ORTHOGNATHIC IMPLANT AND METHODS OF USE

• US 20110269100A1
• Filed: 04/29/2010
• Published: 11/03/2011
• Est. Priority Date: 04/29/2010
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Furrer, Andre, Zillig, Timo, Metzger, Marc Christian
• Granted Patent: US 9,066,733 B2
• Time in Patent Office: Days
• US Class Current: 433/72
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/176 for the jaw guiding dental drills A61C1/082
• 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 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/8071 for the jaw
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• 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 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 6/51 for dentistry
• CPC Class Codes: A61C 8/0031 Juxtaosseous implants, i.e. implants lying over the outer surface of the jaw bone
• CPC Class Codes: A61C 8/0089 Implanting tools or instruments
• CPC Class Codes: A61C 9/004 Means or methods for taking digitized impressions
• CPC Class Codes: G05B 19/182 characterised by the machine tool function, e.g. thread cutting, cam making, tool direction control G05B19/21 - G05B19/40 take precedence
• CPC Class Codes: G05B 2219/49023 3-D printing, layer of powder, add drops of binder in layer, new powder
• CPC Class Codes: G16B 5/00 ICT specially adapted for modelling or simulations in systems biology, e.g. gene-regulatory networks, protein interaction networks or metabolic networks

Abstract

An implant for use in orthognathic surgery of a maxilla may include a longitudinal plate member and a plurality of pre-shaped fingers extending from an upper edge of the plate member. The longitudinal plate member is pre-shaped to correspond to the pre-operative shape of the maxilla; and the fingers are pre-shaped to correspond to the shape of the maxilla. The fingers may be pre-shaped to correspond to either the pre-operative shape or the post-operative shape of the maxilla.

Claims

1. An implant for use in orthognathic surgery, the implant comprising:

a plate member pre-shaped to correspond to a pre-operative shape of a maxilla, and at least one fixation aperture that extends through the plate member and is configured to receive a bone fixation element so as to secure the plate member to the maxilla; and

a plurality of fingers extending out from the plate member, the fingers pre-shaped to correspond to the shape of the maxilla.

2. The implant of claim 1, wherein the fingers are pre-shaped to correspond to the pre-operative shape of the maxilla.

3. The implant of claim 2, wherein either the plate member or the pre-shaped fingers include apertures that are arranged to provide a template for pre-osteotomy drilling of fixation element receiving holes in a maxilla at locations corresponding to predetermined post-osteotomy fixation points for a bone plate.

4. The implant of claim 1, wherein the fingers are pre-shaped to correspond to the post-operative shape of the maxilla.

5. The implant of claim 4, wherein each finger includes at least one aperture configured to receive a fixation element.

6. The implant of claim 5, wherein the plate member includes at least on aperture configured to receive a fixation element.

7. The bone plate of claim 6, wherein at least one aperture of the plate member is vertically aligned with at least one of the fingers.

8. The bone plate of claim 1, wherein the plate member includes a bridging portion that divides the plate member into a first portion and a second portion.

9. The bone plate of claim 8, wherein the bridging portion is removable.

10. The bone plate of claim 8, wherein the bridging portion includes a reference hole.

11. The bone plate of claim 1, wherein the fingers are spaced apart along the plate member and extend substantially perpendicularly relative to the plate member.

12. An implant configured to join a first part of bone to a second part of bone after a segmentation procedure that separates the first part of the bone from the second part of the bone, the implant comprising:

a plate member that is pre-shaped, prior to the segmentation procedure, so as to correspond to an outer surface of the first part of the bone, the plate member including at least one aperture configured to receive a fixation element so as to secure the plate member to the first part of the bone;

a holding structure that extends from the plate member and is pre-shaped so as to correspond to the second part of the bone after the segmentation procedure.

13. The implant of claim 12, wherein the plate member is pre-shaped, prior to the segmentation procedure, so as to correspond to an outer surface of the first part of the bone after the segmentation procedure.

14. The implant of claim 12, wherein the bone is a maxilla.

15. The implant of claim 14, wherein pre-shaped means shaped to correspond to the first and second parts of the maxilla prior to the plate member and the holding structure being secured to the first and second parts of the maxilla.

16. The implant of claim 14, wherein pre-shaped means shaped to correspond to the first and second parts of the maxilla before the first part is segmented from the second part.

17. The implant of claim 14, wherein the holding structure comprises a plurality of fingers that are each pre-shaped, prior to the segmentation procedure, so as to correspond to an outer surface of the second part of the maxilla after the segmentation procedure.

18. The implant of claim 17, wherein the at least one aperture of the plate member is vertically aligned with one of the fingers.

19. The implant of claim 14, wherein the plate member includes a bridging portion that divides the plate member into a first portion and a second portion.

20. The implant of claim 19, wherein the bridging portion is removable.

21. The implant of claim 19, wherein the bridging portion includes a reference hole.

22. An osteotomy guiding implant for use in orthognathic surgery, the osteotomy guiding implant comprising:

a plate member that is pre-shaped to correspond to a pre-operative shape of a maxilla;

a template portion extending from the plate member that is pre-shaped to correspond to a pre-operative shape of the maxilla, the template portion defining a plurality of apertures, such that the apertures are arranged to provide a template for pre-osteotomy drilling holes that define a cutting guide path in the maxilla so as to separate a segmented portion of the maxilla from an integral portion of the maxilla.

23. The osteotomy guiding implant of claim 22, wherein the template portion comprises a plurality of fingers, each finger defining one of the apertures.

24. The osteotomy guiding implant of claim 22, wherein the plate member defines a plurality of apertures configured to receive a drill.

25. The osteotomy guiding implant of claim 22, wherein the plate member includes a reference hole.

26. An orthognathic surgical kit comprising:

an osteotomy guiding implant comprising a plate member and defining a plurality of apertures, the apertures being arranged to provide a template for pre-osteotomy drilling holes that define a cutting guide path in a maxilla so as to separate a segmented portion of the maxilla from an integral portion of the maxilla; and

a bone fixation implant comprising

a plate member pre-shaped to correspond to the segmented portion of the maxilla;

at least one finger that extends from the plate member and is pre-shaped to correspond to the integral portion of the maxilla.

27. The surgical kit of claim 26, wherein the plate member of the osteotomy guiding implant is pre-shaped to correspond to the pre-operative shape of the maxilla.

28. The surgical kit of claim 26, wherein (i) the plate member of the osteotomy guiding implant includes a plurality of fingers that extend from the plate member.

29. The surgical kit of claim 26, further comprising a plurality of fixation elements.

30. The surgical kit of claim 26, wherein the plate member of the bone fixation implant includes a bridging portion that divides the plate member into a first portion and a second portion.

31. The surgical kit of claim 30, wherein the bridging portion is removable.

32. The surgical kit of claim 26, wherein (i) the plate member of the osteotomy guiding implant and the plate member of the bone fixation implant each include a reference aperture, and (ii) the reference apertures each correspond to a common fixation element receiving hole formed in the maxilla.

33. The surgical kit of claim 26, wherein the guide path is between the holes.

34. The surgical kit of claim 26, wherein the osteotomy guiding implant further defines a second plurality of apertures that are arranged to provide a template for pre-osteotomy drilling holes that define a position on the maxilla to place the and secure the bone implant.

35. A method for correcting the shape of a maxilla, the method comprising the steps of:

determining a plurality of locations on the maxilla;

positioning a guiding implant comprising guiding apertures arranged to align with the plurality of locations;

drilling a plurality of holes in the maxilla through the guiding apertures of the guiding implant;

identifying a guide path between the drilled holes;

separating the maxilla into at least a first portion and a second portion based on the guide path;

positioning a pre-shaped bone fixation implant arranged to fix the first and second portions of the maxilla in a desired relative position; and

securing the bone fixation implant to the maxilla.

36. The method of claim 35, wherein the bone fixation implant is secured to the maxilla by screwing a fixation element through the bone fixation implant and into the maxilla.

37. The method of claim 35, wherein the maxilla is separated along the guide path.

38. The method of claim 35, further comprising removing a bridge from the bone fixation implant.

39. The method of claim 35, wherein the guiding implant is pre-shaped to correspond to the pre-operative shape of the maxilla.

40. A method of customizing a pre-shaped implant for use in orthognathic surgery of a maxilla, the method comprising:

obtaining a pre-operative 3-D model of a patient'"'"'s maxilla in a computer, whereby a first portion of the maxilla and a second portion of a maxilla define a first relative position;

manipulating the pre-operative 3-D model of the maxilla into a planned post-operative shape whereby the first portion of the maxilla and the second portion of the maxilla define a second relative position that is different than the first relative position; and

custom constructing a bone fixation implant to match the planned post-operative shape of the maxilla, the implant including a plate member pre-shaped to attach to the first portion of the maxilla, and at least one finger extending from the plate member shaped to attach to the second portion of the maxilla.

41. The method of claim 40, further comprising, custom constructing a guiding implant to match the pre-operative shape of the patient'"'"'s maxilla, the guiding implant including a plate member defining a plurality of apertures, the apertures being arranged to provide a template for pre-osteotomy drilling of holes in the maxilla.

42. The method of claim 40, wherein the bone fixation implant is constructed from Titanium.

43. A bone fixation implant configured to be separated into at least two separate bone implant segments, the single bone fixation implant comprising:

a plate member having a first portion, and a second portion separated by a bridge portion the first and second portion each including at least one aperture configured to receive a fixation element so as to secure the plate member to bone; and

at least one finger extending from each of the first and second portions, each finger including at least one aperture configured to receive a fixation element so as to secure each finger to bone,

wherein the bridge portion is removable to thereby separate the first portion of the plate member from the second portion of the plate member after the plate member has been secured to bone.

44. The bone fixation implant of claim 43, wherein the first portion extends from the bridge portion at a first junction, and the second portion extends from the bridge portion at a second junction.

45. The bone fixation implant of claim 44, wherein the first and second junctions are weakened.

46. The bone fixation implant of claim 44, wherein (i) the bridge portion comprises a plate and an extension extending from each end of the plate, and (ii) the junctions are located at the ends of the extensions.