CN117679142A - Intraoral double-layer cortical bone piece bone grafting guide plate and manufacturing method thereof - Google Patents
Intraoral double-layer cortical bone piece bone grafting guide plate and manufacturing method thereof Download PDFInfo
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- CN117679142A CN117679142A CN202311788575.XA CN202311788575A CN117679142A CN 117679142 A CN117679142 A CN 117679142A CN 202311788575 A CN202311788575 A CN 202311788575A CN 117679142 A CN117679142 A CN 117679142A
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 256
- 230000001054 cortical effect Effects 0.000 title claims abstract description 35
- 238000004519 manufacturing process Methods 0.000 title claims abstract description 24
- 230000014759 maintenance of location Effects 0.000 claims abstract description 133
- 210000003254 palate Anatomy 0.000 claims abstract description 92
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 claims abstract description 57
- 229910052719 titanium Inorganic materials 0.000 claims abstract description 57
- 239000010936 titanium Substances 0.000 claims abstract description 57
- 210000002455 dental arch Anatomy 0.000 claims abstract description 7
- 238000002513 implantation Methods 0.000 claims abstract description 5
- 239000007943 implant Substances 0.000 claims description 26
- 239000000758 substrate Substances 0.000 claims description 15
- 210000001847 jaw Anatomy 0.000 claims description 12
- 230000007547 defect Effects 0.000 claims description 10
- 238000005520 cutting process Methods 0.000 claims description 8
- 238000000034 method Methods 0.000 claims description 8
- 239000000463 material Substances 0.000 claims description 6
- 210000004513 dentition Anatomy 0.000 claims description 5
- 230000036346 tooth eruption Effects 0.000 claims description 5
- 238000003384 imaging method Methods 0.000 claims description 3
- 230000002093 peripheral effect Effects 0.000 claims description 3
- 230000000717 retained effect Effects 0.000 claims description 3
- 210000004872 soft tissue Anatomy 0.000 claims description 3
- 210000001519 tissue Anatomy 0.000 claims description 3
- 238000002591 computed tomography Methods 0.000 claims description 2
- 230000011218 segmentation Effects 0.000 claims description 2
- 230000008719 thickening Effects 0.000 claims description 2
- 206010044048 Tooth missing Diseases 0.000 claims 4
- 210000000332 tooth crown Anatomy 0.000 claims 4
- 239000012634 fragment Substances 0.000 description 28
- 238000005516 engineering process Methods 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 208000014674 injury Diseases 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 238000007408 cone-beam computed tomography Methods 0.000 description 2
- 230000001419 dependent effect Effects 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 238000009966 trimming Methods 0.000 description 2
- 210000001909 alveolar process Anatomy 0.000 description 1
- 230000003416 augmentation Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000001627 detrimental effect Effects 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000000214 mouth Anatomy 0.000 description 1
- 230000011164 ossification Effects 0.000 description 1
- 201000001245 periodontitis Diseases 0.000 description 1
- 230000000250 revascularization Effects 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
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Abstract
The invention relates to the technical field of oral implantation, in particular to an intraoral double-layer cortical bone sheet bone grafting guide plate and a manufacturing method thereof. The guide plate comprises a bone receiving area tooth supporting type base plate for covering a dental arch, wherein a labial bolt channel and a palate bolt channel are arranged on the bone receiving area tooth supporting type base plate, a labial bone piece retention splint is detachably arranged in the labial bolt channel through a labial bone piece retention splint connector, and a palate bone piece retention splint is detachably arranged in the palate bolt channel through a palate bone piece retention splint connector; the elevation of the labial bone plate retention splint is provided with at least one labial bone plate retention titanium nail assembly indicating hole which is matched with the fixed titanium nail and used for indicating the position of the fixed titanium nail, and the elevation of the palate bone plate retention splint is provided with at least one palate bone plate retention titanium nail assembly indicating hole which is matched with the fixed titanium nail and used for indicating the position of the fixed titanium nail. The intraoral double-layer cortical bone plate bone grafting guide plate has the advantages of simple structure, reasonable design, convenience in use, reduction of operation errors and reduction of operation difficulty.
Description
Technical Field
The invention relates to the technical field of oral implantation, in particular to an intraoral double-layer cortical bone sheet bone grafting guide plate and a manufacturing method thereof.
Background
Severe periodontitis, trauma, long-term missing teeth, or failed implants, etc., can create alveolar ridge horizontal and vertical three-dimensional bone defects, and it is challenging to reconstruct such severe bone defects and obtain long-term stable aesthetic effects. Autologous bone grafting is currently the gold standard for the reconstruction of severe bone defects. The three-dimensional bone reconstruction is carried out by adopting a cortical bone slice technology, namely, a traditional autologous bone block slice is cut into 2 bone slices with the thickness of about 1mm, the bone walls of the defects of the labial cheek side and the lingual palate side are respectively restored, and autologous bones are filled between the bone slices, so that the vertical and horizontal bone reconstruction is completed. The method can increase bone increment range, facilitate early revascularization, and promote osteogenesis of bone region. However, this technique has two major difficulties:
(1) The operation of implanting the bone fragments is carried out by bare hands of doctors, the operation is completely dependent on the experience of the doctors, the trimming of the bone fragments and the shaping of the bone grafting materials are dependent on clinical insight, standardized and personalized standards are lacking, and the ideal bone grafting effect is difficult to obtain. Excessive trimming of bone fragments often occurs and the bone grafting requirement cannot be met; or insufficient bone fragment finishing is not only detrimental to the success of the bone augmentation procedure, but also increases the difficulty of tension-free wound closure.
(2) The free bone pieces do not need to be completely attached to the irregular bone surface of the implanted bed, and how to realize accurate positioning and firm fixation of the free bone pieces in the implanted area, especially how to accurately position and fix the palate side bone pieces in the bone-receiving area, so that the height and the position of the crest of the reconstructed dental canal are accurately controlled, and the method is the most critical factor for ensuring good bone reconstruction effect.
Therefore, how to design a brand-new double-layer cortical bone piece bone grafting guide plate to accurately indicate the three-dimensional position of a bone grafting site, further reduce operation trauma, reduce operation risk, shorten operation time, avoid the occurrence of complications such as injury of adjacent tooth roots, and improve operation efficiency, and become one of technical problems to be solved urgently by those skilled in the art.
Disclosure of Invention
Aiming at the problems in the prior art, the invention aims to provide an intraoral double-layer cortical bone sheet bone grafting guide plate and a manufacturing method thereof.
The intraoral double-layer cortical bone grafting guide plate is completely different from the traditional guide plate in design, the bone chip retention guide plate and the tooth support type base plate are creatively divided into an accessory and a base plate, the two bone chip retention guide plates share the same base plate and are connected with the base plate through bolts, flexible taking and wearing can be realized in operation, and materials are greatly saved.
The conventional integrated guide plate must find common locating channels of all parts during design and manufacture, and meanwhile, all structures cannot enter a non-inverted concave area, so that the problem that the guide plate is difficult to locate or cannot locate easily occurs. The split type design is adopted, so that the difficult problem that the guide plate cannot be worn in design and manufacture can be avoided.
According to the invention, the problem that the bone piece retention splint is difficult to directly dislocation due to the position limitation of the fixed bone pieces after the two bone pieces are fixed by the titanium nails is solved, the dislocation direction of the labial-palate bone piece retention splint is subjected to personalized design by adjusting the bolt direction of the joint of the splint and the base plate, the labial-palate bone piece retention splint moves tangentially from the gingival direction and is dislocated, and the design and manufacturing problems that the guide plate cannot be extracted are skillfully solved.
Specifically, the application provides the following technical scheme:
an intraoral double-layer cortical bone piece bone grafting guide plate comprises a bone receiving area tooth supporting base plate for covering a dental arch, wherein a labial bolt channel and a palate bolt channel are arranged on the bone receiving area tooth supporting base plate, a labial bone piece retention splint is detachably arranged in the labial bolt channel through a labial bone piece retention splint connector, and a palate bone piece retention splint is detachably arranged in the palate bolt channel through a palate bone piece retention splint connector; the elevation of the labial bone plate retention splint is provided with at least one labial bone plate retention titanium nail assembly indicating hole which is matched with the fixed titanium nail and used for indicating the position of the fixed titanium nail, and the elevation of the palate bone plate retention splint is provided with at least one palate bone plate retention titanium nail assembly indicating hole which is matched with the fixed titanium nail and used for indicating the position of the fixed titanium nail.
Furthermore, the labial side bolt way is in an n shape, and the palate side bolt way is in a straight shape.
Further, the labial lamina retention splint connector is L-shaped, the upper end of the labial lamina retention splint connector is connected with the bottom surface of the labial lamina retention splint, the end of the lower part is connected with a labial bolt body, and the labial bolt body is matched with the cavity of the labial bolt channel.
Furthermore, the jaw-side bone piece retention splint connector is 7-shaped, the upper part of the jaw-side bone piece retention splint connector is connected with the side surface of the jaw-side bone piece retention splint, the lower end of the jaw-side bone piece retention splint connector is connected with the jaw-side bolt body, and the jaw-side bolt body is matched with the cavity of the jaw-side bolt channel.
Furthermore, 2-3 in-place indication windows are arranged on the bone receiving area tooth supporting type base plate.
The invention relates to a manufacturing method of an intraoral double-layer cortical bone piece bone grafting guide plate, which comprises the following steps: (1) establishing an alveolar bone three-dimensional model; (2) repair to guided prosthesis and implant designs; (3) bone grafting design for repairing the guided bone defect area; (4) design of a bone-receiving area tooth supporting type substrate; (5) design of bone fragment retention splints and connectors; (6) And manufacturing each part of the intraoral double-layer cortical bone sheet bone grafting guide plate.
Further, the step (1) is specifically to obtain three-dimensional imaging data of the jawbone by using cone beam computer tomography, and perform threshold segmentation in a data file to obtain a three-dimensional reconstructed jawbone model; using a 3Shape scanner to obtain a dentition model, registering the dentition model with a jaw model by using corresponding characteristic points on a dental crown in 3Shape software, and thus obtaining a combined digital model containing tooth and jaw information;
further, in the step (2), specifically, in the 3shape software, according to the tooth position and the number of the missing teeth in the missing teeth area, a standard tooth shape model corresponding to the missing teeth is imported, and according to the gap of the missing teeth, the adjacent teeth and the opposite teeth, the volume and the shape of the virtual wax type are adjusted, and the number, the shape and the position of the missing teeth area restoration are designed; in a 3Shape implant planning module, repairing to plan the number, model, position and implantation angle of ideal implants, and representing the implants by long cylinders; when the ideal implant position is designed, the coronal direction is 3-4mm below the ideal gingival margin, the buccal tongue is positioned at the palate/lingual side of the ideal gingival margin and is not protruded from the palate side of the ideal prosthesis, and the mesial-distal direction is positioned in the middle of the mesial-distal restoration space of the adjacent tooth.
Further, the step (3) is specifically to draw the range of the bone to be planted around the bone defect area according to the bone quantity requirement around the implant and the aesthetic requirement of the bone bow outline, and subtract the jaw model after virtual bone planting from the original jaw model without virtual bone planting to obtain the three-dimensional shape of the bone slice to be planted; the coronal surface of the bone slice is positioned at a position 3mm below the ideal gingival margin, and the root tip surface at least reaches 2/3 of the length of the implant; the thickness of the bone fragments should ensure a bone mass of at least 2mm around the implant.
Further, the step (4) is to select a plurality of adjacent stable teeth on two sides of the bone receiving area, select the surface part of the crown non-undercut area with the high point crown shape, uniformly thicken to 2mm-3mm to the outside of the tooth surface to form a bone receiving area tooth supporting substrate model, and cover at least 6-8 teeth across the dental arch, so that the bone receiving area tooth supporting substrate is attached to the outside of the dental crown, the inside of the dental crown and the occlusal surface of the dental crown; opening holes at corresponding positions in the near and far of the bone-receiving area tooth support type substrate model to generate 2-3 in-place indication windows for observing whether teeth are closely attached to the tissue surface of the substrate; the tooth supporting base plate of the osseous zone is provided with a convex labial bolt way and a palate bolt way close to the cheek tongue side of the operation area.
Further, the step (5) is specifically to generate a labial bone fragment retention splint and a palate bone fragment retention splint which conform to the shape and the position of the bone fragments according to the determined bone fragment outline and boundary, wherein the width and the thickness of the labial bone fragment retention splint and the palate bone fragment retention splint are at least 2mm;
the outer sides of the labial bone piece retention splint and the palate bone piece retention splint are respectively provided with a straight line or a fold line type labial bone piece retention splint connector and a palate bone piece retention splint connector, and the width and the thickness of the labial bone piece retention splint connector and the palate bone piece retention splint connector are 2mm;
then generating a labial plug and a palate plug which are connected with the labial bone plate retention splint connector and are matched with the labial plug and the palate plug supporting type basal plate plug of the bone receiving area of the labial plug and the palate plug, and ensuring that the connection structure of the labial plug and the palate plug is not contacted with peripheral soft tissues;
the labial bone plate retention splint and the palate bone plate retention splint are respectively provided with labial bone plate retention titanium nail assembly indicating holes and palate bone plate retention titanium nail assembly indicating holes for assembling the retention titanium nails, the diameters of the labial bone plate retention titanium nail assembly indicating holes and the palate bone plate retention titanium nail assembly indicating holes are matched with the diameters of the selected titanium nails, and the edges of the labial bone plate retention titanium nail assembly indicating holes and the palate bone plate retention titanium nail assembly indicating holes are thickened for indicating the direction when the drill needle enters;
the bolt direction at the joint of the labial bone piece retention splint and the base plate is a gingival cutting direction, and the labial bone piece retention splint moves tangentially from the gingival cutting direction and dislocates after the bone pieces are retained; the bolt direction at the joint of the palate side bone slice retaining splint and the base plate is labial palate direction, and the palate side bone slice retaining splint moves from labial side to palate side and dislocates after bone slice retention.
Further, in the step (6), the guide plate material is specifically made of pure titanium, each component of the intraoral double-layered cortical bone-grafting guide plate is manufactured by using a five-axis machining center (308 s2, willmin-Macodel SA) to cut a titanium disc (adenatec GmbH) according to the model structure designed in the steps (1) - (5), and the different components of the guide plate are assembled together through connecting screws.
Compared with the prior art, the intraoral double-layer cortical bone piece bone grafting guide plate and the manufacturing method thereof have at least the following beneficial effects:
the intraoral double-layer cortical bone grafting guide plate is simple in structure, scientific and reasonable in design and convenient to use, the digital design plug type double-layer cortical bone grafting guide plate is used for the double-layer cortical bone grafting technology for the first time, bone fragments are stably fixed to facilitate fixation of titanium nails, surgical errors are reduced, surgical difficulty is reduced, measuring and designing steps and time in a doctor operation are reduced, and a doctor is assisted to complete the whole operation more accurately, efficiently, minimally invasively and safely.
The manufacturing method can apply the digital technology of repairing as the guide to the bone increment operation of planting, designs the preoperative bone grafting position, thickness, length and width accurately by taking the repair as the guide, designs the size of the bone fragment model according to the design, designs the digital guide plate according to the determined bone grafting boundary, further adopts the digital control cutting technology to manufacture the tooth supporting substrate and the bone fragment retention guide plate, can be put into use through simple assembly in vitro, has strong practicability, and can be widely popularized and applied in the field of oral cavity planting and related fields.
The intraoral double-layer cortical bone grafting guide plate and the manufacturing method thereof are further described below with reference to the accompanying drawings.
Drawings
FIG. 1 is a schematic view of an intraoral double-layered cortical bone plate bone grafting guide;
FIG. 2 is a schematic view of a labial lamina retention splint;
fig. 3 is a schematic view of a palatine side bone plate retention splint.
Wherein, 1-is received bone district tooth and is supported base plate, 2-instruction window that takes one's place, 3-labial side bolt way, 4-labial side bolt body, 5-labial side bone piece retention splint connector, 6-labial side bone piece retention splint, 7-labial side bone piece retention titanium nail assembly instruction hole, 8-palate side bolt way, 9-palate side bolt body, 10-palate side bone piece retention splint connector, 11-palate side bone piece retention splint, 12-palate side bone piece retention titanium nail assembly instruction hole.
Detailed Description
As shown in fig. 1-3, an intraoral double-layered cortical bone plate implant guide comprises a bone receiving area tooth supporting base plate 1 covering a dental arch, wherein a labial bolt way 3 and a palate bolt way 8 are arranged on the bone receiving area tooth supporting base plate 1, a labial bone plate retention splint 6 is detachably arranged in the labial bolt way 3 through a labial bone plate retention splint connector 5, and a palate bone plate retention splint 11 is detachably arranged in the palate bolt way 8 through a palate bone plate retention splint connector 10; the elevation of the labial bone plate retention splint 6 is provided with 2 labial bone plate retention titanium nail assembly indicating holes 7 which are matched with the fixed titanium nails and are used for indicating the positions of the fixed titanium nails, and the elevation of the palate bone plate retention splint 11 is provided with 2 palate bone plate retention titanium nail assembly indicating holes 12 which are matched with the fixed titanium nails and are used for indicating the positions of the fixed titanium nails.
Wherein, the labial bolt way 3 is in an n shape, and the palate bolt way 8 is in a straight shape.
The labial lamina retention splint connector 5 is L-shaped, the upper end of which is connected with the bottom surface of the labial lamina retention splint 6, the lower end is connected with the labial bolt 4, and the labial bolt 4 is matched with the cavity of the labial bolt channel 3. The palate side bone plate retention splint connector 10 is 7-shaped, the upper part is connected with the side surface of the palate side bone plate retention splint 11, the lower end is connected with the palate side bolt body 9, and the palate side bolt body 9 is matched with the cavity of the palate side bolt channel 8.
2-3 in-place indication windows 2 are arranged on the bone receiving area tooth supporting type base plate 1. The two labial bone plate retention titanium nail assembly indicating holes 7 and the two palate bone plate retention titanium nail assembly indicating holes 12 are vertically arranged.
The manufacturing method of the intraoral double-layer cortical bone sheet bone grafting guide plate comprises the following specific steps:
(1) Establishing an alveolar bone three-dimensional model
The three-dimensional imaging data of the jawbone (DICOM format) is obtained using Cone Beam Computed Tomography (CBCT), and thresholding is performed in a DICOM file to obtain a three-dimensional reconstructed jawbone model in STL file format. A 3Shape scanner is used to obtain a dentition model (STL format), which is registered in 3Shape software with corresponding feature points on the crown, and a jaw model, to obtain a combined digital model containing tooth and jaw information.
(2) Prosthetic-oriented prosthesis and implant design
In the 3shape software, according to the tooth position and the tooth number of the missing tooth region, a standard tooth shape model corresponding to the missing tooth is imported, and according to the gap of the missing tooth, the adjacent tooth and the opposite tooth, the volume and the shape of the virtual wax type are adjusted, and the number, the shape and the position of the missing tooth region restoration are designed. In the 3Shape implant planning module, the number, model, position and implantation angle of the ideal implant are planned by repairing as guiding, and the implant is represented by a long cylinder. When the ideal implant position is designed, the coronal direction is 3-4mm below an ideal gingival margin, the buccal tongue is positioned at the side of an ideal gingival margin palate (tongue) for 2mm, and meanwhile, the coronal direction does not protrude from the palate side of an ideal restoration, and the mesial-distal direction is positioned in the middle of a restoration space near the distal tooth.
(3) Bone grafting design for bone defect area with repair as guide
And drawing the range of the bone to be planted around the bone defect area according to the bone quantity requirement around the implant and the aesthetic requirement of the bone bow outline, and subtracting the jaw model after virtual bone planting from the original jaw model without virtual bone planting to obtain the three-dimensional shape of the bone slice to be planted. The coronal plane of the bone fragments is positioned at a position 3mm below the ideal gingival margin, and the root tip plane is at least 2/3 of the length of the implant. The thickness of the bone fragments should ensure a bone mass of at least 2mm around the implant.
(4) Design of bone-receiving area tooth supporting type base plate
Selecting a plurality of adjacent stable teeth on two sides of a bone receiving area, selecting the surface part of a crown-shaped high-point crown-square non-undercut area, and uniformly thickening to 2mm-3mm to the outside of a tooth surface to form a bone receiving area tooth supporting substrate model, wherein at least 6-8 teeth are covered across a dental arch, so that the bone receiving area tooth supporting substrate is attached to the outer side of a dental crown, the inner side of the dental crown and the occlusal surface of the dental crown; opening holes at corresponding positions in the near and far of the bone-receiving area tooth support type substrate model to generate 2-3 in-place indication windows for observing whether teeth are closely attached to the tissue surface of the substrate; the convex labial and palate side bolt channels 3 and 8 are arranged on the buccal and lingual side of the tooth supporting base plate of the osseous region, which is close to the operation region.
(5) Design of bone slice retention splint and connector
In this step, the bone fragment retention splint includes a labial bone fragment retention splint 6, a palate bone fragment retention splint 11, the connecting body includes a labial bone fragment retention splint connecting body 5, a palate bone fragment retention splint connecting body 10, the pegs include a labial peg 3, a palate peg 8, the pegs include a labial peg 4, a palate peg 9, and the indication holes include a labial bone fragment retention titanium nail fitting indication hole 7, a palate bone fragment retention titanium nail fitting indication hole 12.
Firstly, according to the determined bone piece outline and boundary, generating a bone piece retention splint which accords with the shape and position of the bone piece, wherein the width and the thickness are at least 2mm;
the outer side of the bone slice retention splint is provided with a connecting body which can be designed into a straight line or a broken line, and the width and the thickness of the connecting body are 2mm;
then, the labial pin 4 and the palate pin 9 which are connected with the bone plate retention splint connector and are matched with the labial pin 3 and the palate pin 8 are generated, and the labial pin 4 and the palate pin 9 are required to be ensured not to contact with peripheral soft tissues so as to be capable of being worn pre-operatively. The combined double-layer bone slice bone grafting guide plate can be integrally connected through the screw and the bolt type detachable device, and the guide plate can be stored, sterilized and clinically used conveniently.
Setting a retention titanium nail assembly indication hole on the bone piece retention splint, wherein the diameter of the indication hole is matched with the diameter of the selected titanium nail, and the edge of the indication hole is thickened for indicating the direction when the drill point enters;
considering the problem that the bone fragments on the two sides are difficult to directly dislocate due to the position limitation of the fixed bone fragments after the bone fragments on the two sides are fixed by the titanium nails, the dislocating direction of the bone fragment on the labial palate side is personalized design, namely: the bolt direction at the joint of the labial bone piece retention splint and the base plate is a gingival cutting direction, and the labial bone piece retention splint moves tangentially from the gingival cutting direction and dislocates after the bone pieces are retained; the bolt direction at the joint of the palate side bone slice retaining splint and the base plate is labial palate direction, and the palate side bone slice retaining splint moves from labial side to palate side and dislocates after bone slice retention.
(6) Manufacturing of parts of intraoral double-layer cortical bone piece bone grafting guide plate
The guide plate material is made of pure titanium, according to the model structure designed in the steps (1) - (5), a five-axis machining center (308S 2, willemin-Macodel SA) is used for cutting a titanium disc (Adentitec GmbH) to manufacture all parts of the intraoral double-layer cortical bone piece bone grafting guide plate, and the different parts of the guide plate are assembled together through connecting screws.
The above examples are only illustrative of the preferred embodiments of the present invention and are not intended to limit the scope of the present invention, and various modifications and improvements made by those skilled in the art to the technical solution of the present invention should fall within the scope of protection defined by the claims of the present invention without departing from the spirit of the present invention.
Claims (10)
1. An intraoral double-layered cortical bone piece bone grafting guide plate, which is characterized in that: comprises a bone receiving area tooth supporting base plate (1) which covers the dental arch, wherein a labial side bolt way (3) and a palate side bolt way (8) are arranged on the bone receiving area tooth supporting base plate (1), the labial bone piece retention splint (6) is detachably arranged in the labial bolt way (3) through a labial bone piece retention splint connector (5), and the palate bone piece retention splint (11) is detachably arranged in the palate bolt way (8) through a palate bone piece retention splint connector (10); the elevation of the labial bone piece retention splint (6) is provided with at least one labial bone piece retention titanium nail assembly indicating hole (7) which is matched with the fixed titanium nail and is used for indicating the position of the fixed titanium nail, and the elevation of the palate bone piece retention splint (11) is provided with at least one palate bone piece retention titanium nail assembly indicating hole (12) which is matched with the fixed titanium nail and is used for indicating the position of the fixed titanium nail.
2. An intraoral double-layered cortical bone plate bone grafting guide according to claim 1, wherein: the labial side bolt channel (3) is in an n shape, and the palate side bolt channel (8) is in a straight shape.
3. An intraoral double-layered cortical bone plate bone grafting guide according to claim 2, wherein: the labial bone piece retention splint connector (5) is L-shaped, the upper end of the labial bone piece retention splint connector is connected with the bottom surface of the labial bone piece retention splint (6), the end part of the lower part is connected with the labial bolt body (4), and the labial bolt body (4) is matched with the cavity of the labial bolt channel (3).
4. An intraoral double-layered cortical bone plate bone grafting guide according to claim 3, wherein: the jaw-side bone piece retention splint connector (10) is 7-shaped, the upper part of the jaw-side bone piece retention splint connector is connected with the side face of the jaw-side bone piece retention splint (11), the lower end of the jaw-side bone piece retention splint connector is connected with the jaw-side bolt body (9), and the jaw-side bolt body (9) is matched with the cavity of the jaw-side bolt channel (8).
5. An intraoral double-layered cortical bone plate bone grafting guide according to claim 4, wherein: 2-3 in-place indication windows (2) are arranged on the bone receiving area tooth supporting type base plate (1).
6. A method of manufacturing an intraoral double-layered cortical bone plate bone grafting guide according to any one of claims 1-5, comprising the steps of: (1) establishing an alveolar bone three-dimensional model; (2) repairing is the design of a guided prosthesis and an implant; (3) bone grafting design with repair as guiding bone defect area; (4) designing a bone receiving area tooth supporting type substrate; (5) the designs of the labial bone piece retention splint (6), the palate bone piece retention splint (11), the labial bone piece retention splint connector (5) and the palate bone piece retention splint connector (10); (6) and manufacturing each part of the intraoral double-layer cortical bone sheet bone grafting guide plate.
7. The method for manufacturing the intraoral double-layered cortical bone plate bone grafting guide according to claim 6, wherein: the step (1) is specifically that cone beam computer tomography is used for obtaining three-dimensional imaging data of the jawbone, and threshold segmentation is carried out in a data file so as to obtain a three-dimensional reconstructed jawbone model; using a 3Shape scanner to obtain a dentition model, registering the dentition model with a jaw model by using corresponding characteristic points on a dental crown in 3Shape software, and thus obtaining a combined digital model containing tooth and jaw information;
the step (2) is that in 3shape software, according to the tooth position and the tooth number of the tooth missing area, a standard tooth shape model corresponding to the tooth missing is imported, and according to the gap of the tooth missing, the adjacent teeth and the opposite teeth, the volume and the shape of the virtual wax type are adjusted, and the number, the shape and the position of the tooth missing area restoration are designed; in a 3Shape implant planning module, repairing to plan the number, model, position and implantation angle of ideal implants, and representing the implants by long cylinders; when the ideal implant position is designed, the coronal direction is 3-4mm below the ideal gingival margin, the buccal tongue is positioned at the palate/lingual side of the ideal gingival margin and is not protruded from the palate side of the ideal prosthesis, and the mesial-distal direction is positioned in the middle of the mesial-distal restoration space of the adjacent tooth.
8. The method for manufacturing the intraoral double-layered cortical bone plate bone grafting guide according to claim 7, wherein: the step (3) is specifically that the range of the bone to be planted around the bone defect area is depicted according to the bone quantity requirement around the implant and the aesthetic requirement of the bone bow outline, and the jaw model after virtual bone planting is subtracted from the original jaw model without virtual bone planting to obtain the three-dimensional shape of the bone slice to be planted; the coronal surface of the bone slice is positioned at a position 3mm below the ideal gingival margin, the root tip surface at least reaches 2/3 of the length of the implant, and the thickness of the bone slice ensures that the bone quantity around the implant is at least 2mm;
selecting a plurality of adjacent stable teeth on two sides of a bone receiving area, selecting a surface part of a crown-shaped high-point crown-square non-undercut area of the tooth crown, and uniformly thickening to 2mm-3mm to the outside of a tooth surface to form a bone receiving area tooth supporting substrate model, and covering at least 6-8 teeth across a dental arch to enable the bone receiving area tooth supporting substrate to be attached to the outer side of the tooth crown, the inner side of the tooth crown and the occlusal surface of the tooth crown; opening holes at corresponding positions in the near and far of the bone-receiving area tooth support type substrate model to generate 2-3 in-place indication windows for observing whether teeth are closely attached to the tissue surface of the substrate; the tooth supporting base plate of the osseous zone is provided with a convex labial bolt way and a palate bolt way close to the cheek tongue side of the operation area.
9. The method for manufacturing the intraoral double-layer cortical bone plate bone grafting guide according to claim 8, wherein: according to the determined bone piece outline and boundary, generating a labial bone piece retention splint and a palate bone piece retention splint which accord with the bone piece shape and position, wherein the width and the thickness of the labial bone piece retention splint and the palate bone piece retention splint are at least 2mm;
the outer sides of the labial bone piece retention splint and the palate bone piece retention splint are respectively provided with a straight line or a fold line type labial bone piece retention splint connector and a palate bone piece retention splint connector, and the width and the thickness of the labial bone piece retention splint connector and the palate bone piece retention splint connector are 2mm;
then generating a labial bolt body and a palate bolt body which are connected with the labial bone plate retention splint connector and are matched with the labial bolt channel and the palate bolt channel, wherein the labial bolt body and the palate bolt body are required to be ensured not to be contacted with peripheral soft tissues;
the labial bone plate retention splint and the palate bone plate retention splint are respectively provided with labial bone plate retention titanium nail assembly indicating holes and palate bone plate retention titanium nail assembly indicating holes for assembling the retention titanium nails, the diameters of the labial bone plate retention titanium nail assembly indicating holes and the palate bone plate retention titanium nail assembly indicating holes are matched with the diameters of the selected titanium nails, and the edges of the labial bone plate retention titanium nail assembly indicating holes and the palate bone plate retention titanium nail assembly indicating holes are thickened for indicating the direction when the drill needle enters;
the bolt direction at the joint of the labial bone piece retention splint and the base plate is a gingival cutting direction, and the labial bone piece retention splint moves tangentially from the gingival cutting direction and dislocates after the bone pieces are retained; the bolt direction at the joint of the palate side bone slice retaining splint and the base plate is labial palate direction, and the palate side bone slice retaining splint moves from labial side to palate side and dislocates after bone slice retention.
10. The method for manufacturing the intraoral double-layer cortical bone sheet bone grafting guide according to claim 9, wherein: the step (6) is to select pure titanium materials as guide plate materials, cut all parts of the double-layer cortical bone plate bone grafting guide plate in the titanium disc manufacturing port by using a five-axis machining center according to the model structure designed in the steps (1) - (5), and assemble the different parts of the guide plate together by connecting screws.
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| CN112057132A (en) * | 2020-10-13 | 2020-12-11 | 四川大学 | In-situ bone taking and grafting indication guide plate in horizontal bone augmentation and manufacturing method thereof |
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| CN116407309A (en) * | 2023-04-21 | 2023-07-11 | 北京大学口腔医学院 | Whole-course guide plate for bone slice interlayer bone grafting synchronous planting and manufacturing method |
| CN116785000A (en) * | 2022-05-16 | 2023-09-22 | 上海交通大学医学院附属第九人民医院 | Preparation method of bone material implantation guide plate |
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|---|---|---|---|---|
| CN112057132A (en) * | 2020-10-13 | 2020-12-11 | 四川大学 | In-situ bone taking and grafting indication guide plate in horizontal bone augmentation and manufacturing method thereof |
| WO2022116929A1 (en) * | 2020-12-02 | 2022-06-09 | 四川大学 | Axial and depth verification guide plate for implanting, and method for fabrication thereof |
| CN216570276U (en) * | 2021-02-20 | 2022-05-24 | 四川大学 | Tooth-supported fibula in-place guide plate for implant guiding |
| CN116785000A (en) * | 2022-05-16 | 2023-09-22 | 上海交通大学医学院附属第九人民医院 | Preparation method of bone material implantation guide plate |
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