CN106821550B - Split type jaw defect prosthesis preparation method - Google Patents
Split type jaw defect prosthesis preparation method Download PDFInfo
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- CN106821550B CN106821550B CN201611206152.2A CN201611206152A CN106821550B CN 106821550 B CN106821550 B CN 106821550B CN 201611206152 A CN201611206152 A CN 201611206152A CN 106821550 B CN106821550 B CN 106821550B
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- disabler
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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
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Chemical & Material Sciences (AREA)
- Manufacturing & Machinery (AREA)
- Materials Engineering (AREA)
- Transplantation (AREA)
- Life Sciences & Earth Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
- Dental Prosthetics (AREA)
Abstract
The present invention provides a kind of split type jaw defect prosthesis preparation methods, by establishing a complete counterfeit recovering technology preparation route of digital jaw defect, are almost suitble to the patient of all jaw defects.Therapeutic process greatly simplifies, and considerably reduces manual processing 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 for improving prosthesis making, improve disabler sealing effect, shorten the production cycle, very have practical value.
Description
Technical field
The invention belongs to medical domains, and in particular to a kind of split type jaw defect prosthesis preparation method.
Background technology
Patient's maxilla local defect, mouth and nose chamber is caused to communicate due to oral and maxillofacial tumor, wound, deformity etc.,
The obstacle of many physiological functions, such as the leakage of mouth and nose chamber, masticatory function obstacle when high nasal sound, diet can be brought to patient.Moreover, jaw
Bone defect may make patient generate serious mental handicape with facial deformity.Faced with this situation, traditional restorative procedure
It is to obtain complete plaster cast by producing the stamp of defect area, then rely on hand-made one of technician using disabler as base
The integrated prosthesis artificial tooth of plinth, to repair the defect hard and soft tissue of patient, separation mouth nasal cavity restores a part of physiology of patient
Function.Since Maxillofacial defect chamber is deeper, patient has the problems such as limitation of mouth opening and moulage property, doctor to be often difficult to take more
Complete stamp is obtained, produces the discomfort that stamp will also result in patient repeatedly.Meanwhile traditional production method requires very technician
Height, often results in prosthesis maintenance force difference, and disabler closure is insufficient.Many document reports utilize 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 technologies such as CAD and manufacture, reverse-engineering, 3 D-printing are gradually applied
In the counterfeit multiple therapy field of oral-maxillofacial defects, become one of the hot spot of Clinical Science of Stomatology research.There is scholar to utilize spiral
CT reconstruction patients maxillofacial defeet chambers are simulated patient's defect form using three-dimensional printing technology, then are carried out in vitro with prosthesis materials
Filling processing, forms disabler structure;There is scholar using spiral CT three-dimensional rebuilding and reverse Engineering Technology design disabler, is used in combination
3 D-printing obtains resin material disabler, and is that patient makes prosthesis as a stamp part.These researchs are in certain journey
The counterfeit difficulty treated again of jaw defect is reduced on degree, obtains beneficial clinical effectiveness.But the research of this respect is still at present
There is the deficiencies 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, volume is big, and patient is inconvenient for use.Though thering is split type prosthesis to design, obstruction
Device and removable partial denture combination effect are poor, it is difficult to obtain unification functionally;3. there are still defects for disabler sealing effect.
Invention content
In order to overcome the above-mentioned deficiencies of the prior art, the present invention provides a kind of high degree of automation, repairing effect is good
Split type jaw defect prosthesis preparation method.
The split type jaw defect prosthesis preparation method of the present invention, includes the following steps:
A kind of split type jaw defect prosthesis preparation method, which is characterized in that include the following steps:
Step (1):The three-dimensional data that patient's jawbone hard and soft tissue is obtained using CT scan method passes through three-dimensional data pine
It relaxes, cutting and edge suture obtain three-dimensional digital model;
Step (2):Utilize the three-dimensional digital model design disabler top edge line and lower edge line, the top edge
Line is located at nasal cavity side, and the lower edge line is located at buccal side, ensures that nasal cavity side disabler marginal position does not influence patient respiratory work(
Energy;And it measures 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 the soft tissue data, the axial plane form retains to fall
Recessed area provides enough retentions for prosthesis, and obstruction is built using the topographic morphologies of patient's buccal side residue soft tissue
The bottom form of device to be 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 obtain disabler Primary Speciation;Ensure disabler side wall, bottom wall thickness 4-5mm, so that silastic material is had and close
Suitable thickness and elasticity.
Step (4):It is mechanical by disabler Primary Speciation described in forward engineering software building and removable partial denture
Volume morphing is connected, and designs outer profile, by the disabler Primary Speciation and described local justice is plucked using Boolean calculation
Tooth mechanically connects volume morphing 3-D graphic and is merged, and forms the final three-dimensional configuration of disabler;
Step (5):According to the cloudy shape type box body structure of the final three-dimensional configuration design personalized of the disabler, with institute
Main die joint is designed based on the lower edge line of the final three-dimensional configuration for the disabler stated, according to final the three of the disabler
The secondary die joint of undercut size, Position Design at least two of the lower mode cavity of form is tieed up, while designing cone column positioning device, and is set
The first mo(u)ld top half box cover structure and the second mo(u)ld top half box cover structure are counted out, the first mo(u)ld top half box cover structure includes connection volume morphing, institute
It states the second mo(u)ld top half box cover structure and does not include connection volume morphing, obtain personalized female box overall structure;
Step (6):Personalized female box is obtained according to the female box overall structure using 3 D-printing;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 load twice;
Step (8):The disabler and the connector clinic are tried on, and defect of dentition is taken in patient-worn
Secondary method stamp, and removable partial denture making is carried out according to the secondary method stamp, and complete artificial tooth and company in vitro
The bonding of junctor finally obtains split type jaw defect prosthesis.
Preferably, in the step (1), three dimensions of patient's jawbone hard and soft tissue are obtained using CT scan method
According in the placement cotton roll isolation of patient's upper jaw vestibular ditch in scanning.Soft or hard group can be more clearly reconstructed around defect chamber in this way
The three-dimensional configuration knitted.
Preferably, the lower edge line of the final three-dimensional configuration of disabler described in the step (5) is lacked positioned at jawbone
It damages on the outside of accent between 4-5mm.When making removable partial denture impression taking, moulage can be by disabler edge pressure in this way
Compel to normal mucosa surface, enhances mouth and nose chamber isolation effect.
Preferably, it is characterized in that, removable partial denture described in the step (4) mechanically connects volume morphing and described
Outer profile size is changed by size scaling.To adapt to different jaw defect situations.
Preferably, it is characterized in that, the 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 box cover,
Fully the disabler is obtained after solidification;
Step (7.2) removes the first mo(u)ld top half box cover, the connector sky intracavitary administration dentistry self-curing resin material on disabler
Material, lid the second mo(u)ld top half box cover fully obtain the connector after solidification.It so not only makes easier, but also makes obstruction
Device and connector are more closely connected, increase retention effect
Preferably, it is characterized in that, in the step (8), the preliminary impression material of secondary method stamp is silicon rubber, is printed eventually
Mold materials is alginates.
The beneficial effects of the invention are as follows:
A complete counterfeit recovering technology route of digital jaw defect is established, the patient of all jaw defects is almost suitble to.
Therapeutic process greatly simplifies, and considerably reduces manual processing 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 for improving prosthesis making, improve resistance
Device sealing effect is filled in, the production cycle is shortened.
The counterfeit process treated again can be demonstrated on computers, simulates prosthesis extending range and size, predict disabler
Form and final repairing effect, reduce complication generation, promote the exchange between doctors and patients, make entire therapeutic process
It is vivid and specific.
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 implementation mode
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 cotton roll to separate buccal mucosa in patient's upper jaw vestibular ditch area, patient's tongue body is advised not contact palate and micro- gaping
CT scan is carried out under state, gathered data carries out three respectively by the setting of different grayscale threshold values 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 processing
Formula).Soft patient tissues' three-dimensional data is split, extraction for the maxillary dentition of disabler three dimensional design, upper jaw vestibular,
The relevant portions data such as palate, defect chamber, nasal cavity.
2) disabler lower edges line is designed according to the three-dimensional data of 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, does not influence breathing and the function of pronunciation of patient;Lower edge line is located at buccal side
On normal mucosa, the anatomic forms such as lip, buccal frenum are avoided, and ensure, apart from the uniform 4-5mm in defect edge, it is poor to form disabler
Edge configuration, in favor of sealing effect.
3) the axial plane form for utilizing the soft tissue data structure disabler between lower edges line, retains certain undercut area
Enough retentions are provided for disabler.The bottom shape of disabler is built using the topographic morphologies of patient's buccal side residue soft tissue
State, and the normal soft tissue form of oral mucosa is smooth continuously connects, and deviates (Offset) 0.5mm to buccal side, makes disabler
Edge forms non-uniform thickness.Principle is scaled by equal proportion and designs the hollow external morphology of disabler, is adjusted and is protected by three dimensions
Disabler side wall, bottom wall thickness 4-5mm are demonstrate,proved, ensures that silastic material has suitable thickness and elasticity.Finally by disabler axis
Face, bottom and internal data carry out edge suture, form the whole 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 wrap up the silicon rubber of connector
Glue material has the thickness of 3-5mm.Principle is scaled by figure equal proportion in three-dimensional software and adjusts size, and is 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, prevent stress concentration herein and fracture.
5) according to the cloudy shape flask of the three-dimensional graphics design of disabler personalization 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 connects disabler lower edge line and flask boundary line by curved surface bridging technology, forms 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, assembled convenient for flask.According to the undercut of lower mode cavity
Several secondary die joints of size, Position Design make silicon rubber disabler smoothly demould in order to open box operation.Between secondary die joint
Design design cone column positioning device.The break-through duct that finally design diameter is 5mm on flask inner surface, during making dress glue
Extra silastic material can smoothly overflow.Two mo(u)ld top half box covers are constructed in flask design, one includes connection volume morphing,
One does not include connection volume morphing, is respectively used to make disabler and connector.
6) various pieces of designed cloudy shape flask three-dimensional configuration are arranged into uniform array in a coordinate system, with three-dimensional
Printer makes the cloudy shape flask of personalization of transparent resin material, and carries out external assembly test, keeps the various pieces of flask accurate
Really critically it is combined together to form an overall structure.
7) it utilizes to load twice and makes disabler and connector successively.Counterfeit multiplexing silastic material first is injected in lower mode cavity,
Lid includes the mo(u)ld top half box cover of connection volume morphing, fully obtains silicon rubber disabler after solidification.Mo(u)ld top half box cover is removed again, in disabler
On connector sky intracavitary administration dentistry self-curing resin material, lid without connection volume morphing mo(u)ld top half box cover, fully solidification after obtain
Obtain the connector of resin material.
8) disabler and connector clinic are tried on, and the secondary method stamp of defect of dentition, preliminary impression material are taken in patient-worn
Material is silicon rubber, and final impression material is alginates.Conventional removable partial denture makes, and completes the viscous of artificial tooth and connector 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 complete counterfeit recovering technology route of digital jaw defect is established, the patient of all jaw defects is almost suitble to.
Therapeutic process greatly simplifies, and considerably reduces manual processing 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 for improving prosthesis making, improve resistance
Device sealing effect is filled in, the production cycle is shortened.
The counterfeit process treated again can be demonstrated on computers, simulates prosthesis extending range and size, predict disabler
Form and final repairing effect, reduce complication generation, promote the exchange between doctors and patients, make entire therapeutic process
It is vivid and specific.And it is built on the basis of advanced digitizing technique for main innovative point with removable partial denture combination
A kind of counterfeit multiple therapeutic modality of new jaw defect is found, and forms a rational technology path.
Specific embodiments of the present invention are described in detail above, but it is intended only as example, the present invention is simultaneously unlimited
It is formed on particular embodiments described above.To those skilled in the art, it is any to the equivalent modifications that carry out of the present invention and
It substitutes also all among scope of the invention.Therefore, without departing from the spirit and scope of the invention made by impartial conversion and
Modification, all should be contained within the scope of the invention.
Claims (5)
1. a kind of split type jaw defect prosthesis preparation method, which is characterized in that include the following steps:
Step (1):The three-dimensional data that patient's jawbone hard and soft tissue is obtained using CT scan method, loose by three-dimensional data,
It cuts and edge suture obtains three-dimensional digital model;
Step (2):Utilize the three-dimensional digital model design disabler top edge line and lower edge line, top edge line position
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
Organization data and the topographic morphologies for building patient's buccal side residue soft tissue;
Step (3):The axial plane form of disabler is built using the soft tissue data, the axial plane form retains undercut
Area, the bottom form of disabler is built using the topographic morphologies of patient's buccal side residue soft tissue, and passes through equal proportion
The hollow external morphology of scaling design disabler, integration obtain disabler Primary Speciation;
Step (4):It is mechanically connect with removable partial denture by the disabler Primary Speciation described in forward engineering software building
Volume morphing, and design outer profile, using Boolean calculation by the disabler Primary Speciation and the 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):According to the cloudy shape type box body structure of the final three-dimensional configuration design personalized of the 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 the disabler
The secondary die joint of undercut size, Position Design at least two of the lower mode cavity of state, while cone column positioning device is designed, and design
First mo(u)ld top half box cover structure and the second mo(u)ld top half box cover structure, the first mo(u)ld top half box cover structure include connection volume morphing, and described the
Two mo(u)ld top half box cover structures do not include connection volume morphing, obtain personalized female box overall structure;
Step (6):Personalized female box is obtained according to the female box overall structure using 3 D-printing;
Step (7):Disabler and connector are made using load twice;
Step (8):The disabler and the connector clinic are tried on, and take the two of defect of dentition in patient-worn
Secondary method stamp, and removable partial denture making is carried out according to the secondary method stamp, and artificial tooth and connector are completed in vitro
Bonding, finally obtain split type jaw defect prosthesis;In the step (1), patient is obtained using CT scan method
The three-dimensional data of jawbone hard and soft tissue places cotton roll isolation in scanning in patient's upper jaw vestibular ditch.
2. split type jaw defect prosthesis preparation method according to claim 1, which is characterized in that the 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.
3. split type jaw defect prosthesis preparation method according to claim 1, which is characterized in that the step (4)
Described in removable partial denture mechanically connect volume morphing and the outer profile changes size by size scaling.
4. split type jaw defect prosthesis preparation method according to claim 1, which is characterized in that the step
(7) 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 box cover, fully
The disabler is obtained after solidification;
Step (7.2) removes the first mo(u)ld top half box cover, the connector sky intracavitary administration dentistry self-curing resin material on disabler, lid
Second mo(u)ld top half box cover fully obtains the connector after solidification.
5. split type jaw defect prosthesis preparation method according to claim 1, which is characterized in that the step
(8) in, the preliminary impression material of secondary method stamp is silicon rubber, and final impression material is alginates.
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CN106821550B true CN106821550B (en) | 2018-08-14 |
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Families Citing this family (4)
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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 |
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 |
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 |
CN113456282B (en) * | 2021-05-07 | 2023-04-07 | 燕飞 | Method for immediately manufacturing plug treatment device after jaw cyst windowing and pressure reducing operation |
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US5163841A (en) * | 1989-02-05 | 1992-11-17 | Josephus Schreinemakers | Correcting articulation defect in dentate human jaw |
CN101292914A (en) * | 2008-06-12 | 2008-10-29 | 上海交通大学 | Symmetrical character maxillofacial prosthesis producing method based on three-dimensional visual sensation measurement |
CN102663818A (en) * | 2012-04-16 | 2012-09-12 | 上海交通大学医学院附属第九人民医院 | Method and device for establishing three-dimensional craniomaxillofacial morphology model |
CN102920534A (en) * | 2012-11-07 | 2013-02-13 | 上海交通大学医学院附属第九人民医院 | Production method of personalized obturator |
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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US5163841A (en) * | 1989-02-05 | 1992-11-17 | Josephus Schreinemakers | Correcting articulation defect in dentate human jaw |
CN101292914A (en) * | 2008-06-12 | 2008-10-29 | 上海交通大学 | Symmetrical character maxillofacial prosthesis producing method based on three-dimensional visual sensation measurement |
CN102663818A (en) * | 2012-04-16 | 2012-09-12 | 上海交通大学医学院附属第九人民医院 | Method and device for establishing three-dimensional craniomaxillofacial morphology model |
CN102920534A (en) * | 2012-11-07 | 2013-02-13 | 上海交通大学医学院附属第九人民医院 | Production method of personalized obturator |
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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