Abstract:
A dental implant assembly containing an integrally-formed universal abutment which has a top section, a bottom section integrally joined to the top section, and a passageway extending through these sections. The passageway is formed by different size bores, initially a larger size than decrease in size. The top section of the abutment has a cross-sectional shape substantially like a polygon; the shape is formed by alternating linear and arcuate walls joining to a bottom section having a cross-sectional shape substantially like a polygon.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation-in-part of U.S. patent application Ser. No. 13/959,161 (filed Aug. 5, 2013), the entirety of which is incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    Dental implants have been known and used since at least the 1930&#39;s. See, for example, U.S. Pat. No. 5,312,254 of Joel L. Rosenlicht. See also U.S. Pat. No. 5,145,371 of Lars Jorneus which discusses the osseointegration method of integrating a dental implant into a patient&#39;s jaw. The disclosure of each of these patents is hereby incorporated by reference into this specification. 
         [0003]    Dental implants are moderately expensive. It often costs from about three to four thousand dollars to implant a tooth into a patient&#39;s mouth. One of the reasons for this substantial cost is the multiplicity of steps required by the implant procedure. These steps will be described below with reference to Nobelpharma catalog PRI 385 B 95.09 3rd edition (published by the Nobelpharma AB, Box 5190, S-402 26 Goteborg, Sweden). 
         [0004]    In the first step of the procedure, an implant (sometimes referred to as a “fixture”) is purchased. See, for example, page 7 of the Nobelpharma catalog and the reference to the 3.75 mm and 4.0 mm titanium fixtures illustrated on such page. 
         [0005]    The fixture is placed into an “instrument set for fixture placement”, which is shown on page 26 of the Nobelpharma catalog. Once the fixture is disposed in the “instrument set” a “fixture mount” is then attached to the fixture by means of a wrench and a screwdriver. The “fixture mount” devices are shown on page 26 of the Nobelpharma catalog. The instruments for fixture placement of the fixture are also shown on page 26 of the Nobelpharma catalog (see wrench part 14 and screwdriver part 16). 
         [0006]    Thereafter, a “connection to contra-angle handpiece” (see part DEC330 on page 52 of the Nobelpharma catalog) is attached to a handpiece; and the implant assembly may then be driven into the jawbone of a patient. Thereafter, the fixture mount is removed from the fixture and a cover screw (see page 9 of the Nobelpharma catalog) is inserted into the fixture. Thereafter, the surgical site is allowed to heal for from about 3 to about 6 months. See, e.g., Branemark/Zarb/Alberektsson: “Tissue Integrated Prostheses” (Quintessence Books, 1985). 
         [0007]    After the healing period, the implant is exposed by surgical procedures and the cover screw is removed. Thereafter, a healing abutment (see part SCPB010 on page 12 of the Nobelpharma catalog) is attached to the fixture. It generally is left in place for from about two to about three weeks, depending upon how the patient&#39;s tissue has healed. Thereafter, the healing abutment is removed and an implant abutment is then attached to the fixture. The type of implant abutment to be used will depend on the requirements of the patient. Thus, e.g., and referring to pages 14 to 16 of the Nobelpharama catalog, one may standard abutment, and ESTHETICONE™ abutment, a CERAONE™ abutment, a “Ball Attachment”, an “Angulated Abutment”, and the like. After multiple visits, the desired single crown is formulated by conventional means. Once the prosthesis has been prepared, it is custom fitted to the patient&#39;s mouth secured to the implant. 
         [0008]    This traditional dental restorative procedure require considerable skill and expertise. Typically, the procedure and the components used for each patient are highly customized. Independent placement of the implant requires selection of an appropriate abutment from hundreds of different options. Essentially, the abutment is selected to both compensate for implant placement inaccuracies and to address the final aesthetic and functional characteristics. Such compromise rarely produces optimal or desirable results for the patient. 
         [0009]    In addition to traditional non-indexed (customized) way of implant and restoration requiring extensive time, labor and costs, various theoretical and practical implications need to be considered for multiple tooth or full-mouth reconstruction. In multiple implant restorations, “draw,” “common path of insertion,” “parallel,” “passivity” and “stability” are terms that describe the most critical objectives of such a procedure. Draw is perhaps best described as the effects of friction, but not binding. 
         [0010]    Multiple implants and their abutments are rarely, if ever, perfectly aligned within the patient&#39;s mouth. Traditional methods of multiple tooth restoration require the heads/abutments and prostheses to be modified or made parallel until a common path of insertion is achieved and until the prosthesis is passive with respect to all of the abutments and soft tissue. In other words, it must be possible to place the prosthesis in position by moving the structure onto the abutments in a straight line (i.e., the common path of insertion), with sufficient friction or draw to ensure a firm fit. Once in place, the prosthesis must be passive, which means it must fit the abutments and the soft tissue profile such that there is no undue tension and no motion can take place. 
         [0011]    These procedures require a myriad number of instruments and customized parts: typically two surgical procedures, many trips by the patient to the dentist, increased treatment times and prolonged healing periods resulting in an overall reduced quality of life for the patient. Further, an expensive, time consuming and labor intensive “trial and error” system is crucial to such procedures because each prosthesis is custom made to the particular shape, design, location and quantity of abutments for each patient. Therefore, not only are the processes tedious and expensive but each surgical procedure introduces a certain element of risk, pain, and suffering. 
         [0012]    In view of the above, there is a need for a dental implant system and associated integrated process of attachment that are simple, predictable and effective. In particular, it is desirable that the dental implant system and attachment process include universal, non-customized and interchangeable components, reduce post-operative infection, improve device/prosthesis strength, prolong its stability, and reduce the overall time for reconstruction procedures. It is also desirable that the dental implant system and associated process enable a practitioner to transfer most of the fabricating, assembling, fitting and adjusting of the final prosthesis from the dental chair side to the bench top in the dental laboratory. 
         [0013]    It is an object of this invention to accomplish at least one of the following: It is an object of this invention to provide a process for implanting a prosthesis in a patient&#39;s mouth which is substantially less expensive, safer, and less-time consuming than the prior art procedures. It is another object of this invention to invent an indexed universal adaptor abutment to replace multiple components and/or abutments used in the implant and restoration process. It is yet another object of this invention to provide a novel stock or preformed implant denture teeth system that can reversibly attached to the adaptor or its extension. It is yet another object of this invention to provide an adaptor screw with extensions to secure the adaptor to the dental implant. It is another object of this invention to provide a novel universal dental abutment. It is yet another object of this invention to provide a novel carrier for such abutment. It is yet another object of this invention to provide a novel fixed, detachable one piece implant supported bridge. It is yet another object of this invention to provide a process for attaching a prosthesis to a patient which process is substantially more accurate than prior art processes. 
       BRIEF DESCRIPTION OF THE INVENTION 
       [0014]    A dental implant assembly is provided that contains an integrally-formed universal abutment which has a top section, a bottom section integrally joined to the top section, and a passageway extending through these sections. The passageway is formed by different size bores, initially a larger size than decrease in size. The top section of the abutment has a cross-sectional shape substantially like a polygon; the shape is formed by alternating linear and arcuate walls joining to a bottom section having a cross-sectional shape substantially like a polygon. 
       [Summarize Agreed Upon Claims After First Draft] 
       [0015]    This brief description of the invention is intended only to provide a brief overview of subject matter disclosed herein according to one or more illustrative embodiments, and does not serve as a guide to interpreting the claims or to define or limit the scope of the invention, which is defined only by the appended claims. This brief description is provided to introduce an illustrative selection of concepts in a simplified form that are further described below in the detailed description. This brief description is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. The claimed subject matter is not limited to implementations that solve any or all disadvantages noted in the background. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]    So that the manner in which the features of the invention can be understood, a detailed description of the invention may be had by reference to certain embodiments, some of which are illustrated in the accompanying drawings. It is to be noted, however, that the drawings illustrate only certain embodiments of this invention and are therefore not to be considered limiting of its scope, for the scope of the invention encompasses other equally effective embodiments. The drawings are not necessarily to scale, emphasis generally being placed upon illustrating the features of certain embodiments of the invention. In the drawings, like numerals are used to indicate like parts throughout the various views. Thus, for further understanding of the invention, reference can be made to the following detailed description, read in connection with the drawings in which: 
           [0017]      FIG. 1A  is a perspective view of one abutment of this invention; 
           [0018]      FIG. 1B  is a top view of an abutment adaptor with a substantially hexagonal exterior shape; 
           [0019]      FIG. 1C  is a cross section view of one abutment adaptor of the invention; 
           [0020]      FIG. 1D  is a cross section view of one abutment adaptor of the invention; 
           [0021]      FIG. 1E  is a cross section view of one abutment adaptor of the invention; 
           [0022]      FIG. 1F  is top view of sections of other embodiments with various shapes such as triangular, square, pentagonal, polygonal cross-sectional shapes; 
           [0023]      FIG. 1G  is a perspective view of the abutment adaptor with the top section as a substantial hexagonal shape and the bottom is a substantial hexagonal shape 
           [0024]      FIG. 1H  is a cross-sectional view of the abutment adaptor of  FIG. 1G ; 
           [0025]      FIG. 1I  is a perspective view of the abutment adaptor with the top section as a substantial hexagonal shape and the bottom is a substantially conical shape; 
           [0026]      FIG. 1J  is a cross-sectional view of the abutment adaptor of  FIG. 1I   
           [0027]      FIG. 2A  is a perspective and sectional views of the abutment adaptor screw with the top section larger than a proximal end, where the top section has a hexagonal recess and a threaded bore located immediate below the hexagonal recess; 
           [0028]      FIG. 2B  is a perspective and sectional view of the abutment adaptor; 
           [0029]      FIG. 3A  is an exploded perspective view illustrating how the abutment retaining screw of  FIG. 2A  may be attached to an abutment adaptor and an implant fixture; 
           [0030]      FIG. 3B  is an exploded perspective view illustrating how the abutment retaining screw of  FIG. 2A  may be attached to an abutment adaptor with a horizontal shoulder; 
           [0031]      FIG. 3C  is an exploded perspective view illustrating how the abutment screw extension can be attached to abutment retaining screw of  FIG. 2A  with the whole implant assembly; 
           [0032]      FIG. 3D  is an exploded perspective view illustrating how a mechanical hex socket/driver can engage the abutment adaptor of the implant assembly to deliver the implant assembly into jaw bone after soft tissue is reflected; 
           [0033]      FIG. 3E  is an exploded perspective view illustrating abutment adaptor of the implant assembly in situ acting as healing abutment to prevent collapse and closure of the soft tissue over the implant assembly; 
           [0034]      FIG. 3F  is an exploded perspective view illustrating the abutment screw extension attached to the abutment adaptor of the implant assembly in situ acting as a scan abutment to allow accurate capture the trajectory and horizontal timing of the hexagonal dental implant assembly in the jaw bone; 
           [0035]      FIG. 3G  is an exploded perspective view illustrating the removal of the abutment adaptor and abutment screw to be replaced by the final crown/adaptor ready to removably attached to the dental implant with the abutment screw; 
           [0036]      FIG. 4A  is an exploded perspective view illustrating abutment screw, abutment and the dental implant ready to retain a stock or pre-formed denture tooth by chemical means; 
           [0037]      FIG. 4B  is an exploded perspective view illustrating abutment screw, abutment and the dental implant ready to retain a stock or pre-formed denture tooth by mechanical means; 
           [0038]      FIG. 4C  a flow diagram depicting an exemplary method of attaching a single dental crown; 
           [0039]      FIG. 5A  is a flow diagram depicting an exemplary method of attaching a one piece dental prosthesis to multiple implants; 
           [0040]      FIG. 5B  is a perspective view of two dental implant assemblies of  FIG. 3E  in the jaw bone with different trajectories, one with abutment screw extension and the other assembly is without the extension; 
           [0041]      FIG. 5C  is an exploded view of two dental implant assemblies of  FIG. 3E  in the jawbone with different trajectories with the abutment adaptor and abutment screw removed; 
           [0042]      FIG. 5D  is a perspective view of two dental implants of  FIG. 3E  with the abutment adaptor and abutment screw removed; and the one-piece dental bridge with two symmetrical protrusions; 
           [0043]      FIG. 5E  is a perspective view of two dental implants of  FIG. 3E  with the abutment adaptor and abutment screw removed with the one-piece dental bridge with two protrusions only one being asymmetrical; 
           [0044]      FIG. 5F  is a perspective view of three dental implants of  FIG. 3E  with the abutment adaptor and abutment screw removed; 
           [0045]      FIG. 6A  is a perspective view of a preformed, stock denture tooth and the indexed hex recess; 
           [0046]      FIG. 6B  is a perspective view of a preformed, stock denture tooth with a hex/indexed recess and their corresponding hex insert. One insert has an expandable wire clip to retain the denture tooth; 
           [0047]      FIG. 7  is a perspective view of two dental implants of  FIG. 3E  with the abutment adaptor and abutment screw removed. The final dental bridge (or 5 teeth) or prosthesis with right one adjusted abutment adaptor proximal ends mechanically attached to the two dental implants with different trajectories. The left implant is chosen as the common path of Insertion, insertion of the one piece multiple implant/adaptor prosthesis can be inserted to both implants and mechanically retained with the removal of one side of the right abutment adaptor proximal hex end (obstruction); 
           [0048]      FIG. 8A  is a perspective view of multiple dental implant assemblies of  FIG. 3E  after implantation; 
           [0049]      FIG. 8B  is a perspective view of multiple dental implant assemblies of  FIG. 3E  with the abutment screw extension attached for intraoral imaging acquisition; 
           [0050]      FIG. 8C  is a perspective view of multiple dental implant assemblies of  FIG. 3E  with the abutment adaptor and abutment screw removed exposing the internal connection or recess of the implant fixture; an abutment adaptor and abutment screw removed from a dental implant is depicted in the same illustration; 
           [0051]      FIG. 8D  is a perspective view of an implant/teeth connector where one end is engaging to all implant fixture recesses and the prosthetic end with pre-formed hexed inserts for the insertion of stock denture crowns; 
           [0052]      FIG. 9  depicts alternative embodiments of a dental implant recess; 
           [0053]      FIG. 10  shows the output of a digital map of the patient&#39;s mouth; 
           [0054]      FIG. 11  depicts the map having been altered to remove the gums and show the relative orientation of the various implants as they extend into the jawbone; 
           [0055]      FIG. 12  illustrates which portions of the protrusions of the dental bridge protrusions must be machined to produce a common path of insertion; and 
           [0056]      FIG. 13  depicts a prosthesis with appropriately machined protrusions. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0057]    Referring to  FIG. 1  A, a perspective view of one abutment adaptor  10  is shown. The universal abutment adaptor  10  is a monolithic structure which consists or consists essentially of titanium or titanium alloy. Alternatively, the abutment adaptor  10  may consist of gold, silver, palladium, vanadium, cobalt alloy, stainless steel, ceramic, high performance engineer plastic (PEEK) and the like. Any of the titanium or titanium alloy materials used in implants may be used to make abutment adaptor  10 . Thus, by way of illustration and not limitation, one may use one or more of the materials disclosed in U.S. Pat. No. 5,373,621 (a titanium/aluminum/vanadium alloy), U.S. Pat. No. 5,372,660 (a titanium/zirconium alloy), U.S. Pat. Nos. 5,358,529, 5,354,390 (a titanium-base microalloy containing at least 98 weight percent of titanium), U.S. Pat. No. 5,334,264 (a nitrided or colored titanium material), U.S. Pat. No. 5,326,362 (a titanium/aluminum/vanadium alloy), U.S. Pat. No. 5,205,921 (a coated titanium implant), U.S. Pat. No. 5,192,323 (a titanium/aluminum/vanadium alloy), and the like. The disclosure of each of these United States patents is hereby incorporated by reference into this specification. 
         [0058]    In one embodiment, the abutment adaptor  10  is machined from pure titanium which is originally in the form of a rod. The titanium meets the standards set forth in A.S.T.M. Standard F 67-88, “Specification for Unalloyed Titanium for Surgical Implant Applications.” In general, the material used, regardless of whether it is titanium, titanium alloy, and/or other material, meet the requirements set forth in A.S.T.M. Standard Test F 981-87 “Practice for Assessment of Compatibility of Bio Materials (Non-Porous) for Surgical Implants”. 
         [0059]    Referring again to  FIG. 1A , it will be seen that abutment adaptor  10  is comprised of a top bore  16  which extends from a top  14  of abutment adaptor  10  to a bottom bore  116 . The hollow top bore  16  is indicated in  FIG. 1B  by a dotted line. Abutment adaptor  10  is comprised of a bottom bore  116  that extends downwardly to form another protrusion  125 . The abutment adaptor  10  comprises a hexagonal portion  24  that has a flat surface, the timing of which matches the flat surface  124  of the protrusion  125 . The abutment adaptor  10  has a step  12  of the top bore  16 , the upper portion of which has a diameter between 1 mm and 10 mm. In one embodiment, the diameter of the top bore  16  is about 3.5 millimeters. In another embodiment, the hollow top bore  16  has a diameter of about 2.0 millimeters. The lower portion of the top bore  16  (i.e. the portion below the step  12 ) has a diameter that is less than the diameter of the upper portion. For example, the lower portion may have a diameter that is between 60% and 99% of the diameter of the upper portion. In one embodiment, the lower portion is between 70 and 90%, or about 80% of the diameter from the upper portion. The distance between the top  14  of abutment adaptor  10  and the step  12  is 2.0 millimeters. In another embodiment, the distance between the top  14  and the step  12  is 3 mm. The distance between top  14  and junction  122  is 3.0 millimeters. In the embodiment depicted in  FIG. 1A , the distance between opposite linear surfaces on the exterior of the hexagonal sleeve is about 3.9 millimeters and the distance between opposite curved surfaces  30  on the exterior of the hexagonal sleeve is about 4.1 millimeters. 
         [0060]      FIG. 1A  illustrates one structure near junction  122 . In one embodiment, the junction  122  is an annular groove. It will be seen that, in the embodiment illustrated, junction  122  is disposed beneath substantially hexagonal portion  24  of abutment adaptor  10 . The junction  122  has a depth (e.g. the depth of an annular groove) which, in one embodiment, is from about 0.0 millimeter to about 5.0 millimeters. In another embodiment, the depth of the junction  122  is between 0.1 mm and 5 mm. In one embodiment, the depth is from about 0.1 to about 1.0 millimeters. In the embodiment illustrated in  FIG. 1A , junction  122  is 0.0 millimeter. In one embodiment the junction  122  has a substantially circular shape to form an annular groove. In another embodiment, the junction  122  has a radius of curvature of from about 0.0 to about 0.2 millimeters. In one embodiment, the radius of curvature of the junction  112  is about 0.10 millimeters. Without wishing to be bound to any particular theory, applicant believes that this structure provides a more secure attachment to devices attachable to abutment adaptor  10 . In the embodiment of  FIG. 1A , the substantially hexagonal portion  24  has rounded corners provided by curved surface  30 . This is also illustrated in  FIG. 1B , which is a top view of the structure of  FIG. 1A . 
         [0061]    Referring to  FIG. 1B , it will be seen that hexagonal portion  24  is comprised of exterior surface which contains alternating linear portions  28  and curved portions  30 . Without wishing to be bound to any particular theory, it is believed that the rounded corners (curved portions  30 ) in this structure are substantially compatible with the patient&#39;s mouth. Thus, e.g., these rounded corners do not irritate the patient&#39;s tongue during eating as much as the sharp corners present on conventional hexagonal structures. In one embodiment, the length of each linear portion  28  may be substantially equal to the length of each of the other linear portions  28 . In one embodiment, the substantially hexagonal shape depicted in  FIG. 1A  is substantially symmetrical. In one embodiment, the length of each linear portion  28  is at least about 1.2 times as long as the length of each curved portion  30 . In one embodiment, the length of each linear portion  28  is at least about three times as great as the length of each curved portion  30 . 
         [0062]      FIG. 1C  depicts another embodiment of the abutment adaptor  10 . The embodiment in  FIG. 1C  comprises the hexagonal portion  24 , joined by the protrusion  125  by junction  122 . In the embodiment of  FIG. 1C  the junction  122  is an annular groove. The protrusion  125  is a hexagonal protrusion as shown in  FIG. 1B . The embodiment of  FIG. 1C  further comprises a rounded extension  127  in the form of a collar or cone. The rounded extension  127  serves to extend the depth of the abutment adaptor  10  to provide increased stability during use. The indexed protrusion  125  translates the indexing of the implant fixture (see implant fixture  340  of  FIG. 3A ) to the abutment adaptor  10 . The lengths  125   a,    127   a  and  24   a  of the protrusion  125 , the rounded extension  127 , and the hexagonal portion  24  are set such that the length  24   a  is about three times the length of length  127   a.  The length  125   a  is about twice the length of the length  127   a.    
         [0063]    As shown in  FIG. 1D , the hexagonal protrusion  125  and the rounded extension  127  are reversed such that the rounded extension  127  is contiguous with the hexagonal portion  24  by way of the junction  122 . The embodiment of  FIG. 1E  is substantially similar to the embodiment of  FIG. 1D  except in that rounded extension  127  is cone shaped such that the cone extends downward and inward. 
         [0064]    As will be apparent to those skilled in the art, the hexagonal portion  24  of abutment adaptor  10  may have an exterior shape which need not be substantially hexagonal but may assume the shape of other polygons provided it is indexed to the timing of the protrusion  125  (see  FIG. 1A ).  FIG. 1F  depicts examples of various shapes of the hexagonal portion  24 . The top of the abutment may have various shapes such as a shape with linear walls (triangular, square, pentagonal, polygonal cross-sectional shapes), curved shapes (reverse curves), splines or cams with lobes capable of engaging two or more surfaces for the purposes of indexing and location of the dental implants. 
         [0065]    Referring to  FIGS. 1G to 1J , and in the embodiments depicted therein, it will be seen that protrusion  125  of abutment adaptor  10  has a substantially hexagonal cross-sectional which is adapted to mate with the internal connections or recess with a hexagonal shape of the upper portion of an implant fixture  340  (see  FIG. 3A ).  FIG. 1H  is a sectional view of the abutment adaptor  10  of  FIG. 1A . Referring to  FIG. 1H , it will be seen that the base  20  of abutment adaptor  10  has a width  42  at its bottom which is substantially less than its width  44  at its top. In general, width  44  is at least about 1.1 times as great as width  42 . In one embodiment, width  44  is 4.7 millimeters, and width  42  is 4.0 millimeters. In the embodiment shown, the distance between opposing linear walls of the hexagonal shape is 2.4 millimeters.  FIG. 1I  and  FIG. 1J  depict a conical protrusion. In the embodiment of  FIG. 1I  and  FIG. 1J , the conical protrusion comprises an indexing feature  129  that engages and is indexed to the implant fixture  340  (see  FIG. 3A ). Examples of suitable indexing features include cams, splines, lobes, gears, and the like. 
         [0066]    In  FIG. 2A  the upper portion of the bore above step  12  has a diameter of about 3.0 mm that is sufficient for an abutment screw  230  to pass through it. In another embodiment stepped step  12  has a diameter 2.0 millimeters. The abutment screw  230  is comprised of an internal bore  132  with internal threads  234  adapted to receive and engage with external threads  530  of an extension  500  and/or a multiplicity of dental prostheses (not shown). The abutment screw  230  is comprised of top section  231  which is adapted to fit within the hollow top bore  16  (see  FIG. 2A ) and mesh with the flat or chamfer section between the step bores therein. The abutment screw  230  is also comprised of external thread  238  which, after passing through abutment adaptor  10 , may be secured to threaded orifice  326  (see  FIG. 3A ) of the implant fixture  340 . A vertical extension  500  of the abutment screw  230  is also disclosed. The extension  500  has a length such that it fully extends through the hollow top bore  16  to expose the external treads  238  such that they can engage the threaded orifice  326  of the implant fixture  340 . In one embodiment the extension  500  is at least 10% to 50% longer than the abutment adaptor  10  such that 1 mm to 10 mm of the external treads  238  is exposed. 
         [0067]    Referring to  FIG. 2B , substantially hexagonal portion  24  extends from the top  14  of abutment adaptor  10  to junction  122 . In one embodiment the distance between top  14  and junction  122  of abutment adaptor  10  extends at least about  55  percent of the entire height of abutment adaptor  10 . In one embodiment, the distance between top  14  and junction  122  is about 3.0 millimeters. The step  12  of the top bore  16  is disposed between the hollow top bore  16  and bottom bore  116  and has a diameter which continually decreases from the hollow top bore  16  to the bottom bore  116 , thereby forming a chamfered or flat surface. In one embodiment the chamfered surface forms an obtuse angle (as measured with respect to the interior wall of the stepped bore  12  of hollow top bore  16 ) of from about 120 to about 150 degrees. 
         [0068]    In another embodiment (not shown) an implant carrier is provided which is adapted to be removably connected to the abutment adaptor  10  and to manually deliver it into the jaw of a patient. In one embodiment, the carrier is an integral assembly which consists essentially of non-toxic plastic material that is medical grade. One may use any of the medical grade material known to those skilled in the art such as, e.g., the plastics described in U.S. Pat. No. 5,356,709 (polypropylene, PEEK, copolymer; styrene/ethylene/butylene/styrene copolymer), U.S. Pat. No. 5,312,251 (medical grade ceramic material), U.S. Pat. No. 5,326,364 (medical grade ceramic) and the like. The disclosure of each of these United States patents is hereby incorporated by reference into this specification. In one embodiment, the carrier consists essentially of high density and performance engineering plastic such as PEEK, polypropylene which is extruded into the desired shape. In one embodiment, removable cover and carrier is color coded to indicate which part it is to be used in connection with. 
         [0069]      FIG. 3A  is an exploded view of the abutment adaptor  10 , the implant fixture  340  and the abutment screw  230 . External threads  238  engage threaded orifice  326 . The protrusion  125  is indexed with respect to the timing of the internal hex wall  324  of the implant fixture  340 . This permits the mechanical engagement of the system to maintain the orientation of the device throughout its installation and function. In conventional systems that install multiple implants non-indexed engagements are traditionally used because practitioners believe the non-indexing approaching is required to overcome different trajectories of multiple implants. In contrast, the disclosed indexed approach provides multiple benefits while allowing multiple implants to be installed simultaneously. These benefits include increase in stability of the system, reduction in complications and a decrease in time and expense. 
         [0070]      FIG. 3B  is an exploded perspective view illustrating that, after retaining abutment screw  230  is passed through abutment adaptor  10 , it may be screwed into threaded orifice  326  of implant fixture  340  and become removably engaged with the internal hex walls  324  of the recess in implant fixture  340  and with the internal threads located within threaded orifice  326 . 
         [0071]    In the embodiment of  FIG. 3B  the junction  122  is dispose between the top part and the bottom part of the hexagonal abutment adaptor. The junction  122  is a ledge that has a thickness and extends vertically downward and inward toward the bottom bore  116  to form a ledge  126  (sometimes referred to as a shouldered collar) with a thickness between 0 mm and 2 mm.  FIG. 3B  illustrates the structure near ledge  126 . In the embodiment illustrated ledge  126  is disposed beneath substantially hexagonal portion  24  of abutment adaptor  10 . Disposed between substantially hexagonal portion  24  and ledge  126  is an annular groove (not shown). Without wishing to be bound to any particular theory, applicant believes that this structure provides a more secure attachment to devices attachable to abutment adaptor  10 . In the embodiment illustrated in  FIG. 3B , implant fixture  340  is comprised of external threads  336  which can be used to secure implant assembly within the jawbone of a patient. 
         [0072]      FIG. 3C  is a perspective view of an assembly  150  comprising the abutment screw  230 , the hexagonal abutment adaptor  10  and the implant fixture  340 . In addition, a removable extension  500  can reversibly attached to the assembly  150  for the prosthetic part of the restorative process (either digitally or manually) without changing any components. The abutment adaptor  10  and abutment screw  230  may be used in conjunction with an implant fixture  340 . This assembly is quite adaptable and may be used with substantially any of the implant fixtures with internal connection known to those skilled in the art. Thus, by way of illustration and not limitation, one may use one or more of the implant fixtures disclosed in U.S. Pat. Nos. 5,338,197; 5,061,181; 5,030,095; 4,960,381; 4,932,868; 4,871,313; 4,854,873; 4,854,872; 4,713,004; 4,468,200; 4,330,891; 4,016,651; 3,672,058; 3,579,831; 2,609,604; 5,376,004; 5,364,268; 5,362,235; 5,302,125 and the like. The disclosure of each of these United States patents is hereby incorporated by reference into this specification. The implant fixture  340  is connected to abutment adaptor  10  by means of the abutment screw  230 . The abutment screw  230  is shown in more detail in  FIG. 2A . 
         [0073]      FIG. 3D  is an exploded cross sectional view of the assembly  150  showing the abutment adaptor  10 , the abutment screw  230  and the implant fixture  340  disposed beneath a socket wrench  152  with a hexagonal bore  154 . As will be apparent to those skilled in the art, socket wrench  152  may be removably attached to the substantially hexagonal portion  24  of the abutment adaptor  10  and used to insert assembly  150  into a hole in the patient&#39;s jaw. Alternatively, or additionally, depending upon the amount of force needed, a carrier may be used for this purpose or, alternatively, to start the insertion of the assembly  150  in the hole. The abutment adaptor has an exterior hexagonal shape; and thus it is adapted to be screwed into the hole in the patient&#39;s jaw by a socket wrench  152  with the matching hexagonal bore  154 . It will be apparent, however, that the means of inserting the assembly  150  into the hole in the patient&#39;s jaw will vary with the type of implant fixture  340  used. Thus, for example, when the exterior shape of implant fixture  340  is substantially cylindrical, a seating tool (such as a mallet) may be used. These procedures are well known to those skilled in the art. 
         [0074]      FIG. 3E  is a cross sectional perspective view of the assembly  150  in the jaw bone under healing condition for a period of time for the bone to fuse with the titanium implant assembly. The hexagonal abutment adaptor  10  acts as a healing abutment keeping the soft tissue apart exposing the top section of the abutment adaptor  10  thus avoiding the second stage exposure surgery. Alternative, a healing ball may be used (see U.S. Pat. No. 5,564,924; 6,068,479; 7,207,800; 8,500,449 and 5,733,124). The disclosure of each of these United States patents is hereby incorporated by reference into this specification. In one embodiment, the healing ball consists essentially of medical grade material such as, e.g., medical grade polyethylene, high performance plastic (PEEK). In one embodiment, healing ball consists essentially of high-density polyethylene or titanium. 
         [0075]      FIG. 3F  is a partial perspective view of the implant fixture  340 , when implant  340  is “osseintegrated” to the bone without mobility or pain. The three dimensional position of the hexagonal abutment adaptor  10  and implant fixture  340  can be scan intra-orally and determined with the extension  500  removably attached to the internal threads  234  of the abutment screw  230  (both not shown) acting as a scan body. The extension  500 , together with healing ball, described elsewhere is used to perform the manual transfer of the assembly  150  into working stone model. Thus, as will be apparent to those skilled in the art, the hexagonal abutment adaptor  10  is universal and may be used in conjunction with many different types of prosthetic applications. It thus affords the dental practitioner substantially more flexibility than does the prior art systems, which utilize a substantial number of parts which are adapted for specific applications. 
         [0076]    Thus, by way of further illustration, and referring to  FIG. 3F , the impression process may be incorporated into a fixed detachable implant supported bridge. See, e.g., U.S. Pat. No. 5,174,954, the entire disclosure of which is hereby incorporated by reference into this specification. 
         [0077]      FIG. 3G  is an exploded perspective view of a dental crown  450  which incorporated the top section of the hexagonal abutment adaptor  10  into the crown  450  proper while exposing only the protrusion  125  and top bore  16 . After removal of the universal hex abutment adaptor  10 , the abutment screw  230  can be used to attach the crown  450  to the internal hex walls  324  matching the “timing” of both hexes replacing universal hex abutment adaptor  10 . Because the timing of the indexed dental crown  450 , and the timing of the implant fixture  340  matches the timing of the indexed abutment adaptor  10  (now removed) dental crown  450  can be properly attached. 
         [0078]      FIG. 4A  is an exploded view of the implant assembly  150  with a pre-formed, stock denture crown with indexing recess  424  and gingival seat  414 .  FIG. 4B  is another exploded view of implant assembly  150  with a custom made crown  410  with an indexed insert  420 , indexing recess  424  and gingival seat  414 . A retaining screw  411  is also included. 
         [0079]      FIG. 4C  is a flow diagram of one process of the invention for a single crown. In the first step of this process, step  300 , a hole is drilled in the jawbone of the patient sufficiently deep to receive only the length of the implant fixture  340 . In general, this hole is usually from about 8 to about 18 millimeters. Thereafter, in step  302  of the process, implant assembly  150  is delivered to the hole. Placement into the prepared hole is started via a hand carrier or via an engine driven socket wrench. Thereafter, in step  304  of the process, the abutment/implant fixture is driven to a pre-determined position usually with the ledge of the abutment adaptor  10  level with the bone using the engine driven socket wrench at slow speeds (e.g. 30-40 RPM). Thereafter, in step  306  of the process, a suture is applied to the flap around the abutment adaptor  10 . Thereafter, in step  308 , the surgical site is allowed to heal. In general, a healing period of from about 4-5 weeks is desirable. After the desired time of healing, no additional surgical procedure is required, unlike the prior art process (which necessitated second stage surgery to remove the cover screw used in the process and to attach the prosthetic abutment). By comparison with prior art processes, applicant&#39;s prosthetic abutment is already attached. 
         [0080]    At this stage of the process, two options are available. In one embodiment, illustrated in step  310  (also see  FIG. 3F ), the abutment extension guide pin is attached to the abutment screw for intra-oral scanning of the device. The resulting image is imported into a CAD software output to CAM for the digital manufacturing of the dental prosthesis. In another embodiment, illustrated in step  312 , a healing ball is used to transfer the abutment head/device position manually to a stone working model. Traditional lost wax technique can be sued to fabricate the implant supported crown. Thereafter, in step  314 , the final crown  450  can be used to replace the hex abutment adaptor  10 . 
         [0081]    As shown in  FIG. 5A , one embodiment of the present invention contemplates a method  200  of dental reconstruction. The method  200  comprises a step  202  of forming a plurality of holes  301  (see  FIG. 5B ) in a patient&#39;s jawbone  302  during a single surgery. See  FIG. 5B . The holes  301  may be drilled to be sufficiently deep to receive only a length of an implant (see implant assembly  150 ). In general, the holes  301  are about eight to about twenty millimeters deep. The holes  301  are positioned in an edentulous space in the patient&#39;s mouth. In step  204 , an implant device assembly  150  is installed into each of the holes. One exemplary implant  150  is shown in  FIG. 3E . An implant is the portion of a dental prosthesis that is disposed within the jawbone of a patient. The implant assembly  150  is comprises of the hexagonal abutment adaptor  10  and the abutment screw  230  that is secure to the threaded orifice  326  of implant fixture  340 . 
         [0082]    In the embodiment of  FIG. 5B  two device assemblies  150  were disposed in different trajectories and allowed to heal. When the devices are healed (step  206 ) sufficiently, tissue covering the device will shrink exposing partially the hexagonal abutment adaptor  10  and the extension of the abutment screw with extension  500 . The position of each device in relationship to each other and with other remaining oral structures including soft tissue, teeth etc. are scanned to digitally form an accurate image of the implants. The pre-assembled hexagonal abutment serves to obstruct tissue re-growth during healing to avoid a second surgery. After the desired time of healing, no additional surgical procedure is required, unlike the prior art process (which necessitated second stage surgery to remove the cover screw used in the process and to attach the prosthetic abutment). By comparison with prior art processes, applicant&#39;s abutment is already attached or pre-assembled. Healing aids may be used to promote healing. For example, the implant fixture  340  may include coated surfaces. See U.S. Pat. No. 7,207,800, the content of which is hereby incorporated by reference. The indexing of the flat-edged protrusion of the hexagonal abutment allows the protrusion to relate to the three dimensional location of the device therefore the precise three dimensional location of the internal hex walls  324  of the implant fixture  340 . See  FIG. 3B . 
         [0083]    The exemplary internal hex wall  324  of  FIG. 3B  has at least two adjacent walls that form an angle relative to one another such that the recess is not merely circular. In the exemplary embodiment depicted there are six flat-edged walls that form the internal hex wall  324  to provide a hexagonal recess. In other embodiments, more or fewer flat-edged walls are provided. Such walls allow for the engagement of an abutment engaging the implant fixture for anti-rotational and other indexing means. In other embodiments (e.g.  FIG. 3C ) the recess or internal cavity or shaft consists of a threaded portion, and a two part interlock chamber contiguous to the said threaded portion including multi-lobed surfaces in a first part, and a plurality of lobes, slots or grooves in a second part. The anti-rotational part completes a series of functions. First, its main function is to prevent the piece from rotating in relation to the dental implant. Furthermore, in the event that the piece is a prosthetic element, the anti-rotational part guarantees the resistance of the implant during the insertion phase of the prosthetic element and facilitate the positioning and insertion of the prosthetic element, creating a guide to facilitate the assembly of the prosthetic element on the dental implant. Any protrusions may be connected to a dental implant, such that the implant and the protrusions are capable of being connected to each other by an internal connection. The protrusion behaves as a male element and the dental implant recess behaves as a female element. The inventive internal connection guarantees great strength and resists biting forces over the long term. In the exemplary embodiment there are six splines and the male protrusions have equal number of splines in order to mate into a stable interconnections. Yet in another embodiment, the recess consist of a threaded portion disposed beneath two adjacent flat-edged walls portion and further dispose beneath a tapered portion whereby the top tapered portion terminate to the neck and surface of implant. The one or more illustrative embodiments are intended only to provide a brief overview of subject matter disclosed herein. The combination of different engaging geometric configurations such as lobes, flat edged walls, cylinders, taper, conical, triangular, square, octagonal, polygonal, threads, splines, gears and the different vertical disposition of each or in combination thereof can be made to match the recess and protrusions to form a stable connection or mate between the implants and the abutment/prosthesis. See also U.S. Pat. Nos. 4,960,381; 6,733,291; 7,108,510; 8,123,524; 5,897,319; 7,108,510; 6,537,070; 7,396,231; 5,195,892; and patent publications 2012/0310286; 2012/0021381; 2013/0183637; 2008/0261176; the entire content of which is hereby incorporated by reference into this specification. 
         [0084]    Referring again to  FIG. 5A , in step  208  of method  200 , the patient&#39;s mouth is digitally mapped with a computer to produce a three dimensional map including a map of the location of the implants of each hole. In this fashion, the relative position of each of the implants is determined. Alternatively, in step  312  of method  200 , with extension  500 , a healing ball is attached to each hex abutment adaptor  10  for each assembly  150 . The entire healing ball is splinted together using a chemical auto-polymerized resin luted together as one unit. After unscrewing all the extensions, the splinted healing ball framework can be pick up or incorporated in a wash putty final impression. A hexagonal abutment adaptor analog can be used to replicate the device positions in the mouth on a stone model (step  314 ). Traditional lost wax technique can be sued to fabricate the implant supported crown (step  316 ) from the stone model. 
         [0085]    Step  208  will now be described in further detail with reference to the example depicted in  FIG. 5B . During step  208 , the longitudinal axis of each implant can be determined by extension of the abutment screw with the extension  500  to exaggerate the orientation of the implant assembly  150 . For example, and with reference to  FIG. 5B , a longitudinal axis  500   a  is determined for an implant  150   a  whereas a different longitudinal axis  500   b  is determined for an implant  150   b.  To facilitate such a determination, the extension  500  may include optical or radiographic markers that permit a computer or receiver to identify the longitudinal axis of the protrusion  125 . Other suitable optical markers may also be used, including colored surfaces with various patterns. The extension  500  extends the height of the implant assembly  150  to facilitate the accurate optical registration of the implants image in the jawbone in relationship to oral structures, such as existing dentition, oral tissues anatomical landmarks. The length of the extension must be sufficiently long to accurately capture the internal trajectory of each implant fixture. A length from about 2 mm to 20 mm may be used. In one embodiment, the length is from about 5 mm to about 12 mm. In another embodiment the length is from about 8 mm to about 12 mm. In yet another embodiment, the length is 10 mm. 
         [0086]    A digital dental map is produced with laser, optical, coherence tomography, wherein the abutment screw extension  500  facilitates integrated acquisition of the implant fixture  340  accurately. The extension  500  permits accurate determination one axis of orientation (e.g. Y-axis). The hexagonal portion  24  (see  FIG. 1A ) provides multiple flat walls to accurately determine the other axes of orientation (e.g. X-axis and Z-axis). Other imaging devices and methods that allow the non-contact, non-invasive capture or re-constitution of the relative orientation of the multiple implants in the jawbone are also contemplated for use with the present method. A digital map is formed from dental software acquired by the scanned image. In step  210 , typical workflow from laser, optical intra-oral scanned images produce highly accurate computer-aided drawings (CAD) files, build and edit virtual model for use in computer-aided manufacturing (CAM) (step  212 ). With available open source CAD/CAM software, a final prosthesis can be produces substractively or additively from various suitable, biocompatible dental materials such as but not limited to fabricate a multitude of restorations including inlays, onlays, veneers, full crowns and bridges. The restorations are fabricated from a number of materials including resin, porcelain and acrylic using prefabricated milling blocks of the chosen material (e.g. zirconia and titanium). Other suitable materials include lithium disilicate glass ceramic, hybrid cerics, leucite-reinforced glass ceramics, nickel-free cobalt chrome alloys, high performance engineering plastic (PEEK) and the like. The dental implant system and associated process enable a practitioner to form a final prosthesis, including an infinite number of facsimiles of the final prosthesis, based on a laser, 3D optical intraoral or table top scan impression that is designed and manufactured from CAD CAM processes to produce and insert the final prosthesis. In the example depicted in  FIG. 5C  an exploded perspective view of assembly  150  showing that the internal hex walls  324  of the implant fixture  340  is a hexagonal recess and the protrusion  125  is a hexagonal protrusion. 
         [0087]    As shown in  FIG. 5D  the final dental bridge or prosthesis with two abutment adaptor proximal ends are ready to attach to the two dental implants. In step  212 , based on the three dimensional map, at least a section  700  (see  FIG. 5E ) of a protrusion  610  is machined to produce a common path of insertion of the first and second protrusions  608 ,  610  into the recesses  324   a,    324   b  of the first implant  340   a  and the second implant  340   b .  FIG. 5E  shows the section  700  as incompatible with the recess and this section should be removed in order to create a common path of insertion for the one-piece dental prosthesis  606 . The final dental bridge or prosthesis with two abutment adaptor proximal ends ready to attach to the two dental implants. A common path of insertion was achieved with the removal of one side of the abutment adaptor proximal hex end (obstruction) to allow the dental bridge to mechanically engage the two dental implants. 
         [0088]    In the example of  FIG. 5E , and in step  214 , a first crown  601  is attached to a second crown  602  with a bridge  604  to form the dental prosthesis  606 . An abutment is that portion of a dental prosthesis that removably connects to the implant and remains disposed above the patient&#39;s jawbone and gum line. The abutment can be incorporated into the prosthetic teeth itself or configured to receive a secondary prosthesis, such as custom or pre-formed denture crown  400  (see  FIG. 6A ). The secondary prosthesis may be attached to the abutment using, for example, dental cement. The first crown  601  and second crown  602  have respective first and second protrusions  608 ,  610  which have at least two adjacent flat-edged walls (e.g.  608   a,    608   b ). The first and second protrusions  608 ,  610  extend below the bridge  604 . In one embodiment, the first and second protrusions  608 ,  610  extend below the abutment for a length of about 1-30 mm so as not to interfere with transitional dentures. In the exemplary embodiment of  FIG. 5E , there are six flat-edged walls that form hexagonal protrusions. In other embodiments, more or fewer flat-edged walls are provided. The flat-edged walls provide an indexing position, also referred to as a timed position, and permit the protrusions to be fixedly inserted into a corresponding recess while preventing the protrusions from rotating in the recess. For example, with six flat-edged walls present, six indexed positions are provided. The bridge  604  may be formed from any tooth-looking or tooth-functioning materials such as zirconia, porcelain, titanium, acrylic teeth forming materials, plastic, polymers, and laser consolidated processes. 
         [0089]    In practice, the protrusions  608 ,  610  often do not perfectly align with the recesses  324   a,    324   b  of the implant fixtures  340   a,    340   b  after the bridge  604  is formed. Due to the presence of the bridge  604 , one cannot simply re-orientate the angle of insertion. It is undesirable to individually place the implants in the jawbone and thereafter form the bridge as this is a time consuming and costly process. To obviate the need for such a step, the crowns  601 ,  602  and their corresponding protrusions  608 ,  610  may be machined from a prefabricated common piece. For example, in one embodiment, the prefabricated common piece may provide the same hexagonal protrusion on all such pieces. Then, after the bridge  604  has been formed, comparison of the prosthesis  606  to the digital map produced in step  208  informs the practitioner which sections of which protrusion should be removed to provide a common path of insertion. For example, and with reference to  FIG. 5E , it can be determined from this digital map that a section  700  of the protrusion  610  is obstructing or incorrectly contacting section  702  of the recess  324   b , thereby preventing the prosthesis  606  from being correctly fit with both implant fixtures  340   a  and  340   b.  The example depicted in  FIG. 5E  shows the protrusion  608  may have a cross section that is symmetrical. In the same embodiment, the protrusion  610  has a cross section that is asymmetrical by the absence of part of the protrusions  700 . 
         [0090]    In  FIG. 5E  the jawbone and implants are shown for illustrative purposes only. It should be noted that the practitioner can determine which sections to remove by machining based on the digital map and there is no need to engage in a time consuming and costly trial-and-error process chairside and intra-orally with the actual patient&#39;s jawbone. The disclosed method circumvents the need to fabricate intermediary components such as individual, separate parallel abutments, abutment screws and other custom components in order to establish a “common path of insertion” to allow insertion of the prosthesis into all recesses simultaneously. In step  214 , once the protrusion has been machined, the prosthesis  606  may be properly inserted into recesses  324   a,    324   b  of the patient&#39;s jawbone via a common path of insertion. Various attachment mechanisms may be used including dental cement and/or screw attachments. 
         [0091]      FIG. 5F  further illustrates the concept with three implant assemblies in different trajectories. The center implant device is chosen as the path of insertion for the one-piece implant supported prosthesis. One side of both hex abutment adaptor protrusions are obstructing and required the removal of the outer side of both left and right protrusion to be able to insert into the three implant recess with different trajectories. The final dental bridge or prosthesis with three abutment proximal ends is ready to attach to the three dental implants with different trajectories. The middle implant is chosen as the common path of insertion of the one piece multiple implant/adaptor prosthesis for insertion into all three implants with the removal of one side of each of the two abutment adaptor proximal hex ends (obstruction). 
         [0092]      FIG. 6A  is perspective view of a preformed stock denture crown  400  with an indexed recess  424  on one end to allow engagement into a corresponding hex post. The ledge  414  formed at the end of the post can be used to support vertical biting forces. The material can be of composite, porcelain or any teeth like material similar in strength, color and texture. In another embodiment, indexed inserts  924  are provided that allow a mechanical interlocking of the pre-formed denture crown to the hex post with corresponding elevations. 
         [0093]      FIG. 6B  is another embodiment of pre-formed indexed denture crown or teeth set that has an expandable ring  432  for mechanical positive interlocking engagement to the indexed post with corresponding annular grove  430 . In another embodiment, the indexed insert  420  can be chemically bonded to the recess of the pre-formed denture crowns. 
         [0094]      FIG. 7  is an illustration of a one-piece five unit dental bridge or connector supported by two implant fixtures with different trajectories. The attachment of the indexed abutment protrusion by removal of section  700  was adjusted to allow insertion to indexed recess secured with abutment screws to the threaded orifice  326  for both implant fixtures. The prosthetic end has five indexed inserts  924  with their corresponding pre-formed stock denture crowns  400  attached chemically or mechanically. 
         [0095]    The digital files of these stock preformed denture crowns set can be imported into the CAD implant/teeth library. Once the patient is satisfied with the teeth set up at the try-on procedure, the teeth arrangement can be scanned and related accurately to the implant fixtures for the fabrication of the implant teeth connector  900  (see  FIG. 8C ). After the connector  900  is engaged with all implant fixtures, then the set of pre-formed stock denture teeth can be attached to individual corresponding posts  920  or inserts  924  on the connector  900 . In this fashion a common connector  900  provides indexed protrusions (e.g. protrusions  608 ,  610 ) that connect to universal abutment adaptors  10  to provide posts  920  for subsequent attachment of preformed stock crowns  400 . 
         [0096]      FIGS. 8A to 8D  depict the execution of another exemplary method wherein the prosthesis is formed from pure grade V titanium.  FIG. 8A  depicts multiple implants after they have been installed into a patient&#39;s upper jawbone. Hexagonal recesses are depicted in the exemplary embodiment. In  FIG. 8B  a schematic depiction of the relative orientation of the various implants is shown with the longitudinal axes illustrated. A plurality of extensions  500  are also shown. In  FIG. 8B , an optical intraoral scanner is used to digitally map the location of the abutment screw extensions  500  and the hexagonal abutment adaptor  10  and thereby determine the relative orientation of the various implant fixtures  340 . 
         [0097]      FIG. 8C  depicts the internal recesses of all implant fixtures exposed by removal of the universal abutment adaptor  10  and abutment screw  230 . An implant teeth connector  900  with properly adjusted protrusions  608 ,  610  (e.g. with section  700  removed) were ready to insert to all implant fixtures  340  with a common path of insertion. In another embodiment  FIG. 8D  depicts another implant teeth connector  920  where the teeth attachment are from inserts of hexagonal index inserts corresponding to preformed, stock denture teeth. 
         [0098]    In the embodiment of  FIG. 9  the internal connection of the implant fixture is in the form of a spline. 
         [0099]    An exemplary digital map is depicted in  FIG. 10 .  FIG. 10  shows the output on a computer screen of a digital map of the patient&#39;s mouth. In  FIG. 11 , the map has been altered to remove the gums and show the relative orientation of the various implants as they extend into the jawbone. A digital bridge is also created in the computer using the un-machined protrusion geometries. In  FIG. 12 , the computer determines which portions of the protrusions must be machined to produce a common path of insertion. In  FIG. 13  a prosthesis with appropriately machined protrusions is provided that has a common path of insertion into the implants. With a digital map of the prosthesis, an actual prosthesis may be formed using convention fabrication techniques, such as lathing. In one such embodiment, a common piece (e.g. a block of a given material) is lathed to produce a monolithic prosthesis. 
         [0100]    One embodiment of the present invention also contemplates a method of forming a dental prosthetic comprising fixing a stud element in a predetermined site, placing a removable protective element on the stud element and forming a first impression over the protective element at the predetermined site. The method also includes removing the protective element from the stud element with the first impression, mounting an abutment in the protective element contained in the first impression, forming a second impression over the abutment such that the second impression substantially replicates the predetermined site, and creating prosthesis by relying on information provided by the second impression. 
         [0101]    Another embodiment of the present invention contemplates a method of forming a dental prosthetic comprising providing a first impression which replicates a dental site, inserting a fixation element into the first impression, providing a second impression which replicates the dental site and retains the fixation element and modifying the fixation element on the second impression as needed so as to provide sufficient information to create the prosthetic. 
         [0102]    Yet another embodiment of the present invention contemplates a model for creating a dental prosthetic comprising a form replicating the region of an edentulous space within a patient&#39;s mouth, the form having an analog abutment protruding from the region, and the analog abutment having a modification created to ensure insertability and removability of a prosthetic within a patient&#39;s mouth. 
         [0103]    This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.