News Column

Patent Application Titled "Patient-Specific Dental Prosthesis and Gingival Contouring Developed by Predictive Modeling" Published Online

September 11, 2014



By a News Reporter-Staff News Editor at Politics & Government Week -- According to news reporting originating from Washington, D.C., by VerticalNews journalists, a patent application by the inventors Herrington, Stephen M. (Naples, FL); Suttin, Zachary B. (West Palm Beach, FL), filed on February 19, 2013, was made available online on August 28, 2014.

The assignee for this patent application is Biomet 3i, Llc.

Reporters obtained the following quote from the background information supplied by the inventors: "The dental restoration of a partially or wholly edentulous patient with artificial dentition can be accomplished through several methods involving a dental implant. One common method has two stages. In the first stage, an incision is made through the gingiva to expose the underlying bone. An artificial tooth root, in the form of a dental implant, is placed in the jawbone for osseointegration. The dental implant generally includes a threaded bore to receive a retaining screw for holding mating components thereon. During the first stage, the gum tissue overlying the implant is sutured and heals as the osseointegration process continues.

"Once the osseointegration process has sufficiently advanced, the second stage is initiated. Here, the gingival tissue is re-opened to expose an end of the dental implant. A healing component or healing abutment is fastened to the exposed end of the dental implant to allow the gingival tissue to heal therearound. The healing abutment is then removed and a prosthesis, which involves an abutment and artificial crown fitting over the abutment, is secured to the dental implant through the gingival aperture created by the healing abutment.

"In an alternative method, the healing abutment can be placed on the dental implant immediately after the implant has been installed and before osseointegration. In this method, the osseointegration phase and gingival-healing step into a one-step process.

"In a further alternative, the dental implant can be immediately loaded by use of a temporary prosthesis placed on the dental implant after it has been installed. In that situation, the gingival tissue heals around the temporary abutment.

"Regardless of the method that is used, a primary goal is to have the soft tissue heal around the prosthesis in a predictable manner (i.e., similar to the patient's adjacent teeth) so that the prosthesis and soft tissue contours appear more natural. There are, however, many clinical factors that may impact the ability of the soft tissue to grow around and be preserved against the prosthesis, including at least the following (i) the patient's age, (ii) the patient's sex, (iii) the patient's race, (iv) the location of the implant-abutment interface relative to the bone, (v) the material of the abutment, (vi) the surface treatment on the abutment, (vii) the amount of surface area of the abutment exposed to the soft tissue, (viii) the soft-tissue displacement required when placing the prosthesis at the site after the second-phase soft-tissue healing process is complete, (ix) the type of bone at the implant installation, and (x) the patient's health conditions (e.g., smoker, diabetic, etc.).

"Implant dentistry restorative methods have advanced to the digital world such that the scanning of the patient' mouth, of the impression of the patient's mouth, or the model of a patient's mouth provides the information needed for restoring the case. That information can be used to develop a patient-specific (i.e., custom) prosthesis for the patient. Some examples of the technology are discussed in U.S. Pat. Nos. 8,353,703, 8,257,083, 8,185,224, which are commonly owned and hereby incorporated by reference in their entireties. In these more modern digital dentistry systems, the creation of the design (the abutment and the crown to fit on the abutment) and the finalization of the design are generally accomplished by design technicians and dental laboratory personnel using CAD-CAM software. However, in the current systems, the designs are typically based on what the current patient requires based on his or her conditions. While the design technicians and dental laboratory personnel may rely on their experiences in designing other prostheses, the success of the soft-tissue outcome on the previously designed prostheses does not play a part in the current design.

"A need exists for a patient-specific restorative system that leverages the knowledge of the soft-tissue outcomes of previous patients to develop a design for a prosthesis for a current patient. In doing so, the system provides a greater certainty that the predicted soft-tissue outcome for the current patient will become a reality for the current patient."

In addition to obtaining background information on this patent application, VerticalNews editors also obtained the inventors' summary information for this patent application: "The present invention relates to a method of designing a patient-specific prosthesis for a current patient. The method comprises receiving scan data of a mouth of the current patient to identify conditions at a location at which the patient-specific prosthesis is to be placed on a dental implant, and determining at least two clinical factors for the current patient. The method further includes identifying a desired outcome for soft tissue for the current patient at the location, and accessing a database having soft-tissue-outcome information for each of a plurality of previous patients. The database further includes clinical-factor information for each of the plurality of previous patients. Based on the soft-tissue-outcome information and the clinical-factor information for at least a first previous patient of the plurality of previous patients being related to the current patient's desired outcome and the current patient's at least two clinical factors, the method includes developing a design for the patient-specific prosthesis for the current patient that includes design features used by an actual previous prosthesis for the first previous patient.

"In an alternative embodiment, a method of designing a patient-specific prosthesis for a current patient comprises accessing a database that stores information for each of a plurality of previous patients. The information for each previous patient includes (i) clinical-factor information, (ii) prosthetic information relating to the prosthesis used on the previous patient and (iii) soft-tissue-outcome information. Based on a relationship between (i) clinical factors and desired soft-tissue outcome for the current patient and (ii) the clinical-factor information and the soft-tissue-outcome information for a first previous patient from the plurality of previous patients, the method includes selecting the prosthetic information for the first previous patient as part of a baseline design for the patient-specific prosthesis, and modifying the baseline design to develop a final design for the patient-specific prosthesis.

"In a further embodiment, a method of designing a dental prosthesis for a current patient comprises identifying, within a database, a previous patient from a plurality of patients that has an actual prosthesis and an actual soft-tissue outcome that are similar to a desired soft-tissue outcome and a virtual prosthesis for a current patient. The method further includes using design features from the actual prosthesis from the identified previous patient to develop a final design for the prosthesis for the current patient.

"In yet another alternative, a method of designing a dental prosthesis for a current patient comprises identifying, within a database, a subset of previous patients from a plurality of patients that had the same tooth replaced as the current patient is having, and identifying, from the subset of previous patients, a first previous patient that has an actual prosthesis that is similar to a virtual prosthesis for a current patient. The method further includes using design features from the actual prosthesis from the identified first previous patient to develop a final design for the prosthesis for the current patient.

"In another alternative, the present invention is a method of designing a dental prosthesis for a current patient, comprising receiving scan data from a mouth of a current patient, and, by use of the scan data, locating a dental implant that is installed in the mouth of the current patient. The method further includes, by use of the scan data, developing a desired soft-tissue outcome and a desired prosthesis shell for the current patient. The desired prosthesis shell representing an estimated volume adjacent to the dental implant that is to be occupied by the prosthesis. The method also includes (i) identifying, within a database, a first previous patient and a second previous patient each of whom has at least two clinical conditions similar to clinical conditions of the current patient, (ii) accessing, from the database, design information for a first prosthesis used on the first previous patient and for a second prosthesis used on the second previous patient, and (iii) based on the design information and the desired prosthesis shell, developing a final design for the dental prosthesis for the current patient.

"Additional aspects of the present disclosure will be apparent to those of ordinary skill in the art in view of the detailed description of various implementations, which is made with reference to the drawings, a brief description of which is provided below.

BRIEF DESCRIPTION OF THE DRAWINGS

"The foregoing and other advantages of the disclosure will become apparent upon reading the following detailed description and upon reference to the drawings.

"FIG. 1A is a perspective view of a current patient's mouth in which an implant has been placed to replace tooth #9 in the patient.

"FIG. 1B is a perspective view of an intra-oral scan for locating the implant in the patient of FIG. 1A;

"FIG. 1C is a model on a computer display that is based on the scan data obtained in FIG. 1B;

"FIG. 1D is a model on a computer display that is based on the scan data obtained in FIG. 1B, and with a desired outcome for a prosthesis and the soft tissue for the current patient;

"FIG. 2 is a block diagram illustrating the connection of the prosthesis design system with the clinical locations and the prosthetic manufacturing facility;

"FIG. 3 is a depiction of a computer display of the actual outcomes for four previous patients who have had tooth #9 replaced;

"FIG. 4 is a depiction of a computer display illustrating the prosthesis for one of the previous patients of FIG. 3 and options for manipulation of the previous patient's prosthesis (abutment and/or crown) to develop a design for the current patient's prosthesis;

"FIG. 5 is a flow chart describing one method of developing a design for the current patient's prosthesis by use of the prosthesis design system of FIG. 2;

"FIG. 6 is a flow chart describing one method of selecting, from a database associated with the prosthesis design of FIG. 2, a subset of previous patients that have information useful in developing a design for the current patient's prosthesis;

"FIG. 7 is a flow chart describing one method of entering a patient's clinical factors, desired soft-tissue outcome, and actual soft-tissue outcome in the database associated with the prosthesis design of FIG. 2;

"FIG. 8 is an illustration of a soft-tissue outcome and prosthesis with the factors of soft-tissue contour, soft-tissue height, and soft-tissue inter-papilla fullness displayed;

"FIGS. 9A and 9B are illustrations of a different soft-tissue outcome in that the soft-tissue height is different relative to FIG. 8;

"FIGS. 10A and 10B are illustrations of a different soft-tissue outcome in that the soft-tissue height and the soft-tissue inter-papilla fullness are different relative to FIG. 8;

"FIG. 11 is an illustration of a different soft-tissue outcome in that the soft-tissue contour is different relative to FIG. 8;

"FIG. 12 graphically illustrates the development of a current patient's prosthesis by merging of design features from two prostheses used by two previous patients, as described relative to Table III.

"FIG. 13 is a flow chart describing another method of developing a design for the current patient's prosthesis by use of the prosthesis design system of FIG. 2;

"FIG. 14 graphically illustrates the development of another current patient's prosthesis by merging of design features from three prostheses used by three previous patients, as described relative to Table IV;

"FIG. 15 illustrates a prosthesis with some of the basic geometric design elements; and

"FIG. 16 graphically illustrates the development of yet another current patient's prosthesis by merging of design features from two prostheses used by two previous patients, as described relative to Table V.

"While the present disclosure is susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and will be described in detail herein. It should be understood, however, that the present disclosure is not intended to be limited to the particular forms disclosed. Rather, the present disclosure is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure as defined by the appended claims."

For more information, see this patent application: Herrington, Stephen M.; Suttin, Zachary B. Patient-Specific Dental Prosthesis and Gingival Contouring Developed by Predictive Modeling. Filed February 19, 2013 and posted August 28, 2014. Patent URL: http://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.html&r=2894&p=58&f=G&l=50&d=PG01&S1=20140821.PD.&OS=PD/20140821&RS=PD/20140821

Keywords for this news article include: Biomet 3i, Biomet 3i Llc, Bone Research, Dentistry, Medical Devices, Prosthetics.

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