CN112402014A - Positioning and registering device and method for digital surgical navigation system - Google Patents

Positioning and registering device and method for digital surgical navigation system Download PDF

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CN112402014A
CN112402014A CN202011421555.5A CN202011421555A CN112402014A CN 112402014 A CN112402014 A CN 112402014A CN 202011421555 A CN202011421555 A CN 202011421555A CN 112402014 A CN112402014 A CN 112402014A
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positioning
registration
coordinate system
navigation system
navigator
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章征贵
陈云
雷业新
谢韬
卢曙光
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Suzhou Dikaier Medical Technology Co ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition

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  • General Health & Medical Sciences (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
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Abstract

The invention provides a positioning and registering device and a method for a digital surgical navigation system, which can simplify the navigation and registering link before oral dental surgery, shorten the surgery time and improve the surgery experience of patients and doctors; the dental jaw reference locator is connected with a dental jaw reference locator through a connecting rod, the positioning and registering device comprises a shell, registering mark points are arranged on the upper surface of the shell, the lower surface of the shell is of an inwards concave structure, an installation opening is formed in the shell, one end of the connecting rod is connected with the shell through being inserted into the installation opening, and a printing film filler is filled in the inwards concave opening of the shell.

Description

Positioning and registering device and method for digital surgical navigation system
Technical Field
The invention relates to the technical field of surgical operation positioning and registration, in particular to a positioning and registration device and a method for a digital operation navigation system.
Background
In modern operations such as dental restoration and implantation, in order to improve the accuracy and success rate of the operations, a digital operation navigation system is usually adopted as an aid; the digital operation navigation system firstly takes a CT image of the head of a patient, guides the CT image of the patient into computer software for operation scheme design, and registers the dental jaw of the patient to a navigator coordinate system in real time by wearing a registration device, a fixing device and a dental jaw reference positioner on the tooth before an operation, and then realizes operation navigation by real-time positioning of the navigator in the operation process; although the above-mentioned method can realize the surgical navigation, the traditional method is that the registration device and the fixing device of the reference locator of the jaw are two parts, the patient needs to wear the two devices at the same time in a period of time in the operation, the patient feels certain discomfort, and when the registration is carried out, the registration device is worn in the mouth of the patient by a doctor to carry out intraoral registration after the patient lies on the operating table, at the moment, the view field of the navigator is shielded by the facial tissues of people and the registration can not be seen, so that the configuration device can not be directly positioned, the position of the registration device can be obtained only by touching the mark points on the registration device one by one through the tips of other instruments which can be seen by the navigator to carry out position acquisition, therefore, the result of the registration of each coordinate system is calculated, and the registration process takes a long time (usually greater than or equal to 5 minutes), which has a certain adverse effect on the medical experience of the patient and the operation convenience of the doctor.
Disclosure of Invention
In view of the above problems, the present invention provides a positioning and registering device and method for a digital surgical navigation system, which can simplify the navigation and registering process before the oral dental surgery, shorten the surgery time, and improve the surgery experience of patients and doctors.
The technical scheme is as follows: a positioning and registering device for a digital surgical navigation system is connected with a dental reference positioner through a connecting rod, and is characterized in that: the positioning and registering device comprises a shell, registering mark points are arranged on the upper surface of the shell, the lower surface of the shell is of an inward concave structure, a mounting opening is formed in the shell, one end of the connecting rod is inserted into the mounting opening to be connected with the shell, and printing film fillers are filled in the inward concave opening of the shell.
Furthermore, the registration mark points are made of highly reflective materials;
further, the number of the registration mark points is at least three, and the registration mark points are dispersedly arranged on the upper surface of the shell;
furthermore, the printing film filler adopts temperature-sensitive resin or silicon rubber;
a positioning and registering method for a digital operation navigation system is characterized in that: which comprises the following steps:
s1, firstly, before operation, filling impression filling materials into the inner concave opening of the shell, wearing a positioning and registering device on the teeth of a patient before the impression filling materials are solidified, shooting CT after the impression filling materials are solidified, then taking out the positioning and registering device from the mouth of the patient, and leading CT images into a navigation system for operation scheme design, thereby determining the positions of the teeth needing to be operated and the positions of the positioning and registering device in the CT;
s2, before operation, assembling the positioning and registering device and the dental reference locator together to form a dental reference locator group, facing the dental reference locator group to a navigator, and completing registration of a coordinate system and a CT coordinate system of the dental reference locator through the navigation system;
s3, when the operation is started, the positioning and registering device is worn on the patient mouth again, and the wearing position is kept consistent with that during the CT shooting, so that the CT coordinate system and the patient coordinate system are basically coincident;
s4, in the operation process, the doctor uses the operation instrument with the characteristic mark to operate, the position of the tip point of the operation instrument in the navigator coordinate system is obtained through the navigation system, and the coordinate position is converted into a CT coordinate system;
s5, the navigation system compares the position of the target surgical tooth position in the CT coordinate system with the real-time position of the tip point of the surgical instrument in the CT coordinate system, and displays navigation prompt information on a software interface of the navigation system, so that a doctor is guided to operate the surgical instrument correctly.
Further, in step S1, the position of the tooth position to be operated is recorded as (x) in the CTct,yct,zct) (ii) a The gray values of all the registration mark points of the positioning and registration device in the CT image are obviously different from the gray values of human tissues, the image of the region is subjected to edge extraction through image processing to obtain the positions of all the registration mark points in the CT, and the positions are marked as Mpos CT { (x) CTj,yj,zj) 1,2, … m, where m is the number of registration mark points;
further, in step S2, the set of dental reference locators is faced to the navigator, and n sets of transformation matrices of the dental reference locators in the navigator and position coordinates of all m registration mark points of the positioning and registration device in the navigator are acquired and recorded as (T)a1,MPosNav1)，(Ta2,MPosNav2)…(Tan,MPosNavn)，
Wherein: t isaiI is 1,2, … n, which represents the transformation matrix of the dental reference locator in the navigator, and is a matrix with 4 rows and 4 columns;
MPosNavi＝{[MPxji,MPyji,MPzji]T1,2,. m }: a set of three-dimensional coordinates representing all m registration mark points of the positioning and registration device in the navigator;
by the formula
Figure BDA0002822579590000031
Calculating to obtain the position MPosRef of the jth registration mark point of the positioning and registration device in the dental reference locator coordinate systemj，MPosRefjIs MPosRefTempjA matrix of 3 rows and 1 column made up of the first three elements of (a); defining MposRef as { MPosRef j1,2, … m, representing a set of positions of m registration mark points of the positioning and registration device in a dental reference locator coordinate system; then, registering the MposRef to the MposCT through a point cloud registration algorithm to obtain a dental reference locator coordinate systemCT coordinate system transformation matrix T1；
Further, in the step S4, the dental reference locator and the surgical instrument are located by the navigator, and the real-time transformation matrix of the dental reference locator in the navigator is recorded as T2Recording the real-time transformation matrix of the surgical instrument in the navigator as T3And by the formula TipPosCT ═ T1×(T2 -1×(T3X TipPosTool)), calculating the real-time position TipPosCT of the surgical instrument tip point in the CT coordinate system, wherein the TipPosTool represents the position of the surgical instrument tip point in the surgical instrument coordinate system.
The invention has the advantages that the positioning and registering device is integrated with the registering mark points and the mounting port of the dental reference locator, a patient wears the positioning and registering device to shoot CT before operation, the CT is led into software of a navigation system to carry out operation scheme design, the positioning and registering device and the dental reference locator are assembled together before operation, and then the registration of the coordinate system of the registering device and the dental reference locator can be directly finished outside the mouth of the patient, so that the time and operation of the registration link of a doctor during operation can be reduced, the experience of the doctor and the patient using the digital navigation system is improved, and compared with the traditional scheme in which the registration device and the fixing device are respectively needed, the invention can save additional fixing devices, simplify the operation process, reduce the product cost and improve the convenience of the use of the user.
Drawings
FIG. 1 is a schematic perspective view of the present invention;
FIG. 2 is a schematic view of the present invention in assembled configuration with a reference dental locator.
Detailed Description
As shown in fig. 1 and 2, a positioning and registering device for a digital surgical navigation system is connected with a reference dental positioner 2 through a connecting rod 1, the positioning and registering device comprises a shell 3, 3 registration mark points 4 are dispersedly arranged on the upper surface of the shell 3, the registration mark points 4 are made of highly reflective materials, or materials with colors having large contrast difference with the colors of the shell 3, and can reflect infrared light emitted by a navigator and form images in a CT image, and gray values in the CT image are obviously different from human tissues; the arrangement of the registration mark points 4 is asymmetrical, namely, the patterns formed by connecting the points do not have the conditions of equilateral triangle, rectangle and the like; the lower surface of the shell 3 is of a concave structure, a mounting port 5 is formed in the shell 3, one end of the connecting rod 1 is connected with the shell 3 through being inserted into the mounting port 5, impression fillers similar to temperature-sensitive resin or other silica gel are filled in the concave opening of the shell 3 and can be buckled on teeth of a patient, after the fillers are cured, the positioning and registering device can be stably fixed on the teeth and is not easy to loosen, after the fillers are cured, tooth marks of the teeth of the patient can be left, and the positioning and registering device can still be restored to a position for CT shooting when being worn repeatedly; the concave structure of the shell 3 can ensure that the filled temperature-sensitive resin and the positioning and registering device can be firmly combined.
By combining the characteristics, the positioning and registering device can simultaneously register a CT coordinate system, a patient coordinate system and a dental reference locator 2 coordinate system, and compared with the traditional scheme in which a registering device and a fixing device are respectively needed, the invention can save an additional fixing device and simplify the operation process.
A method of positional registration for a digital surgical navigation system, comprising the steps of:
s1, firstly, before operation, filling impression filler into an inner recess of the shell 3, wearing a positioning and registering device on teeth of a patient before the impression filler (such as temperature-sensitive resin which is heated and softened or filling uncured silicon rubber) is cured, shooting CT after the impression filler is cured, then taking out the positioning and registering device from the mouth of the patient, and introducing a CT image into a navigation system for designing an operation scheme, thereby determining the position of the teeth needing to be operated and the position of the positioning and registering device in the CT;
specifically, the position of the tooth to be operated is marked as ToothPosCT (x)ct,yct,zct) (ii) a The positions of all the registration mark points 4 in the CT can be identified through the CT image processing, and the material density of the registration mark points 4 is very highIf the gray value in the CT image is significantly different from the human tissue, the positions of all the registration mark points 4 in the CT can be obtained by performing edge extraction on the image of the region through image processing, and the position is recorded as MposCT { (x)j,yj,zj) 1,2, … m, where m is the number of registration mark points;
s2, when preparing for surgery, a doctor or an assistant assembles the positioning and registering device and the dental reference locator 2 together to form a dental reference locator group, all the parts are in rigid connection, the dental reference locator group faces to a navigator, the navigator can select an infrared binocular navigator, and the navigator receives infrared light emitted or reflected by the object surface mark points through a binocular camera and locates the position and the posture of the object; then, the registration of the coordinate system of the reference locator of the jaw and the CT coordinate system is completed through a navigation system;
specifically, the dental reference locator group faces the navigator, the transformation matrix of n groups of dental reference locators in the navigator and the position coordinates of all m registration mark points of the positioning registration device in the navigator are collected and recorded as (T)a1,MPosNav1)，(Ta2,MPosNav2)…(Tan,MPosNavn)，
Wherein, TaiI is 1,2, … n, which represents the transformation matrix of the dental reference locator in the navigator, and is a matrix with 4 rows and 4 columns;
MPosNavi＝{[MPxji,MPyji,MPzji]T|j＝1,2,..m}，MPosNavia set of three-dimensional coordinates in the navigator representing all m registration mark points of the positioning registration device, i being 1,2, … n;
by the formula
Figure BDA0002822579590000051
Calculating to obtain the position MPosRef of the jth registration mark point of the positioning and registration device in the dental reference locator coordinate systemj，MPosRefjIs MPosRefTempjThe first three elements of (a) is a 3-row 1-column matrix, MposRef refers to m MPosRefsjIs defined as a set ofMposRef of { MPosRef j1,2, … m, which represents the position set of m registration mark points of the positioning registration device in the dental reference locator coordinate system; then, registering the MposRef to the coordinates MposCT of all the registration mark points in the CT by using the existing point cloud registration algorithm Landmarker to obtain a transformation matrix T from the dental reference locator coordinate system to the CT coordinate system1；
Step S2 can be completed in the preparation process before operation, and is not needed to be performed in the mouth of the patient after the patient lies down, so the time of the operation process can be shortened;
s3, when the operation is started, the positioning and registering device is worn on the patient mouth again, and the wearing position is kept consistent with that when the CT is shot, so that the CT coordinate system is basically coincident with the patient coordinate system;
s4, in the operation process, the doctor uses the operation instrument with the characteristic mark to perform the operation, obtains the position of the tip point of the operation instrument in the navigator coordinate system through the navigation system, and converts the coordinate position to the CT coordinate system;
specifically, the dental reference locator and the surgical instrument are positioned through the navigator, and a real-time transformation matrix of the dental reference locator in the navigator is recorded as T2Recording the real-time transformation matrix of the surgical instrument in the navigator as T3And by the formula TipPosCT ═ T1×(T2 -1×(T3X TipPosTool)), calculating to obtain the real-time position TipPosCT of the surgical instrument tip point in the CT coordinate system, wherein the TipPosTool represents the position of the surgical instrument tip point in the surgical instrument coordinate system;
s5, the navigation system compares the coordinate position TipPosCT with the ToothPosCT, and displays navigation prompt information on a software interface of the navigation system, namely, the current position TipPosCT of the tip of the surgical instrument of the doctor and the target position ToothPosCT which needs to be reached are prompted through a target map and a depth indication on the software interface, so that the doctor can adjust the angle and the depth of the surgical instrument in real time according to the software interface, and under an ideal condition, the tip position and the target position of the surgical instrument coincide when the surgery is finished, thereby guiding the doctor to correctly operate the surgical instrument and improving the precision and the success rate of the surgery.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein. Any reference sign in a claim should not be construed as limiting the claim concerned.
Furthermore, it should be understood that although the present description refers to embodiments, not every embodiment may contain only a single embodiment, and such description is for clarity only, and those skilled in the art should integrate the description, and the embodiments may be combined as appropriate to form other embodiments understood by those skilled in the art.

Claims (8)

1. A positioning and registering device for a digital surgical navigation system is connected with a dental reference positioner through a connecting rod, and is characterized in that: the positioning and registering device comprises a shell, registering mark points are arranged on the upper surface of the shell, the lower surface of the shell is of an inward concave structure, a mounting opening is formed in the shell, one end of the connecting rod is inserted into the mounting opening to be connected with the shell, and printing film fillers are filled in the inward concave opening of the shell.
2. The positioning and registration device for the digital surgical navigation system according to claim 1, wherein: the registration mark points are made of high-reflectivity materials.
3. The positioning and registration device for the digital surgical navigation system according to claim 1, wherein: the number of the registration mark points is at least three, and the registration mark points are dispersedly arranged on the upper surface of the shell.
4. The positioning and registration device for the digital surgical navigation system according to claim 1, wherein: the printing film filler adopts temperature-sensitive resin or silicon rubber.
5. A positioning and registering method for a digital operation navigation system is characterized in that: the positioning and registering device for the digital surgical navigation system comprises the positioning and registering device as claimed in any one of claims 1 to 4, wherein the positioning and registering method comprises the following steps:
s1, firstly, before operation, filling impression filling materials into the inner concave opening of the shell, wearing a positioning and registering device on the teeth of a patient before the impression filling materials are solidified, shooting CT after the impression filling materials are solidified, then taking out the positioning and registering device from the mouth of the patient, and leading CT images into a navigation system for operation scheme design, thereby determining the positions of the teeth needing to be operated and the positions of the positioning and registering device in the CT;
s2, before operation, assembling the positioning and registering device and the dental reference locator together to form a dental reference locator group, facing the dental reference locator group to a navigator, and completing registration of a coordinate system and a CT coordinate system of the dental reference locator through the navigation system;
s3, when the operation is started, the positioning and registering device is worn on the patient mouth again, and the wearing position is kept consistent with that during the CT shooting, so that the CT coordinate system and the patient coordinate system are basically coincident;
s4, in the operation process, the doctor uses the operation instrument with the characteristic mark to operate, the position of the tip point of the operation instrument in the navigator coordinate system is obtained through the navigation system, and the coordinate position is converted into a CT coordinate system;
s5, the navigation system compares the position of the target surgical tooth position in the CT coordinate system with the real-time position of the tip point of the surgical instrument in the CT coordinate system, and displays navigation prompt information on a software interface of the navigation system, so that a doctor is guided to operate the surgical instrument correctly.
6. The positioning and registration method for the digital surgical navigation system according to claim 5, wherein: in step S1, the position of the tooth position to be operated is marked as tooth position (x) in CTct,yct,zct) (ii) a The gray values of all the registration mark points of the positioning and registration device in the CT image are obviously different from the gray values of human tissues, the image of the region is subjected to edge extraction through image processing to obtain the positions of all the registration mark points in the CT, and the positions are marked as Mpos CT { (x) CTj,yj,zj) And | j ═ 1,2, … m }, wherein m is the number of registration marker points.
7. The positioning and registration method for the digital surgical navigation system according to claim 6, wherein: in step S2, the set of dental reference locators is faced to the navigator, and n sets of transformation matrices of the dental reference locators in the navigator and position coordinates of all m registration mark points of the positioning and registration device in the navigator are acquired and recorded as (T)a1,MPosNav1)，(Ta2,MPosNav2)…(Tan,MPosNavn)，
Wherein: t isaiI is 1,2, … n, which represents the transformation matrix of the dental reference locator in the navigator, and is a matrix with 4 rows and 4 columns;
MPosNavi＝{[MPxji,MPyji,MPzji]T1,2,. m }: a set of three-dimensional coordinates representing all m registration mark points of the positioning and registration device in the navigator;
by the formula
Figure FDA0002822579580000021
Calculating to obtain the jth registration mark point of the positioning and registration device in the reference positioning of the dental jawPosition of machine coordinate system MPosRefj，MPosRefjIs MPosRefTempjA matrix of 3 rows and 1 column made up of the first three elements of (a); defining MposRef as { MPosRefj1,2, … m, representing a set of positions of m registration mark points of the positioning and registration device in a dental reference locator coordinate system; then, registering the MposRef to the MposCT through a point cloud registration algorithm to obtain a transformation matrix T from a dental reference locator coordinate system to a CT coordinate system1。
8. The positioning and registration method for the digital surgical navigation system according to claim 7, wherein: in the step S4, the dental reference locator and the surgical instrument are located by the navigator, and the real-time transformation matrix of the dental reference locator in the navigator is recorded as T2Recording the real-time transformation matrix of the surgical instrument in the navigator as T3And by the formula TipPosCT ═ T1×(T2 -1×(T3X TipPosTool)), calculating the real-time position TipPosCT of the surgical instrument tip point in the CT coordinate system, wherein the TipPosTool represents the position of the surgical instrument tip point in the surgical instrument coordinate system.
CN202011421555.5A 2020-12-08 2020-12-08 Positioning and registering device and method for digital surgical navigation system Pending CN112402014A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117379179A (en) * 2023-12-07 2024-01-12 深圳卡尔文科技有限公司 External physical point navigation registration method, system and storage medium

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117379179A (en) * 2023-12-07 2024-01-12 深圳卡尔文科技有限公司 External physical point navigation registration method, system and storage medium
CN117379179B (en) * 2023-12-07 2024-02-06 深圳卡尔文科技有限公司 External physical point navigation registration method, system and storage medium

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