Adapter for fastening a prosthesis

Abstract

An adapter for securely fastening a prosthesis to a bone implant. The adapter has a proximate end with a plurality of vertical walls extending parallel to the longitudinal axis and upwardly to provide a first anti-rotational indexing feature. An arcuate wall extends upwardly and inwardly toward the longitudinal axis. Two slanted walls, each having a flat surface that is non-parallel and non-perpendicular to the longitudinal axis are also present.

Description

05417.0001W001ADAPTER FOR FASTENING A PROSTHESISCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to, and is a non-provisional of, U.S. Patent Application 63 / 777,422 (filed March 25, 2025), the entirety of which is incorporated herein by reference.BACKGROUND OF THE INVENTION

[0002] The subject matter disclosed herein relates to implants for fastening a prosthesis to a bone implant and, in some embodiments, adapters therefor.

[0003] Across a range of industries spanning dental implantology and orthopedic reconstruction to aerospace, robotics, and automotive engineering; secure, long-lasting connections between multiple components in different trajectories are essential.However, conventional fastening methods, such as mechanical fasteners (e.g., screws) or chemical adhesives (e.g., cement), often struggle to maintain integrity when components are placed at varying trajectories or vertical positions. In response, prior art abutments and analogous connection systems typically rely on conical or tapered, multi-piece configurations to compensate for misalignments. While these specialized solutions can mitigate certain issues, they frequently experience uneven load distribution, instability, or micromovements over time, ultimately causing loosening, component fatigue, and, in extreme cases, fractures.

[0004] This persistent problem is further compounded where design or material constraints make more robust solutions (such as seamless one-piece or welded connections) impractical or impossible. Consequently, there remains a pressing need for an advanced fastening system that accommodates diverse trajectories and vertical alignments without sacrificing stability, durability, or ease of maintenance. While a variety of methodologies have been developed in an attempt to address these shortcomings, no solution has been entirely satisfactory. An improved system is therefore desired.05417.0001W001

[0005] The discussion above is merely provided for general background information and is not intended to be used as an aid in determining the scope of the claimed subject matter.SUMMARY

[0006] An adapter is disclosed for securely fastening a prosthesis to a bone implant. The adapter has a proximate end with a plurality of vertical walls extending parallel to the longitudinal axis and upwardly from a flange to provide a first anti-rotational indexing feature. An arcuate wall extends upwardly from the flange and inwardly toward the longitudinal axis. Two slanted walls, each having a flat surface that is non-parallel and non-perpendicular to the longitudinal axis are also present.

[0007] In a first embodiment, an adapter for securely fastening a prosthesis to a bone implant is provided. The adapter comprising: a body comprising a proximate end, a distal end and a stepped bore extending along a longitudinal axis of the body through at least a portion of the proximate end, wherein the proximate end and the distal end are monolithic; the proximate end comprising: a flange; a plurality of vertical walls extending parallel to the longitudinal axis and upwardly from the flange, each vertical wall directly connecting to at least one adjacent vertical wall by an internal angle 0vof at least 90°, thereby providing a first anti-rotational indexing feature; an arcuate wall with a terminal ledge that directly contacts at least 45%, but less than 100%, of a top circumference of the stepped bore, the arcuate wall extending upwardly from the flange and inwardly toward the longitudinal axis; and two slanted walls, each having a flat surface that is non-parallel and non-perpendicular to the longitudinal axis.

[0008] In a second embodiment, an adapter for securely fastening a prosthesis to a bone implant is provided. The adapter comprising: a body comprising a proximate end, a distal end and a stepped bore extending along a longitudinal axis of the body through at least a portion of the proximate end, wherein the proximate end and the distal end are monolithic; the proximate end comprising: a plurality of vertical walls extending parallel to the longitudinal axis and upwardly, each vertical wall directly connecting to at least05417.0001W001one adjacent vertical wall by an internal angle 0Vof at least 90°, thereby providing a first anti-rotational indexing feature; an arcuate wall with a terminal ledge that directly contacts at least 45%, but less than 100%, of a top circumference of the stepped bore, the arcuate wall extending upwardly and inwardly toward the longitudinal axis; two slanted walls, each having a flat surface that is non-parallel and non-perpendicular to the longitudinal axis.

[0009] In a third embodiment, an implant prosthetic assembly is provided. The assembly comprising: a plurality of bone implants; a plurality of adapters, each adapter having the structure of the adapter of claim 1 and being coupled to a respective one of the plurality of bone implants; and a prosthesis comprising a plurality of indexed recesses configured to receive respective proximate ends of a respective adaptor in the plurality of adapters, wherein the prosthesis is removably insertable onto the plurality of adapters along an unobstructed seating trajectory by telescopic sliding engagement over a nonzero travel distance such that the telescopic sliding engagement generates measurable frictional resistance while remaining substantially free of binding.

[0010] This brief description of the invention is intended only to provide a brief overview of subject matter disclosed herein according to one or more illustrative embodiments and does not serve as a guide to interpreting the claims or to define or limit the scope of the invention, which is defined only by the appended claims. This brief description is provided to introduce an illustrative selection of concepts in a simplified form that are further described below in the detailed description. This brief description is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. The claimed subject matter is not limited to implementations that solve any or all disadvantages noted in the background.BRIEF DESCRIPTION OF THE DRAWINGS

[0011] So that the manner in which the features of the invention can be understood, a detailed description of the invention may be had by reference to certain embodiments,05417.0001W001some of which are illustrated in the accompanying drawings. It is to be noted, however, that the drawings illustrate only certain embodiments of this invention and are therefore not to be considered limiting of its scope, for the scope of the invention encompasses other equally effective embodiments. The drawings are not necessarily to scale, emphasis generally being placed upon illustrating the features of certain embodiments of the invention. In the drawings, like numerals are used to indicate like parts throughout the various views. Thus, for further understanding of the invention, reference can be made to the following detailed description, read in connection with the drawings in which:

[0012] FIG. 1A depicts one embodiment of an adaptor.

[0013] FIG. IB depicts the adaptor used in a first manner.

[0014] FIG. 1C depicts the adaptor used in a second manner.

[0015] FIG. 2A depicts a proximate end of the adaptor.

[0016] FIG. 2B depicts a plan view of the proximate end of the adaptor.

[0017] FIG. 3A depicts the proximate end of the adaptor with specific angles labeled.

[0018] FIG. 3B is a side view of the proximate end of the adaptor.

[0019] FIG. 3C is a perspective view of one embodiment of an adaptor with specific angles labeled.

[0020] FIG. 3D, FIG. 3E and FIG. 3F are side views of other embodiments of the adaptor.

[0021] FIG. 4 depict a side view of the adaptor and a plan view of the distal end. FIG.4 depict a side view of the adaptor and a plan view of the distal end.

[0022] FIG. 5 A illustrates one manner of using the adaptor in conjunction with a bone implant and a prosthesis.

[0023] FIG. 5B are plan views of several bone implants that the adaptor can non-rotatably engage with.

[0024] FIG. 5C illustrates another manner of using the adaptor.

[0025] FIG. 5D illustrates yet another manner of using the adaptor.05417.0001W001

[0026] FIG. 6A depicts the proximate end of the adaptor used with an alternate embodiment of a distal end.

[0027] FIG. 6B depicts the proximate end of the adaptor used with a variety of different distal ends.

[0028] FIG. 7A depicts the proximate end of the adaptor used with yet another embodiment of a distal end.

[0029] FIG. 7B shows the proximate end with a variety of distal ends.

[0030] FIG. 7C shows multiple adaptors that provide an unobstructed seating trajectory for a monolithic prosthesis.

[0031] FIG. 7D provides an alternative view of multiple adaptors that provide an unobstructed seating trajectory.

[0032] FIG. 7E provides yet another view of multiple adaptors that provide an unobstructed seating trajectory.

[0033] FIG. 8A and FIG. 8B provide views of two different adaptors with arcuate walls of different heights.

[0034] FIG. 9 depicts an adaptor with an arcuate wall comprising alternating flat and arcuate sections.

[0035] FIG. 10 depicts an adaptor with an angled flange that forms a V-grove.

[0036] FIG. 11 depicts another embodiment of an adaptor.

[0037] FIG. 12A, FIG. 12B and FIG. 12C are schematic depictions of several control implant assemblies and a test assembly.

[0038] FIG. 12D and FIG. 12E are graphs of friction forces during removal and insertion of the implant assemblies of FIG. 12A.

[0039] FIG. 12F is a bar graph of mean dislodgment forces of the implant assemblies of FIG. 12A, FIG. 12B and FIG. 12C.DETAILED DESCRIPTION OF THE INVENTION

[0040] FIG. 1A depicts an adaptor 100. The adaptor 100 comprises a proximate end 102 and a distal end 104 that, in one embodiment, are monolithic with respect to each05417.0001W001other. In some embodiments, the proximate end 102 is attached, either directly or indirectly, to a bone implant or a prothesis.

[0041] Referring to FIG. IB, in one embodiment, the distal end 104 is configured to attach to an indexed recess 116 of a bone implant 118, wherein the indexed recess 116 mates with the distal end 104. An indexed recess is a recess that has at least one flat side edge that provides anti-rotational engagement to the adaptor 100. The mated indexed recess 116 in FIG. IB is shown schematically but has an indexed shape, such as at least one flat wall. In some embodiments, the index shape has, for example, tapered walls and a hexagonal recess. In the embodiment of FIG. IB, a prothesis 108 is shown that receives the proximate end 102 within an indexed recess 110 such that rotation of the prothesis 108 is not permitted.

[0042] Alternatively, and with reference to FIG. 1C, and as will be discussed in detail elsewhere in this specification, the distal end 104 may have a particular shape that is selected to non-rotatably mate, either directly or indirectly, with the indexed recess 110 of the prosthesis 108. In such an embodiment, the proximate end 102 is configured to non-rotatably mate to the indexed recess 116 of the bone implant 118.

[0043] FIG. 2A and FIG. 2B depict perspective and top views, respectively, of the proximate end 102 wherein the distal end 104 has been omitted for simplicity of illustration. Referring to FIG. 2A, a stepped bore 200 with a step 202 is present. In use, a screw (not shown) is disposed within the stepped bore 200 with the wide head of the screw engaging the step 202. The stepped bore 200 extends through at least a portion of the proximate end 102 to define a longitudinal axis 204. In some embodiments, the stepped bore 200 extends through the proximate end 102 and at least partially into the distal end 104. In other embodiments, the stepped bore 200 extends through the proximate end 102 and the distal end 104 such that the screw passes through the entire adaptor 100 and mates with a threaded receptacle within a bone implant (not shown). A plurality of vertical walls (e.g. vertical walls 206a, 206b, 206c) are present that extend vertically by a height 230, relative to a flange 208. In the embodiment of FIG. 2A and FIG. 2B, the flange extends perpendicular to the longitudinal axis 204. Each vertical wall05417.0001W001is directly adjacent to at least one other such wall and connected thereto by an internal vertical wall angle 0v(see FIG. 3A) of 90° or more (e.g. an obtuse angle or a right angle). For example, vertical wall 206c is adjacent vertical wall 206b. Vertical wall 206b is adjacent both vertical wall 206a and vertical wall 206c. The plurality of vertical walls, when engaged to a respective mated surface, provide anti-rotational engagement. The vertical walls extend from the flange 208 to a terminus 210 and have exposed surfaces that extend parallel the longitudinal axis 204. At least two such vertical walls are present, each of which is flat over its exposed surface. In other embodiments, three, four, five, six, seven, eight or more vertical walls are present. In the embodiment of FIG. 2A, seven vertical walls are present.

[0044] In the embodiment of FIG. 2A, two slanted walls 212 are present. The slanted walls 212 are flat over their exposed surface and extend along direction 214. The exposed surface of the slanted walls 212 are non-parallel, and non-perpendicular, with the longitudinal axis 204. The slanted walls 212 slope upwardly at an angle 0s(see FIG. 3A) relative to the flange 208. In one embodiment, the angle 0sis at least 90° (e.g. an obtuse angle). In another embodiment, 0sis greater than 90° but less than 135°, greater than 90° but less than 130°, greater than 90° but less than 125°, greater than 90° but less than 120°, greater than 90° but less than 115° or greater than 90° but less than 110°. The exposed surface of the slanted walls 212 increases in width toward a terminus 224. Each slanted wall 212 is adjacent to one, and only one, of the vertical walls and is connected thereto by an angle 0w(see FIG. 3A, FIG. 3C). The angle 0wis generally 90° +5° or 90°. The angle 0xis generally from 90° to 135°, from 100° to 125°, from 110 to 120° or 90°.

[0045] Referring again to FIG. 2 A, one arcuate wall 216 is present that is directly adjacent the two slanted walls 212. The arcuate wall 216 defines an arc 218 that is concentric with respect to the circumference of the flange 208 such that a gap 220 is present that has a constant width between a lower edge of the arcuate wall 216 and the outer edge of the flange 208. The arcuate wall 216 slopes upwardly and inwardly to a terminal ledge 222 by an angle 0a(see FIG. 3A) relative to the flange 208. In one embodiment, the angle 0ais at least 90° (e.g. an obtuse angle). For example, the angle 0a05417.0001W001may be greater than 90° but less than 130°, greater than 95° but less than 125°, greater than 100°, but less than 120° or greater than 105° but less than 115°. The angle 9ais constant over the height of the arcuate wall such that the arcuate wall does not curve over its height 228.

[0046] The stepped bore 200 is circumscribed by the terminal ledge 222 and a top surface 226. The plurality of vertical walls 406a, 406b, 406c and the slanted walls 212 are contiguous with the top surface 226. The terminal ledge 222 directly contacts at least 45%, but less than 100%, of the top circumference of the stepped bore 200. In other embodiments, the terminal ledge 222 directly contacts from 45% to 80%, from 45% to 60%, or from 45% to 55% of the top circumference of the stepped bore 200. Similarly, the top surface 226 directly contacts the plurality of vertical walls 206a, 206b, 206c and directly contacts at least 45%, but less than 100%, of the top circumference of the stepped bore 200. In other embodiments, the top surface 226 directly contacts from 45% to 80%, from 45% to 60%, or from 45% to 55% of the top circumference of the stepped bore 200. The top surface 226 is, in some embodiments, perpendicular to the longitudinal axis 204. FIG. 2B provides a top plan view of the embodiment of FIG. 2A. FIG. 3 A depicts the embodiment of FIG. 2 A with the arcuate angle 0a, the slanted angle 0sand the vertical wall angle 0vdepicted.

[0047] FIG. 3B is a plan sideview of the proximate end 102 of FIG. 1 A that illustrates further detail. The distal end 104 has been omitted for simplicity of illustration. The proximate end 102 comprises a tapered region 300, with a height 302, that is in direct contact with, the flange 208. The flange 208 has a diameter 304 that defines the outermost diameter of the adaptor 100. The tapered region 300 tapers downwardly toward distal end 104 and inwardly toward the longitudinal axis 204 by a first tapering angle 0tl. The distal terminus of the tapered region 300 defines a lower diameter 306, which is less than the diameter 304 of the flange 208. The first tapering angle 0tlis an acute angle that is, for example, greater than 0° but less than 90°, from 10° to 80°, from 20° to 70°, from 30° to 60° or from 40° to 50°, as measured parallel to the longitudinal axis 204. The height 302 is, for example, between 0.1mm to 10mm, 0.1mm05417.0001W001to 5 mm or 1mm. The tapered region 300 may be surface treated to vary its surface roughness, relative to the proximate end 102, to enhance biomechanical and biological integrate (e.g. promote osseointegration and soft tissue attachment). In this manner, the proximate end 102 and the distal end 104 have different degrees of surface roughness to enhance biomechanical and biological integration with both hard and soft tissues. In the embodiment of FIG. 3B, the flange 208 extends perpendicular to the longitudinal axis 208 while the vertical walls are disposed at an angle 0Lrelative to the flange 208. In the embodiment of adaptor 100, the angle 0Lis right angle.

[0048] In other embodiments, and with reference to FIG. 3D, the lower diameter 306 of the distal terminus of the tapered region 300 is greater than the diameter 304 of the flange 208. In this manner, the tapered region 300 tapers downwardly toward distal end 104 and outwardly away from the longitudinal axis 204 by a second tapering angle 0t2. The second tapering angle 0t2is an obtuse angle that is, for example, greater than 90° but less than 180°, from 100° to 170°, from 110° to 160°, from 120° to 150° or from 125° to 135°, as measured parallel to the longitudinal axis 204.

[0049] Referring to FIG. 3E, in other embodiments, the tapered region 300 is replaced with a spacer region 301 that has parallel vertical walls such that the lower diameter 306 is the same as the diameter 304 of the flange 208. Like tapered region 300, spacer region 301 has a height 302.

[0050] Referring to FIG. 3F, in other embodiments, the flange 208 is omitted. In one such embodiment, the spacer region 301 is present with vertical sidewalls that extend parallel to the longitudinal axis 204 over a height 302.

[0051] Referring to FIG. 4, the distal end 104 is configured in a manner similar to the proximate end 102. The distal end 104 comprises an arcuate wall 416 configured as described with respect to the arcuate wall 216, and vertical walls 406 configured as described with respect to the vertical walls 206a, 206b, 206c. Two slanted walls 412 are present that are configured as described with respect to the slanted walls 212. The arcuate wall 416 has a height 417. The vertical walls 406 have a height 407. Four vertical walls 406 are shown in FIG. 4 but, just as with vertical walls 206a, 206b, 206c, a05417.0001W001different number of vertical walls may be present in other embodiments. In the embodiment of FIG. 4, the height 417 and the height 407 are the same. In another embodiment, the height 417 is less than the height 407 (see, for example, FIG. 8B).

[0052] The arcuate wall of the proximate end 102 faces a first direction 420 that is perpendicular to the longitudinal axis 204. The arcuate wall 417 of the distal end 104 faces a second direction 422 that is also perpendicular to the longitudinal axis 204. The first direction 420 and the second direction 422 are opposite. The embodiment of FIG. 4 also has a second tapered section 400 that is disposed between, and directly adjacent, both the tapered region 300, the vertical walls 406 and the arcuate wall 416. Like tapered region 300, the second taper section 400 has a height 430. The second tapered section 400 tapers downwardly toward the distal end 104 and inwardly toward the longitudinal axis 204 by a second tapering angle 0t2. The distal terminus of the second tapered region 400 defines a lower diameter 432, which is less than the lower diameter 306 of the tapered region 300 (see FIG. 3B). In some embodiments, the second tapering angle 0t2is an acute angle that is, for example, greater than 0° but less than 90°, from 10° to 80°, from 20° to 70°, from 30° to 60° or from 40° to 50°, as measured parallel to the longitudinal axis 204. In some embodiments, the second tapered angle 0t2is less than the first tapered angle 0tl.

[0053] Referring to FIG. 5 A, the shapes of the proximate end 102 and the distal end 104 are selected to non- rotatably mate with one or more indexed recesses created manually or digitally via additive or subtractive methods for the customized prosthesis 508 and / or bone implants 518. For example, In the embodiment of FIG. 5 A, the proximate end 102 is configured to non-rotatably mate with the indexed recess 510 of the prothesis 508 while also non-rotatably mating with a wide variety of other commercially available indexed recesses. Likewise, the distal end 104 is configured to non-rotatably mate with the indexed recess 516 of the bone implant 518 but also non-rotatably mate with a wide variety of other commercially available recesses. FIG. 5B shows plan views of recesses of several commercially available bone implants. Recess shapes include hexagonal, octagonal, triangular, circular, star-shaped (e.g. an eight-pointed star), etc.

Claims

05417.0001W001For example, bone implant 520 depicts a cone shape with non-parallel sidewalls and having a six-point star-shaped connection such as the one solid under the brand name TORX® connection. Bone implant 522 depicts a cone shape with an octagonal connection. Bone implant 524 depicts a cylindrical shape with a trilobe connection. Bone implant 526 depicts a cone shape with a torx connection. Bone implant 528 depicts a cone shape with a cross form index. Bone implant 530 depicts a cone shape with a spline connection. Bone implant 532 depicts a cone shape with a cross-fit form. The cone shapes are wider near the opening of the bone implant and narrow over the length of the implant. In certain embodiments, such as the bone implant 522, a conical portion having a reduced diameter is positioned below the anti-rotational octagonal feature.[0054] Referring to FIG. 5C, the adaptor 100 is shown in conjunction with a transitional abutment screw 514. In use, a retaining screw 536 extends through a hole in a prothesis 534, secured to the abutment screw 514. The abutment screw 514 extends through the stepped bore in the adaptor 100 and engages mated threads in the bone implant 518. In the embodiment of FIG. 5D, the distal end 104 of the adaptor 100 is configured to connect to the prothesis 534 via abutment screw 514. The retaining screw 536 secures the prosthesis 534 to abutment screw 514. The proximate end 102 of the adaptor 100 is embedded within a bone implant 538.[0055] FIG 6A depicts an adaptor 600 which comprises the proximate end 102 and a distal end 604 that is a bone implant. FIG. 6B depicts various embodiments wherein the distal end 604 are different bone implants. In some embodiments, the adaptor 600 includes a tapered region 300 (see FIG. 3B). In other embodiments, the adaptor 600 omits a tapered region 300. See, for example, FIG. 3F. Each of the depicted embodiments has an exterior surface that is at least partially threaded such that the distal end 604 can be implanted at least partially below bone-level. The exterior surfaces are generally cylindrical. In some embodiments, the cylinder has parallel sidewalls. In other embodiment, the cylinder has conically shaped sidewalls that narrow in diameter over the length of the cylinder. In some embodiments, wherein the distal end 604 is a bone implant, the distal end is coated with a bioactive material and with different degrees of05417.0001W001surface roughness that promotes soft tissue stability, such as hydroxyapatite and / or surface etched to provide pores that promote osseointegration.[0056] The proximate end 102 may be monolithically connected to the distal end 604. Alternatively, the proximate end may be removably connected to the distal end 604 and secured thereto by a screw that fits into a threaded receptacle in the distal end 604.[0057] Referring to FIG. 7A, in some embodiments, the distal end 104 is replaced with a distal end 604. In the embodiment of FIG. 7A, an adaptor 700 is depicted, wherein the distal end 604 has at least one flat vertical edge 714 that non-rotatably mates with a corresponding indexed recess in either a bone implant (not shown) or in a prothesis (not shown). In the embodiment of FIG. 7A, the flat side vertical edge 714 provides a hexagonal terminus 716. In other embodiments, an octagonal terminus is provided.[0058] FIG. 7B illustrates side views of adaptors with various distal ends 604 that corresponding to the bone implants shown in plan view in FIG. 5B. Adapter 720 depicts a conical shape with non-parallel sidewalls and includes a six-point star-shaped anti-rotational connection similar to those marketed under the brand name TORX®. Adapter 722 illustrates a conical shape with an octagonal connection. Adapter 724 shows a cylindrical shape with a trilobe connection. Adapter 726 features a conical shape with a TORX® connection. Adapter 728 depicts a conical shape with a cross-form index.Adapter 730 presents a conical shape with a spline connection. Adapter 732 illustrates a conical shape with a cross-fit form connection. Each conical adapter widens immediately beneath the proximate end 102 and tapers along the distal end 104. In certain embodiments, such as adapter 722, a conical portion having a smaller diameter is disposed beneath the anti-rotational octagonal feature.[0059] Referring to FIG. 7C, multiple bone implants 702 are disposed below a bonelevel 706. A monolithic prosthesis 704 is attached to each of the bone implants 702 with respective adaptors 700 with an unobstructed seating trajectory 708. In one embodiment, the prosthesis 704 is monolithic due to the presence of splints that stop components of the prosthesis from being rotated. With conventional adaptors, installation of such a05417.0001W001monolithic prosthetic is extremely difficult, if not impossible, without compromising the integrity of the prosthetic-implant connection. In contrast, the adaptors disclosed in this specification can be rotated (see arrow 710) to permit the user to find and align with an unobstructed seating trajectory. Referring to FIG. 7D, adaptors are shown that are disposed within a surgical guide 701. The arcuate walls of each adaptor are shown facing area 712. As shown in FIG. 7E, rotation about arrow 710 provides an unobstructed seating trajectory for multiple implants. The use of the surgical guide 701 permits the user to pre-align the arcuate walls (and thus pre-align the areas 712) to produce an unobstructed seating trajectory of insertion. Such pre-aligning is sometimes referred to as rotational timing alignment. In this manner, each adaptor can be rotated about its longitudinal axis (rotational indexing and timing) to orient clearance regions and / or anti-rotational surfaces relative to an adjacent adaptor. This enables seating of a splinted prosthesis along a single unobstructed seating trajectory without interference between adjacent adaptors or prosthesis recess geometries. The arcuate wall 216 provides a relief region. During seating, there is guided telescopic engagement with or without friction along a controlled insertion / removal travel path. When fully seated, the design provides maximized overlapping contact surfaces, supporting engagement and retention.[0060] Referring to FIG. 8 A, and the adaptor depicted therein, an arcuate wall 816 extends upwardly and inwardly from a flange 808 to a terminal ledge 822 by a height 800. Similarly, vertical walls 806 extend vertically upward to a surface top 826 by a height 802. In the embodiment of FIG. 8A, the height 800 and the height 802 are equal such that the terminal ledge 822 is coplanar with the top surface 826. FIG. 8B depicts another embodiment wherein the height 800 is less than the height 802 such that the terminal ledge 822 is not coplanar with the top surface 826 (e.g. height 800 is less than the height 802). The slanted walls 812 have the same height 802 as the vertical walls 806.[0061] The arcuate wall 416 need not be a single continuous curve over its entire width, as shown in FIG. 2A. Instead, as shown in FIG. 9, an arcuate wall 916 is depicted that includes alternating arcuate sections 902 and flat sections 900 that, collectively,05417.0001W001follow an arcuate path. The alternate flat and arcuate walls serve to introduce additional anti-rotational engagement, thereby enhancing mechanical stability. This design is particularly important for circumventing obstructions in multi-implant situations, ensuring a more adaptable and secure fit in complex clinical scenarios.[0062] For multiple prosthetic-implant connections, a high degree of integrity is provided by simultaneously including (1) a telescopic connection wherein the proximate end 102 extends into the indexed recess of the prothesis by a significant length (“tube-in-tube connection”), (2) a large contact surface between flat edges of the adaptor and corresponding flat edges of the indexed recess and (3) anti-rotational engagement of the flat edges.[0063] The prothesis may be a permanent prothesis (such as a dental prothesis, or surgical scaffolding for the reconstruction bones, cheekbones, eye sockets, ears, etc.) or a temporary prothesis (e.g. healing abutment, transfer coping, scan bodies, etc.).[0064] The abutment may be formed of biocompatible material such as titanium, zirconia, a titanium-zirconia composite, a high-performance plastic such a polyether ether ketone (PEEK). By way of illustration and not limitation, one may use one or more of the materials disclosed in United States Patent 5,373,621.[0065] FIG. 10 depicts an embodiment a proximate end 1000 of an adaptor with an angled flange 1002 that is angled from longitudinal axis 1004 by a flange angle Of that is an acute angle. The flange angle Of may be, for example, greater than 0 and less than 90°, greater than 10° and less than 80°, greater than 20° and less than 70°, greater than 30° and less than 60°, or greater than 40° and less than 50°. In this manner, the angled flange 1002 forms a V-groove 1003 that circumscribes the vertical walls and arcuate wall 1016. The proximate end 1000 of adaptor may be used in conjunction with any of the distal ends described in this disclosure. This structural adaptation enhances stability and mechanical interlocking, deflect cement over extrusion away from gingival sulcus, improving the overall performance of the implant system in various clinical applications by ensuring secure engagement and alignment of implant components.05417.0001W001[0066] FIG. 11 depicts the proximate end 1100 of an adaptor wherein a vertical wall 1106 is disposed at an angle 0Lrelative to a flange 1108, wherein the angle 0Lis not a 90° angle. The arcuate wall 1116 is disposed at an angle 0a. As previously described with regard to other embodiments, the angle 0amay be greater than 90° but less than 130°, greater than 95° but less than 125°, greater than 100°, but less than 120° or greater than 105° but less than 115°. In the embodiment of FIG. 11 , the angle 0Lis an obtuse angle that is the same or different than the angle 0a. The angle 0Lmay be greater than 90° but less than 130°, greater than 95° but less than 125°, greater than 100°, but less than 120° or greater than 105° but less than 115°. The proximate end 1100 of adaptor may be used in conjunction with any of the distal ends described in this disclosure.[0067] In multiple-unit restorations with non-parallel implant trajectories, the disclosed adapters enable a splinted prosthesis or a one-piece monolithic prosthesis to be removably seated by telescopic sliding engagement. This sliding engagement produces a frictional resistance during insertion without binding and transitions at terminal seating into broad-area wall-to-wall contact to resist functional loading and improve retention under cemented conditions. The adapters comprising either (a) a modular intermediate adapter configured to couple between the prosthesis (e.g. prosthesis 108) and a bone implant (e.g. bone plant 118) as shown in FIG. IB and FIG. 1C, or (b) an implant-integrated adapter in which the adapter is monolithic with the bone implant (see FIG. 6B).[0068] During the sliding engagement, frictional resistance can be tolerance determined and generated by contact between one or more adapter wall surfaces (including the plurality of vertical walls 206a, 206b, 206c, the two slanted walls 212, and the arcuate wall 216) and corresponding recess wall surfaces. The frictional resistance may be quantified as an insertion force profile and / or a removal force profile as a function of displacement. Advantageously, the adapter is configured to generate measurable frictional resistance while avoiding binding, such that the prosthesis remains insertable along the unobstructed seating trajectory even in non-parallel, multi-unit trajectories. In certain embodiments, binding avoidance is facilitated by one or more of05417.0001W001(1) lead-in geometry provided by the arcuate wall and / or slanted walls, (2) a controlled clearance or relief region along at least a portion of the engagement length, (3) progressive engagement wherein contact area increases with displacement, and / or (4) rotational timing of each adapter about its longitudinal axis to establish the unobstructed seating trajectory.[0069] In a fully seated configuration (i.e. at the end of the insertion travel), the wall surfaces of the adapter are configured to contact corresponding recess wall surfaces such that at least the vertical walls, the slanted walls, and the arcuate wall collectively provide broad-area wall-to-wall contact. This terminal seating contact increases the effective contact surface area and improves resistance to functional loading, micromotion, and loosening.[0070] Comparative Example: Cemented Splinted Retention; unexpected hierarchy [0071] Referring to FIG. 12 A, in one non-limiting comparative evaluation of cemented splinted copings, a first control assembly 1201 comprised of two parallel hexagonal adaptors 1201a, 1201b with splinted copings 1211 was tested. In FIG. 12B, a second assembly 1202 is shown that is comprised of two parallel adaptors 100 with splinted copings 1212. In FIG. 12C, a third assembly 1203 is shown that is comprised of two adaptors 100 under a converging condition with splinted copings 1213 (e.g., angle 1204A, relative to vertical, of approximately 15 degrees) were also tested. Each of these splinted copings 1211, 1212 and 1213 were moved into, and out of, hexagonal adaptors 1201a and 1201b and / or adaptor 100. The hexagonal adaptors 1201a, 1201b and adaptors 100 were securely disposed within the indexed recess 116 of the bone implant 118 but are shown in exploded view for clarity. All adapter 100 positions and angles were secondary to the bone implant 118 and indexed recess 116. The mean force during removal is shown in FIG. 12D. The mean force during insertion is shown in FIG. 12E.[0072] In this example, removal testing showed that the control assembly 1201 exhibited the highest retention force, and retention forces for the hybrid assemblies 1202, 1203 were lower, including the converging hybrid assembly 1203. Notably, the disclosed adapter 100, when used in a corresponding splinted coping 1212 or 1213, provides05417.0001W001measurable frictional engagement during insertion without binding, and provides broadarea contact at terminal seating, which is associated with improved retention behavior under cemented conditions relative to certain tapered or multi-piece compensatory designs. The converging configuration does not compromise support of the monolithic prosthesis 704 when splinted coping telescopically connected with multiple adaptors 700 with different trajectories. Cement splinted coping dislodgement testing was performed to assess retention between the prosthesis 704 and adaptors 700, the retention being related to the total contact area therebetween. This is the biphasic properties where no binding occurs and when seated provides similar support as when the devices were parallel, in other words no need to place the bone implant parallel.[0073] FIG. 12D and FIG. 12E show mean friction-travel profiles during telescopic removal and insertion of splinted copings on parallel and convergent abutment designs. Removal (FIG. 12D) and insertion (FIG. 12E) frictional force (mean ± SD) are plotted versus travel distance (-0.10 to 2.50 mm; 0.25-mm increments) for two-unit splinted copings seated on parallel hexagonal assembly 1201, parallel assembly 1202, and 15° convergent assembly 1203. Each specimen underwent a repeated sequence of removal, insertion, removal, insertion, yielding two removal traces and two insertion traces per specimen. Group summaries were computed using master models as independent replicates (n = 5 master’s per group), with 10 specimens per master (N = 50 specimens per group), corresponding to adaptor 100 traces per group per direction (50 specimens x 2 traces). Error bars represent the standard deviation across master-mean profiles.Across designs, profiles demonstrate travel-dependent resistance consistent with telescopic wall engagement, with parallel assembly 1201 exhibiting higher resistance near seating and 15° convergent assembly 1203 showing a distinct redistribution of resistance later along the travel path.[0074] FIG. 12D is a bar graph showing mean dislodgment force of the experiments of FIG. 12B and FIG. 12C. The bar graph shows the mean dislodgment force (kgF) for cemented splinted copings seated on parallel hexagonal adaptor 1201a, parallel assembly05417.0001W0011202, and 15° converging assembly 1203. Error bars represent ± 1 standard deviation. The asterisk indicates significantly greater dislodgment force for assembly 1201 compared with both assembly 1202 and assembly 1203 (p < 0.001), while assembly 1202 and assembly 1203 were not significantly different (p > 0.05). (n = 50 measurements per group; 5 master models x 10 variations).[0075] The disclosed adaptor provides a one-piece implant bridge that seats with a precise snap-fit that may be digitally made. The abutment provides strong stability before screws are used to secure it, resulting in faster, simpler and more predictable placement and function, even in challenging angulation cases. From a straightforward scan or impression taken by the restorative dentist (digital preferred), the dental lab / CAD-CAM team can produce (1) one single, one-piece prosthesis (bridge), (2) a built-in connection feature inside the prosthesis that interfaces with a standard singletooth abutment connection, designed so it does not block seating or make insertion difficult (3) a prosthesis that passively seats and “snap-fits” into place (it goes on smoothly without forcing), (4) close, broad contact where the prosthesis meets the abutment (the “abutment-to-prosthesis” interface), (5) a fit that provides meaningful hold and stability even before screws are placed (so it does not feel loose during seating / handling) and (6) a fit that minimizes load on the retaining screws once they’re inserted, because the stability comes primarily from the precision interface, not screw pull-down.[0076] The design reduces or removes extra components between the implant, abutment, and bridge which reduces the number of parts and thereby reduces the number of points of potential failure. After the bone implants were placed, the adaptor allows the transfer of most restorative procedures from the dental chair to a controlled dental laboratory manufacturing environment reducing time, cost and suffering for patient and stress for the dentist. The design enables a direct intra-oral scan to be used more reliably for fabrication, because the design is intended to seat passively and precisely. The design helps manage highly divergent implants that are challenging for traditional custom05417.0001W001solutions, without relying on aggressive screw pull-down to “force” fit. With good scans and CAD / CAM manufacturing, the design permits a “seat-and-secure” installation rather than repeated insert / adjust cycles. Because the adaptor has inherent retention, fewer “through-the-adaptor” screw channels may be needed, improving strength and esthetics. The adaptor is designed to be routine to place, even in complex cases, reducing stress during delivery appointments. The abutment design permits faster appointments and fewer remakes / adjustments that can mean efficiency and savings for the practice and patient. The abutment design also provides a simpler, more predictable approach can make complex implant restorations more accessible and scalable. The same “snap-in” concept can support interim prostheses during treatment, improving patient comfort and function. The approach can be applied across brands as long as one end of the adaptor is integrally attaches and is designed for that brand.[0077] Approximately or about: As used herein, the term “approximately” or “about,” as applied to one or more values of interest, refers to a value that is similar to a stated reference value. In certain embodiments, the term “approximately” or “about” refers to a range of values that fall within 25%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, or less in either direction (greater than or less than) of the stated reference value unless otherwise stated or otherwise evident from the context (except where such number would exceed 100% of a possible value).[0078] This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.05417.0001W001What is claimed is:

1. An adapter for securely fastening a prosthesis to a bone implant, the adapter comprising:a body comprising a proximate end, a distal end and a stepped bore extending along a longitudinal axis of the body through at least a portion of the proximate end, wherein the proximate end and the distal end are monolithic; the proximate end comprising:a flange;a plurality of vertical walls extending parallel to the longitudinal axis and upwardly from the flange, each vertical wall directly connecting to at least one adjacent vertical wall by an internal angle 0vof at least 90°, thereby providing a first anti-rotational indexing feature;an arcuate wall with a terminal ledge that directly contacts at least 45%, but less than 100%, of a top circumference of the stepped bore, the arcuate wall extending upwardly from the flange and inwardly toward the longitudinal axis;two slanted walls, each having a flat surface that is non-parallel and nonperpendicular to the longitudinal axis.

2. The adaptor as recited in claim 1, the adaptor comprising a tapered region that is in direct contact with the flange, the flange having a diameter that defines an outermost diameter of the adaptor, the tapered region tapering downwardly toward the distal end and inwardly toward the longitudinal axis by a tapering angle 0tl.

3. The adaptor as recited in claim 1, the adaptor comprising a tapered region that is in direct contact with the flange, the flange having a diameter that defines an outermost diameter of the adaptor, the tapered region tapering downwardly toward the distal end and outwardly away from the longitudinal axis by a tapering angle 0t2.05417.0001W0014. The adapter as recited in claim 1 , wherein the distal end comprises a terminus with at least one flat vertical edge, thereby providing an anti-rotational feature.

5. The adapter as recited in claim 1, wherein the distal end has a hexagonal terminus.

6. The adapter as recited in claim 1 , wherein the distal end is a bone implant.

7. The adapter as recited in claim 1 , wherein the distal end is a bone implant that is a cylinder.

8. The adapter as recited in claim 1, wherein the distal end is a bone implant with conically shaped sidewalls that narrow in diameter over a length of the distal end.

9. The adapter as recited in claim 1 , wherein the stepped bore extends through the proximate end and at least partially into the distal end.

10. The adapter as recited in claim 1, wherein the stepped bore extends through the proximate end and through the distal end.

11. The adaptor as recited in claim 1, wherein the terminal ledge of the arcuate wall directly contacts at least 45%, but less than 80%, of the top circumference of the stepped bore.

12. The adaptor as recited in claim 1, wherein the terminal ledge of the arcuate wall directly contacts at least 45%, but less than 60%, of the top circumference of the stepped bore.

13. The adaptor as recited in claim 1, wherein the terminal ledge of the arcuate wall directly contacts at least 45%, but less than 55%, of the top circumference of the stepped bore.

14. The adaptor as recited in claim 1, wherein each vertical wall in the plurality of vertical walls are directly contiguous with a top surface.05417.0001W00115. The adaptor as recited in claim 1, wherein the flat surfaces of the two slanted walls are disposed at an angle (0S) to the flange that is obtuse.

16. The adaptor as recited in claim 13, wherein the top surface of the plurality of vertical walls is coplanar with the terminal ledge of the arcuate wall.

17. The adaptor as recited in claim 14, wherein the top surface of the plurality of vertical walls is not coplanar with the terminal ledge of the arcuate wall.

18. An adapter for securely fastening a prosthesis to a bone implant, the adapter comprising:a body comprising a proximate end, a distal end and a stepped bore extending along a longitudinal axis of the body through at least a portion of the proximate end, wherein the proximate end and the distal end are monolithic; the proximate end comprising:a plurality of vertical walls extending parallel to the longitudinal axis and upwardly, each vertical wall directly connecting to at least one adjacent vertical wall by an internal angle 0vof at least 90°, thereby providing a first anti-rotational indexing feature;an arcuate wall with a terminal ledge that directly contacts at least 45%, but less than 100%, of a top circumference of the stepped bore, the arcuate wall extending upwardly and inwardly toward the longitudinal axis;two slanted walls, each having a flat surface that is non-parallel and nonperpendicular to the longitudinal axis.

19. The adaptor as recited in claim 18, wherein the proximate end comprises a spacer region with parallel vertical sidewalls, the plurality of vertical walls and the arcuate wall in direct contact with the spacer region and extending upwardly therefrom.05417.0001W00120. An implant prosthetic assembly comprising:a plurality of bone implants;a plurality of adapters, each adapter having the structure of the adapter of claim 1 and being coupled to a respective one of the plurality of bone implants; and a prosthesis comprising a plurality of indexed recesses configured to receive respective proximate ends of a respective adaptor in the plurality of adapters, wherein the prosthesis is removably insertable onto the plurality of adapters along an unobstructed seating trajectory by telescopic sliding engagement over a non-zero travel distance such that the telescopic sliding engagement generates measurable frictional resistance while remaining substantially free of binding.

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