CN109199614B - Jaw bone positioning and fixing device for navigation positioning and mandible fixing in robot dental implant operation process - Google Patents
Jaw bone positioning and fixing device for navigation positioning and mandible fixing in robot dental implant operation process Download PDFInfo
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- CN109199614B CN109199614B CN201811131594.4A CN201811131594A CN109199614B CN 109199614 B CN109199614 B CN 109199614B CN 201811131594 A CN201811131594 A CN 201811131594A CN 109199614 B CN109199614 B CN 109199614B
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- 210000004373 mandible Anatomy 0.000 title claims abstract description 26
- 239000004053 dental implant Substances 0.000 title claims description 21
- 210000001847 jaw Anatomy 0.000 title claims description 18
- 238000000034 method Methods 0.000 title claims description 10
- 230000008569 process Effects 0.000 title description 7
- 210000000214 mouth Anatomy 0.000 claims abstract description 35
- 210000003625 skull Anatomy 0.000 claims abstract description 23
- 239000003550 marker Substances 0.000 claims abstract description 19
- 238000001356 surgical procedure Methods 0.000 claims abstract description 12
- 239000007943 implant Substances 0.000 claims abstract description 7
- 230000026058 directional locomotion Effects 0.000 claims description 2
- 238000002513 implantation Methods 0.000 abstract description 12
- 238000002432 robotic surgery Methods 0.000 abstract 1
- 238000002591 computed tomography Methods 0.000 description 7
- 210000003128 head Anatomy 0.000 description 5
- 230000033001 locomotion Effects 0.000 description 5
- 210000000988 bone and bone Anatomy 0.000 description 2
- 229910052602 gypsum Inorganic materials 0.000 description 2
- 239000010440 gypsum Substances 0.000 description 2
- 230000000007 visual effect Effects 0.000 description 2
- 230000009471 action Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000001055 chewing effect Effects 0.000 description 1
- 238000007408 cone-beam computed tomography Methods 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 239000012567 medical material Substances 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 231100000252 nontoxic Toxicity 0.000 description 1
- 230000003000 nontoxic effect Effects 0.000 description 1
- 239000011505 plaster Substances 0.000 description 1
- 238000012827 research and development Methods 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
- 230000009182 swimming Effects 0.000 description 1
Classifications
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- 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
- A61C8/0089—Implanting tools or instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Robotics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Epidemiology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurosurgery (AREA)
- Pathology (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
- Dental Prosthetics (AREA)
Abstract
The utility model provides a jawbone location fixing device for navigation location and mandible are fixed in the operation of robot implant, skull support both sides are connected with oral cavity mouth gag through two flexible mechanical devices that are connected with rotation-flexible mechanical device as the center, the tongue baffle is connected in oral cavity mouth gag lower extreme both sides, mandibular tray both ends link to each other with oral cavity mouth gag through another flexible mechanical device respectively, the orientation is moved the locator and is installed on the flexible mechanical device that the skull support both sides link to each other, the operation location marker for image navigation is fixed on orientation and is moved locator symmetry central line, the opening angle department of oral cavity mouth gag rotation-flexible mechanical device and all flexible mechanical device are last to install the calibrated scale. The invention avoids interference generated during robotic surgery and can improve the precision of the preparation link of the implantation surgery cavity, the safety of the implantation surgery and the navigation positioning precision of the surgery.
Description
Technical Field
The invention relates to the field of medical instruments for oral and maxillofacial surgery, in particular to a jawbone positioning and fixing device for navigation positioning and mandibular fixation in a robotic dental implant operation process.
Background
After the teeth are lost, the currently preferred restoration mode is artificial dental implant restoration, namely, artificial dental implants are implanted into jawbone through operation, and a base table and a dental crown are connected on the artificial dental implants, so that the functions of chewing, appearance and the like of a patient are restored. In the traditional dental implant operation, in links such as cavity preparation, implant screwing and the like, the head and the mandible of a patient are fixed by bare hands of medical staff, and operation operations such as cavity preparation and the like are carried out by holding an implant mobile phone; with the research and development of robotic surgical systems, robotic dental implant techniques have begun to find clinical application. By utilizing a robot tooth implantation system, a preoperative patient wears a positioning marker in an oral cavity and shoots CT/CBCT data, then a planting scheme is planned, the intraoperative robot realizes accurate positioning through the positioning marker, and the robot system autonomously completes operations such as hole preparation and the like according to visual navigation under the monitoring of a doctor. The robot tooth implantation technology can obviously improve the automation degree and precision of the tooth implantation operation, is an important development direction in the field of the current oral implantation, and has better application situations.
The biggest problem of utilizing the robot system to carry out implant operation to the mandible lies in that the mandible is movable skeleton, if hold patient's mandible with the hand in the art and realize fixed and location, easily produce the interference with the robot, simultaneously under axial drilling force, bare-handed stability of hardly guaranteeing the mandible produces the deviation, seriously influences the precision of robot implant operation. At present, in a robot tooth implantation system, a positioning marker fixed in a patient's oral cavity is generally utilized, and the real-time position of a mandible is captured and determined by means of infrared, machine vision, electromagnetic positioning and the like, but the response speed of the positioning modes is slower, the clamping is easily caused by large calculation amount caused by the real-time acquisition of images, and meanwhile, the precision of the positioning modes has room for improvement. On the one hand, as the operation positioning marker is fixed in the operation area of the oral cavity of the patient, the operation space of the robot system can be influenced to easily generate interference, and on the other hand, for the whole-mouth/half-mouth toothless patient, the operation positioning marker is inevitably provided with a position deviation when being worn in CT shooting before operation and secondary positioning in operation, and the dental implant operation precision is also influenced to a certain extent.
Disclosure of Invention
In order to solve the problem of real-time positioning of a jawbone when a robot operation system performs dental implant operation on a patient, the problem of stability of the jawbone under the action of operation force and the problem of operation precision caused by the stability of the jawbone, the invention provides a jawbone positioning and fixing device for navigation positioning and jawbone fixing in the process of robot dental implant operation.
The technical scheme adopted for solving the technical problems is as follows:
a jaw bone positioning and fixing device for navigation positioning and mandible fixing in a robot dental implant operation process comprises an oral cavity mouth gag, a tongue baffle, a mandible tray, a skull support, a direction movement positioner and an operation positioning marker for image navigation;
the skull support both sides are connected with the oral cavity mouth gag through two telescopic mechanical devices that regard rotation-telescopic mechanical device as the center, keep off the tongue board and connect in oral cavity mouth gag lower extreme both sides, lower jaw tray both ends link to each other with the oral cavity mouth gag through another telescopic mechanical device respectively, the orientation is moved the locator and is installed on the telescopic mechanical device that the skull support both sides link to each other, the operation location marker for image navigation is fixed on the orientation and is moved locator symmetry central line, the opening angle department of oral cavity mouth gag rotation-telescopic mechanical device and all telescopic mechanical devices are last to install the calibrated scale.
Further, the telescopic mechanical device comprises a sliding sleeve, a sliding rod, a knob and a screw, wherein the sliding rod is slidably positioned in the sliding sleeve, a corresponding threaded hole is formed in the surface of the sliding sleeve, one end of the screw passes through the threaded hole to be in contact with the sliding rod, the other end of the screw is fixedly connected with the knob, the screw is controlled to advance/retreat through the knob to generate friction force on the sliding rod, and the sliding rod is further fixed/loosened, so that the length of the telescopic mechanical device is adjusted.
The rotary-telescopic mechanical device comprises a telescopic mechanical device and a rotary mechanical device, the telescopic mechanical device comprises a sliding sleeve, a sliding rod, a knob and a screw, the sliding rod is slidably positioned in the sliding sleeve, a corresponding threaded hole is formed in the surface of the sliding sleeve, one end of the screw passes through the threaded hole to be in contact with the sliding rod, and the other end of the screw is fixedly connected with the knob; the rotary mechanical device comprises a centering rotor and a wheel disc, wherein the wheel disc is arranged on the sliding rod and rotatably arranged on the centering rotor, and the wheel disc is a rotary output end of the rotary-telescopic mechanical device.
Still further, the oral cavity mouth gag consists of a jaw type supporting cutting sleeve and a spring locking device with a dial; for opening the patient's upper and lower jaws and measuring their opening angle.
The scale comprises a linear scale for measuring all telescopic lengths on the device and an arc scale for measuring the rotation angle.
The direction moving positioner is formed by combining telescopic mechanical devices in two directions perpendicular to the horizontal plane and the coronal plane of a human body, and the positions of the surgical positioning markers are precisely controlled by fine adjustment of the two directions through a knob on the telescopic device.
The skull support comprises an inner layer and an outer layer, wherein the inner layer is formed by a soft cushion and is used for contacting the outline of the skull of a patient; the outer layer is formed by a plastic shell and is used for generating supporting force and transmitting the supporting force to the mandibular tray so as to be matched with the mouth gag to stabilize the mandible, and the telescopic mechanical device on the symmetrical axis of the skull support is fixedly connected with the two ends of the outer layer of the support and is used for adjusting the whole width of the positioning and fixing device.
The beneficial effects of the invention are mainly shown in the following steps: 1. the jaw positioning and fixing device replaces the operation of holding the mandible by the hand of the operator required by the traditional dental implant operation, and avoids the interference generated during the robot operation; 2. in the process of preparing the hole on the mandible by the robot, the mandible fixing device provides guarantee for the static stability of the mandible, and the precision of the preparation link of the hole in the implantation operation is greatly improved; 3. compared with the prior art, the operation positioning marker for image navigation on the device increases the operation space of the oral operation and improves the safety of the dental implantation operation; 4. solves the problem that the original surgical positioning marker has position deviation when worn before and during operation for two times, and further improves the surgical navigation positioning precision.
Drawings
Fig. 1 is an overall schematic view of a jawbone positioning and fixing device for navigation positioning and mandible fixation in robotic dental implant surgery according to the present invention.
Fig. 2 is a schematic view of a rotary-telescopic mechanical left-view device on a mandibular fixation device.
Detailed Description
The invention is further described below with reference to the accompanying drawings.
Referring to fig. 1 and 2, a jaw bone positioning and fixing device for navigation positioning and mandibular bone fixation during robotic dental implant surgery includes an oral cavity mouth gag 6, a tongue deflector 10, a mandibular tray 9, a skull mount 1, a directional movement positioner 15, and a surgical positioning marker for image navigation;
the two sides of the skull support 1 are connected with the oral cavity mouth gag 6 through two telescopic mechanical devices 5b and 5c which are connected by taking a rotary-telescopic mechanical device 5e as a center, the tongue baffle plate 10 is connected at two sides of the lower end of the oral cavity mouth gag 6, two ends of the mandibular tray 9 are respectively connected with the oral cavity mouth gag 6 through another telescopic mechanical device 5d, the direction movement locator 15 is arranged on the telescopic mechanical devices 5b which are connected at two sides of the skull support, the operation positioning marker 8 for image navigation is fixed on the symmetrical central line of the direction movement locator 15, and the opening angle of the oral cavity mouth gag 6, the rotary-telescopic mechanical devices and all the telescopic mechanical devices are provided with the dial 3.
Further, the telescopic mechanical device comprises a sliding sleeve 13, a sliding rod 14, a knob 12 and a screw 11, wherein the sliding rod 14 is slidably positioned in the sliding sleeve 13, a corresponding threaded hole is formed in the surface of the sliding sleeve 13, one end of the screw 11 passes through the threaded hole to be in contact with the sliding rod 14, the other end of the screw 11 is fixedly connected with the knob 12, and the knob 12 controls the screw to advance/retract to generate friction force to the sliding rod 14 so as to fix/loosen the sliding rod 14, so that the length of the telescopic mechanical device is adjusted.
The rotary-telescopic mechanical device comprises a telescopic mechanical device and a rotary mechanical device, the telescopic mechanical device comprises a sliding sleeve 13, a sliding rod 14, a knob 12 and a screw 11, the sliding rod is slidably positioned in the sliding sleeve, a corresponding threaded hole is formed in the surface of the sliding sleeve, one end of the screw passes through the threaded hole to be in contact with the sliding rod, and the other end of the screw is fixedly connected with the knob; the rotary mechanical device comprises a centering rotor and a wheel disc, wherein the wheel disc is arranged on the sliding rod and rotatably arranged on the centering rotor, and the wheel disc is a rotary output end of the rotary-telescopic mechanical device.
Still further, the oral cavity mouth gag 6 consists of a jaw type supporting cutting sleeve and a spring locking device 7 with a dial; for opening the patient's upper and lower jaws and measuring their opening angle.
The dials include linear dials 3a, 3c, 3d, 3f for measuring all telescopic lengths on the device and arc dials 3b, 3e for measuring the rotation angle.
The direction moving positioner 15 comprises two telescopic mechanical devices 5a and 5b which are vertical to the horizontal plane and the coronal plane of the human body, and the positions of the surgical positioning markers are precisely controlled by fine adjustment of the two directions through a knob on the telescopic devices.
The skull support 1 comprises an inner layer and an outer layer, wherein the inner layer 2 is formed by a soft cushion and is used for contacting the outline of the skull of a patient; the outer layer 4 is composed of a plastic shell and is used for generating supporting force to be transmitted to the mandibular tray so as to be matched with the mouth gag to stabilize the mandible, and the telescopic mechanical device 5f on the symmetrical axis of the skull support is fixedly connected with two ends of the outer layer of the support and is used for adjusting the whole width of the positioning and fixing device.
The tongue deflector 10 is constructed of a non-toxic medical material for preventing intraoperative patient's tongue from swimming to the alveolar bone to interfere with robotic work.
The mandible tray 9 is a fixed disc with a shape similar to that of a mandible, and is used for supporting the mandible of a patient and is matched with an opening device so as to fix the mandible movement of the patient after opening.
The surgical positioning marker for image navigation comprises a plurality of marking points which are easy to identify by infrared rays and are used for accurately positioning the surgical robot.
The implementation process of the embodiment is as follows: for the previous dental implant patients, the jaw bone positioning and fixing device is worn first, then CT data are shot, and operations such as plaster mold taking, model registration, design of an implant operation scheme and the like are performed. Before the operation starts, the operator wears the device for the patient again to help complete the robot dental implant operation. The method comprises the following specific steps:
firstly, wearing the device on the head of a patient, and finding out the basic fitting position of the skull of the patient and the bracket 1 by moving the jawbone positioning device and the telescopic mechanical device 5f on the rough adjusting skull bracket 1;
secondly, the patient opens the oral cavity, and a doctor adjusts the oral cavity mouth gag 6, coarse adjusting telescopic mechanical devices 5b, 5c and 5f, a rotary-telescopic mechanical device 5e and the like on the device according to the actual size of the oral cavity, so that the oral cavity mouth gag stably supports the upper jaw and the lower jaw of the oral cavity and is in coordination with the jaw positioning and fixing device to be attached to the head of the patient, and locks the spring device 7;
thirdly, adjusting the skull mount 1 by adjusting the telescopic mechanical device 5d and moving the mandible tray 9 until the tray clings to the mandible, and finding the best fitting position with the skull;
fourthly, finely adjusting all telescopic mechanical devices and rotary-telescopic mechanical devices to enable the whole jaw positioning and fixing device to be in coordination and close contact with the head of a patient, and simultaneously screwing all knobs on the device to enable the whole jaw positioning and fixing device to be completely locked with the head of the patient;
fifthly, taking the uppermost point of the auricle of the patient and the most protruding point of the nose tip of the patient as the up-down reference point and the front-back reference point respectively so as to finely adjust the direction movement positioner 15 to determine the optimal position of the navigation operation positioning marker 8 in the operation area;
sixthly, recording all the data of the dial 3 on the mandibular positioning and fixing device, and shooting CT (computed tomography) and taking a die from gypsum in the oral cavity for the patient;
seventh, analyzing CT data of a patient, reconstructing a three-dimensional model of a jawbone model and comprising a marker based on the CT data, reconstructing an outlet inner surface model according to gypsum model scanning data, performing model registration, designing a three-dimensional implantation surgery scheme on the basis, designing a surgery guide plate and the like;
eighth step, wearing the jawbone positioning and fixing device again before the operation of the patient, finely adjusting the device according to the data recorded before the operation to completely coincide with the position worn before the operation, so that the mandible is fixed and kept stable during the operation, and simultaneously registering the positioning marker 8 with the marker in the three-dimensional model through a visual positioning system in a robot system, thereby ensuring that the three-dimensional operation scheme is completely consistent with the spatial position of the oral cavity of the patient, and carrying out the robotic tooth implantation operation at the moment, so that the tooth implantation scheme planned before the operation is accurately realized in the oral cavity of the patient through a robotic operation system.
The embodiments described in the present specification are merely examples of implementation forms of the inventive concept, and the scope of protection of the present invention should not be construed as being limited to the specific forms set forth in the embodiments, but the scope of protection of the present invention and equivalent technical means that can be conceived by those skilled in the art based on the inventive concept.
Claims (5)
1. A jaw location fixing device that is arranged in robot implant operation in-process navigation location and mandible fixed, its characterized in that: comprises an oral cavity mouth gag, a tongue baffle, a mandibular tray, a skull support, a directional movement positioner and an operation positioning marker for image navigation;
the two sides of the skull support are connected with the oral cavity opening device through two telescopic mechanical devices which are connected with each other by taking the rotary mechanical device as a center, the tongue baffle is connected with the two sides of the lower end of the oral cavity opening device, the two ends of the mandibular tray are respectively connected with the oral cavity opening device through another telescopic mechanical device, the direction moving positioner is arranged on the telescopic mechanical devices which are connected with the two sides of the skull support, the operation positioning marker for image navigation is fixed on the symmetrical central line of the direction moving positioner, and the opening angle of the oral cavity opening device, the rotary mechanical device and the telescopic mechanical device are provided with dials;
the telescopic mechanical device comprises a sliding sleeve, a sliding rod, a knob and a screw, wherein the sliding rod is slidably positioned in the sliding sleeve, a corresponding threaded hole is formed in the surface of the sliding sleeve, one end of the screw passes through the threaded hole to be in contact with the sliding rod, the other end of the screw is fixedly connected with the knob, and the knob is used for controlling the screw to advance/retreat to generate friction force on the sliding rod so as to fix/loosen the sliding rod, so that the length of the telescopic mechanical device is adjusted;
the rotary mechanical device comprises a centering rotor and a wheel disc, wherein the wheel disc is arranged on the sliding rod and is rotatably arranged on the centering rotor, and the wheel disc is a rotary output end of the rotary mechanical device.
2. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the oral cavity mouth gag consists of a dental supporting cutting sleeve and a spring locking device with a dial.
3. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the scale comprises a linear scale for measuring all telescopic lengths on the device and an arc scale for measuring the rotation angle.
4. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the direction moving positioner is formed by combining telescopic mechanical devices in two directions perpendicular to the horizontal plane and the coronal plane of a human body.
5. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the skull support comprises an inner layer and an outer layer, wherein the inner layer is composed of a soft cushion, the outer layer is composed of a plastic shell, and a telescopic mechanical device on the symmetry axis of the skull support is fixedly connected with two ends of the outer layer of the support.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811131594.4A CN109199614B (en) | 2018-09-27 | 2018-09-27 | Jaw bone positioning and fixing device for navigation positioning and mandible fixing in robot dental implant operation process |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811131594.4A CN109199614B (en) | 2018-09-27 | 2018-09-27 | Jaw bone positioning and fixing device for navigation positioning and mandible fixing in robot dental implant operation process |
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| CN109199614A CN109199614A (en) | 2019-01-15 |
| CN109199614B true CN109199614B (en) | 2023-12-19 |
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Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110200738B (en) * | 2019-05-28 | 2024-05-14 | 中南大学湘雅二医院 | Mandibular lifting and opening device and method for keeping air passage unblocked by mandibular lifting and opening device |
| CN112043417B (en) * | 2020-10-14 | 2021-12-31 | 山东大学齐鲁医院(青岛) | Head support for oral cavity surgery |
| CN112641495B (en) * | 2020-11-12 | 2022-02-08 | 南京医科大学附属口腔医院 | Recording, positioning and recovering device for position relation of condyle process in mandibular branch sagittal dissection operation |
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| CN109199614A (en) | 2019-01-15 |
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