DE10029256A1 - Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former - Google Patents

Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former

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Publication number
DE10029256A1
DE10029256A1 DE2000129256 DE10029256A DE10029256A1 DE 10029256 A1 DE10029256 A1 DE 10029256A1 DE 2000129256 DE2000129256 DE 2000129256 DE 10029256 A DE10029256 A DE 10029256A DE 10029256 A1 DE10029256 A1 DE 10029256A1
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Germany
Prior art keywords
model
drilling template
artificial teeth
working model
image
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Withdrawn
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DE2000129256
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German (de)
Inventor
Stefan Wolz
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Stefan Wolz
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Publication date
Application filed by Stefan Wolz filed Critical Stefan Wolz
Priority to DE2000129256 priority Critical patent/DE10029256A1/en
Publication of DE10029256A1 publication Critical patent/DE10029256A1/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08Machine parts specially adapted for dentistry
    • A61C1/082Positioning or guiding, e.g. of drills
    • A61C1/084Positioning or guiding, e.g. of drills of implanting tools

Abstract

The invention relates to a method for producing a boring jig for implanting artificial teeth by means of CAD-CAM. The location of the boring channel (4) is established using an image of the jaw bone (5) on a screen. The inventive method consists of generating a digital model of the tooth set by laser-scanning a working model or its negative mould. A boring jig blank (3) is then cast onto the working model or produced by cutting from a whole unit. By digitally generating a cross-sectional image of the jaw bone (5), it is possible to establish an optimal location for the boring channel (4). This image can then be superimposed with an X-ray image in order to prevent critical areas (6) inside the bone from being opened. The inventive jig enables artificial teeth to be implanted without any risk.

Description

Das Implantieren von künstlichen Zähnen kann, was das Material als solches betrifft, als ausgereifte Technik bezeichnet werden. The implantation of artificial teeth can, in terms of the material as such, are referred to as mature technology. Probleme bestehen jedoch bei dem Bohren der Löcher für die Implantateinsätze. However, problems exist with the drilling of the holes for the implant applications. Hier ist viel Erfahrung und fachmännisches Gespür des Zahnarztes erforderlich. Here a lot of experience and craftsmanship sense of the dentist is required. Trotzdem gelingt nicht jede Bohrung, was sehr nachteilige Folgen für den Patienten hat. Nevertheless, do not succeed each hole, which has very negative consequences for the patient.

Aus diesem Grunde wurden schon die verschiedensten Bohrschablonen entwickelt, die dem Zahnarzt die Bohrtiefe und die Bohrrichtung vorgeben. For this reason, various drill guides have already been developed that tell the dentist the drilling depth and the drilling direction. Beispiele solcher Bohrschablonen finden sich in der EP-A-0 774 238, der US- A- 5 800 168 oder der FR-A- 2 645 733. Diese Schablonen gewährleisten zwar das Bohren entsprechend den vorher eingestellten Winkeln, sodaß handwerkliche Fehler vermieden werden können. Examples of such drilling templates can be found in EP-A-0774238, US-A-5800168 or FR-A-2 645 733. These templates while ensuring the drilling according to preset angles, so that technical mistakes to avoid can. Eine Gewähr, daß die gebohrten Löcher an der richtigen Stelle sitzen, ist jedoch damit nicht gegeben. A guarantee that the drilled holes are in the correct position is, but in order not given.

Eine andere Überwachung der Bohrerstellung wird in der EP-A-0 834 292 gelehrt. Another monitoring the bit position is taught in EP-A-0834292. Hier kann der Zahnarzt auf einem Bildschirm verfolgen, ob er den Bohrer, dessen Stellung durch Sensoren und einen Computer überwacht wird, in der richtigen Lage hält. Here the dentist can track on a screen, if he keeps the drill whose position is monitored by sensors and a computer in the correct position. Auch bei diesem Stand der Technik geht es nur darum, den Bohrer in einer vorher eingestellten Lage zu halten. Also in this prior art, it's all about keeping the drill in a preset position.

Aus der FR-A- 2 687 947 ist ein CAD/CAM-Verfahren zur Herstellung einer Bohrschablone bekannt, bei dem dem Patienten ein Schablonenrohling in den Mund appliziert wird und mittels Röntgenstrahlen eine Aufnahme des Kieferknochens mit aufgestecktem Schablonenrohling gemacht wird. From FR-A-2687947 a CAD / CAM method for producing a drilling template is known to the patient a stencil blank is applied in the mouth and a receptacle of the jaw bone is made with attached stencil blank by means of X-rays. Zur Feststellung der genauen Lage auf dem Röntgenbild besitzt der Schablonenrohling mindestens einen Markierungspunkt aus radioopakem Material. To determine the exact location on the X-ray image of the stencil blank has at least one marker of radiopaque material. Das Röntgenbild wird digitalisiert, sodaß mit den ansich bekannten CAD/CAM-Methoden die Richtung des Bohrkanals festgelegt werden kann. The X-ray image is digitized, so that the direction of the drill channel can be set with the ansich known CAD / CAM methods. Entsprechend wird in dem Schablonenrohling die Bohrung vorgenommen. Accordingly, the hole is made in the stencil blank. Die so erhaltene Schablone soll gewährleisten, daß im Inneren des Kieferknochens keine Nerven, Wurzeln oder Arterien angebohrt werden. The stencil thus obtained is to ensure that are drilled in the inside of the jawbone no nerve roots or arteries. Der wesentliche Nachteil diese Verfahrens ist es, daß auf dem Bildschirm nur ein zweidimensionales Bild erzeugt werden kann. The main disadvantage of this method is that only a two-dimensional image can be produced on the screen.

Ein ähnliches, aber noch komplizierteres Verfahren zur Herstellung einer Bohrschablone wird in der US-A-5 967 777 offenbart. A similar but even more complicated process for the manufacture of a drilling template is disclosed in US-A-5,967,777. Bei diesem Verfahren wird das zu digitalisierende Bild in einem Computertomographen erstellt. In this process the image to be digitized will be created in a computer tomograph. Der in den Mund des Patienten eingesetzte Schablonenvorläufer besitzt bereits die Form der zu implantierenden Zähne. The template precursor used in the patient's mouth already has the shape of the teeth to be implanted. In der US-A- 5 967 777 ist auch ausgeführt, daß mit diesem Verfahren Bilder des Kieferknochens im Querschnitt und Längsschnitt erzielt werden können. In US-A- 5,967,777 is also designed such that can be achieved with this method, images of the jaw bone in cross section and longitudinal section. Alleine wegen der hohen Kosten dürfte sich ein CT-Verfahren in der Praxis jedoch nicht durchsetzten. Just because of the high cost of a CT method in practice, however, should not be translated.

Es ist daher Aufgabe der im Anspruch 1 angegebenen Erfindung, mittels des CAD/CAM-Verfahrens ein Verfahren zur Herstellung einer Bohrschablone anzugeben, das einerseits einfach ist, andrerseits eine optimalere Festlegung der Bohrung mit größter Sicherheit erlaubt. It is therefore an object of the features specified in claim 1 the invention to provide a method for producing a drilling template by means of the CAD / CAM technique, on the one hand easily, on the other hand a more optimal setting of the bore allows with great safety.

Vorteilhafte Weiterbildungen der Erfindung sind in den Unteransprüchen beschrieben. Advantageous developments of the invention are described in the subclaims.

Einzelheiten der Erfindung ergeben sich aus der nachstehenden Beschreibung anhand der Zeichnungen. Details of the invention will become apparent from the following description with reference to the drawings.

Hierin zeigen: The drawings are:

Fig. 1 ein Arbeitsmodell eines Kiefers in Draufsicht; 1 shows a working model of a jaw in plan view.

Fig. 2 das Arbeitsmodell nach Fig. 1 mit einem angegossenen Bohrschablonenrohling; FIG. 2 shows the working model according to Fig 1 with a molded Bohrschablonenrohling.

Fig. 3 einen Querschnitt durch das Arbeitsmodell gemäß Schnitt MM in Fig. 2. Fig. 3 shows a cross section through the working model according to section MM in Fig. 2.

Von einem Kiefer eines Patienten wird zunächst ein Arbeitsmodell angefertigt, das in Fig. 1 mit 1 bezeichnet ist. First, a working model is made of a jaw of a patient, which is designated in FIG. 1 1. Mit 2 ist die Lücke bezeichnet, in die ein Zahn implantiert werden soll. 2, the gap is referred to, in which a tooth to be implanted. Die Herstellung solcher Arbeitsmodelle ist notorischer Stand der Technik und braucht nicht weiter beschrieben werden. The production of such working models is notorious state of the art and need not be further described.

Zur Erstellung eines digitalen Modells von diesem Arbeitsmodell wird es mit einem Laserstrahl abgetastet und die topographische Form in einem Computer gespeichert. To create a digital model of this working model, it is scanned with a laser beam and the topographic form stored in a computer. Zum Abtasten des Modells wird zweckmäßigerweise ein Verfahren benutzt, daß als konoskopisches Messen bezeichnet wird, das auf dem Prinzip der konoskopischen Holographie beruht. For scanning the model, a method is suitably used that is called conoscopic measuring which is based on the principle of conoscopic holography. Zur digitalen Erfassung der Oberfläche existiert eine Flächenrückführungssoftware mit dem Namen SurfaceExplorer. Digital acquisition of the surface is a reverse engineering software called SurfaceExplorer exists.

Das digitale, Modell läßt sich prinzipiell auch durch Abtasten der Negativform (Abdruck) des Kiefers erzeugen. The digital model can in principle also by scanning the negative mold (impression) of the jaw produce. Von einer direkten Abtastung des Gebisses des Patienten aber wird wegen der zu erwartenden Schwierigkeiten abgesehen. From a direct scan of the patient's teeth but is apart because of the anticipated difficulties.

Im Bereich der Zahnlücke 2 wird am Arbeitsmodell 1 anschließend der Rohling einer Bohrschablone angegossen. In the area of the tooth gap, the blank 2 of a drilling template is cast at the working model 1 then. Als Material kann ein in der Dentaltechnik üblicher Prothesenkunststoff verwendet werden. As the material of a usual in dental technology prosthesis plastic can be used. Wichtig dabei ist, daß auch benachbarte festsitzende Zähne mit eingegossen werden, damit die Lage der Schablone genau fixiert ist. It is important that also adjacent fixed teeth are molded in, so that the position of the stencil is precisely fixed.

Alternativ herzu ist das Herausfräsen aus dem Vollen mittels der gespeicherten Daten möglich. Alternatively, near, milling out from the solid by means of the stored data is possible.

Falls es für erforderlich gehalten wird, kann die Form des fertigen Rohlings 3 ebenfalls digital erfaßt werden, sodaß ein Bild eines Arbeitsmodelles mit aufgesetztem Bohrschablonenrohling auf dem Bildschirm erstellt werden kann. If it is deemed necessary, the shape of the finished blank 3 can also be digitally recorded so that an image of a working model can be created with attached Bohrschablonenrohling on the screen.

Mit einem zur Verfügung stehenden 3D-Graphikprogramm lassen sich nun durch das Kiefermodell beliebige Schnitte legen. With an available 3D graphics program can now be set by the jaw model any cuts. Ein solches Bild ist mit aufgesetztem Bohrschabonenrohling in Fig. 3 schematisch dargestellt. Such an image is shown with attached Bohrschabonenrohling in Fig. 3 schematically. Mit 5 ist der Kieferkochen bezeichnet, in den die Bohrung 4 für den Implantateinsatz eingebracht werden soll. 5 with the jaw cooking is indicated, in which the bore 4 to be introduced to the implant fixture.

Bei der Herstellung des Bohrkanals 4 im Kieferknochen 5 muß größte Sorgfalt darauf gelegt werden, daß im Inneren des Knochens keine Nervenstränge, Arterien, Wurzeln benachbarter Zähne oder Hohlräume (hiatus maxilaris) angebohrt werden, da dies fatale Folgen für den Patienten hat. In the preparation of the drilling channel 4 in the jaw bone 5 greatest care must be paid to ensuring that no nerves, arteries, roots of adjacent teeth or cavities inside the bone (hiatus maxillary) to be drilled, as this has serious consequences for the patient. Zu diesem Zwecke ist es empfehlenswert, auf das virtuelle Bild des Implantatbereiches eine Röntgenaufnahme kongruent abzubilden. To this end, it is recommended to map to the virtual image of the implant area of ​​a radiograph congruent. Daher sollte eine Röntgenaufnahme des Implantatbereiches zusammen mit einem aufgesetztem Bohrschablonenrohling gemacht werden, der mindestens einen radioopaken Marker, z. Therefore, an X-ray image of the implant area should be made together with a mounted Bohrschablonenrohling, the at least one radiopaque marker, such. B. in Form einer 3 mm starken Stahlkugel, besitzt. B. in the form of a 3 mm thick steel ball has. Dieser Marker erlaubt auf dem Bildschirm eine genaue Einstellung der Größenverhältnisse. These markers allowed on the screen an accurate adjustment of proportions.

Auf dem Bildschirm kann nun ein Bild erzeugt werden, das schematisch der Fig. 3 entspricht. On the screen, a picture can be created now, which corresponds schematically in FIG. 3.

Der Zahntechniker legt nun den zunächst nur virtuell vorhandenen Bohrkanal 4 hinsichtlich Durchmesser und Lage optimal in den Kieferknochen 5 , wobei er den Bereich 6 , der auf keinen Fall verletzt werden darf, ausspart. The dental technician is now presenting the first of only virtually existing drill hole 4 with regard to diameter and location perfectly into the jawbone 5, in which he leaves out the area 6, which may be violated under any circumstances. Durch Herstellung verschiedener Schnitte auf dem Bildschirm ist dann auch zu erkennen, ob in jedem Bereich genügend Knochenmaterial vorhanden ist, insbesondere, ob die Abstände zum Zahnfleisch auf beiden Seiten des Kieferknochens und zu den gefährlichen Bereichen ausreichend sind. By making various cuts on the screen is then to see if enough bone material is present in every area, especially if the distances are sufficient to the gums on both sides of the jawbone and the dangerous areas. Nachdem die Lage des Bohrkanals endgültig festgelegt ist, wird mittels der CAM-Technik dieser im Bohrschablonenrohling ausgebohrt, wobei der Rohling zweckmäßigerweise auf dem Arbeitsmodell aufsitzt, sodaß auch im Arbeitsmodell eine Bohrung erzeugt wird, die genau der späteren Bohrung im Kieferknochen des Patienten entspricht. After the location of the drilling channel is finally determined, this will be drilled in the Bohrschablonenrohling by the CAM technique the blank expediently seated on the working model, so that a hole is generated in the working model, which corresponds exactly to the later hole in the jaw bone of the patient. Diese Arbeitsweise ermöglicht dann auch das Durchsägen des Arbeitsmodelles im Bereich der Bohrung als letzte Kontrolle. This procedure also makes it possible the sawing through the working model in the area of ​​the hole as a last control.

Da das Material der Bohrschablone relativ weich ist, wird empfohlen, die Bohrung in der Schablone mit einer Metallhülse (nicht gezeigt) auszukleiden, damit eine absolut exakte Führung des vom Zahnarzt zu bedienenden Bohrers gewährleistet ist. Since the material of the surgical template is relatively soft, it is recommended that the hole in the mask with a metal sleeve (not shown) to line, so that an absolutely precise guiding of the to-use by the dentist's drill is ensured. Ebenfalls kann ein Anschlag (nicht gezeigt) an der Bohrschablone vorgesehen werden, der auf den Bohrer des Zahnarztes abgestimmt ist und der die Bohrtiefe begrenzt. Also, a stop may be provided on the drilling template (not shown), which is tuned to the drill of the dentist and which limits the drilling depth.

Mit der erfindungsgemäß hergestellten Bohrschablone wird folglich auch weniger erfahrenen Zahnärzten ein Hilfsmittel an die Hand gegeben, was der Implanierungstechnik zu einen weiteren Durchbruch verhelfen kann. Consequently, with the drilling template according to the invention less experienced dentists will be given a tool at hand, what the Implanierungstechnik can make for another breakthrough.

Claims (4)

1. Verfahren zur Herstellung einer Bohrschablone zum Implantieren künstlicher Zähne mittels der CAD/CAM-Technik, wobei die Lage des Bohrkanals ( 4 ) anhand einer Abbildung des Kieferknochens auf einem Bildschirm festgelegt wird, dadurch gekennzeichnet , 1. A method for producing a drilling template for implanting artificial teeth by means of the CAD / CAM technique, the position of the drilling channel (4) is determined based on an image of the jaw bone on one screen, characterized in
daß durch Laserabtastung eines Arbeitsmodells ( 1 ) oder dessen Negativform ein digitales Modell des Gebisses erzeugt wird, that a digital model of the dentition is produced by laser scanning a working model (1) or the negative mold,
daß entweder durch Angießen an das Arbeitsmodell ( 1 ) ein Bohrschablonenrohling ( 3 ) erzeugt wird, that either by direct casting with the working model (1) a Bohrschablonenrohling (3) is generated,
oder daß mittels der gespeicherten Daten der Bohrschablonenrohling ( 3 ) aus dem Vollen gefräst wird, or that (3) is milled from the solid by means of the stored data of the Bohrschablonenrohling,
und daß durch Erzeugen mehrere Querschnittsbilder des digitalisierten Kieferknochens ( 5 ) die optimale Lage des Bohrkanals ( 4 ) festgelegt wird. and that the optimum position of the drilling channel (4) is defined by generating a plurality of cross-sectional images of the digitized jaw bone (5).
2. Verfahren nach Anspruch 1, dadurch gekennzeichnet, daß auf das digitale Modell des Gebisses ein Röntgenbild des Gebisses kongruent abgebildet wird. 2. The method according to claim 1, characterized in that an X-ray image of the dentition is mapped congruently onto the digital model of the dentition.
3. Verfahren nach Anspruch 2, dadurch gekennzeichnet, daß zur Positionierung der beiden Bilder der Bohrschablonenrohling ( 3 ) mit mindestens einem radioopaken Marker versehen wird. 3. The method according to claim 2, characterized in that is provided for the positioning of the two images of the Bohrschablonenrohling (3) with at least one radiopaque marker.
4. Verfahren nach Anspruch 3, dadurch gekennzeichnet, das der Marker eine Stahlkugel ist. 4. The method according to claim 3, characterized in that the marker which is a steel ball.
DE2000129256 2000-06-14 2000-06-14 Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former Withdrawn DE10029256A1 (en)

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DE2000129256 DE10029256A1 (en) 2000-06-14 2000-06-14 Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former

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DE2000129256 DE10029256A1 (en) 2000-06-14 2000-06-14 Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former
PCT/DE2001/002099 WO2001095824A1 (en) 2000-06-14 2001-06-02 Method for producing a boring jig for implanting artificial teeth

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