CN101530349A - Method for producing combination support type computer-assisted positioning and guiding die plate for oral cavity implanting - Google Patents
Method for producing combination support type computer-assisted positioning and guiding die plate for oral cavity implanting Download PDFInfo
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- CN101530349A CN101530349A CN200910048727A CN200910048727A CN101530349A CN 101530349 A CN101530349 A CN 101530349A CN 200910048727 A CN200910048727 A CN 200910048727A CN 200910048727 A CN200910048727 A CN 200910048727A CN 101530349 A CN101530349 A CN 101530349A
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Abstract
The invention provides a method for producing combination support type computer-assisted positioning and guiding die plate for oral cavity implanting, belonging to the technical field of medical apparatus. The method comprises the steps of: computer assisted surgery planning; image registering; positioning and guiding die plate designing; and rapid prototyping. In the process of the surgery, doctors only need to put the guiding die plate into the oral cavities of the patients and depend on the positioning between alveolar bones or mucosal and adjacent teeth of hypodontia areas so as to carry out the implant surgery according to the introductions of the guidance metal sleeves which are predesigned in the die plates. The invention solves the difficulties of the traditional guide plate that the positioning is inaccurate, the precision is low, the reliability is insufficient and the security is difficultly ensured.
Description
Technical field
What the present invention relates to is a kind of manufacture method of guiding die plate of medical equipment technical field, particularly a kind of manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting.
Background technology
At present, the tooth-planting operation has substituted multiple conventional restorative procedure to a great extent, becomes the routine clinical means of recovering dentition defect.Yet it also is the higher operation of a kind of risk.Because the anatomical features of jawbone (as: maxillary sinus chamber, the upper jaw left and right sides, the interior inferior alveolar nerve vascular bundle of mandibular bone etc.) itself, and other symptom relevant with dentition defect (as: absorption of periodontal disease, wound, local patholoic change excision or senile alveolar bone and atrophy etc.), make the bone amount and the bone height deficiency at corresponding missing tooth position; While is owing to the restriction of position in the art and surgical field of view, make prediction and actual position and the direction of implanting that deviation very easily take place, thereby cause the damage of growing area bone splits, perforation and near nervus mandibularis, maxillary sinus, adjacent teeth, cause the generation of the Zhou Yan of implantation body, influence the long-term success rate of implantation body.In a word, in the tooth-planting operation process, how to maximally utilise the bone amount, guarantee the safety of accuracy with the contiguous important physiological tissue structure of implantation body's implantation, and art preplanning and simulation can be provided, proposed a challenging difficult problem to the clinician.
To ensure operation safety, to improve the operation precision is traditional implant surgery locating guiding template that purpose designs, can improve the reliability of implant operation treatment plan to a certain extent, but owing to conventional template is made and to be based on that the radiology X-ray film carries out, and the X-ray film eclipsed bidimensional image that is structure, density resolution is low, and because the relation of shooting angle, organizational structure has distortion and amplification in various degree, therefore, there are shortcomings such as accuracy is not high, precision not enough, operation easier is bigger in the template of finally making.Though occurred guiding die plate technology in recent years based on the CT image, because the precision of tomography sequence medical image such as CT own are not high, can not reflect accurately that the tooth tooth closes face, still can't fundamentally solve the problem that the Template Location difficulty is big, precision is not enough.
Find through retrieval, occur " area of computer aided tooth-planting surgery locating guiding template " technology and be applied to clinical (Ganz SD.Presurgical planning with CT-derivedfabrication of surgicalguides.J Oral Maxillofac Surg 2005 prior art; 63:59-71), it carries out three-dimensional art preplanning by the tooth-planting aided design system based on the CT image, with intend to implant the position, quantity of implantation body, separately data messages such as direction, angle and the degree of depth are converted into the stl file form as the control parameter, with fast prototype method processing, make guiding die plate.This technology has been eliminated the gap of conventional template and support surface, and the location more is tending towards rationally, the direction of guiding is more accurate, and easy to operate, more helps holding tram and the direction that implantation body implants clinically.But in this technology,, cause Template Location position form not unique, make art preplanning scheme that to a certain degree deviation take place in the clinical metastasis process, influence final borehole accuracy because the mucosa or the surface of bone that only depend on the edentulous region alveolar ridge crest support.
Summary of the invention
The objective of the invention is at the deficiencies in the prior art, provide a kind of manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting, with the difficult problem that the location is inaccurate, precision is not high, reliability not enough, safety is difficult to be protected that solves traditional guide plate.The present invention adopts the template of two kinds of different support patterns, by the support of uniting of adjacent teeth, makes higher, the better reliability of its firm position, thereby improves positioning accuracy greatly.
The present invention is achieved by the following technical solutions, the present invention includes following steps:
A. computer assisted surgery planning: the patient is carried out the scanning of tomography sequence medical image; to scan the tomography sequence medical image that obtains then and carry out Geometric Modeling acquisition cranium jaw face three-dimensional reconstruction model; obtain along alveolar bone bow line unfolded sequential parameter curved panoramic picture and any cross sectional image perpendicular to alveolar bone bow line; on Geometric Modeling, place virtual implantation body with the two-dimensional/three-dimensional interactive mode; and by the doctor according to the type of clinical needs to virtual implantation body; the position; direction is optimized adjustment, finally determines the cylinder model of each virtual implantation body along the axis extension of this implantation body.
Described Geometric Modeling is meant: adopt the three-dimensional visualization technique in the Medical Image Processing that tomography sequence medical image is transformed to threedimensional model;
B. image registration: the patient's denture plaster model behind delivery is carried out laser scanning, the cranium jaw face three-dimensional reconstruction model that obtains among laser denture threedimensional model that utilizes the medical figure registration technology to scan then to obtain and the step a carries out registration, thereby the denture threedimensional model is added in the cranium jaw surface model, form a comprehensive threedimensional model, its denture partly is a laser scanning data, and other parts are tomography sequence medical image as alveolar bone, jawbone etc.
The concrete steps of described registration are meant: the adjacent teeth model in patient's agomphosis zone is cut out from laser denture threedimensional model and cranium jaw face three-dimensional reconstruction model respectively, utilize image registration techniques then, the adjacent teeth model of the laser denture threedimensional model that cuts out is added in the cranium jaw face three-dimensional reconstruction model after the cutting, forms a comprehensive threedimensional model.
C. positioning and guiding die plate designing: the former mold type of Design Orientation guiding die plate at first, this former mold type is called in patient's agomphosis zone to the comprehensive threedimensional model that is obtained by the b step, and with itself and alveolar bone or mucosa, adjacent teeth and carry out boolean by the cylinder model that a step obtains and ask and subtract, thereby obtain having the locating guiding template computer model of pore space structure, the shape of this hole is the shape of cylinder model, and the outer surface of alveolar bone, mucosa or the adjacent teeth in the inner surface of this hole and agomphosis zone matches.
The former mold type of described locating guiding template is meant that this model is according to the strip thin slice model of patient's dental arch shape curve simulation with the basic cad model that generates template, and the thickness of this model is 1-2mm.
Described dental arch pattern curve is to carry out match by a series of point ranges of extracting the denture surface, according to patient's individual variation, generates a wide 13-18mm, the strip thin slice of thick 1-2mm along the dental arch pattern curve.
The shape of described strip thin slice can also have cylindrical boss or observation window structure.
D. rapid prototyping processing: according to the locating guiding template computer model that obtains by the c step, adopt acrylic resin to be processed as the template material object through rapid prototyping by liquid photosensitive selectivity solidification method as raw material, and the guiding metal sleeve is installed in hole, the sterilization back is standby.Carry out in the process in operation, the doctor need only place guiding die plate in the patient oral cavity, relies on the alveolar bone in agomphosis zone or the location of mucosa and adjacent teeth, can carry out implant operation according to the guiding of the guiding metal sleeve of design in advance in the template.
Making for titanium alloy or rustless steel of described guiding metal sleeve.
To sum up, the present invention has made full use of laser scanner technique and tomography sequence scanning technology advantage separately, and the laser scanning data precision can reach 0.05mm, but only can reflect the outer surface information of object; Tomography sequential image data Z directional precision is 0.625～1.25mm just generally, but can reflect the anatomical tissue structure internal information), produce the alveolar bone or the uniting of mucosa and adjacent teeth that rely on patient's agomphosis zone and support the location type template, solved problems such as the conventional template accuracy is not high, precision not enough, operation easier is bigger.The present invention can make the doctor guarantee the safety of accuracy with the contiguous important physiological tissue structure of implantation body's implantation in operation process, and maximally utilises the bone amount.For the patient, can reduce operation wound, improve the success rate at a specified future date of implantation body, thereby improve its life quality; For the clinician, can reduce the difficulty of implant operation effectively, this class complicated operation of tooth-planting is grasped by the vast graduate of medical colleges and schools, improve the popularity rate of implant operation.
Description of drawings
Fig. 1 is among the embodiment, the cylinder model sketch map that each implantation body extends along its axis behind the surgery planning;
Fig. 2 is among the embodiment, cuts out the adjacent teeth sketch map from denture threedimensional model (laser scanning data);
Fig. 3 is among the embodiment, cuts out the adjacent teeth sketch map from oral cavity cranium jaw face threedimensional model (tomography sequence medical image);
Fig. 4 is among the embodiment, by Boolean calculation and the template threedimensional model sketch map through obtaining after the CAD design;
Fig. 5 is among the embodiment, the resin template sketch map that utilizes rapid prototyping technology to make.
The specific embodiment
Below in conjunction with accompanying drawing embodiments of the invention are elaborated, present embodiment is being to implement under the prerequisite with the technical solution of the present invention, provided detailed embodiment and concrete operating process, but protection scope of the present invention is not limited to following embodiment.
As shown in Figure 1 to Figure 3, patient's upper jaw right side dentition defect is numbered: 2,3,4,5, and according to its practical situation and diagnosis, the locating guiding template of intending adopting bone-adjacent teeth to unite support undergos surgery, and the template construct process is as follows:
(a) computer assisted surgery planning: the patient is carried out the scanning of tomography sequence medical image, read in this data, and reconstruct the two dimensional image of cranium jaw face threedimensional model and all directions, place virtual implantation body with the two-dimensional/three-dimensional interactive mode on this basis, the doctor is optimized adjustment according to clinical needs, position, the orientation adjustment of implantation body are arrived optimum efficiency, and implanting 4 pieces of diameters altogether is 5mm, and length is the SCREW-LINE of 13mm
CAMLOG implantation body 1 finally obtains the cylinder model that each implantation body 1 extends along its axis, as shown in Figure 1.
(b) image registration: at first utilize laser scanning equipment, patient's denture plaster model behind delivery is scanned, adjacent teeth model 2 and 3 with the agomphosis zone cuts out from denture threedimensional model (being obtained by laser scanning data) and cranium jaw face threedimensional model (being obtained by tomography sequence medical image) respectively then, shown in Fig. 2,3; Utilize image registration techniques again, with the adjacent teeth model (laser scanning data) that cuts out be added to the cutting after cranium jaw surface model (tomography sequence medical image) in, form a comprehensive threedimensional model, its denture partly is a laser scanning data, and other parts are tomography sequence medical image as alveolar bone, jawbone etc.
(c) positioning and guiding die plate designing: at first designing a strip thin slice with patient's dental arch shape is the former mold type of locating guiding template, this former mold type is called in patient's agomphosis zone to the comprehensive threedimensional model that is obtained by the b step, and with itself and alveolar bone, adjacent teeth and carry out boolean by the cylinder model that a step obtains and ask and subtract, thereby obtain having the locating guiding template computer model of hole, the alveolar bone in its inner surface and agomphosis zone and the outer surface of adjacent teeth match.In addition, also design has structures such as cylindrical boss 4 and observation window on template, as shown in Figure 4.
(d) rapid prototyping processing: according to the computer model of locating guiding template, adopt acrylic resin to be processed as the template material object as raw material through rapid prototyping by the SLA method, and guiding metal sleeve 5 (as shown in Figure 5) is installed in hole, the sterilization back is standby.
Carry out in the process in operation, the doctor need only be positioned guiding die plate in the patient oral cavity, can carry out implant operation according to the guiding of the guiding metal sleeve of design in advance in the template.Because rely on the alveolar bone in agomphosis zone and uniting of adjacent teeth to support the location in the art, feasible location is highly stable, accurate, the doctor is easy and simple to handle, and operating time shortens, 4 pieces of CAMLOG implantation bodys of final implantation smoothly.Postoperative CT shows implantation body's direction and position ideal, and is consistent with art preplanning scheme, and reasonable with the relation of other anatomical structure on every side, the operation quality significantly improves.
Claims (8)
1, a kind of manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting is characterized in that, may further comprise the steps:
A. computer assisted surgery planning: the patient is carried out the scanning of tomography sequence medical image, to scan the tomography sequence medical image that obtains then and carry out Geometric Modeling acquisition cranium jaw face three-dimensional reconstruction model, obtain along alveolar bone bow line unfolded sequential parameter curved panoramic picture and any cross sectional image perpendicular to alveolar bone bow line, on Geometric Modeling, place virtual implantation body with the two-dimensional/three-dimensional interactive mode, and to the type of virtual implantation body, the position, direction is optimized adjustment, finally determines the cylinder model of each virtual implantation body along the axis extension of this implantation body;
B. image registration: the patient's denture plaster model behind delivery is carried out laser scanning, to scan the cranium jaw face three-dimensional reconstruction model that obtains among the laser denture threedimensional model that obtains and the step a then and carry out registration, thereby the denture threedimensional model is added in the cranium jaw surface model, form a comprehensive threedimensional model, its denture partly is a laser scanning data, and alveolar bone, jawbone are tomography sequence medical image;
C. positioning and guiding die plate designing: the former mold type of Design Orientation guiding die plate at first, this former mold type is called in patient's agomphosis zone to the comprehensive threedimensional model that is obtained by the b step, and with itself and alveolar bone or mucosa, adjacent teeth and carry out boolean by the cylinder model that a step obtains and ask and subtract, thereby obtain having the locating guiding template computer model of pore space structure;
D. rapid prototyping processing: according to the locating guiding template computer model that obtains by the c step, be processed as the template material object through rapid prototyping, and the guiding metal sleeve is installed in hole, rely on the alveolar bone in agomphosis zone or the location of mucosa and adjacent teeth, carry out implant operation according to the guiding of the guiding metal sleeve of design in advance in the template.
2, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1, it is characterized in that described Geometric Modeling is meant: adopt the three-dimensional visualization technique in the Medical Image Processing that tomography sequence medical image is transformed to threedimensional model.
3, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1, it is characterized in that, the concrete steps of described registration are meant: the adjacent teeth model in agomphosis zone is cut out from laser denture threedimensional model and cranium jaw face three-dimensional reconstruction model respectively, utilize image registration techniques then, the adjacent teeth model of the laser denture threedimensional model that cuts out is added in the cranium jaw face three-dimensional reconstruction model after the cutting, forms a comprehensive threedimensional model.
4, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1, it is characterized in that, the former mold type of described locating guiding template is meant with the basic cad model that generates template, this model is according to the strip thin slice model of patient's dental arch shape curve simulation, and the thickness of this model is 1-2mm.
5, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1, it is characterized in that, described dental arch pattern curve is to carry out match by a series of point ranges of extracting the denture surface, generate a wide 13-18mm, the strip thin slice of thick 1-2mm along the dental arch pattern curve.
6, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1 is characterized in that, the shape of described strip thin slice has cylindrical boss or observation window structure.
7, the manufacture method of combination support type computer assisted positioning and guiding die plate for oral cavity implanting according to claim 1, it is characterized in that, the shape that is shaped as cylinder model of described hole, the outer surface of alveolar bone, mucosa or the adjacent teeth in the inner surface of this hole and agomphosis zone matches.
8, the manufacture method of computer-assisted positioning and guiding die plate for oral cavity implanting according to claim 1 is characterized in that, the making for titanium alloy or rustless steel of described guiding metal sleeve.
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| CN101822575A (en) * | 2010-04-15 | 2010-09-08 | 浙江工业大学 | Method of making partial-anodontia tooth implantation surgical guide plate |
| CN101828974A (en) * | 2010-05-27 | 2010-09-15 | 南京医科大学附属口腔医院 | Manufacturing method of implant denture individualized positioning guide plate |
| CN102379747A (en) * | 2011-08-17 | 2012-03-21 | 杭州正驰达精密机械有限公司 | Transverse entering type denture implant guide plate and use method thereof |
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| CN107661152A (en) * | 2017-09-19 | 2018-02-06 | 广州医科大学附属口腔医院（广州医科大学羊城医院） | A kind of preparation method of orientable digitlization tip of a root surgical operation guide plate |
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| CN101822575A (en) * | 2010-04-15 | 2010-09-08 | 浙江工业大学 | Method of making partial-anodontia tooth implantation surgical guide plate |
| CN101828974B (en) * | 2010-05-27 | 2012-12-19 | 南京医科大学附属口腔医院 | Manufacturing method of implant denture individualized positioning guide plate |
| CN101828974A (en) * | 2010-05-27 | 2010-09-15 | 南京医科大学附属口腔医院 | Manufacturing method of implant denture individualized positioning guide plate |
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| CN102626347A (en) * | 2012-04-26 | 2012-08-08 | 上海优益基医疗器械有限公司 | Method for manufacturing oral implant positioning guiding template based on CBCT data |
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| CN104042352B (en) * | 2013-03-13 | 2016-03-02 | 西安市恒惠科技有限公司 | The laser scanning data of tooth and the matching process of tomographic data |
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| CN103284808B (en) * | 2013-06-17 | 2015-12-23 | 上海正雅齿科科技有限公司 | A kind of manufacture method of oral cavity implanting tooth positioning guide plate |
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| CN108771570A (en) * | 2018-06-11 | 2018-11-09 | 广州市健齿生物科技有限公司 | The preparation method of personalized standby hole guide plate |
| CN113543743A (en) * | 2019-03-08 | 2021-10-22 | 艾西欧卡德有限公司 | Modeling of patient-individualized prosthetic items |
| CN113543743B (en) * | 2019-03-08 | 2023-09-05 | 艾西欧卡德有限公司 | Modeling of patient-independent dental prostheses |
| CN114159176A (en) * | 2021-12-06 | 2022-03-11 | 北京大清西格科技有限公司 | Guiding mechanism for dental implant surgery and manufacturing method thereof |
| CN114631909A (en) * | 2022-03-21 | 2022-06-17 | 西安交通大学口腔医院 | Oral cavity edentulous position specification measuring equipment adopting optical imaging technology |
| CN114631909B (en) * | 2022-03-21 | 2024-01-12 | 西安交通大学口腔医院 | Oral cavity tooth-missing part specification measuring equipment adopting optical imaging technology |
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