Abstract:
A cordless pre-calibrated torque driver with a detachable abutment holder for driving prosthetics on dental implants. The main object of the present invention is to provide a portable cordless driver for prosthetics on implants with a pre-calibrate torque. The pre-calibrated torque is achieved by a special embodied mechanism on the motor shaft. Another object of the present invention is to provide a portable pre-calibrated torque driver with a detachable abutment holder, which prevents torque delivery to the implant whenever an abutment is tightened or released from it. The holder also enables easy access to posterior implants and one sole hand practice. For that purpose, the present Invention further provides for an organizing device designed to be used along with a cordless driver that can unload the healing caps from the driver. Using a single hand, a dentist can quickly load and unload healing caps from implants to said organizer and back, and abutments with an attached holder from laboratory model to implants and back and without risking implant stability in the bone by torque delivery from the driver (typically 25 Ncm). These devices and methods significantly reduce chair time needed to restore dental implants and contribute to improve success rates of implants.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit under 35 USC 119(e) from U.S. provisional application 60/898,743 filed Feb. 1, 2007, the disclosure of which is included herein by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention generally relates to devices for dental implants, and more particularly to devices with pre-calibrated torque and with an abutment holder for driving prosthetics on implants and methods of use. 
       BACKGROUND OF THE INVENTION AND PRIOR ART 
       [0003]    The term “handpiece” is a generic and euphemistic term for generic dental tools. A dental handpiece is typically held and operated by a dentist with a sole hand. The terms “driver”, “handpiece”, “dental handpiece”, “contra angle handpiece” and “latch head” are used herein interchangeably. The driver as used herein also uses a contra angle head to accept latch burs. 
         [0004]    The term “prosthetic screw” as used herein refers to screws used to attach various abutments, healing caps and copings to implants or their analogues, and “prosthetics” is the procedure of using those parts. 
         [0005]    The term “driver tip” as used herein refers to interface of latch bur that are held and operated by a dental latch head handpiece and are suitable and fit to various prosthetic screw heads. A driver tip is also known as “chuck”. 
         [0006]    Today, dentists are using a hand driver for implant prosthetics and then a manual pre calibrated torque wrench to fasten the screws.  FIG. 1  depicts an example of a pre-calibrated torque wrench of prior art and  FIG. 2  depicts an example of an abutment holder of prior art, which are too weak to prevent rotation torque from an implant when applied by any kind of driver. While using a driver to fasten the abutment screw, a separate tool—an abutment holder, such as abutment holder  80 , is also used to hold and position abutments, especially for posterior implants where there are limited access and poor visibility.  FIG. 3  illustrates a side view of an abutment  50 , having a hexagonal base  54 , designed for internal hex implant.  FIG. 4  depicts a latch driver tip  40  to fit screw head  53  (usually hex), an abutment  50  and abutment screw  52 , and  FIG. 5  illustrates the pre-calibrated torque wrench  20  shown in  FIG. 1 , operatively used to tighten abutment  50  to implant hex  60 .  FIG. 5  illustrates implant  60  (internal hex) with hexagonal cavity  62 , into which the hexagonal base  54  of abutment  50  is inserted. When driver  15 , with/without torque wrench  20 , tightens screw  52  in clockwise direction  41 , abutment  50  deliver the torque  41  to the implant hex  62 . Similarly, the torque force is also transferred in a releasing action in the opposite direction. 
         [0007]    While doing prosthetics on implants, the dentist needs to exchanges the healing caps (or healing abutments) with abutments prepared on a stone model. Generally, this try-in process is repeated several times, till a final satisfactory restoration can be delivered to the patient. 
         [0008]    Furthermore, when healing caps are removed from the implants, the per-implanter tissue tends to cover implants edge in a minute, so it is important to work quickly, without losing the healing caps order or having dislodgements from the hand driver. 
         [0009]    Another problem arises when using hand drivers: the dentist hand which is in or in front of the patient&#39;s mouth obscures his field of view. The “prosthetic parts driver for easy access to posterior implants” (SALVIN, USA-2006 catalogue) is built as a contra angle manual handpiece to cope with that problem, but it requires both hands and thus, even an abutment holder cannot be used at the same time and a torque wrench is still needed separately. 
         [0010]    When trying to seat abutments for a fabricated bridge on posterior implants (try-in), access is difficult. Usually, assistance is required by an abutment holder. For example, U.S. Pat. No. 6,471,515, given to Feuer, describes an abutment holder. This tool&#39;s grasping force is very limited like other existed today is used just to help to correctly position the abutment on the implant hex, with no connection to the action of screwing in the abutment screw, There is therefore a need, and it would be highly advantageous to use easier and time consuming techniques for holding an abutment while driving its screw on implant. 
         [0011]    Tightening an abutment to a fixture is done with a pre-calibrated torque wrench. The most popular wrench  20  with a preset torque is “DynaTorque wrench” (depicted in  FIG. 1 ). “3i” and “Antogyr” have manual contra angle preset torque wrench. The recommended torque value for tightening an abutment screw is usually 25 Ncm. (To open, an extra torque of 3-5 Ncm is needed.) There is a strong debate on the accuracy of wrenches after prolonged usage (Accuracy of implant torque wrench following time in clinical service, Int J Prosthodontics 1997 November-December; (6):562-7). It should be noted that the torque applied by any a hand driver or a wrench on the abutment screw, during tightening or releasing it, is delivered thoroughly to the connected implant, since the abutment tries to rotate inside the implant hex (internal hex). This action can cause, especially in early loading of an implant, at least a partial failure of the osseo-integration, means the connection in the bone-implant interface since micro-fractures of this biological connection might happen from that. To avoid this problem, dentists usually use lighter forces when tightening abutment screws in the prosthetic phase. 
         [0012]    A pre-calibrated torque motor for prosthetics does not exist yet. Phisio-dispensers and endo torque devices are “torque controlled” by current changing (motor halt at once). This mechanism is not accurate like a “pre-calibrated torque” which is one accurate value sensed from the screw at distal end of shaft, that limits the torque delivered while motor still rotating (same principle as in the manual device) Similarly, “Nobelbiocare” presents with a drilling unit, Osseoset 200, that might work for tightening prosthetics with variable speeds and torque control—again, neither the pre-calibrated torque nor the method of this invention. 
         [0013]    U.S. Pat. No. 6,607,385, given to Sevcik et al, provides a method and a device added to an existing dental and surgical handpiece for limiting the torque to a preset force. The suggested device is a whirred device (an outer, not embodied mechanism) designed for screwing in implants (not for prosthetics), without the intention to cope with posterior abutment access, nor using any holder. 
         [0014]    Single hand technique for driving prosthetics on implants requires an electrical cordless preset torque driver. Today, only endodontic cordless devices like Endomate TC (“NSK”), and. TRI auto ZX (“J. Morita”) exist in the market. They use a geared latch head with a plastic body. Like many other endo torque devices they have “torque control” and auto-reverse mechanism. While TRI lacks a “start button” on the handpiece neck, the Endomate is operated by one momentary finger key (forward)—not two independent (forward and reverse) as provided by the present invention. Both devices use rechargeable batteries and own a control panel on the rear plastic body to determine torque (values are too small for prosthetics) and speed, depending on the endodontic file used, resistance, etc. 
         [0015]    U.S. Pat. No. 4,355,977, given to Ota et al, and U.S. Pat. No. 4,619,614, given to Baba et al, are examples of improvements to cordless dental handpieces with batteries storage and an incorporated electric motor for other than implant treatment, so torque and speed do not suit driving prosthetics on implants. 
         [0016]    There is therefore a need for a cordless preset torque tool for driving prosthetics quickly by sole hand in one step. 
         [0017]    During the prosthetic stage for dental implants the dentist takes the healing caps off the implants and places them in patient&#39;s tray, while trying to keep them in order. One hand method requires a special organizer to load and unload the healing caps with the driver. 
         [0018]    Prior art devices offer various trays such as described in WO0057810, given to Kvarnstroem Bjarne et al, WO2004100819, given to Barnes Richard, GB1507325 given to Kaj Backstrom et al, and others. None of the prior art tray devices are designed to firmly hold healing caps by matching the healing caps threads and/or the abutment holder that is part of this invention. 
         [0019]    There is therefore a need for a dentist using a single hand technique to have an organizing tool that unloads/loads healing caps from/to the driver, thus enable fast exchanging with abutments before the gums partially cover the implants. 
       SUMMARY OF THE INVENTION 
       [0020]    The principal intention of the present invention includes providing a cordless preset torque driver, with a detachable abutment holder for driving prosthetics quickly onto and from implants in the limited space of a human being mouth. 
         [0021]    An aspect of the present invention is to provide a cordless prosthetic parts driver with a detachable abutment holder to ease access and allow a single hand technique. The abutment holder provided by the present invention functions simultaneously with the driver. The simultaneous use of the driver band the abutment holder enables a single hand practice with abutments and improves the access to the inner teeth implants. 
         [0022]    According to the teachings of the present invention a cordless, contra angle, pre-calibrated torque prosthetic parts driver for dental implants is provided. The driver includes: (a) an electric motor with gear mechanism; and (b) A latch head capable of holding a latch bur with various tips operatively adaptive to various prosthetic screw heads to various driver lengths matching various heights of abutments; and (c) a pre-calibrated torque mechanism having a preset torque value. The electric motor with gear mechanism is capable of turning the latch head in forward and backward directions. 
         [0023]    The present invention further includes an abutment holder, preferably detachable, that enables driving abutments with a single hand technique without transferring torque to the implants. The abutment holder includes a mechanism for grasping an abutment and a mechanism for attaching the holder to the driver latch head. The grasping mechanism firmly holds an abutment and prevents the abutment from rotating, and thereby prevents the transfer of torque forces from the abutment to a coupled implant, when the abutment is being driven into the implant or out of the implant. 
         [0024]    The present invention further provides, as part of the single hand method, an organizing device that includes orderly tapped holes with various screw threads, to hold healing caps and/or healing abutments. 
         [0025]    The pre-calibrated torque mechanism includes two discs, two latches in grooves and a retaining spring ring. The spring ring holds the discs together and sets, together with the shape of the grooves, a single pre-calibrated torque value, thereby preventing a prosthetic screw from being tightened with a force surpassing the pre-calibrated torque value, and wherein when the tightening force reaches the preset torque value, the latches overcome the force applied by the retaining spring ring thereby disengaging the two discs, and thereby causing a temporary separation of the latch head shaft from the driver motor shaft. 
         [0026]    Using the cordless driver of the present invention together with the organizer of the present invention, the dentist, by one hand, can load and unload healing caps between patient&#39;s mouth and the organizer, and abutments between the laboratory model and the implants with a preset torque. 
         [0027]    The driver of the present invention replaces three prior art devices: a hand/manual driver; an abutment holder, which requires a second hand; and a manual pre-calibrated torque wrench, 
         [0028]    The driver provides an easier access to posterior fixtures. Compared to the using of a hand driver with a regular abutment holder, driver tip here is already within the screw of a grasped abutment, so only 20 mm of vertical space is needed for mounting the abutment onto a vacant implant, while even when using the shortest hand driver, the fingers used and the abutment height require more than 30 mm of space above the fixture. 
         [0029]    Hence, one aspect of the present invention is to provide a cordless, contra angle driver for driving prosthetic parts, especially on posterior implants with a pre-calibrated torque. The pre-calibration is done by a special embodied mechanism. 
         [0030]    Another aspect of the present invention is to provide a cordless prosthetic parts driver with abutment holder to ease access and allow safer sole hand techniques. 
         [0031]    An aspect of the present invention is to provide a tool that will “hold and release” healing caps in a certain order, during prosthetic procedures, thus allow for a single hand method. 
         [0032]    The pre-calibrated torque driver may also be used with a straight nose cone (better access to areas like anterior maxilla). 
         [0033]    The drivers of the present invention typically use an electric motor, typically powered by batteries, placed in a battery compartment and hence the driver is referred to as a cordless driver. But the present invention is not limited to a batteries powered motor and the driver of the present invention can be also powered by an external electric power or by compressed air, as exists in dental units. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0034]    The present invention will become fully understood from the detailed description given herein below and the accompanying drawings, which are given by way of illustration and example only and thus not limitative of the present invention, and wherein: 
           [0035]      FIG. 1  (prior art) depicts an example of a pre-calibrated torque wrench of prior art; 
           [0036]      FIG. 2  (prior art) depicts an example of an abutment holder of prior art; 
           [0037]      FIG. 3  (prior art) illustrates a side view of an abutment designed for internal hex implant, including an enlargement of the undercut area; 
           [0038]      FIG. 4  (prior art) depicts a latched driver tip, with an abutment and the abutment screw; 
           [0039]      FIG. 5  (prior art) illustrates the pre-calibrated torque wrench shown in  FIG. 1 , operatively used to tighten an abutment to the implant hex with a designated screw, optionally using a hex driver; 
           [0040]      FIG. 6  illustrates a cordless pre-calibrated torque driver with mini latch head, according to an embodiment of the present invention; 
           [0041]      FIG. 7  illustrates a cordless pre-calibrated torque driver with a straight nose cone, according to an embodiment of the present invention; 
           [0042]      FIG. 8   a  is a side perspective view illustration of an abutment holder, according to the preferred embodiment of the present invention; 
           [0043]      FIG. 8   b  is a top perspective view illustration of the abutment holder, shown in  FIG. 8   a;    
           [0044]      FIG. 8   c  is a bottom view illustration of the abutment holder, shown in  FIG. 8   a;    
           [0045]      FIG. 9  illustrates the cordless pre-calibrated torque driver shown in  FIG. 6 , with the abutment holder, shown in  FIG. 8   a , attached to the driver; 
           [0046]      FIG. 10  illustrates the cordless pre-calibrated torque driver shown in  FIG. 6 , with a healing cap (abutment holder detached; 
           [0047]      FIG. 11  depicts the cordless pre-calibrated torque driver shown in  FIG. 6 , assembled with an abutment and the abutment holder, shown in  FIG. 8   a.    
           [0048]      FIG. 12  depicts an organizer for attaching healing caps and hold other accessories, according to embodiments of the present invention; 
           [0049]      FIG. 13  is a schematic block diagram illustrating the usage of the driver with the organizer, according to an embodiment of the present invention; 
           [0050]      FIG. 14  depicts a laboratory stone model of implanted jaw with two analogues and abutments; 
           [0051]      FIG. 15  is a frontal view of the pre-calibrated torque mechanism, according to an embodiment of the present invention; 
           [0052]      FIG. 16  is a partial cross section lateral view of the pre-calibrated torque mechanism, according to an embodiment of the present invention; and 
           [0053]      FIG. 17  illustrates the interface between the contra angle latch head and the pre-calibrated torque mechanism, according to an embodiment of the present invention. 
       
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0054]    The present invention will now be described more fully hereinafter with reference to the accompanying drawings, in which preferred embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided, so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. 
         [0055]    Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The methods and examples provided herein are illustrative only and not intended to be limiting. 
         [0056]    By way of introduction, the principal intentions of the present invention include to provide a cordless device for driving prosthetic parts on implants with a pre-calibrated torque, and a one hand method of using it. The pre-calibration is done by a special embodied mechanism. Another object of the present invention is to provide a cordless driver with an abutment holder that improves access to posterior implants. 
         [0057]    It should be noted that regarding effectiveness, the driver of the present invention is clearly more effective than prior art drivers, since the prior art abutment holders are simple grasping tools that occupies one of the dentist&#39;s hands (while holding a conventional driver in the other), while the abutment holder of the present invention is self-held, attached to the handpiece, allowing a single-hand-technique while leaving one of the dentist&#39;s hands free for other tasks. Above all, the abutment holder protects the implant from the torque used to tighten/release the abutment screw by producing an equal anti rotational moment to counteract and absorb that torque in the connected driver&#39;s head. Furthermore, the abutment holder is a miniature tool which almost completely eliminates the problem associated with prior art practice, of worksite obscuring. 
         [0058]    By way of introduction, other intentions of the present invention include to provide a single hand method with an organizing device that quickly unloads the healing caps from the driver. The organizing device includes orderly tapped holes with various screw threads to hold healing caps and a special compartment to load/unload the abutment holder by sole hand. The device is a supporting device for a dentist, especially when using a driver with a single hand, according to the present invention. The dentist can efficiently unload on the organizing device healing caps. For the sake of clarity, the organizing device can be used also for healing/temporary abutments and any other dental item, various driver tips, etc. 
         [0059]    Reference is now made to the drawings.  FIG. 6  illustrates cordless pre-calibrated torque driver  100  with mini latch head  130 , according to embodiments of the present invention. Rear part  110  of the body of driver  100  may serve as a batteries compartment and the shape of rear part  110  can be adapted to the batteries type used. Middle part  120  of the body of driver  100  preferably contains a motor and a gear, including a pre-calibrated torque mechanism. This is the preferred arrangement but the present invention is not limited to the described arrangement. For example, the torque mechanism or gear can be built inside head  130  of device  100 . 
         [0060]    Driver  140  illustrated In  FIG. 7 , illustrates an option of using a straight nose cone  142  instead of contra angle, which functions as anterior upper jaw screwdriver or as orthopedic screwdriver. 
         [0061]    As shown in  FIG. 3 , abutment  50  preferably includes flattened anti-rotational area  55  and small undercut area  56 , two useful components for enhancing the grabbing method. 
         [0062]    Reference is now made to  FIG. 8   a , which is a side perspective view illustration of abutment holder  500 , according to the preferred embodiment of the present invention.  FIG. 8   b  is a top perspective view illustration and  FIG. 8   c  is a bottom view illustration of abutment holder  500 , shown in  FIG. 8   a . Abutment holder  500 , as well as other abutment holders, operatively stops and/or prevents the rotation of abutment  50 , when being attached or detached by cordless pre-calibrated torque driver  100 . 
         [0063]    Reference is now made to  FIG. 11 , which illustrates cordless pre-calibrated torque driver  100 , assembled with abutment  50  being held by abutment holder  500 , shown in  FIG. 8   a . Reference is also made to  FIG. 10 , which illustrates cordless pre-calibrated torque driver  100 , with a healing cap  70  (abutment holder not attached). When operating driver  100 , the motor operatively turns either healing cap  70  or abutment screw  52  in or out (as desired), as respectively shown in  FIGS. 10 and 11 . The shape and/or diameter of insert  550  respectively adapted to the shape of the selected abutment  50  and to the length of the tip of driver  40  being disposed into hex cavity  53  of abutment screw  52 . Hence, each abutment holder  500  is specific to each abutment  50  design. While tightening a screw  52  in direction  41  with torque driver  100 , abutment holder  500  stops and prevents rotation of abutment  50 . The torque pressure on flattened area  55  is transferred to fastening arms  570  which absorb the transferred torque by the contact areas with the body of driver  100 . It should be noted that more than one flattened area might be in the circumference of abutment  50 . Similar transfer of torque force occur when opening a tightened screw  52  with driver  100  having abutment holder  500  attached to driver  100 . This principle is very useful for handling dental implants, since the torque is prevented from being transferred to the implant, unlike all other tools or methods known today, that transfer the applied torque directly to the implant, through hex  62 , and risk the implant connection with the surrounding bone. The torque transferred to implant may also cause an implant to fail, especially when dealing with early loading when just part of the osseo-integration has occurred. 
         [0064]    Reference is also made to  FIGS. 15 and 16 .  FIG. 15  depicts a frontal view of pre-calibrated torque mechanism  400  including motor shaft  450  of driver  100 , according to embodiments of the present invention.  FIG. 16  is a partial cross section AA′ lateral view of pre-calibrated torque mechanism  400 , shown in  FIG. 15 . When screwing in abutment  50 , the first momentary press key  122  (see  FIG. 6 ) is pressed (“in”, for example) and torque mechanism  400  terminates the spin of a screw at a preset torque force while motor  450  continues to run. When unscrewing, a separate second momentary press key  122  is pressed (“out”, for example) and the screw will receive the full motor force, due to asymmetrical shape of grooves  422  that do not allow torque limiting mechanism to operate when opening a screw. This usage of the torque force is the preferred method, but the present invention is not limited by it, and any other mechanism can be utilized, including various preset torque values in the mechanism. 
         [0065]    The tightening/releasing method of abutment  50  enables a one hand technique. An abutment is typically located with flattened side  55  preferably pointing towards the buccal side (lips side), to allow access and fitting to flat area  555  of insert  550  direction of holder  500 . Figure  14  depicts a laboratory stone model  90  of implanted jaw with two analogues  60  and abutments  50 . After releasing screw  52 , abutment  50  is taken from model  90 , positioned and tightened as is in the patients&#39; mouth. 
         [0066]    Abutment holder  500  shown in  FIG. 8   a  is given as examples only and other embodiments of such holder and attachments to latch head  130  can be designed and used. 
         [0067]      FIG. 9  depicts driver  100  assembled with abutment holder  500 , ready for operation, according to embodiments of the present invention. Abutment holder  500  is stably attached to the latch head  130  by fastening arms  570 . 
         [0068]    Optionally, abutment holders  500  include a hole  560  respectively, which is used to mount abutment holders  500  onto a corresponding pin  160  on latch head  130  (see  FIG. 10 ), and thereby abutment  50  can be held at a proper distance from latch driver tip  40 . 
         [0069]    The operational steps of using driver  100  will now be described coupled with abutment holder  500 , but the present invention in not limited by to abutment holder  500 , and any other abutment holder can be designed to perform the task of stopping and/or preventing the rotation of abutment  50  and thereby prevent the transfer of torque moment to implant  60 . 
         [0070]    In embodiments of the present invention the abutment holders, such as abutment holder  500  are attachable/detachable to/from driver  100 . 
         [0071]    In embodiments of the present invention the abutment holders, such as abutment holder  500  are affixed to driver  100 . 
         [0072]    The operational steps of using driver  100  with abutment holder  500 , to transfer an abutment  50  between a laboratory model  90  and patient&#39;s  10  mouth, are as follows:
       a) Place the latch driver tip  40  onto screw  52  of abutment  50 , while insert  550  with properly directional flattened area  555  grab flattened area  55  of abutment  50  positioned on model  90 .   b) Turn on motor  450  of driver  100  in rewind direction to catch screw  52  and to release abutment  50  from model  90  and hold abutment  50 .  FIG. 11  illustrates driver  100 , assembled with abutment  50  being held by abutment holder  500 .   c) Transfer held abutment  50  to the patient&#39;s mouth maintaining respective position as on hexagonal analogue base  54  in stone model  90     d) Turn on motor  450  in forward direction to attach abutment  50  to implant  60  using the appropriate torque (typically, a clicking sound is heard when done).   e) Pull to detach device  100  from abutment  50 .   f) After try—in the process is done same way vise versa.       
 
         [0079]    The present invention also provides for an apparatus that facilitates an efficient, flexible and user-friendly method to take out healing caps  70  with every check of bridge structure (porcelain on metal or zirconium) in patient&#39;s mouth. Reference is also made to  FIG. 12 , which illustrates organizer  200 , according to embodiments of the present invention. Using a single hand, the dentist loads the healing caps  70  and unloads them into special organizer  200 , developed for that purpose. An organizer of the present invention can take different shapes and layouts with any number of threaded holes  218 . In organizer  200 , for example, the layout of threaded holes  218  are designed to simulate the mouth structure and thus enables keeping healing caps  70  in implants location order. Organizer  200  also contains compartments  212  that can hold other items and a compartment  214  to fit and catch abutment holder  500  on “abutment like” structure (possibly exchangeable) and a compartment  215  to hold the driver when not in use. 
         [0080]    During preparation of a porcelain fused to metal bridge (or any other type), the restorative dentist needs to transfer abutments  50  from the laboratory model  90  to patient&#39;s  10  mouth and back several times, before the final restoration takes place. When trying-in the abutments  50 , the dentist needs to take out healing caps  70 . It should be noted that after taking out healing caps  70  from implants  60 , the working time should be as short as possible, before gums partially cover the vacant implants  60 . Organizer  200  helps to shorten that time. 
         [0081]    Referring to  FIG. 13 , a schematic block diagram illustrating the method of usage of driver  100  with organizer  200 , according to an embodiment of the present invention, is shown. The restorative dentist takes (action  210 ) healing caps  70  out of the mouth of patient&#39;s  10 , and puts them in a designated location in the organizer  200 . Operating motor  450  for a second forward will position a healing cap  70  firmly in the threaded hole, so it stays there when pulling up the driver. The dentist now using device  100 , attaches holder  500  from compartment  214 , takes every abutment  50  from the laboratory model  90 , and attaches (action  220 ) each abutment  50  onto a vacant implant  60 . After checking and determining accuracy of abutments grinding and bridge fabrication, the process continues in a reverse order. The dentist removes abutments  50  from implants  60  and puts (action  230 ) them back onto laboratory model  90 , using device  100  with the still attached holder  500 . Then, dentist detaches holder  500  by pressing holder  500  down with the thumb and the finger on the lower edges, preferably back to compartment  214  in organizer  200 . The last step is to put (action  240 ) healing caps  70  back from organizer  200  onto vacant implants  60 . As explained, in steps  210  and  240 , holder  500  is not in use and is preferably held in organizer  200  (It is useful also for autoclaving the holder). 
         [0082]    It should be noted that when holder  500  is not needed as an anti-rotational device, for example when screwing in or out healing caps  70  (as shown in  FIG. 10 ), which are typically made of one piece, then holder  500  is detached from head  130  by pulling down fasteners  570  using two fingers on holder  500  bottom into organizer cavity  214  with small “abutment like” pillar. Attaching holder  500  from cavity  214  in the organizer  200  to the driver  100  is done easily by one hand while pressing on fasteners  570  using neck  130  of driver  100 . 
         [0083]    When screwing an abutment screw  52  in, screw  52  spin is terminated when the torque force needed reaches the pre-calibrated torque value, as pre designed into mechanism  400 . Referring to  FIGS. 15 and 16 , one embodiment for presetting the threshold torque force is shown, but the present invention is not limited by it, and any other mechanism known in the art can be used, including a mechanism that gives two or three preset torque values. 
         [0084]    In this embodiment, the mechanism includes two discs ( 410  and  420 ), two latches  430  (connected with pins to disc  410 ), and a retaining ring  440  that presses the free ends of latches  430  into sloped grooves  422  in disc  420 . Spring ring  440  can be any type of spring, including spring ring, retaining ring, rubber o-ring and so on and so forth. It should be noted that it is possible to change spring ring/o-ring  440  by the user and thereby change the preset torque value. 
         [0085]      FIG. 17  illustrates the interface to the pre-calibrated torque mechanism, according to an embodiment of the present invention. Bearing  426  which is part of an altered “doriot” latch head  130  has a pin  427  that is operatively inserted in gap  421 in disc  420 . 
         [0086]    Referring back to  FIGS. 15 and 16  as well as to  FIG. 17 , the first disc  410 , firmly attached to motor shaft  450  and turns with the motor shaft. Disc  410  owns two latches  430 . The free ends of latches  430  are held by a retaining ring  440  in grooves  422  within torque disc  420 , such that all rotate with the motor shaft as a single unit. But when the resistance from a screwed in screw  52 , sensed by torque disc  420  through pin  427  that was inserted in gap  421 , exceeds the pre-calibrated torque value, latches  430  (while pushing the retaining ring  440 ) get out (step  442 ) from sloped grooves  422 . After the separation of discs  410  and  420 , motor shaft turns without transferring more torque to screw  52 . The preset torque value is achieved by a combination of the angle of slopes  422  and retaining ring  440  force. Latches  430  return  442  into grooves  422 , only if the torque applied on torque disc  420  by pin  427  is again below the pre-calibrated torque value. If motor  450  is still activated, battery energy is preserved, since motor  450  is not “stuck”, but the clicking sound is an indication to stop it. Grooves  422  which are not symmetrical, allow latches  430  to get out above the preset torque only in forward direction of motor  450 ; thus rewind operation needed to open a tightened screw takes advantage of the full motor torque. 
         [0087]    In embodiments of the present invention driver  100  is used for endodontic applications and/or for implantology. 
         [0088]    The invention being thus described in terms of embodiments and examples, it will be obvious that the same may be varied in many ways. Such variations are not to be regarded as a departure from the spirit and scope of the invention, and all such modifications as would be obvious to one skilled in the art, are intended to be included within the scope of the following claims.