BG67398B1 - Method of creating, processing, support and use of oral and maxillofacial database and method for dental veneers thereof - Google Patents

Abstract

The methods shall be applied in dentistry, restorative procedures and research. It performs an intraoral scan of the patient's teeth at intervals in time. Computed tomography (CBCT) of the patient's mouth is also performed and a patient file is created from the images from each scan. They are saved and used for subsequent restoration of dental status. The first scanning (3, 3n) for the patient (2, 2n) file (4, 4n) by intraoral scanner is at the occlusion of the first permanent teeth, and the computed tomography (CBCT) imaging (6, 6n) is determined individually. This creates the maxillofacial oral status of each patient by adding to his file a photo image (7, 7n) of the face , as all files (4, 4n) are saved in a database for the oral and maxillofacial status (5). From the images from the intraoral scanner, CBCT and the photo image are made combined images (8, 8n) as well as intermediate images, representing overlapping of selected images by at least one of the means used - the intraoral scanner, CBCT and camera. By means of the images the maxillofacial status database (5) is updated and supported. The database (5), besides (A) restoration of dental status, can be used for at least one of following: (B) diagnosis of other diseases, (C) making dental veneers, (D) creating dental forms marketing (E) identification of natural persons (E) research. According to the created method for making dental veneers using the database for the maxillofacial status, whereby a 3D image of the patient's teeth is downloaded from the database in its entirety, after which the dentin and tooth enamel parts of each tooth are printed separately on a 3D printer (10), thus obtaining two components, which are glued with a composite mediator, and then is made an occlusal splint for the teeth in the dentition and an occlusal register is printed out.

Description

(54) METHOD OF CREATING, PROCESSING, MAINTAINING AND USING A DATABASE OF FACIAL-JAW STATUS AND METHOD OF MAKING DENTAL SETS

Field of technique

The invention relates to a method for creating, processing, maintaining and using a database of maxillofacial statuses, as well as to a method for manufacturing dental fillings that will be used in dentistry, for restorative procedures and conducting research.

Prior art

From US Patent Application No. US 2018/0184891 A1, a method for creating and maintaining a database of dental status, as well as its use, is known. The method, according to said application, includes intraoral panoramic imaging by a medical professional of at least a portion of a patient's mouth when using an intraoral mirror equipped with a camera. Filming is done before and after each dental treatment. The images taken are three-dimensional and are saved on a server remote from the mirror (e.g. cloud), and subsequent three-dimensional images realized in a subsequent image are also saved at each subsequent visit to the medical specialist. The method also includes connecting an X-ray image (X-ray image) to the panoramic three-dimensional image of the same location of the patient's mouth. The database stores historical information about the patient's condition, including historical panoramic 3D images of the patient's mouth. Access to the database is provided through a detector to recognize the healthcare professional's face or at least his eyes, thus the patient information file is only accessible to his healthcare professional. The use of a username and password for access is also provided for. The use of the database consists in conducting dental treatment for the subsequent restoration of dental status, including for prosthetics, orthodontics, restorative dentistry, maxillofacial prosthetics, restorative, diagnostic and oral and maxillofacial surgery.

From an international application published as WO 2016/182444 A1 a method is known for manufacturing dental fillings, in which a sample is taken from a 3D-image of a designed CAD dental model (i.e. molar tooth and splint) in a database, which is is cut into thin slices and each is projected onto the bottom layer of the printer's resin tank. Next is the transfer of resin mixtures into the resin tank, starting the printing process. Printing is done in successive layers after each previous layer is fully traced and cured, and continues until the object is finally formed. This is followed by washing and final curing in a UV chamber for another 5 hours.

The known solution forms a database that contains incomplete information and does not allow high accuracy of restoration of the maxillofacial status of the patient, as well as does not create conditions for using the data in other areas outside of the specific restoration work. In addition, the method of making dental inlays is complex, requires a significant amount of time and uses theoretically designed 3D-images, resulting in a distortion of the actual appearance of the patient for whom the thus created dental objects will be used.

Technical essence of the invention

The problem faced by the invention is to create a method for creating, processing, maintaining and using a database of maxillofacial status, including to create a method for manufacturing dental fillings that allow efficient processing of the necessary images, allow high accuracy of the manufactured details for restorative dentistry or prosthetics, as well as to allow conducting a wide range of research.

A method of creating, processing, maintaining and using a maxillofacial status database includes imaging with an intraoral scanner the teeth of a patient, the imaging continuing at selected time intervals, whereby a patient record is created. In the file, the images from each recording, during which a computed tomography (CT) scan of the respective patient's mouth is also taken, are recorded, and the patient's file is supplemented with a recording of both types of each subsequent dental manipulation performed. All images are saved and used for subsequent restoration of dental status. According to the invention, the first imaging for a patient's record by intraoral scanner is at the entry into occlusion of the first permanent teeth, and imaging by computed tomography (CT) is determined individually. In doing so, a maxillofacial status is created for each patient by adding a photo image of their face to their patient file. All files are saved in a database of maxillofacial status, and from the images captured by the intraoral scanner, by the CVST and the photo image, composite images are made at a selected time interval. At the same time, intermediate images are also created, representing an overlay of selected images from at least one of the tools used - the intraoral scanner, CVST and camera, with which the database of maxillofacial status is updated and maintained. In this, combined images and intermediate images are produced by specialized software, and the database of maxillofacial status, in addition to restoring dental status A, is also used for at least one of: diagnosing other diseases B, making dental fillings C , creating a market for dental forms D, identification of natural persons D, scientific research E.

The diagnosis of other diseases B is carried out by comparing several previous records of the maxillofacial status from the patient's file, with which it is established whether there is accelerated tooth wear or other type of change, and if there is such a recommendation is issued to the patient for continuation of treatment in another medical facility or by another medical specialist.

Creating a B-market for tooth molds involves offering at least one set of tooth molds through an electronic catalog, where, after the images are purchased by a customer, a corresponding type of restoration is made from them.

The identification of individuals D is performed by capturing at least an intraoral camera image of the unrecognizable person and then comparing the resulting images with the 3D-images available in the maxillofacial status database by the same means until identity is established.

Based on the established identity of the 3D image, the corresponding face-capture composite image is retrieved from the database, directly visualizing the character.

Scientific research E is carried out by measurements and comparisons of the three-dimensional images (3, 3n), (6, 6n), (7, 7n), (8, 8n) from the maxillofacial status database (5) by relevant scientific organizations .

The specialized software includes the steps: connecting to the database from which the file of the particular patient is selected, then a selection is made from the available images, for which reference points are determined identical to each of the images. Registration is performed on these reference points, obtaining a composite image, which is also saved in the database, and in a next step, the differences between the last and previous images are determined, analysis is performed, and then diagnosis is performed. The selection of available images in the maxillofacial status database depends on the specific application and includes at least one of the following groups: a series of images taken only with an intraoral scanner; a series of images taken only with SVT; a series of intermediate images from the intraoral scanner and CVST; a series of composite images taken with the intraoral scanner, CVST, and digital camera.

A method was also created for making dental fillings, in which a 3D image of teeth is downloaded from a database and teeth are printed on a 3D printer, in which the database of maxillofacial status is created, according to the method indicated in the previous texts, where the 3D image is of a patient's teeth in their optimal integrity, and the 3D printer prints on the dentin and enamel part of each tooth separately with the corresponding color, producing two components that are bonded with a composite intermediate and then a positioning splint is made that corresponds to the exact position of the teeth in the dental rows, according to the 3D image, and an occlusal register is printed.

The advantages of the invention are that a database has been created containing images of the maxillofacial status of natural persons for a long period of time, beginning with their childhood, and an opportunity has been created for efficient processing of the necessary images and achieving high accuracy of the produced details of restorative dentistry, prosthetics and orthodontic intervention while preserving the actual appearance of the patient, as well as an opportunity to conduct a wide range of diagnostic, scientific, criminal research, including an opportunity to create a market for dental forms.

Explanation of the attached figures

Figure 1 is a block diagram of the method according to the invention;

Figure 2 - block diagram of specialized software used according to the invention.

Figure 3 - Composite image obtained by overlaying intraoral camera imaging, CT imaging, and facial imaging.

Examples of implementation of the invention

Each individual's teeth are unique in themselves, analogous to fingerprints. The anatomy of the permanent teeth, on the other hand, is extremely important in maintaining the proper function of the masticatory apparatus. The method was created in order to achieve high accuracy in the restoration of these teeth in form and function in case of their loss or violation of their integrity, as well as to provide sufficient information for conducting various studies.

For greater clarity of the method implementation, figure 1 presents a block diagram of the method according to the invention.

The method for creating, processing, maintaining and using a maxillofacial status database consists of the following:

The initial step in creating a maxillofacial status is to have a medical professional 1, such as a dentist and/or dental assistant, perform an intraoral scanner scan of the patient's teeth 2.

Patients, as shown in Figure 1, are usually multiple, so a patient labeled 2n is also noted. Filming is performed immediately after entering occlusion of the first permanent teeth. With this recording, a 3D image 3 is obtained. In years, the recording continues at certain time intervals or only at the visits of the patient 2, 2n. The uneven interval between recordings formed by patient visits would negatively affect the accuracy and objectivity when using the recordings of the recordings later, therefore the interval was determined in advance. Alternatively, 3D images of the teeth can also be obtained by first making an impression, which is then scanned.

The next step is to create a file 4, 4n of the patient 2, 2n, in which file 4, 4n the 3D image obtained from each acquisition is recorded. The file 4, 4n of the patient 2, 2n is supplemented with a recording of each subsequent manipulation performed in his mouth.

When recording with the intraoral scanner, a computed tomography (CT) scan of the mouth of the respective patient is also performed 2, 2n. The CCT-image 6, 6n obtained with the computed tomography, which is 3D, is also recorded in the created file 4, 4n of the patient 2, 2n. The starting moment for imaging by computed tomography (CT) is determined individually by the dentist. It is recommended that this happen after the eruption of all permanent teeth of the patient 2, 2n.

A photo image 7, 7n of the patient's face captured with a suitable digital camera is also created. The resulting 2D photo image 7, 7n of the face of the patient 2, 2n is also recorded in the file 4, 4n of the patient 2, 2n at the time intervals determined by the dental practitioner.

Each patient file 4, 4n is stored in a centralized database of maxillofacial status 5, preferably in the cloud, being assigned, for example, a unique identification number. The created file 4, 4n is accessed with the unique identification number through a password and code accessible to the patient 2, 2n and his dentist 1. It is also appropriate to use other, different forms of identification and access control, which do not limits and does not go beyond the scope of the invention.

At the specified period, the 3D images captured by the intraoral scanner 3, 3n and the computed tomography 6, 6n, as well as the photo images 7, 7n captured by the digital camera, are processed by superimposing each other, resulting in a combined image 8, 8n. Thus, a combined image 8, 8n that is up-to-date at the relevant time is added to the patient's file, which forms the maxillofacial status of the patient 2, 2n at the same time. In this way, the established database of maxillofacial status 5 is maintained.

In the various cases of use of the created database 5, it is also appropriate to create an intermediate image at a certain point in time, which consists of superimposing the 3D images taken only with the intraoral scanner, only with the computed tomography or both.

The combined image, like any intermediate image, is obtained by using specialized software 9, whose principle block diagram is shown in figure 2.

The specialized software 9 includes the following steps: S1 - connection to the centralized database 5, from which the file 4, 4n of the specific patient 2, 2n is selected with its unique number, then, in a subsequent step S2 - a selection is made from the available images 3 , 6, 7, depending on the specific application, a choice of

- a series of images 3, 3n taken only with an intraoral scanner;

- a series of images 6, 6n, taken only with SVST;

- a series of intermediate images from the intraoral scanner and CVST;

- a series of combined images 8, 8n taken with the intraoral scanner, the CVST and the digital camera.

Then, for each of the indicated groups of images, step S3 is made - selection of reference points identical for each of the images and S4 - registration on these reference points is carried out, and in the next step S5 a superimposed collective image is obtained, called in the method combined 8, 8n or intermediate. It shows the changes that have occurred over time.

The resulting images are also saved in the database 5.

In the next step S6 of the specialized software 9, the differences between the last and the previous images are determined, and S7 an analysis is carried out, after which step S8 diagnosis is carried out, i.e. based on the changes that have occurred, an opinion of the medical specialist 1 is formed.

If it is necessary to restore the maxillofacial status of the patient 2, 2n, an up-to-date recording is carried out, for example with an intraoral camera, which is superimposed with the available images on the selected reference points, analyzing and determining the differences, which are made by appropriate technical means, for example 3D-printer, CNC-machine, etc.

When the use of the created maxillofacial status database 5 is, for example, for identification, an actual capture is first performed, for example with an intraoral scanner, then a comparison is made between the captured actual images 16 and those available in the database. Then, if there is a match, the last available composite image 8, 8n of the individual is downloaded, thus completing the identification.

The maintenance of the created database of maxillofacial status 5 by imaging with the three devices continues over the years, and at any moment, it contains up-to-date information on the date of the last imaging for each patient 2, 2n, individual.

It is recommended that the database 5 be globally accessible, but a regional status would not go beyond the scope of the present invention.

The use of the maxillofacial status database 5 is carried out in the following exemplary cases, non-exhaustively indicated:

A. In dental treatment for subsequent restoration of individual intraoral status:

Case 1 - caries - In the case of the need to treat caries, the medical specialist 1, more precisely the dentist, "prepares" the caries site and scans the tooth with an intraoral camera or takes an impression, which is also scanned. After that, it downloads from the database 5 images of the corresponding tooth from the last intact image, superimposes it with the image after the preparation and sends the data to the 3P-printer 10, which makes a filling from the correspondingly set material. It is then installed in place in the tooth, restoring its proper function and aesthetics.

Case 2 - Abrasion Processing - 3P-image 3, 3n of the unabraded dentition taken with the intraoral scanner is downloaded from database 5 and tooth restoration is performed on it, analogously to using the database in case 1. Thus, the teeth will they look exactly as they did before the abrasion.

Case 3 - restoration of a missing tooth - From the 3P-image 3, 3n taken with the intraoral scanner and saved in the patient's file before the loss of the tooth, the corresponding tooth or group of teeth required for the restoration is extracted and based on this 3P -image a crown, bridge or other is made based on the model of the intact teeth before the loss in order to preserve function and aesthetics. In the event that it is necessary, from the CVST image 6, 6n, it is also possible to restore the jaw bone, for example, when removing a tumor or when recovering after an accident. If the bone is affected, it can be restored by downloading the images from the CVST-image 6, 6n before the pathology, sending them to the 3P-printer 10, which produces them and then, operatively, they are placed in the affected place. If the medical professional 1 determines that an implant or a series of implants will be used, it is best to use the intermediate combined image or the combined image 8, 8n saved in the corresponding file 4, 4n.

Case 4 - prostheses in case of total edentulism. The current intraoral status of the respective patient is captured with an intraoral scanner. Then, the obtained 3D image is superimposed with a previous intermediate and/or combined image 8, 8n in which all teeth are present and, using a 3D printer, the teeth are printed individually, which are an exact copy of the teeth before the changes took place , with the material of the prosthesis below them having a height and thickness compensating for lost bone and mucosa. Thus, the prosthesis corresponds to the individual intraoral status of the specific patient, and theoretically constructed tooth rows are not used, and maximum convenience and comfort have been achieved when using the prostheses.

Case 5 - Restoration with implants: the available combined image 8, 8n is extracted from the scanner, the tomography and the photo image taken before edentulization, where the edentulous jaw is scanned, and this image is overlaid with the available combined image. Based on this, a surgical guide is printed using commercially available software designed for this purpose, which determines the exact position of the implants, corresponding to the position of the teeth before they fell out. The crowns themselves are made as described in case 3.

Case 6 - Pathologies of the bones - the image 6, 6n of the bone is extracted from the last recorded tomography (CTS), conducting an examination for the early detection of tumors, cysts, etc., which makes it possible to take the necessary treatment measures. In the case of resulting fractures, it is possible to restore the position of the bones before the trauma.

Case 7 - Orthodontic treatment - supporting the early detection, diagnosis and treatment of changes before they deepen. The information captured and saved in the file 4, 4n of the patient 2, 2n who needs orthodontic intervention, included in the intermediate and/or combined image 8, 8n at the time of the intervention, is sent to specialized software 11 of those existing on the market, which calculates and digitally visualizes the stages necessary to achieve alignment in the dental arches and based on these stages, orthodontic appliances are made. Such a treatment is significantly more precise and shorter than the existing one.

B. Other diseases - diagnosis

Periodically, the medical specialist 1 and more specifically the dentist - performs a comparison of several previous records of dental status from the file 4, 4n of the patient 2, 2n stored in the database 5. If, for example, accelerated tooth wear is detected or other type of change, the patient is given a recommendation to continue treatment in another medical facility or by another medical specialist. Examples: If the 3D-image 6, 6n of the CVST pathological formations are noticed in the patient, a recommendation is issued for the continuation of the treatment by a maxillofacial surgeon. In another case, if accelerated tooth movement is observed, patient 2, 2n is given a referral and referral to an orthodontist. The examples given are not exhaustive.

C. Fabrication of fillings and prostheses in case of total edentulism

Custom dentures are made by downloading a 3D image of teeth from a database and printing teeth on a 3D printer.

- According to the invention, the database is created according to the method described above, and the downloaded 3D image 3, 3n is of the patient's teeth 2, 2n in their optimal integrity.

The 3D printer prints the dentine and enamel parts of each tooth separately with the corresponding color, resulting in two components. The two components are extracted from the 3D image 3, 3n by software known on the market.

The two components are bonded together with a composite intermediate.

A positioning splint is made that matches the exact position of the teeth in the dental rows.

An occlusal register is printed with the 3D printer.

The manufactured fittings are embedded in a prosthetic plate, according to known technologies, and as a final product a total or partial tooth-prosthetic construction is obtained.

D. Creating a market for dental molds and dental fillings

Upon performing the imaging of the maxillofacial status of the patient 2, 2n, he is offered his tooth forms to become part of an e-commerce marketplace that offers a set of tooth forms or crowns from an electronic catalog for a fee. The offered tooth forms are selected by another patient, referred to herein as "client 13" X or Y, if he does not like his own, he can request from his medical professional 14 the selected tooth forms for replacement. This is achieved by the customer 13X, 13 Y selecting with their medical specialist 14 the appropriate shape, purchasing it from the virtual market and having dental veneers made with the chosen shape. Subsequently, the veneers are placed on the patient's teeth pending his approval. Subject to approval, the appropriate type of restorative structures, including temporary or permanent, are made.

E. Identification Use.

In the event of a crime or serious incident in which the face of the patient 2, 2n is unrecognizable 17 , it is envisaged that the government of the respective country of which the patient 2, 2n is a citizen will use, through its specialized structures 15 , the information from the database 5 for facial recognition - jaw status because, as described above, each individual's teeth are unique and unrepeatable. In order to achieve the comparison, a 3D intraoral image is first taken by an intraoral camera or by SCT of the unrecognizable face, and then the resulting images 16 are compared with the 3D images 3, 3n, 6, 6n available in the database, taken with the same means. When the identity of the 3D image is established, the corresponding face-capture combined image 8, 8n is retrieved from the database, which directly visualizes the character. Thus the individual is unmistakably identified.

F. Scientific research

The created database 5 of maxillofacial statuses of patients 2, 2n is provided to scientific organizations doing anthropometric, etiological and other studies.

Scientific studies (E) are performed by measurements and comparisons of the three-dimensional images (3, 3n), (6, 6n), (7, 7n), (8, 8n) from the maxillofacial status database (5) of respective scientific organizations, including performing analyzes for representatives of different races and communities, and patients 2, 2n are not hampered by these studies.

Claims (9)

1. A method of creating, processing, maintaining, and using a database of maxillofacial status, comprising imaging with an intraoral scanner the teeth of a patient, the imaging continuing at selected time intervals, wherein a patient file is created, wherein a file the images of each recording, during which a computed tomography (CT) scan of the mouth of the respective patient is also taken, are recorded, and the patient's file is supplemented with a recording of both types of each subsequent dental manipulation performed, and the images are saved and used for subsequent restoration of dental status, characterized in that the first image (3, 3n) for the record (4, 4n) of a patient (2, 2n) by an intraoral scanner is at the entry into occlusion of the first permanent teeth, and the image by computed tomography (CVST) (6, 6n) is determined individually, in which the maxillofacial status of each patient (2, 2n) is created by adding to the patient's file (4, 4n) a photo image (7, 7n) of his face, with all the files (4, 4n) saved in a database of maxillofacial status (5), and from the images captured by the intraoral scanner (3, 3n), by the CVST (6, 6n) and the photo image (7, 7n) combined images (8, 8n) of the selected time-interval are created, while intermediate images are also created, representing an overlay of selected images from at least one of the used means - the intraoral scanner, the CVST and a camera, with which it is updated and maintains the maxillofacial status database (5), wherein the combined images (8, 8n) and intermediate images are produced by specialized software (9), and the maxillofacial status database (5) except for (A) restoration of dental status, is also used for at least one of: (B) diagnosing other diseases, (C) making dental fillings, (D) creating a market for dental molds, (E) identifying individuals, (E) scientific research. 2. A method according to claim 1, characterized in that the diagnosis (B) of other diseases is carried out by comparing several previous records of maxillofacial status from the patient's file (4, 4n) to determine whether there is accelerated wear of the teeth or another type of change, and in the presence of such a recommendation is issued to the patient to continue the treatment in another medical facility or by another medical specialist. 3. A method according to claim 1, characterized in that the creation of a marketplace (D) for dental molds comprises offering at least one set of dental molds via an electronic catalog, wherein, after purchasing the images from a customer 13X, 13Y , a corresponding type of restorative construction is made on them. 4. A method according to claim 1, characterized in that the identification of natural persons (E) is carried out by capturing at least an intraoral camera of the unrecognizable person (17) and then the obtained images (16) are compared with those available in the database (5) 3 D-images with the same means until identity is established. 5. Method according to claim 4, characterized in that, based on the established identity of the 3D image, the corresponding combined image (8, 8n) with face capture is output from the database (5), directly visualizing the character. 6. Method according to claim 1, characterized in that the scientific studies (E) are carried out by measurements and comparisons of the three-dimensional images (3, 3n), (6, 6n), (7, 7n), (8, 8n ) from the maxillofacial status database (5) from relevant scientific organizations. 7. Method according to claim 1, characterized in that the specialized software (9) includes the steps: connecting to the database (S1) from which the file of the specific patient is selected, then making a selection from the available images (S2) , for which reference points (S3) identical to each of the images are determined and registration (S4) is performed on these reference points, obtaining a composite image (S5) which is also saved in the database (5), and in next step (S6) the differences between the last and previous images are determined, analysis is performed (S7), then diagnosis is performed (S8). 8. Method according to claim 7, characterized in that the selection from the available images in the maxillofacial status database (5) depends on the specific application and includes at least one of the following groups: a series of images (3, 3n) taken with an intraoral scanner only; a series of images (6, 6n) taken only with SVT; a series of intermediate images from the intraoral scanner and CVST; a series of composite images (8, 8n) taken with the intraoral scanner, CVST, and digital camera. 9. A method for manufacturing dental fillings, wherein a 3D image of teeth is downloaded from a database and teeth are printed on a 3D printer, characterized in that the database is the maxillofacial status database created according to claim 1, and the 3D image is of the patient's teeth in their optimal integrity, and the 3D printer (10) prints the dentine and enamel parts of each tooth separately with the corresponding color, obtaining two components which are bonded with a composite intermediate, and then a positioning splint is made corresponding to the exact position of the teeth in the dental rows according to the 3D image and an occlusal register is printed.