CN111821046B - Root canal treatment guide plate and preparation method thereof - Google Patents

Root canal treatment guide plate and preparation method thereof Download PDF

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Publication number
CN111821046B
CN111821046B CN202010700610.8A CN202010700610A CN111821046B CN 111821046 B CN111821046 B CN 111821046B CN 202010700610 A CN202010700610 A CN 202010700610A CN 111821046 B CN111821046 B CN 111821046B
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guide
root canal
base
tooth
channel
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CN111821046A (en
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夏泽洋
徐桂文
熊璟
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Shenzhen Institute of Advanced Technology of CAS
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Shenzhen Institute of Advanced Technology of CAS
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Priority to PCT/CN2021/097812 priority patent/WO2022017008A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00Filling or capping teeth
    • A61C5/40Implements for surgical treatment of the roots or nerves of the teeth; Nerve needles; Methods or instruments for medication of the roots
    • A61C5/42Files for root canals; Handgrips or guiding means therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00Filling or capping teeth
    • A61C5/40Implements for surgical treatment of the roots or nerves of the teeth; Nerve needles; Methods or instruments for medication of the roots

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Neurosurgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

The invention provides a root canal treatment guide plate and a preparation method thereof. This root canal therapy baffle includes the base, sets up the guide holder on the base and installs the guider on the guide holder, wherein, the base is fixed with the laminating of suffering tooth in the treatment process, the guide holder with the base passes through location connection structure and connects, the last root canal guide channel that sets up of guider, guider installs according to the root canal passageway direction of suffering tooth on the guide holder to direction and position through adaptability regulation root canal guide channel guide root canal therapy apparatus fixes a position via root canal guide channel to suffering tooth root canal in the treatment process. The guide plate for root canal treatment provided by the invention can be subjected to adaptive fine adjustment in the process of matching the guide plate channel and the root canal channel, so that the positioning precision of the root canal of the affected tooth is improved.

Description

Root canal treatment guide plate and preparation method thereof
Technical Field
The invention relates to the technical field of oral auxiliary medical instruments, in particular to a root canal treatment guide plate and a preparation method thereof.
Background
In the dental treatment, especially in the root canal therapy process, in order to obtain more accurate root canal route, use CBCT to scan the sick tooth usually, combine relevant software preparation patient tooth model and root canal passageway, extend the root canal route again, preparation root canal baffle, make root canal pulp opening apparatus along baffle passageway entering pulp cavity (root canal), but because the baffle passageway that the reason of theoretical error and actual error leads to and root canal passageway incomplete match or because the curved structure of root canal itself, can not guarantee that the baffle passageway is optimum angle, and then can not guarantee baffle and root canal passageway complete matching.
In the clinical root canal treatment process, because the complicated anatomical structure of root canal system to when the root canal calcification or carry out the micro apical surgery, the root canal direction is difficult to confirm or the root canal passageway is not smooth, in order to carry out the accurate positioning to the root canal hole, it is a fine choice to adopt the supplementary mode of location baffle. The root canal guide plate can accurately position the root canal orifice and obtain the root canal access, thereby reducing the occurrence of iatrogenic injury, retaining the tooth tissue to the maximum extent and improving the success rate of the root canal treatment of the affected tooth. The root canal guide generally adopts a form that a tooth body is matched with a fixed restoration (root canal guide), and the accuracy of the root canal guide is related to the sealing degree of the tooth body and the fixed restoration. Research shows that the dental root canal guide plate has certain position error and angle error in the matching process. Therefore, in order to match the root canal guide path with the root canal path to the maximum extent through the root canal orifice, reduce the influence of actual errors on the matching, and provide a flexible support for the endodontic instrument during treatment, a soft root canal guide with a channel capable of being finely adjusted will solve the above problems to the maximum extent.
The existing clinical root canal guide channel usually adopts a fixed structure, and once the channel is designed, the angle of the channel is difficult to change. When the cooperation of actual baffle passageway and root canal passageway is not good or need carry out angular adjustment because of root canal structure reason, do not possess the function of carrying out the adaptability fine setting according to actual error or demand in the implementation.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provides a root canal treatment guide plate and a preparation method thereof.
According to a first aspect of the present invention, there is provided an endodontic guide comprising a base, a guide holder provided on the base, and a guide means mounted on the guide holder, wherein the base is attached to a diseased tooth during a treatment, the guide holder and the base are connected by a positioning connection structure, a root canal guide passage is provided on the guide means, the guide means is mounted on the guide holder according to a direction of the root canal passage of the diseased tooth, and a endodontic instrument is guided to position a root canal of the diseased tooth through the root canal guide passage by adaptively adjusting the direction and position of the root canal guide passage during the treatment.
In one embodiment, the guide is provided with one or more root canal guide channels, and the guide is configured to achieve multiple degrees of freedom of movement on the guide block.
In one embodiment, the guide means is a ball bearing guide means provided with a support arc surface and a universal ball provided with one or more root canal guide channels, the ball bearing guide means being arranged to roll freely on the guide shoe.
In one embodiment, the guide and the base comprise soft body materials of the same or different elastic moduli.
In one embodiment, a plurality of guide seats and a corresponding plurality of ball bearing guides are provided on the base according to the number of the affected teeth, each guide seat and corresponding ball bearing guide corresponding to one affected tooth.
In one embodiment, the lower surface of the guide seat is provided with a positioning connection structure corresponding to the upper surface of the base, and the positioning connection structure is a clamping groove, a buckle or a mortise-tenon joint.
In one embodiment, a guide rail or screw rod positioning structure is arranged in the plane of the upper surface of the base along two directions perpendicular to each other, so that the guide seat can be subjected to in-plane position adjustment.
According to a second aspect of the present invention, there is provided a method of manufacturing an endodontic guide plate. The method comprises the following steps:
carrying out CBCT scanning on the jaw of the patient;
marking the scope of a medullary cavity by using software to the CBCT scanning result of the patient jaw to obtain medullary cavity data;
reconstructing the medullary cavity data acquired by three-dimensional graphic processing software to obtain a tooth CT digital three-dimensional model;
manufacturing a tooth optical digital three-dimensional model by using a dental model optical scanner;
carrying out virtual registration on the obtained tooth CT digital three-dimensional model and the obtained tooth optical digital three-dimensional model to form a tooth integral digital three-dimensional model;
constructing a base of the digital root canal guide plate by using Boolean operation based on the digital three-dimensional model of the whole tooth;
a root canal channel guide seat is arranged on the base, and the root canal channel guide in the root canal guide plate is determined according to the tooth integral digital three-dimensional model and the central axis of the root canal channel of the affected tooth;
and installing the guide device on the guide seat according to the determined guide of the root canal channel.
In one embodiment, the base and the guide are fabricated using 3D printing.
In one embodiment, the base and the guided seat are integrally or separately fabricated.
Compared with the prior art, the invention has the advantages that the soft root canal treatment guide plate with the position and the angle capable of being finely adjusted is provided, after the guide plate is fixed on the teeth of a patient, the direction of a root canal channel can be finely adjusted through the guide device, the position can be finely adjusted through the guide seat made of soft materials, the influence of the angle and the position error is reduced, and the vibration generated by a treatment instrument can be absorbed to a certain degree due to the soft property of the guide seat, so that the position change of the guide plate is prevented.
Drawings
The invention is illustrated and described only by way of example and not by way of limitation in the scope of the invention as set forth in the following drawings, in which:
fig. 1 is a schematic view of an endodontic guide assembly according to one embodiment of the present invention.
Fig. 2 is a partial sectional view of an endodontic guide assembly according to one embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions, design methods, and advantages of the present invention more apparent, the present invention will be further described in detail by specific embodiments with reference to the accompanying drawings. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In all examples shown and discussed herein, any particular value should be construed as merely illustrative, and not as a limitation. Thus, other examples of the exemplary embodiments may have different values.
Techniques, methods, and apparatus known to those of ordinary skill in the relevant art may not be discussed in detail but are intended to be part of the specification where appropriate.
In one embodiment, the invention provides an endodontic guide comprising a base, a guide block, and a guide. The base is used for being attached to the affected tooth in the root canal treatment process. The base and the guide seat are connected and fixed through a positioning connection structure. The guide device can be installed on the guide base according to the direction of the root canal channel of the affected tooth. The guiding device is provided with one or more root canal guide channels, and in the root canal treatment process, the position and the direction of the guide channels on the guiding device can be adaptively adjusted so as to guide the root canal treatment instrument to position the root canal of the affected tooth through the root canal guide channels. Preferably, in order to improve the root canal positioning accuracy and avoid influencing the treatment process due to a large adjustment of the guide, the guide is designed to be suitable for fine-tuning the direction of the root canal guide channel and the guide holder is designed to be suitable for fine-tuning the position.
In order to fine-tune the direction of the root canal guide channel in the guide, the guide can be designed to move in multiple degrees of freedom on the guide base, for example, using a spherical or ellipsoidal structure.
In a preferred embodiment, the guide device is a ball bearing guide device, the base and the guide seat are made of soft materials, and the direction-adjustable ball bearing guide device is installed in the guide seat. And obtaining the optimal angle of the guide plate channel through position fine adjustment of the guide seat and direction fine adjustment of the ball bearing guide channel.
In the following description, in order to more clearly describe the idea of the present invention, a soft endodontic guide provided with a ball bearing guide will be described as an example.
Specifically, referring to fig. 1 and 2, taking a ball bearing guide as an example, the endodontic guide of this embodiment includes a base 1, a guide base 2, and a ball bearing guide 3. The base 1 is designed according to the scanned image of the teeth of the patient and can be accurately matched and fixed with the teeth of the patient. For example, the base 1 is preferably made of soft material and is nested on the surface of the teeth of the patient, and the upper surface (with reference to the actual operation process) of the base 1 is provided with a positioning connection structure for connecting with the guide seat 2. The guide base 2 is preferably made of a soft material, which can be finely adjusted in shape to a small extent, and can absorb vibrations generated by the surgical instrument during the endodontic treatment to a certain extent due to its good flexibility. The lower surface of the guide seat 2 is provided with a positioning connection structure corresponding to the upper surface of the base 1. A ball bearing guide device 3 is arranged in the guide seat 2.
Referring to fig. 2, the ball bearing guide 3 has a support arc surface 301 and a universal ball 302. The support arc surface 301 is used to fix the universal ball 302 in the guide base 2 and to freely roll in the guide base. The universal ball 302 is provided with a root canal guide channel 303, and the root canal guide channel 303 can be provided in one or more. The diameter of the root canal guide channel 303 is determined according to the outer diameter of the treatment instrument, and the present invention is not limited thereto.
In one embodiment, the positioning connection structure between the guide seat 2 and the base 1 may be a plurality of ways, such as a slot connection, a snap connection, or a mortise and tenon connection combining concave and convex portions.
In another embodiment, the upper surface of the base 1 may be provided with positioning structures such as guide rails or screw rods along two directions perpendicular to each other, so that the guide base 2 can perform position adjustment in the plane.
It should be understood that, in practical use, the base 1 and the guide base 2 may be manufactured separately as separate parts or may be manufactured integrally, and the whole structure may be manufactured by using materials with the same or different elastic moduli from bottom to top.
In the existing root canal treatment process, a guide plate channel is generally made of a material with high hardness (such as alloy), when a surgical instrument (such as a root canal file) works, large vibration is often generated, and adverse results generated by the vibration are amplified at the weakest position (such as the matching position of a tooth body and a fixed prosthesis), so that the position is changed, and the matching precision is influenced. The embodiment of the invention preferably adopts soft materials to manufacture the guide seat, can absorb shock to a certain degree and prevent the position of the treatment guide plate from changing.
In one embodiment, the process of preparing the endodontic guide includes the steps of:
step S21, before operation, CBCT scan is performed on the patient' S mouth and jaw.
And step S22, marking the scope of the pulp cavity by using software to the CBCT scanning result of the patient oromandibular, obtaining pulp cavity data, and obtaining the central axis of the root canal channel.
For example, the scope of the medullary cavity is labeled on the CBCT scan of the patient's orojaw using Mimics16.0 software to obtain the final data, including the central axis of the canal of the affected tooth.
And step S23, reconstructing the medullary cavity data obtained by the three-dimensional graphic processing software to obtain a tooth CT digital three-dimensional model.
And step S24, manufacturing the tooth optical digital three-dimensional model by using the dental model optical scanner.
And step S25, virtually registering the obtained tooth CT digital three-dimensional model and the obtained tooth optical digital three-dimensional model to form an integral tooth digital three-dimensional model.
And step S26, constructing a base of the digital root canal guide plate by using Boolean operation based on the digital three-dimensional model of the whole tooth.
Because the base is made of soft material, the elastic modulus is relatively low, and the base has good flexibility and adaptability, and can be embedded on the surface of the teeth of a patient.
And step S27, installing a root canal channel guide seat on the base, determining the root canal channel guide in the root canal guide plate according to the tooth integral digital three-dimensional model and the central axis of the root canal channel, and determining the position and the direction of the root canal channel guide.
Specifically, a root canal channel guide seat is arranged on the base, and the guide seat is made of soft material with stimulation response characteristics. And the guide of the root canal channel in the root canal guide plate is determined according to the tooth model and the central axis of the root canal channel.
Step S28, the guide is mounted on the guide base and its direction is preliminarily fixed according to the root canal passage direction.
For example, a ball bearing guide is mounted on a guide block, the direction of which is preliminarily fixed according to the direction of the root canal passage.
In the preparation process, the base and the guide seat can be printed in a 3D printing mode.
For further understanding of the present invention, the actual operation of the endodontic guide provided is described in detail below.
Specifically, first, the root canal treatment guide is integrally attached to the patient's tooth through the base thereof, and the position and orientation of the external timing at the preparation stage are maintained, and the root canal treatment instrument (e.g., a root canal file) positions the root canal of the affected tooth through the root canal guide passage 303. When deviation appears in the initial angle of the channel or needs to be adjusted according to the hand feeling of an operator, angle fine adjustment can be carried out through the ball bearing guide device, and when deviation appears in the initial position of the channel or needs to be adjusted, shape fine adjustment can be carried out to a certain extent due to the soft material property of the guide seat, so that the influence of errors is reduced. And after the shape fine adjustment is finished, applying external stimulation to the guide seat to fix the shape of the guide seat. During the treatment process, the guide seat and the base made of soft materials can absorb the vibration generated by the treatment instrument to a certain extent, thereby preventing the position change of the root canal treatment guide plate.
In one embodiment, for the case where a plurality of affected teeth need to be treated, a plurality of guide seats and a plurality of ball bearing guides may be provided, positioned on the base, to correspond to the different affected teeth.
In another embodiment, aiming at the condition that a plurality of root canals on a single tooth need to be treated, a plurality of root canal guide channels can be simultaneously arranged on the universal ball, and a doctor can finely adjust the direction and the position of the root canal guide channel by utilizing the direction adjusting function of the ball bearing guide device and the soft material properties of the guide seat and the base according to the requirement or the hand feeling in the operation process, so that the root canal guide channel is consistent with the root canal channel of the sick tooth in direction.
In the embodiment, the position and angle fine-adjustable soft root canal treatment guide plate is fixed on the teeth of a patient, the direction of a root canal channel can be finely adjusted through the ball bearing guide device, the position can be finely adjusted through the guide seat made of soft materials, the influence of the angle and position errors is reduced, the hand feeling of a doctor is exerted, and due to the soft property of the guide seat, the vibration generated by a treatment instrument can be absorbed to a certain degree, and the position change of the guide plate is prevented.
In summary, the guide plate for root canal treatment provided by the invention can improve the guiding precision of the guide plate by performing adaptive fine adjustment on the angle and the position of the root canal guide channel on the guide device. And through setting up base, guide holder etc. that contain the software material, can absorb the vibrations that therapeutic instrument produced to a certain extent in the treatment process, prevent the baffle position change, further improved root canal positioning accuracy and improved root canal therapy and experienced.
It should be noted that, although the steps are described in a specific order, the steps are not necessarily performed in the specific order, and in fact, some of the steps may be performed concurrently or even in a changed order as long as the required functions are achieved.
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. The terminology used herein is chosen in order to best explain the principles of the embodiments, the practical application, or improvements made to the technology in the marketplace, or to enable others of ordinary skill in the art to understand the embodiments disclosed herein.

Claims (7)

1. A root canal treatment guide plate comprises a base, a guide seat arranged on the base and a guide device arranged on the guide seat, wherein the base is fixedly attached to a diseased tooth in a fitting mode during treatment, the guide seat and the base are connected through a positioning connection structure, a root canal guide channel is arranged on the guide device, the guide device is arranged on the guide seat according to the direction of the root canal channel of the diseased tooth, and a root canal treatment instrument is guided to position a root canal of the diseased tooth through the root canal guide channel by adaptively adjusting the direction and the position of the root canal guide channel during treatment;
wherein the guide device is provided with one or more root canal guide channels, and the guide device is configured to realize multi-degree-of-freedom movement on the guide seat;
the guide device is a ball bearing guide device, the ball bearing guide device is provided with a support cambered surface and a universal ball, one or more root canal guide channels are arranged on the universal ball, and the ball bearing guide device is arranged to freely roll on the guide seat;
wherein, the guide seat and the base comprise soft body materials with the same or different elastic moduli.
2. The endodontic guide of claim 1 wherein a plurality of guide sockets and a corresponding plurality of ball bearing guides are provided on the base according to the number of affected teeth, each guide socket and corresponding ball bearing guide corresponding to one affected tooth.
3. The endodontic guide of claim 1 wherein said guide base lower surface is provided with a positioning connection corresponding to said base upper surface, said positioning connection being a snap, a snap or a mortise and tenon connection.
4. The endodontic guide of claim 1 wherein said base has guide or lead screw positioning structure in two directions perpendicular to each other in a plane of an upper surface of said base for in-plane positional adjustment of said guide base.
5. A method for preparing a guide plate for root canal therapy comprises the following steps:
carrying out CBCT scanning on the jaw of the patient;
marking the scope of a medullary cavity by using software to the CBCT scanning result of the patient jaw to obtain medullary cavity data;
reconstructing the medullary cavity data acquired by three-dimensional graphic processing software to obtain a tooth CT digital three-dimensional model;
manufacturing a tooth optical digital three-dimensional model by using a dental model optical scanner;
carrying out virtual registration on the obtained tooth CT digital three-dimensional model and the obtained tooth optical digital three-dimensional model to form a tooth integral digital three-dimensional model;
constructing a base of the digital root canal guide plate by using Boolean operation based on the digital three-dimensional model of the whole tooth;
a root canal channel guide seat is arranged on the base, and the root canal channel guide in the root canal guide plate is determined according to the tooth integral digital three-dimensional model and the central axis of the root canal channel of the affected tooth;
mounting a guide on a guide block according to the determined root canal channel guide, wherein the guide is provided with one or more root canal guide channels, and the guide is configured to achieve multiple degrees of freedom of movement on the guide block;
the guide device is a ball bearing guide device, the ball bearing guide device is provided with a support cambered surface and a universal ball, one or more root canal guide channels are arranged on the universal ball, and the ball bearing guide device is arranged to freely roll on the guide seat;
wherein, the guide seat and the base comprise soft body materials with the same or different elastic moduli.
6. The method for preparing an endodontic guide according to claim 5, wherein the base and the guide are fabricated using 3D printing.
7. The method of preparing an endodontic guide according to claim 5, wherein the base and the guide are integrally or separately manufactured.
CN202010700610.8A 2020-07-20 2020-07-20 Root canal treatment guide plate and preparation method thereof Active CN111821046B (en)

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PCT/CN2021/097812 WO2022017008A1 (en) 2020-07-20 2021-06-02 Root canal treatment guide plate and manufacturing method therefor

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