# US 10,869,705 B2 · Implant and guide

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- Number: US 10,869,705 B2
- Document ID: US10869705B2
- Status: Granted
- Kind: B2
- Application number: 15/096,645
- Filed: 2016-04-12
- Published: 2016-08-04
- Granted: 2020-12-22
- Earliest claimed: 2012-12-12
- Assignees: Obl; Universite Pierre Et Marie Curie (Paris 6); Assistance Publique—Hôpitaux de Paris (Paris)
- Applicants: Obl S.A.; Université Pierre et Marie Curie (Paris 6); Assistance Publique—Hôpitaux de Paris (Paris)
- Inventors: Guillaume Dubois; Patrick Goudot; Thomas Schouman
- Web page: https://patentgrep.com/patent/US10869705B2

## CPC

- A61B 17/8061: {specially adapted for particular bones (A61B17/70 and A61B17/74 take precedence)}
- A61B 17/151: {for corrective osteotomy}
- A61B 17/1673: {for the jaw}
- A61B 17/1728: {for holes for bone plates or plate screws}
- A61B 17/176: {for the jaw}
- A61B 17/8071: {for the jaw}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61F 2/2803: {for mandibular reconstruction (temporo-mandibular joints A61F2/3099; bone plates for the jaw A61B17/8071)}
- A61F 2/2875: {Skull or cranium (A61F2/2803 takes precedence; joints for temporo-mandibular [TM] joints [TMJ] A61F2/3099)}
- A61F 2/30942: {for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques}
- G06T 17/00: Three-dimensional [3D] modelling for computer graphics
- A61B 2017/568: {produced with shape and dimensions specific for an individual patient}
- A61B 2017/681: {Alignment, compression, or distraction mechanisms}
- A61B 2034/102: {Modelling of surgical devices, implants or prosthesis}
- A61B 2034/104: {Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/108: {Computer aided selection or customisation of medical implants or cutting guides}
- A61F 2002/2807: {Chin implants}
- A61F 2002/2882: {Malar or zygomatic implants}
- A61F 2002/2889: {Maxillary, premaxillary or molar implants}
- A61F 2002/30622: {Implant for fusing a joint or bone material}
- A61F 2002/30948: {using computerized tomography, i.e. CT scans}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL

## Abstract

An implant and guide are described, together with methods for configuring the same. The implant and guide are for maxillofacial osteosynthesis and may be provided as a kit. Three-dimensional models of the pre- and post-operative anatomy are used to define attachment points. These attachment points are used to define a structure for the implant and the guide.

## Claims

### Claim 1

A kit for maxillofacial osteosynthesis comprising:
a maxillofacial implant for osteosynthesis comprising:
a first plurality of apertures for coupling the implant to a first maxillofacial bone portion of a patient;
a second plurality of apertures for coupling the implant to a second maxillofacial bone portion of the patient; and
a monolithic three-dimensional structure that couples the first and second plurality of apertures;
wherein the three-dimensional structure has a shape that varies in each of three dimensions to arrange the second maxillofacial bone portion relative to the first maxillofacial bone portion in accordance with a desired post-operative orientation,
wherein the implant is arranged to arrange the second maxillofacial bone portion relative to the first maxillofacial bone portion following an osteotomy that defines at least one cut that results in the second maxillofacial bone portion being separated from the first maxillofacial bone portion, said osteotomy resulting in an absence of any bone coupling the first and second bone portions together,
wherein the desired post-operative orientation corresponds to a selected arrangement of the second maxillofacial bone portion in relation to the first maxillofacial bone portion, said arrangement comprising at least one of a translation and a rotation of the second maxillofacial bone portion in relation to the first maxillofacial bone portion;
wherein said first and second plurality of apertures are defined on the implant based on at least one location of one or more anatomical features of the patient; and
a maxillofacial surgical guide comprising:
a third plurality of apertures for guiding a drilling operation with respect to the first maxillofacial bone portion of the patient;
a fourth plurality of apertures for guiding the drilling operation with respect to the second maxillofacial bone portion of the patient; and
a monolithic three-dimensional structure for the surgical guide that couples the third and fourth plurality of apertures,
wherein the monolithic three-dimensional structure for the surgical guide defines an inner surface that varies in each of three dimensions,
wherein the inner surface has a shape that aligns with an outer surface defined by the first maxillofacial bone portion and the second maxillofacial bone portion in a pre-operative state,
wherein the monolithic three-dimensional structure for the surgical guide is configured such that the inner surface aligns with the outer surface in a single configuration in three-dimensional space,
wherein said third and fourth plurality of apertures are defined on the surgical guide based on the at least one location of the one or more anatomical features of the patient;
wherein locations of the third and fourth plurality of apertures in the maxillofacial surgical guide correspond to mapped locations of the first and second plurality of apertures in the maxillofacial implant;
wherein the locations of the third and fourth plurality of apertures in the maxillofacial surgical guide correspond to a pre-operative maxillofacial anatomy; and
wherein the locations of the first and second plurality of apertures in the maxillofacial implant correspond to a desired post-operative maxillofacial anatomy.

### Claim 2 (depends on 1)

The kit of claim 1, wherein the maxillofacial surgical guide further comprises:
at least one drill bush associated with one of the third or fourth plurality of apertures,
wherein the at least one drill bush has a height determined in relation to at least one location of one or more anatomical features of the patient.

### Claim 3 (depends on 1)

The kit of claim 1, wherein the monolithic three-dimensional structure for the surgical guide comprises one or more osteotomy guides, each osteotomy guide indicating a location for at least one cut.

### Claim 4 (depends on 1)

The kit of claim 1, wherein the maxillofacial surgical guide further comprises:
one or more apertures for attaching the monolithic three-dimensional structure for the surgical guide to one or more of the pre-operative first and second maxillofacial bone portions.

### Claim 5 (depends on 4)

The kit of claim 4, wherein at least one of said one or more apertures for attaching the monolithic three-dimensional structure for the surgical guide is co-incident with a defined osteotomy cut.

### Claim 6 (depends on 1)

The kit of claim 1, wherein each aperture of the maxillofacial implant has a bore and an angle of orientation for an axis of the one or more of the bores is also defined based on the at least one location of the one or more anatomical features of the patient.

### Claim 7 (depends on 6)

The kit of claim 6, wherein the axis is offset from a further axis that is defined as perpendicular to the surface of the first or second maxillofacial bone portion.

### Claim 8 (depends on 1)

The kit of claim 1, wherein each aperture of the maxillofacial surgical guide has a bore and an angle of orientation for an axis of the one or more of the bores is also defined based on the at least one location of the one or more anatomical features of the patient.

### Claim 9 (depends on 8)

The kit of claim 8, wherein the axis is offset from a further axis that is defined as perpendicular to the surface of the first or second maxillofacial bone portion.

### Claim 10 (depends on 1)

The kit of claim 1, wherein a portion of a first structure for said implant distinguishes said first structure from a second structure for a second implant.

### Claim 11 (depends on 1)

The kit of claim 1, wherein a portion of a first structure for said surgical guide distinguishes said first structure from a second structure for a second surgical guide.

### Claim 12 (depends on 1)

The kit of claim 1, wherein the first and second plurality of apertures are defined on the implant such that at least a coupling length of the structure between a first set of adjacent apertures is different from a coupling length of the structure between a second set of adjacent apertures, and
wherein the first and second sets of adjacent apertures comprise two sets of apertures with each set comprising:
adjacent apertures on the implant for coupling to the same maxillofacial bone portion; or
a first aperture on the implant for coupling to the first maxillofacial bone portion and a second, adjacent, aperture on the implant for coupling to the second maxillofacial bone portion.

### Claim 13 (depends on 1)

The kit of claim 1, wherein the maxillofacial implant comprises:
a first portion having a defined inner surface that matches an outer surface defined by an anatomy of the first maxillofacial bone portion; and
a second portion having a defined inner surface that matches an outer surface defined by an anatomy of the second maxillofacial bone portion.

### Claim 14 (depends on 1)

The kit of claim 1, wherein said third and fourth plurality of apertures are defined on the surgical guide such that at least a coupling length of the structure between a first set of adjacent apertures is different from a coupling length of the structure between a second set of adjacent apertures, and
wherein the first and second sets of adjacent apertures comprise two sets of apertures with each set comprising:
adjacent apertures on the surgical guide for coupling to the same maxillofacial bone portion; or
a first aperture on the surgical guide for coupling to the first maxillofacial bone portion and a second, adjacent, aperture on the surgical guide for coupling to the second maxillofacial bone portion.
