CN114770949A - Grid-shaped front tooth preparation observation plate and digital preparation method thereof - Google Patents
Grid-shaped front tooth preparation observation plate and digital preparation method thereof Download PDFInfo
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- CN114770949A CN114770949A CN202210397003.8A CN202210397003A CN114770949A CN 114770949 A CN114770949 A CN 114770949A CN 202210397003 A CN202210397003 A CN 202210397003A CN 114770949 A CN114770949 A CN 114770949A
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- 238000002360 preparation method Methods 0.000 title claims abstract description 101
- 238000000034 method Methods 0.000 claims abstract description 18
- 238000004519 manufacturing process Methods 0.000 claims abstract description 10
- 230000008439 repair process Effects 0.000 claims description 13
- 239000000463 material Substances 0.000 claims description 9
- 238000013461 design Methods 0.000 claims description 7
- 238000003745 diagnosis Methods 0.000 claims description 7
- 239000000758 substrate Substances 0.000 claims description 6
- 230000001788 irregular Effects 0.000 claims description 3
- 238000000016 photochemical curing Methods 0.000 claims description 3
- 210000004872 soft tissue Anatomy 0.000 claims description 3
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 claims description 2
- 210000004195 gingiva Anatomy 0.000 claims description 2
- 238000005406 washing Methods 0.000 claims 1
- 230000000007 visual effect Effects 0.000 abstract description 7
- 230000008569 process Effects 0.000 description 6
- 238000005259 measurement Methods 0.000 description 5
- 210000001519 tissue Anatomy 0.000 description 4
- 229920002379 silicone rubber Polymers 0.000 description 3
- 239000000919 ceramic Substances 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 229910052573 porcelain Inorganic materials 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
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Classifications
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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
-
- 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
-
- 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
- B33Y80/00—Products made by additive manufacturing
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29L—INDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
- B29L2031/00—Other particular articles
- B29L2031/753—Medical equipment; Accessories therefor
Abstract
The invention discloses a grid-shaped front tooth preparation observation plate and a digital preparation method thereof, and belongs to the technical field of digital preparation. The method takes the inner side surface of the tooth preparation indicating plate as a reference surface, the space formed by the tooth preparation indicating plate and the prepared preparation surface is uniformly transited from the gingival margin to the incisal margin, the grid is convenient for multi-point observation, and the thickness of the personalized indicating plate can help a doctor to better evaluate the tooth preparation amount and can meet the requirements of tooth preparation and prosthesis manufacturing. The tooth preparation observation plate can improve the problem that the tooth grinding amount is difficult to judge in clinic to a certain extent, and the tooth preparation amount can be accurately evaluated under the direct vision condition by carrying out visual observation through the grating with the thickness of 1mm or personalized thickness.
Description
Technical Field
The invention belongs to the technical field of digital preparation, and particularly relates to a grid-shaped front tooth preparation observation plate and a digital preparation method thereof.
Background
Porcelain veneering is a common aesthetic restoration of anterior teeth. The wax pattern is used for diagnosis and repair, and after the doctor and the patient confirm the repair effect, the next step is tooth preparation. In the clinical operation process, on the basis of meeting the veneering preparation space requirement, the autologous tooth tissue is hoped to be reserved as far as possible. It is the goal of the restorative doctor how to quantify dental preparation in a digital manner, preserving healthy dental tissue as much as possible, thereby reducing the incidence of pulp irritation symptoms.
In the traditional method, the tooth preparation amount is observed through a silicon rubber impression, only one observation window can be obtained in the mode, a new observation window needs to be obtained by continuously cutting off the silicon rubber, and the clinical application is very inconvenient. The existing tooth quantitative preparation auxiliary method comprises a TRS system and a First Fit system, which can solve the problem of tooth preparation amount to a certain extent, but have certain limitations. The TRS system can only carry out fixed-point rough measurement and cannot obtain data of all tooth surface sites, and the First system has high use technical requirements and needs specific instruments, so that the cost is increased.
In the chinese patent website, a patent named "personalized tooth preparation step-by-step indication guide made by digital design" was retrieved (cn201811343388.x), describing the application of multiple guides using digital design and printing. Although the preparation amount of each preparation surface can be controlled more accurately, the preparation method is complex to use, has more steps and has higher operation requirement. Steps or the like may be formed between the respective preparatory surfaces due to an improper operation.
In a patent (CN202010459049.9) entitled "method for digitally preparing a dental preparation guide with triple rigid constraint and guidance", a precise dental preparation is achieved by using triple constraint preparation tooth surfaces, but after the guide is applied, the joint between the preparation surfaces needs to be trimmed. Therefore, the use of such a preparation guide plate can only prepare a cylindrical surface, but cannot prepare a spherical surface, and the prepared surface after the preparation of the anterior teeth is not a cylindrical surface but a uniformly transitional curved surface.
Therefore, the current digital preparation technology still cannot meet the requirements of tooth preparation and restoration manufacturing, and particularly cannot accurately observe and evaluate the preparation amount of teeth at any time.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention aims to provide an anterior tooth preparation observation plate and a digital preparation method thereof, which can accurately observe and evaluate the preparation amount of teeth at any time in the tooth preparation process so as to meet the requirements of tooth preparation and prosthesis manufacturing.
In order to achieve the purpose, the invention adopts the following technical scheme to realize the purpose:
the invention discloses a digital preparation method of a grid-shaped front tooth preparation observation plate, which comprises the following steps of:
1) acquiring oral scanning data after a patient tries to wear the diagnosis prosthesis;
2) adjusting the modified model in the dental prosthesis design software according to the trial wearing condition of the diagnostic prosthesis and then determining the final shape of the prosthesis;
3) importing a final restoration model in digital design software, and manufacturing a grid-shaped front tooth standby tooth observation plate;
4) and printing the front tooth standby tooth observation plate by using a 3D printer, and performing post-treatment to obtain the grid-shaped front tooth standby tooth observation plate.
Preferably, in the step 2), the relative prosthesis form is finely adjusted according to the feedback in the repair process, and the final prosthesis form is determined; if the tooth form is irregular, simulating the restoration form in digital software to be used as a final restoration model of the restoration.
Preferably, in step 2), the dental prosthesis design software is Exocad software, 3Shape software or UPCAD software; the digital Design software in the step 3) adopts Geomic Wrap, Geomic Design, Geomic studio, Imageware, CopyCAD or RapidForm and other software.
Preferably, in step 3), the operation of manufacturing the grid-shaped anterior tooth preparation observation plate is as follows:
drawing an edge line, determining the coverage area of the tooth preparation observation plate, copying the coverage area into a new object, uniformly taking out the shell for 1mm towards the closed direction, and generating a substrate;
establishing three grids on each tooth in the tooth preparation area, wherein the grids pass through the neck of the tooth and end at the gum;
and performing Boolean operation on the grating plate and the substrate to obtain the grating-shaped front tooth backup observation plate.
Further preferably, the coverage ranges are: the posterior teeth cover one third of the combined surface of the dental crown and do not exceed the external high point line; the anterior teeth cover 3-5mm below the gingival margin and do not enter soft tissue undercut.
Preferably, in the step 4), printing the tooth preparation observation plate by using a 3D printer specifically comprises: a dental observation plate is printed by a dental 3D printer and guide plate materials, and the thickness of the printing layer is set to be 50 micrometers or 100 micrometers.
Further preferably, a Sprintray printer and a scientific guide material are used.
Preferably, the post-treatment in step 4) is a 5 minute wash with 95% alcohol solution, manual removal of the support followed by 30 minutes of photocuring at 40 ℃).
The invention also discloses the grid-shaped observation plate for the front tooth preparation, which is prepared by the digital preparation method, wherein the thickness of the grid-shaped observation plate for the front tooth preparation is 1mm, three grids are arranged on each tooth surface to be prepared at intervals of 1mm, and the grids cross the neck of a tooth and stop at gingiva.
Compared with the prior art, the invention has the following beneficial effects:
the digital preparation method of the observation plate for preparing the front tooth, disclosed by the invention, takes the inner side surface of the indication plate for preparing the tooth as a reference surface, and a space formed by the indication plate and the prepared preparation surface is uniformly transited from a gingival margin to an incisal margin, a grid is convenient for multi-point observation, and the thickness of the individualized indication plate can also help a doctor to better evaluate the preparation amount of the tooth, so that the requirements of tooth preparation and prosthesis manufacturing can be met. The concrete advantages are as follows:
1. the tooth preparation observation plate can improve the problem that the tooth grinding amount is difficult to judge in clinic to a certain extent, is particularly higher in application value for doctors, and can accurately evaluate the tooth preparation amount under the direct vision condition by carrying out visual observation through the grating with the thickness of 1mm or personalized thickness.
2. In clinical application, the tooth preparation observation plate can conveniently remove the grids which are observed one by one, and can provide a better observation visual angle for the next observation site; and the auxiliary of other instruments is not needed, so that the clinical operation difficulty is reduced.
3. The standby tooth observation plate only needs to be printed after the design is finished, and a model does not need to be printed, so that the material cost of the standby tooth observation plate is effectively reduced: only about 4mL of material is needed for printing one observation plate, the cost is estimated to be about 6 to 10 according to the price of various guide plate materials on the market, and the method is more economical compared with a silicon rubber guide plate method (the cost is about 15 to 20). Compared with a TRS system and a First Fit system, the system has the advantages of lower cost, easy manufacture and simple operation.
Drawings
FIG. 1 is a flow chart of the steps performed in the present invention;
FIG. 2 is a plan view of the final repair configuration;
FIG. 3 is a design drawing of a dental viewing plate in a digital software; wherein, (a) is a top view of the prepared tooth observation plate after the design is finished; (b) is a front view;
FIG. 4 is a solid view of the prepared tooth observation plate printed by the 3D printer;
FIG. 5 is a diagram of an application entity of a tooth-preparing observation plate; wherein, (a) is a front view of the application of the dental viewing plate on the model; (b) is a side view;
FIG. 6 is a measurement of tooth preparation in an example application; the method comprises the following steps that (a) a measurable curve is obtained by applying a vertical section after pre-preparation and post-preparation mouth scanning models are registered; (b) measurement sites after sectioning for preliminary measurements.
Detailed Description
In order to make those skilled in the art better understand the technical solutions of the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be obtained by a person skilled in the art without making any creative effort based on the embodiments in the present invention, shall fall within the protection scope of the present invention.
It is noted that the terms "comprises" and "comprising," and any variations thereof, in the description and claims of the present invention, are intended to cover a non-exclusive inclusion, such that a process, method, system, article, or apparatus that comprises a list of steps or elements is not necessarily limited to those steps or elements expressly listed, but may include other steps or elements not expressly listed or inherent to such process, method, article, or apparatus.
The invention is described in further detail below with reference to the accompanying drawings:
as shown in fig. 1, a method for designing and manufacturing an anterior tooth preparation observation plate by using a digital technology specifically comprises the following steps:
1) acquiring oral scan data after the patient tries to wear the diagnosis prosthesis: after the diagnosis and repair are finished, determining a rough repair form according to adjustment in the trial wearing process of the patient, carrying out intraoral scanning, acquiring intraoral scanning data of the patient after the diagnosis and repair are finished, and exporting and storing the intraoral scanning data in an STL format;
2) adjusting the modified model according to the trial wearing condition of the diagnosed prosthesis by using dental prosthesis design software such as Exocad and the like, and then determining the final shape of the prosthesis: according to the feedback of the patient and the doctor in the process of diagnosing and repairing, the relative repairing body form is finely adjusted to determine the final repairing body form; if the tooth form of the patient is irregular and the diagnosis and repair can not be carried out, the repair form can be simulated in the digital software, and the tooth form can be used as the final form of the prosthesis after being approved by the patient;
3) importing a final repair model in digital design software, and manufacturing a tooth preparation observation plate: and importing the final restoration model into digital design software such as Geomagic Wrap, drawing an edge line, and determining the coverage range of the tooth preparation observation plate. The posterior teeth cover one third of the combined surface of the dental crown and do not exceed the external high point line; the anterior teeth cover 3-5mm below the gingival margin and do not enter soft tissue to be undercut. And copying the coverage area into a new object, and uniformly drawing the shell for 1mm towards the closed direction to generate the substrate. Three grates are built on each tooth in the preparation area and the grates end up at the gums across the neck of the tooth. Performing Boolean operation on the grating plate and the substrate to obtain a grating observation plate;
4) printing a tooth preparation observation plate by using a 3D printer: using a dental 3D printer with guide plate material, such as sprintry printer and surgical guide material, a dental viewing plate was printed with a print layer thickness set at 50 or 100 microns;
5) post-printing treatment observation panel: cleaning, removing the support and photocuring;
6) the clinical application is as follows: the device can be worn in the mouth at any time during the tooth preparation process, and doctors can observe from different visual angles to estimate the tooth tissue removal amount of each site. The doctor can remove the guide plate grids one by one very conveniently to provide a better observation field.
3 grating-shaped structures are placed at the position of each tooth surface to be prepared at intervals of 1 mm; and the thickness of the observation plate is 1mm, and a doctor can conveniently obtain visual evaluation of the tooth grinding amount by comparing the observation plate with the thickness of 1mm adjacent to the tooth preparation gap in the visual observation process.
When the tooth preparation observation plate is used, partial grids which are observed are removed one by one, and a better observation visual angle can be provided for the next observation site.
As shown in fig. 6, a closed curve of the removed dental tissue is obtained by establishing a section perpendicular to the prepared tooth surface by registering the pre-preparation and post-preparation oral scan models of the dental body with posterior teeth in the Geomangic Wrap software. Each prepared tooth was subjected to the above-described method to obtain 3 mesial, median and distal measurement curves. The preparation amounts (height, unit mm) of the neck, the middle, the tip and the cut end are manually measured, and the average value of the preparation amounts of the 6 anterior teeth at different positions is calculated, so that the preparation amounts of the neck are 0.62 +/-0.26 mm, the middle is 0.70 +/-0.23 mm, the tip is 0.70 +/-0.29 mm, and the cut end is 1.15 +/-0.28 mm. The preparation amount of the ceramic veneer is in accordance with clinical standards, and the preparation surface is in arc transition, so that the requirements of aesthetic repair and ceramic veneer repair are met. The actual prepared oral scan data is compared with the simulated prepared form in the software in a 3D mode, and the RMS value of the oral scan data is calculated to be 0.13 +/-0.10 mm. The precision is within 0.2mm of the clinically acceptable range.
In clinical data, it was found that the accuracy of the preparation (0.15 ± 0.10) by a young doctor using the dental preparation scope is significantly better than that of the freehand preparation (0.43 ± 0.25), and the preparation has significant statistical significance (P < 0.05), and has no statistical difference from the freehand preparation result (0.13 ± 0.09) of a senior physician. The tooth preparation observation plate used by senior citizens has no statistical difference with the free-hand preparation result. This shows that the dental preparation scope of the present invention is more suitable for use by inexperienced young physicians, and can quickly shorten the distance to experienced physicians.
The above-mentioned contents are only for illustrating the technical idea of the present invention, and the protection scope of the present invention is not limited thereby, and any modification made on the basis of the technical idea of the present invention falls within the protection scope of the claims of the present invention.
Claims (9)
1. A digital preparation method of a grid-shaped front tooth preparation observation plate is characterized by comprising the following steps:
1) acquiring oral scanning data after a patient tries to wear the diagnosis prosthesis;
2) adjusting the modified model in the dental prosthesis design software according to the trial wearing condition of the diagnostic prosthesis and then determining the final shape of the prosthesis;
3) importing a final restoration model in digital design software, and manufacturing a grid-shaped anterior tooth preparation observation plate;
4) and printing the front tooth spare tooth observation plate by using a 3D printer, and performing post-treatment to obtain the grid-shaped front tooth spare tooth observation plate.
2. The digital preparation method of the grid-shaped anterior tooth preparation observation plate according to claim 1, wherein in the step 2), the relative prosthesis form is finely adjusted according to the feedback in the repair process to determine the final prosthesis form; if the tooth form is irregular, simulating the restoration form in digital software to be used as a final restoration model of the restoration.
3. The digital preparation method of the grid-shaped anterior tooth preparation observation plate according to claim 1, wherein in the step 2), the dental restoration design software is Exocad software, 3Shape software or UPCAD software; the digital Design software in the step 3) adopts Geomic Wrap, Geomic Design, Geomic studio, Imageware, CopyCAD or RapidForm software.
4. The digital preparation method of the grid-shaped anterior tooth preparation observation plate as claimed in claim 1, wherein the step 3) of preparing the grid-shaped anterior tooth preparation observation plate comprises the following specific operations:
drawing an edge line, determining the coverage area of the tooth preparation observation plate, copying the coverage area into a new object, uniformly taking out the shell for 1mm towards the closed direction, and generating a substrate;
establishing three grids on each tooth in the tooth preparation area, wherein the grids pass through the neck of the tooth and end at the gum;
and performing Boolean operation on the grating plate and the substrate to obtain the grating-shaped front tooth standby tooth observation plate.
5. The digital preparation method of a grid-shaped anterior denture observation plate according to claim 4, wherein the coverage is as follows: the posterior tooth covers one third of the occlusal surface of the dental crown, and does not exceed the external high point line; the anterior teeth cover 3-5mm below the gingival margin and do not enter soft tissues and fall into the concave.
6. The digital preparation method of the grid-shaped front tooth-preparation observation plate according to claim 1, wherein in the step 4), the step of printing the tooth-preparation observation plate by using a 3D printer specifically comprises the following steps: a dental observation plate is printed by a dental 3D printer and guide plate materials, and the thickness of the printing layer is set to be 50 micrometers or 100 micrometers.
7. The method for digitally preparing a grid-like anterior tooth-preparing observation plate according to claim 6, wherein a Sprintray printer and a surgical guide material are used.
8. The digital preparation method of grid-like anterior dental viewing plate of claim 1, wherein the post-treatment in step 4) is washing with 95% alcohol solution for 5 minutes, manually removing the support, and photocuring at 40 ℃ for 30 minutes).
9. The grid-shaped front tooth standby observation plate prepared by the digital preparation method of any one of claims 1 to 8 is characterized in that the thickness of the grid-shaped front tooth standby observation plate is 1mm, three grids are arranged on each tooth surface to be prepared at intervals of 1mm, and the grids cross over the neck of a tooth and are stopped at gingiva.
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| US20180071062A1 (en) * | 2015-03-20 | 2018-03-15 | 3M Innovative Properties Company | A method of making a dental restoration |
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