CN216455394U - Prepared guide plate and removable partial denture support - Google Patents

Prepared guide plate and removable partial denture support Download PDF

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CN216455394U
CN216455394U CN202122224230.4U CN202122224230U CN216455394U CN 216455394 U CN216455394 U CN 216455394U CN 202122224230 U CN202122224230 U CN 202122224230U CN 216455394 U CN216455394 U CN 216455394U
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area
covering
structure covering
implant
tooth
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吴江
赵湘辉
高勃
王辽辽
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Air Force Medical University of PLA
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Air Force Medical University of PLA
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Abstract

The utility model discloses a preparation guide plate and a removable partial denture framework. The disclosed preparation guide plate comprises a structure covering a tooth lacking area and a structure covering adjacent teeth, wherein the structure covering the adjacent teeth is provided with a structure covering an area to be abraded, and the structure covering the area to be abraded is close to the structure covering the tooth lacking area; the thickness of the structure covering the area to be ground is smaller than that of the structure covering the rest area of the same adjacent tooth, and a thickness fall surface is formed between the structure covering the area to be ground and the structure covering the rest area of the same adjacent tooth, wherein the thickness fall surface is a planar structure with the direction consistent with the implantation direction of the implant to be implanted. The removable partial denture framework is disclosed to be used with the prepped guide plate. The utility model solves the problems that the removable partial denture in-place way direction is not consistent with the implant implantation direction in the prior art, the long-term retention effect of the denture is influenced, and the implant bone absorption is easy to cause.

Description

Prepared guide plate and removable partial denture support
Technical Field
The utility model belongs to the technical field of oral cavity digitization, and particularly relates to a preparation guide plate and a removable partial denture support.
Background
In the field of oral medicine, dentition defects are one of the most common oral diseases. Repair is usually performed using a fixed bridge, removable partial dentures, or implant dentures. Fixed bridge dentures have low patient acceptance due to the need to abrade a large amount of healthy dental tissue. The removable partial denture has the advantages of low cost, micro-wound, wide adaptation, and the like, and is widely applied. However, due to the structural characteristics, it is necessary to design a snap ring, a bracket, etc. on the remaining teeth to improve the overall retention and stabilization effects. Therefore, the remaining teeth are subject to great stress during use, which affects their health. Secondly, in the patient population with more missing teeth, the removable partial denture can not be well retained and stabilized due to poor conditions of the remained teeth, and the using effect is greatly reduced.
In view of the above, for a patient with a lot of missing teeth, it is considered that a small number of implants (1-2) are implanted in the missing tooth area, then a metal bracket type removable partial denture (composed of a removable denture bracket and a defective area artificial tooth) is manufactured, and then the removable partial denture is fixed on the upper part of the implant by stably combining the anode structure of the upper abutment (mainly including a magnet, a locator, a ball cap, etc.) of the implant with the cathode structure of the abutment in the reserved space of the removable partial denture base area. Thus, the partial false tooth can be removed, and good stability and retention can be obtained through the abutment structure, and the effective function of the false tooth is ensured; meanwhile, the implant also provides good support, and the absorption of alveolar bone is slowed down. The implant has the advantages of good retention effect of the implant and moderate price of the removable partial denture, and is also called as an implant support type removable partial denture clinically.
At present, use clinically to prepare the baffle and carry out the implantation of implant, ensure when carrying out the implant nest hole and prepare, can go on according to predesign to avoid important blood vessel and nerve in the alveolar bone, prevent the damage. Common fabrication methods are manual simple guides and digitally designed/fabricated guides.
However, in practical use, it is also found that, when the bracket type removable partial denture is manufactured, a guide plane is prepared on the residual natural teeth; due to the lack of practical reference, the doctor can only complete the grinding of the pilot plane or the implantation of the implant by means of two-dimensional image photographs or approximate impressions, and as a result, the orientation of the stented removable partial denture in the implant path differs from the implant implantation orientation. After the removable denture is used for a period of time, the parts connected with the abutment of the base plate of the removable denture are seriously worn, the retention effect of the removable partial denture is seriously influenced, and meanwhile, the implant can be subjected to larger lateral force due to the fact that the picking direction (the in-place direction) of the denture is not consistent with the implantation direction of the implant in the long-term removing and wearing process of the removable partial denture, so that the bone absorption around the implant is caused.
SUMMERY OF THE UTILITY MODEL
In view of the shortcomings or drawbacks of the prior art, the present invention provides a preliminary template model building method.
Therefore, the preparation guide plate provided by the utility model comprises a structure covering a tooth lacking area, a structure covering adjacent teeth and an implant preformed hole, wherein the structure covering the adjacent teeth is provided with a structure covering an area to be abraded, and the structure covering the area to be abraded is close to the structure covering the tooth lacking area; the opening direction of the implant preformed hole is consistent with the implantation direction of an implant to be implanted; the thickness of the structure covering the area to be ground is smaller than that of the structure covering the rest area of the same adjacent tooth, and a thickness fall surface is formed between the structure covering the area to be ground and the structure covering the rest area of the same adjacent tooth, wherein the thickness fall surface is a planar structure with the direction consistent with the implantation direction of the implant to be implanted.
The structure covering the adjacent teeth is provided with a structure covering the area to be abraded, and the structure covering the area to be abraded is close to the structure covering the area lacking the teeth; the thickness of the structure covering the area to be ground is smaller than that of the structure covering the rest area of the same adjacent tooth, and a thickness fall surface is formed between the structure covering the area to be ground and the structure covering the rest area of the same adjacent tooth, wherein the thickness fall surface is a planar structure with the direction consistent with the implantation direction of the implant to be implanted.
Optionally, an arch step structure is formed between the structure for coating the region to be abraded and the structure for coating the rest region of the same adjacent tooth.
Optionally, the preparation guide plate comprises a structure covering 2-4 teeth including adjacent teeth on one side or two sides of the edentulous area.
Optionally, an observation hole is formed in the preliminary guide model.
The utility model also provides a removable partial denture framework matched with the preparation guide plate. Therefore, the removable partial denture support comprises a snap ring attached to natural teeth, a structure covering a tooth lacking area and a structure covering an inner side guide plane of adjacent teeth, wherein the inner side guide plane of the adjacent teeth is a plane exposed after an area to be abraded is removed along the thickness fall plane, and the structure covering the inner side guide plane of the adjacent teeth is a plane structure consistent with the thickness fall plane in direction.
The utility model can be used for removable false teeth of implant auxiliary retention, achieves the consistency of the positioning direction and the implant direction, avoids the inconsistency of the positioning direction of the removable false teeth and the implant implantation direction in clinic, further generates the influence of bad stress on implant osseointegration and residual natural tooth periodontal health, and improves the success rate and long-term use effect.
The utility model simultaneously completes the modeling and preparation of the removable partial denture and the implant based on the digital technology, and solves the problems that the removable partial denture in-place direction is not consistent with the implant implantation direction in the prior art, the long-term retention effect of the denture is influenced, and the implant bone absorption is easy to cause.
Drawings
FIG. 1 is an example of a preliminary guide structure prepared by the present invention;
FIG. 2 is another exemplary structure of a preliminary guide prepared according to the present invention;
FIG. 3 is an exemplary removable partial denture attachment structure made in accordance with the present invention;
FIG. 4 is a schematic view of the oral cavity with a missing tooth area in the example;
FIG. 5 is the CBCT data of FIG. 4, wherein the left panel: sagittal, right panel: coronal;
FIG. 6 is the orographic data of FIG. 4;
FIG. 7 is the fitted data of FIGS. 5 and 6, shown from different angles;
FIG. 8 is a schematic plan view of the inside guide of the adjacent tooth of the data of FIG. 7;
FIG. 9 is an example of preparatory template model data generated in an embodiment, the two figures being schematic diagrams respectively illustrating different orientations;
FIG. 10 is another example of preliminary template model data generated in an embodiment;
FIG. 11 is an example of removable partial denture framework model data generated in an embodiment;
FIG. 12 is an example of a use process of the preparation guide of FIG. 11; (a) wearing a preparation guide plate in the mouth; (b) grinding a prepared RPD guide plane under the assistance of a prepared guide plate; (c) the whole preparation of the planting nest is completed under the guidance of the preparation guide plate; (d) implanting an implant and installing an upper abutment; (e) the position of the implanted implant is consistent with the design; (f) to complete the wearing of removable partial denture at the same time.
Detailed Description
Unless otherwise indicated, the terms or methods herein are understood or implemented in accordance with conventional wisdom by one of ordinary skill in the art.
The structure of the prepared guide plate of the utility model is shown in figure 1, the prepared guide plate 1 comprises a structure 2 covering a tooth lacking area and a structure covering adjacent teeth, wherein the structure covering the adjacent teeth is provided with a structure 4 covering the inner side to-be-milled area of the adjacent teeth, the other parts are structures 7 covering the rest area of the same adjacent teeth, the thickness of the part of the structure 4 covering the inner side to-be-milled area of the adjacent teeth is smaller than that of the structure covering the rest area of the same adjacent teeth, so that a thickness fall surface, namely a guide plane 3 on the inner side of the adjacent teeth is formed between the structure 7 covering the rest area of the adjacent teeth and the structure 4 covering the inner side to-be-milled area of the adjacent teeth, and the direction of the guide plane 3 is consistent with the implantation direction of an implant to be implanted. The preparation guide plate with the structure can be used for grinding and preparing the inner side guide plane of the natural adjacent tooth before the removable partial denture is worn, and the corresponding denture can be smoothly worn in the designed in-place direction. The thickness of the area to be abraded is determined according to the tooth missing condition of a patient, the dental tissue for blocking the false tooth in place needs to be abraded, and the clinical abrasion thickness is about 0.5-1mm generally. The preparation guide plate is provided with a structure with a thin thickness at the position of the area to be ground, can play a role in grinding and buffering in clinical use, can better work with the guide plane on the inner side of the adjacent tooth in a matching way, and is convenient to operate while being effectively positioned. In a preferred embodiment, the prepared guide plate of the present invention is provided with an observation window 5 to facilitate the clinical operation of observing the natural tooth or the relevant area.
As shown in fig. 2, the preparation guide of another structure further includes an implant preparation hole 6 in addition to the preparation guide of fig. 1, and the direction of the implant preparation hole 6 is the same as the implantation direction of the implant to be implanted.
The adjacent teeth refer to teeth on two sides or one side of the edentulous area, which are close to the edentulous area. The preparation guide plate disclosed by the utility model covers adjacent teeth of the tooth lacking area or covers two, three or four teeth including the adjacent teeth except other covering structures, and is determined according to the tooth size and tooth lacking conditions of the cavity.
Referring to fig. 3, a removable partial denture framework used in cooperation with the inventive prepped guide is provided with a snap ring 9 fitted to a natural tooth, a structure 10 covering an edentulous area, which is generally provided with a plurality of holes 13 for fixing a denture, on a framework 8 of the removable partial denture framework provided with a structure 12 for fixing and covering an implant, and a fixing structure 11 having a rear end embedded in a denture, unlike the conventional framework, the framework of the present invention is provided with guide plane structures (14, 15, 16) covering the inner sides of adjacent teeth. The removable false tooth made by the bracket can be matched with the guide plane on the inner side of the natural adjacent tooth, thereby avoiding abrasion and direction dislocation when wearing or removing the false tooth.
The prepared guide plate and the removable partial denture provided by the utility model can be prepared by adopting a traditional molding method and also can be prepared by adopting a 3D printing method.
A specific 3D printing preparation method comprises the following steps of preparing a preparation guide plate and a removable partial denture framework by a 3D printing method through an established model, wherein the material used in the 3D printing method of the preparation guide plate is a resin material, and the material used in the 3D printing method of the removable partial denture framework is metal. The modeling method of the numerical model of the prepared guide plate comprises the following steps:
step 1, performing implant simulation implantation in oral CBCT data of a tooth lacking area, determining an implant implantation site and an implant implantation direction, and obtaining CBCT data comprising the implant implantation site and the implant implantation direction marked;
step 2, generating a simulated implant in the oral scanning data of the oral cavity with the edentulous area according to the implant implantation site and the implant implantation direction obtained in the step 1, and marking the in-place channel direction of the removable partial denture, wherein the in-place channel direction is consistent with the implant implantation direction;
step 3, in the oral-cavity-scanning data processed in the step 2, taking a plane in which the in-position channel direction is located and a plane tangent to the inner side of an adjacent tooth as a reference guide plane, under the premise of not changing the direction of the reference guide plane, translating the reference guide plane to a position close to the inner side of the adjacent tooth, inserting the reference guide plane into the adjacent tooth, forming an intersecting surface of the reference guide plane and the adjacent tooth, wherein local data of the adjacent tooth are stored on one side of the intersecting surface close to the edentulous area, the local data of the adjacent tooth are areas to be abraded, and the intersecting surface forms a guide plane on the inner side of the adjacent tooth; when a plurality of adjacent teeth exist, processing each adjacent tooth in sequence, and forming a corresponding guide plane on the inner side of each adjacent tooth;
and 4, generating a preparation guide plate model according to the tooth lacking area, the adjacent teeth, the guide planes on the inner sides of the adjacent teeth and the to-be-abraded area in the oral scanning data processed in the step 3, wherein the preparation guide plate model comprises a structure covering the tooth lacking area and a structure covering the adjacent teeth, the thickness of the structure covering the to-be-abraded area on the structure covering the adjacent teeth is smaller than that of the structures covering the rest areas of the same adjacent teeth, meanwhile, the thickness fall surface between the structure covering the to-be-abraded area and the structures covering the rest areas of the same adjacent teeth covers the local part of the guide planes on the inner sides of the adjacent teeth, and the thickness fall surface is a planar structure with the same direction as the guide planes on the inner sides of the adjacent teeth.
In some embodiments, the prepared guide model further comprises an implant prepared hole, and the opening of the implant prepared hole is oriented to be consistent with the implant implantation direction.
The construction method of the removable partial denture framework model comprises the following steps:
and generating a removable partial denture framework model according to the oral scanning data processed in the third step, wherein the removable partial denture framework model comprises a snap ring jointed with the natural tooth and a structure covering the tooth lacking area and the inner side guide plane of the adjacent tooth, and the structure covering the inner side guide plane of the adjacent tooth is a plane structure with the same direction as the inner side guide plane of the adjacent tooth in the third step.
The CBCT data refers to cone beam CT data, the simulated implantation of the CBCT data implant can be carried out in implant aided design software (such as Simplan software) during modeling, namely the scanned CBCT data is imported into the Simplan software, a proper implant implantation site and direction are determined according to clinical medical knowledge, the simulated implantation of the implant is carried out, the data analysis can be carried out on the bone density, the bone height and the width of a tooth lacking area, a proper implant is preliminarily selected for simulated implantation, the implant implantation site and direction are confirmed according to the positions of adjacent teeth and setose pith teeth, and the CBCT data comprising the implant implantation direction and the implant implantation direction marked with the implant implantation direction are obtained.
In the oral scanning data which are from the same oral cavity to be repaired and CBCT data, generating a simulated implant according to the implant implantation site and implantation direction determined in the CBCT data, and marking the in-situ direction of the removable partial denture, wherein the in-situ direction is consistent with the implant implantation direction. The oral scan data (also referred to as digitized tooth-grass data herein) is data generated in the digital application software (e.g. 3Shape software) of the oral cavity to be repaired by scanning the inside of the oral cavity to be repaired with an oral scan device, or alternatively, data generated in the digital application software (e.g. 3Shape software) of the oral cavity can be scanned by taking an initial impression and then using a bin type scanning device. In the specific scheme, fitting can be carried out on the oral scanning data and CBCT data which are generated with the implant and marked with the direction of the implant, a simulated implant is generated in the data after fitting, and the direction of the in-place path of the removable partial denture is marked, wherein the direction of the in-place path is consistent with the implantation direction of the implant. The fitting specifically refers to implant implantation site and direction data determined by introducing CBCT data (or Simplan software) into 3shape software.
The present invention will be described in detail below with reference to the accompanying drawings and specific embodiments.
Example 1:
this embodiment relates to a method for constructing a model of an oral preparation guide to be restored as shown in fig. 4. The specific method comprises the following steps:
firstly, carrying out cone beam CT scanning on the oral cavity shown in figure 4 to obtain CBCT data shown in figure 5, importing the scanned CBCT data into Simplan software, carrying out data analysis on bone density, bone height and width of a tooth lacking area, carrying out simulated implant of the implant, and confirming the implant implantation site and direction according to the positions of adjacent teeth and opposite teeth;
secondly, intraorally scanning dentition needing to be repaired in the oral cavity shown in fig. 4, jaw teeth and a grain biting relationship to obtain oral scanning data (also called digital grain data) shown in fig. 6, and importing the oral scanning data into 3Shape viewer software; fitting the digital bluegrass model with the CBCT image data processed in the first step, specifically, importing data of implant implantation sites and directions determined in Simplan software into 3shape software, and embodying the implant simulated implantation direction and position determined in the first step in oral scan data, namely, the gray cylindrical object shown in fig. 7 is the implant implantation position and direction, and adjusting and determining the removable local denture in-situ channel direction (black arrow) by combining the implantation direction of the implant to ensure that the implant implantation direction is consistent with the in-situ channel direction;
thirdly, in the oral-cavity-scanning data processed in the second step, taking a plane in which the in-position channel direction is located and a plane tangent to the inner side of the adjacent tooth as a reference guide plane, on the premise of not changing the direction of the reference guide plane, translating the reference guide plane to a position close to the inner side of the adjacent tooth, inserting the reference guide plane into the adjacent tooth, forming an intersecting surface of the reference guide plane and the adjacent tooth, wherein local data of the adjacent tooth are stored on one side of the intersecting surface close to the edentulous area, the local data of the adjacent tooth are areas to be abraded, and the intersecting surface forms a guide plane on the inner side of the adjacent tooth; when a plurality of adjacent teeth exist, processing each adjacent tooth in sequence, and forming a corresponding guide plane on the inner side of each adjacent tooth; as shown in 8, the arrow indicates the inner side guide plane of the adjacent tooth formed by simulated grinding on software according to the design;
fourthly, generating a preparation guide plate model according to the tooth lacking area, the adjacent teeth, the guide planes on the inner sides of the adjacent teeth and the area to be ground in the oral scanning data processed in the third step, specifically generating a preparation guide plate with implant implantation and guide plane preparation in 3Shape software, and providing a good reference plane for later-stage clinical preparation by adopting step marks at the guide plane preparation position; FIG. 9 shows the implant preparation guide and the adjacent tooth inner side guide plane (white arrow indicates the step guide of the adjacent tooth inner side guide plane) as designed and completed in this embodiment; in other embodiments, where an implant is not required, the preliminary template model generated is shown in FIG. 10;
fifthly, generating the stent model shown in fig. 11 in the 3Shape software, wherein white arrows indicate guide plane structures covering the inner sides of corresponding adjacent teeth on the stent as shown in fig. 11.
Example 2:
in this embodiment, according to the model created in embodiment 1, the 3D printing technology is respectively used to complete the fabrication of the removable partial denture framework made of titanium alloy and the preparation guide plate (the printing material of the preparation guide plate in this embodiment is specifically photosensitive resin), and the removable partial denture is further processed on the removable partial denture framework made of titanium alloy.
Clinical use examples of prepeg and removable partial dentures prepared in the above examples:
referring to fig. 12, the preparation guide is placed in the mouth of the patient for fitting and confirmation, and grinding is started at the structure covering the area to be ground by using a high-speed turbine with reference to the step (i.e., the inner guide plane of the adjacent tooth) on the preparation guide until the grinding preparation of the guide plane of the inner side of each natural adjacent tooth in the mouth is completed;
furthermore, under the guidance of the planting hole on the preparation guide plate, the whole-process navigation is applied to complete the implantation of the implant, after the implant is implanted, on the basis of obtaining good initial stability, an upper abutment (locator, magnetic or spherical cap abutment) is connected with the implant, a removable partial denture is worn at the same time, the implant implantation and the removable partial denture synchronous repair are completed, the tooth is coated, and the falling positioning effect can be achieved in the grinding process.
After 2 months, the cathode part of the abutment is arranged in the reserved space of the removable partial denture tissue surface and is worn in the mouth to finish the final repair, and the guide plane on the bracket is matched with the direction from the inner side of the natural adjacent tooth to the unilateral surface.
It should be noted that the above-mentioned embodiments are only examples of the present invention, and the present invention is not limited thereto, and those skilled in the relevant art can make substitutions, modifications and combinations based on the spirit and concept of the present invention within the scope of the present invention.

Claims (6)

1. A preparation guide plate is characterized by comprising a structure for covering a tooth lacking area, a structure for covering adjacent teeth and an implant preformed hole, wherein the structure for covering the adjacent teeth is provided with a structure for covering an area to be abraded, and the structure for covering the area to be abraded is close to the structure for covering the tooth lacking area; the opening direction of the implant preformed hole is consistent with the implantation direction of an implant to be implanted; the thickness of the structure covering the area to be ground is smaller than that of the structure covering the rest area of the same adjacent tooth, and a thickness fall surface is formed between the structure covering the area to be ground and the structure covering the rest area of the same adjacent tooth, wherein the thickness fall surface is a planar structure with the direction consistent with the implantation direction of the implant to be implanted.
2. The preparation guide of claim 1, wherein the preparation guide comprises a structure covering the edentulous area and a structure covering the adjacent teeth, the structure covering the adjacent teeth is provided with a structure covering the area to be abraded, and the structure covering the area to be abraded is next to the structure covering the edentulous area; the thickness of the structure covering the area to be ground is smaller than that of the structure covering the rest area of the same adjacent tooth, and a thickness fall surface is formed between the structure covering the area to be ground and the structure covering the rest area of the same adjacent tooth, wherein the thickness fall surface is a planar structure with the direction consistent with the implantation direction of the implant to be implanted.
3. A preparation guide as claimed in claim 1 or 2, wherein the structure covering the area to be abraded and the structure covering the rest of the same adjacent tooth have an arcuate step structure therebetween.
4. A preparation guide as claimed in claim 1 or 2, wherein the preparation guide includes a structure to cover 2-4 teeth including adjacent teeth on one or both sides of the edentulous area.
5. A preliminary guide according to claim 1 or 2, wherein the preliminary guide model is provided with a viewing aperture.
6. A removable partial denture mount for use with the prepeg guide of claim 1, wherein: the removable partial denture support comprises a snap ring attached to a natural tooth, a structure covering a tooth lacking area and a structure covering an inner side guide plane of an adjacent tooth, wherein the inner side guide plane of the adjacent tooth is an edge, a plane exposed after an area to be abraded is taken away from a thickness drop surface, and the structure covering the inner side guide plane of the adjacent tooth is a planar structure consistent with the direction of the thickness drop surface.
CN202122224230.4U 2021-09-14 2021-09-14 Prepared guide plate and removable partial denture support Active CN216455394U (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113925635A (en) * 2021-09-14 2022-01-14 中国人民解放军空军军医大学 Construction method and manufacturing method of preparation guide plate and removable partial denture framework model
CN115500973A (en) * 2022-08-25 2022-12-23 中国人民解放军空军军医大学 Removable partial denture framework model construction method and manufacturing method

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113925635A (en) * 2021-09-14 2022-01-14 中国人民解放军空军军医大学 Construction method and manufacturing method of preparation guide plate and removable partial denture framework model
CN113925635B (en) * 2021-09-14 2022-06-28 中国人民解放军空军军医大学 Construction method and manufacturing method of preparation guide plate and removable partial denture framework model
CN115500973A (en) * 2022-08-25 2022-12-23 中国人民解放军空军军医大学 Removable partial denture framework model construction method and manufacturing method

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