EP2663255A2

EP2663255A2 - Method for planning a dental prosthesis implant arrangement and a reference arrangement

Info

Publication number: EP2663255A2
Application number: EP12713635.6A
Authority: EP
Inventors: Roland PARDELLER; Andreas Geier
Original assignee: ZFX Innovation GmbH
Current assignee: ZFX Innovation GmbH
Priority date: 2011-03-21
Filing date: 2012-03-21
Publication date: 2013-11-20
Also published as: WO2012126924A2; DE102011014555A1; US20130252202A1; WO2012126924A3

Abstract

The invention includes an apparatus and a method for planning a dental prosthesis implant arrangement. An oral reference arrangement (e.g., a dental tray) can include an alignment portion, configured for extra-oral placement, and having surfaces configured to receive and display an optical reference plane projected from an external reference system. The optical reference plane can provide a reference to align the oral reference arrangement and/or teeth and a jaw of a patient for imaging and subsequent planning of a dental prosthesis implant. A method of planning a dental prosthesis implant arrangement can include initial imaging of the teeth and the jaw of the patient, while the above-described oral reference arrangement is detachably mounted to the teeth and/or jaw of the patient. Three-dimensional information relating to the oral reference arrangement, the teeth, and/or the jaw can be used to generate a virtual model of the teeth and/or the jaw.

Description

Method for planning a dental implant placement and reference arrangement

The present invention relates to a method for planning a dental prosthesis implant assembly.

Conventionally, dental implant arrays are planned by first making a real model of the dentition using an impression of a patient's dentition. The real model largely reproduces the positional relationships of the teeth (so-called occlusion) as well as the topography of the gums. Subsequently, with the help of wax modeling - so-called "wax-up" - a preliminary planning of the dental prosthesis implants is made. The wax model thus provides a first impression of how the missing natural teeth of the patient can be replaced by dental replacement implants.

The wax model serves as a template for the creation of another model made of material, which provides a sufficiently good contrast in radiographs, so-called radioopaque material. The model of radiopaque material is placed in the patient and, if necessary, adjusted. With the model inserted, a computer tomography (CT) or a dental volume tomography (DVT) is made from the patient's jaw. The data obtained provides information on how the model lies relative to the teeth and the jaw. Based on the data, a final planning of the implant positions and, in particular, the precau- bores for anchoring the implant or implants.

In the method described above, at least two sessions with the patient are required, since the wax-up and the production of the model from radio-opaque material are associated with considerable expenditure of time, which moreover can only be carried out by specialized personnel, which means corresponding costs pulls. Also problematic is often a correct positioning of the model of radio-opaque material in the oral cavity of the patient and a positionally accurate alignment of the patient even in the CT or the DVT examination. Furthermore, subsequent changes to the model are possible only with relatively great effort. If the patient decides that the overall impression created by the model is not satisfactory, the wax-up procedure and the preparation of the radiopaque model must be repeated.

Another disadvantage of the method described above is that it can be decided only after performing the CT or the DVT, whether the surgical procedure for implantation of the dental prosthesis implantation can actually be performed as planned, since only then it is clear what the condition of the jaw bone , It may be necessary to revise the model, which requires a repetition of the above steps.

Overall, it should be noted that although the method described above, although generally good results, but it is associated with considerable time and expense. It is therefore an object of the present invention to provide a method enabling faster and less expensive planning of dental prosthetic implant assemblies. This object is achieved by a method having the features of claim 1.

According to the invention, the method comprises using a reference arrangement which has at least one alignment arrangement which can be used as an aid for determining the position of the reference arrangement. The reference arrangement is releasably attached to a patient, in particular to the dentition of the patient or to the patient's jaw in spatially fixed auxiliary points. Such auxiliary points may for example be temporary auxiliary implants for fixing the reference arrangement. The attachment of the reference assembly to the bit or to the auxiliary points ensures that said components are in fixed spatial relationship to one another.

Subsequently, the spatial position of the reference arrangement is aligned by means of an alignment of the alignment arrangement relative to an external reference system. As a result, the patient's jaw and jaw are ultimately brought into a defined position.

After aligning the reference arrangement, the dentition and the jaw are simultaneously detected three-dimensionally and a corresponding data record is generated. Based on the generated data set, a virtual model of the dentition and / or the jaw is generated. The virtual model is clearly within the scope of the prior alignment of the reference array with respect to an external reference system Space oriented and can therefore be used for further planning a dental prosthesis implant assembly.

By means of a suitable method, for example by means of an imaging method, data are thus obtained by a simultaneous detection of the bit and the jaw by means of a suitable method, which reproduce the anatomical conditions in the area of the patient's bit and jaw. The data form a dataset that forms the basis for a virtual model of the dentition and / or the jaw. For example, the virtual model is calculated from the generated data record.

In particular, the virtual model is generated directly based on the generated data set. That except for transformations of the data set, e.g. possibly required transformations of the data format, are no complicated intermediate steps between the data acquisition and the

Creation of the virtual model provided. The data record is thus essentially fed directly into the model calculation.

In other words, in contrast to conventional methods, a three-dimensional recording of the actual situation of the dentition of the patient and his jaw takes place right at the beginning of the planning. The data set obtained is clearly defined on the basis of the orientation of the reference arrangement and its attachment to the denture and / or to corresponding auxiliary points, so that the subsequent planning steps are simplified.

It is understood that the term "dental prosthesis implant arrangement" can be understood both individual dental implant implants as well as arrangements and combinations of several individual dental implant implants. According to a development of the method according to the invention, an extraoral region of the patient, in particular a section of the patient's face in the area of the jaw, is detected three-dimensionally. This makes it possible, for example, to consider aspects of extraoral aesthetics when planning the dental implant placement.

In particular, a three-dimensional detection of characteristic elements of the reference arrangement takes place simultaneously with the three-dimensional detection of the extraoral region of the patient. Alternatively or additionally, it may be provided that the simultaneous three-dimensional detection of the dentition and the jaw comprises a simultaneous three-dimensional detection of characteristic elements of the reference arrangement.

According to the embodiments of the method described above, it is thus possible to simultaneously grasp the dentition, the jaw, the extraoral area of the patient and / or characteristic elements of the reference arrangement three-dimensionally in order to be able to generate the data record required for the specific application.

According to one embodiment of the method, a reference arrangement is used in which at least one characteristic element-in particular three characteristic elements-is arranged on the extraorally arranged alignment arrangement of the reference arrangement.

In particular, a reference arrangement is used in which at least one characteristic element is designed such that it is optically detectable. Further, it is possible to use a reference arrangement in which the characteristic elements - or at least a subset of the characteristic elements - each have a spherical reference body which is connected to a shaft, wherein the shaft, in particular releasably connected to the reference arrangement is. Such elements are easily detectable and allow exact referencing of the recorded data of the patient. By releasably attaching the characteristic elements, these can be attached to the reference arrangement as needed, for example in different positions. In addition, it allows reuse of the characteristic elements in an exchange of the reference arrangement.

According to one embodiment of the method, a computer-assisted virtual preliminary planning of the dental prosthesis implant arrangement is carried out on the basis of the virtual model. For example, the virtual model generated from the data set is fed into a suitable planning program. If characteristic elements are provided, the referencing of the data set can be done easily. The determination of the spatial position of the characteristic elements of the reference arrangement, for example specific reference markers, makes it possible to assign the data points of the acquired data record on the basis of the desired position of the characteristic elements, which is stored or can be stored as a reference system in such planning programs. In other words, these elements create a unique frame of reference to which the data points can be "hooked". Data sets collected using other imaging methods can be easily integrated on the basis of this reference system.

The program then plans which implants are used where. The shape and position of the dental implant implant Order can be adapted and optimized on the basis of the spatially clearly referenced virtual model. In particular, the virtual model is used directly for pre-planning. That is, except for minor transformations of the data set, eg, possibly required transformations of the data format, no costly intermediate steps are required in order to use the virtual model for pre-planning. In other words, the virtual model is such that it can essentially serve directly as a basis for pre-planning. Furthermore, as part of the virtual preliminary planning, a virtual tooth replacement implant model and / or a virtual model of the oral cavity of the patient can be created, which can serve as a basis for further planning steps. The virtual dental prosthesis implant model and / or the virtual model of the oral cavity of the patient - or at least a model of part of the oral cavity - can be presented to the patient comparatively quickly after completing the three-dimensional acquisition of the dentition and the jaw, so that the preliminary planning - and thus essential Parts of the planning of the dental implant placement - can already be performed during a session. The existence of the virtual tooth replacement implant model and / or the virtual model of the patient's oral cavity further makes it easy to make changes to the model that can be instantly visualized. In addition, a cost estimate can already be made based on the available data so that the patient can quickly be provided with all the information that is essential for making a decision. For example, datasets of the dentition and the jaw can be combined with data sets of the extraoral jaw region of the patient in order to be able to take into account the influence of the virtually determined dental implant arrangement on the extraoral aesthetics of the patient already in the virtual pre-planning phase.

After release of the dental prosthesis implant model and / or the virtual model of the oral cavity - optionally after making adjustments and / or changes - at least a part of the components of the dental prosthesis implant assembly can be machined using the data of the virtual dental prosthesis implant model. In other words, the electronically present data of the dental prosthetic implant model directly - the term "directly" in this context includes pure transformations of the data set, such as a transformation of the data format - can be provided to suitable machines or devices, thus making the required components is guaranteed without time and / or precision losses. According to one embodiment of the method, the detection of the dentition, the jaw and the characteristic elements of the reference arrangement can take place with the aid of a computer tomography or a dental volume tomography. The aforementioned imaging methods provide an exact replica of the present situation. The corresponding data records can be quickly and easily electronically processed further.

The detection of the extraoral region of the patient and / or of extraorally arranged characteristic elements of the reference arrangement can be carried out optically. It can be provided that at least one component of the external reference system, in particular a reference plane, is projected onto the reference arrangement by a light beam, in particular by a laser beam. The orientation of the reference arrangement may be based on the reference plane. Once alignment has been completed, the reference arrangement is arranged in a predefined position relative to the reference plane, the position of which in turn is known and is clearly defined, for example, with respect to the gantry of a CT device. For example, the reference arrangement is brought into a substantially horizontally arranged reference plane. A positioning of the reference arrangement within the reference plane and / or parallel thereto can be effected, for example, by aligning a prominent point in the head region of the patient relative to a further marking, in particular a laser marking.

A light beam in the sense used above means a beam of any geometry. The light steel may, for example, have a circular, oval or rectangular cross-section. The light beam can be fanned out, for example by suitable means - for example by a moving mirror - to produce the desired reference plane. By a diaphragm arrangement, a flat light beam can also be generated, which can be used as a reference plane. According to a further embodiment of the method according to the invention, the reference arrangement is releasably attached to the jaw of the patient by means of an impression compound and / or directly or indirectly on the patient's jaw. The invention further relates to a reference arrangement for detachable connection to a denture and / or a jaw of a patient, comprising: a connection unit for producing a releasable connection of the reference arrangement with the denture and / or with the patient's jaw in spatially fixed connection auxiliary points .

an alignment arrangement disposed in a position of use extraorally, which is rigidly connected to the connection unit and which is configured such that the reference arrangement can be aligned specifically in a defined position relative to an external reference system, and

at least three reference elements, each having a predetermined position with respect to the reference arrangement.

The reference elements form a fixed reference system, which in turn can be coupled with the aid of the alignment arrangement with an external reference system. Due to the detachable connection of the connection unit with the patient and the denture and / or the jaw are placed in a fixed spatial reference. In other words, the reference arrangement makes it possible to align a denture and / or a jaw of a patient in a three-dimensional manner in a known spatial position and to be able to use the corresponding data for further treatment steps and / or planning of a dental prosthesis implant arrangement. The alignment arrangement serves as an aid with which the reference arrangement can be brought into the desired position or with which the position of the reference arrangement relative to the external reference system can be verified. According to an advantageous embodiment, at least a subset of the reference elements is arranged on the connection unit. All reference elements can also be provided there. In particular, the reference elements in the position of use are at least partially arranged intraorally. The spatial proximity of the reference elements to the dentition or to the jaw allows a more precise definition of the position of the individual components of the dentition or of the jaw relative to the reference system defined by the reference elements. The alignment arrangement has, in particular, two surfaces which are arranged at an angle to one another and which are designed such that they are suitable for aligning the reference arrangement relative to at least one reference plane of the reference system. The surfaces include, for example, an angle between about 30 ° and 150 °, preferably an angle between see about 60 ° to 120 °, a.

The surfaces can be arranged substantially vertically in the position of use, in particular in a sitting or standing position of the patient.

According to one embodiment, the surfaces are designed in such a way that they can be optically projected onto at least one reference plane in such a way that the reference plane on the surface can be optically read in order to make it possible to align the reference arrangement relative to the reference plane. It is advantageous if the nature of the surfaces is designed so that the optical projection of the reference plane is clearly visible. For example, the surface is roughened for this purpose.

For example, a reference plane can be easily projected by a laser. The reference plane generated by the laser can be used to align a mark provided on the surfaces, that is, for example, the position of the reference arrangement is changed until the projection of the reference plane and the mark come to cover or are aligned parallel to each other. For example, a stroke, notch or edge may act as a marker.

In order to facilitate an operation of the reference arrangement and its spatial orientation, the alignment arrangement may be designed handle or handle-like. In particular, the alignment arrangement biases a plane which is arranged substantially horizontally in the position of use or in an aligned position. The aforesaid surfaces may be attached to outer surfaces of the alignment assembly, i. be arranged in the position of use facing away from the patient's face.

In order to facilitate alignment of the reference arrangement with respect to a sagittal plane of the patient, the alignment arrangement can have on its upper and / or lower side in the position of use a marking, in particular a notch, which runs essentially in the anterior-posterior direction. For example, the notch may be oriented to be placed between the anterior teeth, if any.

A compact construction of the reference arrangement results when the alignment arrangement and the connection unit are arranged substantially in one plane and / or have substantially the same thickness.

An efficient and inexpensive embodiment of the releasable attachment provides for the use of an impression mass. The connection unit can therefore have a receptacle for the impression mass. The In particular, the receptacle comprises a depression which is delimited at least in sections by an edge boundary.

To ensure that the impression compound is not separated from the denture of the patient when releasing the Referenzan- order also from the connection unit, the edge boundary may be at least partially provided with an undercut. When the impression material is cured, a form-fitting connection is made between the impression compound and the edge boundary, and thus the reference arrangement. The receptacle may additionally or alternatively have retention openings which extend from an upper position in the use position to a lower side of the connection unit or the reference arrangement in the position of use. In other words, the retention openings pass through the connection unit. As their cross-section widens toward the side of the connection unit facing away from the receptacle, a positive connection is likewise produced when the impression material enters the retention openings, which prevents the impression compound from being removed from the patient's mouth during removal of the reference arrangement Reference arrangement triggers. In particular, the retention openings have a conical cross section.

The receptacle can be provided with spacers which extend from a bottom of the receptacle and which are in particular web-shaped in order to prevent large-area contact between parts of the dent and the bottom of the receptacle.

The reference elements may be detachably connected to the reference arrangement. On the one hand, this allows the reuse of the reference elements, on the other hand, they can be used at different points in the Reference arrangement can be positioned, for example, to realize different reference systems.

The reference elements in particular each have a spherical reference body which is connected to a shaft, wherein the shaft can be inserted into a corresponding bore on the reference arrangement. The spherical configuration of the reference body allows a precise determination of the position of the corresponding reference element. By using at least partially radio-opaque material for at least a portion of the reference elements, preferably for at least the reference body, the positioning of the reference elements is facilitated since the contrast generated by the material in CT or DVT examinations is greater than that of natural materials.

According to an embodiment of the reference arrangement which is simple and inexpensive to produce, the connection unit and the alignment arrangement are formed in one piece. In particular, the reference arrangement is made of plastic, in particular Plexiglas. The reference arrangement can be provided for single use.

The present invention further relates to the use of a reference arrangement according to at least one of the embodiments described above in at least one of the embodiments of the inventive method described above.

Further embodiments of the invention are given in the description, the claims and the drawings. Hereinafter, an embodiment of the reference arrangement according to the invention will be explained purely by way of example with reference to the accompanying drawings. 1 shows an embodiment of the reference arrangement according to the invention in a perspective view,

Fig. 2 shows the reference arrangement of Fig. 1 in a plan view, Fig. 3 and 4 is a front view and a side view of the reference arrangement of Fig. 1 and Refe

Fig. 5 shows an embodiment of a reference element. 1 shows a centering spoon 10 with an alignment section 12 and a spoon body 14. The alignment section 12 serves to align the spatial position of the centering spoon 10 relative to an external reference system when the centering spoon 10 is attached to a dentition and / or a jaw of a patient , For this purpose, a receptacle 16, which is designed as a depression of the spoon body 14, provided with an impression mass, in which the dentition and / or the jaw of the patient is pressed. It goes without saying that the centering spoon 10 can be used both on the lower jaw and on the upper jaw of the patient.

After attaching the centering spoon 10 to the patient, curing of the impression material is awaited. The Zentrierlöffel 10 is thus spatially fixed to the patient. Subsequently, the patient's head is aligned relative to an external reference system, as will be explained in more detail below. During the curing of the impression compound, it is simultaneously positively connected to the centering spoon 10, since it has penetrated into undercuts 18 in an edge section 20 laterally delimiting the receptacle 16 and hardened there. In addition, retention openings 22 are provided which traverse the bucket body 14 and which have a conical shape in a cross section which widens toward the side of the bucket body 14 facing away from the impression mass. The retention openings 22 thereby act in a similar form as the undercuts 18.

In order to take into account the cramped conditions in the mouth of the patient, the spoon body 14 may be flattened and / or made narrower, in particular in the retromolar area. For example, a lowering of the edge portion 20 may be provided.

In order to prevent the denture over a large area rests on a bottom 24 of the receptacle 16 when the Zentrierlöffel 10 is attached to the patient, web-like spacers 26 are provided which protrude from the bottom 24.

The bucket body 14 has a plurality of reference element bores 28 into which reference elements to be described below can be inserted. To establish a reference system, it is not necessary lent that all holes 28 are equipped with reference elements. The targeted placement of certain holes 28 different reference system can be defined. The holes 28 penetrate the bucket body 14, so that the reference elements can be inserted into the bucket body 14 both from the top and from the bottom. The alignment section 12 of the centering spoon 10 has a shape symmetrical with respect to a notch 30. The notch 30 extends in a position of use of the centering spoon 10 substantially in an anterior-posterior direction. In positioning the centering tray 10, the notch 30 is oriented to extend approximately between the anterior teeth of the patient, thereby defining a sagittal plane. The notch 30 can also be provided on the underside of the centering spoon 10, which is not visible in FIG. 1, as can be seen in FIG. A V-shaped recess 31 additionally facilitates the correct positioning of the centering spoon 10 with respect to the sagittal plane.

After attachment of the centering spoon 10, the head of the patient is aligned by projecting a reference plane on perpendicular to the notch 30 extending end faces 32 of the handle or handle-like alignment portion 12. At the same time, the reference plane is also projected onto side surfaces 34 of the alignment section 12. The surfaces 32, 34 are arranged substantially vertically in the position of use of the centering spoon 10. The surfaces 32, 34 enclose an angle other than zero or 180 °. When a projection of the reference plane on the surfaces 32, 34 is parallel to the respective upper and lower boundary edges of the surfaces 32 and 34, it is ensured that the Zentrierlöffel 10 is in the reference plane. However, an alignment does not necessarily have to be based on the named edges. Alternatively or additionally, for example, markings in the form of lines and / or notches may be provided on the surfaces 32, 34.

The alignment section 12 of the Zentrierlöffels 10 allows, despite its structurally simple design exact alignment of the Centering spoon 10 with respect to the reference plane. Since the alignment portion 12 is formed integrally with the bucket body 14, positioning errors due to improper mounting can be eliminated, which can occur in multi-part centering spoons. The Zentrierlöffel 10 may for example be a cost-effective and designed as a disposable plastic part. In particular, acrylic glass is a suitable material for producing the centering spoon 10.

Holes 28 'which can likewise be equipped with reference elements, if necessary, are arranged on the alignment section 12.

FIG. 2 shows a plan view of the centering spoon 10 in order to illustrate the relative position of the surfaces 32, 34. In the illustrated embodiment, the angle is slightly over 105 °. It is understood that this angle can be varied as needed. It is only decisive that the surfaces 32, 34 are not parallel, since otherwise no clear alignment of the centering spoon 10 with respect to the reference plane can take place.

In the area of the spoon body 14, the contours of the undercuts 18 are indicated by dashed lines. In the region of the alignment section 12, the dashed lines indicate the position of the bores 28 '.

3 shows a front view of the centering spoon 10. In an aligned state of the centering spoon 10, the reference plane R extends both parallel to an upper edge 36 and parallel to a lower edge 38 of the surfaces 32, 34th It can also be seen from FIG. 3 that the centering spoon 10 is of a flat design, ie the alignment section 12 and the spoon body 14 are arranged in one plane. The alignment portion 12 and the bucket body 14 also have a substantially same vertical extent. This can also be seen in FIG. 4, which shows a side view of the centering spoon 10.

FIG. 5 shows a reference element 40, which has a spherical reference body 42 and a shaft 44. To fasten the reference element 40 to the centering spoon 10, the shaft 44 is inserted into one of the bores 28, 28 '. A frusto-conical intermediate portion 46 determines how far the shaft 44 can be inserted into the respective bore 28, 28 ', so that the position of the center of the reference body 42 with respect to the Zentrierlöffel 10 is clearly defined. The shape of the intermediate section 46 tapering towards the reference body 42 leads to a constriction 48, so that the spherical shape of the reference body 42 can be easily recognized in a CT or DVT examination and, consequently, the position of the center point of the reference body 42 can be determined exactly can. The positions of the reference bodies 42 determined by the abovementioned examinations can also be compared with corresponding desired values, for example, in order to validate the data obtained by the examinations and - if necessary - to correct them. In addition, the reference elements 40 form a reference system that allows a simple fusion of data sets obtained by different methods.

Based on the electronically available data from the examinations, the teeth and the jaw can be precisely recorded with the aid of suitable programs and displayed accurately. With a suitable planning software can also be an embodiment of the required dental prosthesis implants be planned virtually with great precision. In addition, a preview of the dentition and the jaw can be made showing a situation after implantation of the dental prosthesis implants. The computer-aided data acquisition of the actual state of the oral cavity of the patient, the virtual pre-planning of the dental prosthesis implant arrangement on the basis of the recorded data and the representation of a preview of the situation after completion of treatment can be performed in a simple manner and quickly compared to conventional methods. The patient can therefore be presented with a virtual model of the dentition already after the first treatment. If necessary, the model can also be adapted virtually with little effort. A cost estimate can also be quickly created based on the available data. As soon as the patient agrees with the proposed implantation model, a more precise planning can be entered based on the available data, which for example includes a more precise virtual determination of the drill holes to be made for the placement of the implants. The available data can also be used to produce patient-specific implants. From the above explanations, it can be seen that basically no physical model of the tooth replacement implant arrangement has to be created in the inventive method in the planning phase, since the impression mass ultimately only serves for fastening the centering spoon to the dentition or the jaw of the patient, thus the patient's head can be aligned correctly by this. The possible omission of a physical model by the method according to the invention leads to a reduction of the required work steps and thus to a reduction of the treatment costs. In addition, the patient can be given a better impression of how his teeth look after completion of the treatment. Of course, those involved are free to use the data they already have to create such a physical model. Such a model can also be created based on the impression of the dentition of the patient in the impression mass.

LIST OF REFERENCE NUMBERS

10 centering spoons

12 alignment section

14 bucket bodies

16 recording

18 undercut

20 edge section

22 retention opening

24 floor

26 spacers

28, 28 'reference element bore

30 notch

31 recess

32 face

34 side surface

36 top edge

38 lower edge

40 reference element

42 reference body

44 shaft

46 intermediate section

48 constriction

angle

R reference level

Claims

claims

Method for planning a dental prosthesis implant assembly comprising:

to use a reference arrangement, which has at least one alignment arrangement (12), which can be used as an aid for determining the position of the reference arrangement;

releasably attaching the reference assembly (10) to a patient, particularly the patient's bit and / or auxillary points fixed to the patient's jaw, wherein at least the alignment assembly (12) of the reference assembly (10) is disposed extraorally; aligning the spatial location of the reference assembly (10) by means of alignment of the alignment assembly (12) relative to an external reference system;

to simultaneously grasp the teeth and the jaw three-dimensionally and to generate a corresponding dataset; and

to generate a virtual model of the dentition and / or the jaw based on the generated data set.

Method according to claim 1,

By doing so, that is

an extraoral area of the patient, in particular a portion of the patient's face in the region of the jaw, is detected three-dimensionally.

Method according to claim 2,

characterized in that a three-dimensional detection of characteristic elements (40) of the reference arrangement (10) takes place simultaneously with the three-dimensional detection of the extraoral area of the patient.

Method according to at least one of the preceding claims, characterized in that

the simultaneous three-dimensional detection of the dentition and the jaw comprises a simultaneous three-dimensional detection of characteristic elements (40) of the reference arrangement (10).

Method according to claim 3 or 4,

characterized in that

a reference arrangement is used in which at least one characteristic element (40) is arranged on the extraorally arranged alignment arrangement (12) of the reference arrangement (10).

Method according to at least one of claims 3 to 5,

characterized in that

a reference arrangement is used in which at least one characteristic element (40) is designed such that it is optically detectable.

Method according to at least one of claims 3 to 6,

characterized in that

a reference arrangement is used in which the characteristic elements (40) each have a spherical reference body (42) which is connected to a shaft (44), wherein the shaft (44), in particular detachably connected to the reference arrangement (10) ,

8. The method according to at least one of the preceding claims, characterized in that

a computer-aided virtual pre-planning of the dental implant placement is made on the basis of the virtual model.

9. The method according to claim 8,

characterized in that

the preliminary planning is made directly on the basis of the virtual model.

Method according to claim 8 or 9,

characterized in that

In the context of the virtual pre-planning, a virtual tooth replacement implant model and / or a virtual model of at least part of the oral cavity of the patient are created, the estimated costs for the production of the real dental prosthesis implant preferably also being calculated and output.

Method according to claim 10,

characterized in that

after release of the dental prosthetic implant model and / or the virtual model of the oral cavity by the patient, at least a portion of the components of the dental prosthetic implant assembly is machined using the virtual dental replacement implant model data.

Method according to at least one of the preceding claims, characterized in that

the detection of the dentition, the jaw and / or at least a subset of the characteristic elements (40) of the reference arrangement (10) using a computed tomography or a dental volume tomography takes place.

13. The method according to at least one of claims 2 to 12,

characterized in that

the detection of the extraoral area of the patient and / or of extraorally arranged characteristic elements (40) of the reference arrangement (10) is carried out optically.

14. The method according to at least one of the preceding claims, characterized in that

at least one component of the external reference system, in particular a reference plane (R), is projected onto the reference arrangement (10) by a light beam, in particular by a laser beam.

15. The method according to at least one of the preceding claims, characterized in that

the reference assembly (10) is releasably secured to the denture and / or the jaw of the patient by means of an impression mass.

16. Reference arrangement for detachable connection with the denture

and / or the jaw of a patient, comprising:

a connection unit (14) for producing a releasable connection of the reference arrangement with the denture and / or with the patient's jaw in spatially fixed connection auxiliary points;

an alignment arrangement (12) arranged at least partially in the position of use, which is rigidly connected to the connection unit (14) and which is configured in such a way that the reference arrangement relative to a component (R) of an external reference system is specifically aligned in a defined position; and

at least three reference elements (40) each having a predetermined position with respect to the reference array.

17. reference arrangement according to claim 16,

characterized in that

at least a subset of the reference elements (40), in particular all reference elements (40), are arranged on the connection unit (14) or on the alignment arrangement (12).

18. Reference arrangement according to claim 16 or 17,

characterized in that

the alignment arrangement (12) has at least two obliquely arranged surfaces (32, 34), which are designed such that they are suitable for aligning the reference arrangement relative to at least one reference plane (R) of the reference system, wherein the surfaces (32, 34) in particular an angle () of 30 ° to 150 °, preferably an angle of 60 ° to 120 ° include.

19. reference arrangement according to claim 18,

characterized in that

the surfaces (32, 34) are arranged substantially vertically in the position of use.

20. reference arrangement according to claim 18 or 19,

characterized in that the surfaces (32, 34) are designed in such a way that they can be optically projected onto at least one reference plane (R) such that the reference plane (R) is optically readable on the surface in order to align the reference arrangement relative to the reference plane (R) to allow, wherein the surfaces (32, 34) are roughened in particular.

21. Reference arrangement according to at least one of claims 16 to 20,

characterized in that

the alignment arrangement (12) is handle-shaped or handle-like.

22. Reference arrangement according to at least one of claims 16 to 21,

characterized in that

the alignment arrangement (12) has on its upper and / or lower side in the position of use a marking, in particular at least one notch (30), which runs essentially in the anterior-posterior direction.

23. reference arrangement according to at least one of claims 16 to 22,

characterized in that

the alignment arrangement (12) and the connection unit (14) are arranged substantially in one plane and / or have substantially the same thickness.

24. reference arrangement according to at least one of claims 16 to 23,

characterized in that the connection unit (14) has a receptacle (16) for an impression compound which in particular comprises a recess which is delimited at least in sections by a boundary (20).

25. reference arrangement according to claim 24,

characterized in that

the edge boundary (20) is provided at least in sections with a bottom cut (18) and / or that the receptacle (16) has a plurality of the retention openings (22) connecting upper and lower sides of the reference arrangement, as seen in the position of use have a cross-section which widens toward a side of the reference arrangement facing away from the bit.

26. reference arrangement according to at least one of claims 16 to 25,

characterized in that

the receptacle (16) has spacers (26) which extend from a bottom (24) of the receptacle (16) and which are in particular web-like, in order to ensure large-area contact between parts of the dent and the bottom (24) of the receptacle (16 ) to prevent.

27. reference arrangement according to at least one of claims 16 to 26,

characterized in that

the reference elements (40) are releasably connected to the reference arrangement.

28. reference arrangement according to at least one of claims 16 to 27,

characterized in that

the reference elements (40) each have a spherical reference body (42) which is connected to a shaft (44), wherein the shaft (44) is insertable into a corresponding bore (28, 28 ') on the reference arrangement.

29. reference arrangement according to at least one of claims 16 to 28,

characterized in that

the connection unit (14) and the alignment arrangement (12) are integrally formed.

30. Use of a reference arrangement according to at least one of claims 16 to 29 in a method according to at least one of claims 1 to 15.