CN103405276A - Digitalized making method of dental orthodontic appliance and fixed appliance - Google Patents
Digitalized making method of dental orthodontic appliance and fixed appliance Download PDFInfo
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- CN103405276A CN103405276A CN2013102899898A CN201310289989A CN103405276A CN 103405276 A CN103405276 A CN 103405276A CN 2013102899898 A CN2013102899898 A CN 2013102899898A CN 201310289989 A CN201310289989 A CN 201310289989A CN 103405276 A CN103405276 A CN 103405276A
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Abstract
The invention discloses a digitalized making method of a dental orthodontic appliance. The digitalized making method comprises the steps of acquiring CT (Computed Tomography) data and carrying out intraoral scanning; reconstructing a three-dimensional oral tissue model to obtain bones and teeth; reconstructing intraoral scanning data to obtain gingivas and accurate teeth; compounding two models to obtain a composite model; calculating key parameters including tooth movement amount, required orthodontic force and moment, and force applying mode and the like, discharging a treated target dentition; accurately calculating a mode of moving each tooth and a movement distance or an angle, calculating a required force and moment; calculating required shape and size parameters of an SMP force applying mechanism, and further designing a force applying unit; generating an immobilizing structure according to the three-dimensional model of each tooth on the basis of the surface; designing accessories according to certain special movements so as to obtain an integral structure of an integrated orthodontic appliance; making an integrated orthodontic appliance by using a three-dimensional printer integrally formed from multiple materials, and providing the integrated orthodontic appliance for being clinically used by a doctor; and during clinical use, heating the integrated orthodontic appliance to a phase change temperature to ensure that the force applying unit becomes soft and is conveniently adhered and fixed on the surface of the tooth. An integrated fixed appliance manufactured by using the method comprises a force applying unit, an immobilizing unit and accessories.
Description
Background technology
The oral cavity Fixed Orthodontics is for tooth arrangement deformity or grinds one's teeth and close that (tooth is combined into a word, lower same), utilize the apparatus of rescuing of the compositions such as arch wire, bracket, tooth is applied to machinery and rescue force and moment, adjust face skeleton, tooth and the triangular balance and coordination of jaw facial muscle meat, improve face type, aligning and improve masticatory efficiency after rescuing after a while.20 beginnings of the century, the U.S. dentist Edward Angle that is described as the father of modern correction starts to design dental appliance, has released edgewise technique to nineteen twenty-eight, has established the basis of modern orthodontics.U.S. correction doctor Andrews had proposed six standards that best natural tooth closes in 1970, and had invented straight wire appliance on the basis of edgewise appliance, used convenient.At present, the straight arch wire of application locking bracket is rescued the mainstream technology that becomes mouth cavity orthodontic, its key is to use the bracket corresponding to the special parameter of different tooth position to compensate the size difference between every tooth and lines of occlusion, and equally arch wire is bent without image space silk begg appliance again.China is until just introduce edgewise technique the eighties in last century, and over more than 30 year, mainly to digest and assimilate and to be applied as the master, main orthodontic appliance such as self-locking bracket locked still dependence on import at present, and price is high.The outpatients of the annual correction of China only has hundreds of thousands, and sickness rate that data show China's teenager patho-occlusion is in 50% left and right, along with economic development and growth in the living standard, China to the demand of orthodontic treatment by rapid growth, in the urgent need to having the orthodontic appliance of independent intellectual property right.
In mouth cavity orthodontic, the Main Function of arch wire is by with bracket, coordinating, and tooth and dental arch that needs are moved apply corresponding force and moment, realize the movement of tooth.Traditional metal arch wire is because the power decay applied is very fast, and mechanical property is stable not, and the alloy arch wire that is progressively had shape memory function replaces.The mechanical characteristic that the orthodontic arch filament that the shape-memory materials such as Nitinol are made can provide is better than traditional alloy material, can the less and stable power of rescuing of sustained release.Its operation principle is that the normal teeth nut of human oral cavity is carried out to statistical analysis and grouping according to size, according to this grouping, makes the arch wire of one group of normal size, and its shape is consistent with the normal teeth arc-shaped, is the ideal form after correction patient denture comes into line; During clinical practice, correction doctor according to the dental arch size of patient's reality from the immediate arch wire of selected shape and size the arch wire of standard; This arch wire through doctor's operation make that its changes is curved, torsion etc. is fixed on patient's tooth in the standard bracket, under the oral temperature environment, arch wire is understood Slow Deformation return to initial standard shape, with bracket, coordinates the load that Tooth Movement is provided, and realizes the movement of tooth.
At present, greatest problem in the Fixed Orthodontics of measured shape memory arch wire and straight silk bow supporting groove is that arch wire and bracket are all the shape and size of standard, size by the standard bracket on different tooth position changes to compensate the position difference between different dental and normal occlusion line, and there is difference in everyone Tooth Size, lines of occlusion also can be different from normal data.Therefore current straight wire appliance is not considered individual variation, the power of rescuing inaccuracy that it provides, easily cause the unnecessary amount of movement of tooth, need to constantly adjust therapeutic scheme and the adjustment appliance compensates and revises at therapeutic process, extended treatment time and increased Operative risk.
On the other hand, the doctor, in the clinical implementation process, needs the position of manual definite bracket and implements to paste, and workload is very large.The guide plate that passes through calculating Aided Design and the indirect stickup of 3 D-printing making bracket that latest developments are got up can help the doctor to find rapidly the tram on bracket upper teeth surface, alleviate to a certain extent doctor's labor intensity, but its design process complexity, precision are difficult to guarantee.And reach one to two year rescue process, the needs of patients regular return visit, to change arch wire, brings inconvenience to the patient, increases treatment cost.
Summary of the invention
In order to overcome the above-mentioned deficiency of prior art, the present invention proposes a kind of by the develop digitized manufacture method of as a whole novel integrated fixed appliance of arch wire and bracket.
The manufacture method of orthodontic appliance of the present invention comprises following making step:
1) CT data acquisition: the CT image of taking position, patient oral cavity, CT scan can utilize spiral CT to carry out in the sweep spacing that is not more than 1 millimeter, in also can utilizing, the visual field and above dentistry cone-beam shape CT (CBCT) carry out, to guarantee to scan the zone of patient's socket of the eye lower edge to complete lower jaw.The result of scanning is preserved with the Medical Image Format DICOM file of standard.
2) oral cavity tissue reconstructing three-dimensional model: the medical image of CT scan is input to Medical Image Processing and three-dimensional reconstruction software such as MIMICS, the reconstruction patients oral cavity model, reconstruction model comprises tooth and alveolar bone, in order to obtain each independently tooth, when image is processed by root of the tooth from whole image, separating, to obtain comprising the complete tooth of corona and root of the tooth, the gap between root of the tooth and alveolar bone is the periodontal membrane tissue.
3) scan and rebuild oral surfaces: because the model by the CT image reconstruction includes only sclerous tissues, be tooth and skeleton, and the CT image has fault in enlargement to tooth.Therefore in order to obtain gingival surface data and accurate tooth, utilize a mouthful interscan instrument scan patients oral cavity, obtain the oral surfaces data, with the STL form, preserve, then utilize reverse reconstruction software such as Geomagic to process scan-data, reconstruct the threedimensional model of oral surfaces, this model is overlapped with the model of rebuilding based on CT, obtain comprising the composite model of tooth, alveolar bone and gingival surface.
4) on composite model, according to patient's tooth misalignment, work up the step of Tooth Movement, and discharge the target denture after treatment, work out the orthodontic treatment scheme.According to the contrast of target denture and original denture, calculate and comprise tooth translational movement, amount of spin, required force and moment and ratio thereof, the afterburning key parameters such as step rescued.
5) force and moment required according to Tooth Movement, by the thermodynamical model of SMP material, calculate the shape and size parameter of each section SMP force application mechanism, and then design application of force cell geometry, obtains its threedimensional model.
6) take the required force and moment of Tooth Movement is parameter, utilizes three-dimensional Static Calculation formula, calculates retain strength required on every tooth, and then obtains on the fixing unit size with the crown surfaces fitting part.Then according to the threedimensional model of every tooth, take its surface is basis, the basic configuration of the method generation holding structure of thicken by curved surface.Because every dental surface all has complicated curve form, therefore can realize self poisoning by laminating, and without designing in addition the guide plate of indirectly pasting.
7) space closure after as exodontia according to some special movements of tooth, design special adnexa such as song.
8) the seamless contact of overlap joint formation between the 3-D geometric model of adjacent application of force unit, fixing unit and adnexa in twos, the design hasp increases connection power between faying surface simultaneously, obtain the overall structure of integral type appliance, the geometric model number that this overall structure comprises is the summation of application of force unit number and fixing unit number and adnexa number, and each geometric model is preserved with the STL data format.
9) the STL data of all geometric models of integral type appliance are input in the control computer of Connex350 type of 3 D Printer such as Objet company, with the one-time formed 3 D stereo printing technique of multiple material, make, offer the clinical use of doctor.During printing, locus and original design being consistent of each geometric model of integral type in rescuing, can not change, constant with mutual alignment relation after guaranteeing to print.Because adjacent model in twos in all geometric models of integral type appliance is seamless overlap joint, increased simultaneously hasp structure, therefore print the entity of latter two material natural affixed and by hasp, strengthen connection, the integral body of formation integral type appliance.Wherein the material of application of force unit and adnexa is the SMP material, can adopt and be proved polyurethane (Polyurethane, the PU) material with shape memory function and good biological blending, and the fixing unit adopts high-intensity macromolecular material.
10) during clinical use, the integral type appliance is heated to phase transition temperature (50 ° of C left and right) and makes application of force unit become soft, be adhesively fixed on easily dental surface.Under the oral temperature environment, softening inversion occurs in soft phase in application of force unit gradually, returns to one-time formed original shape, and continual and steady orthodontic therapy power is provided.
The described phase transition temperature of step 10 is 50 ° of C.
A kind of fixed appliance obtained according to said method, it is characterized in that comprising: application of force unit: made by the SMP material, with personalized correction scheme, be complementary and have personalized three dimensions geometry, for providing Tooth Movement required complex three-dimensional force and moment, with motions such as the translation that realizes tooth, control root, rotation, torsions; The fixing unit: by the high strength macromolecular material, made, the crown surfaces laminating with every tooth, have personalized shape, and the retain strength of appliance in the process of rescuing is provided; Because tooth surface has complicated curved-surface structure, can be by fixing unit and tooth surface are fitted tightly and realize self poisoning, and without the positioning guide plate that is designed in addition indirect stickup; Adnexa: be used to the force and moment of specific position and specific (special) requirements is provided, as each yeast inoculation, drag hook; Described application of force unit, fixing unit, adnexa are by the seamless contact of geometric model and utilize hasp structure to increase connection power, realize the one-shot forming manufacture with 3 D-printing.
Advantage of the present invention is: the SMP material with shape memory function is made application of force unit, is compounded to form mutually the overall structure of appliance with the corona fixing unit of macromolecular material, and this structure has the personalized shape be complementary with patient self tooth arrangement; By the fixing unit self poisoning that the surface curve shape with every tooth is fitted fully, realize Rapid pasting, and, without the indirect stickup guide plate that is designed in addition location, reduce difficulty and the intensity of doctor's clinical manipulation.Simultaneously, the shape by SMP application of force unit under the oral temperature environment recovers to provide orthodontic power stable, that continue, realizes personalized orthodontic treatment, and number of times is paid a return visit by the treatment time and the hospital that reduce the patient wear appliance.
The accompanying drawing explanation
Fig. 1 is the structural representation of the fixed appliance of made of the present invention
Fig. 1 a is SMP application of force unit sectional drawing
Fig. 1 b is the using state figure of the fixed appliance of made of the present invention
Fig. 2 is dental and alveolar bone threedimensional model schematic diagram
Fig. 3 is the composite model of tooth, alveolar bone and gingival surface
The schematic diagram of the target denture after Fig. 4 the invention process
The specific embodiment
With reference to accompanying drawing 1-4:
The manufacture method of orthodontic appliance of the present invention comprises following making step:
1) CT data acquisition: the CT image of taking position, patient oral cavity, CT scan can utilize spiral CT to carry out in the sweep spacing that is not more than 1 millimeter, in also can utilizing, the visual field and above dentistry cone-beam shape CT (CBCT) carry out, to guarantee to scan the zone of patient's socket of the eye lower edge to complete lower jaw.The result of scanning is preserved with the Medical Image Format DICOM file of standard.
2) oral cavity tissue reconstructing three-dimensional model: the medical image of CT scan is input to Medical Image Processing and three-dimensional reconstruction software such as MIMICS, the reconstruction patients oral cavity model, reconstruction model comprises tooth and alveolar bone.In order to obtain each independently tooth, when image is processed by root of the tooth from whole image, separating, to obtain comprising the complete tooth of corona and root of the tooth, the gap between root of the tooth and alveolar bone is the periodontal membrane tissue, as shown in Figure 2.
3) scan and rebuild oral surfaces: because the model by the CT image reconstruction includes only sclerous tissues, be tooth and skeleton, and the CT image has fault in enlargement to tooth.Therefore in order to obtain gingival surface data and accurate tooth, utilize a mouthful interscan instrument scan patients oral cavity, obtaining the oral surfaces data preserves with the STL form, then utilize reverse reconstruction software such as Geomagic to process scan-data, reconstruct the threedimensional model of oral surfaces, this model is overlapped with the model of rebuilding based on CT, obtain comprising the composite model of tooth, alveolar bone and gingival surface, as shown in Figure 3.
4) on composite model, according to patient's tooth misalignment, work up the step of Tooth Movement, and discharge the target denture after treatment, work out the orthodontic treatment scheme.According to the contrast of target denture and original denture, calculate and comprise tooth translational movement, amount of spin, required force and moment and ratio thereof, the afterburning key parameters such as step rescued, as shown in Figure 4.
5) force and moment required according to Tooth Movement, by the thermodynamical model of SMP material, calculate the shape and size parameter of each section SMP force application mechanism, and then design application of force cell geometry, obtains its threedimensional model.
6) take the required force and moment of Tooth Movement is parameter, utilizes three-dimensional Static Calculation formula, calculates retain strength required on every tooth, and then obtains on the fixing unit size with the crown surfaces fitting part.Then according to the threedimensional model of every tooth, take its surface is basis, the basic configuration of the method generation holding structure of thicken by curved surface.Because every dental surface all has complicated curve form, therefore can realize self poisoning by laminating, and without designing in addition the guide plate of indirectly pasting.
7) space closure after as exodontia according to some special movements of tooth, design special adnexa such as song.
8) the seamless contact of overlap joint formation between the 3-D geometric model of adjacent application of force unit, fixing unit and adnexa in twos, the design hasp increases connection power between faying surface simultaneously, obtain the overall structure of integral type appliance shown in Figure 1, the geometric model number that this overall structure comprises is the summation of application of force unit number and fixing unit number and adnexa number, and each geometric model is preserved with the STL data format.
9) the STL data of all geometric models of integral type appliance are input in the control computer of Connex350 type of 3 D Printer such as Objet company, with the one-time formed 3 D stereo printing technique of multiple material, make, offer the clinical use of doctor.During printing, locus and original design being consistent of each geometric model of integral type in rescuing, can not change, constant with mutual alignment relation after guaranteeing to print.Because adjacent model in twos in all geometric models of integral type appliance is seamless overlap joint, increased simultaneously hasp structure, therefore print the entity of latter two material natural affixed and by hasp, strengthen connection, the integral body of formation integral type appliance.Wherein the material of application of force unit and adnexa is the SMP material, can adopt and be proved polyurethane (Polyurethane, the PU) material with shape memory function and good biological blending, and the fixing unit adopts high-intensity macromolecular material;
10) during clinical use, the integral type appliance is heated to phase transition temperature (50 ° of C left and right) and makes application of force unit become soft, be adhesively fixed on easily dental surface.Under the oral temperature environment, softening inversion occurs in soft phase in application of force unit gradually, returns to one-time formed original shape, and continual and steady orthodontic therapy power is provided.
The described phase transition temperature of step 10 is 50 ° of C.
The described polyurethane of step 9 (Polyurethane, PU) material, by fixedly hard phase 4.4 ' methylene carbanil and the soft phase polycaprolactone of inversion (poly-ε-caprolactone, PCL) caulked copolymerization.As a kind of typical SMP material, can buy in the market the raw material of synthetic PU, then utilize material Preparation equipment synthetic PU material met the demands under condition of different temperatures.
The fixed appliance for personalized orthodontic treatment that this method obtains, this appliance forms as a whole by SMP application of force unit 1, macromolecular material corona fixing unit 2 and adnexa 3.In order to obtain the personalized shape with patient self denture Data Matching, after by patient CT data reconstruction, going out to comprise the three-dimensional oral cavity model of skeleton and tooth, with the data after the interscan of patient oral cavity is rebuild, overlap the composite model that obtains comprising tooth, skeleton and gingival soft tissue, tooth arrangement and skeleton condition according to the patient, work up the orthodontic treatment scheme, the final denture after obtaining medical treatment is arranged; On this basis, design respectively the structure of application of force unit and fixing unit, its shape namely is complementary with denture and tooth position after orthodontic treatment, is the shape in the memory that need to recover of SMP application of force unit; During clinical manipulation, the integral type appliance is placed in to certain temperature environment and makes its deliquescing, the form of then pasting by the fixing unit can be fixed on the corona in the patient oral cavity easily.
This invention cardinal principle as shown in Figure 1, is divided into application of force unit, corona fixing unit and adnexa by appliance:
(1) application of force unit 1: made by the SMP material, with personalized correction scheme, be complementary and have personalized three dimensions geometry, circle as shown in the figure, square or triangle equal section, for providing Tooth Movement required complex three-dimensional force and moment, with motions such as the translation that realizes tooth, control root, rotation, torsions.
(2) the fixing unit 2: by the high strength macromolecular material, made, the crown surfaces laminating with every tooth, have personalized shape, and the retain strength of appliance in the process of rescuing is provided.Because tooth surface has complicated curved-surface structure, can be by fixing unit and crown surfaces are fitted tightly and realize self poisoning, and without the positioning guide plate that is designed in addition indirect stickup.
(3) adnexa 3: be used to the force and moment of specific position and specific (special) requirements is provided, as each yeast inoculation, drag hook etc.
Described application of force unit, fixing unit, adnexa are by the seamless contact of geometric model and utilize hasp structure to increase connection power, realize the one-shot forming manufacture with 3 D-printing.
Claims (3)
1. the manufacture method of orthodontic appliance of the present invention comprises following making step:
1) CT data acquisition: the CT image of taking position, patient oral cavity, CT scan can utilize spiral CT to carry out in the sweep spacing that is not more than 1 millimeter, in also can utilizing, the visual field and above dentistry cone-beam shape CT (CBCT) carry out, to guarantee to scan the zone of patient's socket of the eye lower edge to complete lower jaw.The result of scanning is preserved with the Medical Image Format DICOM file of standard.
2) oral cavity tissue reconstructing three-dimensional model: the medical image of CT scan is input to Medical Image Processing and three-dimensional reconstruction software such as MIMICS, the reconstruction patients oral cavity model, reconstruction model comprises tooth and alveolar bone.In order to obtain each independently tooth, when image is processed by root of the tooth from whole image, separating, to obtain comprising the complete tooth of corona and root of the tooth, the gap between root of the tooth and alveolar bone is the periodontal membrane tissue.
3) scan and rebuild oral surfaces: because the model by the CT image reconstruction includes only sclerous tissues, be tooth and skeleton, and the CT image has fault in enlargement to tooth.Therefore in order to obtain gingival surface data and accurate tooth, utilize a mouthful interscan instrument scan patients oral cavity, obtaining the oral surfaces data preserves with the STL form, then utilize reverse reconstruction software such as Geomagic to process scan-data, reconstruct the threedimensional model of oral surfaces, this model is overlapped with the model of rebuilding based on CT, obtain comprising the composite model of tooth, alveolar bone and gingival surface.
4) on composite model, according to patient's tooth misalignment, work up the step of Tooth Movement, and discharge the target denture after treatment, work out the orthodontic treatment scheme.According to the contrast of target denture and original denture, calculate and comprise tooth translational movement, amount of spin, required force and moment and ratio thereof, the afterburning key parameters such as step rescued.
5) force and moment required according to Tooth Movement, by the thermodynamical model of SMP material, calculate the shape and size parameter of each section SMP force application mechanism, and then design application of force cell geometry, obtains its threedimensional model.
6) take the required force and moment of Tooth Movement is parameter, utilizes three-dimensional Static Calculation formula, calculates retain strength required on every tooth, and then obtains on the fixing unit size with the crown surfaces fitting part.Then according to the threedimensional model of every tooth, take its surface is basis, the basic configuration of the method generation holding structure of thicken by curved surface.Because every dental surface all has complicated curve form, therefore can realize self poisoning by laminating, and without designing in addition the guide plate of indirectly pasting.
7) space closure after as exodontia according to some special movements of tooth, design special adnexa such as song.
8) the seamless contact of overlap joint formation between the 3-D geometric model of adjacent application of force unit, fixing unit and adnexa in twos, the design hasp increases connection power between faying surface simultaneously, obtain the overall structure of integral type appliance, the geometric model number that this overall structure comprises is the summation of application of force unit number and fixing unit number and adnexa number, and each geometric model is preserved with the STL data format.
9) the STL data of all geometric models of integral type appliance are input in the control computer of Connex350 type of 3 D Printer such as Objet company, with the one-time formed 3 D stereo printing technique of multiple material, make, offer the clinical use of doctor.During printing, locus and original design being consistent of each geometric model of integral type in rescuing, can not change, constant with mutual alignment relation after guaranteeing to print.Because adjacent model in twos in all geometric models of integral type appliance is seamless overlap joint, increased simultaneously hasp structure, therefore print the entity of latter two material natural affixed and by hasp, strengthen connection, the integral body of formation integral type appliance.Wherein the material of application of force unit and adnexa is the SMP material, can adopt and be proved polyurethane (Polyurethane, the PU) material with shape memory function and good biological blending, and the fixing unit adopts high-intensity macromolecular material.
10) during clinical use, the integral type appliance is heated to phase transition temperature (50 ° of C left and right) and makes application of force unit become soft, be adhesively fixed on easily dental surface.Under the oral temperature environment, softening inversion occurs in soft phase in application of force unit gradually, returns to one-time formed original shape, and continual and steady orthodontic therapy power is provided.
2. the method for claim 1, it is characterized in that: the described phase transition temperature of step 10 is 50 ° of C.
3. according to the described method of claim 1 or 2, make the integral type fixed appliance obtained for one kind, it is characterized in that comprising: application of force unit: made by the SMP material, with personalized correction scheme, be complementary and have personalized three dimensions geometry, for providing Tooth Movement required complex three-dimensional force and moment, with motions such as the translation that realizes tooth, control root, rotation, torsions; The fixing unit: by macromolecular material, made, the crown surfaces laminating with every tooth, have personalized shape, and the retain strength of appliance in the process of rescuing is provided.Because tooth surface has complicated curved-surface structure, can be by fixing unit and tooth surface are fitted tightly and realize self poisoning, and without the positioning guide plate that is designed in addition indirect stickup; Adnexa: be used to song or the drag hook of force and moment that specific position and specific (special) requirements are provided; Described application of force unit, fixing unit, adnexa are by the seamless contact of geometric model and utilize hasp structure to increase connection power, realize the one-shot forming manufacture with 3 D-printing.
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