CN109446738B - Bone surface anchoring type dental implant design method with topological optimization structure and implant - Google Patents
Bone surface anchoring type dental implant design method with topological optimization structure and implant Download PDFInfo
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- CN109446738B CN109446738B CN201811561092.5A CN201811561092A CN109446738B CN 109446738 B CN109446738 B CN 109446738B CN 201811561092 A CN201811561092 A CN 201811561092A CN 109446738 B CN109446738 B CN 109446738B
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06F—ELECTRIC DIGITAL DATA PROCESSING
- G06F30/00—Computer-aided design [CAD]
- G06F30/20—Design optimisation, verification or simulation
- G06F30/23—Design optimisation, verification or simulation using finite element methods [FEM] or finite difference methods [FDM]
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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
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- G—PHYSICS
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- G06F—ELECTRIC DIGITAL DATA PROCESSING
- G06F2119/00—Details relating to the type or aim of the analysis or the optimisation
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Abstract
A method for designing a bone-surface anchored dental implant with a topologically optimized structure, comprising the steps of: 1) Acquiring an oral cavity and maxillofacial CT image of a patient, and reconstructing a mandibular bone three-dimensional model of the patient by using medical image processing software, wherein the reconstructed model also comprises a mandibular nerve tube anatomical structure; 2) Measuring and evaluating the situation of missing teeth and the situation of bone mass of an implant implantation position in medical image processing software, determining the position of a repair base station, and preparing a comprehensive repair scheme; determining implant position and form: implanting a conventional cylindrical or conical dental implant at a location where the bone mass is sufficient or less than sufficient; in the position of serious bone quantity shortage, the bone surface anchoring type implant is designed. The invention provides a bone surface anchoring type dental implant design method with a topological optimization structure and an implant, which are different from the traditional subperiosteal implant and root-shaped implant and do not need bone increment operation.
Description
Technical Field
The invention relates to a bone surface anchoring type dental implant design method with a topological optimization structure and an implant.
Background
Currently, with the increasing development of society, the pursuit of oral aesthetics is becoming higher and higher. Defects in the teeth affect the oral relationship and also detract from the aesthetic appearance. The implant has the advantages of attractive appearance, comfort, high chewing efficiency and the like, and becomes a main choice for repairing the missing teeth increasingly. However, the conventional root-shaped implant has high requirements on bone mass, including bone height and bone width, which are required to meet the requirements of implant surgery. There may be a risk of failure in the dental implant restoration if the amount of alveolar bone is insufficient, including insufficient bone width leading to the implant side penetrating out of the alveolar bone, insufficient bone height leading to implant exposure and insufficient initial stability, etc. Clinically, the situation of insufficient bone mass caused by factors such as periodontal disease, jawbone disease, trauma, tumor and the like is more, and the application of the dental implant restoration technology is limited.
In order to increase the bone mass during root-shaped implant implantation, the problem of a small amount of bone deficiency is solved clinically by filling bone powder and covering periosteum, or the problem of serious bone mass deficiency is solved by surgical modes such as autologous bone grafting, surgical cleavage, traction osteogenesis and the like, but the problems of bone mass increment are solved by the modes through surgery, the recovery is carried out for a period of time, then the dental implant surgery is carried out, the operation process is complex, the operation times are increased, the difficulty of dental implant repair and the time of treatment are increased, the operation cost is high, and meanwhile, the problems of surgical area infection, limited bone increment and the like are also solved.
In fact, before the application of root-shaped (including cylindrical or conical) implants based on the concept of osseointegration, an implant based on a special scaffold structure of subperiosteal bone fixation, namely subperiosteal implant, has been applied in the 1930 s. But it is manufactured by exposing the bone surface by operation and taking out the mold, then manufacturing the bracket of the subperiosteum implant closely attached to the bone surface by casting, and then performing implantation by a second operation. The root-shaped implant is gradually eliminated after appearance due to complex operation, longer manufacturing process and larger operation wound. But the implant is directly fixed on the bone surface, and provides a solution for solving the problem of repairing the root-shaped implant when the bone facing quantity is insufficient. Particularly, in recent years, along with the development and application of digital technologies such as medical image acquisition, three-dimensional reconstruction of maxillofacial tissues, digital accurate design of surgical schemes, 3D printing of titanium metal, optimal design, biomechanical finite element analysis and the like, the personalized subperiosteal dental implant with direct anchoring of bone surfaces has higher feasibility when the accurate design and manufacture are completed before operation and implantation is completed through one-time operation.
Disclosure of Invention
In order to solve the problem that multiple phases of operations are needed when the dental implant is restored under the condition of serious bone quantity deficiency of a patient, namely, the bone quantity is supplemented first and then the implant is implanted, the invention provides a bone surface anchoring type dental implant design method with a topological optimization structure and an implant, which are different from the traditional subperiosteum implant and root implant and do not need to perform bone increment operation.
The technical scheme adopted for solving the technical problems is as follows:
a method for designing a bone-surface anchored dental implant with a topologically optimized structure, comprising the steps of:
1) Acquiring an oral cavity and maxillofacial CT image of a patient, and reconstructing a mandibular bone three-dimensional model of the patient by using medical image processing software, wherein the reconstructed model also comprises a mandibular nerve tube anatomical structure;
2) Measuring and evaluating the situation of missing teeth and the situation of bone mass of a dental implant implantation position in medical image processing software, determining the position of a repair base station, and preparing a comprehensive repair scheme; determining dental implant position and form: implanting a conventional cylindrical or conical dental implant at a location where the bone mass is sufficient or less than sufficient; designing a bone surface anchoring type dental implant at a position with serious bone quantity shortage;
3) According to the comprehensive restoration scheme, determining the restoration position of the bone surface anchoring type dental implant, namely the position of an upper restoration base, and designing a three-dimensional model of the restoration base by referring to the standard structure of the base;
4) Designing a bone surface anchoring structure of an anchoring type dental implant with a topological optimization structure:
(4.1) determining a fixation region: including the active area and the fixed location of the entire bone surface anchoring structure;
(4.2) designing an initial anchoring plate through a curved surface thickening function based on the fixing area of the bone surface;
(4.3) constructing a mandible biomechanical model, loading an biting force load at a base station position, and performing topological optimization on the bone surface anchoring structure by using finite element software to obtain an initial optimized structure of the anchoring structure;
(4.4) carrying out standardization design according to the initial optimized structure of the bone surface anchoring structure to obtain an anchoring structure with a fixed hole and a regular structure;
5) The anchoring structure can be subjected to multiple topological optimization to obtain the bone surface anchoring structure with the best mechanical property;
6) Performing Boolean operation on the bone surface anchoring structure and the abutment three-dimensional model to obtain a complete bone surface anchoring type dental implant three-dimensional model with a topological optimization structure;
7) The designed bone surface anchoring type dental implant is manufactured by printing with a 3D printing technology, and the material can be titanium alloy or PEKK polymer material;
8) The bone surface anchoring type dental implant is subjected to surface treatment to obtain the bone surface anchoring type dental implant with a topology optimization structure, which can be applied to clinic.
Further, the design method further comprises the following steps: to facilitate surgeon surgery, personalized surgical guides may be designed for intraoperative positioning, including determining staple position.
The implant constructed according to the bone surface anchoring dental implant design method with the topology optimization structure comprises a repairing base for installing false teeth and a bone surface anchoring structure for supporting and fixing, wherein the bone surface anchoring structure comprises a supporting unit for supporting the repairing base and a fixing unit for fixing a mandible fixing area, the repairing base is arranged at the center of the top of the supporting unit and is integrally formed with the supporting unit, the supporting unit is provided with fixing units along the front side and the rear side, each fixing unit is provided with a mounting through hole for fixing a mandible, the upper end of each fixing unit is integrally formed with the supporting unit, the lower end of each fixing unit extends downwards, and the bone surface anchoring structure is fixedly connected with the mandible fixing area through titanium nails.
Furthermore, the repairing base and the bone surface anchoring structure are both made of titanium alloy or PEKK high polymer materials.
Still further, fixed unit is provided with four, and two sets of respectively set up in the front and back both sides of supporting element, is equipped with two installation through-holes on every fixed unit respectively.
Furthermore, the bone surface anchoring structure has optimal mechanical properties by performing multiple topological optimization, and the mounting through holes on the fixing units avoid important anatomical structures of the fixing areas.
The beneficial effects of the invention are mainly shown in the following steps: compared with the traditional dental implant, the dental implant is not limited by the bone quantity of the alveolar bone, and can be used for dental implantation on the premise of not filling the bone quantity; the original multi-stage operation is simplified into one-stage operation, so that the expected dental implantation can be completed, the operation time can be reduced, the economic burden of a patient can be reduced, and the practicability is good; the tooth implant after topological optimization can meet the strength requirement and the process requirement.
Drawings
Fig. 1 is a schematic view of a bone model of an oral site.
FIG. 2 is a schematic illustration of a preliminary location of a prosthetic base station.
FIG. 3 is a schematic view of an initial anchor plate structure.
Fig. 4 is a schematic diagram of the results after a first topology optimization.
Fig. 5 is a schematic view of a standard anchoring structure.
FIG. 6 is a schematic diagram of a composite model in which one planting position is topologically optimized by way of example.
FIG. 7 is a flow chart of an implementation of multiple topology optimization.
Fig. 8 is a schematic representation of a bone-plane anchoring structure after multiple topological optimizations.
Fig. 9 is a schematic view of a dental implant of the present invention.
Detailed Description
The invention is further described below with reference to the accompanying drawings.
Referring to fig. 1 to 9, a method for designing a bone-surface anchored dental implant with a topologically optimized structure includes the steps of:
1) Acquiring an oral cavity and maxillofacial CT image of a patient, reconstructing a three-dimensional model of the mandible 1 of the patient by using medical image processing software such as Mimics, wherein the reconstructed model also comprises important anatomical structures such as mandibular nerve tubes 11 and the like, as shown in figure 1;
2) Measuring and evaluating the situation of missing teeth and the situation of bone mass of a dental implant implantation position in medical image processing software such as ceramics, determining the position 2 of a restoration base station by considering factors such as oral biomechanics, the size of a dental crown, the position requirements of adjacent and opposite jaws and the like, and preparing a comprehensive restoration scheme; determining dental implant position and form: implanting a conventional cylindrical or conical dental implant at a location where the bone mass is sufficient or less than sufficient; designing a bone surface anchoring type dental implant at a position with serious bone quantity shortage;
3) According to the comprehensive restoration scheme, determining the restoration position of the bone surface anchoring type dental implant, namely the position of an upper restoration base station, as shown in fig. 2, and designing a three-dimensional model of the restoration base station by referring to the standard structure of the base station;
4) Designing a bone surface anchoring structure of an anchoring type dental implant with a topological optimization structure:
(4.1) determining a fixation region: according to biomechanical principle and considering the conditions of avoiding important anatomical structures of tooth root, mandibular nerve duct and the like, determining a fixing area comprising an action area and a fixing position of the whole bone surface anchoring structure;
(4.2) designing an initial anchor plate based on the fixing area of the bone surface through a curved surface thickening function, as shown in fig. 3;
(4.3) constructing a mandible biomechanical model, loading an occlusion force load at a base station position, performing topological optimization on a bone surface anchoring structure by using finite element software such as Abaqus, wherein a topological optimization result diagram is shown in fig. 4, 42 represents a region with small stress, 41 represents a region with large stress, and obtaining an initial optimized structure of the anchoring structure;
(4.4) carrying out standardization design according to the initial optimized structure of the bone surface anchoring structure to obtain an anchoring structure with fixed holes and a regular structure, as shown in fig. 5;
5) The anchoring structure can be subjected to multiple topological optimization, one planting position is taken as an example, a composite model for topological optimization is shown in fig. 6, an implementation flow is shown in fig. 7, the first step is the building of a mandible and bone surface anchoring structure model, the second step is the building of a finite element model, the third step is the topological optimization design, the fourth step is the evaluation of the bone surface anchoring structure after topological optimization, if the bone surface anchoring structure with the best mechanical property is properly obtained, the third step is continuously carried out if the bone surface anchoring structure with the best mechanical property is not properly obtained, and the topological optimization design is continued until the bone surface anchoring structure with the best mechanical property is obtained;
6) And (3) carrying out Boolean operation on the bone face anchoring structure and the abutment three-dimensional model to obtain a complete bone face anchoring type dental implant three-dimensional model with a topological optimization structure, as shown in fig. 9.
7) The designed bone surface anchoring type dental implant is manufactured by printing with a 3D printing technology, and the material can be titanium alloy or PEKK polymer material;
8) Performing post-treatment such as polishing, acid etching and the like on the bone surface anchoring type dental implant to obtain the bone surface anchoring type dental implant with a topological optimization structure, which can be applied to clinic;
to facilitate surgeon surgery, personalized surgical guides may be designed for intraoperative positioning, including determining staple position.
The implant constructed according to the bone surface anchoring dental implant design method with the topology optimization structure comprises a repair base 9 for installing false teeth and a bone surface anchoring structure 5 for supporting and fixing, wherein the bone surface anchoring structure 5 comprises a supporting unit 51 for supporting the repair base and a fixing unit 52 for fixing with a mandible fixing area, the supporting unit 51 is integrally formed with the repair base 9, the fixing units 52 are arranged on the front side and the rear side of the supporting unit 51, each fixing unit 52 is provided with an installation through hole 53 for fixing on a mandible, and the bone surface anchoring structure 5 is fixedly connected with the mandible fixing area through titanium nails.
The repairing base 9 and the bone surface anchoring structure 5 are made of titanium alloy or PEKK polymer materials.
The fixing position of the fixing unit 52, i.e., the position of the mounting through hole 53, avoids important anatomical structures of the fixing area.
The bone surface anchoring structure 5 performs a plurality of topological optimizations to meet the best mechanical properties.
Two fixing units 52 are respectively arranged on the front side and the rear side of the supporting unit 51 of the bone surface anchoring structure 5, and two mounting through holes 53 are respectively arranged on each fixing unit 52. Each fixing unit 52 is further provided with a strip-shaped hollow according to the multiple topology optimization results. Of course, the bone surface anchoring structure may be not fixed, i.e. the number of the fixing units 52 and the mounting holes 53 is not unique, and the structure may be variable according to different planting conditions and topology optimization results.
When in use, the personalized operation guide plate is firstly placed in the mouth of a patient, then the bone surface anchoring type dental implant with a topological optimization structure is placed at a proper position according to the position of the repair base station, and finally the dental implant is fixedly connected with the mandible through titanium nails. It is noted that the location of the fixation must avoid the important anatomy of the mandible.
According to the invention, under the condition of not performing multiple operations, according to the stress conditions of teeth and tissues around the teeth at the repairing position, the bone surface anchoring type dental implant which is directly anchored on the bone surface and has a topological optimization structure is designed, and the 3D printing technology is fully utilized, so that the problem of dental implant repairing with serious bone quantity deficiency can be effectively solved.
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 also equivalent technical means that can be conceived by those skilled in the art according to the inventive concept.
Claims (6)
1. A design method of bone surface anchoring type dental implant with a topological optimization structure is characterized in that
In the following steps: the design method comprises the following steps:
1) Acquiring an oral cavity and maxillofacial CT image of a patient, and reconstructing a mandibular bone three-dimensional model of the patient by using medical image processing software, wherein the reconstructed model also comprises a mandibular nerve tube anatomical structure;
2) Measuring and evaluating the situation of missing teeth and the situation of bone mass of a dental implant implantation position in medical image processing software, determining the position of a repair base station, and preparing a comprehensive repair scheme; determining dental implant position and form: implanting a conventional cylindrical or conical dental implant at a location where the bone mass is sufficient or less than sufficient; designing a bone surface anchoring type dental implant at a position with serious bone quantity shortage;
3) According to the comprehensive restoration scheme, determining the restoration position of the bone surface anchoring type dental implant, namely the position of an upper restoration base, and designing a three-dimensional model of the restoration base by referring to the standard structure of the base;
4) Designing a bone surface anchoring structure of an anchoring type dental implant with a topological optimization structure:
(4.1) determining a fixation region: including the active area and the fixed location of the entire bone surface anchoring structure;
(4.2) designing an initial anchoring plate through a curved surface thickening function based on the fixing area of the bone surface;
(4.3) constructing a mandible biomechanical model, loading an biting force load at a base station position, and performing topological optimization on the bone surface anchoring structure by using finite element software to obtain an initial optimized structure of the anchoring structure;
(4.4) carrying out standardization design according to the initial optimized structure of the bone surface anchoring structure to obtain an anchoring structure with a fixed hole and a regular structure;
5) The anchoring structure can be subjected to multiple topological optimization to obtain the bone surface anchoring structure with the best mechanical property;
6) Performing Boolean operation on the bone surface anchoring structure and the abutment three-dimensional model to obtain a complete bone surface anchoring type dental implant three-dimensional model with a topological optimization structure;
7) The designed bone surface anchoring type dental implant is manufactured by printing with a 3D printing technology, and the material can be titanium alloy or PEKK polymer material;
8) The bone surface anchoring type dental implant is subjected to surface treatment to obtain the bone surface anchoring type dental implant with a topology optimization structure, which can be applied to clinic.
2. Bone-surface anchored dental implant design with topologically optimized structure as in claim 1
The method is characterized in that: the design method further comprises the following steps: to facilitate surgeon surgery, personalized surgical guides may be designed for intraoperative positioning, including determining staple position.
3. Bone-surface anchored dental implant with topologically optimized structure according to claim 1
The implant constructed by the body design method is characterized in that: the implant is including the prosthetic base that is used for installing the artificial tooth and be used for supporting fixed bone face anchoring structure, bone face anchoring structure is including the supporting element that is used for supporting prosthetic base and the fixed unit of fixed region with the mandible, prosthetic base sets up in supporting element top center department and both integrated into one piece, the supporting element all is equipped with fixed unit along front and back both sides to all be equipped with the installation through-hole that is used for fixing on the mandible on every fixed unit, the upper end of every fixed unit all with supporting element integrated into one piece, and the lower extreme downwardly extending of every fixed unit, bone face anchoring structure passes through titanium nail and the fixed regional rigid coupling of mandible.
4. The implant of claim 3, wherein: the repairing base and the bone surface anchoring structure are made of titanium alloy or PEKK high polymer materials.
5. The implant of claim 3 or 4, wherein: the fixing units are four, two fixing units are respectively arranged on the front side and the rear side of the supporting unit, and each fixing unit is provided with two mounting through holes.
6. The implant of claim 3 or 4, wherein: the bone surface anchoring structure has optimal mechanical property by performing multiple topological optimization, and the installation through holes on the fixing units avoid important anatomical structures of the fixing areas.
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| CN109977590A (en) * | 2019-04-09 | 2019-07-05 | 哈尔滨理工大学 | A kind of titanium implant structural optimization method based on age factor |
| CN110613533B (en) * | 2019-09-23 | 2023-11-07 | 浙江工业大学 | PEKK personalized implant design and manufacturing method for mandibular box defect repair and implant |
| CN113813063B (en) * | 2020-11-25 | 2023-05-09 | 广州市弘健生物医用制品科技有限公司 | Support structure for repairing atrophic alveolar bone |
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