ~n angle o~ approximately 6 deg~ees relative to the longit~ n~l axis o~ the impla~t 414~ These two ~urraceq 420 and 422 ~e~ at an annular uppermo~
portion 424 o~ the implan~ 414-The in~e~ s~r~ace 418 o~ the i~pla~t 414 th~s de~ines a ~rustoc~nica} region 426 abo~e a threaded region 4Z8 de~ined ~y a ~hre~ded s~rface CA 02238016 1998-0~-15 WOs7/~7907 ~CT~ss6~l84~?
-3~-430 This arr~nge~en~ allows ~he ~emporary abu~men~ 4~2 to be direc~ly threaded onco the implant 414, ob~iating the need f or a separa~e ~c~ew.
The temporary abutme~t 4~2 th~ doe~ ~ot ha~e a ~entral bore extendlng all the way .herethrough, i~s~ead ha~iny an ~pper ca~ity 432 de~ined by an inne~ wall 434 The i~ner ~all ~34 ha~ an upper portion ~ 6 co~prising SlX sur~aces 438 each ~a~i~g ~n elliptical or o~oid depression ~40 ~or~ed therei~ Inner wall 434 also has a cylindrical portion 44~ The upper cavity 432 operates i~ the ~ame ba~ic manner as the ~irst and second portions o~ the ce~tral bore 322 de~cri~ed abo~e eo allow components having a ~ase ~or~ion ~ch as the ~a~e po~tion 3~6 o~ the impresYion coping 354 described above to be attached to the temporary abutm~n~ 412 Formed on a lo~er portion o~ ehe tempora~y abutm~nt llO i8 an inwardly ~cing ~rustoconical s~r~ace 444 and a~ o~twardl~ ~cing ~r~stoconical sur~ace ~46. The sur~ace3 4~4 and 446 are sized and ~im~n~ioned to m2tch ehe sur~aces 420 and 418, respectively, ~ormed on the implant 414. The abutme~t outer sur~ace ~46 ~urther comprises a threaded portion ~50 below the ~rustoconical portion 448 The sur~ace portions g46, 448, ~nd 450 are ~rr~nge~ ~na dimensioned relative to ea~h o~her ~o allow the t~mporary a~uc~ent ~lO to be ~hreaded o~o the implan~ ~14 ~s ~ollows The Chreaded sur~ace portion 450 e~gages ~he threaded inner s-~r~ce portion 430 o~ ~he impla~ 414 s~ch that, ~hen the ab~t 4~2 i~ ~o~te abo~ i~s W O 97tl7907 PCTrUS96/18~47 axis, these threaded sur~aces engage to displace the ~emporary abutmen~ 412 towards the impla~
- 414 ~ some point, the sur~ace~ 446 and 448 will enga~e the ~r~aces 420 and 418 to s~gly attach the temporary ~b~tment 4122 onto the implant 414 ~he abutment can ~hen be use~ in the same basic ~anner as the temporary ab~tments o~ the present i~vention as desc~ibe~ abo~e Anot~e~ aqpect o~ the p~esent inve~tion not readily appare~L ~rom the drawings i-Q the relati~e size o~ ~he various components shown and descrihed ~erein For example, the temporary abutments ma~
:be sold with di~erent ex~ernal dlaIrLe~er~ D ~ FIG .
19C) An appropriate abutmen~ di,~eter is then ~e~ected ~or a partic~lar si~ation Other compo~ents, s~ch as the cap 218 and impressio~
copiny 226, need not ~e pro~ided i~ di~ere~t size~ to match the di~erent diamete~s of the temporary abu~ment Thus, once the exterDal diameter D is ~electe~, ~o ot~er size choices need be made in implement the procedure o~ the pr~sen~
inve~ion This allows, ~or example, only one type o~ cap 218 need be man~actured a~d kept in in~en~ory F~om the ~oregoing, it sho~ld be ~lear ~hat the i~vention ~ay be embodied in other speci~ic ~on~s ~ithout departing ~rom the spirit or essen~ial charac~eris~ics thereo~ ~ The prese~t embo~i~nts a~e there~ore to be considered in all respe~s as illustrative and not restr~cti~e
The temporary abutme~t 4~2 th~ doe~ ~ot ha~e a ~entral bore extendlng all the way .herethrough, i~s~ead ha~iny an ~pper ca~ity 432 de~ined by an inne~ wall 434 The i~ner ~all ~34 ha~ an upper portion ~ 6 co~prising SlX sur~aces 438 each ~a~i~g ~n elliptical or o~oid depression ~40 ~or~ed therei~ Inner wall 434 also has a cylindrical portion 44~ The upper cavity 432 operates i~ the ~ame ba~ic manner as the ~irst and second portions o~ the ce~tral bore 322 de~cri~ed abo~e eo allow components having a ~ase ~or~ion ~ch as the ~a~e po~tion 3~6 o~ the impresYion coping 354 described above to be attached to the temporary abutm~n~ 412 Formed on a lo~er portion o~ ehe tempora~y abutm~nt llO i8 an inwardly ~cing ~rustoconical s~r~ace 444 and a~ o~twardl~ ~cing ~r~stoconical sur~ace ~46. The sur~ace3 4~4 and 446 are sized and ~im~n~ioned to m2tch ehe sur~aces 420 and 418, respectively, ~ormed on the implant 414. The abutme~t outer sur~ace ~46 ~urther comprises a threaded portion ~50 below the ~rustoconical portion 448 The sur~ace portions g46, 448, ~nd 450 are ~rr~nge~ ~na dimensioned relative to ea~h o~her ~o allow the t~mporary a~uc~ent ~lO to be ~hreaded o~o the implan~ ~14 ~s ~ollows The Chreaded sur~ace portion 450 e~gages ~he threaded inner s-~r~ce portion 430 o~ ~he impla~ 414 s~ch that, ~hen the ab~t 4~2 i~ ~o~te abo~ i~s W O 97tl7907 PCTrUS96/18~47 axis, these threaded sur~aces engage to displace the ~emporary abutmen~ 412 towards the impla~
- 414 ~ some point, the sur~ace~ 446 and 448 will enga~e the ~r~aces 420 and 418 to s~gly attach the temporary ~b~tment 4122 onto the implant 414 ~he abutment can ~hen be use~ in the same basic ~anner as the temporary ab~tments o~ the present i~vention as desc~ibe~ abo~e Anot~e~ aqpect o~ the p~esent inve~tion not readily appare~L ~rom the drawings i-Q the relati~e size o~ ~he various components shown and descrihed ~erein For example, the temporary abutments ma~
:be sold with di~erent ex~ernal dlaIrLe~er~ D ~ FIG .
19C) An appropriate abutmen~ di,~eter is then ~e~ected ~or a partic~lar si~ation Other compo~ents, s~ch as the cap 218 and impressio~
copiny 226, need not ~e pro~ided i~ di~ere~t size~ to match the di~erent diamete~s of the temporary abu~ment Thus, once the exterDal diameter D is ~electe~, ~o ot~er size choices need be made in implement the procedure o~ the pr~sen~
inve~ion This allows, ~or example, only one type o~ cap 218 need be man~actured a~d kept in in~en~ory F~om the ~oregoing, it sho~ld be ~lear ~hat the i~vention ~ay be embodied in other speci~ic ~on~s ~ithout departing ~rom the spirit or essen~ial charac~eris~ics thereo~ ~ The prese~t embo~i~nts a~e there~ore to be considered in all respe~s as illustrative and not restr~cti~e
Claims
I claim:
A prosthodontic procedure for transferring a location of an implant member implanted in a patient's mouth to a model of the patient's mouth, comprising the steps of:
providing a first temporary abutment member having a bore defined by an inner wall of the first temporary abutment member;
displacing the first temporary abutment member such that it engages the implant member;
fastening the first temporary abutment member to the implant member by passing a fastener through the bore in the first temporary abutment member and into a threaded cavity in the implant member;
providing a prosthodontic member having a base portion;
forming a recess on one of the abutment member inner wall and the base portion of the prosthodontic member;
forming a projection on the other of the abutment member inner wall and the base portion of the prosthodontic member;
displacing the prosthodontic member towards the first temporary abutment member until the projection engages the recess to form a snap fit that prevents inadvertent removal of the prosthodontic member but which allows the prosthodontic member to be removed by application of deliberate force thereon;
forming an impression of the patients mouth.
such that the prosthodontic member is embedded in the impression;
applying deliberate force to the impression such that the projection disengages from the recess, thereby allowing the impression and the prosthodontic member embedded therein to be removed from the patient's mouth;
providing a second temporary abutment member;
attaching the second temporary abutment member to the prosthodontic member embedded in the impression;
providing an analog of the implant member;
attaching the analog of the implant member to the second temporary abutment member to form an impression assembly; and forming the model of the patient's mouth from the impression assembly.
A prosthodontic procedure as recited in claim 1, further comprising the step of forming one of the first temporary abutment member and the prosthetic member out of plastic.
A prosthodontic procedure as recited in claim 2, in which both the first temporary abutment member and the prosthetic member are formed out of plastic.
A prosthodontic procedure as recited in claim 3, in which the prosthodontic member is an impression member.
A prosthodontic procedure as recited in claim 1, in which the prosthodontic member is an impression member, the procedure further comprising the steps of:
fabricating a prosthetic tooth using the model;
mounting the prosthetic tooth onto the implant.
A prosthodontic assembly comprising:
an implant member implanted into a patient's jaw bone;
a first prosthodontic member having an inner surface defining a bore having first and second bore portions, where the first bore portion is adapted to mate with a portion of the implant member;
a second prosthodontic member having a base portion adapted to mate with the second bore portion, where the second prosthodontic member is in a desired position relative to the first prosthodontic member when the base portion mates with the second bore portion;
a fastener extending through the bore and into a threaded cavity in the implant member to fix the first prosthodontic member relative to the implant member; and attachment means comprising a projection and a recess for attaching the second prosthodontic member onto the first prosthodontic member in the desired position, where the projection engages the recess such that the second prosthodontic member is attached to the first prosthodontic member in a manner that resists inadvertent removal of the second prosthodontic member from the first prosthodontic member but allows removal of the second prosthodontic member from the first prosthodontic member by application of deliberate, manual force on the second prosthodontic member in a direction away from the first prosthodontic member.
A prosthodontic assembly as recited in claim 6, in which the projection is formed on one of the inner surface of the first prosthodontic member and the base portion of the second prosthodontic member and the recess is formed on the other of the inner surface of the first prosthodontic member and the base portion of the second prosthodontic member, the projection being sized, dimensioned, and located relative to the recess to enter and engage the recess when the second prosthodontic member is in the desired position.
A prosthodontic assembly as recited in claim 7, in which at least one of the first and second prosthodontic members is made of plastic.
A prosthodontic assembly as recited in claim 8, in which both the first and second prosthodontic members are made of plastic.
A prosthodontic assembly as recited in claim 6, in which at least one of the first and second prosthodontic member is injection molded out of plastic.
A prosthodontic assembly as recited in claim 6, in which the first prosthodontic member is an abutment member.
A prosthodontic assembly as recited in claim 11, in which the bore extends through the abutment member.
A prosthodontic assembly as recited in claim 12, in which the inner surface of the abutment member further defines a third bore portion for receiving the screw member in a manner that allows the screw member to rotate relative to the abutment member until the screw member engages the inner surface to securely hold the abutment member against the implant member.
14. A prosthodontic assembly as recited in claim 13, in which the first bore portion is adapted to receive a portion of the implant member in a manner that prevents rotation of the abutment member relative to the implant member when the abutment member is attached to the implant member.
15. A prosthodontic assembly as recited in claim 11, in which the second abutment member is an abutment cap that covers the bore in the temporary abutment member.
16. A prosthodontic assembly as recited in claim 11, in which the second abutment member is an impression member configured to be embedded in impression material.
17. A prosthodontic assembly as recited in claim 11, in which the second abutment member is cast in gold during fabrication of a prosthetic member.
18. A prosthodontic assembly as recited in claim 11, in which the second abutment member is a temporary cylinder.
A prosthodontic assembly as recited in claim 11, in which the second abutment member is surgical impression member adapted to be embedded in impression material to indicate a location of an implant member.
A prosthodontic procedure comprising the steps of:
osseointegrating a first implant member at a desired location;
attaching a first temporary abutment member to the first implant member;
attaching an abutment cap member onto the first temporary abutment member;
allowing gingival tissue around the first temporary abutment member to heal;
removing the abutment cap member from the first temporary abutment member;
attaching an impression member onto the first temporary abutment member;
applying impression material to the impression member;
allowing the impression material to solidify to form an impression in which the impression member is embedded;
removing the impression member from the first temporary abutment member with the impression member still embedded in the impression;
attaching a second implant member onto a second temporary abutment member attaching the second temporary abutment member to the impression member embedded in the impression;
applying model material to the second temporary abutment member and second implant member, allowing the model material to solidify to form a model in which the second implant member is embedded;
removing the second temporary abutment member from the impression member;
removing the second temporary abutment member from the second implant member, attaching a permanent abutment member to the second implant member;
forming a prosthetic member on the permanent abutment member;
removing the first temporary abutment member from the first implant member; and attaching the permanent abutment member and prosthetic member to the first implant member.
21. A procedure as recited in claim 20, in which the step of attaching the abutment cap member onto the first temporary abutment member comprises the steps of:
forming a projection on one of an inner surface of the first temporary abutment member and a base portion of the abutment cap member; and forming a recess on the other of the inner surface of the first temporary abutment member and the base portion of the abutment cap member, wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the abutment cap member is attached to the first temporary abutment member.
A procedure as recited in claim 20, in which the step of removing the abutment cap member from the first temporary abutment member comprises the step of applying deliberate manual force to the abutment cap member in a direction away from the first temporary abutment member.
A procedure as recited in claim 20, in which the step of attaching the impression member onto the first temporary abutment member comprises the steps of:
forming a projection on one of an inner surface or the first temporary abutment member and a base portion of the impression member; and forming a recess on the other of the inner surface of the first temporary abutment member and the base portion of the impression member, wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the impression member is attached to the first temporary abutment member.
A procedure as recited in claim 20, in which the step of removing the impression member from the first temporary abutment member comprises the step of applying deliberate manual force to the impression in a direction away from the first temporary abutment member.
A procedure as recited in claim 20, in which the step of attaching the second temporary abutment member onto the impression member comprises the steps of;
forming a projection on one of a base portion of the impression member and an inner surface of the second temporary abutment member; and forming a recess on the other of the base portion of the impression member and the inner surface of the second temporary abutment member; wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the second temporary abutment member is attached to the impression member.
A procedure as recited in claim 20, in which the step of removing the second temporary abutment member from the impression member comprises the step of applying deliberate manual force to the model in a direction away from the impression member.
27. A procedure as recited in claim 20, in which the step of attaching the first temporary abutment member onto the implant member comprises the steps of;
forming a bore in the first temporary abutment member defined by an inner wall thereof;
forming a threaded chamber in the implant member;
providing a screw member having a threaded portion adapted to engage the threaded chamber in the implant member and an increased diameter portion;
passing the threaded portion of the screw member through the bore in the first temporary abutment member; and rotating the screw member such that the threaded portion thereof engages the threaded cavity in the implant member, thereby displacing the screw member until the increased diameter portion thereof engages the inner wall of the first temporary abutment member.
28. A procedure as recited in claim 27, in which the step of attaching the first temporary abutment member onto the implant member comprises the steps of;
forming a body portion on the implant member;
forming the bore in the first temporary abutment member such that the bore contains a receiving portion adapted to receive the body portion on the implant member; wherein the body portion of the implant member engages a portion of the inner wall of the first temporary abutment member that defines the receiving portion of the bore to prevent rotation of the first temporary abutment member relative to the implant member.
29. A method as recited in claim 20, in which the at least one of the first temporary abutment member, abutment cap, impression member, second temporary abutment member is made of plastic.
A prosthodontic procedure for transferring a location of an implant member implanted in a patient's mouth to a model of the patient's mouth, comprising the steps of:
providing a first temporary abutment member having a bore defined by an inner wall of the first temporary abutment member;
displacing the first temporary abutment member such that it engages the implant member;
fastening the first temporary abutment member to the implant member by passing a fastener through the bore in the first temporary abutment member and into a threaded cavity in the implant member;
providing a prosthodontic member having a base portion;
forming a recess on one of the abutment member inner wall and the base portion of the prosthodontic member;
forming a projection on the other of the abutment member inner wall and the base portion of the prosthodontic member;
displacing the prosthodontic member towards the first temporary abutment member until the projection engages the recess to form a snap fit that prevents inadvertent removal of the prosthodontic member but which allows the prosthodontic member to be removed by application of deliberate force thereon;
forming an impression of the patients mouth.
such that the prosthodontic member is embedded in the impression;
applying deliberate force to the impression such that the projection disengages from the recess, thereby allowing the impression and the prosthodontic member embedded therein to be removed from the patient's mouth;
providing a second temporary abutment member;
attaching the second temporary abutment member to the prosthodontic member embedded in the impression;
providing an analog of the implant member;
attaching the analog of the implant member to the second temporary abutment member to form an impression assembly; and forming the model of the patient's mouth from the impression assembly.
A prosthodontic procedure as recited in claim 1, further comprising the step of forming one of the first temporary abutment member and the prosthetic member out of plastic.
A prosthodontic procedure as recited in claim 2, in which both the first temporary abutment member and the prosthetic member are formed out of plastic.
A prosthodontic procedure as recited in claim 3, in which the prosthodontic member is an impression member.
A prosthodontic procedure as recited in claim 1, in which the prosthodontic member is an impression member, the procedure further comprising the steps of:
fabricating a prosthetic tooth using the model;
mounting the prosthetic tooth onto the implant.
A prosthodontic assembly comprising:
an implant member implanted into a patient's jaw bone;
a first prosthodontic member having an inner surface defining a bore having first and second bore portions, where the first bore portion is adapted to mate with a portion of the implant member;
a second prosthodontic member having a base portion adapted to mate with the second bore portion, where the second prosthodontic member is in a desired position relative to the first prosthodontic member when the base portion mates with the second bore portion;
a fastener extending through the bore and into a threaded cavity in the implant member to fix the first prosthodontic member relative to the implant member; and attachment means comprising a projection and a recess for attaching the second prosthodontic member onto the first prosthodontic member in the desired position, where the projection engages the recess such that the second prosthodontic member is attached to the first prosthodontic member in a manner that resists inadvertent removal of the second prosthodontic member from the first prosthodontic member but allows removal of the second prosthodontic member from the first prosthodontic member by application of deliberate, manual force on the second prosthodontic member in a direction away from the first prosthodontic member.
A prosthodontic assembly as recited in claim 6, in which the projection is formed on one of the inner surface of the first prosthodontic member and the base portion of the second prosthodontic member and the recess is formed on the other of the inner surface of the first prosthodontic member and the base portion of the second prosthodontic member, the projection being sized, dimensioned, and located relative to the recess to enter and engage the recess when the second prosthodontic member is in the desired position.
A prosthodontic assembly as recited in claim 7, in which at least one of the first and second prosthodontic members is made of plastic.
A prosthodontic assembly as recited in claim 8, in which both the first and second prosthodontic members are made of plastic.
A prosthodontic assembly as recited in claim 6, in which at least one of the first and second prosthodontic member is injection molded out of plastic.
A prosthodontic assembly as recited in claim 6, in which the first prosthodontic member is an abutment member.
A prosthodontic assembly as recited in claim 11, in which the bore extends through the abutment member.
A prosthodontic assembly as recited in claim 12, in which the inner surface of the abutment member further defines a third bore portion for receiving the screw member in a manner that allows the screw member to rotate relative to the abutment member until the screw member engages the inner surface to securely hold the abutment member against the implant member.
14. A prosthodontic assembly as recited in claim 13, in which the first bore portion is adapted to receive a portion of the implant member in a manner that prevents rotation of the abutment member relative to the implant member when the abutment member is attached to the implant member.
15. A prosthodontic assembly as recited in claim 11, in which the second abutment member is an abutment cap that covers the bore in the temporary abutment member.
16. A prosthodontic assembly as recited in claim 11, in which the second abutment member is an impression member configured to be embedded in impression material.
17. A prosthodontic assembly as recited in claim 11, in which the second abutment member is cast in gold during fabrication of a prosthetic member.
18. A prosthodontic assembly as recited in claim 11, in which the second abutment member is a temporary cylinder.
A prosthodontic assembly as recited in claim 11, in which the second abutment member is surgical impression member adapted to be embedded in impression material to indicate a location of an implant member.
A prosthodontic procedure comprising the steps of:
osseointegrating a first implant member at a desired location;
attaching a first temporary abutment member to the first implant member;
attaching an abutment cap member onto the first temporary abutment member;
allowing gingival tissue around the first temporary abutment member to heal;
removing the abutment cap member from the first temporary abutment member;
attaching an impression member onto the first temporary abutment member;
applying impression material to the impression member;
allowing the impression material to solidify to form an impression in which the impression member is embedded;
removing the impression member from the first temporary abutment member with the impression member still embedded in the impression;
attaching a second implant member onto a second temporary abutment member attaching the second temporary abutment member to the impression member embedded in the impression;
applying model material to the second temporary abutment member and second implant member, allowing the model material to solidify to form a model in which the second implant member is embedded;
removing the second temporary abutment member from the impression member;
removing the second temporary abutment member from the second implant member, attaching a permanent abutment member to the second implant member;
forming a prosthetic member on the permanent abutment member;
removing the first temporary abutment member from the first implant member; and attaching the permanent abutment member and prosthetic member to the first implant member.
21. A procedure as recited in claim 20, in which the step of attaching the abutment cap member onto the first temporary abutment member comprises the steps of:
forming a projection on one of an inner surface of the first temporary abutment member and a base portion of the abutment cap member; and forming a recess on the other of the inner surface of the first temporary abutment member and the base portion of the abutment cap member, wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the abutment cap member is attached to the first temporary abutment member.
A procedure as recited in claim 20, in which the step of removing the abutment cap member from the first temporary abutment member comprises the step of applying deliberate manual force to the abutment cap member in a direction away from the first temporary abutment member.
A procedure as recited in claim 20, in which the step of attaching the impression member onto the first temporary abutment member comprises the steps of:
forming a projection on one of an inner surface or the first temporary abutment member and a base portion of the impression member; and forming a recess on the other of the inner surface of the first temporary abutment member and the base portion of the impression member, wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the impression member is attached to the first temporary abutment member.
A procedure as recited in claim 20, in which the step of removing the impression member from the first temporary abutment member comprises the step of applying deliberate manual force to the impression in a direction away from the first temporary abutment member.
A procedure as recited in claim 20, in which the step of attaching the second temporary abutment member onto the impression member comprises the steps of;
forming a projection on one of a base portion of the impression member and an inner surface of the second temporary abutment member; and forming a recess on the other of the base portion of the impression member and the inner surface of the second temporary abutment member; wherein the projection is sized, dimensioned, and located relative to the recess to enter and engage the recess when the second temporary abutment member is attached to the impression member.
A procedure as recited in claim 20, in which the step of removing the second temporary abutment member from the impression member comprises the step of applying deliberate manual force to the model in a direction away from the impression member.
27. A procedure as recited in claim 20, in which the step of attaching the first temporary abutment member onto the implant member comprises the steps of;
forming a bore in the first temporary abutment member defined by an inner wall thereof;
forming a threaded chamber in the implant member;
providing a screw member having a threaded portion adapted to engage the threaded chamber in the implant member and an increased diameter portion;
passing the threaded portion of the screw member through the bore in the first temporary abutment member; and rotating the screw member such that the threaded portion thereof engages the threaded cavity in the implant member, thereby displacing the screw member until the increased diameter portion thereof engages the inner wall of the first temporary abutment member.
28. A procedure as recited in claim 27, in which the step of attaching the first temporary abutment member onto the implant member comprises the steps of;
forming a body portion on the implant member;
forming the bore in the first temporary abutment member such that the bore contains a receiving portion adapted to receive the body portion on the implant member; wherein the body portion of the implant member engages a portion of the inner wall of the first temporary abutment member that defines the receiving portion of the bore to prevent rotation of the first temporary abutment member relative to the implant member.
29. A method as recited in claim 20, in which the at least one of the first temporary abutment member, abutment cap, impression member, second temporary abutment member is made of plastic.
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
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US695595P | 1995-11-17 | 1995-11-17 | |
US60/006,955 | 1995-11-17 | ||
US08/748,364 | 1996-11-13 | ||
US08/748,364 US5904483A (en) | 1995-11-17 | 1996-11-13 | Dental implant systems and methods |
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CA2238016A1 true CA2238016A1 (en) | 1997-05-22 |
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CA002238016A Abandoned CA2238016A1 (en) | 1995-11-17 | 1996-11-15 | Dental implant systems and methods |
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AU (1) | AU1406397A (en) |
CA (1) | CA2238016A1 (en) |
WO (1) | WO1997017907A1 (en) |
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2001
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US5904483A (en) | 1999-05-18 |
AU1406397A (en) | 1997-06-05 |
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