FR3050637A1 - DEVICE FOR ENABLING THE FIXATION OF ONE OR MORE DENTAL IMPLANTS ON THE UPPER MAXILLARY VIA THE SINUSIAN CAVITY - Google Patents

Abstract

The invention relates to a device for fixing one or more dental implants on the upper jaw of a patient, comprising, with a view to fixing implants in an intrasinus cavity made on said patient: • at least one implant (1) axially elongate comprising, in the proximity of its head, at least one connector area (5) designed to be able to receive by lateral sliding at least one fixing element (3), and / or by axial sliding at least one fixing element (2 ), as well as: • one or more fixing elements chosen from the group consisting of: • fixing EIS elements (3) to be inserted by lateral sliding on a part of the lateral surface of an implant (1), • fixing EIS elements ( 2) to be inserted by axial sliding and tightly applied on or near at least a part of the head of an implant (1), and while the elements (2) and (3) can optionally be interconnected , and while lesdi All fixing elements can be connected to the implants by a post or a screw.

Description

DEVICE FOR ENABLING THE FIXATION OF ONE OR MORE DENTAL IMPLANTS ON THE UPPER MAXILLARY VIA THE

SINUSIAN CAVITY

FIELD OF THE INVENTION

The present invention relates to the field of dentistry, and more particularly to a device for rendering operational and reliable the fixation of one or more dental implants in the maxilla of an individual or subject, while the implant or implants are intended to be placed in the sinus during im "sinus lift". The invention also relates to the elements involved in the composition of said device, and singularly each of the elements of such a device which, in cooperation with at least one of the others, contributes to make operational and reliable such a fixation.

In the man, in the maxillary upper, the maxillary sinus descends quite low in the region of the upper premolars and molars.

During tooth extraction in this region, bone melting results in bone and gum healing. The remaining bone height is often only 1-7 mm, which is insufficient for a dental prosthesis implant, because the implants have a length of between 10 and 14 mm for this region.

TECHNOLOGICAL BACKGROUND At the present time, when there is a lack of sinus bone in order for the implantation of implants on the upper jaw to succeed in the state, a "sinus lift" is performed. say that a lateral bony window is opened to lift the lower membrane of the sinus, in order to place a biomaterial in a cavity thus formed between the raised membrane and the bone of the sinus bottom.

There are several biomaterials filling the sinus bottom, the most used being those based on β-tricalcium phosphate and hydroxyapatite.

This biomaterial, trapped with patient's blood, will surround the implant (s) for a period of 4 to 5 months. To simplify the presentation and its reading, it was agreed to mention "the" implants, even if only one is considered, because what is explained below applies mutatis mutandis in both cases.

In addition, the implants are placed necessarily through a small bone orifice, which orifice will necessarily have an inflammation, because the bone is traumatized. This inflammatory phase is always accompanied by a destruction of this bone orifice, so the natural bone around the neck of the implants. It is for this reason that implants can be lost about 1 month later, at the beginning of the healing phase, when the bone repair begins, thanks to the return of the bone on the surface of the implants. But during this phase of the first month, it is possible that the implants are expelled either in the oral cavity, or inside the sinus as evidenced by many articles on this subject.

This longevity that the biomaterial has will promote the neoformation of bone that solidifies around the implants which, it should be remembered, are cylindrical, cylindro-conical or conical. After 4-5 months, the implants are activated for the purpose for which they are intended, by the installation of prosthetic abutments and the tightening of the abutment screws under a force between 25 and 35 newtons, which is the norm allowed to then allow the laying of crowns on said pillars. Nevertheless, the neoformed bone does not have the same density or hardness as the natural bone of the patient. It can then arise problems during the implementation of implants during the clamping phase.

These are real problems, which remove the sinus lift much of its reliability, despite its many indications. It should also be remembered that the implants have a cylindrical, cylindro-conical or conical shape, and present 2/3 of their volume in the void, under the sinus membrane, which is currently expressed by the image of heels needles embedded in the biomaterial.

SUMMARY OF THE INVENTION

It has now been found that the resolution of the problem mentioned above can be approached by an increase in the volume of this implant implanted in the sinus, by the provision of at least one intrasinusic fixing element (ci). -after called "fixative EIS") fixed on the implant, on its end intrasinusienne, laterally and / or axially, so that the biomaterial encircles and traps this new implant to a greater extent, because one thus increases its stability and its fixity to solve the problem mentioned above during the first month of healing, and also to solve the problem of tightening when starting the implant 4-5 months later.

In addition, the device according to the invention is defined and designed to have numerous cavities allowing the biomaterial to lodge there and thus the future bone to fix. Said device also has the advantage of being compact and allow to lift the sinus membrane only to a limited extent, without aggression.

The present invention provides an attractive and effective solution for increasing the volume of the implant in the sinus, which gives the biomaterial the ability to effectively encircle and trap the implant thus equipped, because its volume and presence of numerous cavities allow the biomaterial to lodge there and thus the future bone to fix itself.

The device thus designed and described hereinafter with reference to embodiments given solely by way of illustrative and non-limiting examples, makes it possible to avoid the so-called "stiletto" concept of implants placed in the sinus during of a "sinus lift".

The implants to which the invention applies are of all types, in particular those which are conical, cylindro-conical or cylindrical. In addition, when several implants are placed, one can, through the meeting of the corresponding devices, achieve a contention system that makes this operation even more reliable.

In the subsequent step of putting implants into operation, prosthetic abutments are placed on them to produce dental prostheses, such as crowns, bridges, etc.). These pillars are tightened at their connecting screw under a force between about 25 and 35 newtons.

With prior art implants, this considerable force can sometimes detach the implants from the newly formed bone, causing their loss.

Such an increase in the volume and therefore the contact area available for bone neoformation, as well as the increase in the resistance in the vertical direction (which is by convention the longitudinal direction of the implant) and in the lateral direction of the fact. of the volume thus procured as well as the entanglement of the neoformed bone in the cavities and niches provided by said device, and also in the direction of rotation relative to the implantation orifice, make the implants then stronger and more durable than traditional implants, despite the nature of the neoformed bone, which remains the same.

Moreover, the resistance to rotational forces during tightening of the prosthetic abutments is greatly increased.

In addition, in the case where two or more implants are juxtaposed, the contention brings even more resistance and fixity.

It follows in particular that; • during the first months after implant placement and the fixation element (s), the healing of the neoformed bone around the implants proceeds smoothly; • after the healing period of 4-5 months, chewing, which involves significant vertical and lateral forces, also proceeds smoothly; • after the healing period of 4-5 months, the prosthetic abutments on these implants by tightening to around 25-35 newtons are performed without any problem; The volume provided by the fixing elements increases the surface of the contact surface considerably, especially since, as an option, said fixing elements may have extensions of various kinds and in various directions, thus increasing the volume and the fixity implants with such extensions; and • when there are several implants, the possibility of bringing together the fixing elements to be considered brings a greater fixity, by a restraining effect of the implants.

BRIEF DESCRIPTION OF THE DRAWINGS The invention will be better understood, and other objects, advantages and features thereof will appear more clearly, in the light of the following detailed description of the preferred embodiments, given for illustrative purposes only and in no way limiting, while appended to the said description are plates of drawings in which:

1 shows, in exploded diagrammatic and exploded perspective view, an embodiment of a device according to the invention, with separate representation of two intra-sinus elements to be inserted on the implant.

FIG. 2 represents a diagrammatic front view in section of an implant head comprising two fixing elements according to the invention.

3 shows a partial schematic sectional view of a set of two implants of which only the head and a part of the body are shown, each provided with a set of two fixing elements according to the invention, while the fixing element laterally insert is designed and arranged to secure the two implants simultaneously.

4 shows, in a cavalier perspective, the lateral insertion fixing element for the embodiment described in FIG.

Figure 5 shows a perspective view of a screw-in implant, the head of which is arranged to receive a fixing element (EIS) as shown in exploded above said head.

Figure 6 shows a perspective view of a screw-in implant and two upper fixing elements according to a variant of Figure 5, the upper fixing member being secured to a lower fixing member. The connection between the upper element and the lower element is performed by one or more connecting pieces, such as for example one or more bars (only one being shown in Fig. 6). The lower fixative element, which is truncated annular shape, is pushed through the narrowed portion such that the two fixing elements have their common axis with that of the implant. Downward axial movement drives the assembly to its locking position on the implant.

Figure 7 is a perspective view of the variant according to Figure 5, with the upper fixing EIS elements introduced from above.

FIG. 8 is a perspective view of an exploded view showing an implant according to the invention and, separately, two elements respectively designed for lateral insertion and for axial insertion, from above, these two elements being able to be nested one in the other;

FIG. 9 represents, in partial schematic section, the head and the threaded part of the body of an implant according to the invention and, in their final position on said implant, the cross section of the two fixing elements forming a fastening securing assembly of implant according to the invention; and

FIG. 10 is a top view in a cavalier perspective of a double fixing element, laterally insertable by pushing transversely to the longitudinal axis of two vicinal implants, said element being provided with slots for the insertion of the descending lateral tab of each of the two complementary elements adapted to be inserted by downward translation from the top of the head of their respective implant.

In FIGS. 1 to 10, reference numeral 8 represents a fastening orifice with tenon or screw, which would pass through the fixing EIS and the implant to ensure fixation.

DETAILED DESCRIPTION OF THE INVENTION

It has been found that the above-mentioned objectives, ie the exceptional reliability of the implant by the addition of fixative EIS elements during the compression phase and after the healing phase, as well as others, can to be achieved with a device and its essential components for fixing, in the upper jaw of a subject, dental implants using the devices and fixative elements described herein.

In general, the device intended to ensure the fixation of one or more dental implants on the upper maxillary of a patient basically comprises, for the purpose of fixing them in an intrasinus cavity produced on said patient: at least one implant 1 axially elongate having, in the proximity of its head, at least one connector zone 5 of advantageously circular, triangular, square, diamond-shaped or polygonal cross-section designed to be able to receive by lateral sliding (that is to say substantially perpendicular to the longitudinal axis of said implant) at least one fixing element 3, and also by axial sliding (that is to say parallel to the axis of the implant) at least one fixing element 2, as well as: At least one fixing element comprising at least one element chosen from fixing elements 2 and 3 (hereinafter referred to as Intra-Sinusic Elements, or abbreviated EIS) for be introduced into an intrasinusierme cavity previously constituted by the realization of a bone window through the lateral cortical bone and by lifting the lower and lateral membrane of the maxillary sinus, thus allowing the fixation of implants in the intrasinusierme cavity, in the right of the site on which one or more implants 1 must be attached, while said one or more fixative elements are selected from the group consisting of: • fixative EIS elements 3 designed and arranged to be able to be inserted by lateral sliding and tightly applied on to less than a portion of the implant implant side surface; • fixative EIS elements 2 designed and arranged to be able to be inserted by axial sliding and tightly applied on or near at least a portion of the head of an implant, and • a combination of fixable EIS elements 2, 3 capable of being interconnected, and which are co nfigurés and / or arranged to be able to be fixed vm to each other and possibly on one or more respective positions of the implant itself.

Combinations of fixative EIS elements selected from those of the tomes referenced 2 and 2, 3 and 3, 2 and 3, and any other combinations of fixing EIS are conceivable, with the further possibility that they are connectable to one another or to each other. no.

Once they are properly inserted on the implant, said fixative EIS elements make it possible to prevent, resorb or reduce any displacement by rotation, translation and / or instability of fixation of said implant.

Reference is made hereinafter to the embodiment shown in Figs 1-4 of the accompanying drawings.

In the following, "medial connectivity" means a connector which is neither on the head of the implant, nor at the opposite end thereof, but simply at any point along the body of said implant, even close to the head of said implant.

The actual implants may be on a conventional basis. They are advantageously chosen from implants comprising an oblong, threaded, non-threaded or partially threaded body, and the implants comprising an oblong body, having grooves or the like allowing them to be impacted by means of a mallet.

In one embodiment, said implants may optionally, towards their distal end or head, that is to say the end that enters the sinus cavity, a structure having on its periphery, successively, two or more of two peripheral beads 4 succeeding one another along the side wall of said implant 1, said beads having any section and being intended to serve as a limit or stop for receiving the fixing element 2 and the fixing element or elements 3 intended to be inserted by lateral sliding movement, that is to say substantially transversely to the axis of the implant 1. At their distal end or head, said implants 1 preferably have a flat or substantially flat cross section. A flat section has the advantage that it avoids protrusions directed towards the sinus membrane, and / or that it makes it possible to obtain a substantially flat surface during its opening at the surface of the upper plane, surrounding said distal end of the fixing element 2, once it is inserted on this distal part of the implant, by sliding or translation along the longitudinal axis of the implant.

In the direction from the distal end to the proximal end, the following two beads or pairs of optional beads 4 have the function of delimiting the zone in which the sliding or sliding of a fixing element 3 must be carried out. inserted laterally, on and along the appropriate section of the implant 1.

The peripheral geometry of the zones thus deflected between the aforementioned beads may be arbitrary. In practice, it is advantageous for it to have a polygonal geometry or preferably of square or even triangular cross-section, in particular but not exclusively between the second and third of the aforementioned beads, although any other geometry suitable for a suitable sliding of the fixer element is also suitable.

The said implants may be screw-type or impact type (that is to say arranged to be implemented by means of a mallet, by a striking action with it).

The said implants may be made of various materials, in particular of metal, ceramic or zirconia, of polyetheretherketone type material called Peek (semi-crystalline thermostable thermoplastic polymer marketed by ICI), or others, in particular of any other material, biocompatible to be usable in the sinuses. The fixing EIS element 2 is intended to be inserted by longitudinal sliding from top to bottom, that is to say parallel to the longitudinal axis of the implant 1, from the distal end and in the direction of the proximal end of it.

In general, the first and second elements 2, 3 above are not a priori permutable. They may, however, be, provided that each comprises two male elements 6 spaced apart, each towards one of the two ends of the element forming the oblong implant, and in this case the nipple or extension (cylindrical, cylindrical, conical, or triangular cross-section, square, polygonal, or circular) of one of said elements is able to slid into one of the two respective cavities 7 of the other element, while in the other case the nipple or cylindrical extension of the other element remains free after the insertion of said element by sliding on the appropriate area of the implant, which provides an additional advantage S5mergic that said nipple or cylindrical extension remaining free can be inserted into the mass of material used for bone neoformation mentioned above.

The device according to the invention may comprise a single implant 1, as well as a fixing element 2 and / or a fixing element 3 each, or even only one of the two types of fixing elements only.

The device according to the invention may, as a variant, comprise a set of several implants 1, as well as a fixing element 2 and / or a multiple fixing element 3, or single chaam, or even only one of the two types of implant. fixative elements only. By way of illustration, in the present description and the appended drawings, the numeral 8 represents orifices, whether through or blind, circular or polygonal, threaded or not, and which are able to receive fastening lugs or fastening screws.

The assemblies thus recommended are, for example, joints of the tenon-mortise type, or more generally assemblies between male-female parts.

Said fixative EIS elements may have any shape, but they are preferably substantially parallelepipedic and have the specificities illustrated in the figures, in particular the connection protuberances 6 and respectively through-through and non-through recesses C, as well as the orifices 8.

In the present description and the appended drawings, the term "fixation" or "fixer" means the technical effect consisting of a firm retention of the parts concerned, either with each other or with respect to another part or part of the device according to the invention. But additionally and additionally by these terms is also meant a positive retention and aggregation effect of the biomaterial powder subsequently distributed around the device according to the invention and in the crevices thereof, which contributes positively to the integrity. and the stability of the whole.

In the present description, the term "closely applied" is understood to mean the state in which the wall of the fixing element intended to be applied by lateral or longitudinal sliding on a suitable wall portion of the implant concerned, has a shape and an orientation adapted to closely match the shapes and orientations of the wall portion of the implant on which this sliding application will take place.

In order to make all the elements 1 to 3 of this embodiment of the device according to the present invention functional, the implant 1 placed in a sinus cavity is inserted on the head B of the implant, according to the lateral introduction options EIS 3 and or by axial insertion of an EIS 2. In doing so, the EIS 2 having a through orifice A, of appropriate shape, size and orientation, is slid over the head zone B of the implant 1, until it abuts on the appropriate face of the EIS 3 previously slidably placed on the implant 1, with the appropriate orientation. The protuberances 6 of the EIS 2 may be of any shape, but preferably cylindrical, cylindro-conical, or triangular cross-section, square, polygonal or other. The insertion of these protuberances 6 in the housings 7 of the EIS 3 can be performed by friction or clipping. among other means of securing. These EIS elements can also be fixed with tenons and / or screws.

Once such an assembly is made, cavities and niches appear, the presence of which is beneficial for the deployment and fixation on larger surfaces of the biomaterial for osteogenesis.

In the embodiment having two or more twin implants, the EIS inserted by lateral insertion can be secured, thus achieving effective and beneficial restraint.

It should be noted here, and the following description will mount in more detail (with reference to the accompanying drawings) that, according to the embodiments envisaged, it is expected that one or other of the aforementioned fixing elements, or both of them are called to slide on the home wall of the implant (see in particular Figs 5-7). It should then be ensured that the receiving implant has an adequate wall, smooth or rough depending on the intended function, ranging from a simple fixation to a fixation with osseointegration, as well as the right of completion of the initial slide that the right displacement of the same fixing element by additional sliding along the wall of the implant (1), in one or other of the directions relative to the head thereof.

In practice, said shape and orientation correspondences of the respective walls of the implant and of a fixing element intended to allow said walls to be applied closely to one another, are realized by an identity or similarity of the shapes that are either flat, either concave or convex, and their orientations.

More concretely and purely for illustrative purposes, in this first embodiment of the invention, the implants have on their body and their ends at least one zone which may be, for example, non-cylindrical, of triangular cross-section. , square, diamond-shaped, symmetrical or asymmetric polygonal, intended to receive a fixing element which can be inserted on the implant either axially (in the axis of the implant), or laterally (see FIG. ), while each element 2 and 3 has an outer surface that can cooperate perfectly with the surface of the corresponding area on the implant 1. The fixing element can be fixed on the implant by means such as, for example, tenons (eg transfixers, self - locking, etc.) / or screws or others.

For a unitary implant, once the sinus membrane has been lifted, the implant is placed in the little bone of the sub-sinus cortex, most of the implant being exposed in the intrasinus cavity. . The implant is positioned so that the fixation hole looks at the bone window made in the lateral bone.

Referring now to Figs. 5-7 which illustrate another alternative embodiment of the object of the present invention, it is seen that an implant 1 of known type is composed of a body and a cylindro-conical threaded head and provided with grooves or branches , or else substantially longitudinal slots 9 along several lines which are suitably distributed over the periphery of the head of the implant 1. According to the invention, a first fixing element 3 is introduced by lateral sliding, which is itself surmounted by im element for fixing from the top, according to a longitudinal insertion axis with respect to the longitudinal axis of symmetry of the implant 1. In this case, the lateral fastening element 3 is advantageously "open", c ' that is to say that its peripheral wall is incomplete, preferably on a part of its periphery which corresponds substantially to 1/4-1/3 of the perimeter of said element. The implant itself then comprises a tapered non-threaded zone 5 to allow the passage on its periphery of at least one laterally inserted open fixing FIS element and / or of a longitudinal insertion fixing element, which are then slid longitudinally. to reach the locking position resulting from the widening of the sliding wall, in practice of cylindro-conical shape.

In the embodiment shown in FIG. 6, the assembly thus constituted, comprising the fixing elements 3 and 2 held together by one or more connecting bars 10, is thus introduced laterally, so that the upper element 2 passes laterally slightly above the vertex of the head of the implant 1. Once the element 3 is introduced to surround, but with play, the periphery of said implant over most of its surface to be applied to said implant, is lowered the set of two fixing FIS elements 2, 3 and their connecting member 10, to a position ensuring a stability of the assembly, so its stiffening.

It should be noted that, in practice, the fixing EIS elements 2 and 3 are, in this embodiment, preferably of annular shape (open with regard to the EIS intended to be introduced laterally) and advantageously provided on their inner face pins (preferably four pins judiciously distributed) to facilitate the sliding and maintaining the orientation of the fixing elements in functional combination with the grooves or longitudinal slots. Again, the EIS can be provided with orifices 8 blocking, for receiving a pin or a screw that can pass through and reach a suitable hole in the implant 1.

In an embodiment of the same type as the previous one, but comprising a set of two vicinal implants, a set of two fixing elements 2 joined together by a bracket on which is fixed, or which includes, an extension itself, is recommended. provided with through holes for easy gripping and placement, while said extension also provides an increase in volume to the EIS element fixer concerned. In this variant, the stability of the implants is thus reinforced by the dual and combined action of several fixing elements 2, introduced longitudinally (compression effect).

In yet another embodiment illustrated in Figs. 8-9, the assembly according to the invention comprises an implant 1, and two fixing elements respectively 3 (for lateral introduction) and 2 (for axial insertion). The element 3 comprises a slot 7 intended to receive by introduction from top to bottom the lug 6 of the element 2, which itself comprises a through-hole, of square cross-section, intended to insert it by sliding on the head of the implant 1, whose dimensions must be adapted.

As to the element shown in FIG. 10, it is an alternative embodiment of the element 3 of FIG. 8, which as we see is intended to group two fixing elements on the same bracket that joins two implants 1 vicinal. Fixing the fixing element 2 on one or both of the implants or both, and on this stem is then optional. The invention also relates to fixing elements or intrasinusal parts as described above, for lateral and / or axial insertion in relation to the respective devices and implants to which they are more particularly intended.

In general and in summary, the present invention makes it possible to: • during the bone neoformation phase of a duration of 4 to 5 months, increase the volume, increase the contact surface, increase the fixity of the implants, which they be conical, cylindro-conical, or cylindrical, and thus obtain the implants do not detach from the biomaterial used for bone neoformation, or even the low natural bone volume present at the neck of the implants, which is low as it is indicated above; • after the bone neoformation phase, increase the resistance to the rotational forces applied during the tightening of the prosthetic abutments, increase the resistance to vertical and lateral chewing forces, increase the fixity of the implant (s).

As a result: the healing of neoformed bone around the implants goes smoothly; the traction of the prosthetic abutments on these implants under a tightening of 25-35 newtons also goes smoothly; mastication involving large, vertical and lateral forces does not cause problems; the volume provided by the implant and its fixing elements increases very significantly the contact area with bone neoformation; when several implants are combined, the possibility of joining the bodies of these makes it possible to achieve a greater fixity by a restraining effect of the implants.

Fixing elements may also have optional extensions (see Fig. 7 ref 11 and Fig 8, ref 6) which may be of various shapes, of various natures, and oriented in various directions. These extensions increase the volume and the ability to fix (or fix) implants.

Claims (20)

1. Device intended to ensure the fixation of one or more dental implants on the upper jaw of a patient, characterized in that it comprises, for the attachment of implants in an intrasinus cavity made on said patient: at least one axially elongate implant (1) having, in the vicinity of its head, at least one connector zone (5) designed to be able to receive by lateral sliding at least one fixing element (3), and / or by sliding axial at least one fixing element (2), as well as: • at least one fixing element comprising at least one element chosen from fixing elements, abbreviated EIS fixators, (2) and (3) intended to be introduced into an intrasinus cavity previously constituted by the realization of a bone window through the lateral cortical bone and by lifting of the lower and lateral membrane of the maxillary sinus, thus allowing implant fixation. ts in the intrasinus cavity, to the right of the site on which one or more implants (1) are to be attached, while said im or more fixative elements are selected from the group consisting of: • fixative EIS elements (3) designed and arranged to being capable of being inserted by lateral sliding and closely applied on at least a part of the lateral surface of an implant (1), • fixing EIS elements (2) designed and arranged to be able to be inserted by axial sliding and closely applied at or near at least a portion of the head of an implant (1), and • a combination of fixable EIS elements (2, 3) which can be interconnected, and which are configured and / or arranged to can be fixed to each other and possibly to one or more respective positions of the implant (1) itself. 2. Device according to claim 1, characterized in that it comprises combinations of fixing EIS elements selected from those of types referenced (2) and (2,3) and (3,2) and (3). 3. Device according to one of claims 1 or 2, characterized in that said connector zone (5) has a circular cross section, triangular, square, diamond or polygonal. 4. Device according to any one of claims 1 to 3, characterized in that the implants (1) have on their body and / or their ends at least one zone which may be non-cylindrical, of triangular cross section, square, in rhombus or polygonal, symmetrical or asymmetrical, intended to receive a fixing element which can be inserted on the implant (1) either axially or laterally. 5. Device according to any one of claims 1 to 4, characterized in that each element intended for fixing intrasinusian element (2) and / or (3) has an outer surface that can cooperate perfectly with the surface of the corresponding zone. of the implant (1). 6. Device according to claim 5, characterized in that said elements intended for fixing intrasinusian element comprise means for enabling them to prevent, resorb or mitigate any displacement by rotation, translation and / or instability of attachment of said implant. 7. Device according to claim 6, characterized in that the implants (1) are chosen from implants comprising xm oblong body, threaded, non-threaded or partially threaded, and the implants having an oblong body, having grooves or the like to be impacted by im mallet. 8. Device according to claim 6, characterized in that the implants (1) have optionally, towards their distal end or head, that is to say the end which enters the sinus cavity, a structure comprising on its periphery, successively, two or three peripheral beads (4) succeeding one another along the side wall of said implant, said beads having any section and being intended to serve as limit or abutment for receiving a fixing element (3) intended to be inserted by lateral sliding movement, that is to say substantially transversely to the axis of the implant (1). 9. Device according to any one of claims 1 to 8, characterized in that said implants have, at their distal end or head, a flat or substantially flat cross section. 10. Device according to any one of claims 1 to 8, characterized in that said implants have from their distal end at least three beads (4), constituted by a first peripheral bead at a suitable distance to serve as a stop. a fixing element (2) inserted axially, said first bead being followed by at least two other peripheral beads defining two by two zones (5) into which insertion elements (3) are inserted laterally. 11. Device according to claim 10, characterized in that the peripheral geometry of the zones (5) thus defined between said beads (4) is polygonal, preferably square or triangular cross section. 12. Device according to any one of claims 1 to 11, characterized in that said implants of metal, ceramic or zirconia, or polyetheretherketone type material, which is a thermostable thermoplastic semicrystalline polymer. 13. Device according to any one of claims 1 to 11, characterized in that the possible assemblies between fixing elements are t5q? E mortise-tenon, or assemblies between male-female parts. 14. Device according to any one of claims 1 to 11, characterized in that the implant and / or the fixing elements comprise orifices, through or blind, circular or polygonal, threaded or not. said orifices being able to receive fastening lugs or fixing screws. 15. Device according to any one of claims 1 to 11, characterized in that the implant (1) comprises a non-threaded narrowed area (9) to allow the passage on its periphery of at least one fixing element (3). ) open introduced laterally. 16. Device according to any one of claims 1 to 11, characterized in that it comprises a single implant (1), and a fixing element (2) and / or a fixing element (3) each unique. 17. Device according to any one of claims 1 to 11, characterized in that it comprises a set of several implants (1), and a fixing element (2) and / or a fixing element (3) multiples. 18. Device according to any one of claims 1 to 17, characterized in that said fixing elements are substantially parallelepiped and provided with protrusions (6) of connection and recesses respectively through (A) and non-through (C), as well as orifices (8). 19. Device according to any one of claims 1 to 18, characterized in that the implant (1) host has a wall (5) adequate, smooth or rough according to the intended function, ranging from a simple attachment to a fixation with osseointegration, both at the end of the initial sliding and the right of the displacement of the same fixing element by an additional sliding along the wall of the implant (1), in one or the other directions relative to the head of it. 20. Device according to claim 15, characterized in that the implant (1) is composed of a body and a cylindro-conical threaded head and provided with grooves or grooves (9), or substantially longitudinal slots, along several lines suitably distributed over the periphery of the implant head (1).