EP-4739249-A1 - GUIDE FOR ZYGOMATIC IMPLANT SURGERY

EP4739249A1EP 4739249 A1EP4739249 A1EP 4739249A1EP-4739249-A1

Abstract

Guide (1) for zygomatic implant surgery comprising: a pair of guiding bodies (2, 3) defining a seat (4) adapted to house a working tool (5, 6, 7), of which: a first guiding body (2); a second guiding body (3) comprising an half-bushing (8) having a section which is conformed to a semi-circumference; a connecting body (9); wherein: the first guiding body (2) comprises a slotted portion (10) comprising a first extremal stretch (10a), a second extremal stretch (10b) and a joint stretch (10c); the first extremal stretch (10a) has a substantially semi-circumference conformation with concavity opposite that of the half-bushing (8); the extremal stretches (10a, 10b) and the joint stretch (10c) bound an elongated slot (10a, 10b, 10c) adapted to guide the working tool (5, 6, 7).

Inventors

GRANDI, Tommaso
GRANDI, Antonio

Assignees

J DENTAL CARE SRL

Dates

Publication Date: 20260513
Application Date: 20240705

Claims (1)

CLAIMS 1) Guide (1) for zygomatic implant surgery, comprising: at least one pair of guiding bodies (2, 3) defining at least one longitudinal seat (4) adapted to house at least one working tool (5, 6, 7), of which: at least a first guiding body (2) arranged, in use, in the proximity of the residual bone crest of a maxillary bone (M) of a patient; at least a second guiding body (3) arranged, in use, in the proximity of the base of a zygomatic bone (Z) of a patient and comprising at least one half-bushing (8) having a section which is substantially conformed to a semi-circumference and defining a respective first median axis (Al); at least one connecting body (9) positioned between said guiding bodies (2, 3); characterized by the fact that: said first guiding body (2) comprises at least one slotted portion (10) comprising, in turn, at least a first extremal stretch (10a), at least a second extremal stretch (10b) and at least a joint stretch (10c) positioned between said extremal stretches (10a, 10b); said first extremal stretch (10a) has a substantially semi-circumference conformation with concavity opposite that of said half-bushing (8) and defines a respective second median axis (A2) substantially coincident with said first median axis (Al); and that said extremal stretches (10a, 10b) and said joint stretch (10c) bound an elongated slot (10a, 10b, 10c) along a direction transverse to said median axes (Al, A2) and adapted to guide said working tool (5, 6, 7). 2) Guide (1) according to claim 1, characterized by the fact that said second extremal stretch (10b) has a substantially semi-circumference conformation with concavity opposite that of said first extremal stretch (10a) and defines a respective third median axis (A3) substantially parallel to said first median axis (Al) and to said second median axis (A2). 3) Guide (1) according to one or more of the preceding claims, characterized by the fact that said joint stretch (10c) has a substantially straight conformation. 4) Guide (1) according to one or more of the preceding claims, characterized by the fact that at least one of either said first guiding body (2) or said second guiding body (3) comprises, respectively: at least a first anchoring portion (11) associated with said slotted portion (10) and adapted to anchor to said connecting body (9); and at least a second anchoring portion (12) associated with said half-bushing (8) and adapted to anchor to said connecting body (9). 5) Guide (1) according to claim 4, characterized by the fact that at least one of said anchoring portions (11, 12) is at least partly threaded. 6) Guide (1) according to one or more of the preceding claims, characterized by the fact that at least one of said guiding bodies (2, 3) is made at least partly of at least one metallic material. 7) Guide (1) according to one or more of the preceding claims, characterized by the fact that: said slotted portion (10) and said half-bushing (8) define a working volume (V) within which said working tool (5, 6, 7) is movable; and by the fact that said connecting body (9) is arranged externally to said working volume (V). 8) Guide (1) according to one or more of the preceding claims, characterized by the fact that said connecting body (9) is obtained from a digital reconstruction of at least part of the oral cavity of the patient. 9) Guide (1) according to one or more of the preceding claims, characterized by the fact that said connecting body (9) is made at least partly of resin. 10) Kit (13) for zygomatic implant surgery, characterized by the fact that it comprises: at least one guide (1) according to one or more of the preceding claims; a plurality of working tools (5, 6, 7), each insertable within said seat (4), of which: - at least a first dental burr (5) comprising: - at least a first proximal portion (5a) connectable to a device (D) for setting in rotation; - at least a first median working portion (5b) insertable within said slotted portion (10) and adapted to remove part of the maxillary bone (M) to obtain at least one substantially cylindrical housing (H) having a predefined diameter; - at least a first smooth distal portion (5c) which can be coupled to said halfbushing (8) and adapted to be placed in support on a corresponding apical portion of the zygomatic bone (Z) without removal of the zygomatic bone (Z); - at least a second dental burr (6) comprising: - at least a second proximal portion (6a) connectable to said device (D) for setting in rotation; - at least a second median non-working portion (6b) insertable within said housing (H) without removal of the maxillary bone (M); - at least a second distal working portion (6c) adapted to pierce the zygomatic bone (Z) so that at least one apical hole (F) is obtained on the latter. at least one zygomatic implant (7) comprising at least one threaded pin (7a) which has a diameter corresponding to said predefined diameter and can be grafted into said housing (H) and into said apical hole (F).

Description

GUIDE FOR ZYGOMATIC IMPLANT SURGERY Technical Field The present invention relates to a guide for zygomatic implant surgery. Background Art As is well known, a dental implant substantially consists of a screw which is placed within the alveolar bone to replace a tooth that is extracted or is missing. This allows an abutment to be attached thereto, protruding externally from the cavity and serving a structural function, onto which the dental crown is affixed, replacing the missing tooth in its appearance and function. In this regard, one of the most cutting-edge solutions for patients with severe maxillary atrophy is rehabilitative surgery using zygomatic implants. Specifically, this approach involves the use of endosseous dental implants having significantly greater length than traditional implants and are designed, instead of inserting into the maxillary bone alone as the latter do, to anchor into the zygomatic bone. This technique is, however, marked by considerable practical difficulties and, as it requires highly specialized anatomical and surgical skills, is particularly complex to perform freehand in a precise and repeatable manner. In this regard, bone-supported/fixed guides are known to date specially designed to stabilize the movements of the burr when making osteotomies and, at the same time, to guide the subsequent insertion of the dental implant within the zygomatic bone. A first example of such guides is provided by patent document IT102018000006998. Specifically, this document describes a guide comprising a first half-bushing and a second half-bushing, connected to each other and defining a common longitudinal median axis, having a semi-circular cross-section with opposite concavities. Specifically, half-bushings define a seat into which a working element, e.g. of the type of a dentist’ s burr, can be inserted, movable along the median axis and rotatable around that axis. In more detail, the first half-bushing is arranged in a maxillary crestal position with vestibular concavity and determines the working depth of the working element (i.e., the vestibular-palatal sinking), while the second half-bushing is arranged at the zygomatic region. The special construction of the aforementioned guide and, in particular, the fact that the half-bushings have opposite concavities, makes it possible to stabilize the burr by applying thereon a momentum of forces directed to push it towards the concavity of the first half-bushing and, at the same time, towards the concavity of the second halfbushing. At the same time, the fact that the half-bushings have a semicircular conformation and are, therefore, open allows minimizing the overall dimensions of the guide within the oral cavity, leaving much of the latter accessible for performing the surgical operation and allowing the dentist to move the burr with greater freedom of movement. Despite this, the guide described in IT102018000006998 is not without drawbacks. In fact, while, on the one hand, the fact of providing open semi-bushings makes it possible to achieve the aforementioned advantages, this same fact implies, on the other hand, that moving of the burr in the vestibular-palatal and palatal-vestibular directions is completely free and, therefore, solely entrusted to the manual skills of the dentist. It is straightforward to appreciate how this fact can result, under certain circumstances, in excessive burr strokes which, leading to the risk of contact between the burr and the adjacent tissues, compromise the overall safety of the procedure. Not only that, but such strokes can also undermine the correct directionality of the osteotomy made on the maxillary bone and on the zygomatic bone, consequently leading to a high probability that the implant will be placed incorrectly. That said, a second type of guides for zygomatic implant surgery disclosed by patent document EP3843655 is known in the state of the art. In the present case, within this document, an apparatus for the insertion of zygomatic implants is described comprising: a guide fixable to the maxillary bone in a removable manner and provided with an anterior and posterior hollow template, spaced apart from each other and aligned along one direction of insertion of a zygomatic implant; and a working tool (e.g., of the type of a dental burr) insertable into the guide and provided with a spherical head that serves as a fulcrum and with an abrasive surface which, as a result of the rotation around the spherical head, can be displaced from a first position to a second position wherein it is placed within the front template along the direction of insertion. By rotating the working tool around the spherical head, therefore, the abrasive surface can perform the osteotomy on the maxillary bone, allowing the subsequent insertion of the implant into the seat thus created. It should be noted, however, that the apparatus of EP3843655 suffers from limitations quite similar to those complained about in the gu