ACCURATE ANALOGS FOR BONE GRAFT PROSTHESES USING COMPUTER GENERATED ANATOMICAL MODELS

• US 20130269165A1
• Filed: 03/14/2013
• Published: 10/17/2013
• Est. Priority Date: 08/31/2001
• Status: Active Grant

• Current Assignee: CLM Analogs LLC
• Original Assignee: Leonard Marotta
• Inventors: Marotta, Leonard
• Granted Patent: US 8,790,408 B2
• Time in Patent Office: Days
• US Class Current: 29/428
• CPC Class Codes: A61B 17/8685 comprising multiple separate parts
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61C 1/084 of implanting tools
• CPC Class Codes: A61C 13/0004 Computer-assisted sizing or machining of dental prostheses
• CPC Class Codes: A61C 8/0001 Impression means for implants, e.g. impression coping
• CPC Class Codes: A61C 8/0096 Implants for use in orthodontic treatment
• CPC Class Codes: A61C 8/0098 Immediate loaded implants
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: Y10T 29/49826 Assembling or joining

Abstract

Pre-surgical planning for cranial, facial, limb and digit muscular and bone reconstruction includes preparing a computer generated anatomical model for determining a locational position for a dental implant, a surgical bone implant to repair missing bone in the cranium, limbs and digits and to install ear, eye or nose prostheses. The computer generated anatomical model is made from medical imagery and computer aided design. A surgical guide is prepared with oversize holes in registration with analogs for the dental or surgical bone implants to be inserted in the anatomical model. The surgical guide is fitted atop each analog, and bonded to the anatomical model at a predetermined angle of the analog in the anatomy. The surgical guide is removed and attached to the anatomy of a patient for accurate drilling for insertion of the implants or prostheses into the body of the patient.

Claims

1. A method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits of a patient with a prosthesis attachable to the cranium, jaw, limbs or digits of the patient with one or more attachment members comprising the steps of:

a. preparing a physical anatomical model made in a stereographic machine that is controlled by a computer;

said computer using medical images of the patient for preparation of the physical anatomical model by the stereographic machine;

b. determining a locational position and orientation for a surgical bone implant to repair missing bone in the cranium, jaw, limbs or digits of the patient, to install an ear prosthesis, an eye prostheses, a nose prostheses, a limb prosthesis or a digit prosthesis;

c. using the physical anatomical model and preparing a surgical guide with oversize holes in registration with respective analogs for the attachment members securing surgical bone and cartilage implants to be inserted to the cranium, jaw, limbs or digits of the patient at the locational positions and orientations determined by a surgeon for the physical anatomical model, each said analog being an elongated structural member having at least one anti-rotational projection extending from said elongated structural member;

d. fitting said surgical guide atop each said elongated analog structural member, and bonding a respective surgical guide sleeve for said surgical guide to the physical anatomical model at a locational position and orientation of the analog in the physical anatomical model, and;

e. removing said surgical guide attached for accurate drilling during the surgical procedure for insertion of the bone and cartilage implants onto the skull or jaw of patient at a location analogous to said location and orientation of said analog in said physical anatomical model.

2. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said at least one anti-rotational projection extends radially from said analog pin.

3. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said at least one anti-rotational projection extends parallel to an axial length of said analog pin.

4. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said surgical guide comprises an assembly of:

said surgical guide sleeve supported by a form-fitting open support mount mountable over an anatomical structure,

an adapter to adjust the height of said surgical guide sleeve above the analog, and

a screw threaded through said surgical guide sleeve, said form-fitting open support mount and said adapter from the top to secure the said surgical guide assembly to said analog below.

5. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said computer generated model is produced by the fabrication of a solid object by at least one additive method selected from the group consisting of stereolithography, laminated object manufacturing, solid freeform fabrication, and fused deposition modeling.

6. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein a three dimensional shape of said computer generated skull model made in said stereographic machine is determined by computer CAD design.

7. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein a three-dimensional shape of said computer generated skull model made in said stereographic machine is determined by medical images.

8. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said medical images are selected from the group consisting of x-rays, sonograms, CT Scans, nuclear imaging and magnetic resonance MRI imaging.

9. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 1 wherein said surgical guide is placed over a donor bone graft site harvested from the patient or from a cadaver, which is implanted to repair bone or cartilage damaged by trauma, infection, disease or surgery in a different part of the body.

10. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 9 wherein bone is harvested from a donor site in the body of a patient and three dimensional models are made of both the donor site and of the receptor site in the body of the patient, wherein said models are used to plan respective coordinated surgeries at said donor bone graft site and said receptor site to create said surgical guides for precise prostheses fit and joining by attachment members or with surgical screws/pins.

11. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a portion of a skull jaw with dental implants.

12. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is selected from the group consisting of a nose, an eye, an ear and a finger digit portion.

13. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a removable member removable for sanitary cleaning, said removable member attached to a permanently implanted frame, said removable prostheses attachable by attachment members to said permanently attached frame.

14. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a knee replacement structure attachable by insertion attachment members implanted into a bone of a leg.

15. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a hip replacement structure attachable by insertion attachment members implanted into a bone of a pelvic region of the body.

16. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a plate attachable to a fractured bone and attached to said fractured bone by insertion attachment members implanted into a bone of a pelvic region of the body.

17. The method for pre-surgical planning for reconstruction of the cranium, jaw, limbs and digits as in claim 10 wherein said prostheses is a bone graft from a donor bone to repair a region with extensive damage in the mandible, further comprising the steps of wherein said model is used with analogs for teeth crowns, where positioning of said analogs conform to holes in said in bone graft, as determined by holes in said surgical guide,

wherein further the damaged region of the patient'"'"'s lower jaw is surgically extracted and then a segmentectomy is performed of the lower jaw, by cutting the damaged bone into a predetermined carved out recess, to be filled by said bone graft from said donor bone site,

wherein further shaping of said recess is performed using subtractive methods of the damaged area in the patient'"'"'s jaw,

wherein further, before said donor bone graft is harvested, it is scanned so that an accurate model in a different biocompatible material can be later made by a 3D printing technique,

wherein further autogenous bone is used to reduce tissue rejection problems,

wherein further after said autogenous bone graft is placed in the repaired jaw, osseointegration is promoted to bond the donor bone graft and the repaired mandible intimately,

wherein further teeth analogs are used to locate replacements for damaged teeth with implant crowns, respectively.