Dental bone foundation guide with BUR instrument guide features

Abstract

An apparatus includes a first guide and a second guide. The first guide includes an arcuate horizontal body portion. A rear su1face of the horizontal body portion is configured to closely mate with a front-facing bone structure of an alveolar arch of a patient. The second guide includes a body and a coupling member. The body defines a passageway that is configured to receive a bone reducing instrument. The coupling member is configured to mate with the horizontal body portion of the first guide. The body and the coupling member are configured to position the passageway along a second 'horizontal plane that is parallel with the first horizontal plane. The coupling member is configured to enable the second guide to relative to the first guide along the second horizontal plane and thereby guide the bone reducing instrument along the second horizontal plane.

Description

DENTAL BONE FOUNDATION GUIDE WITH BUR INSTRUMENT GUIDE FEATURES BACKGROUND

[0001] &Jme patients may develop tooth I oss warranting prosthetic replacement. Some instances may warrant a full dental arch restoration. To properly seat a permanent dental prosthetic, ii may be necessary to remodel dental bone structures, therelby providing a substantially fl at foundation for the prosthetic. A fler pro vi ding a substanti al I y fl alfoundati on, the dental surgeon may drill passageways into the bone in which to sacure implants. Once these passagev,,ays are formed and the implants are secured therein, the surgeon may secure the prosthetic to the implants, thereby permanently affixing the prosthetic to the patient's bone.

[0002] Various forms of hardware may be u!:ed to perform the above-des:ri bed surgical procedure. Examples of such hardware and asrociated procedures are described in U.S. Pat. No. 8,899,984, entitled "CT-Ba!:ed, Side-Loading Surgical and Laboratory Dental Implant Guide System and Method," issued December 2, 2014; U.S. Pat. No. 9,504,533, entitled "Endentulous Surgical Guide," issued November 29, 2016; U.S. Pat. No. 9,693,834, entitled "lmplant-Ba!:ed Attachment System for Dental Implant Surgical Guide and Method," issued July 4, 2017; U.S. Pat. No. 9,795,458, entitled" Dental Surgical Implant Guide and Prosthesis Combination and Method of Use," issued October 24, 2017; U.S. F\Jb. No. 2014 / 0272778, entitled " Bone Foundation Guide and Method of Use," published September 18, 2014; U.S. F\Jb. No. 2015 / 0010881, aititled "Bone Foundation Guide and Method of Use," published January 8, 2015; U.S. F\Jb. No. 2016 / 0038255, entitled" Bone Foundation Guide System and Method," published February 11, 2016; U.S. F\Jb. No. 2017 / 0112591, entitled" Bone Foundation Guide System and Method," published April 27, 2017; U.S. F\Jb. No. 2017 / 0112592, entitled" Method of Using an Endentulous Surgical Guide," published April 27, 2017; and U.S. F\Jb. No. 2017 / 0252126, entitled "Bone Foundation Guide System and Method," published September 7, 2017.

[0003] While several dental surgical systems and methods have been made and u!:ed, it is believed that no one prior to the inventors has made or u!:ed the invention des:ri bed in the appended claims. -1- Date reçue / Received date 2026-01-28 BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The drawi ngsand detai I ed de;.:ri pti on that fol low are intended to be merely i 11 us:rative and are not intended to Ii mit the scope of the invention as conternpl ated by the inventors.

[0006] Fl G. 1 depicts a peropectiveview of an exemplary bone foundation guide;

[0006] Fl G. 2 depicts another perspective view of the bone foundation guide of Fl G. 1;

[0007] Fl G. 3depictsa front elevation view of the bone foundation guide of FIG. 1;

[0008] Fl G. 4A depicts a perspective view of the bone foundation guide of Fl G. 1 mounted to an alveolar ridge of a patient, before a bone reduction procedure;

[0009] Fl G. 4B depicts a perspective view of the bone foundation guide of FIG. 1 mounted to an alveolar ridge of a patient, after a bone reduction procedure;

[0010] Fl G. 5 depicts a perspective view of an exemplary bur guide that may be mounted to the bone foundation guide of FIG. 1;

[0011] Fl G. 6 depicts another perspective view of the bur guide of Fl G. 5;

[0012] Fl G. 7 depicts a peropective view of a shaft of a bur ins:rument dioposed in the bur guide of FIG. 5;

[0013] Fl G. 8 depi ctsa peropective view of the bur gui deaf Fl G. 5 mounted to the bone foundation guideof FIG. 1;

[0014] Fl G. 9 depicts a cross-sectional view of the bur guide of FIG. 5 mounted to the bone foundation guide of FIG. 1, with the bone foundation guide mounted to an alveolar ridge of a patient, and with the shaft of a bur instrument dioposed in the bur guide and removing bone from the alveolar ridge;

[0016] Fl G. 10 depicts a perspective view of another exemplary bur guide;

[0016] Fl G. 11 depicts another peropectiveview of the bur guide of FIG. 10;

[0017] Fl G. 12 depicts a perspective view of an exemplary variation of the bur guide of FIG. 10;

[0018] Fl G. 13 depicts a perspective view of an exemplary alternative bone foundation guide that -2- Date reçue / Received date 2026-01-28 is configured to couple with the bur guide of Fl G. 10 or the bur guide of Fl G. 11;

[0019] FIG. 14 depicts a perspective view of the bur guide of FIG. 10 mounted to the bone foundation guide of Fl G. 13; and

[0020] FIG. 15 depicts a cross-sectional view of the bur guide of FIG. 10 mounted to the bone foundation guide of Fl G. 13, with the bone foundation guide mounted to an alveolar ridge of a patient, and with the shaft of a bur instrument disposed in the bur guide and removing bone from the alveolar ridge. DETAILED DESCRIPTION

[0021] The following description of certain examples of the invention should not be used to limit the scope of the present invention. The drawings, which are not necessari I y to scale, depict selected embodiments and are not intended to Ii mil the scope of the invention. The detai I ed description illustrates by way of example, not by Waif of limitation, the principles of the invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the bes: modes contemplated for carrying out the invention. As will be realized, the invention is capable of other different or equivalent aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.

[0022] Any one or more of the teachings, expressions, vers ons, exam pl es, etc. described herein may be combined with any one or more of the other teachings, expressions, versons, examples, etc. that are describe:! herein. The following-described teachings, expressions, versions, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those skilled in the art in view of theteachingsherein. SJch modifications and variations are intended to be included within the scope of the claims.

[0023] As used herein, the terms" about" or" approximately" for any numerical values or ranges indicate a suitable di mens onal tolerance that allows the part or collection of components to function for its intended purpose as described herein. More specifically, "about" or -3- Date reçue / Received date 2026-01-28 "approximately" may refer to the range of values ±10% of the recited vaue, e.g. "about 90%" may refer to the range of values from 81% to 99%. In addition, as used herein, the terms" patient," "host," "user," and" subject" refer to any human or animal subject and are not intended to limit the systems or methods to human use, although use of the subject invention in a human patient represents a preferred embodiment.

[0024] I. Exemplary Bone Foundation Gui de

[0026] Fl GS. 1-3 show an exemplary bone foundation guide (100), or bone reduction guide, that may be used in combination with other components•in a surgical procedure as described below. Bone foundation guide (100) includes a horizontal body portion (110) and a pair of upright body portions (130). Horizontal body portion (110) extends along a horizontal plane and defines an arcuate shape corresponding to an alveolar arch of a patient, as described in greater detail below. Upright body portions (130) are located at each end of the arc defined by horizontal body portion (110). In s.:imeversions, bone foundation guide (100) is generated based on a three-dimensional digital model that is created based on a three-dimensional digital model of the patient's oral anatomy. 9.Jch a process may be performed in accordance with the teachings of any of the various patent references cited herein; and / or in accordance with the nE'equence® Guided Prostheti cs:ID Kit and workfl ow by National Dentex, LLC of Palm Beach Gardens, Florida.

[0026] Horizontal body portion (110) includes a front surface (112), a rear surface(114), an upper surface· (116), and a lower su'rface (118). The terrris" upper" and "lower" are being used herein in the exemplary context of bone foundation guide (100) and other devices being mounted to the mandibular alveolar arch. However, as noted below, s.:imeversionsof bone foundation guide (100) may be mounted to the maxillary alveolar arch, in which cases upper surface (116) would in fact be presented downwardly; and lower s.:iurce (118) upwardly. Use of the terms" upper" and" lower" should therefore not be read as limiting the alveolar ridge to which bone foundation guide ( 100) may be secured.

[0027] In the present example, rear surface (114) is configured to correspond directly to the configuration of the front-facing surface of the patient's alveolar arch, to thereby provide full surface-to-surface contact along the entirety of rear surface (114) when bone -4- Date reçue / Received date 2026-01-28 foundation guide (100) is fully seated on the alveolar arch. Rear surface (114) is thus configured to closely mate with a correspondi ng region of the bone structure of the al vedl ar arch of the patient. The configuration of rear surface(114) is customized per patient in this example, such that the configuration of rear surface (114) is based upon the anatomical surface geometry embodied in the three-dimensional digital model of the patient's anatomy. Upper surface(116) is substantially flat in this example, to thereby provide a substantially horizontal plane for guidance of an osteotomy bone reduction procedure as described below. In SJme other versions, upper surface (116) is undulating. In such versions, the undulations of upper surface (116) may be ·positioned and configured to correspond with positions of prosthetic teeth that will ultimately be installed in the patient's mouth. This may ultimately provide a more natural appearance at the interface between the guml i ne and the prosthetic teeth.

[0028] Horizontal body portion (110) alSJ includes a plurality of pasxigeways (120, 124) extending from front surface ( 112) to rear surface ( 114). Passageways ( 120) are configured to align with corresponding pasxigeways of other devices as will be described in greater detail below. Passageways (124) are configured to receive fasteners to s-ecure bone foundation guide (100) to the alveolar ridge of a patient. By way of. example only, bone foundation guide (100) may be s-ecured to the alveolar ridge via pins, s::rews, or other features disposed in passageways (124). Passageways (124) are surrounded by cyl i ndraceous stand-off features ( 122) in the present example. stand-off features ( 122) are . . . configured to reinforce the structural integrity of horizontal body portion (110) in the regions around pasxigeways ( 124).

[0029] Each upright body portion (130) includes a vertically extending front surface (132), a horizontally extending upper surface (134), a vertically extending inner surface (136), and a lower surface (137). A slot (138) is formed through each upright body portion (130). In the present example, surfaces (132, 134, 136) are generally flat. A gap (139) extends laterally between inner surfaces (136). Lower surface (137) is configured to correspond directly to the configuration of an upwardly facing surface of the patient' salveolar arch (or the downwardly facing surface when bone foundation guide (100) is mounted to the maxillary alveolar arch), to thereby provide full surface-to-surface contact along the -5- Date reçue / Received date 2026-01-28 entirety of lower surface (137! when bone foundation guide (100) is fully seated on the alveolar arch. Lower surface (137) is thus configured to closely mate with the bone structure of a corre;pondi ng region of the alveolar ridge of the pati en!. The configuration of I ower surface ( 137) is customized per patient in this example, such that the configurali on of lower SJrface (137) is based upon the anatomical s.1rface geometry embodied in the three-ct i me-is onal di gi !al model of the pati en!' s anatomy.

[0030] As best seen in FIG. 3, each lower surface (137) is postioned vertically higher than the horizontal plane of upper s.1rface (116) in this example. Smilarly, slots (138) are also postioned vertically higher than the horizontal plane of upper surface (116) in this example.

[0031] Thosesl<illed in the art will recognize that bone foundation guide(100) of thisexamplehas only onesngle horizontal body portion (110) in this example. The sngle horizontal body portion (110) is configured to fit only on the buccal sde of a patient's alveolar arch in this exam pl e-regardl ess of whether it is the mandibular alveolar arch or the maxillary alveolar arch-as will be described in greater detail below. Unlike conventional bone foundation guides, there is no add iii anal horizontal body portion (110) that fits on the palatal or Ii ngual sde of the alveolar arch. This may provide in a reduced cost to manufacture bone foundation guide (100) due to the reduction of materials. Omitting a horizontal body portion (110) that fits on the palatal or lingual sde of the alveolar arch may also reduce the amount of gum (G) tissue that needs to be moved away from bone (B) during installation of bone foundation guide (100) on the alveolar arch. The omission of a horizontal body portion (110) that fits on the palatal or lingual sde of the alveolar arch may also improve the accuracy of seating of bone foundation guide (100) on the alveolar arch because the palatal or lingual tissue does not interfere with or otherwise contact horizontal body portion. In addition, the absence of a horizontal body portion (110) that fits on the palatal or lingual side of the alveolar arch may also improve visualization of anatomical structures such as arteries attached to gingiva, etc. The omission of a horizontal body portion (110) that fits on the palatal or lingual sde of the alveolar arch may also assist in keeping the implant sites irrigated and cool. other potential advantages of the configuration of bone foundation guide (100) of the present example will be apparent to those skilled in the art -6- Date reçue / Received date 2026-01-28 in view oftheteachingsherein.

[0032] By way of example only, bone foundation guide (100) may be formed using rapid prototyping equipment (e.g., 3D printing or other additive manufacturing, etc.), baFed on a three-dimensional digital model as noted above. By way of further example only, bone foundation guide (100) may be formed of plastic, metal, otlier materials, and combinations thereof. Various suitable ways in which bone foundation guide (100) may be formed will be apparent to those s<illed in the art in view of the teachings herein.

[0033] II. Exemplary Bone Reduction Procedure

[0034] FIGS. 4A-4B show different stages of an exemplary surgical procedure in which bone foundation guide (100) is used to guide reduction of bone on an alveolar arch of a patient. As shown in FIG. 4A, bone foundation guide (100) is positioned over an aveolar arch of a patient. In the present example, the alveolar arch is the mandibular alveolar arch, though the same procedure and similar equipment may be used on the maxillary alveolar arch. The only difference would be the bone foundation guide (100) having a customized configuration to fit on the maxillary alveolar arch.

[0036] As shown, before bone foundation guide ( 100) is i nstal I ed, the surgeon i nci = the gum (G) along the ridge of the alveolar a-ch and peels the gum (G) cmay, leaving flaps(F) to reveal bone (B). In the present example, bone foundation guide (100) rests entirely on bone (B), without being supported by any gum (G) tissue. As is also shown in FIG. 4A, the patient in this cagi is missing several teeth, leaving behind sockets (S), with a few teeth (T) remaining .. In order to fixedly secure bone foundation guide (100) to the bone (B), the surgeon may drive pins, s;;rews, or other fastener devices through passageways (124). SJch fastener devices may be removable to facilitate removal of bone foundation guide (100) after the procedure is complete. With bone foundation guide (100) being installed on the bone (B), horizontal body portion (110) extends only along the buccal side of the alveolar arch. No horizontally extending portion of bone foundation guide (100) wraps along the lingual (or palatal) side of the alveolar arch. Lower surfaces (137) of upright body portions(130) rest on the upper ridge of the alveolar arch, thereby supplementing the structural support provided by the fastener devices that are disposed in passageways ( 124) -7- Date reçue / Received date 2026-01-28 and bone (B).

[0036] After 93Curing bone foundation guide(100) to bonea;shown in Fl G. 4A, the surgeon may remove the remaining teeth (T) using any suitable techniques. In s:>me cases, the surgeon may then 93CUre a strut assembly (not shown) to bone foundation guide (100). The strut assembly may include reprerentations of teeth that will be incorporated into a prosthetic that will ultimately be mounted to the alveolar arch. By way of example only, the strut assembly may be configured and operable in accordance with at least s:>me of the teachings of U.S. Pat. App. No. 62 / 697,549, entitled" Dental Bone Foundation Guide with Palatal or Lingual Side Gap," filed July 13, 2018.

[0037] To 93Curethestrut assembly to bone foundation guide (100), the operator may in~ tabs of the strut assembly into corresponding slots (138) of bone foundation guide (100). The operator may al s:> insert pins, screws, or other fastener devices through openings ( 120) and corresponding openings of the strut assembly to further 93Cure the strut assembly to bone foundation guide ( 100). V\lith the strut assembly coup! ed with bone foundation guide ( 100), the surgeon may establish a state of occlusion between the representative teeth of the strut assembly and the teeth of the opposing alveolar ridge of the patient. This may be done as a previeN to confirm that the teeth of the planned prosthetic will be an appropriate fit for the patient, si nee the teeth of the strut assembly match the placement and configuration of the teeth of the planned prosthetic. After confirming the appropriate fit, the surgeon may remove the strut assembly from bone foundation guide ( 100). Of course, this use of a strut assembly is merely optional. Bone foundation guide (100) may be used in various procedures that do not include use of a strut assembly.

[0038] Next, the physician may perform an osteotomy or bone reduction procedure on the alveolar ridge. This may include using a conventional bur or other cutting instrument to remove all portions of the bone (B) that protrudes above the upper surface (116) of bone foundation guide (100). In s:>me instances, the physician may a:!d material to bone (B). Such a:tded material may be formed in part by bone material that has just been removed from the alveolar ridge. In either case, the end result of such procedures may look similar to the state shown in FIG. 4B, in which a flush bone surface (FBS) is established. This flush bone surface (FBS) is substantially coplanar with the upper surface (116) of bone -8- Date reçue / Received date 2026-01-28 foundation guide (100), such that bone foundation guide (100) serves asa bone reduction guide. To achieve this flush bone surface ( FBS), the surgeon may use upper surface ( 116) to provide a visual cue, and in some cases structural support, for the instrumentation that is used to remove the bone (B) protruding above upper surface (116) and / or for the instrumentation that is used to add material to the bone (B) to achieve a flat, planar flush bone surface (FBS). Bone foundation guide (100) may thusprovidestructural and / or visual guidance for instrumentation during a bone reduction procedure. Bone foundation guide (100) may also provide structural and / or visual guidance for a bone augmentation procedure. The degree of bone reduction and bone augmentation that is required may vary patient to patient, depending on the extent to which bone reduction and bone augmentation is required along the alveolar arch in order to achieveaflat, planar flush bonesurface(FBS) that is flush with upper surface (116).

[0039] After completing the bone reduction (and perhaps bone augmentation) procedure, the surgeon may couple a surgical guide (not shown) with bone foundation guide (100). By way of example only, the strut assembly may be configured and operable in accordance with at least some of theteachingsof U.S Pat. App. No. 62 / 697,549, entitled" Dental Bone Foundation Guide with Palatal or Lingual Sde Gap," filed July 13, 2018. To secure the surgical guide to bone foundation guide (100), the operator may insert tabs of the surgical guide into corresponding slots (138) of bone foundciion guide (100). The operator may also insert pins, scret-1s, or other fastener devices through openings (120) and corresponding openings of the surgical guide to further secure the strut assembly to bone foundation guide (100). After the surgical guide and bone foundation guide (100) are . . . coupled together, the surgeon may insert a drill or other instrument successvely in guide passageNaysof the surgical guide to form openings in bone (B) to receive implants. The surgeon may then insert the implants and associated installation instrumentation through the passageways of the surgical guide to install the implants. After the implants are installed, the surgeon may install abutments on the implants, again via the passaget-1aysof the surgi ca guide. After the abutments are i nstal I ed, the surgeon may remove the surgical guide and bone foundation guide (100) from the alveolar arch.

[0040] In some versions of the procedure, before or after the implants and abutments are i nstal I ed, -9- Date reçue / Received date 2026-01-28 the surgeon may aloo position a tissue-spacing gasket about the implants and abutments and then recure a temporary prosthetic to the abutments, with the tissue-spacing gasket being configured to mimic lhethicknessof the gum (G) tissue forming flaps(F). &!ch a tissue-spacing gasket and temporary prosthetic may be configured and operable in accordance with the teachings of any of the various patent references cited herein. The surgeon may eventual I y remove the tissue-spacing gcB<et and temporary prosthetic, bring the flaps (F) back over the alveolar ridge and stitch the gum (G) tissue around the abutments, and then recure the final prosthetic to the abutments. Agan, !his may be performed in accordance with the teachings of any of the various patent references cited herein.

[0041] The foregoing example of how bone foundation guide (100) may be used in a medical procedure is merely i 11 ustrati ve. Bone foundation guide ( 100) may be used in vari ousother kinds of medical procedures and in combination with various other kinds of devices. Other suitable ways in which bone foundation guide (100) may be used will be apparent to those skilled in the art in view of the teachings herein.

[0042] Ill. Exemplary Bur Guide

[0043] As noted above, bone foundation guide (100) may serve two separate purposes when mounted to a patient's alveolar ridge-serving as a bone reduction guide (and perhaps a bone augmentation guide); and serving as a structural foundation upon which other devices • (e.g., strut assembly, surgical guide, etc.) are supported. When bone foundation guide (100) is used as a bone reduction guide for a bur instrument or other bone cutting instrument, ii may be difficult for oome surgeon to quickly and accurately achieve a flush bone surface (FBS) that is substantially coplanar with the upper surface (116) of bone foundation guide (100). It may therefore be desirable to provide an adapter for bone foundation guide ( 100) that serves as a guide for a bur instrument or other bone cutting instrument, thereby making it easier for a surgeon to quickly and accurately achieve a flush bone surface (FBS) that is substantially coplanar with the upper surface (116) of bone foundation guide (100). Examples of such guide adapters are de&:ribed in greater detail below. -10- Date reçue / Received date 2026-01-28

[0044] Fl GS. 5-9 siow an exemplary bur guide (200) that may be used to assist in guiding a bur instrument (300) in relation to bone foundation guide (100) and in relation to the bone (B) of the alve:>lar ridge of the patient. Bur guide (200) of this example comprisesa body (210) with a first horizontal portion (212), a second horizontal portion (214), and a vertical portion (216). Both horizontal portions (212, 214) extend distally in relation to vertical portion (216), defining a notch (220) therebetween. First horizontal portion (212) als:i extends proximally in relation to vertical portion (216) in this example. First horizontal portion (212) defines a passageway (230) extending from a proximal face (232) of first horizontal portion (212) to a distal face (234) of first horizontal portion.

[0046] As siown in Fl G. 7, passageway (230) is sized to receive a siaft (322) of a bur bit (320) of a bur instrument (300), &JCh that an operator grasping a handle assambly (310) (s::hematically represented in FIG. 7) may insert bur bit (320) through passageway (230) at proximal face (232), with bur bit (320) eventually exiting at distal face (234). In the present example, a mechanism in handle aSS=mbly (310) is operable to cauS:bur bit (320) to rotate about the longitudinal axis of siaft (322), and this rotary movement of bur bit (320) is operable to cut bone (B). In s:ime versions, bur bit (320) is configured such that the entire length of siaft (322) extending through passageway (230) is smooth; while only the portion of siaft (322) that is distal to passageway (230) includes features that are configured to cut bone.

[0046] Passageway (230) of the present example has a circular cross-9:Cti onal profile with an inner diameter that is szed just slightly larger than the outer diameter of siaft (322)-large enough to permit siaft (322) to rotate within passageway (230) but smal I enough to provide at least s:ime degree of structural support to siaft (322). In s:ime versons, a busiing, ferrule, and / or other component is positioned in passageway (230) to facilitate rotation of siaft (322) in passageway (230). As yet another merely i 11 ustrative variation, passageway (230) may have a cross-S:Ctional profile that is rectangular or otherwiS: non-circular. In such variations, bur guide (200) may be configured to cooperate with a bone cutting instrument that utilizes a saw or other reciprocating cutting element to cut bone (B). other suitable variations of passageway (230) and bone cutting instruments that may be i nS:rted through passageway (230) will be apparent to thOS: skilled in the art in view of the -11- Date reçue / Received date 2026-01-28 teachings herein.

[0047] As shown in FIG. 8, bur guide(200) may be coupled with bonefoundationguide (100). In particular, notch (220) of bur guide (220) is configured to receive horizontal body portion (110). The fit between notch(220) and horizontal body portion (110) allows bur guide (200) to slide along the arch of horizontal body portion (110) along the x-y plane; while preventing movement of bur guide (200) along the z-axis. In this example, thex-y plane is parallel with upper surface (116) of horizontal body portion (110). During use of bur guide (200), bur guide (200) may slide along the arch of horizontal body portion (110) along the x-y plane in the regions between cylindra:eous stand-off features (122). Bur guide (200) may als:i slide along the arch of horizontal body portion (110) along the x-y plane in the regions between cylindraceous sand-off features (122) and upright body porti ans ( 130). I n s:ime vari ati ans of bone foundation guide (100), stand-off features ( 122) are reconfigured to al I ow bur guide (200) to slide freely along the entire I ength of horizontal body portion (110), from one upright body portion (130) to the other upright body portion (130).

[0048] Fl G. 9 shows shaft (322) of bur bit (320) disposa:I in passageway (230) while bone foundation guide (100) is mounted to an alveolar arch of a patient. As shown, bur bit (320) cuts bone (B) as guided by bur guide(200). While shaft (322) isdisposa:I in passageway (230) and bur bit (320) is activated to rotate, the opa-ator may slide bur ins:rument (300) and bur guide (200) together along horizontal body portion (110), along the x-y plane, thereby cutting bone (B) along an x-y plane. The operator may &ill provide substantial s:ructural support to bur instrument (300) by maintaining a grip on handle assembly (310); while bur guide (200) providess:ime support to bur bit (320) to facilitate s:eady, sweeping movement of bur but (320) along an x-y plane. In s:ime instances, the operator may need to either remove bur bit (320) from bur guide (200) or slightly pivot bur guide (200) about the z-axis in order for bur bit (320) to reach bone (B) in the regions of the alveolar arch corresponding to stand-off features (122).

[0049] Upon completion of the sweeping movement of bur i narument (300) and bur guide (200) along the x-y plane, the final result may be a flat, planar bone surface like the flush bone surface (FBS) shown in Fl G. 4B and described above. In s:ime versions of bur guide (200), -12- Date reçue / Received date 2026-01-28 passageway (230) is configured to poslti on bur bit (320) just slightly above upper surface (116) of bone foundation guide (100), such that the flush bone surface (FBS) is coplanar with upper surface (116) of bone foundation guide (100). In rome other versions of bur guide (200), passageway (230) is configured to position bur bit (320) at a height where the final cut surface of bone (B) is slightly higher than upper surface (116) yet extends along an x-y pla,e that parallel with the plane of upper surface (116). In such versions, the strut assembly, surgical guide, or other device(s) that is'are used in conjunction with bone foundation guide ( 100) may be configured to account for the slight offset between the final cut surface of bone (B) and upper surface (116). As yet another merely illus:rative variation, where upper surface (116) is undulating ins:ead of being flatasdes:ribed above, bur guide (200) may traverl:e the undulations and the final cut surface of bone (B) may therefore alro be undulating to complement the undulations of upper surface (116). As noted above, this ultimately provide a more·natural appearance at the interface between the gumli ne and prosthetic teeth that are ultimately l:eeured to the bone (B).

[0060] Fi'GS. 10-11 and 14-15 show another exemplary bur guide (500) that may be used to cl$is: in guiding a bur ins:rument (300) in relation to a slightly different bone foundation guide (600) and in relation to the bone (B) of the alveolar ridge of the patient. Bur guide (400) of this exanple compri= a body (410) with a passageway (430) extending between a proximal face (412) and dis:al face (414) of body (410). A prong (420) projects dis:ally from dis:al face(414) of body (410). Passageway (430) is sized to receive a shaft (322) of a bur bit (320) of a bur instruma,t (300), such that an operator grasping a handleasl:embly (310) of bur ins:rument (300) may inl:ert bur bit (320) through passageway (430) at - - . . proximal face (412), with bur bit (320) eventually exiting at distal face(414). In rome versions, bur bit (320) is configured such that the a,ti re length of shaft (322) extending through pa;sageway (430) is smooth; while only the portion of shaft (322) that isdis:al to passageway (430) includes features that are configured to cut bone.

[0061] Passageway (430) of thepr~texamplehasacirculc:V" croS&mional profile with an inner diameter that is sized just slightly larger than the outer diameter of shaft (322)-large enough to permit shaft (322) to rotate within passageway ( 430) but smal I enough to provide at leas: rome degree of s:ructural support to shaft (322). In rome versions, a bushing, -13- Date reçue / Received date 2026-01-28 ferrule, and / or other component is positioned in passageway (430) to facilitate rotation of shaft (322) in passageway (430). As yet another merely illustrative variation, passageway (430) may have a cross-sectional profile that is rectaigular or otherwise non-circular. In such variations, bur guide (400) may be configured to cooperate with a bone cutting instrumentthat utilizes a saw or other reciprocating cutting element to cut bone(B). other suitable variations of passageway (430) and bone cutting instruments that may be inserted through passageway (430) will be apparent to those skilled in the art in view of the teachings herein.

[0062] A"ong (420) is configured to fit in a sot (650) of bone foundation guide (600) and thereby support body (410) as bur guide (400) sides along the arch of horizontal body portion (610) of bone foundation guide (600) as described in. greater detail below. While prong (420) is shown as having a squared distal end in thisexample, other versions may provide a rounded distal end of prong (420). FIG. 12 shows an exemplary variation of bur guide (400). In particular, Fl G. 12 shows a bur guide (500) that is substantially identical to bur guide (400), with bur guide (500) having a body (510) and a passageway (530) extending from a proximal face to a distal face(514) of body (510). However, unlikeburguide(400), bur guide (500) of this example includes a prong (520) with a wheel (530) coupled with a yoke (522) at the distal end of prong (520). Wheel (530) is configured to spin freely in yoke(522) about an axis that is perpendicular to prong (520). In this example, the rotation axis for wheel (530) is parallel to the z-axi s shown in Fl G. 14, such that the rotation axis . . . is perpendicular to the x-y plane associated with upper surface (616) of bone foundation guide (600). The pre. sence and free rotatability of wheel (530) .m ay facilitate s,,veeping movement of bur guide (500) along the arch of horizontal body portion {610) of bone foundation guide (600) as described in greater detail below.

[0063] FIGS 13°15 show bone foundation guide (600) that is particularly suited for use with bur guide (500). Bone foundation guide (600) is substantially identical to bone foundation guide (100) in that bone foundation guide (600) of this example includes horizontal body portion (610) with a front surface (612), a rear surface (614), and an upper surface(616); stand-off features (622) with corresponding passageways (624); and upright body portions (630) at each end of horizontal body portion (610). -14- Date reçue / Received date 2026-01-28

[0064] Uni i ke bone foundation guide( 100), bone foundation guide (600) of this example includes four slots(650) formed in front surface (612) of horizontal body portion (610). Sots(650) extend along anx-y plane that is parallel with thex-y plane defined by upper surface(616). Two of the slots (650) extend between stand-off features (622). The other two slots (650) each extend between a stand-off feature (622) and corresponding upright body portion (630), In s:>me other versions, stand-off features (622) are omitted. In s:>me such versions, bone foundation guide(600) only'includesone singleslot (650) that extends continuously from one upright body portion (630) to the other upright body portion (630).

[0066] While upper surface (616) is substantially flat in this example, upper surface (616) may instead be undulating as des:ri bed above in the context of upper surface ( 116). Regardless of whether upper surface (616) is undulating, slots (650) may define undulating paths to thereby provide undulating movement (along the y-z plane) as prong (420, 520) traverses slots (650). 9.Jch undulations may provide undulating movement of bur bit (320), which may in turn provide an undulating cut surface of bone (B), which may ultimately provide a more natural appearance at the interface between the guml i ne and theprostheti c teeth.

[0066] As shown in FIG. 14, bur guide (400) may be coupled with bone foundation guide (600). In particular, each slot (650) of bone foundation guide (600) is configured to receive prong (420) of bone foundation guide (600). The fit between prong (420) and slot (650) allows bur guide (400) to slide along the arch of horizontal body portion (610) along the x-y plane; . while preventing movement of bur guide (400) along thez-axis. In this example, thex-y plane ispa-allel with upper surface (616) of horizontal body portion (610). During use of bur guide(400), bur guide (400) may slide along the arch of horizontal body portion (610) along the x-y plane in the regions between cylindraceous stand-off features (622). Bur guide (400) may als:> slide along the arch of horizontal body portion (610) along thex-y plane in the regions between cylindraceous stand-off features (622) and upright body portions (630).

[0067] Fl G. 15 shows shaft (322) of bur bit (320) disposed in paESageway (430) while bone foundation guide (600) is mounted to an alveolar arch of a patient. As shown, bur bit (320) cuts bone (B) as guided by bur guide (400). While shaft (322) is disposed in paESaQeivay (430) and bur bit (320) is activated to rotate, the operator may slide bur instrument (300) -15- Date reçue / Received date 2026-01-28 and bur guide (400) together along horizontal body portion (610), along the x-y plane, thereby cutting bone (B) along an x-y plane. The operator may &ill provide substantial structural support to bur instrument (300) by maintaining a grip on handleasrembly (310); whileburguide(400) providess:imesupport to bur bit (320) to facilitate steady, s,veeping movement of bur but (320) along an x-y plane. In s:ime instances, the operator may need to either remove bur bit (320) from bur guide (400) or slightly pivot bur guide (400) about the z-axis in order for bur bit (320) to reach bone (B) in the regions of the alveolar arch corresponding to stand-off features (622).

[0068] Upon completion of the s,veeping movement of bur instrument (300) and bur guide (400) along the x-y plane, the final result may be a flat, planar bone surface like the flush bone surface (FBS) shown in Fl G. 4B and described above. In s:ime versions of bur guide ( 400), pass:igeway (430) is configured to position bur bit (320) just slightly above upper surface (616) of bone foundation guide (600), such that the flush bone surface (FBS) is coplanar with upper surface (616) of bone foundation guide (600). In s:ime other versions of bur guide (400), pass:igeway (430) is configured to position bur bit (320) at a height where the final cut surface of bone (B) is sightly higher than upper surface (616) yet extends along an x-y plane that parallel with the plane of upper surface (616). In such versions, the strut asrembly, surgical guide, or other device(s) that is'are ured in conjunction with bone foundation guide (600) may be configured to account for the sight offret between the final cut surface of bone (B) and upper surface (616).

[0069] 1 / Vhiletheforegoing examples include one burguide(200) that relies in part on a horizontal portion (214) under a lower surface (118) of a bone foundation guide (100) to provide structural stability to bur guide (200) along the z-axis, and another bur guide (400, 500) that relies in part on a distally extending prong (420, 520) to provide structural stability to bur guide (400, 500) along the z-axi s, s:ime variations may include both such features. For instance, bur guide (400, 500) may be modified to include a horizontal member like horizontal portion (214) that engages lower surface (618) of bone foundation guide (600). SUch an additional horizontal member may cooperate with prong (420, 520) to provide additional stability to bur guide (400, 500) along the z-axis. Other features that may be incorporated into a bur guide (200, 400, 500) to provide structural stabi lily along thez-axis -16- Date reçue / Received date 2026-01-28 will be apparent to those skilled in the art in view of the teachings herein.

[0060] As another merely illustrativevcriation, burguide(200,400, 500) may includeoneor more I ateral openings in fluid communication with passageway (230, 430, 530). &!ch openings may be configured to enable irrigation fluid (e.g., water, etc.) to reach passageway (230, 430, 530), to thereby provide liquid cooling at the interface between shaft (322) and passageway (230, 430, 530).

[0061] IV. Exemplary Combinations

[0062] The following examples relate to various non-exhaus:ive ways in which the teachings herein may be combined or applied. It should be unders:ood that the following examples are not intended to res:ri ct the coverage of any claims that may be presented at any ti me in thisapplication or in subsequent filingsof thisapplication. No dis:laimer is intended. The following examples are being provided for nothing more than merely i 11 ustrative purposas. It is contemplated that the vcrious teachings herein may be arranged and applied in numerous other ways. It is affi contemplated that ffime variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a succesa::,r in intere& to the inventors. If any claims are presented i n this appl i cation or in subsequent fi Ii ngs related to this application that include additional features beyond those referred to below, those additional features shal I not be preSJmed to have been added for any r=n relating topatentability.

[0063] .Example 1

[0064] An apparatus comprising: (a) a firs: guide comprising a horizontal body portion, wherein the horizontal body portion has an arcuate configuration, wherein the horizontal body portion includes: (i) a firs: horizontal surface, wherein the firs: horizontal surface is flat and defines a firs: horizontal plane, (ii) a front surface, (iii) a rear surface, whereinthe rear surface is configured to closely mate with a front-facing bone s:ructure of an alveolar arch of a patient, and (iv) a second horizontal surface, wherein the front and rear surfaces extend between the firs: and second horizontal surfaces; and (b) a second guide comprising: (i) a body defining a passageway, wherein the passageway is configured to receive a bone -17- Date reçue / Received date 2026-01-28 reducing ins:rument, and (ii) a coupling member configured to mate with the horizontal body portion of the firs: guide, wherein the body and the coup Ii ng member are configured to position the passageway along a second horizontal plane that is parallel with the first horizontal plane, wherein the coupling member is configured to enalblethesecond guide to relative to the firs: guide along the second horizontal plane and therelby guide the bone reducing instrument along the second horizontal plane.

[0066] Example2

[0066] The apparatus of Example 1, wherein the first guide further comprires a pair of upright portions, each upright portion being positioned at a respective end of the horizontal body portion.

[0067] Example 3

[0068] The apparatus of any one or more of Examples 1 through 2, wherein the body of the second guide comprises: (A) a firs: horizontal portion, (B) a second horizontal portion, and (C) a vertical portion extending between the firs: and second horizontal portion.

[0069] Example4

[0070] The apparatus of Example 3, wherein the fi rs: horizontal portion extends distal I y in relation to the vertical portion, wherein the second horizontal portion extends di s:al I y in relation to thevertica portion.

[0071] Examples

[0072] The apparatus of Example 4, wherein the body of the second guidedefinesa notch, wherein the notch is defined by the vertical portion and the regions of the firs: and second horizontal portions extending distally in relation to theverticai portion.

[0073] Example6 [007 4] The apparatus of Example 5, wherein the notch is configured to receive the horizontal body portion of the firs: guide, such that the vertical portion and the regions of the firs: and second horizontal portions extending distally in relation to the vertical portion together define the coupling member. -18- Date reçue / Received date 2026-01-28

[0076] Example 7

[0076] The apparatus of any one or more of Examples 4 through 6, wherein the first horizontal portion further extends proximally in relation to the vertical portion.

[0077] Example 8

[0078] The apparatus of Example 7, wherein the passageway extends through the first horizontal portion.

[0079] Example9

[0080] The apparatus of any one or more of Examples 1 through 8, wherein the passageway has a circular cross-section.

[0081] Example 10

[0082] The apparatus of any one or more of Examples 1 through 9, the second guide further comprising a bushing or ferrule in the passageway.

[0083] Example 11

[0084] The apparatus of any one or more of Examples 1 through 10, further comprising a bur instrument having a bur shaft, the bur shaft being configured to fit in the passageway, the bur shaft having a distal portion configured to reduce bone.

[0086] Example 12

[0086] The apparatus of any one or more of Examples 1 through 11, the coupling member comprising a prong extending distal I y from the body.

[0087] Example 13

[0088] The apparatus of Example 12, the front surface of the horizontal body portion defining at I east one si ot, wherein the at least one slot i sconfi gured to receive the prong of the coup Ii ng member.

[0089] Example 14

[0090] The apparatus of Example 13, wherein the at least onesl ot is configured to al low the recond -19- Date reçue / Received date 2026-01-28 guide to slide along at least a portion of the arcuate configuration of the first guide.

[0091] Example 15

[0092] The apparatus of any one or more of Examples 12 through 14, wherein the prong includes a wheel located at a distal end of the prong.

[0093] Example 16

[0094] A method of reducing bone onan alveolar ridge of a patient, the method comprising: (a) securing a first guide to the alveolar ridge of the patient, wherein the first guide has an arcuate configuration com pl ementi ng an arcuate configuration of the alveolar ridge, wherein the alveolar ridge includes bone protruding past a first horizontal surface of the first guide, the first horizontal surface extending along a first horizontal plane; (b) securing a second guide to the first guide, wherein the second guide defines a passageway; (c) inserting a·working element of a bone reduction instrument through the passageway, wherein the passageway is configured to position the working element along a second horizontal plane that is parallel with the first horizontal plane; (d) activating the bone reduction instrument while the working element is disposed in the passageway; and (e) moving the second guide along the first guide, tt:iereby moving the working element of the bone reduction instrument along the second horizontal plane while the bone reduction instrument is activated, wherein the working element reduces the bone that is protruding past the first horizontal surface of the fi_rst guide.

[0096] Example 17

[0096] The method of Example 16, wherein the act of securing the second gui deto the first guide comprises positioning a horizontal body portion of the first guide in a notch defined by the second guide.

[0097] Example 18

[0098] The method of any one or more of Examples 16 through 17, wherein the act of securing the second guide to the first guide comprises positioning a prong of the second guide in a slot defined by a horizontal body portion ofthe first guide. -20- Date reçue / Received date 2026-01-28

[0099] Example 19

[00100] The method of any one or more of Exam pl es 16 through 18, wherein the working element compri res a bur bit.

[00101]

[00102] Example20 The method of Example 19, wherein activating the bone reduction instrument comprires rotating the bur bit.

[00103]

[00104] Example21 The method of any one or more of Examples 16 through 20, further comprising moving gum ti $lie away f ram bone of the alveolar ridge to expose the bone of the alveolar ridge, wherein the act of moving the gum ti$Ue is performed before the act of securing the first guide to the alveolar ridge.

[00106]

[00106] Example22 The method of Example 21, wherein the first guide isrecured only to the exposed bone, s.Jchthat the first guide is not recured to any gum ti$Ue.

[00107]

[00108] V. Mis:el I aneous It siould be understood that any of the examples described herein may include various other features in addition to or in Ii eu of thosedes::ri bed above. By way of example only, any of the examples des::ribed herein may al&> include one or more of the various features dis::losed in any of the various references.

[00109] It siould be understood that any one or more of the teachings, expressions, embodiments, examples, etc. des::ribed herein may be combined with any one or more of the other teachings, expressi ans, embodiments, exam pl es, etc. that are des::ri bed herein. The above-des::ribed teachings, expressions, embodiments, examples, etc. siould therefore not be viewed in i&>lalion relative to each other. Variouss.Jitablewaysin which the teachings herein may be combined will be readily apparent to those skilled in theartin view of the teachings herein. 9.Jch modi ficati ans and vari ati ans are intended to be included within the s::ope of the claims. -21- Date reçue / Received date 2026-01-28

[00110] Having shown and described various versions of the present invention, further adaptations of the methods and &ys:ems des::ribed herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the =pe of the present invention. ::?everal of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, versions, geometrics, materials, dimensions, ratios, s:eps, and thelikedis:ussad above are i 11 us:rative and are not required. Accordingly, the g;ope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of s:ructure and operation shown and des::ribed in the specification and drawings. -22~

Claims

I / we claim:

1. An apparatus comprising: (a) a first guide comprisng a horizontal body portion, wherein the horizontal body portion ha, an arcuate configuration, wherein the horizontal body portion includes: (i) a first horizontal surface, wherein the first horizontal surface is flat and defines a first horizontal plane, (ii) a front surface, (iii) a rear surface, wherein the rear surface is configured to closely mate with a front-facing bone structure of an alveolar a-ch of a patient, and (iv) a second horizontal surface, wherein the front and rear surfaces extend between the first and second horizontal surfaces; and (b) a second guide comprising: (i) a body defining a passageway, wherein the passageway is configured to receive a bone reducing instrument, and (ii) a coupling member configured to mate with the horizontal body portion of the fi rst guide, wherein the body and the coupling member are configured to postion the • passageway along a second horizontal plane that is paral I el with the • first horizontal plane; wherein the coupling member is configured to enable the second guide to relative to the first guide along the second horizontal plane and thereby guide the bone reducing instrument along the second horizontal plane.

2. The apparatus of claim 1, wherein the first guide further comprises a pair of upright portions, each upright portion being postioned at a respective end of the horizontal body portion. -23- Date reçue / Received date 2026-01-28 3. The apparatus of claim 1, wherein the body of the second guide comprises: (A) a first horizontal portion, (B) a second horizontal portion, and (C) a vertical portion extending between the first and second horizontal portion.

4. The apparatus of claim 3, wherein the first horizontal portion extends distally in relation to the vertical portion, wherein the second horizontal portion extends distally in relation to the vertical portion.

5. The apparatus of claim 4, wherein the body of the second guide defines a notch, wherein the notch is defined by the vertical portion and the regions of the first and second horizontal portions extending distally in relation to the vertical portion.

6. The apparatus of claim 5, wherein the notch is configured to re::eivethe horizontal body portion of the first guide, such that the vertical portion a,d the regions of the first and second horizontal porti onsextendi ng distally in relation to the vertical portion together define the coupling member.

7. The apparatus of claim 4, wherein the first horizontal portion further extends proximally in relation to the vertical portion.

8. The apparatus of claim 7, wherein the pc5SaQeway extends through the first horizontal portion.

9. The apparatus of claim 1, wherein the passageway has a circular cross-section.

10. The apparatus of claim 1, the second guide further comprising a bushing or ferrule in the passageway.

11. The apparatus of claim 1, further comprising a bur instrument having a bur shaft, -24- Date reçue / Received date 2026-01-28 the bur shaft being configured to fit in the passageway, the bur shaft having a distal portion configured to reduce bone.

12. The apparatus of claim 1, the coupling member comprising a prong extending distally from the body.

13. The apparatus of cl ai m 12, the f rant rurface of the horizontal body portion defining at I east one slot, wherei n the at I east one slot is configured to receive the prong of the coup! i ng member.

14. The apparatus of claim 13, wherein the at least one slot is configured to allow the 93COnd guide to slide along at least aportion of the arcuate configuration of the first guide.

15. The apparatus of claim 12, wherein the prong includes a wheel located at a distal end of the prong.

16. A method of reducing bone on an alveolar ridge of a patient, the method comprising: (a) S=Curing a first guide to the alveolar ridge of the patient, wherein the first guide has an arcuate configuration complementing an arcuate configuration of the alveolar ridge, wherein the alveolar ridge includes bone protruding past a first horizontal rurface of the first guide, the first horizontal rurface extending along a first horizontal plane; (b) S=Curing a 93COnd guide to the first guide, wherein the 93COnd guide defines a passageway; (c) inserting a working element of a bone reduction instrument through the passageway, wherein the passageway is configured to position the working element along a 93COnd horizontal plane that is parallel with the first horizontal plane; (d) activating the bone reduction instrument while the working element is dispo~ in the passageway; and Date reçue / Received date 2026-01-28 (e) moving the second guide along the fir& guide, thereby moving the working element of the bone reduction instrument along the second horizontal plane while the bone reduction instrument is activated, wherein the working element reduces the bone that is protruding past the first horizontal surface of the first guide.

17. The method of claim 16, wherein the act of securing the second guide to the first guide comprises positioning a horizontal body portion of the first guide in a notch defined by the second guide.

18. The.method of claim 16, wherein the act of securing the second guide to the first guide comprises positioning a prong of the second guide in a slot defined by a horizontal body portion of the first guide.

19. The method of claim 16, wherein the working element comprises a bur bit.

20. The method of claim 19, wherein activating the bone reduction instrument compri sesrotati ng the bur bit.

21. The method of any one or more of claims 16 through 20, further comprising moving gum tissue away from bone of the alveolar ridge to expose the bone of the alveolar ridge, wherein the act of moving the gum tissue .is performed before the act of securing the first guide to the alveolar ridge. • 22. The method of claim 21, whereinthefirst guideissecuredonlytotheexposed bone, such that the first guide is not secured to any gum tissue. -26-