| CLAIMS 1. An odontologic device (1) for use in sinus-lift, comprising: a main body or assembly (2), in its turn having an internal compartment (30) apt to receive a liquid agent for the lifting of the sinus membrane and an operating element (4) apt to allow a controlled outlet of said liquid agent from said compartment (30); and a substantially tubular dispensing terminal (100), connected or removably connectable to said main body or assembly (2) so as to be in communication with said internal compartment (30), which dispensing terminal (100) has a first inlet cross section (101 ), through which it receives the liquid agent coming from said internal compartment (30), and a second outlet cross section (102), at which the liquid agent is dispensed into a recess between jaw bone and sinus membrane, wherein said cross sections (101, 102) develop onto non-parallel planes. 2. The odontologic device (1) according to claim 1 , comprising a plurality of dispensing terminals (100, 200, 300), each of which: - is removably connectible to said main body or assembly (2) so as to be in communication with said internal compartment (30), - is substantially tubular, - has a first inlet cross section (101 , 201 , 301 ), through which it receives the liquid agent coming from said internal compartment (30), and a second outlet cross section (102, 202, 302), at which the liquid agent is dispensed into a recess between jaw bone and sinus membrane, wherein said cross sections develop on non-parallel planes, which outlet sections (102, 202, 302) have different diameters. 3. The odontologic device (1) according to the preceding claims, comprising three dispensing terminals (100, 200, 300). 4. The odontologic device (1) according to the preceding claim, wherein the respective outlet sections (102, 202, 302) of said dispensing terminals (100, 200, 300) are substantially circular and have a diameter equal respectively to 2 mm, 3 mm and 4 mm. 5. The odontologic device (1 ) according to any one of the preceding claims, wherein said main body or assembly (2) is substantially syringe-shaped, in turn comprising a hollow element (3) defining said internal compartment (30) and inside which it is slidably movable a plunger (4) that can be operated by a user. 6. The odontologic device (1 ) according to the preceding claim, wherein said hollow element (3) has, at an inlet section of said plunger (4), gripping means (31). 7. The odontologic device (1) according to the preceding claim, wherein said gripping means comprises one or more projecting tabs (31). 8. The odontologic device (1) according to any one of the claims 5 to 7, wherein said plunger (4) has, at its own end portion into contact with the liquid, sealing means (40). 9. The odontologic device (1) according to the preceding claim, wherein said sealing means comprises a skirt element (40). 10.The odontologic device (1) according to claim 8 or 9, wherein said sealing means comprises a rubber tip (40). 11. The odontologic device (1) according to any one of the preceding claims, wherein said or each dispensing terminal (100) has a longitudinal development with a cross section decreasing toward the outside of said compartment (30). 12.The odontologic device (1) according to the preceding claim, wherein said or each dispensing terminal (100) has a substantially conical longitudinal taper. 13. The odontologic device (1) according to any one of the preceding claims, wherein said or each dispensing terminal (100) has a longitudinal development at least partially substantially arcuate. 14. The odontologic device (1) according to any one of the preceding claims, which is of disposable type. 15.A sinus-lift method, providing the use of a device according to any one of the preceding claims. |
DESCRIPTION Field of the Invention
The present invention refers to an odontologic device for use in sinus-lift interventions and a corresponding implantology technique.
Background of the Invention In the dental implantology field there is often the need to insert prosthetic implants at edentulous zones in the molar and premolar area of the upper arch. However, in said area, which is proximal to the skeletal cavities denominated maxillary sinuses, a bone availability such as to allow a reliable anchoring of the prosthetic implant is often absent. To increase bone amount available in the molar area of the upper arch, in preparation to the insertion of one or more dental implants, a technique known as sinus-lift is commonly adopted, which provides the grafting of autologous, heterologous or mixed prosthetic bone material into a recess obtained between the maxillary sinus and the membrane - or mucosa - covering it, substantially so as to supplement the tissue of the upper jaw bone.
To obtain space needed for insertion of said reinforcing bone material, it is necessary to elevate (i.e., "lift") the sinus membrane. To this end, the known art envisages the making of a so-cailed bone window, generally rectangular, in the vestibular (i.e., "external") wall of the upper jaw bone in the molar and/or premolar region, at the edentulous zone where prosthetic implants are to be inserted. Such a "window" is made, upon detachment of soft tissues after crestal incision, with use of rotary instruments such as rose-head burrs or, more recently, by piezoelectric surgery.
The above-mentioned window is required above all in order to gain access to the sinus membrane, so as to detach it from the bottom and side bone walls of the sinus itself and then insert the above-mentioned supplementing material, which has to act as guide for the formation of new bone for supporting the actual dental implant.
Such a membrane-detaching step is carried out manually; likewise, the membrane itself is lifted manually, to then proceed with the insertion of biomaterial apt to support it in an elevated position, with a "tent effect". In the same surgical time, should residual bone thickness allow sufficient retention (typically in the presence of 4-5 mm of residual bone), there are carried out the inserting of the dental implant or implants, generally of Titanium, then the filling of the bone breach with a biomaterial, its covering with a collagen membrane or other optionally reabsorbable material, and lastly the closing of the surgical wound. In case residual bone amount be not sufficient to guarantee dental implant stability, only the filling of the recess with biomaterial is carried out and implant inserting is postponed/deferred of about 6-9 months.
However, the surgical technique described hereto for sinus-lift is rather invasive, above all due to the need to make the above-mentioned bone window. Moreover, such a need entails significant surgical risks for the operator (in particular, dissection of vases such as the alveoloantral artery, rupture of sinus membrane, or infections) and is often a cause of suffering for the patient. In connection with this latter aspect, tumefaction and hematomas are almost the rule.
Summary of the Invention
Therefore, the technical problem set and solved by the present invention is that of providing an odontologic device for sinus-lift interventions allowing to overcome the drawbacks mentioned above with reference to the known art.
Such a problem is solved by an odontologic device according to claim 1.
Preferred features of the present invention are set forth in the dependent claims thereof.
The main advantage of the invention lies in the fact that it allows to eliminate the need to make the bone window on the vestibular wall described with reference to the known art. In particular, the device allows to proceed via the so-called crestal path only, like for the inserting of a standard dental implant in a zone where an adequate bone structure height is present.
Hence, the intervention proves much less traumatic for the patient, who in most cases resumes his/her normal everyday life without complaining of any inconvenience.
Moreover, the risk of rupture of the sinus membrane is drastically reduced with respect to the traditional intervention, since pressure exerted by the fluid dispensed is certainly less aggressive than the manual metallic surgical detachers utilized to perform the same function in traditional interventions. In addition, the device of the invention is mechanically simple and extremely handy for the operator.
Brief Description of the Figures Other advantages, features and operation steps of the present invention will be made evident in the following detailed description of some embodiments thereof, given by way of example and not for limitative purposes. Reference will be made to the figures of the annexed drawings, wherein:
Figure 1 shows a front view of the preferred embodiment of the odontologic device of the invention, depicting a main body or assembly thereof;
Figures 2A, 2B and 2C show each a front view of a respective dispensing terminal of the device of Figure 1 ; and
Figure 3 shows a schematic perspective view of a main step of a sinus-lift intervention carried out with the device of Figure 1.
Detailed description of preferred embodiments
Referring initially to Figures 1 and 2A-2C, an odontologic device for use in sinus-lift interventions according to a preferred embodiment of the invention is generally denoted by 1. The device 1 comprises first of all a main body or assembly 2, shown in Figure 1 , which in the present example is substantially syringe-shaped. In particular, the main body or assembly 2 comprises a hollow cylindrical element 3, open topwise and bottomwise, defining an internal compartment 30, it also substantially cylindrical and inside which a plunger 4 is slidably movable. The internal compartment 30 is apt to receive a liquid agent that, as will be illustrated in greater detail hereinafter, is apt to be dispensed for the lifting of the sinus membrane by a user's operation of the plunger 4. Such an operation is apt to allow a controlled outlet of said liquid from the compartment 30. Preferably, the capacity of the compartment 30 ranges from 10 to 20 ml or beyond, according to the specific intervention needs.
The hollow cylindrical element 3 has, at an inlet section of the plunger 4 defined by its own top opening, gripping means that in the present example consists in a pair of projecting transversal tabs 31. To facilitate insertion of a finger therebelow, each tab 31 is tilted downward at least in correspondence of its end section. In a position longitudinally opposite to that of the tab 31 , the hollow element 3 comprises an outlet portion 32 for outletting the liquid agent. Such an outlet portion 32 has a substantially conical taper that ends, in correspondence of its smaller section, with the bottom opening of the hollow element 3. When the device 1 is not in use, a closure cap 5 may be provided for the terminal end of such tapered portion 32.
The plunger 4 has, at its own end portion into contact with the liquid, sealing means 40. In the present example, such sealing means is implemented by a skirt element, and more specifically a so-called rubber tip. Moreover, the main body or assembly 2 is associated to one or more dispensing terminals. In the present example, three interchangeable terminals are provided - one of them shown in each of Figures 2A-2C - removably connectible to the body or assembly 2 at the bottom opening of the latter, so as to be in communication with the internal compartment 30. Referring initially to Figure 2A, a first dispensing terminal, denoted by 100, has a substantially tubular structure, it being internally hollow. The terminal 100 has a first circular or substantially circular inlet cross section 101 , through which it receives the liquid agent coming from the internal compartment 30 of the body 3, and a second circular or substantially circular outlet cross section 102, at which the liquid agent is dispensed into a recess between jaw bone and membrane of the corresponding sinus, as will be detailed hereinafter.
The terminal 100 has a longitudinal development with a cross section decreasing from the first section 101 to the second section 102.
Such first and second cross sections 101 and 102 develop on non-parallel planes by virtue of the fact that the terminal itself has a substantially arcuate development, in particular at a portion thereof distal with respect to the first section 101.
Essentially, the terminal 100 has a substantially beak-shaped structure.
The second and third terminals, respectively shown in Figures 2B and 2C and denoted by 200 and 300, have the same structure of the first terminal 100 and therefore will not be further described.
The difference among the three terminals lies in the diameter of the outlet section, diameter respectively denoted by 103, 203 and 303, which is increasing from the first to the third one and, in a preferred embodiment, is equal respectively to 2 mm, 3 mm and 4 mm. In alternative embodiments, such diameters may be changed to adapt them to the various lines of burrs for dental implants. Preferably, the entire device 1 or at least the terminal or terminals thereof are of disposable type. Alternatively, some or all of such components may be made of a (re-)sterilizable metal alloy.
The operation steps of the above-described device 1 in a sinus-lift intervention are illustrated hereinafter.
First of all, preferably the device 1 employs sterile saline as a liquid agent.
After soft tissue cutting and detachment, limited to the sole crestal zone, a bore is made on the bone crest, in the zone in which the dental implant is to be inserted, by an implant burr with a 2-mm diameter (or a different one, depending on the line of implants used), until reaching the bone cortex delimiting the floor of the sinus recess.
Subsequently, the same burr is gently advanced until piercing the above-mentioned cortex, taking care not to damage the sinus membrane, i.e. rapidly retracting the burr as soon as a yielding in the resistance is detected.
Then, the device 1 is used, filled with sterile saline and with the 2-mm terminal 100. In particular, as shown in Figure 3, the tip of the terminal 100 (i.e., the outlet section 102) is placed on the bone bore and, attempting to create a seal by a slight pressure, a gentle pressing of the plunger 4 is begun. Thus, according to Pascal's principle (pressure exerted on a point of a fluid mass is transmitted on any other point thereof and in all directions with the same intensity on alike surfaces), saline contained in the internal compartment 30, atraumatically induces the lifting of the maxillary sinus membrane.
Then, upon depthometer measurement for detecting the degree of elevation achieved (at this stage usually of 4-5 mm), the bore is widened with a burr having a larger diameter (3 mm), and then again by use of the device 1 with a 3-mm terminal 200 (or a different one, depending on the implant line used) a further lifting of the membrane is carried out.
Subsequently, the sequence is repeated with the larger-diameter burr and the corresponding 4-mm 0 terminal (or a different one, coherently with what has been mentioned above for the other two terminals 100 and 200, in connection to the diameter of the implant that is to be positioned).
Finally, through the bore biomaterial is inserted, and then the Titanium dental implant, should the amount of residual bone allow it. Otherwise, the implant will be inserted in a subsequent surgical time, i.e. after about 6-9 months (time needed for the biomaterial-filled recess to be colonized by the patient's new bone).
By now, it will be better appreciated that the invention makes the intervention extremely simple for the operator, who, by working in the bone crest region only, eliminates the risk of causing the vascular damages described with reference to the known art. On the other hand, in the unfortunate instance of a perforation occurring in the membrane of the maxillary sinus, in the case of the invention it suffices to reclose the surgical wound of the mucosa in order to be able to re-intervene after about 30 days, once healing has occurred.
The present invention has been hereto described with reference to preferred embodiments thereof. It is understood that other embodiments might exist, all falling within the concept of the same invention, as defined by the protective scope of the claims hereinafter.