CN111214299A - Manufacturing method of orthodontic micro-screw guide plate and orthodontic micro-screw guide plate - Google Patents

Manufacturing method of orthodontic micro-screw guide plate and orthodontic micro-screw guide plate Download PDF

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CN111214299A
CN111214299A CN202010085012.4A CN202010085012A CN111214299A CN 111214299 A CN111214299 A CN 111214299A CN 202010085012 A CN202010085012 A CN 202010085012A CN 111214299 A CN111214299 A CN 111214299A
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micro
model
orthodontic
screw
data
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CN111214299B (en
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韩冰
陈贵
赵一姣
王勇
吕汶諠
卫彦
张云帆
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Peking University School of Stomatology
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Peking University School of Stomatology
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Priority to PCT/CN2020/104916 priority patent/WO2021159667A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/002Orthodontic computer assisted systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089Implanting tools or instruments
    • A61C8/009Implanting tools or instruments for selecting the right implanting element, e.g. templates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0093Features of implants not otherwise provided for
    • A61C8/0096Implants for use in orthodontic treatment
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06TIMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T17/00Three dimensional [3D] modelling, e.g. data description of 3D objects

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  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
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Abstract

The invention discloses a manufacturing method of an orthodontic micro-screw guide plate and the orthodontic micro-screw guide plate, comprising the following steps: 1) making a dentition model of the patient; 2) acquiring CBCT image data, oral cavity scanning data and dentition model scanning data of the patient; 3) acquiring tooth three-dimensional image data from the CBCT image data; 4) establishing a virtual dental model by using the tooth three-dimensional image data, the oral cavity scanning data and the dentition model scanning data; 5) determining an implantation point and an operation approach of a micro screw according to the virtual dental model; 6) establishing a three-dimensional model of the orthodontic micro-screw guide plate on the virtual dental model according to the implantation point and the surgical approach; 7) outputting the three-dimensional model data of the orthodontic micro-screw guide plate, and manufacturing the orthodontic micro-screw guide plate according to the three-dimensional model data. The orthodontic micro-screw guide plate provided by the invention is more beneficial to improving the accuracy of the implantation position of the micro-screw, and can greatly reduce the risk of implantation operation of the micro-implant screw.

Description

Manufacturing method of orthodontic micro-screw guide plate and orthodontic micro-screw guide plate
Technical Field
The invention belongs to the technical field of tooth orthodontics, and particularly relates to an orthodontics micro-screw guide plate and a manufacturing method thereof.
Background
Compared with the traditional orthodontic anchorage, the micro screw can provide absolute anchorage, does not depend on the cooperation of patients, has the advantages of small volume, flexible use and the like, is widely used clinically since the 90 s of the 20 th century, and plays an important role in treating some complex and serious malposed deformities. However, the implantation of the minisize surgical operation has risks of damaging the normal anatomy, postoperative infection and the like, and complications, wherein the greatest risk is to damage the tooth root, the tooth bone is abraded by the light person, and the tooth root is longitudinally split by the heavy person, so that the tooth can not be preserved. In order to effectively avoid the risk of tooth root injury, scholars design various guide plates to assist the implantation of the micro-screws from 2005, and the micro-screw guide plates reported in the literature at present have the problems that the design process is complex, the precision cannot completely meet the clinical requirements and the like.
Therefore, the development of the manufacturing method of the orthodontic micro-screw guide plate and the orthodontic micro-screw guide plate is expected, the design process of the orthodontic micro-screw guide plate is simplified, the precision and the efficiency are improved, the manufactured micro-screw guide plate can assist the orthodontic micro-screw to be accurately implanted, the tooth root is prevented from being damaged in the implanting process of the micro-screw, and the orthodontic micro-screw guide plate is convenient for clinical application.
Disclosure of Invention
The invention aims to provide an orthodontic micro-screw guide plate and a manufacturing method thereof, which simplify the design process of the micro-screw guide plate, improve the precision and the efficiency and reduce the risk of implantation operation of micro-implant nails.
In order to achieve the above object, the present invention provides a method for manufacturing an orthodontic miniscrew guide plate, comprising the steps of:
1) making a dentition model of the patient;
2) acquiring CBCT image data, oral cavity scanning data and dentition model scanning data of the patient;
3) acquiring tooth three-dimensional image data from the CBCT image data;
4) matching the tooth three-dimensional image data, the oral cavity scanning data and the dentition model scanning data through the external shape of a dental crown to establish a virtual dental model;
5) determining an implantation point and an operation approach of a micro screw according to the virtual dental model;
6) establishing three-dimensional models of a hollow cylinder and a pair of fixing plates on the virtual dental model according to the implantation point and the surgical approach, and then establishing a three-dimensional model of a connecting rod to connect the three-dimensional models of the hollow cylinder and the fixing plates to form a three-dimensional model of the orthodontic micro-screw guide plate;
7) outputting the three-dimensional model data of the orthodontic micro-screw guide plate, and manufacturing the orthodontic micro-screw guide plate according to the three-dimensional model data.
Preferably, the step 2) includes:
2.1) scanning the jaw bone and dentition of a patient by a CBCT scanner to obtain CBCT image data containing the jaw bone and the dentition;
2.2) scanning the gingiva and dentition of the patient by an intraoral scanner to obtain the oral cavity scanning data containing soft tissues and dental crowns;
2.3) scanning the dentition model of the patient through a model scanner to obtain the scanning data of the dentition model.
Preferably, the step 2) further comprises:
when a patient is scanned by the CBCT scanner, the orbital-ear plane of the patient is parallel to the ground, the central line of the plane is vertical to the ground, and the dental jaw keeps the crossing and malposition occlusion relationship of the dental cusps;
when the gum and the dentition of a patient are scanned by the intraoral scanner, a scanning head of the intraoral scanner extends into the oral cavity of the patient and scans along the surface of the dentition.
Preferably, said step 2.3) comprises:
and scanning the upper jaw and the lower jaw of the dentition model and the occlusion state of the upper jaw and the lower jaw when the dental cusps are crossed and dislocated to obtain the scanning data of the dentition model.
Preferably, the step 3) includes:
and separating the tooth image data from the alveolar bone image data by adjusting the threshold of the CBCT image data so as to extract the tooth three-dimensional image data.
Preferably, the step 4) includes:
4.1) taking the scan data of the dentition model as a reference, and enabling the tooth three-dimensional image data to be superposed with the scan data of the dentition model through the external shape of a dental crown;
4.2) taking the scan data of the dentition model as a reference, and enabling the oral cavity scan data to be superposed with the scan data of the dentition model and the three-dimensional image data of the teeth through the external shape of the dental crown;
4.3) fixing the relative positions of the scan data of the dentition model, the three-dimensional image data of the teeth and the scan data of the oral cavity, and establishing the virtual dental model which comprises three-dimensional data of tooth roots and soft tissues.
Preferably, the step 5) includes:
in the virtual dental model, according to the positions of soft tissues and tooth roots, the implantation points of the micro screws are selected and the implantation direction is designed, so that the micro screws can enter the soft tissues and are positioned between two adjacent tooth roots, and the operation approach is determined.
Preferably, the step 6) includes:
6.1) establishing a three-dimensional model of the hollow cylinder at the implantation point, so that the small-diameter end of the hollow cylinder faces the implantation point;
6.2) calibrating the axial direction of the hollow cylinder according to the surgical approach, so that the axial direction of the hollow cylinder is superposed with the implantation direction of the micro-screw and passes through the implantation point;
6.3) dividing the hollow cylinder into two parts along the plane where the axis is located;
6.4) respectively establishing a three-dimensional model of the fixing plate on the adjacent occlusal surfaces at two sides of the implantation point;
6.5) establishing a three-dimensional model of the connecting rod, and connecting the three-dimensional models of the pair of fixing plates with the three-dimensional model of the hollow cylinder to form the three-dimensional model of the orthodontic micro-screw guide plate.
Preferably, the step 7) includes:
and preparing the orthodontic micro-screw guide plate by three-dimensional printing according to the three-dimensional model data of the orthodontic micro-screw guide plate.
The invention also provides an orthodontic miniscrew guide plate, which is prepared by the method and comprises the following steps:
the hollow cylinder is in a step shape and comprises a large-diameter end and a small-diameter end, the plane where the axis of the hollow cylinder is located divides the hollow cylinder into two parts, and the two parts are connected through a connecting piece;
the pair of fixing plates are respectively connected to one part of the hollow cylinder through a connecting rod and are respectively used for being fixed on adjacent occlusal surfaces at two sides of a micro-screw implantation point;
when the pair of fixing plates are respectively fixed on adjacent occlusal surfaces at two sides of the implantation point of the micro screw, the small diameter end of the hollow cylinder faces the implantation point of the micro screw, the axial direction of the hollow cylinder coincides with the implantation direction of the micro screw, the small diameter end is used for restraining the implantation direction of the micro screw, and the large diameter end is used for restraining the implantation direction of the micro screw implantation handle.
The invention has the beneficial effects that:
1. after the virtual dental model is established through CBCT image data, oral cavity scanning data and dentition model scanning data of a patient, technicians can design an optimal micro screw access in the virtual dental model according to soft tissue and tooth root information in the virtual dental model and establish a three-dimensional model of the orthodontic micro screw guide plate on the virtual dental model, so that the orthodontic micro screw guide plate is more fit with the oral cavity structure of the patient when in use, the constraint on the planting direction and the planting position of the micro screw is more accurate, the damage to the tooth root is avoided, the improvement of the accuracy of the implanting position of the micro screw is more facilitated, the risk of the implanting operation of the micro implanting screw is greatly reduced, the design difficulty of the orthodontic micro screw guide plate can be reduced by using the method, and the design efficiency is improved.
2. When the orthodontic micro screw guide plate is used, the pair of fixing plates are placed on the adjacent occlusal surfaces on two sides of a micro screw implantation point, the micro screw and the implantation handle are subjected to double restraint through the hollow cylinder in the implantation process, after the tip of the micro screw enters the alveolar bone to a proper depth, the connecting piece is cut off, the hollow cylinder is taken down, and the pair of fixing plates are taken down to complete the implantation process.
Additional features and advantages of the invention will be set forth in the detailed description which follows.
Drawings
The above and other objects, features and advantages of the present invention will become more apparent by describing in more detail exemplary embodiments thereof with reference to the attached drawings, in which like reference numerals generally represent like parts throughout.
Fig. 1 shows a flow diagram of a method of manufacturing an orthodontic miniscrew guide according to one embodiment of the invention.
Fig. 2 illustrates a bucco-lingual view of a dual-constrained split orthodontic miniscrew guide according to one embodiment of the invention.
Fig. 3 illustrates a gingival view of a double-constrained split orthodontic miniscrew guide according to one embodiment of the invention.
Fig. 4 illustrates a mesial-distal view of a dual-constrained split orthodontic miniscrew guide according to one embodiment of the invention.
Description of the reference numerals
1. A hollow cylinder; 1.1, a small diameter end; 1.2, a large-diameter end; 2. a visible window; 3. a retention groove; 4. fixing a leather ring; 5. a connecting rod; 6. and (7) fixing the plate.
Detailed Description
Preferred embodiments of the present invention will be described in more detail below. While the following describes preferred embodiments of the present invention, it should be understood that the present invention may be embodied in various forms and should not be limited by the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art.
In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," "clockwise," "counterclockwise," "axial," "radial," "circumferential," and the like are used in the orientations and positional relationships indicated in the drawings for convenience in describing the invention and to simplify the description, and are not intended to indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be considered limiting of the invention.
The manufacturing method of the orthodontic miniscrew guide plate comprises the following steps:
1) making a dentition model of the patient;
2) acquiring CBCT image data, oral cavity scanning data and dentition model scanning data of a patient;
3) acquiring tooth three-dimensional image data from CBCT image data;
4) matching the tooth three-dimensional image data, the oral cavity scanning data and the dentition model scanning data through the external shape of the dental crown to establish a virtual dental model;
5) determining an implantation point and an operation approach of the micro screw according to the virtual dental model;
6) establishing three-dimensional models of a hollow cylinder and a pair of fixing plates on the virtual dental model according to the implantation point and the surgical approach, and then establishing a three-dimensional model of a connecting rod to connect the three-dimensional model of the hollow cylinder with the three-dimensional models of the pair of fixing plates to form a three-dimensional model of the orthodontic micro-screw guide plate;
7) and outputting the three-dimensional model data of the orthodontic micro-screw guide plate, and preparing the orthodontic micro-screw guide plate according to the three-dimensional model data.
Specifically, after the virtual dental model is established through CBCT image data, oral cavity scanning data and dentition model scanning data of a patient, technicians can design an optimal micro screw access in the virtual dental model according to soft tissue and tooth root information in the virtual dental model and establish a three-dimensional model of the orthodontic micro screw guide plate on the optimal micro screw access, so that the orthodontic micro screw guide plate is more fit with the oral cavity structure of the patient when in use, the constraint on the micro screw implantation direction and position is more accurate, the tooth root is prevented from being damaged, the improvement of the accuracy of the implantation position of the micro screw is facilitated, the risk of the implantation operation of the micro implant screw is greatly reduced, the design difficulty of the orthodontic micro screw guide plate can be reduced by using the method, and the design efficiency is improved.
The orthodontic micro-screw guide plate prepared by the steps can be used for designing the optimal micro-screw implantation position by fully combining the information of periodontal soft tissues, tooth roots, jawbones and other hard tissues in the mouth, so that the success rate and the stability of a micro-screw operation are improved.
The CBCT image is a cone beam CT image.
Preferably, step 2) comprises:
2.1) scanning the jaw bone and dentition of a patient by a CBCT scanner to obtain CBCT image data containing the jaw bone and the dentition;
2.2) scanning the gingiva and the dentition of the patient by an intraoral scanner to obtain oral cavity scanning data containing soft tissues and dental crowns;
and 2.3) scanning the dentition model of the patient through the model scanner to obtain the dentition model scanning data.
Specifically, the oral cavity scanning data contain intraoral periodontal tissue information, and an operator can determine the implantation point of the micro screw according to the position of the attached gingiva, so that the success rate and the stability of the micro screw surgery are improved.
Preferably, step 2) further comprises:
when a patient is scanned by the CBCT scanner, the orbital-ear plane of the patient is parallel to the ground, the central line of the plane is vertical to the ground, and the dental jaw keeps the crossing and malposition occlusion relationship of the dental cusps;
when the gum and the dentition of a patient are scanned by the intraoral scanner, a scanning head of the intraoral scanner extends into the oral cavity of the patient and scans along the surface of the dentition.
Preferably, step 2.3) comprises:
and scanning the upper jaw and the lower jaw of the dentition model and the occlusion state of the upper jaw and the lower jaw when the dental cusps are staggered to obtain the scanning data of the dentition model.
Preferably, step 3) comprises:
and separating the tooth image data from the alveolar bone image data by adjusting the threshold of the CBCT image data so as to extract the tooth three-dimensional image data.
Specifically, dentition information extracted by adjusting the CBCT threshold value comprises the root position, and an operator can draw up the implantation position of the micro screw by referring to the root position, so that the implantation safety and stability are improved.
Preferably, step 4) comprises:
4.1) taking the scan data of the dentition model as a reference, and enabling the three-dimensional image data of the tooth to be superposed with the scan data of the dentition model through the external shape of the dental crown;
4.2) taking the scan data of the dentition model as a reference, and enabling the oral cavity scan data to be superposed with the scan data of the dentition model and the three-dimensional tooth image data through the external shape of the dental crown;
and 4.3) fixing the relative positions of the scan data of the dentition model, the three-dimensional image data of the teeth and the scan data of the oral cavity, and establishing a virtual dental model which comprises three-dimensional data of tooth roots and soft tissues.
Specifically, scan data of the dentition model, three-dimensional image data of the teeth and scan data of the oral cavity are overlapped according to matching of the tooth crowns of all teeth in the mouth, so that the overlapping can be more accurate, and the overlapping degree of the actual implantation part of the micro screw and the part in the virtual design is higher.
Preferably, step 5) comprises:
in the virtual dental model, according to the positions of soft tissues and tooth roots, the implantation points of the micro screws are selected and the implantation direction is designed, so that the micro screws can enter the soft tissues and are positioned between two adjacent tooth roots, and the operation approach is determined.
Preferably, step 6) comprises:
6.1) establishing a three-dimensional model of the hollow cylinder at the implantation point, so that the small-diameter end of the hollow cylinder faces the implantation point;
6.2) calibrating the axis direction of the hollow cylinder according to the surgical approach, so that the axis direction of the hollow cylinder is superposed with the implantation direction of the micro screw and passes through the implantation point;
6.3) dividing the hollow cylinder into two parts along the plane where the axis is located;
6.4) respectively establishing a three-dimensional model of the fixing plate on the adjacent occlusal surfaces at two sides of the implantation point;
6.5) establishing a three-dimensional model of the connecting rod, and connecting the three-dimensional models of the pair of fixing plates with the three-dimensional model of the hollow cylinder to form the three-dimensional model of the orthodontic micro-screw guide plate.
Preferably, step 7) comprises:
and preparing the orthodontic micro-screw guide plate by three-dimensional printing according to the three-dimensional model data of the orthodontic micro-screw guide plate.
Particularly, the three-dimensional printing integrated forming speed is high, the error is small, and the integrating degree is higher during use.
The orthodontic miniscrew guide of the invention comprises:
the hollow cylinder is in a step shape and comprises a large-diameter end and a small-diameter end, the plane where the axis of the hollow cylinder is located divides the hollow cylinder into two parts, and the two parts are connected through a connecting piece;
the pair of fixing plates are respectively connected to one part of the hollow cylinder through a connecting rod and are respectively used for being fixed on adjacent occlusal surfaces at two sides of a micro-screw implantation point;
when a pair of fixing plates are respectively fixed on adjacent occlusal surfaces at two sides of the implantation point of the micro screw, the small diameter end of the hollow cylinder faces the implantation point of the micro screw, the axial direction of the hollow cylinder coincides with the implantation direction of the micro screw, the small diameter end is used for restraining the implantation direction of the micro screw, and the large diameter end is used for restraining the implantation direction of the micro screw implantation handle.
Specifically, when the orthodontic micro screw guide plate is used, the pair of fixing plates are placed on adjacent occlusal surfaces on two sides of a micro screw implantation point, the micro screw and the implantation handle are subjected to double restraint through the hollow cylinder in the implantation process, the connecting piece is cut off after the tip of the micro screw enters the alveolar bone to a proper depth, the hollow cylinder is taken down, and the pair of fixing plates are taken down to complete the implantation process.
Preferably, an annular retention groove is formed in the outer wall of the large-diameter end of the hollow cylinder along the circumferential direction of the large-diameter end, the connecting piece is a retention leather ring, and the retention leather ring is sleeved on the large-diameter end and located in the retention groove.
Particularly, the pair of arc-shaped constraining bodies are connected by the retention leather ring for convenient shearing, and the retention leather ring can be prevented from moving on the hollow cylinder by arranging the retention groove.
Preferably, the retention groove has a depth of 0.8mm to 1mm and a width of 0.8mm to 1.2 mm.
Preferably, the side wall of the hollow cylinder is provided with a visible window, and the visible window penetrates through the small-diameter end along the axial direction of the hollow cylinder and extends to the middle of the large-diameter end.
Particularly, the implantation condition of the micro screw can be observed in the implantation process through the visual window, and the smooth proceeding of the micro screw implantation operation is ensured.
Preferably, the visualization window is located at a division of the hollow cylinder.
Preferably, the width of the visible window is 2.5-3.5 mm.
Preferably, the shapes of the pair of fixing plates are respectively matched with the occlusal surface and the occlusal surface of the profile high points of the adjacent tooth axial surfaces at two sides of the implantation point of the micro screw.
Specifically, the shape of the fixing plate is respectively matched with the matching side and the occlusal surface of the high point of the shaft surface appearance, so that the positioning of the hollow cylinder is more accurate and stable.
Preferably, the wall thickness of the large-diameter end is 1mm-1.2mm, and the wall thickness of the small-diameter end is 0.6mm-0.8 mm.
Preferably, the connecting rod is a cylindrical rod with a diameter of 0.4mm-0.6 mm.
Examples
Fig. 1 shows a flow chart of a method of manufacturing an orthodontic miniscrew guide according to the present embodiment; fig. 2 shows a bucco-lingual view of a double-constrained split orthodontic miniscrew guide according to the present embodiment; fig. 3 shows a gingival-oriented view of a double-constrained split orthodontic miniscrew guide according to the present embodiment; fig. 4 shows a mesial-distal view of a dual-constrained split orthodontic miniscrew guide according to the present embodiment.
As shown in figures 1-4 of the drawings,
the manufacturing method of the orthodontic miniscrew guide plate comprises the following steps:
1) making a dentition model of the patient;
2) enabling the plane of the orbital ears of the patient to be parallel to the ground, enabling the plane central line to be vertical to the ground, enabling the dental jaw to keep the occlusion relation of the cusps in a staggered mode, and scanning the jaw and the dentition of the patient through a CBCT scanner to obtain CBCT image data containing the jaw and the dentition;
3) extending a scanning head of a 3shape Trios scanner into the oral cavity of a patient, and scanning the gum and the dentition of the patient along the surface of the dentition to obtain oral cavity scanning data containing soft tissues and the dental crown;
4) scanning the upper jaw and the lower jaw of the dentition model and the occlusion state of the upper jaw and the lower jaw when the dental cusps are staggered by using a 3shape scanner to obtain dentition model scanning data;
5) reconstructing CBCT image data by using MIMICS18.0 software (a medical image control system), and separating tooth and alveolar bone data by adjusting the threshold of the CBCT image data to obtain tooth three-dimensional image data;
6) and applying GeomagicWrap2017 software (scanning data processing software) to enable the tooth three-dimensional image data and the oral cavity scanning data to be overlapped with the scan data of the dentition model through the external shape of the dental crown, fixing the relative positions of the scan data of the dentition model, the three-dimensional image data of the tooth and the oral cavity scanning data, and establishing a virtual dental model, wherein the virtual dental model comprises three-dimensional data of a tooth root and soft tissues.
7) In the virtual dental model, according to the positions of soft tissues and tooth roots, selecting implantation points of the micro screws and designing implantation directions, so that the micro screws can enter the soft tissues and are positioned between two adjacent tooth roots, and an operation approach is determined;
8) application 3 ShapeApplenaceDesignerTMSoftware (dental appliance design software) is led into a virtual dental model, a three-dimensional model of a hollow cylinder is built at an implantation point of the virtual dental model, the small diameter end of the hollow cylinder faces the implantation point, the axis direction of the hollow cylinder is calibrated according to an operation approach, the axis direction of the hollow cylinder is coincided with the implantation direction of a micro screw and passes through the implantation point, the plane where the axis of the hollow cylinder is located is divided into two parts, three-dimensional models of fixing plates are respectively built on adjacent occlusal surfaces at two sides of the implantation point, and the three-dimensional models of connecting rods are built to connect the three-dimensional models of a pair of fixing plates with the three-dimensional model of the hollow cylinder to form the three-dimensional model of the orthodontic micro screw guide plate.
9) And outputting the three-dimensional model data of the orthodontic micro-screw guide plate, and preparing the orthodontic micro-screw guide plate through three-dimensional printing according to the three-dimensional model data of the orthodontic micro-screw guide plate.
The size of the orthodontic micro-screw guide plate can be adjusted according to micro-screws of different brands and handle design, and personalized design can also be carried out according to preferences.
After the virtual dental model is established through CBCT image data, oral cavity scanning data and dentition model scanning data of a patient, technicians can design an optimal micro screw access in the virtual dental model according to soft tissue and tooth root information in the virtual dental model and establish a three-dimensional model of the orthodontic micro screw guide plate on the virtual dental model, so that the orthodontic micro screw guide plate is more fit with the oral cavity structure of the patient when in use, the restraint on the planting direction and the planting position of the micro screw is more accurate, the damage to the tooth root is avoided, the improvement on the accuracy of the implanting position of the micro screw is more facilitated, and the risk of the micro implanting operation is greatly reduced.
This just abnormal little screw baffle includes:
the pair of arc restraining bodies 1 are mutually buckled through connecting pieces to form a hollow cylinder, the hollow cylinder is in a step shape and comprises a large-diameter end 1.2 and a small-diameter end 1.1, the wall thickness of the large-diameter end 1.2 is 1mm, the wall thickness of the small-diameter end 1.1 is 0.7mm, an annular retention groove 3 is arranged on the outer wall of the large-diameter end 1.2 of the hollow cylinder along the circumferential direction of the large-diameter end 1.2, the depth of the retention groove 3 is 0.8mm, the width of the retention groove is 1mm, the connecting pieces are retention leather rings 4, the large-diameter end 1.2 is sleeved with the retention leather rings 4 and located in the retention groove 3, the cross sections of the retention leather rings 4 are circular and 2mm in diameter, the visual window 2 is located at the joint of the pair of arc restraining bodies 1 and is respectively sunken towards the inner sides of the pair of the arc restraining bodies 1, the visual window 2 penetrates through the small-diameter end 1.1 and extends to the middle of the large-; the shapes of the pair of fixing plates 6 are respectively matched with the occlusion faces and the occlusal faces of the appearance high points of the adjacent tooth axial surfaces at two sides of the implantation point of the micro screw, each fixing plate 6 is connected with an arc restraint body 1 through a connecting rod 5, and the connecting rod 5 is a cylindrical rod with the diameter of 0.5 mm;
wherein, each arc restraint body 1, one connecting rod 5 and one fixing plate 6 are integrally formed through three-dimensional printing.
When the pair of fixing plates 6 are respectively fixed on the adjacent occlusal surfaces at two sides of the implantation point of the micro screw, the small diameter end 1.1 of the hollow cylinder faces the implantation point of the micro screw, and the axial direction of the hollow cylinder coincides with the implantation direction of the micro screw, so that the small diameter end 1.1 restrains the implantation direction of the micro screw, and the large diameter end 1.2 restrains the implantation direction of the micro screw implantation handle.
When the orthodontic micro screw guide plate is used, the pair of fixing plates are placed on the adjacent occlusal surfaces on two sides of the micro screw implantation point, the micro screw and the implantation handle are subjected to double restraint through the hollow cylinder in the implantation process, after the tip of the micro screw enters the alveolar bone to a proper depth, the connecting piece is cut off, the hollow cylinder is taken down, and the pair of fixing plates 3 is taken down to complete the implantation process.
Having described embodiments of the present invention, the foregoing description is intended to be exemplary, not exhaustive, and not limited to the embodiments disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the described embodiments.

Claims (10)

1. A method of manufacturing an orthodontic miniscrew guide, comprising the steps of:
1) making a dentition model of the patient;
2) acquiring CBCT image data, oral cavity scanning data and dentition model scanning data of the patient;
3) acquiring tooth three-dimensional image data from the CBCT image data;
4) matching the tooth three-dimensional image data, the oral cavity scanning data and the dentition model scanning data through the external shape of a dental crown to establish a virtual dental model;
5) determining an implantation point and an operation approach of a micro screw according to the virtual dental model;
6) establishing three-dimensional models of a hollow cylinder and a pair of fixing plates on the virtual dental model according to the implantation point and the surgical approach, and then establishing a three-dimensional model of a connecting rod to connect the three-dimensional models of the hollow cylinder and the fixing plates to form a three-dimensional model of the orthodontic micro-screw guide plate;
7) outputting the three-dimensional model data of the orthodontic micro-screw guide plate, and manufacturing the orthodontic micro-screw guide plate according to the three-dimensional model data.
2. The method of manufacturing an orthodontic miniscrew guide of claim 1, wherein the step 2) comprises:
2.1) scanning the jaw bone and dentition of a patient by a CBCT scanner to obtain CBCT image data containing the jaw bone and the dentition;
2.2) scanning the gingiva and dentition of the patient by an intraoral scanner to obtain the oral cavity scanning data containing soft tissues and dental crowns;
2.3) scanning the dentition model of the patient through a model scanner to obtain the scanning data of the dentition model.
3. The method of manufacturing an orthodontic miniscrew guide of claim 2, wherein the step 2) further comprises:
when a patient is scanned by the CBCT scanner, the orbital-ear plane of the patient is parallel to the ground, the central line of the plane is vertical to the ground, and the dental jaw keeps the crossing and malposition occlusion relationship of the dental cusps;
when the gum and the dentition of a patient are scanned by the intraoral scanner, a scanning head of the intraoral scanner extends into the oral cavity of the patient and scans along the surface of the dentition.
4. The method of manufacturing an orthodontic miniscrew guide of claim 2, wherein the step 2.3) comprises:
and scanning the upper jaw and the lower jaw of the dentition model and the occlusion state of the upper jaw and the lower jaw when the dental cusps are crossed and dislocated to obtain the scanning data of the dentition model.
5. The method of manufacturing an orthodontic miniscrew guide of claim 1, wherein the step 3) comprises:
and separating the tooth image data from the alveolar bone image data by adjusting the threshold of the CBCT image data so as to extract the tooth three-dimensional image data.
6. The method of manufacturing an orthodontic miniscrew guide of claim 1, wherein the step 4) comprises:
4.1) taking the scan data of the dentition model as a reference, and enabling the tooth three-dimensional image data to be superposed with the scan data of the dentition model through the external shape of a dental crown;
4.2) taking the scan data of the dentition model as a reference, and enabling the oral cavity scan data to be superposed with the scan data of the dentition model and the three-dimensional image data of the teeth through the external shape of the dental crown;
4.3) fixing the relative positions of the scan data of the dentition model, the three-dimensional image data of the teeth and the scan data of the oral cavity, and establishing the virtual dental model which comprises three-dimensional data of tooth roots and soft tissues.
7. The method of manufacturing an orthodontic miniscrew guide of claim 6, wherein the step 5) comprises:
in the virtual dental model, according to the positions of soft tissues and tooth roots, the implantation points of the micro screws are selected and the implantation direction is designed, so that the micro screws can enter the soft tissues and are positioned between two adjacent tooth roots, and the operation approach is determined.
8. The method of manufacturing an orthodontic miniscrew guide of claim 1, wherein the step 6) comprises:
6.1) establishing a three-dimensional model of the hollow cylinder at the implantation point, so that the small-diameter end of the hollow cylinder faces the implantation point;
6.2) calibrating the axial direction of the hollow cylinder according to the surgical approach, so that the axial direction of the hollow cylinder is superposed with the implantation direction of the micro-screw and passes through the implantation point;
6.3) dividing the hollow cylinder into two parts along the plane where the axis is located;
6.4) respectively establishing a three-dimensional model of the fixing plate on the adjacent occlusal surfaces at two sides of the implantation point;
6.5) establishing a three-dimensional model of the connecting rod, and connecting the three-dimensional models of the pair of fixing plates with the three-dimensional model of the hollow cylinder to form the three-dimensional model of the orthodontic micro-screw guide plate.
9. The method of manufacturing an orthodontic miniscrew guide of claim 1, wherein the step 7) comprises:
and preparing the orthodontic micro-screw guide plate by three-dimensional printing according to the three-dimensional model data of the orthodontic micro-screw guide plate.
10. An orthodontic miniscrew guide made by the method of making an orthodontic miniscrew guide of any one of claims 1-9, comprising:
the hollow cylinder is in a step shape and comprises a large-diameter end and a small-diameter end, the plane where the axis of the hollow cylinder is located divides the hollow cylinder into two parts, and the two parts are connected through a connecting piece;
the pair of fixing plates are respectively connected to one part of the hollow cylinder through a connecting rod and are respectively used for being fixed on adjacent occlusal surfaces at two sides of a micro-screw implantation point;
when the pair of fixing plates are respectively fixed on adjacent occlusal surfaces at two sides of the implantation point of the micro screw, the small diameter end of the hollow cylinder faces the implantation point of the micro screw, the axial direction of the hollow cylinder coincides with the implantation direction of the micro screw, the small diameter end is used for restraining the implantation direction of the micro screw, and the large diameter end is used for restraining the implantation direction of the micro screw implantation handle.
CN202010085012.4A 2020-02-10 2020-02-10 Manufacturing method of orthodontic micro-screw guide plate and orthodontic micro-screw guide plate Active CN111214299B (en)

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