CN111803235A - Periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system and forming method thereof - Google Patents

Periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system and forming method thereof Download PDF

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Publication number
CN111803235A
CN111803235A CN202010802920.0A CN202010802920A CN111803235A CN 111803235 A CN111803235 A CN 111803235A CN 202010802920 A CN202010802920 A CN 202010802920A CN 111803235 A CN111803235 A CN 111803235A
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periodontal
orthodontic treatment
alveolar bone
ultrasonic
guide plate
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陈珺
李文杰
刘斌杰
卢燕勤
刘欧胜
曾彦
程静怡
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Central South University
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Central South University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00Dental auxiliary appliances
    • A61C19/06Implements for therapeutic treatment

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  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
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  • Life Sciences & Earth Sciences (AREA)
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  • General Health & Medical Sciences (AREA)
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  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

The invention discloses an auxiliary orthodontic treatment operation guide plate system for periodontal accelerated osteogenesis and a forming method thereof, wherein the guide plate system comprises an ultrasonic positioning alarm device and a guide plate body adopting 3D printing, the guide plate body comprises a tooth surface fixing plate which can be attached and fixed on a dental crown and an alveolar bone fixing plate which is opposite to alveolar bone cortical bone, the ultrasonic positioning alarm device comprises an ultrasonic probe and an alarm, the tooth surface fixing plate is provided with a dental crown attaching surface which is attached to the dental crown, and the alveolar bone fixing plate is provided with a guide hole which is used for drilling the alveolar bone cortical bone and a probe jack which is used for inserting the ultrasonic probe and faces to the drilling position. The invention can realize the purposes of accurate positioning of the bone cortex removing area and reduction of operation complications; furthermore, in the drilling process, the ultrasonic positioning monitoring alarm of the drilling depth can be realized, the purpose of preventing the tooth root, the nerve and the important tissue structure from being damaged due to the over-deep drilling can be avoided, and the safety of the operation is further improved.

Description

Periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system and forming method thereof
Technical Field
The invention belongs to the technical field of medical auxiliary instruments, and particularly relates to a 3D printing periodontal accelerated osteogenesis auxiliary orthodontic treatment operation guide plate system with an ultrasonic positioning alarm function and a forming method.
Background
Malocclusion affects the patient's aesthetics, periodontal and mental health. With the development of economy, more and more adults are treated with orthodontic treatment, but treatment time and cost lasting 2-3 years is a major challenge in adult orthodontics. How to shorten the tooth movement time and thus the time for the entire orthodontic treatment is the focus of research by many clinicians and researchers. In recent years, Periodontal Accelerated osteogenesis assisted orthodontic treatment (PAOO) has been effective in accelerating orthodontic tooth movement, and this technique purposefully cuts alveolar bone cortex through surgery to reduce the resistance of natural bone to movement of orthodontic teeth, thereby shortening the entire orthodontic treatment period. The technology can also reduce the traditional complications of orthodontic treatment such as tooth root absorption, demineralization and the like; meanwhile, the technology can effectively improve the quantity and quality of periodontal tissues because the bone grafting obtains more bone support.
The removal of cortical bone around the tooth root is the key of PAOO, and the operator should leave the crest of the alveolar ridge for 2-3mm during operation to avoid important anatomical structures such as maxillary sinus, inferior alveolar neural tube, mental foramen, tooth root and the like, thereby avoiding iatrogenic injury. Many times, the root portions are very close to each other due to crowding of the dentition, and great care must be taken to avoid unnecessary iatrogenic damage.
However, the current position location of the bone and cortex removal of the PAOO operation is that a periodontist combines with CBCT of a patient, and the determined result is that the anatomical structure of an operation area is lack of accurate knowledge, so that the operation efficiency is low, the risk is high, and the probability of occurrence of iatrogenic injuries such as tooth root injury and the like is high especially for a novice doctor who just starts to contact the operation.
Disclosure of Invention
The invention aims to provide a periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system and a forming method, so as to solve the problems.
In order to achieve the purpose, the invention firstly discloses an operation guide plate system for periodontal accelerated osteogenesis auxiliary orthodontic treatment, which comprises a guide plate body adopting 3D printing, wherein the guide plate body comprises a tooth surface fixing plate which can be attached and fixed on a dental crown and an alveolar bone fixing plate opposite to alveolar bone cortical bone, a dental crown attaching surface attached to the dental crown is arranged on the tooth surface fixing plate, and a guide hole for drilling the alveolar bone cortical bone is arranged on the alveolar bone fixing plate.
Further, still include ultrasonic localization alarm device, ultrasonic localization alarm device includes ultrasonic probe and alarm, still be provided with on the alveolar bone position fixing plate and be used for pegging graft ultrasonic probe's probe jack, ultrasonic probe with guiding hole corresponds and towards the drilling position, ultrasonic probe and alarm are connected.
Further, still including installing roller card locator on the alveolar bone position fixing plate, roller card locator includes I shape guide rail and U type slider, the both sides face of I shape guide rail is provided with the spout of vertical extension, be provided with the spout tooth in the spout, the both sides pin joint of U type slider has the gyro wheel, be provided with on the gyro wheel can with spout tooth meshing's gyro wheel tooth, the I shape guide rail is provided with and can link up the through-hole of alveolar bone cortex of bone, probe jack and guiding hole set up on the U type slider.
Further, still including installing roller card locator on the alveolar bone position-fixing plate, roller card locator includes I shape guide rail and U type slider, the both sides face of I shape guide rail is provided with the spout of vertical extension, be provided with the spout tooth in the spout, the both sides pin joint of U type slider has the gyro wheel, be provided with on the gyro wheel can with spout tooth meshing's gyro wheel tooth, the I shape guide rail is provided with and can link up to the through-hole of alveolar bone cortex of bone, the guiding hole sets up on the U type slider.
Further, the guide holes are uniformly arranged along the vertical direction of the teeth.
Furthermore, the guide holes are positioned between the tooth roots of two teeth, the upper ends of the guide holes are 2-3mm away from the crest of the alveolar ridge, the lower ends of the guide holes are 2-4mm away from the lower part of the apex of the alveolar ridge, and the distance between the guide holes in the vertical direction is 2-3 mm.
Furthermore, one side of the roller is provided with a rubber layer for increasing the friction force with the sliding groove.
Furthermore, the ultrasonic positioning alarm device further comprises a wireless sensor and a single chip microcomputer, the ultrasonic probe is connected with the wireless sensor, the wireless sensor is connected with the single chip microcomputer, and the single chip microcomputer is connected with the alarm.
Then, the invention discloses a forming method of a periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system, which comprises the following steps:
step 1: acquiring oral CBCT data of a patient, and importing E3D three-dimensional design software;
step 2: scanning the mouth of a patient by using an iTero intraoral scanner to obtain a three-dimensional digital model of dentition including part of mucous membrane;
and step 3: scanning a drill bit for removing bone cortex of the dental ultrasonic osteotome by using a micro CT to obtain accurate drill bit three-dimensional data;
and 4, step 4: importing the CBCT data and the three-dimensional dentition digital model data into E3D software for accurate matching to obtain a jaw bone CT model fusing the high-precision three-dimensional dentition and alveolar bone data;
and 5: determining a drill bit point for removing bone cortex and a hole entering direction;
step 6: the periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate device is printed by using a rapid prototyping technology.
Further, in the step 5, the drill bit site for removing the bone cortex and the drilling direction should avoid the anatomical structure which is easy to cause iatrogenic injury.
Compared with the prior art, the invention has the advantages that:
according to the invention, the 3D printing periodontal accelerated osteogenesis auxiliary orthodontic treatment (PAOO) surgical guide plate system with the ultrasonic positioning alarm function and the design method thereof are used for achieving the purposes of accurately positioning the bone cortex removing area and reducing surgical complications; furthermore, in the drilling process, the ultrasonic positioning monitoring alarm of the drilling depth can be realized, the purpose of preventing the tooth root, the nerve and the important anatomical structure from being damaged due to the over-deep drilling can be avoided, and the safety of the operation is further improved.
The present invention will be described in further detail below with reference to the accompanying drawings.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the invention and, together with the description, serve to explain the invention and not to limit the invention. In the drawings:
FIG. 1 is a schematic view of a tooth site of a periodontal accelerated osteogenesis assisted orthodontic treatment procedure disclosed herein;
fig. 2 is a schematic structural view (excluding a roller card positioner) of a periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system according to one or two preferred embodiments of the present invention;
fig. 3 is a schematic structural diagram of a periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system according to a third embodiment of the present invention;
fig. 4 is a schematic side view of a periodontal accelerated osteogenesis aid orthodontic treatment surgical guide system according to the fourth embodiment of the present invention;
fig. 5 is a schematic alarm diagram of a periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system according to second, third and fourth embodiments of the present invention.
Illustration of the drawings:
1. a guide plate body; 2. a crown of a tooth; 3. a tooth surface retention plate; 4. alveolar bone cortical bone; 5. alveolar bone position-retaining plates; 6. a guide hole; 7. an I-shaped guide rail; 8. a U-shaped slider; 9. a chute; 10. a roller; 11. a through hole; 12. a probe jack; 13. a drill bit; 14. an ultrasonic probe; 15. a wireless sensor; 16. a single chip microcomputer; 17. an alarm.
Detailed Description
The embodiments of the invention will be described in detail below with reference to the drawings, but the invention can be implemented in many different ways as defined and covered by the claims.
The first embodiment is as follows:
as shown in fig. 1, 2 and 5, the invention firstly discloses a periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system, which comprises a guide plate body 1 printed by a transparent high polymer material 3D, wherein the guide plate body 1 comprises a tooth surface fixing plate 3 which can be attached and fixed on a dental crown 2 and an alveolar bone fixing plate 5 which is opposite to alveolar bone cortical bone 4, the tooth surface fixing plate 3 is provided with a dental crown attaching surface attached to the dental crown 2, and the alveolar bone fixing plate 5 is provided with a guide hole 6 for drilling the alveolar bone cortical bone 4, so that a drill bit 13 is guided through the guide hole 6, the drilling efficiency and the positioning precision are improved, and the purpose of reducing surgical complications is achieved.
In the embodiment, during specific setting, the guide holes 6 are uniformly arranged along the vertical direction of the tooth roots, the guide holes 6 are positioned between the tooth roots of two teeth, the upper ends of the guide holes 6 are 2-3mm away from the crest of the alveolar ridge, the lower ends of the guide holes 6 are 2-4mm away from the lower part of the apical ridge, and the distance between the guide holes 6 in the vertical direction is 2-3 mm.
Then, the invention discloses a forming method of a periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system, which comprises the following steps:
step 1: acquiring oral CBCT data of a patient, and importing E3D three-dimensional design software;
step 2: scanning the mouth of a patient by using an iTero intraoral scanner to obtain a three-dimensional digital model of dentition including part of mucous membrane;
and step 3: scanning a dental ultrasonic osteotome bone cortical drill by using a micro CT to obtain accurate three-dimensional data of the drill bit 13;
and 4, step 4: importing the CBCT data and the three-dimensional dentition digital model data into E3D software for accurate matching to obtain a jaw bone CT model fusing the high-precision three-dimensional dentition data;
and 5: determining a position of a drill bit 13 for removing bone cortex and a hole entering direction;
step 6: printing out a periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate device by using a rapid prototyping technology;
in this embodiment, in step 5, the position of the drill 13 for removing the bone cortex and the direction of the access hole should be kept away from the anatomical structures which are prone to cause iatrogenic injuries, such as the maxillary sinus, the inferior alveolar nerve canal, the mental foramen, the tooth root, etc.
Example two:
in this embodiment, an ultrasonic positioning alarm device is added on the basis of the first embodiment, the ultrasonic positioning alarm device comprises an ultrasonic probe 14 and an alarm 17, and specifically, a probe insertion hole 12 is correspondingly matched on one side of the guide hole 6 and used for inserting the ultrasonic probe 14, and the ultrasonic probe 14 faces the position of the drill hole. The ultrasonic positioning alarm device further comprises a wireless sensor 15 and a single chip microcomputer 16, the ultrasonic probe 14 is connected with the wireless sensor 15, the wireless sensor 15 is connected with the single chip microcomputer 16, and the single chip microcomputer 16 is connected with an alarm 17. The ultrasonic probe 14 adopts Ultrasonix # C5-2, the wireless sensor 15 adopts NRF24L07, the singlechip 16 adopts STC-51 series STC89C52 singlechips as a main control chip, and the alarm 17 adopts HYR1704U type, wherein the singlechip 16 can distinguish the layer and the position of the drill bit 13 according to the acoustic properties of cortical bone, cancellous bone, periodontal ligament and cementum; thus, after step 6 of example one, step 7 is added: the ultrasonic probe 14 can generate ultrasonic waves to the drill bit 13, judge the tissue contacted by the drill bit 13 and the depth thereof according to the change of the frequency, and trigger an alarm system when approaching the periodontal ligament and the tooth root, wherein the step 7 only exists in a system provided with an ultrasonic positioning alarm device. And then the related data in the whole operation process is recorded and analyzed, so that the first prompt alarm can be given when the cortical bone is broken through, and the serious alarm can be given when the cortical bone is contacted with the periodontal ligament to prevent the drill bit 13 from further penetrating and further damaging the tooth root. In the invention, ultrasonic wave refers to mechanical wave with frequency higher than 20kHz, and the ultrasonic sensor converts electric energy and ultrasonic energy mutually by utilizing the principle of piezoelectric effect, namely when the ultrasonic wave is transmitted, the electric energy is converted to transmit the ultrasonic wave; and converts the ultrasonic vibration into an electrical signal when the echo is received. The ultrasonic alarm principle of the invention is similar to that of an ultrasonic flaw detector widely applied in the engineering field, ultrasonic waves can be reflected on the interface of two media with different acoustic impedances, and the amount of the reflected energy is related to the difference of the acoustic impedances of the media on the two sides of the interface and the orientation and the size of the interface. Therefore, the invention improves the prior ultrasonic osteotome system by utilizing the acoustic impedance difference of the tooth root, the periodontal ligament and the alveolar bone and applying the technologies of single chip microcomputer 16 control, signal identification, ultrasonic ranging and the like, designs the ultrasonic osteotome with the ultrasonic positioning and alarming function, and is matched with a 3D printing periodontal accelerated osteogenesis auxiliary orthodontic treatment (PAOO) operation guide plate to perform operation positioning and bone removal more accurately and reduce the operation complications such as tooth root damage, neurovascular damage and the like to the maximum extent.
Example three:
in this embodiment, on the basis of the first embodiment, as shown in fig. 3 and 4, the dental alveolar bone fixation plate further comprises a roller clamp positioner installed on the alveolar bone fixation plate 5, the roller clamp positioner comprises an i-shaped guide rail 7 and a U-shaped slider 8, two sides of the i-shaped guide rail 7 are provided with vertically extending sliding grooves 9, sliding groove teeth are arranged in the sliding grooves 9, two sides of the U-shaped slider 8 are pivoted with rollers 10, the rollers 10 are provided with roller teeth capable of being engaged with the sliding groove teeth, the i-shaped guide rail 7 is provided with a through hole 11 capable of penetrating through cortical bone of the alveolar bone, the i-shaped guide rail 7 is provided with a through hole 11, and the guide hole 6 is arranged on the U-shaped slider 8, so that, during drilling in the vertical direction of the tooth root of an operator, a drill bit 13 can be rapidly inserted into the roller 10 for drilling, the operation process of drilling is simplified, one side of the roller 10 is provided with a rubber, the rubber layer is attached to the I-shaped guide rail 7.
Example four:
in this embodiment, on the basis of the third embodiment, an ultrasonic positioning alarm device is further arranged on the U-shaped slider 8, and similarly, the ultrasonic positioning alarm device includes an ultrasonic probe 14 and an alarm 17, wherein a probe jack 12 for plugging the ultrasonic probe 14 is arranged on the U-shaped slider 8, and similarly, the ultrasonic probes 14 correspond to the guide holes 6 one to one and face the drilling position.
The above is only a preferred embodiment of the present invention, and is not intended to limit the present invention, and various modifications and changes will occur to those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (10)

1. The utility model provides a periodontal accelerates to become supplementary orthodontic treatment operation baffle system of bone, a serial communication port, including baffle body (1) that adopts 3D to print, baffle body (1) is including can laminating fix tooth face position fixing plate (3) on dental crown (2) and alveolar bone position fixing plate (5) relative with alveolar bone cortex lycii (4), be provided with on tooth face position fixing plate (3) with the dental crown binding face of dental crown (2) laminating, be provided with guiding hole (6) that are used for drilling alveolar bone cortex lycii (4) on alveolar bone position fixing plate (5).
2. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system according to claim 1, further comprising an ultrasonic positioning alarm device, wherein the ultrasonic positioning alarm device comprises an ultrasonic probe (14) and an alarm (17), a probe insertion hole (12) for inserting the ultrasonic probe (14) is further arranged on the alveolar bone retention plate (5), the ultrasonic probe (14) corresponds to the guide hole (6) and faces towards a drilling position, and the ultrasonic probe (14) is connected with the alarm (17).
3. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system according to claim 2, further comprising a roller clamp positioner installed on the alveolar bone fixation plate (5), wherein the roller clamp positioner comprises an I-shaped guide rail (7) and a U-shaped slider (8), two side surfaces of the I-shaped guide rail (7) are provided with vertically extending sliding grooves (9), sliding groove teeth are arranged in the sliding grooves (9), two sides of the U-shaped slider (8) are pivoted with rollers (10), the rollers (10) are provided with roller teeth capable of being engaged with the sliding groove teeth, the I-shaped guide rail (7) is provided with a through hole (11) capable of penetrating through the alveolar bone cortex (4), and the probe insertion hole (12) and the guide hole (6) are arranged on the U-shaped slider (8).
4. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system according to claim 1, further comprising a roller clamp positioner installed on the alveolar bone fixation plate (5), wherein the roller clamp positioner comprises an I-shaped guide rail (7) and a U-shaped slider (8), two side surfaces of the I-shaped guide rail (7) are provided with vertically extending sliding grooves (9), sliding groove teeth are arranged in the sliding grooves (9), two sides of the U-shaped slider (8) are pivoted with rollers (10), the rollers (10) are provided with roller teeth capable of being engaged with the sliding groove teeth, the I-shaped guide rail (7) is provided with a through hole (11) capable of penetrating through the alveolar bone cortex (4), and the guide hole (6) is arranged on the U-shaped slider (8).
5. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide system according to any one of claims 1 to 4, wherein the pilot holes (6) are uniformly arranged along the vertical direction of the tooth root.
6. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide system according to any one of claims 1 to 4, wherein the pilot holes (6) are located between the roots of two teeth, the upper ends of the pilot holes (6) are 2 to 3mm from the crest of the alveolar ridge, the lower ends of the pilot holes are 2 to 4mm from the lower part of the apical ridge, and the distance between the pilot holes (6) in the vertical direction of the roots is 2 to 3 mm.
7. Periodontal accelerated osteogenesis aid orthodontic treatment surgical guide system according to claim 3 or 4, characterized in that one side of the roller (10) is provided with a rubber layer to increase friction with the runner.
8. The periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system according to claim 2 or 3, wherein the ultrasonic positioning alarm device further comprises a wireless sensor (15) and a single chip microcomputer (16), the ultrasonic probe (14) is connected with the wireless sensor (15), the wireless sensor (15) is connected with the single chip microcomputer (16), and the single chip microcomputer (16) is connected with the alarm (17).
9. A method for forming a periodontal accelerated osteogenesis aided orthodontic treatment surgical guide system, comprising the periodontal accelerated osteogenesis aided orthodontic treatment surgical guide system according to any one of claims 1 to 8, comprising the steps of:
step 1: acquiring oral CBCT data of a patient, and importing E3D three-dimensional design software;
step 2: scanning the mouth of a patient by using an iTero intraoral scanner to obtain a three-dimensional digital model of dentition including part of mucous membrane;
and step 3: scanning a drill bit (13) for removing bone cortex of the dental ultrasonic osteotome by using micro CT to obtain accurate drill bit three-dimensional data;
and 4, step 4: importing the CBCT data and the three-dimensional dentition digital model data into E3D software for accurate matching to obtain a jaw bone CT model fusing the high-precision three-dimensional dentition and alveolar bone data;
and 5: determining the position and the hole entering direction of a drill bit (13) for removing bone cortex;
step 6: the periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate device is printed by using a rapid prototyping technology.
10. The method for forming a periodontal accelerated osteogenesis aid orthodontic treatment surgical guide plate system according to claim 9, wherein in said step 5, the drill site for decorticating and the approach direction should avoid the anatomical structures which are susceptible to iatrogenic injuries.
CN202010802920.0A 2020-08-11 2020-08-11 Periodontal accelerated osteogenesis auxiliary orthodontic treatment surgical guide plate system and forming method thereof Pending CN111803235A (en)

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CN113813072A (en) * 2021-09-15 2021-12-21 孙江 3D printed periodontal auxiliary accelerated osteogenesis orthodontic treatment surgical guide plate and preparation method thereof

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