Patent Publication Number: US-2021161625-A1

Title: Dental implant prosthetic and surgical life-saving kit

Description:
RELATED APPLICATION 
     This application is a divisional application of prior application Ser. No. 16/699,065, filed Nov. 28, 2019. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates in general to the field of implant dentistry and in more particular to a set of instruments which includes features that should provide an improvement to the underlying procedure in the implant dentistry as well as matters pertaining to patient safety. 
     BACKGROUND OF THE INVENTION 
     Dental implants have been widely used for single-tooth replacements up to full-arch rehabilitations. The long-term predictability of Osseo-integrated oral implants is well documented. A dental implant system consists of an implant that is surgically implanted in maxilla or mandible (upper or lower jaw), and an abutment that mates with the implant once the implant successfully Osseo-integrates to the bone. Depending on the specific system used, an abutment can include a machined connection mechanism within itself or can be clamped onto the implant by means of an abutment screw. The dental prosthesis is then fabricated over the abutment. 
     To perform this procedure there are many small parts/particles e.g. healing abutments, impression coping and abutments to fix the implant and its components. During dental-implant procedure, those small parts may fall into patient&#39;s mouth or throat. This is a common incidence due to the small size of the parts, slippery and lubricated environment by saliva and unwanted movement of patient&#39;s tongue. 
     The fallen objects may pass through two routes; either through food passage or air way passage. Ingestion of artificial crowns and small implant particles such as abutments, impression coping, healing abutment and screwdriver accounts for major share of accidental swallowing by patients. This may result in serious complications such as intestinal perforation. Aspiration of foreign bodies during dental treatment is considered as medical emergency that requires prompt removal. It could create serious life-threatening complications. In this case, Bronchoscopy examination will be done using flexible cable under conscious sedation. Then, micro forceps must be used to remove the object. It is the responsibility of the dentist to see that none of the working parts and instruments fall, especially when the working site is at the posterior teeth. 
     The existing literature describes mainly the options available for treating the ingestion of sharp and blunt objects during routine dental procedures, but it does not include the prevention of swallowing or aspiration of components used during dental implant placement. As far as the different dental implant components are concerned, it only elaborates on how to secure an implant hex driver, by using dental floss, has been described. 
     To prevent such accidental complications, ingestion/aspiration, the prevailing standard practice guidelines need to be followed. The guidelines are, however, confined to the use of gauze throat screens or floss ligatures. But, that is not enough. The practitioners ought to be enabled to take some preventative measures in the form of using some instruments to protect their components from being swallowed or aspirated accidentally, offering extra comfort and assurance to the dentists while resulting in a higher and better standard protection for the patients. 
     Moreover, dental implants are not implanted exactly parallel to adjacent teeth roots normally, based on:
         Surgical limitations such as: Bone topography, Anatomical landmarks, Bone resorption;   Prosthetic considerations: Occlusion issues, Dental space analyzing, specified prosthetic treatment plans;   The innate nature of manual surgical procedures, the surgeon does not have an accurate and precise way to locate the adjacent roots, and   Sometimes because of lack of experience and accuracy.       

     While the implant is not parallel to Occlusal plan based on the above-mentioned criteria, the abutment should be parallel to adjacent teeth-long axes and perpendicular to occlusal plan, for restorative purposes and to adhere to prosthetics fundamentals, therefore as the screw of the abutment is being placed and tighten parallel to the long axes of the implant, the access-hole to the abutment screw head inside the body of the abutment, would not be at very top of the abutment (the shape of implant abutment is like cone-frustum) in most cases. 
     In this manner, conventional lock-in grasping tools in dentistry, such as needle-holders, hemostats, forceps, are not practically useful by blocking the access-hole of the abutment to the screw-head (located on sides of abutment cone) to grasp the components. 
     To overcome the above-mentioned problems, the present invention provides a special “Dental Implant Prosthetic and surgical life-saving kit” to assist the dentist to establish and maintain a firm grasp over the components during transfer from working cast to the patient&#39;s mouth and vice versa. 
     SUMMARY OF THE INVENTION 
     In a preferred embodiment, the present invention is a dental tool for installing a dental abutment. The dental tool is an implant prosthetic and surgical holder to hold the dental implant components during the implant procedure and provide safety standards to eliminate hazards of complications resulting from ingestion of small objects. 
     The dental tool comprises of a handle that connects to a head portion by a hinge. The head portion of the dental tool configured to selectively retain an abutment, impression coping, or a healing abutment, during a dental procedure and can pivot relative to the handle to enable the dentist to reach various positions within a patient&#39;s mouth. It can be extended up to 90 degrees at each direction (180° range). Rotational head makes it usable on any part of the jaws and cover all clinical implant position and angulation possibilities. 
     The head comprises an aperture to receive a ring-shaped ratchet with a center hole to hold an abutment in place while affixing the abutment to an implant. The center hole of the ratchet has a Key-Hole design, that provides a complete approach and access to implant-driver tip to the screw head, regarding to any abutment-body angulation, position and screw access hole. The inner walls of the key-hole have 3°-degree convergences at any plan of the walls in order to grasp, lock and hold implant abutments which have cone-frustum designs with 2°-3° convergences in each wall. 
     The abutment, impression coping, or healing abutment is being inserted into the key-hole of the dental tool and can be positioned in place to fasten the abutment into an implant by a screwdriver. Once positioned over the implant, the dentist can hold the dental tool to adjust the position of the abutment on the implant and thread the screw into the implant. Once the abutment or other components are secured to the implant, the dental tool  100  can be released and removed from the mouth of the patient. 
     The head portion of the dental tool provide a locking mechanism to adjustably hold the ratchet inside the aperture. The ratchet has grip retaining gaps extended continuously around the outer side wall thereof in communication with a catch portion of the aperture to be rotatably and firmly grasp the ratchet. Once the abutment or other components are inserted within the dental tool; the dentist can transport the abutment or other components to the desired location within a patient mouth to affix the abutment or other components to an implant. 
     Additionally, or alternatively, the handle can be in various shapes to aid the dentist in placing the dental tool within the oral cavity. The handle can be straight, curved, or have a combination of straight sections and curved sections. 
     In another embodiment, the present dental tool comprises of a handle having two hinges on its proximal end to receive two heads to enable the practitioner to transfer two abutments or other components at the same time. 
     The present invention can be produced as a kit of a complementary set of tools to all dental implant procedures, especially prosthetic treatment and this kit can provide the various shape of handles and head portions to prevent major life-threatening hazards. 
     It is therefore an object of the present invention to provide a dental tool for safe insertion and extrusion of components which eliminates hazards such as reduction or elimination of complications resulting from ingestion or aspiration of small objects. 
     It is further another object of the present invention to provide a dental tool that can be used for all implant brands in the market and even to all forms and shapes of abutments, either prefabricated or customized types. 
     It is another object of the present invention to provide a better vision for the practitioner during the implant procedure. 
     It is another object of the present invention to provide a dental tool for holding the dental components in correct position during screwing down and unscrewing. 
     It is another object of the present invention to eliminating risk of components and small parts from falling on the ground that most often result in disruption of patient&#39;s treatment. 
     It is another object of the present invention to saves a great deal of time by providing a faster and safer technique, which allows the transferring of implant-components in and out of the mouth cavity, thereby saving costs for the patients as well as a higher return for the dentist. 
     It is another object of the present invention to create a better opportunity for the dental practitioner to make it easier to prevent the complications normally associated with such a procedure. These complications include the accidental swallowing or aspiration of the components of the dental implant. 
     It is another object of the present invention to provide a Key-Hole design to hold the abutment in the implant process, that provides a complete approach and access to implant-driver tip to the screw head, regarding to any abutment-body angulation, position and screw access. 
     It is another object of the present invention to provide a rotational head that can be extended up to 90 degrees in each direction (180 range) which makes it practical at any part of the jaws and cover all clinical implant position and angulation possibilities. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments herein will hereinafter be described in conjunction with the appended drawings provided to illustrate and not to limit the scope of the claims, wherein like designations denote like elements, and in which: 
         FIG. 1  is a perspective view of the dental implant prosthetic and surgical tool; 
         FIG. 2  is a perspective view of the head portion of the dental tool; 
         FIG. 3A  is a perspective view of the ratchet of the head portion; 
         FIG. 3B  is a perspective top view of the ratchet of the head portion; 
         FIG. 4A  is a perspective view of the head portion showing the insertion of the ring into the aperture of the head portion; 
         FIG. 4B  is a perspective view of the head portion showing the insertion of the ring into the aperture of the head portion; 
         FIG. 4C  is a perspective view of the head portion showing the insertion of the ring into the aperture of the head portion; 
         FIG. 5A  is a front view of the dental tool showing the handle pivotable with respect to the head portion to the right; 
         FIG. 5B  is a front view of the dental tool showing the handle pivotable with respect to the head portion to the right and extended to 90 degrees; 
         FIG. 5C  is a front view of the dental tool showing the handle pivotable with respect to the head portion to the right and extended to 90 degrees; 
         FIG. 6  is a perspective view depicting the dental tool adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 7A  is a cross sectional view of the present invention adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 7B  is a cross sectional view of the present invention for assistance in the driving of the screw into an implant; 
         FIG. 8  is a top view showing the present invention adjustably grasping an abutment for assistance in implant procedure; 
         FIG. 9  shows the present invention used for 2 implant sites of a patient; 
         FIG. 10  is a perspective view of anther embodiment of the present invention; 
         FIG. 11  shows the head portion of the present invention according to  FIG. 10 ; 
         FIG. 12  is a perspective view of the present invention adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 13A  is a front view of another embodiment of the present invention; 
         FIG. 13B  is a front view of the head portion of another embodiment of the present invention; 
         FIG. 14A  shows the head portion of the present invention; 
         FIG. 14B  is a perspective view of the head portion; 
         FIG. 15A  is a perspective view of the present invention adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 15B  is a perspective view of the present invention adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 16  is a perspective view of another embodiment of the present invention; 
         FIG. 17  shows various configurations of replaceable head portions according to  FIG. 16 ; 
         FIG. 18  is a perspective view of the present invention adjustably grasping an abutment for assistance in the driving of the screw into an implant; 
         FIG. 19  is a perspective view of another embodiment of the present invention; 
         FIG. 20  shows the present invention with various head portions; 
         FIG. 21  shows the present invention with various head portion; 
         FIG. 22  is a perspective view of the present invention adjustably grasping two abutments for assistance in the driving of the screws into implants; 
         FIG. 23A  is a perspective view of another embodiment of the present invention; 
         FIG. 23B  is a perspective view of the head portion according to  FIG. 23A ; 
         FIG. 23C  is a perspective view of the head portion according to  FIG. 23A ; 
         FIG. 24A  is a perspective view of another embodiment of the present invention; 
         FIG. 24B  is a perspective view of the head portion according to  FIG. 24A ; 
         FIG. 24C  is a perspective view of the head portion according to  FIG. 24A ; 
         FIG. 25A  is a perspective view of another embodiment of the present invention; 
         FIG. 25B  is a perspective view of the head portion according to  FIG. 25A ; 
         FIG. 25C  is a perspective view of the head portion according to  FIG. 25A ; 
         FIG. 26A  is a perspective view of another embodiment of the present invention; 
         FIG. 26B  is a perspective view of the head portion according to  FIG. 26A ; 
         FIG. 26C  is a perspective view of the head portion according to  FIG. 26A ; 
         FIG. 27  is a perspective view of the present invention showing another application of the present invention, and 
         FIG. 28  is a perspective view of the implanted abutment positioned ready to mount replacement teeth. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
       FIGS. 1 to 9  show the first embodiment of the present dental implant prosthetic holder  100  comprising of a handle  10  that connects to a head portion  12  via a hinge. The handle  10  is pivotally connected to the head portion  12  from the proximal end at a pivot point  18 . The head portion  12  of the dental tool  100  configured to hold an abutment during a dental procedure and can be moved to the left side and the right side and be secured at each direction. It can be extended up to 90 degrees at each direction (180° range) which is one of the key features of the present invention. 
     According to  FIGS. 4A and 4B , the head  12  comprises of an aperture  20  with a circular inner side wall  21  adapted to receive a cylindrical ring shape ratchet  14 . A locking mechanism is provided on the head portion  12  to rotatably fix and hold the ratchet  14  inside the aperture  20 . The ratchet  14  has a key-shape-hole  15  in the centre comprising of a circular section  15   a  and a stem section  15   b  adapted to hold an abutment  30  in place while affixing the abutment  30  to an implant  40 . The key-hole  15  has an inner side wall  24  with 3 degree convergences from the upper surface towards the lower surface of the ratchet  14  in order to grasp, lock and hold implant abutment  30  which have cone-frustum designs with 2°-3° convergences in each wall. This structure of the key-hole  15  enables to insert and grip a variety of different sized abutments  30  in the key-hole  15 . 
     As shown in  FIGS. 3A and 3B , the key-hole  15  design, provides a complete approach and access to implant-driver tip to the screw head, regarding to any abutment-body angulation, position and screw access hole. The screw head can access through the stem section  15   b  of the key-hole  15  to the implant-driver tip while the implant abutment  30  is securely placed into the circular section  15   a  of the key-hole  15 . 
     Again, as shown in  FIGS. 3A, 4A-4C , a locking mechanism is provided to moveably fix the rachet  14  inside the aperture  20  and prevent extra movement of the rachet  14  after fixation of the abutment  30 . The inner side wall  21  of the aperture  20  has a moveable catch mechanism which moves forward and backward in a groove  17  provided on the sides of the head portion  12 . The catch mechanism comprises a knob  11  slidably movable by a lever  13  in communication with the grip retaining gaps  19  extended continuously around the outer side wall of the rachet  14  to rotatably and firmly grasp the ratchet  14 . 
     As shown in  FIGS. 5A-5C , the head  12  is pivotably connected to the handle  10  to selectively pivot between an upright position ( FIG. 5A ) to an angled position ( FIG. 5B ) and to a perpendicular position ( FIG. 5C ) to enable the dentist to reach various positions within a patient&#39;s mouth. Alternatively, the handle  10  can be in various shapes to aid the dentist in placing the dental tool  100  within the oral cavity. The head  12  can be angled various axis relative to the handle  10 . This angled arrangement can generally aid in the placement of the dental tool  100  within a patient&#39;s mouth and proximate to a work site. Furthermore, the head  12  can pivot, rotate, or move relative to the handle  10 . 
       FIGS. 6 to 9  show the dental tool  100  during the operation. As shown in  FIG. 6 , the abutment  30  is inserted into the key-hole  15  and being held within the key-hole  15 . Once the abutment  30  is engaged within the dental tool  100  the dentist can transport the abutment  30  to the desired location within a patients mouth to affix the abutment  30  to an implant  40 . Generally abutments  30  have a hole  31  in which an adjusting screw  80  can be inserted to fasten the abutment  30  onto the implant  40 . Once positioned over the implant  40 , the dentist can hold the dental tool  100  to adjust the position of the abutment  30  on the implant  40 . The key-shape structure provides a space for the screw  80  to fix the abutment  30 . The screw head can access through the stem section  15   b  of the key-hole  15  to the implant-driver tip while the implant abutment  30  is securely placed into the circular section  15   a  of the key-hole  15 . Once the abutment  30  is secured to the implant  40 , the dental tool  100  can be released and removed from the mouth. 
     The head  12  can be in various shapes and sizes such that it can easily be placed within the oral cavity. The dimension of the head  12  can vary in various shape of the heads but it is desirable to have a length about 1 to-1.5 cm and a width about 4.5 mm or 6.5 mm. The handle  10  can be generally straight, curved, or have a combination of straight sections and curved sections. In some embodiments, the handle  10  has a length in the range of about 5 cm to about 7 cm. 
     The head portion  12  and the handle  10  are made from the same material. Any suitable material can be used. In some embodiments, the head portion  12  and the handle  10  can be made from medical titanium alloy or stainless steel. In some embodiments, portions of the dental tool  100 , such as the entire head  12  or components of the head can be replaceable. In some embodiments, the entire tool  100 , or portions thereof, can be sterilized (i.e. via autoclaving) or disinfected in between uses. In some embodiments the dental tool  100  is provided as a “dental tool kit” comprising a plurality of replaceable and/or interchangeable components. 
     In another embodiment of the present invention which is disclosed in  FIGS. 10 to 12 ; the dental tool  200  comprises of a handle  201  pivotally connected to the head  202  from its proximal end at a pivot point via an adjusting screw  206 . The head  202  of the dental tool  200  can be moved to the left and the right and be secured at each direction. It can be extended up to 90 degrees at each direction (180 range) which is one of the key features of this invention. 
     An oval-shaped central hole  203  is provided on the centre of the head portion  202  and provides a fastening mechanism to fix and lock the dental abutment in the central hole  203 . A curved adjustable plate  204  is installed at the proximal end of the central hole  203 , which is adjustable by a screw knob  205 . The central bore  203  provides fractures on the inner side walls which facilitate the movement of the adjustable plate  204  inside the central hole  203 . In operation, the abutment  30  is inserted into the central hole  203  and grasped and fixed by the curved adjustable plate into the hole  203  and being held within the hole  203 . Once the abutment  30  is engaged within the dental tool  200  the dentist can transport the abutment  30  to the desired location within a patient mouth to affix the abutment  30  to an implant  40 . 
       FIGS. 13A-13B, 14A-14B, 15A-15B  show another embodiment of the dental tool  300  with a handle  301  that connects the head  302  via a hinge to the adjusting screw  303 . The head  302  contains a square-shaped opening  304  and a slot  305  on the side of the head  302  which is used to insert and remove square plate  306 . The square-plate  306  has a thickness of 3 mm and consists of a key-hole  307  in the centre with a divergency of 3 degrees on the walls to insert an abutment  30 . The handle  301  is pivotally connected to the head  302  from the proximal end at the pivot point by a screw  303  so that the head can move 90-degrees to the right and left based on appropriate angle which is needed via insertion. Various interchangeable square plates  306  with different key-hole sizes and angles  307  can be used in this dental tool  300 . The head  302  can be moved to the left and the right and be secured at each direction. It can be extended up to 90 degrees at each direction (180 range). 
     According to  FIGS. 16 to 18 , the dental tool  400  has a handle  401  that connects by an adjusting screw  403  to the head  402 . The head is a series of interchangeable solid plates with thickness of 3 mm, including a key-hole shape opening  404  which can be on various areas on the plates. The head  402  can be separated from the handle  401  and replaced with various shapes of heads by suitable connection techniques. There is a range of applicable shape and diameters for key-holes  404  on each plate in order to accommodate various sizes of abutments and implant parts. The main advantage and distinction of this embodiment is that the heads  402  can be attached to the handle, in both ends, at the top and at the bottom. 
     As shown in  FIG. 17 , each plate provides two connecting areas  407  and  408  to be connected to the handle. The keyhole walls display a divergency of 3 degrees. The head  402  can be moved to the left and the right and be secured at each direction. It can be extended up to 90 degrees at each direction (180 range). 
     According to  FIGS. 19 to 22 , in another embodiment, the present dental tool  500  consists of a handle  501  having two hinges on its proximal end to receive two heads, a first head  502  and a second head  503 . The heads  502  and  503  are connected via hinges in a distance apart to two adjusting screws  504  and  505 . The heads  502  and  503  have a length about 1-1.5 cm and a width about 4.5-6.5 mm and can be removed and replaced. 
     In operation the dental tool  500  can be used for installment of two abutments  30  and  32  at a time. The first head  502  is connected to the distal end of the handle  501  by an adjusting screw  504  on a first connection point and fixed thereon. The second head  503  is attached by a second adjusting screw  505  in a distance to the first head  502  on a second connection point. The second screw  505  can be slidably move in a slot  506  on the handle  501  to adjust the distance between the first head  502  and the second head  503 . The range of the movement is about 10-15 mm. Various head portions can be used in this dental tool  500  to operate as one single unit. The heads of the dental tool  500  cannot be moved to the left and the right and be secured at each direction. 
     According to  FIG. 23A to 26C , in another embodiment, the handle of the dental tool is not straight and can be connected to various head portions with an angle about 115 degrees  601 . This helps the practitioner to find better access to the implant sites in some cases especially in posterior areas of the mouth. The angle of the head portion to the handle can be fixed such that it is configured to access a certain side of a patient&#39;s mouth. The head portion can be attachable to the handle through a hinge. 
     The present dental tool in accordance with the present disclosure can be provided in “kit form.” For example, a kit may comprise different type of heads a straight handle, an angled handle and a plurality of interchangeable heads. Additionally, or alternatively, the kit may comprise a plurality of replacement portions for the heads. As shown in  FIG. 27 , the practitioner can securely work on various implant sites with various embodiments of the dental  100  and  200 . 
       FIG. 28  shows an implant  40  positioned into the patients jawbone by using the present invention ready to mount replacement teeth or a bridge into that area. 
     With respect to the above description, it is to be realized that the optimum relationships for the parts of the invention in regard to size, shape, form, materials, function and manner of operation, assembly and use are deemed readily apparent and obvious to those skilled in the art, and all equivalent relationships to those illustrated in the drawings and described in the specification are intended to be encompassed by the present invention.