Implants, device and method for joining tissue parts

• US 7,335,205 B2
• Filed: 03/04/2002
• Issued: 02/26/2008
• Est. Priority Date: 03/02/2001
• Status: Expired due to Term

• Current Assignee: Woodwelding AG
• Original Assignee: Woodwelding AG
• Inventors: Torriani, Laurent, Aeschlimann, Marcel, Mayer, Jorg, Lanci, Antonino
• Primary Examiner(s): Robert; Eduardo C.
• Assistant Examiner(s): Araj; Michael J
• Application Number:
  US10/415,454
• Publication Number:
  US 20040030341A1
• Time in Patent Office: 2,185 Days
• Field of Search: 606/72, 606/76, 606/77, 433/172, 433/173, 433/201.1
• US Class Current: 606/232
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/688 for reattaching pieces of the skull
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/8085 with pliable or malleable elements or having a mesh-like structure, e.g. small strips A61B17/8071, A61B17/8076 take precedence
• CPC Class Codes: A61B 17/84 Fasteners therefor or fasteners being internal fixation devices
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/866 Material or manufacture
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00955 thermoplastic
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• CPC Class Codes: A61C 8/0012 characterised by the material or composition, e.g. ceramics, surface layer, metal alloy use of specific materials A61K6/00
• CPC Class Codes: A61C 8/0016 polymeric material
• CPC Class Codes: A61C 8/0018 characterised by the shape
• CPC Class Codes: A61F 2/0077 Special surfaces of prostheses, e.g. for improving ingrowth A61F2/30767 takes precedence
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/2846 Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects nets or sleeves applied to surface of endoprostheses A61F2/30907; bone plates A61B17/80; bone regeneration in dental surgery A61C8/0006
• CPC Class Codes: A61F 2/2875 : Skull or cranium A61F2/2803 and A61F2/3099 take precedence
• CPC Class Codes: A61F 2/30749 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3662 : Femoral shafts
• CPC Class Codes: A61F 2/4601 : for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30064 : Coating or prosthesis-covering structure made of biodegradable material
• CPC Class Codes: A61F 2002/30065 : thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
• CPC Class Codes: A61F 2002/30067 : Coating or prosthesis-covering structure made of thermoplastic material
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/3611 : Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3625 : Necks
• CPC Class Codes: A61F 2002/465 : using heating means
• CPC Class Codes: A61F 2002/4683 : by applying ultrasonic vibrations
• CPC Class Codes: A61F 2210/0071 : thermoplastic
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: B29C 65/00 : Joining or sealing of preformed parts , e.g. welding of plastics materials; Apparatus therefor general aspects of processes or apparatus for joining preformed parts B29C66/00; using porous material formed by internal pressure generated therein for joining preformed parts B29C44/1228, B29C44/326
• CPC Class Codes: B29C 65/08 : using ultrasonic vibrations non-plastics element to plastics elements B29C65/645
• CPC Class Codes: B29C 65/48 : using adhesives , i.e. using supplementary joining material; solvent bonding
• CPC Class Codes: B29C 65/54 : between pre-assembled parts
• CPC Class Codes: B29C 65/562 : using extra joining elements, i.e. which are not integral with the parts to be joined using plastic snap elements B29C65/58; using plastic rivets B29C65/601
• CPC Class Codes: B29C 65/601 : using extra riveting elements, i.e. the rivets being non-integral with the parts to be joined
• CPC Class Codes: B29C 65/603 : the rivets being pushed in blind holes
• CPC Class Codes: B29C 66/1122 : Single lap to lap joints, i.e. overlap joints B29C66/45, B29C66/472, B29C66/52272 take precedence
• CPC Class Codes: B29C 66/126 : Tenon and mortise joints tenons and mortises for positioning purposes B29C65/7814
• CPC Class Codes: B29C 66/21 : said joint lines being formed by a single dot or dash or by several dots or dashes, i.e. spot joining or spot welding
• CPC Class Codes: B29C 66/30326 : in the form of porosity
• CPC Class Codes: B29C 66/5324 : said single elements being substantially annular, i.e. of finite length B29C66/5326 takes precedence
• CPC Class Codes: B29C 66/5346 : said single elements being substantially flat
• CPC Class Codes: B29C 66/542 : joining hollow covers or hollow bottoms to open ends of container bodies
• CPC Class Codes: B29C 66/61 : Joining from or joining on the inside for making tubes by bending sheets and joining from the inside B29C53/387
• CPC Class Codes: B29C 66/652 : moving the welding tool around the fixed article
• CPC Class Codes: B29C 66/71 : characterised by the composition of the plastics material of the parts to be joined welding bar compositions B29C65/125
• CPC Class Codes: B29C 66/7212 : characterised by the composition of the fibres
• CPC Class Codes: B29C 66/727 : being porous, e.g. foam
• CPC Class Codes: B29C 66/73161 : Roughness or rugosity
• CPC Class Codes: B29C 66/73791 : biodegradable
• CPC Class Codes: B29C 66/7392 : characterised by the material of at least one of the parts being a thermoplastic
• CPC Class Codes: B29C 66/81423 : being concave
• CPC Class Codes: B29C 66/81429 : comprising a single tooth
• CPC Class Codes: B29C 66/81431 : comprising a single cavity, e.g. a groove
• CPC Class Codes: B29C 66/81433 : being toothed, i.e. comprising several teeth or pins comprising a single tooth B29C66/81429, or being patterned
• CPC Class Codes: B29C 66/8322 : Joining or pressing tools reciprocating along one axis
• CPC Class Codes: B29C 66/836 : Moving relative to and tangentially to the parts to be joined, e.g. transversely to the displacement of the parts to be joined, e.g. using a X-Y table B29C66/65 takes precedence
• CPC Class Codes: B29C 66/9513 : characterised by specific vibration frequency values or ranges
• CPC Class Codes: B29C 66/9517 : characterised by specific vibration amplitude values or ranges
• CPC Class Codes: B29K 2005/00 : Use of polysaccharides or derivatives as moulding material
• CPC Class Codes: B29K 2023/04 : Polymers of ethylene
• CPC Class Codes: B29K 2023/06 : PE, i.e. polyethylene
• CPC Class Codes: B29K 2027/00 : Use of polyvinylhalogenides or derivatives thereof as moulding material
• CPC Class Codes: B29K 2027/06 : PVC, i.e. polyvinylchloride
• CPC Class Codes: B29K 2027/12 : containing fluorine
• CPC Class Codes: B29K 2033/08 : Polymers of acrylic acid esters, e.g. PMA, i.e. polymethylacrylate
• CPC Class Codes: B29K 2033/12 : Polymers of methacrylic acid esters, e.g. PMMA, i.e. polymethylmethacrylate
• CPC Class Codes: B29K 2067/00 : Use of polyesters or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2067/043 : PGA, i.e. polyglycolic acid or polyglycolide
• CPC Class Codes: B29K 2067/046 : PLA, i.e. polylactic acid or polylactide
• CPC Class Codes: B29K 2069/00 : Use of PC, i.e. polycarbonates or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2071/00 : Use of polyethers , e.g. PEEK, i.e. polyether-etherketone or PEK, i.e. polyetherketone or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2075/00 : Use of PU, i.e. polyureas or polyurethanes or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2077/00 : Use of PA, i.e. polyamides, e.g. polyesteramides or derivatives thereof, as moulding material
• CPC Class Codes: B29K 2079/085 : Thermoplastic polyimides, e.g. polyesterimides, PEI, i.e. polyetherimides, or polyamideimides; Derivatives thereof
• CPC Class Codes: B29K 2081/06 : PSU, i.e. polysulfones; PES, i.e. polyethersulfones or derivatives thereof
• CPC Class Codes: B29K 2307/04 : Carbon
• CPC Class Codes: B29K 2309/08 : Glass
• CPC Class Codes: Y10S 606/908 : Bioabsorbable material
• CPC Class Codes: Y10S 606/915 : Toolkit for installing or removing cortical plate
• CPC Class Codes: Y10S 606/916 : Tool for installing or removing orthopedic fastener

Abstract

Implants (7) for forming a positive connection with human or animal parts include a material, such as thermoplastics and thixotropic materials, that can be liquefied by means of mechanical energy. The implants (7) are brought into contact with the tissue part, are subjected to the action of ultrasonic energy while being pressed against the tissue part. The liquefiable material liquefies and is pressed into openings or surface asperities of the tissue part so that, once solidified, the implant is positively joined thereto. The implantation involves the use of an implantation device that includes a generator (2), an oscillating element, and a resonator (6). The generator (2) causes the oscillating element to mechanically oscillate, and the element transmits the oscillations to the resonator (6). The resonator (6) is used to press the implant (7) against the tissue part to transmit oscillations to the implant (7).

Claims

1. A method for creating a positive-fit connection capable of load-bearing to a tissue part in a human or animal body, the method comprising the steps of:

providing an implant comprising a biocompatible material being liquefiable by mechanical oscillation,

positioning the implant on the tissue part in a manner such that an implant region of the liquefiable material is in contact or can be brought into contact with the tissue part,

impinging the positioned implant with mechanical oscillation and simultaneously pressing the implant against the tissue part for a time sufficient for liquefying at least a part of the liquefiable material and for pressing it into surface unevennesses, cavities or pores of the tissue part and

letting the liquefiable material pressed into said surface unevennesses, cavities or pores to re-solidify and, in a re-solidified state to constitute the positive-fit connection.

2. The method according to claim 1, wherein the mechanical oscillation for impinging the implant has a predominantly same direction as the pressing of the implant against the tissue.

3. The method according to claim 1, wherein the step of impinging and simultaneous pressing comprises contacting the implant with a transition element which is actively coupled to a resonator of an implantation device, wherein a distal end of the transition element oscillates predominantly perpendicularly to the direction in which the implant is pressed against the tissue part.

4. The method according to claim 1, wherein the step of impinging and simultaneous pressing comprises creating the surface unevennesses, cavities or pores in the tissue part by hydrostatic pressure.

5. The method according to claim 1, and further comprising a step of mechanically creating the surface unevennesses, cavities or pores in the tissue part.

6. The method according to claim 1, wherein the step of letting the liquefiable material to re-solidify comprises stopping the mechanical oscillation, while still pressing the implant against the tissue part.

7. The method according to claim 1, wherein the mechanical oscillation has a frequency of between 2 and 200 kHz.

8. The method according to claim 1, wherein the step of impinging and simultaneous pressing comprises contacting the implant with a resonator of an implantation device.

9. The method according to claim 8, wherein

the implantation device comprises a generator, an oscillation element and a resonator, the generator being designed for exciting the oscillation element into mechanical oscillation, the resonator and the oscillation element being connected to form an oscillation unit, and a distal end of the resonator being adapted to a proximal face of the implant for transmission of the mechanical oscillations from the resonator to the implant and for pressing the implant against the tissue part.

10. The method according to claim 9, wherein the distal end of the resonator or a distal resonator part is equipped for predominantly oscillating in a longitudinal direction and to press the implant against the tissue part in the same direction.

11. The method according to claim 9, wherein the resonator comprises a transition element which is actively coupled to the resonator, wherein a distal end of the transition element is equipped for predominantly oscillating perpendicularly to a longitudinal direction and to press the implant against the tissue part in the longitudinal direction.

12. The method according to claim 9, wherein the implantation device is designed for mechanical oscillations of the resonator with a frequency between 2 and 200 kHz.

13. The method according to claim 9, wherein the implantation device is designed for a distal end of the resonator to oscillate with an amplitude of between 1 and 100 μ

m.

14. The method according to claim 9, wherein the oscillation element is a piezoelectric or magnetostrictive oscillator.

15. The method according to claim 9, wherein the implantation device is equipped for setting various frequencies of the mechanical oscillations, various frequency patterns and/or various energy pulsations and wherein the kit further comprises setting instructions for different ones of the implants.

16. The method according to claim 9, wherein the resonator of the implantation device comprises a proximal part and a distal part, the distal part being exchangeably fixed to the proximal part.

17. The method according to claim 1, wherein the step of positioning and the step of impinging and simultaneous pressing comprise minimal invasive surgery.

18. The method according to claim 1, wherein the step of impinging and simultaneous pressing further comprises dissipating heat through a cooling fluid or a heat conducting element.

19. The method according to claim 1, wherein the tissue part comprises living tissue.

20. The method according to claim 1, wherein the tissue part is a human or animal bone part, cartilage part, ligament part or tendon part.

21. The method according to claim 1, and further comprising a step of connecting another tissue part, a suture, a cerclage wire, means for supporting or replacing a tissue part, or a therapeutic auxiliary device to the implant.

22. The method according to claim 1, wherein the tissue part comprises cancellous bone tissue and the liquefiable material is pressed into pores of the cancellous bone tissue.

23. The method according to claim 22, wherein the cancellous bone tissue is osteoporotic bone tissue and is fortified by the liquefiable material pressed into the pores.

24. The method according to claim 1, wherein the implant further comprises a proximal face suitable for transmission of mechanical oscillation into the implant and for simultaneously pressing the implant against the tissue part and a contact surface to be brought into contact with the tissue part, wherein the liquefiable material is arranged to be liquefied by the mechanical oscillation on the contact surface or in a position from which it can be pressed onto the contact surface.

25. The method according to claim 24, wherein the liquefiable material has thermoplastic or thixotropic properties.

26. The method according to claim 1, wherein the liquefiable material is at least partly resorbable.

27. The method according to claim 1, wherein the liquefiable material further comprises foreign phases or substances having further functions.

28. The method according to claim 1, wherein the implant is designed to be suitable as an anchoring means for an artificial support or fixation element, for a prosthesis of a joint ball or socket, for an artificial tooth, bridge or tooth prosthesis, for a suture thread, for a cerclage wire or for a therapeutic auxiliary device.

29. The method according to claim 1, wherein the implant comprises a sleeve (13) of a non-liquefiable material wherein the liquefieable material is arranged in an inside of the sleeve wherein the sleeve comprises opening (58) for exit of the liquefied material and wherein in the step of impinging and simultaneously pressing, a distal end of a resonator is positioned against a proximal face of the liquefiable material.

30. The method according to claim 29, wherein the liquefiable material is resorbable and the sleeve (13) at least partly has a bioactive surface.

31. The method according to claim 29, wherein the implant is a screw and the step of positioning comprises screwing the implant into bone tissue.

32. The method according to claim 31, wherein the implant is a tension screw and is used together with a trochanter plate for fixing a fractured femoral neck bone.

33. The method according to claim 1, wherein the implant is shaped as a plate (35 and 36) or film (35).

34. The method according to claim 33, wherein the plate or film (35) is of one layer.

35. The method according to claim 33, wherein the plate (35 and 36) or film comprises a layer of the liquefiable material and a layer of a non-liquefiable material, and wherein the liquefiable material covers at least a part of one surface of the non-liquefiable material, and wherein the liquefiable material layer and the non-liquefiable material layer are connected to one another by positive fit or material fit.

36. The method according to claim 33, wherein the implant is positioned over a bone fracture or across a gap between two bone plates or between a bone plate and an artificial plate replacing a bone plate and wherein the step of impinging and simultaneously pressing is carried out on both sides of the fracture or gap.

37. A method for creating a positive-fit connection capable of load-bearing to a tissue part in a human or animal body, the method comprising the steps of:

providing a pin- or dowel-shaped implant comprising a proximal face, a contact surface to be brought into contact with the tissue part, and a first material being biocompatible, having thermoplastic properties, and being liquefiable by mechanical oscillation, the first material constituting at least part of the contact surface,

positioning the implant on the tissue part in a manner such that at least part of the contact surface is in contact with the tissue part,

impinging the proximal face of the positioned implant with mechanical oscillation and simultaneously pressing the implant against the tissue part for a time sufficient for liquefying at least part of the liquefiable material in contact with the tissue part and for pressing it into surface unevennesses, cavities or pores of the tissue part, and

letting the liquefiable material pressed into said surface unevennesses, cavities or pores to re-solidify and, in a re-solidified state, to constitute the positive-fit connection.

38. The method according to claim 37, wherein the mechanical oscillation for impinging the implant has a predominantly same direction as the pressing of the implant against the tissue part.

39. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises contacting the implant with a transition element which is actively coupled to a resonator of an implantation device, wherein a distal end of the transition element oscillates predominantly perpendicularly to the direction in which the implant is pressed against the tissue part.

40. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises creating the surface unevennesses, cavities or pores in the tissue part by hydrostatic pressure.

41. The method according to claim 37, and further comprising a step of mechanically creating the surface unevennesses, cavities or pores in the tissue part.

42. The method according to claim 37, wherein the step of letting the liquefiable material to re-solidify comprises stopping the mechanical oscillation, while still pressing the implant against the tissue part.

43. The method according to claim 37, wherein the mechanical oscillation has a frequency of between 2 and 200 kHz.

44. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises pressing with a force of 0.5 to 5 N per mm2 of implant cross section.

45. The method according to claim 37, wherein the step of positioning and simultaneous pressing comprises minimal invasive surgery.

46. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises dissipating heat from the implantation site through a cooling fluid or a heat conducting element.

47. The method according to claim 37, wherein the tissue part comprises living tissue.

48. The method according to claim 37, wherein said tissue part is a human or animal bone part, cartilage part, ligament part or tendon part.

49. The method according to claim 37, and further comprising a step of connecting another tissue part, a means for supporting or replacing a tissue part, a suture, a cerclage wire, or a therapeutic auxiliary device to the implant.

50. The method according to claim 37, and further comprising a step of providing an opening in the tissue part, wherein the step of positioning comprises positioning the implant in the tissue opening.

51. The method according to claim 50, wherein the step of providing an opening in the tissue part comprises drilling the opening.

52. The method according to claim 50, wherein the tissue part is a bone part with an outer layer of cortical bone and inner cancellous bone and wherein the step of providing an opening in the tissue part comprises opening the cortical layer only.

53. The method according to claim 50, wherein the tissue part is a bone part comprising an outer layer of cortical bone, wherein the step of providing an opening comprises opening the cortical layer and wherein surface unevennesses or a surface roughness are created on the walls of the opening in the cortical layer.

54. The method according to claim 53, wherein a thread is created in the walls of the opening in the cortical layer.

55. The method according to claim 50, wherein a cross section of the opening provided in the tissue part is sufficiently smaller than a corresponding cross section of the implant, for achieving a friction-fit between a wall of the opening and the implant.

56. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises driving the implant into the tissue part to form an opening therein.

57. The method according to claim 37, wherein the step of impinging and simultaneous pressing comprises guiding the implant with the aid of an implant guide.

58. The method according to claim 57, wherein the implant is guided in a tubular guide or with the aid of a guide wire.

59. The method according to claim 37, wherein, for the step of positioning and for the step of impinging and simultaneous pressing, a proximal implant end is fixed to a distal end of a resonator of an implantation device.

60. The method accordinci to claim 59, wherein:

the implantation device comprises a generator, an oscillation element and a resonator, the generator being designed for exciting the oscillation element into mechanical oscillation, the resonator and the oscillation element being connected to form an oscillation unit, and a distal resonator end being adapted to the proximal face of the implant for transmission of the mechanical oscillations from the resonator into the implant and for pressing the implant against the tissue part.

61. The method according to claim 60, wherein the oscillation element is a piezoelectric or magnetostrictive oscillator.

62. The method according to claim 60, wherein the oscillation unit is driven to oscillate with a frequency between 2 and 200 kHz.

63. The method according to claim 60, wherein the resonator comprises a proximal part and a distal part, the distal part being exchangeably fixed to the proximal part.

64. The method according to claim 60, wherein the generator and the oscillation unit are designed for a distal resonator end to oscillate with an amplitude of between 1 and 100 μ

m.

65. The method according to claim 60, wherein the implantation device further comprises a housing and an implant guide supported on the housing.

66. The method according to claim 65, wherein the implant is a dental implant.

67. The method according to claim 60, wherein the distal end of the of the resonator is equipped for oscillating in a longitudinal direction and to press the implant against the tissue part in the same longitudinal direction.

68. The method according to claim 60, wherein the resonator comprises a transition element which is actively coupled to the resonator, wherein a distal end of the transition element is equipped for predominantly oscillating perpendicularly to a longitudinal direction and to press the implant against the tissue part in the longidtudinal direction.

69. The method according to claim 60, wherein the implantation device is equipped for setting various frequencies of the mechanical oscillations, various frequency patterns and/or various energy pulsations and wherein the kit further comprises setting instructions for different ones of the implants.

70. The method according to claim 60, wherein the resonator comprises a proximal part and a distal part, the distal part being exchangeably fixed to the proximal part.

71. The method according to claim 60, wherein the resonator or a distal part thereof is adapted for minimal invasive surgery.

72. The method according to claim 60, wherein the resonator of the implantation device or a distal part thereof is exchangeable and sterilizeable.

73. The method according to claim 60, wherein a proximal send of the implant and a distal end of the resonator comprise cooperating holding means for the proximal implant end to be able to be held at the distal resonator end.

74. The method according to claim 73, wherein the cooperating holding means comprise elements of a snap-closure, materials suitable to be bonded together, a securing pin, or a threaded bolt.

75. The method according to claim 73, wherein the proximal end of the implant consists of the first material and wherein a distal face of the resonator carries at least one energy director.

76. The method according to claim 60, wherein a distal face of the resonator or of a distal resonator part corresponds in cross section to the proximal face of the implants.

77. The method according to claim 37, wherein, for the step of impinging and simultaneous pressing, a distal end of a resonator of an implantation device is positioned on the proximal face of the implant and acts like a hammer thereon.

78. The method according to claim 77, wherein the proximal face of the implant comprises a second material which is not liquefiable under implantation conditions.

79. The method according to claim 77, wherein the proximal face of the implant comprises the first material and a distal face of the resonator comprises at least one energy director and wherein the method comprises a step of deform ing the proximal face of the implant with the aid of the distal face of the resonator and mechanical oscillation.

80. The method according to claim 79, wherein the step of deforming is carried out before the step of positioning and further comprises bonding the deformed proximal face of the implant to the distal face of the resonator.

81. The method according to claim 77, wherein the implantation device comprises a generator, an oscillation element and a resonator, the generator being designed for exciting the oscillation element into mechanical oscillation, the resonator and the oscillation element being connected to form an oscillation unit, and a distal resonator end being adapted to the proximal face of the implant for transmission of the mechanical oscillations from the resonator into the implant and for pressing the implant against the tissue part.

82. The method according to claim 37, wherein the implant comprises a core of a second material which is not liquefiable under implantation conditions.

83. The method according to claim 82, wherein the core is removed after implantation.

84. The method according to claim 83, wherein the core is a guide wire.

85. The method according to claim 82, wherein the implant is a part of a prosthesis and the step of positioning comprises positioning said prothesis part in bone tissue.

86. The method according to claim 82, wherein the implant is a dental implant and the step of positioning comprises positioning the implant in an opening in a jaw bone.

87. The method according to claim 37, wherein the step of positioning comprises positioning the implant through a tendon or ligament onto bone tissue situated underneath the tendon or ligament or into an opening provided in the bone tissue underneath the tendon or ligament.

88. The method according to claim 37, wherein a further implant which has the shape of a plate is attached to the tissue part with the aid of the implant or with the aid of a plurality of the implants.

89. The method according to claim 88, wherein the plate is fixed to a proximal end of the implant or implants.

90. The method according to claim 88, wherein the plate is a fixation or stabilization plate.

91. The method according to claim 90, wherein the fixation or stabilization plate is positioned across a bone fracture or laceration.

92. The method according to claim 90, wherein the fixation or stabilization plate is positioned in a head region of a patient for repair or reconstruction purposes.

93. The method according to claim 90, wherein the fixation or stabilization plate is positioned across a gap between two calvaria parts or between a calvaria part and an artificial cover plate replacing a calvaria part.

94. The method according to claim 90, wherein the fixation or stabilization plate is positioned over at least two vertebral bodies.

95. The method according to claim 94, wherein the plate is elastically deformable.

96. The method according to claim 88, wherein the plate comprises at least one through opening and, in the step of positioning, the plate is positioned against the tissue part and the implant is positioned through the through opening in the plate onto the tissue part or into an opening provided in the tissue part.

97. The method according to claim 96, wherein the proximal implant end comprises a head having a larger cross section than a cross section of the through opening.

98. The method according to claim 96, wherein the plate consists of a second material, which is not liquefiable under implantation conditions, and the step of impinging and simultaneous pressing comprises pressing the first material into the through opening, which comprises a wall with unevennesses, cavities or pores.

99. The method according to claim 96, wherein the plate consists of a third material having thermoplastic properties and the step of impinging and simultaneous pressing comprises welding or adhering a region of the implant comprising the first material into the opening of the plate.

100. The method according to claim 96, wherein the step of impinging and simultaneous pressing comprises driving the implant into the bone tissue sufficiently for the proximal implant end to be flush with an outer surface of the plate.

101. The method according to claim 37, wherein the implant has a plurality of different cross sections between a distal and a proximal end thereof.

102. The method according to claim 101, comprising steps between different cross sections.

103. The method method according to claim 37, wherein the first material is a non-resorbable or a resorbable polymer.

104. The method according to claim 103, wherein the first material is a polyethylene (PE), a polymethyl metacrylate (PMME), a polycarbonate (PC), a polyamide, a polyester, a polyacrylate, a polymer based on lactic acid and/or glycolic acid, a polyhydroxyalkanoate (PHA), a polycaprolactone (PCL), a polysaccharide, a polydioxanone (PD), a polyanhydride or a corresponding copolymer.

105. The method according to claim 104, wherein the polymer based on lactic acid and/or glycolic acid is PLA, PLLA, PGA, or PLGA.

106. The method according to 37, wherein the first material further contains foreign phases or additional substances suitable for reinforcing, swelling or rendering porous the material, or for promotion of healing or regeneration, or for furthering x-ray visibility.

107. The method according to claim 106, wherein the additional substance is a growth factor, an antibiotic, an inflammation inhibitor or a buffer.

108. The method according to claim 106, wherein the foreign phases are fibers or whiskers.

109. The method according to claim 37, wherein implant surfaces of the first material are equipped with energy directors in the form of projecting pyramids, cones, hemispheres or ribs.

110. The method according to claim 37, wherein implant surfaces of the first material comprise axially extending ribs which constitute humps or corners of an implant cross section.

111. The method according to claim 37, wherein the distal implant end is pointed or tapers to a plurality of point-like or linear tip regions.

112. The method according to claim 37, wherein the first material constitutes the whole implant.

113. The method according to claim 37, wherein the implant comprises a core with a proximal end, a distal end and a circumferential surface between the proximal end and the distal end and consisting of a second material which is not liquefiable at implantation conditions, and wherein the first material is arranged on the distal end of the core and/or on the circumferential surface of the core.

114. The method according to claim 113, wherein the second material of the core is a metal, a ceramic material, a glass, a polymer or a composite material.

115. The method according to claim 113, wherein the second material comprises titanium, a cobalt-chrome alloy, polyetheraryl ketone, polyfluoro- and/or polychloroethylene, polyetherimide, polyethersulphone, polyvinylchloride, polyurethane, polysulphone, polyester, aluminium oxide, zirconium oxide, a silicate, a calcium phosphate ceramic or glass, or a carbon fiber reinforced high-temperature thermoplastic polymer.

116. The method according to claim 113, wherein the first material is resorbable and the core comprises a bioactive surface.

117. The method according to claim 113, wherein the core is a stem of a joint prosthesis.

118. The method according to claim 113, wherein the implant is a dental implant to be implanted in a jaw bone.

119. The method according to claim 37, wherein a proximal implant end comprises a head.

120. The method according to claim 37, wherein the implant is designed for replacing a further tissue part or for fastening a further tissue part, a therapeutic auxiliary device, a suture, a cerclage wire, an artificial support or fixation element, an artificial joint socket or ball, or an artificial tooth, bridge or tooth prosthesis.

121. The method according to claim 37, wherein, for being held by a distal end of a resonator, a proximal end of the implant is equipped with an inner thread, a resilient head or a through bore.

122. The method according to claim 37, wherein the connection to be created is a pointwise, depth-effective connection.

123. The method according to claim 37, wherein the connection to be created is a large-surfaced, superficial connection.

124. The method according to claim 123, wherein suitable tissue surface regions are roughened before positioning the implant (7).