CN112842589A - Guide plate for trimming autologous massive bone grafting bone block - Google Patents
Guide plate for trimming autologous massive bone grafting bone block Download PDFInfo
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- CN112842589A CN112842589A CN202110277984.8A CN202110277984A CN112842589A CN 112842589 A CN112842589 A CN 112842589A CN 202110277984 A CN202110277984 A CN 202110277984A CN 112842589 A CN112842589 A CN 112842589A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
- A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
- B29C64/30—Auxiliary operations or equipment
- B29C64/386—Data acquisition or data processing for additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
- Y02P10/00—Technologies related to metal processing
- Y02P10/25—Process efficiency
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Abstract
The invention discloses a self-block bone graft bone block trimming guide plate, which is characterized in that the specific form of a bone receiving area is obtained through imaging data before operation, the specific contour of the surface of the bone receiving area is extracted from virtual software, the specific contour of the surface of the bone receiving area is thickened to the thickness of 1-2 mm along the outer side direction of a bone surface to form an STL file, and then the STL file is directly printed out by using a 3D printer through a medical transparent resin material. The guide plate can be used for guiding the bone block to be trimmed in the operation, the bone block is placed on the guide plate to be observed, so that an operator is guided to trim the transplanted bone block, particularly the joint surface of the bone block and the jaw bone of the affected area, the exposure time of the actual affected bone area and the probability of being polluted by the bone area can be reduced, and the improvement of the operation effect is facilitated.
Description
Technical Field
The invention belongs to the technical field of tooth implantation restoration, and particularly relates to a trimming guide plate for an autologous block bone graft bone block.
Background
The implant restoration technology after tooth loss is gradually widely applied, however, the tooth loss is usually accompanied with bone defect, the reconstruction of severe bone defect is a difficult point of oral implant, and for larger bone defect, the massive bone transplantation is a well-known operation mode with the most effective and most definite long-term effect. Cubic bone transplantation is including getting bone and two processes of bone grafting, the bone piece of implanting will be favorable to the osteogenesis effect with receiving the good laminating in bone district, however the bone piece of taking down in the actual art often is difficult to with receiving the bone district and laminating completely, there is great space between the two usually, need be repeatedly put into the bone piece of taking out and receive the bone district to compare, observe and grind and change, this process needs the patient to open a mouthful cooperation, but in the actual operation, often because of the intraoral field of vision is not good, factor influence observation effect such as the bone bed oozing blood of receiving the bone district, and increase the risk of art district pollution and increase operation time.
Fig. 1 shows a part of a jawbone in which the bone quantity of an edentulous area is insufficient and massive bone is required to be implanted before implantation, and a dotted line part in fig. 1 shows a part of a bone receiving area in which bone is required to be implanted, so that the bone quantity remaining in the edentulous area is insufficient to meet the requirement of dental implant implantation due to tooth loss accompanied by reconstruction and absorption of the jawbone, and thus bone augmentation surgery is required before implant implantation. The autogenous bone is the gold standard of bone increment, and when the thickness of the residual bone of the intended planting site is less than 4mm, the autogenous block bone transplantation is needed to ensure the final bone increment effect. The operation needs to select a proper bone taking site according to the specific condition of bone defect at a bone receiving area, namely a site where a block-shaped bone needs to be implanted, the bone taking operation is implemented, then the taken-off bone block is properly trimmed and then implanted into the bone receiving area, the bone grafting mode belongs to free bone grafting, in order to ensure that the implanted bone block can survive and realize ideal bone formation effect, strict aseptic operation of the operation must be ensured, and the implanted bone block needs to be contacted with the bone receiving area in as much area as possible, namely, the surface where the implanted bone block is attached to the bone receiving area, namely, the inner surface of the implanted bone block needs to be contacted with the outer surface of the bone receiving area in as much area as possible, so that the survival of the implanted bone block can be ensured. However, in the conventional operation, the inner surface of the removed bone block is often difficult to be well attached to the outer surface of the bone receiving area, an effective reference method is lacked in the operation, the technical sensitivity of the surgical operation is high, and the wide application of the technique is limited.
The inner surface of the bone block to be implanted, which is attached to the affected area, needs to have an optimal surface morphological characteristic, the morphological characteristic can be obtained by subtracting the surface of the bone block to be removed from the surface of the affected area through 'Boolean' operation in virtual design software, and a bone grinding tool can be used for trimming the bone block in actual operation. Traditional method among the prior art is for the doctor directly will take off the bone piece place receive the bone district to observe, make the change according to the result of observing, however, because observe in patient's mouth, receive observation angle influence and receive the influence of bone district oozing blood, direct observation's effect is relatively poor, can't see the interior surface of free bone piece of transplanting clearly and the actual laminating condition that receives the bone district, and put free bone piece into and receive the bone district repeatedly, increased free bone piece and received the contaminated risk in bone district, increased operation time and intraoperative patient's discomfort. Under the condition that no guide plate is arranged, a doctor needs to repeatedly place the bone blocks in the bone receiving area for comparison and trimming, observation in the doctor operation is often influenced due to limited visual field, the risk of pollution exists on the surface of the bone receiving area where the bone blocks are repeatedly placed in the mouth of a patient, and the infection risk of the operation is increased. Therefore, a guide plate which can provide better reference for bone block trimming for a doctor needs to be designed to assist the doctor in the bone block trimming operation.
Disclosure of Invention
The invention provides a trimming guide plate for autologous massive bone grafting bone blocks, aiming at overcoming the defects in the prior art.
The invention is realized by the following technical scheme: the invention discloses an autologous block bone graft trimming guide plate, which is used for acquiring the specific form of a bone receiving area through imaging data before an operation, extracting the specific contour of the surface of the bone receiving area in virtual software, thickening the specific contour of the surface of the bone receiving area to the thickness of 1-2 mm along the outer side direction of a bone surface to form an STL file, and then directly printing the STL file by using a medical transparent resin material through a 3D printer to obtain the autologous block bone graft trimming guide plate, wherein the autologous block bone graft trimming guide plate comprises the jaw bone surface characteristic required to be subjected to bone increment in a tooth lacking area, the bone surface characteristic required to be subjected to bone increment in the tooth lacking area at the periphery of a part 1-2 cm away from the bone increment part and the surface characteristic of teeth adjacent to the tooth lacking area.
Preferably, the surface features of the teeth adjacent to the edentulous region are surface features of two teeth on each of the mesial and distal sides.
Preferably, the virtual software is Geomagic Studio software.
Preferably, the specific contour of the surface of the bone receiving area is thickened to a thickness of 1-2 mm along the outer side direction of the bone surface to form an STL file.
The invention has the beneficial effects that: clinically, bone defect repair and reconstruction usually adopt a bone-taking and transplanting operation of a massive bone, but the taken bone block is usually difficult to be well jointed with a bone receiving area, so that the bone-forming effect is influenced. The concrete manufacturing process of the bone block trimming guide plate comprises the following steps: the specific shape of the bone receiving area is obtained through imaging data before operation, the specific contour of the surface of the bone receiving area is extracted from virtual software such as Geomagic Studio, the contour is thickened to the thickness of 1-2 mm along the outer side direction of the bone surface, and then the bone receiving area is printed and manufactured by medical transparent resin materials. Utilize this baffle just can instruct the bone piece to repair in the art, because whole baffle is transparent, can put the bone piece on this baffle, again from opposite another side see the bone piece clearly with the laminating degree on baffle surface, the surface profile of baffle is the surface profile who receives the bone region promptly, observe on putting the bone piece on the baffle, can observe the position and the size in space better, thereby guide the art person to adopt finishing tools such as head of a grinder to repair the bone piece, the exposure time that actually receives the bone region has been reduced, the contaminated chance of actually receiving the bone region has also been reduced simultaneously, the bone piece of finishing on finishing the baffle of putting can directly be used for fixing to actually receiving the bone region, thereby reduce the operation time, be favorable to improving the operation effect.
The invention provides the guide plate which can provide better bone block trimming reference for a doctor to assist the doctor in trimming the bone block, can avoid the discomfort in the operation caused by repeated large opening of the mouth of the patient, better reduces the operation time of the operation and the risk of pollution, improves the effect of trimming the bone block and ensures that the bone block can be better attached to a bone receiving area. The bone block trimming guide plate made of the completely transparent 3D printing material can greatly reduce the operation time, reduce the opening time of a patient in operation, reduce the exposure time of a bone receiving area, reduce the in-vitro time of the bone block, and is favorable for improving the bone forming effect and relieving the postoperative reaction of the patient. Simultaneously, can assist the doctor to observe the actual laminating condition of bone piece and bone receiving area better through this baffle, guide the doctor to repair cubic bone better to realize the free bone piece of implantation and receive the better laminating in bone area, be favorable to improving the osteogenesis rate of bone grafting, reduce the absorption of implanting the bone piece.
Drawings
Fig. 1 is a schematic view of the overall structure of a jaw bone; FIG. 1 includes the jawbone bone surface of the intended implantation site in the bone defect area and the adjacent teeth around the edentulous area;
FIG. 2 is a schematic view of the self-mass bone graft block trimming guide;
FIG. 3 is a photograph of the upper surface of the autologous bone graft trimming guide in use;
FIG. 4 is a photograph of the lower surface of the autogenous block bone graft trimming guide in use;
in the figure: 1-bone defect area; 2-an outer contour suitable for implantation in a bone block; 3-the edentulous area is adjacent to the teeth.
Fig. 2 is a part of the surface characteristics of fig. 1, which are surface characteristics of a tooth lacking area and a surrounding structure thereof, wherein a dotted line range indicates that a bone defect exists in the tooth lacking area and a site needing bone increment is required, the trimming guide plate is made of medical transparent resin material when being thickened to 1-2 mm along the outer side direction of a bone surface, and the bone block repairing guide plate is used for planning bone block implantation in the tooth lacking area. Fig. 4 is a photograph of the lower surface of the used state of the guide for trimming autologous bone graft blocks, from which the adhesion of the bone blocks to the upper surface of the guide (representing the surface of the jaw bone) can be observed during use.
Detailed Description
The invention is described in detail below with reference to the figures and the detailed description.
As shown in fig. 1 to 4, the invention discloses an autologous block bone graft trimming guide plate, which is used for acquiring the specific shape of a bone receiving area through imaging data before an operation, extracting the specific contour of the surface of the bone receiving area in virtual software, thickening the specific contour of the surface of the bone receiving area to the thickness of 1-2 mm along the outer side direction of the bone surface to form an STL file, and then directly printing the STL file by using a medical transparent resin material through a 3D printer to obtain the autologous block bone graft trimming guide plate, wherein the autologous block bone graft trimming guide plate comprises the jaw bone surface characteristics of a bone defect area 1 needing bone increment, the bone surface characteristics of the bone surface of a tooth lacking area needing bone increment and the surface characteristics of teeth 3 adjacent to the tooth lacking area, wherein the bone surface characteristics are 1-2 cm away from the periphery of the bone increment. Preferably, the surface features of the tooth-lacking area adjacent to the teeth 3 are the surface features of two teeth at the near middle side and the far middle side respectively, the virtual software is Geomagic Studio software, the specific contour of the surface of the bone receiving area is thickened to the thickness of 1-2 mm along the outer side direction of the bone surface, and an STL file is formed.
The specific design and manufacturing process of the trimming guide plate designed by the invention comprises the following steps: extracting bone surface morphological characteristics of a bone receiving area and surface morphologies of 2-3 teeth adjacent to two sides of a tooth lacking area from virtual software Geomagic Studio, using the thin sheet with the bone surface morphological characteristics and the tooth surface morphological characteristics as the upper surface of a guide plate, wherein the upper surface is completely the same as the surface of the bone receiving area, the surface morphologies are copied for the actual bone receiving area, then using a shell drawing command under a polygon menu in Geomagic Studio software to thicken the upper surface to about 1-2 mm along the outer side direction of the upper surface, and using the other surface of the guide plate corresponding to the upper surface as the lower surface of the guide plate. The operation can form an STL file in the virtual software, and the guide plate can be printed by using a 3D printer and a fully transparent medical resin material. Can directly utilize this baffle to repair bone piece in the art, because of this baffle is complete transparent, the part that the upper surface that should this baffle corresponds is planted to the free bone piece that will take off needs to be repaired, bone piece and the upper surface that receives the medial surface of bone district contact and baffle contact, place the outer contour line 2 that is fit for implanting the bone piece and carry out simple centre gripping with bone piece and baffle through doctor's hand or centre gripping apparatus with bone piece and baffle fixedly, alright observe the laminating degree of bone piece and baffle upper surface through the lower surface of baffle directly, can directly observe the relatively poor position of laminating, and carry out corresponding repairment. Until the medial surface of repairing this free bone piece reaches the laminating degree that satisfies the requirement of bone piece osteogenesis with the baffle upper surface after, then can directly put free bone piece to the intraoral actual bone area that receives of patient, the position that the relative reality of adjustment bone piece received the bone area is the same with the relative baffle of bone piece in position, directly uses the screw to fix the bone piece to the implantation process that receives the bone area and can accomplish cubic bone.
Finally, it should be noted that the above-mentioned contents are only used for illustrating the technical solutions of the present invention, and not for limiting the protection scope of the present invention, and that the simple modifications or equivalent substitutions of the technical solutions of the present invention by those of ordinary skill in the art can be made without departing from the spirit and scope of the technical solutions of the present invention.
Claims (4)
1. The utility model provides a baffle is maintained to cubic bone grafting bone piece of autologous which characterized in that: the trimming guide plate for the autologous massive bone grafting bone block is obtained by obtaining the specific form of a bone receiving area through imaging data before an operation, extracting the specific contour of the surface of the bone receiving area from virtual software, thickening the specific contour of the surface of the bone receiving area to the thickness of 1-2 mm along the outer side direction of the bone surface to form an STL file, and then directly printing the STL file by using a medical transparent resin material through a 3D printer to obtain the trimming guide plate for the autologous massive bone grafting bone block, wherein the trimming guide plate for the autologous massive bone grafting bone block comprises the jaw bone surface characteristics of a tooth lacking area needing bone increment, the bone surface characteristics of a tooth lacking area needing bone increment and the surface characteristics of teeth adjacent to the tooth lacking area, wherein the bone surface characteristics are 1-2 cm away from the periphery of the tooth lacking area.
2. The autologous bulk bone graft trimming guide of claim 1, wherein: the surface features of the teeth adjacent to the edentulous area are the surface features of two teeth on the mesial side and the distal side respectively.
3. The autologous bulk bone graft trimming guide of claim 1, wherein: the virtual software is Geomagic Studio software.
4. The autologous bulk bone graft trimming guide of claim 1, wherein: and thickening the specific contour of the surface of the bone receiving area to the thickness of 1-2 mm along the outer side direction of the bone surface and forming an STL file.
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CN202110277984.8A CN112842589B (en) | 2021-03-15 | 2021-03-15 | Autologous block bone graft bone block trimming guide plate |
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CN202110277984.8A CN112842589B (en) | 2021-03-15 | 2021-03-15 | Autologous block bone graft bone block trimming guide plate |
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CN112842589B CN112842589B (en) | 2023-07-21 |
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Cited By (1)
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CN114366359A (en) * | 2022-02-10 | 2022-04-19 | 北京大学口腔医学院 | Manufacturing method of digital combined guide plate suitable for bone increment synchronous planting |
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CN114366359A (en) * | 2022-02-10 | 2022-04-19 | 北京大学口腔医学院 | Manufacturing method of digital combined guide plate suitable for bone increment synchronous planting |
CN114366359B (en) * | 2022-02-10 | 2024-03-12 | 北京大学口腔医学院 | Manufacturing method of digital combined guide plate suitable for bone increment synchronous planting |
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