DE102006038744B4 - A bite device, a bite plate, and a method of positioning a patient when taken with an X-ray device - Google Patents

Abstract

A bite device (2) for positioning a patient (3) for producing a receptacle with an X-ray receiving device (1) comprising at least one fastening part (4) arranged on the X-ray receiving device (1) and at least one bite plate (5) movable relative to the fastening part (4) 16), wherein on the fastening part (4) a first connecting part (7) for the bite plate (5, 16) is provided, wherein when biting the bite plate (5, 16) in the region of the first connecting part (7) in engagement with the first Connecting piece (7) can be brought and wherein the bite plate (5, 16) in the region of the first connecting part (7) from the fastening part (4) is separable, characterized in that the first connecting part (7) has a first connecting surface (7.1) in the form of a Ball portion and the Aufbissplatte (5, 16) a corresponding second or third connecting part (9, 18) with a second or third connecting surface (9.1, 18.1) in the form of a hollow hemisphere or a circular opening.

Description

Technical area

The invention relates to a bite device for positioning a patient for producing a recording with an X-ray recording device. In this case, the bite device comprises at least one fastening part arranged on the X-ray receiving device and at least one bite plate movable relative to the fastening part, wherein a connecting part for the bite plate is provided on the fastening part.

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

State of the art

For positioning a patient in a dental X-ray device, light sights are generally used. In dental x-ray devices with head vertical positioning, positioning is accomplished by the patient biting on a bite portion that is connected to the dental x-ray machine and whose positional relationship to the dental x-ray unit is known. Positioning a patient while seated or standing can be accomplished by means of a chin rest or a strap, which reduces patient comfort when using straps. In dental X-ray devices with horizontal positioning of the head positioning often takes place by supporting the head on a special cushion.

However, these types of positioning have the disadvantage that they permit slight changes in the position of the patient's head during the X-ray exposure and thus lead to errors in the X-ray images in the form of movement artifacts or for X-ray recording of volumes that deviate from the desired 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 19629708 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.

The US 5,090,047 A discloses a device for positioning an image sensor, for example an X-ray film, in the mouth of a patient at a certain distance from the X-ray source.

The US 2002/0160337 A1 discloses a method for computer-assisted modification of an impression.

The DE 20 2005 009 782 U1 shows a Bohr stencil manufacturing and planning tripod.

The skull of a patient is fixed in position in the deep drawing rails of a bite fork for data acquisition by means of X-ray. In this case, the X-ray device is precisely adjusted when taking transversal slice exposures and tomographies are made possible exactly at a marked implant position.

The mentioned methods have the disadvantage; that when biting on a Aufbissteil or on a bite fork for slipping or deformation of these can come. Moreover, with the upper jaw fixed, the lower jaw can be positioned differently with respect to the upper jaw within the anatomical degrees of freedom. This can lead to incorrect positioning.

Accordingly, it is the object of this invention to provide a bite device which permits precise positioning of both the maxilla and the mandible with a known positional relationship to the x-ray apparatus.

Presentation of the invention

This object is achieved by the specified devices and. Procedure solved.

According to the invention, the bite device for positioning a patient to produce a receptacle with an X-ray receiving device comprise at least one fastening part arranged on the X-ray receiving device and at least one bite plate movable relative to the fastening part, wherein a connecting part for the bite plate is provided on the fastening part.

The bite plate is separable from the fastening part in the region of the connecting part. When biting the bite plate in the region of the connecting part in engagement with the connecting part can be brought. In this case, the bite plate on a connecting part in the form of a pick hemisphere or a circular opening.

When biting, the lower jaw arch and the upper jaw arch are moved towards each other. As a result, compressive forces are transmitted from the upper or lower jaw arch to the upper or lower bite plate and from the lower or upper jaw arch to the fastening part, so that the fastening part and the upper and lower bite plate are 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 coefficient of friction between the surfaces of the connecting part and the Aufbissplatte it comes to frictional forces, which lead to frictional engagement.

A mandibular arch can include a healthy row of teeth, but also have artificial tooth replacement parts or toothless areas with a gingival surface. In addition, the bite device can be used for fully edentulous mandibular arch.

The fastening part has a fixed distance to the X-ray recording device and makes it possible to fix the patient during a recording in the recording area. At least the bite plate for the upper mandibular arch has a fixed positional relationship to the skull of the patient, since the upper mandibular arch is anatomically connected to the skull structures.

One advantage is that the fastening part is indirectly brought into engagement with the bite plates via connection parts provided for this purpose. Thus, in contrast to the direct biting on a Aufbissteil prevents it comes during recording to slipping or deformation of the bite and thus changes in position of the respective mandibular arch before or during recording.

A further advantage is that at least one bite plate can be attached separately from the fastening part in the oral cavity of the patient. Thus, the comfort for the patient is increased because it is not, as in known bite devices, positioned at a fixed to the Rönügenaufnahmeeinrichtung Aufbissteil, but independent of this.

Advantageously, the connecting part may have a connecting surface in the form of a spherical section and the bite plate a corresponding second or third connecting part with a second or third connecting surface in the form of a hollow hemisphere or a circular opening.

This makes it possible to adjust the bite plate about the center of the ball portion, so that the upper mandibular arch and thus the head of the patient or the lower mandibular arch can be brought into the desired angular position relative to the X-ray receiving device.

Advantageously, the bite plate can have a support surface designed to fit at least parts of the mandibular arch.

The support surface may be, for example, an impression of a mandibular arch on which the mandibular arch is applied to secure the bite plate to the mandibular arch.

Thereby, the bite plate can be repeatedly brought into a specific relative position to the mandibular arch.

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

As a result, the support surface at least partially on the negative shape of the mandibular arch and thereby allows accurate and reproducible positioning of the bite plate on the mandibular arch.

Advantageously, the bite device may have an upper bite plate for attaching the upper mandibular arch and a lower bite plate for securing the lower mandibular arch.

This fixes Aufbissplatten on both mandibular arch for the positioning of the patient and biting the two Bite plates brought into engagement with the fastening part. The lower jaw is thus fixed in biting despite its freedom of movement relative to the upper jaw repeatable in a desired position.

The lower bite plate can advantageously have the lower third connecting part, which is suitable for the first connecting part on the fastening part.

This would allow the mating connection parts to be precisely engaged.

Advantageously, the bite plate may have a guide means for guiding the first connection part.

This facilitates the merging of the first connecting part of the fastening part with the second connecting part of the upper bite plate, because the first connecting part of the fastening part, for example a ball section, becomes along the guide means, for example a guide trough, to the second connecting part of the upper bite plate, for example one hollow hemisphere led.

Advantageously, the upper and lower bite plates may comprise latching means for, when biting, bringing the upper bite plate into a latching position relative to the lower bite plate, wherein in the latched position the bite plates are brought into engagement with the fixture against play. Upon further biting, the upper and lower bite plates are movable beyond the latched position.

The biting can be done by squeezing the mandibular arch through a practitioner or directly by the patient himself. If the mandibular arches belong to a denture model, the two mandibular archs must be compressed by a mechanical clamping device when biting.

When biting, the upper and lower bite plates are moved towards each other and the bite plates approach. At an initial approach, the latching means engage and the bite plates enter a latched position. Upon further biting an approximation of the bite plates beyond the latching position follows, which can be fixed by the applied pressure forces the bite plates relative to the fastening part.

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

Advantageously, a material of the second and third connecting part of the bite plate can be combined with a material of the first connecting part of the fastening part so that a frictional engagement for fixing between the connecting parts of the bite plates and the first connecting part can be produced by biting.

For this purpose, a combination of materials can be selected, which has a high static friction coefficient with smooth surfaces. In addition, the stiction between the connecting parts can be increased by a greater roughness of the connecting surfaces, which leads to mechanical toothing on contact of the connecting surfaces. The connecting surfaces can be designed in shape so that they form a positive connection upon contact. When biting pressure forces of the mandibular arch are transferred to the Aufbissplatten and act as normal forces on the connecting surfaces of the connecting parts, so that depending on the static friction coefficient friction forces arise that lead to frictional engagement. Mechanical toothing and positive connections on the connecting surfaces can lead to additional forces for fixation.

Advantageously, the second and / or third connecting part of the Aufbissplatte lie after placement on the respective mandibular arch within the oral cavity of the patient.

Characterized the pressure forces arising during biting are transmitted to the connecting parts within the oral cavity of the patient and lead there to increased frictional forces, because the normal forces are distributed more uniformly over the connecting surfaces as it is the case for lying outside of the oral cavity connecting parts. In addition, when connecting parts located outside the oral cavity, a higher torque is exerted on the bite plate, whereby 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 during a recording with an X-ray receiving device, be designed so that the bite plate has a connecting part in a central region and in the edge region a support surface at least for parts of a mandibular arch.

As a result, the connecting part is located on the bite plate in the oral cavity of the patient. The edge region is the arcuate edge in which the support surface at least for parts of a Dental arch is attached. The remainder of the arcuate edge is the central region.

The forces occurring when biting act on the bearing surfaces in the edge region and lead to a low torque on the connecting part. As a result, a fixation of the bite plate relative to the fastening part is made possible even with the application of low forces.

Advantageously, the connecting part may be a bearing and the support surface may have an impression of at least part of a mandibular arch.

Thereby, the bite plate can be precisely and repeatedly engaged with the attachment part. The fastening part can be moved within the storage for fine positioning.

Advantageously, the bite plate may comprise an attachment part with the support surface and a base part with the second connection part, wherein the attachment part is separable from the base part.

As a result, when fitting different patients, the matching to the respective mandibular attachment parts can be exchanged, wherein the same base part is used. Another advantage is that a drilling template can be worked out less expensive from the attachment than from a whole bite plate without base, because less material is removed.

Advantageously, the upper bite plate in the edge region have the impression of the upper mandibular arch.

This allows the bite plate to accommodate the upper mandibular arch.

Advantageously, the lower bite plate in the edge region have the impression of the lower mandibular arch.

This allows the lower bite plate to accommodate the lower mandibular arch.

The bite plate has a connecting part in the form of a hollow hemisphere or a circular opening.

Thereby, a connecting part of the fastening part can be mounted in the hemisphere or circular aperture and moved for fine positioning.

Advantageously, the bite plate may have a guide means to the connecting part, preferably in the form of a guide trough.

As a result, the first connecting part of the fastening part can be guided to the connecting part of the bite plate.

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

Advantageously, the bite plate can have markers which can be recognized by X-radiation and by light or touch sensors.

The markers must have an X-ray absorptivity that is significantly different from the absorbance of the bite plate material. The degree of absorption is a measure of the absorbed intensity of the X-radiation. At a lower absorption level, the markers appear dark on an X-ray. At higher absorbance the markers appear brighter. The reflection spectrum of the markers must be different from the reflection spectrum of the surrounding surface with the same incident light in order to be detected by optical sensors. When scanning with push-button sensors, the markers must have a characteristic surface in order to be recognized.

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

As a result, the frictional engagement between the connecting parts located inside the oral cavity is improved when biting in comparison to connecting parts located outside the oral cavity, because the pressure forces of the mandibular arch lead to more uniformly distributed normal forces on the connecting surfaces and thus to higher frictional forces. In addition, the pressure forces on the arcuate mandibular arch to torques that compensate each other by opposing force arms, so that the entire torque is lower on the Aufbissplatten lying within the oral cavity connecting parts and thus tilting the Aufbissplatte is prevented from the respective mandibular arch.

The fastening part has at the end facing the patient on a connecting part in the form of a spherical section.

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

Advantageously, the connecting part may consist of an initially deformable material which, after a deformation of at least 0.1 mm and at most 3 mm, does not allow any further deformation.

When biting, compression forces occur at the connection parts of the bite plates and the attachment part. 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 consists of a hard core part, which is covered with an elastic layer with a thickness of at least 0.1 mm.

As a result, the connecting part of a bite plate when biting first deforms the elastic layer and then strikes the hard core part.

Another invention is a method for positioning the mandibular arch in a recording with an X-ray device, wherein each a bite plate for attaching the upper and lower mandibular arch are provided individually matching the anatomical situation. This bite plate can be made, for example, in the dental laboratory or briefly before taking. The bite plates are placed on the respective mandibular arch. The mandibular arch may be a patient's natural mandibular arch, with the mouth wide open or mandibular arch of a denture model. The connecting parts of the upper bite plate and the attachment part are brought into contact with each other. In this case, the practitioner can move the head of the patient or the patient himself his head so that the connecting parts are guided to each other and come into contact.

In the further method step, the connecting parts of the lower bite plate and the fastening part are brought into contact with each other. In this case, the practitioner or the patient himself can move the lower mandibular arch as long as within the anatomical degrees of freedom with respect to the upper mandibular arch until the connecting parts of the lower mandibular arch and the fastening part come into contact.

The connection parts of the bite plates are moved towards each other until they engage with the corresponding connection part of the attachment part and form a frictional connection with this connection part, so that the bite plates are fixed to the attachment part. The practitioner may be crushed or the patient may, by biting, result in a frictional engagement between the connecting parts of the two bite plates and the fastener.

An advantage of this method is that the practitioner or the patient by the movement of the head and the lower jaw relative to the head must bring the connecting parts in contact with each other in order to fix the bite plate relative to the fastening part can. The jaws are thereby repeatedly fixed at the desired position relative to the X-ray receiving device and relative to each other.

According to the invention, a method for positioning the mandibular arch in a recording with an X-ray receiving device is called, wherein an upper bite plate for attaching 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 denture model must be wide open to facilitate placement.

The connecting parts of the upper bite plate and the attachment part are brought into contact with each other. The upper mandibular arch or the patient's head can be moved by the practitioner or the patient himself until the connecting parts come into contact with each other.

The connection parts of the upper bite plate and the attachment part are moved towards each other until engagement and form a frictional engagement, so that the upper bite plate is fixed relative to the attachment part. The two mandibular arches may be compressed by the practitioner or the patient themselves so that the lower mandibular arch bites directly onto the lower side of the attachment member and exerts compressive forces that result in frictional engagement between the upper bite plate attachment members and the attachment member.

This procedure can be used to accurately position the maxillary arch and thus the head. The lower jawbone remains movable within the anatomical degrees of freedom relative to the upper jawbone, and can assume different positions when biting.

An advantage of this method is that only the upper bite plate is used and the mandibular arch bites directly onto the lower side of the fixation part. For better power transmission, for example, a bite surface with grooves can be attached to the underside of the fastening part.

A further method according to the invention for positioning the mandibular arch in a recording with an X-ray recording device is that a lower bite plate for fixing the lower mandibular arch is provided individually matching the anatomical situation.

The lower bite plate is placed on the lower mandibular arch. In doing so, a denture model or the patient's mouth must be open.

The connection parts of the lower bite plate and the attachment part are brought into contact with each other. The lower mandibular arch is moved by a practitioner or the patient himself, bringing the connectors together.

The connection parts of the lower bite plate and the attachment part are moved towards each other until engagement and form a frictional engagement, so that the lower bite plate is fixed relative to the attachment part. The two mandibular arches may be compressed by the practitioner or the patient themselves so that the upper mandibular arch bites directly onto the upper side of the attachment member and exerts compressive forces that result in frictional engagement between the connecting parts of the lower bite plate and the attachment part.

This method corresponds to the aforementioned method with the difference that the lower mandibular arch is positioned and exerts pressure forces on the upper side of the fastening part by biting the upper mandibular arch. For better power transmission, a bite surface with grooves can be attached to the upper side of the fastening part.

Advantageously, in the initial movement of the second or third connecting part of the upper or lower bite plate on the first connecting part of the fastening part, the second and third connecting part can be pressed slightly against the first connecting part and reach a latching position, wherein the bite plate relative to the fastening part to Fine positioning remains mobile. In the snap-in position the fine positioning can be carried out by the practitioner himself or by his instructions to the patient, in order in particular to precisely set the desired angular position of the bite plates.

Advantageously, the upper or lower bite plate for attachment of the upper or lower mandibular arch is made individually matching the anatomical situation. Production can be carried out in a dental laboratory or directly at the treatment center. An individual bite plate may include an impression of the mandibular arch that is made by means of a thermosetting molding compound.

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

This makes it easier to bring the connecting parts in contact with each other. The guide means may have the shape of a trough to the connecting part of the bite plate.

Advantageously, implant planning can be carried out on the basis of the data from the X-ray image. In this case, the bite plate on markers that specify a coordinate system in which the planned implant is fixed with respect to its position and orientation.

As a result, the markers, which can also be detected in the x-ray image, provide a coordinate system in which the position information of the planned implants and the anatomical structures such as teeth, root canals and jawbones are determined.

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

Advantageously, the bite plate can be inserted into a processing machine and the markers can be detected by sensors, so that bores are introduced into the bite plate in the coordinate system defined by the markers, the extension of which has the position and orientation of the planned implant.

For detecting the markers, it is possible, for example, to use light or touch sensors which, on the basis of the reflection spectrum, distinguish the markers from the surrounding material.

The markers on the bite plates provide the coordinate system of the radiograph in which the implant planning was performed. Thus, the position of the implants against the Aufbissplatten is known. The processing machine can then be controlled automatically to perform the holes in the Aufbissplatten.

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

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

Advantageously, drill sleeves can be introduced into the holes and the bite plate can be reworked so that it can be used as a drilling template for attaching the implant bore for the implant to be used.

An advantage is that the drill sleeves serve as a guide for the drill and allow precise implant holes to be made.

Another advantage is that the drilling templates are not manufactured in an additional process, but from the already existing Aufbissplatten. This leads to a reduction in production costs. In addition, possible errors that would occur when transferring position information of the planned implants with respect to the mandibular arch for a separate manufacturing method of drilling templates are prevented.

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

As a result, the same base part can be used for a plurality of patient-specific attachment parts. In addition, in order to make a drilling template, less material must be removed during the post-processing of the attachment than with a whole bite plate.

Advantageously, a model of the upper or lower mandibular arch of the patient can 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 the coordinate system defined by the markers is registered.

The model corresponds in shape at least partially to the respective mandibular arch. The coordinate system defined by the markers is registered by the processing machine, so that the position information of the planned implants can be transferred from the implant planning to the model.

Advantageously, the bite plate can be removed from the model and, taking into account the coordinate system, a hole can be made in the model with the position and orientation of the planned implant. The holes can be made by means of a computer-controlled drilling device taking into account the position information of the planned implants. For this, sticks are inserted into the holes on the model. A template shaped to fit the model is placed on the model and drill sleeves are attached to the rods, so that the template with the drill sleeves can be used as a drilling template for introducing the holes for the implants to be used.

This will set the drill sleeves along the axes of the holes for the planned implants.

list of figures

• 1 eine Gesamtansicht einer Röntgenaufnahme;
• 2 eine Aufbissvorrichtung im getrennten Zustand;
• 3 Aufbissvorrichtung aus 3 im zusammengeführten Zustand;
• 4a obere Aufbissplatte aus der Sicht von unten;
• 4b obere Aufbissplatte aus der Sicht von oben;
• 5a ein Befestigungsteil für beide Aufbissplatten;
• 5b ein Befestigungsteil nur für die obere Aufbissplatte;
• 6a eine Aufbissvorrichtung mit beiden Aufbissplatten;
• 6b eine Seitenansicht der Aufbissvorrichtung aus 6a in der Mundhöhle des Patienten;
• 7a eine Seitenansicht der Aufbissvorrichtung wie in 6b nur mit der oberen Aufbissplatte;
• 7b eine Seitenansicht der Aufbissvorrichtung wie in 6b nur mit der unteren Aufbissplatte;
• 8 Aufbissvorrichtung wie in 6a mit Einrastmitteln an den Aufbissplatten;
• 9 eine Bearbeitungsmaschine mit einer darauf eingespannten Bohrschablone;
• 10 eine Bohrschablone für den oberen Kieferbogen;
• 11 ein Modell des oberen Kieferbogens mit der oberen Aufbissplatte;
• 12 eine Bohrschablone auf dem Modell aus 11.

Embodiments of 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 its 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 snap-in position, there is 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 compressive 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 an implant planning was carried out on the basis of the 3D X-ray image, wherein the position and orientation of the implants to be used was determined. 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.

LIST OF REFERENCE NUMBERS

1

X-ray system

2

bite device

3

patient

3.1

upper mandibular arch

4

attachment portion

3.2

lower mandibular arch

5

upper bite plate

6

connector

7

Connecting part on the fastening part

7.1

Connecting surface on the fastening part

7.2

upper connection surface

7.3

lower connection surface

7.4

elastic layer

7.5

hard core part

8th

Aufbissleiste

9

Connecting part at the bite plate

9.1

Connecting surface on the bite plate

10

imprint

11

Guide means, guide tray

12

attachment

13

base

14

deepening

15

grooves

16

Lower bite plate

17

Impression of the lower mandibular arch

18

Connecting part of the lower bite plate

18.1

Connecting surface of the connecting part 18

19

Latching means on the upper bite plate

20

Latching means on 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 pine-tree bow

50

Drilling on the model

51

rod

5.1

Central area of the upper bite plate

5.2

Edge area of the upper bite plate

16.1

Central area of lower bite plate

16.2

Edge area of the lower bite plate

Claims (23)

A bite device (2) for positioning a patient (3) for producing a receptacle with an X-ray receiving device (1) comprising at least one fastening part (4) arranged on the X-ray receiving device (1) and at least one bite plate (5) movable relative to the fastening part (4) 16), wherein on the fastening part (4) a first connecting part (7) for the bite plate (5, 16) is provided, wherein when biting the bite plate (5, 16) in the region of the first connecting part (7) in engagement with the first Connecting piece (7) can be brought and wherein the bite plate (5, 16) in the region of the first connecting part (7) from the fastening part (4) is separable, characterized in that the first connecting part (7) has a first connecting surface (7.1) in the form of a Ball portion and the Aufbissplatte (5, 16) corresponding thereto a second or third connecting part (9, 18) with a second or third connection surface (9.1, 18.1) in the form e having a hollow hemisphere or a circular opening. Bite device (2) after Claim 1 , characterized in that the bite plate (5, 16) has a fitting precisely to at least parts of the mandibular arch (3.1, 3.2) formed bearing surface. Bite device (2) according to one of Claims 1 to 2 , characterized in that the bite plate (5, 16) includes an impression (10, 17) of at least part of the mandibular arch (3.1, 3.2). Bite device (2) according to one of Claims 1 to 3 , characterized in that the bite device (2) has an upper bite plate (5) for fixing the upper mandibular arch (3.1) and a lower bite plate (16) for fixing the lower mandibular arch (3.2). Bite device (2) after Claim 4 , characterized in that the lower bite plate (16) has a first connecting part (7) matching lower third connecting part (18). Bite device (2) according to one of Claims 1 to 4 , characterized in that the bite plate (5, 16) has a guide means (11) for guiding the first connecting part (7). Bite device (2) according to one of Claims 4 or 5 , characterized in that the upper and lower bite plates (5, 16) latching means (19, 20) to bring when biting the upper bite plate (5) in a latching position relative to the lower bite plate (16), wherein in the latched position Bite plates (5, 16) are brought into engagement with a play relative to the fastening part (4), wherein on further biting the upper and lower bite plate (5, 16) beyond the latching position to each other is movable. Bite device (2) after Claim 5 or the Claims 5 and 7 , characterized in that a material of the second and third Connection part (9, 18) of the Aufbissplatten (5, 16) with a material of the first connecting part (7) of the fastening part (4) is combined so that by the biting frictional engagement for fixing between the second and third connecting parts (9, 18) the Aufbissplatten (5, 16) and the first connecting part (7) can be produced. Bite device (2) after Claim 4 . 5 . 7 or 8th , characterized in that the second and / or third connecting part (9, 18) after placement on the respective mandibular arch (3.1, 3.2) within the oral cavity of the patient (3). Biting device according to one of the preceding claims, characterized in that the first connecting part (7) consists of an initially deformable material, which allows no deformation after a deformation of at least 0.1 mm and at most 3 mm. Biting device according to one of the preceding claims, characterized in that the first connecting part (7) consists of a hard core part (7.5), which is covered with an elastic layer (7.4) with a thickness of at least 0.1 mm. Bite plate (5, 16) for positioning a patient (3) in a recording with an X-ray recording device (1), wherein the bite plate (5, 16) has a connecting part (9, 18) in a central region (5.1) and in the edge region ( 5.2) has a bearing surface (10, 17) at least for parts of a mandibular arch (3.1, 3.2) of a patient, characterized in that the bite plate (5, 16) has a connecting part (9, 18) in the form of a hollow hemisphere or a circular opening having. Bite plate (5, 16) after Claim 12 , characterized in that the connecting part (9, 18) is a bearing and the support surface has an impression (10, 17) of at least part of a mandibular arch (3.1, 3.2). Bite plate (5, 16) after Claim 12 or 13 , characterized in that the bite plate (5, 16) comprises an attachment part (12) with the support surface (10, 17) and a base part (13) with the connection part (9), wherein the attachment part (12) from the base part (13) is separable. Bite plate (5) after one of Claims 12 to 14 , characterized in that the Aufbissplatte (5) is designed as an upper Aufbissplatte having in the edge region (5.2) the impression (10) of the upper mandibular arch (3.1) or that the Aufbissplatte (5) is designed as a lower bite plate (16), in the edge region (16.2) has the impression (17) of a lower mandibular arch (3.2). Bite plate (5) after one of Claims 12 to 15 , characterized in that the bite plate (5) has a guide means (11) to the connecting part (9, 18). Bite plate (5) after Claim 16 , characterized in that the guide means (11) is formed in the form of a guide trough. Bite plate (5, 16) after one of Claims 12 to 17 , characterized in that the bite plate (5, 16) markers (32) which are visible by X-ray radiation and by light or tactile sensors. Use of a bite plate (5, 16) according to one of Claims 12 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). Method for positioning the mandibular arch (3.1, 3.2) of a patient during a recording with an X-ray recording device (1), characterized in that - a lower and / or upper bite plate (5, 16) for fastening the upper or lower mandibular arch (3.1, 3.2) of a patient (3) is provided individually matching the anatomical situation, - that the bite plate (s) (5, 16) is placed on the respective mandibular arch (3.1, 3.2), - that connecting parts (7, 9) the upper bite plate (5) and the fixing part (4) are brought into contact with each other and / or connecting parts (7, 18) of the lower bite plate (16) and the fixing part (4) are brought into contact with each other, - that the connecting parts (9 , 18) of the bite plate (s) (5, 16) and the attachment part (4) towards each other until engagement of the connection part (9, 18) or the connection parts of the bite plate (s) (5, 16) with the corresponding connection part (7) of Be fastening part (4) are moved and form a frictional connection to this connection part (7) of the fastening part (4), so that the bite plate (s) (5, 16) is fixed to the fastening part (4), wherein at the initial movement one of the connecting parts (9, 18) of the bite plate (5, 16) on the connecting part (7) of the fastening part (4) the connecting part (9, 18) of the bite plate (5, 16) slightly against the connecting part (7) of the fastening part ( 4) is pressed and enters a latching position, wherein the Aufbissplatte (s) (5, 16) relative to the fastening part (4) remains movable for fine positioning or remain. Method according to the preceding claim, characterized in that the bite plate (5, 16) for fixing the mandibular arch (3.1, 3.2) individually made to fit the anatomical situation. Method according to one of Claims 20 or 21 , characterized in that the connecting part (7) of the fastening part (4) along a guide means (11) on the bite plate (5, 16) to the connecting part (9, 18) of the bite plate (5, 16) is guided and the connecting parts (7 , 9, 18) are brought into contact there with each other. An X-ray device (1) comprising a bite device according to one of Claims 1 to 11 and / or a bite plate according to one of Claims 12 to 18 ,

Images