CN106725946A - The method for prefabricating and application method of a kind of Dental implant surgery provisional prosthesis - Google Patents
The method for prefabricating and application method of a kind of Dental implant surgery provisional prosthesis Download PDFInfo
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- CN106725946A CN106725946A CN201611254389.8A CN201611254389A CN106725946A CN 106725946 A CN106725946 A CN 106725946A CN 201611254389 A CN201611254389 A CN 201611254389A CN 106725946 A CN106725946 A CN 106725946A
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- provisional prosthesis
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- provisional
- tooth
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- 238000000034 method Methods 0.000 title claims abstract description 35
- 239000004053 dental implant Substances 0.000 title claims abstract description 23
- 238000001356 surgical procedure Methods 0.000 title claims abstract description 21
- 238000013461 design Methods 0.000 claims abstract description 24
- 239000011505 plaster Substances 0.000 claims abstract description 17
- 229910052602 gypsum Inorganic materials 0.000 claims abstract description 12
- 239000010440 gypsum Substances 0.000 claims abstract description 12
- 238000002513 implantation Methods 0.000 claims abstract description 8
- 210000000988 bone and bone Anatomy 0.000 claims description 51
- 210000000214 mouth Anatomy 0.000 claims description 9
- 230000008859 change Effects 0.000 claims description 8
- 238000007408 cone-beam computed tomography Methods 0.000 claims description 8
- 210000003456 pulmonary alveoli Anatomy 0.000 claims description 6
- 230000001010 compromised effect Effects 0.000 claims description 4
- 239000000463 material Substances 0.000 claims description 4
- 230000004048 modification Effects 0.000 claims description 4
- 238000012986 modification Methods 0.000 claims description 4
- 229910052500 inorganic mineral Inorganic materials 0.000 claims description 3
- 239000011707 mineral Substances 0.000 claims description 3
- 239000011664 nicotinic acid Substances 0.000 claims description 3
- 230000003239 periodontal effect Effects 0.000 claims description 3
- 230000009467 reduction Effects 0.000 claims description 3
- 238000004088 simulation Methods 0.000 claims description 3
- 238000005299 abrasion Methods 0.000 claims 1
- 230000006378 damage Effects 0.000 description 5
- 238000005516 engineering process Methods 0.000 description 4
- 230000035876 healing Effects 0.000 description 4
- 230000008439 repair process Effects 0.000 description 4
- 241000337665 Phatnoma Species 0.000 description 3
- RVTZCBVAJQQJTK-UHFFFAOYSA-N oxygen(2-);zirconium(4+) Chemical compound [O-2].[O-2].[Zr+4] RVTZCBVAJQQJTK-UHFFFAOYSA-N 0.000 description 3
- 230000002980 postoperative effect Effects 0.000 description 3
- 238000011084 recovery Methods 0.000 description 3
- 229910001928 zirconium oxide Inorganic materials 0.000 description 3
- 210000000981 epithelium Anatomy 0.000 description 2
- 230000035479 physiological effects, processes and functions Effects 0.000 description 2
- 229910052573 porcelain Inorganic materials 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 206010043183 Teething Diseases 0.000 description 1
- 239000011365 complex material Substances 0.000 description 1
- 239000002421 finishing Substances 0.000 description 1
- 201000005562 gingival recession Diseases 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 230000006698 induction Effects 0.000 description 1
- 238000009940 knitting Methods 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000010882 preoperative diagnosis Methods 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 238000002407 reforming Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000036346 tooth eruption Effects 0.000 description 1
- 238000012800 visualization Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C13/00—Dental prostheses; Making same
- A61C13/0003—Making bridge-work, inlays, implants or the like
- A61C13/0004—Computer-assisted sizing or machining of dental prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C13/00—Dental prostheses; Making same
- A61C13/0001—In-situ dentures; Trial or temporary dentures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
- A61C8/005—Connecting devices for joining an upper structure with an implant member, e.g. spacers
Landscapes
- Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Epidemiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dental Preparations (AREA)
- Dental Prosthetics (AREA)
Abstract
A kind of method for prefabricating of Dental implant surgery provisional prosthesis, make gypsum work mould type, obtain patient's jawbone CT data, registering plaster cast and jawbone CT data, design provisional prosthesis, it is determined that the position of plantation and planting body specification, make the plantation guide plate used during Dental implant surgery, the accurate location of control planting body implantation.Using the method for provisional prosthesis, using the method for prefabricating of Dental implant surgery provisional prosthesis, the form of final dummy and provisional prosthesis to wear gum form completely the same.Using the method for provisional prosthesis, base station of the provisional prosthesis as final dummy is changed in intraoral direct mill.The present invention has without planting modulus when the surface of a wound is opened, and can at utmost protect the advantage of gum.
Description
Technical field
Invention is related to department of stomatology tooth-implanting medical instruments field, and particularly one kind makes provisional prosthesis before tooth implantation
The method that induction gum form reduces gingival lesions.
Background technology
CAD/CAM technologies are continued to develop, through in whole Dental implantion therapeutic process, including preoperative diagnosis
Design, Guan Qiao during reparation makes;The technology has quick, visualization, the characteristics of accurate.Dental implantion technical know-how is in the past few years sent out
Exhibition is rapid, from initial knitting can not be interfered to can a range of planting body fine motion do not influence the bone of planting body to heal
Close, from gum under heal into wear gum healing develop into immediate implant Immediate prosthesis in recent years.
Reparation after conventional scheme plantation generally requires the making for carrying out dummy again after the completion of synosteosis, it is necessary to 5-
6 physician office visits.Including CT, operation, postoperative further consultation, secondary operation, modulus type makes dummy.In the process,
Gum needs, by two to three finishings, have damage to gum.Especially need to carry out temporary crown in aesthstic area to mould tooth
The treatment procedure of gum, can repeatedly be plucked and wear provisional prosthesis even base station, and the destruction that can be caused repeatedly is sticked to gingival epithelium.Have
Scholar completes the scheme of the making of provisional prosthesis using installing base station in art, no longer needs to pluck when last reparation
Base station is worn, this avoid the epithelium attachment on avulsion base station, the damage of gum is caused so that gingival recession, but still needs are plucked
Modification temporary crown is worn, also there is disturbance to gum:Learn to use and working model is made in art, pre-production CAD/CAM's
Dummy, when the second phase gum is opened, is directly connected to permanent base station, and permanent dummy, simplifies program.This scheme
Need to carry out the second stage of operation of planting body, increased the wound of operation.There is scholar using preoperative making guide plate positioning planting body, art
Middle to install permanent base station, modulus is preced with zirconium oxide bottom hat, postoperative bottom, makes provisional prosthesis, but postoperative gingival edge change in location
Original bottom hat is just uncoordinated afterwards, especially premolar teeth and labial teeth aesthetics region.
The content of the invention
Provisional prosthesis is planted it is an object of the invention to provide a kind of making for being capable of simple and fast, gum can be induced
Acquisition meets the form of physiological requirement, reduces gum wound and provisional prosthesis can be after intraoral adjusting and reforming directly as permanent
The method for prefabricating of the Dental implant surgery provisional prosthesis of dummy base station.
A kind of method for prefabricating of Dental implant surgery provisional prosthesis, comprises the following steps:
1), take the former of the preoperative upper jaw oral cavity denture of patient and the former of lower jaw oral cavity denture;The occlusion of lower tooth is closed on record
System;The feminine gender of patient oral cavity denture is turned over and irrigates into plaster cast;By upper jaw plaster cast and lower jaw plaster cast according to occlusion
Relation aligns to form gypsum work mould type;Working model represents the true alignment between the intraoral tooth of patient, gum;
Patient CBCT, obtains the jawbone CT data of patient;
2), scanning gypsum work mould type, obtain digitlization gypsum work mould type, will digitlization plaster cast enter with jawbone CT data
Row registration, forms digital operation model after registration(Such as the tooth for digitizing gypsum work mould type is matched somebody with somebody with the tooth in CT data
It is accurate);
3), on digital operation model after registration, the gum form Design according to upper lower tooth occluding relation and adjacent teeth is repaiied temporarily
Complex, provisional prosthesis is used to mould the gum form in future, and the design requirement of provisional prosthesis is:Gum form is met with neighbour
Tooth is coordinated and gingival margin meets biological width to the distance between alveolar bone, and the gum form of wearing of provisional prosthesis is the tooth
The gum nest form of position natural teeth;
4), gum form worn according to provisional prosthesis, the biological width design between gingival margin form and gum alveolar bone
The form of planting body absconsio, it is determined that the position of plantation and planting body specification;
5), the plantation guide plate that uses, the accurate location of control planting body implantation when making Dental implant surgery.
Further, step 1)In, the natural teeth that CBCT collection growing areas and growing area close on is used as plantation guide plate design
CT data.CBCT collections are relations between alveolar bone and tooth, that is, sclerous tissues relation;Plaster cast expression is outer
Shape profile, two model denss in dente are total, so can just be built after the tooth matching of plaster cast and jawbone CT data is overlapped
Vertical tooth, gum these external and spatial relations between inherent alveolar bone.
Further, step 3)In, the method for designing provisional prosthesis is:Teething is separated on digital operation model after registration
The position form of gum and alveolar bone;The alveolus Bones morphology of growing area is digitized according to adjacent healthy periodontal alveolus Bones morphology
Simulation gradual change is bionical, and Bionic Design goes out the form of crown margin, and the form of crown margin determines the form of following gum;Foundation is faced
When dummy tooth body structure outline and go out gum form;Growing area alveolar bone and virtual provisional prosthesis are matched,
Artificial tooth gingival edge meets biological width to the distance of alveolar bone.
Further, step 4)In, when designing the form of planting body absconsio, judge whether the bone amount of alveolar bone is sufficient, in bone
Absconsio form is planted in amendment as needed in the case of amount abundance;According to the shape of adjacent teeth in the case of the Bone mineral change of alveolar bone
The design that state and gingival margin form are compromised.The form that dummy goes out gum also will be the form for meeting physiological requirement, significantly
Go out gum form better than traditional circle, plantation absconsio form is by designer according to adjacent teeth and offside Homonym teeth and agomphosis position
The intrinsic physiology rule design of tooth body neck form.
A kind of method of use provisional prosthesis:Using the method for prefabricating of Dental implant surgery provisional prosthesis, finally repair
The form of complex is completely the same with the form of provisional prosthesis.Therefore, the gum profile of wearing of final dummy is matched completely.Gum
After healing, provisional prosthesis is removed, provisional prosthesis is replaced with final dummy, the form of gum is not changed.
Personalized provisional prosthesis height reduction can be adjust and reform into individual character in the case where dental implants stability is inadequate
The cover screw fixture cover of change, prevent unstable planting body because by be engaged influenceed loosen.Planting body stability(ISQ)During less than 70,
Then dental implants stability is not enough to support provisional prosthesis.So it is accomplished by using above-mentioned recovery scenario.Certain patient needs more
It is also required to when repair complex material using above-mentioned recovery scenario.
A kind of method of use provisional prosthesis:Provisional prosthesis is made of high-strength material(Such as zirconium oxide, full porcelain,
Or metal etc.), after the completion of tooth implantation is completed, gum heals, provisional prosthesis is changed as final dummy in intraoral direct mill
Base station, then by final dummy be bonded in provisional prosthesis mill change after base station on, complete repair.So face without dismounting
When dummy, there is no secondary damage to gum.Final dummy can be using the final dummy of prior art.
A kind of method of use provisional prosthesis:Make final using the method for prefabricating of Dental implant surgery provisional prosthesis
Dummy, the gum form of final dummy is completely the same with the gum form of provisional prosthesis.It is not enough in planting body stability
To support during provisional prosthesis, reduction provisional prosthesis is adjust and reform, provisional prosthesis modification is turned into personalized planting body healing
Cap.This method is applicable to remove the situation of provisional prosthesis.
The invention has the advantages that:The present invention is for realizing the step recovery scenario of tooth-implanting one(STF, start to final).
Before Dental implant surgery, according to the dummy that Digitization modelling is adapted to edentulous region alveolar bone and gum, planting body,
When Plant plane is designed, the design of dummy is taken into account, dummy is made in Dental implant surgery so as to avoid, without planting
The modulus when surface of a wound is opened is planted, gum can be at utmost protected.
Specific embodiment
Embodiment 1
A kind of preparation method of Dental implant surgery provisional prosthesis, comprises the following steps:
1), take the former of the preoperative upper jaw oral cavity denture of patient and the former of lower jaw oral cavity denture;The occlusion of lower tooth is closed on record
System;The feminine gender of patient oral cavity denture is turned over and irrigates into plaster cast;By upper jaw plaster cast and lower jaw plaster cast according to occlusion
Relation aligns to form gypsum work mould type;Working model represents the true alignment between the intraoral tooth of patient, gum;
Patient CBCT, obtains the jawbone CT data of patient;
2), scanning gypsum work mould type, obtain digitlization gypsum work mould type, will digitlization plaster cast enter with jawbone CT data
Row registration, forms digital operation model after registration(Such as the tooth for digitizing gypsum work mould type is matched somebody with somebody with the tooth in CT data
It is accurate);
3), on digital operation model after registration, the gum form Design according to upper lower tooth occluding relation and adjacent teeth is repaiied temporarily
Complex, provisional prosthesis is used to mould the gum form in future, and the design requirement of provisional prosthesis is:Gum form is met with neighbour
Tooth is coordinated and gingival margin meets biological width to the distance between alveolar bone, and the gum form of wearing of provisional prosthesis is the tooth
The gum nest form of position natural teeth;Biological width is defined according to textbook, usually 3mm or so.
4), gum form, the biological width between gingival margin form and gum alveolar bone worn according to provisional prosthesis
The form of planting body absconsio is designed, it is determined that the position of plantation and planting body specification;
5), the plantation guide plate that uses, the accurate location of control planting body implantation when making Dental implant surgery.
Step 1)In, the natural teeth that CBCT collection growing areas and growing area close on is used as plantation guide plate design CT data.
CBCT collections are relations between alveolar bone and tooth, that is, sclerous tissues relation;Plaster cast expression is appearance profile,
Two model denss in dente are total, so can just set up tooth, tooth after the tooth matching of plaster cast and jawbone CT data is overlapped
Spatial relation between gum these external and inherent alveolar bones.
Step 3)In, the method for designing provisional prosthesis is:After registration gum and tooth are isolated on digital operation model
The position form of groove bone;The alveolus Bones morphology of growing area is digitized simulation gradually according to adjacent healthy periodontal alveolus Bones morphology
Become bionical, Bionic Design goes out the form of crown margin, the form of crown margin determines the form of following gum;Set up interim reparation
The tooth body structure outline of body and go out gum form;Growing area alveolar bone and virtual provisional prosthesis are matched, dental prosthesis
Gum edge meets biological width to the distance of alveolar bone.
Step 4)In, when designing the form of planting body absconsio, judge whether the bone amount of alveolar bone is sufficient, sufficient in bone amount
In the case of as needed amendment plantation absconsio form;According to the form and gum of adjacent teeth in the case of the Bone mineral change of alveolar bone
The design that edge form is compromised.Since when provisional prosthesis is when adjacent teeth coordination and biological width is met, provisional prosthesis
The gum form that goes out just determine, the form for going out gum according to provisional prosthesis is so accomplished by derive the form of alveolar bone
With the position of planting body, if being accomplished by abrading part alveolar bone in the case that alveolar bone is more, that is, alveolar bone is higher
Top, so as to be matched with provisional prosthesis.If phatnoma bone height not enough if need interim reparation form Design carry out it is appropriate
Association, reduces gingival edge to coordinate phatnoma bone height or bone grafting to increase phatnoma bone height.It is exactly briefly provisional prosthesis
To coordinate and alveolar bone between, meet biological width.Even if being compromised according to the form and gingival margin form of adjacent teeth
Design, the form that dummy goes out gum also will be the form for meeting physiological requirement, is significantly better than traditional circle and goes out gum shape
State, plantation absconsio form is by designer according to adjacent teeth and offside Homonym teeth and the intrinsic physiology of agomphosis position tooth body neck form
Learn rule design.
Embodiment 2
A kind of method of use provisional prosthesis:Provisional prosthesis is made of high-strength material(Such as zirconium oxide, full porcelain, or gold
Category etc.), after the completion of tooth implantation is completed, gum heals, base of the provisional prosthesis as final dummy is changed in intraoral direct mill
, then be bonded in final dummy on the base station after provisional prosthesis mill changes by platform, completes to repair.So repaiied temporarily without dismounting
Complex, does not have secondary damage to gum.Final dummy can be using the final dummy of prior art.
Embodiment 3
A kind of method of use provisional prosthesis:Final reparation is made using the method for prefabricating of Dental implant surgery provisional prosthesis
Body, the gum form of final dummy is completely the same with the gum form of provisional prosthesis.
This method is applicable to remove the situation of provisional prosthesis.When planting body stable measurement value is less than 70 then
Think that the stability of planting body is not enough to support provisional prosthesis, provisional prosthesis modification is turned into personalized planting body healing
Cap.
Content described in this specification embodiment is only enumerating to the way of realization of present inventive concept, guarantor of the invention
Shield scope is not construed as being only limitted to the concrete form that embodiment is stated, protection scope of the present invention is also and in this area skill
Art personnel according to present inventive concept it is conceivable that equivalent technologies mean.
Claims (7)
1. a kind of method for prefabricating of Dental implant surgery provisional prosthesis, comprises the following steps:
1), take the former of the preoperative upper jaw oral cavity denture of patient and the former of lower jaw oral cavity denture;The occlusion of lower tooth is closed on record
System;The feminine gender of patient oral cavity denture is turned over and irrigates into plaster cast;By upper jaw plaster cast and lower jaw plaster cast according to occlusion
Relation aligns to form gypsum work mould type;Working model represents the true alignment between the intraoral tooth of patient, gum;
Patient CBCT, obtains the jawbone CT data of patient;
2), scanning gypsum work mould type, obtain digitlization gypsum work mould type, will digitlization plaster cast enter with jawbone CT data
Row registration, forms digital operation model after registration;
3), on digital operation model after registration, the gum form Design according to upper lower tooth occluding relation and adjacent teeth is repaiied temporarily
Complex, provisional prosthesis is used to mould the gum form in future, and the design requirement of provisional prosthesis is:Gum form is met with neighbour
Tooth is coordinated and gingival margin meets biological width to the distance between alveolar bone, and the gum form of wearing of provisional prosthesis is the tooth
The gum nest form of position natural teeth;
4), gum form worn according to provisional prosthesis, the biological width design between gingival margin form and gum alveolar bone
The form of planting body absconsio, it is determined that the position of plantation and planting body specification;
5), the plantation guide plate that uses, the accurate location of control planting body implantation when making Dental implant surgery.
2. the method for prefabricating of Dental implant surgery provisional prosthesis as claimed in claim 1, it is characterised in that:Step 1)In,
The natural teeth that CBCT collection growing areas and growing area close on is used as plantation guide plate design CT data.
3. the method for prefabricating of Dental implant surgery provisional prosthesis as claimed in claim 1 or 2, it is characterised in that:Step 3)
In, the method for designing provisional prosthesis is:The position form of gum and alveolar bone is isolated on digital operation model after registration;
The alveolus Bones morphology of growing area according to adjacent healthy periodontal alveolus Bones morphology be digitized simulation gradual change it is bionical, Bionic Design
Go out the form of crown margin, the form of crown margin determines the form of following gum;Set up the tooth body structure wheel of provisional prosthesis
It is wide and go out gum form;Growing area alveolar bone and virtual provisional prosthesis are matched, artificial tooth gingival edge to alveolar bone
Distance meet biological width.
4. the method for prefabricating of Dental implant surgery provisional prosthesis as claimed in claim 3, it is characterised in that:Step 4)In,
When designing the form of planting body absconsio, judge whether the bone amount of alveolar bone is sufficient, repaiied as needed in the case of bone amount abundance
Whole plantation absconsio form;What form and gingival margin form in the case of the Bone mineral change of alveolar bone according to adjacent teeth were compromised
Design.
5. a kind of method of use provisional prosthesis, it is characterised in that:Using Dental implant surgery as claimed in claim 1 with facing
When dummy method for prefabricating, the gum form of final dummy is completely the same with the gum form of provisional prosthesis.
6. the method for provisional prosthesis is used as claimed in claim 5, it is characterised in that:Branch is not enough in planting body stability
When holding provisional prosthesis, reduction provisional prosthesis is adjust and reform, provisional prosthesis modification is turned into personalized planting body cover screw fixture cover.
7. a kind of method of use provisional prosthesis, it is characterised in that:Provisional prosthesis uses tooth kind as claimed in claim 1
Operation is planted to be made with the method for prefabricating of provisional prosthesis, with high-strength material, after the completion of tooth implantation is completed, gum heals,
Intraoral direct mill changes base station of the provisional prosthesis as final dummy, and final dummy then is bonded in into provisional prosthesis mill
On the base station for making into, final reparation is completed, provisional prosthesis is using the material system that low elastic modulus, abrasion degree are higher than natural teeth
Into.
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CN109009511A (en) * | 2018-06-21 | 2018-12-18 | 四川大学 | A kind of three-dimensional analysis standby tooth guide plate production method and application method based on 3D printing |
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