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ImplantRelated Patent Categories: Dentistry, Prosthodontics, Holding Or Positioning Denture In Mouth, By Fastening To JawboneImplant description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20070092851, Implant. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application is a divisional of U.S. patent application Ser. No. 10/117,310 filed Apr. 5, 2002, entitled "IMPLANT", the entirety of which is incorporated herein by reference. FIELD OF THE INVENTION [0002] The present invention is directed to a novel implant and to a novel method of treatment related thereto. [0003] In particular the invention relates to a threaded implant intended to be screwed into bone, preferably into jawbone, and for tightly fitting a prosthesis, including a spacer portion, in the screwed-in position. [0004] This implant includes an implant body, that is insertable in a hole made in bone and a spacer element attachable to the implant body. The implant body has a blind bore open on one end which is a coronal end and closed at the opposite end. The spacer is attachable in a twisting prevented manner to the coronal end of the implant body and has a centering collar which is insertable into the hollow cylindrical annular recess formed by a blind bore in the implant body adjacent the coronal end while a shoulder of the spacer is received on the outer edge of the body at the corona end. The twisting preventing means for the spacer in the implant body bore can also cooperate with a tool during insertion of the implant body in to the bone. This tool can apart from being an inserter tool also carry the implant body to the hole by internal cooperation with the bore at the coronal end including the twisting prevention means. The invention also relates to an arrangement for a threaded implant body of the said type and to a method for anchoring the implant body in bone, preferably in jawbone. BACKGROUND [0005] Implants also intended to be screwed into bone are presented in International Patent Application No WO00/09031. Such implants, are also commercially available products by Nobel Biocare under the name Replace Select, and by Altatec Biotechnologies under the name of the Camlog Implant System. For these implants, the tool and spacer connection element have been combined in a common position inside the implant body and they are commonly delivered with a pre-mounted fixture mount. The arrangement with an internal connection provides easier handling and results in better feedback during the procedure of the prosthetic connection than a conventional external hex arrangement, i.e. Branemark System. However, International Patent Application No WO00/27300 describes a separated tool and prosthesis "socket", which is a completely different type of connection and thereby implant, namely a type which does not only have a blind bore projecting inwards from the coronal end according to the above, but can be provided with a part which projects upwards from the coronal end, i.e. an external hex, which is arranged with a rotational preventing connection for a prosthesis structure and a geometric separate connection for a tool during insertion in to the bone. This also allows a tool to be used in carrying the implant body to the prepared site in the bone and thus excludes the need for fixture mounts, pre-mounted or not. This technique used to insert an implant body instead of using a conventional fixture mount being attached to the implant body during insertion, has recently gained a lot of appreciation and replaced a large number of the conventional fixture mounts being used due to its ease of use. [0006] Yet another completely different type of implant is presented in U.S. Pat. No. 5,823,776, namely a type of which the implant body constitutes of a cylindrical body and thus no external threads. This type of cylindrical implants are however not suitable in all situations and do not provide initial stability within the bone as provided by a threaded implant body. [0007] The internal connection as shown by the prior art references above do not exist in relation to an insertion tool without using a fixture mount pre-mounted or not, which is in contradiction to the implant shown in WO 00/27300. The invention aims to solve this problem among others for an internal connection. [0008] The same type of implant can be used for two-stage or one-stage procedures. The internal connections according to Replace Select and the Camlog Implant System above show a large vertical height, which is not optimal for a two-stage procedure. In addition they all have obtained internal space for the spacer connection deep into the bore by thinning the implant body wall and thus decreasing the strength of the implant body but still the coronal height might exceed an unacceptable level which can lead to penetration of the mucosa and risk for excessive forces and thereby risk of loosing the implant during the healing period. This problem will be dealt with by the provided solution. [0009] A common problem of the internal connection as can be shown by the references above is that the plug of the spacer need to have a sufficient wall thickness and thus influencing the outer and/or inner diameter. This results in either a decrease wall thickness of the implant body, as for the Camlog Implant System, or to less space for an internal spacer screw, as for the Replace system. The first case will lead a weakened implant body and the second to a decreased strength of the spacer connection and a discrepancy in a system where compatibility shall withstand. [0010] The solution described in WO 00/27300 has a weak point in terms of mechanical strength since the wall thickness due to compatibility is bound to be thin. This fact implies high angular tolerances to fit the "internal tool socket" within the external hex, and thus complicated production. Also these points are corrected with the invention. [0011] This lack of space given by the solution described in WO 00/27300 also gives in hand that the "internal tool sockets" are limited in radial thickness and tangential width and thus strength implying that the insertion tool need to be manufactured in a special grade of stainless steel making the tool expensive. [0012] At very high insertion torque there is always a risk of damaging the small "internal tool sockets" described in WO 00/27300. This solution is dependent on the use of a special high grade c.p. titanium or alloyed titanium, whose clinical effects compared to a lower grade c.p. titanium have been up for debate for years. This is also solved by the invention. [0013] Failure of an implant due to abutment screw loosening and subsequent fatigue fracture of abutment screw and the implant is a real problem in implant treatment. It should be noted that hereinafter that the terms abutment and spacer are used interchangeably. This would be well understood by one skilled in the art. Even though the risk is little (<1% of the cases) the result could be devastating to the patient in terms of physical harm and to the clinician in economical terms. Implant manufacturers have dealt with the problem in different ways. [0014] There are several patents that reflects this work, for example, U.S. Pat. No. 5,947,733 to Straumann, and also commercially available products like the Astra Tech Implants Dental System. The patent describes the use of an internal cone which forms a stiff intersection thus relieving the internal screw bending and tensile stresses and creating a rigid connection in terms of rotational and bending movements and minimizing the risk for screw loosening. However the internal cone technique has received criticism for the final aesthetical result and so far there is no good proposal how to incorporate the internal solution with a functional carrying system, such as the Stargrip system available from Nobel Biocare. In addition the internal cones have too little flexibility during bending and thus the load is transferred directly down to the bone. A natural tooth has an elastic layer, therefore it is desirable to have an implant with some degree of bending flexibility which will distribute the bending forces more evenly. For the most common abutment connection used today, e.g. comprising an external hex fitting, techniques have been proposed, for example, by the 3i "Restorative Catalogue" (nr CATRC Rev.2/00) and by U.S. Pat. No. 5,334,024 to Sulzer Dental, which includes press fit or friction fit and thus extremely high tolerances. These solutions are mainly made to minimize rotational movements and to a less degree the bending movements between the implant and the abutment and thus avoiding screw loosening. The external hexes present at the market today range from 0.6 to 1.0 mm which is too low to avoid excessive bending movements with or with out fine tolerances and/or different fit solutions. As a remark higher hexes would not be suitable due to for example aesthetical reasons. [0015] As stated herein before there exists benefits with internal connections over external connections and one more benefit is a stronger resistance to bending forces. One such internal solution is described in the U.S. Pat. No. 4,960,381 with the preferred embodiment of an internal hex. A possible and obvious solution to increase the resistance to screw loosening would be to add the same features as described above for the external hex. The demand on high tolerances would however remain the same and there is still no solution to incorporate means for the insertion tool to be able to carry the implant. [0016] The design of the deep internal "tube" connection is represented by the previous mentioned Replace Select and the Camlog Implant System, and provides an even stronger resistance to bending than the prior mentioned internal hex. For example the tube design for the Camlog Implant System is claimed in "Camlog Connection--Requirements for reliable implant prosthetic treatment concept; tooth for tooth restoration", Quintessenz 50, 10, 1-18 (1999), to prevent screw loosening by being 100% rotation free and a form and forced based connection. However, this is only achievable by the extreme high tolerances adapted, which is a draw back and also true for Replace Select together with the previous restrictions of this type of deep internal connection. [0017] So for a preferred connection between the prosthetics and the implant, there is no solution with an internal connection that reduces the risk for abutment screw loosening with press- or friction-fit and at the same time benefits from a strong but still controlled flexible abutment connection and relative low tolerances compared to the deep internal "tube" connections. [0018] Therefore, one object of the present invention is to provide an implant wherein the case of a combination of improved insertion handling and prosthetic connection together with ease and cost effectiveness of manufacturing is ensured and at the same time obtaining the highest possible strength of the implant. Furthermore, it is a further object of the present invention to provide an implant system which minimizes the demand for high tolerances. SUMMARY OF THE INVENTION [0019] Thus, according to a first aspect of the invention we provide an implant for a tightly fitting prosthesis, said implant comprising; [0020] an externally threaded implant body intended to be screwed into bone using an insertion tool, the body being provided with an internal open ended axial bore and an indexing region at the open end of the bore, the indexing region being provided with a connection to support a spacer element and having means for co-operating with the spacer element to prevent twisting between the spacer element, the implant body and the insertion tool characterized in that that the axial length of the indexing region does not overlap, eg does not substantially overlap, with the external thread. [0021] The indexing region preferentially comprises a positive connection region, a guidance region and a centering region. In particular, the indexing region permits the insertion tool to provide a carrying function for positioning the implant. 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