DE102016004885B4 - A method for producing and / or forming a spacer element for a dental prosthesis system or a spacer element or dental replacement system produced accordingly - Google Patents

Abstract

Method for producing and / or forming a spacer element (7) for a dental prosthesis system (8), wherein the spacer element (7) between a first tooth replacement means (5), namely an implant (9a) and a second tooth replacement means (5), in particular an abutment (5a), an abutment crown, a further implant means, a prosthesis or a partial denture is arranged, wherein at least a first end portion (7a) of the spacer element (7) with the implant (9a) and at least a second end portion (7b) of the spacer element (7 ) is brought into effective contact with the second tooth replacement means (5), and wherein the outer region (7c), in particular the outer circumference of the spacer element (7) - at least partially with a jawbone tissue (10) in a state arranged in a particular human oral cavity ) and / or at least partially with a bone regeneration material (11) and / or at least partially with soft tissue, in particular with a Gi ngiva tissue (3), can be brought into contact, characterized in that, after the implant (9a) is arranged in the jawbone of a person, over the visible end region (9b) of the implant (9a) remaining free space determined to the outer soft tissue boundary is, and that on the basis of the determined measurement data then an individual spacer element (7), namely produced and / or used with a correspondingly specific vertical height (h), wherein the surface of the outer region (7c) of the spacer element (7) at least partially as an uneven structure is formed.

Description

The invention relates to a method for producing and / or forming a spacer element for a dental prosthesis system according to the features of the preamble of claim 1. Furthermore, the invention relates to a prepared according to the aforementioned method spacer element according to the claims 4 and 10. Furthermore, the invention relates to a Denture system with the features of the preamble of claim 12.

In the prior art, different embodiments of dental replacement agent systems, in particular of implant and / or Abutmentsystemen known. Such implant and / or Abutmentsysteme be used in patients to connect in particular artificial teeth, especially ceramic with the jawbone of the patient effectively. Here, first, an implant, vzw. made of titanium in the jawbone (lower or upper jaw) of the patient arranged or fastened, in particular screwed into the jawbone of the patient. The visible end region of the implant, that is to say the end region of the implant which protrudes from the jawbone in the direction of the oral cavity, is then connected to an abutment or abutment crown or can be connected to the abutment or the abutment crown, in particular with the aid of a separate fixation screw. On the abutment itself is then an artificial tooth and / or a dental crown, in particular made of ceramic can be arranged (or an abutment crown corresponding formable), which is then - effectively connected to the jaw bone on the implant. The known tooth replacement agent systems therefore have a first tooth replacement agent, namely the implant and a second tooth replacement, in particular an abutment or an abutment crown.

That's how it shows 1a in schematic representation, first a row of teeth 1 an upper jaw with teeth 2 a patient. It is also easy to see the soft tissue in the oral cavity 3 , especially the gingival tissue from which the teeth are made 2 also protrude accordingly. The teeth shown here 2a are of natural origin, being the tooth 2 B Here is an artificial tooth. The 1a shows a row of teeth 1 in the upper jaw of a patient after an appropriate dental treatment or after an orthodontic treatment.

On the other hand shows 1b a schematic representation of the upper jaw of the corresponding patient before the dental or orthodontic treatment. Good to see here is the row of teeth 1 in the upper jaw of the patient, and in particular not yet prepared natural teeth 2a , as well as a "tooth gap 4 ". One can already see clearly in the tooth gap 4 here arranged - second - dentures 5 namely an abutment 5a , which is arranged on a, not shown here in detail, in the jawbone (upper jaw) anchored - first - tooth replacement means, namely on an implant. On the in 1 illustrated abutment 5a can then be an "artificial tooth 2 B "Or a corresponding tooth crown, in particular made of ceramic, are arranged so that - in the end - then (even after appropriate orthodontic treatment) the row of teeth 1 in 1a is realized.

Continue in the 1a and 1b good to see is a dashed line 6 , The dashed line 6 should here - at least partially - represent a desired or aesthetic gingival course. It is in 1a good to see that here is the course of the line 6 in the area of the artificial tooth 2 B such is that above the line 6 another tooth neck of the artificial tooth 2 B "Exposed", ie the actual gingiva tissue 3 is not enclosed. This is because of how it looks 1b seen that the abutment there 5a essentially "too deep" to the area of the gingiva tissue 3 extends, namely here in 1b via the corresponding dashed line 6 extends partially upwards or the upper portion of the abutment 5a above the line 6 not of soft tissue or gingiva tissue 3 is enclosed. The abutment 5a especially now extends over the line 6 out, because this is in the 1b Implant, not shown, is anchored or fastened substantially too deeply in the jawbone (upper jaw) of the patient. Therefore, the abutment also extends 5a essentially too deep into the area of the gingiva tissue 3 in or in the area of the artificial tooth 2 B here above the line 6 then no gingival tissue 3 present when the artificial tooth 2 B accordingly in the tooth gap 4 on the abutment 5 has been arranged or fixed.

From the notes to the 1a and 1b becomes clear that when an implant has been inserted "too deep" in the jawbone of a patient, a supply essentially only as by the 1a and 1b shown, can be done. In practice, implants that have been inserted too deeply must even be partially explanted again, the jawbone must then be regenerated / rebuilt, and then finally a new implant is to be inserted so that an optimal restoration, in particular a garland-shaped embodiment of the gingiva tissue 3 as well as through the line 6 in the 1a and 1b represented, is possible. The problem with the dental prosthesis systems known in the prior art is therefore, in particular the corresponding optimal heightwise insertion of the implant (as a first dental prosthesis) and / or the resulting in particular height-wise arrangement of the second dental prosthesis, here in the 1a and 1b of the abutment and / or the artificial tooth.

Thus spacer elements for a dental prosthesis system, in particular for an implant and / or abutment system are known in the prior art (eg "MULTI-IM" spacer sleeves), such spacer elements, namely at least a first end region of the spacer element with an implant and at least a second end region of the spacer element can be connected to an abutment. Here, a first end region of the known spacer elements on a screw extension, which is screwed into an implant accordingly. A second end region of the spacer element, in particular, has a receptacle with an internal thread into which, in particular, an abutment can be screwed. The distance elements known in the art are available in predetermined sizes, in particular in predetermined vertical lengths between 1 mm to 4 mm in total length. With the help of these spacers then in 1a and 1b described problems are at least partially improved, because with the help of such a spacer element, which can be arranged between the implant and the abutment, then the height alignment or the height-wise distance of the abutment 5a to the gingiva tissue 3 (see. 1a and 1b ) can be regulated or adjusted accordingly.

So is out of the WO 2004/037110 A1 a screw-type dental implant is known, which has a bone screw and a neck part. The neck part can be attached to the bone screw and connected to the bone screw with a fastening screw. In this case, the bone screw has a surface promoting osseointegration and the neck part has a hygiene-friendly surface.

From the WO 2015/157784 A1 For example, a dental implant system for bone regeneration of a bone defect site of a jawbone is known. The dental implant system comprises an implant to be anchored in the jawbone with a threaded bore. A film is arranged to cover the bone defect site, wherein between the implant and the film, a spacer element can be arranged and with the aid of a fastening screw on the one hand the film, on the other hand, the spacer element is attachable to the implant.

Finally, also from the US 6,537,070 B1 a similar trained dental implant system known, as previously described.

However, the spacer elements known from the prior art for dental replacement agent systems, in particular for implant and / or abutment systems, are not yet optimally configured. An optimal garland-like course of a corresponding line 6 (see. 1a and 1b ), as desired, is almost unrealizable. In particular, the outer region, in particular the outer circumference of the spacer element-at least partially with a jawbone tissue and / or at least partially with a bone regeneration material and / or at least partially with soft tissue, in particular with the gingiva-in a state arranged in a human oral cavity. Tissue come into contact. However, it is problematic in the spacer elements known in the prior art that the outer region, in particular the outer circumference of the spacer elements, is difficult to bring into contact with the jawbone tissue or the bone regeneration material or the respective jawbone tissue and / or bone regeneration material is difficult to adhere to the spacer element , Furthermore, it is particularly problematic that - as already mentioned above - an optimal garland-shaped line 6 a gingiva tissue 3 , as in the 1a and 1b through the local dashed line 6 indicated, but with the well-known in the art distance elements just not so optimally feasible. The systems known in the prior art serve in particular to support "thick gingiva tissue".

The invention is therefore based on the object, the above-mentioned method, spacer element and tooth replacement agent system now such and further, that on the one hand, the connection / adhesion of jawbone tissue and / or bone regeneration material is improved on the spacer element, on the other hand, the höhenmäß orientation of a -zweiten- dental prosthesis improved and / or an improved garland-shaped gingival tissue border is feasible.

For the aforementioned method, the aforementioned object is now achieved by the features of claim 1. Corresponding spacer elements are according to the claims 4 such as 10 now according to the corresponding method, in particular produced according to claim 1. Furthermore, an inventive tooth replacement agent system by the features of claim 12 specified.

After the implant is arranged in the jawbone of a person (of a patient), the free space remaining substantially above the visible end region of the implant is extended to the outer soft tissue border, in particular to the outer gingival tissue boundary is at least partially determined, wherein based on the determined measurement data then for this person (or for this patient) individual spacer element, namely made with a specific vertical height.

By implementing the aforementioned features, the disadvantages described above are avoided and achieved corresponding advantages.

The surface of the outer region of the spacer element is now at least partially roughened and / or has at least partially an uneven structure. This allows an improved, in particular optimal connection / adhesion of a jawbone tissue and / or a bone regeneration material, which is brought into contact respectively with the outer region, in particular with the outer periphery of the spacer element. As a result, it is now possible in particular to regenerate the jawbone optimally in the region of the spacer element, since new jawbone or new jawbone tissue can now be created adjacent to the outer region, in particular adjacent to the outer circumference of the spacer element, and can also deposit well here. It is conceivable that a first portion of the outer periphery of the spacer element is roughened and / or at least partially an uneven structure, in particular therefore suitable for the adhesion of jawbone tissue or bone excitation material is formed, but a second portion of the outer periphery of the spacer element is smooth, is particularly suitable for attachment of soft tissue, in particular of gingival tissue. With a smooth second portion is then also a "good deal" between the soft tissue, in particular the gingiva tissue and the spacer realized so that - in the end - then a, in particular very clearly running gingival tissue border can be realized.

It is now also the height alignment or the arrangement / positioning of a second tooth replacement means, in particular an artificial tooth optimized or optimized. Because after the first tooth replacement means designed as an implant has been arranged or fastened in the jawbone of a person / a patient, the free space remaining between the visible end area of the implant and the outer soft tissue boundary, in particular to the outer gingival tissue boundary, becomes at least partially , in particular completely determined. Based on the measurement data thus determined, an individual spacer element, namely with a specific vertical height, is then produced for this person / patient. As a result, the spacer is made with a specific vertical height so that then by the arrangement of such an individual spacer between a jaw bone implant and the second tooth replacement, in particular the abutment, then the height alignment of the second dental prosthesis, in particular of the abutment and so that a height-oriented alignment of a tooth to be arranged on the abutment is optimized. Alternatively, one or the dental prosthesis system may also have a plurality of spacer elements which each have different different standard sizes, in particular different different vertical heights, in which case a specific spacer element with a specific height is selected or used for the respective patient, which seems suitable. After the free space remaining between the visible end region of the implant and the outer gingival tissue boundary has then been determined, a specific spacer element with the desired vertical height for the respective patient could then be selected and used from the standard sizes, namely a previously described spacer element with a roughened and / or uneven surface of the outer area. As a result, a visually especially garland-shaped gingival tissue border can be realized in a simple manner.

In the end, the disadvantages mentioned above are therefore avoided and achieved corresponding advantages.

• 1a/1b ein im Stand der Technik bekanntes Zahnersatzmittelsystem bzw. teilweise dessen Komponenten mit einem auf einem Abutment angeordneten künstlichen Zahn (vgl. 1a) bzw. ein Abutment ohne einen auf dem Abutment angeordneten künstlichen Zahn (vgl. 1b) in teilweise schematischer Darstellung in der Mundhöhle eines Patienten,
• 2a/2b eine erste Ausführungsform für ein erfindungsgemäßes Distanzelement bzw. für ein erfindungsgemäßes Zahnersatzmittelsystem, einerseits schematisch dargestellt mit zwischen einem ersten Zahnersatzmittel, nämlich einem Implantat und einem zweiten Zahnersatzmittel, insbesondere einem Abutment angeordnetem Distanzelement (vgl. 2a) bzw. in entsprechender explosiver schematischer Darstellung (vgl. 2b),
• 3a/3b/3c eine zweite Ausführungsform für ein erfindungsgemäßes Distanzelement bzw. für ein erfindungsgemäßes Zahnersatzmittelsystem, einerseits schematisch dargestellt mit zwischen dem ersten Zahnersatzmittel, nämlich dem Implantat und dem zweiten Zahnersatzmittel, insbesondere dem Abutment angeordnetem Distanzelement (vgl. 3a) bzw. in entsprechender explosiver schematischer Darstellung (vgl. 3b) bzw. eine als Verbindungsmittel ausgeführte separate Baueinheit (vgl. 3c), und
• 4a/4bin schematischer Darstellung ein erfindungsgemäßes Distanzelement bzw. ein erfindungsgemäßes Zahnersatzmittelsystem mit zwischen dem ersten Zahnersatzmittel, nämlich einem Implantat und dem zweiten Zahnersatzmittel, insbesondere einem Abutment angeordneten Distanzelement (vgl. 4a), wobei hier eine Regeneration des Kieferknochens realisiert wird bzw. dargestellt ist, sowie eine entsprechende schematische Teilansicht, teilweise geschnitten von oben (vgl. 4b).

There are now a variety of ways the inventive method, the spacer element or the dental prosthesis system in an advantageous manner to design and further. For this purpose, first of all for the method to the claims subordinate to claim 1 2 or 3, with respect to the spacer element according to the claims made on the claims 4 to 11 and with respect to the dental prosthesis system to claim 12 may be referenced. In the following, the preferred embodiments of the invention with reference to the following description and the accompanying drawings may now be described in more detail. In the drawing shows:

• 1a / 1b a dental prosthesis system known in the prior art or, in some cases, its components with an artificial tooth arranged on an abutment (cf. 1a ) or an abutment without an artificial tooth arranged on the abutment (cf. 1b ) in a partially schematic representation in the oral cavity of a patient,
• 2a / 2 B a first embodiment of an inventive spacer element or for a dental prosthesis system according to the invention, on the one hand shown schematically with between a first tooth replacement means, namely an implant and a second tooth replacement means, in particular an abutment arranged spacer element (see. 2a ) or in a corresponding explosive schematic representation (see. 2 B )
• 3a / 3b / 3c a second embodiment of an inventive spacer element or for a dental prosthesis system according to the invention, on the one hand shown schematically with between the first tooth replacement means, namely the implant and the second tooth replacement means, in particular the abutment arranged spacer element (see. 3a ) or in a corresponding explosive schematic representation (see. 3b ) or designed as a connecting means separate unit (see. 3c ), and
• 4a / 4b a schematic representation of an inventive spacer element or a dental prosthesis system according to the invention with between the first tooth replacement means, namely an implant and the second tooth replacement means, in particular an abutment arranged spacer element (see. 4a ), in which case a regeneration of the jawbone is or is realized, and a corresponding schematic partial view, partially cut from above (see FIG. 4b ).

The 1a and 1b show the already known prior art, as already described above.

The 2 to 4 show a spacer element according to the invention 7 or a tooth replacement agent system according to the invention 8th , here in particular an implant and / or abutment system 8a with a corresponding spacer element 7 which has been produced in particular by the process according to the invention.

In the following explanation of the 2 to 4 Be as far as possible, the reference numerals used accordingly, which also in the 1a and 1b may have been used for the local components, may be noted.

That in the 2 to 4 apparent spacer element 7 for a dentifrice system 8th , in particular for an implant and / or abutment system 8a is between as an implant 9a executed first tooth replacement agent 9 and a second dentifrice 5 , here in particular an abutment 5a arranged. As another second tooth replacement 5 instead of an abutment 5a In particular, an abutment crown (an abutment and a crown made as a "workpiece") or a prosthesis or partial denture or another implant means, such as in particular a ridge or a ball head element (Kugelkopflocator) or a connector into consideration. Here are also quite combinations of a second tooth agent 5 For example, a prosthesis or a partial denture can be arranged on a web or a ball head locator, wherein the web or the Kugelkopflocator then with the spacer element 7 is connectable. The latter is particularly dependent on the particular specific embodiment of the dental prosthesis system 8th or the desired "implant composite" to be realized. In the "implant composite" to be realized anchored and / or fixed in particular the first dental prosthesis 9 namely, the implant 9a then - in the end - the "implant composite" in the jawbone, with the second denture 5 In particular, the possibilities described above are conceivable. In this case, the term "further implant means" mentioned above also means, in particular, a web, a connector or a ball head element (as a respective second tooth replacement means), which is in particular effectively connectable to the spacer element. In particular, the respective second tooth replacement agent 5 but is not anchored or fixed directly in the jawbone, but indirectly with the help of the spacer element 7 and / or the implant 9a , The in the 2 to 4 illustrated second tooth replacement agent 5 However, in the preferred embodiment shown here, in particular each as an abutment 5a (or as an abutment crown). In this preferred embodiment, therefore, the inventive principle may be described in more detail:

It is at least a first end area 7a of the spacer element 7 with the first tooth replacement 9 namely with the implant 9a and at least a second end region 7b of the spacer element 7 with a second dentifrice 5 , here in particular an abutment 5a effectively brought into contact, in particular effectively connectable. The outer area 7c , in particular the outer circumference of the spacer element 7 can - at least in a arranged in a particular human oral cavity state - at least partially with a jawbone or a jawbone tissue 10 and / or at least partially with a bone regeneration material 11 and / or vzw., if at all, only to a small extent at least partially with soft tissue, in particular with a gingiva tissue 3 be in contact or be brought into contact.

So is out of the 2a . 3a and 4a in essence, that here is the implant 9a in the jawbone tissue 10 (or in the jawbone 10 ) arranged accordingly, especially here attached, especially here in the jawbone tissue 10 screwed / screwed. The essential component of the implant 9a therefore extends into the jawbone tissue 10 , here a particularly visible end 9b of the implant 9a is visually visible in the oral cavity or from the jawbone tissue 10 slightly outstretched.

Furthermore, in the 2a . 3a . 4a and 4b , in particular also soft tissue, in particular a gingiva tissue 3 shown schematically or a gingival tissue border 3a shown schematically or visible.

The surface of the outer area 7c of the spacer element 7 is at least partially roughened and / or has at least partially an uneven structure, in particular therefore has at least partially a "roughened structure" and / or at least partially a "topographically uneven course", in particular the surface of the outer area 7c is then for the attachment of jawbone tissue 10 trained or suitable. From the 2a . 2 B . 3a . 3b and 4a is clear to see that the surface of the outer area 7c here in particular at least one thread 12 , in particular several threads 12 having. By the realization of the threads 12 gets the surface of the outer area 7c of the spacer element 7 an "uneven structure". The term "uneven" or "uneven structure" can therefore be understood or understood to mean a surface or a surface finish which, on the basis of a realized specific topography, for example with the aid of threads and / or grooves, is correspondingly "uneven" , Alternatively, however, the surface can also be produced correspondingly "roughened" or "rough" or be designed correspondingly "rough", in particular also without a specific topography having to be realized. In the following, therefore, it will first be explained in particular how a "roughened" surface or a "roughened or rough structure" of the surface can be realized in order to ensure an adhesion of bone tissue or of jawbone tissue, in particular optimally. Thus, the surface of the outer region of the spacer element can also be correspondingly "roughened or become and / or have a corresponding roughened or rough structure", in particular without a specific topography (for example, by means of threads, notches and / or grooves can be realized) exists.

It is conceivable that the "roughened structure" or "rough structure" of the surface of the outer area 7c of the spacer element 7 is realized in a certain way, for example, that a surface roughness in the manufacture of the spacer element 7 especially in the sintering process, in particular the surface of the outer region is processed accordingly. For example, the roughened structure of the surface of the outer portion of the spacer could also be realized by a sandblasting method, a water jet method, a laser beam method, a milling method, a printing method, and / or an etching method. In particular, the surface of the outer region of the spacer element can therefore be "roughened" corresponding procedurally.

Also, material-forming processes, such as rolling, embossing, pressing or the like for realizing a "roughened structure" and / or a "uneven structure" of the outer region of the spacer element are conceivable.

Also, roughness of the surface of the outer region may be realized by, for example, brushing, grinding, turning, etching or pickling.

Also conceivable for the production / realization of a "roughened structure" or else an "uneven structure" of the surface of the outer area are also machining, molding or forming processes.

Finally, it is even conceivable that an additional material is applied to the surface of the outer region of the spacer element, for example, a particle-binder mixture, ie the outer region of the spacer element with the particle-binder mixture "sprinkles" and with this particle binder Mixture is connected to realize a corresponding rough and / or uneven surface of the outer region.

In particular, the combination of the possibilities described above, ie not only the formation of a "rough structure" or not only the formation of a "uneven structure", but the combination of the formation of a "roughened structure" and a "uneven structure" for the surface the outer region of the spacer element is conceivable. For example, threads may be provided on the outer region of the spacer element, wherein the threaded portions themselves, in particular the thread flanks are additionally roughened in addition.

The roughening of the surface of the outer area 7c of the spacer element 7 or the corresponding "rough structure" of the surface of the outer area 7c and / or an "uneven structure" of the surface of the outer area 7c of the spacer element 7 allows a good investment / Attachment of jawbone tissue 10 and / or bone regeneration material 11 at the outer area 7c of the spacer element 7 , in particular on the outer circumference, of the spacer element 7 ,

The surface of the outer area 7c of the spacer element 7 may in particular have an average roughness R _a of 0.8 to 2.2 microns. It is also conceivable that the corresponding roughness, ie the "rough and / or uneven structure", is realized with the aid of a plurality of pores. It is conceivable that a plurality of pores with a pore diameter of in particular at least 10 μm is then realized on the surface of the outer region of the spacer element. The pore diameter of such pores / cavities on the surface of the outer region of the spacer element can in particular also be in a range of 30 to 100 μm, in particular also in a range of greater than 30 μm. In particular pore diameter / cavities with pore sizes or pore diameters of 75 to 400 microns have been found to be particularly advantageous.

The 2 to 4 is essentially now common that the first end 7a of the spacer element 7 a first connection means 13 for effective connection with the implant 9a , in particular a helical extension 13a having. The first connection means 13 or the helical extension 13a is with a recording 14 in the implant 9a , in particular with a threaded hole 14a (or a recess with internal thread) engageable, in particular screwed.

Furthermore, the second end region 7b of the spacer element 7 a second connecting means 15 for effective connection with the second dentifrice 5 , especially the abutment 5a , in particular a threaded hole 15a (or a recess with internal thread). In the tapped hole 15a is a helical extension 16 of the second dentifrice 5 , in particular of the abutment 5a screwed in accordingly.

The dentifrice system 8th , in particular here an implant and / or abutment system 8a is in explosive representation in particular in the 2 B and 3b shown. It is obvious that the first end area 7a of the spacer element 7 on its front side a first contact surface for the contact with the implant 9a and the second end area 7b of the spacer element 7 on its front side a second contact surface for the contact with the second tooth replacement means 5 , especially with the abutment 5a having. The respective mounted state of the tooth replacement system 8th , in particular of the implant and / or abutment system 8a with the spacer element 7 is in the 2a . 3a and 4a shown.

2a and 2 B shows a first embodiment of a spacer 7 and the 3a and 3b a second embodiment of a spacer element 7 ,

In the first embodiment of the spacer element 7 according to the 2a and 2 B is the first connection means 13 or the helical extension 13a at the first contact surface of the spacer element 7 formed or the second connection means 15 , namely the threaded hole 15a essentially in the body of the spacer element 7 formed, with the threaded hole 15a from the second contact surface inwards into the body of the spacer element 7 extends.

Unlike the 2a and 2 B is in the second embodiment of the spacer element 7 according to the 3a and 3b the first and second connecting means 13 and 15 as a separate unit 19 trained, as in 3c shown in a single representation schematically, with this separate unit 19 then again in a spacer element 7 arranged and / or fastened, as well as essentially from the 3a or. 3b seen.

The in the 2 . 3 or. 4 illustrated first and second connecting means 13 and 15 are here for the preferred embodiment of the dentifrice system 8th , in particular for the implant and / or abutment system 8a executed or represented. Depending on a particular specific tooth replacement agent system, such first and second connection means can also be configured otherwise, in particular be realized, for example, as a latching and / or plug connection. It is also conceivable that the first and / or second connecting means is formed as an internal thread and in particular can be screwed onto an external thread of the implant or the second dental prosthesis. The respective first or second connecting means may therefore be formed as an internal or external thread.

Also in the 2 . 3 or. 4 illustrated case or the corresponding training is conceivable in the reverse manner, for example, that a helical extension of the spacer element with the second tooth replacement means, here the abutment can be brought into engagement and a helical extension of the implant with a recess of the spacer element is engageable. The formation of the first and second connecting means is therefore in particular also dependent on a specific dental prosthesis system as such.

As a further alternative for the formation of the spacer element and / or the respective design of the first and second tooth replacement means, it is also conceivable for the spacer element to have a passage opening, in particular to be substantially annular. The spacer element can then be arranged between the first and second tooth replacement means, the first and second tooth replacement means then having respective connection means, of which at least one connection means at least partially penetrates the passage opening of the spacer element, so that the first and / or second tooth replacement means then interact directly with one another is connectable or are. For example, a second tooth replacement, in particular an abutment then at the corresponding end a correspondingly long threaded pin or a helical extension, which passes through the through hole of the spacer element, wherein the end of the helical extension is screwed into a receptacle of the first dental prosthesis. The spacer element is then arranged between the first and second dental prosthesis means and is in effective contact with the first and second dental prosthesis means, but is "pressed in" between the first and second dental prosthesis as it were. The connecting means are then formed on the first and / or second tooth replacement means and are connected substantially directly to each other. Also for this alternative described above, corresponding latching or plug connections or the like could be provided as connecting means.

In addition, it may be stated that the 2a . 2 B . 3a . 3b and 4a essentially one on the abutment 5a already arranged artificial tooth 2 B show or represent, in particular abutment 5a and tooth 2 B can also be designed as an "abutment crown".

In the preferred embodiment of the spacer element according to the invention 7 or the dentifrice system 8th has the spacer element 7 a specific height H which is then tailored to the respective person or to the respective patient. For the production of a spacer element 7 with a specific height H In particular, reference may now be made to the following comments on the method according to the invention. It is also conceivable, however, for a tooth replacement agent system to already have a plurality of spacer elements in different standard sizes, that is, each with different heights H and that then a particular spacer with a specific height H used or selected accordingly. In the preferred embodiment of the spacer element according to the invention 7 or the dentifrice system 8th therefore has the spacer element 7 an at least partially roughened and / or at least partially uneven surface on the outer region 7c on, wherein the spacer element 7 is also tailored to a specific person / patient individually, namely the spacer element 7 So a specific height H having. In a further preferred embodiment, the surface of the outer region of the spacer element can be roughened in a first partial region and / or be at least partially uneven and be smooth or flat in a second partial region. The first subregion is then suitable for the attachment of jawbone tissue and the second subarea for the attachment of soft tissue, in particular of gingival tissue. Such a spacer then again has a specific height tuned for a particular patient H on.

The following may now in particular on the basis of 4a and 4b the method according to the invention will be explained in more detail:

Between the first tooth replacement 9 , here the implant 9a and a second dentifrice 5 , in particular an abutment 5a becomes the spacer element 7 arranged. This becomes the first end area 7a of the spacer element 7 with the implant 9a and the second end area 7b of the spacer element 7 with the second dentifrice 5 , especially with the abutment 5a effectively brought into contact, in particular effectively connected, in particular via first and second connection means 13 or. 15 and / or corresponding corresponding counterparts on the implant 9a or on the second tooth replacement agent 5 , here at the abutment 5a like the picture shown here 14 (Tapped 14a) or the helical extension 16 , If the implant 9a in the jawbone tissue 10 arranged, in particular fixed, comes the outer area 7c of the spacer element 7 , in particular the outer circumference - at least partially with a jawbone tissue in a state arranged in a particular human oral cavity 10 and / or at least partially with a bone regeneration material 11 and / or at least partially in contact with soft tissue, in particular with a gingiva tissue. Preferably, then the the outer periphery of the spacer element 7 , especially the outer area 7c of the spacer element 7 surrounding area with boundary elements 17 and 18 Accordingly, so limited, so that the space with bone regeneration material 11 can be filled, as from the 4a and 4b seen. This serves in particular the jawbone structure or the regeneration of the jawbone tissue 10 especially in the interspace where the bone regeneration material 11 filled is then trained or can train. It is also conceivable Arrangement of a bone block, a "boning" or the like or other augmentative methods.

In the method according to the invention is now after the implant 9a in the jawbone 10 or in the jawbone tissue 10 a person / patient is disposed substantially above the visible end region 9b of the implant 9a permanent clearance to the outer soft tissue border, in particular to the outer gingival tissue border 3a at least partially mediated and / or measured, where, based on the measured data determined then an individual for this person spacer element 7 namely with a specific vertical height H manufactured and / or used.

This becomes the one above the visible end 9b of the implant 9a remaining free space determined, in particular scanned, measured in particular with a laser scanner. Thereafter, the specific spacer element 7 in particular produced from an ingot with the aid of a milling and / or drilling machine, wherein the milling and / or drilling machine, the measurement data, in particular the laser scanner are supplied and the spacer element 7 with a specific vertical height H can be realized or produced accordingly. The free space can also be molded, in particular be determined by conventional measurement using an impression mass. The spacer element can be designed as a 3-D pressure component or as a casting. In particular, in this case also the dimension of the entire spacer element 7 , in particular the dimensioning of the outer area 7c , So the outer circumference according to the measurement data are dimensioned so that not only the specific vertical height H through the spacer element 7 is realized, but also the remaining space - if desired - by a corresponding dimensioned spacer element 7 Accordingly, at least partially filled.

As a result, but the specific vertical height H of the spacer element 7 dimensioned as desired, in particular adapted to the particular circumstances of a particular person / a patient individually, whereby the height-wise alignment of the second tooth replacement means 5 , especially the abutment 5a or an artificial tooth 2 B is optimized, especially regardless of how deep the implant 9a in the jawbone or in the jawbone tissue 10 has been advertised. It is also conceivable that several spacer elements, in particular provided in a dental prosthesis system, the different vertical heights H and then for a particular patient the respective desired spacer element having a desired certain vertical height H selected or used. About a specifically trained spacer element 7 with a specific vertical height H leaves a second tooth replacement 5 ie an artificial tooth / abutment 5a or also a prosthesis, a partial denture and / or a web or a ball head element (Kugelkopflocator) in terms of height so that also a visually optimized garland-like gingival tissue border 3a and a good bone structure is feasible. That's the specific vertical height H having spacer element 7 also has a roughened and / or uneven surface on the outer area 7c on (as explained above). Also, a spacer element with a combination, namely in particular with a roughened and / or uneven first portion for realizing a bone structure and a smooth second portion, wherein the smooth second portion for adhesion of the soft tissue, in particular the gingiva is used, as previously mentioned, is conceivable , in particular according to the inventive method produced. The 2 . 3 and 4 show here with the solid line the free space at least partially limiting outer gingival tissue border 3a where the dashed line 6 should represent the gingival tissue border after treatment.

As materials for the spacer 7 In particular, the following materials are suitable: titanium, zirconium and all biocompatible stable materials.

In the end, the disadvantages mentioned above are avoided and achieved corresponding advantages.

LIST OF REFERENCE NUMBERS

1

Row of teeth (upper jaw)

2

teeth

2a

natural tooth

2 B

artificial tooth

3

Gingival tissue

3a

Gingival tissue limit

4

gap

5

second dentifrice

5a

abutment

6

line

7

spacer

7a

first end area

7b

second end area

7c

outer area

8th

Dentures resources system

8a

Implant and / or abutment system

9

first dentifrice

9a

implant

9b

end

10

Jawbone tissue

11

Bone regeneration material

12

thread

13

first connecting means

13a

helical extension

14

admission

14a

threaded hole

15

second connection means

15a

threaded hole

16

helical extension

17

limit

18

limit

19

unit

H

specific vertical height

Claims (12)

Method for producing and / or forming a spacer element (7) for a dental prosthesis system (8), wherein the spacer element (7) between a first tooth replacement means (5), namely an implant (9a) and a second tooth replacement means (5), in particular an abutment (5a), an abutment crown, a further implant means, a prosthesis or a partial denture is arranged, wherein at least a first end portion (7a) of the spacer element (7) with the implant (9a) and at least a second end portion (7b) of the spacer element (7 ) is brought into effective contact with the second tooth replacement means (5), and wherein the outer region (7c), in particular the outer circumference of the spacer element (7) - at least partially with a jawbone tissue (10) in a state arranged in a particular human oral cavity ) and / or at least partially with a bone regeneration material (11) and / or at least partially with soft tissue, in particular with a Gi ngiva tissue (3), can be brought into contact, characterized in that, after the implant (9a) is arranged in the jawbone of a person, over the visible end region (9b) of the implant (9a) remaining free space determined to the outer soft tissue boundary is, and that on the basis of the determined measurement data then an individual spacer element (7), namely produced and / or used with a correspondingly specific vertical height (h), wherein the surface of the outer region (7c) of the spacer element (7) at least partially as an uneven structure is formed. Method according to Claim 1 , characterized in that over the visible end region (9b) of the implant (9a) remaining free space is measured, namely is scanned with a laser scanner or is determined by means of an impression mass. Method according to one of Claims 1 or 2 , characterized in that the spacer element (7) made of an ingot by means of a milling and / or drilling machine or as a casting or as a 3-D printer component, in particular milled, printed and / or cast. Distance element (7) for a dental prosthesis system (8), produced according to one of Claims 1 to 3 wherein the spacer element (7) can be arranged between a first tooth replacement means (9) and a second tooth replacement means (5), wherein the first tooth replacement means (9) is designed and / or embodied as an implant (9a) and wherein the second tooth replacement means (5 ) is designed and / or embodied as an abutment (5a), as an abutment crown, as a further implant means, as a prosthesis or as a partial prosthesis, wherein at least a first end region (7a) of the spacer element (7) with the implant (9a) and at least one second end region (7b) of the spacer element (7) can be effectively brought into contact with the second tooth replacement device (5), and the outer region (7c), in particular the outer circumference of the spacer element (7), in one in particular human oral cavity arranged state - at least partially with a jawbone tissue (10) and / or at least partially with a bone regeneration material (11) and / or at least partially with Weic fabric, in particular with a gingiva fabric (3), can be brought into contact, characterized in that the surface of the outer region (7c) of the spacer element (7) is at least partially roughened and / or at least partially has an uneven structure, wherein the surface of the outer region (7c) is adapted for the attachment of jawbone tissue, wherein the spacer element (7) has a specific vertical height (h) matched to a specific person or to a specific patient, and wherein the first end region (7a) of the spacer element (7) a first connecting means (13) for effective connection with the implant (9a) and the second end portion (7b) of the spacer element (7) has a second connecting means (15) for effective connection with the second tooth replacement means (5). Distance element after Claim 4 , characterized in that the surface of the outer region (7c) and the outer region (7c) at least one thread (12), in particular a plurality of threads (12). Distance element according to one of Claims 4 or 5 , characterized in that the first end portion (7a) as a first connecting means (13) for effective connection with the implant (9a) has a helical extension (13). Distance element according to one of Claims 4 to 6 , characterized in that the second end portion (7b) as a second connecting means (15) for effective connection with the second tooth replacement means (5) has a threaded bore (15a). Distance element according to one of Claims 4 to 7 , characterized in that the first end region (7a) has on its front side a first abutment surface for contact with the implant (9a) and / or the second end region (7b) on its front side a second abutment surface for contact with the second tooth replacement device (5 ) having. Distance element according to one of Claims 4 to 8th , characterized in that between the first end portion and the implant and / or between the second end portion and the second tooth replacement means a latching and / or plug connection is realized. Distance element (7) for a dental prosthesis system (8), produced according to one of Claims 1 to 3 wherein the spacer element (7) can be arranged between a first tooth replacement means (9) and a second tooth replacement means (5), wherein the first tooth replacement means (9) is designed and / or embodied as an implant (9a) and wherein the second tooth replacement means (5 ) is designed and / or embodied as an abutment (5a), as an abutment crown, as a further implant means, as a prosthesis or as a partial prosthesis, wherein at least a first end region (7a) of the spacer element (7) with the implant (9a) and at least one second end region (7b) of the spacer element (7) can be effectively brought into contact with the second tooth replacement device (5), and the outer region (7c), in particular the outer circumference of the spacer element (7), in one in particular human oral cavity arranged state - at least partially with a jawbone tissue (10) and / or at least partially with a bone regeneration material (11) and / or at least partially with Weic fabric, in particular with a gingiva fabric (3), can be brought into contact, characterized in that the surface of the outer region of the spacer element is at least partially roughened and / or at least partially has an uneven structure, wherein the surface of the outer region for the attachment of jawbone tissue is formed, wherein the spacer element has a specific person or for a specific patient tuned specific vertical height and wherein the spacer element has a passage opening, in particular annular, and that the spacer element between the first and second tooth replacement means arranged or can be arranged, wherein the first and the second tooth replacement means comprises the passage opening of the spacer element at least partially cross-through respective connecting means, which are effectively connected or connected to each other. Distance element according to one of Claims 4 to 10 , characterized in that a first portion of the surface of the outer region of the spacer element is roughened and / or has an uneven structure, wherein a second portion of the surface of the outer region is smooth or planar, and wherein the first portion for attachment of Jawbone tissue and the second portion for attachment of soft tissue is used. Tooth replacement system (8), comprising at least a first and a second tooth replacement means (9,5) and with a plurality of spacer elements (7), wherein the first tooth replacement means (9) as an implant (9a) is formed and / or executed and / or second tooth replacement means (5) is designed and / or embodied in particular as an abutment (5a), as an abutment crown, as a further implant means, as a prosthesis or as a partial prosthesis, wherein a spacer element (7) between the implant (9a) and the second tooth replacement means (5) can be arranged, wherein at least a first end portion (7a) of the spacer element (7) with the implant (9a) and at least a second end portion (7b) of the spacer element (7) with the second tooth replacement means (5) in effective contact can be brought, and wherein the outer region (7c), in particular the outer circumference of the spacer element (7) - at least partially in a arranged in a particular human oral cavity state Jawbone tissue (10) and / or at least partially in contact with a bone regeneration material (11) and / or at least partially with soft tissue, in particular with a gingiva tissue (3), characterized in that the plurality of spacer elements each have different different standard sizes, namely, have different different vertical heights, wherein, in particular, after the remaining between the visible end of the implant and the outer gingival tissue border clearance for a patient is determined, for the patient a certain distance element with a certain height is searchable and usable, and wherein the outer region of the spacer element has a roughened and / or uneven surface.

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