EP2203891A2 - Enregistrements stratifiés en vue de la planification d'un implant - Google Patents

Enregistrements stratifiés en vue de la planification d'un implant

Info

Publication number
EP2203891A2
EP2203891A2 EP08804423A EP08804423A EP2203891A2 EP 2203891 A2 EP2203891 A2 EP 2203891A2 EP 08804423 A EP08804423 A EP 08804423A EP 08804423 A EP08804423 A EP 08804423A EP 2203891 A2 EP2203891 A2 EP 2203891A2
Authority
EP
European Patent Office
Prior art keywords
axis
plane
implant
reference point
coordinate system
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.)
Withdrawn
Application number
EP08804423A
Other languages
German (de)
English (en)
Inventor
Niels Hanssen
Frank BÜLLESFELD
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.)
SICAT GmbH and Co KG
Original Assignee
SICAT GmbH and Co KG
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 SICAT GmbH and Co KG filed Critical SICAT GmbH and Co KG
Publication of EP2203891A2 publication Critical patent/EP2203891A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/0002—Inspection of images, e.g. flaw detection
    • G06T7/0012—Biomedical image inspection
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/70—Determining position or orientation of objects or cameras
    • G06T7/73—Determining position or orientation of objects or cameras using feature-based methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • A61B2090/3762—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/51—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for dentistry
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10072—Tomographic images
    • G06T2207/10081—Computed x-ray tomography [CT]
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30008—Bone
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30052—Implant; Prosthesis

Definitions

  • the present invention relates to a method for creating and presenting slices generated from a set of volume data, the volume data being taken with a tomographic acquisition device, for example a "cone beam CT" device, representing the jaw region of a patient, wherein associated with the volume data are planning data describing the position of an implant to be inserted into the jaw and having an implant axis, defining a coordinate system adapted to a panorama curve spanned by the mutually orthogonal vectors u, v, w, wherein for the generation and Presentation of a slice image, a presentation plane is selected that intersects an implant described by the planning data.
  • a tomographic acquisition device for example a "cone beam CT" device
  • planning data describing the position of an implant to be inserted into the jaw and having an implant axis
  • a coordinate system adapted to a panorama curve spanned by the mutually orthogonal vectors u, v, w
  • a presentation plane is selected that intersects an implant described by the planning data.
  • drilling templates can be created on the basis of the planning data, for example, which are then placed on the corresponding jaw area during treatment and the degree of freedom for the doctor in the bore to be prepared limit.
  • the preparation of such surgical guides is relatively complicated, so that the doctor often decides to make the hole "freehand" on the basis of the present from the planning generated cross-sectional images.He is oriented initially particularly like a panoramic projection, which gives him the necessary overview.
  • the doctor In the case of hands-free surgery, however, the doctor must be provided with the most accurate representation possible of the anatomy and of the implant to be inserted therein.
  • representations are known that present to the doctor cuts that are oriented on a global rectangular (x, y, z) - coordinate system.
  • a single layer along one of the major axes contains too little information to properly assess the location of the implant.
  • a volumetric 3-D view of the anatomy with the implants provides a relatively good estimate of the orientation of the implants relative to one another, the position of the implants in relation to the bone and the nerve canal is only roughly apparent to the physician.
  • This anatomy-adapted coordinate system (p, q, r) follows with its p-coordinate the curved course of the jaw along a previously defined panoramic curve. While the r coordinate corresponds to the vertical z coordinate of the (x, y, z) coordinate system, the q coordinate is perpendicular to p and r.
  • TSA transversal sectional views
  • LSA lateral sectional views
  • the inclination of an implant in the mesial-distal direction can be assessed.
  • the object of the invention is therefore to provide a generic method which can be easily implemented and which ensures a meaningful for the treating physician representation of a planned implant respectively its engagement channel in relation to the surrounding anatomy of the jaw.
  • the basic idea of the invention is to transform the coordinate system in such a way that informative slice images can be presented to the physician through the jaw, which on the one hand align with the panorama curve or optionally on a panoramic surface and which, on the other hand, are each parallel to the implant axis, which forms an axis of symmetry .
  • a tilting of the otherwise vertically aligned transverse or lateral layer is carried out, adapted to the position of the planned implant, so that the implant axis comes to lie in these two layers.
  • An essential point of the construction on which this invention is based is that the two layers are tilted independently of one another. In this way, for the doctor, the entire cross section of the implant can be seen from both of the views available to him.
  • the invention is also based essentially on the fact that the implant has an axis of symmetry as the implant axis, as is the case in particular with cylindrical implants.
  • the essential point of the invention is the introduction of a coordinate system based on the axes u, v and w.
  • the (x, y, z) system is a global, Cartesian, non-jaw-fitted coordinate system whose origin lies somewhere in the space, eg in the center of the head, where the z-axis corresponds to the vertical body axis and the (x, y) plane horizontally intersects the body, is the (u v, w) system is a local, mandibular coordinate system.
  • local means that the (u, v, w) system is always defined with respect to a reference point, while only a single global (x, y, z) system and a single global (p, q, r) - System exists, there are infinitely many (u, v, w) systems, namely at each reference point of one
  • the origin of this (u, v, w) coordinate system lies in the reference point and thus somewhere in the space, in particular somewhere on the implant axis
  • the u-axis is then to correspond to the tangent at the perpendicular point of the reference point to the panorama curve through the reference point and the v-axis of the orthogonal to the panorama curve through the reference point
  • the w-axis corresponds to the z-axis.
  • the transverse layer is tilted about the v-axis or the lateral layer about the u-axis, so that the buccal-oral tilting or the mesial-distal tilting, respectively, becomes visible as an angle between the implant axis and the perpendicular within the layer, when the representation of the layers - as it is advantageous - in a coordinate system corresponding to the patient with horizontal base plane and vertical body axis is displayed.
  • the procedure according to the invention not only aids in the implementation of the planning, but also in the planning of the implants, since such a representation is particularly good to see how the implant is arranged in relation to the surrounding anatomy. Thus, any planning errors, such as the penetration of the implant into critical areas, can be avoided much better than before.
  • the adaptation is carried out automatically by a computer which carries out the following steps in the implementation, wherein
  • the v axis that is orthogonal to the panorama curve or the panoramic area is constructed, which intersects the implant axis, the intersection forming a reference point.
  • the panoramic surface is formed by the vertically uplifting panorama curve, it is the same, no matter whether the panorama curve or the panorama surface forms the basis for the construction of the v-axis. It makes a difference in the case of panoramic surfaces that have distortions in the vertical.
  • the reference point thus constructed on the implant axis is chosen as the origin of the coordinate system.
  • a w-axis passing through the reference point is defined such that the implant axis lies in the v, w-plane.
  • the v, w plane, which forms a first base plane, is therefore rotated about the v axis.
  • the physician is now presented with this first base level or a plane parallel thereto on the screen.
  • the output is made via a printer, for example
  • the physician can now optimally recognize the position of the implant in the jaw. It is advantageous if the cuts are displayed in relation to the body-related horizontal, so that the doctor of the tilt angle of the implant is visible. If several transversal representation planes are detected, these may be e.g. be presented on a common overview. For the doctor, however, especially the central presentation level is particularly interesting. In this "implant-targeted TSA," the buccal-oral tilt of the implant is easily recognizable, or alternatively, there is the interactive display on the screen, where you can interactively move the display plane parallel.
  • a second base plane can be constructed by looking for a u axis intersecting the implant axis at a reference point which is parallel to the tangent to the panorama curve, the tangents being determined in particular by the point of intersection of the perpendicular of the reference point on the panorama curve passes.
  • the w-axis of the coordinate system is defined so that the implant axis lies in the u, w plane.
  • the u, w plane, which forms a second base plane, is therefore rotated about the u axis.
  • the doctor is now presented with this second base level or a plane parallel thereto.
  • the doctor can particularly well recognize the position of the implant in relation to the adjacent teeth.
  • the mesial-distal inclination of the implant can be clearly recognized
  • the physician can again eg display one or more TSAs together with at least one LSA in a common image It is advantageous to display the views on the screen and / or on the printer and to display the respective section lines with the other display levels in. Analogous to the TSA, there is also the interactive display on the screen in the case of the LSA you can move the presentation layer interactively in parallel.
  • Rotating around the implant axis is an important aspect of the invention in the context of interactive presentation. So the doctor can e.g. As part of the final inspection, rotate the display plane completely around the implant to make sure that the implant sits well in the bone in all directions, not only in the two excellent directions orthogonal and tangent to the panoramic curve.
  • a rotation about the implant axis can be made, wherein the tilt angle with respect.
  • the axes u and v are rotated about the axis w at the desired angle of rotation before tilting the display plane into the implant axis.
  • the advantage of detecting the tilt angle outweighs the disadvantage of the slightly moving implant significantly. If the implant eg in the TSA by 10 ° tilted and in the LSA by 20 °, then the implant tilts slightly during rotation from the TSA into the LSA from 10 ° to 20 °.
  • the display plane at the end of the construction can be rotated in such a way that the impiant is always aligned vertically.
  • Figure 2 shows the construction of a tilted transverse plane and a tilted lateral plane
  • Figure 3 is a planning report.
  • FIG. 1 shows a plane 1 which is initially defined in the global 3D origin coordinate system defined by the vectors x, y and z.
  • a panorama curve 2 is defined in level 1, which follows the course of the jaw.
  • a jaw-adapted coordinate system spanned across the axes u, v, w is defined according to the invention, the w axis being initially oriented vertically and corresponding to the original z direction , The v axis is orthogonal (transversal) on the panorama curve 2, while u is tangential (lateral).
  • FIG. 1 a shows a conventional transversal layer 3 and a transverse layer 4 tilted against it and rotated about the axis v.
  • Figure 1 b Accordingly, a conventional lateral layer 5 and a decks tipped and rotated about the axis u lateral layer 6 is shown.
  • the axes are also shown in FIG. 2, in which also the cylindrical implant 7 with its symmetry axis 8 can be seen.
  • a v-axis 10 orthogonal to the panorama curve is sought, which intersects the implant axis 8 at a reference point 11.
  • the reference point 11 is chosen as the origin of the new coordinate system.
  • a w ' axis passing through the reference point is defined so that the implant axis 8 lies in the v, w ' plane. This is done by tilting the first vertical w-axis about the v-axis by an angle ⁇ and turning it into the w ' axis.
  • the u-axis 14 intersects the implant axis 15 at a reference point 16 and parallel to the tangent 17 to the panorama curve 9 at the perpendicular point of the reference point on the panoramic curve.
  • the w axis 18 of the coordinate system is tilted (w 'axis 19) so that the implant axis 15 lies in the u, w ' plane. This is done by tilting the first vertical w-vector around the u-vector by an angle ß and turning it into the vector w ' .
  • top left shows the tilted lateral section through the implant axis.
  • Top right is a plan view is shown, in which the implant No. 36, and the lateral layer and the transverse layers 20 are indicated.
  • the tilt of the implant in the buccal-oral direction (and thus the tilting of the LSA) can be seen in the central TSA.
  • the tilting of the implant in the mesial-distal direction (and thus the tilting of the TSAs) can be recognized in the LSA.
  • a reference point on the implant axis is selected.
  • the solder is cut from the reference point to the panorama curve.
  • the u-axis is parallel to the tangents to the panorama curve through the plumb point
  • the v-axis is the orthogonal to the panorama curve through the reference point (and thus through the perpendicular point)
  • the w axis corresponds to the z axis
  • the u-axis and the v-axis are rotated about the w-axis.
  • TSA The (v, w) plane is tilted about the v axis until the implant axis is in the (v, w) plane
  • LSA The (u, w) plane is tilted about the u axis until the implant axis lies in the (u, w) plane
  • TSA The (v, w) plane is rotated around the u-axis until the w-axis corresponds to the implant axis
  • LSA The (uw) plane is rotated around the v axis until the w axis corresponds to the implant axis

Landscapes

  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Quality & Reliability (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Image Processing (AREA)
  • Image Generation (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Dental Prosthetics (AREA)

Abstract

Procédé d'établissement et de présentation d'images stratifiées, qui sont générées à partir d'un ensemble de données volumiques, les données volumiques étant prises au moyen d'un appareil d'enregistrement tomographique, par exemple au moyen d'un appareil du type 'cone beam CT', et représentant la zone maxillaire d'un patient. Des données de planification sont associées aux données volumiques, lesquelles illustrent la position d'un implant à introduire dans le maxillaire et présentant un axe d'implant. Ainsi se trouve défini un système de coordonnées adapté à une courbe panoramique ou à une surface panoramique, système qui s'étire à partir des vecteurs u, v, w perpendiculaires entre eux, ce qui permet de sélectionner, pour l'établissement et la présentation d'une image stratifiée, un plan de représentation qui coupe un implant décrit par les données de planification. Dans un premier cas, le vecteur v est orthogonal à la surface panoramique et/ou à la courbe panoramique, et coupe l'axe de l'implant en un point de référence, ledit point de référence étant choisi comme origine du système de coordonnées, le vecteur w passant par le point de référence, basculant de façon que l'axe d'implant se situe dans le plan v, w. Le plan v, w forme un premier plan de base, et un plan de représentation parallèle au premier plan de base est sélectionné. Dans un second cas, le vecteur u coupe l'axe d'implant en un point de référence et est parallèle aux tangentes à la courbe panoramique au point de prise du point de référence sur la courbe panoramique, le vecteur w du système de coordonnées étant basculé de façon que l'axe de l'implant se situe dans le plan u, w, ledit plan u, w formant un second plan de base, et un plan de représentation parallèle au second plan de base étant sélectionné.
EP08804423A 2007-10-30 2008-09-18 Enregistrements stratifiés en vue de la planification d'un implant Withdrawn EP2203891A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007051719A DE102007051719A1 (de) 2007-10-30 2007-10-30 Schichtaufnahmen zur Implantatplanung
PCT/EP2008/062488 WO2009056399A2 (fr) 2007-10-30 2008-09-18 Enregistrements stratifiés en vue de la planification d'un implant

Publications (1)

Publication Number Publication Date
EP2203891A2 true EP2203891A2 (fr) 2010-07-07

Family

ID=40514173

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08804423A Withdrawn EP2203891A2 (fr) 2007-10-30 2008-09-18 Enregistrements stratifiés en vue de la planification d'un implant

Country Status (5)

Country Link
US (1) US20100296716A1 (fr)
EP (1) EP2203891A2 (fr)
JP (1) JP2011501991A (fr)
DE (1) DE102007051719A1 (fr)
WO (1) WO2009056399A2 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4971402B2 (ja) * 2009-09-24 2012-07-11 株式会社アイキャット 二次元画像表示装置
US10350010B2 (en) * 2016-11-14 2019-07-16 Intai Technology Corp. Method and system for verifying panoramic images of implants

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Publication number Priority date Publication date Assignee Title
DE19922279A1 (de) * 1999-05-11 2000-11-16 Friedrich Schiller Uni Jena Bu Verfahren zur Generierung patientenspezifischer Implantate
DE10008053A1 (de) * 2000-02-22 2001-09-06 Siemens Ag Röntgeneinrichtung und medizinischer Arbeitsplatz für die Diagnostik und für chirurgische Eingriffe im Kopf - und Kiefernbereich eines Patienten
JP2003245289A (ja) * 2002-02-22 2003-09-02 Univ Nihon 歯科用インプラント施術支援装置
DE10306793A1 (de) * 2002-05-21 2003-12-04 Plus Endoprothetik Ag Rotkreuz Anordnung und Verfahren zur intraoperativen Festlegung der Lage eines Gelenkersatzimplantats
DE102004001273A1 (de) * 2004-01-08 2005-08-04 "Stiftung Caesar" (Center Of Advanced European Studies And Research) Verfahren zur Erzeugung eines Schnittbildes
DE102005055896B4 (de) * 2005-11-14 2013-11-21 Stiftung Caesar"(Center Of Advanced European Studies And Research) Panoramaschichtaufnahmen zur Implantatplanung
TWI284030B (en) * 2005-12-29 2007-07-21 Pou Yuen Technology Co Ltd Manufacture method of tooth implant veneer
US7840053B2 (en) * 2007-04-05 2010-11-23 Liao Hstau Y System and methods for tomography image reconstruction

Non-Patent Citations (1)

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Title
See references of WO2009056399A2 *

Also Published As

Publication number Publication date
DE102007051719A1 (de) 2009-05-07
WO2009056399A3 (fr) 2009-10-29
US20100296716A1 (en) 2010-11-25
JP2011501991A (ja) 2011-01-20
WO2009056399A2 (fr) 2009-05-07

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