EP2391297A1 - Maquette d'occlusion - Google Patents

Maquette d'occlusion

Info

Publication number
EP2391297A1
EP2391297A1 EP09776354A EP09776354A EP2391297A1 EP 2391297 A1 EP2391297 A1 EP 2391297A1 EP 09776354 A EP09776354 A EP 09776354A EP 09776354 A EP09776354 A EP 09776354A EP 2391297 A1 EP2391297 A1 EP 2391297A1
Authority
EP
European Patent Office
Prior art keywords
template
jaw
bite
workpiece
recording
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Withdrawn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
EP09776354A
Other languages
German (de)
English (en)
Inventor
Ady Palti
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP2391297A1 publication Critical patent/EP2391297A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A61C9/0006—Impression trays
    • 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
    • A61C9/0053—Optical means or methods, e.g. scanning the teeth by a laser or light beam

Definitions

  • the invention relates to an occlusion template having a bite region intended to be received in the oral cavity of a patient and to bite the patient with his teeth on a bite surface of that bite region.
  • a template comprises a plurality of three-dimensionally formed position markers, each having predetermined dimensions, are mounted at predetermined locations of the template and are recognizable as position marks on an image of the patient's jaw or jaw area made on the bite area during biting.
  • the invention is directed to applications of such templates.
  • Such a template is used, for example, by dental technicians, dentists, oral surgeons or orthodontists for a tooth or jaw area to be treated with an implant, orthodontic, orthodontic, oral or surgical treatment with regard to its position, orientation and volume before the actual Treatment or actual surgery to be able to prepare the treatment or surgery.
  • position, orientation and volume of the tooth or jaw region which can be determined in particular via image recordings by means of X-ray, CT (computed tomography), VT (volume tomography), MRI (magnetic resonance imaging, magnetic resonance imaging) or an ultrasound procedure
  • the appropriate implant or prosthetic, orthopedic, regulatory, or surgical treatment may be selected, planned, created, and prepared.
  • the known templates have a fixed Size. In the following, the invention will be explained without loss of generality essentially based on the example of dental implants.
  • Dental implants are foreign bodies inserted in the jawbone.
  • the field of dentistry which deals with the implantation of dental implants in the jawbone, is referred to as implantology. Due to their usefulness as carriers of dental prostheses, dental implants assume the function of artificial tooth roots.
  • a drilling template is needed, which is made by means of a processing device.
  • the position markers have the task of forming a fixed and reproducible reference position, from which the position, orientation and volume are possible by means of corresponding distance and size comparisons.
  • the position markers are designed so that they are on the one hand on the picture taken during image capture, such as CT or X-ray visible and measurable and on the other hand, the preparation of the dental procedure and the work of the dental technician not impair.
  • the templates known in the art have three position markers which are arranged at a distance in the bite region of the template.
  • a position marker lies in the front of the center of the incisors and a position marker in the area of a left or right molar.
  • the position markers form a common plane which is parallel to or identical to the plane formed by the template and in particular the occlusal plane of the jaw.
  • the template is referred to as occlusion template or bite template.
  • jaw surgical templates In jaw surgery, such templates are also referred to as jaw surgical templates.
  • the position markers are arranged at a great distance from each other.
  • the image data obtained by means of image recordings can also be corrected or calibrated with the aid of the known position of the position markers, for example against distortion effects, in order to achieve high accuracy of the entire treatment, for example an implantation or an orthodontic treatment.
  • the data obtained by means of planning software during the planning of the treatment for example an implant, can also be applied directly to an automatic processing device for precisely performing corresponding processing steps on a jaw-surgical workpiece, a jaw processing template, a jaw model or an orthodontic splint, in particular by drilling, milling or inserting a positioning aid, which is used to guide a jaw surgical tool in bone processing transferred.
  • the object of the present invention is to make available a template which is suitable, for example, for orthodontic or orthodontic treatment and which makes it possible to produce image recordings with lower costs and reduced radiation exposure.
  • An occlusion template according to the invention for dental technicians and dentists, in particular for making a surgical template for dental implants thus comprises a bite area which is provided for receiving into the oral cavity of a patient and biting the patient with his teeth on a bite surface of this bite area, and several three-dimensional formed position markers, each having predetermined dimensions are attached to predetermined locations of the template and on an image of the jaw or jaw area of the patient, which is made during the biting on the bite area, are recognizable as position marks, and has the peculiarity that they has more than three position markers, which are each arranged in the bite area.
  • the invention not only has the advantages of enabling image recordings limited to smaller areas with lower costs and a reduced radiation exposure, but can, in a further embodiment, realize the following additional advantages:
  • the upper and lower jaws can be recorded at the same time, which further reduces the radiation exposure.
  • the bite situation in the occlusal plane can be shaped with a bite mass.
  • the template may be used to adjust a jaw surgical workpiece to a zero position in a processing device.
  • the template may be used to adjust or fix the patient's head in the imaging device, e.g. CT or VT, in which the image acquisition process is used.
  • the imaging device e.g. CT or VT
  • FIG. 1 is a plan view of a first inventive template
  • FIG. 2 is a plan view of a second template according to the invention.
  • FIG. 3 shows a plan view of a third template according to the invention
  • FIG. 4 shows a three-dimensional view of FIG. 1,
  • Fig. 5 is a three-dimensional view of Figure 2 and
  • FIG. 6 is a three-dimensional view of Figure 3.
  • FIG. 1 shows a plan view of a first template 1 according to the invention. It comprises a bite region 2 which is designed to be received in the oral cavity of a patient and to bite the patient with his teeth
  • the stencil 1 has a plurality of three-dimensionally formed position markers P, in the present embodiment a total of 9 position markers P1-P9.
  • the position markers P1-P9 each have predetermined dimensions and are attached to predetermined locations of the template 1. They consist of an X-ray contrast material, such as titanium or ceramic, so that they are recognizable as position marks on a recording, for example CT or X-ray of the patient's jaw or jaw area, which is made on the bite area 2 during the biting.
  • the position markers P1-P9 are each arranged in the bite region 2 of the template 1.
  • the template 1 consists of a low-X-ray material, such as plastic or a material used in the production by 3D printing material. In order to be able to more clearly recognize the template 1 in the receptacle, for example CT or X-ray photography, it may comprise a portion of a barium material, e.g. Barium sulfate included.
  • the nine position markers P1-P9 each form triangles which are arranged in the occlusal plane of the jaw.
  • the occlusal plane is predetermined by the bite surface 3 of the template 1, which is preferably flat or planar.
  • the template 1 preferably has a position marker P1, which is arranged on the axis of symmetry extending in the longitudinal direction of the jaw, preferably in the distal region of the template 1 or the bite surface 3.
  • the position markers P1-P9 advantageously form triangles whose extent in the longitudinal direction of the jaw is between 20 mm and 60 mm, preferably between 30 mm and 40 mm.
  • the extension of the triangles formed by the position markers P1-P9 in the transverse direction of the jaw is advantageously between 25 mm and 50 mm, preferably between 30 mm and 40 mm. This arrangement ensures that in each case three position markers P lie in the field of view of a small, locally limited image acquisition, for example a CT image. In the figures, the respective dimensions are given in mm.
  • the position markers P1-P9 can be designed, for example, as spheres or as circular cylinders whose longitudinal axes are perpendicular to the occlusal plane of the jaw, ie perpendicular to the bite surface 3.
  • the diameter of the position markers P1-P9 is advantageously between 1.0 mm and 2.5 mm, preferably between 1.5 mm and 2.1 mm. Larger diameters may cause artifacts in CT images.
  • the height of the position markers P1-P9 is advantageously between 5.0 mm and 7.0 mm. As a result, it is also possible to produce a CT image with a large layer spacing, for example 2 mm.
  • the position markers P1-P9 preferably project beyond the bite surface 3, preferably all with the same projection.
  • the geometric arrangement of the position markers P1-P9 is such that they are arranged symmetrically to the longitudinal direction of the jaw.
  • the template 1 comprises pairs of position markers P, which are arranged in the same longitudinal position, relative to the longitudinal direction of the jaw, on both sides next to the bite surface 3 or in the edge region of the bite surface 3.
  • the bite region 2 is preferably formed arcuate.
  • the bite surface 3 has an approximate U-shape, with one U-leg bearing the position markers P2, P3, P6, P7 and the other U-leg bearing the position markers P4, P5, P8 and P9.
  • the U-base which connects the two U-legs, carries the position marker Pl, which is arranged on the longitudinal direction of the jaw extending symmetry axis in the distal region of the template 1.
  • a projection 4 on the template 1 which protrudes from the oral cavity of the bite on the template 1 patient. It can be used to position the patient when taking the picture.
  • the projection 4 can be received, for example, in a corresponding receiving device, placed on a support or carry a one- or two-dimensional dragonfly.
  • the projection 4 may also be one or more mounting reference marks. 5 have, which are mounted at a predetermined position on the template 1 and by means of which the template 1 in a defined position in a corresponding to the mounting reference marks 5 recording, for example, for setting a zero position, is clamped.
  • the mounting reference marks 5 may, for example, comprise one or more holes, openings or recesses mounted in the template 1.
  • the bite surface 3 has increased at its lateral edges, i. up or down over the bite surface 3 protruding edge webs 6 on. They give the bite surface 3 a certain rigidity and can prevent the lateral running down of a bite surface mounted on the bite 3. Such an impression material can be arranged on the bite surface 3 for removing a bite impression of the jaw.
  • the position markers P1-P9 are bordered by border webs 7, which protrude beyond the bite surface 3.
  • the border webs 7 can advantageously be formed by the edge webs 6 or connected to them via connecting webs 8.
  • the Umrandungs- webs 7 serve to keep the position marker P1-P9 firmly in position.
  • the projection 4 has at its edge and across the surface extending reinforcing webs.
  • FIG. 4 shows a perspective view of the template 1 of FIG. 1. It can be seen that it has two bite surfaces 3, namely an upper bite surface 3 for the upper jaw and a lower bite surface 3 for the lower jaw. Both can be provided with an impression material for removing a bite impression of the jaw. Furthermore, it can also be clearly seen in the figure that the edge webs 6, border webs 7 and connecting webs 8 each protrude upwards and downwards over the bite surfaces 3. This also applies to the position markers P1-P9 enclosed by the border webs 7, which preferably project beyond the upper and lower bite surface 3 with the same supernatant, so that the occlusal plane divides the position markers P1-P9 in half. Accordingly, the edge webs 6 and the border webs 7 both stand via the upper and the lower bite surface 3 via, preferably with the same supernatant.
  • FIG. 2 shows a template 1, which differs from the template shown in FIG. 1 in that the bite surface 3 is designed for a somewhat larger jaw, in that the bite surface 3 is slightly widened in the transverse direction, so that the two U -Skeleton have a greater distance from each other, and in the longitudinal direction of the jaw is slightly extended, so that the two U-legs are slightly extended.
  • the position markers P1-P9 and the mounting reference marks 5 are in absolute coordinates seen at the exact same location as in the template in Figure 1. For this reason, lying on the outside of the U-legs position markers P2, P5, P6 and P9 are denser has moved to the bite surface 3 and the distance between the position marker P7 and P8 to the inside of the U-legs has increased.
  • FIG. 3 A correspondingly further enlarged embodiment of the template 1 is shown in FIG. 3, in which the opening width of the U-legs for further adaptation to even larger jaws is further increased and the U-legs are somewhat longer.
  • the position markers P2, P5, P6 and P9 are brought closer or closer to the bite surface 3 and the distance of the position markers P7 and P8 from the inside of the U legs has increased.
  • FIGS. 5 and 6 show corresponding perspective views of the templates 1 of FIGS. 2 and 3.
  • the templates 1 illustrated in FIGS. 1 to 3 belong to a set of occlusion templates comprising a plurality, preferably two to four (small, medium, large and extra large), preferably three sizes (small, medium and large) of templates 1, wherein distinguish the templates of a set with regard to the extent, dimensions or positions of the bite surfaces 3 in their longitudinal and / or transverse directions, the positions of the position markers P being the same for all templates of a set with respect to the position in a jaw.
  • the templates 1 have a projection which bites from the oral cavity of a stencil Patients protrudes, the projection has at least one mounting reference mark 5, which is attached to a predetermined position on the template 1 and by means of the template 1 in a defined position in a corresponding with the mounting reference mark 5 recording is clamped, the positions of the mounting reference marks 5 at all templates 1 of a sentence, in relation to the position in a jaw, are the same.
  • a template 1 according to the invention can be used, for example, as follows.
  • An implant which is made of a ceramic mass or metal and anchored in the bone, is used, the implant root on which the artificial tooth crown is attached.
  • a hole for the implant root must be inserted into the jaw at the site of the lost tooth. Since the artificial tooth crown harmoniously integrate into the row of teeth, the implant root should have the largest possible diameter for better fit and the bone supply in the jaw is limited, the position and angular orientation of the hole must be exactly predetermined and adhered to.
  • a drilling template is usually first created, which at the predetermined location has an angularly adjusted drill sleeve whose inner diameter corresponds to the diameter corresponds to a pilot drill for the jaw bore.
  • the surgical template is worn by the patient drilling the pilot hole.
  • This surgical template can be produced using a jaw model of the patient or purely from image recordings, for example X-ray or computer tomographically obtained data.
  • the necessary information for the determination of the direction of drilling information about the extent of the jaw bone by means of a C image acquisition, such as a computed tomography obtained, with different sectional views are possible through the jaw.
  • the drilling sleeves can be mounted in the drilling template by means of an automated processing device, avoiding inaccuracies which would have to be corrected by widening the pilot bore in the jaw.
  • a template e.g. Drilling template made for the model.
  • Drilling template made for the model.
  • positioning aids are introduced at the implantation sites, which serve to guide the surgical tools in bone processing.
  • the positioning aids are usually sleeves. The attachment of the sleeves in the template is usually done by pouring, Einpo- lymer ensue or screwing.
  • Surgical templates are thus auxiliary devices in order to make it easier for the implantologist to introduce a bore into the jawbone of a patient into which the implant is to be inserted.
  • the drilling template has a borehole created on the jaw model, which serves as a guide for the drill when the bore is introduced into the jawbone.
  • the drill hole should have the correct position and angular position.
  • the template 1 according to the invention can be used for making such a surgical template for dental implants or generally for processing a jaw-surgical workpiece.
  • the precise measurement of the position of the head of the patient and his teeth and their transfer to the workpiece is important for diagnosis and treatment.
  • the position of the occlusal plane of the patient which can be determined very accurately with a template 1 according to the invention, is very important.
  • the occlusal plane is an approximated, artificial or imaginary plane formed by the cut surface of the upper and lower teeth.
  • the position of the occlusal plane can be determined with the inventive template 1 to three-dimensionally determine the position of the teeth to the rest of the head.
  • a template 1 In a method for calibrating or correcting an image acquisition of a jaw or jaw region of a patient who bites on the bite region of a template 1 when taking the image, a template 1 according to the invention is used to make the image and the images of position markers P1-P9 in the Recording will be evaluated to calibrate or correct the recording.
  • the jaw dressing jig comprises a positioning aid for guiding the jaw surgical tool in bone processing, and wherein an image of a jaw or jaw area of a patient,
  • a template according to the invention it is possible for a template according to the invention to be used when making the image and for the images of position markers P1-P9 in the recording for planning and / or Setting the positioning aid in the jaw-machining template or to edit the jaw-machining template are evaluated.
  • a method for processing a jaw-surgical workpiece in particular a jaw-making template, a jaw model or an orthodontic splint, in particular by drilling, milling or insertion of a positioning aid, which serves for guiding a jaw-surgical tool in bone processing, with a processing device, wherein for planning the processing an image of a jaw or jaw region of a patient who bites on the bite region 2 of a template 1 when making the recording, it is possible that when making the recording, a template according to the invention 1 is used and the images of position markers P1-P9 be evaluated in the recording for planning and / or controlling the processing of the jaw-surgical workpiece.
  • a method for positioning an orthodontic work piece, in particular a jaw processing template, a jaw dells or an orthodontic splint, in a processing device for processing a jaw-like surgical workpiece, in particular by drilling or milling comprising taking an image of a jaw or jaw area of a patient biting the bite area 2 of a template 1 when making the image, and Making an impression of the jaw or jaw area
  • the jaw surgical workpiece is aligned by means of the impression and a positioning in a zero position relative to the template and the jaw surgical workpiece in this zero position for editing is aligned in the processing device.
  • the coordinates obtained during the preparation of the recording are transferred to the workpiece, ie the workpiece is brought to edit in a defined position, which correlates with the position of the jaw when making the recording.
  • the alignment of the zero position of the jaw surgical workpiece for editing with the processing device in the processing device wherein the template is clamped in a predetermined orientation in a template receiving the processing device and the workpiece in an alignable workpiece holder of the processing device , the workpiece holder is aligned with respect to the template holder for adjusting the zero position of the workpiece and fixed in the zero position and then the workpiece is processed in the zero position in the processing device.
  • the alignment of the zero position of the jaw surgical workpiece for processing with the processing device takes place in a positioning device external to the processing device, comprising a template receptacle for clamping the template 1 in a predetermined orientation relative to the processing device and an alignable one Has workpiece holder for clamping and aligning the workpiece, wherein the workpiece holder relative to the template Auf- would be aligned to set the zero position of the workpiece and fixed in the zero position and then the workpiece holder is moved with the workpiece in the zero position in the processing device for machining the workpiece.
  • a mechanical or magnetic support of the workpiece holder may be provided in the positioning device and processing device.
  • Such a zero positioning of a bite template 1 is carried out, for example, as follows.
  • the designed as a U-shaped bite fork template 1 with the integrated, for example, nine position markers P1-P9, for example, with a length of 6 mm and a diameter of 2 mm, is first equipped with a plastic bite material.
  • the template 1 is inserted into the mouth of the patient.
  • the patient bites both the maxilla and the mandible with the chewing surfaces of his teeth into the bite mass and onto the fork base, i. the bite surface until the bite material has hardened.
  • the result is a bite template 1, with which the patient is sent to an institute to produce a three-dimensional image, for example an X-ray image in the form of a so-called CT.
  • the resulting data record is stored, for example, in DICOM format and burned to CD.
  • the recorded position markers P and their known positions on the template 1 are the basis of calculation for the further planning of the treatment.
  • the position markers P are aligned perpendicular to the zero plane.
  • an orthogonal system computation every point which is located in the recording ie to determine its coordinates.
  • the nine position markers P1-P9 can be divided into groups of three.
  • the resulting triangles are arranged in such a way that they can be meaningfully detected radiographically in the posterior region as well as in the anterior region. If you make a head CT, all new position markers P1-P9 can be seen in the recording. If you make a partial image, which can be taken with a new generation of equipment, only segments of the jaw can be seen on the radiograph, for example, a partial volume recording, covering a maximum range of 40 mm. With this recording technique, the small triangles can be detected in the posterior region as well as in the front teeth.
  • the bite template 1 is articulated in a positioner outside the processing device with the aid of the example made of gypsum jaw models in the zero position.
  • the jaw model is aligned by means of an adjustable and fixable clamping device, which is also referred to as an articulator, on the bite template 1 and fixed in the aligned zero position.
  • the articulated jaw model that articulates in the zero position in a tensioning device with magnetic recording in the positioning device was, is implemented with the clamping device in the processing device and serves there for fixing the patch thereon, still provided with no holes implant drilling template.
  • the already calculated coordinates can be used and the machining device can be used to drill the places intended for implantation into the drilling template.
  • the guide sleeves are used.
  • the surgical template can be inserted into the patient's jaw, and pilot bores are drilled through the guide sleeves into the jaws for the implants by means of a pilot drill.

Landscapes

  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

L'invention concerne une maquette d'occlusion 1 comportant des repères de position P qui présentent des dimensions prédéfinies, qui sont placés en des points prédéfinis de la maquette 1 et qui peuvent être identifiés en tant que repères de position sur une prise de vue de la mâchoire ou d'une partie de la mâchoire d'un patient. L'invention vise à permettre d'exploiter des radiographies limitées localement. A cet effet, la maquette 1 présente plus de trois repères de position P1-P9 qui sont chacun disposés dans la zone de morsure de la maquette 1.
EP09776354A 2009-01-30 2009-01-30 Maquette d'occlusion Withdrawn EP2391297A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2009/000631 WO2010085981A1 (fr) 2009-01-30 2009-01-30 Maquette d'occlusion

Publications (1)

Publication Number Publication Date
EP2391297A1 true EP2391297A1 (fr) 2011-12-07

Family

ID=41165585

Family Applications (1)

Application Number Title Priority Date Filing Date
EP09776354A Withdrawn EP2391297A1 (fr) 2009-01-30 2009-01-30 Maquette d'occlusion

Country Status (3)

Country Link
US (1) US20120028211A1 (fr)
EP (1) EP2391297A1 (fr)
WO (1) WO2010085981A1 (fr)

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JP6670509B2 (ja) * 2017-01-20 2020-03-25 台達電子工業股▲ふん▼有限公司Ｄｅｌｔａ Ｅｌｅｃｔｒｏｎｉｃｓ，Ｉｎｃ． コンピュータ断層撮像システムの造影方法
IT201700012278A1 (it) * 2017-02-06 2018-08-06 Paolo Bernardi dispositivo per orientare immagini tac e immagini da scansioni ottiche per l'implantologia dentale
CN107184286B (zh) * 2017-06-30 2023-09-12 深圳市倍康美医疗电子商务有限公司 一种放射导板取模装置

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Also Published As

Publication number Publication date
US20120028211A1 (en) 2012-02-02
WO2010085981A1 (fr) 2010-08-05

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