WO2014044783A2

WO2014044783A2 - Method for simulating dynamic occlusion

Info

Publication number: WO2014044783A2
Application number: PCT/EP2013/069533
Authority: WO
Inventors: Wajeeh Khan
Original assignee: Ortho Caps Gmbh
Priority date: 2012-09-19
Filing date: 2013-09-19
Publication date: 2014-03-27
Also published as: WO2014044783A3

Abstract

The invention relates to a method for simulating the dynamic occlusion between upper and lower jaw, in which a virtual denture model is imaged in a virtual articulator on the basis of 3D scan data of the actual state of the upper and lower jaw and axiographic data of a patient such that the simulation of the jaw movement for verifying the dynamic occlusion can be undertaken on the basis of the combination of the virtual denture model and the virtual articulator. By way of example, the method can be applied in the production of orthodontic devices for treating craniomandibular dysfunctions.

Description

Method for simulating dynamic occlusion

The temporomandibular joint is one of the most important joints of the human or animal body, as both food intake and articulation are closely linked to the function of this joint. In humans, every word is determined by the interaction of the temporomandibular joint, tongue, tooth position, larynx and lungs.

Disturbances in partial functions usually have major effects on the overall system, whereby the structural, functional, biochemical and mental dysregulations of the muscle or joint function of the temporomandibular joints are of particular importance. Malformations in the jaw area are summarized under the term craniomandibular dysfunction (CMD). As a collective term CMD is used for a number of clinical symptoms of the masticatory muscles and / or the temporomandibular joint as well as the associated structures in the mouth and head area. For a sound diagnosis, it is therefore essential to consider the areas of myopathy, arthopathy and occlusopathy in the jaw area separately.

Occlusive disorders are often encountered problems. In this context, occlusion refers to all contacts between the teeth of the upper and lower jaw. The contact points lie on the occlusal plane, which is not planar, but curved in sagittal and transversal planes. The static occlusion is further differentiated from the dynamic occlusion. While in the static occlusion the tooth contacts are detected without movement of the lower jaw in intercuspidation, one speaks of dynamic occlusion of the tooth contacts due to the lower jaw movement. The dynamic occlusion can in turn, depending on which teeth are considered, be converted into the dynamic see occlusion of the anterior guidance, canine guidance or - if there are several teeth group tooth guidance. Another aspect is the precontact of the teeth, ie the premature contact of a tooth or a group of teeth during bite or lower jaw movements out of the occlusion, which can cause significant damage to the entire periodontium apparatus.

While static occlusion is accomplished with a simple plaster model of the maxilla and mandible, one uses the dynamic occlusion of the axiography, a kinematic method to record traces of movement of the lower jaw. The records are used to determine an individual hinge axis for the jaw joints. In addition, the limit movements of the lower jaw are registered. For this purpose, various electronic or mechanical recording devices are known, with the help of an exact model transfer into an articulator is possible.

Articulators are devices for simulating jaw movement. For this purpose, the plaster models of the dental arches of the upper and lower jaw are mounted in occlusion in the articulator. Subsequently, the movement of the jaws can be simulated to each other, which serves as a basis for making dentures, partial and full dentures or splints. The transfer of the collected Axiographiedaten in an articulator on the one hand and the production of plaster models of upper and lower jaw for attachment in an articulator on the other hand, however, is time consuming, buggy and in terms of Zahnbögenmodelle and the articulators material-intensive and expensive.

So far, some methods and devices have been used to measure and record the movement of the human jaw, including: mechanical, electronic, ultrasound, and electromagnetic techniques. These systems typically have a physical structure ("frame") attached to each of the upper and lower jaws, measuring and recording the relative movement between the frames.

These so-called frame-based jaw tracking systems are cumbersome, time-consuming to be properly positioned on the patient, have limited accuracy, and their presence naturally interferes with an individual's natural jaw movement.

Moreover, these systems have significant practical limitations, as the data received from the frames must be synchronized with each other and, moreover a direct three-dimensional ("3D") model representation of the dentition is not directly possible but a detour through articulators must be gone.

The object of the present invention is therefore to provide a method which avoids the disadvantages described. In particular, a method is to be provided in which it is possible to dispense with articulators. Therefore, the present invention also provides diagnostic methods that allow objective insight into the various components of the chewing organ and also enable the evaluation of functional overall procedures.

The present invention therefore relates to a method for simulating the dynamic occlusion between upper and lower jaw, comprising the following method steps:

I) Providing 3D scan data of the actual condition of the upper and lower jaw of a patient for calculating a virtual denture model from upper and lower jaw,

II) providing axiographic data on the mandibular motion of the patient,

III) Transferring the data from I) into a virtual dentition model from the upper and lower jaw and transferring the data from II) into a virtual anatomical articulator for simulating the jaw movement,

IV) producing a combination of the virtual dentition model and the virtual articulator,

V) Simulation of the jaw movement to verify the dynamic occlusion based on the combination of the virtual dentition model and the virtual articulator.

VI) Calculation and modification of the simulated jaw movement with respect to the desired target state of the dynamic occlusion.

For the first time, the method has been able to virtually replace the real articulators for clarifying the dynamic occlusion with a digital imaging procedure. The associated advantages are therefore obvious: Since the process is data-based, costs and material for a complex articulator are eliminated. In addition, the costs for the production of individual dental arch plaster models for assembly in the hospital are also eliminated Articulator, which in turn leads to a huge time savings. Another advantage is the purely digital handling, which is less error-prone and easier to use, since the computer-aided method can be learned faster than dealing with the existing real articulator devices. Only the recording of the data, ie the production of bite marks on the one hand and the axiographic measurement of the temporomandibular joint on the other hand requires dental expertise. On the basis of this data acquisition, according to step I) of the method, 3D scan data are provided on the actual condition of the upper and lower jaw of a patient, so that a virtual dentition model of upper and lower jaw can be calculated.

In one embodiment of the method, the provision of the 3D scan data in step I) is based on the acquisition of data by means of an interoral scan or by means of a positive tooth model produced by means of an impression. In the impression procedure, dental technicians first take an impression of the actual condition of the upper and lower jaw bows. From this impression, a model, preferably made of plaster, then made. Based on the model, 3D scan can be used to determine data and provide it for further processing in the method described herein.

Furthermore, according to step II) of the method, axiographic data are provided for the lower jaw movement of patients. For this purpose traces of movement of the lower jaw are recorded, so that subsequently the individual hinge axis for the temporomandibular joints can be determined. In addition, the limit movements of the lower jaw are registered. Kinematic methods are used to collect the data. To capture this data, different axiography systems are known in practice. In one embodiment of the method, the provision of the axiographic data in step II) is based on electromechanically, opto-electronically and / or ultrasound-determined data. Table 1 gives an overview of the most commonly used electronic systems for the purposes of axial measurement and the associated type of measurement:

Table 1 :

Manufacturer System Location of measurement Type of measurement Gamma CADIAX Compact II articulated electromechanical

Gamma CADIAX Diagnostic close to the knee electromechanical

Dentron Freecorder BlueFox articulated opto electronically

SAM AXIOGRAPH articulated electromechanical

SAM Axio quick Recorder articulated ultrasound

KaVo ARCUSdigma articulates ultrasound

Zebris Jaw Motion Analyzer articulates ultrasound

The data collected by the axiographic measurement is provided for further use in the method according to step II) of the method.

In step III) of the method, the data provided in step I) are transferred to a virtual dentition model. For this purpose, the 3D scan data of the upper and lower jaw tooth arches, which are, for example, as CAD files, read into a computer and transferred into a virtual upper and lower jaw model. Accordingly, the axiography data is used, which is converted into a virtual anatomical articulator for simulating the jaw movement. By merging the data sets from the virtual dentition model and the virtual articulator in step IV) of the method, a virtual digital model of a dentition model and an articulator is created, with the aid of which all work on dynamic occlusion can be simulated which would otherwise only be performed with a jaw plaster. model in a real articulator would be possible.

In a further embodiment of the method, the resulting virtual articulator has setting options selected from the group consisting of: Bennett angle, joint inclination, terminal Schnarnierachse, anterior guidance, immidiate side shift and progressive side shift on. Thus, with the virtual articulator all setting options can be simulated, which correspond to those of a real articulator. This is particularly advantageous as it allows the real articulator to be completely replaced without any limitation in the assessment of the occlusion. With the virtual articulator thus mean value articulators, partially adjustable articulators as well as full value articulators are equally replaced. A simulation of the jaw movement for verifying the dynamic occlusion according to step V) of the method is thus virtually feasible. As already mentioned, special attention is paid to the dynamic occlusion on the basis of which a real articulator was previously unavoidable, whereas a denture model was sufficient for the assessment of the static occlusion.

In another embodiment of the method, the virtual articulator is a non-Arcon or Arcon articulator. In the case of the non-Arcon articulator, the structure of the virtual device is the same as in a man's jaw, so that the condyles are placed in the upper part of the articulator. In the Arcon articulator, the virtual structure corresponds to the human anatomical conditions of the temporomandibular joint. However, the arrangement has no effect on the functions of the virtual articulator, since the relative movement of the lower jaw to the upper jaw is the same in both technical approaches.

In a further embodiment of the method, the transfer of the data in step III) and the combination in step IV) takes place via suitable program-controlled data interfaces. In particular, for reading in the axiographic data suitable interfaces are held in accordance with the most common Axiographiesysteme to make the transfer of data as simple as possible. The same applies to the 3D scan data of the alveolar arch models. Depending on the data format provided, the computer-controlled system used in the present method recognizes the individual formats and combines them into a digital set of dentition model and articulator. The resulting digital combination of dentition model and articulator is thus digitally imaged, so that one can also speak of a digital imaging method in the present method.

In a further embodiment of the method, the calculation and modification in step VI) shows the iterative occlusion profile from the actual to the desired state. The iterative approximation from the actual state to the desired state is advantageous, in particular for therapeutic applications, since the individual intermediate steps can thus be optimally imaged on the way to the desired state for the treating medical specialist in the case of functional disorders of the temporomandibular joint. According to the number of iterative steps, e.g. Plan occlusal rail therapies better and implement them in appropriate orthodontic splints.

In a further embodiment of the method, the simulated jaw movement calculated and modified in step VI) is therefore provided in an additional step VII) for the calculation and production of a real denture, a partial denture, a total denture or an orthodontic appliance. The simulation of the In this way, the calculated data on dynamic occlusion can be integrated one-to-one into common generative production methods for creating real denture models as a basis for the fabrication of dentures and orthodontic correction devices. With this further step, the circle between the present digital imaging method and the production techniques for dental prostheses or aids is therefore closed out due to an insufficient dynamic occlusion. However, this method is generally used in all areas of diagnostics and therapy of craniomandibular dysfunctions.

In a particular aspect, however, there is provided a method of generatively producing a dental prosthesis, a partial denture, a full denture, or an orthodontic appliance, wherein the manufacturing is based on the dynamic occlusion simulation method described above. Further applications for the present method result in addition to orthodontics in the field of forensics and, of course, in the field of research and development.

Particularly preferred to the above, the present invention provides in a further aspect, further methods that allow in particular the detection and measurement of the movements of the jaw and thus also for the diagnosis of craniomandibular dysfunction (CMD) are suitable as well as for the preparation of appropriate treatment aids to malposition to treat the mandibular arches or malfunctioning of the temporomandibular joint.

In particular, for the first time, a method is provided which displays in real time the movement of the jaw and temporomandibular joint without virtual articulators and possibly provides further relevant measurement data. Dysfunctions and myoathropathies in the chewing system, occlusion disorders, parafunction of the masticatory apparatus and / or chronic temporomandibular joint diseases can also be diagnosed with the method according to the invention.

According to the invention, only one scanning device is used to create the virtual denture models and to record the lower jaw movement. This is achieved by means of a so-called visual 3D tracking method, as mentioned below. Another advantage of this method lies in the fact that during the treatment of the patient, the movement of his lower jaw is recorded and even directly after the recording together with the patient, the computer-aided diagnosis can take place without expensive and time-consuming use of virtual articulators. A great advantage of the present method is that only one measurement must be performed on the patient and not, as usual, at least 2 or more to obtain a reliable measurement.

So-called haptic feedback computer programs can be used for the diagnosis, which can represent and measure the anatomical peculiarities of the condyle of the temporomandibular joint, the occlusion of the jaw, whereby a virtual diagnosis can be provided for the first time without the need for operative measures. In contrast to the prior art, the methods provided here have more cost-effective and time-shortened methods.

The method according to the invention makes use of the effect that the upper jaw, the temporomandibular joint and the skull plate, i. the bony structures of the skull are rigid entities that do not maintain their relations to each other within the space during movements of the e.g. Chewing organ change. These patient-specific relations of the bony structures are uniquely determined by a static snapshot, e.g. Bite impressions, if necessary in addition an x-ray, which can also be created during a routine examination, generated.

Using a tracking method, the chewing movements of a patient are tracked, measured and recorded. This digital real-time data path, which already contains all the information of the patient's chewing motion, can then be placed via the virtual dentition model and the patient's temporomandibular joint by means of a suitable 3D or CAD soft- ware, whereby the chewing motion on the virtual dentition and joint , is transmitted. This is a particular advantage of the method according to the invention, since other devices and programs used in the prior art merely provide a data packet which virtually cumbersomely simulates and calculates a movement of the chewing organ via synchronization signals and virtual articulation software. Further analysis on the bony structures is not possible.

This has the advantage that the tracking data provides the 3D coordination data of the lower jaw movement in the room as well as generating additional measurement data and this information directly with the digital 3D view of the static images of the bony structures of the patient's skull can be superimposed and displayed without further steps are required.

Thus, for the first time in a very short time, all the data required to visualize and analyze the dynamic occlusion of the jaw, the movement of the lower jaw, the effect of the movement on the bony structures such as the temporomandibular joint.

In addition to the virtual articulation, the otherwise customary synchronization steps and signals which otherwise necessarily have to be performed in the known methods of the prior art are also eliminated. For example, in the ultrasound system of Kordaß, see also the international application WO2012 / 016832, the ultrasound system and the optical measuring system must be synchronized by infrared light pulses. As a result, additional lighting units and an additional infrared system are needed.

In addition, in the 3D visual tracking method according to the invention, no unnecessary cables need to be attached to the patient since the tracking method works like a movie camera recognizing marking elements.

Therefore, the present invention relates to a method for digitally detecting the movement of a lower jaw in relation to the bony structures of the skull of a patient by means of a 3D scan and a 3D tracking method, comprising the steps:

I) provision of 3D scan data of the actual condition of the upper and lower jaw of a patient for calculating a virtual dentition model from upper and lower jaw,

II) detecting movements of the lower jaw relative to a bony structure of the skull of a patient by means of at least one optical marking unit;

III) Overlaying the digital data from step I) with the data from step II) to virtually represent the jaw movement of the patient.

In a preferred embodiment, no virtual articulator is used here. In a preferred embodiment, no cables are attached to the patient. In a further aspect, the present invention relates to a method for digital imaging or diagnosis of craniomandibular dysfunction (CMD), comprising the following method steps:

II) detecting movements of the lower jaw relative to another bony structure of the skull of a patient by means of at least one optical marking unit;

III) overlaying the digital data from step I) with the data from step II) to virtually represent the jaw movement of the patient;

where jaw joint dysregulation and / or occlusion disorder is indicative of CMD.

In one embodiment, the bony structure in the two methods mentioned above is selected from the group consisting of: upper jaw, skull plate and temporomandibular joint or a combination thereof. In a preferred embodiment, the present method comprises the additional step of V) optionally modifying the digital jaw movement. According to the invention, by means of suitable computer programs, such as a CAD and / or 3D and / or haptic feedback software, a target state of the teeth, the mandibular arches (alone or both) can be calculated by digitally correcting the previously observed malposition, function or movement of the temporomandibular joint (simulated) becomes.

In a preferred embodiment, a 3D image of the temporomandibular joint of the patient is also performed in step I). Suitable methods for analysis of the temporomandibular joint include, for example, 3D x-ray analysis, MRI, CT, digital volume tomography (DVT), angiography, ultrasound or other imaging methods that make it possible to visualize bone structures such as the temporomandibular joint.

Likewise, the method according to the invention can be combined with a 3D analysis such as digital volume tomography (CBCT) or 3D X-ray analysis, whereby the TMJ movement and the surrounding hard tissue structures can be reproduced 1: 1 simultaneously for the movement of the lower jaw for the first time. Bone thickness and texture can be safely determined and examined. As a result, a comprehensive real - time analysis can be created in a single session and correlations between the Tooth / jaw movement to each other and with the movements in the jaw (tooth roots) and the temporomandibular joint in various chewing / grinding movements are examined.

In an alternative embodiment, the present invention relates to a method for digital imaging or diagnosis of craniomandibular dysfunction (CMD), comprising the following steps:

I) Obtain optical digitization data from a mandibular arch or both mandibular arch models or partial models of a jaw or both jaws;

II) gain digital data by means of 3D tracking, which represent a chewing movement of a patient in real time;

III) subsequent CAD construction of the aforementioned digital data; and

IV) If necessary, calculate one should describe mandibular position or the individual teeth so that the temporomandibular joint is relieved.

First, the created positive models of the patient are transformed into a virtual dentition model. For this purpose, the 3D scan data of the upper and lower dental archs that are present are read into a computer and transferred into a virtual upper and lower jaw model. Also, routine dentition registrations of the patient are made by having the patient bite on a wax platelet or some hardening mass is applied to the teeth and the patient bites until the mass hardens. Based on these registrations, the teeth of the upper and lower jaw can be determined to each other, this gearing is also scanned.

On the basis of one or both positive models of the lower and upper jaw, the optical marking unit, a holder which cooperates with the measuring system, is produced. This is designed in such a way that it can be worn without hindering the patient while chewing and yet it is firmly anchored in the oral cavity. In addition, at least one extension projects out of the oral cavity, to which active or passive marking elements, so-called position sensors, the marking elements, are attached.

Such extensions, also referred to as para-occlusal cups, are known in the prior art and can be used, for example, as a cap, splint (patient-specific) or by means of a dental adhesive or rubber on the teeth of the preferably lower jaw (universal), be attached. For other possible embodiments, see the publication of Rüge and Kordaß, 2008, Computational Visualization of Dynamic Occlusion, digital dental news, 6-12 or EP 0316297 B 1. In one embodiment of the present invention, the marking unit is not or is a patient-specific device accurate, ie patient-specific devices.

The advantage of first using positive models for the digital dentition model is based on the quality of the 3D scan. Therefore, it is also included in the invention that an intraoral scan without positive models could be made directly from the mandible and maxilla. However, such a recording carries the risk that not all details of the teeth can be imaged or through the additional information in the form of the tongue and the oral cavity and the later out of this information can lead to quality losses of the digital recordings. Of course, such a configuration would be conceivable if u.a. the computing power of the computer in the near future is significantly higher.

In one embodiment of the method, the acquisition and / or provision of the digital data in step I) is based on the recording by means of a 3 D scanner, which is able to digitally transmit optical signals to a software, which converts them into a 3D view ., can create a virtual mandibular arch and / or dentition model. Related cameras and software, i. 3 D scanners are known to the person skilled in the art.

In most cases, 3D scanners consist of a sensor, e.g. a camera that can be enclosed in an apparatus and a computer workstation that visualizes the digital recordings and on which the data can be further processed.

Any camera system that is able to create 3D images of the mandibular arch and / or the maxillary arch or digitally reproduce image can be used.

Preferably, the recording of the transition stages ("actual stages") of the simulated orthodontic correction movement with the aid of an imaging method selected from the group a) stereo photography or 3D photography

b) Stereo video graphics or 3D videography

c) 3D real-time scanning

d) 3D tracking e) 3D surveying method

f) light field photography

For data input, an imaging method or method or a combination of the two methods can be used. 3D measuring methods are based on so-called coordinate measuring arms, as offered for example by the company FARO Technologies.

Light field cameras differ in their construction from other cameras. A light field camera has an image sensor, which is located behind a special lens grid. Thanks to the numerous lenses, individual points of light do not fall on the sensor. Rather, each light point is expanded into a circle. The microlenses arranged between the objective and the sensor ensure that not only the amount of incident light but also its direction of propagation can be detected. From this information, it is then possible to calculate virtual planes of sharpness which finally make it possible to make decisive modifications to this after taking a picture. The light field recorded with a light field camera contains such a large amount of information that it is possible to switch between a three-dimensional and a two-dimensional image without any problems, while also being able to change the depth of field without any problems. In this way, three-dimensional images usable in the context of the present invention can also be generated. Light field cameras are offered, for example, by Raytrix GmbH.

Preferred within the scope of the present invention is a high-resolution optical digitizer, which can also quickly and accurately deliver three-dimensional measurement data, which is also referred to as 3D or visual or 3D visual tracking method.

In a further embodiment, marking elements are applied to at least the para-occlusion spoon before the scan in step II). Through this placement of marking elements on the para-occlusion spoon which is located in the lower jaw and optionally attached to the upper jaw / head / face or the like, the lower jaw movement of a patient can be recorded with the 3D tracking method and for the first time in real time, ie ready in real time be put. 3D tracking is also referred to in the context of the present invention as a visual tracking. Preferably, the marking elements are designed as high-contrast structure. Particularly preferably, the marking elements are designed as small geometric surfaces, points, stars, squares, reflective surfaces or illuminants (fluorescent, glossy, etc.). Each entity can be used as a marker as long as it provides enough contrast to the ground to be detected by a sensor.

In one embodiment, 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 marker elements or a plurality of the marker elements may be applied to the inside or outside of a tooth or other location in the mouth or face of the patient as a larger coherent element such as a strip, etc. are applied to the teeth and / or the spoon and / or the headband and / or the headband.

It is important that so many marking elements are applied until all six degrees of freedom are reliably determined. Additional elements, for example on a headband of the patient, are optional and serve to break out movements of the head when the patient's head moves significantly during the chewing motion. As a result, the patient would no longer have to sit in a seated, i. remain as quiet as possible, but could also record the chewing movements while standing or walking. This would be beneficial for animals or small children, whereas for adult human patients this is not necessary.

In addition, with the 3D tracking method not only the horizontal coordinates of the lower jaw movement, but also a chewing force coordinate for assessing the "bite" in the third (vertical) dimension can be determined.

For example, after placing the spoon in the patient's mouth, the patient chews on a chewing gum and / or simulates a chewing motion for a period of time. This is filmed with one of the visual tracking cameras listed above.

The 3 D / visual tracking method is based on the registration and tracking of certain points, the so-called "tracking points" provided by the marker elements. The movement of an object in 3-D space can be tracked using this method when using at least 3 tracking points / object. The software can track the position of these points during movement and thus determine the exact position of the object after or during the movement. Related devices are known to the skilled person; See, for example, US Pat. 6,608,688, or US7336375. However, in none of the previously known methods is the direct use of this data for the representation of a chewing process shown or suggested. Thus, the mandibular motion is created because during 3D tracking over a period of time, for example 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50 or 60 seconds, 1, 2 , 3, 4, 5, 6, 7, 8, 9, 10, 20 minutes the change of the marking points relative to the space ie a fixed point outside the face (practice occlusion), and / or for example a frame which is attached close to the patient, or measured on the patient's skull, maxillary arch and / or jaw joint.

Since imaging techniques and tracking vectors are subject to constant development with a resulting increase in performance, no minimum duration can and need to be determined in this respect. Tracking experiences can also be part of the imaging process.

In one embodiment, the software can simultaneously display the image data of the 3D scan and the tracking points in real time or in real time in an image. Based on these recordings of the marker points, a recorded jaw movement can be replayed and analyzed. Likewise, by means of common software, an altered, i.e. Target occlusion to be created or simulated.

Also, the effect of the force acting on the temporomandibular joint by the chewing motion can be analyzed for every second or moment of motion. So-called haptic feedback programs can help. Such programs are well known in the art and aid in diagnosis. The haptic 3D modeling software Cloud9 by Anarkik3D, in addition to 3D modeling, also offers its own 3D mouse. With the help of such a special mouse, you can not only navigate virtually through the room, but also receive haptic feedback on the 3D model. Also Labor Virtual Prototyping system used by SensAble Technologies, Inc.®. can be used.

Based on this data, a comprehensive diagnostic procedure can be provided for the first time allowing the skilled person to image the movement of the teeth in the lower and upper jaw relative to the movement of the temporomandibular joint and optionally also the tooth roots. lend and perform simulations of the dynamic occlusion in the actual and target state and much more.

The calculated by the inventive method of jaw movement data can thus be integrated one-to-one into common generative manufacturing process for creating real denture models as a basis for the preparation of dental prosthesis and orthodontic correction devices. For the implementation thereof, instructions are known in the art. For example, the scanned surfaces can be read into the surveying program for three-dimensional diagnosis and therapy planning VoXim® (IVS Solutions, Chemnitz, Germany) and processed further. Otherwise, the simulated target data can also be sent directly to the CAM or 3D Printer to create the dentures and / or orthodontic correction devices directly.

In a further aspect, the present invention relates to a method for producing a dental device or a denture, such as inlays, implants, crowns, partial crowns or tabletops, which is used in the treatment of temporomandibular dysfunction, comprising the following steps:

i) obtaining optical digitization data from a mandibular arch or both mandibular artery models or partial models of a jaw or both jaws;

ii) obtaining digital data by means of 3D tracking a chewing movement of a patient in real time;

iii) subsequent CAD construction of the aforementioned digital data

iv) calculate the mandibular position or the individual teeth so that the temporomandibular joint is relieved

v) provide a dental device.

The dental medical device may be an orthodontic treatment instrument, such as brackets, Aligner, retainers, Nachtschienen, Knirschschienen, Aufbissschinen, or a positive and / or negative model of at least one stage based on the obtained digital data of the method according to the invention by means of a CAM technique. Further instructions can be found in WO0141670, in which a method for the production of dental prostheses is shown. In this case, the orthodontic treatment aid can be based both on the digital data or data record that were recorded during the scan and / or on the calculated data or data records that represent a simulation of an optimized (target state / stage) dental arrangement. Likewise, any snapshot, also called target stage, of the simulated sequence of movements, ie a multiplicity of desired stages, or the data records relating thereto, can be used.

This can be done for example by 3D plotting or CNC milling of a positive and / or negative model, or an orthodontic treatment aid based on the records that were taken from an actual or target stage.

Moreover, the method is also suitable for making crunchy bars, chillers and the like, without the need to create mechanical articulators or similar motion analysis on physical positive models using sophisticated denture registries. In addition, with the aid of the present method, for the first time in real time, in the presence of the patient, all the necessary data can be generated that is necessary for the preparation of a diagnosis and a treatment plan, whereby it can be coordinated directly with the patient. The present invention will be explained by the figures shown below. The figures show specific embodiments and are not intended to limit the invention in any way:

The figures show the individual steps of the method shown schematically. In step I), the 3D scan data from the actual state of the upper and lower jaw of a patient for the calculation of a virtual dentition model from upper and lower jaw are provided. In step II) the axiographic data on the mandibular movement of the patient are provided. Step I) and step II) can be parallel in time and are not to be regarded as arranged in chronological succession. Subsequently, in step III) (FIG. 1), the data from I) and II) are transferred into a virtual dentition model from upper and lower jaw or into a virtual anatomical articulator for simulating the jaw movement. This is followed by the production of a combination of the virtual dentition model and the virtual articulator in step IV) (FIG. 2). With the combination of the denture model and the virtual articulator containing the axiographic data, in step V) (FIG. 3) the simulation of the Jaw movement to verify the dynamic occlusion done by the combination. Based on the simulation, in step VI) (FIG. 4), the calculation and modification of the simulated jaw movement with respect to the desired So 11 state of the dynamic occlusion takes place.

FIG. 5 shows a patient (1) in whose oral cavity a possible embodiment of a paraocclusion spoon (2) is located. On the para-occlusion spoon (2) are the marker elements (3) which can be detected by the 3 D tracking method. In Fig. 6, the para-occlusion spoon (2) is shown in a further embodiment in which the part located in the mouth is configured as a patient-specific splint and three passive marking elements (3) are applied to the rod protruding from the mouth are. A sensor can detect marking elements (3) and records the movement of the marking elements (3) over time. The received signals (digital) are sent to a computer workstation. Based on the virtual mandibular arch model data previously provided, movement of the mandibular arches is calculated and the recorded movement sequence is displayed using the mandibular arch model (5). The patient-specific relations of the bony structures are uniquely determined by a static snapshot, e.g. Bite impressions and possibly additionally created by a 3D X-ray and scanned with the help of a 3D scanner, which also later performs the 3D tracking method (see Fig. 1 and not shown), and as a digital 3D mandibular arch model (5).

Claims

Claims:

1. A method for digitally recording the movement of a mandible in relation to the bony structures of the skull of a patient by means of a 3D scan and a 3D tracking method, comprising the steps:

IV) Providing 3D scan data on the actual condition of the upper and lower jaw of a patient for calculating a virtual denture model from upper and lower jaw,

V) detecting movements of the lower jaw relative to another bony structure of the skull of a patient by means of at least one optical marking unit (2, 4);

VI) overlay the digital data from step I) with the data from step II) to virtually represent the jaw movement of the patient.

2. A method for the diagnosis of craniomandibular dysfunction (CMD), comprising the following method steps:

where jaw joint dysregulation and / or occlusion disorder is indicative of CMD.

3. The method of claim 1 or 2, wherein in step II) at least one additional measurement result is detected that the relative movement of the patient's skull positioned in 3D space.

4. The method of claim 1 or 2, wherein in addition to step I), a 3D analysis of the temporomandibular joint of the patient is performed. Method according to one of the preceding claims, wherein the detection of the change in position of the markings is carried out by means of an imaging method selected from the group consisting of:

a) Stereo photography or 3D photography

b) Stereo video graphics or 3D videography

c) 3D real-time scanning

d) 3D tracking

e) 3D surveying and

f) light field photography.

A method of manufacturing a dental device used to treat temporomandibular joint dysfunction comprising the following steps:

I) Obtain optical digitization data from a mandibular arch or both mandibular arch models (5) or partial models of a jaw or both jaws;

III) subsequent CAD construction of the aforementioned digital data

IV) calculate a target state of the mandibular arch; and

V) provide a dental device.

Method for simulating the dynamic occlusion between upper and lower jaw, comprising the following method steps:

II) providing axiographic data on the mandibular motion of the patient,

IV) producing a combination of the virtual dentition model and the virtual articulator, V) Simulation of the jaw movement to verify the dynamic occlusion based on the combination of the virtual dentition model and the virtual articulator.

8. The method according to claim 7, wherein the provision of the 3D scan data in step I) is based on the acquisition of data by means of an interoral scan or by means of a positive tooth model produced by means of an impression.

9. The method according to any one of the preceding claims, characterized in that the provision of the axiographic data in step II) based on electromechanical, optoelectronic and / or ultrasound-based data.

10. The method according to any one of the preceding claims, characterized in that the virtual articulator setting options selected from the group of: Bennett angle, joint inclination, terminal Schnarnierachse, anterior guidance, immidiate side shift and progressive side shift has.

11. The method according to any one of the preceding claims, characterized in that the virtual articulator is a non-Arcon or Arcon articulator.

12. The method according to any one of the preceding claims, characterized in that the transfer of the data in step III) and the combination in step IV) takes place via suitable program-controlled data interfaces.

13. The method according to any one of the preceding claims, characterized in that the calculation and modification in step VI) of the iterative Okklusionsverlauf from actual to desired state is displayed.

14. The method according to any one of the preceding claims, characterized in that in an additional step VII) in step VI) calculated and modified simulated jaw movement for the calculation and production of a real denture, a partial denture, a full denture or an orthodontic appliance are provided. Method for the generative production of a dental prosthesis, a partial denture, a total denture or an orthodontic appliance, characterized in that the preparation is based on the method for simulating the dynamic occlusion according to one of claims 7 to 14.