KR100672796B1 - Medical Implants - Google Patents

Abstract

The present invention is an implant (1) for receiving a coupling pin (17, 17 ', 17 ") of a medical element, comprising a longitudinal axis (9), a distal end (3), and a proximal end (4), From its proximal end 4 the receiving recess 10 for the engaging pins 17, 17 ′, 17 ″ extends into the interior of the implant 1 along the direction of the longitudinal axis 9, the implant 1 Is coupled to the inner skin surface of the receiving hole in the bone of the human or animal body by shape engagement or frictional binding at its outer skin surface, and engages pins 17, 17 ', 17 "fitted to the receiving recess 10. ) Is an anchor 1 which can be anchored in its receiving recess 10 by clamping, heat bonding, gluing, or cementing, in which the medical element is anchored and its cross section of the implant 1 is fixed. The implant by the contact surface 18 of the head 16 projecting radially outward beyond the cross section of the receiving recess 10 at the proximal end 4 It is in full contact with the contact surface 5 of the implant 1 assigned to the proximal end 4 of 1. The receiving recess 10 has a cylindrical section 10Z, the cylindrical section 10Z having a cross section. This tapered section 10V is joined. The coupling pins 17, 17 ', 17 "also have a cylindrical section 17Z, and the cylindrical section 17Z is joined by a section 17V having a tapered cross section. do.

Description

Medical Implants {MEDICAL IMPLANT}

The present invention is an implant for receiving a coupling pin of a medical element, comprising an longitudinal axis, a distal end, and a proximal end, from which the receiving recess for the coupling pin extends from the proximal end into the interior of the implant along the direction of the longitudinal axis. The implant can be coupled to the inner skin surface of the receiving hole in the bone of the human body or animal body by shape binding or frictional binding at its outer skin surface, and the coupling pins fitted to the receiving recess are clamped, heated bonded, glued, Or by cementing an anchoring into the receiving recess, in which the medical element is anchored to the contact surface of the head portion projecting radially outward beyond the cross section of the receiving recess at the proximal end of the implant. The entire surface is in contact with the contact surface of the implant assigned to the proximal end of the implant, and the outside of the cross section of the receiving recess. Will at least partially on the implant that is not circular.

Implant systems of that type are widespread, for example in the field of dentistry. In that case, the medical element to be received is formed by, for example, a denture, a closure cap, an impression post, or a gingiva former. The implant is for example screwed into the jawbone.                 

Implant systems of the type presumed at the outset are known, for example, from US Pat. No. 5,961,328. The engagement pin of the medical element and the receiving recess of the implant are interlocked according to the key locking principle, in which case it projects beyond the engagement pin in the radial direction and into the corresponding recess in the head of the implant with the medical element inserted. The interlocking lock element provides protection against torsion. The receiving recess has a conical section starting from the proximal end of the implant, the conical section being joined by a cylindrical section whose cross section coincides with the cross section at the end of the conical section. The engagement pin of the medical element inserted into the receiving recess is shaped to be tapered toward its distal end in cross section, in which case the outline of the engagement pin is concave extending in the longitudinal section and has a serrated surface structure. However, the cross section of the engagement pin is not circular, but rather the longitudinal strip is pulled out on one side as compared to the rotationally symmetrical configuration to form a flat surface section of the skin surface extending parallel to the longitudinal axis of the engagement pin.

Such known implant systems, on the one hand, are very complex and expensive to manufacture, and on the other hand, the form of transmitting force to the conical section connected to the head portion of the medical element is not optimized. In other words, the reduced shape of the cross section limits the possibility of receiving forces in the transverse direction of the longitudinal axis of the engagement pin, especially when the medical element is loaded to one side, thereby limiting the medical element in the worst case. An inclined movement may occur.

Dentures known from WO 99/29255 consist of a lower part, a middle part and an upper part and a crown overlying the upper part. Such dentures are inserted into the correspondingly conical receiving holes, which are fitted in the implant by the conical bottom as a whole, which must be inserted into the jawbone in advance and fully occluded there. The principle of the clamping cone applies when the engagement between the engagement pin and the receiving recess. By allowing the denture to twist about the longitudinal axis of the engagement pin, the position of the denture can be precisely adjusted and adjusted, especially in the case of large loads, during the insertion process, especially during rotation about the vertical axis of the denture. The disadvantage is that it can not be guaranteed to sufficiently prevent the denture from twisting in the implant.

An alternative to the implant system described above is the screw connection between the denture and the implant, which is the most widespread type of connection characterized by being simply reversible. However, it is considered disadvantageous in such screw engagements that a lot of time is spent on screwing in the fixing screw, especially when the number of dentures is very large, and often the endurance life of such a system is insufficient. That is, the entire thread pitch of the threaded joint never shows the same support behavior due to the manufacturing conditions, because in some individual sections an elevated force or moment transfer occurs and in other sections a degraded force or moment transfer occurs. For that reason, an inconsistent load condition occurs, resulting in unintentional deformation and stress concentration. As a result, the screw connection may be damaged or the overload between the implant and the bone may be overloaded, resulting in complete loss of the implant in the worst case.

It is an object of the present invention to provide an implant system in which the engagement between the medical element and the implant is simple, wherein the engagement is characterized in that it evenly transmits force over a large area and prevents twisting.

Such an object starts with an implant of the type presupposed at the outset, in which, according to the invention, the receiving recess has a cylindrical section starting from the proximal end of the implant, the section having a tapered cross section being contiguous, The pin is likewise provided with a cylindrical section, starting from the head of the medical element, with the cylindrical section having a section with a tapered cross section.

Frontal contact at the contact surface ensures uniform force transfer from the medical element to the implant, thereby preventing stress concentrations and consequent material overload and material damage. In particular, the cylindrical section of the mating pin, together with the cylindrical section of the receiving recess fitted therein, ensures a secure fixation, in which the separating face between the medical element and the inner epidermal surface of the implant, even if the force is transmitted from the side to the medical element The tension component is not generated at. Thus, in the implant according to the invention, the safety against separation and detachment becomes very high, whether the medical element is heat bonded, bonded or cemented.

For example, a non-circular cross section, which may be in the form of (chamfered) polygons (triangles, squares, pentagons, etc.), ovals, or ovals or any other plane form, means that the engagement pin of the medical element is about its longitudinal axis. To prevent it from rotating. In addition, the angular position of the medical element associated with the rotation about the vertical axis is clearly defined, which makes it unnecessary to complexly adjust the position of the medical element during insertion. The inherent engagement between the implant and the engagement pin is by clamping, heat bonding, gluing, or cementing.

According to the arrangement of the invention, the length of the cylindrical section of the engagement pin measured in the direction of the longitudinal axis of the implant is also arranged to be smaller than the length of the cylindrical section of the receiving recess measured in the direction of the longitudinal axis of the implant. Thereby, the contact surface of the medical element on one side and the contact surface of the implant on the other side can be reliably contacted, which is essential for uniform force transmission over a large area. Such differences in length are sized to allow individual elements to always be contacted in the area of the contact surface, even in the worst case, taking into account manufacturing tolerances. However, choosing such a large difference in length should be avoided in order to avoid unnecessarily wide gaps between the engagement pin and the receiving recess in the area where the cross section is diminished.

A very preferred configuration is such that the contact surface is annular and extends in a plane perpendicular to the longitudinal axis of the implant. By such a configuration, the cost in manufacturing the implant can be kept very low.

The distal end of the coupling pin between the anchor pin and the wall of the storage recess to prevent pressure build up that may in some cases prevent screw engagement movement when inserting the coupling pin into the receiving recess. One or more exhaust channels are formed that extend from to the proximal end of the implant.

It is highly desirable that the contact surface of the implant be provided with one or more exhaust grooves extending from the exhaust channel to the epidermal surface of the implant. In this way, no unobstructed discharge of air pushed out by the engagement pins is ensured.

In any case, it is important that the engagement pin is formed to be sized relative to the storage recess such that it can be inserted into the storage recess until the contact surface of the head contacts the contact surface of the implant.

A further configuration of the implant according to the invention consists in having a plurality of annular grooves or spiral grooves in which the wall of the receiving recess extends in a plane perpendicular to the longitudinal axis of the implant. Such annular grooves or helical grooves are on the one hand considered to facilitate the assembly process, in particular in the final stage. In particular, compression of the surfaces in contact with each other is prevented, and good guidance of the coupling pins is realized. In addition, when the engagement pin is secured by an adhesive, an adhesive ring, or the like, a spiral adhesive bead is formed in the annular groove or the spiral groove to receive the axial force.

According to another configuration of the invention, the wall of the receiving recess comprises at least one medical element, such as a closure cap, a gingiformer, an impression post, and / or an elastic clip element of the temporary denture that can be engaged in shape engagement. With a recess. In this way, all parts that are only to be temporarily coupled to the implant can be simply inserted into the receiving recess and thereby connected to the implant in a predetermined precise position. The clip element preferably provides engagement by shape engagement which can be released again by the corresponding axial force, whereby the clip element is preferably chamfered so that a trouble-free separation is possible. Force transfer is via the end face during the transition time. The time it takes to achieve a coupling between only temporarily used parts and the implant is significantly reduced, which results in significant time gains, especially when feeding multiple implants simultaneously.

In a preferred configuration of the implant according to the invention, the cross section of the receiving recess has the shape of a chamfered rectangle in the vicinity of the proximal end of the implant and the shape of a chamfered square in the vicinity of its bottom, wherein the transition between the cross-sectional forms described above Is not abrupt. In that case, it is important that the length of the short side of the rectangle coincides with the length of the side of the square.

Furthermore, according to the invention, the cross section abuts in full contact with the contact surface of the implant assigned to the proximal end of the implant by the contact surface of the head portion projecting radially outward beyond the cross section of the receiving recess at the proximal end of the implant, A medical element is provided in which the outline of the cross section of the engagement pin does not at least partially become circular. In this way, torsion is simply prevented without jeopardizing the coupling, and a larger torque can be accommodated. That is, it becomes possible to insert the implant into the bone, for example with a preassembled closure cap or gingival former.

In a preferred configuration, the engaging pin has a rectangular cross section in the vicinity of its proximal end, with the chamfering or cutting being greater than the rectangular corner of the cross section of the receiving recess at the point at which the corner of the cross section is assigned to the anchoring state. And wherein the engagement pin has a square cross section chamfered in the vicinity of its distal end, wherein the corner of the cross section is larger than the square corner of the transverse cross section of the receiving recess at the point at which the corner is assigned to the anchoring state. It is chamfered.

The distal end of the engagement pin also has a axially projecting clip element that can engage in a recess in the receiving recess of the implant in the assembled state. Thereby, the time required for assembly can be significantly shortened compared to screwed or temporary adhesive and cemented joints.

Shaped engagement by the clip element can be released very simply when the section of its skin surface, which is located outside of the receiving recess in the assembled state, has two or more opposing recesses. In such a recess a hook-shaped contact element of a pliers-shaped tool is introduced, for example, again from the implant by application of a corresponding axial force, such as a clipped closure cap, a clipped gingival former, an impression post, and / or a temporary denture. Can be removed.

When the recess forms an annular groove with a V-shaped cross section, a shape bond can be made simply between the recess and the tool which removes the closing cap, the gingiva former, the impression post, and / or the temporary denture.

According to another configuration of the present invention, in the case of a final denture, the skin surface of the engagement pin has a plurality of annular grooves each extending in a plane perpendicular to the longitudinal axis of the engagement pin, the annular groove having an anchor Measures to correspond with the annular groove in the wall of the receiving recess in the fixed state.

Hereinafter, the present invention will be described in more detail based on the embodiments shown in the accompanying drawings. Among the accompanying drawings,

1 is a cross sectional view of an implant with the closure cap clipped;

2 is a top view of the closure cap;

3 is a plan view of the implant after the closure cap is removed;

4 is a cross-sectional view taken along line IV-IV of the implant according to FIG. 1;

5 is a cross-sectional view taken along the line VV of the implant according to FIG. 1;

6 is a partially enlarged view of the engagement zone of the clip element;

7 is a partially enlarged view schematically showing that the cross-sections of the implant and engagement pin begin to diminish differently;

FIG. 8 is similar to FIG. 1 but with a sectional view of the implant with the gingival former clamped;

FIG. 9 is a cross-sectional view of an implant similar to FIG. 8 but with a trans-gingival occlusal slit in the gingival former;

10 is a cross-sectional view of the raw material of a temporary denture in a laboratory implant;

FIG. 11 is similar to FIG. 10 but in cross section of the completed temporary denture;

FIG. 12 is a cross sectional view of a temporary denture in an implant according to the invention, similar to FIG. 11;

FIG. 13 is similar to FIG. 10 but with a cross sectional view of the final denture;

FIG. 14 is similar to FIG. 11 but with a cross sectional view of the final denture;

FIG. 15 is similar to FIG. 12 but with a cross sectional view of the final denture;

FIG. 16 is similar to FIG. 15 but with a cross sectional view of the final denture with the engagement pin having an annular groove in the epidermal surface.

1 to 5, a titanium implant 1 can be seen in which the basic shape is approximately conical and the male screw 2 is provided on the outer skin surface thereof. Such an implant 1 has a proximal end 4 formed by a rounded distal end 3 and an approximately annular end face 5. The implant 1 has a cylindrical shape with a high gloss polished epidermal surface 7 in a section 6 adjacent the end face 5. In the subsequent threaded section 8, the implant 1 is formed conical. Starting from the end face 5, an accommodating recess 10 extends parallel to the longitudinal axis 9 of the implant 1, which accompanies the entire length of the section 6 and the screw. It extends over the partial length of section 8.

As can be seen from the schematic view according to FIG. 7, the receiving recess 10 is first provided with a cylindrical section 10Z starting from the proximal end of the implant 1, the cylindrical section 10Z having a reduced cross section. The section 10V is joined. Correspondingly, the engagement pin 17 of the denture to be inserted also has a cylindrical section (1) whose diameter is slightly smaller than the diameter of the receiving recess 10 in the cylindrical section 10Z, starting from the head 16. 17Z). The cylindrical section 17Z of the coupling pin 17 is joined to the section 17V whose cross section is diminished. Since the length 6a of the cylindrical section 17Z of the coupling pin 17 is slightly shorter than the length 6b of the cylindrical section 10Z of the receiving recess 10, the coupling pin in the tapered region 10V, 17V. 17 is excluded from contacting the wall 12 of the receiving recess 10. Rather, by fitting the components as such, it is ensured that the contact surfaces 5, 18 are brought into full contact at the proximal end of the implant 1. The difference between the lengths 6a, 6B, i.e. the axial spacing between the circular edge 12a at the engagement pin 17 and the circular edge 12b at the proximal end of the implant 1, is the worst case manufacturing tolerance. Is always sized to maintain the minimum spacing in sections (10V, 17V). Otherwise, the length difference is kept as small as possible so that the gap size in the diminishing zones 10V and 17V is kept small.

As can be seen from FIGS. 3 to 7, the cross section of the receiving recess 10 in the cylindrical section 10Z is consistently accompanied by the shape of a chamfered rectangle. The cross section of the accommodating recess 10 is continuously tapered starting from the screw zone 8 such that the bottom 11 of the accommodating recess 10 exhibits a square chamfered in its cross section (see FIG. 5). In the screw section 8, the transition from the chamfered rectangular cross section to the chamfered square cross section takes place without succession.

As can be seen in particular from FIG. 1, the wall 12 of the receiving recess 10 has a plurality of annular grooves 13 oriented perpendicular to the longitudinal axis 9. In addition, the wall 12 has upper and lower clip grooves 14o and 14u, the function of which will be described later with reference to FIG.

The implant 1 shown in FIG. 1 is inserted with a closing cap 15 consisting of a generally cylindrical head 16 and a coupling pin 17 oriented coaxially with and extending into the receiving recess 10. do. The contact surface 18 of the head portion 16 is in contact with the end surface 5 of the implant 1 in the form of frictional engagement.                 

As can be seen from FIG. 3, the engagement pin 17 exhibits an approximately rectangular cross section in the upper section, the corner area of which the engagement pin 17 and the receiving lid in the chamfered area of the cross section of the receiving recess 10. Four exhaust channels 19a are cut between the walls 12 of the recess 10. Thus, when the engagement pin 17 is inserted into the receiving recess 10, air can be pushed out and taken out upward without pressure formation that interferes with the assembly process, and the air is pushed out of the end face 5 of the implant. It can be provided to the outside through the four exhaust grooves (19b) extending radially outward.

The closure cap 15 stays in the implant 1 only temporarily after implantation, so it is only engaged with the implant 1 by four clip elements 20 that engage the clip grooves 14o. Instead of engaging the clip element 20 with the upper clip groove 14o as shown in FIG. 1, it is also possible to engage the lower clip groove 14u when the engagement pin 17 is of a corresponding length. .

The closing cap 15 has already been inserted into the implant by the manufacturer of the implant 1, on the one hand, after making the corresponding hole in the jawbone, the screw 1 engaging the slit 21 shown in FIG. 2. ) To rotate the Based on the cross section of the engagement pin 17 and the cross section of the receiving recess 10 fitted therein, the torque can be transmitted to the implant 1 via the closing cap 15. After implantation, the closing cap 15 stays in the implant 1 and on the other hand protects the receiving recess 10 from foreign contaminants.

After the implant 1 is inserted into the jawbone, the occlusion is completed after about 3 to 6 months until the mucosa covering the closing cap 15 can be opened again by the second procedure. The closing cap 15 is removed for this purpose by engaging the pliers with the V-shaped annular groove 22 of the head 16 so that the entire closing cap 15 is upwardly along the axial direction by a light pull. It will be removed from the implant. Now, in the receiving recess 10 of the implant 10 a gingival former 23 as shown in FIG. 8 is inserted. The fixing principle of the gingival former is the same as that in the closing cap 15. 8 representatively shows that the clip element 20 of the gingival 23 is engaged in the lower annular groove 14u. However, it is also conceivable that the gingiva former 23 is engaged with the clip element 20 in the upper annular groove 14o.

9 shows gingival formers with slits such as those used in transitional gingival occlusion of the implant.

FIG. 10 shows a laboratory implant 1L in which the raw material 24 of the temporary denture is also inserted by the coupling pin 17. Such raw material 24 is truncated conical and extends at an angle α of 15 ° starting from the end face 5L of the laboratory implant 1L. As such, the inclined position of the implant 1 or 1L relative to the adjacent tooth or another implant can be adjusted over a wide range of angles in all directions. The engagement pin 17 of the raw material 24 also has a clip element 20 which ensures an uncomplicated fixation and removal of the raw material 24.

FIG. 11 shows a temporary denture 25 which is finished and manufactured by cutting in a dental laboratory. An external ceramic layer is attached onto the polished raw material.                 

The finished temporary denture 25 can then be secured there by the clip element 20 until it is introduced into the implant 1 in the patient and the patient can be provided with the final denture 28 ( See FIG. 12).

Such final denture 28 is made of truncated conical raw material 27 (see FIG. 13) at its head, like temporary denture 25, which raw material 27 is inclined in all directions over a wide range of angles. Allows you to correct The engagement pin 17 'of the final denture 28 or its raw material 27 does not have a clip element, but a receiving recess 10 over the entire length of the engagement pin 17' except for the rounded area. ) To the cross-sectional shape. On the basis of the annular groove 13 in the wall 12 of the receiving recess 10, the engagement pin 17 allows the end face of the head portion of the raw material 27 to contact the end face of the implant 1L for the workroom. Until it can be introduced without any problem. By varying the start of the "conical", the engagement by frictional binding is ensured via the contact surfaces 5, 18 (see also FIG. 7). Starting from such a position where the raw material 27 is assembled into the laboratory implant 1L, the final form of the denture 28 also attached with the ceramic layer 26 can be produced (see FIG. 11). ).

The final denture 28 is removed from the laboratory implant 1L and inserted into the implant 1 in the jawbone to complete the procedure. In such an assembled state, the two contact surfaces 5, 18 are brought into contact with each other by frictional binding. Friction binding is also made between the outer skin surface of the engagement pin 17 and the wall of the receiving recess 10, which is formed by adhesive or cement or in the case of heat bonding by clamping force.

According to FIG. 15, a suitable adhesive or cement is applied to the skin surface 29 of the coupling pin 17 ′ and the contact surface 18 of the head portion, such adhesive or cement being received recess during insertion of the coupling pin 17 ′. The annular groove 13 in (10) is almost completely filled. That is, after curing of the adhesive, there is an adhesive bead fixed on the coupling pin 17 'to form a shape-bound bond with the implant 1. Further friction bonding is achieved by the contact surfaces 8 and 15, in which case the area is only very thinly glued to fill the surface roughness of the contact surface, which causes material contact between the implant / denture in spite of the adhesive. . In any case, the adhesive should be prevented from flowing out to the sides of the contact surfaces 5 and 18.

The strength of the engagement between the denture 28 and the implant 1 is such that the annular groove in the wall 12 of the receiving recess 10 is provided with a plurality of annular grooves 13 " It is further improved when it corresponds to (13). Such a configuration is shown in FIG. In that case, an adhesive ring having a circular or oval cross section is formed to form a shape-bound bond between the denture 28 and the implant 1.

Claims (17)

An implant 1 for receiving a coupling pin 17, 17 ′, 17 ″ of a medical element, comprising a longitudinal axis 9, a distal end 3, and a proximal end 4, the proximal end of which is provided. The receiving recess 10 for the engagement pins 17, 17 ', 17 "extends from (4) into the interior of the implant 1 along the direction of the longitudinal axis 9, with the implant 1 at its outer side. The engagement pins 17, 17 ′, 17 ″ fitted to the inner recessed surface of the receiving hole in the bones of the human body or animal body by shape binding or frictional binding at the skin surface and which are fitted to the receiving recess 10 are clamped. Can be anchored in the receiving recess 10 by heat bonding, gluing, or cementing, wherein the medical element is in an anchored state with a receiving recess whose cross section is at the proximal end 4 of the implant 1. An implant assigned to the proximal end 4 of the implant 1 by the contact surface 18 of the head 16 protruding radially outward beyond the cross section of 10. In the implant (1) in full contact with the contact surface (5) of the lanyard (1) and the outer periphery of the cross section of the receiving recess (10) at least partially circular, The receiving recess 10 has a cylindrical section 10Z starting from the proximal end 4 of the implant 1, and the cylindrical section 10Z is joined with a section 10V having a tapered cross section. The pins 17, 17 ', 17 "likewise have a cylindrical section 17Z starting from the head 16 of the medical element, the section 17Z having a section 17V of which the cross section is diminished connected to the cylindrical section 17Z. The cross section of the receiving recess 10 takes the form of a chamfered rectangle in the vicinity of the proximal end 4 of the implant 1 and of the chamfered square in the vicinity of its bottom 11, as described above. An implant for receiving a pin of a medical element, characterized in that the transition between cross-sectional shapes is not abrupt. The length 6a of the cylindrical section 17Z of the coupling pins 17, 17 ′, 17 ″ measured in the direction of the longitudinal axis 9 of the implant 1 is also the implant 1. Implant characterized in that it is smaller than the length (6b) of the cylindrical section (10Z) of the receiving recess (10) measured in the direction of the longitudinal axis (9) of. 3. Implant according to claim 1 or 2, characterized in that the contact surface (5) is annular and extends in a plane perpendicular to the longitudinal axis (9) of the implant (1). A coupling pin (17, 17 ', 17) between the coupling pin (17, 17', 17 ") in the anchored state and the wall (12) of the receiving recess (10). And at least one exhaust channel (19a) extending from the distal end face of ") to the proximal end (4) of the implant (1). 5. Implant according to claim 4, characterized in that the contact surface (5) of the implant (1) is provided with at least one exhaust groove (19b) extending from the exhaust channel (19a) to the epidermal surface of the implant (1). The wall 12 of the receiving recess 10 is provided with a plurality of annular grooves 13 each extending in a plane perpendicular to the longitudinal axis 9 of the implant 1. Or having a spiral groove. 3. The implant of claim 1 or 2, wherein the wall of the receiving recess (10) has at least one recess in which the elastic clip element (20) of the medical element can be engaged in shape engagement. The cross-section of the receiving recess 10 is in the form of a chamfered rectangle in the vicinity of the proximal end 4 of the implant 1, and in the vicinity of its bottom 11. An implant having a square shape, wherein the transition between the cross-sectional shapes described above is not rapid. The implant of claim 8, wherein the length of the short side of the rectangle matches the length of the side of the square. The implant as claimed in claim 1, wherein the implant is provided for receiving the denture. The proximal end of the implant 1 by its contact surface 18 of the head 16 protruding radially outward beyond the cross section of the receiving recess 10 at the proximal end 4 of the implant 1. It is in full contact with the contact surface 5 of the implant 1 assigned to the end 4, and the outline of the cross section of the coupling pins 17, 17 ', 17 "is not at least partially circular, and the coupling pin 17, 17 ', 17 "have a cylindrical section 17Z starting from the head 16, and the cylindrical section 17Z is joined with a section 17V having a reduced cross section, The distal end of the engagement pin 17 is characterized in that it comprises a axially projecting clip element 20 that can engage in a recess in the receiving recess 10 of the implant 1 in an assembled state. Element. 12. A receiving recess according to claim 11, wherein the engagement pins 17, 17 ', 17 "have a rectangular cross section in the vicinity of their proximal end, the corners of which are assigned to anchor anchors. A chamfered or cut larger than the rectangular corner of the cross section of (10) and in the vicinity of its distal end is provided with a square shaped cross section, with the corners of the cross section being assigned to anchor anchors. A medical element, characterized in that it is chamfered larger than a square corner of the cross section of the seth (10). delete 12. The medical element of claim 11 wherein the section of the epidermal surface positioned outside the receiving recess in the assembled state has two or more opposing recesses. The medical element according to claim 14, wherein the recess forms an annular groove (22) having a V-shaped cross section. 13. Medical element according to claim 11 or 12, characterized in that the medical element is any one or more of a closing cap (15), gingival former (23), impression post, denture (25). 13. The skin surface of the engagement pin 17 "has a plurality of annular grooves 13" each extending in a plane perpendicular to the longitudinal axis of the engagement pin 17 ", The annular groove (13) is characterized in that it corresponds to the annular groove (13) in the wall (12) of the receiving recess (10) with the denture (28) anchored.

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