Specification
1
A method for receiving a medical element in a manipulation apparatus, a manipulation apparatus
for a medical element and implant
The invention relates at first to a method for receiving a medical element in a manipulation
apparatus, with the medical element being received by means of a receiving element in such a
way that it can be inserted in an implant by means of a manipulation apparatus having the
receiving element or can be removed from the implant, with the receiving element being
introduced into the receiving recess in a longitudinal direction of a receiving recess of the
medical element and being secured in the receiving recess by means of a clip element against
displacement in the longitudinal direction. The invention further relates to a manipulation
apparatus for a medical element, comprising a receiving element by means of which the medical
element can be received for insertion into an implant or for removal from the implant, with the
receiving element being introducible into a receiving recess of the medical element in a
longitudinal direction of the receiving recess and being securable by means of a clip element
against displacement in the longitudinal direction, and finally to an implant which can be
implanted in a bone by screwing into a receiving bore.
Within the scope of generally known implant systems in the dental area, medical elements such
as substitute teeth, healing caps, impression posts or gingival former are not held directly by
hand by the surgeon and by the dental technician in the lab, but are received by specially
adjusted manipulation apparatuses. It is known especially in this respect to receive the medical
elements by means of a pincer-like receiving element which is arranged on the manipulation
apparatus. The receiving element engages for this purpose into recesses or grooves provided
circumferentially on the side of the medical element. The medical element is secured against
inadvertent detachment from the manipulation apparatus in such a way that the opening of the
pincer-like receiving element is blocked.
For the implantation, a sleeve-like implant with a simple cover or healing cap is inserted at first
into the bone. As soon as this implant, which at first is without function and is therefore not
loaded mechanically, has healed in and is rigidly connected with the bone, the healing cap can be
removed by means of the manipulation apparatus and any desired medical element can be
inserted instead. Individual missing natural teeth can be replaced by artificial, but fixed substitute
teeth. Such implant systems are also suitable for closing larger gaps in teeth with several natural
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teeth missing side by side or for restructuring a completely new set of teeth without any
remaining natural teeth.
When removing a healing cap from an implanted implant that has healed into the jawbone, the
gums enclosing the implant should be damaged as little as possible. Moreover, in the dental field
the implant often only has a small distance to the adjacent teeth (or implants) for medical reasons.
The space available for handling the manipulation apparatus is thus usually very tight.
A method and a manipulation apparatus of the kind mentioned above is disclosed for example by
US Pat. No. 6,644,969 B2. The application of the proposed implant system is improved over the
previous use of receiving elements attacking on the side in a pincer-like way in such a way that a
receiving element arranged as a clip receiving element engages in a receiving recess of a healing
cap provided for this purpose.
In this known implant system, the healing cap is also snapped into the implant, with the clipping
force which holds the healing cap in the implant being larger than the clipping force which holds
the receiving element of the manipulation apparatus used for the insertion in the receiving recess
of the healing cap. After the insertion of the healing cap the manipulation apparatus can be
removed from the same, with the healing cap remaining in the implant. In order to remove the
healing cap from the implant again, a second receiving element which is formed on the same
manipulation apparatus is introduced into the receiving recess whose clipping force is higher
than the one in the healing cap in the implant.
Object of the invention
The invention is based on the object of simplifying manipulation of the medical element.
Solution
Based on the known methods, it is proposed at first in accordance with the invention that a
securing element is introduced in the longitudinal direction into the clip element in such a way
that the clip element is spread open and/or blocked perpendicular to the longitudinal direction.
On the one hand, such a pin-like securing element can fix a wing of a clipped connection in the
"clipped-in" position, which wing is held in an articulated manner (i.e. load-free) on the
manipulation apparatus. On the other hand, the combination with a resilient wing is also useful
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which in its initial position is deflected radially to the inside, i.e. it is "clipped out". The clip
element is then simultaneously "clipped in" and secured in the holding position only by insertion
of the securing element. When the securing element is removed again, the clip element is
simultaneously "clipped out" of the holding position and the medical element can be detached
from the implant without any resistance.
As compared with the known methods, it is not necessary to manipulate in the environment but
only above the medical element when receiving the medical element according to the method in
accordance with the invention by means of the manipulation apparatus. Manipulation of the
medical element is thus made significantly more easy, especially in environments of restricted
space. Even when implanting directly adjacent to a tooth or an adjacent implant, the insertion or
removal of a medical element does not pose any major problem.
Based on the known manipulation apparatuses it is thus proposed that a securing element can be
introduced into the clip element in the longitudinal direction in such a way that the clip element
is spread out and/or blocked perpendicular to the longitudinal direction. In combination with a
respective medical element, such a manipulation apparatus in accordance with the invention
allows carrying out the method in accordance with the invention.
A manipulation apparatus in accordance with the invention especially preferably comprises a clip
element which is arranged on the receiving element and which comprises at least one wing
movable transversally to the longitudinal direction which can be brought into engagement in a
non-positive manner with an inner jacket surface of the receiving recess. Clip elements, which
are elements that clip into a fitting receiving recess upon insertion and offer a defined resistance
to releasing the connection, represent a possibility of connecting a manipulation apparatus with
the medical element which can be manipulated in an especially simple way.
Preferably, the movable wing of the clip element is resiliency connected with the receiving
element of the manipulation apparatus in accordance with the invention. The movable wing has a
defined position in the non-tensioned initial position and can be brought to the tensioned state by
exerting a similarly defined force. The initial position can especially be the position in which the
wing deflects radially to the outside, i.e. it is clipped in. The wing itself then assumes the
function of a securing element.
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The securing element can be inserted in an advantageous manner in the longitudinal direction
into the clip element in a manipulation apparatus in accordance with the invention in such a way
that the clip element is widened perpendicular to the longitudinal direction. On the one hand,
such a pin-like securing element can fix a wing of a clipped connection in the "clipped-in"
position, which wing is held in an articulated manner (i.e. load-free) on the manipulation
apparatus. On the other hand, the combination with a resilient wing is also useful which in its
initial position is deflected radially to the inside, i.e. it is "clipped out". The clip element is then
simultaneously "clipped in" and secured in the holding position only by insertion of the securing
element. When the securing element is removed again, the clip element is simultaneously
"clipped out" of the holding position and the medical element can be detached from the implant
without any resistance.
It has further been proven as being advantageous when the receiving element of a manipulation
apparatus in accordance with the invention comprises a projection in an outer jacket surface
which faces outwardly perpendicularly to the longitudinal direction and which can be brought
into engagement with a respective recess in the inner jacket surface of the receiving recess.
A manipulation apparatus in accordance with the invention which is arranged in this way is
connected in an especially secure manner in the longitudinal direction by the interlocking
connection with the receiving recess of the medical element. Alternatively, the use of rough
surfaces in the corresponding jacket surfaces is useful, so that the manipulation apparatus and the
medical element are securely connected in the longitudinal direction by a defined friction-type
connection.
Said projection can especially be formed by an elastic securing which is incorporated in the outer
jacket surface. Securing rings made of an elastomer material which can also be biocompatible
are available on the market in a large variety and at a low price. The manipulation apparatus in
accordance with the invention can thus be produced in a very simple and cost-effective manner.
Based on the known medical elements it is proposed in accordance with the invention to provide
a receiving recess, into which a receiving element of the manipulation apparatus can be
introduced in a longitudinal direction of the receiving recess and in which the receiving element
can be secured by means of a securing ring against displacement in the longitudinal direction.
The medical element in accordance with the invention allows executing the method in
accordance with the invention in combination with a respective manipulation apparatus.
5
A medical element in accordance with the invention preferably comprises a recess which faces
outwardly perpendicularly to the longitudinal direction in an inner jacket surface of the receiving
recess, which recess can be brought into engagement with a respective projection in an outer
jacket surface of the receiving element. Such a medical element in accordance with the invention
can be inserted together with the manipulation apparatus in accordance with the invention as
described above with a respective projection in the outer jacket surface.
Based on the known implants, it is proposed in accordance with the invention that the implant is
pre-mounted with a medical element, which is a healing cap, with a torque being introducible in
the longitudinal direction for screwing in the implant in the receiving recess of the medical
element by means of a manipulation apparatus introduced in an interlocking manner. An implant
which is thus pre-mounted can be implanted without any direct contact of the actual implant
body with a manipulation element and without any risk of damage or surface wear which is
usually accompanied with such contact. Moreover, the pre-mounted healing cap offers sufficient
guarantee for the unimpaired sterility even of the cavity in the implant body in which the final
medical element is to be received after the healing.
Embodiments
The invention is now explained in closer detail by reference to embodiments, wherein the figures
show in combination with a medical element in accordance with the invention:
Fig. 1 shows a first;
Fig. 2 shows a second, and
Fig. 3 shows a third manipulation apparatus in accordance with the invention.
The manipulation apparatus 1 in accordance with the invention as shown in Fig. 1 is an insertion
tool or "insertion post" for use with a rotatable tool holder (the so-called dentist's drill) which is
not shown, is usually driven pneumatically and by means of which a medical element 2, which is
a healing cap, can be received.
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The manipulation apparatus 1 is made of special steel and has a cylindrical oblong basic body 3
which starts out from a standardized connecting bracket (the so-called "elbow bracket") and
which after a slight bulging section 4 ends in a clearly narrower pin-like receiving element 5 as
compared with the basic body 3. The receiving element 5 has a circumferential groove 7 in its
jacket 6 with a securing element 8 incorporated therein, which is a retaining ring, and
perpendicular to the longitudinal direction 9 a non-rotation-symmetrical profile (not shown), so
that a torque can be transmitted in the longitudinal direction 9 via the receiving element 5.
The medical element 2 comprises a clip element 10 and a head area 11 which is enlarged in a
cap-like manner, is rounded off to the sides at the top and has a receiving recess 12 which is
adjusted to the shape of the receiving element 5 of the manipulation apparatus 1. The receiving
recess 12 comprises in its jacket 13 a circumferential, outwardly facing recess 14 which is
perpendicular to the longitudinal direction 9.
For implanting an implant 15 which is pre-mounted with the medical element 2 (only shown in
Fig. 3) into a receiving bore in a bone (not shown), the receiving element 5 of the manipulation
apparatus 1 is introduced into the receiving recess 12 of the medical element 2, where it is
secured against inadvertent releasing by latching of the securing element 8 in the recess 14 in the
jacket surface 13 of the receiving recess 12. The medical element 2 is connected with the implant
15 via the clip element 10 which is also suitable for transmitting a torque, so that the implant 15
can be screwed into the receiving bore through rotation of the manipulation apparatus 1. The
connection of the manipulation apparatus 1 with the medical element 2 is arranged in such a way
that the tensile forces which are transmitted here are considerably lower than those that can be
transmitted in the connection between the medical element 2 and the implant 15. The
manipulation apparatus 1 can be removed from the implant 15 by simple pulling, with the
medical element 2 remaining in the same.
The second manipulation apparatus 16 in accordance with the invention as shown in Fig. 2 is an
alternative insertion tool, by means of which the medical element 2, which is the healing cap
(known from Fig. 1), can be received. In contrast to the first manipulation apparatus 1 in
accordance with Fig. 1, the second manipulation apparatus 16 allows a manual implantation of
the implant 15 (not shown here) instead of the use of the dentist's drill. Instead of the machine
connection bracket, this manipulation apparatus 16 which is also made of special steel comprises
for this purpose a clearly enlarged, knurled head 17.
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The third manipulation apparatus 18 in accordance with the invention as shown in Fig. 3 is a
positioning and withdrawal tool for the medical element 2 or for a gingival former (not shown) in
the further course of the implantation. The manipulation apparatus 18 comprises a substantially
tubular basic body 19 with an enlarged handle end 20 for manual handling, a securing element
21 which is introduced into the basic body 19 and a receiving element 22 which is arranged
relative to the handle end 20 as a clip element.
In the region of the receiving element 22, the outer jacket surface 23 of the manipulation
apparatus 18 comprises attached projections 24 perpendicular to the longitudinal direction 9
which face outwardly. The receiving element 22 comprises four tongues 26 which are formed by
four incisions 25 in the longitudinal direction 9, of which there may be at least one and up to
eight thereof, and preferably four to six, and which tongues are connected with the basic body 19
in an elastic resilient manner. Basic body 19 and the securing element 21 of the manipulation
apparatus 18 are made of metal or a biocompatible plastic by means of injection molding. The
securing element 21 comprises a circumferential groove 29 in the jacket surface 27 of the first
cylindrical section 28, in which a silicone ring 30 is inserted as an anti-slip means.
For removing the medical element 2 from the implant 15 which has healed into the jawbone (not
shown), the receiving element 22 of the third manipulation apparatus 18 is introduced into the
receiving recess 12 of the medical element 2 and the clip element is spread out by the
introduction of the securing element 21. The connection of the manipulation apparatus 18 with
the medical element 2 is arranged in such a way that the tensile forces which are transmitted here
clearly exceed the ones which can be transmitted in the connection between the medical element
2 and the implant 15. The medical element 2 can be removed simply from the implant 15 by
pulling the manipulation apparatus 18.
In a further embodiment with a fourth manipulation apparatus which is not shown separately but
corresponds substantially to Fig. 3, its receiving element is introduced into the receiving recess
12 of the medical element 2 in which the pretensioned clip element is spread out automatically
and thus will "clip in". The connection of the fourth manipulation apparatus with the medical
element 2 is arranged in such a way that the tensile forces that are transmitted here fall below
those which can be transmitted in the connection between the medical element 2 and the implant
15.
8
After the insertion of the implant 15 which is pre-mounted with the medical element 2, the fourth
manipulation apparatus can be removed without any further manipulation from the medical
element 2, with the same remaining securely in the implant as a result of the higher holding
forces. For removing the medical element 2, the fourth manipulation apparatus is again
introduced into the receiving recess 12 of the medical element 2, where it will automatically
spread out again. By introducing the securing element 21 into the clip element, the clip element
is now blocked in such a way that the tensile forces which are transmitted here will clearly
exceed those which can be transmitted in the connection between the medical element 2 and the
implant 15. The medical element 2 can be removed again by simply pulling with the fourth
manipulation apparatus.
The Figs, show as follows:
1 Manipulation apparatus
2 Medical element
3 Basic body
4 Enlargement
5 Receiving element
6 Jacket surface
7 Groove
8 Clip element
9 Longitudinal direction
10 Clip element
11 Head area
12 Receiving recess
13 Jacket surface
14 Recess
15 Implant
16 Manipulation apparatus
17 Head
18 Manipulation apparatus
19 Basic body
20 Handle end
21 Securing element
22 Receiving element
23 Jacket surface
24 Projection
25 Incision
26 Tongue
27 Jacket surface
28 Cylindrical section
29 Groove
30 Silicone ring
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CLAIMS:
1. A method for receiving a medical element (2) in a manipulation apparatus (1, 16, 18),
with the medical element (2) being received by means of a receiving element (5, 22) in
such a way that it can be inserted in an implant (15) by means of a manipulation
apparatus (1, 16, 18) having the receiving element (5, 22) or can be removed from the
implant, with the receiving element (5, 22) being introduced into the receiving recess (12)
in a longitudinal direction (9) of a receiving recess (12) of the medical element (2) and
being secured in the receiving recess (12) by means of a clip element against
displacement in the longitudinal direction (9), characterized in that a securing element
(21) is introduced in the longitudinal direction (9) into the clip element in such a way that
the clip element is spread open and/or blocked perpendicular to the longitudinal direction
(9).
2. A manipulation apparatus (1, 16, 18) for a medical element (2), comprising a receiving
element (5, 22) by means of which the medical element (2) can be received for insertion
into an implant (15) or for removal from the implant (15), with the receiving element (5,
22) being introducible into a receiving recess (12) of the medical element (2) in a
longitudinal direction (9) of the receiving recess (12) and being securable by means of a
clip element against displacement in the longitudinal direction (9), characterized in that
securing element (21) can be introduced in the longitudinal direction (9) into the clip
element in such a way that the clip element is spread open and/or blocked perpendicular
to the longitudinal direction (9).
3. A manipulation apparatus (18) according to the preceding claim, characterized by a clip
element arranged on the receiving element (22), comprising at least one wing which is
movable transversally to the longitudinal direction (9) and which can be brought into
engagement in a non-positive manner with an inner jacket surface (13) of the receiving
recess (12).
4. A manipulation apparatus (18) according to the preceding claim, characterized in that the
wing is connected in a resilient manner with the receiving element (22).
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5. A manipulation apparatus (1, 16, 18) according to one of the claims 2 to 4, characterized
in that the receiving element (5, 22) comprises in an outer jacket surface (6) a projection
(24) which faces outwardly perpendicular to the longitudinal direction (9) and which can
be brought into engagement with a respective recess (14) in the inner jacket surface (13)
of the receiving recess (12).
6. A manipulation apparatus (1, 16) according to the preceding claim, characterized in that
the projection (24) is formed by an elastic securing ring incorporated in the outer jacket
surface (6).
7. An implant (15) which can be implanted in a bone by screwing into a receiving bore,
characterized in that the implant (15) is pre-mounted with a medical element (2), which is
a healing cap, with a torque being introducible for screwing in the implant (15) in a
receiving recess (12) of the medical element (2) in accordance with one of the claims 2 to
6 by means of a manipulation apparatus (1, 16, 18) introduced in an interlocking manner.
A method is disclosed for receiving a medical element (2) in a manipulation apparatus (18), with
the medical element (2) being received by means of a receiving element (22) in such a way that it
can be inserted in an implant (15), or be removed therefrom, by means of a manipulation
apparatus (18) having the receiving element (22), with the receiving element (22) being
introduced into the receiving recess in a longitudinal direction (9) of a receiving recess of the
medical element (2) and being secured in the receiving recess by means of a clip element against
displacement in the longitudinal direction (9), and further a manipulation apparatus (18) for a
medical element (2), comprising a receiving element (22) by means of which the medical
element (2) can be received for insertion into an implant (15) or for removal from the implant
(15), with the receiving element (22) being introducible into a receiving recess of the medical
element (2) in a longitudinal direction (9) of the receiving recess and being securable by means
of a clip element against displacement in the longitudinal direction (9), and finally an implant (15)
which can be implanted in a bone by being screwed into a receiving bore.
It is proposed that within the framework of the method a securing element (21) is introduced in
the longitudinal direction (9) into the clip element in such a way that the clip element is spread
open and/or blocked perpendicular to the longitudinal direction (9), that further the securing
element (21) in the manipulation apparatus (18) can be inserted in the longitudinal direction (9)
into the clip element in such a way that the clip element is spread out and/or blocked
perpendicular to the longitudinal direction (9), and finally an implant (15) which is pre-mounted
with a medical element (2), which is a healing cap, with a torque being introducible in the
longitudinal direction (9) for screwing in the implant (15) in the receiving recess of the medical
element (2) by means of a proposed manipulation apparatus (18) introduced in an interlocking
manner.
