The present invention relates to a fixing plate for
Application in dentistry. In particular, the invention relates
a fixation plate for use in the oral cavity of a patient
and in the dental treatment system according to the claims.
a dental prosthetic workpiece (for example inlay, crown,
Dentures, etc.) are used, methods are still used today
which the patient to be treated high physical and mental
when inserting a crown (eg gold crown, VMK crown,
Galvanokrone, Reinkeramikkrone, etc.), the patient must at least
be subjected to two, sometimes painful interventions. In one
For example, the first surgical step is the affected tooth
grinded. Then a temporary
Prosthesis (temporary) attached. At another meeting will
then the permanently remaining dental prosthetic workpiece (crown)
In the DE 199 59 383 C1
a device for the preparation of at least one tooth for receiving a crown, bridge or the like is described.
Moreover, in the DE 44 43 929 C1
a method for patient-specific production and supply of dental prosthetic workpieces described.
The US 2003/0165791 A1
describes a parts kit to arrange a drilling axis of a dental drill head at a desired position in the oral cavity of a patient.
Furthermore, the describes GB 512181
a device for use in dentistry, comprising a pen equipped with means whereby the device can be placed in the oral cavity of a patient and a guide for a dental instrument can be rotatably mounted on the pin to allow the instrument to be located at different locations in the oral cavity can be used.
of these devices or these methods, it can, the treatment period
to significantly reduce the onset of a dental prosthetic workpiece
and / or to facilitate the handling during surgery considerably.
Therefore, it has been the object of the present invention to overcome the problems of the prior art
to avoid the technique.
The object is achieved by the device according to the invention and the method
solved according to the independent claims. Further
advantageous embodiments of the invention are specified in the dependent claims.
According to a first aspect of the present invention, a fixation plate ( 10 ) for use in dentistry, wherein the fixation plate ( 10 ) at least a portion of a personalized occlusal profile ( 20 ) and at least one web guiding structure ( 30 ) for guiding a treatment tool ( 40 ).
This fixation plate provides a structure that fits perfectly
be introduced into the mouth of a patient and supported on the chewing surface profile
can. The so introduced into the mouth fixation plate is then
slip-proof in the appropriate oral cavity on the teeth over the
Storage of the intended occlusal surface
fixed. Due to the likewise provided web guide structures can now the
Doctor support a treatment tool so that this along the
Web guiding structures
is moved and the previously provided web guiding structures per tooth with
the treatment tool can be driven. This way will
those in the web guiding structures
Realized geometry accurately transferred to the tooth and in this way
an example previously set in the computer geometry over the web guide structure
transferred to the tooth by means of the treatment tool. This can be individual
Deviations from different doctors
be avoided because in this way the predefined
Transfer structure to the tooth
can be. Due to the precise fixing of the plate in the oral cavity over the
on the one hand and the predetermined web guiding structure, which in the fixing plate
is introduced on the other hand, can thus a predetermined shape
the teeth to be treated
by means of a treatment tool via the web guiding structure
the fixation plate according to the invention
accurately transferred to the at least one tooth to be treated
The fixation plate ( 10 ) may vary in material, shape, surface, surface texture.
the fixation plate as materials metal, ZrO2, titanium, acrylic,
high-strength plastics, glass or a combination of these materials
used. Preferably, all materials used are sterilizable.
Shape of the fixing plate is preferably a circular sector or especially
preferably an elliptical sector. The shape of the fixation plate, at
Inclusion of all teeth
a jaw, should preferably be designed so that an upper jaw
(Direction: from caudal) or a lower jaw (direction: from cranial)
the fixation plate is imaged. For example, for recording
of only 4 molars,
For example, the fixation plate may preferably be rectangular. A horseshoe shape
to save material as possible
take. The shape is as well
preferably the respective jaw structure of the patient to be treated
customized. It can preferably be adapted to these individually or
also used to align, for example, a bone fracture
become. The fixation plate is on both not normally shaped,
as well as deformed forms (for example, after an accident) applicable.
A device for opening or keeping open is preferred
Upper and lower jaw hen vorgese as firmly attachable essay on the fixation plate.
As a result, an operation by the constant held opening angle
the two jaws facilitates and at the same time falling out
prevents the fixing plate. For example, the on
the lower jaw patch plate with an extendable,
lockable cylinder can be supported on the palate. For fixation are
furthermore also adhesives possible,
which are mentioned in more detail in one of the following sections.
Fixation plate has several distinctive surfaces. As the top surface becomes
designated. The upper surface
has a size that
preferably lingually and in front of the row of teeth enough space is around web guiding structures
to bring in the plate. When
front side surface
becomes the visible, frontal surface
the fixing plate with inserted plate indicates which of
Is visible in the anterior direction. The width of the side surface and
Thus, the depth of the fixation plate should preferably be so wide
or deep, that the depth of the web guiding structure for treatment
sufficient. The depth of engagement of a treatment tool depends on
the depth of the web guiding structure
and thus the depth of the fixation plate.
The fixation plate is preferably smooth and fine pored. A storage
by bacteria should be avoided. The fixation plate
is preferably sterilizable. In addition, the surface structure indicates
prefers web guiding structures
on that for
an intervention are necessary. The surface structure may also be preferred
Have recesses and more preferably chewing profile sections.
The fixation plate ( 10 ) has at least a portion of a personalized occlusal profile ( 20 ) on.
may preferably be the surface profile
in inverse form, which can be seen when one
take a look at the upper jaw (direction: from caudal), or the
Lower jaw (direction: viewed from cranial). This consideration
both the visually visible two-dimensional surface and the topography of this
as well as minimal parts of the outer tooth surface, d.
H. of enamel. For a better understanding, the chewing profile can also
be compared with a negative mold (impression) of a denture impression.
personified is a chewing profile which
no standard profile, but exactly the "impression" or the impression of the tooth
or the teeth
of the patient to be treated. By the personalization
a very high hold and thus a precise treatment can be achieved.
the occlusal profile
exactly corresponds to the geometry in the mouth of a patient can
the fixation plate are placed in the mouth of a patient
and the occlusal profile
the fixation plate and the teeth
of the patient. This way will
the fixation plate set exactly in the mouth of the patient
so no play of the fixation plate on the patient's jaw
or sections thereof are embedded in the fixing plate.
This can in the casting process, as well as preferably in the milling process
with computer-controlled (CNC) milling machines
done, which are fed with 3D CAD information. Prefers
one this data by for example an impression, a scanning of the
Pine or teeth,
a magnetic resonance tomography or an x-ray of the jaw area.
As already mentioned, it is possible, for example, cutouts, that is to say only one tooth profile, preferably more than one tooth profile, to be introduced into the fixing plate. As a particularly preferred embodiment, an embodiment is provided with a chewing profile for three teeth. The individual chewing profile sections are preferably distributed as uniformly as possible in the fixation plate in order to avoid tilting properties. The more chewing profile sections are introduced into the fixing plate, the higher the degree of hold. If only partial occlusal surface profiles are introduced into the fixation plate, the remaining teeth can be accommodated by, for example, a continuous tooth canal without a lateral holding function. This tooth canal replaces, as one Art placeholder, the missing chewing profile sections in the row of teeth.
introduced profiles in the fixing plate provide a backlash-free
Fixation of the fixation plate in the mouth and a restriction to
to a translational degree of freedom. The two rotary ones
Degrees of freedom are due to the multiple support of the fixing plate
through the chewing profiles
eliminated, the third rotational degree of freedom over the
Lateral support of the occlusal profile. On the one hand
this will be over
the tooth surface topography,
on the other hand about
the partial outer enclosure of the
Enamel achieved. Two translatory degrees of freedom will be
and eliminates the structural nature of the chewing profiles.
stays that way, for example
the application example "Fixierungsplatte
on lower jaw ",
one degree of freedom (direction: to cranial) left. About this degree of freedom is
the fixation plate at all
First introduced into the oral cavity and there - in this case on the lower jaw - set.
The treatment will now ensure that the fixation plate
is not reversed along this degree of freedom again.
This can be achieved in various ways, preferably by its own weight
the fixation plate, which rests on the lower jaw, especially
preferred by clamping fit of the clearance milled recesses, most
Furthermore, the fixation plate is preferably punctiform with adhesive wax
fixed. For introducing the adhesive wax is preferably an access
to the supporting one
Tooth on the surface
Milled the plate.
After use, the wax, preferably by heating, with
removed an instrument again.
a further preferred embodiment
the fixation plate has such a high dead weight that the remaining degree of freedom
Furthermore, the fixation plate ( 10 ) at least one web guiding structure ( 30 ) on.
Railway management structure
serves for recording and / or leadership
a treatment tool and is inserted into the fixation plate.
This is preferably done by all usual in mechanical engineering
Material-removing processes, such as drilling, sawing, milling, cutting
(especially laser cutting), etc. Particularly preferred is the
since a feed in all three translational directions is possible here
and high precision
Results can be achieved with high surface quality
Railway management structure
images the contour which is transferred from the treatment tool to the treatment object,
According to the invention a
shall be. In this case, the web guiding structure can be a guide,
which leads the engagement segment of the treatment tool directly or
receives the treatment tool.
this way it is possible
that the treatment tool engages along the web guide structure in this
and so led
is that the actual tool of the treatment tool, for example
a milling machine,
in contact with the tooth
comes. Since the engagement segment of the treatment tool in the web guide structure
engages it is not possible for the surgeon, the treatment tool
and in this case, for example, the milling head in other areas
method, such as the web guiding structure
In this way, the pre-established geometry, through
the web guiding structure
is set very precisely and precisely on the treated
by the tiller
as long as tooth material ablates,
until the engaging segments of the treatment tool due to
Resistance of the boundaries of the web guiding structure another
Abrading the tooth by the treatment tool no longer
The geometry to be transferred to the tooth can thus be determined and incorporated into the web guiding structure, before the tooth actually has to be prepared. It is thus possible, for example, to record the actual data of the individual teeth, to load them into a data processing program and then to determine there an optimized structure of the prepared teeth on the one hand and the geometry of the dental prosthesis or the crowns on the other hand. It can then be the inserts or crowns are already made without that had to be made an intervention on the teeth until then. The provided by the data processing system ground geometry of the teeth (target state) can then be included in the likewise preferably designed by the data processing system fixing plate in the form of web guiding structure. The surgeon, who then removes the web guiding structure on the individual teeth with the treatment tool with the fixing plate used, transmits the structures of the desired state determined and determined in the computer to the individual teeth. In an immediately following step, the prefabricated crowns can then be used, without the patient having to appear after the preparation of the teeth to a second appointment, in which then the subsequently manufactured crowns would be used. Particularly preferably, the treatment tool can be measured individually, ie, for example be scanned by laser and this data can be used in the computer for the determination of the web guiding structure. It is also preferred that when selecting the desired structure or the desired state, a cement gap is programmed, which takes into account the fact that when introducing bridges or crowns these are cemented onto the prepared tooth and thereby a corresponding space requirement for consists of the cement to be introduced. It is also possible that filling preparations are predetermined by the computer in the desired state via this structure, which can subsequently be finally treated with laboratory-produced fillings (inlays) or even plastic filling materials. Particularly advantageous can be introduced in this way an implant. Thus, in a first step, a bore for an implant can be made via the fixation lath and this can be inserted. In the next step, the implant structure or the abutment can be prepared via the fixation plate and the geometry of the path guidance structure laid there. In addition, because the fixation plate fixes the geometry to the adjacent teeth, the preparation of the implant assembly can correct for any inaccuracies in the placement of the implant relative to the adjacent teeth, as this will accurately match the geometry to the implant structure according to the tracking structure on the fixation plate throughout the space is introduced.
Treatment tool is preferably a tool for engagement
is designed in the tooth. These are preferably around
a precision mechanical device,
with a chuck for the use of various types of tools for the surgical field.
The treatment tool may preferably be either by hand or by
Robots are moved. Especially preferred is the variant with
manual operation, because so expensive and expensive robotics elements
can be saved.
Treatment tools are preferably all used in dentistry
Used drives, particularly preferably turbine-driven or
air-driven, most preferably electrically powered drilling
and milling feed,
suitable for the treatment of hard tooth substances or bone
In a preferred embodiment, the fixation plate ( 10 ) a recess ( 21 ) on.
Recess becomes a continuous
the fixing plate understood according to the invention on a
Position of a tooth is located in the continuous row of teeth. considered
for example, the fixation plate on the lower jaw (direction:
from cranial) would
you look through a recess an exposed tooth from above
By a recess, for example, a region of the gums
or the jawbone or the space between two together
become visible. The recess exposes a processing area, on
which performed an intervention
shall be. The recess preferably has a sufficiently large distance
between treatment object and fixation plate, so that the
Handling the necessary
Treatment tools is easily possible.
The fixation plate ( 10 ) has a recess ( 21 ) for a tooth to be treated ( 41 ) is provided.
Recesses prefers to expose individual teeth to be treated.
a preferred embodiment
are several teeth
to treat a jaw and above each
To be treated tooth is a recess. Here is the advantage
that all teeth
can be treated through the plate. The more recesses
are in the fixation plate, the fewer occlusal profile sections
are available for fixing the fixation plate in the oral cavity.
In a further preferred embodiment, the fixation plate ( 10 ) a recess ( 21 ), which at least partially by a cover plate ( 22 ), which on the tooth-facing side a chewing profile section of the opposite tooth ( 41 ) having.
Cover plate can be made of the same material or from another
Material be made as the fixing plate.
Cover plates can
for example, the entire surface
hide the recesses. This facilitates spatial positioning,
because the edge of the cover plate with the recess, for example, is form-fitting.
Particularly preferably, the cover plates are manufactured in that a fixing plate is made without recess and then exposed only in the edge region of a desired recess this edge region, except for small areas (webs), which leave the material in the recess and fix. In this way, the surgeon can remove the remaining areas (webs) during the desired intervention on the individual tooth and expose the recess by removing the residual material (the cover plate). The fact that thus the fixation plate is supported on the entire chewing surface, can by removing material in the edge region of the planned recess for each tooth, the chewing profile in the fixation as Support for the fixation plate in the oral cavity. The single tooth to be treated is then treated by exposing the recess by removing any leftover ridges and then preparing this tooth. After completion of the preparation of the individual tooth, the recess can then be closed by the exposed recess, for example, by adhesive or hard silicone or cement or plastic in such a way that the prepared tooth, on the one hand, and the fixing plate, on the other hand, are glued and fixed to one another in the specified orientation. Thus, this filler then takes over the fixation of the fixation plate at the site of the treated tooth and the next recess can be exposed to prepare the next tooth. In this way, the fixation plate remains precisely defined at all times in the oral cavity. So there is not the problem that in the preparation of many teeth towards the end less and less support points of the fixation plate would be present in the mouth.
a further embodiment
Is it possible,
that the cover plate only partially the recess and thus the
Tooth, or its occlusal profile hidden. Here, for example
the occlusal profile
be used for example, the almost identical lateral support
or hold in general, like a cover plate with full occlusal profile
a preferred embodiment
is the fixing plate, for example, with the desired
and the desired placeholders,
manufactured according to one of the aforementioned production possibilities. Then be
the cover plates from the existing fixing plate preferred
This creates recesses over
the teeth to be treated
and cover plates with the desired chewing profile sections
the opposite of the cover plates
a further preferred embodiment
The cover plates are made of a different material, as the
Fixie ing plate made and afterwards in the fixation plate
In a further preferred embodiment, the fixation plate ( 10 ) Connecting bridges ( 23 ) between the cover plate ( 22 ) and the fixing plate ( 10 ) on.
Connecting webs serve as mentioned above the connection of cover plate
and fixation plate. The connecting webs are preferably of hers
such that the position of the cover plate, with the associated chewing profile section,
is located exactly where normally chunk profile section
without recess and cover plate would have been.
Connecting webs are in their length, width,
Shape and number variable according to requirements. The more connecting bridges
be mounted between cover plate and fixing plate, the more stable
becomes the connection. Preferably, three webs, particularly preferred
four bars provided. With increasing width of the webs and length (depending on
the depth of the cover plate) are similar stable conditions
one. The stability
should preferably be increased
are, the fewer support points the fixation plate has and, for example
these points of support are the cover plates.
For example, it is preferable to use a material which is easy with the treatment tool
can be removed
without having to change the type of tool. For example
a tooth with a router
are ground, it first breaks through the connecting bridge.
The cover plate can now be removed. Then follows the planned
Intervention on the treatment object.
Connecting bars have the big advantage
preferably to be a detachable part of the fixation plate,
after removal by, for example, a quick-drying filling material
can be replaced. This preserves the stability of the system
For example, at the extreme, the entire row of teeth of a jaw
be treated without losing stability.
In a further preferred embodiment, the fixation plate ( 10 ) as a web guiding structure ( 30 ) a groove ( 31 ) and / or a guide rail ( 32 ) and / or a bore ( 33 ) in the fixation plate ( 10 ) on.
a preferred embodiment
can the web guiding structure
to be a groove. This is preferably the case when a tooth is ground
and a crown is to be cemented. The groove is here
preferably a self-contained web, similar to an oval. In a
another preferred embodiment
the groove can also only a part of a closed track
be. This is preferably the case if at a later date
a partial crown is to be used. The grooves are preferred
left and right next to a recess in a row of teeth in the
Milled fixation plate.
The grooves are preferably exact copies of one another
the guide elements,
which are attached to the treatment tool to guarantee. The
the course of the track be different depths.
In a further preferred embodiment, the treatment tool ( 40 ) at least one guide element ( 43 ) exhibit.
or the guide elements
are preferably attached to the treatment tool. These will
Favor in the web guide elements
in order to form a system in combination, which preferably has a translatory
Degree of freedom, more preferably two translatory degrees of freedom
Has. Is the web guiding structure
a bore, preferably only one degree of freedom is provided, for example
a groove are preferably provided two degrees of freedom to a
To enable procedures along the groove and in the depth.
are the guiding elements
in axial section around. This is preferably a cost effective
Production, especially preferred good guidance in grooves with curves.
Furthermore, the guide elements should
as smooth as possible
to catch and tilt in the web guiding structures
to avoid. The gap should be
preferably be very small to the tight machining tolerances
not to exceed in dentistry.
The machining tolerances are in the milling preferably at 10 microns, especially
preferably at 5 μm,
most preferably 1 μm.
a further preferred embodiment
have the guide elements
a rounded end, for a pinpoint guidance with respect to example
to have the groove depth.
as web guide elements "may be preferred
more than two, more preferably three guide elements, a "three-legged tripod" exhibit,
which optimal leadership
In a further preferred embodiment, the treatment tool ( 40 ) two guide elements ( 43 ) on.
are preferably used when the web guiding structure is two parallel
has running grooves. With two guide elements can at this
Constellation for example, a milling head exactly around the outside of the
Enamel led around
be transferred, the guide elements
the uplifts and depressions of the groove directly on the engaging
a further embodiment
are the guiding elements
Extendable at a distance from the engaging tool. This makes possible,
for example, four web guiding structures
on the same fixation plate two different procedures for a treatment object
For example, by using the first two web guiding structures
in a first step, a tooth to be treated from the outside ground
and, for example, in a second step with a ball drill
a reduction in the middle of the same tooth are introduced. From
Treatment step one to treatment step two must, for example
only the guide elements
become. Preferably, a tool change is then made.
In a further preferred embodiment, the treatment tool ( 40 ) a feed ( 41 ) for receiving rotating or cutting tools ( 42 ), in particular milling cutters, grinders, drills or saws.
For example, feed can be a standard food for use in medical technology
be occurring tools. For
and drill is preferably a three-jaw chuck, for optimal
Center the tools use. For example, sawing or
other cutting tools are suitable for clamping chucks. Comes in, for example
rotating cutting blade, as preferably used by a flex
the lining is preferably a blade holder for rotating cutting blades.
In a further preferred embodiment, the treatment tool ( 40 ) a gingiva deflector ( 44 ) on.
Gingiva deflector is preferred as protection of the gums when rotating
Tools such as milling cutters
used. Here, for example, when grinding a tooth of
Tooth enamel can be treated without damaging the gums
to destroy engaging tools.
In a further preferred embodiment, the treatment tool ( 40 ) a camera ( 45 ) on.
Camera may preferably be a high resolution miniature camera,
which preferably films the intervention site. The recording can, for example
be thrown in the operating room of a beamer on a screen
or on a screen. The surgeon can thereby
an enlarged picture
of the procedure and thereby preferentially respond better to complications.
Furthermore you can
with the help of a digital video camera, for example, snapshots of
the surgery will be done.
Particular preference is given to certain treatment tools also differently shaped guide elements, which are introduced into the web guiding structures. In this way can ver be avoided, that engages the one treatment tool in the web guiding structures of another provided treatment tool. Thus, for example, a milling head can be used for grinding the edge regions of a tooth to be prepared, and a coarser ball milling machine can smoothly grind the upper region of the tooth to be prepared in a second step via a second web guiding structure. The corresponding web guiding structures can be provided integrally or adjacent to one another on the fixing plate and the individual treatment tools can engage via their respective guide elements in the intended web guiding structures.
It can also be provided that individual preparation steps are also preferred
be carried out with different fixing plates, one after the other
be applied. For example, it is conceivable that a first
is performed with a first fixing plate, this fixing plate
then removed and a second fixation plate used
will be on the then more web guiding structures
are provided, which is a further preparation in a second step
define. Likewise, it is conceivable, for example, in osteotomy
that with a first fixation plate the jawbone in two places
is severed and through a second fixation plate of the jaw
is now fixed in a spread position, in which a predefined
Gap created between the severed areas in the jaw
becomes. After using this second fixation plate and the definition
the distance of the jawbone ends to each other can now, for example
a splint of the sawed
Jawbone in this desired
second position. It goes without saying, too
provide more than two fixation plates to appropriate preparation plate
map. Also, the geometry and space requirements of the web guiding structures can
that two fixing plates are used, in which web guide structures
are introduced, which would otherwise overlap.
The description of the figures will be further preferred embodiments
shown. The figures show:
1 a schematic representation of a fixing plate
2 a schematic representation of a chewing profile
3 a schematic representation of a fixing plate
4 a schematic representation of an enlarged section of a fixing plate
5 a schematic representation of a treatment tool according to an embodiment of the present invention
In 1 a schematic representation of a fixing plate will be described. View a) represents the fixation plate from a top-to-side perspective, view b) the fixation plate from a bottom-to-side perspective, and view c) represents the mandible from a top-to-side perspective.
In view a) becomes the top 60 represented in the form of an ellipse sector or as a semi-ellipse. In the top 60 is a recess 21 admitted. The recess 21 is like that in the fixation plate 10 provided that when placing the plate, the recess 21 positionally accurate over the tooth 41 lies. Side of the recess 21 There are left and right respectively a web guiding structure 30 that are grooves in this case. The grooves of both web guiding structures are identical. This refers to track length, track shape, width and depth of the groove. The bottom 62 in view b) has the same shape as the top 60 , The distance between top 60 and bottom 62 is called height h. The width b is referred to as the length of the minor axis of the half-ellipse. The depth t is referred to as the length of the semi-major axis of the half-ellipse. The front 61 is described by the clamping of the elliptical arc in the x direction. The backside 63 is achieved by clamping the minor axis in the x direction. In view c) is schematically a lower jaw with associated teeth 41 shown. The bottom has a chewing profile 20 the teeth 41 of the lower jaw 65 on.
To get a treatment of the tooth 41 perform the fixation plate 10 with the bottom 62 , or with the chewing profile 20 on the teeth 41 of the dentition 65 firmly attached. As a result, the freedom of movement of the fixation plate 10 limited to a translatory degree of freedom in the x direction. When placing the treatment tool 40 or its guide elements 43 in the web guiding structures 30 engages the router 42 over the recess 21 in the enamel of the tooth 41 one. When moving the treatment tool 40 becomes the trajectory of the web guiding structures 30 on the tooth to be treated 41 transfer.
In 2 is a schematic representation of a chewing profile 20 shown in cross section. The illustration includes a schematic side view of the left lower jaw with teeth three-one through three-eight. The fixation plate 10 from ZrO2, has a personalized occlusal profile from the side view 20 of these teeth. The A drawn line A marks this profile. The lower jaw sits firmly with the teeth in this chewing profile 20 the fixation plate 10 with an indicated recess 21 , This recess 21 is with a plastic cover plate 22 hidden, which on the tooth-facing side, the chewing profile section 20.1 of the tooth three-seven. The gap between cover plate 22 and fixation plate 10 closes a temporary plastic connecting bar 23 ,
The personalized occlusal profile 20 serves to fix the plate 10 and forms a play-free, detachable connection with the teeth of the lower jaw. When subjected to mechanical stress, the fixation plate offers good support and thus enables precise interventions, which require the connection of tooth fixation plate as a reference surface. All degrees of freedom are eliminated except for a translational, whereby the weight of the plate of this degree of freedom can be neglected. Gravity pushes the fixation plate 10 on the lower jaw. When engaging with a milling head, the connecting webs are removed without having to clamp a special tool. The webs are removed without "smearing" by the heat development of the milling process and contaminate the milling head. The cover plate remains untouched during the cutting process of the webs and can then be lifted. This is done with the help of tweezers or another fine gripping tool.
In 3 is a schematic representation of a fixing plate 10 shown. The illustration shows a fixing plate in a plan view of the top. In the underside of the fixation plate is a chewing profile 20 let in (dashed lines). The row of teeth of the occlusal profile in the fixation plate has three recesses 21.1 . 21.2 and 21.3 on. The rectangular recess 21.3 allows engagement in the jawbone (not according to the invention). recess 21.2 allows drilling into the jawbone or screwing in an endosseous implant (not according to the invention). recess 21.1 is from a cover plate 22 obscured and allows a grinding of the underlying tooth 41 , connecting webs 23 connect the cover plate 22 with the fixing plate 10 , Web guiding structures 30.1 and 30.2 with identical grooves 31.1 and 31.2 lie left and right next to the recess 21.1 ,
The fixation plate 10 is then placed with the bottom on a jaw and is thus set stable. The occlusal profile is in engagement with the teeth of the lower jaw and thus prevents slippage of the fixation plate in the oral cavity. Thereafter, by introducing a treatment tool to the recess 21.1 the cover plate 22 be removed by removing the webs and then the underlying tooth be prepared by the treatment tool. For this purpose, the guide elements of the treatment tool in the respective web guiding structures 30.1 respectively. 30.2 brought in. Along the intended grooves 31.1 , and 31.2 are then moved along the guide elements of the treatment tool, so that the treat- ment tool itself through the recess 21.1 the underlying tooth 41 according to the specified geometry of the web guiding structures 30.1 respectively. 30.2 treated. The geometry thus determined is thus on the tooth 41 transferred and this prepared, for example, for receiving a prefabricated crown. In a further step, this crown can be applied directly to the prepared tooth stump 41 be applied without the patient having to come to a second appointment.
About the recess 21.2 It is possible, for example, to introduce an implant (not according to the invention). This is a hole through the recess 21.2 carried out, in which the treatment tool, ie here the drill, on the two guide elements 33.1 and 33.2 at a specified angle to a predefined depth. Angle and depth of the bore are determined by the web guiding structures 33.1 and 33.2 specified. In a second step, an implant is inserted exactly along this hole and locked in the lower jaw.
About the recess 21.3 It is possible, for example, to cut the lower jaw with a saw (not according to the invention). For this purpose, as a treatment tool a saw in the recess 21.3 introduced and guide elements of this saw in the web guiding structures 32.1 and 32.2 introduced. The guide elements of the saw become in these web guiding structures 32.1 and 32.2 guided and cause the saw through the recess 21.3 in a predefined area the lower jaw is severed.
In this way it is possible with the fixing plate shown 10 to represent the most diverse requirement profiles in the dental and / or oral surgery treatment.
In 4 is a schematic representation of an enlargement of a fixing plate 10 shown.
In 4a is a plan view of the area of a tooth to be treated, while the 4b represents the same area in cross section.
In 4a is a recess 21 with a cover plate 22 locked. The cover plate 22 is with the fixing plate 10 over four bridges 23 connected and thus fixed. Right and left of the recess 21 are web guiding structures 30.1 , and 30.2 provided, which serve to receive the guide elements of a treatment tool.
In 4b is the representation of 4a shown in cross section along the dashed line S. In this figure it can be seen that the web guiding structures 30.1 and 30.2 have a profile that is traversed by the guide elements of the treatment tool and thereby the geometry is given, which on the tooth 41 is to be transferred. Also shown is the chewing profile 20 on the underside of the cover plate 22 , which in the figure, the tooth is still spaced and thus the fixation plate has not yet been applied to the tooth. A condition is shown which illustrates the situation during the introduction of the fixation plate into the oral cavity before the fixation plate now finally engages the tooth 41 is brought.
When performing the tooth preparation, the surgeon now brings a treatment tool or the guide elements of the treatment tool into the web guiding structures 30.1 and 30.2 and remove first the webs 23 then the cover plate 22 refer to. The now exposed recess 21 serves to carry out the tool of the treatment tool and by tracing the web guiding structures 30.1 and 30.2 through the guide elements of the treatment tool now the prefabricated geometry on the tooth 41 transfer. After the preparation of the tooth (and the insertion of a crown) can the recess 22 then preferably be glued with a filler such that the prepared tooth 41 and the fixation plate 10 firmly connected and fixed together again.
In 5 is a schematic representation of a treatment tool 40 according to an embodiment of the present invention. The illustration shows a milling machine from the side view. The milling machine comprises a milling head 42 , clamped in a lining 41 , a gingiva deflector 44 , two guide elements 43 and a camera 45 , The milling head 42 Made of durable titanium and is in a three-jaw chuck 41 clamped. The guide elements 43 are mounted on the non-rotating part of the milling machine and protrude on opposite sides of the cutter housing. The digital video camera 45 is installed at a prefabricated position in the cutter housing and runs almost parallel to the milling head, with a slight angle towards the milling head. The gingiva deflector also runs parallel to and immediately adjacent to the milling head.
The treatment tool 40 is designed for manual operation. This allows the surgeon to feel how the procedure is going. Resistances during the movement process are so noticeable and errors or complications are easier to avoid. The guide elements attached to the cutter housing 43 are used in the web guiding structures (grooves). The prescribed path is taken by the guide elements 43 feels and this course on the milling machine or the cutter 42 transfer. The guide elements 43 help the surgeon to grind the tooth. A blurring is impossible by the leadership structures. The router 42 carries the tooth enamel at the predetermined locations of the web guiding structure. The goal is to obtain a smooth, precise, clean processing surface. The gingival deflector holds the gum from contact with the milling head during surgery. A violation of the gums can be ruled out and thereby the regeneration process at the surgical site can be accelerated. The camera delivers high-resolution, enlarged images of the operation during the procedure. Due to the slight angle of attack relative to the milling head, the operation can be observed directly at the site of intervention.
In this way, with the fixation plate and the corresponding method for the preparation of teeth and the treatment tool with the guide elements 43 an apparatus and method for simpler, more efficient, and more accurate dental procedures.
- fixation plate
- connecting webs
- Railway management structure
- guide rail
- treatment tool
- Tools of the treatment tool ( 40 )
- guide element
the fixation plate
the fixation plate
the fixation plate
the fixation plate
- Height of the fixation plate
the fixation plate
the fixation plate