CN116407309A

CN116407309A - Whole-course guide plate for bone slice interlayer bone grafting synchronous planting and manufacturing method

Info

Publication number: CN116407309A
Application number: CN202310433087.0A
Authority: CN
Inventors: 祝宁; 高贤明; 张育祯; 刘嘉昱; 张宇
Original assignee: Peking University School of Stomatology
Current assignee: Peking University School of Stomatology
Priority date: 2023-04-21
Filing date: 2023-04-21
Publication date: 2023-07-11

Abstract

The invention relates to a whole-course guide plate for bone slice interlayer bone grafting synchronous planting and a manufacturing method thereof, comprising an implantation guide plate, a bone slice positioning trimming plate, a bone taking area tooth positioning device, a bone cutting guide plate, a tooth missing area tooth model and a bone taking area tooth model of a bone slice and an implant, wherein the top of the implantation guide plate of the bone slice and the implant is connected with the bottom of the bone slice positioning trimming plate, a plurality of positioning points corresponding to the positions of a bone supply area can be arranged in the bone receiving area through guide drilling holes on the bone slice positioning trimming plate, and the taken bone slice can be accurately transplanted into the bone receiving area; the bone cutting guide plate can be connected with a bone taking area tooth positioning device and can be fixed in a bone taking area according to the plurality of positioning points; the invention can realize accurate, minimally invasive and safe acquisition of intraoral autologous bone fragments, can provide the doctor with the whole flow guidance of bone fragment acquisition, trimming, implantation and implant implantation, reduces the operation difficulty, and assists the doctor to finish the whole operation more accurately, efficiently and safely.

Description

Whole-course guide plate for bone slice interlayer bone grafting synchronous planting and manufacturing method

Technical Field

The invention relates to the technical field of medical treatment, in particular to a whole-course guide plate for bone slice interlayer bone grafting synchronous planting and a manufacturing method thereof.

Background

Good function and aesthetics of the oral implant restoration depends on the ideal position of implant implantation and proper tissue increment in the defect state of the alveolar bone. When the missing teeth are accompanied by the missing teeth area bone tissue defects, the bone increment is needed, and the treatment period and the visit times can be increased. Bone plate interlayer bone grafting, which is also known to the learner as bone plate technique or cortical bone interlayer bone augmentation technique or interlayer bone grafting technique, refers to obtaining a block bone from itself, dividing it into several thin bone plates, fixing the bone plates to the edentulous area using a retention screw, and filling the gap between the bone plates and the original bone of the edentulous area with a granular bone augmentation material. For patients with vertical bone defects, the three-dimensional bone defect reconstruction of the labial (cheek) and lingual (palate) sides of the tooth-missing region can be completed by using a double-layer bone slice interlayer bone grafting technology; whereas for patients with only horizontal bone defects, horizontal bone defect reconstruction can be accomplished using single-layer bone flap interlayer bone grafting techniques. The technique requires that the autologous bone pieces taken from the patient are respectively fixed on the labial and palate sides to restore the defective bone wall, the autologous broken bone or artificial bone increment material is filled between the two bone pieces, or the autologous bone pieces are singly placed on the labial or palate sides, and the granular bone increment material is filled between the bone pieces and the original bone. Compared with the traditional autologous massive bone grafting technology, the bone slice of the bone slice interlayer bone grafting technology is used as an autologous biological membrane, can be used for protecting internal broken bones, provides a stable osteogenic environment, can obtain a larger bone increment profile by using a smaller bone quantity, and simultaneously can accelerate early vascularization by using granular bone increment materials filled in the bone slice, wherein autologous granular bones in the granular bone increment materials have rich growth factors and osteoblasts, and are beneficial to the combination of the implant and bones thereof.

The bone slice interlayer bone grafting comprises two steps of taking bone and grafting bone, and relates to two parts of a bone supply area and a bone receiving area, and the bone slice interlayer bone grafting is a preferred bone supply area for the bone supply area because the intraoral bone supply area has the advantages of small wound, good dimensional stability of bone of an intramembrane bone formation origin, high patient acceptability and the like; aiming at a bone receiving area, the edge of an implanted bone piece is required to be well adhered with the rest original bone in a tooth-missing area and can realize stable fixation, meanwhile, the distance between the bone pieces on the lip (cheek) side and the tongue (palate) side is required to be proper, if the distance is too small, the requirement of sufficient bone quantity around the implant cannot be met, if the distance is too large, excessive bone grafting can be caused, unnecessary wounds are increased, the using amount of granular bone increment materials required to be filled in the interior is increased, and meanwhile, the tension after soft tissue suturing is increased, so that the risk of fracture of the wounds is increased. However, in the conventional free-hand operation, there are many technical difficulties in respect of the above requirements, such as: the appearance and the size of the bone fragments cannot accurately reconstruct the bone defect area, the bone fragments cannot be accurately positioned and fixed when being implanted, the bone fragments are difficult to punch and fix, the technical sensitivity is high, and the like, and the difficulties limit the popularization and the application of the technology. Meanwhile, how to fully utilize intraoral bone sources to obtain bone fragments with proper sizes and shapes on the premise of avoiding nerve and adjacent tooth injuries, and how to trim the removed bone fragments to enable the edges of the removed bone fragments to be attached to original bones and transplanted and fixed to proper positions of bone receiving areas, namely, realizing accurate positioning and firm fixation of the bone fragments, is a difficult problem of bone fragment interlayer bone grafting operation, and is a difficult problem to be solved clinically urgently at present.

At present, along with development of a digitizing technology and expansion of an application range, the digital technology has become an important auxiliary means for dental implantation and tissue defect reconstruction, and by means of technologies such as multi-source data fusion, digital three-dimensional design, digital processing and the like, a more accurate, efficient, minimally invasive and safe operation scheme can be realized. For example, the three-dimensional imaging data of the jawbone and the scanning data of the tooth model can be fused, various digital guide plates can be designed and manufactured, and the accurate positioning of the guide plates can be realized by reflecting the position information of the teeth in the guide plates. At present, various guide plate technologies with or without tooth positioning are designed by a plurality of students in the prior literature, but no report on a digital guide plate technology capable of realizing synchronous planting of a sandwich bone increment technology is yet seen. The problems of how to safely obtain a plurality of bone fragments with proper size, how to trim the extracted bone fragments to ensure that the edges of the extracted bone fragments are well attached to the bone receiving area, how to accurately position and firmly fix the extracted bone fragments so as to reconstruct the aesthetic outline of the bone defect area, etc. remain unsolved, and the design and implementation of the full-flow digitization of the bone fragment sandwich bone grafting are critical for accurately realizing the full-flow digitization of the bone fragment sandwich bone grafting by utilizing a digitization method. Therefore, aiming at the difficulty of the prior bone grafting technique of the bone grafting interlayer, we invented a whole-course guide plate technique for the synchronous planting of the bone grafting interlayer, which is used for realizing accurate, minimally invasive, efficient and safe operation effect and reducing the sensitivity of surgical technique.

Disclosure of Invention

The invention relates to a whole-course guide plate for bone slice interlayer bone grafting synchronous planting and a manufacturing method thereof, which can realize accurate, minimally invasive and safe acquisition of intraoral autologous bone slices, provide the whole flow guidance of bone slice acquisition, trimming, implantation and implant implantation for doctors, reduce the operation difficulty and assist the doctors to finish the whole operation more accurately, efficiently and safely.

The invention aims to provide a whole-course guide plate for bone slice interlayer bone grafting synchronous planting and a manufacturing method thereof, and in view of small size of the bone cutting guide plate, stable fixation of bone cutting guide plate retention nails and separation design of the bone cutting guide plate, a plurality of intraoral autologous bone slices can be accurately, minimally invasively and safely obtained; the bone piece positioning and trimming plate can be inserted into the bone piece positioning groove, the bone piece positioning and trimming can be realized by combining the bone piece positioning and trimming plate and the bone piece positioning and trimming plate, a bone receiving area can be punched by utilizing a guide drilling hole on the bone piece positioning and trimming plate, and then the bone piece can be accurately implanted into the bone piece by utilizing the bone piece positioning groove according to the designed bone piece implantation position and direction; the dental bone model printed by the resin material can be used for assisting preoperative test wearing of the combined guide plate, and assisting in trimming of intraoperative bone chips and assisting in obtaining a proper amount of well-mixed granular bone filling material. The combined guide plate can guide doctors to complete all processes of bone slice acquisition, trimming, implantation and implant implantation synchronous with bone grafting, and can achieve bone grafting and implant synchronous completion under the condition of avoiding mutual interference of the implant and bone slice bone grafting nails, so that treatment period is shortened, operation difficulty is reduced, and doctors are assisted to complete operation more accurately, efficiently, safely and minimally invasively.

In order to achieve the above purpose, the invention has the following technical scheme:

the invention relates to a whole-course guide plate for bone slice interlayer bone grafting synchronous planting, which comprises an implantation guide plate of a bone slice and an implant, a bone slice positioning and trimming plate, a bone taking area tooth positioning device, a bone cutting guide plate, a tooth missing area tooth model and a bone taking area tooth model, wherein the tops of the implantation guide plates of the bone slice and the implant are connected with the bottoms of the bone slice positioning and trimming plate; the bone cutting guide plate can be connected with a bone taking area tooth positioning device and can be fixed in a bone taking area according to the plurality of positioning points; the dental bone model in the tooth-missing area and the dental bone model in the bone-taking area can be used for guide plate fitting, and can also be used for determining the volume of artificial granular bone filling materials to be implanted, so that the autologous bone particles obtained by trimming bone chips can be fully mixed with a proper amount of artificial granular bone materials and then implanted quickly.

Wherein: the bone piece and implant implantation guide plate comprises an implant guide ring (1), a receiving area tooth positioning substrate (2), a connecting rod a (3), a bone piece positioning groove a (4), a bone piece positioning groove b (5) and a connecting rod b (8); the receiving area tooth positioning substrate (2) is connected with the implant guiding ring (1) through a connecting rod a (3), and the bone piece positioning groove a (4) and the bone piece positioning groove b (5) are connected with the receiving area tooth positioning substrate (2) through a connecting rod b (8); the bone slice positioning groove a (4) comprises a bone grafting nail implantation guide hole a1 (17), a bone grafting nail implantation guide hole a2 (18) and a bone slice in-place observation window (21), and the bone slice positioning groove b (5) comprises a bone grafting nail implantation guide hole b1 (19) and a bone grafting nail implantation guide hole b2 (20).

Wherein: the bone piece positioning and trimming plate comprises a bone piece positioning and trimming plate a (6) and a bone piece positioning and trimming plate b (7); wherein the bone slice positioning and trimming plate a (6) comprises a guiding drill point ring a1 (13) and a guiding drill point ring a2 (14), a hole passage in the middle of the guiding drill point ring a1 (13) is a guiding drill point hole a1 (9), and a hole passage in the middle of the guiding drill point ring a2 (14) is a guiding drill point hole a2 (10); the bone slice positioning and trimming plate b (7) comprises a guide drill point ring b1 (15) and a guide drill point ring b2 (16), wherein a hole passage in the middle of the guide drill point ring b1 (15) is a guide drill point hole b1 (11), and a hole passage in the middle of the guide drill point ring b2 (16) is a guide drill point hole b2 (12); the bone piece positioning and trimming plate a (6) and the bone piece positioning and trimming plate b (7) can be connected through the bone grafting nail a1 (40) which is designed in a digital virtual mode and the bone grafting nail a2 (41) which is designed in a digital virtual mode.

Wherein: the bone piece and implant implantation guide plate comprises an implant guide ring (1), a receiving area tooth positioning substrate (2), a connecting rod a (3), a bone piece positioning groove a (4), a bone piece positioning groove b (5) and a connecting rod b (8); the receiving area tooth positioning substrate (2) is connected with the implant guiding ring (1) through a connecting rod a (3), and the bone piece positioning groove a (4) and the bone piece positioning groove b (5) are connected with the receiving area tooth positioning substrate (2) through a connecting rod b (8); the bone slice positioning groove a (4) comprises a bone screw implantation guide hole a1 (17), a bone screw implantation guide hole a2 (18) and a bone slice in-place observation window (21), and the bone slice positioning groove b (5) comprises a bone screw implantation guide hole b1 (19) and a bone screw implantation guide hole b2 (20);

Wherein: the bone piece positioning and trimming plate comprises a bone piece positioning and trimming plate a (6) and a bone piece positioning and trimming plate b (7); wherein the bone slice positioning and trimming plate a (6) comprises a guiding drill point ring a1 (13) and a guiding drill point ring a2 (14), a hole passage in the middle of the guiding drill point ring a1 (13) is a guiding drill point hole a1 (9), and a hole passage in the middle of the guiding drill point ring a2 (14) is a guiding drill point hole a2 (10); the bone slice positioning and trimming plate b (7) comprises a guide drill point ring b1 (15) and a guide drill point ring b2 (16), wherein a hole passage in the middle of the guide drill point ring b1 (15) is a guide drill point hole b1 (11), and a hole passage in the middle of the guide drill point ring b2 (16) is a guide drill point hole b2 (12); the bone piece positioning and trimming plate a (6) and the bone piece positioning and trimming plate b (7) can be connected through a digital virtual design bone grafting nail a1 (40) and a digital virtual design bone grafting nail a2 (41);

wherein: the bone taking area tooth positioning device comprises a bone taking area tooth positioning substrate (22), a guiding drill point ring A1 (25), a guiding drill point ring A2 (26), a guiding drill point ring c (28), a connecting rod d (29) and a connecting rod c (44); wherein, the hole passage in the middle of the guide drill point ring A1 (25) is a guide drill point hole A1 (23), the hole passage in the middle of the guide drill point ring A2 (26) is a guide drill point hole A2 (24), and the hole passage in the middle of the guide drill point ring c (28) is a guide drill point hole c (27);

The osteotomy guide comprises an osteotomy guide outer frame (42) and an osteotomy guide partition frame (36); wherein, the osteotomy guide frame (42) is provided with an osteotomy guide plate 2 (32), an osteotomy guide plate 3 (33), an osteotomy guide plate 4 (34), an osteotomy guide plate 5 (35) and an osteotomy guide plate retention hole c (30); an osteotomy guide plate 1 (31) is arranged on the osteotomy guide plate partition frame (36); the groove between the outer frame (42) of the osteotomy guide and the parting frame (36) of the osteotomy guide is a parting cutting groove (48) of the osteotomy guide;

the bone taking area tooth positioning substrate (22) can be connected with the bone cutting guide plate outer frame (42) through a connecting rod d (29), a connecting rod c (44), a guide drill needle ring A1 (25), a guide drill needle ring A2 (26) and a guide drill needle ring c (28).

The invention relates to a whole-course guide plate for bone slice interlayer bone grafting synchronous planting and a manufacturing method thereof, which comprises the following design steps:

1) Reconstructing a jaw bone model and superposing a dentition scanning model to generate a dental bone model of a dental defect area and a dental bone model of a bone taking area: obtaining a dentition scanning model of a patient, wherein the dentition scanning model of the patient can be obtained through an intraoral scanning mode or is obtained through a mode of scanning a dentition gypsum model of the patient, photographing a jawbone CBCT for the patient, obtaining data in a Dicom format, importing the data into a Mimics Research software, reconstructing a jawbone model of an original bone and a tooth containing a missing tooth area and a bone and a tooth of a bone area to be extracted by utilizing a 'Masks' -calcate Part 'command, storing the model into an STL format, importing the jawbone model and the dentition scanning data into a geomic Studio software, selecting a crown Part on the jawbone model, right clicking the jawbone model, clicking a menu column' Alignment '-Best Fit Aligment', selecting the dentition scanning model in a 'Float' frame, and clicking an 'applied' to realize registration of the dentition scanning model to the jawbone model by taking the crown Part on the jawbone model as a reference; clicking a menu bar from 'Polygons' to 'Trim with Curve', respectively cutting out a dental crown part in a jaw model and a non-dental crown part in a dentition scanning model, simultaneously selecting two models after cutting out, clicking a menu bar from 'Polygons' to 'Combine', combining the two models into a whole, namely a dental model, trimming the dental model by utilizing the functions from 'Polygons' to 'Trim with Curve', and respectively generating a preliminary dental model of a dental defect area and a preliminary dental model of a dental defect area by only reserving a plurality of teeth and surfaces of a jaw adjacent to the dental defect area;

2) Designing a dental-deficiency area to-be-implanted implant model and a to-be-implanted bone slice model: in the Mimics Research software, a standard dental crown model of a corresponding dental deficiency site is imported, the standard dental crown model is moved to a dental deficiency area by utilizing a command of ' Move ' and ' Rotate ', a plurality of target dental crown restoration bodies are formed according to the shapes of the dental deficiency gap, adjacent teeth and the standard dental crown model, a plurality of implant-like bodies corresponding to the target dental crown design are arranged, the implant-like bodies can be represented by cylinders with different diameters and lengths generated by a command of ' Analyze ' menu ' to ' Cylinder ' to ' Draw ', the number of implant-like bodies is at least 1, the implant-like bodies are ensured to be positioned in a jaw bone to obtain enough initial stability, the position and angle of the implant-like bodies can meet the restoration requirement of the target dental crown restoration bodies, the long axis of the implant-like bodies generally penetrates out from the central position of the front lingual side or rear occlusal side of the target dental crown restoration bodies, and the crest top side of the implant-like bodies is approximately 3-4mm away from the gingival margin position of the target dental crown; then reconstructing the target bone increment alveolar bone morphology of the bone defect part of the tooth-missing area, which comprises the following specific steps: the method comprises the steps that a plurality of cylinders representing an implant to be implanted are copied through a 'duplex' command, a cylinder model obtained through right click copying is selected, a 'Properties' command is selected, a Radius value is increased by 2mm, a plurality of new cylinders which are 2mm larger than the Radius of the implant cylinder can be obtained, according to the requirement that the periphery of the implant needs to have 2mm of bone mass to keep the long-term stability of the implant, the plurality of thickened cylinders represent the requirement of an increase range of bone mass, a plurality of sheets with the thickness of about 0.5-2mm are respectively generated on the lip side or the cheek side and the tongue side or the palate side of the thickened cylinders, the thickened cylinders are completely positioned inside bone sheets on the lip side or the cheek side and the tongue side or the palate side and are in contact with the bone sheets, the bone sheet angle is adjusted, the root side and the near-far middle side of the bone sheets can be in more contact with the rest alveolar bone of an edentum zone, the crest top side of the bone sheets and the crest top side of the implant are slightly beyond the top position of the implant by 380-1 mm of the crown top of the implant, the number of the crown top of the implant is designed to be approximately equal to the crest top of the bone mass of the implant, and the depth of the bone mass is 0-1mm is designed to be in the depth of the ultra-0 mm of the bone mass in the depth of the model, and the depth of the bone model is designed to be in the depth of the ridge-0 mm; then, a plurality of long cylinders which are approximately perpendicular to the bone plate to be implanted model and penetrate through the bone plates on the labial side or the buccal side and the lingual side or the palate side and the original bone in the tooth-missing area at the same time, wherein the diameter of the long cylinders is 1-2mm, the positions and the angles of the long cylinders need to avoid important anatomical structures of tooth roots, nerves and blood vessels in the implant to be implanted and the jaw bone in the tooth-missing area, and a safe distance of more than 1-2mm is reserved, and the long cylinders represent a plurality of bone grafting nails for fixing the bone plate to be implanted in the jaw bone, so that a bone grafting nail model with a digital virtual design is obtained; then the bone plate model to be implanted and the bone grafting nail model are processed by Boolean Operation →

Subtracting the commands of the 'sub' to obtain a bone fragment model to be implanted with a plurality of bone grafting nail holes;

3) Manufacturing an implantation guide plate of a bone plate and an implant: in Geomagic Studio software, sequentially right clicking the cylinder models designed in the step 2) to select a 'duplex' command for replication, changing the height of the replicated cylinders to generate a plurality of new cylinders, enabling the height of the new cylinders to be from 3mm from the top of the original bone crest of the tooth missing region to 7mm from the top of the original bone crest of the tooth missing region, namely, the length of the new cylinders to be 4mm, selecting a proper diameter pressing plate with the radius of the pressing plate being larger than the radius of the implant according to the radius of the pressing plate in the selected planting guide tool box, newly creating a plurality of thickened cylinders with the same axes and lengths as the new cylinders and with the radius being larger than the radius of the pressing plate in the selected planting guide tool box, newly creating a plurality of cylinders with the axes and the length being the same as the new cylinders and the radius of the pressing plate in the selected planting guide tool box, and utilizing 'Boolean' to the cylinders

Subtracting the commands of the 'sub', obtaining a plurality of implant guide rings with the length of 4mm and the thickness of 2mm, wherein a passage in the middle of each implant guide ring is a path for implant implantation, the position and the angle of each implant guide ring can guide the position and the angle of implant implantation, the height position of each implant guide ring can prompt the depth position of implant implantation, and the implant guide rings can accurately guide the preparation of an implant cavity and the accurate implantation of an implant by matching with a pressing plate in a matched implant guide plate tool box; cutting to obtain sheets on the square surfaces of the outline high-point crowns of a plurality of non-loosening crowns adjacent to the tooth-missing region on the two sides of the tooth-missing region by utilizing the commands from 'Polygons' to 'Trim with Curve', thickening the cut crowns Shell sheets to 1-2mm along the outer side direction of the crowns to form a receiving-region tooth positioning substrate model, wherein the receiving-region tooth positioning substrate model is a concave Shell with the thickness of 1-2mm, and the inner concave surface is consistent with the corresponding crown surface; selecting a plurality of inner side surface thin sheets and outer side surface thin sheets of a bone plate model to be implanted and a surface thin sheet model of a crest top surface close to the crest top of an tooth socket by utilizing a Bounded Components function, thickening 3 thin sheet planes selected from each bone plate model to form a groove-shaped device along the outer side direction of the bone plate model by utilizing a Polygons-Shell command until the thickness is 0.5-1mm, respectively extending a cylinder model representing bone nails to be implanted into the bone plate to form a plurality of new cylinders along two ends of a long axis of the cylinder by 2-3mm, generating a thickened cylinder with the same axis and length as the plurality of new cylinders and with the radius increased by 1-2mm, subtracting the plurality of groove-shaped devices from the plurality of thickened cylinders by utilizing a Boolean-Substract command to obtain a plurality of groove-shaped devices with preliminary bone nail implantation guide holes, then subtracting a plurality of thickened cylinders from a new cylinder by using a 'Boolean' command, obtaining a plurality of hollow rings, cutting the hollow rings by using the inner side surface Plane of the vertical outer side groove plate of each groove-shaped device by using the 'polygens' to 'Trim with Plane' function, deleting the cut part in the middle of the hollow rings, reserving the short hollow rings which are positioned on the outer side groove plate of each groove-shaped device and are implanted into the inner side of the guide hole and the outer side of the groove-shaped device far away from the original bone by using the preliminary bone grafting nail on the outer side groove plate of each groove-shaped device, the reserved short hollow rings are guide drill needle rings, the middle passage in the guide drill needle rings is guide drill holes, can be used for guiding the drilling holes to punch the original bone in the tooth-missing area, adding the guide drill needle rings and the groove-shaped devices by using the 'Boolean' Union command, obtaining preliminary bone piece positioning grooves, dividing the preliminary bone piece positioning grooves by utilizing the functions of ' polygens ', ' Trim with Plane ', copying ' Duplicate ' and deleting the guide drill rings of the two preliminary bone piece positioning grooves corresponding to ' Delete ' and the parts of the root parts of the two preliminary bone piece positioning grooves on the labial side or the buccal side and the lingual side or the palate side along the horizontal direction, and then manufacturing a bone piece positioning observation window, thereby obtaining a plurality of bone piece positioning grooves, retaining semicircular hole-shaped bone implant nail implantation guide holes on the bone piece positioning grooves, and adding the corresponding copied parts, namely the guide drill rings and the parts of the root parts of the preliminary bone piece positioning grooves by utilizing ' Boolean ' - ' commands to generate a bone piece positioning trimming plate, wherein the guide drill rings are connected with the bone implant nail implantation guide holes on the corresponding bone piece positioning grooves in an inserting manner, and the bone piece positioning trimming plate can be inserted into the bone piece positioning grooves by utilizing the guide drill rings on the guide drill rings to form a combined bone piece positioning groove for positioning and can be used for trimming bone piece implantation guide holes on the bone piece positioning guide plate after being implanted into the bone piece positioning groove; designing a rod-shaped connecting structure to connect a plurality of implant guide rings and a receiving area tooth positioning substrate model, marking the connecting structure as a connecting rod a, designing a rod-shaped connecting structure to connect a plurality of bone piece positioning grooves and a receiving area tooth positioning substrate model, marking the connecting structure as a connecting rod b, finally combining the implant guide ring model, the receiving area tooth positioning substrate model, the connecting rod a model, the bone piece positioning groove model and the connecting rod b model by utilizing a menu bar ' Polygons ' -Combine ' command to form an integrated device, namely an implant guide plate of bone piece and implant, observing a positioning channel of the implant guide plate, ensuring that the implant guide plate can be positioned on the tooth-lacking area tooth model without interference, namely ensuring that the implant guide plate can be positioned without interference in a state of cutting open exposed bone surfaces of soft tissues in an operation;

4) Selecting a bone taking area and generating an osteotomy guide plate: in Geomagic Studio software, the 'Object Mover' function under the 'Tools' menu is utilized to enable the plurality of digital virtual design bone fragment models with bone grafting nail holes generated in the step 2) to be moved in parallel and overlapped together along the long axis direction of the digital virtual design bone grafting nails, the bone fragment models which are overlapped together in parallel are combined to form a whole, namely the bone fragment combined model with the bone grafting nail holes, by utilizing the menu bar 'Polygons' to 'Combine' command, the bone fragment combined model is moved to a safe bone extraction area of the jaw bone model by utilizing the 'Tools' to 'Object Mover' function, the placement of the bone fragment combined model is adjusted, the bone fragment combined model is placed at a proper bone extraction site, and the position of the bone fragment combined model is adjusted to ensure that: (1) the bone slice combination model is at least 2-3mm away from important anatomical structures such as a jawbone nerve tube, a blood vessel, a tooth root and the like; (2) the direction of the bone grafting nail hole on the bone slice combination model is approximately perpendicular to the jaw surface of the bone taking area; (4) the bone slice combination model is completely positioned in the jaw bone tissue of the bone taking area; (5) the outer contour surface of the bone slice combination model is close to the bone surface of the bone taking area as much as possible; making a projection form of the bone slice combination model on the jaw surface of the bone taking area along the direction of the bone grafting nail hole on the bone slice combination model, generating a plurality of straight line and/or curve osteotomy lines and osteotomy planes according to the outermost peripheral outline of the surface slice obtained by projection, and making a plurality of vertical osteotomy planes according to the dividing planes among a plurality of bone slices in the bone slice combination model; selecting a jaw surface around a bone region, uniformly thickening the selected jaw surface sheet to the outer side of a jaw by 2-3mm by using a 'Polygons' to 'Shell' command to form a jaw surface sheet, combining each osteotomy Plane with the sheet by using a menu bar 'Polygons' to 'Combine' command, and drawing an outer frame line of an osteotomy guide plate on the sheet by using a 'Polygons' to 'Trim with/Trim with Curve' command to ensure that: (1) a distance of 1-2mm is reserved between the outer frame line of the osteotomy guide plate and each osteotomy plane, and the distance is the width of the outer frame of the osteotomy guide plate; (2) a plurality of long cylinders with the diameter of 1-2mm are designed between the outer frame line of the osteotomy guide plate and the osteotomy plane and used for representing the osteotomy guide plate retention nails, the positions and the angles of the long cylinders are adjusted, so that 2-3mm safe distances are reserved between the implantation positions and important anatomical structures, and the periphery of the retention nails is about 1-2mm wide from the outer frame line of the osteotomy guide plate; the overlapping part between the plurality of osteotomy planes and the thickened jaw surface thin plate is a plurality of osteotomy guide plates, the part of the thickened jaw surface thin plate between the osteotomy guide plates and outside the outline border line of the osteotomy guide plates is deleted to form a preliminary osteotomy guide plate model, wherein a plurality of horizontal division frames between the vertical division planes are the division frames of the osteotomy guide plates, linear shallow grooves are formed at the juncture of the division frames of the osteotomy guide plates and the outer frame of the osteotomy guide plates, namely the division cutting grooves of the osteotomy guide plates are formed, the positions for cutting the osteotomy guide plates can be indicated in the operation, and then the osteotomy guide plate model with a plurality of osteotomy guide plate retention holes c can be obtained by carrying out ' Boolean ' sub ' operation on a plurality of long cylinders representing osteotomy guide plate retention nails and the osteotomy guide plate model;

5) Generating a bone taking area tooth positioning device: in Geomagic Studio software, a plurality of new cylinders which are the same as the axis of the long cylinder representing the osteotomy guide plate retention nail in the step 4) and have the diameter and the height of 5-6mm are newly built, the space positions of the new cylinders are adjusted along the long axis to be 1-2mm away from the jaw surface of the osteotomy region, and the new cylinders and the long cylinder representing the osteotomy guide plate retention nail in the step 4) are subjected to 'Boolean' to 'sub' operation to obtain a plurality of guide drill needle ring c models of the osteotomy region tooth positioning device, wherein the middle holes are guide drill needle holes c; newly creating a plurality of new cylinders which are the same as the axes of the long cylinders representing bone grafting nails moving to the bone grafting region in the step 4) and have the diameters and the heights of 5-6mm, adjusting the spatial positions of the new cylinders along the long axes to ensure that the spatial positions are 1-2mm away from the jaw bone surface of the bone grafting region, and then carrying out Boolean ' to ' sub ' operation on the new cylinders representing the bone grafting nails on the bone grafting region combined model in the step 4) to obtain a plurality of guide drill needle ring models of the bone grafting region tooth positioning device, wherein the middle holes are guide drill needle holes; cutting the high-point crown square surfaces of the shapes of the plurality of non-loosening crowns adjacent to the bone taking area by utilizing the commands from the Polygons to the Trim with the Curve, thickening the cut sheet to 1-2mm along the external direction of the crowns by utilizing the commands from the Polygons to the Shell to form a bone taking area tooth positioning substrate model, wherein the inner concave surface of the tooth positioning substrate model is consistent with the corresponding crown surface; setting a rod-shaped connecting structure to connect a plurality of guide drill needle ring models and bone taking area tooth positioning substrate models, marking the connecting structure as a connecting rod c, setting the rod-shaped connecting structure to connect a plurality of guide drill needle ring models and bone taking area tooth positioning substrate models, and marking the connecting structure as a connecting rod d; finally, the guide drill point ring model, the bone taking area tooth positioning base plate model, the connecting rod c model and the connecting rod d model are combined by utilizing a menu bar 'Polygons' to 'Combine' command to form an integral device, and the positioning channel is observed, so that the bone taking area tooth model can be positioned without interference, namely, the condition that the exposed bone surface of the soft tissue can be cut in operation is indicated, and the integral device is the bone taking area tooth positioning device;

6) A whole-course guide plate component for bone slice interlayer bone grafting synchronous planting: in Geomagic studio software, placing a bone piece and an implant guide plate and a bone piece positioning and trimming plate of an implant at corresponding positions of a primary dental defect area dental bone model, subtracting the bone nail which is designed in a digital virtual mode from the primary dental defect area dental bone model by using a Boolean command to obtain a dental defect area dental bone model with a bone nail hole, and fixing the implant guide plate and the bone piece positioning and trimming plate of the bone piece and the implant on the dental defect area dental bone model by using an elongated screw; the bone taking area tooth positioning device and the bone cutting guide plate are placed at the corresponding positions of the preliminary bone taking area tooth model, the digital virtual design bone cutting guide plate retention nails and the preliminary bone taking area tooth model are subtracted by using a 'Boolean' to 'partial' command to obtain the bone taking area tooth model with retention nail holes, the bone taking area tooth positioning device and the bone cutting guide plate can be fixed on the bone taking area tooth model by using the slender screws, and all guide plate components are placed in the same coordinate system, so that all components of the whole guide plate for bone slice interlayer bone grafting synchronous planting can be connected into a tooth deficiency area and a bone taking area through the slender screws, and convenience is provided for storage, disinfection, transfer and clinical use of the guide plate;

7) Designing and measuring the osteotomy depth of each osteotomy guide plate and the drilling depths of a plurality of guide drilling holes in the mic Research software, so as to ensure that important anatomical structures such as nerves, blood vessels, tooth roots and the like are avoided;

8) Introducing the whole guide plate for bone plate interlayer bone grafting synchronous planting generated in the step 6) into three-dimensional printing software, and three-dimensionally printing a medical titanium alloy material or a cobalt-chromium alloy metal material to manufacture an implant guide plate, a bone plate positioning and trimming plate, a bone taking area tooth positioning device and an osteotomy guide plate of a bone plate and an implant; printing a dental bone model of a tooth-missing area and a dental bone model of a bone-taking area by using a medical resin material; the bone slice positioning and trimming plate is used for trimming morphological edges of the removed bone slice and punching original bones of a bone receiving area together after being connected with the bone slice positioning and trimming plate, the critical part edge morphology of the bone slice required to be implanted in the bone receiving area is the same as that of the bone slice required to be implanted in the bone receiving area, good bonding with the original bones of the bone receiving area can be realized by contrasting the bone slice trimmed by the bone slice positioning and trimming plate, a plurality of positioning points corresponding to the positions of the bone receiving area can be arranged on the bone slice positioning and trimming plate through guide drill holes, and the taken bone slice can be accurately transplanted into the bone receiving area; the bone cutting guide plate can be connected with a tooth positioning device of a bone taking area and can be fixed in the bone taking area according to the plurality of positioning points, and the bone cutting guide plate is used for guiding a bone cutting instrument to cut a plurality of bone fragments on the jawbone; the dental bone model in the tooth-missing area and the dental bone model in the bone-taking area can be used for guide plate trial wearing before operation, auxiliary bone slice trimming in operation can also be used for determining the volume of artificial granular bone filling materials to be implanted, and the automatic bone grains obtained by trimming the bone slice can be conveniently and fully mixed with a proper amount of artificial granular bone materials and then be quickly implanted.

The invention has the advantages that:

1. the invention can realize the full-flow digital operation guidance of the implant for bone slice interlayer bone grafting synchronization, can guide the acquisition, the trimming and the implantation of the bone slice and the synchronization implantation of the implant in the whole process, can avoid the position interference of the bone grafting nail and the implant by utilizing the accurate guidance of the guide plate, can realize the implantation of the implant in the bone grafting synchronization, shortens the treatment period of patients and reduces the operation times. The technical scheme provided by the invention can provide reference and guidance of the whole operation flow for a clinician, reduce the steps and time of measurement and design in the operation of the doctor, reduce the operation difficulty and reduce the dependence on the operation experience of the doctor while improving the operation effect. According to the thought of 'taking a prosthesis as a guide to design dental implants and bone increment', a plurality of to-be-implanted three-dimensional bone fragment models and a plurality of bone grafting nail models for fixing the to-be-implanted three-dimensional bone fragment models on original bones in a tooth-missing area are designed and generated, a plurality of bone fragment positioning grooves and bone fragment positioning and trimming plates are designed and generated, and the form of the to-be-implanted bone fragments and the three-dimensional space positions of the to-be-implanted bone fragments can be recorded after the two parts are connected through bolts; the designed bone slice models are overlapped to form an integral model, a proper bone taking site can be found by translating and rotating to a safe bone taking area, a bone grafting nail hole which is to be implanted into the bone slice model can be moved into bone tissue of the bone taking area together, and the bone slice model is translated out of a bone surface according to the direction of the bone grafting nail hole, so that the space position of the bone slice which is to be cut is obtained when the bone taking area is used. The bone piece positioning and trimming plate and the bone piece positioning groove can realize multiple functions: when the bone slice positioning and trimming plate is used, the bone slice positioning and trimming plate is connected with the bone slice positioning slot through the pin, and the bone defect area is perforated by the guide drill ring on the bone slice positioning and trimming plate, and the formed holes are consistent with the directions and positions of the holes on the cut bone slice, so that the bone slice positioning and trimming plate can be used for positioning and fixing the bone slice; the guide drilling holes are matched with holes on the bone piece model to position the accurate positions of the bone pieces in the bone piece positioning grooves, then the edges of key parts of the bone pieces are trimmed according to the bone piece positioning trimming plate, namely the edges of the bone piece which are approximately square at the root of the bone piece and contact with the original bone in the near and far directions of the bone piece, and the edge shape of the bone piece positioning trimming plate (except the edges connected with the grooves) is identical to the edge shape of the key parts of the bone pieces which are required to be implanted in the designed bone receiving area, so that the bone pieces can be used as references for trimming the bone pieces, the trimmed bone pieces can be well attached to the original bone in the bone receiving area as much as possible, and the increased operation time, the bone piece separation time and the risk of operation pollution caused by the fact that a doctor repeatedly places the bone pieces into the bone receiving area for trial comparison due to lack of the proper bone piece edge shape and bone area references can be effectively avoided; and after finishing, the bone slice positioning finishing plate is taken down, and the bone slice is fixed on the jaw bone by directly utilizing the bone grafting nails to penetrate through the bone grafting nail implantation guide holes on the bone slice positioning grooves, so that the bone slice can be guided to be accurately positioned and firmly fixed in the bone receiving area.

2. In the bone slice obtaining link, the bone taking area tooth positioning device has multiple functions: firstly, a bone surface can be punched by utilizing a bone taking area tooth positioning device, the hole can be used for accurately positioning a bone cutting guide plate, and can be directly used for fixing a bone cutting guide plate on a jawbone through a fixing nail; the bone cutting guide plate is fixed in the bone cutting area by utilizing the fixture nails, the bone cutting guide plate does not need to be fixed in an auxiliary manner when the bone is cut, the bone cutting guide plate part after the tooth positioning device is taken down is smaller and more comfortable for a patient, and the interference of the structures such as the tooth positioning device, the intermediate connecting device and the like on the bone cutting machinery and the visual field of doctors in the bone cutting process can be avoided. Meanwhile, the split type design of taking the bones can enable different parts to be made of different materials, for example, the osteotomy guide plate needs to guide osteotomy instruments to osteotomy, and enough strength and hardness must be ensured, so that high-strength metal materials are used, and the materials can simultaneously reduce the volume of the guide plate and reduce the notch; the tooth positioning device can be printed by using a metal material or a medical resin material for reducing the cost. Meanwhile, the bone cutting guide plate can accurately, efficiently and controllably obtain bone fragments, the size of the bone fragments to be cut is basically the same as that of the bone fragments to be implanted, a plurality of bone fragments can be obtained by using one bone cutting guide plate in the same bone taking area through the separation grooves of the bone cutting guide plate, the bone fragments are sequentially cut and taken down on the jawbone, and the problems that in the prior art, the bone fragments are difficult to cut and easily collapse and pollute due to the fact that the bone fragments are firstly obtained and then divided into a plurality of bone fragments by free hand operation can be avoided.

3. In clinical application, the dental model of the dental defect area and the bone taking area of the patient printed by using the resin material has multiple functions: firstly, the method can be used for pre-operation trial wearing of each metal guide plate, after the guide plates are printed, each guide plate can be respectively tried on a dental bone model of a printed dental defect area and a dental bone taking area, once the situation that the guide plates cannot be positioned and the like occurs, corresponding grinding adjustment or redesign production can be carried out in time according to the situation before operation, and the situation that the guide plates cannot be used in operation can be avoided; in addition, because the whole bone grafting area after bone grafting is covered with the collagen film in clinical application, the absorbable collagen film can be cut in vitro by using the reference of the guide plate of the dental bone model positioned in the tooth deficiency area; in addition, the trimmed bone chips can be placed into the bone chips and the implant guide plate of the implant and then placed into the dental bone model of the dental area, the trimmed bone chips are ground at the moment to remove the collected autogenous crushed bone and fill the internal gaps of the bone chips and the dental bone model of the dental area, then the artificial granular bone substitute material is poured into the gap until the gap is completely filled, thus the volume of the artificial granular bone substitute material which can be definitely needed to be implanted is poured into a sterile cup for full mixing, and finally the mixed granular bone mixture is filled after the bone chips are fixed in the intraoral bone receiving area.

4. According to the invention, all bone drill drilling operations are completed under the guidance of the guide drilling holes according to the designed position, direction and depth, and the bone drill, the bone grafting nail and the implant can avoid the anatomical structures of nerves, blood vessels, adjacent tooth roots and upper jaw Dou Dengchong in the jawbone through the digital virtual software design, and meanwhile, the implant can not be implanted at the same time when the bone grafting is performed due to the mutual interference of the bone grafting nail and the implanted implant, so that the operation safety can be improved; according to the guide plate proposal provided by the invention, all drilling operations can be directly operated on the whole jawbone of a patient, and the problems of careless collapse, pollution and difficult drilling of the bone fragments caused by difficult fixation of the free bone when the removed free bone fragments (fragments) are drilled in the previous operation can be effectively avoided.

5. The invention can be combined with other designs to increase corresponding functions, and for a patient needing to lift the maxillary sinus at the same time, a windowing guide plate of the maxillary sinus can be designed, in particular, a maxillary sinus windowing groove is designed by sketching on a lip (cheek) side bone plate positioning and trimming plate; meanwhile, if the jawbone is buried with multiple teeth and buried with stumps, the corresponding indication window can be designed on the labial (buccal) bone slice positioning and trimming plate for corresponding guiding in operation or be independently connected with the bone receiving area tooth positioning device to serve as another part of the guide plate.

6. All the components of the invention can be connected into two whole bodies, the bone slice and the implant guide plate of the implant and the bone slice positioning and trimming plate can be fixed on the dental model of the dental defect area by using the slender screw, and the bone taking area dental positioning device and the bone cutting guide plate can be fixed on the dental model of the bone taking area by using the slender screw, so that all the components of the whole-course guide plate for the bone slice interlayer bone grafting synchronous planting can be connected into the dental defect area and the bone taking area into two whole bodies by the slender screw, thereby providing convenience for storage, disinfection, transfer and clinical use of the guide plate

Drawings

FIG. 1 is an enlarged schematic view of the structure of an implant guide plate, bone fragment positioning and trimming plate of the bone fragment and implant of the present invention;

FIG. 2 is an enlarged schematic view of the left side view of the implant guide plate, bone fragment positioning and trimming plate of the bone fragment and implant of the present invention;

FIG. 3 is an enlarged schematic view of the rear side view of the implant guide plate, bone fragment positioning and trimming plate of the bone fragment and implant of the present invention;

FIG. 4 is a schematic side structural view of an implant guide plate with bone plate positioning and trimming plate of the bone plate and implant of the present invention, matching a digitized virtually designed bone plate to be implanted, a digitized virtually designed bone nail to be implanted, and a digitized virtually designed implant to be implanted;

FIG. 5 is a schematic view of the use and installation of a digitized virtual design of a bone fragment to be implanted, a digitized virtual design of a bone screw, and a digitized virtual design of a bone implant to be implanted in a top view;

FIG. 6 is a schematic view of the use and installation of the implant guide plate with bone plate positioning and trimming plate of the bone plate and implant of the present invention;

FIG. 7 is an enlarged schematic view of the structure of the osteotomy guide plate of the present invention;

FIG. 8 is an enlarged schematic view of the structure of the osteotomy guide retention nail of the digital virtual design for attachment of the osteotomy guide of the present invention;

FIG. 9 is an enlarged schematic view of the structure of the bone removal area tooth positioning device of the present invention;

FIG. 10 is an enlarged view of the structure of the bone removal region tooth positioning device of the present invention after being mated with an osteotomy guide plate;

FIG. 11 is a schematic view of the use and installation of the bone removal region tooth positioning device of the present invention in combination with an osteotomy guide plate;

FIG. 12 is a schematic view of the use of the osteotomy plate of the digitized virtual design of the present invention;

FIG. 13 is an enlarged schematic view of a digitized virtual design of a bone fragment to be implanted a and a digitized virtual design of a bone fragment to be implanted b of the present invention;

FIG. 14 is a schematic view of the overall assembly use and installation of a full-length guide plate for bone slice interlayer bone graft contemporaneous planting according to the present invention.

In the figure:

1-an implant guide ring; 2-a receiving area tooth positioning substrate; 3-connecting rod a; 4-bone slice positioning groove a; 5-bone slice positioning groove b; 6-bone fragment positioning and trimming plate a; 7-bone fragment positioning and trimming plate b; 8-connecting rod b; 9-guiding the drill hole a1;10 guiding the drill hole a2; 11-guiding the drill hole b1; 12-guiding the drilling hole b2; 13-guiding the drill point ring a1; 14-guiding the drill point ring a2; 15-guiding the drill point ring b1; 16-guiding the drill point ring b2; 17-bone grafting nails are implanted into the guide holes a1; 18-bone grafting nails are implanted into the guide holes a2; 19-bone grafting nails are implanted into the guide holes b1; 20-bone grafting nails are implanted into the guide holes b2; 21-bone fragment in-place viewing window; 22-taking a bone region tooth positioning substrate; 23-guiding the drilling hole A1; 24-guiding the drilling hole A2; 25-guiding the drill point ring A1; 26-guiding the drill point ring A2; 27-guiding the drilling hole c; 28-guiding the drill point ring c; 29-connecting rod d; 30-osteotomy guide retention hole c; 31-osteotomy guide plate 1; 32-osteotomy guide plate 2; 33-osteotomy guide plate 3; 34-osteotomy guide plate 4; 35-osteotomy guide plate 5; 36-osteotomy guide spacer frame; 37-digitizing the virtually designed implant to be implanted; 38-digitizing the virtual designed bone fragment a to be implanted; 39-digitizing the virtual designed bone fragment to be implanted b; 40-digitizing the virtually designed bone graft nail a1; 41-digitizing the virtually designed bone graft nail a2; 42-an outer frame of the osteotomy guide plate; 43-outer frame wire of osteotomy guide plate; 44-connecting rod c; 45-digitizing the virtually designed osteotomy guide plate retention nails; 46-a bone grafting nail hole a1 with a digital virtual design; 47-digitally virtually designed bone-grafting nail holes a2; 48-cutting guide plate separating cutting grooves; 49-digitizing the virtual design of the jawbone osteotomy plane; 50-a dental model of the edentulous area; 51-taking a dental bone model of the bone region.

Detailed Description

The following examples are illustrative of the invention and are not intended to limit the scope of the invention.

See fig. 1-13;

The use method of the invention (which can be operated on a model):

1. try-on: fitting bone chips and implant guide plates and bone chip positioning and trimming plates of implants on the dental bone model of the tooth-missing area; fitting the bone taking area tooth positioning device and the bone cutting guide plate on the bone taking area tooth model, and if the guide plate cannot be positioned in place, the positioning is unstable and the like during fitting, re-designing and manufacturing corresponding components in time;

2. and (3) disinfection: the method comprises the steps of (1) sterilizing all metal parts of a whole-course guide plate for bone slice interlayer bone grafting synchronous planting by using a high-pressure high-temperature sterilizer before operation; sterilizing the dental bone model of the edentulous area and the dental bone model of the bone taking area of the resin material by using ethylene oxide for sterilization;

3. exposing the bone surface of the operative region: the position of the guide plate is designed with a notch when the examination is worn, and the bone surfaces of the tooth missing area and the bone taking area are respectively exposed;

4. implant implantation in the edentulous area and drilling of the original bone: the bone slice and the implantation guide plate of the implant are positioned at the corresponding tooth position of the tooth missing area, the groove part of the tooth positioning substrate of the receiving area is completely attached to the surface of the corresponding tooth, a series of hole preparation drill pins of the implant cavity and pressing plates matched with the inner diameters of the implant guide rings are used for preparing the implant cavity along the holes in the implant guide rings, the original bone of the tooth missing area is subjected to implant cavity preparation according to the designed drilling depth, after the cavity preparation is finished, a plurality of implants of corresponding types are implanted along the implant guide rings, and the implant implantation operation is finished; then a plurality of bone slice positioning trimming plates are connected with corresponding bone slice positioning grooves through guide drill rings and bone grafting nails which are implanted into guide holes in a bolt mode, bone drills are used for drilling original bones in a tooth-missing area along guide drill holes on the bone slice positioning trimming plates according to designed drilling depths, and after drilling is completed, bone slices and implant implantation guide plates of implants are taken down together with the bone slice positioning trimming plates connected with the bone slice positioning trimming plates;

4. Drilling holes in a bone taking area, positioning and fixing a bone cutting guide plate: positioning the bone taking area tooth positioning device on the corresponding bone taking area tooth row of the patient, enabling the groove part of the bone taking area tooth positioning substrate to be completely attached to the surface of the corresponding tooth, drilling holes on the bone surface according to the designed drilling depth by using a bone drill along the inner diameter of a plurality of guide drill holes on the bone taking area tooth positioning device, and taking down the bone taking area tooth positioning device after all drilling holes are completed; at this time, a plurality of screw retention holes are reserved on the bone surface of the bone site to be extracted, the screw retention holes are correspondingly matched with the positions of a plurality of bone cutting guide plate retention holes on the bone cutting guide plate, the bone cutting guide plate retention holes on the bone cutting guide plate are correspondingly matched with the positions of the holes on the bone surface which are completed under the guidance of the guide drilling holes c of the tooth positioning device of the bone extraction area, and the bone cutting guide plate is directly fixed on the bone surface of the bone site to be extracted along the inner diameter of each bone cutting guide plate retention hole by using screws;

5. obtaining autologous bone fragments by using an osteotomy guide plate: the method comprises the steps of firstly clinging to four osteotomy guide plates at the outermost side of an osteotomy guide plate by using ultrasonic bone knives or splitting drills and other instruments, cutting bones according to the position and the direction indicated by the osteotomy guide plates and the osteotomy depth of each designed plane, then cutting off a first autologous bone piece, taking out the bone piece at the outermost side with bone grafting nail holes, cutting off the bone piece along the osteotomy guide plate separation grooves by using splitting drills, cutting off and taking off the bone cutting guide plate separation frames, and continuing to complete osteotomy along the osteotomy guide plates in a grid at the inner side of the bone cutting guide plates, so that the next bone piece is obtained, and repeating the steps until all the designed bone pieces with bone grafting nail holes are obtained; loosening the retention nails of the osteotomy guide plate, and removing the osteotomy guide plate;

6. Positioning and trimming the removed plurality of autologous bone fragments: placing the obtained bone fragments into corresponding bone fragment positioning grooves connected with bone fragment positioning and trimming plates, enabling bone grafting nail holes on the bone fragments to be correspondingly matched with guide drilling holes on the bone fragment positioning and trimming plates so as to position accurate positions of the bone fragments in the bone fragment positioning grooves, trimming the bone fragments along the root and near-far side edges of the bone fragment positioning and trimming plates and the near-far side edges of the bone fragment positioning grooves by using tools such as a straight grinding head and the like, removing redundant parts on the bone fragments, taking down the bone fragment positioning and trimming plates after trimming, putting an implantation guide plate with the bone fragments and an implant into a dental model of a dental defect area, checking the fitting condition of the bone fragment edges and the part representing original bone on the dental model of the dental defect area, and continuing trimming the bone fragments until the fitting condition of the bone fragments and the dental model of the dental defect area representing the original bone is good if the fitting condition exists;

7. obtaining proper amount of mixture of autogenous crushed bones and artificial granular bone substitute materials which are uniformly mixed: grinding the autologous crushed bone blocks obtained in the process of trimming the bone fragments into granular autologous crushed bone, pouring the granular autologous crushed bone blocks into the space between the bone fragments which are put in the implant guide plate of the implant and put on the dental bone model in the tooth-missing area in the step 6, pouring artificial granular bone substitute materials into the rest gaps between the bone fragments until the designed bone increment space between the bone fragments is filled, and then collecting the granular autologous crushed bone between the bone fragments and the artificial granular bone substitute materials into a sterile container and fully and uniformly mixing the granular autologous crushed bone and the artificial granular bone substitute materials for standby;

8. Positioning and fixing bone fragments in the tooth-missing area: the bone slice positioning and trimming plate is taken down, the bone slice with the bone slice and the implant are put on the corresponding positions of the tooth-missing area, a plurality of bone-planting nails sequentially penetrate through the bone-planting nail implantation guide holes on the implant guide plate of the corresponding bone slice and implant, the bone-planting nail holes on the bone slice, the holes on the original bone of the tooth-missing area, the bone-planting nail holes on the bone slice on the other side, and the bone-planting nail guide holes on the implant guide plate of the bone slice and implant on the other side, so that the bone slice is accurately fixed on the original bone of the tooth-missing area according to the designed positions, and then the implant guide plate of the bone slice and implant is taken down;

9. implanting a particulate bone augmentation material: implanting the uniformly mixed bone increment material obtained in the step 7 between bone fragments;

10. stitching: and performing tension-reducing stitching on the soft tissues of the osteogenic region, and stitching the osteogenic region.

Because the invention is a personalized combined guide plate, all parts of the guide plate need to be integrated into a whole, and the cross exchange with other parts of the guide plate is prevented; therefore, before the invention is used for disinfection, the bone slice and the implant guide plate and the bone slice positioning and trimming plate of the implant can be fixed on the tooth bone model of the tooth-missing area by using the slender screw, and the tooth positioning device of the bone taking area and the bone cutting guide plate can be fixed on the tooth bone model of the bone taking area by using the slender screw to form two parts, thereby being convenient for matched disinfection and storage; refer to fig. 14.

As described above, the present invention can be more fully realized. The foregoing is merely a more reasonable embodiment of the present invention, and the scope of the present invention is not limited thereto, and any insubstantial modifications of the present invention based on the technical solution of the present invention are included in the scope of the present invention.

Claims

1. A whole baffle that is used for bone piece intermediate layer to plant bone synchronization planting, its characterized in that: the implant guide plate, the bone piece positioning and trimming plate, the bone taking area tooth positioning device, the bone cutting guide plate, the tooth missing area tooth model and the bone taking area tooth model are included, the implant guide plate top of the bone piece and the implant is connected with the bone piece positioning and trimming plate bottom, the bone cutting guide plate can be connected with the bone taking area tooth positioning device and also can be fixed in the bone taking area according to the plurality of positioning points, and the tooth missing area tooth model and the bone taking area tooth model can be used for guide plate trial wear.

2. A full-stroke guide for use in bone slice interlayer bone graft contemporaneous planting as claimed in claim 1, wherein:

the bone piece and implant implantation guide plate comprises an implant guide ring (1), a receiving area tooth positioning substrate (2), a connecting rod a (3), a bone piece positioning groove a (4), a bone piece positioning groove b (5) and a connecting rod b (8); the receiving area tooth positioning substrate (2) is connected with the implant guiding ring (1) through a connecting rod a (3), and the bone piece positioning groove a (4) and the bone piece positioning groove b (5) are connected with the receiving area tooth positioning substrate (2) through a connecting rod b (8); the bone slice positioning groove a (4) comprises a bone grafting nail implantation guide hole a1 (17), a bone grafting nail implantation guide hole a2 (18) and a bone slice in-place observation window (21), and the bone slice positioning groove b (5) comprises a bone grafting nail implantation guide hole b1 (19) and a bone grafting nail implantation guide hole b2 (20).

3. A full-stroke guide for use in bone slice interlayer bone graft contemporaneous planting as claimed in claim 1, wherein:

the bone piece positioning and trimming plate comprises a bone piece positioning and trimming plate a (6) and a bone piece positioning and trimming plate b (7); wherein the bone slice positioning and trimming plate a (6) comprises a guiding drill point ring a1 (13) and a guiding drill point ring a2 (14), a hole passage in the middle of the guiding drill point ring a1 (13) is a guiding drill point hole a1 (9), and a hole passage in the middle of the guiding drill point ring a2 (14) is a guiding drill point hole a2 (10); the bone slice positioning and trimming plate b (7) comprises a guide drill point ring b1 (15) and a guide drill point ring b2 (16), wherein a hole passage in the middle of the guide drill point ring b1 (15) is a guide drill point hole b1 (11), and a hole passage in the middle of the guide drill point ring b2 (16) is a guide drill point hole b2 (12); the bone piece positioning and trimming plate a (6) and the bone piece positioning and trimming plate b (7) can be connected through the bone grafting nail a1 (40) which is designed in a digital virtual mode and the bone grafting nail a2 (41) which is designed in a digital virtual mode.

4. A full-stroke guide for use in bone slice interlayer bone graft contemporaneous planting as claimed in claim 1, wherein:

the bone taking area tooth positioning device comprises a bone taking area tooth positioning substrate (22), a guiding drill point ring A1 (25), a guiding drill point ring A2 (26), a guiding drill point ring c (28), a connecting rod d (29) and a connecting rod c (44); wherein, the hole passage in the middle of the guide drill point ring A1 (25) is a guide drill point hole A1 (23), the hole passage in the middle of the guide drill point ring A2 (26) is a guide drill point hole A2 (24), and the hole passage in the middle of the guide drill point ring c (28) is a guide drill point hole c (27);

5. The method for manufacturing the whole-course guide plate for bone slice interlayer bone grafting synchronous planting according to claim 1, which is characterized by comprising the following design steps:

2) Designing a dental-deficiency area to-be-implanted implant model and a to-be-implanted bone slice model: in the Mimics Research software, a standard dental crown model of a corresponding dental deficiency site is imported, the standard dental crown model is moved to a dental deficiency area by utilizing a command of ' Move ' and ' Rotate ', a plurality of target dental crown restoration bodies are formed according to the shapes of the dental deficiency gap, adjacent teeth and the standard dental crown model, a plurality of implant-like bodies corresponding to the target dental crown design are arranged, the implant-like bodies can be represented by cylinders with different diameters and lengths generated by a command of ' Analyze ' menu ' to ' Cylinder ' to ' Draw ', the number of implant-like bodies is at least 1, the implant-like bodies are ensured to be positioned in a jaw bone to obtain enough initial stability, the position and angle of the implant-like bodies can meet the restoration requirement of the target dental crown restoration bodies, the long axis of the implant-like bodies generally penetrates out from the central position of the front lingual side or rear occlusal side of the target dental crown restoration bodies, and the crest top side of the implant-like bodies is approximately 3-4mm away from the gingival margin position of the target dental crown; then reconstructing the target bone increment alveolar bone morphology of the bone defect part of the tooth-missing area, which comprises the following specific steps: the method comprises the steps that a plurality of cylinders representing an implant to be implanted are copied through a 'duplex' command, a cylinder model obtained through right click copying is selected, a 'Properties' command is selected, a Radius value is increased by 2mm, a plurality of new cylinders which are 2mm larger than the Radius of the implant cylinder can be obtained, according to the requirement that the periphery of the implant needs to have 2mm of bone mass to keep the long-term stability of the implant, the plurality of thickened cylinders represent the requirement of an increase range of bone mass, a plurality of sheets with the thickness of about 0.5-2mm are respectively generated on the lip side or the cheek side and the tongue side or the palate side of the thickened cylinders, the thickened cylinders are completely positioned inside bone sheets on the lip side or the cheek side and the tongue side or the palate side and are in contact with the bone sheets, the bone sheet angle is adjusted, the root side and the near-far middle side of the bone sheets can be in more contact with the rest alveolar bone of an edentum zone, the crest top side of the bone sheets and the crest top side of the implant are slightly beyond the top position of the implant by 380-1 mm of the crown top of the implant, the number of the crown top of the implant is designed to be approximately equal to the crest top of the bone mass of the implant, and the depth of the bone mass is 0-1mm is designed to be in the depth of the ultra-0 mm of the bone mass in the depth of the model, and the depth of the bone model is designed to be in the depth of the ridge-0 mm; then, a plurality of long cylinders which are approximately perpendicular to the bone plate to be implanted model and penetrate through the bone plates on the labial side or the buccal side and the lingual side or the palate side and the original bone in the tooth-missing area at the same time, wherein the diameter of the long cylinders is 1-2mm, the positions and the angles of the long cylinders need to avoid important anatomical structures of tooth roots, nerves and blood vessels in the implant to be implanted and the jaw bone in the tooth-missing area, and a safe distance of more than 1-2mm is reserved, and the long cylinders represent a plurality of bone grafting nails for fixing the bone plate to be implanted in the jaw bone, so that a bone grafting nail model with a digital virtual design is obtained; then, the bone plate model to be implanted and the bone nail model are subjected to subtraction according to the command of Boolean Operation to sub so as to obtain the bone plate model to be implanted with a plurality of bone nail holes;

3) Manufacturing an implantation guide plate of a bone plate and an implant: in Geomagic Studio software, sequentially right clicking the cylinder models designed in the step 2) to represent the implant to be implanted, selecting a 'duplex' command for replication, changing the height of the replicated cylinders, generating a plurality of new cylinders, enabling the heights of the new cylinders to be from 3mm away from the top of an original bone ridge of a tooth missing region to 7mm away from the top of the original bone ridge of the tooth missing region, namely, 4mm in length, selecting a pressing plate with a proper diameter according to the radius of the pressing plate in the selected planting guide tool box, newly creating a plurality of thickened cylinders with the same axes and lengths as the new cylinders and the radius larger than the radius of the pressing plate in the selected planting guide tool box by 2mm, a plurality of cylinders representing the pressing plates, the axes and the lengths of which are the same as those of the new cylinders, and the radiuses of which are the same as those of the pressing plates in the selected planting guide plate tool box, are newly built, the thickened cylinders and the cylinders representing the pressing plates are subtracted by utilizing a Boolean command, a plurality of planting body guide rings with the lengths of 4mm and the thicknesses of 2mm are obtained, the passages in the middle of the planting body guide rings are paths for planting the planting body, the positions and the angles of the planting body guide rings can guide the positions and the angles of the planting body, the height positions of the planting body guide rings can prompt the depth positions of the planting body, and the planting body guide rings can accurately guide the preparation of planting holes and the accurate planting of the planting body when being matched with the pressing plates in the matched planting guide plate tool box; cutting to obtain sheets on the square surfaces of the outline high-point crowns of a plurality of non-loosening crowns adjacent to the tooth-missing region on the two sides of the tooth-missing region by utilizing the commands from 'Polygons' to 'Trim with Curve', thickening the cut crowns Shell sheets to 1-2mm along the outer side direction of the crowns to form a receiving-region tooth positioning substrate model, wherein the receiving-region tooth positioning substrate model is a concave Shell with the thickness of 1-2mm, and the inner concave surface is consistent with the corresponding crown surface; selecting a plurality of inner side surface thin sheets and outer side surface thin sheets of a bone plate model to be implanted and a surface thin sheet model of a crest top surface close to the crest top of an tooth socket by utilizing a Bounded Components function, thickening 3 thin sheet planes selected from each bone plate model to form a groove-shaped device along the outer side direction of the bone plate model by utilizing a Polygons-Shell command until the thickness is 0.5-1mm, respectively extending a cylinder model representing bone nails to be implanted into the bone plate to form a plurality of new cylinders along two ends of a long axis of the cylinder by 2-3mm, generating a thickened cylinder with the same axis and length as the plurality of new cylinders and with the radius increased by 1-2mm, subtracting the plurality of groove-shaped devices from the plurality of thickened cylinders by utilizing a Boolean-Substract command to obtain a plurality of groove-shaped devices with preliminary bone nail implantation guide holes, then subtracting a plurality of thickened cylinders from a new cylinder by using a 'Boolean' command, obtaining a plurality of hollow rings, cutting the hollow rings by using the inner side surface Plane of the vertical outer side groove plate of each groove-shaped device by using the 'polygens' to 'Trim with Plane' function, deleting the cut part in the middle of the hollow rings, reserving the short hollow rings which are positioned on the outer side groove plate of each groove-shaped device and are implanted into the inner side of the guide hole and the outer side of the groove-shaped device far away from the original bone by using the preliminary bone grafting nail on the outer side groove plate of each groove-shaped device, the reserved short hollow rings are guide drill needle rings, the middle passage in the guide drill needle rings is guide drill holes, can be used for guiding the drilling holes to punch the original bone in the tooth-missing area, adding the guide drill needle rings and the groove-shaped devices by using the 'Boolean' Union command, obtaining preliminary bone piece positioning grooves, then the functions of 'Polygons' - 'Trim with Plane' are utilized, and the planes which bisect the plurality of guiding drill point rings along the horizontal direction are utilized to divide and copy the preliminary bone slice positioning grooves

The method comprises the steps of 'duplex' deleting the guide drill rings of the two preliminary bone piece positioning grooves corresponding to 'Delete' and the parts of the lip side or cheek side and tongue side or palate side and the root parts of the guide drill rings, then manufacturing bone piece positioning observation windows, so as to obtain a plurality of bone piece positioning grooves, reserving semicircular bone piece implantation guide holes on the bone piece positioning grooves, adding the corresponding copied parts, namely the guide drill rings and the parts of the root parts of the preliminary bone piece positioning grooves by using 'Boolean' to 'Union' commands to generate a bone piece positioning and trimming plate, wherein the bone piece positioning and trimming plate is provided with the guide drill rings, the guide drill rings are connected with the bone piece implantation guide holes on the corresponding bone piece positioning grooves in an inserting mode, the bone piece positioning and trimming plate can be inserted into the bone piece positioning grooves to form a combined device by using the guide drill rings on the bone piece positioning and trimming plate to be jointly used for punching the original bone in a tooth missing area, and after the bone piece positioning and trimming plate is taken down, the bone piece positioning and guiding bone piece implantation guide nails on the bone piece positioning grooves can be implanted by using the bone piece positioning pins on the bone piece positioning grooves; designing a rod-shaped connecting structure to connect a plurality of implant guide rings and a receiving area tooth positioning substrate model, marking the connecting structure as a connecting rod a, designing a rod-shaped connecting structure to connect a plurality of bone piece positioning grooves and a receiving area tooth positioning substrate model, marking the connecting structure as a connecting rod b, finally combining the implant guide ring model, the receiving area tooth positioning substrate model, the connecting rod a model, the bone piece positioning groove model and the connecting rod b model by utilizing a menu bar ' Polygons ' -Combine ' command to form an integrated device, namely an implant guide plate of bone piece and implant, observing a positioning channel of the implant guide plate, ensuring that the implant guide plate can be positioned on the tooth-lacking area tooth model without interference, namely ensuring that the implant guide plate can be positioned without interference in a state of cutting open exposed bone surfaces of soft tissues in an operation;

4) Selecting a bone taking area and generating an osteotomy guide plate: in Geomagic Studio software, the 'Object Mover' function under the 'Tools' menu is utilized to enable the plurality of digital virtual design bone fragment models with bone grafting nail holes generated in the step 2) to be moved in parallel and overlapped together along the long axis direction of the digital virtual design bone grafting nails, the bone fragment models which are overlapped together in parallel are combined to form a whole, namely the bone fragment combined model with the bone grafting nail holes, by utilizing the menu bar 'Polygons' to 'Combine' command, the bone fragment combined model is moved to a safe bone extraction area of the jaw bone model by utilizing the 'Tools' to 'Object Mover' function, the placement of the bone fragment combined model is adjusted, the bone fragment combined model is placed at a proper bone extraction site, and the position of the bone fragment combined model is adjusted to ensure that: (1) the bone slice combination model is at least 2-3mm away from important anatomical structures such as a jawbone nerve tube, a blood vessel, a tooth root and the like; (2) the direction of the bone grafting nail hole on the bone slice combination model is approximately perpendicular to the jaw surface of the bone taking area; (4) the bone slice combination model is completely positioned in the jaw bone tissue of the bone taking area; (5) the outer contour surface of the bone slice combination model is close to the bone surface of the bone taking area as much as possible; making a projection form of the bone slice combination model on the jaw surface of the bone taking area along the direction of the bone grafting nail hole on the bone slice combination model, generating a plurality of straight line and/or curve osteotomy lines and osteotomy planes according to the outermost peripheral outline of the surface slice obtained by projection, and making a plurality of vertical osteotomy planes according to the dividing planes among a plurality of bone slices in the bone slice combination model; selecting the jaw surface around the bone region, uniformly thickening the selected jaw surface sheet to the outer side of the jaw by 2-3mm by using a command of 'Polygons' to 'Shell' to form a jaw surface sheet, combining each osteotomy plane with the sheet by using a command of a menu bar 'Polygons' to 'Combine', and then using the sheet

The commands of 'Polygons' - 'Trim with Plane'/'Trim with Curve' draw the outer frame line of the osteotomy guide plate, ensure: (1) a distance of 1-2mm is reserved between the outer frame line of the osteotomy guide plate and each osteotomy plane, and the distance is the width of the outer frame of the osteotomy guide plate; (2) a plurality of long cylinders with the diameter of 1-2mm are designed between the outer frame line of the osteotomy guide plate and the osteotomy plane and used for representing the osteotomy guide plate retention nails, the positions and the angles of the long cylinders are adjusted, so that 2-3mm safe distances are reserved between the implantation positions and important anatomical structures, and the periphery of the retention nails is about 1-2mm wide from the outer frame line of the osteotomy guide plate; the overlapping part between the plurality of osteotomy planes and the thickened jaw surface thin plate is a plurality of osteotomy guide plates, the part of the thickened jaw surface thin plate between the osteotomy guide plates and outside the outline border line of the osteotomy guide plates is deleted to form a preliminary osteotomy guide plate model, wherein a plurality of horizontal division frames between the vertical division planes are the division frames of the osteotomy guide plates, linear shallow grooves are formed at the juncture of the division frames of the osteotomy guide plates and the outer frame of the osteotomy guide plates, namely the division cutting grooves of the osteotomy guide plates are formed, the positions for cutting the osteotomy guide plates can be indicated in the operation, and then the osteotomy guide plate model with a plurality of osteotomy guide plate retention holes c can be obtained by carrying out ' Boolean ' sub ' operation on a plurality of long cylinders representing osteotomy guide plate retention nails and the osteotomy guide plate model;

5) Generating a bone taking area tooth positioning device: in Geomagic Studio software, a plurality of new cylinders which are the same as the axis of the long cylinder representing the osteotomy guide plate retention nail in the step 4) and have the diameter and the height of 5-6mm are newly built, the space positions of the new cylinders are adjusted along the long axis to be 1-2mm away from the jaw surface of the osteotomy region, and the new cylinders and the long cylinder representing the osteotomy guide plate retention nail in the step 4) are subjected to 'Boolean' to 'sub' operation to obtain a plurality of guide drill needle ring c models of the osteotomy region tooth positioning device, wherein the middle holes are guide drill needle holes c; newly creating a plurality of new cylinders which are the same as the axes of the long cylinders representing bone grafting nails moving to the bone grafting region in the step 4) and have the diameters and the heights of 5-6mm, adjusting the spatial positions of the new cylinders along the long axes to ensure that the spatial positions are 1-2mm away from the jaw bone surface of the bone grafting region, and then carrying out Boolean ' to ' sub ' operation on the new cylinders representing the bone grafting nails on the bone grafting region combined model in the step 4) to obtain a plurality of guide drill needle ring models of the bone grafting region tooth positioning device, wherein the middle holes are guide drill needle holes; cutting the high-point crown square surfaces of the shapes of the plurality of non-loosening crowns adjacent to the bone taking area by utilizing the commands from the Polygons to the Trim with the Curve, thickening the cut sheet to 1-2mm along the external direction of the crowns by utilizing the commands from the Polygons to the Shell to form a bone taking area tooth positioning substrate model, wherein the inner concave surface of the tooth positioning substrate model is consistent with the corresponding crown surface; setting a rod-shaped connecting structure to connect a plurality of guide drill needle ring models and bone taking area tooth positioning substrate models, marking the connecting structure as a connecting rod c, setting the rod-shaped connecting structure to connect a plurality of guide drill needle ring models and bone taking area tooth positioning substrate models, and marking the connecting structure as a connecting rod d; finally, the guide drill point ring model c, the guide drill point ring model, the bone taking area tooth positioning base plate model, the connecting rod c model and the connecting rod d model are combined by utilizing a menu bar 'Polygons' to 'Combine' command to form an integral device, the positioning channel is observed, the bone taking area tooth model can be ensured to be positioned without interference, namely, the condition that the exposed bone surface of the soft tissue can be cut in operation is indicated, and the integral device is the bone taking area tooth positioning device.

6. A whole baffle subassembly that is used for bone slice intermediate layer to plant bone synchronization to plant: in Geomagic studio software, placing a bone piece and an implant guide plate and a bone piece positioning and trimming plate of an implant at corresponding positions of a primary dental defect area dental bone model, subtracting the bone nail which is designed in a digital virtual mode from the primary dental defect area dental bone model by using a Boolean command to obtain a dental defect area dental bone model with a bone nail hole, and fixing the implant guide plate and the bone piece positioning and trimming plate of the bone piece and the implant on the dental defect area dental bone model by using an elongated screw; the bone taking area tooth positioning device and the bone cutting guide plate are placed at the corresponding positions of the preliminary bone taking area tooth model, the digital virtual design bone cutting guide plate retention nails and the preliminary bone taking area tooth model are subtracted by using a 'Boolean' to 'partial' command to obtain the bone taking area tooth model with retention nail holes, the bone taking area tooth positioning device and the bone cutting guide plate can be fixed on the bone taking area tooth model by using the slender screws, and all guide plate components are placed in the same coordinate system, so that all components of the whole guide plate for bone slice interlayer bone grafting synchronous planting can be connected into a tooth deficiency area and a bone taking area through the slender screws, and convenience is provided for storage, disinfection, transfer and clinical use of the guide plate;

8) Introducing the whole guide plate for bone plate interlayer bone grafting synchronous planting generated in the step 6) into three-dimensional printing software, and three-dimensionally printing a medical titanium alloy material or a cobalt-chromium alloy metal material to manufacture an implant guide plate, a bone plate positioning and trimming plate, a bone taking area tooth positioning device and an osteotomy guide plate of a bone plate and an implant; printing a dental bone model of a tooth-missing area and a dental bone model of a bone-taking area by using a medical resin material.