CN111823595B

CN111823595B - Personalized intraoral stent for deep-covered crowds

Info

Publication number: CN111823595B
Application number: CN202010623847.0A
Authority: CN
Inventors: 刘展; 马赫迪; 舒敬恒
Original assignee: Sichuan University
Current assignee: Sichuan University
Priority date: 2020-07-01
Filing date: 2020-07-01
Publication date: 2022-04-08
Anticipated expiration: 2040-07-01
Also published as: CN111823595A

Abstract

A novel individualized intraoral stent for dark crowd that covers belongs to clinical oral technical field, concretely relates to individualized intraoral stent suitable for dark crowd that covers, connects tooth and motion capture instrument or mark point. According to the dentition model of the deeply-covered testee, the design of the personalized intraoral stent is carried out by using modeling software, and polylactic acid is used for one-time printing and molding. The method adopts computer software for modeling and model processing, is simple and convenient to operate, can customize the shape of the bracket according to the requirement, has high applicability, does not need to process a real dental model, and can greatly save detection consumables. Finally, the intraoral support is printed and formed through 3D, so that the time for manually debugging the support is saved, the detection efficiency is obviously improved, and the detection cost is reduced.

Description

Personalized intraoral stent for deep-covered crowds

Technical Field

The invention belongs to the technical field of clinical oral cavity, and particularly relates to a personalized intraoral bracket which is suitable for deep-covered people and connects teeth with a motion capture instrument or a mark point.

Background

As is known, the temporomandibular joint, consisting of the condyles, the articular nodules and the temporomandibular fossa, is a pair of linked joints, belonging to the load-bearing organs. Temporomandibular joint and many facial muscles are involved in daily oral movements not less than 2000 times a day. The temporomandibular joint disorder syndrome is a temporomandibular joint disease, and has the characteristics of high morbidity, low cure rate and easy relapse, which not only brings great trouble to patients and seriously reduces the life quality of the patients, but also is a problem which is always concerned in the oral health field. For many patients, before clinical symptoms appear, the temporomandibular joint changes slightly, but not detected, and goes to medical care until obvious symptoms appear, which is one of the reasons for the low cure rate. Furthermore, the lack of judgment criteria for the treatment of temporomandibular joint disorder syndrome is also responsible for the high recurrence rate after treatment. Therefore, a maxillofacial motion detecting apparatus is introduced to detect a motion trajectory of a mandible when performing some oral functions, and the health degree of a temporomandibular joint is evaluated by parameters such as its repeatability, smoothness, and range of motion.

Maxillofacial motion detection is being incorporated into more and more clinical testing procedures due to its convenience, repeatability and lack of impact on subject health. One of the most important devices for maxillofacial motion detection is the intraoral bracket that connects the tracking device to the lower dentition of the human body. However, the manufacturing process of the conventional intraoral stent is too complicated, and the procedures of shooting CT, taking a dental cast, taking a maxillary frame and the like are required, so that the manufacturing process needs a patient to go to a hospital for many times and is time-consuming. Furthermore, the deep occlusal characteristics of most deep-occlusal populations make it difficult to detect jaw-facial movements. Deep synechia is a malocclusion caused by the abnormal vertical development of the upper and lower dental arches and/or the maxilla. Meaning that the upper anterior incisor margin overlaps the lower anterior crown length 1/3 or the lower anterior bite above the upper anterior lingual side 1/3. For deep-bite patients, in the apical-staggered state, the upper incisors will push against the normal intraoral shelf, resulting in abnormal occlusion of the deep-bite subject and affecting many of their motion detections, such as: tapping, cutting and biting, chewing, etc. Therefore, in order to solve the above-mentioned needs, improve the diagnosis efficiency and reduce the burden of the patient, an efficient and accurate design and manufacturing method of the intraoral stent for the deep-covered population is necessary.

Disclosure of Invention

The invention aims to provide a design and a manufacturing method of a personalized intraoral stent manufactured by 3D printing and used for the jaw and facial function motion detection of a deep-draping subject, the method obtains satisfactory results in the aspect of manufacturing the personalized intraoral stent connecting a motion tracking device with a mark point and a tooth, the special intraoral stent can be created for the subject by a tooth model of the deep-draping subject, the intermediate processes of debugging the stent and the like in the past are omitted, the time is saved, and the detection cost is also saved.

In order to obtain the personalized intraoral stent which is manufactured by 3D printing and used for the jaw-facial function movement detection of the deep-covered testee, the invention adopts the following technical scheme, and the specific steps are as follows:

(1) obtaining a deep-overlay subject CT image: performing CT scanning on the jaw face of the subject, preferably, the patient is in a supine position during scanning, the orbital-ear plane is vertical to the horizontal plane, the scanning plane is parallel to the orbital-ear plane of the patient, and the mandible is positioned at the cusp of the patient in an staggered manner;

(2) three-dimensional modeling of the following dentition: exporting the scanned data file into a digital imaging and communications in medicine (DICOM) format, and importing the file into computer-assisted three-dimensional modeling software to establish a three-dimensional digital model of the lower dentition;

(3) modeling of personalized intraoral stents: designing the surfaces of the brackets, which are contacted with teeth, according to buccal models of first and second molars of lower jaw of a testee, so that the parts of the brackets, from incisors to premolars, are not contacted with the teeth, the parts of the upper incisors to premolars, from dentition, can freely enter gaps between lower dentition and personalized intraoral brackets, the testee can conveniently and deeply cover the normal oral cavity movement of the testee, the part of the intraoral brackets, which is connected with a tracking device, does not need personalized design, and the designed intraoral bracket file is guided into a 3D printer;

(4) printing and forming: according to the personalized intraoral stent file introduced in the step (3), sequentially printing the stent with the required shape layer by utilizing polylactic acid;

further, the polylactic acid used in the step (4) is a thermoplastic aliphatic polyester.

The invention has the advantages that:

1. 3D printing molding is carried out by utilizing a computer model, and the detection cost is reduced due to the mold-free manufacturing;

2. the CT dentition model of the deeply-covered testee is utilized to build an individualized intraoral support for the testee, the precision is high, the matching degree with the teeth of the testee is extremely high, and the time for debugging the model is saved;

3. the problem that normal oral cavity movement is difficult to carry out after a deep-covered subject wears a common intraoral support is solved.

Drawings

FIG. 1 is a top view of a deep-skinned subject lower dentition model and a personalized intraoral stent model suitable for the deep-skinned subject in modeling software;

FIG. 2 is a side view of a model of a lower dental sample of a deep-skinned subject and a model of a personalized intraoral stent for the deep-skinned subject in modeling software;

FIG. 3 is a schematic view of the initial state of the stent;

FIG. 4 is a top view of a model of a lower dentition of a deep-skinned subject;

FIG. 5 is a schematic view of a stent after individualized design;

in the figure: 1 is a first molar, 2 is a second molar, 3 is a deep-covering special personalized intraoral bracket, and 4 is a connecting part of the intraoral bracket and a motion tracking device.

Detailed Description

The specific implementation case is as follows:

for ease of understanding, the invention will be explained in detail below with reference to an example and the accompanying drawings. Since the invention can be properly expanded, and the specification cannot fully enumerate all experimental schemes, all other embodiments obtained by the improvement without creative efforts based on the examples cited in the specification fall within the protection scope of the invention;

and selecting one volunteer to be tested for deep coverage, and carrying out CT scanning on the maxillofacial region of the volunteer. Preferably, the patient takes a supine position during scanning, the orbital-ear plane is vertical to the horizontal plane, the scanning plane is parallel to the orbital-ear plane of the patient, and the mandible is positioned at the apex of the teeth in an staggered manner;

preferably, exporting the scanned data file into a digital imaging and communications in medicine (DICOM) format, and importing the file into computer-assisted three-dimensional modeling software to establish a three-dimensional digital model;

preferably, a model of the lower dentition is established using the data file generated by the CT;

further, the buccal side surfaces of the first and second molars of the established mandible model are used for carrying out intraoral stent design, a stent model which can be matched with the buccal side surfaces of the first and second molars of a deep-covered volunteer is obtained, the individualized intraoral stent model before design is shown in fig. 3, and the lower dentition model of the volunteer is shown in fig. 4; the completed personalized intraoral stent is set up as shown in fig. 5.

And further exporting the established personalized intraoral stent into a 3D printing file format, and generating the stent through 3D printing. Preferably, the material of the printing support is polylactic acid.

Claims

1. Utilize 3D to print the individualized intraoral support that the preparation is used for dark crowd that closes, its characterized in that designs and makes according to following step:

(1) obtaining a CT image of the upper jaw and the lower jaw of a deep-covering subject in the cusp crossing dislocation: carrying out CT scanning on the jaw face of a deep-covered subject, wherein the patient is in a supine position during scanning, the orbital-ear plane is vertical to the horizontal plane, and the scanning plane is parallel to the orbital-ear plane of the patient;

(2) three-dimensional modeling of the following dentition: exporting the scanned data file into a DICOM format of a medical digital imaging and communication file, and importing the file into computer-assisted three-dimensional modeling software to establish a three-dimensional digital model of the lower dentition;

(3) personalized intraoral stent modeling suitable for deep-skinned subjects: designing the surfaces of the brackets, which are contacted with teeth, according to buccal models of first and second molars of lower jaw of a testee, so that the parts of the brackets, from incisors to premolars, are not contacted with the teeth, the parts of the upper incisors to premolars, from dentition, can freely enter gaps between lower dentition and personalized intraoral brackets, the testee can conveniently and deeply cover the normal oral cavity movement of the testee, the part of the brackets, which is connected with a tracking device, does not need personalized design, and the designed intraoral bracket file is guided into a 3D printer;

(4) printing and forming: printing the bracket with the required shape layer by utilizing polylactic acid according to the personalized intraoral bracket file led in the step (3);

the personalized intraoral bracket suitable for the deeply-covered testee starts from the second molar on one side of the lower dentition and ends at the same position on the other side, and a bayonet is designed at the initial position, so that the error of the connection between the manufactured finished product and the real dentition is minimized;

the portion of the personalized intraoral support suitable for deep-fitting a subject in contact with the lower dentition is limited to the buccal sides of the first and second molars, and the support is not in contact with the premolars and incisors;

and (4) sequentially carrying out layered printing on the polylactic acid serving as the material according to the personalized intraoral stent model designed in the step (3).

2. The method for manufacturing the personalized intraoral stent for the deep-skinned population by using 3D printing as claimed in claim 1, wherein the CT image of the deep-skinned subject obtained in the step (1) is a real human body CT image.

3. The method for manufacturing the personalized intraoral stent for the deep-skinned population by using 3D printing as claimed in claim 1, wherein the dentition model in the step (2) is a digitized three-dimensional model constructed by computer-aided modeling by using a human body CT image of a real deep-skinned subject.

4. The method for manufacturing the personalized intraoral stent for the deep-fitting population by using 3D printing as claimed in claim 1, wherein the step (3) of modeling the personalized intraoral stent for the deep-fitting subject designs and constructs the buccal contact part of the intraoral stent with the first and second molars by using the first and second molars of the lower dental model in the step (2).