FIELD OF THE INVENTION

The present invention relates to dental implant systems, more particularly to abutments for such systems. The present invention further relates to methods for positioning dental abutments. In one aspect, the present invention relates to a dental abutment comprising a rotatable member comprising a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises one or more voids for receiving dental adhesives, the one or more voids being in fluid connection with the distal end of the through channel, and the remainder of the through channel being separated from the one or more voids by a barrier.

BACKGROUND

Dental prostheses are used to restore intraoral defects such as missing teeth or teeth parts. When used for replacing a missing tooth or teeth, dental prostheses typically comprise a dental implant, an abutment, and a crown, denture or bridge. The dental implant serves as a substitute for the tooth root and is placed in the jawbone as to form the foundation for replacement teeth. Dental implants are typically shaped as a cylindrical or tapered post. The crown is a replacement tooth which can be custom made to match natural teeth. The crown/prosthesis is typically attached to the dental implant via an abutment, which acts as a connector between the dental implant and the crown/prosthesis. The abutment is typically attached to the implant by means of an internal connection, or alternatively, by means of an external connection.

Dental implants are typically positioned into the alveolar bone of the patient. Depending on factors such as the patient ^' s bone architecture, neighbouring dental implants and/or implants of the same jaw are often inserted in a non-parallel manner. In such cases, angulated abutments are required for compensating the angled position of the dental implant.

Angulated abutments can be custom made, for example via true milling or 3D printing. However, the preparation of custom abutments is labour-intensive and expensive, and can cause long waiting times for the patient. These problems can be mitigated by using standard angulated abutments. A standard angulated abutment typically allows for correcting a specific angle only. Accordingly, a large stock of different angulated abutments is required in order to be able to select the optimal angle. This can be particularly problematic when multiple dental implants are positioned into the same jaw bone, wherein the longitudinal axes of the abutments are preferably parallel to each other. Indeed, it is nearly impossible to accurately determine the required angle with the naked eye, such that the standard abutments often need to be selected via trial-and-error.

In order to mitigate the above problems, a number of universal angulated abutments have been developed. Universal angulated abutments allow for adjusting the orientation of the abutment within a certain range of angles. US patent 5,564,922 describes a dental abutment assembly comprising a ball-and-socket joint. The orientation of the abutment is fixed via matching positive and negative dimples on the ball and socket of the joint, or via a screw. However, this does not always result in a reliable fixation.

Accordingly, there is a need for abutments which mitigate at least one of the above problems.

SUMMARY OF THE INVENTION

Described herein are, amongst others, dental implant systems and dental abutments which allow for an orientation in a wide range of angles, and which can be reliably fixed in a particular orientation. More particularly, the dental abutments described herein comprise a fixing member, wherein the position of the fixing member can be fixed into a socket by using dental adhesives. In order to achieve this, the dental abutments comprise a rotatable member comprising the fixing member, the rotatable member is provided with a channel along its entire length, and the fixing member comprises one or more voids, the one or more voids being in fluid connection with the through channel. In a first aspect, the present invention provides a rotatable member for use in universal angulated abutments comprising a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises one or more voids for receiving dental adhesives, the one or more voids being in fluid connection with the distal end of the through channel, and the remainder of the through channel being separated from the one or more voids by a barrier. In a 2 ^nd aspect, the present invention provides the rotatable member according to aspect

1 wherein the fixing member comprises a support member, the support member being circumferentially attached to the distal end of the rotatable member, the rotatable member further comprising a closing member, the closing member being circumferentially attached to the proximal shaft portion, and the rotatable member further comprising a void between the support member and the closing member.

In a 3 ^rd aspect, the present invention provides the rotatable member according to aspect

2 wherein the closing member has a proximal side and a distal side, the distal side facing the void between the closing member and the support member, wherein the closing member comprises one or more channels in fluid connection with said void, the one or more channels further being in fluid connection with the proximal side of the closing member.

In a 4 ^th aspect, the present invention provides the rotatable member according to aspect 1 wherein the fixing member is a rounded portion and wherein the one or more voids are recesses provided in the outer surface of the rounded portion, the recesses being in fluid connection with the distal end of the through channel.

In a 5 ^th aspect, the present invention provides the rotatable member according to aspect

4 wherein the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel.

In a 6 ^th aspect, the present invention provides the rotatable member according to aspect 5, wherein the plurality of grooves taper towards the proximal shaft portion.

In a 7 ^th aspect, the present invention provides the rotatable member according to aspect

5 or 6, wherein the plurality of grooves is distributed radially around the distal end of the through channel.

In an 8 ^th aspect, the present invention provides the rotatable member according to any one of aspects 5 to 7, wherein the outer surface of the rounded portion is provided with

- a first plurality of grooves in fluid connection with the distal end of the through channel;

- a second plurality of grooves running towards the interface between the shaft portion and the rounded portion; and

- an intermediate recess positioned between the first plurality of grooves and the second plurality of grooves, wherein the first plurality of grooves and the second plurality of grooves are in fluid connection with each other through the intermediate recess. In a 9 aspect, the present invention provides the rotatable member according to aspect 8, wherein the intermediate recess has a textured surface.

In a 10 ^th aspect, the present invention provides a universal angulated abutment comprising

- a rotatable member according to any one of aspects 1 to 1 1 ; and,

- an intermediate coupling device comprising a proximal end and a distal end, wherein the proximal end is configured for rotatably receiving the fixing member.

In an 1 1 ^th aspect, the present invention provides a universal angulated abutment according to aspect 10 further comprising an annular member configured for rotatably attaching the rotatable member to the intermediate coupling device; wherein the annular member and the intermediate coupling device comprise matching attachment means; and wherein the annular member and the intermediate coupling device are configured for forming a socket for rotatably receiving the fixing member of the rotatable member, the socket being in fluid connection with the channel of the rotatable member.

In a 12 ^th aspect, the present invention provides the universal angulated abutment according to aspect 1 1 wherein

- the rotatable member is a rotatable member according to any one of aspects 2 to 3; and,

- the socket comprises a plurality of abutment positioning aids.

In a 13 ^th aspect, the present invention provides the universal angulated abutment according to aspect 12 wherein the plurality of abutment positioning aids are selected from the list comprising: protrusions of the intermediate coupling device, protrusions of the annular member, metal strips attached to the annular member, metal strips attached to the intermediate coupling device, and combinations thereof.

In a 14 ^th aspect, the present invention provides the universal angulated abutment according to aspect 1 1 wherein

- the rotatable member is a rotatable member according to any one of aspects 5 to 9; and,

- the socket formed by the intermediate coupling device and the annular member is a concave socket configured for rotatably engaging the distal rounded portion of the dental abutment to form a ball and socket joint, the concave socket preferably having a textured surface. In a 15 aspect, the present invention provides a method of fixating a rotatable member according to any one of aspects 1 to 9 with respect to an intermediate coupling device, the method comprising the steps:

(a) providing a universal angulated abutment according to any one of aspects 10 to 14;

(b) selecting a desired orientation for the rotatable member;

(c) providing dental adhesives to the socket and to one or more voids of the fixing member of the rotatable member, via the through channel; and

(d) curing the dental adhesive, thereby fixing the position of the rotatable member relative to the intermediate coupling device.

Additionally or alternatively, the 15 ^th aspect of the present invention provides a method of fixating a rotatable member according to any one of aspects 1 to 9 with respect to an intermediate coupling device, the method comprising the steps:

(a) providing a universal angulated abutment according to any one of aspects 10 to 14;

(b) selecting a desired orientation for the rotatable member;

(c) providing dental adhesives and/or dental filler to the socket and to one or more voids of the fixing member of the rotatable member, via the through channel; and

(d) curing the dental adhesive, thereby fixing the position of the rotatable member relative to the intermediate coupling device.

In a 16 ^th aspect, the present invention provides a rotatable member comprising a proximal shaft portion connected to a distal rounded portion, the shaft portion and the rounded portion being provided with a through channel having a proximal end and a distal end, wherein the rounded portion is configured as the socket of a ball-socket joint and wherein the inner surface of the rounded portion is provided with recesses in fluid connection with the distal end of the through channel.

In a 17 ^th aspect, the present invention provides the rotatable member according to aspect 16 wherein the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel. This may allow for coupling of rotatable members provided herein to intermediate coupling devices.

In an 18 ^th aspect, the present invention provides the rotatable member according to aspect 17 wherein the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel. In a 19 aspect, the present invention provides the rotatable member according to aspect 18 wherein the plurality of grooves is distributed radially around the distal end of the through channel.

In a 20 ^th aspect, the present invention provides the rotatable member according to aspect 19 wherein the inner surface of the rounded portion is provided with

- a plurality of grooves in fluid connection with the distal end of the through channel; and,

- an intermediate recess wherein the plurality of grooves is in fluid connection with each other through the intermediate recess.

In a 21 ^st aspect, the present invention provides the rotatable member according to aspect 20 wherein the intermediate recess has a textured surface.

In a 22 ^nd aspect, the present invention provides the rotatable member according to any one of aspects 18-21 wherein the grooves of the plurality of grooves have a depth of at least 0.050 mm to at most 2.0 mm, preferably of at least 0.40 mm to at most 0.80 mm. In a 23 ^rd aspect, the present invention provides a universal angulated abutment comprising:

- a rotatable member comprising a proximal shaft portion connected to a distal rounded portion, the shaft portion and the rounded portion being provided with a through channel having a proximal end and a distal end, wherein the rounded portion is configured as the socket of a ball-socket joint and in wherein the inner surface of the rounded portion is provided with recesses in fluid connection with the distal end of the through channel; and

- an intermediate coupling device, the intermediate coupling device comprising a proximal end and a distal end, wherein the proximal end is provided with a ball which fits with the socket of the rotatable member as to form a ball and socket joint.

In a 24 ^th aspect, the present invention provides the universal angulated abutment according to aspect 23 wherein the concave socket has a textured surface.

In a 25 ^th aspect, the present invention provides a method of fixating a rotatable member provided herein with respect to an intermediate coupling device, the method comprising the steps:

(a) providing a universal angulated abutment according to aspect 23;

(b) selecting a desired orientation for the rotatable member;

(c) providing dental adhesives to the socket and to one or more voids of the fixing member of the rotatable member, via the through channel; and (d) curing the dental adhesives, thereby fixing the position of the rotatable member relative to the intermediate coupling device.

In a 26 ^th aspect, the present invention comprises a kit for forming a universal angulated abutment, the kit comprising a rotatable member, an annular member, and an intermediate coupling device wherein the rotatable member, the annular member, and the intermediate coupling device are a rotatable member, an annular member, and an intermediate coupling device provided herein.

The above and other characteristics, features and advantages of the present invention will become apparent from the following detailed description, which illustrates, by way of example, the principles of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The following description of the figures of specific embodiments of the invention is merely exemplary in nature and is not intended to limit the present teachings, their application or uses. Throughout the drawings, corresponding reference numerals indicate like or corresponding parts and features.

Fig. 1 Side view of a particular embodiment of a rotatable member (1 ) as described herein, having a shaft portion (2) and a rounded portion (3).

Fig. 2 Perspective view of a rounded portion (3) and a part of the shaft portion (2) of a particular embodiment of the rotatable member (1 ) as described herein.

Fig. 3 Side view of a particular embodiment of the dental abutment (1 ) as described herein, wherein the rounded portion (3) of the dental abutment (1 ) is positioned in a socket (10) formed by an intermediate coupling device (14) and an annular member (9). Fig. 4 Close-up of annular member (9).

Fig. 5 Two views of a particular embodiment of an intermediate coupling device (14) as described herein, wherein the intermediate coupling device (14) comprises a ball configured for matching the socket of a rotatable member in a ball-socket joint.

Fig. 6 Assembled dental abutment (16) comprising an intermediate coupling device (14) and a rotatable member, wherein the rotatable member comprises a shaft portion (2) and a socket (10), and wherein the rotatable member is rotatably attached to the intermediate coupling device (14) by means of an annular member (9).

Fig. 7 Two views of a rotatable member (1 ). Fig. 8 Panel A: cross-sectional view of a universal angulated abutment (16) according to the present invention. The universal angulated abutment (16) comprises a rotatable member (1 ), an annular member (9), and an intermediate coupling device (14). Panels B and C show opposing views on the rotatable member (1 ).

Fig. 9 Assembly comprising a dental implant (8) and an intermediate coupling device (14) according to the State-of-the-Art. The dental implant (8) and the intermediate coupling device (14) are connected by means of an internal connection (24).

Fig. 10 Rotatable member (1 ) also shown in Fig. 1 , in which the remainder of the through channel (26) is indicated. The rotatable member (1 ) comprises a proximal end (25) and a distal end (24). The rotatable member also comprises a shaft portion (2) and a rounded portion (3). The rounded portion (3) serves as a fixing member. The rounded portion (3) comprises voids, i.e. grooves (5,6), and an intermediate recess (7). The voids are in fluid connection with the distal end (24) of the through channel (4). The voids are separated from the remainder (26) of the through channel by means of the walls (27) of the through channel (4). The walls (27) of the through channel thus serve as a barrier between the through channel on the one hand and the grooves (5,6) and intermediate recess (7) on the other hand. The walls of the through channel comprise the shaft portion (2) and the rounded portion (3).

Fig. 11 shows a cross-sectional view of a universal angulated abutment as in Fig. 8. One additional feature, namely a positioning rod (28), is shown. The positioning rod (28) allows selecting a position of the rotatable member (1 ) relative to the position of the intermediate coupling device (14) during abutment installation. The positioning rod (28) is reversibly fixed to the intermediate coupling device (14) by means of a screw connection in a fixation socket (29).

In the figures, the following numbering is used:

1 - rotatable member; 2 - shaft portion; 3 - rounded portion; 4 - channel; 5, 6 - grooves; 7 - intermediate recess; 8 - dental implant; 9 - annular member; 10 - socket; 12 - dental adhesive flow indicator; 13 - positioning aid; 14 - intermediate coupling device; 15 - closing member; 16 - abutment; 17 - fixing member; 18 - channel; 19 - screw thread; 20 - void; 21 - intermediate duct; 22 - perforation; 23 - support member; 24 - internal connection; 24 - distal end; 25 - proximal end; 26 - remainder of the through channel; 27 - walls of the through channel, 28 - positioning rod; 29 - fixation socket. DETAILED DESCRIPTION

The present invention will be described with respect to particular embodiments but the invention is not limited thereto but only by the claims. Any reference signs in the claims shall not be construed as limiting the scope thereof.

As used herein, the singular forms "a", "an", and "the" include both singular and plural referents unless the context clearly dictates otherwise.

The terms "comprising", "comprises" and "comprised of" as used herein are synonymous with "including", "includes" or "containing", "contains", and are inclusive or open-ended and do not exclude additional, non-recited members, elements or method steps. The terms "comprising", "comprises" and "comprised of" when referring to recited components, elements or method steps also include embodiments which "consist of" the recited components, elements or method steps.

Furthermore, the terms "first", "second", "third" and the "like" in the description and in the claims, are used for distinguishing between similar elements and not necessarily for describing a sequential or chronological order, unless specified. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other sequences than described or illustrated herein.

Reference throughout this specification to "one embodiment" or "an embodiment" means that a particular feature, structure or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases "in one embodiment" or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures or characteristics may be combined in any suitable manner, as would be apparent to a person skilled in the art from this disclosure, in one or more embodiments. Furthermore, while some embodiments described herein include some but not other features included in other embodiments, combinations of features of different embodiments are meant to be within the scope of the invention, and form different embodiments, as would be understood by those in the art. For example, in the appended claims, any of the features of the claimed embodiments can be used in any combination.

The values as used herein when referring to a measurable value such as a parameter, an amount, a temporal duration, and the like, is meant to encompass variations of +/-10% or less, preferably +/-5% or less, more preferably or less, and still more preferably +/-0.1 % or less of and from the specified value, insofar such variations are appropriate to perform in the disclosed invention. It is to be understood that each value as used herein is itself also specifically, and preferably, disclosed.

The recitation of numerical ranges by endpoints includes all numbers and fractions subsumed within the respective ranges, as well as the recited endpoints.

All documents cited in the present specification are hereby incorporated by reference in their entirety.

Unless otherwise defined, all terms used in disclosing the invention, including technical and scientific terms, have the meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. By means of further guidance, definitions for the terms used in the description are included to better appreciate the teaching of the present invention. The terms or definitions used herein are provided solely to aid in the understanding of the invention. Provided herein are dental implant systems, universal angulated abutments, rotatable members for use in universal angulated abutments, and methods of their use.

The rotatable members provided herein are fixable to dental implants or to intermediate coupling members by means of dental adhesives. As an alternative to dental adhesives, dental filler may be used. Intermediate coupling devices have a proximal end and a distal end, wherein the proximal end is configured for receiving a rotatable member, and wherein the distal end is configured for bonding with a dental implant. A rotatable member is the part of a dental abutment which, during normal use, is in direct contact with a dental prosthesis such as a crown, bridge, or denture.

In particular embodiments, the universal angulated abutments provided herein comprise an intermediate coupling device which is connectable to an annular member. The intermediate coupling device and the annular member cooperate to form a socket. The socket is configured for rotatable engaging the fixing member of a rotatable member. However, in particular embodiments, the socket is made out of one piece. This can be done by means of, for example, 3D printing techniques, or by welding the joint between an annular member and an intermediate coupling device.

The term "dental implant system" as used herein refers to an assembly of a dental implant and a dental abutment, which can be used for supporting a dental prosthesis, such as a crown, bridge, denture, or the like. The term "dental implant" as used herein refers to the part of a dental implant system which is inserted into the patient's bone and/or other tissue, for example the dental implant is inserted in a patient's jawbone. The term "dental abutment" as used herein refers to a part of a dental implant system that is configured to be coupled a dental implant and to support a prosthesis. The dental abutment typically forms a connection between a dental implant and a dental prosthesis. While a dental implant is positioned within the bone, a dental abutment typically extends from the bone. The dental abutments as described herein are universal angulated abutments, implying that a single abutment can allow for achieving a desired angular orientation within a given range of angles, for example any angular orientation within a cone having an aperture angle of 80°. The dental implant systems described herein comprise a dental abutment and a dental implant and/or intermediate coupling device, wherein the abutment comprises a rotatable member which can be rotated relative to the dental implant and/or intermediate coupling device via a joint, for example a ball-and- socket joint.

Preferably, dental abutments provided herein are removably connectable to dental implants, for example by means of screw thread. Accordingly, dental abutments can be easily removed from dental implants when necessary; for example when a rotatable member detaches from an intermediate coupling device due to mechanical failure, or when a rotatable member is accidentally fixated under an inappropriate angle. Typically, the rotatable member is coupled to an intermediate coupling device. In order to allow coupling of rotatable member and intermediate coupling device, rotatable members described herein comprise a fixing member, for example a rounded distal portion. In particular embodiments, when the fixing member comprises a rounded distal portion, the rounded distal portion is configured for forming the ball-part of the ball-and- socket joint between an intermediate coupling device and a rotatable member, as detailed below. However, as described elsewhere herein, the rounded distal portion may alternatively be configured for forming the socket-part of the ball-and-socket joint between intermediate coupling device and rotatable member. The relative position of the shaft portion and the intermediate coupling device can be fixed by using dental adhesives such as cement or glue. In particular, fixation of the shaft portion by means of dental adhesives may involve passing dental adhesive through an internal bore or internal channel through the shaft portion. The fixing member generally comprises one or more voids which are in fluid connection with the internal bore or internal channel such that dental adhesives introduced through the internal bore or internal channel may be directed to the voids. The internal bore or internal channel is also referred to as the through channel. These characteristics will be explained in more detail below.

The rotatable members described herein comprise a proximal shaft portion which is connected to a distal fixing member. The terms "proximal" and "distal" as used herein refer to the relative position of parts of an object with respect to a prosthesis when positioned on the abutment. Accordingly, the proximal shaft portion faces the prosthesis while the distal fixing member faces away from the prosthesis, when the prosthesis is positioned on the abutment. The recitation "proximal shaft portion" is also referred to herein as "shaft portion".

The dental abutment comprising the shaft portion and the fixing member is preferably manufactured as a single piece. However, it is envisaged that in certain embodiments, the shaft portion and the fixing member may be manufactured as separate pieces, which can be connected to each other to form a rotatable member as described herein. The shaft portion and fixing member form a rigid assembly. More particularly, the shaft portion and rounded portion are typically manufactured such that they remain rigid during normal use of the dental abutment.

The dental abutments described herein may be manufactured in various ways, including milling and additive manufacturing technologies such as 3D printing. Suitable 3D printing techniques which may be used for the manufacture of the present abutments include, but are not limited to, stereo lithography and laser sintering.

In one aspect, the present invention comprises a rotatable member for use in universal angulated abutments. The rotatable member comprises a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises one or more voids for receiving dental adhesives, the one or more voids being in fluid connection with the distal end of the through channel. Preferably, the remainder of the through channel is separated from the one or more voids by a barrier. Preferably the barrier comprises the walls of the through channel. Such rotatable members allow for the uniform and even flow of dental adhesives around the fixing member, thereby strengthening the bond between the rotatable member and other parts of universal angulated abutments. Typically, the voids are placed on the outside of the fixing member. Conversely, the through channel generally runs through the inside of the fixing member. The barrier of the rotatable member is typically formed by cooperation of the rotatable member with an intermediate coupling device and an annular member, as can be seen in the figures provided herein. Additionally or alternatively, a rotatable member according to the first aspect of the present invention may be described as follows: A rotatable member for use in universal angulated abutments comprising a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises one or more voids for receiving dental adhesives, the one or more voids being in fluid connection with the distal end of the through channel, and the remainder of the through channel being separated from the one or more voids by the wall of the through channel.

The recitation "the remainder of the through channel being separated from the one or more voids by the wall of the through channef can be interpreted as follows: dental adhesives or dental filler flowing from the proximal end of the through channel to the voids are forced by the barrier to flow via the distal end of the through channel. The barrier generally corresponds to the walls of the through channel. Additionally or alternatively, a rotatable member according to the first aspect of the present invention may be described differently still. In particular, the voids may also be described as a plurality of recessed features on the outer surface of the fixing member. Accordingly, in some embodiments, provided herein is a rotatable member for use in universal angulated abutments comprising a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises a plurality of recessed features for receiving dental adhesives, the plurality of recessed features being in fluid connection with the distal end of the through channel, and the remainder of the through channel being separated from the plurality of recessed features by the wall of the through channel.

Additionally or alternative, the rotatable member according to the first aspect of the present invention may be described in wording which is different still: Provided herein is a rotatable member for use in universal anulgated abutments comprising a proximal shaft portion connected to a distal fixing member, the shaft portion and the fixing member being provided with a through channel for receiving dental adhesives, the through channel having a proximal end and a distal end, wherein the fixing member comprises one or more voids for receiving dental adhesives on the outer surface of the fixing member, the one or more voids being shaped as recesses, and the one or more voids being separated from the through, by the walls of the through channel, except at the distal end of the through channel, the distal end of the through channel being provided with a fluid connection between the voids and the through channel.

Additionally or alternatively, the rotatable member according to the first aspect of the present invention may be described in yet different wording: Provided herein is a rotatable member for use in universal angulated abutments. The rotatable member comprises a proximal shaft portion connected to a distal fixing member. The shaft portion and the fixing member are provided with a through channel for receiving dental adhesives. The through channel has a proximal end and a distal end. The fixing member comprises a plurality of recessed features for receiving dental adhesives. The plurality of reessed features is provided on the outer surface of the fixing member. The plurality of recessed features is connected to the distal end of the through channel. This connection may be described as a fluid connection. The recessed features may alternatively be named voids. At the positions on the fixing member where the recessed features are not connected to the distal end of the through channel, the recessed features are separated from the through channel by the body of the fixing member. The body of the fixing member also forms the walls of the through channel.

In particular embodiments, the voids are in fluid connection with the proximal end of the through channel. However, in such embodiments, the dental adhesives should be applied to the proximal end of the through channel, the dental adhesives should flow through the through channel, and the dental adhesives should flow into the voids via the distal end of the through channel. In other words, the walls of the through channel form a barrier which forces fluids flowing from the proximal end of the through channel to the voids to flow via the distal end of the through channel. This is readily accomplished by means of universal angulated abutments comprising these rotatable members, as set out in detail below. The term "void" as used herein refers to an opening inside the smallest convex hull enclosing the fixing member, and/or around the smallest convex hull enclosing the fixing member, preferably within a distance of at most 10.0 mm of the fixing member, for example within a distance of at most 2.5 mm of the fixing member. Universal angulated abutments and methods according to the present invention are described in detail below. In particular embodiments, the voids comprise one or more recesses in the fixing member. Preferably, the term "void" as used herein refers to an opening inside the smallest convex hull enclosing the fixing member. Generally, the voids can be described as recessed features in the outer surface of the fixing member.

The term "remainder" as used herein is used in its normal meaning of a remaining part. In particular, the term "remainder" in the recitation "... the one or more voids being in fluid connection with the distal end of the through channel, and the remainder of the through channel..." refers to the entirety of the through channel except for its distal end. In other words, the term "remainder" in the above recitation refers to the proximal end of the through channel and the middle part of the through channel, up to but excluding its distal end. Accordingly, the voids are connected to the through channel only at the distal end of the through channel.

The term "separated" as used herein is used in its normal meaning of being dispersed in space. In particular, the recitation "the remainder of the through channel is separated from the one or more voids by a barrier" refers to the parts of the through channel except for its distal end are spatially separated/ brought at a certain distance from each other by means of the barrier. Preferably, the barrier comprises the walls of the through channel. The term "barrier" as used herein refers to an entity which separates two or more other entities. In particular, in the context of the present disclosure, a barrier separates the one or more voids and the parts of the though channel excluding the through channel's distal end.

When several channels, recesses and/or voids are "in fluid connection", dental adhesives applied to one of the channels, recesses and/or voids, can flow into the remaining channels, recesses and/or voids. For example, when dental adhesives are applied to a through channel in fluid connection with several voids, the dental adhesives flow from the through channel to the voids.

The shaft portion is the part of the rotatable member which is used for making a connection to a prosthesis and contains a bore which allows dental adhesives to flow through the rotatable member. The shaft portion may have any of a variety of shapes. For example, the shaft portion may have a longitudinal, straight shape. Some shaft portions provided herein have a length/width ratio of at least 1 .5, or of at least 2. In particular embodiments, the shaft portion has a cylindrical shape, a conical shape, or combinations thereof. In particular embodiments, the shaft portion tapers towards its proximal end, which may facilitate connecting a prosthesis to the shaft portion. In particular embodiments, the shaft portion may have an overall spherical shape, a hemispherical shape, or any other shape which is suitable for connecting to a dental prosthesis.

In particular embodiments, the through channel does not comprise screw thread. Rotatable members according to the present invention are configured to be fixated by means of dental adhesive as opposed to screws. Accordingly, there is no need for screw thread in the through channel. However, it is unlikely that screw thread would impair the proper functioning of the rotatable members provided herein.

The fixing member is a structure which is suitable for being rigidly linked to a dental implant or an intermediate coupling device by means of dental adhesives, as described in more detail later on. The term "dental adhesives" as used herein refers to synthetic materials which are used in dentistry as restorative materials or adhesives.

The voids are in fluid connection with the channel. More specifically, the voids are configured for receiving dental adhesives via the channel. This is achieved by providing a fluid connection between the voids and the channel. Preferably, the only fluid connection between the voids and the through channel is an opening in the rotatable member at the distal end of the through channel, for example as shown in Fig. 2. In other words, the opening in the rotatable member at the distant end of the through channel does not extend along the rotatable member towards the proximal shaft portion. The total length of the rotatable member typically is from about 3 mm to 25 mm, preferably from about 5 mm to about 15 mm, for example about 10 mm. Typically, when a rotatable member is installed on an intermediate coupling device, the length of the rotatable member extending beyond the intermediate coupling device is from about 5 mm to about 13 mm. The optimal length may depend on the anatomy of the patient who receives or who is to receive the rotatable member. Typically, the patient is a human patient.

The rotatable member described herein is at least partially hollow. More particularly, the rotatable member comprises a through channel, also referred to herein as "channel". The channel typically runs along the entire length of the rotatable member, and preferably runs along the longitudinal axis of the rotatable member. Accordingly, the through channel runs through the proximal shaft portion as well as through the fixing member. More particularly, the proximal end of the through channel corresponds to the proximal end of the shaft portion, while the distal end of the through channel corresponds to the distal end of the fixing member. The through channel allows for providing dental adhesives to the voids of the fixing member, via the proximal end of the rotatable member. This allows for the fixation of the position of the rotatable member relative to an intermediate coupling device (see further).

In particular embodiments, the through channel has a straight shape. It is envisaged however, that in certain embodiments the through channel may not be straight. The transverse cross section of the through channel may have various shapes, for example round, ellipsoidal, square, polygonal, etc. In preferred embodiments, the through channel has a round transverse cross section. This may allow for a better flow of dental adhesives through the channel. In some embodiments, the channel may have a cylindrical shape, and the channel may have a width or diameter ranging from at least 0.5 mm to at most 8mm, preferably from at least 0.8 mm to at most 1 .5 mm.

The fixing member comprises one or more voids being in fluid connection with the distal end of the through channel. Preferably, the outer surface of the fixing member comprises one or more voids. Preferably, the one or more voids are one or more recesses which are in fluid connection with the distal end of the through channel of the rotatable member. In particular, the one or more voids allow for flowing liquid (generally the liquid comprises dental adhesives) towards the interface between the shaft portion and the fixing member. The one or more voids can be regarded as providing pathways along which dental adhesives can flow on and/or near the surface of the fixing member.

Whereas the one or more voids are connected to the distal end of the through channel, the one or more voids are preferably provided with a barrier between the voids and the remainder of the through channel. The barrier typically comprises the wall of the through channel. An exemplary embodiment is shown in Fig. 2. This facilitates the even spread of dental adhesives around the fixing member, which improves the fixation of the rotatable member once the dental adhesives are hardened.

When the fixing member is positioned into a corresponding socket as to obtain a joint between a rotatable member and an intermediate coupling device, the channel can be provided with dental adhesive, which can then flow from the channel into the voids, thereby providing the surface of the fixing member portion with dental adhesive, the dental adhesive further filling the voids and the socket. The position of the fixing member (and thus of the rotatable member) in the socket is then fixed upon hardening of the dental adhesive. Accordingly, the provision of the rotatable member with a through channel and a fixing member as described herein, allows for the fixation of the rotatable member via dental adhesives. Methods for fixating abutments provided herein are provided later on.

In particular embodiments, the outer surface of the fixing member comprises metal trabeculae. Metal trabeculae are a specific surface texture which allows for the ingress of dental adhesives. This may enhance the bond between rotatable members and intermediate coupling devices and/or dental implants. Intermediate coupling devices and dental implants are described in more detail later on.

In particular embodiments, the rotatable member comprises a fixing member comprising a support member, the support member being circumferentially attached to the distal end of the rotatable member, the rotatable member further comprising a closing member, the closing member being circumferentially attached to the proximal shaft portion, and the rotatable member further comprising a void between the support member and the closing member.

Overall, universal angulated abutments comprising such rotatable members allow for very efficient fixation of rotatable members at a desirable angle.

In particular embodiments, the support member comprises a disk. This may further enhance the efficiency of fixation.

A support member is a part of a specific type of fixing member which is configured for supporting the rotatable member in a socket, as set-out in more detail below.

The term "closing member" as used herein refers to a structure such as a rounded flange which is attached to the shaft portion of an abutment provided herein. The closing member is configured for forming a dental adhesive-permeable obstruction to dental adhesive flow during fixation of an abutment in a socket of a dental implant or intermediate coupling device, as is detailed later on.

In particular embodiments, the closing member has a proximal side and a distal side, the distal side facing the void between the closing member and the support member, wherein the closing member comprises one or more channels in fluid connection with said void, the one or more channels further being in fluid connection with the proximal side of the closing member.

As further discussed below, during abutment installation, dental adhesive overflows through openings between the closing member and a socket to which rotatable member is rotatably attached, after the socket has been filled with dental adhesive.

The dental adhesive overflow is visible for a dentist who installs the abutment and its occurrence can be advantageously used as an indication that the socket is filled with dental adhesives. The closing member, and the channels in the closing member provide an opening which provides about the same resistance to dental adhesive flow regardless of the angular orientation of the abutment in the socket. This may facilitate abutment installation.

In particular embodiments, the support member comprises a proximal side and a distal side, the proximal side facing a void in the fixing member, and the distal side of the support member comprising channels which provide fluid connection between the distal end of the through channel and the void in the fixing member.

In particular embodiments, the distance between the support member and the closing member is from at least 0.50 mm to at most 6.0 mm.

In particular embodiments, the rotatable member comprises a fixing member wherein the fixing member is a rounded portion and wherein the one or more voids are recesses provided in the outer surface of the rounded portion, the recesses being in fluid connection with the distal end of the through channel.

The rotatable member comprising the shaft portion and the rounded portion is preferably manufactured as a single piece. However, it is envisaged that in certain embodiments, the shaft portion and the rounded portion may be manufactured as separate pieces, which can be connected to each other to form a rotatable member as described herein. The shaft portion and rounded portion form a rigid assembly. More particularly, the shaft portion and rounded portion are typically manufactured such that they do not deform during normal use of the dental abutment.

In particular, the distal rounded portion may function as the part of the rotatable member which is used for positioning the abutment onto or into an intermediate coupling device. In other words, the distal rounded portion may function as a fixing member. In particular embodiments, the distal rounded portion has a convex shape, which allows for forming a ball-and-socket joint, together with an intermediate coupling device (see further). Moreover, the distal rounded portion may provide the ball of a ball-and-socket type joint. The distal rounded portion may have roughly spherical shape, or may be shaped as a spherical cap, such as a hemisphere.

In particular embodiments, the outer surface of the distal rounded portion is provided with one or more recesses which are in fluid connection with the distal end of the through channel of the abutment. More particularly, the one or more recesses allow for liquid flow along the one or more recesses from the distal end of the through channel towards the interface between the shaft portion and the distal rounded portion. The recesses can be regarded as providing canals along which dental adhesive is allowed to flow on the surface of the rounded portion. In addition, as explained in more detail below, dental adhesives can flow through the remainder of a socket. The socket may be formed by a rounded portion, an intermediate coupling device, and an annular member. Accordingly, whereas the recesses are connected to the distal end of the through channel, the recesses are provided with a bottom which provides a barrier between the recesses and the remainder of the through channel. In particular embodiments, the recesses have a depth from at least 0.05 to at most 3 mm, preferably from at least 0.05 mm to at most 0.7 mm.

Preferably, the recesses do not cut through the entire rounded portion. In other words, the recesses are in fluid connection with the distal end of the through channel, and are separated from the rest of the through channel by means of a barrier comprising the wall of the through channel. This may have a beneficial effect on the strength of the dental abutment.

When the rounded portion is positioned into a corresponding socket as to obtain a ball- and-socket joint, the channel can be provided with dental adhesive, which can then flow from the channel into the recesses, thereby providing the surface of the rounded portion with dental adhesives. The position of the rounded portion (and thus of the abutment) in the socket is then fixed upon hardening of the dental adhesive. Accordingly, the provision of the abutment with a through channel and recesses as described herein, allows for the fixation of the abutment via dental adhesives.

In particular embodiments, the recesses comprise a plurality of grooves or slots. The grooves or slots can provide canals which allow for flowing dental adhesive over the surface of the rounded portion. In preferred embodiments, the recesses comprise a plurality of grooves, wherein each of the plurality of grooves is in direct fluid connection with the distal end of the through channel. In further embodiments, the recesses may further comprise one or more grooves which are only indirectly connected with the distal end of the through channel. The grooves which are in direct fluid connection with the channel are preferably evenly provided around the distal end of the channel. In certain embodiments, the grooves which are in direct fluid connection with the distal end of the through channel may extend radially from the distal end of the channel. However, it is envisaged that in certain embodiments other configurations can be used.

As described above, the recesses and thus also the grooves allow for flowing liquid along the recesses from the distal end of the through channel towards the interface between the shaft portion and the rounded portion. In particular embodiments, one or more of the grooves taper towards the proximal shaft of the rotatable member. The term "tapering" as used herein refers to gradual diminution of thickness and/or cross section. Tapered grooves can allow for a more controlled distribution of dental adhesive over the surface of the rounded portion. Indeed, tapered grooves can result in a pressure build-up as dental adhesive advances in the groove. Due to the pressure build-up, the dental adhesive preferentially flows towards grooves wherein the dental adhesive is least advanced, thereby leading to a more equalized dental adhesive distribution.

The terms "proximal shaft portion" and "distal rounded portion" are also referred to herein as "shaft portion" and "rounded portion", respectively.

The terms "proximal" and "distal" as used herein refer to the relative position of parts of an object with respect to a prosthesis when positioned on the abutment. Accordingly, the proximal shaft portion faces the prosthesis while the distal rounded portion faces away from the prosthesis, when the prosthesis is positioned on the dental abutment.

In particular embodiments, the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel. This may allow efficient distribution of dental adhesive around the rounded portion during abutment installation.

In particular embodiments, the plurality of grooves tapers towards the proximal shaft portion. This may further enhance the efficiency of dental adhesive distribution around the rounded portion during abutment installation.

In particular embodiments, the plurality of grooves is distributed radially around the distal end of the through channel. This may further enhance the efficiency of dental adhesive distribution around the rounded portion during abutment installation. In particular embodiments, the outer surface of the rounded portion is provided with

- a first plurality of grooves in fluid connection with the distal end of the through channel;

- a second plurality of grooves running towards the interface between the shaft portion and the rounded portion; and

- an intermediate recess positioned between the first plurality of grooves and the second plurality of grooves, wherein the first plurality of grooves and the second plurality of grooves are in fluid connection with each other through the intermediate recess.

Accordingly, particular embodiments, the outer surface may be provided with a first plurality of grooves in (direct) fluid connection with the distal end of the through channel; and a second plurality of grooves running towards the interface between the rotatable member's shaft and rounded portion; wherein the first plurality of grooves and second plurality of grooves are in fluid connection through an intermediate recess provided on the outer surface of the rounded portion. The grooves in direct fluid connection with the distal end of the through channel are considered distal grooves and the grooves running towards the shaft-rounded portion interface are considered proximal grooves. The intermediate recess is positioned between the proximal grooves and the distal grooves. The intermediate recess is a recessed area of the rounded portion's surface. The intermediate recess allows for providing a relatively large surface area of the rounded portion's surface in connection with dental adhesive, thereby allowing for optimal fixation. In particular embodiments, the intermediate recess may have a non-smooth, i.e. textured (bottom) surface, for example a ribbed or studded surface. In particular embodiments, the texture of the intermediate recess comprises metal trabeculae. This allows for increasing the contact surface between the rounded portion and the dental adhesive used for fixation of the abutment. In particular embodiments, the intermediate recess may have a ribbed surface wherein the ribs are directed perpendicularly to the proximal and/or distal grooves. This may facilitate an equal distribution of dental adhesives along the surface of the rounded portion.

In particular embodiments, the first plurality of grooves extend radially from the distal end of the through channel, whereas the second plurality of grooves extend radially from the interface between the shaft portion and the rounded portion. This allows for further optimization of the distribution of dental adhesive along the surface of the rounded portion.

In particular embodiments, the plurality of grooves has a depth of at least 0.050 mm to at most 2.0 mm, preferably of at least 0.40 mm to at most 0.80 mm. This may further enhance dental adhesive distribution around the rounded portion during abutment installation.

In particular embodiments, the intermediate recess has a textured surface. This may further enhance dental adhesive distribution around the rounded portion during abutment installation.

In particular embodiments, the surface texture comprises metal trabeculae. Metal trabeculae allow for the ingress of dental adhesives, which may enhance the fixation between a rotatable member and an intermediate coupling device and/or a dental implant. Intermediate coupling devices and dental implants are described in more detail below.

In a further aspect, the present invention provides a universal angulated abutment comprising

- a rotatable member provided herein; and,

- an intermediate coupling device comprising a proximal end and a distal end, wherein the proximal end is configured for rotatably receiving the fixing member. Such universal angulated abutments allow for very efficient fixation of dental prostheses. In particular embodiments, the intermediate coupling device comprises a socket for enclosing a fixing member of a rotatable member provided herein. The intermediate coupling device may be made simultaneously with the rotatable member by means of an additive manufacturing technique such as 3D printing, wherein the fixing member of the rotatable member is manufactured in the space enclosed by the socket. Alternatively, the socket may be formed out of two parts which are welded together, for example an intermediate coupling device and an annular member which are welded together to form a socket, the socket enclosing the fixing member of a rotatable member. The annular member and the intermediate coupling device are described in more detail below.

Preferably, the intermediate coupling device comprises a proximal part for receiving a fixing member, and a distal part for cooperating with a dental implant. In turn, the part of the implant which couples with the intermediate coupling device during normal use comprises a coupling portion for engaging the intermediate coupling device. The coupling portion may be attachable to the dental implant by means of, for example, screw thread or a conical connection. Preferably, the implant and the intermediate coupling device may be connectable by means of an internal connection (shown in Fig. 9). Alternatively, the implant and the intermediate coupling device may be connectable by means of an external connection. Preferably, the size of the intermediate coupling device and of the annular member determined according to a patient's anatomy, especially according to the distance between a dental implant and the edge of a patient's gum; the thickness of gum changes from patient to patient. Ideally, the size of the intermediate coupling device and the size of the annular member are adapted such that the top of the annular member extends beyond a patient's gum. It will be understood that the intermediate coupling device can have various heights and shapes, as will be understood by the skilled person. Similarly, the annular member can have various shapes and heights as well, and does not need to be perfectly annular per se. In particular, the annular member may comprise protrusions and recesses which may improve the grip of a dentist's tools on the annular member during abutment installation.

Generally, the rotatable member and the intermediate coupling device cooperate to form a fluidic path through which voids provided on the outer surface of the fixing member can be filled with dental adhesives and/or filler. Preferably, the dental adhesives and/or filler are applied via the proximal end of the through channel. The dental adhesives and/or filler then flow through the through channel, and into the voids via the distal end of the through channel. The part of the dental implant facing away from the abutment during normal use may have a longitudinal and preferably cylindrical shape, similar to the shape of typical dental implants known in the art. The dental implant may be provided with a threaded external surface for facilitating the introduction of the dental implant into bone.

The socket is typically provided such that, when the fixing member of the rotatable member is positioned within the socket, the rotatable member is allowed to move within a range of different orientations relative to the intermediate coupling device and/or the dental implant. Particular configurations of such sockets are provided in the examples and the figures. Typically, the longitudinal axis of the rotatable member is allowed to move over a range of angles within a cone. In particular embodiments, the longitudinal axis of the rotatable member is allowed to move within a cone having an aperture angle, i.e. the maximal angle between two generatrix lines, of at least 10° to at most 120°, preferably of at least 15° to at most 60°, for example about 20°, for example about 25°, for example about 80°.

The socket is typically further provided such that dental adhesive can flow from the distal end of the channel towards the interface between the fixing member and the shaft potion, via the voids in the fixing member, and/or via open space in the socket.

In particular embodiments, the socket is formed out of a single part.

Preferably, the socket comprises similar recesses as the fixing member. Accordingly, the socket may comprise recesses having a depth from at least 0.05 to at most 3 mm, preferably from at least 0.05 mm to at most 0.7 mm. Recesses in both socket and fixing member may enhance the mechanical strength of universal angulated abutments provided herein after dental adhesive has been introduced to the socket, and after the dental adhesive has set. In particular embodiments, the universal angulated abutment further comprises an annular member configured for rotatably attaching the rotatable member to the intermediate coupling device; wherein the annular member and the intermediate coupling device comprise matching attachment means; and wherein the annular member and the intermediate coupling device are configured for forming a socket for rotatably receiving the fixing member of the rotatable member, the socket being in fluid connection with the channel of the rotatable member.

In other words, the intermediate coupling device cooperates with an annular member to form a socket. The intermediate coupling device may be attached to the annular member by means of matching screw thread. Or formulated differently still, the socket can be formed in two or more parts which can be separated from each other. In particular, the socket may be made out of a first part comprised in an intermediate coupling device and a second part being a removable annular member. In particular, the part of the socket comprised in the intermediate coupling device is configured for receiving the fixing member of a rotatable member. The annular member may then be positioned on, and/or connected to, the intermediate coupling device, thereby forming a socket. The annular member and intermediate coupling device may be provided with matching threads which allow for screwing the annular member on or off the intermediate coupling device. Preferably, the annular member comprises an undercut, which can help to keep the fixing member in the socket. The undercut is the portion of the annular member which extends from the annular member's edge towards the annular member's centre.

In particular, the annular member is configured to surround a shaft portion. Preferably, the annular member is configured to narrowly surround a shaft portion, the innermost diameter of the annular member preferably being at least 0.50 mm to at most 2.0 mm bigger than the diameter of outer diameter of the shaft portion. Preferably, the inner surface of the annular member comprises a tapered portion, for example region D2 in Figure 4. The tapered portion features an increasing diameter with increasing distance from the part of the annular member which is configured to form a socket. This may increase the angle over which an abutment can rotate in a socket. In particular embodiments, the tapered portion may describe a truncated cone, the side of the truncated cone being formed by the innermost surface of the annular member, and the ground and top planes of the truncated cone being formed by imaginary planes defined by the start and end of the tapered portion. In particular embodiments, the angle between two opposing generatrix lines of the truncated cone may be 20 degrees to 120 degrees, preferably about 30 degrees. In particular embodiments, the angle between two opposing generatrix lines of the truncated cone corresponds to the aperture angle of the cone in which the rotatable member can be rotated when it positioned in the socket. In particular embodiments, the universal angulated abutment comprises a rotatable member wherein the rotatable member comprises a fixing member comprising a support member, the support member being circumferentially attached to the distal end of the rotatable member, the rotatable member further comprising a closing member, the closing member being circumferentially attached to the proximal shaft portion, and the rotatable member further comprising a void between the rotatable member and the fixing member. Optionally, the closing member has a proximal side and a distal side, the distal side facing the void between the closing member and the support member, wherein the closing member comprises one or more channels in fluid connection with said void, the channels further being in fluid connection with the proximal side of the closing member. Furthermore, the universal angulated abutment comprises a socket, the socket being formed by an intermediate coupling device and an annular member, the socket comprising a plurality of abutment positioning aids.

This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices. Preferably, the closing member obstructs the opening in the annular member regardless of the angular position of the rotatable member. This may be accomplished by providing closing members of which the distance between the rim on the closing member and the central longitudinal axis of the rotatable member is equal to, or greater than the diameter of the inner opening of the annular member.

The socket is typically further provided such that dental adhesives can flow from the distal end of the channel towards the interface between the fixing members and shaft, via voids provided in and/or around of the fixing member and/or via open space in the socket.

In particular embodiments, the plurality of abutment positioning aids are selected from the list comprising: protrusions of the intermediate coupling device, protrusions of the annular member, metal strips attached to the annular member, metal strips attached to the intermediate coupling device, and combinations thereof. This helps the efficient positioning of rotatable members in sockets.

In particular embodiments,

- the rotatable member is a dental abutment of which the fixing member is a rounded portion and the one or more voids are recesses provided in the outer surface of the rounded portion, the recesses being in fluid connection with the distal end of the through channel; and,

- the socket of the intermediate coupling device is a concave socket configured for rotatably engaging the distal rounded portion of the rotatable member to form a ball and socket joint, the concave socket preferably having a textured surface.

The recitation "the rotatable member is a dental abutment" should be read as the rotatable member being comprised in a dental abutment.

Accordingly, in particular embodiments,

- the fixing member is a rounded portion and the one or more voids are recesses provided in the outer surface of the rounded portion, the recesses being in fluid connection with the distal end of the through channel; and,

- the socket of the intermediate coupling device is a concave socket configured for rotatably engaging the distal rounded portion of the rotatable member to form a ball and socket joint, the concave socket preferably having a textured surface. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices. Preferably, the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel. Preferably, the plurality of grooves taper towards the proximal shaft. Preferably, the plurality of grooves are distributed radially around the distal end of the through channel.

Preferably, the outer surface of the rounded portion is provided with

- a first plurality of grooves in fluid connection with the distal end of the through channel;

- a second plurality of grooves running towards the interface between the shaft portion and the rounded portion; and

- an intermediate recess positioned between the first plurality of grooves and the second plurality of grooves, wherein the first plurality of grooves and the second plurality of grooves are in fluid connection with each other through the intermediate recess.

Preferably, the intermediate recess has a textured surface. Preferably, the plurality of grooves has a depth of at least 0.050 mm to at most 2.0 mm, preferably of at least 0.40 mm to at most 0.80 mm. In contrast with conventional ball-and-socket joints, ball-and- socket joints provided by the present universal angulated abutments not necessarily need to allow for a smooth movement of the ball within the socket. Indeed, the joint should allow for movement of the abutment relative to the socket, but not necessarily with a minimal amount of friction. In particular embodiments the socket has a textured surface. This allows for enlarging the contact surface of the socket with dental adhesive, which can result in a stronger fixation. In certain embodiments, the surface of the concave socket may be provided with one or more recesses for receiving a fixation tool or the like.

The configuration of sockets provided herein is such that dental adhesives can flow from the distal end of the channel of rotatable members towards the interface between the fixing member and the shaft portion, via the grooves and/or recesses provided in the outer surface of the rounded surface and/or via open space in the socket.

In a further aspect, the present invention comprises a dental implant system comprising a dental implant and a universal angulated abutment provided herein. Such dental implant systems allow efficiently choosing the direction of the rotatable member, irrespective of the orientation of the dental implant. Accordingly, placing dental prostheses is greatly facilitated. In a further aspect, the present invention provides a method of fixating a rotatable member provided herein with respect to an intermediate coupling device, the method comprising the steps:

(a) providing a universal angulated abutment provided herein;

(b) selecting a desired orientation for the rotatable member;

(c) providing dental adhesives to the socket and to one or more voids of the fixing member of the rotatable member, via the through channel; and

(d) curing the dental adhesive, thereby fixing the position of the rotatable member relative to the intermediate coupling device.

Accordingly, rotatable members may be placed in an efficient and effective manner on intermediate coupling devices.

In step (a) of the present method, the universal angulated abutment is preferably provided in a state wherein the fixing member of the rotatable member is positioned into the concave socket of the intermediate coupling device. However, when the universal angulated abutment is provided in a state in which the fixing member is not provided in the socket, step (a) is followed by a step in which the fixing member is positioned in the socket.

The concave socket may be formed out of one piece, e.g. by means of 3D printing technologies. Alternatively, the concave socket may be formed out of two pieces, e.g. an intermediate coupling device and an annular member. The annular member may be attached to the intermediate coupling device by fastening means chosen from the list comprising screw thread and weld seams.

An intermediate coupling device is typically positioned on a dental implant. The dental implant is typically previously positioned into the patient's bone. Accordingly, no invasive steps on the patient's body are required for positioning the universal angulated abutment on the dental implant. Methods for the positioning of dental implants as such are well known in the art.

In particular embodiments, step (a) comprises the step: fixing a rotatable member to an intermediate coupling device, thereby rotatably attaching the rotatable member to the intermediate coupling device. In particular embodiments, the rotatable member is attached to the intermediate coupling device by means of an annular member, wherein the annular member and the intermediate coupling device cooperate to form a socket, the socket enclosing the fixing member of the rotatable member. As described above, the fixing member of the rotatable member and the socket of the intermediate coupling device cooperate to form a joint which allows moving the rotatable member relative to the intermediate coupling device and the dental implant within a given range. Within this range, a desired or optimal orientation of the rotatable member relative to the intermediate coupling device and relative to the implant can be selected. This is done in step (b) of the present method.

The desired orientation can be determined by aligning the rotatable member with another rotatable member, with one or more teeth, and/or other points of reference. In particular embodiments, the desired orientation is determined by using an accessory guiding tool.

Once the desired orientation is determined, the position of the rotatable member within the socket can be fixed. This is done by providing the abutment with dental adhesive. More particularly, dental adhesive is injected in the through channel of the rotatable member, which then flows into the voids provided on the surface of the fixing member, for example into the recesses provided on the surface of a rounded portion. Furthermore, dental adhesives flow in open spaces in the socket. Typical dental adhesives suitable for such purpose are liquid or viscous (paste-like) dental adhesives which harden or solidify upon curing. Various suitable dental adhesives are known in the art, which may be chemically cured or light-cured. In particular embodiments, the dental adhesives may be selected from the list comprising glass ionomer cements, dental adhesive modified glass ionomer cements, and dental adhesive based cements.

As the (uncured) dental adhesive is liquid or viscous before curing, the order of steps (b) and (c) is not critical for the present method. In certain embodiments, steps (b) and (c) may be performed simultaneously.

Once the rotatable member is positioned in the desired orientation and provided with dental adhesive as described above, the position of the rotatable member may be fixed by curing the dental adhesive, in step (d) of the present method. The term "curing" as used herein refers to chemical and/or physical processes which result in a change of the physical state of a dental adhesive material, more particularly a transformation to a solid state. Preferred ways of curing dental adhesive depend on the type of dental adhesive which is used, and are as such well known in the art.

In some embodiments, the socket-part of the ball-socket joint by which the rotatable member engages the intermediate coupling device is formed by the rounded portion and the ball-part of the joint is formed by the intermediate coupling device. In other words, the fixing member of the rotatable member comprises the socket-part of a ball-socket joint, and the intermediate coupling device comprises the ball-part of a ball-socket joint. Preferably, the ball-part of the joint is comprised in the intermediate coupling device and/or the socket-part of the joint comprised in the rounded portion, features grooves and/or recesses. Note that the grooves and/or recesses are specific voids, the details of which have been described before. The socket formed by the rounded portion is configured to mate with the ball formed by the intermediate coupling device. The ball- socket joint preferably allows the shaft portion to be moveable over three rotational degrees of freedom, which may greatly facilitate placing dental prostheses. An annular member may be provided, wherein the annular member is attached to the intermediate coupling device, preferably by means of screw-thread, wherein the annular member comprises an inwardly extending overhang which is configured for keeping the rounded portion in place on the intermediate coupling device.

Accordingly, the present invention comprises a rotatable member comprising a proximal shaft portion connected to a distal rounded portion, the shaft portion and the rounded portion being provided with a through channel having a proximal end and a distal end, wherein the rounded portion is configured as the socket of a ball-socket joint and wherein the inner surface of the rounded portion is provided with recesses in fluid connection with the distal end of the through channel. An exemplary embodiment is shown in figure 7.

In particular embodiments, the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices and/or annular members.

In particular embodiments, the plurality of grooves is distributed radially around the distal end of the through channel. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices.

In particular embodiments the inner surface of the rounded portion is provided with

- a plurality of grooves in fluid connection with the distal end of the through channel; and, - an intermediate recess wherein the plurality of grooves is in fluid connection with each other through the intermediate recess.

This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices.

In particular embodiments, the intermediate recess has a textured surface. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices. In particular embodiments, the grooves of the plurality of grooves have a depth of at least 0.050 mm to at most 2.0 mm, preferably of at least 0.40 mm to at most 0.80 mm. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices. Further provided herein are universal angulated abutments comprising a rotatable member as described above. More particularly, provided herein is a universal angulated abutment comprising a rotatable member provided herein; and an intermediate coupling device.

In particular, the present invention comprises a universal angulated abutment comprising:

- a rotatable member comprising a proximal shaft portion connected to a distal rounded portion, the shaft portion and the rounded portion being provided with a through channel having a proximal end and a distal end, wherein the rounded portion is configured as the socket of a ball-socket joint and in wherein the inner surface of the rounded portion is provided with recesses in fluid connection with the distal end of the through channel; and

- an intermediate coupling device, the intermediate coupling device comprising a proximal end and a distal end, wherein the proximal end is provided with a ball which fits with the socket of the rotatable member as to form a ball and socket joint.

This may allow for efficient coupling of universal angulated abutments provided herein to dental implants.

Preferably, the recesses comprise a plurality of grooves in fluid connection with the distal end of the through channel.

Preferably, the plurality of grooves is distributed radially around the distal end of the through channel. Preferably, the inner surface of the rounded portion is provided with

- a plurality of grooves in fluid connection with the distal end of the through channel; and,

- an intermediate recess wherein the plurality of grooves is in fluid connection with each other through the intermediate recess.

Preferably, the intermediate recess has a textured surface.

Preferably, the grooves of the plurality of grooves have a depth of at least 0.050 mm to at most 2.0 mm, preferably of at least 0.40 mm to at most 0.80 mm.

As before, and in contrast with conventional ball-and-socket joints, ball-and-socket joints provided by the present universal angulated abutments do not necessarily need to allow for a smooth movement of the ball within the socket. Indeed, the joint should allow for movement of the rotatable member relative to the socket, but not necessarily with a minimal amount of friction. In particular embodiments, the ball may have a textured surface.

In particular embodiments, the concave socket has a textured surface. This may allow for efficient coupling of rotatable members provided herein to intermediate coupling devices.

In particular embodiments, the surface texture comprises metal trabeculae. Metal trabeculae allow for the ingress of dental adhesives, which may enhance the fixation between a rotatable member and an intermediate coupling device.

In a further aspect, the present invention provides a method of fixating a rotatable member provided herein with respect to an intermediate coupling device, the method comprising the steps:

(a) providing a universal angulated abutment provided herein;

(b) selecting a desired orientation for the rotatable member;

(c) providing dental adhesives or filler to the socket and to one or more voids of the fixing member of the rotatable member, via the through channel; and

(d) curing the dental adhesives or filler, thereby fixing the position of the rotatable member relative to the intermediate coupling device.

This is an efficient method for fixating rotatable members in a desired orientation with respect to an intermediate coupling device. In some embodiments, a positioning rod is used in step (b). This allows for easier selection of a desired orientation for the rotatable member relative to the intermediate coupling device. In some embodiments, the positioning rod is a titanium rod.

In some embodiments, the positioning rod is fixable to the intermediate coupling device. In some embodiments, the fixation is accomplished by means of a screw connection or a cold seal. Preferably, the intermediate coupling device comprises a fixation socket and the fixation rod is fixable in a fixation socket in the intermediate coupling device. Preferably, the fixation of the positioning rod to the intermediate coupling device is reversible. Accordingly, the positioning rod may be removed when desired, for example when the rotatable member has been placed in a desired position with respect to the intermediate coupling device.

In a further aspect, the present invention comprises a kit for forming a universal angulated abutment, the kit comprising a rotatable member, an annular member, and an intermediate coupling device. Preferably, the rotatable member is a rotatable member provided herein. Preferably, the annular member is an annular member provided herein. Preferably, the intermediate coupling device is an intermediate coupling device provided herein. More preferably, the rotatable member, the annular member, and the intermediate coupling device are a rotatable member, an annular member, and an intermediate coupling device provided herein.

Preferably, the dental abutment, rotatable member, dental implants, annular members, and intermediate coupling devices described herein may be made of the same or different materials. Suitable materials include, but are not limited to titania (titanium oxide), zirconia (zirconium dioxide), titanium, titanium alloys, chromium-cobalt alloy, polyether ether ketone (PEEK) type polymers, and polyamides. Such materials can provide the required strength, rigidity, and biocompatibility of the rotatable members, dental abutments, dental implants, annular members, and intermediate coupling devices provided herein.

Preferably, the dental adhesive is a glass ionomer cement. In particular embodiments, the dental adhesive is selected from glass ionomer cements, dental adhesive modified glass ionomer cements, dental adhesive based cements, silicones, ethers, and gutta percha. Accordingly, universal angulated abutments provided herein may be efficiently fixed to dental implants or intermediate coupling devices. As an alternative to dental adhesives, dental fillers may be used instead.

Whereas the present text recites that the connection between rotatable members and dental implants is mediated by intermediate coupling devices, alternatives are envisaged as well. In particular, dental implant systems are envisaged in which the rotatable member is directly connected to a dental implant without the interference of an intermediate coupling device. Accordingly, an implant can be provided with a proximal side and a distal side, wherein the distal side of the implant is configured for forming a connection with bone, and the proximal side of the implant is configured for connecting with a rotatable member. For example, a dental implant may be provided with a socket for enclosing a fixing member. In particular, the socket of the implant is a socket which is described in the context of intermediate coupling devices. For example, the dental implant may be provided with a ball for cooperating with an annular member and a socket of a rotatable member, as provided herein.

The following examples are provided for the purpose of illustrating the present invention and by no means are meant and in no way should be interpreted to limit the scope of the present invention. EXAMPLES

Fig. 1 shows a side view of a particular embodiment of the rotatable member (1 ) as described herein. Fig. 2 shows a perspective view of a part of the same rotatable member (1 ), and Fig. 3 shows an abutment (16) comprising the same rotatable member (1 ), and further comprising a socket (10) formed by an intermediate coupling device (14) and an annular member (9). The rotatable member (1 ) is positioned in the socket (10). The rotatable member (1 ) has a shaft portion (2) and a rounded portion (3), which are provided with a single central channel (4). The shaft portion (2) allows for positioning a crown or other prosthesis onto the rotatable member (1 ). The rounded portion (3) cooperates with a socket (10) of an intermediate coupling device (14), thereby forming a ball-and-socket joint. The ball-and-socket joint allows for changing the position of the rotatable member (1 ) within a cone with an opening angle of about 30°. Two outer positions of the rotatable member (1 ) are represented in Fig. 3 by dashed lines.

The abutment (16) comprises a removable annular member (9) which cooperates with the intermediate coupling device (14) to form the socket. In particular, the annular member (9) and the intermediate coupling device (14) comprise matching screw thread (not shown), which allows screwing the annular member (9) to the intermediate coupling device, thereby forming a socket for rotatably holding a rounded portion (3) of a rotatable member (1 ). Also, the annular member (9) provides an undercut which prevents the rotatable member (1 ) from falling out of the socket (10).

The outer surface of the rounded portion (3) is provided with recesses (5,6,7). More particularly, the surface of the rounded portion (3) is provided with a first series of grooves (5) running towards the shaft portion, the grooves being radially distributed around the distal end of the central channel (4) and in direct fluid connection with the central channel (4). The surface of the rounded portion (3) is further provided with a second series of grooves (6) running up to the shaft portion. The second series of grooves (6) is in fluid connection with the first series of grooves (5) via an intermediate recess (7). The surface of the intermediate recess (7) is ribbed to improve the flow of dental adhesive and to increase the surface area.

When the rotatable member (1 ) is positioned in a socket (10), dental adhesive may be provided to the channel (4). The dental adhesive can then flow from the channel (4) to the recesses (5, 6, 7), thereby providing the surface of the rounded portion (3) and any other void between the walls of the socket (10) and the rounded portion (3) with dental adhesive. The first and second series of grooves (5, 6) are tapered towards the shaft portion (2), in order to obtain a homogeneous flow of the dental adhesive over the surface of the rounded portion (3) towards the shaft portion. As the dental adhesive reaches the end of the second series of grooves (6), the dental adhesive may be cured, thereby fixing the position of the dental abutment (1 ) relative to the intermediate coupling device (14).

Whereas the present example recites an intermediate coupling device (14), a dental implant may be used equivalently, provided that the dental implant comprises the features of the intermediate coupling device which allow cooperation with an annular member and a rotatable member.

As a further example, reference is made to a particular annular member shown in Fig. 4. The annular member is configured to surround a shaft portion. In particular, the annular member is configured to tightly surround a shaft portion, the outermost diameter of the shaft portion being 0.75 mm smaller than the innermost diameter of the annular member. Furthermore, the annular member comprises a tapered portion, indicated as region D2. The tapered portion features an increasing diameter with increasing distance from the part of the annular member which is configured to form a socket. In particular, the tapered portion may describe a truncated cone, the side of the truncated cone being formed by the innermost surface of the annular member, and the ground and top planes of the cone being formed by imaginary planes defined by the start and end of the tapered portion. The angle between two opposing generatrix lines of the truncated cone is 30 degrees. Additional dimensions of the annular member are: distance D-i = 6.50 mm, distance D ₂ = 0.32 mm, distance D ₃ is 2.5 mm, distance D ₄ is 1 .5 mm, and radius Ri is 2.1 mm. As a further example, reference is made to figures 4 to 7. Fig. 4 shows two views of an annular member (9). Fig. 5 shows two views of an intermediate coupling device (14). Fig. 6 shows an abutment (16). Fig. 7 shows two views of a rotatable member (1 ).

The rotatable member (1 ) of the present example comprises a shaft portion (2) and a rounded portion (3). The shaft portion (2) is hollow, being shaped as an elongated shell enclosing a channel. The channel is not indicated in figures 4 to 7, but its position is similar to the position of the channel shown in figures 1 and 2; running through the proximal shaft portion (2), to the distal rounded portion (3). In other words, the channel extends from the distal rounded portion (3), and through the length of the entire shaft portion (2).

The rotatable member (1 ) is connectable to an intermediate coupling device (14) by means of a ball and socket joint. Whereas in the previous example, the ball-part of the joint was formed by the rounded portion (3), and the socket-part of the joint was formed by the intermediate coupling device (14); the reverse is true in the present example: the socket-part of the joint is formed by the rounded portion (3) and the ball-part of the joint is formed by the intermediate coupling device (14).

Fig. 4 shows a detailed view of the annular member (9).

As shown in Fig. 5, the ball-part of the joint, comprised in the intermediate coupling device (14), features grooves (5,6) and intermediate recesses.

Fig. 6 shows an abutment (16) comprising an intermediate coupling device (14), an annular member (9), and a rotatable member. The socket (10) formed by the rounded portion (3) mates with the ball formed by the intermediate coupling device (14). The ball- socket joint allows the shaft portion (2) to be moveable over three rotational degrees of freedom, which may greatly facilitate placing dental prostheses. An annular member (9) is attached to the intermediate coupling device (14) by means of screw-thread. The annular member comprises an inwardly extending overhang which is configured for keeping the rounded portion (3) in place on the intermediate coupling device (14).

Fig. 7 shows two views of a rotatable member (1 ). The rotatable member (1 ) comprises a shaft portion (2) and a rounded portion (3). The rounded portion (3) is formed as a socket configured for engaging with a matching ball in an intermediate coupling device (not shown). The inside of the rounded portion (3) comprises grooves (5) and intermediate recesses (7). The rounded portion further comprises perforations (22). For clarity, the perforations (22) are only shown in Fig. 7.

Whereas the present example recites an intermediate coupling device (14), a dental implant may be used equivalently, provided that the dental implant comprises the features of the intermediate coupling device which allow cooperation with an annular member and a rotatable member.

As a further example, reference is made to Fig. 8. Fig. 8 shows three panels. Panel A shows a close-up cross-sectional view of a universal angulated abutment (16) according to the present invention. Panel B shows a view on the rotatable member, from the side of the shaft portion, and along the axis of the through channel. Panel C shows a view on the rotatable member, from the side of the fixing member, and along the axis of the through channel.

The universal angulated abutment (16) comprises a rotatable member (1 ), an annular member (9), and an intermediate coupling device (14).

The rotatable member (1 ) comprises a shaft portion (2), a closing member (15) and a support member (23). The support member (23) is a particular sort of fixing member which is designed to support the rotatable member (1 ) in a socket (10) of a universal angulated abutment (16). A channel (4) is provided through the shaft portion (2) and through the support member (23). In particular, support member (17) is attached to one of the ends of the shaft portion (2). The closing member (15) is circumferentially attached to the shaft portion (2) at a distance of 1 .0 mm from the disk. Between the support member (23) and the closing member (15), a void (20) is provided. The void (20) is in fluid connection with the channel (4), as is shown in detail in panels B and C of figure 8, which are discussed in detail later on.

The intermediate coupling device (14) and the annular member (9) are reversibly attachable to each other by means of matching screw thread. The intermediate coupling device (14) and the annular member (9) form a socket (10) which rotatably holds the rotatable member (1 ), in particular the following parts of the rotatable member (1 ): the support member (23), the closing member (15), and the part of the shaft portion (2) between the fixing member (17) and the closing member (15). The socket (10) further comprises a positioning aid (13). The positioning aid (13) comprises a plurality of metal strips. 0.50 mm to 2.0 mm wide openings are left between the metal strips. The metal strips are configured to support the rotatable member (1 ) in a fixation position, which is accomplished by providing the metal strips in a rounded shell, the rounded shell supporting the support member (23) in a fixation position. A fixation position is a configuration in which a rotatable member (1 ) can be installed on an implant or an intermediate coupling device (14) to support a dental prosthesis later on. A rotatable member (1 ) is still be rotatable in a fixating position, unless the rotatable member (1 ) has been fixated by means of cured dental adhesives.

Fig. 8 also shows the flow of dental adhesives which are used to fixate the rotatable member (1 ) on the intermediate coupling device (14). In particular, the flow of dental adhesives is indicated by means of adhesive flow indicators (12), shown as arrows. Dental adhesives are introduced via the channel (4) of the rotatable member (1 ), and through the channel (4), the dental adhesives flow into the socket (10) and the void (20). More specifically, as dental adhesives are introduced through the channel (4), the dental adhesives slowly fill the socket (10) and the void (20), flowing through intermediate ducts (21 ) and channels (18) of the positioning aid (13), and through openings between the metal strips of the positioning aid (13). When the socket (10) is filled with dental adhesives, the dental adhesives overflow through channels (18) in the closing member (15). Such an overflow of dental adhesives is visible for a dentist who installs the abutment and its occurrence can be advantageously used as an indication that the socket (10) is filled with dental adhesives. Following this indication, provision of dental adhesives through the channel (4) is ceased, the rotatable member (1 ) is rotated to a final hardening position, and the dental adhesives are cured. In the final hardening position, the rotatable member has the orientation which it retains during its useful service life as support for a dental crown or a dental bridge.

As mentioned before, panel B of fig. 8 shows a view on the rotatable member (1 ), from the side of the shaft portion (2), and along the axis of the through channel. The closing member (15) comprises channels for providing fluid connection between the socket (10), the void (20) and the surroundings of the universal angulated abutment (16) as shown in panel A. As mentioned before, panel C shows a view on the rotatable member (1 ), from the side of the support member (23), and along the axis of the through channel (4). The support member (23) comprises a plurality of channels (18) which are in fluid connection with the channel (4), the intermediate connection being mediated by intermediate ducts (21 ). Whereas the present example recites an intermediate coupling device (14), a dental implant may be used instead of the intermediate coupling device (14), provided that the dental implant comprises the features of the intermediate coupling device which allow cooperation with an annular member (14) and a rotatable member (1 ).