Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/0003—Making bridge-work, inlays, implants or the like
  • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C5/00—Filling or capping teeth
  • A61C5/70—Tooth crowns; Making thereof
  • A61C5/77—Methods or devices for making crowns

Definitions

• the invention relates to a method and a system for producing a dental prosthesis.
• a dental prosthesis - be it crowns, bridges, a partial denture or a complete denture - consists of an outer shell and a marginal part, which usually comprises a framework.
• the outer shell must meet aesthetic requirements and allow the functionally appropriate articulation depending on the tooth.
• the marginal part must be designed so that the prosthesis can be firmly anchored in the mouth of a patient - permanent or removable.
• the preparation model and the inner crowns are produced.
• the inner crowns primary crowns
• the fixation impression are applied.
• the design model and the register template are produced in the laboratory.
• the facebow transfer, the Kieferrelationsbetician and the model assembly are then back in the clinic.
• the teeth are set up in wax and the teeth are set up in the clinic.
• the outer crowns (secondary crowns) and the connector framework (tertiary structure) are produced in the laboratory.
• the design and processing of the scaffolds is based primarily on aesthetic aspects, which is why the scaffolding is as graceful as possible, even at the expense of the be designed. The adequate dimensioning of the frameworks can not be reliably controlled in practice.
• the construction of the ceramic masses on the metal framework - whose thermal expansion coefficients must be coordinated - is done by mixing a ceramic powder with distilled water and applying the thus obtained slurry with a brush on the surfaces to be veneered.
• the ceramic compositions are layered side by side or stacked.
• the built-up shape which thus depends variably on the skill of the individual dental technician, is then sintered in the ceramic kiln at the appropriate temperature. The results are not identically reproducible, especially in the case of structures that comprise several teeth.
• the connector framework is then re-tried along with the definitive wax dentition in the clinic.
• the object is first achieved by a method for producing a dental prosthesis, which comprises the following steps:
• the data of the teeth to be replaced and their surroundings are also recorded.
• the detection can be carried out by conventional methods, e.g. based on a model.
• the environment is u.a. together from the facial morphology and the derived facial framework and determines significantly the selection and placement of the teeth.
• these relationships are described in detail.
• the vertical center line crossing the occlusion line is a fixed size. From the relationship of the total facial framework, which corresponds to the extent of the bone structure, and the vestibular framework around the receptors of the eyes, nose and mouth, an age-related set-up of the teeth can be seen.
• the denture to be used is then selected from a selection of prefabricated dental prostheses.
• the data of prefabricated dental prostheses are stored in a database.
• Such dental prostheses can z. For example be made, manufactured and commercially available, polycromatic sets of teeth. But it can also dentures, which consist exclusively of tooth enamel mimicking materials (plastic, ceramic, or other suitable materials), be.
• the data required for this is recorded when the environment is recorded. This can e.g. done with image recognition. From this it can be deduced, with the aid of recognized rules, which dental prosthesis parts in the database can be set up according to these rules and which not. The latter can be excluded. The exact content of such rules is irrelevant to the practice of the invention. Any rule that relates the data of the environment and the dental prostheses with each other, should be sufficient.
• the tooth replacement parts to be used are then selected. Since the outer shell of the remaining after the exclusion of inappropriate dental prosthesis parts in the database dental prosthesis parts are all technically suitable and have been preselected according to the rules contained in the database, in principle, any combination can be used. The selection can be made fully automatically. Subsequently, the selected dental prosthesis parts are virtually integrated into the patient's teeth according to the usual installation rules and presented in the environment based on the collected data and with the aid of imaging software. The patient can already see in this phase what the selected denture will look like after completion and integration. If he is not satisfied with the result, another combination of dental prosthesis parts can be selected and the result displayed.
• the outer shell of the selected dental prosthetic items may also be virtually processed until an aesthetically acceptable result is achieved.
• the installation of the selected dental prosthesis parts can be modified.
• the data of an actual situation in the patient's mouth are recorded after the preparation of the teeth to be replaced and insertion of any implants. This is again done by the usual methods and can also be done on the basis of a model.
• the consistency of the selected dental prosthesis parts with the data of the actual situation after the preparation is checked.
• the tooth replacement parts are then modified according to the data of the actual situation after preparation.
• the dental prostheses can be processed and / or provided with the conventional substructures such as scaffolding for this purpose.
• the consistency check In the preceding step, therefore, it is also checked whether the remaining material thickness is sufficient in the case of the machining required in view of the present situation or whether there is sufficient space for the required framework.
• the technical requirements with respect to minimum layer thicknesses, connector thicknesses and configuration can be found eg in the material-specific ISO standards and are used for this purpose.
• the preparation can also be reworked and the method can only be repeated from the step of recording the actual situation after the preparation.
• the advantage of the method according to the invention is that the generation of the dental prosthesis does not take place, as is usual in the prior art, from the inside to the outside, ie from the prepared tooth to the outer sheath, but starting from the outer sheath to fit onto the prepared tooth.
• dentures can be easily made from prefabricated sets of teeth according to the modular principle. Since the outer shell of the tooth is determined in the first step, the result to be achieved can be quickly visualized and assessed. For the first time, the patient has the opportunity to see his appearance in advance after the treatment. In addition, an interim supply of the patient made of plastic can be generated inexpensively with the recorded data.
• the computationally determined data for such elements can be stored. All components of the dental prosthesis can then be manufactured directly afterwards. This ensures that the scaffolds responsible for the stability and durability of the dentures are not manufactured arbitrarily manually but according to objective specifications. In addition, the patient can assess the aesthetic effect of the selected denture even in the planning phase.
• the selected dental prostheses are preferably modified in the CAD process.
• the object according to the invention is furthermore achieved by a system for the preparation of dental prostheses comprising the following elements: Means for collecting the data of the teeth to be replaced and their environment;
• the system comprises a database in which the data of ready-made Zahner sentence parts are stored.
• the system includes means for acquiring the data of the teeth to be replaced and their environment as well as for the virtual representation of the dentures in the environment integrated into the dentition of the patient according to customary installation rules.
• the system includes means for excluding from the database such dental prosthetic items that are inappropriate due to environmental data due to functional and / or aesthetic and / or stability considerations.
• Appropriate resources are also provided to select dental prostheses from the database.
• the system In order to record the actual situation in the mouth of a patient after the preparation of the teeth to be replaced and insertion of any implants, the system also has appropriate means, as well as means for checking the consistency of the selected dental prostheses with the data of the actual situation after Preparation. With appropriate comparison algorithms it can be determined whether the selected dental prosthesis parts in their marginal part are adaptable to the situation after preparation. Is this using the usual criteria, such. B. stability, not the case, may optionally be provided means that represent the required adjustment, for. B. further preparation, modified installation or alternative materials.
• the purpose of the pretreatment was to allow the tissues to heal in order to carry out extensive surgical measures (autologous iliac crest grafts, soft tissue conditioning and finally insertion of the possible implants due to the situation).
• the jaw relation determination was used to determine the horizontal and vertical jaw relation and encode it in such a way that it was reproducible.
• the data of the actual situation of the affected teeth were scanned by models of the patient.
• the system proposed data from pre-fabricated dental prostheses available in a database, excluding any unsuitable dental prostheses, for the use of possible dental prostheses and generated a design proposal.
• the recorded data of the environment were considered, the facial aesthetics and functional factors z. For example, according to the rules of determined night and the list proposed accordingly.
• the patient was digitally photographed face-to-face and bilaterally with an imaging system.
• the occlusion line and the commissure line were determined with the data stored on the system side.
• the corresponding levels were generated.
• the relevant vertical lines were generated. (Center line, line on which the axis position of the Canini is to be arranged).
• the proposed result could be visualized in the visible range.
• the provisional restoration was prepared, which also represented the outer shell of the future dental prosthesis.
• the provisional restoration used already showed the final result in terms of its external shape and color, which is a particular advantage of the method.
• the vertical midline that crosses the occlusion line forms a fixed size.
• the systemic virtual stylization to geometric figures is used to determine optimal facial proportions.
• the program used for this purpose makes use of the fact that the facial receptors are placed parallel to the upper and lower edge of the vestibular frame. Likewise the fact that a line drawn from the outer edge of the eye to the outer lip edge runs parallel to the outer vertical boundary line.
• the program can determine the lower occlusion line visible with the mouth open.
• the axis direction of the caninis can be derived from the parallelism with the vertical lines of the facial framework. Based on this, the subdivision of the areas for the lateral and central incisors can be determined according to the rules of the "golden section".
• the system prescribes a virtual representation of the resulting procedural set-up because the program contains and can be applied to the rules described in various publications (see, for example, Claude Rufenacht: Principles of Aesthetic Integration, Quintessenz, Berlin 2000). This can be discussed with the patient and navigated within the systemic dental prosthesis sub-bank. The achievable result of denture restoration, the outer aesthetic and functional sheath, is now predictable.
• FIGS. 2 a and 2 b illustrate how, according to the jaw relation determination and production of the models, as well as the jaw-oriented orientation ren the models z. B. in an articulator or virtually by a suitable program and method, the models and their relation to each other scanned and correlated with the previously obtained patient data.
• the outer molds proposed by the system to provide a temporary restoration are taken from a corresponding physical bearing and, in a CNN machine, the data from the contours taken from the existing tooth or implant structures Internal fit is achieved by milling or grinding the lumen.
• the data of the made variations of the outer surfaces serve to generate the outer surfaces, as well as to produce the outer fit by milling or grinding up to the preparation limits the outer fit.
• the provisional care can be incorporated. It corresponds to the result obtained in step 1.
• FIG. 2a shows in the posterior region between maxillary implant regio 6 and mandibular implant regio 6 not enough space for a framework made of ceramic.
• the system proposes a different solution accordingly.
• a framework made of titanium in this case (FIGS. 5 c, d) requires considerably less overall height and is therefore suitable here. The patient has to make the compromise to accept a not completely metal-free solution.
• FIG. 5a shows the ready-made abutments
• FIG. 5b shows the lower jaw model with the individualized abutments in the section seen from the lingual side, right lateral and lateral lateral
• Figures 5c to 5f show the dental prosthesis parts which are manufactured for the supply of the lower jaw.
• the fabrikatorisch prefabricated, polycromatic outer crowns in Figure 5e correspond in their outer figure those from the provisional supply.
• the inner recess of the outer crown takes into account their material-related minimum wall thickness and the geometry of the framework structures (Figure 5d).
• FIG. 6 c shows the zirconium oxide primary structure, which are screwed in the mouth onto the implants and are cut from the zirconia B curls (FIG. 6 b).
• a mesiostructure which ensures the holding of the detachable part on the screwed-on part, is galvanically deposited from fine gold in a defined thickness (FIG. 6d). After a brief manual adjustment to the primary framework, a perfect fit is predictable (Figure 6e).
• FIG. 6f the secondary structure made of zirconium oxide is produced on another CNN machine (FIG. 6f).
• the fabrikatorisch prefabricated outer crowns in Figure 6i analogous to the lower jaw supply in their outer figure those from the provisional supply.
• the inner recess takes into account the material-related minimum wall thickness, as well as the cumulative dimensions of the framework structures (primary, mesio and secondary parts).
• Figures 7a to 7c show the complete dentures after joining the items on the models, right lateral, frontal, left lateral.
• the prefabricated dental prostheses can consist exclusively of tooth enamel-imitating material (FIG. 9a).
• the framework structure will mimic the structure and shape of the toothed dentin ( Figure 9b).
• Figure 9b a complement of the outer figure (outer shell) and supporting structure (in this case with the outer figure of the imitated, natural dentin structure).
• the bridge Connected to one another, the bridge can then be fastened to the prepared tooth stumps (FIG. 9c).

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• 2006
  • 2006-09-14 DE DE102006043284A patent/DE102006043284A1/de not_active Withdrawn
• 2007
  • 2007-09-14 US US12/441,500 patent/US8406908B2/en not_active Expired - Fee Related
  • 2007-09-14 WO PCT/EP2007/008031 patent/WO2008031614A1/de active Application Filing
  • 2007-09-14 CA CA002663482A patent/CA2663482A1/en not_active Abandoned
  • 2007-09-14 RU RU2009113818/14A patent/RU2009113818A/ru not_active Application Discontinuation
  • 2007-09-14 JP JP2009527749A patent/JP5096471B2/ja not_active Expired - Fee Related
  • 2007-09-14 EP EP07818170A patent/EP2068754A1/de not_active Withdrawn
  • 2007-09-14 BR BRPI0716790-3A patent/BRPI0716790A2/pt not_active IP Right Cessation
  • 2007-09-14 AU AU2007296845A patent/AU2007296845A1/en not_active Abandoned
• 2009
  • 2009-03-15 IL IL197599A patent/IL197599A0/en unknown

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