Tissue-enhancing abutment and adjustable coping device for dental implants

A tissue-enhancing adjustable device having an abutment assembly and an coronally adjustable coping assembly adapted to fit virtually all dental implant devices. The coping assembly has a rotatable coping adjuster and a threaded section thereon extending from its bottom toward its top and being in mating cooperation with a threaded bore on the abutment assembly. A tension device on the coping adjuster is adapted to exert tension on the coping assembly in an coronal direction and away from the abutment assembly at all times, particular during the adjustment process. The outer surface of the coping assembly has an annular skirt adjacent to a lower section which is of a roughened texture up to a point above the annular skirt. This facilitates better tissue growth around a post-operative site and permits adherence of tissue to the coping assembly and further permits future coronal adjustments without disturbing the tissue.

BACKGROUND OF THE INVENTION 
This present invention relates to an improvement in prosthodontic 
restoration devices, and more particularly to an implant restoration 
device which fosters coronal tissue growth for a more aesthetic natural 
gingival architecture before insertion of the implant restoration 
(artificial tooth). 
Restorative dentistry for an edentulous patient has advanced significantly 
over the past years. Bone-embedded implants utilizing various posts or 
abutments and coping devices are virtually commonplace in the art. Two 
important facets to restorative dentistry remain the shape and size of the 
implant restoration and, more importantly, gingival architecture adjacent 
to the restorative site for a proper implant restoration clinical 
procedure. To attain adequate gingival height (gingival crest), the field 
has devised numerous devices and methods. Each tooth extraction results in 
an extraction socket or concavity in the now edentulous ridge. For 
purposes of this application, that socket shall be referred to as the 
implant site. The gingival crest at the implant site (this crest hereafter 
referred to as the post-operative gingival crest) is generally below the 
normal pre-operative gingival crest of the remaining teeth. The ability to 
regenerate or augment tissue in a coronal direction is more difficult to 
perform successfully than in any other direction. Yet it is in the coronal 
direction where such need exists. 
While prior art patents uncovered deal with improved abutments and 
implants, none has the ability to enhance tissue growth in a coronally 
adjustable manner to achieve a more consistent post-operative gingival 
crest in relation to the pre-operative gingival crest as does the present 
invention. Presently the only way to enhance the gingival tissue is 
through a surgical procedure; i.e., a gingival graft taken from some part 
of the mouth, usual the hard palate. Even with surgery, obtaining a well 
shaped gingival architecture, specifically the papilla, is difficult, if 
not impossible Pat. No. 5,316,476 issued to Krauser describes a dental 
implant for holding a dental prosthesis in place after implantation into a 
bone. This implant has shallow circumferential grooves to permit bone to 
grow entirely therein such that the bone adheres thereto. A cap is 
attached to the implant. It has as outward expanding truncoconical head 
and is left in place to keep the upper portion of the implant free of 
tissue and ready for the attachment of the prothesis. 
Pat. No. 5,344,457 issued to Pilliar, et.al., also relates to an implant 
anchored into bone and/or fibrous tissue to which a prothesis may be 
attached. The implant has a lower region and an upper region. The lower 
region is attached to bone. It has a porous surface into which bone may 
grown thereby anchoring the implant thereto. In one embodiment the upper 
region is coated with a bioreactive coating to allow direct bonding of 
bone and/or gingival tissue and to inhibit apical epithelial migration. 
U.S. Pat. No. 5,350,302 issued to Marlin describes abutments posts, 
gingival collars, and universal adapters with fixation screws for use with 
dental implants. The top of the adaptor has an indexed projection, the 
gingival collar is also indexed. The respective indexing provides for 
angle correction in the horizontal plane by the counter-rotation of the 
gingival collar and the head of the post. The post head has a variety of 
angles to facilitate vertical angle correction where necessary. The 
angle-correcting features (horizontal and vertical) allow for precise 
overall angle correction of implant placement. 
U.S. Pat. No. 5,571,016 issued to Ingber, et.al., describes a bone-embedded 
implant having an abutment post through which a variety of arrangements 
and types of prosthetics may be supported. This abutment also supports the 
use of separate copings. The abutment further has an access bore to 
accommodate threaded screw fasteners which carry a deformable washer and 
are adapted to hold the dental implant as assembled and to seal the 
gingival tissue region into which the abutment post is fitted. 
None of these prior art inventions accommodates or facilitates coronal 
gingival marginal growth about the implant site; nor, and more 
importantly, do any of the prior art inventions provide for an 
adjustability to such growth. 
Accordingly, several objects and advantages of my invention are: 
to facilitate gingival tissue growth concentrically and coronally; 
to provide for coronal adjustment of gingival growth while simultaneously 
preventing lateral dislodgement of such growth; 
to provide for fabrication of the device to fit different kinds, types, 
sizes, and shapes of implant bodies; and 
to realize a final aesthetic gingival sculpting after completion of the 
prosthetic restoration. 
Any abutment and implant device may be adapted for use in conjunction 
and/or combination with the adjustable coronal tension-exerting coping of 
the present invention. The foregoing has outlined some of the more 
pertinent objects of the present invention. These objects should be 
construed to be merely illustrative of some of the more prominent features 
and applications of the intended invention. Many other beneficial results 
can be attained by applying the disclosed invention in a different manner 
or by modifying the invention within the scope of the disclosure. 
Accordingly, other objects and a fuller understanding of the invention may 
be had by referring to the summary of the invention and the detailed 
description of the preferred embodiment in addition to the scope of the 
invention defined by the claims taken in conjunction with the accompanying 
drawings. 
BRIEF SUMMARY OF THE INVENTION 
The above-noted problems, among others, are overcome by the present 
invention. Briefly stated, the present invention has an abutment assembly 
and a coping assembly which fosters and facilitates tissue growth, is 
adjustable, and is suited for dental implants. The abutment assembly 
comprises an abutment member, an abutment anchoring means for anchoring 
the abutment assembly into an implant with the anchoring means having a 
threaded abutment bore terminating at a ledge therein, and a coupling 
means for coupling the abutment member to the abutment anchoring means. 
The coping assembly has a rotatable coping adjuster and a threaded section 
thereon extending from its bottom toward its top and being in mating 
cooperation with the threaded bore. A tension means on the coping adjuster 
is adapted to exert tension on the coping assembly in an opposing 
direction from the abutment assembly. The coping member has an outer 
surface having an annular skirt adjacent to a lower section and a 
roughened texture thereon to a point adjacent to the annular skirt, for 
the purpose of facilitating tissue growth. It further has a coupling means 
for coupling the coping adjuster onto the coping member. The adjuster 
permits a coronal movement of the coping assembly as tissue grows and 
adheres to the roughened section. 
The foregoing has outlined the more pertinent and important features of the 
present invention in order that the detailed description of the invention 
that follows may be better understood so the present contributions to the 
art may be more fully appreciated. Additional features of the present 
invention will be described hereinafter which form the subject of the 
claims. It should be appreciated by those skilled in the art that the 
conception and the disclosed specific embodiment may be readily utilized 
as a basis for modifying or designing other structures and methods for 
carrying out the same purposes of the present invention. It also should be 
realized by those skilled in the art that such equivalent constructions 
and methods do not depart from the spirit and scope of the inventions as 
set forth in the appended claims.

DETAILED DESCRIPTION OF THE INVENTION 
Referring now to the drawings in detail, which are not to scale but are 
drawn for ease of understanding the invention, and in particular to FIGS. 
1 and 4, the tissue-enhancing abutment and adjustable coping device 
constructed in accordance with a preferred embodiment of the present 
invention is seated on top of implant 90. The device is comprised of a 
healing abutment assembly 20 having an abutment member 30 which is 
substantially cylindrical and seated on the implant 90, said implant 90 
having an implant ledge 92 and a threaded implant bore 96. The abutment 
member 30 is secured to the implant 90 by an an anchoring means. In the 
embodiment shown, the anchoring means comprises an abutment screw 40. 
Abutment screw 40 has an abutment screw top 41, abutment screw bottom 42, 
and abutment screw threading 46 threaded substantially from the abutment 
screw bottom 42 toward the abutment screw top 41. From the abutment screw 
top 41, substantially centered thereon, is an abutment bore 48 which is 
threaded. The abutment bore 48 extends downward terminating at an abutment 
ledge 50 contained within the abutment bore 48. 
Below the head of the abutment screw 40 are a first step 54 and a second 
step 56. In use, the abutment member 30 is placed on the implant ledge 92. 
The abutment screw threading 46 is in mating cooperation with the implant 
bore threading 96. The abutment screw 40 is tightened and secured to the 
implant 90 by these cooperating threads. In one embodiment of the 
invention, as the abutment screw 40 is tightened, the first step 54 comes 
to securely rest on the abutment recess 34 adjacent to and below the 
abutment member top 31. In yet another embodiment, it can rest on the 
abutment member top 31. The second step 56 and the coronal hex 94 of the 
implant 90 each abut the inner walls of the abutment member 30. By this 
process, the healing abutment assembly 20 is secured to the implant 90. 
This is referred to as the abutment assembly coupling. 
Referring now to FIGS. 1 and 3A, the device further has a coping assembly 
60 which seats on top of and over the healing abutment assembly 20. The 
coping assembly 60 has a coping member 80 into which a coping screw 70 is 
rotatably connected. The coping screw 70 has a coping screw top 71 and a 
coping screw bottom 72. More generally, this may be referred to as the 
coping adjuster which has a coping adjuster top and a coping adjuster 
bottom. The underside of the coping screw top has a coping screw step 78. 
From the coping screw bottom 72 and substantially upward, the coping screw 
is threaded 76. The coping screw threading 76 is in mating cooperating 
with the threading within the abutment screw bore 48. Horizontally 
encircling an area below the coping screw step 78 is a coping screw ring 
74. 
The coping member 80 has a coping member top 81 and a coping member bottom 
82. Adjacent to the coping member top 81 and within the inner walls of the 
coping member a channel 84 is formed. As shown in FIG. 3A, this channel 84 
may be formed within the inner wall of the coping member 80; or, as shown 
in FIG. 3B, the channel 184 may be formed by two opposing protrusions on 
the inner wall of the coping member 180. The respective channels are 
adapted to rotatably accept, mate with, and retain the coping screw ring 
74 thereby rotatably securing the coping screw 70 to the coping member 80. 
This is referred to as the coping assembly coupling means. Below the 
coping screw ring 74, the inner walls of the coping member 80 overlay and 
slidingly abut the outer walls of the abutment member 30. 
Once the healing abutment assembly 20 is in place, the coping assembly 60 
is mated with the healing abutment assembly 20 by mating and tightening 
the coping screw 70 (or adjuster) into the abutment bore 48. The coping 
screw bottom 72 is substantially less in length than is the abutment bore 
48 such that the coping screw bottom 72 does not touch the abutment ledge 
50 therein. Although the mating of the healing abutment assembly 20 with 
the coping assembly 60 is secure when so tightened, when coronal 
adjustments are made, tolerances within the respective threads prevents a 
completely static fit; the two assemblies are subject to some play or 
movement. Such play or movement vertically militates against optimum 
coronal gingival growth and is counterproductive to coronal growth and 
maintenance. Given the minute distances with which we are dealing, even 
minimal movement is counterproductive to optimal coronal gingival growth. 
To mitigate this movement, I have devised a tension means to cooperate with 
the two assemblies in opposing directions. One embodiment of this tension 
means is shown in FIG. 1. It consists of a bias member or spring 68 
adjacent to the coping screw bottom 72. The spring 68 is attached to the 
coping screw bottom 72 and is of sufficient length and tension to 
forcefully rest on the abutment ledge 50 within the abutment bore 48. When 
initially inserted, the coping screw 70 seats onto the healing abutment 
assembly 20. As tissue growth begins and increases, the objective then is 
to facilitate coronal movement of the tissue. This is accomplished by 
unscrewing, minimally and in suitable increments, the coping screw 70. 
When this is done, the initial tight fit between coping screw and the 
abutment screw top 71 is destroyed. Once this is effected, as explained 
above, the vertical movement associated with the tolerances relative to 
the respective threads is realized. The force of the spring 68 in opposing 
directions maintains the coronal distance integrity of the coping assembly 
60 from the healing abutment assembly 20 and prevents any undesired 
movement, retreat, or dislodging of the growing tissue. 
FIG. 2 shows a second embodiment of this tension means to be a biasing 
washer (or a Belleville-like washer) 168 as the bias member. It is 
attached in between the coping screw 70 and the abutment screw top 41. The 
spring 68 of the previous embodiment is not necessary in this embodiment, 
though it may be used as a complement thereto. As the coping screw 70 is 
unscrewed from its initial tight fit, the Belleville-like washer 168 
forces the coping screw 72 upward from the healing abutment assembly 20 
thereby maintaining coronal distance integrity of the device. 
To make these coronal adjustments, I have included in my device, on the 
coping screw top 71 a coping adjustment member 66. This is a standard 
slotted, hexed, or similarly shaped adjustment member suited to accept a 
mating adjustment tool (not shown) and to screw-in or un-screw the coping 
assembly 60 into or out from the healing abutment assembly 20. 
The shape, texture, and dimensions of the outer surface of the coping 
member 80 are important features to further facilitate gingival growth 
overall and, coronally in particular. The total length of the exterior of 
the coping is generally about 6 mm to 8 mm. This includes both a smooth 
surface and a roughened surface 88. The exterior surface below the smooth 
surface is a semi-rough surface as denoted by reference numeral 88 in 
FIGS. 1 and 2 (refer also to FIGS. 5 and 6). This roughened (or rough) 
surface ranges in height from about 1.5 mm to about 3.0 mm. A 
titanium-plasma spray may be used to establish this semi-rough surface 
although any similar such spray or compound, suited for the intended 
purpose, may be used. The function of the semi-rough surface is to 
facilitate and foster soft tissue, after it grows post-operatively, to 
adhere to it. 
The smooth surface ranges in height from about 5 mm to about 5.5 mm. Any 
material such as, but not limited to, titanium, may be used for the smooth 
surface. The function of this smooth exterior surface is to prevent excess 
tissue inflammation at the gingival margin area. Any smooth-like material 
suited for the intended purpose will suffice. The coping member 80 also 
has an annular skirt 83 there around located substantially above the 
coping member bottom 82. An upper section is defined on the exterior 
surface of the coping member 80 at a point above the annular skirt 83. A 
lower section is defined at a point below the annular skirt 83. 
The combination of the smooth surface and the rough surface encourages 
direct mechanical attachment of the tissue to the rough surface and 
permits the growing tissue to closely approximate or touch the smooth 
surface but not to mechanically adhere to it. 
The unique outward flanged contour of the upper section of the coping 
member 80, which terminates at the annular skirt 83 and recedes radially 
inward therefrom to the coping member bottom 82, further facilitates 
tissue growth, especially from below the underside of the coping member 
80, and attachment of all surrounding tissue growth to the coping member 
80. As seen in FIG. 2, the flange terminates at the coping skirt 83, an 
annular skirt adjacent to the coping member bottom 82. As indicated above, 
from the coping skirt 83 on down, the exterior surface of the coping 
member 80 retreats radially inward terminating at point located at the 
coping member bottom 82 in close relationship to the perimeter of the 
implant ledge 92. 
The contour of the coping member 80 as well as the rough surface thereof 
are important for good tissue adherence and growth. Good adherence and 
growth can be achieved where the vertical dimension of the lower section 
in relation to the overall height of the coping member bears a ratio of 
between about 1.0:4.5 to about 1.0:6.0. Better results are achieved with 
ratios from between about 1.0:2.8 to about 1.0:3.5. Best results can be 
achieved with ratios from between about 1.0:2.6 to about 1.0:2.3. 
Additionally, good tissue adherence and growth can be achieved where the 
vertical dimensions of the smooth surface in relation to the rough surface 
of the coping member bears a ratio of between about 1.00:0.27 to about 
1.00:0.60. Better results are achieved with ratios from between about 
1.00:0.30 to about 1.00:0.50. Best results can be achieved with ratios 
from between about 1.00:0.35 to about 1.00:0.40. 
Once the tissue adheres, the coping assembly 60 can be adjusted vertically 
away from the healing abutment assembly 20 in suitable increments as 
warranted by the circumstances and desired result. The tension means 
(spring 68 or Bellville-like washer 168) keeps the adjustment of the 
device coronally forced and prevents any reverse movement due to play 
associated with the tolerances of the abutment bore threading 48 and the 
coping screw threading 76. The tension means facilitates a smooth, 
unabated coronal adjustment bringing with it, the tissue attached to the 
rough surface 88 of the coping member 80. The coping screw ring 74 and 
mating coping channel 84 or 184 permits rotation of the coping screw 70 
without tandem rotation of the coping member 80. Such rotation of the 
coping member 80 would weaken the attached tissue and, possibly, dislodge 
it. This tension means assists in forcing a perpetual coronal movement of 
the coping assembly 60 regardless of whether or not the device is being 
adjusted. The tension exists at all times. 
FIGS. 5 through 7 show the coping assembly 60 inserted over the abutment 
member 30 and the follow-on tissue growth and associated gingival crests. 
Pre-operative gingival crest 111 is between a patient's teeth 118. The 
implant 90 is anchored to a patient's bone 119. Tissue 114 covers the 
lower portion of the teeth 118. The extraction site, referred to as the 
implant site 116, reveals a post-operative gingival crest 112 as 
substantially lower that the pre-operative gingival crest 111. The device 
used a directed facilitates the coronal extension of the gingival crest 
112A from within and around the implant site as depicted in FIG. 7. The 
phantom line denotes the original post-operative gingival crest. 
Once tissue grows and adheres to the lower section, the coping member 80 is 
again adjusted coronally. The `void` created by the stretched tissue is 
filled by additional tissue as a result. By repeating this procedure, the 
post-operative gingival crest can be substantially moved coronally to a 
crest substantially near in height as the pre-operative gingival crest. 
Such continued and repeated adjustment also fortifies previously grown 
tissue. After sufficient soft tissue has adhered and stabilized, the 
coping assembly 60 is removed from the healing abutment assembly 20. This 
is accomplished by use of a cutting tool to release the soft tissue 
attached to the coping member 80. A special such tool, fitting the coping 
member 80 cuts and releases the tissue therefrom. A clean cut is made, the 
tissue left relatively intact at a suitable post-operative gingival crest. 
A temporary tissue maintenance cover screw having a design and shape 
similar to the coping, but with a smooth surface, is then inserted onto 
the abutment to maintain the new tissue position during the fabrication of 
the implant restoration. Thereafter the implant restoration is inserted 
onto the abutment assembly 20 having sufficient soft tissue therearound to 
render a substantially uniform gingival crest appearance throughout. 
The present disclosure includes that contained in the present claims as 
well as that of the foregoing description. Although this invention has 
been described in its preferred forms with a certain degree of 
particularity, it is understood that the present disclosure of the 
preferred form has been made only by way of example and numerous changes 
in the details of construction and combination and arrangement of parts 
may be resorted to without departing from the spirit and scope of the 
invention. Accordingly, the scope of the invention should be determined 
not by the embodiments! illustrated, but by the appended claims and their 
legal equivalents.