DE102009052119A1 - A system consisting of a screw that can be turned into the bone, a screwdriver and a retaining cap, which together act as a system to facilitate handling and handling during the preparation and screwing process of the screw and reduce the risk of injury and contamination - Google Patents

Abstract

The invention describes a system which consists of a screw (S) provided for screwing into the bone, a screw-in instrument provided for this purpose, also called a blade (K), and a retaining cap (EST). To simplify handling before and when screwing in the screw, the preassembled system should be steam-sterilizable at the dentist's and can be screwed in directly by hand or by machine without much preparation. According to the invention, the system is characterized in that the screw can be preassembled between the cap and the screw-in instrument with a releasable connection and thereby surrounds the screw. Advantageously, enclosing the screw is not air-tight or water-vapor-tight and / or the screwing instrument is only surrounded by the cap to such an extent that the screwing instrument can be inserted into a mechanical screwing device without removing the cap or the handpiece on the screwing instrument can be fully used .

Description

The invention relates to a simplification in handling and risk minimization when screwing and handling screws that are screwed into the bone, preferably in the human jaw.

In orthodontics, the main therapeutic goal is the targeted and controlled movement of teeth. Such a translational or rotational movement of a tooth is only possible by a force is applied to the tooth to the appropriate extent, which can move this against the jaw. This force is then applied over suitable fixing means over comparatively long periods of time on the respective tooth, until it assumes the desired positioning and / or orientation in the oral cavity. However, a suitable support of the force-exerting element in the oral cavity is necessary for targeted application of a tooth with such a suitably chosen force, for example via brackets, wires, rubbers or other suitable force-exerting elements.

Usually, such a support of the force-applying elements is made on a further tooth, for example, two suitably positioned teeth are connected to each other via a clamping element, which is then biased to train. However, such an approach has the disadvantage that it conceptually two teeth are applied symmetrically with forces, but this is actually intended and desired only for one of the teeth. The targeted repositioning of the one tooth is thus inevitably associated with an undesirable or only conditionally acceptable change in position of the other tooth.

In order to counteract this, an anchoring via one-piece temporary screws, the so-called orthodontic anchoring screws, can also be carried out, which are temporarily introduced into the jawbone and removed again after the tooth has been displaced. In contrast to dental implant materials, which are designed for a permanent integration in the jawbone and the longest possible stable ingrowth, anchoring screws of this kind must therefore be introduced in such a way that a later removal from the bone remains possible. In contrast, when using such anchoring screws but necessarily to be noted that during the active therapy phase, ie during the actual application of force of the desired forces in the tooth requiring treatment, a reliable and resilient fit of the respective, provided as counterpoint anchoring screw is essential.

For supporting prostheses or for securing and / or supporting other aids, screws are used which are preferably screwed into the bone in the jawbone and protrude through the skin or mucous membrane in order to fix them to them or to use them as an abutment for support ,

In reconstructive surgery, after bone fractures or bone segment transplantation, screws are used to fix these bone segments. For stabilization also plates, usually made of titanium or a titanium alloy are used, which are fastened by screws to the bone. These screws are commonly referred to as Osseosyntheseschrauben.

Screws that are screwed into the bone in their application have special storage conditions before screwing into the bone to ensure sterility. With dental implants, these are individually packaged and sterilized by the manufacturer under the purest conditions. This means that each individual implant is in a separate individual packaging and is usually only opened during the operation in order to insert it directly into the bone, usually screw it in.

Such a process is particularly necessary if a surface-roughening treatment was carried out as a whole or only partially with the implant or the screw to be introduced into the bone. The rougher a surface is the greater the risk that impurities accumulate on it that are difficult or impossible to remove. Therefore implants that have been heavily roughened are packaged sterile and immediately screwed into the bone after opening the package. If the implants remain free of a roughening process or if only a small degree of roughening is carried out, sterile packaging can be dispensed with by the manufacturer. Such implants or screws can be sent to the practitioner without sterilization. The dentist takes over the sterilization and possibly also a previous cleaning of the implants or screws. With orthodontic mini implants, Transgingivalschrauben and Ossteosyntheseschrauben a sterile dispatch of screws from the manufacturer to the practitioner is rarely practiced. Usually, these are packaged cleanly by the manufacturer, but first sterilized by the attending physician. Since it is usually delivered in unclean packaging, usually has to be cleaned before.

Partially the screws are also welded in sterile hoses. Sterile hoses initially consist of two foils / paper foils welded together in such a way that they form a tube structure. One of the slides is translucent to see what is in it. The other film is permeable to water vapor. Both films are not bacteria permeable. In this tube can be introduced to be sterilized objects. After both ends of the tube are welded, the inside of the tube can be sterilized with steam in a sterilizer.

In most cases, the screws are unpacked at the attending physician and incorporated or sorted into a specially designed and reusable (re-sterilizable) packaging or housing. In these cases, the tool needed for screwing is often stored. These cases are called trays. The and show possible trays in which the screws can be sorted and stored with and without tools or accessories. These trays are sealed in a sterile tube before treatment (before screwing the screws into the bone) and then sterilized.

shows a Trayboden (TB) in which several mold cavities are present. It is a screwdriver compartment (SDF), a tweezer compartment (PF), an empty compartment (LF) for other utensils and a plurality of screw compartments (SF) which are shown in the section enlargement AA of the area A and partially filled with screws (S). Insertion tool 1 (EDI-1) and 2 (EDI-2) are housed in the designated Formausnehmungen. The carrying lid (TD) can be moved in the tray lid guide (TDF) to protect the items stored in the tray from falling out.

shows another carrying version with a tray bottom (TB), a screwdriver compartment (SDF), screw compartments (SF) and a tray lid guide (TDF).

Orthodontists usually do not work surgically. In principle, however, every orthodontist is entitled to use orthodontic mini-implants in patients. Some orthodontists use the mini implants without prior training and some only after they have attended training. Others, in turn, have their patients place mini implants with other mostly surgical dentists, oral surgeons or oral and maxillofacial surgeons. This concept is referred to as a referral concept. Usually, the orthodontist transfers his patients to the mini-implant placement colleagues and tells them where (lower jaw / upper jaw, oral / vestibular, etc.) he would like to have the mini-implant placed. The screws, tool and tray are then either stored by the surgical dentist or sent by the orthodontist to the surgical dentist for each insertion. Here it would also be an advantage if the range of screws, tools, accessories and tray are as small as possible.

In a patient session, an orthodontic mini-implant is usually used. The number of mini-implants to be placed can also go up to 4. In most trays there is room for a lot of screws. This is also due to the fact that some manufacturers have very many different screw variants with different screw lengths, diameters, heads etc. in their assortment. For this reason alone, it makes sense to have only a few screw types in a system. All unused screws in the tray, the tool and the entire tray must then be cleaned and re-sterilized, even if only one screw was used. The subsequent cleaning and sterilization takes a not inconsiderable amount of time. For this time and the time the tray needs to cool, the tray is blocked and can not be used. If a practitioner has 10 patients in a row with which one or more screws have to be set, he needs several trays in order to be able to do this. Keeping sterilized trays in place will tie up cleaning and sterilizing capacity and, moreover, much capital. The fewer screw types in a system, the fewer tools and special accessories required, the lower the capital commitment and the cleaning and sterilization effort for the practitioner. From this perspective, it would be an advantage if each screw and each tool were individually packaged and only become non-sterile when actually used. It is only important that the practitioner has easy and quick access to all screws, tools and accessories during treatment.

The screws described above are usually handled manually with a passive screwing tool (eg screwdriver ) or via a screwdriver (also called a blade ), which is introduced into the bone by an active insertion tool (eg motor-driven contra-angle handpiece or other motor-driven insertion instrument).

Shows a screwdriver. Usually, a handle (GR) is rotatably mounted on the hand turn, via which the torque is applied for screwing. The Torque is transmitted through a mostly interchangeable blade (K) and the screw insert (SE), which is formed on the front part of the blade and which has a rotary locking mechanism in addition to the screw to be screwed in.

In the literature and practice, two different variants are described in the process of screwing.

Version 1:

Screwing the screws into a preformed into the bone mold cavity, preferably a bore. For this purpose, a screw is required, which has based on the thread in the bone either a self-cutting and or self-forming properties.

Variant 2:

Direct screwing of the screw into the bone without prior action on the bone. For this type of insertion of screws into the bone, it is useful in the design of the screw in addition to the properties described in variant 1 additionally integrate a self-drilling property.

Before screwing the screws into the bone, the screw must be mounted on the driving tool / driver. The Eindrehinstruments have at one end a receptacle for the screw, which have a rotary locking against the screw. These ratchets are executed on the instrument side as a die and or patrix. In a particularly advantageous embodiment, the plugged screw has an inhibiting and or blocking effect against the falling off of the screw from the screwing instrument. This hamper should be easily separable after screwing in the screw.

• • Aufnahme bzw. Ankopplung an ein motorisch angetriebenes und händisch führbaren Eindrehwerkzeuges ( ). Z. B. eine Aufnahme an ein H&W Winkelstück.
• • Aufnahme bzw. Ankopplung an ein Werkzeug mit welchem ein manueller bzw. händischer Eindrehvorgang der Schrauben in den Knochen erfolgen soll.
• • Einen Griff bzw. eine Gestaltung welche für die händische Aufnahme und einen manuellen bzw. händischen Eindrehvorgang der Schrauben in den Knochen geeignet ist.

The side opposite the driver of the screw receptacle side can have different shapes and properties. Usually, the instruments have at least one of the following properties.

• • Recording or coupling to a motor-driven and manually operated screwing tool ( ). For example, a picture of an H & W elbow.
• • Recording or coupling to a tool with which a manual or manual screwing of the screws into the bone should take place.
• • A handle or a design which is suitable for manual recording and a manual or manual screwing of the screws into the bone.

If the driver does not have a handle at the end opposite the screw but a connection for connecting to another screwdriver or insertion instrument, it is called a "blade". This blade is then attached to another insertion instrument. If it has a handpiece, it is commonly referred to as a "screwdriver".

Before inserting the mini-implants into the jaw, the screw (mini-implant) is placed on the driver (blade, screwdriver, etc.). In the best case, this means that with the screwdriver, the screw from the tray or the sterile packaging must be included. In less favorable cases, either the blade on the insertion tool (screwdriver, H & W angle piece, etc.) must be plugged and then taken the screw from the tray or vice versa. This can be very complicated and cumbersome because the screw for sterility reasons not in the hand (even if gloves are worn) may be taken. If the screw is first taken up with the blade and then coupled to the screwing-in tool there is a risk that the screw detaches from the blade and falls off. Here, a simplification of the recording procedure would be useful to simplify the conditions on the patient before inserting the screw. Any simplification would make the insertion of the screws safer and faster.

The aim of the invention is the simplification of the handling and risk minimization based on the sterility and the secure hold of the screw on the driver with respect to the preparation of the screwing. In addition, the goal was still to reduce the number of components to be re-sterilized, thus minimizing the formation of capital for the practitioner.

The object is achieved by the screw is applied before sterilization on the blade or the screwdriver and is fixed there with an additional component. This component is hereinafter referred to as "one-piece tray" or "holding cap". Subsequently, the blade or the screwdriver can be welded and sterilized separately in a sterile tube. However, the one-piece tray must enclose the screw so that a violation of the sterile tube is prevented.

• • Die Schrauben können in Ruhe mit einem Handschuh auf die Klinge bzw. den Schraubendreher vor der eigentlichen Behandlung aufgebracht werden.
• • Die Arbeitszeit für das Aufstecken kann vom Personal der Behandler durchgeführt werden, was kostengünstiger ist als wenn es vom Behandler durchgeführt wird. Zusätzlich entlastet es den Behandler und verkürz die Behandlungszeit.
• • Das Einstücktray schützt den Behandler, das Personal und den Patienten vor versehentlichen Verletzungen an der spitzen Schraube, denn der Behandler kann ähnlich wie bei einer Spritze, das Einfacktray erst direkt vor dem Eindrehen abnehmen.
• • Durch das Abnehmen des Einstücktrays erst kurz vor dem Eindrehen wird die Schraube vor dem versehentlichen Abfallen von der Klinge bzw. dem Eindrehwerkzeug geschützt.
• • Arbeitet der Behandler mit einer Klinge, die an einen Schraubendreher, ein H&W Winkelstück oder an ein anderes Endrehwerkzeug angekoppelt werden muss, kann der Behandler die Klinge am Einstücktray mit der Hand aufnehmen und sehr komfortabel, ohne Verletzungsrisiko und ohne Gefahr einer Kontamination bedingt durch Berührungen an das Eindrehwerkzeug ankoppeln.
• • Das komplizierte und umständliche Aufnehmen der Schraube aus einem Tray oder einer Sterilverpackung entfällt während der Behandlung.
• • Der Behandler muss nach dem Eindrehen nur die Werkzeuge reinigen und sterilisieren die er auch tatsächlich verwendet hat.

This procedure offers the following advantages:

• • The screws can be applied at rest with a glove on the blade or the screwdriver before the actual treatment.
• • The working time for attachment can be carried out by the staff of the practitioner, which is less expensive than if it is carried out by the practitioner. In addition, it relieves the practitioner and shortens the treatment time.
• • The one-piece tray protects the practitioner, the staff and the patient from accidental injuries to the pointed screw, because the practitioner can, similar to a syringe, only remove the single-coat tray immediately before screwing it in.
• • By removing the one-piece tray until just before screwing in, the screw is protected from accidental falling off of the blade or screwdriver.
• • If the practitioner uses a blade that needs to be coupled to a screwdriver, H & W elbow, or other finishing tool, the practitioner can easily pick up the blade on the one-piece tray and comfortably, with no risk of injury or contamination due to contact connect to the screwing tool.
• • The complicated and cumbersome recording of the screw from a tray or a sterile packaging is eliminated during the treatment.
• • After screwing in, the dentist only needs to clean and sterilize the tools he actually used.

• 1. Schnappverschluss
• 2. Verklemmen über eine konische Selbsthemmung
• 3. Verklemmen über eine parallelwandige Hemmung
• 4. Bajonettverschluss
• 5. Verschrauben

This one-piece tray or this holding cap can be attached with different mechanical methods. The attachment method should be carried out expediently with a detachable connection. A releasable connection is defined as a connection which can be disassembled without destroying a component of the connection system. In this case, the compound itself is intended primarily to prevent inadvertent disconnection, disengagement or disintegration of the components involved in the system due to gravity or forces caused by transport, sterilization, assembly to other tools or other movements or activities in dealing with The connection system should be performed and should not explicitly lead to the connection being disconnected. Particularly favorable methods for the detachable connection are:

• 1. snap closure
• 2. Jamming over a conical self-locking
• 3. Jamming via a parallel-walled escapement
• 4. Bayonet lock
• 5. Screw

With regard to the simple handling of the entire system, it would be favorable to use a method which can apply or remove the holding cap by means of a linear movement. This is only possible with methods 1, 2, and 3.

Method 1 describes the method used in the syringe cap of syringes. However, the requirement for the system is lower. With the retaining cap described here, the screw must be held at a defined position in the insertion instrument. The accuracy in the positioning of the retaining cap is not optimal due to the conical attachment method.

A parallel-walled inhibition has the disadvantage that the haptic signal, which receives the person when plugging in is only an end stop. Slips in the meantime, the screw, there is a risk that this can only be detected optically and not haptically. Particularly favorable is a snap closure. Over this one gets the haptic information of the latching, which is at the same time the proof for the correct seat of the screw.

shows a can be coupled to an elbow blade with a screw in which a screw head can dip and is secured by means of a rotary locking against twisting and thus in some z. B. bone can be screwed. From the right, the angle piece connection (WSA), the blade shank (KS) and the screw insert (SE) are located. The screw insert (SE) is externally provided with 2 cylindrical areas (ZB-1 and ZB-2), a conical area (KB) and a groove (N). About the two cylindrical areas (ZB-1 and ZB-2) can be made a releasable connection in the form of a cylindrical escapement. The conical section (KB) provides a releasable connection as a conical self-locking feature. The groove (N) allows due to its undercut a snap closure in which a tab can engage.

The exploded view of a variant with a snap closure is on shown. shows the blade (K), the screw (S) and the Einstücktry (EST) with integrated milled (EF) which during assembly a springy Allow the tabs (L) to widen to allow the blade (K) to penetrate into the one-piece tray (EST). The restoring forces of the tabs (L) allow the tabs in the groove of the blade (K). The engagement of the tabs provides a haptic feedback and provides information as to whether the one-piece tray in the blade is properly engaged and continues to provide information about the correct fit of the screw in the overall system.

shows a screw with the threaded portions 1 and 2 (GB-1 and GB-2), a non-threaded screw shank (S-Sch), a screw head (SK) with integrated screw plate (ST) is executed.

shows the sectional view of the one-piece tray (EST), the screw (S) and the blade (K) in the assembled state. In this embodiment, the screw located on the screw head of the blade (K) and the Einstücktray (EFT) is enclosed in such a way that the screw S is secured against movements in the axial blade direction as long as the detachable connection between Einstücktray (EST) and blade (K) not solved or destroyed. For improved steam sterilizability, the opening 1 (Ö-1) on the one-piece tray (EST) and the ventilation hole (BEB) on the blade (K) are mounted. In steam sterilization, it is important that the hot water vapor can reach as many surfaces as possible to thermally sterilize it.

A few places that are not perfectly accessible can also be heated sufficiently high enough by the thermal conductivity of the components to be sterilized, and thus also sterilized.

shows an embodiment of the one-piece tray / the holding cap with a snap closure. The outer shape of the one-piece tray initially corresponds approximately to a pipe. The four millings (EF-1-EF-4) result in four tabs (L-1-L-4) which have a spring effect. The material thickness, the milling width, the milling length, the number of millings and the material of the one-piece tray can be used to influence and adjust the spring action of the straps. The milled grooves (EF-1-EF-4) additionally provide improved steam sterilizability as they behave like an orifice or bore with respect to steam sterilizability. A single tray or the holding cap can with a screw, and both with a blade (ie, a screwdriver, which has a connection to a powered screwing tool) and with instruments that allow manual insertion and or here not further listed insertion or insertion instruments according to the invention Form system.

• 1. die Überlappung des rotatorischen Gesperres zwischen der Schraube und dem Einbringinstrument (Klinge, Schraubendreher, etc.) muss groß genug sein, um die Schraube ohne zusätzlichen Aufwand nach dem entfernen der Haltekappe einschrauben zu können. Hierbei muss das zum Eindrehinstrument axiale Spiel der Schraube kleiner sein als die Länge/die Überlappung des rotatorischen Gesperres zwischen der Schraube und dem Eindrehinstrument
• 2. Bohrungen bzw. Öffnungen in dem Einstücktray/der Haltekappe und oder dem Eindrehinstrument müssen so ausgelegt sein, dass eine Wasserdampfsterilisierbarkeit gewährleistet ist, wobei vorteilhafter Weise die Bedeckung der Schraube durch die Haltekappe so weit geht, dass keine Verletzungsgefahr (Patient, Behandler, beteiligte Personen, Sterilschlauch, etc.) durch die Schraube geht, d. h. dass die Schraube an keiner Stelle aus der Haltekappe/dem Einstücktray heraussteht.
• 3. Vorteilhafter Weise ist der dem Einstücktray abgewendete Bereich des Eindrehinstrumentes nicht von dem Einstücktray umgeben bzw. ummantelt. Hieraus ergibt sich der Vorteil, dass das Eindrehinstrument entweder direkt und ohne Entfernen des Einstücktrays (z. B. Klinge) direkt und vollständig in ein angetriebenes Eindrehwerkzeug eingeführt und unter Umständen in diesem verriegelt werden kann. Handelt es sich bei dem Einbringinstrument um ein manuelles Eindrehinstrument (z. B. ein Schraubendreher) sollte der gesamte von der eindrehenden Hand benötigte Bereich nicht von dem Einstücktray/der Haltekappe ummantelt bzw. umschlossen sein, damit das System am Schraubendreher aus dem Sterilschlauch entnommen werden kann, mit einer Hand die Haltekappe entfernt werden kann und anschließend die Schraube ohne Umgreifen eingedreht werden kann.

When tuning the system, it is important to note the following parameters.

• 1. The overlap of the rotary locking mechanism between the screw and the insertion instrument (blade, screwdriver, etc.) must be large enough to allow the screw to be screwed in without additional effort after removing the retaining cap. In this case, the axial play of the screw to the insertion instrument must be smaller than the length / overlap of the rotary locking mechanism between the screw and the insertion instrument
• 2. Holes or openings in the Einstücktray / the retaining cap and or the Eindrehinstrument must be designed so that a Wasserstampfsterilisierbarkeit is ensured, advantageously the covering of the screw through the retaining cap goes so far that no risk of injury (patient, practitioner involved People, sterile hose, etc.) goes through the screw, ie that the screw does not protrude from the holding cap / the Einstücktray at any point.
• Advantageously, the area of the insertion instrument facing away from the one-piece tray is not surrounded or encased by the one-piece tray. This results in the advantage that the insertion instrument can be inserted directly and completely into a driven screwing tool either directly or without removal of the one-piece tray (eg blade) and possibly locked in it. If the insertion instrument is a manual insertion instrument (eg a screwdriver), the entire area required by the inserting hand should not be covered by the one-piece tray / retaining cap, so that the system can be removed from the sterile tube using a screwdriver can, with one hand, the retaining cap can be removed and then the screw can be screwed without grasping.

To simplify the application, another cap enclosing the remaining area of the Einbringinstrumentes possible but may be disturbing (sectional view with two caps). If a freestanding area, ie a portion of the insertion instrument not enclosed or encased in the one-piece tray, represents a risk of injury to persons and / or the sterile tube, it is advantageous to cover this area with the aid of a second protective / holding cap. shows such a system consisting of the original system [screw (S), Eindrehinstrument z. B. blade (K) and the one-piece tray (EST)] and an additional cap (ZK) the at least one further area of the Eindrehinstrumentes but advantageously envelops the entire Eindrehinstrument or encloses. shows to those at the Retaining cap recognizable tabs (L-2 and L-4) the additional cap also includes tabs (L-5, L-6) which fulfill the function of a detachable connection between the retaining cap and additional cap. After unpacking the system from the sterile tubing, the extra cap (ZK) can be removed by holding the one-piece tray without the components of the remaining system falling apart. Subsequently, z. B. in a blade of the designated area of the blade inserted into a driven Einbinginstrument and may be locked therein. It is important that there is a detachable connection between the one-piece tray and the additional cap.

The releasable connection between the screw in the insertion instrument (blade, screwdriver, etc.) and or the one-piece tray and the auxiliary cap may be made with the following principles. Conical escapement, parallel escapement, snap lock, balls which have a spring effect (eg by means of an O-ring) in the undercuts, eg. B. intervene holes or other variants will not be discussed in detail here

As material for the one-piece tray or the holding cap are basically all materials that do not have too high elasticity. It must be prevented that the one-piece tray or the retaining cap is deformed so much in the area of normal use that a risk of injury from the screw can go out. To ensure steam sterilizability, it makes sense to use a metal or a plastic. The metal for the one-piece tray or holding cap should be chosen so that it can not come to chemical and / or electrochemical corrosion either before, during and / or after contact with the screw and / or the instrument before, during and / or after steam sterilization. For this purpose, titanium or alloys would include the titanium as the main ingredient or as an ingredient or alloys containing iron, chromium, cobalt, molybdenum, zirconium, tantalum as the main ingredient or at least as an ingredient. If the one-piece tray or the holding cap is made of plastic, it must be ensured that the plastic is steam-sterilisable and remains dimensionally stable at the temperature of the steam sterilizer (about 150 °) and does not release toxic or health-endangering substances. Preferably, some POM materials are suitable, but PEEK is particularly suitable. A combination of metal and plastic is also conceivable. If the elastic inherent force of the material of which the one-piece tray or the holding cap is made is not sufficient to maintain the escapement with the screw and the insertion instrument, an additional component of metal, plastic, silicone, rubber, etc. may be advantageous be used.

To secure and improve the sterilizability in steam sterilizer, it is advantageous to avoid a tight seal between the Einstücktray or the retaining cap, the screw and the Einbringinstrument. Furthermore, it is favorable for one to provide the Einbringinstrument and the other Einstücktray or the retaining cap with holes to favor the contact between the water vapor and the screw, the Einbringinstrument and Einstücktray or the retaining cap. The holes, milled holes or openings on the one-piece tray or the holding cap and the Einbringinstrument are on the . . . and shown. The holes fulfill the purpose that the steam sterilizer in all openings and mold cavities can form a negative pressure or a vacuum and then all areas can be wetted with water vapor to actually sterilize all surfaces of the components.

• 1. Er kann das Subsystem bestehend aus Schraube und Haltekappe direkt sterilisieren und anschließend die Schraube zur Vermeidung einer Kontamination berührungslos an der Haltekappe greifend auf ein Eindrehinstrument aufstecken und somit das erfindungsgemäße System bilden, anwenden und die Schraube eindrehen.
• 2. Er kann das Subsystem bestehend aus Schraube und Haltekappe direkt auf ein Eindrehinstrument montieren und somit das erfindungsgemäße System bilden, es anschließend sterilisieren, anwenden und die Schraube eindrehen.

The system described here consists of a screw, a retaining cap and a driver. This has made handling easier, minimizing the risk of injury to persons and the sterile hose, and minimizing risk of screw contamination when handling the screw. The installation takes place in a sensible manner at the attending physician before the steam sterilization. If screws are used where there is a high risk of contamination and or should the handling be further improved, an even more advantageous variation of a system component is possible. Is introduced in addition to the releasable connection between the driver and the retaining cap, a second releasable connection between the retaining cap and the screw, which is effective only when not inserted Eindrehinstrument, consequently when inserting the Eindrehinstrumentes is disabled and advantageously by the detachable connection between Driver and screw is replaced, but when removing the driver prevents the detachable connection between the screw and the retaining cap is effective again, a pre-assembly of two components of the system is possible. Consequently, the subsystem comprising the screw and the retaining cap can be plugged onto the insertion instrument or the insertion instrument can be inserted into the retaining cap which contains the screw, then the retaining cap can be removed without the screw detaching from the insertion instrument. This is achieved by first a releasable connection between the screw and retaining cap prevents the screw can be omitted from the retaining cap. By introducing the Eindrehinstrumentes the releasable connection between the screw and retaining cap is overridden and by at least a detachable connection, namely the replaced between the screw and the Eindrehinstrument, advantageously additionally by a detachable connection between the Eindrehinstrument and the retaining cap. Upon removal of the retaining cap, the releasable connection between the retaining cap and the driver is disabled without re-activating the releasable connection between the screw and the retaining cap. All that remains now is the detachable connection between the screw and the insertion instrument, which is required to screw the screw into the bone without the risk of it falling off the insertion instrument. There is now the additional advantage that the manufacturer can mount the already cleaned screws in the holding cap or in the one-piece tray. Receives the practitioner of this subsystem consisting of the retaining cap and the screw which is secured by means of a detachable connection in the retaining cap against falling out, he has two possible and favorable approaches.

• 1. He can sterilize the subsystem consisting of screw and retaining cap directly and then attach the screw to avoid contamination on the retaining cap without touching a screwing on instrument and thus form the system of the invention, apply and screw the screw.
• 2. He can mount the subsystem consisting of screw and retaining cap directly on a Eindrehinstrument and thus form the system of the invention, then sterilize it, apply and screw the screw.

Both variants have the advantage that no component which is in direct contact with the patient during the treatment (screw, screw insert on the screw-in piece, etc.) must be touched with the hands and or with another instrument (eg tweezers). This is called a no-touch system. This concept of the no-touch system can be maintained very easily and without further aids (eg with tweezers).

The execution of the additional releasable connection which is to be effective between the screw and the retaining cap can by a conical escapement, parallel escapement, a snap closure, a releasable lock also by means of additional components such. B. spring elements, rubber elements, balls, rods, etc. be executed.

LIST OF REFERENCE NUMBERS

A

Area with holes / inserts / compartments for screws

AA

Magnification of A

S

screw

SF

screw trade

TDF

Traydeckelführung

EDI 1

Driver-1 in tray for EDI-1

EDI-2

Driver-2 in compartment for EDI-2

LF

Empty compartment for more utensils

TD

supporting cover

TB

support base

SDF

screwdriver specialist

PF

tweezers specialist

SE

screw insertion

K

blade

HDS

Hand turning piece

GR

grip

ZB-1

Cylindrical area 1

ZB-2

Cylindrical area-1

BEB

Ventilation hole

KB

Conical area

KS

blade shaft

WSA

Angle connection

N

groove

EST

One-piece tray or holding cap

EF

milled

GB-1

Thread area 1

GB-2

Thread area 2

S-Sch

screw shaft

SK

screw head

ST

helical Disk

E-1

Opening 1

E-2

Opening 2

L

flap

L-1-L-6

Tab 1 to tab 6

EF-EF-1-4

Milling 1 to milling 4

ZEF 1

Additional milling 1

ZEF 2

Additional milling 2

ZK

additional cap

pictures

1st tray

2nd tray

3. screwdriver

4. Elbow

5. Exploded view one-piece tray, screw, blade / screwdriver

6. screw

7. Sectional view of the assembled system consisting of a screw, a blade and a one-piece tray

8. One-piece tray

9. Cross-sectional view of a mounted system consisting of a screw, a blade, a one-piece tray and an additional cap

Claims (10)

A system comprising at least one retaining cap, which may also be referred to as a one-piece tray (EST), a screw (S) and an instrument (eg K), which is provided for manual and / or mechanical screwing of the screw, wherein the retaining cap surrounds a screw provided for insertion into the bone, preferably in the jawbone of a human, and characterized in that it serves by means of a re-releasable connection to an instrument which is used for insertion of the screw, the screw between itself and that for inserting the screw stored instrument. A system according to claim 1, wherein the sub-system comprising the retaining cap and the instrument does not enclose the screw in an air-tight or water vapor-tight manner. A system according to claim 1, wherein the retaining cap only partially surrounds the insertion instrument to which it has a releasable connection A system according to claim 1, wherein the releasable connection comprises a snap closure. A system according to claim 1, wherein the releasable connection has a conical escapement. A system according to claim 1, wherein the releasable connection comprises parallel-walled escapement. A system according to claim 1, wherein the releasable connection comprises a bayonet lock. A system according to claim 1, wherein the releasable connection comprises a screw connection. A system according to claim 1, wherein the releasable connection comprises a combination of at least two variants of claims 4-8. A system according to any one of the preceding claims, wherein the screw and the retaining cap form an additional subsystem and there is a releasable connection between them.

Images