Arrangement for using osteoinductive or bioactive material to induce bone and/or increase the stability of implants in the jaw bone, and an implant intended for this purpose
The stability of an implant (5) which is fitted in a jaw bone hole created by tooth root extraction is increased using osteoinductive material. Bone formation in the space between the implant and the bone wall is also stimulated. In an initial stage, the implant is anchored or fitted in the hole. With its outer parts (5a) the implant extends into a part (4a) of the hole which has a cross-sectional area exceeding the cross-sectional area of the outer parts (5a) of the implant. The soft tissue of the jaw bone, with possible periosteum, covers the implant and the space to form a closed space (4a). The bioactive material consists of growth-stimulating substances (GSS) arranged on the implant In a stage of incorporation, GSS passes outward into body fluid which has penetrated into the closed space and interacts with cells present in the fluid so that new bone is formed around the outer parts (5a) of the implant. The invention also relates to a use and to an implant. The invention also simplifies the handling of implants.
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Arrangement for using osteoinductive or bioactive material to induce bone and/or increase the stability of implants in the jaw bone, and an implant intended for this purpose.
The present invention relates to an arrangement for using osteoinductive material to induce bone and/or increase the stability of implants applied in jaw bone holes which have been created by tooth root extraction. In an initial stage, the implant is anchored or fitted in the hole via its inner parts, and with its outer parts it extends into a part of the hole which has a cross-sectional area exceeding the cross-sectional area of the outer parts of the implant. The outer parts of the hole, the implant and the soft tissue of the jaw bone, with or without periosteum, constitute a closed space at said outer parts.
The invention also relates to a use in a jaw bone hole created by tooth root extraction which has given the hole a cross-sectional area at the outer parts of the hole which exceeds the cross-sectional area of the hole at its inner parts.
The invention also relates to an implant which can be fitted in a jaw bone hole created by tooth root extraction and arranged with its outer parts extending into a part of the hole which has a cross-sectional area exceeding the cross-sectional area of the outer parts.
The terms “inner” and “outer” parts refer to the locations in the longitudinal direction, i.e. the inner parts are located farthest into the jaw bone, and the outer parts are situated at outer parts of the jaw bone. Said terms thus do not relate, for example, to parts of the implant lying on the outside or on the inside.
Reference may be made in this connection to patent applications SE 9901972-1 and WO 00/72778 filed by the same Applicant and with the same inventor as in the present patent application.
Reference may also be made to the article published by, inter alia, the inventor of the present patent application and entitled “Properties of a New Porous Oxide Surface on Titanium Implants, Volume 1: The Oxidized Titanium Surface, Applied Osseointegration Research”.
In connection with jaw bone holes of said type, it is already known to fit implants and to fill the space situated between the implant and the outer parts of the jaw bone hole with substrates of various types, for example substrate in the form of autologous bone, allogenic bone, xenografts, or synthetic material, for example in the form of or comprising calcium phosphates (e.g. hydroxylapatite). The space thus filled with substrate is sewn closed or covered over with the soft tissue, possibly in combination with some form of covering membrane. A characteristic of the substrate is that it is resorbable to a greater or lesser extent and is gradually replaced by bone. Doses of different substrates are available on the market from a number of companies operating on the market. Reference is made quite generally to these known substrates.
It has been found, however, that the known substrates are not always able to satisfy the strict requirements placed on dental fittings of the type in question. The requirements also vary considerably from one person to another, which means that it is difficult to develop general and satisfactory methods and arrangements for stabilizing the implants sufficiently and in an acceptable way.
The present invention aims to solve these problems among others and proposes a novel use of implants which in one embodiment can be of a type known per se. The implants are in this case of the type which in some way or another has been provided with growth-stimulating substance(s) (GSS) which in a known manner is/are able to generate new bone, i.e. in this case jaw bone, in cooperation with cells, for example stem cells, which are found in the body and occur for example in body fluid formed in the cavities of the body which have been subjected to an intervention, for example in the form of tooth extraction. By introducing said GSS into cell-containing body fluids, the interaction between GSS and the cells can initiate formation of new bone or new bone parts. In accordance with the invention, this gives a much improved anchoring function for the implant in question, which can thus be anchored with much improved stability compared to the previously known techniques according to the above.
It is also known that the space in the jaw bone is often replaced with soft tissue instead of bone, which does not satisfy the requirements set. The invention also intends to solve this problem.
There is also a need to simplify the tooth replacement work carried out by the surgeon, dentist or other person performing treatment. When using bone from the patient's iliac crest, for example, problems may arise because the process of obtaining bone from the iliac crest can be quite extensive and painful. In some countries there are also restrictions which mean that a person providing treatment in the area of dentistry cannot carry out any interventions on other parts of the body. This can therefore entail the cooperation of a number of different specialists, which considerably increases the costs of the fitting and replacement work.
The feature which can principally be regarded as characterizing an arrangement according to the invention is, inter alia, that the bioactive material consists of GSS arranged on or in the implant, for example on its outer surface or outer thread, at its outer parts. In a stage of incorporation of the implant, said GSS passes outward into body fluid which has penetrated or is penetrating from the surrounding tissue and periosteum into the aforementioned closed space and interacts with cells present in the fluid, which leads to formation of new bone around said outer parts of the implant.
In one embodiment of the inventive concept, GSS can be arranged in principle only at or on said outer parts of the implant. GSS can also be arranged as one or more layers lying on the outside of the implant's outer part or outer thread. GSS can also be arranged together with one or more layers of, for example, calcium phosphate (s). The implant can be provided in a manner known per se with a reservoir function for GSS, and this can consist of porous outer layers and/or oxide layers arranged at least at said outer parts of the implant. In one embodiment, GSS can also be combined with bone substitute of known type, which can be applied as layers directly on the surface or thread.
The feature which can principally be regarded as characterizing a use according to the invention is that, for new production of bone in a space closed with periosteum between an implant and the wall of the hole in the jaw bone, use is made of GSS grafted onto the outer parts of the implant and passing outward into cell-containing body fluid which penetrates or has penetrated into the space.
Further characteristics of the subject matter of the invention are set out in the attached dependent claims.
As regards implants, there is a need to be able to abandon the conventional production methods for implants and instead be able to cast or mill these from a blank. The implant must be able to have a shape corresponding to the jaw bone hole in question, so that it is possible to anchor the implant without having to use threads, for example, in the implant and jaw bone. The invention also solves this problem.
The feature which can principally be regarded as characterizing an implant according to the invention is, inter alia, that it is provided with growth-stimulating substance(s) (GSS) interacting with cells in body fluid so that new bone is formed. In addition, the implant can have its inner parts configured as tooth root shapes. Further developments of the implant are set out in the attached dependent claims.
By means of what has been proposed above, a considerably improved anchoring of the implant in the jaw bone hole is achieved, despite the fact that from the start the latter has a greater cross-sectional area than the actual implant at the outer parts. Using the formed closed space, a body fluid space can be formed and an effective production of new bone is achieved in an optimum manner with the correct amount of GSS in relation to the volume of the space. The presently practiced or proposed technique for applying GSS to implants can be used advantageously and in this way the front line of the new technique can be pushed forward considerably. The GSS used can be matrix molecules, growth factors, differentiation factors, peptides with growth-stimulating properties, etc.
A presently proposed embodiment of an arrangement, a use and an implant according to the invention will be described below with reference to the attached drawings, in which
In
In
Thus, an implant known per se can be used in the tooth replacement function. An implant which in a known manner or a novel manner is provided with grafted or otherwise applied GSS is used in the jaw bone hole in question. The implant can be screwed into the hole using the self-tapping principle. Alternatively, the hole can be threaded to match an implant. This pre-threading can also take place in a manner known per se. The newly formed bone contributes to strong stabilization of the implant in the jaw bone hole. The amount of GSS can in this case be related to the volume of the closed space, the clinical situation and/or the tooth which is to be replaced with the implant/dental construction, etc. The hole around the implant can be covered with a membrane or a protective part of a type known per se. The implant is preferably made of titanium but can consist of another biocompatible material, for example ceramic.
In
Upon extraction of the tooth 13 according to
It also lies within the possibilities of the invention that the line of the jaw bone hole can be acted upon using tools, for example drilling tools, so that wider parts situated at the bottom can easily match passages in the hole which have been narrower from the start. In
In
The invention is not limited to the embodiment shown above by way of example, and instead it can be modified within the scope of the attached patent claims and the inventive concept.
Reference may be made here to patent applications submitted to the Swedish patent office on the same day as the present patent application and by the same Applicant and inventor. Said applications have the following titles:
- a) “Arrangement for using bioactive material to build up a bone-based lateral support for implants in the jaw bone”.
- b) “Arrangement for implants bearing growth-stimulating substance or substances, and one such implant”.
- c) “Arrangement of two or more implants provided with growth-stimulating substance(s)”.
- d) “Arrangement for increasing the stress resistance of implants, and one such implant”.
Claims
1. An arrangement for using osteoinductive material to induce bone and/or increase the stability of an implant (5) which is fitted in a jaw bone hole (4) created by tooth root extraction and where, in an initial stage, the implant is on the one hand anchored or fitted in the hole via its inner parts (5b) and, with its outer parts (5a), extends into a part (4a) of the hole which has a cross-sectional area (d′) exceeding the cross-sectional area (D′) of the outer parts (5a) of the implant, and, on the other hand, is arranged to form a closed space (4a) together with soft tissue, with or without periosteum, characterized in that the osteoinductive material of comprises growth-stimulating substance(s) (GSS) arranged on or in the implant, at its outer parts (5a), which substance or substances, in a stage of incorporation following the initial stage, pass outward into body fluid (9) which has penetrated into the closed space and interact with cells present in the fluid so that new bone is formed around the outer parts (5a) of the implant.
2. The arrangement as claimed in patent claim 1, characterized in that the growth-stimulating substance or substances is/are arranged in principle only on or at said outer parts of the implant.
3. The arrangement as claimed in patent claim 1, characterized in that the growth-stimulating substance or substances is/are arranged as one or more layers lying on the outside of the implant's outer surface or outer thread.
4. The arrangement as claimed in claim 1, characterized in that the implant is arranged with a reservoir function for the growth-stimulating substance or substances and optionally other bone-growth-stimulating means and/or means increasing bone volume and/or means producing new bone.
5. The arrangement as claimed in patent claim 4, characterized in that the reservoir function comprises outer layers provided with pores and/or oxide layers on at least said outer parts (5a).
6. The arrangement as claimed in claim 1, characterized in that bone substitute is arranged in parts of the closed space (4a), for example near to or on said outer parts (5a), together with said growth-stimulating substance(s).
7. The use in a jaw bone hole created by tooth root extraction which has given the hole (4) a cross-sectional area at outer parts (4a) of the hole exceeding the hole's cross-sectional area at its inner parts (4b), characterized in that, for new production of bone in a space (4a) closed with periosteum between an implant (5) and the wall (4a′) of the hole, use is made of growth-stimulating substance(s) grafted onto the implant and interacting with cell-containing body fluid (10) which penetrates or has penetrated into the space (4a).
8. The use as claimed in patent claim 7, characterized in that growth-stimulating substance(s) included in layers alone or together with other material is/are used as a source of new production of bone.
9. The use as claimed in patent claim 7, characterized in that said growth-stimulating substance(s) is/are used together with volume-increasing/stimulating substrate.
10. An implant which can be fitted in a jaw bone hole (4) created by tooth root extraction and arranged with its outer parts (5a) extending into a part (4a) of the hole which has a cross-sectional area (d′) exceeding the cross-sectional area (D′) of said outer parts, characterized in that it is on the one hand provided with osteoinductive material in the form of growth-stimulating substance(s) (GSS) arranged, in connection with the jaw bone hole, to interact with cells in the body fluid so that new bone is formed, and, on the other hand, its inner parts are formed in close or substantial conjunction with the extent of the hole in the jaw bone at the inner parts.
11. The implant as claimed in patent claim 10, characterized in that the implant is arranged to extend in substantially the same line as the tooth root.
12. The implant as claimed in patent claim 10, characterized in that the implant, at its inner parts, is curved in relation to the main longitudinal extent of the implant.
13. The implant as claimed in patent claim 12, characterized in that the implant is designed with two or three parts completely or partially curved in relation to the main direction.
14. The implant as claimed in claim 10, characterized in that, when it is fitted in the hole, one or more spaces can be formed between the inner parts and the hole's wall(s), in which space or spaces said interaction is intended to take place.
15. The arrangement as claimed in claim 2, characterized in that the growth-stimulating substance or substances is/are arranged as one or more layers lying on the outside of the implant's outer surface or outer thread.
16. The arrangement as claimed in claim 2, characterized in that the implant is arranged with a reservoir function for the growth-stimulating substance or substances and optionally other bone-growth-stimulating means and/or means increasing bone volume and/or means producing new bone.
17. The arrangement as claimed in claim 3, characterized in that the implant is arranged with a reservoir function for the growth-stimulating substance or substances and optionally other bone-growth-stimulating means and/or means increasing bone volume and/or means producing new bone.
18. The arrangement as claimed in claim 2, characterized in that bone substitute is arranged in parts of the closed space (4a), for example near to or on said outer parts (Sa), together with said growth-stimulating substance(s).
19. The arrangement as claimed in claim 3, characterized in that bone substitute is arranged in parts of the closed space (4a), for example near to or on said outer parts (5a), together with said growth-stimulating substance(s).
20. The arrangement as claimed in claim 4, characterized in that bone substitute is arranged in parts of the closed space (4a), for example near to or on said outer parts (5a), together with said growth-stimulating substance(s).
Type: Application
Filed: Jun 26, 2003
Publication Date: Sep 22, 2005
Applicant: Nobel Biocare AB (publ.) (Goteborg)
Inventor: Jan Hall (Goteborg)
Application Number: 10/521,743