DE102006038744A1 - A bite device, bite plate, fastener and method of positioning a patient in an X-ray imaging device - Google Patents

Abstract

The invention relates to a bite device, a bite plate, a fastening part and a method for positioning a patient for producing a recording with an X-ray recording device. The bite device comprises the fastening part, which is arranged on the X-ray receiving device, and at least one bite plate movable relative to the fastening part. On the fastening part, a connection part for the bite plate is provided. In this case, the bite plate is separable from the fastening part in the region of the connecting part and when biting the bite plate is brought into engagement with the fastening part in the region of the connecting part.

Description

Technical area

The The invention relates to a bite device for positioning a Patient to take a picture with an X-ray device. In this case, the biting device comprises at least one of the X-ray receiving device arranged fastening part and at least one opposite to the Mounting part movable bite plate, wherein on the fastening part a connecting part for the bite plate is provided.

One Another object of the invention is a method for positioning a patient in a recording with an X-ray device.

State of the art

to Positioning a patient in a dental X-ray machine usually light sights application. With dental X-ray devices with vertical positioning of the head is a positioning in that the patient bites on a bite, the connected to the dental X-ray machine is and its positional relationship to the dental X-ray device is known. The positioning a patient sitting or standing can by means of a chin rest or a belt, wherein when using belts of the Patient comfort restricted becomes. For dental X-ray machines with horizontal Positioning of the head is often done over a positioning support of the head on a special pillow.

These However, types of positioning have the disadvantage that they while the radiograph minor position changes Allow the patient's head and thereby errors in the X-rays in the form of motion artifacts or for X-ray recording of volumes, the of the desired Differ in volume.

In the DE 102 50 005 A1 there is disclosed a bite device for correctly positioning a patient in a panoramic x-ray exposure. The bite device includes a holder portion fixedly disposed relative to the X-ray apparatus, a plate pivotable against the holder portion having a bite portion into which the patient bites, and means for detecting the swing angle between the plate and the holder portion. The relative position of the occlusal plane of the patient to the x-ray apparatus is determined by measuring the angle between the plate and the holding part and determining the inclination of the plate. The bite section may be provided with a bite insert having a bite groove at the top and bottom, each receiving the dental arch from the patient's upper or lower jaw.

In the EP 1 043 960 B1 there is disclosed a method of making a dental implant assembly for receiving dentures to be placed over the gum. The structure has several Zahnimplantatflansche and a lying on the gingival tissue bridge to which a denture is attached. A method step of the method includes creating an image of prosthetic teeth to be placed over the gum, comprising artificial dentures. The dentures are clamped during the recording in a positioning device.

In the DE 196 29 708 A1 is a procedure for the preoperative planning of dental implants and the definition of drilling coordinates in the jaw by computer-aided evaluation of primary data from bone structure imaging in the upper and lower jaw and implementation of the determined implant coordinates in a drilling template for the preparation of the implant site.

Of the skull a patient is for data acquisition by means of X-ray in the thermoforming a Bite fork fixed in position. In this case, the X-ray device is when taking Transversalschichtaufnahmen precise adjusted and layered exactly at a marked implant position be enabled.

The mentioned method have the disadvantage that when biting on a Aufbissteil or on a bite fork for slipping or Deformation of these can come.

Furthermore For fixed upper jaw, the lower jaw can with respect to Upper jaw different in anatomical degrees of freedom be positioned. This can lead to incorrect positioning to lead.

The It is therefore an object of this invention to provide a bite device to provide a precise Positioning of both the maxilla and the mandible with a known positional relationship with the X-ray device.

Presentation of the invention

These Task is solved by the specified devices and methods.

According to the invention, the bite device for positioning a patient to create a recording with an X-ray device at least one on the Rönt genaufnahmeeinrichtung arranged fastening part and min at least one opposite the fastening part movable bite plate, wherein on the fastening part a connecting part is provided for the bite plate.

The Bite plate can in the region of the connecting part of the fastening part be separable. When you bite can the bite plate in the region of the connecting part in engagement be brought with the connecting part.

At the bite open the lower mandibular arch and the upper mandibular arch become emotional. This causes pressure forces from the upper or lower mandibular arch to the upper or lower Bite plate and from the lower or upper mandibular arch on the Transfer fastening part, so that the fastening part and the upper or lower bite plate be moved towards each other and this bite plate with the connecting part is brought into engagement with the fastening part. With sufficient compressive forces and a sufficiently large one Friction coefficient between the surfaces of the connecting part and The bite plate causes frictional forces which lead to friction.

One Mandibular arch can include a healthy row of teeth, but also artificial Have dental or edentulous areas with a gingival surface. About that In addition, the bite device can be used for completely edentulous mandibular arch become.

The Mounting part has a fixed distance to the X-ray device on and allows it, the patient during a recording in the recording area to fix. At least the bite plate for the upper mandibular arch has a fixed positional relationship to the skull of the Patients on, as the upper arch of the mandible anatomically with the skull structures connected is.

One The advantage is that the fastening part with the Aufbissplatten indirectly via dedicated connecting parts be engaged. Thus, in contrast to the direct bite open an uptight section prevents it from slipping during recording or to a deformation of the Aufbissteils and thus to changes in position the respective mandibular arch comes before or during the recording.

One Another advantage is that at least one bite plate separately be attached by the fastening part in the mouth of the patient can. This is the comfort for increased the patient, because he does not, as in known bite devices, on a fixed with the X-ray device connected but not independent of this.

advantageously, For example, the connection part may have a connection surface in the form of a spherical section and the bite plate a corresponding second or third Connecting part with a second or third connection surface in shape a hollow hemisphere or a circular opening.

Thereby is it possible to adjust the bite plate around the center of the ball section, so that the upper arch of the mandible and thus the head of the patient or the lower mandibular arch in the desired angular position opposite the X-ray system can be brought.

advantageously, The bite plate can be an exact fit to at least parts of the mandibular arch trained bearing surface exhibit.

The bearing surface For example, it may be an impression of a mandibular arch on which the mandibular arch is applied to the bite plate on the mandibular arch to fix.

Thereby The bite plate can be repeated in a specific relative position be brought to the mandibular arch.

advantageously, the bite plate may include an impression of at least a portion of the mandibular arch.

Thereby has the bearing surface at least in part the negative shape of the mandibular arch, thereby enabling a precise and reproducible positioning of the bite plate on the mandibular arch.

advantageously, the bite device may have an upper bite plate for attachment of the upper arch of the mandible and a lower bite plate for attachment of the lower mandibular arch.

Thereby be for the positioning of the patient bite plates on both mandibular arch attached and biting The two Aufbissplatten be engaged with the fastening part brought. The lower jaw is so biting despite his freedom of movement the upper jaw repeatably fixed in a desired position.

advantageously, can the lower bite plate to the first connection part on Fastening part matching lower third connecting part.

Thereby could the mating connecting parts are precisely engaged.

advantageously, The bite plate can be a guide to the leadership of the first connection part.

Thereby will merge the patient the first connecting part of the fastening part with the second Connection part of the upper bite plate easier, because the first Connecting part of the fastening part, for example a ball section, is along the guide means, for example, a guide trough, to the second connection part of the upper bite plate, for example a hollow hemisphere led.

advantageously, the upper and lower bite plates can have latching means, at the bite the upper bite plate in a latching position relative to the bring lower bite plate, wherein in the locked position the Bite plates brought into engagement with a game against the mounting part are. With further biting is the upper and lower Aufbissplatte over the latching addition to each other movable.

The bite open can by squeezing the mandibular arch by a practitioner or directly through the Patients themselves. If the mandibular arch to a denture model belong, must through both jawbone when biting through a mechanical tensioning device are compressed.

At the bite open the upper and lower bite plates are moved towards each other and it comes to an approximation the bite plates. Rest at an initial approach the latching means and the Aufbissplatten reach into a latching position. With further biting follows an approximation the bite plates over the Einraststellung addition, whereby by the exerted pressure forces the Aufbissplatten across from can be fixed to the fastening part.

By the mechanical play in the latching position makes it possible the bite plates around the fastening part for fine positioning to move the patient's head in its angular position.

advantageously, may be a material of the second and third connecting part of the bite plate with a material of the first connecting part of the fastening part be combined so that by biting a frictional connection for fixation between the connecting parts of the Aufbissplatten and the first Connecting part can be produced.

To can be chosen a combination of materials that a high Has static friction coefficients on smooth surfaces. In addition, can the stiction between the connecting parts by a stronger roughness the connecting surfaces, which leads to mechanical toothing on contact of the connecting surfaces can be increased. The connecting surfaces can be designed in their shape so that they form a positive connection upon contact form. When you bite become pressure forces of the mandibular arch transferred to the Aufbissplatten and act as normal forces on the connection surfaces the connecting parts, so that depending on the static coefficient of friction Haftreibkräfte arise, which lead to friction. Mechanical gears and positive connections on the connecting surfaces can lead to more personnel lead to fixation.

advantageously, can the second and / or third connection part of the bite plate after placement on the respective mandibular arch within the oral cavity lie of the patient.

Thereby Be the biting resulting pressure forces transmitted to the connectors within the oral cavity of the patient and lead there to increased Friction, because the normal forces more even over the Distributed connecting surfaces are as it is outside the oral cavity lying connecting parts is the case. In addition, being outside the oral cavity lying connecting parts a higher Torque applied to the bite plate, causing a tilting of the Bite plate on the mandibular arch can be caused.

According to the invention, the Bite plate for positioning the mandibular arch of a patient in a photograph with an X-ray recording device, be so designed that the bite plate is a connecting part in a central area and in the edge area a support surface at least for parts of a Has mandibular arch.

Thereby the connecting part is located on the bite plate in the oral cavity of the Patients. The edge region is the arcuate edge in which the bearing surface at least for parts a dental arch is attached. The rest within the arcuate edge lying area is the central area.

The when biting occurring forces act on the bearing surfaces in the edge area and lead to a low torque on the connecting part. This will be a Fixation of the bite plate against the fastening part already when using low forces allows.

advantageously, the connecting part may be a bearing and the bearing surface a Have at least a portion of a mandibular arch.

Thereby the bite plate can be precise and repeatably engageable with the fastener. The fastening part can be positioned inside the bearing for fine positioning to be moved.

advantageously, the bite plate can be an attachment with the support surface and a base part with the second connecting part, wherein the attachment part is separable from the base part.

Thereby can when taking pictures of different patients to the respective mandibular arch matching top parts are exchanged, with the same base part is used. Another advantage is that a drilling template less expensive from the attachment than from a whole bite plate without Base part can be worked out because less material to remove is.

advantageously, the upper bite plate in the edge area can be the impression of the upper Have mandibular arch.

Thereby The bite plate can take up the upper mandibular arch.

advantageously, The lower bite plate in the edge area can be the impression of the lower Have mandibular arch.

Thereby The lower bite plate can accommodate the lower mandibular arch.

advantageously, the bite plate can be a connecting part in the form of a hollow Hemisphere or a circular Have opening.

Thereby may be a connecting part of the fastening part in the hemisphere or circular aperture stored and moved for fine positioning.

advantageously, The bite plate can be a guide to the connecting part, preferably in the form of a guide trough, exhibit.

Thereby may be the first connecting part of the fastening part to the connecting part guided the bite plate become.

This facilitates the patient the two connecting parts by feeling a merge mechanical pressure resistance.

advantageously, For example, the bite plate may have markers exposed by X-rays and can be recognized by light or touch sensors.

The Need markers an absorption degree for X-rays significantly, depending on the degree of absorption of the material the bite plate is different. The degree of absorption is a measure of the absorbed intensity the X-ray radiation. At a lower absorption level the markers appear on one X-ray photograph dark. At a higher Absorbency, the markers appear lighter. The reflection spectrum the marker must be reflected by the reflection spectrum of the surrounding surface same radiated light to pass through optical sensors to be recognized. When scanning with push-button sensors, the Markers have a characteristic surface to be recognized become.

advantageously, can the connecting part of the bite plate after putting on the respective mandibular arch lie within the oral cavity of the patient.

Thereby gets biting the frictional engagement between the connecting parts located inside the oral cavity compared to outside the oral cavity lying connecting parts improved because the pressure forces of Mandibular arch to evenly distributed normal forces at the connection surfaces and thus to higher ones frictional forces to lead. About that lead out the pressure forces at the arcuate Mandibular arch to torques that are opposite Power arms compensate each other, so that the total torque on the Aufbissplatten lying within the mouth cavity connecting parts is smaller and thus tilting the bite plate against the each mandibular arch is prevented.

According to the invention is a Fastener for positioning the mandibular arch of a patient called at a recording with an X-ray device the radiographic device can be appropriate. The fastening part points to the patient directed end a connecting part in the form of a spherical section on.

Thereby the fastening part has a fixed distance to the X-ray recording device, which is taken into account in the positioning of the patient to the relative Location of the patient's head to the X-ray device to determine. The respective bite plate can in the engaged position be swiveled around the ball for fine positioning.

advantageously, For example, the connecting part may be made of an initially deformable material consist after a deformation of at least 0.1 mm and at most 3 mm does not allow further deformation.

When biting, pressure forces occur at the connecting parts of the bite plates and the fastener partly on. In this case, the connecting part of the fastening part is first deformed by at least 0.1 mm and at most 3 mm until no further deformation is possible and the Aufbissplatten are fixed relative to the fastening part.

advantageously, the connecting part may consist of a hard core part which with an elastic layer having a thickness of at least 0.1 mm is disguised.

Thereby first deforms the connecting part of a bite plate when biting elastic layer and then abuts the hard core part.

A Another invention is a method for positioning the mandibular arch in a photograph with an X-ray recording device, each with a bite plate for attachment of the upper and of the lower arch of the mandible individually to the anatomical situation are provided. This bite plate, for example, in the dental laboratory or be made shortly before the recording. The bite plates are placed on the respective mandibular arch. The mandibular arch can natural mandibular arch a patient whose mouth must be wide open, or mandibular arch a dentition model. The connecting parts of the upper bite plate and the fastening part are brought into contact with each other. In doing so, the practitioner can see the head of the patient or the patient even move his head so that the connecting parts to each other guided be and get in touch.

in the Another process step, the connecting parts of the lower Bite plate and the attachment part brought into contact with each other. there the practitioner or the patient may himself lower the mandibular arch, as long as within the anatomical degrees of freedom opposite to the upper mandibular arch move up the connecting parts of the lower Kieferbogens and attaching part in contact. The Connecting parts of the bite plates become close together an engagement with the corresponding connecting part of the fastening part moves and form a frictional connection to this connecting part, so that the Aufbissplatten be fixed to the fastening part. The practitioner can by squeezing or the patient can by the biting to a frictional engagement between the connecting parts of the two Aufbissplatten and the fastening part.

One Advantage of this procedure is that the practitioner or the patient by the movement of the head and the lower jaw relative to Head must bring the connecting parts in contact with each other to the bite plate opposite to be able to fix the fastening part. The jaws are thereby repeatable at the desired Position opposite the X-ray device and fixed relative to each other.

According to the invention is a Method for positioning the mandibular arch during a recording with an X-ray device called, with an upper bite plate for attachment of the upper mandibular arch is provided individually matching the anatomical situation.

The upper bite plate is placed on the upper mandibular arch. The mouth of a patient or a denture model has to go far to be open, to facilitate placement.

The Connecting parts of the upper bite plate and the fastening part are brought into contact with each other. The upper mandibular arch or the patient's head may be by the practitioner or the patient himself be moved until the connecting parts in contact with each other reach.

The Connecting parts of the upper bite plate and the fastening part are moved towards each other until engagement and form a frictional engagement, so that the upper bite plate is fixed relative to the fastening part becomes. The two mandibular arch can be compressed by the practitioner or the patient himself, so that the lower jaw arch directly onto the lower side of the attachment part bites and pressure forces exerts the frictional engagement between the connecting parts of the upper bite plate and the fastening part.

This Procedure can be used to the upper mandibular arch and thus to position the head exactly. The lower jaw arch stays inside the anatomical degrees of freedom with respect to the upper arch of the mandible movable and can bite take different positions.

One Advantage of this procedure is that only the upper bite plate is used and bite the mandibular arch directly onto the lower side of the attachment. to better power transmission can, for example, a bite surface with at the bottom of the fastening part Grooved be attached.

One Another inventive method for Positioning of the mandibular arch when recording with an X-ray device is that a lower bite plate for attaching the Lower mandibular arch individually to the anatomical situation provided.

The lower bite plate is placed on the lower mandibular arch. It must have a Gebissmo be open or the patient's mouth open.

The Connecting parts of the lower bite plate and the fastening part are brought into contact with each other. The lower jawbone is going through a practitioner or the patient himself moves, with the connecting parts be merged.

The Connecting parts of the lower bite plate and the fastening part are moved towards each other until engagement and form a frictional connection so that the lower bite plate is fixed opposite the attachment part becomes. The two mandibular arch can be compressed by the practitioner or the patient himself, allowing the upper mandibular arch directly to the upper side of the attachment part bites and pressure forces exerts the frictional engagement between the connecting parts of the lower bite plate and the fastening part.

This Method corresponds to the previously mentioned method with the difference that the lower mandibular arch is positioned and by biting the upper mandibular pressure forces on the upper side of the fastening part exercises. For better power transmission can at the top of the attachment part with a bite surface Grooved be attached.

advantageously, can at the initial movement of the second and third connecting parts of the upper and lower Bite plate on the first connection part of the fastening part the second and third connecting part slightly against the first connecting part depressed be and get into a latching position, the bite plate across from the fastening part remains movable for fine positioning. In the engagement can be by the practitioner himself or by his Instructions to the patient the fine positioning are performed in particular the desired angular position to precisely set the bite plates.

advantageously, can the upper or lower bite plate for attaching the upper or lower mandibular arch individually to the anatomical situation is manufactured. The manufacturing can be done in a dental laboratory or directly take place at the treatment center. An individual bite plate can an impression of the mandibular arch, by means of a hardening Mold is made.

advantageously, the first connecting part of the fastening part can along a guide means be performed on the bite plate to the connecting part of the bite plate and the connecting parts are brought into contact there with each other. The first connection part can be achieved by a movement of the patient's head be guided by a practitioner or the patient himself.

Thereby it is easier to the connecting parts in contact with each other bring. The guiding means can the shape of a converging to the connecting part of the bite plate Have hollow.

advantageously, can be based on the data from the radiograph performed an implant planning become. The bite plate has markers that form a coordinate system specify in which the planned implant with respect to its position and orientation is fixed.

Thereby give the markers, which are also detectable in the x-ray are, a coordinate system in which the position information of the planned implants and anatomical structures such as teeth, root canals and jawbones be determined.

The Application of markers and light or push-button sensors for transmission of the coordinate system from implant planning to a processing machine, advantageously requires a 3D X-ray representation by means of known 3D X-ray devices can be generated. The markers can thereby in the spatial Representation recognized in a simple manner and in their exact spatial Location to be determined.

advantageously, The bite plate can be used in a processing machine and the markers can be detected by sensors, so that in by the markers set Coordinate system bores are introduced in the bite plate, their extension has the position and orientation of the planned implant.

to Detection of the markers can For example, light or touch sensors are used, based on of the reflection spectrum distinguish the markers from the surrounding material.

The Markers on the bite plates give the X-ray image coordinate system before the implant planning was carried out. Thus, the situation of the implants known the bite plates. The processing machine can then automatically be driven to perform the holes in the Aufbissplatten.

Advantageously, the bite plate can be positioned in a processing machine with a unique positional relationship to the processing machine, so that the relative position of the planned implants is known and a hole is introduced into the bite plate whose extensions has the position and orientation of the planned implant.

Thereby are no markers and no sensors in the processing machine necessary. The bite plate is clearly in the processing machine positioned, for example by placing the bite plate on defined areas the processing machine whose position relative to the processing machine is known.

advantageously, can in the holes drill sleeves can be introduced and the bite plate can be reworked be that they as a drilling template for attachment of the implant bore for the implant to be used is usable.

One Advantage is that the drill sleeves as a guide for the Drill and allow to install precise implant holes.

One Another advantage is that the drilling templates are not in an additional Process, but are made from the already existing Aufbissplatten. this leads to to a reduction of production costs. Furthermore become possible mistakes prevents the transmission of location information of the planned implants with respect to the Mandibular arch for a separate manufacturing process of drilling templates occur would.

advantageously, the bite plate from an attachment with an imprint the each mandibular arch and consist of a base part. For post-processing for use as a drilling template is the attachment with the impression removed from the base part.

Thereby can use the same base part for several patient-specific attachments are used. Furthermore In order to make a drilling template, less material in the Post-processing of the attachment to be removed as a whole Bite plate.

advantageously, may be a model of the upper or lower arch of the patient be clamped in a processing machine. The corresponding Bite plate is placed on the model. The markers on the bite plate are detected by sensors and that determined by the markers Coordinate system is registered.

The Model corresponds in shape at least partially to the respective Arch. The coordinate system defined by the markers becomes registered by the machine tool, so that the position information of planned implants from implant planning to the model can.

advantageously, the bite plate can be removed from the model and taken into account of the coordinate system can be a hole in the model with position and orientation of the planned implant are introduced. The Drilling can taking into account by means of a computer-controlled drilling device the location information of the planned implants done. To do this rod inserted into the holes on the model. A perfect fit to the model Shaped template will be placed on the model and on the chopsticks drill sleeves attached so that the template with the drill sleeves as a drilling template for Introduction of the holes for the implants to be used can be used.

Thereby become the drill sleeves set along the axes of the holes for the planned implants.

Brief description of the drawings

embodiments The invention are illustrated in the drawing. It shows the

1 an overall view of an X-ray;

2 a bite device in the separated state;

3 Bite off 3 in the merged state;

4a upper bite plate seen from below;

4b upper bite plate seen from above;

5a a fastening part for both Aufbissplatten;

5b a fastening part only for the upper Aufbissplatte;

6a a bite device with both bite plates;

6b a side view of the bite from 6a in the oral cavity of the patient;

7a a side view of the bite device as in 6b only with the upper bite plate;

7b a side view of the bite device as in 6b only with the lower bite plate;

8th Bite device as in 6a with latching means on the bite plates;

9 a processing machine with a drilling template clamped thereon;

10 a drill template for the upper mandibular arch;

11 a model of the upper jawbone with the upper bite plate;

12 a drill template on the model 11 ,

Embodiments of the invention

The 1 shows the overall view of an X-ray device 1 , The X-ray device 1 includes a bite device 2 for positioning a patient 3 for taking a picture with the X-ray recording device 1 , Especially the oral cavity of the patient with an upper mandibular arch 3.1 and a lower mandibular arch 3.2 should be recorded. In the illustrated X-ray device 1 it is a dental Cone-Beam X-ray scanner. The bite device 2 includes a fastening part 4 attached to the X-ray device 1 is attached and an upper bite plate 5 in the oral cavity of the patient 3 is appropriate.

The 2 shows the bite device 2 consisting of the fastening part 4 and the upper bite plate 5 , The fastening part 4 is at one end via a plug connection 6 firmly with the X-ray device 1 out 1 connected and has at the opposite end a connecting part 7 with a connection surface 7.1 in the form of a sphere section. In the middle area has the attachment part 4 a bite strip 8th on, from the upper side of the bite plate 5 is created and the patient 3 out 1 with his lower jaw arch on the lower side of the bite strip 8th it bites.

The bite plate 5 has a connecting part 9 with a connection surface 9.1 in the form of a circular opening in a central area 5.1 on. In a border area 5.2 has the bite plate 5 an impression 10 of the patient's upper arch 3 on.

The 3 shows the bite device 2 , wherein the connecting part 7 the fastening part 4 with the connecting part 9 the bite plate 5 is engaged. The interface 7.1 in the form of a spherical section allows the bite plate 5 relative to the fastening part 4 to adjust the center of the ball section for fine positioning, the angular position of the upper mandibular arch and thus the patient's head 3 relative to the X-ray device 1 out 1 to position.

The upper bite plate 5 is placed on the upper mandibular arch. When bitten by the patient 3 out 1 Pressure forces through the upper arch of the mandible to the upper bite plate 5 and through the lower jaw arch to the lower side of the bite bar 8th exerted, so that it leads to a frictional connection between the connecting parts 7 and 9 comes and the patient 3 out 1 thus fixed in position.

The 4a shows another embodiment of the upper bite plate 5 from the bottom view. The connecting part 9 has a connection surface 9.1 in the form of a hollow hemisphere and serves as a storage for the connecting part 7 with a connection surface 7.1 in the form of a sphere section. A guide 11 in the form of a guide trough leads the spherical connecting part 7 to the connecting part 9 the bite plate. This makes it easier for the patient 3 out 1 by moving his head the two connecting parts 7 and 9 merge. A lower bite plate may be designed in the same way with a guide means and a third connection part with a connection surface.

The 4b shows the bite plate 5 out 4a in the view from above. The bite plate 5 includes an attachment 12 with the patient-specific impression 10 and a base part 13 , At the edge of the base part 13 there is a depression 14 in which the attachment part 12 of the upper mandibular arch is fastened by plug connections. The attachment 12 can from the base part 13 be separated and replaced with an attachment that fits the upper jawbone of another patient. A lower bite plate can accordingly an attachment with an impression of the lower mandibular arch and a base part 13 include. This can be the same base part 13 as part of the upper bite plate 5 and the lower bite plate.

The 5a shows a fastening part 4 from the perspective of obliquely above, the one end of a plug connection 6 and at the opposite end the connecting part 7 with a connection surface 7.1 has in the form of a ball cutout. In this case, the connecting part protrudes 7 on both sides of the bite strip with an upper connecting surface 7.2 and a lower connection surface 7.3 out. The upper connection surface 7.2 can with the interface 9.1 the upper bite plate 9 and the lower connection surface 7.3 can be brought into engagement with the connecting surface of the lower bite plate, not shown.

The connecting part 7 consists of an elastic layer 7.4 with a thickness of 0.5 mm and an inner hard core part 7.5 , This initially becomes the elastic layer at initial biting 7.4 deformed, leaving the bite plates opposite the attachment part 4 can be adjusted for fine positioning. Upon further biting, the connecting parts of the bite plates hit the inner hard core part 7.5 and it comes to frictional engagement with the connecting parts of the fastening part, so that the Aufbissplatten be fixed.

The 5b shows a fastening part 4 from the perspective of diagonally below, that at the connecting part 7 a connection surface 7.2 in the form of an upwardly directed spherical cutout and on the lower side of the bite strip 8th grooves 15 available. This fastening part 4 only with the upper bite plate 5 used. As you bite, pressure forces from the lower jaw arch directly onto the lower side of the bite bar 8th transferred, where there are grooves 15 the slipping in the longitudinal direction of the connecting part 7 prevent. An attachment for the lower bite plate can be made the same with the difference that the connecting part 7 a connection surface 7.3 out 5a in the form of a downward spherical section only.

The 6a shows a bite device 2 comprising a fastening part 4 , an upper bite plate 5 and a lower bite plate 16 , The fastening part 4 is in 5a shown and has a connection surface 7.2 to the upper bite plate 5 and a connection surface 7.3 to the lower bite plate 16 on, which are not shown. The upper bite plate 5 is in the 2 shown. It points in the edge area 5.2 an impression 10 of the upper arch of the mandible and in the central area 5.1 a connecting part 9 with a connection surface 9.1 in the form of a circular aperture for connection to the upper interface 7.2 , on. The lower bite plate 16 points in a border area 16.1 an impression 17 the lower mandibular arch and in the central area a connecting part 18 with a connection surface 18.1 in the form of a circular aperture for connection to the lower connection surface 7.3 on.

At initial biting by the patient 3 out 1 reach the upper connecting surfaces 9.1 . 7.2 and the lower connection surfaces 18.1 . 7.3 engaged and can still be moved against each other for fine positioning. Upon further biting frictional engagement between the connecting surfaces and the Aufbissplatten 5 and 16 are thus opposite the attachment part 4 fixed.

The 6b shows a side view of the bite device 2 out 6a in the oral cavity of the patient 3 , The upper bite plate 5 is at the upper mandibular arch 3.1 of the patient 3 and the lower bite plate 16 is at the lower mandibular arch 3.2 of the patient 3 attached. By occurring during biting pressure forces of the patient 3 were the bite plates 5 and 16 moving towards each other and the connecting part 9 the upper bite plate 5 opposite the connecting part 7 at the upper connecting surfaces 9.1 . 7.2 fixed. The connecting part 18 the lower bite plate 16 was opposite the connecting part 7 at the lower connecting surfaces 18.1 . 7.3 fixed.

The connecting parts 9 . 7 and 18 are located within the oral cavity of the patient during positioning 3 behind the arched mandibular arch 3.1 and 3.2 in the direction of the pharynx.

The 7a shows a side view of the bite device 2 as in 6b in the oral cavity of the patient 3 with the difference that only the upper bite plate 5 is used. When biting, the lower mandibular arch exercises 3.2 Pressure forces on the lower side of the fastening part 4 so that the connecting part 9 opposite the connecting part 7 at the upper connecting surfaces 9.1 and 7.2 be fixed. To better transfer the pressure forces are grooves 15 on the lower side of the connecting part 4 arranged.

The 7b shows a side view of the bite device 2 as in 6b in the oral cavity of the patient 3 with the difference that only the lower bite plate 16 is used. When biting, the upper mandibular arch exercises 3.1 Pressure forces on the upper side of the fastening part 4 out 5b out, leaving the connecting part 18 opposite the connecting part 7 at the lower connecting surfaces 18.1 and 7.3 be fixed. To better transfer the pressure forces are grooves 15 on the upper side of the connecting part 4 arranged.

The 8th shows the bite device 2 as in 6a with a latching means 19 on the upper bite plate and a matching latching device 20 at the lower bite plate. At initial biting, the latching means snap 19 and 20 one another and the Aufbissplatten get into the engaged position. In the latching position be still little play between the upper connecting surfaces 7.2 . 9.1 and the lower connection surfaces 18.1 and 7.3 so the bite plates 5 and 16 in its angular position about the center of the connecting part 7 can be adjusted for fine positioning.

Upon further biting unlock the latching means 19 and 20 and the latch is left. The pressure forces lead to a frictional connection between the upper connecting surfaces 7.2 . 9.1 and the lower connection surfaces 18.1 and 7.3 and the bite plates 5 and 16 be opposite the attachment part 4 fixed.

The 9 shows a processing machine 30 with a drilling template clamped on it 31 , The drilling template has markers 32 on, whose position of sensors 33 is determined. The markers 32 give a coordinate system 34 in which carried out on the basis of the 3D radiograph implant planning, with the position and orientation of the implant to be used has been established. The drilling template 31 is provided around holes for the implants to be inserted into the jawbone of the patient 3 out 1 contribute. For this purpose, by means of a drilling device 35 computerized drilling 36 at the drilling template 31 performed, their extension along the drilling axes 37 has the positions and orientation of the holes for the planned implants. The processing machine 30 is also intended, for example, in the manufacture of the drilling template 31 from the upper bite plate 5 out 2 or from the attachment 4b manufacture. For attachment of holes and removal of material can be next to the bite plate 5 or 16, the attachment 12 Also prefabricated template blanks or models of mandibular arch in the stencil blanks or models of mandibular arch in the processing machine 30 be clamped.

The 10 shows the patient's upper arch 3 out 1 at the the drilling template 31 is appropriate. The template was removed from the upper bite plate 5 out 4b manufactured. This was the attachment 12 from the base part 13 removed and into the processing machine 30 cocked and the excess material was removed, leaving only the impression 14 the upper jaw arch was recessed. From the positions of the markers 32 became the coordinate system 34 determined in which the implant planning was carried out on the basis of the X-ray. The markers 32 at the in the processing machine 30 clamped attachment 12 be through the sensors 33 measured and based on the detected positions, the drilling device 35 at the processing machine 30 be controlled so that bores 36 in the attachment 12 The extensions of the planned drill holes for the implants with the drill axes are applied 37 represent. In the holes 36 be drilling sleeves 38 used as a guide for a drill to attach the holes for the implants.

Alternatively, the drilling template 30 also from a whole bite plate 5 as in 2 be worked out so that the impression 10 is omitted.

The 11 shows a model 40 of the upper jawbone with a bite plate placed thereon 5 , where markers 32 at the bite plate 5 are arranged.

In another method of making a surgical template 31 becomes the model 40 clamped in a processing machine, the bite plate 5 with markers 32 put on the markers 32 through sensors 33 and recognized by the markers 32 fixed coordinate system 34 through the processing machine 30 registered.

In the 12 is displayed as the drilling template 30 after registration 11 will be produced.

Through a drilling device on the machine are drilling holes 50 along the drilling axes 37 in the model 40 brought in. rod 51 be in the holes 50 plugged in. One in shape to the model 40 suitable drilling template 30 is put on and on the chopsticks 51 become the drill sleeves 38 at the drilling template 31 appropriate. This will ensure that the drill sleeves 38 along the drilling axes 37 at the drilling template 31 be attached.

1

X-ray system

2

bite device

3

patient

3.1

upper mandibular arch

4

attachment portion

3.2

lower mandibular arch

5

upper biteplate

6

connector

7

connecting part on the fastening part

7.1

Interface at the attachment portion

7.2

upper interface

7.3

lower interface

7.4

elastic layer

7.5

tough core part

8th

Aufbissleiste

9

connecting part at the bite plate

9.1

Connecting surface at the biteplate

10

imprint

11

Guide means guide depression

12

attachment

13

base

14

deepening

15

grooves

16

Lower biteplate

17

imprint the lower mandibular arch

18

connecting part the lower bite plate

18.1

Connecting surface of the connecting part 18

19

latching at the upper bite plate

20

latching at the lower bite plate

30

processing machine

31

Drilling templates

32

marker

33

sensors

34

coordinate system

35

drilling

36

drilling

37

drilling axes

38

drill sleeves

40

model of a mandibular arch

50

drilling on the model

51

rod

5.1

central Area of upper bite plate

5.2

border area the upper bite plate

16.1

central Area of lower bite plate

16.2

border area the lower bite plate

Claims (35)

Bite device ( 2 ) for positioning a patient ( 3 ) for taking a picture with an X-ray recording device ( 1 ) comprising at least one at the X-ray recording device ( 1 ) arranged fastening part ( 4 ) and at least one opposite the fastening part ( 4 ) movable bite plate ( 5 . 16 ), wherein on the fastening part ( 4 ) a connecting part ( 7 ) for the bite plate ( 5 . 16 ), characterized in that the bite plate ( 5 . 16 ) in the region of the connecting part ( 7 ) from the fastening part ( 4 ) is separable and that when biting the bite plate ( 5 . 16 ) in the region of the connecting part ( 7 ) in engagement with the connecting part ( 7 ) can be brought. Bite device ( 2 ) according to claim 1, characterized in that the connecting part ( 7 ) a connection surface ( 7.1 ) in the form of a spherical section and the bite plate ( 5 . 16 ) a corresponding second or third connecting part ( 9 . 18 ) with a second or third connection area ( 9.1 . 18.1 ) in the form of a hollow hemisphere or a circular opening. Bite device ( 2 ) according to claim 1 or 2, characterized in that the bite plate ( 5 . 16 ) an exact fit to at least parts of the mandibular arch ( 3.1 . 3.2 ) has formed contact surface. Bite device ( 2 ) according to one of claims 1 to 3, characterized in that the bite plate ( 5 . 16 ) an impression ( 10 . 17 ) at least part of the mandibular arch ( 3.1 . 3.2 ) includes. Bite device ( 2 ) according to one of claims 1 to 4, characterized in that the bite device ( 2 ) an upper bite plate ( 5 ) for fixing the upper mandibular arch ( 3.1 ) and a lower bite plate ( 16 ) for fixing the lower arch of the mandible ( 3.2 ) having. Bite device ( 2 ) according to claim 5, characterized in that the lower bite plate ( 16 ) that to the first connecting part ( 7 ) matching lower third connecting part ( 18 ) having. Bite device ( 2 ) according to one of claims 1 to 5, characterized in that the bite plate ( 5 . 16 ) a guiding means ( 11 ) for guiding the first connecting part ( 7 ) having. Bite device ( 2 ) according to one of claims 1 to 7, characterized in that the upper and lower bite plate ( 5 . 16 ) Latching means ( 19 . 20 ) when biting the upper bite plate ( 5 ) in a latching position relative to the lower bite plate ( 16 ), wherein in the latching position the bite plates ( 5 . 16 ) in engagement with a game against the fastening part ( 4 ), with further biting the upper and lower bite plates ( 5 . 16 ) is movable beyond the latching position to each other. Bite device ( 2 ) according to one of claims 1 to 8, characterized in that a material of the second and third connecting part ( 9 . 18 ) of the bite plate ( 5 . 16 ) with a material of the first connecting part ( 5 ) of the fastening part ( 4 ) is combined so that by the biting frictional engagement for fixing between the connecting parts ( 9 . 18 ) of the bite plates ( 5 . 16 ) and the first connection part ( 7 ) can be produced. Bite device ( 2 ) according to one of claims 1 to 9, characterized in that the second and / or third connecting part ( 9 . 18 ) of the bite plate ( 5 . 16 ) after placement on the respective mandibular arch ( 3.1 . 3.2 ) within the oral cavity of the patient ( 3 ) lies. Bite plate ( 5 . 16 ) for positioning a patient ( 3 ) in a recording with an X-ray recording device ( 1 ), characterized in that the bite plate ( 5 . 16 ) a connecting part ( 9 . 18 ) in a central area ( 5.1 ) and in the edge area ( 5.2 ) a support surface ( 10 . 17 ) at least for parts of a mandibular arch ( 3.1 . 3.2 ) having. Bite plate ( 5 . 16 ) according to claim 11, characterized in that the connecting part ( 9 . 18 ) is a bearing and the bearing surface an impression ( 10 . 17 ) at least part of a mandibular arch ( 3.1 . 3.2 ) having. Bite plate ( 5 . 16 ) according to claim 11 or 12, characterized in that the bite plate ( 5 . 16 ) an attachment ( 12 ) with the support surface ( 10 . 17 ) and a base part ( 13 ) with the second connecting part ( 9 ), wherein the attachment part ( 12 ) from Base part ( 13 ) is separable. Bite plate ( 5 ) according to claim 11 to 13, characterized in that the upper bite plate ( 5 ) at the edge ( 5.2 ) the impression ( 10 ) of the upper mandibular arch ( 3.1 ) having. Bite plate ( 16 ) according to one of claims 11 to 14, characterized in that the lower bite plate ( 16 ) at the edge ( 16.2 ) the impression ( 17 ) of the lower mandibular arch ( 3.2 ) having. Bite plate ( 5 . 16 ) according to one of claims 11 to 15, characterized in that the bite plate ( 5 . 16 ) a connecting part ( 9 . 18 ) in the form of a hollow hemisphere or a circular opening. Bite plate ( 5 ) according to one of claims 11 to 16, characterized in that the bite plate ( 5 ) a guiding means ( 11 ) to the connection part ( 9 . 18 ), preferably in the form of a guide trough. Bite plate ( 5 . 16 ) according to one of claims 11 to 17, characterized in that the bite plate ( 5 . 16 ) Markers ( 32 ), which are detectable by X-radiation and by light or touch sensors. Bite plate ( 5 . 16 ) according to one of claims 11 to 18, characterized in that the connecting part ( 9 . 18 ) of the bite plate ( 5 . 16 ) after placement on the respective mandibular arch ( 3.1 . 3.2 ) within the oral cavity of the patient ( 3 ) lies. Mounting part ( 4 ) for positioning the mandibular arch ( 3.1 . 3.2 ) in a recording with an X-ray recording device ( 1 ), wherein the fastening part ( 4 ) is attached to the X-ray recording device, characterized in that the fastening part ( 4 ) on to the patient ( 3 ) directed end a connecting part ( 7 ) in the form of a spherical segment. Mounting part ( 4 ) according to claim 20, characterized in that the connecting part ( 7 ) consists of an initially deformable material which, after deformation of at least 0.1 mm and not more than 3 mm, does not allow any further deformation. Mounting part ( 4 ) according to one of claims 20 or 21, characterized in that the connecting part ( 7 ) from a hard core part ( 7.5 ), which is provided with an elastic layer ( 7.4 ) is covered with a thickness of at least 0.1 mm. Method for positioning the mandibular arch ( 3.1 . 3.2 ) in a recording with an X-ray recording device ( 1 ), characterized in that - in each case a bite plate ( 5 . 16 ) for attaching the upper and lower mandibular arch ( 3.2 ) is provided individually matching the anatomical situation, - that the Aufbissplatten ( 5 . 16 ) on the respective mandibular arch ( 3.1 . 3.2 ), - that the connecting parts ( 7 . 9 ) of the upper bite plate ( 5 ) and the fastening part ( 4 ) are brought into contact with each other, - that the connecting parts ( 7 . 18 ) of the lower bite plate ( 16 ) and the fastening part ( 4 ) are brought into contact with each other, - that the connecting parts ( 9 . 18 ) of the bite plates ( 5 . 16 ) towards each other until engagement with the corresponding connecting part ( 7 ) of the fastening part ( 4 ) and a frictional connection to this connecting part ( 7 ), so that the bite plates ( 5 . 16 ) to the fastening part ( 4 ) are fixed. Method for positioning the mandibular arch ( 3.1 . 3.2 ) in a recording with an X-ray recording device ( 1 ), characterized in that - an upper bite plate ( 5 ) for fixing the upper mandibular arch ( 3.1 ) is provided individually matching the anatomical situation, - that the upper bite plate ( 5 ) on the upper mandibular arch ( 3.1 ), - that the connecting parts ( 7 . 9 ) of the upper bite plate ( 5 ) and the fastening part ( 4 ) are brought into contact with each other, - that the connecting parts ( 7 . 9 ) of the upper bite plate ( 5 ) and the fastening part ( 4 ) are moved towards each other until engagement and form a frictional engagement, so that the upper bite plate ( 5 ) opposite the fastening part ( 4 ) is fixed. Method for positioning the mandibular arch ( 3.1 . 3.2 ) in a recording with an X-ray recording device ( 1 ), characterized in that - a lower bite plate ( 16 ) for fixing the lower arch of the mandible ( 3.2 ) is provided individually matching the anatomical situation, - that the lower bite plate ( 16 ) on the lower mandibular arch ( 3.2 ), - that the connecting parts ( 7 . 18 ) of the lower bite plate ( 16 ) and the fastening part ( 4 ) are brought into contact with each other, - that the connecting parts ( 7 . 18 ) of the lower bite plate ( 16 ) and the fastening part ( 4 ) are moved towards each other until engagement and form a frictional connection, so that the lower bite plate ( 16 ) opposite the fastening part ( 4 ) is fixed. Method according to one of claims 23 to 25, characterized in that during the initial movement of the connecting part ( 9 . 18 ) of the bite plate ( 5 . 16 ) on the connecting part ( 7 ) of Be fastening part ( 4 ) the connecting part ( 5 . 16 ) slightly against the connecting part ( 7 ) is pressed and comes into a latching position, wherein the bite plate ( 5 . 16 ) opposite the fastening part ( 4 ) remains movable for fine positioning. Method according to one of claims 23 to 26, characterized in that the bite plate ( 5 . 16 ) for fixing the mandibular arch ( 3.1 . 3.2 ) is manufactured individually to match the anatomical situation. Method according to one of claims 23 to 27, characterized in that the first connecting part ( 7 ) of the fastening part ( 4 ) along a guide means ( 11 ) on the bite plate ( 5 . 16 ) to the connection part ( 9 . 18 ) of the bite plate ( 5 . 16 ) and the connecting parts ( 7 . 9 . 18 ) are brought into contact there. Method according to one of claims 23 to 26, characterized in that based on the data from the X-ray implant planning is performed that the bite plate ( 5 . 16 ) Markers ( 32 ) having a coordinate system ( 34 ), in which the planned implant is determined with respect to its position and orientation. A method according to claim 27, characterized in that the bite plate ( 5 . 16 ) in a Bearbeitungsma machine ( 30 ) and the markers ( 32 ) by sensors ( 33 ), so that in by the markers ( 32 ) coordinate system ( 34 ) Drilling ( 36 ) in the bite plate ( 5 . 16 ), the extension of which has the position and orientation of the planned implant. Method according to one of claims 23 to 26, characterized in that the bite plate ( 5 . 16 ) in a processing machine ( 30 ) with a unique positional relationship to the processing machine ( 30 ), so that the relative position of the planned implants is known and a bore ( 36 ) into the bite plate ( 5 . 16 ), the extension of which has the position and orientation of the planned implant. A method according to claim 28 or 29, characterized in that in the holes ( 36 ) Drill sleeves ( 38 ) and the bite plate ( 5 ) is reworked so that it can be used as a drilling template ( 31 ) is used for attaching the implant bore for the implant to be used. A method according to claim 30, characterized in that the bite plate ( 5 . 16 ) from an attachment ( 12 ) with an imprint ( 10 . 17 ) of the respective mandibular arch ( 3.1 . 3.2 ) and from a base part ( 13 ) and for post-processing for use as a drilling template ( 31 ) the attachment ( 12 ) with the imprint ( 10 . 17 ) from the base part ( 13 ) is removed. Method according to one of claims 23 to 26, characterized in that a model ( 40 ) of the upper and lower mandibular arch ( 3.1 . 3.2 ) of the patient ( 3 ) in a processing machine ( 30 ) is clamped, that the corresponding bite plate ( 5 . 16 ) on the model ( 40 ) is set, that the markers ( 32 ) on the bite plate ( 5 . 16 ) by sensors ( 33 ) and the markers ( 32 ) fixed coordinate system ( 34 ) is registered. A method according to claim 32, characterized in that the bite plate ( 5 . 16 ) of the model ( 40 ) and considering the coordinate system ( 34 ) a hole in the model ( 40 ) with the position and orientation of the planned implant is introduced, that rods ( 51 ) into the holes ( 50 ) on the model ( 40 ), an exact fit to the model ( 40 ) shaped stencil on the model ( 40 ) and on the sticks ( 51 ) Drill sleeves ( 38 ), so that the template with the drill sleeves ( 38 ) as a drilling template ( 31 ) can be used to introduce the holes for the implants to be used.