Paired templates for placing dental implants and enhancing registration for denture prosthetics attached to the implants

Abstract

A denture is registered and secured to implants with the help of paired surgical-prosthetic implants fabricated based on 3D imaging of the patient's mouth and the denture. The surgical template has guide holes that are located and oriented to guide dental instrumentation forming accurately located and oriented osteotomies for the implants. The prosthetic template conforms to the denture and has guide holes that are located and oriented such that connection holes in the denture can be formed through the guide holes in the paired prosthetic template. The connection holes clear the replacement teeth of the denture and line up with the implants. Attachment elements can be inserted through the connection holes in the denture to secure the denture to the implants.

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         11 . A method of making a tangible surgical template that facilitates dental implant placement in a patient's jawbone and a tangible prosthetic template that is paired to but is physically separate from the tangible surgical template and a tangible denture, which tangible prosthetic template facilitates forming connection holes in the tangible denture and fastening the tangible denture to the implants, said method comprising:
 providing a tangible denture configured for a completely or partially edentulous patient;   imaging the patient's mouth and jawbone and the tangible denture with a three-dimensional (3D) imaging modality configured to generate a 3D image of the patient's mouth and of the tangible denture;   processing the 3D image with a computer configured to generate:
 a. a 3D virtual model of implant placement in the patient conforming to selected rules regarding bone dimensions and implant location for supporting the tangible denture; 
 b. a 3D virtual model of a paired surgical template that conforms in shape to the patient's jawbone and has guide holes for guiding the placement of the implants in the jawbone; 
 c. a 3D virtual model of a paired prosthetic template with guide holes conforming to the implant placements and to the tangible denture; and 
 d. a 3D virtual model of the tangible denture, with connection holes through the virtual denture that conform both to the implant placement and to selected rules regarding clearance from elements of the tangible denture; and 
   using the 3D virtual models to fabricate the tangible paired surgical template for implant placement and the physically separate prosthetic template for forming the connection holes in the tangible denture and attaching the tangible denture to the implants.   
     
     
         12 . The method of  claim 11  in which the processing comprises using a computer platform programmed with computer-aided design software to generate the virtual models. 
     
     
         13 . The method of  claim 12  in which the step of using a computer platform comprises interactively adjusting one or more of the virtual models through inputs via an interface with the platform. 
     
     
         14 . The method of  claim 11  in which the processing comprises generating the virtual model of the tangible denture with connection holes that are larger than implant abutment cylinders for connecting the denture to the implants to thereby leave space between the connection holes in the tangible denture and the cylinders allowing fine adjustments of the fit between the tangible denture and the cylinders. 
     
     
         15 . A computer program stored in non-transitory form in a computer-readable medium, said program comprising computer language instructions that when executed by a programmed computer carry out the steps of:
 receiving a three-dimensional (3D) image of a patient's mouth, including a jawbone, taken with a 3D imaging modality and a virtual 3D model of a tangible denture for the patient's mouth;   processing the 3D images with a computer configured to generate:
 a. a 3D virtual model of implant placement in the patient conforming to selected rules regarding bone dimensions and implant location for supporting the tangible denture; 
 b. a 3D virtual model of a tangible paired surgical template that conforms to the patient's mouth and jawbone and has guide holes for guiding the placement of the implants in the jawbone; 
 c. a 3D virtual model of a tangible paired prosthetic template that is physically separate from the tangible surgical template and has guide holes conforming to the implant placements and to the tangible denture; and 
 d. a 3D virtual model of the tangible denture, with connection holes through the tangible denture that conform both to the implant placement and to selected rules regarding clearance from elements of the tangible denture. 
   
     
     
         16 . The computer program of  claim 15  further comprising instructions that when carried out by program-controlled computer equipment carry out the step of fabricating tangible paired templates conforming to the virtual model. 
     
     
         17 . The computer program of  claim 15  further comprising instructions that when carried out by program-controlled computer equipment carry out the step of fabricating a tangible denture conforming to the virtual model. 
     
     
         18 . A set of paired templates and a denture comprising:
 a surgical template comprising guide holes for locating and orienting dental instrumentation in creating osteotomies in a patient's jawbone for implants having selected locations and orientations when placed in the jawbone;   a denture with replacement teeth; and   a prosthetic template paired with but physically separate from the surgical template and the denture and having guide holes for locating and orienting dental instrumentation in creating connection holes in the denture that conform in location and orientation to the implants and clearing the denture's replacement teeth;   wherein the connection holes in the denture line up axially with the guide holes in each of the templates and with the implants; and   the guide holes in the prosthetic template are configured for passage through them of attachment elements for connecting the denture to the implants when the implants are in place in the patient's mouth and jawbone, the denture is in place over the implants and the paired prosthetic template is over the denture; and   the configuration of the denture and its connection holes line up axially with the implant osteotomies such that the implants can be placed into the osteotomies through the connection holes created by the prosthetic template.   
     
     
         19 . The set of  claim 17  in which the connection holes in the denture are larger than the attachment elements to leave free space for fine adjustment of the denture relative to the implants. 
     
     
         20 . The set of  claim 17  in which the guide holes in the paired prosthetic template are lined with inserts of a material protecting the prosthetic template from damage due to rotation of dental instrumentation therein. 
     
     
         21 . The set of  claim 17  including implant abutment cylinders configured to loosely fit in the connection holes of the denture to thereby leave space around the cylinders allowing for fine adjustment of the denture relative to the implants, which space can be filled with curable resin to secure the denture in place following the fine adjustment.