DE102007029115B4 - Fixation plate and method of use - Google Patents

Fixation plate and method of use

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Publication number
DE102007029115B4
DE102007029115B4 DE200710029115 DE102007029115A DE102007029115B4 DE 102007029115 B4 DE102007029115 B4 DE 102007029115B4 DE 200710029115 DE200710029115 DE 200710029115 DE 102007029115 A DE102007029115 A DE 102007029115A DE 102007029115 B4 DE102007029115 B4 DE 102007029115B4
Authority
DE
Germany
Prior art keywords
fixation plate
tooth
plate
treatment tool
preferably
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
DE200710029115
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German (de)
Other versions
DE102007029115A1 (en
Inventor
Thomas Engelhardt
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ENGELHARDT, THOMAS, DR. MED. DR. MED. DENT., W, CH
Original Assignee
Engelhardt, Thomas, Dr. med. Dr. med. dent.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Engelhardt, Thomas, Dr. med. Dr. med. dent. filed Critical Engelhardt, Thomas, Dr. med. Dr. med. dent.
Priority to DE200710029115 priority Critical patent/DE102007029115B4/en
Publication of DE102007029115A1 publication Critical patent/DE102007029115A1/en
Application granted granted Critical
Publication of DE102007029115B4 publication Critical patent/DE102007029115B4/en
Application status is Expired - Fee Related legal-status Critical
Anticipated expiration legal-status Critical

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Classifications

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

Abstract

The fixation plate (10) for use in dentistry, wherein the fixation plate (10) comprises at least a portion of a personalized occlusal profile (20) and at least one web guiding structure (30) for guiding a treatment tool (40) and wherein the web guiding structure (30) has a contour which is transferable from the treatment tool (40) to a tooth (41).

Description

  • The 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.
  • Should a dental prosthetic workpiece (for example inlay, crown, Implant, bridge, Dentures, etc.) are used, methods are still used today which the patient to be treated high physical and mental Suspend stress.
  • For example 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) used.
  • 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.
  • Furthermore, in the DE-Auslegeschrift 17 66 012 a drill jig for use in grinding a tooth of a patient 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.
  • None 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.
  • task Therefore, it has been the object of the present invention to overcome the problems of the prior art to avoid the technique.
  • These 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 ).
  • With 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 Kauflächenprofil 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 become.
  • The fixation plate ( 10 ) may vary in material, shape, surface, surface texture.
  • Prefers be for 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.
  • The 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 is also possible, to save material as possible many teeth 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.
  • The Fixation plate has several distinctive surfaces. As the top surface becomes the teeth opposite surface 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 surface structure 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.
  • When Kauflächenprofil may preferably be the surface profile the teeth 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 includes both the visually visible two-dimensional surface and the topography of this Area, 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.
  • When 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.
  • There 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 and lets so no play of the fixation plate on the patient's jaw to.
  • The Kauflächenprofil, 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 receives 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.
  • The 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 also over the support and eliminates the structural nature of the chewing profiles.
  • It 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. While 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 preferably over Adhesives.
  • Of 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.
  • In a further preferred embodiment the fixation plate has such a high dead weight that the remaining degree of freedom almost negligible is.
  • Furthermore, the fixation plate ( 10 ) at least one web guiding structure ( 30 ) on.
  • The 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 milling, since a feed in all three translational directions is possible here and high precision Results can be achieved with high surface quality can.
  • The Railway management structure images the contour which is transferred from the treatment tool to the treatment object, According to the invention a Tooth, transmitted shall be. In this case, the web guiding structure can be a guide, which leads the engagement segment of the treatment tool directly or guide elements receives the treatment tool.
  • On 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 this allows. In this way, the pre-established geometry, through the web guiding structure is set very precisely and precisely on the treated Transfer tooth, 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 allow.
  • 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.
  • The 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.
  • When 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 are.
  • In a preferred embodiment, the fixation plate ( 10 ) a recess ( 21 ) on.
  • When Recess becomes a continuous Gap in 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 can. By a recess, for example, a region of the gums or the jawbone or the space between two together lying teeth 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.
  • As above described Recesses prefers to expose individual teeth to be treated.
  • In 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.
  • These Cover plate can be made of the same material or from another Material be made as the fixing plate.
  • The 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.
  • In 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 key points the occlusal profile be used for example, the almost identical lateral support or hold in general, like a cover plate with full occlusal profile provide.
  • In a preferred embodiment is the fixing plate, for example, with the desired Kauflächenprofil and the desired placeholders, manufactured according to one of the aforementioned production possibilities. Then be the cover plates from the existing fixing plate preferred milled. This creates recesses over the teeth to be treated and cover plates with the desired chewing profile sections the opposite of the cover plates Teeth.
  • In 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 used.
  • In a further preferred embodiment, the fixation plate ( 10 ) Connecting bridges ( 23 ) between the cover plate ( 22 ) and the fixing plate ( 10 ) on.
  • The Connecting webs serve as mentioned above the connection of cover plate and fixation plate. The connecting webs are preferably of hers Length ago 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.
  • The 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.
  • there 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.
  • The 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.
  • In 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 parallel guidance the guide elements, which are attached to the treatment tool to guarantee. The Grooves can preferably over the course of the track be different depths.
  • In a further preferred embodiment, the treatment tool ( 40 ) at least one guide element ( 43 ) exhibit.
  • The guide element or the guide elements are preferably attached to the treatment tool. These will Favor in the web guide elements introduced, 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.
  • Prefers 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 surface 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.
  • In a further preferred embodiment have the guide elements a rounded end, for a pinpoint guidance with respect to example to have the groove depth.
  • in the Case "holes as web guide elements "may be preferred more than two, more preferably three guide elements, a "three-legged tripod" exhibit, which optimal leadership and stability for one precise Bore offers.
  • In a further preferred embodiment, the treatment tool ( 40 ) two guide elements ( 43 ) on.
  • Two guide elements 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 Milling head.
  • In 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 enable. 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 extended 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.
  • The For example, feed can be a standard food for use in medical technology be occurring tools. For Grinder, cutter 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.
  • Of the 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.
  • The 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 key points 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.
  • Especially 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 preparation step 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 possible, provide more than two fixation plates to appropriate preparation plate map. Also, the geometry and space requirements of the web guiding structures can cause that two fixing plates are used, in which web guide structures are introduced, which would otherwise overlap.
  • In 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.
  • 10
    fixation plate
    20
    Kauflächenprofil
    21
    recess
    22
    cover
    23
    connecting webs
    30
    Railway management structure
    31
    groove
    32
    guide rail
    33
    drilling
    40
    treatment tool
    41
    tooth
    42
    Tools of the treatment tool ( 40 )
    43
    guide element
    44
    Gingivaabweiser
    45
    camera
    60
    top the fixation plate
    61
    front the fixation plate
    62
    bottom the fixation plate
    63
    back the fixation plate
    65
    jaw
    H
    Height of the fixation plate
    b
    width the fixation plate
    t
    depth the fixation plate

Claims (10)

  1. 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 ) and wherein the web guiding structure ( 30 ) depicts a contour that is separated from the treatment tool ( 40 ) on a tooth ( 41 ), is transferable.
  2. Fixation plate ( 10 ) according to claim 1, wherein the fixing plate ( 10 ) at least one recess ( 21 ) for the tooth ( 41 ) having.
  3. Fixation plate ( 10 ) according to one of claims 1 or 2, wherein the recess ( 21 ) at least partially by a cover plate ( 22 ), which on the tooth-facing side a chewing profile section of the opposite tooth ( 41 ) having.
  4. Fixation plate ( 10 ) according to one of claims 1 to 3, wherein connecting webs ( 23 ) between the cover plate ( 22 ) and the fixing plate ( 10 ) are provided.
  5. Fixation plate ( 10 ) according to one of claims 1 to 4, wherein the web guiding structure ( 30 ) a groove ( 31 ) in the fixation plate ( 10 ) having.
  6. A dental treatment system comprising a fixation plate ( 10 ) according to one of claims 1 to 5, further comprising a treatment tool ( 40 ) which at least one guide element ( 43 ) having.
  7. A dental treatment system according to claim 6, wherein the treatment tool ( 40 ) two guide elements ( 43 ) having.
  8. Dental treatment system according to one of claims 6 or 7, wherein the treatment tool ( 40 ) a feed ( 41 ) for receiving rotating or cutting tools ( 42 ), in particular milling cutters, grinders, drills or saws.
  9. Dental treatment system according to one of claims 6 to 8, wherein the treatment tool ( 40 ) a gingiva deflector ( 44 ) having.
  10. Dental treatment system according to one of claims 6 to 9, wherein the treatment tool ( 40 ) a camera ( 45 ) having.
DE200710029115 2007-06-25 2007-06-25 Fixation plate and method of use Expired - Fee Related DE102007029115B4 (en)

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DE200710029115 DE102007029115B4 (en) 2007-06-25 2007-06-25 Fixation plate and method of use
PCT/EP2008/005105 WO2009000505A1 (en) 2007-06-25 2008-06-24 Fixing plate and method for the use thereof

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