ES2938069A1 - EXTERNAL AND INTERNAL HEXAGONAL IMPLANTS FOR MAXILLARY SINUSES IN ATROPHIC MAXILLA WITH BONE HEIGHT OF 3 TO 7 MM AND ASSOCIATED SURGICAL PROTOCOL (Machine-translation by Google Translate, not legally binding) - Google Patents

Abstract

The objective of the present invention is the development of external and internal hexagon implants, exclusively for maxillary sinuses in atrophic maxillae with bone height of 3 to 7 mm, thus producing alveolar reconstruction, where the implants present unique characteristics with a framework that allows that within it the bone tissue is regenerated and that it also allows vascularization and the passage of all the growth factors necessary for development and subsequent formation in situ. The implants of the invention make it possible to isolate the environment where the cells that have the capacity to fibro-integrate it are, so the capsule is manufactured in a biocompatible material, such as titanium (grade IV), the external and internal part of the implants present special characteristics for bone development where the SLA process is carried out (acid-etched, large-grained and sandblasted implant surface) and that increases the speed at which bone formation is produced -integration. The invention also shows a surgical protocol for the placement of the implants. (Machine-translation by Google Translate, not legally binding)

Description

DESCRIPTION

EXTERNAL AND INTERNAL HEXAGONAL IMPLANTS FOR MAXILLARY SINUSES IN ATROPHIC MAXILLA WITH BONE HEIGHT OF 3 TO 7 MM AND ASSOCIATED SURGICAL PROTOCOL

OBJECT OF THE INVENTION

The objective of the present invention is the development of exclusive external and internal hexagonal implants for maxillary sinuses in atrophic maxillae, thus producing alveolar reconstruction without raising the sinus floor (3 to 7 mm bone height), within the framework of the implant, where These implants are treated using an SLA (Sandblasted Large Grain Acid Etched Implant Surface) process that increases the speed at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface roughness at multiple levels. The invention also shows a surgical protocol for the placement of the implants.

BACKGROUND OF THE INVENTION

A dental implant is a "root" device used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth. Dental implants, abutments, and dentures are collectively referred to as dental restorations or implant systems that resemble a tooth or group of teeth (referred to as a "restoration" or "implant system") as replacements for missing teeth. A dental implant usually looks similar to a real tooth root and is placed inside the jaw bone to replace the missing tooth root. After implantation the surface fuses with the surrounding jaw bone (osseointegration), dental abutments and dental prostheses such as crowns, bridges or implant-supported dentures can be installed. Dental abutments and dentures allow the patient to use the restorations for chewing (also called chewing load).

The process of placing dental implants into a patient's jaw bone is called dental implantation and is a very strenuous surgical procedure, resulting in bone damage at the bone-implant interface. A relatively long healing period follows this dental implantation process, which lasts at least around two to three months and can extend to six months. During the healing period, bone damage is repaired and replaced with new bone tissue (active biological bone remodeling) and direct bone. Growth or fusion between the surface of the implant and the bone tissue surrounding the implant (osseo-integration) is also achieved. If the healing time is too short before masticatory force is applied to the implant, the implant could fail due to bone damage in the pre-existing interstitial bone, weak new bone tissues, and an unstable bone-implant interface with partial osseointegration. The masticatory force applied on an insufficiently healed implant creates excessive micro-motion between the bone and the implant surface, resulting in the development of fibrous tissue at the interface, which could block further osseointegration and cause a eventual failure of the implant system.

Most titanium or titanium alloy dental implants are cylindrical devices that are inserted into the bones of the mouth to later place the teeth or dental pieces on them. Dental implants can be threaded and/or impacted.

All cylindrical implants have a portion that, once fixed, will come into direct contact with the bone surface. These implants are made, as we have previously mentioned, based on titanium or titanium alloys, and in all cases they have a polished area called the "neck" which is the area that emerges from the bone surface and on which it will be applied. carry out the insertion with the prosthetic part of the implant. To avoid or reduce any possible direct masticatory force being applied to the implant, the installed implant is protected under a healing cap during the healing period. After a sufficient healing period, a second surgery is performed to install an abutment and a prosthesis (artificial tooth crown). The combination of these two surgeries is often used in an implant system that is involved in a dental replacement for the missing tooth.

Bone tissue constantly undergoes a remodeling process, that is, it is reabsorbed by osteoclasts and replaced by new bone formed by osteoblasts. This process of remodeling substitution, which begins at six weeks of intrauterine life, and continues until the death of the individual, constitutes the biological basis responsible for the fact that, under certain circumstances, bone tissue can be regenerated with tissue identical to the original, without repair. with fibrous tissue, which represents the biological foundation that allows the osseo-integration of dental implants, regardless of their loading moment.

Among the factors that lead to failure of bone integration are: Premature loading of the system (before 3 months for the mandible and before 6 months for the maxilla). Invagination of the epithelium. Overheating of the bone during surgical preparation (over 47°C is detrimental). The placement of the implant with an excess of pressure that causes bone necrosis. The implant does not fit the artificial socket exactly (needs 0.5mm or less space).

The SLA process (Sandblasted Large Grain Acid Etched Implant Surface) is the best known surface treatment process, as it creates surface roughness with the aim of improving osseointegration through greater bone-implant contact. . The SLA process increases the rate at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface a higher roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseointegration, SLA can help provide greater implant stability that will ultimately extend its longevity.

In the state of the art, there are implants that allow the surface of the implant to be treated, such as Korean patent application KR2014-0143295, which describes a dental implant that includes an antimicrobial coating layer and a surface treatment method thereof. The invention describes implants made of titanium and coated on the surface of the implant with titanium nanotubes in order to prevent peri-implantitis, where a drug is adsorbed on the coating layer nanotube in order to prevent peri-implantitis with the help of the drug eluted after the implant procedure. However, the above-described invention has a drawback that the amount of eluted drug is small so as to decrease the antimicrobial effects and degradation of the adhesion between the implants and the alveolar bone may be caused by the nanotube coating.

US20120141955 patent application describes a hybrid dental implant having a screw body including a middle part having an interior cavity and one or more lateral openings. The invention further describes that a drug is delivered through the side openings to promote bone regeneration around the implant. However, it has the disadvantage that the lateral openings have a rectilinear shape in order to degrade the resistance of the implant, and the adhesion between the implant and the bone. socket is weakened so as to impair the mechanical stability of the implant.

US patent application US20150230889 describes a hybrid dental implant comprising a screw body having one or more lateral openings that extend while rotating in the form of a helix. The invention states that a drug is injected through an open space in the upper part, being delivered through the side openings, in such a way that it allows thus accelerating bone regeneration around the implant. However, the above-described invention has a disadvantage that a connecting part of the teeth and the body part of the screw are separated from each other and the implant is manufactured with a type of separation to lower the mechanical stability. In addition, the injected drug spreads in a short period of time together with the injection, and as a result, sufficient time required to induce activation of bone cells is not guaranteed.

The objective of the present invention is the development of exclusive external and internal hexagonal implants for maxillary sinuses without raising the sinus floor (bone height 3 to 7 mm) in atrophic maxillae, thus producing alveolar reconstruction within the framework of the implant, where said implants are treated using an SLA (Sandblasted Large Grain Acid Etched Implant Surface) process that increases the speed at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface a increased roughness at multiple levels, this allows osteoblasts to proliferate and adhere to the implant surface, through osseointegration, SLA treatment helps provide greater implant stability which will ultimately lengthen its longevity.

DESCRIPTION OF THE DRAWINGS

To complement the description that is being made and in order to help a better understanding of the characteristics of the invention, according to a preferred example of its practical implementation, a set of drawings is attached as an integral part of said description. where, with an illustrative and non-limiting nature, the following has been represented:

Figure 1.- Shows a view of the external hexagon implant element (1) of the invention, where the different elements are shown.

Figure 2.- shows a view of the outer capsule (8) for the external hexagon implant, with its elements.

Figure 3.- Shows a view of the external hexagon implant element (1) assembled in the capsule (8).

Figure 4.- Shows a top view of the base (11) that incorporates two holes (12) for the introduction of the screws in the external hexagon implants.

Figure 5.- shows a view of the internal hexagon implant element (1') of the invention, where the different elements are shown.

Figure 6.- shows a view of the outer capsule (8') for the internal hexagon implant, with its elements.

Figure 7.- Shows a view of the internal hexagon implant element (1') assembled in the capsule (8').

Figure 8.- Shows a top view of the base (11') that incorporates two holes (12') for the introduction of the screws in the internal hexagon implants.

DESCRIPTION OF THE INVENTION

In general terms there are two types of implants in the teeth: external connection and internal connection. In the internal connection the crown is connected inside the implant, in the external connection the crown is placed resting on the implant. Today the most used is the internal connection because the loosening of the prosthesis is less and errors in implant placement can be corrected.

External connection implants were designed with the sole purpose of assisting in the placement of the implant in the patient's mouth, but they were never designed to resist forces other than in mandibular sectors in edentulous patients and in fixed screw-retained rehabilitation. When this type of implant was later used for partial or single-unit restorations, the hexagon came to be used to prevent rotation of the intermediate and crown. Over time, scientific evidence and daily practice in the implantology industry observed the drawbacks of this type of implant; deficiencies that produced great failures in the rehabilitations and, consequently, dissatisfaction of the patient carrying them. The through screws that held and fixed the prosthesis or the crowns to the implants did not take long, once they were in place, to loosen and, in the worst case (which is very common) to break, causing a failure in the rehabilitations. On some occasions, this mobility of the implants, due to the loosening of their prosthesis screws, caused bone loss in the affected implants, producing peri-implant diseases and a great risk of their loss.

The external hexagon is used in many cases when making splints (where many implants are used for full arch rehabilitations), because some non-ideal position in the placement can be corrected in the prosthetic part either with angular abutments or the so-called UCLAS that They are given the desired shape and cast into metal.

Internal connection implants arise from the need to solve all these drawbacks. Their design is based on the support in the distribution of forces, not only externally with a hexagon of one or another certain height, but it has an internal union in a large part of the interior of the implant, producing greater stability in the implant crown as a whole.

In this case, the implant is designed with a shape that allows the abutment that joins the implant and the prosthesis, can be inserted a few millimeters inside the implant itself. Internal connection implants provide great stability and sealing to the union of the implant and the prosthesis. This type of solution minimizes external connection problems: loosening and bacterial filtration. In addition, it transmits the forces directly from the pillar to the internal hexagon and its stabilizing area.

The objective of the present invention is the development of exclusive implants for maxillary sinuses without raising the sinus floor (bone height of 3 to 7 mm) in atrophic maxillae, thus producing alveolar reconstruction, where the implants present unique characteristics with a framework that allows that within it the bone tissue is regenerated and that it also allows vascularization and the passage of all the growth factors necessary for development and subsequent formation in situ. The implants of the invention make it possible to isolate the environment where the cells that have the capacity to fibro-integrate it are, so the capsule is manufactured in a biocompatible material, such as titanium (grade IV), the external and internal part of the implants have characteristics special for bone development where the SLA process is carried out (acid-etched, large-grained and sandblasted implant surface) and that increases the speed at which bone-integration occurs, giving the surface a greater roughness in multiple levels, so that osteoblasts proliferate and adhere to the implant surface. Through osseointegration, the SLA process can help provide greater implant stability that will ultimately extend its longevity, the implant features an internal structure with space and holes for bone filler materials to produce the scaffolding for development bone, and space for them.

Another objective of the invention is to show a simple protocol that can be used by any implantologist for the placement of implants in atrophic maxillary sinuses, without the need for sophisticated devices or having such advanced training to perform the surgical act. The protocol is accompanied by a special implant design for these cases, since the implant has unique characteristics to avoid adhesions of unwanted tissues for osseointegration, internally it has characteristics for bone development (SLA treatment), space for the bone fillings, a barrier to the environment where the filling materials will be found and protected, and the regeneration of the sinus membrane, which achieves primary anchorage in an atrophic area where it is difficult to achieve due to atrophy.

PREFERRED EMBODIMENT OF THE INVENTION

In general, external hexagon implants have an implant element (1), where a perforation (2') has been made internally along it, where said perforation is made up of a hexagonal structure at the top (2) leaving the rest of the grooved perforation for the accommodation of a screw that, when inserted, allows the tooth to be fixed to the implant element (1). The exterior of the hexagonal structure (2) is located above the implant element (1), protruding from the upper cross section of the implant element (1); a neck arranged in the upper part of the body of the implant (1) with a surface (3) of titanium, smooth and polished to facilitate the adhesion of the gum cells; an implant body (4) arranged in the central part of the implant element (1) that makes it possible to give stability to the whole assembly; and an apex (5) arranged at the lower end of the implant element (1) and which allows it to be anchored in the bone.

In the cases of internal hexagon implants, the anchoring system does not protrude from the support surface of the implant element (1) or the upper cross section of the implant element (1), that is, the hexagonal structure is placed inside the perforation made in the implant element.

The external and internal hexagon implants of the present invention present a series of characteristics that allow increasing the speed at which osseointegration occurs through the use of a combination of sandblasting and acid etching to give the surface a greater roughness in multiple levels. Sandblasted Large Grain Acid Etched (SLA) implant surface is a type of surface treatment that creates surface roughness with the goal of improving osseointegration through increased bone-implant contact.

The external hexagon implant of the present invention is made up of an implant element (1), where a perforation (2') has been made internally along its length and finished off at the top by a hexagonal structure (2) that is located above the implant element (1), overhanging the upper cross section of said implant element (1); a neck arranged below the hexagonal structure (2) with a first surface (3) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3') inferior to the first that presents micro- threads to be treated with SLA process (acid etched, sandblasted, coarse grained implant surface). large), which makes it possible to create roughness on the surface with the aim of improving osseointegration, through greater bone-implant contact; an implant body (4) arranged in the central part of the implant element (1), where a plurality of slots (6) have been made at the lower, middle and upper level and which has a plurality of holes (7) between the grooves (6) in at least four directions that cross its entire length. These slots (6) and holes (7) allow an SLA treatment (acid-etched, sandblasted, large-grain implant surface) to be applied with the aim of improving osseointegration through greater bone-implant contact.

The SLA process increases the rate at which osseointegration occurs by using a combination of sandblasting and acid etching to give the surface a higher roughness on multiple levels. This allows osteoblasts to proliferate and adhere to the implant surface. Through osseointegration, SLA treatment helps provide greater implant stability that will ultimately extend its longevity. The implant body (4) is finished off at the bottom by an apex (5) that allows the implant element (1) to be anchored in the bone.

The external hexagonal implant also has a capsule (8) where the body of the implant (1) is inserted and threaded by means of a connection element (9). The capsule (8) is made up of a plurality of holes (10) to be treated equally as the internal surface, by means of an SLA treatment. The capsule (8) can have a cylindrical shape and small flanges to hook a collagen membrane inside.

Finally, the hexagonal implant has a base (11) that incorporates two holes (12) for the introduction of two screws of approximately 1.5mm x 3mm that allow its fixation to the alveolar bone.

The internal hexagonal implant of the present invention, as in the external hexagonal implant, is formed by an implant element (1'), where a perforation (2'') has been made internally along the body of the implant ( 1') and topped at the top by a hexagonal structure (2a) that is located internally and arranged below the upper cross section (3a) of the neck of the implant element (1'); a neck with an upper cross section (3a) of smooth and polished titanium to facilitate the adhesion of the gum cells and a second surface (3b) inferior to the first and with a greater longitudinal section that presents micro-threads to be treated with SLA process (surface etched with acid, sandblasted, large grain), which allows creating roughness on the surface with the aim of improving bone-integration, through greater bone-implant contact; an implant body (4') arranged in the central part of the implant element (1'), where a plurality of slots (6') have been made at the lower, middle and upper level and which has a plurality of holes (7 ') between the grooves (6') in at least four directions that traverse their entire length; and an apex (5') at the bottom of the implant body (4') that allows the implant element (1') to be anchored in the bone.

In this case of internal hexagon implant, the slots (6') and holes (7') also allow the application of an S.L.A. treatment. (acid-etched, sandblasted, large-grain implant surface) with the aim of improving osseointegration through greater bone-implant contact.

The internal hexagonal implant also has a capsule (8') where the body of the implant (1') is inserted and threaded through a connection element (9'). The capsule (8') is made up of a plurality of holes (10') to be treated equally as the internal surface, by means of an SLA treatment. The capsule (8') can have a cylindrical shape and small flanges to hook a collagen membrane inside.

The surgical protocol associated with the placement of external and internal hexagonal dental implants for maxillary sinuses in atrophic maxillae of the present invention requires several stages that start first of all from a clinical and radiographic analysis (Orthopantomography and CT), addition silicone impressions of both jaws, bite registration, Surgery, rinse with chlorhexidine digluconate (0.12%), anesthetize the area to be treated, incision made with a number 15 scalpel that allows a wide flap to be made, where the bone can be well observed, flap separation with syndesmotome (instrument used in dental surgery to separate and cut periodontal tissue and desmodontal fibers before extracting the tooth, in such a way as to avoid external fracture), drilling sequence.

The implants of the invention are prepared, whether external or internal hexagon, each implant is made of type IV titanium, inside the implant body (4) or (4') arranged in the central part of the implant element (1 ) or (1'), an SLA treatment is performed with the aim of improving bone integration through greater contact bone implant in the plurality of slots (6) or (6') at the lower, middle and upper level and in the plurality of holes (7) or (7') between the slots (6) or (6') in at least four directions that cross its entire length for the purpose of injecting filler materials or the 3D superimposition of the bone apposition.

The capsule (8) or (8') is incorporated externally and treated in the holes (10) or (10') in the same way as the implant body (4) or (4'), by means of an SLA treatment, and the union with the rest of the body of the implant is screwed through the connection element (9) or (9'), previously filled with powdered bone regeneration materials of large and small granules mixed with the patient's blood.

The capsule (8) or (8'), any of the aforementioned options (it has a cylindrical shape and small tabs to hook a collagen membrane), so that the entire implant is covered with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant and protecting the dispersion of bone filler material in that pneumatic cavity.

The implant is covered from the upper part, the membrane protruding from the base of the implant, the implant is inserted slowly and when it reaches bone level, two titanium screws of approximately 1.5mm x 3mm are inserted into the holes of the base and They are screwed together with the membrane and overlaid with a barrier of fibrin-rich plasma to achieve initial anchorage or primary stability. Once the implant is screwed and fixed, a suture is made.

With this simple protocol, many dentists worldwide can perform maxillary sinus implants in atrophic maxillae, because it is a simple technique, since osseointegration occurs within the implant, which will be able to be nourished and serve as scaffolding for the new bone formation due to the holes (10) or (10') left on the outside of the implant. All this is thanks to the specific and unique anatomy of the implant that allows vascularization.

The membranes or barriers used are also a primordial factor because we have fibrin-rich plasma that is autogenous and below it the collagen membrane that offers biocompatibility, that is, it does not cause an immune response or chronic inflammation that interferes with the healing of the area. excludes the formation of cells adjacent to the implant, creates and maintains the space for neo-bone formation, gives stability to the filler placed, thus forming a guide for bone development and preventing the filler material from dispersing through the maxillary sinus together with the characteristic that it offers us the implant itself as well.

In addition, the initial anchorage or primary or mechanical stability is achieved through the placement of screws that secure it, to then wait for secondary or biological stability, where new areas of direct contact with the implant surface are formed. When the healing process is complete the primary stability is completely replaced with secondary or biological stability.

Therefore, the protocol must have the following operational stages:

1- Carry out a clinical and radiographic analysis (Orthopantomography and CT (Computerized Tomography,

2- Take impressions with addition silicone of both jaws and bite registration,

3- Perform oral surgery, with the following stages a) Rinse with chlorhexidine digluconate (0.12%), b) anesthesia in the area to be treated, c) incision made with a scalpel to make a wide flap, d) flap separation, e) milling sequence.

4- The implants of the invention are prepared, either external or internal hexagon, inside the implant body (4) or (4') arranged in the central part of the implant element (1) or (1'), where An S.L.A. treatment was carried out in its initial phase. with the aim of improving bone-integration through greater bone-implant contact in the plurality of grooves (6) or (6') at the lower, middle and upper level and in the plurality of holes (7) or (7') between the grooves (6) or (6') in at least four directions that cross its entire length,

5- The capsule (8) or (8') is incorporated and treated in the holes (10) or (10'), injecting and filling with bone filler materials mixed with the patient's blood, and the union is made with the rest of the body of the implant (1) or (1') screwing it through the connection element (9).

6- Cover the entire implant with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant.

7- Cover the implant from the upper part, the membrane protruding from the base of the implant,

8- Insertion of the implant into the maxillary sinus slowly up to bone level, in the base holes (11) or (11') two titanium screws of approximately 1.5mm x 3mm are inserted and screwed together with the membrane

9- Cover above with a fibrin-rich plasma barrier and screw,

10-Suture

With this simple protocol, many dentists worldwide can perform implants

in maxillary sinuses in atrophic jaws, because it is a simple technique, since the

bone-integration occurs within the implant, which will be able to be nourished and serve as scaffolding

for new bone formation due to the holes made on the outside of the implant.

All this is thanks to the specific and unique anatomy of the implant that allows vascularization. The membranes or barriers used are also a primordial factor because a fibrin-rich plasma is obtained that is autogenous and below the collagen membrane that offers biocompatibility, that is, it does not cause an immune response or chronic inflammation that interferes with the healing of the area. , excludes the formation of cells adjacent to the implant, creates and maintains the space for new bone formation, gives stability to the bone filler placed inside the capsule, thus forming a guide for bone development and preventing the filler material from spreading. disperse through the maxillary sinus together

with the characteristic that the implant itself offers us as well.

Claims (1)

1- External hexagonal implants for maxillary sinuses in atrophic jaws with bone height of 3 to 7 mm, where each implant has an implant element (1), where a perforation (2') has been made internally along it and that said perforation is composed in the upper part by a hexagonal structure (2), where the exterior of the hexagonal element (2) is above the implant element (1), that is, protruding from the upper cross section of the element of implant (1), a neck arranged in the upper part of the implant body with a smooth and polished titanium surface (3), an implant body (4) arranged in the central part of the implant element and an apex (5 ) arranged at the lower end of the implant element and that allows it to be anchored in the bone, characterized in that the neck arranged below the hexagonal structure (2) has a first surface (3) made of smooth and polished titanium and a second surface (3') lower than the first one that presents micro-threads to be treated with the SLA process (acid-etched, sandblasted, large-grain surface of the implant), which allows creating roughness on the surface; in the implant body (4) arranged in the central part of the implant element (1), a plurality of slots (6) have been made at the lower, middle and upper level and it has a plurality of holes (7) between the grooves (6) in at least four directions that cross its entire length, where these grooves (6) and holes (7) allow applying an SLA treatment; a capsule (8) where the body of the implant (1) is inserted and threaded by means of a connection element (9), where said capsule (8) is made up of a plurality of holes (10) to be treated equally as the internal surface, by means of an SLA treatment; and a base (11) that incorporates two holes (12) for the introduction of respective screws that allow their fixation to the alveolar bone. 2- External-internal hexagonal implants for maxillary sinuses in atrophic jaws with bone height of 3 to 7 mm, according to claim 1, characterized in that the capsule (8) has a cylindrical shape and small tabs to hook a collagen membrane inside. . 3- External-internal hexagonal implants for maxillary sinuses in atrophic jaws with bone height of 3 to 7 mm, according to claim 1, characterized in that the holes (12) allow the introduction of screws of approximately 1.5mm x 3mm. 4- Internal hexagonal implants for maxillary sinuses in atrophic jaws with a bone height of 3 to 7 mm, where each implant has an implant element (1'), where a perforation (2'') has been made internally along the this and topped at the top by a hexagonal structure (2a) that is located internally and arranged below the upper cross section (3a) of the neck of the implant element (1'), an implant body (4') arranged in the central part of the implant element (1') and an apex (5') arranged at the lower end of the implant element and which allows it to be anchored in the bone, characterized in that the neck presents a second surface (3b) inferior to the first surface (3a) and with a greater longitudinal section presenting micro-threads to be treated with an SLA process (acid-etched, sandblasted, large-grain surface of the implant); in the implant body (4') arranged in the central part of the implant element (1'), a plurality of slots (6') have been made at the lower, middle and upper level and it has a plurality of holes (7 ') between the grooves (6') in at least four directions that traverse their entire length, where these grooves (6') and holes (7') make it possible to apply an SLA treatment; a capsule (8') where the body of the implant (1') is inserted and threaded by means of a connection element (9'), where said capsule (8') is made up of a plurality of holes (10' ) to be treated equally as the internal surface, by means of an SLA treatment; and a base (11') that incorporates two holes (12') for the introduction of two separate screws that allow their fixation to the alveolar bone. 5- Internal hexagonal implants for maxillary sinuses in atrophic jaws with bone height 3 to 7 mm, according to claim 4, characterized in that the capsule (8') has a cylindrical shape and small tabs to hook a collagen membrane inside. 6- External-internal hexagonal implants for maxillary sinuses in atrophic jaws with bone height of 3 to 7 mm, according to claim 4, characterized in that the holes (12') of the base (11') allow the introduction of screws of approximately 1.5mm x 3mm. 7- Surgical protocol for the placement of external hexagonal dental implants with a bone height of 3 to 7 mm of claim 1, characterized in that It has the following operational stages: 1- Carry out a clinical and radiographic analysis, Orthopantomography and CT (Computerized Tomography), 2- Take impressions with addition silicone of both jaws and bite registration, 3- Perform oral surgery, with the following stages a) Rinse with chlorhexidine digluconate (0.12%), b) anesthesia in the area to be treated, c) incision made with a scalpel to make a wide flap, d) flap separation, e) milling sequence. 4- Preparation of implants with external hexagon, inside the implant body (4) arranged in the central part of the implant element (1), an S.L.A. treatment is performed on the initial face. (acid-etched, sandblasted, coarse-grained implant surface) in the plurality of grooves (6) at the lower, middle and upper level and in the plurality of holes (7) between the grooves (6) in at least four directions that They traverse its entire length. 5- The capsule (8) is incorporated and treated in the holes (10), injecting and filling with bone filler materials mixed with patient's blood, and the union with the rest of the body of the implant (1) is made by screwing it through the connection element (9), 6- Cover the entire implant with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant, 7- Cover the implant from the upper part, the membrane protruding from the base of the implant, 8- Insertion of the implant slowly up to bone level, two titanium screws of approximately 1.5mm x 3mm are inserted into the base holes (11) and screwed together with the membrane, 9- Cover above with a fibrin-rich plasma barrier and screw, 10- Suture. 8- Surgical protocol for the placement of internal hexagonal dental implants with a bone height of 3 to 7 mm of claim 4, characterized in that it presents the following operative stages: 1- Carry out a clinical and radiographic analysis, Orthopantomography and CT (Computerized Tomography), 2- Take impressions with addition silicone of both jaws and bite registration, 3- Perform oral surgery, with the following stages a) Rinse with chlorhexidine digluconate (0.12%), b) anesthesia in the area to be treated, c) incision made with a scalpel to make a wide flap, d) flap separation, e) milling sequence. 4- The implants are prepared with an internal hexagon, inside the implant body (4') arranged in the central part of the implant element (1'), an S.L.A. treatment is performed on the initial face. (acid-etched, sandblasted, coarse-grained implant surface) in the plurality of grooves (6') at the lower, middle and upper level and in the plurality of holes (7') between the grooves (6') in at least four directions that traverse its entire length, 5- The capsule (8') is incorporated and treated in the holes (10'), injecting and filling with bone filler materials mixed with the patient's blood and the union is made with the rest of the body of the implant (1') screwing it through the connection element (9'), 6- Cover the entire implant with a collagen membrane of approximately 30 x 40 mm, in such a way that it adapts well to the external face of the implant, 7- Cover the implant from the upper part, the membrane protruding from the base of the implant, 8- Insertion of the implant slowly up to bone level, two titanium screws of approximately 1.5mm x 3mm are inserted into the base holes (11') and screwed together with the membrane, 9- Cover above with a fibrin-rich plasma barrier and screw, 10- Suture.