CN116172734A - Mandibular protrusion repositioning jaw pad and whole-course digital design and manufacturing method thereof - Google Patents

Abstract

The invention discloses a mandibular protrusion repositioning jaw pad and a whole-course digital design and manufacturing method thereof. The method comprises the following steps: acquiring a digital dental printing model and a digital jaw model; carrying out space position registration and segmentation on the digital dentition impression and the digital jawbone model to obtain separated digital upper and lower jawbone models; registering the space positions of the real dentition and the digital upper and lower jaw bone models in a lower jaw movement analysis system to enable a patient to perform lower jaw forward extension and opening and closing movements, so as to obtain a head-face multi-mode fusion image; collecting and recording jaw position relation, temporomandibular joint movement condition and mandibular movement track; performing computer aided design of mandibular protrusion repositioning jaw pad according to therapeutic jaw position data; and finishing the manufacture by adopting a digital milling technology. The mandibular protrusion repositioning jaw pad is suitable for patients with anterior displacement of temporomandibular joint disc, tissue damage after disc, occlusion reconstruction with deficient occlusion height of severely worn back teeth area, and the like.

Description

Mandibular protrusion repositioning jaw pad and whole-course digital design and manufacturing method thereof

Technical Field

The invention relates to the technical field of digital oral treatment, in particular to a mandibular protrusion repositioning jaw pad and a whole-course digital design and manufacturing method thereof.

Background

Temporomandibular joint diseases (Temporomandibular Disorders, TMDs) are one of the common diseases of the oromandibular system, with renaturable joint discal displacement being one of the major categories. The clinical manifestation of the renaturable joint disc anterior displacement is mainly elastance, part of people can be painful, and serious psychological, social and life quality influences can be brought to patients when symptoms are obvious. Common medical means include physical therapy, exercise therapy, jaw pad therapy, injection therapy, temporomandibular arthroscopic minimally invasive therapy, open surgery, and the like. Most patients can achieve better therapeutic results with non-invasive conservative treatment. Occlusion factors are one of the important causes of temporomandibular joint disease, and jaw pad therapy (or

Pad therapy) has been demonstrated to have a better therapeutic effect. Currently, the jaw pad most suitable for treating the anterior displacement of the renaturable joint disc is a mandibular anterior extension repositioning jaw pad, which can move the condyle to the medial band after being worn, eliminating mechanical interference, and reestablishing the normal disc-condyle relationship when closed.

The traditional manufacturing of the forwards-extending repositioning jaw pad requires medical staff to manually acquire the treatment jaw position and carry out mould taking and occlusion relation recording, and the steps have higher technical requirements on the medical staff; the traditional manual manufacturing mode of the forwards-extending repositioning jaw pad has relatively low precision, the steps of manufacturing wax, pouring glue, boxing and the like are required to be carried out, the manufacturing process is complex, the processing period is long, the manufactured finished product often has a certain error, and medical staff is required to carry out long-time adjustment and modification clinically; bubbles and residual chemicals may occur, affecting the stability and safety of long-term use.

The digitization technology is rapidly developed in the field of oral cavity restoration in recent years, has been gradually applied to fixed false teeth, movable false teeth, implant false teeth and the like, brings great innovation to the concepts of traditional die taking and manufacturing modes, and can reduce human errors and simplify manufacturing processes, thereby achieving the purposes of improving precision and shortening manufacturing period.

The Chinese patent application No. 202010921484.9 discloses a method for directly preparing dental pad with oral cavity function by combining hot-pressed film and 3D printing. The invention adopts 3D printing dentition after model restoration of dentition through image processing software, and then uses the printed dentition as a dentition mould to manufacture the dental pad through a traditional film pressing method. However, human errors are unavoidable in the conventional film pressing process, and the method involves a plurality of steps and a plurality of devices, which is inefficient.

Disclosure of Invention

Because of the defects in the prior art, the invention aims to construct a whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad, which can greatly reduce the technical sensitivity of operators, shorten the processing period and improve the manufacturing efficiency and safety.

In order to achieve the above object, in one aspect, the present invention provides a method for designing and manufacturing a mandibular protrusion repositioning jaw pad in a full digital manner, comprising the steps of:

step S1, scanning upper and lower jaw dentitions by using an intraoral three-dimensional scanner and acquiring digital dentition impressions;

s2, shooting a full-skull large-view CBCT and performing three-dimensional reconstruction to obtain a digital jaw model;

s3, carrying out space position registration and segmentation on the digital dentition impression and the digital jaw model to obtain a digital upper jaw model and a digital lower jaw model which are separated;

s4, registering the space positions of the real dentition, the digital maxillary model and the digital mandibular model in a mandibular movement analysis system, and ordering a patient to perform mandibular forward extension and opening and closing movements to obtain a head-face multi-mode fusion image;

s5, acquiring and recording information of jaw position relation, temporomandibular joint movement condition and mandibular movement track by using the mandibular movement analysis system, and repositioning the mandible according to the information to obtain therapeutic jaw position data;

and S6, inputting the therapeutic jaw data into computer-aided manufacturing software, and performing computer-aided manufacturing of the mandibular protrusion repositioning jaw pad by adopting a digital milling technology.

Preferably, in the step S1, when the patient is positioned at the maximum inter-dental interlace position, the three-dimensional data of the upper and lower dentitions are acquired by means of the intraoral three-dimensional scanner, the digitized dentition impression of the patient is created, and the digitized dentition impression is output in the STL format.

Preferably, in the step S2, when the patient is positioned at the maximum inter-dental-interlace position, the full-skull large-view CBCT is photographed and converted into DICOM format, and the maxilla and mandible are three-dimensionally reconstructed using software virtual reality technology to obtain a digitized jaw model, which is output in STL format.

Preferably, in the step S3, computer aided design software is used to match the spatial positions of the high-precision digital dentition impression and the digital jawbone model in a three-dimensional point-to-point registration mode, replace low-precision dentition data on the digital jawbone model, segment the maxilla and the mandible, and respectively obtain the digital jawbone model and the digital mandible model, and output the digital jawbone model and the digital jawbone model in an STL format.

Further, the computer aided design software is Exocad DentalCAD or Planmeca PlanCAD.

Preferably, said step S4 comprises the following sub-steps:

s41, after the digital upper and lower jawbone models are led into a mandibular movement analysis system, a signal receiver matched with the mandibular movement analysis system is worn on the head and the face of a patient, and the real dentition of the patient is registered with the digital upper and lower jawbone in space position based on a tooth occlusal surface point-to-point mode;

and S42, after matching is completed, the patient is instructed to perform mandibular protrusion and opening and closing movements, and the digital maxillary model and the mandibular model are subjected to the movements with the same frequency and the same track as the patient in a mandibular movement analysis system so as to obtain a head-face multi-mode fusion image containing mandibular movement dimensions.

Preferably, said step S5 comprises the following sub-steps:

s51, ordering the patient to perform mandibular forward extension movement to an upper front tooth cutting and cutting state and then performing small opening and closing movement;

s52, selecting the minimum opening position of the temporomandibular joint disc in the glenoid fossa on the muscle force closed path track according to the relative positions of the condyloid process and the temporomandibular joint fossa of the upper and lower digital jaw bone models in the mandibular motion analysis system and the displayed condyloid process motion track, namely the position of the mandible in the joint bounce vanishing position as the therapeutic jaw position;

s53, outputting the digital upper and lower jaw model data with the spatial positions.

Preferably, in the step S6, the manufacturing requirements of the mandibular protrusion repositioning jaw pad are: covering the maxillary whole dentition; bite plate and pair

The teeth have obvious cusp locking relation; the lingual side of the anterior maxillary dental region has a distinct beveled guide area; all teeth reach a stable contact at the same time in the therapeutic jaw position.

Further, the computer-aided manufacturing software is Sirona Inlab or Dental windows.

In another aspect, the present invention provides a mandibular protrusion repositioning jaw pad, which is characterized by being manufactured by the above-mentioned design and manufacturing method.

Compared with the prior art, the invention has the following advantages or beneficial effects:

the whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad can automatically acquire the condylar movement state and the mandibular movement track of a target object through the mandibular movement analysis system, further can acquire the data information of therapeutic jaw positions in a visual state, and combines computer aided design and manufacturing software to carry out high-precision and high-efficiency production. The method is independent of the experience of medical staff, and has the advantages of rapidness, accuracy, easiness in popularization and the like.

Drawings

The invention and its features, aspects and advantages will become more apparent from the detailed description of non-limiting embodiments with reference to the following drawings.

Fig. 1 is a flowchart illustrating the steps of a method for digitally designing and manufacturing a mandibular protrusion repositioning jaw pad throughout the course of a mandibular protrusion repositioning procedure in accordance with an embodiment of the present invention.

Detailed Description

The invention will now be further described with reference to the accompanying drawings and specific examples, which are not intended to limit the invention.

The order of execution of the operations, steps, and the like in the methods shown in the claims, the specification, and the drawings may be performed in any order unless otherwise specified, as long as the output of the preceding process is not used in the following process.

In the following detailed description, numerous specific details are set forth in order to provide a more thorough understanding of the invention. However, it will be apparent to those skilled in the art that well-known techniques and models have not been shown in detail in order to avoid obscuring the spirit of the present invention. Such as intraoral three-dimensional scanners, cone Beam CT (CBCT), computer aided design software, mandibular motion analysis systems, computer aided manufacturing software, and the like.

Furthermore, the terms "comprises," "comprising," and any variations thereof, 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 limited to only those steps or elements but may, optionally, include other steps or elements not listed or inherent to such process, method, article, or apparatus.

Example 1

Referring to fig. 1, the present embodiment provides a method for designing and manufacturing a mandibular protrusion repositioning jaw pad in a full digital manner, which includes the following steps:

and S1, scanning the upper and lower jaw dentitions by using an intraoral three-dimensional scanner and acquiring a digital dentition impression. As an example, specifically, in the step S1, when the patient is positioned at the maximum inter-dental interlace position, three-dimensional data of the upper and lower dentitions are acquired by means of the intraoral three-dimensional scanner of the dentistry, and a digitized dentition impression of the patient is created. In practical application, medical staff can retract lips of the target object through the mouth gag, and scan and record upper and lower dentition and occlusion relation of a patient to be detected by using an intraoral three-dimensional scanner device, so that the digital dentition impression is obtained.

Optionally, the digitized dental impression is in STL (stereolithography) format for subsequent processing of the digitized dental impression results.

And S2, shooting the full-skull large-view CBCT and performing three-dimensional reconstruction to obtain a digital jaw model. As an example, in the step S2, when the patient is positioned at the maximum inter-dental-interlace position, a full-skull large-field oral cavity image is photographed, and the maxilla and the mandible are three-dimensionally reconstructed by using a software virtual reality technology, so as to obtain a digitized jaw model.

Alternatively, the oral image may be a large field of view (FOV) CBCT image covering the temporomandibular joint, the infraorbital margin, the entire dentition.

Optionally, the oral image is a DICOM (Digital Imaging and Communications in Medicine ) image for subsequent processing of the oral image.

Optionally, the digitized jaw model is in STL (stereolithography) format for subsequent processing of the digitized jaw model results.

And step S3, performing spatial position registration and segmentation on the digital dentition impression and the digital jaw model to obtain a separated digital upper jaw model and a digital lower jaw model. As an example, in the step S3, the computer aided design software Exocad is used to perform spatial position matching on the high-precision digitized dentition impression and the digitized jaw model by using a three-dimensional point-to-point registration method, replace low-precision dentition data on the digitized jaw model, and segment the upper and lower jaws to obtain the digitized upper and lower jaw models respectively. It will be appreciated that the computer aided design software need only be capable of performing a spatial position matching function of the high precision digitized dentition impression with the digitized jaw model, and is not limited to Exocad, but may be other computer aided design software such as Planmeca PlanCAD.

Optionally, the digitized jaw model is in STL (stereolithography) format for subsequent processing of the digitized jaw model results.

And S4, registering the space positions of the real dentition, the digital maxillary model and the digital mandibular model in a mandibular movement analysis system, and ordering a patient to perform mandibular protrusion and opening and closing movements to obtain a head-face multi-mode fusion image. As an example, in particular, said step S4 comprises the following sub-steps:

s41, after the digital upper and lower jawbone models are led into a mandibular movement analysis system, a signal receiver matched with the mandibular movement analysis system is worn on the head and the face of a patient, and the real dentition of the patient is registered with the digital upper and lower jawbone in space position based on a tooth occlusal surface point-to-point mode;

and S42, after matching is completed, the patient is instructed to perform mandibular protrusion and opening and closing movements, and the digital maxillary model and the mandibular model are subjected to the movements with the same frequency and the same track as the patient in a mandibular movement analysis system so as to obtain a head-face multi-mode fusion image containing mandibular movement dimensions.

And S5, acquiring and recording information of jaw position relation, temporomandibular joint movement condition and mandibular movement track by using the mandibular movement analysis system, and repositioning the mandible according to the information to obtain therapeutic jaw position data. As an example, in particular, said step S5 comprises the following sub-steps:

s51, ordering the patient to perform mandibular forward extension movement to an upper front tooth cutting and cutting state and then performing small opening and closing movement;

s52, selecting the minimum opening position of the temporomandibular joint disc in the glenoid fossa on the muscle force closed path track according to the relative positions of the condyloid process and the temporomandibular joint fossa of the upper and lower digital jaw bone models in the mandibular motion analysis system and the displayed condyloid process motion track, namely the position of the mandible in the joint bounce vanishing position as the therapeutic jaw position;

s53, outputting the digital upper and lower jaw model data with the spatial positions.

And S6, inputting the therapeutic jaw data into computer-aided manufacturing software Sirona Inlab, and performing computer-aided manufacturing of the mandibular protrusion repositioning jaw pad by adopting a digital milling technology. As an example, in particular, in the step S6, the manufacturing requirements of the mandibular protrusion repositioning jaw pad are: covering the maxillary whole dentition; bite plate and pair

The teeth have obvious cusp locking relation; the lingual side of the anterior maxillary dental region has a distinct beveled guide area; all teeth reach a stable contact at the same time in the therapeutic jaw position.

It will be appreciated that the computer-aided manufacturing software need only be capable of digital milling of therapeutic jaw data, and is not limited to Sirona Inlab, but may be other computer-aided manufacturing software, such as Dental windows.

According to the above description, the whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad according to the present embodiment can obtain the mandibular movement track of the target object through the mandibular movement analysis system, so as to obtain the target jaw position. The method is independent of the experience of medical staff, and has the advantages of rapidness, accuracy, easiness in popularization and the like.

According to the above description, according to the whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad in one or more embodiments of the present invention, an intraoral three-dimensional scanner may be used to scan upper and lower dentitions and obtain digital dentition impressions, after a full-skull large-field CBCT is photographed and three-dimensionally reconstructed to obtain a digital jaw model, the digital jaw model is used as a medium to perform spatial position registration and segmentation to obtain separate digital upper and lower jaw models, and then an optical signal receiver is used as a medium to match the digital dentition impressions with intraoral real dentitions of a target object. The method can guide the upper and lower jaw three-dimensional model established based on the oral cavity image of the target object into a mandibular movement analysis system, so as to track and record the mandibular movement of the target object in real time, and obtain a head-face multi-mode fusion image, so that the temporomandibular joint is dynamically visualized, and medical staff can acquire the needed jaw position relationship conveniently. And performing computer aided design of the mandibular protrusion repositioning jaw pad according to the obtained therapeutic jaw position data, and completing manufacturing of the protrusion repositioning jaw pad by adopting a digital milling technology.

Therefore, the whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad can lead the key step of manufacturing the protrusion repositioning jaw pad, namely obtaining a more ideal and convenient solution for therapeutic jaw position, leading a three-dimensional virtual patient to develop in four-dimensional dynamic direction, leading the dynamic connection between the temporomandibular glenoid fossa and the condylar process and between the upper and lower mandibular dentitions to be more visual, and further realizing the visualization and the dynamics of a digital oral cavity, thereby providing a new clinical solution for medical staff.

Example 2

The present embodiment provides a mandibular protrusion repositioning jaw pad, which is manufactured by the mandibular protrusion repositioning jaw pad design and manufacturing method described in embodiment 1.

To demonstrate whether the resulting mandibular protrusion repositioning jaw pad was effective, the present example was evaluated clinically by three subjects, the criteria for clinical evaluation are as follows, the results are shown in Table 1:

A. 2 weeks after treatment with the protrusion repositioning jaw pad, the maximum opening degree of the patient is higher than that before treatment: increase/unchanged/decrease;

B. the patient's temporomandibular joint pain level 2 weeks after treatment with the protrusion repositioning jaw pad: mitigation/invariant/aggravation;

C. comfort level in the wearing process: good/general/poor;

D. retention: good/general/poor;

E. stability: good/general/poor;

F. patient had or had no pressure pain point: no/no, recording sites;

G. whether there is abnormal stress point of tooth: there are no/there recording sites.

From the clinical evaluation of three subjects on the mandibular protrusion repositioning jaw pad in this embodiment, the mandibular protrusion repositioning jaw pad of this embodiment has good application effect and high industrial application value.

Table 1 clinical evaluation of mandibular protrusion repositioning jaw pad

In summary, the present invention provides a mandibular protrusion repositioning jaw pad and a method for its entire digital design and manufacture. The method comprises the following steps: acquiring a digital dental printing model and a digital jaw model; carrying out space position registration and segmentation on the digital dentition impression and the digital jawbone model to obtain separated digital upper and lower jawbone models; registering the space positions of the real dentition and the digital upper and lower jaw bone models in a lower jaw movement analysis system to enable a patient to perform lower jaw forward extension and opening and closing movements, so as to obtain a head-face multi-mode fusion image; collecting and recording jaw position relation, temporomandibular joint movement condition and mandibular movement track; performing computer aided design of mandibular protrusion repositioning jaw pad according to therapeutic jaw position data; and finishing the manufacture by adopting a digital milling technology. The mandibular protrusion repositioning jaw pad is suitable for patients with anterior displacement of temporomandibular joint disc, tissue damage after disc, occlusion reconstruction with deficient occlusion height of severely worn back teeth area, and the like.

Those skilled in the art will understand that the skilled person can implement the modification in combination with the prior art and the above embodiments, and this will not be repeated here. Such modifications do not affect the essence of the present invention, and are not described herein.

The preferred embodiments of the present invention have been described above. It is to be understood that the invention is not limited to the specific embodiments described above, wherein devices and structures not described in detail are to be understood as being implemented in a manner common in the art; any person skilled in the art can make many possible variations and modifications to the technical solution of the present invention or modifications to equivalent embodiments without departing from the scope of the technical solution of the present invention, using the methods and technical contents disclosed above, without affecting the essential content of the present invention. Therefore, any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention still fall within the scope of the technical solution of the present invention.

Claims (10)

1. The whole-course digital design and manufacturing method of the mandibular protrusion repositioning jaw pad is characterized by comprising the following steps of:

step S1, scanning upper and lower jaw dentitions by using an intraoral three-dimensional scanner and acquiring digital dentition impressions;

s2, shooting a full-skull large-view CBCT and performing three-dimensional reconstruction to obtain a digital jaw model;

s3, carrying out space position registration and segmentation on the digital dentition impression and the digital jaw model to obtain a digital upper jaw model and a digital lower jaw model which are separated;

s4, registering the space positions of the real dentition, the digital maxillary model and the digital mandibular model in a mandibular movement analysis system, and ordering a patient to perform mandibular forward extension and opening and closing movements to obtain a head-face multi-mode fusion image;

s5, acquiring and recording information of jaw position relation, temporomandibular joint movement condition and mandibular movement track by using the mandibular movement analysis system, and repositioning the mandible according to the information to obtain therapeutic jaw position data;

and S6, inputting the therapeutic jaw data into computer-aided manufacturing software, and performing computer-aided manufacturing of the mandibular protrusion repositioning jaw pad by adopting a digital milling technology.

2. The method for designing and manufacturing a mandibular protrusion repositioning jaw pad according to claim 1, wherein in step S1, when the patient is positioned at the maximum inter-dental interlace position, the three-dimensional data of the upper and lower dentitions are acquired by means of a intraoral dental three-dimensional scanner, a digitized dentition impression of the patient is created, and the digitized dentition impression is output in STL format.

3. The method for designing and manufacturing the mandibular protrusion repositioning jaw pad according to claim 1, wherein in step S2, when the patient is positioned at the maximum inter-dental interlace position, the full-skull large-view CBCT is photographed and converted into DICOM format, and the maxilla and mandible are three-dimensionally reconstructed by using software virtual reality technology to obtain a digitized jaw model, and output in STL format.

4. The method for designing and manufacturing the mandibular protrusion repositioning jaw pad according to claim 1, wherein in step S3, computer aided design software is used to match the spatial positions of the digitized impression and the digitized jaw model in a three-dimensional point-to-point registration manner, replace low-precision dentition data on the digitized jaw model, segment the upper and lower jaws, and obtain the digitized upper and lower jaw models, respectively, and output in STL format.

5. The method for digitally designing and fabricating a mandibular protrusion repositioning jaw pad according to claim 4, wherein the computer aided design software is Exocad or Planmeca PlanCAD.

6. The method for the digital design and manufacture of the mandibular protrusion repositioning jaw pad according to claim 1, wherein the step S4 comprises the following sub-steps:

s41, after the digital upper and lower jawbone models are led into a mandibular movement analysis system, a signal receiver matched with the mandibular movement analysis system is worn on the head and the face of a patient, and the real dentition of the patient is registered with the digital upper and lower jawbone in space position based on a tooth occlusal surface point-to-point mode;

and S42, after matching is completed, the patient is instructed to perform mandibular protrusion and opening and closing movements, and the digital maxillary model and the mandibular model are subjected to the movements with the same frequency and the same track as the patient in a mandibular movement analysis system so as to obtain a head-face multi-mode fusion image containing mandibular movement dimensions.

7. The method for the digital design and manufacture of a mandibular protrusion repositioning jaw pad according to claim 1, wherein the step S5 comprises the following sub-steps:

s51, ordering the patient to perform mandibular forward extension movement to an upper front tooth cutting and cutting state and then performing small opening and closing movement;

s52, selecting the minimum opening position of the temporomandibular joint disc in the glenoid fossa on the muscle force closed path track according to the relative positions of the condyloid process and the temporomandibular joint fossa of the upper and lower digital jaw bone models in the mandibular motion analysis system and the displayed condyloid process motion track, namely the position of the mandible in the joint bounce vanishing position as the therapeutic jaw position;

s53, outputting the digital upper and lower jaw model data with the spatial positions.

8. The method for digitally designing and manufacturing a mandibular protrusion repositioning jaw pad according to claim 1, which is specific toCharacterized in that in the step S6, the manufacturing requirements of the mandibular protrusion repositioning jaw pad are as follows: covering the maxillary whole dentition; bite plate and pair

The teeth have obvious cusp locking relation; the lingual side of the anterior maxillary dental region has a distinct beveled guide area; all teeth reach a stable contact at the same time in the therapeutic jaw position.

9. The method for digitally designing and fabricating a mandibular protrusion repositioning jaw pad according to claim 8, wherein the computer-aided fabrication software is Sirona Inlab or Dental windows.

10. A mandibular protrusion repositioning jaw pad produced by the design and production method according to any one of claims 1 to 9.

Images