CN111904665A - Bone increment auxiliary system, design method and bone increment auxiliary device - Google Patents
Bone increment auxiliary system, design method and bone increment auxiliary device Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30—Joints
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- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
- A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
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Abstract
The invention belongs to the technical field of medical instruments, and discloses a bone increment auxiliary system, a design method and a bone increment auxiliary device, wherein a design team comprises a software instrument for calculating the size and the shape of a bone defect, a frame component and a forming component; the frame group comprises a rectangular frame which is used for fixing and accommodating the forming assembly and is provided with an overflow hole; a molding assembly including a molding of bone substitute material. The frame group comprises a rectangular frame which is used for accommodating the forming assembly and is provided with a window on the upper surface and the lower surface. Each axial surface of the frame group is reserved with a row of overflow holes. The forming part comprises an upper forming component and a lower forming component, and the forming components are matched through the frame group. The invention can prepare the viscous bone cake matched with the bone defect, avoids the complex trimming of a clinician and improves the operation efficiency. The required bone substitute material is calculated, the bone substitute material is reasonably applied, and the problems that the alveolar bone cannot be well reconstructed due to insufficient use of the bone substitute material or the alveolar bone cannot be well reconstructed due to excessive use of the bone substitute material or the wound cannot be closed due to excessive accumulation of the bone substitute material are avoided.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a bone increment auxiliary system, a design method and a bone increment auxiliary device, in particular to a dentition defect implanted bone increment auxiliary system.
Background
At present, the dental implant denture can effectively restore the appearance, function, pronunciation and health of teeth of a patient with dentition defect or dentition deletion, and is developed into an important restoration means for dentition defect and dentition deletion at present. Statistically, the standardized incidence rate of missing teeth age around the world is about 2.4%. However, the alveolar bone defect is often accompanied by periodontal disease, jaw trauma and other reasons in the patient with tooth loss, so that the implant cannot obtain an ideal three-dimensional implant space, and therefore, a bone augmentation treatment procedure is often required before or during the implant.
At present, various bone augmentation technologies such as massive bone grafting, bone splitting technology, guided bone regeneration technology and the like have been proposed in clinic, and all of the bone augmentation technologies need to use bone substitute materials with low substitution rate, but because the bone substitute materials adopted in clinic are in fine granular shapes and do not have fixed shapes, in the process of transplanting the bone substitute materials to bone defect areas, the bone substitute materials need to be conveyed to the bone defect areas for a small amount of times, and the bone substitute materials are easy to fall and be polluted in the conveying process. Meanwhile, the bone substitute material has no stable form, is easily influenced by the movement of lips, cheeks and tongue to shift at the early stage of healing, and cannot be well fixed in a bone defect area, so that the bone substitute material escapes, and the osteogenesis effect is poor.
With the continuous development of bone augmentation technology, in order to solve the problem that bone substitute materials are loose and have no fixed form, the following methods are often adopted in clinic: firstly, extracting autologous blood of a patient, mixing the autologous blood with a bone substitute material, and increasing the adhesive force of the bone substitute material by using the blood to form a certain mass; secondly, the autologous blood of the patient is extracted, the fibrin liquid rich in high-concentration growth factors is prepared by centrifuging the autologous blood of the patient, the fibrin liquid is mixed with the bone substitute material, the bone substitute material forms a certain block shape through a net-shaped structure formed by the fibrin, the block shape is called as a sticky bone cake, the sticky bone cake can stably exist for a certain time, and the problems of falling of the bone substitute material, incapability of forming, loss of the bone substitute material and the like can be reduced by a clinician by preparing the sticky bone cake.
Through the above analysis, the problems and defects of the prior art are as follows:
(1) in the prior art, autoblood and bone substitute materials are mixed to form bone substitute material agglomerates, which cannot be trimmed and have the defects of easy breakage, easy formation of blood clots, occupation of osteogenic space and no fixed shape;
(2) in clinical application, alveolar bones are absorbed to different degrees after tooth loss, bone defect forms are different, the size and the form of the prepared viscous bone cake in clinical application cannot be matched with the bone defect, a clinician still needs to manually trim the viscous bone cake, and the trimmed form cannot be matched with the bone defect;
(3) due to the different sizes of bone defects of patients, the dosage of bone substitute materials used for preparing the viscous bone cakes in the operation is usually estimated by a clinician. However, due to the limitation of the experience of the clinician, the estimation method easily causes that the alveolar bone cannot be reconstructed well due to insufficient use of the bone substitute material, or excessive use of the bone substitute material causes material waste and excessive accumulation of the bone substitute material, so that the wound is difficult to close, and the medical cost of a patient is increased;
(4) after a bone defect area is filled with a bone substitute material block or an adhesive bone cake prepared by the prior art, a doctor compacts the bone substitute material block or the adhesive bone cake through a surgical instrument, so that the bone substitute material is easy to escape to the periphery of an operation area, a compact block cannot be formed, fibrous connective tissues grow in easily, and the osteogenesis effect is influenced.
The difficulty in solving the above problems and defects is:
(1) at present, no corresponding instrument is clinically used for accurately forming and compacting the bone substitute material so as to keep the bone substitute material in a compact block shape;
(2) although the implant surgery area can be analyzed in detail before surgery, the amount of the required bone substitute material cannot be calculated accurately, and the method mainly depends on the surgery experience of the surgeon;
(3) when the bone substitute material is trimmed and transported to a bone defect area, the bone substitute material is easy to waste due to loose and dropping because the compactness of the mass or viscous bone cake formed by the bone substitute material is poor, and the operation time is prolonged, so that the discomfort of a patient is increased.
The significance of solving the problems and the defects is as follows: the bone defect area morphology is accurately three-dimensionally analyzed, the required bone substitute material amount is calculated, meanwhile, the bone substitute material is accurately molded, the compactness of the bone substitute material is improved, the operation efficiency can be effectively improved, the operation time is shortened, the discomfort of a patient is reduced, the osteogenesis effect is improved, and the waste of the bone substitute material is avoided.
Disclosure of Invention
In order to solve the problems in the prior art, the invention provides a bone augmentation assisting system, a design method and a bone augmentation assisting device.
The present invention is achieved by a bone augmentation assistance system comprising:
the design group comprises a software instrument for calculating the size and shape of the bone defect, designing and manufacturing a model and forming a component;
the frame group comprises a rectangular frame for accommodating the forming assembly and provided with windows on the upper and lower surfaces;
the molding assembly comprises an upper molding assembly and a lower molding assembly, and the molding assemblies are matched through the frame set.
Furthermore, each axial surface of the frame group is reserved with a row of overflow holes, and the overflow holes are positioned at the junction of the upper forming assembly and the lower forming assembly.
Further, the upper and lower forming assemblies may form a rectangular parallelepiped structure with the rectangular frame, and the axial plane of the forming member is parallel to the axial plane of the rectangular frame.
Furthermore, the upper and lower molding components are vertically matched through the frame set, and the upper and lower molding components are matched to form a hollow structure, wherein the shape of the hollow structure is consistent with the shape of ideal bone augmentation.
Another object of the present invention is to provide a method for designing a bone augmentation assistance system, comprising:
analyzing the jaw bone shape of the bone defect area, calculating the required bone substitute material, obtaining the range of ideal bone increment, designing a corresponding model and a forming component, and preparing the viscous bone cake matched with the bone defect.
Further, the method for designing a bone augmentation assistance system further comprises:
step one, cone beam CT examination is carried out to obtain dicom data, and meanwhile, intra-oral model scanning is carried out to obtain soft and hard tissue form image information;
step two, designing an implantation scheme, namely importing dicom data of cone beam CT and data scanned by an intraoral scanning model into three-dimensional reconstruction software to match cone beam CT reconstructed images with actual intraoral information, restoring ideal alveolar bone three-dimensional form according to an ideal implant three-dimensional position according to an obtained virtual image, and comparing the ideal alveolar bone three-dimensional form with an original alveolar bone form so as to obtain the alveolar bone quantity and three-dimensional form to be restored; designing and manufacturing a corresponding frame and a forming component;
and step three, performing bone increment on the posterior dental area of the lower jaw, using a proper bone substitute material (granular deproteinized calf bone) according to a software analysis result, enabling the lower forming component to enter the interior of the frame through the inner wall of the frame group until the bottom wall of the lower forming component is parallel to the bottom wall of the frame group to form a whole, sequentially filling the bone substitute material and fibrin liquid into the whole through an upper window of the frame group, then positioning the upper forming component group through the upper window of the frame group, and pressing the upper forming component to enable the top wall of the upper forming component to be parallel to the top wall of the frame group, thereby compacting and forming the mucosa bone cake.
Further, the step-dicom data includes jaw bone three-dimensional information, the position of the inferior alveolar neurovascular bundle, the position and size of the maxillary sinus, and any suspicious lesion data information that may occur.
And thirdly, obtaining the mucosa bone cake, and then carrying out bone augmentation molding application in the bone defect area.
Another object of the present invention is to provide a bone augmentation assisting device for assisting the loss of bone augmentation from all teeth in a dental jaw, in which a plurality of teeth in the dental jaw are continuously lost, which is designed by the bone augmentation assisting system.
By combining all the technical schemes, the invention has the advantages and positive effects that:
1. according to the invention, the three-dimensional form of the ideal bone increment is obtained by analyzing the jaw bone form of the bone defect area, and the corresponding frame and the forming component are designed, so that the viscous bone cake matched with the bone defect can be quickly formed, the complex trimming of a clinician is avoided, and the operation efficiency is improved.
2. According to the invention, the required bone substitute material is calculated by analyzing the jaw bone morphology of the bone defect area, and the bone substitute material is reasonably applied, so that the situations that the alveolar bone cannot be well reconstructed due to insufficient use amount of the bone substitute material or the material is wasted due to excessive use of the bone substitute material, and the medical cost of a patient is increased are avoided.
3. According to the invention, the viscous bone cake can be compacted by the forming assembly on the premise of not damaging the shape of the viscous bone cake, so that the compactness of the viscous bone cake is increased, the gaps among the bone substitute material particles are reduced, the possibility of fibrous tissue growth is reduced, and the osteogenesis effect is improved. Meanwhile, the situation that an operator further adopts a surgical instrument to perform compaction operation on the viscous bone cake after filling the viscous bone cake into a bone defect area is avoided, the situation that the integrity of the viscous bone cake is damaged in the compaction process is avoided, and the possibility that the bone substitute material escapes to the non-defect area is reduced.
According to the invention, through the designed frame group and the forming group, the clinical operation efficiency can be obviously improved, the precise shaping of the viscous bone cake can be completed in a short time, the three-dimensional shape of the viscous bone cake is precisely matched with the bone defect area, the operation time is shortened, and the discomfort of a patient is reduced. The viscous bone cake has certain adhesive force, and meanwhile, the viscous bone cake is compacted and formed at one time in the operation by the technology of the invention without additional trimming and compacting actions, so that the damage to the integrity of the viscous bone cake caused by operation is avoided, the viscous bone cake can stably exist in a bone defect area during the healing period, and in addition, the bone forming effect is prevented from being influenced by the escape of bone substitute materials to a non-defect area or excessive gaps among the bone substitute materials; according to the invention, the required bone substitute material is calculated by analyzing the jaw bone morphology of the bone defect area, and the bone substitute material is reasonably applied, so that the situations that the alveolar bone cannot be well reconstructed due to insufficient use amount of the bone substitute material or the material is wasted due to excessive use of the bone substitute material, and the medical cost of a patient is increased are avoided.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings needed to be used in the embodiments of the present application will be briefly described below, and it is obvious that the drawings described below are only some embodiments of the present application, and it is obvious for those skilled in the art that other drawings can be obtained from the drawings without creative efforts.
Fig. 1 is a schematic structural diagram of a bone augmentation assistance system according to an embodiment of the present invention.
Fig. 2 is a perspective view of a bone augmentation assistance system provided by an embodiment of the present invention.
Fig. 3 is a schematic view of a molding assembly of a bone augmentation assistance system according to an embodiment of the present invention.
Fig. 4 is an exploded view of a bone augmentation assistance system provided by an embodiment of the present invention.
Fig. 5 is a flow chart of a method for designing a bone augmentation assistance system according to an embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail with reference to the following embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In the prior art, the alveolar bone can be absorbed to different degrees after the tooth is lost in clinical application, the shapes of bone defects are different, the size and the shape of the prepared viscous bone cake in clinical application cannot be matched with the bone defects, the viscous bone cake still needs to be manually trimmed by a clinician, and the trimmed shape cannot be matched with the bone defects exactly.
Moreover, due to the different sizes of the bone defects of the patients, the dosage of the bone substitute material used for preparing the sticky bone cake in the operation is usually estimated by a clinician. However, due to the limitation of the experience of the clinician, the estimation method is likely to result in insufficient usage of the bone substitute material and failure of good reconstruction of alveolar bone, or excessive usage of the bone substitute material causes material waste, and increases the medical cost of the patient.
In view of the problems in the prior art, the present invention provides a bone augmentation assisting system, a design method, and a bone augmentation assisting device, and the present invention will be described in detail with reference to the accompanying drawings.
As shown in fig. 1 to 4, the bone augmentation assisting system according to the embodiment of the present invention includes a frame assembly 11.
The frame assembly 11 comprises a rectangular frame 111 for accommodating the forming assembly, a window on the upper and lower surfaces, and an overflow hole 112 at the junction of the upper and lower forming assemblies, wherein the overflow hole 112 is circular, and the jaw bone S is replaced by a lower jaw model (bone augmentation can also be applied to alveolar bone of upper jaw),
in the embodiment of the present invention, the present invention is not limited to the case of a single tooth loss, but can be applied to other cases, such as a case where a plurality of teeth in the jaw are continuously lost, a case where all teeth in the jaw are lost, and the like.
In the present embodiment, the forming assembly 12 includes an upper forming assembly 121 and a lower forming assembly 122, and the forming assemblies 121 and 122 are separated from/fitted to the model group 11 through the rectangular frame 111. The upper molding member 121 can be tightly attached to the lower molding member 122, and the outer shape of the upper molding member 121 is consistent with that of the lower molding member 122. The overflow hole 112 is located at the joint of the upper molding assembly 121 and the lower molding assembly 122. That is, the forming member 12 is integrally formed with the rectangular group 11 by the rectangular frame 111, and the integral inner portion 13 has a hollow shape 131 corresponding to the incremental portion of alveolar bone to be restored.
In the present embodiment, the frame assembly includes an upper window 113 and a lower window 114 configured to mate with the upper and lower molding members, and the viscous bone cake is formed by delivering bone substitute material and growth factor-rich fibrin fluid through the windows 113 into the integral interior 13 after the lower molding member 122 is in place and before the upper molding member 121 is in place.
As shown in fig. 5, a method for designing a bone augmentation assistance system according to an embodiment of the present invention includes:
s101, cone beam CT examination is carried out to obtain dicom data, and the cone beam CT can provide quite clear upper and lower jaw images including jaw three-dimensional information, the position of a lower alveolar neurovascular bundle, the position and the size of a maxillary sinus and any suspicious focus which may appear. Meanwhile, intraoral scanning or intraoral model scanning is carried out to obtain the clear soft and hard tissue form in the mouth.
S102, designing a planting scheme; before operation, introducing dicom data of cone beam CT and 3OXZ data of intraoral scanning or model scanning into three-dimensional reconstruction software, matching cone beam CT reconstruction images with actual intraoral information, restoring ideal alveolar bone three-dimensional form according to the obtained virtual image and the ideal three-dimensional position of the implant, and comparing the ideal alveolar bone three-dimensional form with the original alveolar bone form so as to obtain the alveolar bone quantity and form to be restored. And then designing and manufacturing a corresponding frame and a forming component.
S103, referring to fig. 1 and 2, performing a bone augmentation procedure in the posterior dental area of the lower jaw. The mandible model replaces the jawbone S (bone augmentation can also be applied in the alveolar bone of the upper jaw). Before the operation, autologous blood is extracted, fibrin liquid rich in growth factors is obtained through centrifugation, during the operation, a proper bone substitute material is used according to the analysis result of software before the operation, the rectangular frame 111 and the lower forming component 122 are connected through the inner wall of the rectangular frame to form a whole, the bone substitute material is filled into the whole interior 13 through the upper window 113, the fibrin liquid is injected after the bone substitute material is filled, the upper forming component 121 matched with the window is reset, and the mucosa bone cake is compressed and formed. After the viscous bone cake is formed, the upper forming component 121 is pushed downward, so that the viscous bone cake matched with the defect shape of the edentulous bone and the lower forming component 122 can be pushed out of the frame assembly 11.
And S104, transplanting the sticky bone cake to a bone defect area to finish bone augmentation operation.
The above description is only for the purpose of illustrating the present invention and the appended claims are not to be construed as limiting the scope of the invention, which is intended to cover all modifications, equivalents and improvements that are within the spirit and scope of the invention as defined by the appended claims.
Claims (10)
1. A bone augmentation assistance system, comprising:
the design team comprises a software instrument for calculating the size and shape of the bone defect, the frame component and the forming component;
the frame group comprises a rectangular frame which is used for fixing and accommodating the forming assembly and is provided with an overflow hole;
a molding assembly including a molding of bone substitute material.
2. The bone augmentation aid system of claim 1, wherein the frame assembly comprises a rectangular frame windowed on upper and lower sides to receive the molding assembly.
3. The bone augmentation assistance system of claim 1, wherein a row of spillover holes is reserved on each axial face of the frame set.
4. The bone augmentation assistance system of claim 1, wherein the shaped portion comprises upper and lower shaped members that mate by a set of frames.
5. A method of designing a bone augmentation assistance system as claimed in any one of claims 1 to 4, wherein the method of designing the bone augmentation assistance system comprises: analyzing the jaw bone morphology of the bone defect area, calculating the required bone substitute material, obtaining the range of ideal bone increment, designing a corresponding frame and a forming component, and preparing the viscous bone cake matched with the bone defect.
6. The method of designing a bone augmentation assistance system of claim 5, further comprising:
step one, cone beam CT examination is carried out, and dicom data, namely jaw information, is obtained; meanwhile, the intraoral model is scanned to obtain the information of the remaining teeth and soft tissues in the mouth.
Step two, designing an implantation scheme, namely importing dicom data of cone beam CT and data scanned by an intraoral scanning model into three-dimensional reconstruction software, matching and fitting three sites with the same position on the intraoral scanning model through a CT three-dimensional reconstruction image to obtain a three-dimensional jaw bone form with soft and hard tissue information, designing the form of an ideal dental crown according to information of a same tooth on the opposite side of a missing tooth, a gap between the missing tooth and a gingival margin, and determining the three-dimensional position of the ideal implant according to the designed ideal dental crown and the principle that the implant needs to be located 3mm below the ideal gingival margin and the thickness of an alveolar bone on the buccal side of the implant is at least 2 mm; finally, separating and extracting the reconstructed part of the alveolar bone on the labial and buccal sides of the actual defect area to obtain the alveolar bone quantity and form to be recovered; designing and manufacturing a corresponding model and a corresponding molding assembly;
and thirdly, performing bone increment on the posterior dental area of the lower jaw, connecting the model group and the forming group into a whole through a positive buckle and a connecting part by using a proper bone substitute material according to a software analysis result, filling the bone substitute material into the whole through a rectangular window, resetting a rectangular module matched with the window, and forming the mucous membrane bone cake.
7. The method of designing a bone augmentation assistance system as claimed in claim 6, wherein the step-dicom data includes jaw bone three-dimensional information, the position of the inferior alveolar neurovascular bundle, the position and size of the maxillary sinus, and any suspicious lesion data information that may occur.
8. The method of designing a bone augmentation assistance system as claimed in claim 6, wherein the third step of obtaining a mucosal bone cake is followed by bone augmentation modeling application in the bone defect area.
9. The method of designing a bone augmentation assistance system as claimed in claim 6, wherein the desired three-dimensional position of the implant is determined on the basis of the fact that the implant is required to be located 3mm below the desired gingival margin and the thickness of the alveolar bone is at least 2mm on the buccal side of the implant; at the moment, according to the three-dimensional position of the implant and the bone quantity required to be guaranteed to be 2mm on the labial-buccal side of the implant, the ideal alveolar bone three-dimensional form is drawn on the labial-buccal side of the alveolar bone in the actual defect area, and the reconstruction of the ideal alveolar bone three-dimensional form is completed.
10. A bone augmentation assisting device for a plurality of teeth in a tooth jaw, which is designed by the method for designing a bone augmentation assisting system according to claim 5, wherein the teeth in the tooth jaw are all missing.
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