CN106821550A - Split type jaw defect prosthesis preparation method - Google Patents
Split type jaw defect prosthesis preparation method Download PDFInfo
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- CN106821550A CN106821550A CN201611206152.2A CN201611206152A CN106821550A CN 106821550 A CN106821550 A CN 106821550A CN 201611206152 A CN201611206152 A CN 201611206152A CN 106821550 A CN106821550 A CN 106821550A
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- Prior art keywords
- disabler
- patient
- split type
- edge line
- dimensional
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y10/00—Processes of additive manufacturing
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2/2875—Skull or cranium
- A61F2002/2889—Maxillary, premaxillary or molar implants
Abstract
The invention provides a kind of split type jaw defect prosthesis preparation method, it is almost adapted to the patient of all jaw defects by setting up a counterfeit recovering technology syntheti c route of complete digital jaw defect.Therapeutic process is greatly simplified, and considerably reduces manual process operation, alleviates the pain of patient, by the removable partial denture modulus that complicated counterfeit multiple modulus process simplification is conventional defect of dentition.The precision and efficiency of prosthesis making are improve, disabler sealing effect is improved, the production cycle is shortened, very with practical value.
Description
Technical field
The invention belongs to medical domain, and in particular to a kind of split type jaw defect prosthesis preparation method.
Background technology
Because the reasons such as oral and maxillofacial tumor, wound, deformity cause patient's maxilla SOL, mouth and nose chamber to communicate,
The obstacle of many physiological functions can be brought to patient, the leakage of mouth and nose chamber, masticatory function obstacle when nasal sound such as high, diet.And, jaw
Cranial defect may make patient produce serious mental handicape with facial deformity.Faced with this situation, traditional restorative procedure
It is to obtain complete plaster cast by producing the die of defect area, then one is made by hand with disabler as base by technician
The integrated prosthesis artificial tooth of plinth, so as to repair the defect hard and soft tissue of patient, separates mouth and nose chamber, recovers a part of physiology of patient
Function.Because Maxillofacial defect chamber is deeper, the problems such as have limitation of mouth opening and moulage property patient, doctor is often difficult to take more
Die completely is obtained, the discomfort that die will also result in patient is produced repeatedly.Meanwhile, traditional preparation method is required very technician
Height, it is poor to often result in prosthesis retention, and disabler closure is not enough.Many document reports are using planting body auxiliary prosthesis
Maintenance and support, but many jaw defect patient experience radiotherapies, are likely to result in implants failure.
With the development of computer technology, digitizing technique has been increasingly being applied to examining for clinical medicine disease
Disconnected, planning and treatment.Nearly ten years, the new technology such as CAD and manufacture, reverse-engineering, 3 D-printing is progressively applied
In the counterfeit multiple therapy field of oral-maxillofacial defects, one of the focus as Clinical Science of Stomatology research.There is scholar to utilize spiral
CT reconstruction patients maxillofacial defeets chamber, simulates patient's defect form, then carried out in vitro with prosthesis materials using three-dimensional printing technology
Filling processing, forms disabler structure；There is scholar using spiral CT three-dimensional rebuilding and reverse Engineering Technology design disabler, be used in combination
3 D-printing obtains resin material disabler, and as a die part for patient makes prosthesis.These researchs are in certain journey
The difficulty of the counterfeit multiple treatment of jaw defect is reduced on degree, beneficial clinical effectiveness is obtained.But the research of current this respect is still
There is the deficiency of three aspects：1. Design of digital integrated level is relatively low, it is still desirable to a large amount of manual operationss, technique sensitive compared with
It is high；2. prosthesis is still based on unitary design, and volume is big, and patient uses inconvenience.Though there is split type prosthesis to design, obstruction
Device and removable partial denture combination effect are poor, it is difficult to obtain unification functionally；3. disabler sealing effect still suffers from defect.
The content of the invention
In order to overcome the above-mentioned deficiencies of the prior art, the invention provides a kind of high degree of automation, repairing effect is good
Split type jaw defect prosthesis preparation method.
Split type jaw defect prosthesis preparation method of the invention, comprises the following steps：
A kind of split type jaw defect prosthesis preparation method, it is characterised in that comprise the following steps：
Step (1)：The three-dimensional data of patient's jawbone hard and soft tissue is obtained using CT scan method, by three-dimensional data pine
Relax, cut and edge suture acquisition three-dimensional digital model；
Step (2)：Disabler top edge line and lower edge line, the top edge are designed using described three-dimensional digital model
Line is located at nasal cavity side, and the lower edge line is located at buccal side, it is ensured that nasal cavity side disabler marginal position does not influence patient respiratory work(
Energy；And measure the soft tissue data between the top edge line and the lower edge line and structure patient's buccal side residue is soft
The topographic morphologies of tissue；
Step (3)：The axial plane form of disabler is built using described soft tissue data, described axial plane form retains to fall
The recessed area retention enough for prosthesis is provided, obstruction is built using the topographic morphologies of described patient's buccal side residue soft tissue
The bottom form of device, it is continuous with remaining soft tissue the smooth of the edge, and scales the hollow interior of design disabler by equal proportion
Portion's form, integration obtains disabler Primary Speciation；Ensure disabler side wall, bottom wall thickness 4-5mm, there is silastic material and close
Suitable thickness and elasticity.
Step (4)：It is mechanical with removable partial denture by the disabler Primary Speciation described in forward engineering software building
Connection volume morphing, and designs outline, using Boolean calculation is by described disabler Primary Speciation and described plucks local justice
Tooth mechanically connects volume morphing 3-D graphic and is merged, and forms the final three-dimensional configuration of disabler；
Step (5)：The cloudy shape type box body structure of the final three-dimensional configuration design personalized according to described disabler, with institute
Main die joint is designed based on the lower edge line of the final three-dimensional configuration of the disabler stated, according to final the three of described disabler
Undercut size, the secondary die joint of Position Design at least two of the lower mode cavity of form are tieed up, while designing cone column positioner, and is set
The first mo(u)ld top half lid structure and the second mo(u)ld top half lid structure are counted out, the first mo(u)ld top half lid structure includes connection volume morphing, institute
The second mo(u)ld top half lid structure is stated not comprising connection volume morphing, personalized female box overall structure is obtained；
Step (6)：Female box overall structure using 3 D-printing according to obtains personalized female box；Cloudy shape flask
The three-dimensional configuration of overall structure various pieces is arranged into uniform array in a coordinate system.
Step (7)：Disabler and connector are made using loading twice；
Step (8)：Described disabler and described connector clinic are tried on, and defect of dentition is taken in patient-worn
Secondary method die, and removable partial denture making is carried out according to described secondary method die, and complete artificial tooth and company in vitro
The bonding of junctor, finally gives split type jaw defect prosthesis.
It is preferred that in described step (1), three dimensions of patient's jawbone hard and soft tissue are obtained using CT scan method
According in the placement lap isolation of patient's upper jaw vestibular ditch in scanning.So can more clearly reconstruct soft or hard group around defect chamber
The three-dimensional configuration knitted.
It is preferred that the lower edge line of the final three-dimensional configuration of disabler described in described step (5) lacks positioned at jawbone
On the outside of damage accent between 4-5mm.So when removable partial denture impression taking is made, moulage can be by disabler edge pressure
Compel to normal mucosa surface, enhancing mouth and nose chamber isolation effect.
It is preferred that characterized in that, removable partial denture described in the step (4) mechanically connects volume morphing and described
Outline size is changed by size scaling.To adapt to different jaw defect situations.
It is preferred that characterized in that, described step (7) is further comprising the steps of：
Step (7.1) injects counterfeit multiplexing silastic material in the lower mode cavity of personalized female box, covers the first mo(u)ld top half lid,
Fully described disabler is obtained after solidification；
Step (7.2) removes the first mo(u)ld top half lid, the connector sky intracavitary administration dentistry self-curing resin material on disabler
Material, described connector is obtained after lid the second mo(u)ld top half lid, fully solidification.So not only make easier, and make obstruction
Device and connector are more closely connected, increase retention effect
It is preferred that characterized in that, in described step (8), the preliminary impression material of secondary method die is silicon rubber, eventually print
Mold materials is alginates.
The beneficial effects of the invention are as follows：
A counterfeit recovering technology route of complete digital jaw defect is set up, is almost adapted to the patient of all jaw defects.
Therapeutic process is greatly simplified, and considerably reduces manual process operation, alleviates the pain of patient, by complicated counterfeit multiple modulus mistake
Journey is reduced to the removable partial denture modulus of conventional defect of dentition.The precision and efficiency of prosthesis making are improve, resistance is improved
Plug device sealing effect, shortens the production cycle.
The process of counterfeit multiple treatment can be on computers demonstrated, prosthesis extending range and size is simulated, disabler is predicted
Form and final repairing effect, reduce complication generation, promote the exchange between doctors and patients, make whole therapeutic process
Image and it is specific.
Brief description of the drawings：
Fig. 1 is the flow chart of the preparation process of the embodiment of the present invention.
Fig. 2 is connector structure chart between disabler and removable partial denture..
Specific embodiment
The present invention is further described with reference to specific embodiment, to more fully understand the present invention.
As shown in figure 1, the preparation flow of the embodiment of the present invention is as follows
1) add lap to separate buccal mucosa in patient's upper jaw vestibular ditch area, advise patient's tongue body to contact palate and micro- gaping
CT scan is carried out under state, gathered data is set by different GTG threshold values and carries out three respectively to soft patient tissues and bone tissue
Dimension is rebuild, by obtaining patient's upper jaw three-dimensional digital model (STL lattice after a cloud denoising, tri patch, surface smoothing treatment
Formula).Soft patient tissues' three-dimensional data is split, extract maxillary dentition for disabler three dimensional design, upper jaw vestibular,
The relevant portion data such as palate, defect chamber, nasal cavity.
2) the three-dimensional data design disabler lower edges line according to patient's defect chamber hard and soft tissue, top edge line is located at nose
Chamber side, avoids the anatomic forms such as concha, nasal septum, and breathing and the function of pronunciation of patient are not influenceed；Lower edge line is located at buccal side
On normal mucosa, the anatomic forms such as lip, buccal frenum are avoided, and ensured apart from the uniform 4-5mm in defect edge, formed disabler and belittle
Edge configuration, be beneficial to sealing effect.
3) the axial plane form of disabler is built using the soft tissue data between lower edges line, retains certain undercut area
For disabler provides enough retentions.The bottom shape of disabler is built using the topographic morphologies of patient's buccal side residue soft tissue
State, it is smooth with the normal soft tissue form of oral mucosa continuously to connect, and (Offset) 0.5mm is offset to buccal side, make disabler
Edge forms non-uniform thickness.The hollow external morphology of principle design disabler is scaled by equal proportion, is adjusted by three dimensions and protected
Card disabler side wall, bottom wall thickness 4-5mm, it is ensured that silastic material has suitable thickness and elasticity.Finally by disabler axle
Face, bottom and internal data carry out edge suture, form the overall three-dimensional configuration of disabler.
4) as shown in Fig. 2 passing through mechanical connector between forward engineering software building disabler and removable partial denture
Form and exterior contour, including removable partial denture junction 1 and disabler junction 2 so that the silicon rubber of parcel connector
Glue material has the thickness of 3-5mm.Principle is scaled by figure equal proportion in three-dimensional software and adjusts size, and be moved to disabler
Interior suitable position, does not influence respiratory passage unblocked.Disabler and connector 3-D graphic are melted using Boolean calculation (Boolean)
It is combined, and straight angle design is led at connector edge, prevents stress herein from concentrating and fractureing.
5) the personalized cloudy shape flask of the three-dimensional graphics design according to disabler is with secondary process.It is long that flask is defined as fillet
Cube form, makes its each surface exceed disabler maximum boundary 5mm.Main die joint is determined based on the lower edge line of disabler
Position, disabler lower edge line and flask boundary line are connected by curved surface bridging technology, form main die joint.Upper and lower flask it
Between design the retention system of box lid type, and retain the plus tolerance of edge 0.05mm, be easy to flask to assemble.According to the undercut of lower mode cavity
The some secondary die joints of size, Position Design, in order to open box operation, make the smooth demoulding of silicon rubber disabler.Between secondary die joint
Design design cone column positioner.The last intended diameter on flask inner surface is the break-through duct of 5mm, during making dress glue
Unnecessary silastic material can smoothly overflow.Two mo(u)ld top half lids are constructed in flask design, one includes connection volume morphing,
One, not comprising connection volume morphing, is respectively used to make disabler and connector.
6) various pieces of the cloudy shape flask three-dimensional configuration that will be designed are arranged into uniform array in a coordinate system, with three-dimensional
Printer makes personalization the moon shape flask of transparent resin material, and carries out external assembling test, makes the various pieces of flask accurate
Really critically it is combined together to form an overall structure.
7) utilize and load making disabler and connector successively twice.Counterfeit multiplexing silastic material first is injected in lower mode cavity,
Silicon rubber disabler is obtained after mo(u)ld top half lid of the lid comprising connection volume morphing, fully solidification.Mo(u)ld top half lid is removed again, in disabler
On connector sky intracavitary administration dentistry self-curing resin material, obtained after mo(u)ld top half lid of the lid without connection volume morphing, fully solidification
Obtain the connector of resin material.
8) disabler and connector clinic are tried on, and the secondary method die of defect of dentition, preliminary impression material are taken in patient-worn
Expect to be silicon rubber, final impression material is alginates.Conventional removable partial denture is made, and the viscous of artificial tooth and connector is completed in vitro
Knot, ultimately forms disabler and the split type reparation bulk-mode of removable partial denture.
The beneficial effects of the invention are as follows：
A counterfeit recovering technology route of complete digital jaw defect is set up, is almost adapted to the patient of all jaw defects.
Therapeutic process is greatly simplified, and considerably reduces manual process operation, alleviates the pain of patient, by complicated counterfeit multiple modulus mistake
Journey is reduced to the removable partial denture modulus of conventional defect of dentition.The precision and efficiency of prosthesis making are improve, resistance is improved
Plug device sealing effect, shortens the production cycle.
The process of counterfeit multiple treatment can be on computers demonstrated, prosthesis extending range and size is simulated, disabler is predicted
Form and final repairing effect, reduce complication generation, promote the exchange between doctors and patients, make whole therapeutic process
Image and it is specific.And it is main innovative point with removable partial denture combination, is built on the basis of advanced digitizing technique
A kind of counterfeit multiple therapeutic modality of new jaw defect is found, and forms a rational technology path.
Specific embodiment of the invention has been described in detail above, but it is intended only as example, and the present invention is not limited
It is formed on particular embodiments described above.To those skilled in the art, any equivalent modifications carried out to the present invention and
Replacement is also all among scope of the invention.Therefore, the impartial conversion made without departing from the spirit and scope of the invention and
Modification, all should be contained within the scope of the invention.
Claims (6)
1. a kind of split type jaw defect prosthesis preparation method, it is characterised in that comprise the following steps：
Step (1)：The three-dimensional data of patient's jawbone hard and soft tissue is obtained using CT scan method, relaxed by three-dimensional data,
Cut and edge suture obtains three-dimensional digital model；
Step (2)：Disabler top edge line and lower edge line, the top edge line position are designed using described three-dimensional digital model
In nasal cavity side, the lower edge line is located at buccal side, and measures soft group between the top edge line and the lower edge line
The topographic morphologies of organization data and structure patient buccal side residue soft tissue；
Step (3)：The axial plane form of disabler is built using described soft tissue data, described axial plane form retains undercut
Area, the bottom form of disabler is built using the topographic morphologies of described patient's buccal side residue soft tissue, and by equal proportion
The hollow external morphology of scaling design disabler, integration obtains disabler Primary Speciation；
Step (4)：Mechanically it is connected with removable partial denture by the disabler Primary Speciation described in forward engineering software building
Volume morphing, and design outline, using Boolean calculation by described disabler Primary Speciation and described removable partial denture machine
Tool formula connection volume morphing 3-D graphic is merged, and forms the final three-dimensional configuration of disabler；
Step (5)：The cloudy shape type box body structure of the final three-dimensional configuration design personalized according to described disabler, with described
Main die joint is designed based on the lower edge line of the final three-dimensional configuration of disabler, according to the final three-dimensional shaped of described disabler
The secondary die joint of the undercut size of the lower mode cavity of state, Position Design at least two, while designing cone column positioner, and designs
First mo(u)ld top half lid structure and the second mo(u)ld top half lid structure, the first mo(u)ld top half lid structure include connection volume morphing, described the
Two mo(u)ld top half lid structures obtain personalized female box overall structure not comprising connection volume morphing；
Step (6)：Female box overall structure using 3 D-printing according to obtains personalized female box；
Step (7)：Disabler and connector are made using loading twice；
Step (8)：Described disabler and described connector clinic are tried on, and the two of defect of dentition is taken in patient-worn
Secondary method die, and removable partial denture making is carried out according to described secondary method die, and artificial tooth and connector are completed in vitro
Bonding, finally give split type jaw defect prosthesis.
2. split type jaw defect prosthesis preparation method according to claim 1, it is characterised in that described step
(1) in, the three-dimensional data of patient's jawbone hard and soft tissue is obtained using CT scan method, is put in patient's upper jaw vestibular ditch in scanning
Put lap isolation.
3. split type jaw defect prosthesis preparation method according to claim 1, it is characterised in that described step
(5) the lower edge line of the final three-dimensional configuration of the disabler described in is located on the outside of jaw defect accent between 4-5mm.
4. split type jaw defect prosthesis preparation method according to claim 1, it is characterised in that the step (4)
Described in removable partial denture mechanically connect volume morphing and described outline changes size by size scaling.
5. split type jaw defect prosthesis preparation method according to claim 1, it is characterised in that described step
(7) it is further comprising the steps of：
Step (7.1) injects counterfeit multiplexing silastic material in the lower mode cavity of personalized female box, covers the first mo(u)ld top half lid, fully
Described disabler is obtained after solidification；
Step (7.2) removes the first mo(u)ld top half lid, the connector sky intracavitary administration dentistry self-curing resin material on disabler, lid
Described connector is obtained after second mo(u)ld top half lid, fully solidification.
6. split type jaw defect prosthesis preparation method according to claim 1, it is characterised in that described step
(8) in, the preliminary impression material of secondary method die is silicon rubber, and final impression material is alginates.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611206152.2A CN106821550B (en) | 2016-12-23 | 2016-12-23 | Split type jaw defect prosthesis preparation method |
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|---|---|---|---|
| CN201611206152.2A CN106821550B (en) | 2016-12-23 | 2016-12-23 | Split type jaw defect prosthesis preparation method |
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| CN106821550A true CN106821550A (en) | 2017-06-13 |
| CN106821550B CN106821550B (en) | 2018-08-14 |
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| CN201611206152.2A Active CN106821550B (en) | 2016-12-23 | 2016-12-23 | Split type jaw defect prosthesis preparation method |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108460827A (en) * | 2018-02-27 | 2018-08-28 | 上海交通大学医学院附属第九人民医院 | A method of based on multi-source data Design of digital and making disabler model |
| CN109124830A (en) * | 2018-06-22 | 2019-01-04 | 上海交通大学医学院附属第九人民医院 | A kind of prosthesis production method based on Design of digital and numerical control processing and fabricating |
| CN111513881A (en) * | 2020-05-09 | 2020-08-11 | 北京大学口腔医学院 | Method and system for manufacturing maxillary defect prosthesis |
| CN113456282A (en) * | 2021-05-07 | 2021-10-01 | 燕飞 | Method for immediately manufacturing plug treatment device after jaw cyst windowing and pressure reducing operation |
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| CN104881511A (en) * | 2015-04-08 | 2015-09-02 | 上海交通大学医学院附属第九人民医院 | Facial prosthesis three-dimensional data model, female mould box and prosthesis manufacturing method |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108460827A (en) * | 2018-02-27 | 2018-08-28 | 上海交通大学医学院附属第九人民医院 | A method of based on multi-source data Design of digital and making disabler model |
| CN108460827B (en) * | 2018-02-27 | 2022-06-14 | 上海交通大学医学院附属第九人民医院 | Method for digitally designing and manufacturing stopper model based on multi-source data |
| CN109124830A (en) * | 2018-06-22 | 2019-01-04 | 上海交通大学医学院附属第九人民医院 | A kind of prosthesis production method based on Design of digital and numerical control processing and fabricating |
| CN109124830B (en) * | 2018-06-22 | 2021-02-05 | 上海交通大学医学院附属第九人民医院 | Prosthesis manufacturing method based on digital design and numerical control machining manufacturing |
| CN111513881A (en) * | 2020-05-09 | 2020-08-11 | 北京大学口腔医学院 | Method and system for manufacturing maxillary defect prosthesis |
| CN111513881B (en) * | 2020-05-09 | 2021-10-15 | 北京大学口腔医学院 | Method and system for manufacturing maxillary defect prosthesis |
| CN113456282A (en) * | 2021-05-07 | 2021-10-01 | 燕飞 | Method for immediately manufacturing plug treatment device after jaw cyst windowing and pressure reducing operation |
Also Published As
| Publication number | Publication date |
|---|---|
| CN106821550B (en) | 2018-08-14 |
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