CN115957024A

CN115957024A - Accurate positioning method of implant-assisted upper jaw enlarging device

Info

Publication number: CN115957024A
Application number: CN202210321611.0A
Authority: CN
Inventors: 刘苏苏; 夏明泉
Original assignee: Individual
Current assignee: Individual
Priority date: 2022-03-25
Filing date: 2022-03-25
Publication date: 2023-04-14

Abstract

The invention discloses a precise positioning method of an implant-assisted maxillary expansion device, which comprises the following steps: obtaining a three-dimensional craniofacial shape through CBCT, separating a maxilla three-dimensional structure in the craniofacial shape and removing soft tissues; optical scanning is carried out to obtain maxillary three-dimensional scanning data containing surface soft and hard tissue structures; overlapping the maxillary three-dimensional structure and the maxillary three-dimensional scanning data through the tooth structure, then importing the data into a three-dimensional digital structure model of a maxillary expander, determining the specific placement position of the expander according to treatment needs and the positions of adjacent anatomical structures, and further determining the implantation part and the accurate length of the retention implant nail; and acquiring a female die of the maxillary arch expander, matching and superposing the female die and the maxillary three-dimensional scanning data according to the selected position, and performing three-dimensional printing to obtain an entity structure. The expander is repositioned to the solid structure and connected to the fixation member for positional fixation. The invention can accurately place the bow expander, and avoid pressing mucosa; the implantation nail can be accurately selected, so that the damage to local nerve and blood vessels is avoided, and the successful enlargement is ensured.

Description

Accurate positioning method of implant-assisted upper jaw enlarging device

Technical Field

The invention relates to the technical field of oral medicine, in particular to a precise positioning method of an implant-assisted maxillary expansion device.

Background

The maxillary bone arch expander is a maxillary non-operative arch expanding technology, is completely different from the traditional maxillary rapid arch expander and surgical auxiliary maxillary rapid arch expanding, provides a new method for correcting transverse development deficiency of the maxillary bone, and particularly provides a high-efficiency and minimally-invasive bone arch expanding effect for adult patients who finish growth and development; the maxillary bone arch expander is characterized in that an implant nail is placed on a palate part, so that the whole middle structure is expanded, the palatal suture is nearly expanded in parallel, the pterygopalatine suture is cracked, the width between cheekbones is increased, the whole nasal cavity including the upper nasal bone area is widened, and the adverse reactions such as tooth cheek inclination, alveolar bone height reduction and the like are small.

The defects of the existing planting nail in auxiliary expansion are mainly as follows: 1. the placement position is felt by the doctor, is inaccurate and can press the palatal mucosa; 2. the implantation position of the implant nail is empirical, so that the upper jaw incisor tube, the palatine nervus and the rear edge of the palatal plate cannot be avoided effectively; 3: the length of the planting nail is selected inaccurately, and is easy to be too short or too long, so that the expansion effect is not obvious or the planting nail enters the nasal cavity, and the subsequent side effect is caused; in addition, the original bow expander is produced by directly welding flame on the plaster model, and the expansion is generated in the welding process to influence the precision and damage the plaster model, so that the precision of the final product cannot be checked.

Disclosure of Invention

The invention overcomes the defects of the prior art and provides a precise positioning method of an implant auxiliary upper jaw enlarging device.

In order to achieve the purpose, the invention adopts the technical scheme that: a method for accurately positioning an implant-assisted maxillary dilation device is characterized by comprising the following steps of: s1: obtaining a three-dimensional craniofacial shape through CBCT, separating a three-dimensional structure of a maxilla in the craniofacial shape, and removing soft tissues; optical scanning to obtain maxillary three-dimensional scanning data containing surface soft and hard tissue structures; s2: overlapping and matching the maxillary three-dimensional structure and the maxillary three-dimensional scanning data through a tooth structure, attaching a three-dimensional digital structure of a jaw arch expander, and determining the length of the implant nail; s3: and acquiring a female die of the upper jaw arch expander, matching and overlapping the female die and the upper jaw three-dimensional scanning data, obtaining an entity structure through three-dimensional printing, resetting the upper jaw arch expander into the entity structure, and connecting a fixing component for fixing the position.

The invention also provides an accurate positioning method of the implant-assisted maxillary dilation device, which comprises the following steps when the maxillary dilator with the solid structure is connected with the fixing part: A. a maxillary expander, which is characterized in that a fixing part is arranged at the tooth position of the solid structure and the maxillary expander and the fixing part are connected into a whole through quick molding resin; B. removing the upper jaw enlarging device from the solid structure and embedding, exposing only the resin connecting part, and removing the resin after hardening; C. welding the maxillary arch expander and the fixing part, cooling, removing the embedding material, and performing resetting inspection on the solid structure.

In a preferred embodiment of the invention, in the step S2, when the three-dimensional digital structure of the upper jaw expander is added, accurate positioning is realized, and important anatomical structures are avoided.

In a preferred embodiment of the invention, in step S2, the length of the implant nail is determined according to the thickness of the bone plate corresponding to the additional position.

In a preferred embodiment of the present invention, before step S3, the doctor-skill communication is required to confirm the three-dimensional position of the arch expander.

In a preferred embodiment of the present invention, in step S3, the digital structure of the female mold of the maxillary arch expander is obtained through a three-dimensional image boolean operation.

In a preferred embodiment of the invention, the fixing elements are sleeved on the crowns, and a single maxillary arch expander is connected with at least two fixing elements.

In a preferred embodiment of the present invention, in step B, the embedding material is selected from gypsum and quartz sand.

In a preferred embodiment of the present invention, in step C, the maxillary expander and the fixing part are welded into a whole by silver welding.

The invention solves the defects in the background technology, and has the following beneficial effects:

(1) The invention can accurately stack the skeleton and the soft tissue in a tooth positioning mode according to CBCT data and upper jaw three-dimensional scanning data, thereby realizing accurate placement of the arch expander and avoiding pressing mucosa; and according to CBCT data, the implantation length of the implant nail is accurately measured, the implant nail is accurately selected, damage to local nerve vessels is avoided, and successful expansion is ensured.

(2) The invention adopts the three-dimensional printing female die, has high precision, can accurately transfer the position of the virtual arch expander and provides accurate positioning for finally generating the upper jaw expanding device, and adopts a transfer welding method to test a final product on the solid structure comprising the oral upper jaw three-dimensional scanning file and the upper jaw arch expander female die, thereby not damaging the solid structure of the model and providing the function of resetting and checking.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below, it is obvious that the drawings in the following description are only some embodiments described in the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts;

FIG. 1 is a flow chart of the operation of a preferred embodiment of the present invention.

Detailed Description

Reference throughout this specification to "one embodiment," "an embodiment," or "other embodiments" means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least some embodiments, but not necessarily all embodiments, 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, belong to the protection scope of the present invention.

An accurate positioning method of an implant-assisted maxillary dilation device comprises the following steps: obtaining a three-dimensional craniofacial shape through CBCT, separating a three-dimensional structure of a maxilla in the craniofacial shape, and removing soft tissues; optical scanning to obtain maxillary three-dimensional scanning data containing surface soft and hard tissue structures; overlapping and matching the maxillary three-dimensional structure with the maxillary three-dimensional scanning data through a tooth structure, attaching a three-dimensional digital structure of a jaw pantograph expander, and determining the length of a planting nail; and acquiring a female die of the upper jaw arch expander, matching and overlapping the female die and the upper jaw three-dimensional scanning data, obtaining an entity structure through three-dimensional printing, resetting the upper jaw arch expander into the entity structure, and connecting a fixing component for fixing the position. Specifically, a fixing part is arranged at the tooth position of the solid structure, and the upper jaw expander and the fixing part are connected into a whole through rapid molding resin; removing the upper jaw enlarging device from the solid structure and embedding, exposing only the resin connecting part, and removing the resin after hardening; welding the maxillary arch expander and the fixing part, cooling, removing the embedding material, and performing resetting inspection on the solid structure.

It should be noted that, the oral cavity CBCT image of the patient preferably has an oral cavity shape, and based on the projected two-dimensional data, a three-dimensional image can be reconstructed to obtain more accurate skeleton and tooth image data, and the optical appearance image and the three-dimensional skeleton are superimposed by tooth positioning, so that the soft tissue and the teeth are more accurate in the printed entity structure.

Medical-technical communication necessity: the behavior mode of the medical prescription is a biological science-psychology-social medicine mode, doctors not only carry out the synthesis of the restoration body, but also bear the psychological needs of the patients in all aspects, the medical technology and the like, and the doctors not only carry out more accurate communication on the objects but also on the people through the synthesized graphic files.

The flow chart is as shown in the embodiment of FIG. 1:

1. the CBCT data file (dcm format) shot by a patient is imported into a Dolphine Imaging software system to generate a three-dimensional craniofacial shape, the three-dimensional structure of the maxilla is separated, soft tissues are removed, the structures of teeth and bones are reserved, important structural parts are exposed, and the file of the three-dimensional structure of the maxilla (stl format) is exported.

2. An optical scanner is used for obtaining an oral cavity maxilla three-dimensional scanning data file (stl format) of a patient with a soft and hard tissue structure on the surface, 3Shape application design software is introduced, the oral cavity maxilla three-dimensional scanning data file is overlapped with the maxilla three-dimensional structure file of the patient through a tooth structure, loss of X-rays to a real structure is avoided, and accurate three-dimensional structure matching of maxilla teeth is achieved.

3. Loading a three-dimensional digital structure of the maxillary expander in 3Shape application design software, adjusting the placement position of the expander, avoiding important anatomical structures and avoiding compressing soft tissues of the oral cavity; meanwhile, the length of the implant nail with the corresponding length is selected according to the thickness or the structural condition of the bone plate at the corresponding position.

4. And (3) generating a (. Html format) webpage confirmation file from the matched result by using exocad3.0 software, opening the file by using a webpage browser, confirming the three-dimensional position of the bow expander and carrying out a medical-technical communication confirmation scheme.

5. After confirmation, 3shape software is used for carrying out Boolean operation to obtain a female die of the maxillary arch expander, and the female die and the oral maxillary three-dimensional scanning file are combined to obtain a digital file (stl format) containing the oral maxillary three-dimensional scanning file and the female die of the maxillary arch expander.

6. And three-dimensionally printing a maxillary three-dimensional scanning file and a female mold digitalized file of the arch expander generated by 3shape application designer software by using a resin printer to obtain an entity structure, and resetting the metal arch expander into the female mold.

7. The reset metal arch expander and the metal parts on the teeth are connected into a whole by using quick forming resin, the whole is embedded by using an embedding material (gypsum and 80-mesh quartz sand, the proportion is 1).

According to the embodiment, the expander is accurately placed through CBCT data and maxillary three-dimensional scanning data, so that mucosa compression is avoided; and according to CBCT data, the implantation length of the implant nail is accurately measured, the implant nail is accurately selected, damage to local nerve vessels is avoided, and successful expansion is ensured. Meanwhile, the three-dimensional printing female die is adopted, so that high precision is ensured, the position of the virtual arch expander can be accurately transferred, and accurate positioning is provided for finally generating the upper jaw expanding device; and a transfer welding method is adopted to inspect a final product on a solid structure containing an oral cavity upper jaw three-dimensional scanning file and an upper jaw arch expander female die, so that the solid structure of the model cannot be damaged, and a reset checking function can be provided.

In the description of the present invention, it should be noted that, unless explicitly stated or limited otherwise, the terms "fixedly" and "connected" are to be interpreted broadly, and may be either fixedly connected or detachably connected; the terms may be directly connected or indirectly connected through an intermediate, and a person of ordinary skill in the art can understand the specific meaning of the terms in the present invention through specific situations.

While the preferred embodiments of the present invention have been described, it will be apparent to those skilled in the art from this disclosure that various changes and modifications can be made without departing from the spirit and scope of the invention. The technical scope of the present invention is not limited to the content of the specification, and must be determined according to the scope of the claims.

Claims

1. A method for accurately positioning an implant-assisted maxillary dilation device is characterized by comprising the following steps of:

s1: CBCT acquires maxillary three-dimensional structure data of soft tissue removal and maxillary three-dimensional optical scanning data containing surface soft and hard tissue structures;

s2: overlapping and matching the maxillary three-dimensional structure and the maxillary three-dimensional optical scanning data through a tooth structure, and attaching a three-dimensional digital structure of a jaw pantograph expander to determine the length of the implant nail;

s3: simulating a female die of the maxillary arch expander, matching and superposing a female die data structure and the maxillary three-dimensional scanning data, obtaining an entity structure through three-dimensional printing, resetting the maxillary arch expander into the entity structure, and connecting a fixing component for fixing the position.

2. The method of claim 1, wherein the implant-assisted maxillary expansion device comprises: when the maxillary arch expander of the solid structure is connected with the fixing part, the method comprises the following steps:

A. a maxillary expander, which is characterized in that a fixing part is arranged at the tooth position of the solid structure and the maxillary expander and the fixing part are connected into a whole through quick molding resin;

B. removing the maxillary expansion device from the solid structure, embedding, exposing the resin connecting part only, and removing the resin after hardening;

C. welding the maxillary arch expander and the fixing part, cooling, removing the embedding material, and performing resetting inspection on the solid structure.

3. The method for accurately positioning an implant-assisted maxillary expansion device of claim 1, wherein the method comprises: in the step S2, when a three-dimensional digital structure of the upper jaw arch expander is added, an important anatomical structure is avoided.

4. The method of claim 1, wherein the implant-assisted maxillary expansion device comprises: in step S2, the length of the implant nail is determined according to the thickness of the bone plate corresponding to the additional position.

5. The method for accurately positioning an implant-assisted maxillary expansion device of claim 1, wherein the method comprises: before step S3, medical-technical communication is required to confirm the three-dimensional position of the arch expander.

6. The method for accurately positioning an implant-assisted maxillary expansion device of claim 1, wherein the method comprises: in step S3, a female die digital structure of the maxillary arch expander is obtained through three-dimensional image Boolean operation.

7. The method for accurately positioning an implant-assisted maxillary expansion device of claim 2, wherein: the fixing parts are sleeved on the dental crowns, and the single maxillary arch expander is connected with at least two fixing parts.

8. The method of claim 2, wherein the implant-assisted maxillary expansion device comprises: in the step B, the embedding material is prepared by mixing gypsum and quartz sand.

9. The method of claim 2, wherein the implant-assisted maxillary expansion device comprises: and step C, welding the upper jaw arch expander and the fixing part into a whole by adopting a silver welding process.