CN108670447B - Real-time navigation system and method in root canal - Google Patents
Real-time navigation system and method in root canal Download PDFInfo
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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Abstract
The invention discloses a real-time navigation system in a root canal, which comprises a three-dimensional data acquisition module; the device also comprises an electrophysiological feedback device arranged on the treatment instrument and a distance measuring and calculating device connected with the electrophysiological feedback device; the moment measuring and calculating device is connected with the mechanical feedback device; the display module is used for displaying the three-dimensional model of the spatial structure of the root canal system, displaying the real-time position of the root canal therapeutic instrument in the root canal on the three-dimensional model according to the length parameter measured in real time, and simultaneously displaying the direction of the moment parameter and the hardness parameter of the root canal wall contacted by the tip of the current root canal therapeutic instrument. The invention also discloses a real-time navigation method in the root canal. The invention reduces the dependence of users on operation hand feeling and clinical experience, lowers the technical threshold of fine root canal treatment, and effectively improves the accuracy and effectiveness of treatment.
Description
Technical Field
The invention relates to the technical field of dental equipment, in particular to a system and a method for real-time navigation in a root canal.
Background
The root canal therapy technology is the most important oral clinical diagnosis and treatment technology and is the basis for the preservation and repair of the affected teeth of the pulposis and the periapical disease. Successful root canal treatment depends on the surgeon's full understanding and mastery of the root morphology and the internal anatomy of the root canal system. However, the root morphology and root canal anatomy of adult teeth are extremely complex, morphologically irregular, and present a large number of variations and anastomotic branches. Due to the complexity of the root canal system, the success rate of root canal treatment in the conventional method is only about 80%. The accurate understanding of the anatomical morphology and tissue structure of the root canal and root canal system is a difficult point in clinical root canal treatment and retreatment, and is also the key to the development of fine root canal treatment.
In recent years, the success rate of root canal therapy is obviously improved due to the gradual popularization and application of the dental cone beam projection computed tomography (CBCT) and the micro root canal therapy (MCT) in dentistry. Compared with the traditional two-dimensional image of the dental X-ray film, the CBCT can acquire the three-dimensional image of the root canal with higher spatial resolution (about 200 mu m) before the operation, and the accuracy of the CBCT is close to the precision of the gold standard of the in vitro tooth anatomy research such as transparent tooth staining, hard tissue section technology and the like, thereby guiding the clinical treatment operation of an operator. The development of surgical microscopic equipment and instruments also promotes the progress of the root canal treatment technology, and the accuracy and the clinical effect of treatment can be effectively improved by means of sufficient illumination and high-power visual field of the surgical microscopic equipment. However, it should be appreciated that successful application of the above technique still relies on the operator's extensive clinical experience and skilled clinical operative skills. The CBCT preoperative three-dimensional image cannot guide and prompt an operator in real time during operation, but still depends on deep understanding of the operator on the spatial structure of the root canal of the affected tooth to be treated; the higher technical threshold of the micro-root canal therapy also limits the clinical popularization and application of the technology to a certain extent, and an operator can master the micro-root canal technology more skillfully only through strict training; in addition, iatrogenic injuries such as lateral root canal penetration and breakage of root canal treatment instruments due to lack of operational handfeel and clinical experience of an operator still occur.
Disclosure of Invention
The invention aims to provide a real-time navigation system in a root canal, which reduces the dependence of a user on operation hand feeling and clinical experience, thereby reducing the technical threshold of fine root canal treatment, effectively avoiding the occurrence of complications such as lateral penetration of the root canal, breakage of a root canal treatment instrument and the like, and improving the accuracy and effectiveness of treatment.
The real-time navigation system in the root canal comprises a three-dimensional data acquisition module, a three-dimensional navigation module and a three-dimensional navigation module, wherein the three-dimensional data acquisition module is used for acquiring a three-dimensional model of a root canal system space structure of a tooth to be treated before an operation;
the distance measuring and calculating device is used for measuring and calculating the length parameter of the tip of the treatment instrument entering the affected tooth according to an electric signal fed back by the electrophysiological feedback device;
the torque measuring and calculating device is used for measuring and calculating torque parameters borne by the tip of the dental canal therapeutic instrument according to electric signals fed back by the mechanical feedback device so as to measure and calculate hardness parameters of the wall of the dental canal contacted with the dental canal therapeutic instrument;
the three-dimensional model of the spatial structure of the root canal system is displayed, the real-time position of the therapeutic instrument in the root canal is displayed on the three-dimensional model of the spatial structure of the root canal system according to the length parameter measured in real time, and the hardness parameter of the root canal wall contacted with the tip of the therapeutic instrument and the direction of the moment parameter are displayed at the same time.
By the invention, a user of the root canal treatment instrument can visually see the spatial structure of the root canal system of a patient to be treated before operation, know the branch, the number, the walking and the length of the root canal in detail and can make more comprehensive evaluation on the treatment condition and prognosis. In the operation, the accurate positioning of the root canal therapeutic instrument in the current root canal of the affected tooth is displayed on the three-dimensional model in real time, the prompt effect is played for a user, the user can judge whether the root canal therapeutic instrument is in the bifurcation or the apical pore of the root canal currently, and simultaneously, the physical parameters such as the hardness of the root canal wall, the stress direction and the like are displayed, the information can assist and guide the user to finish the key steps such as root canal formation and the like in real time, the dependence of the user on the operation hand feeling and the clinical experience is reduced, the visual operation of the root canal therapy is realized, so that the technical threshold of the fine root canal therapy is reduced, the occurrence of complications such as inaccurate working length, lateral root canal penetration, breakage of the root canal therapeutic instrument is effectively avoided, the accuracy and the effectiveness of the therapy are improved. The positioning of the root canal therapeutic instrument in the affected tooth is to display the length of the tip of the therapeutic instrument entering the affected tooth in the vertical direction of the three-dimensional model of the root canal system space structure in equal proportion, namely, the observer can know the depth of the root canal at which the tip of the root canal therapeutic instrument entering the root canal is positioned, so that the user can pay attention to the structure of the root canal at the depth.
Furthermore, the display module is also connected with the operation microscopic equipment, and the display module is also used for simultaneously displaying the pictures output by the operation microscopic equipment.
The operation microscopic equipment can provide clear and bright visual field for the root canal treatment, so that a user can observe the positions of the treatment instrument in an affected tooth pulp cavity and a root canal orifice in a high-magnification manner under the clear and bright visual field, and parameters such as real-time positioning of the root canal treatment instrument in the root canal, hardness of the root canal wall, stress direction and the like are displayed on the three-dimensional model, so that the user is guided to accurately and efficiently prepare and form the root canal.
Further, the display module is used for displaying the picture output by the surgical microscopic equipment, the three-dimensional model of the spatial structure of the root canal system, the real-time position, the direction of the moment parameter and the hardness parameter in the same picture.
The observation of the user is convenient, and the switching among multiple pictures or multiple devices is not needed.
Further, the display module is also connected with the control unit of the therapeutic apparatus and is further used for acquiring and displaying the current motion parameters of the therapeutic apparatus.
For example, the root canal therapy apparatus such as a file for a nickel titanium root canal machine has a control unit, and can sense the motion parameters of the root canal therapy apparatus, such as the number of revolutions and the like, and the data interface is utilized to acquire the data and then visually display the data on a picture, so that a user can have a plurality of data in the heart and can more accurately and freely go to operate.
Further, the three-dimensional model of the root canal system spatial structure is obtained by three-dimensional reconstruction of a dental cone beam projection computer reconstruction tomographic image or a conventional tomographic image taken by a patient.
The tomography technology is mature, has high imaging precision and is very suitable for the use scene of the invention.
Another object of the present invention is to provide a method for real-time navigation in a root canal, comprising the following steps:
a three-dimensional model of a root canal system space structure is obtained: acquiring a three-dimensional model of a root canal system space structure of a tooth to be treated before an operation through a three-dimensional data acquisition module;
the length parameter measuring and calculating step of the tip of the therapeutic apparatus entering the affected tooth comprises the following steps: utilizing an electrophysiological feedback device arranged on the therapeutic instrument and a distance measuring and calculating device connected with the electrophysiological feedback device to measure and calculate the length parameter of the tip of the therapeutic instrument entering the affected tooth according to an electric signal fed back by the electrophysiological feedback device;
the measurement and calculation steps of the moment parameters borne by the tip of the therapeutic apparatus are as follows: measuring and calculating the moment parameter borne by the tip of the therapeutic instrument and the hardness parameter of the root canal wall contacted with the tip according to the electric signal fed back by the mechanical feedback device by utilizing a mechanical feedback device arranged on the therapeutic instrument and a moment measuring and calculating device connected with the mechanical feedback device;
a display step: and displaying the three-dimensional model of the spatial structure of the root canal system through a display module, displaying the real-time position of the therapeutic instrument in the root canal on the three-dimensional model of the spatial structure of the system according to the length parameter measured in real time, and simultaneously displaying the direction of the moment parameter and the hardness parameter of the root canal wall contacted by the tip of the therapeutic instrument.
By the invention, a user of the root canal treatment instrument can visually see the spatial structure of the root canal system of a patient to be treated before operation, know the branch, the number, the walking and the length of the root canal in detail and can make more comprehensive evaluation on the treatment condition and prognosis. In the operation, through the accurate positioning that shows root canal therapy apparatus in the present place root canal in the sick tooth in real time on three-dimensional model, played the effect of suggestion to the user, the user can judge whether root canal therapy apparatus is in root canal bifurcation or apical pore at present, show physical parameters such as root canal wall hardness, atress direction simultaneously, these information can both assist and guide the user to accomplish key steps such as root canal shaping in real time, reduce the dependence of user to operation feeling and clinical experience, realize the visual operation of root canal therapy, thereby reduce the technological threshold of meticulous root canal therapy, effectively avoid the emergence of complication such as working length is inaccurate, the root canal side is worn, the root canal therapy apparatus breaks, improve the accuracy and the validity of treatment, thereby improve the success rate of root canal therapy.
Further, the step of displaying also comprises the step of displaying the output picture of the operation microscopic equipment through a display module.
The operation microscopic equipment can provide clear and bright visual field for the root canal treatment, so that a user can observe the positions of the treatment instrument in an affected tooth pulp cavity and a root canal orifice in a high-magnification manner under the clear and bright visual field, and the real-time positioning of the root canal treatment instrument in the root canal, the hardness of the root canal wall, the stress direction and other physical parameters are displayed on the three-dimensional model, so that the user is guided to accurately and efficiently prepare and form the root canal.
Further, the method also comprises the step of displaying the picture output by the surgical microscopic equipment, the three-dimensional model of the spatial structure of the root canal system, the real-time position, the direction of the moment parameter and the hardness parameter in the same picture.
The observation of the user is convenient, and the switching among multiple pictures or multiple devices is not needed.
Further, the step of displaying, by a display module, the current motion parameters of the root canal treatment instrument is also included.
For example, the treatment instrument such as a file for a nickel titanium root canal machine has a control unit, and can sense the motion parameters of the treatment instrument, such as the number of revolutions and the like, and the data interface is utilized to acquire the data and then visually display the data on a picture, so that a user can have a heart with a plurality of data and can operate the treatment instrument more accurately and freely.
Further, the three-dimensional model of the root canal system spatial structure is obtained by three-dimensional reconstruction of a dental cone beam projection computer reconstruction tomographic image or a conventional tomographic image taken by a patient.
The tomography technology is mature, high in imaging precision and suitable for the use scene of the invention.
Drawings
Fig. 1 is a schematic functional block diagram of a real-time navigation system in a root canal in an embodiment of the invention.
Fig. 2 is a schematic display interface diagram of a real-time root canal navigation system in the embodiment of the invention.
Detailed Description
The following is further detailed by way of specific embodiments:
the present embodiment implements real-time navigation within the root canal by:
acquiring a three-dimensional model of a root canal system space structure of a tooth to be treated before an operation through a three-dimensional data acquisition module; the three-dimensional model is obtained by performing image cutting and three-dimensional reconstruction on a CBCT tomography image group shot for a patient. If the conditions are limited, CBCT tomographic images cannot be obtained, and the common CT tomographic images can be used for image cutting and three-dimensional reconstruction to obtain a three-dimensional model of the spatial structure of the root canal system.
Measuring and calculating the length parameter of the tip of the dental canal treatment instrument entering the affected tooth according to an electric signal fed back by the electrophysiological feedback device by utilizing the electrophysiological feedback device arranged on the dental canal treatment instrument and the distance measuring and calculating device connected with the electrophysiological feedback device;
measuring and calculating the moment parameter of the tip of the dental canal therapeutic instrument and the hardness parameter of the root canal wall contacted with the tip according to the electric signal fed back by the mechanical feedback device by utilizing a mechanical feedback device arranged on the dental canal therapeutic instrument and a moment measuring and calculating device connected with the mechanical feedback device;
the display module is respectively connected with the surgical microscopic equipment and the control unit of the root canal treatment instrument, a three-dimensional model of a root canal system space structure is displayed through the display module, the real-time position of the root canal treatment instrument in the root canal is displayed on the three-dimensional model according to the length parameter measured in real time, and the direction of the moment parameter is displayed at the same time, the hardness parameter of the root canal wall contacted with the tip of the current root canal treatment instrument and the picture output by the surgical microscopic equipment are displayed to a user of the root canal treatment instrument in the same picture, and if the current root canal treatment instrument is an instrument with motion parameters such as a file for a nickel titanium root canal machine, the motion parameters such as rotating speed and the like also need to be displayed together.
By the method, a user of the root canal treatment instrument can visually see the spatial structure of the root canal system of a patient to be treated before operation, know the branch, the number, the walking and the length of the root canal in detail and can make more comprehensive evaluation on the treatment condition and prognosis. In the operation, the accurate positioning of the root canal therapeutic instrument in the current root canal of the affected tooth is displayed on the three-dimensional model in real time, the prompt effect is played for a user, the user can judge whether the root canal therapeutic instrument is in the root canal bifurcation or the apical pore currently, and simultaneously, the physical parameters such as the hardness of the root canal wall, the stress direction and the like and the motion parameters of the root canal therapeutic instrument such as the rotating speed and the like are displayed, and the information can assist and guide the user to complete key steps such as root canal formation and the like in real time, so that the dependence of the user on the operation hand feeling and the clinical experience is reduced, the visual operation of the root canal therapy is realized, the technical threshold of the fine root canal therapy is reduced, the occurrence of complications such as inaccurate working length, lateral wearing of the root canal, the breakage of the root canal therapeutic instrument is effectively avoided.
The operation microscopic equipment can directly observe the affected tooth from the top in an overlooking way, so that a clear and bright visual field is provided for the root canal treatment, and a user can observe the positions of the treatment instrument in the pulp cavity and the root canal orifice of the affected tooth or in a specific root canal under the clear and bright visual field at a high magnification; and then the real-time positioning of the root canal therapeutic instrument in the root canal, the hardness of the root canal wall, the stress direction and other physical parameters are displayed on the three-dimensional model, so that a user is guided to accurately and efficiently prepare and form the root canal. The observation of the user is convenient, and the switching among multiple pictures or multiple devices is not needed.
The system used in this embodiment is substantially as shown in fig. 1, and includes a three-dimensional data acquisition module for acquiring a three-dimensional model of a spatial structure of a root canal system of a tooth to be treated before an operation; and the three-dimensional model of the spatial structure of the root canal system is obtained by performing image cutting and three-dimensional reconstruction on a CBCT tomography image group shot for a patient.
The device also comprises an electrophysiological feedback device arranged on the dental root canal treatment instrument, and a distance measuring and calculating device connected with the electrophysiological feedback device, and is used for measuring and calculating the length parameter of the tip of the dental root canal treatment instrument entering the affected tooth according to an electric signal fed back by the electrophysiological feedback device;
the torque measuring and calculating device is connected with the mechanical feedback device and is used for measuring and calculating the torque parameter borne by the tip of the dental root canal therapeutic instrument and the hardness parameter of the wall of the dental canal contacted with the tip according to the electric signal fed back by the mechanical feedback device;
the three-dimensional model is used for displaying the three-dimensional model of the spatial structure of the root canal system, displaying the real-time position of the root canal therapeutic instrument in the root canal on the three-dimensional model according to the length parameter measured in real time, and simultaneously displaying the direction of the moment parameter and the hardness parameter of the root canal wall contacted by the tip of the root canal therapeutic instrument.
The display module is also connected with the operation microscopic equipment and is also used for simultaneously displaying the pictures output by the operation microscopic equipment.
And the picture output by the operation microscopic equipment, the three-dimensional model of the spatial structure of the root canal system, the real-time position, the numerical value and the direction of the moment parameter and the hardness parameter are displayed in the same picture.
The display module is also connected with the control unit of the root canal therapy instrument and is also used for acquiring the current motion parameters of the root canal therapy instrument and displaying the current motion parameters.
The principle of the electrophysiological feedback device and the distance measuring and calculating device in this embodiment is that the distance is calculated from the potential difference between different parts of the human body, which is a common technology, such as the root canal length acousto-optic detection device disclosed in CN2050317U, which is well documented in many published technologies, but this embodiment uses similar technologies, but converts the original analog point signal into a digital signal through analog-to-digital conversion, so as to facilitate display; the same mechanical feedback device and the moment measuring and calculating device in the embodiment also adopt the current popular MEMS sensor technology; in addition, the torque measuring and calculating device measures and calculates the current hardness of the root canal wall by using a comparison table of resistance and the hardness of the root canal wall besides measuring and calculating the torque; the comparison table can be imported from the outside or formed by sampling tests on a large number of isolated teeth. These modules can be integrated into existing dental micro-power systems.
After the parameters are measured, the parameters are displayed on a screen shown in FIG. 2 in real time; the root canal treatment instrument related to the example is a file for a nickel titanium root canal machine, the left side of the picture is a real-time picture shot by an operation microscopic device, the right side picture comprises a three-dimensional model of a root canal system space structure, and the approximate position of the instrument in a root canal is displayed through an icon; meanwhile, a plurality of parameters including an imaged stress Direction parameter (Direction), a length parameter (Depth), a root canal wall Hardness parameter (Hardness) and a rotating Speed parameter (Speed) are displayed in parallel.
The graphic display mode of the present invention is not limited to this, and some parameters may be superimposed on the real-time image taken by the surgical microscope apparatus, or all parameters and models may be superimposed on the real-time image taken by the surgical microscope apparatus, and the real-time image taken by the surgical microscope apparatus may be displayed in an Augmented Reality (AR) mode.
The display module in this embodiment may be obtained by modifying the display module of the surgical microscope apparatus, and the parameters and the model may be acquired through the data interface for real-time display, or the image transmitted from the surgical microscope apparatus may be synthesized by the display module in this embodiment, and finally displayed to the user through an image display apparatus separately provided.
The foregoing is merely an example of the present invention, and common general knowledge in the field of known specific structures and characteristics is not described herein in any greater extent than that known in the art at the filing date or prior to the priority date of the application, so that those skilled in the art can now appreciate that all of the above-described techniques in this field and have the ability to apply routine experimentation before this date can be combined with one or more of the present teachings to complete and implement the present invention, and that certain typical known structures or known methods do not pose any impediments to the implementation of the present invention by those skilled in the art. It should be noted that, for those skilled in the art, without departing from the structure of the present invention, several changes and modifications can be made, which should also be regarded as the protection scope of the present invention, and these will not affect the effect of the implementation of the present invention and the practicability of the patent. The scope of the claims of the present application shall be determined by the contents of the claims, and the description of the embodiments and the like in the specification shall be used to explain the contents of the claims.
Claims (3)
1. The real-time navigation system in the root canal is characterized in that: the three-dimensional data acquisition module is used for acquiring a three-dimensional model of a root canal system space structure of a tooth to be treated before an operation;
the distance measuring and calculating device is used for measuring and calculating the length parameter of the tip of the dental root canal therapeutic instrument entering the affected tooth according to an electric signal fed back by the electrophysiological feedback device;
the torque measuring and calculating device is used for measuring and calculating torque parameters borne by the tip of the dental canal therapeutic instrument according to electric signals fed back by the mechanical feedback device so as to measure and calculate hardness parameters of the wall of the dental canal contacted with the dental canal therapeutic instrument;
the system also comprises a display module which is used for displaying the three-dimensional model of the space structure of the root canal system, displaying the real-time position of the root canal therapeutic instrument in the root canal on the three-dimensional model of the space structure of the system according to the length parameter measured in real time, and simultaneously displaying the hardness parameter of the root canal wall contacted with the tip of the root canal therapeutic instrument and the direction of the moment parameter;
the display module is also connected with the operation microscopic equipment and is also used for simultaneously displaying pictures output by the operation microscopic equipment;
the display module is used for displaying the picture output by the operation microscopic equipment, the three-dimensional model of the spatial structure of the root canal system, the real-time position, the direction of the moment parameter and the hardness parameter in the same picture.
2. The endodontic real time navigation system of claim 1, wherein: the display module is also connected with the control unit of the root canal therapy instrument and is also used for acquiring the current motion parameters of the root canal therapy instrument and displaying the current motion parameters.
3. The endodontic real time navigation system of claim 1, wherein: the three-dimensional model of the root canal system space structure is obtained by three-dimensional reconstruction of a dental cone beam projection computer reconstruction tomographic image or a traditional tomographic image shot for a patient.
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| CN109846561A (en) * | 2018-12-26 | 2019-06-07 | 苏州迪凯尔医疗科技有限公司 | Digitize the method, apparatus and system of root canal preparation |
| CN110269715B (en) * | 2019-06-20 | 2020-10-30 | 温州医科大学附属口腔医院 | Root canal monitoring method and system based on AR |
| CN110638548A (en) * | 2019-09-29 | 2020-01-03 | 中国人民解放军陆军军医大学第一附属医院 | Laser ranging and depth setting method applied to dental tissue preparation |
| CN110559091B (en) * | 2019-09-29 | 2021-02-02 | 中国人民解放军陆军军医大学第一附属医院 | Dental handpiece with auxiliary distance measuring and depth fixing functions |
| CN110584943A (en) * | 2019-09-29 | 2019-12-20 | 中国人民解放军陆军军医大学第一附属医院 | Dental comprehensive treatment chair with laser-assisted distance measurement and depth setting functions |
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| CN204600735U (en) * | 2015-02-11 | 2015-09-02 | 广州蓝鼎医疗器械有限公司 | A kind of portable therapeutic instrument for root canal |
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| CN2050317U (en) * | 1989-05-16 | 1990-01-03 | 张庆 | Tooth length acoustoopic detector |
| EP2878335B1 (en) * | 2013-11-10 | 2018-01-03 | Brainsgate Ltd. | Implant and delivery system for neural stimulator |
| JP5791761B1 (en) * | 2014-05-21 | 2015-10-07 | 株式会社モリタ製作所 | Display device for root canal treatment, root canal treatment unit, and method for operating display device for root canal treatment |
| CN105395295B (en) * | 2015-11-24 | 2017-05-10 | 张海钟 | Robot system for treating oral cavity and teeth |
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| CN204600735U (en) * | 2015-02-11 | 2015-09-02 | 广州蓝鼎医疗器械有限公司 | A kind of portable therapeutic instrument for root canal |
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