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WO2009118725A1 - Recouvrement d'une alvéole dentaire - Google Patents

Recouvrement d'une alvéole dentaire Download PDF

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Publication number
WO2009118725A1
WO2009118725A1 PCT/IL2009/000293 IL2009000293W WO2009118725A1 WO 2009118725 A1 WO2009118725 A1 WO 2009118725A1 IL 2009000293 W IL2009000293 W IL 2009000293W WO 2009118725 A1 WO2009118725 A1 WO 2009118725A1
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WO
WIPO (PCT)
Prior art keywords
dental
tooth socket
patch
dental patch
bone graft
Prior art date
Application number
PCT/IL2009/000293
Other languages
English (en)
Inventor
Shay Kahana
Original Assignee
Shay Kahana
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shay Kahana filed Critical Shay Kahana
Publication of WO2009118725A1 publication Critical patent/WO2009118725A1/fr

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Classifications

    • 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
    • A61C8/0003—Not used, see subgroups
    • A61C8/0004—Consolidating natural teeth
    • A61C8/0006—Periodontal tissue or bone regeneration

Definitions

  • the disclosed technique relates to periodontal procedures in general, and to the preparation of a tooth socket for receiving a dental implant in particular.
  • the exposed alveolar bone After the loss of a tooth (e.g., due to injury, disease, or tooth extraction), the exposed alveolar bone gradually undergoes bone resorption, in which the bone tissue is broken down and removed by osteoclasts. As this process continues, the alveolar ridge diminishes in height and width and becomes unable to support a dental implant or other type of tooth replacement. The resorption of the alveolar bone may also lead to occlusion problems, limited facial support and adverse aesthetic consequences. It is usually necessary to perform a bone graft in the alveolus (i.e., tooth socket) after tooth loss, in order to maintain the alveolar ridge and to provide sufficient support for a dental implant to securely integrate.
  • a bone graft in the alveolus i.e., tooth socket
  • the bone graft material which may be bone taken from the patient's own body (autograft), from a different person (allograft), from a different species (xenograft), or synthetic bone substitute (e.g., collagen, ceramics, calcium phosphate or other synthetic materials), is inserted into the alveolus. Subsequently, the area is covered with adjacent bone substitute (e.g., collagen, ceramics, calcium phosphate or other synthetic materials), is inserted into the alveolus. Subsequently, the area is covered with adjacent
  • US Patent No. 6,325,627 to Ashman entitled “Method and apparatus for performing ridge preservation and implant treatment”
  • the dental surgeon drills a hole (3-6mm) apically into the root extraction socket following the extraction, into which the implant is firmly anchored.
  • the surrounding area is filled with hydrated bone graft material (e.g., using blood from the surgical area of the patient's alveolar marrow), to promote new bone growth.
  • the bone graft material may be covered and held in place with a surgical foil, collagen dressing, or by a barrier membrane formed when a synthetic bone alloplast is used as the bone graft material.
  • the installation of the implant may alternatively be delayed until a later time (e.g., for 2-12 months) until sufficient bone growth has been promoted at the extraction socket.
  • US Patent No. 6,394,807 to Robinson entitled “Guided tissue regeneration plate for use in a process for growing jaw bone in anticipation of performing dental implants", is directed towards a plate that promotes growth of atrophied maxillary or mandibular bone to obtain an adequate volume of osseous structure.
  • the plate is secured to the jaw bone by a tenting-type support screw, fixing the guided-tissue regeneration plate some distance from the surface of the bone.
  • a space free from chewing pressure is created, supported by a mesh, between the underside of the gum tissue and the original bone.
  • US Patent No. 7,314,375 to Gault entitled “Provisional dental implant for preparing an alveolus", is directed towards a temporary dental implant for preparing the alveola of an extracted tooth for the subsequent insertion of a definitive dental implant.
  • the temporary implant includes a separable coronary part, which covers and seals a radicular part (e.g., with a temporary cement).
  • the radicular part is hollow and partially porous, may be shaped to match the extracted tooth, and allows diffusion of one or more active substances into the alveola.
  • the temporary implant is held in place, such as by suturing or adhesion, and is removed after a certain period (a few weeks to months) during which the alveola has healed sufficiently.
  • the composition includes a curable admixture of a bone substitute and a crosslinkable prepolymer, which allows the structure to be shaped before it cures.
  • the composition can be used to fill extraction sockets, prevent or repair alveolar bone loss, provide ridge augmentation, and stabilize and support a dental implant while providing immediate function (e.g., chewing).
  • US Patent application publication No. 2007/0160954 to Steiner entitled “Method and device for regenerating bone in preparation for dental implant”, is directed towards a device that is placed into an extraction socket, filling the space left behind after a tooth extraction.
  • the device referred to as a core
  • the core is inserted into the socket filled with bone graft material, at a depth and angle similar to that of the previous tooth.
  • the core and surrounding bone graft may be covered by an ovate pontic.
  • the core is removed from the socket, producing a bone void in which a dental implant can be placed.
  • the core may be shaped as a straight or tapered cylinder.
  • a dental patch operational for temporarily covering a tooth socket of a patient.
  • the dental patch is made of a biocompatible material, such as silicone or titanium foil, and is positioned over the tooth socket immediately after bone grafting of the tooth socket following a tooth extraction.
  • the dental patch is attached to the gums adjacent to the tooth socket, and maintained over the tooth socket until the formation of a thin gum tissue layer between the dental patch and the bone graft material, after which it is removed from the tooth socket, allowing a dental implant procedure to be performed at the tooth socket after sufficient calcification of the bone graft material.
  • a method for temporarily covering a tooth socket of a patient who has undergone a bone graft following a tooth extraction includes the procedure of positioning a dental patch made of a biocompatible material, such as silicone or titanium foil, over the tooth socket immediately after the bone graft.
  • the method further includes the procedures of attaching the dental patch to the gums adjacent to the tooth socket, maintaining the dental patch over the tooth socket until the formation of a thin gum tissue layer between the dental patch and the bone graft material, and removing the dental patch, allowing a dental implant procedure to be performed at the tooth socket after sufficient calcification of the bone graft material.
  • a method for performing a tooth replacement on a patient includes the procedures of extracting a tooth from a tooth socket of the patient, and performing a bone graft in the tooth socket.
  • the method further includes the procedure of temporarily covering the tooth socket filled with bone graft material, by positioning a dental patch made of a biocompatible material, such as silicone or titanium foil, over the tooth socket immediately after the bone graft, attaching the dental patch to the gums adjacent to the tooth socket, maintaining the dental patch over the tooth socket until the formation of a thin gum tissue layer between the dental patch and the bone graft material, and removing the dental patch.
  • the method further includes the procedure of performing a dental implant procedure at the tooth socket after sufficient calcification of the bone graft material.
  • Figure 1 is a schematic illustration of the anatomy of a tooth situated in a tooth socket
  • Figure 2 is a schematic illustration of a dental patch covering a tooth socket that has undergone bone grafting, in accordance with an embodiment of the disclosed technique
  • Figure 3 is a perspective view of a dental patch, constructed and operative in accordance with an embodiment of the disclosed technique
  • Figure 4 is a schematic illustration of a dental implant performed on a calcified bone graft, following the removal of a dental patch from over the tooth socket, in accordance with an embodiment of the disclosed technique
  • Figure 5 is a schematic illustration of a dental patch covering a tooth socket with bone graft material and a dental implant, in accordance with another embodiment of the disclosed technique
  • Figure 6A is a perspective view of a dental patch enforced with wires longitudinally, constructed and operative in accordance with an embodiment of the disclosed technique
  • Figure 6B is a perspective view of a dental patch enforced with wires longitudinally and laterally, constructed and operative in accordance with another embodiment of the disclosed technique
  • Figure 6C is a perspective view of a dental patch enforced with a grid structure, constructed and operative in accordance with a further embodiment of the disclosed technique
  • Figure 6D is a perspective view of a dental patch internally enforced with a net structure, constructed and operative in accordance with yet another embodiment of the disclosed technique
  • Figure 6E is a perspective view of a dental patch externally enforced with a net structure, constructed and operative in accordance with yet a further embodiment of the disclosed technique.
  • Figure 7 is a flow diagram of a method for performing a tooth replacement, operative in accordance with an embodiment of the disclosed technique.
  • the disclosed technique overcomes the disadvantages of the prior art by providing a patch of material, made of silicone or titanium foil, which is positioned over the tooth socket (dental alveolus) after a bone graft, to protect the area during bone regeneration.
  • FIG. 1 is a schematic illustration of the anatomy of a tooth situated in a tooth socket.
  • a tooth 102 includes enamel 104, dentin 106, pulp chamber 108, nerves and blood vessels 110 and root ending 112. Tooth 102 is held inside the tooth socket formed by the alveolar bone 114 that is part of the jawbone (i.e., the maxilla or mandible). Tooth 102 is surrounded by gingiva 116 (i.e., gum tissue) that is attached to the alveolar bone 114. The root of tooth 102 is covered with a layer of cementum 118 (bone-like tissue), which is anchored to alveolar bone 114 through periodontal ligaments 120.
  • gingiva 116 i.e., gum tissue
  • Figure 2 is a schematic illustration of a dental patch covering a tooth socket that has undergone bone grafting, in accordance with an embodiment of the disclosed technique.
  • Figure 3 is a perspective view of a dental patch, constructed and operative in accordance with an embodiment of the disclosed technique.
  • the tooth socket is filled with bone graft material 130.
  • a dental patch 132 is positioned over the tooth socket to cover the area.
  • Dental patch 132 is a rectangular segment of silicone material, with dimensions (i.e., length /, width w, and thickness t) suited to facilitate its placement and coverage over a particular tooth socket.
  • Dental patch 132 is attached to the gingiva 116 adjacent to the tooth socket, such as by suturing the periphery of dental patch 132 to the gingiva 116.
  • a resorbable material such as collagen or a gel foam, may be applied over bone graft material 130 prior to the placement of dental patch 132, in order to facilitate the formation of a blood clot on the area, to isolate bone graft material 130 from direct contact with dental patch 132, and to enable the quick formation of a soft gum tissue layer.
  • the bone graft material 130 undergoes resorption, and there is a gradual formation of new bone in the alveolar ridge (e.g., osteogenesis).
  • dental patch 132 is removed from over the tooth socket.
  • a dental implant procedure may be performed. The bone graft calcification period may vary for different patients and for different types of grafting material, but generally takes about 3-6 months.
  • the presence of dental patch 132 causes a thinner layer of gum tissue to grow than would normally, and prevents the penetration of this gum tissue into the bone graft material 130.
  • Dental patch 132 further stabilizes bone graft material 130 in a fixed position and prevents it from escaping out of the tooth socket, while promoting the initial calcification process. Dental patch 132 also protects bone graft material 130 from germs, bacteria and food debris inside the mouth and ensures that the area remains sufficiently sterilized. Furthermore, as compared with gingival flap surgery, the suturing of dental patch 132 to the gums is a simpler procedure for the dental practitioner, as well as far less painful for the patient.
  • FIG 4 is a schematic illustration of a dental implant performed on a calcified bone graft, following the removal of a dental patch from over the tooth socket, in accordance with an embodiment of the disclosed technique.
  • calcified bone graft 134 undergoes an osteotomy.
  • a dental implant 138 such as a threaded titanium screw, is inserted into the prepared gap, and a new dental crown 136 is affixed to dental implant 138. It is appreciated that the crown may be affixed by other means, or using other types of dental implantation techniques known in the art.
  • a dental implant is inserted into the tooth socket after it is filled with bone graft material, and then the dental patch is placed over the tooth socket.
  • Figure 5 is a schematic illustration of a dental patch covering a tooth socket with bone graft material and a dental implant, in accordance with another embodiment of the disclosed technique.
  • Dental implant 138 is inserted into the bone graft material 130 immediately after the bone graft procedure.
  • dental patch 132 is positioned over the tooth socket, covering both the bone graft material 130 and the dental implant 138 embedded therein.
  • Dental patch 132 is removed after about 2-3 weeks (i.e., after the formation of the soft tissue layer), and the dental implant 138 is left to complete osseointegration with alveolar bone 114.
  • the osseointegration process usually takes several months.
  • a dental crown 136 (Figure 4) (e.g., a temporary crown) can be attached directly to dental implant 138 after implant 138 has been exposed (a temporary crown may be replaced by a permanent crown after full osseointegration has occurred).
  • dental patch 132 eliminates the need for gingival surgery, and thus the process may be performed by a general dentist, rather than a skilled surgical specialist, such as a maxillofacial surgeon or a periodontist.
  • Dental patch 132 may be considered a temporary replacement of the mucous membrane of the gingival flap until it is removed after the formation of the thin gum tissue layer.
  • the use of dental patch 132 in accordance with the disclosed technique serves to accelerate and enhance the calcification of the bone graft material, promote proper healing while preventing undesirable processes in the treated area, and eliminate painful and time consuming surgical procedures, thus ensuring a quicker and healthier recovery and minimal patient suffering.
  • dental patch 132 is typically composed of silicon (i.e., medical silicon), but may alternatively be composed of a different type of biocompatible material, such as titanium foil.
  • Dental patch 132 is typically rectangular in shape, but may be formed in any shape that facilitates its placement and coverage on the tooth socket area.
  • the silicone may be initially fabricated in the form of a single sheet (or strip), which may be cut by the dental practitioner (or an assistant) in a desired shape or size to fit over the tooth socket type (e.g., incisors, molars, and the like) to be treated.
  • the dental patches may be prefabricated in various predefined shapes and sizes to fit the treated area, and the dental practitioner can select a suitable dental patch for use.
  • the dental patch (or the prefabricated sheet) may be kept in a sealed packaging, which is opened by the dental practitioner (and cut into the desired shape if necessary) immediately before the dental patch is to be placed over the tooth socket.
  • the dental patch is generally designed to allow simple insertion and removal.
  • Dental patch 132 may be enforced by a metallic structure, such as a wire structure, a net structure, or a grid structure.
  • the enforcement structure may also have a different form.
  • the enforcement structure may be composed of titanium or another suitable material.
  • the enforcement modifies the resilience of the silicone and allows for the enduring shaping or structuring of dental patch 132, for example in a convex form that is suited to the bulbous or globular shape of the tooth socket filled with bone graft material.
  • Figures 6A, 6B, 6C, 6D and 6E Figure 6A is a perspective view of a dental patch (referenced 142) enforced with wires longitudinally, constructed and operative in accordance with an embodiment of the disclosed technique.
  • Figure 6B is a perspective view of a dental patch (referenced 144) enforced with wires longitudinally and laterally, constructed and operative in accordance with another embodiment of the disclosed technique.
  • Figure 6C is a perspective view of a dental patch (referenced 146) enforced with a grid structure, constructed and operative in accordance with a further embodiment of the disclosed technique.
  • Figure 6D is a perspective view of a dental patch (referenced 148) internally enforced with a net structure, constructed and operative in accordance with yet another embodiment of the disclosed technique.
  • Figure 6E is a perspective view of a dental patch (referenced 150) externally enforced with a net structure, constructed and operative in accordance with yet a further embodiment of the disclosed technique.
  • the enforcement structures depicted in Figures 6A, 6B, 6C and 6D, respectively, are embedded within the dental patch.
  • the enforcement structure depicted in Figure 6E is attached to at least one of the outer surfaces of dental patch 150 (e.g., at the top, at the top and at the bottom, and the like).
  • FIG. 7 is a flow diagram of a method for performing a tooth replacement, operative in accordance with an embodiment of the disclosed technique.
  • a tooth is extracted from a tooth socket of a patient.
  • a bone graft is performed in the tooth socket, following the tooth extraction.
  • tooth extraction also encompasses involuntary tooth loss, such as the loss of a tooth due to injury, trauma, disease, and the like.
  • a dental patch is positioned over the tooth socket immediately after the bone graft.
  • the dental patch is attached to the gums adjacent to the tooth socket.
  • dental patch 132 is positioned over a tooth socket filled with bone graft material 130, and then attached to the gums 116, such as by suturing the periphery of dental patch 132 to gums 116 at the edge of the tooth socket.
  • procedure 170 the dental patch is maintained over the tooth socket until the formation of a thin gum tissue layer between the dental patch and the bone graft material.
  • procedure 172 the dental patch is removed.
  • dental patch 132 is removed from the tooth socket after a thin layer of gum tissue has formed over bone graft material 130 (after about 2-3 weeks).
  • procedure 174 a dental implant procedure is performed at the tooth socket after sufficient calcification of the bone graft material.
  • dental implant 138 is inserted into calcified bone graft 134 (after about 3-6 months), and a dental crown 136 is affixed to dental implant 138.
  • dental implant 138 may alternatively be inserted into bone graft material 130 immediately after the bone graft procedure, and dental crown 136 can be attached directly to dental implant 138 after implant 138 has been exposed

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Developmental Biology & Embryology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Materials For Medical Uses (AREA)

Abstract

L'invention concerne un pansement dentaire (132) et un procédé de recouvrement temporaire d'une alvéole dentaire d'un patient. Le pansement dentaire est réalisé en un matériau biocompatible, par exemple une feuille de silicium ou de titane, et est placé au-dessus de l'alvéole dentaire (120) immédiatement après la greffe d'os de l'alvéole dentaire après l'extraction d'une dent et est fixé sur les gencives en position adjacente à l'alvéole dentaire, par exemple en suturant la périphérie du pansement dentaire sur la gencive. Le pansement dentaire est maintenu au-dessus de l'alvéole dentaire jusqu'à la formation d'une mince couche de tissu gingival entre le pansement dentaire et le matériau de greffe d'os et est ensuite enlevé de l'alvéole dentaire, ce qui permet de réaliser une opération d'implantation d'une dent dans l'alvéole dentaire après calcification suffisante du matériau de greffe d'os. Le pansement dentaire peut être renforcé par une structure métallique.
PCT/IL2009/000293 2008-03-23 2009-03-15 Recouvrement d'une alvéole dentaire WO2009118725A1 (fr)

Applications Claiming Priority (2)

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US3876308P 2008-03-23 2008-03-23
US61/038,763 2008-03-23

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WO2009118725A1 true WO2009118725A1 (fr) 2009-10-01

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9078723B1 (en) 2013-12-20 2015-07-14 Armor Dental, Corp. Dental oral shield device and system
US20220151740A1 (en) * 2019-02-21 2022-05-19 Dentsply Sirona Inc. Dental device for ridge preservation and promotion of jaw bone regeneration in an extraction site

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5032445A (en) * 1984-07-06 1991-07-16 W. L. Gore & Associates Methods and articles for treating periodontal disease and bone defects
WO2000032749A2 (fr) * 1998-12-03 2000-06-08 Gore Enterprise Holdings, Inc. Procedes et articles pour regenerer des tissus vivants
US20010012607A1 (en) * 1996-03-01 2001-08-09 Robinson Dane O. Guided tissue regeneration plate for use in a process for growing jaw bone in anticipation of performing dental implants

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5032445A (en) * 1984-07-06 1991-07-16 W. L. Gore & Associates Methods and articles for treating periodontal disease and bone defects
US20010012607A1 (en) * 1996-03-01 2001-08-09 Robinson Dane O. Guided tissue regeneration plate for use in a process for growing jaw bone in anticipation of performing dental implants
WO2000032749A2 (fr) * 1998-12-03 2000-06-08 Gore Enterprise Holdings, Inc. Procedes et articles pour regenerer des tissus vivants

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9078723B1 (en) 2013-12-20 2015-07-14 Armor Dental, Corp. Dental oral shield device and system
US10463450B2 (en) 2013-12-20 2019-11-05 Armor Dental, Corp. Dental oral shield device and system
US20220151740A1 (en) * 2019-02-21 2022-05-19 Dentsply Sirona Inc. Dental device for ridge preservation and promotion of jaw bone regeneration in an extraction site

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