CN110314003B - Manufacturing method of guide bonding guide plate for digital planting and guide bonding guide plate - Google Patents
Manufacturing method of guide bonding guide plate for digital planting and guide bonding guide plate Download PDFInfo
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- CN110314003B CN110314003B CN201910604060.7A CN201910604060A CN110314003B CN 110314003 B CN110314003 B CN 110314003B CN 201910604060 A CN201910604060 A CN 201910604060A CN 110314003 B CN110314003 B CN 110314003B
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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
- A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
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- 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
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- 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
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Abstract
The invention discloses a method for manufacturing a guide plate for guiding and bonding digital planting, which comprises the following steps: designing a planting operation scheme; obtaining a three-dimensional space of the implant; designing a prosthesis; guiding in place and adhering the guide plate; homogenizing the tissue surface of the prosthesis; punching the guide plate and the prosthesis; and forming the guide plate and the prosthesis. The invention designs and manufactures the temporary prosthesis by changing the digital technology and taking the three-dimensional space relative position of the dental implant designed by the operation as the guidance before the operation, designs and prints the digital immediate repair guide in place and bonds the guide plate at 3D, finishes the in-place under the guide of the guide plate after the implantation operation is finished, restores the space position in the virtual design, bonds the prosthesis and the temporary abutment at the position, and finally finishes the immediate repair.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a manufacturing method of a digital planting guide bonding guide plate and the guide bonding guide plate.
Background
Implant restoration is one of the most common restoration methods for solving the problem of tooth loss and dentition loss, and the 'directed repair' as a restoration means rather than a simple surgical operation becomes a topic of enthusiasm in the planting world in recent years. The Target Restoration Space (TRS) theory provides a solution for the implant Restoration design, and the information such as the outline boundary, arrangement, butt joint relation and the like of the Target Restoration is obtained through actual measurement or deduction by the technologies such as the solid or virtual Restoration design, forecast, functional evaluation and the like, so that the numerical requirement and the transfer quantity relation of the Space position of the Restoration are obtained, and the whole process of clinic and manufacture is guided.
The immediate repair of the planting in the American area has important significance, delayed repair and immediate repair are greatly compared, the temporary crown for planting can support, shape and induce soft tissues in the American area, and the immediate repair can slow retraction of the gingival margin to maintain the gingival shape, support epithelial tissues, stabilize blood clots, be beneficial to healing of the soft tissues and obtain better aesthetic effect. Therefore, the improvement and invention of the instant repair technology are very significant.
The current implantation immediate restoration technology is mainly divided into a direct method and an indirect method, wherein the direct method is to use a finished product tooth or tooth surface to finish the bonding with an abutment in the mouth and finish the subsequent manufacturing outside the mouth, and finally fix the finished product tooth or tooth surface with an implant. The indirect method can be divided into two methods, one method is that an oral cavity is taken and transferred to an external model, the model is manufactured in vitro by a dental technician, and the model is worn back to the body after the manufacture is finished, but the model is required to be taken, so that the operation area is easy to be infected. The other method is digital design and cutting beside the chair, the inside of the mouth is scanned after wearing a scanning rod, the scanning rod is transferred to dental design software, the position of an implant is positioned according to the shape of the scanning rod, a temporary restoration body is designed beside the chair, and then cutting and forming are carried out; however, this method is often the same as the traditional indirect method, and the patient needs to wait for a certain period of time for the preparation, and although the time is shortened, the patient often needs to visit the next clinic to complete the immediate repair. At present, a temporary crown and a personalized abutment at a designed and manufactured position are designed before an operation, and the temporary crown and the personalized abutment are repaired immediately after the operation is finished; the method is characterized in that a digital technology is used for manufacturing a restoration in advance, but the method still lacks universality and is low in tolerance, only a whole-course navigation implant guide plate operation system can be used, the requirement on the manufacturing precision of an operation guide plate is high, and when the position of an implant is adjusted due to unconscious occurrence in the operation, the design of a temporary restoration can be consistent with that in a plan, once a small error exists in the implantation, the restoration can be shifted and twisted and is greatly different from the initial design, so that the gum shaping effect can be greatly reduced.
Therefore, how to use a digital means, based on the surgical design, the prosthesis is manufactured in advance by a brand new method, and the prosthesis is positioned and bonded in a guide plate guiding mode, so that the number of times of patient visits is reduced, the clinical operation time is shortened, and the problem that the position deviation of the prosthesis caused by the inevitable error of the implantation operation is needed to be solved urgently is solved.
Disclosure of Invention
The invention aims to solve the technical problems that the existing planting immediate repair technology generally has the problems of more times of patient treatment, long clinical operation time, deviation of the position of a restoration body and the like, and aims to provide a manufacturing method of a digital planting guide bonding guide plate and a guide bonding guide plate to solve the problems.
The invention is realized by the following technical scheme:
the manufacturing method of the guide plate for the digital planting and bonding comprises the following steps: s1: obtaining DICOM data, a preoperative model and wax pattern data of a patient oral cavity, fitting the preoperative model, the DICOM data and the wax pattern data, selecting an implant system and an implant model according to bone information and wax pattern tooth arrangement information, and determining the position of an implant; s2: deriving a preoperative model, deriving an implant and a base platform model according to the position of the implant, and acquiring a three-dimensional spatial position relation between the implant and the base platform model and the preoperative model; s3: establishing a temporary restoration model according to the three-dimensional spatial position relation and according to a restoration principle, periodontal requirements and planting requirements; s4: establishing a guide plate model according to the temporary restoration model and the preoperative model; the guide plate model is matched with the preoperative model, and the guide plate model completely wraps the temporary restoration model; s5: deleting the triangular patch in the temporary prosthesis model to form an outer tissue empty shell, and endowing the outer tissue empty shell with thickness; s6: punching the temporary prosthesis model with the given thickness and the guide plate model according to the penetrating direction of the implant and/or the base station to generate a final prosthesis model and a final guide plate model; s7: and carrying out solid forming on the final restoration body model and the final guide plate model.
When the method is applied, firstly, DICOM data, a preoperative model and wax pattern data of the oral cavity of a patient need to be acquired, the acquiring mode can be acquired by adopting a scanning mode, and the preoperative model, the DICOM data and the wax pattern data are fitted, so that the specific three-dimensional position of an implant can be obtained, the three-dimensional coordinate of the implant is reflected in the model, and an implant system and an implant model need to be selected according to bone information and wax pattern tooth arrangement information in consideration of the particularity of an implant operation, which is equivalent to the completion of the design of an implant operation scheme; meanwhile, the data can also provide basis for manufacturing the operation guide plate, so that the design process is further simplified, and the dental treatment efficiency is improved.
And then deriving a preoperative model, an implant model and a base model, wherein the implant model and the base model are models comprising two parts of the implant and the base, and because the fitting between the models is performed in S1, the three-dimensional position relationship between the two models can be accurately obtained, and the step is equivalent to the step of obtaining the three-dimensional space of the implant. Then the design of the prosthesis is carried out, which needs to follow the repair principles in medicine, the requirements of the patient's own periodontal conditions and the needs of the patient and the doctor in the implantation.
And then establishing a guide plate model, wherein the guide plate needs to be arranged in the oral cavity of a patient during the operation, so the guide plate model needs to be matched with the preoperative model to facilitate the arrangement during the operation, and the guide plate model needs to be completely wrapped around the temporary prosthesis model in order to accurately arrange the prosthesis to a preset position during the operation. And then, carrying out homogenization treatment on the tissue plane of the prosthesis, wherein the treatment mode is to remove the triangular surface patch inside the temporary prosthesis model and endow the outer tissue with a thickness, the generated model is a primary model of the guide plate, in order to reserve holes required by the operation, punching is required to be carried out according to the penetrating direction of the implant and/or the base station, the punching mode can be carried out in a Boolean operation mode, and finally, the solid forming of the model is carried out. The invention designs and manufactures the temporary prosthesis by changing the digital technology and taking the three-dimensional space relative position of the dental implant designed by the operation as the guidance before the operation, designs and prints the digital immediate repair guide in place and bonds the guide plate at 3D, finishes the in-place under the guide of the guide plate after the implantation operation is finished, restores the space position in the virtual design, bonds the prosthesis and the temporary abutment at the position, and finally finishes the immediate repair.
Further, step S1 includes the following sub-steps: scanning the oral cavity of a patient to obtain a preoperative model containing oral conditions; DICOM data of the patient's mouth is obtained by taking CBCT.
Further, step S4 includes the following sub-steps: the guide plate model is used for wrapping the tooth body except the prosthesis model and extends to 1/3 of the neck of the tooth body.
Further, step S4 includes the following sub-steps: the thickness of the guide plate in the guide plate model is set to be 0.8-1.2 mm.
Further, step S5 includes the following sub-steps: the thickness of the void imparted to the outer tissue is determined by the repair material.
Furthermore, when the repair material adopts the cutting polymethyl methacrylate artificial tooth, the thickness of the outer tissue hollow shell is 0.5-0.7 mm.
Further, step S6 includes the following sub-steps: the punching is carried out by taking the diameter of the base station as a reference and adopting Boolean operation.
Further, step S7 includes the following sub-steps: the guide plate entity and the prosthesis entity are manufactured using a numerical control cutting technique or a 3D printing technique.
The digital planting guide bonding guide plate is prepared by adopting any one of the methods.
Compared with the prior art, the invention has the following advantages and beneficial effects:
1. the invention relates to a manufacturing method of a guide bonding guide plate for digital planting and a guide bonding guide plate, which utilize a brand-new restoration guiding device designed by a brand-new digital design technology and complete immediate restoration in a brand-new guiding mode; the guide plate is used for guiding immediate repair, so that the device is more accurate and completely conforms to preoperative design;
2. the manufacturing method of the guide bonding guide plate for digital implantation and the guide bonding guide plate fully utilize the advantages of a digital technology, the prosthesis is manufactured before an operation, and the teeth can be worn immediately after the operation, so that the clinical immediate repair time is greatly reduced, and the number of times of patients in a clinic is reduced;
3. compared with the method for finishing immediate restoration by using finished teeth, the method for manufacturing the digital implant guide bonding guide plate and the guide bonding guide plate have more aesthetic effect and individuation, can design different shapes according to different patients through digital design, and can finish the immediate restoration with higher aesthetic property by mirroring the same teeth;
4. the manufacturing method of the guide bonding guide plate for digital planting and the guide bonding guide plate have a better gum forming effect and can keep the same design with the preoperative operation, so that the gum forming effect is guaranteed; the method has higher tolerance, and even if an error occurs in the operation process or the whole guide plate is not used for guiding the operation, the efficient and immediate repair can be completed under the technology of the method; the abutment is tightly connected with the neck of the prosthesis, and is highly polished, so that infection and periodontitis inflammation are effectively prevented.
Drawings
The accompanying drawings, which are included to provide a further understanding of the embodiments of the invention and are incorporated in and constitute a part of this application, illustrate embodiment(s) of the invention and together with the description serve to explain the principles of the invention. In the drawings:
FIG. 1 is a schematic diagram of the process steps of the present invention;
FIG. 2 is a schematic view of a plan for an implantation procedure according to the present invention;
FIG. 3 is a schematic diagram of the acquisition of three-dimensional space of the implant according to the present invention;
FIG. 4 is a schematic design view of a prosthesis of the invention;
FIG. 5 is a schematic view of the guide plate design for guiding into position and bonding in accordance with the present invention;
FIG. 6 is a schematic view of tissue homogenization treatment of a prosthesis according to the present invention;
FIG. 7 is a schematic view of the guide plate and prosthesis perforation process of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to examples and accompanying drawings, and the exemplary embodiments and descriptions thereof are only used for explaining the present invention and are not meant to limit the present invention.
Examples
As shown in figure 1, the manufacturing method of the digital planting guide bonding guide plate comprises the following steps: s1: obtaining DICOM data, a preoperative model and wax pattern data of a patient oral cavity, fitting the preoperative model, the DICOM data and the wax pattern data, selecting an implant system and an implant model according to bone information and wax pattern tooth arrangement information, and determining the position of an implant; s2: deriving a preoperative model, deriving an implant and a base platform model according to the position of the implant, and acquiring a three-dimensional spatial position relation between the implant and the base platform model and the preoperative model; s3: establishing a temporary restoration model according to the three-dimensional spatial position relation and according to a restoration principle, periodontal requirements and planting requirements; s4: establishing a guide plate model according to the temporary restoration model and the preoperative model; the guide plate model is matched with the preoperative model, and the guide plate model completely wraps the temporary restoration model; s5: deleting the triangular patch in the temporary prosthesis model to form an outer tissue empty shell, and endowing the outer tissue empty shell with thickness; s6: punching the temporary prosthesis model with the given thickness and the guide plate model according to the penetrating direction of the implant and/or the base station to generate a final prosthesis model and a final guide plate model; s7: and carrying out solid forming on the final restoration body model and the final guide plate model.
In the implementation of this embodiment, firstly, the DICOM data, the preoperative model and the wax model data of the oral cavity of the patient need to be acquired, the acquisition mode can be acquired by adopting a scanning mode, and the preoperative model, the DICOM data and the wax model data are fitted, so that the specific three-dimensional position of the implant can be obtained, which is embodied in the model as the three-dimensional coordinate of the implant, and considering the particularity of the implantation operation, the implantation system and the model of the implant need to be selected according to the bone information and the wax model information, which is equivalent to the completion of the design of the implantation operation scheme.
And then deriving a preoperative model, an implant model and a base model, wherein the implant model and the base model are models comprising two parts of the implant and the base, and because the fitting between the models is performed in S1, the three-dimensional position relationship between the two models can be accurately obtained, and the step is equivalent to the step of obtaining the three-dimensional space of the implant. Then the design of the prosthesis is carried out, which needs to follow the repair principles in medicine, the requirements of the patient's own periodontal conditions and the needs of the patient and the doctor in the implantation.
And then establishing a guide plate model, wherein the guide plate needs to be arranged in the oral cavity of a patient during the operation, so the guide plate model needs to be matched with the preoperative model to facilitate the arrangement during the operation, and the guide plate model needs to be completely wrapped around the temporary prosthesis model in order to accurately arrange the prosthesis to a preset position during the operation. And then, carrying out homogenization treatment on the tissue plane of the prosthesis, wherein the treatment mode is to remove the triangular surface patch inside the temporary prosthesis model and endow the outer tissue with a thickness, the generated model is a primary model of the guide plate, in order to reserve holes required by the operation, punching is required to be carried out according to the penetrating direction of the implant and/or the base station, the punching mode can be carried out in a Boolean operation mode, and finally, the solid forming of the model is carried out. The invention designs and manufactures the temporary prosthesis by changing the digital technology and taking the three-dimensional space relative position of the dental implant designed by the operation as the guidance before the operation, designs and prints the digital immediate repair guide in place and bonds the guide plate at 3D, finishes the in-place under the guide of the guide plate after the implantation operation is finished, restores the space position in the virtual design, bonds the prosthesis and the temporary abutment at the position, and finally finishes the immediate repair.
To further explain the operation of the present embodiment, step S1 includes the following sub-steps: scanning the oral cavity of a patient to obtain a preoperative model containing oral conditions; DICOM data of the patient's mouth is obtained by taking CBCT.
To further explain the operation of the present embodiment, step S4 includes the following sub-steps: the guide plate model is used for wrapping the tooth body except the prosthesis model and extends to 1/3 of the neck of the tooth body.
To further explain the operation of the present embodiment, step S4 further includes the following sub-steps: the thickness of the guide plate in the guide plate model is set to be 0.8-1.2 mm.
To further explain the operation of the present embodiment, step S5 includes the following sub-steps: the thickness of the void imparted to the outer tissue is determined by the repair material.
To further illustrate the working process of the embodiment, when the prosthetic material is an artificial tooth made of cut polymethyl methacrylate, the thickness of the outer tissue shell is 0.5-0.7 mm.
To further explain the operation of the present embodiment, step S6 includes the following sub-steps: the punching is carried out by taking the diameter of the base station as a reference and adopting Boolean operation.
To further explain the operation of the present embodiment, step S7 includes the following sub-steps: the guide plate entity and the prosthesis entity are manufactured using a numerical control cutting technique or a 3D printing technique.
The digital planting guide bonding guide plate is prepared by any one of the methods in the embodiments.
In order to further explain the specific working content of the embodiment, the detailed content in the embodiment includes the following steps:
(1) the design of the planting operation scheme is as follows: after obtaining relevant data of a patient, using implant guide design software to fit CBCT data, preoperative models and wax pattern scanning data, combining information of bones and information of wax pattern tooth arrangement, selecting a Straumann implant system and a model of 3.3 x 14 implant, and placing the implant at the position. Fig. 2 is a schematic view of the design of the implantation surgical plan.
(2) Obtaining the three-dimensional space of the implant: after the design of the planting scheme is finished, the position of the implant is determined, a preoperative model and three-dimensional models of the implant and the base station are derived, and the position relation of the two three-dimensional spaces is obtained. Fig. 3 is a schematic diagram showing the acquisition of the three-dimensional space of the implant.
(3) Designing the prosthesis: and designing the temporary restoration according to the three-dimensional space positions of the implant and the abutment relative to the model and according to the restoration principle, the periodontal requirement and the patient requirement. Fig. 4 is a schematic design diagram of the prosthesis.
(4) Design of guide plate for guiding in place and bonding: the temporary restoration model is used as a substrate, the thickness of the tooth-supporting guide plate is designed to be 1mm, the temporary restoration body is completely wrapped, and the rest of the tooth body extends to the 1/3 position of the neck of the tooth body. Fig. 5 shows a schematic design of the guide plate for guiding into position and adhering.
(5) Homogenizing the tissue surface of the prosthesis: and deleting all triangular patches in the prosthesis to form an outer tissue empty shell, and then inwards endowing the thickness of the outer tissue empty shell, wherein the thickness is set to be 0.6mm according to the thickness requirement of the artificial tooth made of the cut polymethyl methacrylate. Fig. 6 is a schematic diagram of tissue homogenization treatment of the prosthesis.
(6) Punching the guide plate and the prosthesis: according to the penetrating direction of the implant or the abutment, the guide plate and the prosthesis are punched and designed by using Boolean operation based on the diameter of the abutment. FIG. 7 is a schematic view of the guide plate and prosthesis perforation process.
(7) Forming the guide plate and the prosthesis: the guide plate and the prosthesis are manufactured using a numerical control cutting technique or a 3D printing technique.
The above-mentioned embodiments are intended to illustrate the objects, technical solutions and advantages of the present invention in further detail, and it should be understood that the above-mentioned embodiments are merely exemplary embodiments of the present invention, and are not intended to limit the scope of the present invention, and any modifications, equivalent substitutions, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.
Claims (8)
1. The manufacturing method of the guide plate for the digital planting and guide adhesion is characterized by comprising the following steps:
s1: obtaining DICOM data, a preoperative model and wax pattern data of a patient oral cavity, fitting the preoperative model, the DICOM data and the wax pattern data, selecting an implant system and an implant model according to bone information and wax pattern tooth arrangement information, and determining the position of an implant;
s2: deriving a preoperative model, deriving an implant and a base platform model according to the position of the implant, and acquiring a three-dimensional spatial position relation between the implant and the base platform model and the preoperative model;
s3: establishing a temporary restoration model according to the three-dimensional spatial position relation and according to a restoration principle, periodontal requirements and planting requirements;
s4: establishing a guide plate model according to the temporary restoration model and the preoperative model; the guide plate model is matched with the preoperative model, and the guide plate model completely wraps the temporary restoration model; the guide plate model wraps the tooth body except the prosthesis model and extends to 1/3 of the neck of the tooth body, and the rest of the tooth body extends to 1/3 of the neck of the tooth body;
s5: deleting the triangular patch in the temporary prosthesis model to form an outer tissue empty shell, and endowing the outer tissue empty shell with thickness inwards;
s6: punching the temporary restoration model with the given thickness and the guide plate model according to the penetrating direction of the implant and/or the base station to generate a final restoration model and a final guide plate model;
s7: and carrying out solid forming on the final restoration body model and the final guide plate model.
2. The method for manufacturing a digital planting guide sticking guide plate according to claim 1, wherein the step S1 comprises the following substeps:
scanning the oral cavity of a patient to obtain a preoperative model containing oral conditions; DICOM data of the patient's mouth is obtained by taking CBCT.
3. The method for manufacturing the digital planting guide adhesive guide plate according to claim 1, wherein the step S4 further comprises the following substeps:
the thickness of the guide plate in the guide plate model is set to be 0.8-1.2 mm.
4. The method for manufacturing a digital planting guide sticking guide plate according to claim 1, wherein the step S5 comprises the following substeps:
the thickness of the void imparted to the outer tissue is determined by the repair material.
5. The method for manufacturing the digital planting guide adhesion guide plate according to claim 4, wherein when the repair material is a cut polymethyl methacrylate artificial tooth, the thickness of the outer tissue hollow shell is 0.5-0.7 mm.
6. The method for manufacturing a digital planting guide sticking guide plate according to claim 1, wherein the step S6 comprises the following substeps:
the punching is carried out by taking the diameter of the base station as a reference and adopting Boolean operation.
7. The method for manufacturing a digital planting guide sticking guide plate according to claim 1, wherein the step S7 comprises the following substeps:
the guide plate entity and the prosthesis entity are manufactured using a numerical control cutting technique or a 3D printing technique.
8. The digital planting guide and bonding guide plate is characterized by being prepared by the method according to any one of claims 1 to 7.
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| CN111243081A (en) * | 2020-01-08 | 2020-06-05 | 广西医科大学附属口腔医院 | Manufacturing method of resin filling guide plate beside digital chair and guide plate |
| CN111616821B (en) * | 2020-05-20 | 2021-08-17 | 北京联袂义齿技术有限公司 | Digital three-dimensional construction and manufacturing method of personalized planting base station |
| CN112353516B (en) * | 2020-12-02 | 2021-08-31 | 四川大学 | Axial and depth checking guide plate for planting and manufacturing method thereof |
| CN112690912A (en) * | 2021-01-12 | 2021-04-23 | 四川大学 | Guide plate for pile core dismantling and preparation method thereof |
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