Temporary dental prosthesis for use in developing final dental prosthesis

This applicationis a Broadening Reissue of U.S. patent application Ser. No. 13/797,254, filed Mar. 12, 2013, now U.S. Pat. No. 10,813,729; whichclaims the benefit of U.S. Provisional Application No. 61/701,416, filed Sep. 14, 2012; this application is related to U.S. Application Ser. No. 13/797,385, filed Mar. 12, 2013, entitled “Temporary Dental Prosthesis For Use in Developing Final Dental Prosthesis”, each of which is hereby incorporated by reference herein in its entirety.

The present disclosure relates generally to developing a final dental prosthesis. More particularly, the present disclosure relates to using a temporary dental prosthesis in developing a final dental prosthesis.

The dental restoration of a partially or wholly edentulous patient with artificial dentition is typically done in 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 is complete, 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. It should be noted that the healing abutment can be placed on the dental implant immediately after the implant has been installed and before osseointegration, thereby, for some situations, combining the osseointegration step and gingival healing step into a one-step process.

Prior healing abutments were generally round in profile, but the artificial teeth or prostheses that eventually replaced the healing abutments were not. Thus, the gingival tissue would heal around the healing abutments creating a gingival emergence profile that approximated the size and contour of the healing abutment and not the size and contour of the final prosthesis that was eventually attached to the implant. The resulting discrepancies between the emergence profile of the patient's gingiva and the installed final prosthesis could sometimes require additional visits with the dentist or clinician to finalize the installation process and/or compromise the aesthetic outcome of the installed final prosthesis (e.g., the visual look of the patient's gingival tissue abutting the final prosthesis). Thus, in recent years, standard healing abutments have been replaced with temporary prosthetic abutments.

Further, implant dentistry restorative methods have advanced beyond requiring a fixture-level (e.g., dental implant level) impression as the starting point for developing a final dental prosthesis. In some such cases pre-defined scan bodies (e.g., Encode Healing Abutments available from Biomet 3i, LLC) are assembled to the dental implants during the gingival healing stage. The pre-defined scan bodies include scannable features (e.g., markers) that, when scanned and interpreted, provide information about the location and orientation of the underlying dental implant that is used in developing the final dental prosthesis.

Although such methods using pre-defined scan bodies provide many benefits (e.g., improved aesthetics, reduced complexity, and potentially accelerated treatment times), such methods are reliant on scanning technology. A need exists for a patient-specific restorative solution that does not require dedicated pre-defined scan bodies as to further reduce the treatment complexity and improve restorative flexibility. The present disclosure is directed to solving these and other needs.

The present disclosure provides methods for developing and fabricating permanent patient-specific prostheses without needing pre-defined scan bodies. Thus, the methods of the present disclosure can reduce treatment complexity and enhance restorative flexibility, and thereby improve the dental restoration process. In particular, a patient-specific temporary prosthesis (PSTP) is fabricated and then scanned to generate scan data and/or a virtual three-dimensional model of the PSTP that captures all of the contours and details of the PSTP. The PSTP is attached to the implant in the patient's mouth and the gingival tissue is permitted to heal therearound. Subsequently, a clinician determines if the gingival tissue has healed around the PSTP in a desired manner (e.g., aesthetically pleasing manner). If so, a permanent patient-specific prosthesis is created as an exact replica of the PSTP using the scan data and/or the virtual three-dimensional model of the PSTP. If not, depending on the necessary modifications, (i) the PSTP is physically modified and rescanned or (ii) the scan data and/or the virtual three-dimensional model of the PSTP are virtually modified. Then, a permanent patient-specific prosthesis is created as an exact replica of (i) the modified PSTP using scan data and/or a virtual three-dimensional model generated from the rescanning of the modified PSTP or (ii) the virtually modified virtual three-dimensional model of the PSTP. Either way, by scanning the entire PSTP and generating scan data and/or the virtual three-dimensional model of the PSTP: (i) pre-defined scan bodies are not necessary to develop and fabricate the permanent patient-specific prosthesis and (ii) nor are pre-defined scan bodies necessary to determine the location of the implant with respect to the adjacent and/or opposing dentition.

A method of manufacturing a permanent prosthesis for attachment to a dental implant installed in a mouth of a patient includes scanning a patient specific temporary prosthesis (PSTP) to obtain scan data. The PSTP is attached to the dental implant in the mouth of the patient. Gingival tissue surrounding the PSTP is permitted to heal in the mouth of the patient. In response to the aesthetics of the healed gingival tissue surrounding the PSTP in the mouth of the patient being acceptable, the permanent prosthesis is manufactured as a replica of the PSTP using the obtained scan data.

A method of manufacturing a permanent prosthesis for attachment to a dental implant installed in a mouth of a patient includes scanning a patient specific temporary prosthesis (PSTP) to obtain scan data. The PSTP is attached to the dental implant in the mouth of the patient. Gingival tissue surrounding the PSTP is permitted to heal in the mouth of the patient. In response to the aesthetics of the healed gingival tissue surrounding the PSTP in the mouth of the patient not being acceptable, the PSTP is physically modified by (i) removing material from the PSTP, (ii) adding material to the PSTP, or (iii) both.

A method of manufacturing a permanent prosthesis for attachment to a dental implant installed in a mouth of a patient includes generating scan data from a scan of a patient specific temporary prosthesis (PSTP). Subsequent to the PSTP being attached to the dental implant in the mouth of the patient and gingival tissue surrounding the PSTP being permitted to heal in the mouth of the patient, modified scan data is generated from a scan of a physically modified PSTP. The PSTP is physically modified in response to the aesthetics of the healed gingival tissue surrounding the PSTP in the mouth of the patient not being acceptable.

A method of manufacturing a permanent prosthesis includes acquiring scan data including computed tomography (CT) data, intraoral scan (IOS) data, or both, of a mouth of patient. Using the scan data, a location in the mouth of the patient is determined to install a dental implant. Using the scan data and the determined location in the mouth of the patient to install the dental implant, a patient specific temporary prosthesis (PSTP) is virtually designed and virtual PSTP data is generated. Using the virtual PSTP data, the PSTP is manufactured. The dental implant is installed in the mouth of the patient substantially at the determined location. The manufactured PSTP is attached to the dental implant installed in the mouth of the patient. Gingival tissue surrounding the PSTP is permitted to heal in the mouth of the patient. In response to the aesthetics of the healed gingival tissue surrounding the PSTP in the mouth of the patient being acceptable, the permanent prosthesis is manufactured as a replica of the PSTP using the virtual PSTP data.

A method of manufacturing a permanent prosthesis includes acquiring scan data including computed tomography (CT) data, intraoral scan (IOS) data, or both, of a mouth of patient. Using the scan data, a location in the mouth of the patient is determined to install a dental implant. Using the scan data and the determined location in the mouth of the patient to install the dental implant, a patient specific temporary prosthesis (PSTP) is virtually designed and virtual PSTP data is generated. Using the virtual PSTP data, the PSTP is manufactured. The dental implant is installed in the mouth of the patient substantially at the determined location. The manufactured PSTP is attached to the dental implant installed in the mouth of the patient. Gingival tissue surrounding the PSTP is permitted to heal in the mouth of the patient. In response to the aesthetics of the healed gingival tissue surrounding the PSTP in the mouth of the patient not being acceptable, the PSTP is physically modified by (i) removing material from the PSTP, (ii) adding material to the PSTP, or (iii) both.

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.

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.

Referring to, patient-specific temporary prostheses (“PSTPs”)a,b, andc are used to develop final or permanent patient-specific prostheses in accordance with the present disclosure. Further, the PSTPsa,b, andc serve as gingival healing abutments as their exterior surfaces are contoured to aid in the healing of a patient's gingival tissue.

Referring specifically to, the PSTPa has a supragingival regiona and a subgingival regionb, which are separated by a flange. The PSTPa is a one-piece prosthesis in that the supragingival regiona and the subgingival regionb are formed from the same material (e.g., acrylic). Alternatively, the supragingival regiona is permanently attached to the subgingival regionb making the PSTP a one-piece prosthesis. In such an alternative, the supragingival regiona can be made of a first material (e.g., acrylic) and the subgingival regionb can be made of a second material (e.g., metal, such as titanium).

The subgingival regionb includes an anti-rotational feature(e.g., a hexagonal section) for mating with a corresponding anti-rotational feature of an implant (e.g., implantin). The PSTPa is held onto the implantusing a retaining screw. The anti-rotational featureof the PSTPa can be any type of boss (e.g., polygonal boss, star boss, clover boss, etc.) or socket (e.g., polygonal socket, star socket, clover socket, etc.) such that it corresponds with an anti-rotational feature of the underlying implantto prevent relative rotation of the PSTPa with respect to the implant. It is contemplated that the PSTPa (and the other PSTPs of the present disclosure) can be fashioned from gold, titanium, plastic, ceramic, acrylic, or other similar metals or composites, or any combination thereof.

Referring specifically to, the PSTPb is similar to the PSTPa, except that the PSTPb is a two-piece prosthesis. That is, the PSTPb includes a temporary abutmenta and a temporary abutment capb (e.g., temporary crown). The temporary abutment capb is removable from the temporary abutmenta (e.g., in a snap-like fashion and/or in a sliding-like fashion) such that a screwcan attach the temporary abutmenta to the implantand the temporary abutment capb can then be attached to the temporary abutmenta thereafter.

The temporary abutmenta has a supragingival regiona and a subgingival regionb, which are separated by a flange. The subgingival regionb includes an anti-rotational feature(the same as, or similar to, the anti-rotational feature) for mating with a corresponding anti-rotational feature of the implant. The supragingival regiona of the temporary abutmenta includes one or more retention grooves or structuresand an anti-rotational structure (e.g., a flat wall or surface) that is not shown. The retention groovesare configured to mate in a snap-type axial holding engagement with corresponding male circumferential features or structuresof the temporary abutment capb. Alternatively to the temporary abutmenta including retention groovesand the temporary abutment capb including corresponding male circumferential features, dental cement, or the like, can be used to mate (e.g., hold together) the temporary abutmenta with the temporary abutment capb.

The anti-rotational structure (not shown) of the temporary abutmenta is configured to mate in a slideable engagement with a corresponding anti-rotational structureto prevent relative rotation of the temporary abutment capb and the temporary abutmenta. In the illustrated implementation, the anti-rotational structure (not shown) generally extends from a top surface of the temporary abutmenta to the flange. Details on and examples of anti-rotational structures for dental posts (e.g., supragingival regions of temporary abutments) are shown in U.S. Pat. Nos. 6,120,293, 6,159,010, and 8,002,547, each of which is commonly owned by the assignee of the present application and is hereby incorporated by reference herein in its entirety.

Referring specifically to, the PSTPc is similar to the PSTPsa andb, except that the PSTPc is a three-piece prosthesis. That is, the PSTPc includes a temporary abutmenta, a temporary abutment capb, and a temporary crownc. The temporary abutment capb is removable from the temporary abutmenta (e.g., in a snap-like fashion and/or in a sliding-like fashion) such that a screwcan attach the temporary abutmenta to the implantand the temporary abutment capb can then be attached to the temporary abutmenta thereafter. Further, the temporary crownc is mated with and/or bonded to the temporary abutment capb prior to, or after, the temporary abutment capb is attached to the temporary abutmenta. It is contemplated that the temporary crownc is coupled to the temporary abutment capb using cement (e.g., dental cement), glue, bonding agent, a press-fit engagement, a snap or click-type engagement, a screw or bolt, or a combination thereof.

The temporary abutmenta has a supragingival regiona and a subgingival regionb, which are separated by a flange. The subgingival regionb includes an anti-rotational feature(the same as, or similar to, the anti-rotational features,) for mating with a corresponding anti-rotational feature of the implant. The supragingival regiona of the temporary abutmenta includes one or more retention grooves or structuresa and an anti-rotational structureb (e.g., a flat wall or surface). The retention groovesa are configured to mate in a snap-type axial holding engagement with corresponding male circumferential features or structuresof the temporary abutment capb.

The anti-rotational structureb of the temporary abutmenta is configured to mate in a slideable engagement with a corresponding anti-rotational structureto prevent relative rotation of the temporary abutment capb and the temporary abutmenta. In the illustrated implementation, the anti-rotational structureb generally extends from a top surface of the temporary abutmenta to the flange.

Additional details on, and examples of, temporary abutments and/or PSTPs are shown and described in U.S. patent application Ser. No. 13/473,219, filed on May 16, 2012, which is commonly owned by the assignee of the present application and is hereby incorporated by reference herein in its entirety.

Referring to, a clinicianis shown manually modifying and/or customizing the PSTPa,b,c prior to installing the same in a mouthof a patient. That is, one way for the PSTPsa,b, andc to be fabricated is by a clinician removing and/or adding material to a stock or standard temporary prosthetic to create one of the PSTPsa,b,c. The stock or standard PSTP can have an anatomical tooth shape or a non-anatomical tooth shape (e.g., cylindrical, square, etc.). Such a manual method can be accomplished chair side after the implantis installed into the patient's mouthsuch that the patientcan leave with a PSTPa,b,c acting as a temporary tooth and as a gingival healing abutment immediately after the implantis installed.

In some implementations of the present concepts, a kit or package of PSTPs can be supplied to the clinician, where each of the PSTPs in the kit has a preformed anatomical tooth shape of a predetermined size and shape. The clinician can select the appropriate PSTP and begin modifications as necessary for the particular patient. Thus, in such implementations, the clinician is supplied with a variety of preformed PSTPs having different anatomical teeth shapes that can be modified/customized as necessary and attached to the implant.

Alternatively to the manual method described in reference to, referring to, the PSTPsa,b,c can be virtually/digitally designed and fabricated using a milling machine (e.g., a 5 axis milling machine) and/or a rapid prototype machineprior to the implantbeing installed into a mouthof a patient. As shown in, prior to any implants being installed, a computed tomography (“CT”) scan and/or an intraoral scan (IOS) can be taken of the mouthof the patientusing one or more scanners/cameras(e.g., e-ray scanners, etc.). Scan data and/or virtual three-dimensional models generated from the CT and/or IOS scans is transferred to a computer systemincluding software (e.g., CAD software, graphical imaging software, etc.) configured to process the generated scan data and/or virtual three-dimensional models and virtually design a PSTP for the patient. Specifically, the software evaluates the scan data and/or virtual three-dimensional models associated with the teeth and the gingival tissueof the patientsurrounding and adjacent to the planned implant site(e.g., site where a tooth will be removed and replaced with an implant) and accordingly designs a virtual PSTP. After the virtual PSTPis designed, virtual temporary prosthesis data is generated. The virtual temporary prosthesis data includes instructions for the milling and/or rapid prototype machineto execute in order to fabricate the PSTP (e.g., the PSTPsa,b,c). Additional details on rapid prototyping in general can be found in U.S. Pat. No. 8,185,224, which is hereby incorporated by reference herein in its entirety. Additional details on creating bone and soft-tissue digital dental models (e.g., virtual three-dimensional models) from the CT scan and the IOS scan can be found in U.S. Patent Application Publication No. 2011/0129792, which is hereby incorporated by reference herein in its entirety.

Whether the PSTP is manually modified () and/or designed and fabricated using a milling and/or rapid prototype machine (), the outer surfaces of the PSTPsa,b,c are configured to be suitable for replicating the gingival emergence profile formed by a natural tooth (e.g., in a non-round shape). As such, after the PSTPsa,b,c are installed (e.g., attached to the implant) in the mouth of the patient, the patient's gingiva is permitted to heal around the PSTPa,b,c, which results in a gingival emergence profile approximating that of what would be around a natural tooth. In other words, the PSTPa,b,c also acts as a gingival healing abutment.

Now referring to, a methodof manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient is described in reference to a flow chart. Initially, a dental implant (e.g., implant) is installed into the mouth of a patient (). A PSTP, to be attached to the implant, is scanned to obtain scan data of the PSTP () and/or a virtual three-dimensional model of the PSTP. The scanned PSTP can be manually formed and/or modified by a clinician as described in reference to, or the scanned PSTP can be designed virtually based on CT and/or IOS data and machine manufactured as described in reference to(). The PSTP can be scanned using any type or kind of scanner, such as, for example, a 3D dental scanner (e.g., model nos. D500, D700, D710, D800, and D810) available from 3Shape A/S located in Copenhagen, Denmark or a LAVA Chairside Oral Scanner available from 3M located in Saint Paul, Minn. The scanning of the PSTP generates the scan data associated with the PSTP that can be used to create a virtual three-dimensional model of the PSTP. Thus, the scanning of the PSTP captures all of the contours, sizes, and shapes of the PSTP in a digital format that can be displayed as a virtual three-dimensional model of the PSTP on a display device (e.g., computer monitor). Specifically, the entire PSTP is scanned such that the virtual three-dimensional model of the PSTP is a complete virtual replica of the PSTP.

After the PSTP is scanned and the scan data is obtained (), the PSTP is attached to the dental implant (). In some implementations, the PSTP is attached to the dental implant in a non-rotational fashion (e.g., using complementary non-rotational features) and held in place using a screw fastener (e.g., screw,,). After the PSTP is attached to the implant (), the patient's gingival tissue is permitted to heal around the PSTP (). The gingival tissue generally heals in a shape with an emergence contour profile that corresponds to the external contours of the PSTP abutting the gingival tissue.

After the gingival tissue is permitted to heal () for a predetermined amount of time (e.g., a day, two weeks, a month, three months, six months, a year, etc.), the aesthetics of the gingival tissue surrounding the PSTP are checked to determine if the aesthetics of the gingival tissue surrounding the PSTP are acceptable (). By acceptable, it is meant that the gingival tissue is hugging the PSTP in an aesthetically pleasing manner as determined by, for example, a clinician treating the patient. It is also contemplated that in an alternative implementation, the aesthetics can be determined to be acceptable by a computer executing software that analyzes scan data and/or a virtual three-dimensional model generated from a scan of the patient's mouth including the gingival tissue surrounding the PSTP after healing has occurred. Additionally, the aesthetics of the PSTP itself can be checked to determine, for example, if the aesthetics of the supragingival portion of the PSTP are acceptable (e.g., match the size, shape, and/or color of a natural tooth in view of the surrounding teeth).

If the aesthetics of the gingival tissue and/or of the PSTP itself are determined to be acceptable (), a final prosthesis is manufactured as a replica of the PSTP based on the scan data () and/or the virtual three-dimensional model of the PSTP. That is, the scan data from the scan of the PSTP () is used to create an actual and physical replica of the PSTP using, for example, a milling machine and/or a rapid-prototype machine. Thus, the outer contours of the final prosthesis are the same as, or substantially the same as, the outer contours of the PSTP. The final prosthesis can be made of gold, titanium, plastic, ceramic, acrylic, porcelain, or other similar metals or composites, or any combination thereof.

Essentially, the difference between the PSTP and the final prosthesis are the materials that are used and/or the mechanical configuration which is employed to make the PSTP and the final prosthesis. Generally, in some implementations, the PSTP is made of plastic and the final prosthesis is made of a titanium insert with a ceramic crown having a porcelain coating thereon. Thus, in some implementations, the PSTP is physically softer (e.g., easier to modify and relatively less durable) and the final prosthesis is physically harder (harder to modify and relatively more durable) and more aesthetically pleasing (including color and/or shading). By different mechanical configuration it is meant that while the outer contours of the final prosthesis match the outer contours of the PSTP, the final prosthesis can be formed by a different number of subparts or portions as compared to the PSTP. For example, the PSTP can be formed as a unitary piece of plastic and the final prosthesis can be formed by a metal abutment and a ceramic crown attached thereto.

If the aesthetics are determined to not be acceptable (), the PSTP is physically modified to achieve better results (). That is, after additional healing of the gingival tissue is permitted about the physically modified PSTP, better aesthetic results are expected due to the modifications of the PSTP. The PSTP can be manually modified by the clinician treating the patient. Alternatively, the PSTP can be modified using a milling machine and/or a rapid prototype machine. The modifications can be made to the PSTP with the PSTP installed in the patient's mouth and/or with the PSTP removed therefrom. The modifications can include removal of material from the PSTP, additional material being added to the PSTP, material of the PSTP being moved/deformed (e.g., bent, twisted, etc.), or any combinations thereof.

After the PSTP is physically modified (), the modified PSTP is scanned to obtain scan data of the modified PSTP () and/or a virtual three-dimensional model of the modified PSTP. The scan data obtained from the modified PSTP essentially replaces the scan data obtained from the unmodified PSTP described above. The modified PSTP can be scanned () in the same, or similar, manner that the unmodified PSTP was scanned () described above. After the modified PSTP is scanned (), the PSTP is reattached to the implant () and acts (), (), and () are repeated until the aesthetics are found to be acceptable () and then the final prosthesis is manufactured () based on the latest scan data from a scan of the latest modified PSTP.

Now referring to, a methodof manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient is described in reference to a flow chart. The methodincludes acts ()-() which are the same as acts ()-() described above in reference to the methodof. However, the methodfurther includes act () after the modified PSTP is scanned (). After the modified PSTP is scanned (), the final prosthesis is manufactured as a replica of the modified PSTP based on the scan data and/or the virtual three-dimensional model from the scan of the modified PSTP () without rechecking the aesthetics as in the method. That is, in the method, the aesthetics are not rechecked after the modifications to the PSTP (). Foregoing the rechecking of the aesthetics in the methodmay accelerate the treatment time for the patient as compared to the method. A clinician might forego the rechecking of the aesthetics when the modifications to the PSTP are minor and/or supragingival (e.g., modifications are made to the portion of the PSTP not abutting or blocked by the gingival tissue).

Now referring to, a methodof manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient is described in reference to a flow chart. The methodincludes acts ()-() which are the same as acts ()-() described above in reference to the methodof. However, the methodreplaces acts () and () with acts (), (), () in response to the aesthetics being determined to not be acceptable ().

If the aesthetics are determined to not be acceptable (), the patient's mouth (or a portion of the patient's mouth) is scanned to obtain additional scan data () and/or a virtual three-dimensional model of at least a portion of the patient's mouth. In some implementations, the installed PSTP, the adjacent gingival tissue healing therearound, and adjacent and/or opposing teeth are scanned to generate scan data and/or a virtual three-dimensional model of the PSTP, the adjacent gingival tissue, and the adjacent and/or opposing teeth. Then, the originally obtained scan data and/or the virtual three-dimensional model of the PSTP are virtually modified (). Specifically, the scan data and/or the virtual three-dimensional model of the PSTP are virtually modified by the clinician treating the patient and/or another designer. The virtual modifications can be made to the scan data and/or the virtual three-dimensional model of the PSTP with the PSTP remaining in the patient's mouth (e.g., the PSTP does not need to be removed for the virtual modification). The virtual modifications can include virtually removing material from the virtual three-dimensional model of the PSTP and/or virtually adding material to the virtual three-dimensional model of the PSTP. A clinician might virtually modify the scan data of the PSTP (instead of physically modifying the PSTP) when the modifications to the PSTP are minor (e.g., the modifications will not significantly impact the healing of the gingival tissue) and/or supragingival (e.g., modifications are made to the portion of the PSTP not abutting or blocked by the gingival tissue).

After the scan data and/or the virtual three-dimensional model of the PSTP are virtually modified (), the final prosthesis is manufactured as a replica of the virtually modified virtual three-dimensional model of the PSTP (). Specifically, the final prosthesis is manufactured based on the virtually modified scan data of the PSTP () without rechecking the aesthetics as in the methodand without physically modifying the PSTP installed in the mouth of the patient as in the method. That is, in the method, the aesthetics are not rechecked after the virtual modifications to the scan data of the PSTP () and the PSTP installed in the mouth of the patient is not physically modified. As described above, foregoing the rechecking of the aesthetics in the methodmay accelerate the treatment time for the patient as compared to the method. Additionally, foregoing the physical modification to the PSTP avoids and/or reduces potential discomfort and tissue remodeling of the patient resulting from having to endure removal of and replacement of the PSTP during such physical modifications.

Several alternative implementations which are similar to the methods,, andare described below. According to a first alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design. If no modification(s) are necessary, the final prosthesis is designed and fabricated as a replica of the PSTP (e.g., a copymill) using the scan data and/or the virtual three-dimensional model of the PSTP from the scan of the PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The PSTP is removed and the final prosthesis is attached to the implant.

According to a second alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. Then the final prosthesis is designed and fabricated as a replica of the PSTP (e.g., a copymill) using the scan data and/or the virtual three-dimensional model of the PSTP from the scan of the PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The gingival tissue is permitted to heal and then the PSTP is removed and the final prosthesis is attached to the implant. In such an implementation, the clinician does not assess the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design as the final prosthesis is designed and fabricated without waiting for the gingival tissue to heal.

According to a third alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated and attached to the implant installed in the patient's mouth. The gingival tissue is permitted to heal. After healing, the PSTP is removed and the PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is reattached to the implant. The final prosthesis is designed and fabricated as a replica of the PSTP (e.g., a copymill) using the scan data and/or the virtual three-dimensional model of the PSTP from the scan of the PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The PSTP is removed and the final prosthesis is attached to the implant. Thus, in such an alternative, the PSTP is scanned after gingival tissue healing has occurred and is not scanned prior to the PSTP being initially attached to the implant.

According to a fourth alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. After the PSTP is attached to the implant, the mouth of the patient is scanned. Specifically, the attached PSTP and the adjacent and/or opposing teeth are scanned generating additional scan data and/or a virtual three-dimensional model of the attached PSTP and the adjacent and/or opposing teeth of the patient. The additional scan data and the scan data generated from the scan of the entire PSTP can be merged into a merged dataset and/or a merged virtual three-dimensional model. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design. If a modification(s) is necessary, the PSTP is removed from the patient's mouth and physically modified (e.g., material is removed from the PSTP, material is added to the PSTP, or both). The modified PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the modified PSTP. The modified PSTP is then reattached to the implant. Alternatively to removing the PSTP from the patient's mouth and modifying the PSTP outside of the patient's mouth, if the necessary modification(s) is supragingival, the physical modification(s) can be made to the PSTP without removing the PSTP from the patient's mouth and the PSTP can be scanned while still installed in the patient's mouth (e.g., only the viewable portion of the PSTP is scanned). The merged dataset and/or the merged virtual three-dimensional model are updated to include the scan data of the modified PSTP and/or the virtual three-dimensional model of the modified PSTP. The final prosthesis is then designed and fabricated as a replica of the modified PSTP (e.g., a copymill) using the updated merged dataset and/or the updated merged virtual three-dimensional model (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The modified PSTP is removed and the final prosthesis is attached to the implant.

According to a fifth alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design. If a modification(s) is necessary, the PSTP is removed from the patient's mouth and physically modified (e.g., material is removed from the PSTP, material is added to the PSTP, or both). The modified PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the modified PSTP. The modified PSTP is then reattached to the implant. The final prosthesis is then designed and fabricated as a replica of the modified PSTP (e.g., a copymill) using the scan data of the modified PSTP and/or the virtual three-dimensional model of the modified PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The modified PSTP is removed and the final prosthesis is attached to the implant.

According to a sixth alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. After the PSTP is attached to the implant, the mouth of the patient is scanned. Specifically, the attached PSTP and the adjacent and/or opposing teeth are scanned generating additional scan data and/or a virtual three-dimensional model of the attached PSTP and the adjacent and/or opposing teeth of the patient. The additional scan data and the scan data generated from the scan of the entire PSTP are merged into a merged dataset and/or a merged virtual three-dimensional model. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design. If a modification(s) is necessary, the scan data and/or the virtual three-dimensional model of the PSTP is virtually modified (e.g., material is virtually removed from the virtual three-dimensional model of the PSTP, material is virtually added to the virtual three-dimensional model of the PSTP, or both). The merged dataset and/or the merged virtual three-dimensional model are updated to include the virtually modified scan data of the PSTP and/or the virtually modified virtual three-dimensional model of the PSTP. The final prosthesis is then designed and manufactured as a replica of the virtually modified virtual three-dimensional model of the PSTP using the updated merged dataset and/or the updated merged virtual three-dimensional model (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The PSTP is removed and the final prosthesis is attached to the implant.

According to a seventh alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is fabricated. The fabricated PSTP is scanned in its entirety generating scan data and/or a virtual three-dimensional model of the PSTP. Then the PSTP is attached to the implant installed in the patient's mouth. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the PSTP and/or the final prosthesis design. If a modification(s) is necessary, the scan data and/or the virtual three-dimensional model of the PSTP is virtually modified (e.g., material is virtually removed from the virtual three-dimensional model of the PSTP, material is virtually added to the virtual three-dimensional model of the PSTP, or both). The final prosthesis is then designed and manufactured as a replica of the virtually modified virtual three-dimensional model of the PSTP using the virtually modified scan data of the PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The PSTP is removed and the final prosthesis is attached to the implant.

According to an eighth alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is virtually designed using, for example, design software (examples of such software are described herein) to create virtual PSTP data and/or a virtual three-dimensional model of a virtual PSTP. Instructions based on the virtual PSTP data and/or the virtual three-dimensional model of the virtual PSTP are sent to a milling machine and/or a rapid-prototype machine to manufacture an actual PSTP (e.g., the PSTPa,b, andc, or a different PSTP). Then the actual PSTP is fabricated. Then the actual PSTP is attached to the dental implant installed in the patient's mouth. After the actual PSTP is attached to the implant, the mouth of the patient is scanned. Specifically, the attached actual PSTP and the adjacent and/or opposing teeth are scanned generating scan data and/or a virtual three-dimensional model of the attached actual PSTP and the adjacent and/or opposing teeth of the patient. The scan data and the virtual PSTP data from the virtual designing of the PSTP are merged into a merged dataset and/or a merged virtual three-dimensional model. Then the location of the dental implant installed in the mouth of the patient is determined, using, for example, software configured to analyze the merged dataset and/or the merged virtual three-dimensional model. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the actual PSTP and/or the final prosthesis design. If a modification(s) is necessary, the virtual PSTP data and/or the virtual three-dimensional model of the virtual PSTP is virtually modified (e.g., material is virtually removed from the virtual three-dimensional model of the virtual PSTP, material is virtually added to the virtual three-dimensional model of the virtual PSTP, or both). The merged dataset and/or the merged virtual three-dimensional model are updated to include the virtually modified virtual PSTP data of the virtual PSTP and/or the virtually modified virtual three-dimensional model of the virtual PSTP. The final prosthesis is then designed and manufactured as a replica of the virtually modified virtual three-dimensional model of the virtual PSTP using the updated merged dataset and/or the updated merged virtual three-dimensional model (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The actual PSTP is removed and the final prosthesis is attached to the implant.

According to a ninth alternative, a method of manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient includes installing a dental implant into the mouth of the patient. Then a PSTP is virtually designed using, for example, design software (examples of such software are described herein) to create virtual PSTP data and/or a virtual three-dimensional model of a virtual PSTP. Instructions based on the virtual PSTP data and/or the virtual three-dimensional model of the virtual PSTP are sent to a milling machine and/or a rapid-prototype machine to manufacture an actual PSTP (e.g., the PSTPa,b, andc, or a different PSTP). Then the actual PSTP is fabricated. Then the actual PSTP is attached to the dental implant installed in the patient's mouth. After the actual PSTP is attached to the implant, the mouth of the patient is scanned. Specifically, the attached actual PSTP and the adjacent and/or opposing teeth are scanned generating scan data and/or a virtual three-dimensional model of the attached actual PSTP and the adjacent and/or opposing teeth of the patient. The scan data and the virtual PSTP data from the virtual designing of the PSTP are merged into a merged dataset and/or a merged virtual three-dimensional model. Then the location of the dental implant installed in the mouth of the patient is determined, using, for example, software configured to analyze the merged dataset and/or the merged virtual three-dimensional model. The gingival tissue is permitted to heal and then a clinician assesses the site (e.g., visually inspects the site) to determine if any modifications are necessary to the actual PSTP and/or the final prosthesis design. Assuming that the clinician determines that no modifications are necessary, the final prosthesis is designed and manufactured as a replica of the virtual three-dimensional model of the virtual PSTP (e.g., the final prosthesis includes a titanium abutment with a porcelain coated ceramic crown). The actual PSTP is removed and the final prosthesis is attached to the implant.

Now referring to, a methodof manufacturing a permanent patient-specific prosthesis (e.g., a final prosthesis) for attachment to a dental implant (e.g., implant) installed in a mouth of a patient is described in reference to a flow chart. Initially, scan data and/or virtual three-dimensional models of a patient's dental conditions are acquired (). The scan data and/or the virtual three-dimensional models can be generated from a computed tomography (CT) scan and/or an intraoral scan (IOS) of the patient's mouth. The CT scan generates scan data representative of information regarding the bone(s) (e.g., jaw bone) and teeth in a patient's mouth and the IOS scan generates scan data representative of information regarding the soft tissues (e.g., gingival tissue) and teeth in the patient's mouth. Together, the bone, the tooth, and the tissue information can be used to develop a virtual three-dimensional model of a patient's mouth for use in planning a dental restoration site including a dental implant (e.g., implant) and a final prosthesis attached thereto.