CN115828615A - Manufacturing method of digital guide plate for temporomandibular joint cavity injection - Google Patents
Manufacturing method of digital guide plate for temporomandibular joint cavity injection Download PDFInfo
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- CN115828615A CN115828615A CN202211637789.2A CN202211637789A CN115828615A CN 115828615 A CN115828615 A CN 115828615A CN 202211637789 A CN202211637789 A CN 202211637789A CN 115828615 A CN115828615 A CN 115828615A
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Abstract
The invention discloses a method for manufacturing a digital guide plate for temporomandibular joint cavity injection, which is characterized in that image segmentation, three-dimensional reconstruction and image registration are carried out on CT and MRI data of a patient in computer software, so that models of temporomandibular joint condyles, articular discs and articular nodules can be obtained and the relative position relationship of the models can be confirmed, and the positions of an upper joint cavity and a lower joint cavity can be determined. According to the condition of a patient, the medicine is injected into the upper cavity or the lower cavity of the joint, and the position, the angle and the depth of the needle insertion of the injector are simulated in software. A3D printing guide plate which can be attached to the surface of a soft tissue is designed on the basis of the jaw and facial soft tissue reconstructed by CT of a patient in a personalized mode, and a guide hole is determined on the guide plate by combining the needle inserting position, the needle inserting angle and the needle inserting depth. The guide plate comprises a positioning wing which is installed in place in an auxiliary mode and a preset needle inserting guide hole, and can be used for guiding the needle inserting of an injector and medicine injection in joint cavity injection treatment.
Description
Technical Field
The invention belongs to the technical field of medical treatment, and particularly relates to a manufacturing method of a digital guide plate for temporomandibular joint cavity injection.
Background
Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative disease of the joint characterized by synovial inflammation, progressive cartilage destruction and bone resorption. TMJOA can cause pain, joint damage, and dysfunction such as chewing and speaking difficulty, and seriously affect the life quality of patients. TMJOA treatment difficulty is high, and the truly effective treatment means is very limited. Among conservative treatment means of TMJOA, joint cavity injection therapy is a relatively safe and effective way to achieve the purpose of alleviating pain and improving joint movement dysfunction by directly injecting drugs into the upper or lower joint cavity. However, due to the complex anatomy of the temporomandibular joint region, the joint space is divided by the disc into upper and lower spaces. In the treatment of osteoarthritis, doctors usually choose to inject drugs into the upper or lower temporomandibular joint cavity according to the condition of patients, so the accurate positioning of the upper and lower cavities and the avoidance of articular disc damage are the key points for successful joint cavity injection treatment.
The prior art is as follows: at present, doctors are mainly used for joint cavity injection clinically according to experience, the needle insertion depth is not easy to control, the positioning precision of the articular disc and the articular cavity is poor, and the injector is often penetrated into the articular disc or the surface of the condylar and the articular nodule to cause injury and pain in the injection process. Meanwhile, as the articular disc is positioned between the upper and lower cavities of the joint and is positioned far away, the operation under the direct vision is not available, so that the exact injection site is selected.
Disclosure of Invention
The invention aims to provide a manufacturing method of a digital guide plate for temporomandibular joint cavity injection, which solves the problems of complex anatomy of temporomandibular joint areas, large individual difference and poor visibility of patients. The doctor is poor in positioning accuracy when injecting by experience, and the depth of inserting the needle and the position can't accurate control, often need try repeatedly to insert the needle and look for best angle and degree of depth during the injection, and the operation is consuming time and leads to the not good technical problem of treatment easily.
The technical scheme adopted by the invention for solving the technical problems is as follows:
a manufacturing method of a digital guide plate for temporomandibular joint cavity injection comprises the following steps:
s1, obtaining patient maxillofacial spiral CT and MRI data: when shooting, determining a transverse axis of the condyle, then determining an oblique sagittal positioning scanning line according to the transverse axis perpendicular to the transverse axis of the condyle, and storing the temporomandibular joint MRI image into a DICOM format;
s2, determining the positions of the upper temporomandibular joint cavity and the lower joint cavity: introducing DICOM data of CT and MRI of a patient into computer software, separating temporomandibular joint nodules, mandibular condyles and articular discs from a background and establishing a new mask, separating mandibles from teeth, articular fossae and articular discs through Boolean operation, reconstructing models of the temporomandibular joint nodules, the mandibular condyles and the articular discs through a region growing function, and storing the models in an STL format; the position relation of each STL model can be determined through an image registration function, namely the relative position relation of a temporomandibular joint condyle, a joint disc and a joint nodule is determined, so that the positions of an upper joint cavity and a lower joint cavity are determined, and a soft tissue model of the maxillofacial region of a patient is reconstructed according to CT and stored as an STL file for later use;
s3, designing an articular cavity injection guide plate: importing the STL model file in the step S2 into computer software, converting the face data of the region of interest on the soft tissue surface into peripheral 1-3mm volume data on the basis of a jaw and facial soft tissue STL model reconstructed by CT of a patient, designing a 3D printing guide plate which can be attached to the soft tissue surface, determining positioning wings and guide holes, and storing the positioning wings and the guide holes into an STL model format;
s4, 3D printing of the personalized joint cavity injection guide plate: and (4) importing the STL model file formed in the step (S3) into a 3D printer, and printing to generate the joint cavity injection guide plate entity.
The invention discloses a manufacturing method of a digital guide plate for temporomandibular joint cavity injection, wherein in the step S1, at least 5 visible temporomandibular joint discs are taken as temporomandibular joint MRI images.
In the step S2, the maxillofacial bone threshold value is 0-1600, and the articular disc threshold value is 0-235.
According to the manufacturing method of the digital guide plate for temporomandibular joint cavity injection, in the step S3, the region of interest of the soft tissue surface is the region from the bridge of the nose to the front and rear edges and the upper edge of the auricle.
The invention discloses a manufacturing method of a digital guide plate for temporomandibular joint cavity injection, which is characterized in that in the step S3, positioning wings and guide holes are determined, a process STL file is led into a Mimics Research 19.0, a medicine is injected into an upper cavity or a lower cavity of a joint according to the condition of a patient, the needle inserting position, angle and depth of an injector are simulated in a personalized mode, and a cylindrical model matched with a needle head of the injector is designed by utilizing a Medcad function, so that the guide holes are designed on the guide plate.
In the step S4, a printer nozzle is preheated to 70 ℃ before printing, test paper is placed on a tray, a printed trace is checked through a Pattern Test mode, and formal printing is performed after requirements are met.
The invention has the following beneficial effects: a method for manufacturing a digital guide plate for injecting a temporomandibular joint cavity is provided, image segmentation, three-dimensional reconstruction and image registration are carried out on CT and MRI data of a patient in computer software, models of a temporomandibular joint condyle, a joint disc and a joint nodule can be obtained, and the relative position relation of the models can be confirmed, so that the positions of an upper joint cavity and a lower joint cavity are determined. According to the condition of a patient, the medicine is injected into the upper cavity or the lower cavity of the joint, and the position, the angle and the depth of the needle insertion of the injector are simulated in software. A3D printing guide plate which can be attached to the surface of a soft tissue is designed on the basis of the jaw and facial soft tissue reconstructed by CT of a patient in a personalized mode, and a guide hole is determined on the guide plate by combining the needle inserting position, the needle inserting angle and the needle inserting depth. The guide plate comprises a positioning wing which is installed in place in an auxiliary mode and a preset needle inserting guide hole, and can be used for guiding the needle inserting of an injector and medicine injection in the joint cavity injection treatment.
Drawings
The invention will be further described with reference to the accompanying drawings and examples, in which:
fig. 1 is a schematic structural diagram of an embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, 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 some, but not all, embodiments of the present invention. It should be understood that the specific embodiments described herein are merely illustrative of the invention and do not limit the invention. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.
As shown in fig. 1, a method for manufacturing a digital guide plate for temporomandibular joint cavity injection comprises the following steps:
s1, obtaining patient maxillofacial spiral CT and MRI data: during shooting, determining a transverse axis of the condyle, then determining an oblique sagittal positioning scanning line according to the transverse axis perpendicular to the transverse axis of the condyle, and storing the MRI image of the temporomandibular joint into a DICOM format; the thickness of the CT layer is 0.5mm, the working voltage is 120kV, and the current is 7700mA. Cine MRI uses a 1.5T imaging system and temporomandibular joint specific coils. Selecting a fast spin echo sequence T1WI (the parameters are set as follows: the repetition time TR 2300 ms and the echo time TE 47 ms), a T2WI (the parameters are set as follows: the TR 2500 ms and the TE 47 ms), an image acquisition matrix: 288x256, dicom: digital imaging and communications in Medicine.
S2, determining the positions of the upper temporomandibular joint cavity and the lower joint cavity: introducing DICOM data of CT and MRI of a patient into computer software Mimics Research 19.0, setting a maxillofacial skeleton threshold value to be 0-1600 and a joint disc threshold value to be 0-235, separating a temporomandibular joint nodule, a mandibular condyle and a joint disc from a background and establishing a new mask, separating a mandible from teeth, a joint socket and the joint disc by Boolean operation, and reconstructing a model of the temporomandibular joint nodule, the mandibular condyle and the joint disc by a region growing function, wherein the model is in an STL format. The position relation of each STL model can be determined through the image registration function, namely the relative position relation of a temporomandibular joint condyle, a joint disc and a joint nodule is determined, so that the positions of an upper joint cavity and a lower joint cavity are determined, and a soft tissue model of the maxillofacial region of a patient is reconstructed according to CT and stored as an STL file for later use;
s3, designing an articular cavity injection guide plate: importing the STL model file in the step S2 into computer software 3-Matic 11.0, converting the face data of the region of interest on the soft tissue surface into peripheral 1-3mm volume data on the basis of a jaw and face soft tissue STL model reconstructed by patient CT, designing a 3D printing guide plate which can be attached to the soft tissue surface, determining a positioning wing and a guide hole, and storing the positioning wing and the guide hole into an STL model format;
s4, 3D printing of the personalized joint cavity injection guide plate: and (4) importing the STL model file formed in the step (S3) into a 3D printer, and printing to generate the joint cavity injection guide plate entity.
In a preferred embodiment of the invention, the MRI images of the temporomandibular joint in step S1 show at least 5 visible temporomandibular joint discs.
In a preferred embodiment of the present invention, in the step S2, the region of interest of the soft tissue surface in the step S3 is a region from the bridge of the nose to the anterior and posterior edges and the upper edge of the auricle.
In a preferred embodiment of the present invention, the positioning wings and the guide holes are determined in step S3, by importing the process STL file into the Mimics Research 19.0, injecting the drug into the upper or lower joint cavity according to the patient condition, individually simulating the needle insertion position, angle and depth of the injector, and designing a cylindrical model matching the needle of the injector by using the Medcad function, thereby designing the guide holes on the guide plate.
In a preferred embodiment of the present invention, in step S4, the printer head is preheated to 70 degrees before printing, a Test paper is placed on the tray, a print trace is checked through a Pattern Test mode, formal printing is performed after a requirement is met, printing software is turned on, insert imports of STL data of the guide plate, placement is performed and a guide plate position is optimized, whether a guide plate file has an error is checked, and if no error exists, a print job is started. And (3) using a non-toxic resin material which can be sterilized at high temperature and high pressure, cleaning the supporting material after printing, and obtaining the articular cavity injection guide plate entity.
Instructions for use: the 3D prints out and attaches patient's bridge of the nose and auricle upper edge behind the baffle, and the location wing is supplementary fixed, regards as full taking one's place when laminating well, not having unstable condition such as tilting. The guide hole is used as a basis when the guide plate is fixed, the injector is injected into the articular cavity according to the preset position, angle and depth, the process can accurately avoid opening and closing the articular disc, the condylar process and the articular nodule surface, and the cartilage on the surface is prevented from being damaged and causing pain. And injecting the medicine after the injector reaches the preset position, withdrawing the injector and taking down the guide plate to finish injection treatment.
In the description of the present invention, it should be noted that the terms "center", "longitudinal", "lateral", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", etc., indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of description and simplicity of description, but do not indicate or imply that the referred device or element must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art. In addition, in the description of the present invention, "a plurality" means two or more unless otherwise specified.
It will be understood that modifications and variations can be made by persons skilled in the art in light of the above teachings and all such modifications and variations are intended to be included within the scope of the invention as defined in the appended claims.
Claims (6)
1. A manufacturing method of a digital guide plate for temporomandibular joint cavity injection is characterized by comprising the following steps:
s1, obtaining patient maxillofacial spiral CT and MRI data: during shooting, determining a transverse axis of the condyle, then determining an oblique sagittal positioning scanning line according to the transverse axis perpendicular to the transverse axis of the condyle, and storing the MRI image of the temporomandibular joint into a DICOM format;
s2, determining the positions of the upper temporomandibular joint cavity and the lower joint cavity: introducing DICOM data of CT and MRI of a patient into computer software, separating temporomandibular joint nodules, mandibular condyles and articular discs from a background and establishing a new mask, separating mandibles from teeth, articular fossae and articular discs through Boolean operation, reconstructing models of the temporomandibular joint nodules, the mandibular condyles and the articular discs through a region growing function, and storing the models in an STL format; the position relation of each STL model can be determined through an image registration function, namely the relative position relation of a temporomandibular joint condyle, a joint disc and a joint nodule is determined, so that the positions of an upper joint cavity and a lower joint cavity are determined, and a soft tissue model of the maxillofacial region of a patient is reconstructed according to CT and stored as an STL file for later use;
s3, designing an articular cavity injection guide plate: importing the STL model file in the step S2 into computer software, converting the face data of the region of interest on the soft tissue surface into peripheral 1-3mm volume data on the basis of a jaw and facial soft tissue STL model reconstructed by CT of a patient, designing a 3D printing guide plate which can be attached to the soft tissue surface, determining positioning wings and guide holes, and storing the positioning wings and the guide holes into an STL model format;
s4, 3D printing of the personalized joint cavity injection guide plate: and (4) importing the STL model file formed in the step (S3) into a 3D printer, and printing to generate the joint cavity injection guide plate entity.
2. The method for manufacturing a digital guide plate for temporomandibular joint cavity injection according to claim 1, wherein the MRI images of temporomandibular joints in step S1 show at least 5 visible temporomandibular joint discs.
3. The method as claimed in claim 1, wherein in step S2, the maxillofacial bone threshold is 0-1600, and the articular disc threshold is 0-235.
4. The method for manufacturing a digital guide plate for temporomandibular joint cavity injection according to claim 1, wherein the soft tissue surface region of interest in step S3 is the region from the bridge of the nose to the anterior and posterior edges and the upper edge of the auricle.
5. The method as claimed in claim 1, wherein the positioning wings and the guide holes are determined in step S3 by introducing a procedure STL file into a Mimics Research 19.0, injecting a medicine into the upper or lower joint cavity according to the patient condition, individually simulating the position, angle and depth of the needle of the injector, and designing a cylindrical model matching the needle of the injector by using a Medcad function, thereby designing the guide holes on the guide plate.
6. The method for manufacturing a digital guide plate for temporomandibular joint cavity injection according to claim 1, wherein in step S4, the printer head is preheated to 70 degrees before printing, test paper is placed on the tray and the print is checked by a Pattern Test mode, and formal printing is performed after the requirements are met.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202211637789.2A CN115828615A (en) | 2022-12-20 | 2022-12-20 | Manufacturing method of digital guide plate for temporomandibular joint cavity injection |
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| CN202211637789.2A CN115828615A (en) | 2022-12-20 | 2022-12-20 | Manufacturing method of digital guide plate for temporomandibular joint cavity injection |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117332704A (en) * | 2023-12-01 | 2024-01-02 | 福建医科大学附属第一医院 | Temporomandibular joint cavity flushing and injection guide plate generating method and terminal |
| CN117332704B (en) * | 2023-12-01 | 2024-05-28 | 福建医科大学附属第一医院 | Temporomandibular joint cavity flushing and injection guide plate generating method and terminal |
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- 2022-12-20 CN CN202211637789.2A patent/CN115828615A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117332704A (en) * | 2023-12-01 | 2024-01-02 | 福建医科大学附属第一医院 | Temporomandibular joint cavity flushing and injection guide plate generating method and terminal |
| CN117332704B (en) * | 2023-12-01 | 2024-05-28 | 福建医科大学附属第一医院 | Temporomandibular joint cavity flushing and injection guide plate generating method and terminal |
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