EP3790494A1

EP3790494A1 - Method for evaluating a dental situation

Info

Publication number: EP3790494A1
Application number: EP19721630.2A
Authority: EP
Inventors: Philippe Salah; Thomas PELLISSARD; Guillaume GHYSELINCK; Laurent Debraux
Original assignee: Dental Monitoring SAS
Current assignee: Dental Monitoring SAS
Priority date: 2018-05-09
Filing date: 2019-05-07
Publication date: 2021-03-17
Also published as: EP3566673A1; BR112020022787A2; US20210259807A1; WO2019215129A1; CN112423699A

Abstract

The invention relates to a method for preparing a composed response from a value for at least one dental attribute relating to the dental situation of a target patient, said method comprising the following steps: d) selection, by a composition computer, of at least one relevant standard response from a base of standard responses and according to said value of said at least one dental attribute; e) composition of a composed response, by the composition computer, on the basis of said at least one relevant standard response; f) optionally, validation and/or modification of the composed response by a controller; and g) presentation of the optionally validated and/or modified composed response, the selection in step d) and the composition in step e) being determined according to composition rules of a composition protocol. According to said method, before step e), the composition protocol is selected from a base of protocol models and/or is created by selecting a protocol model from a base of protocol models, and then modifying same.

Description

METHOD FOR EVALUATING A DENTAL SITUATION

Technical area

The present invention relates to a method for evaluating a dental situation.

State of the art

It is desirable that each one regularly check his teeth, in particular to assess his dental situation, that is to say in particular to check that the position or appearance of his teeth does not evolve unfavorably or that a device orthodontic is in good condition, or positioned. During orthodontic treatment, this unfavorable development can in particular lead to modifying the treatment. After orthodontic treatment, this unfavorable development, called "recurrence", can lead to a resumption of treatment. Finally, more generally and independently of any treatment, everyone may wish to evaluate whether his dental situation, and in particular his orthodontic situation, is satisfactory.

Classically, the controls are carried out by a dental professional, in particular an orthodontist or a dentist, who alone has a suitable equipment. These controls are therefore expensive. In addition, visits to the dental professional are binding.

FR 3,010,629 describes a method of controlling the positioning of teeth of a patient. Practical information can be generated, in particular to inform the need to urgently consult a dentist or orthodontist.

In order to limit the number of visits, the Applicant has developed a method which, from

a three-dimensional model of a patient's dental arch made before the treatment, called the "initial reference model", and

- a simple "updated" image of the arch taken during the treatment, for example a photograph taken by the patient with his mobile phone, to accurately assess the positioning of the teeth at the time of acquisition of the updated image.

This process consists of an iterative process in which, at each iteration, tooth models of the initial reference model are moved, then optimal conditions of observation of the initial model thus modified (referred to as the "reference model to be tested") are determined, the optimal conditions of observation being defined as the conditions making it possible to observe the reference model to be tested so that the view of said model is as close as possible to the updated image. A succession of "reference models to be tested" is tested until a maximum level of correspondence is reached between a reference model to be tested and the updated image. This last reference model to be tested is then considered as representing the teeth in their position at the time of acquisition of the updated image. Ideally, this model, called the "updated reference model", is a three-dimensional numerical reference model from which the updated image could have been taken if this model had been real. In practice, it effectively represents, with great precision, the teeth in their position at the time of acquisition of the updated image.

Comparison of the initial and updated reference models then makes it possible to evaluate the patient's dental situation. The assessment of the dental situation is conventionally carried out by a centralized computer, remotely processing the requests sent by the patients with their mobile phones and containing the updated images. This process is described in particular in PCT / EP2015 / 074896.

The Applicant has also developed a method implementing an artificial intelligence algorithm, preferably a neural network, and, from a simple updated image of the patient's arch, for example a photograph taken by the patient with his mobile phone, to assess the patient's dental situation. For this purpose, the neural network is previously trained by means of a learning base typically comprising more than 10,000, preferably more than 50,000, preferably more than 100,000 records, each record containing a historical image, of preferably a photo, a "historic" dental arch and a "historical" description providing values for attributes of the historical image, and in particular for attributes to evaluate the patient's dental situation.

Like the method described in PCT / EP2015 / 074896, the evaluation of the dental situation by artificial intelligence is preferably performed by a centralized computer, remotely processing the requests sent by patients with their mobile phones and containing the updated images. Advantageously, the two processes of the Applicant described above limit the number of visits to the dental professional and do not require expensive specific equipment.

However, patients to whom these methods are proposed do not use enough. In particular, we see that many patients stop sending requests after a few weeks.

There is therefore a need for a method that improves the rate of patient participation.

In addition, there is an ongoing need to train patients in good hygiene practices, and in particular brushing teeth.

Finally, the assessment of the dental situation performed by the centralized computer is not always well adapted to the needs of the dental professional. In particular, it may be useless when the dental situation is satisfactory. It may also be insufficiently detailed to make a diagnosis or recommendation.

An object of the present invention is to meet, at least partially, these needs.

Summary of the invention

The invention provides a method for evaluating a dental situation of a target patient, preferably followed by a dental professional, said method comprising the following steps:

a) acquisition, by means of a mobile phone, of at least one image representing a dental arch of the target patient, called "updated image"; b) preparing, by the mobile phone, a request comprising the updated image, and transmitting the request to an analysis computer;

c) analysis of the request by the analysis computer, so as to determine a value for at least one dental attribute relating to the dental situation of the target patient, and transmission of the value of the dental attribute to a composition computer ;

d) selecting, by the composition computer, in a base of standard responses and according to said value of said at least one dental attribute, at least one relevant standard response; e) composing, by the composition computer, a composite response from said at least one relevant standard response;

f) optionally, validation and / or modification of the composite response by a controller;

g) presentation of the composite answer, optionally validated and / or modified; the selection in step d) and the composition in step e) being determined in accordance with compositional rules of a compositional protocol.

According to a first main aspect of the invention, in step g), the composition computer transmits the composite response, optionally validated and / or modified, to the mobile telephone, and on the mobile phone presents the composite response, optionally validated and / or modified.

As will be seen in more detail in the remainder of the description, a method according to the first main aspect of the invention makes it possible to respond in a personalized way, but automatically, to the target patient.

In particular, the inventors have discovered that patients stop sending requests when they do not receive an answer and that dental professionals do not always respond to all the requests they receive. By systematizing the response procedure, the participation rate of patients increases significantly.

The inventors have also observed that the insertion of tips in composite responses advantageously makes it possible to educate patients to good practices, and in particular to improve oral hygiene.

The composition protocol may be common to all patients in a group of patients of the dental professional or may be patient specific.

According to a second main aspect of the invention, in step g), the composition computer transmits and presents to the dental professional the composite response, optionally validated and / or modified.

The composite response may advantageously consist of a medical check-up, and preferably include advice for the dental professional, adapted to the medical check-up. As will be seen in more detail in the following description, a method according to the second main aspect of the invention allows to respond in a personalized way, but automatically, to the dental professional. By defining the composition protocol, the dental professional can for example:

- decide the thresholds from which he wishes a composite response to be transmitted to him, and / or

- define the level of detail he wishes in the composite answer, and / or

- decide whether the composite answer must include medical recommendations, and / or

- decide which information he wishes to highlight in the composite answer, and / or

- define one or more other recipients of the composite response, for example to speed up the ordering of an orthodontic item or prepare the next appointment with the target patient.

According to a third main aspect of the invention, in step g), the composition computer transmits and presents to a third party, that is to a person different from the patient and the dental professional who follows the target patient, the composite response, optionally validated and / or modified.

The third party may be in particular an insurance professional. The target patient may be a person insured by the insurance professional or asking to be insured by the insurance professional.

The compound response may advantageously consist of a medical check-up.

As will be seen in more detail in the following description, a method according to the third main aspect of the invention allows the insurance professional to receive very easily and quickly a report on the patient's situation.

He can thus verify that information which has been provided to him by the target patient independently of the implementation of the method, for example by means of a questionnaire, is in accordance with the composite response. In one embodiment, the information contained in the compound response is used to establish an insurance contract proposal.

Preferably, the dialing computer also composes, as a function of the composite response addressed to the insurance professional, a composite response intended for the target patient and / or a composite response intended for a dental professional who follows the target patient and / or a composite response intended for a dental professional who does not necessarily follow the target patient but who is determined according to the adequacy of his skills with a need for dental treatment determined from the composite response addressed to the insurance professional. These composite responses are sent to the target patient, the dental professional and the dental professional based on the composite response to the insurance professional, respectively.

In one embodiment, the insurance professional

- prepares, according to a composite answer, a proposal for an insurance contract and / or a request for a complementary examination and / or a recommendation from a dental professional and / or a proposal for an upcoming appointment with the patient target and / or advertisement, and

- the address to the target patient and / or a dental professional.

A method according to the invention, in particular according to the main aspects, may also comprise one or more of the following optional features:

the analysis computer is programmed to, in step c):

- measuring the value of the dental attribute on the updated image; and or

- Segment the updated image and measure the value of the dental attribute on a segment of the updated image; and or

- Search, from the updated image, additional information, preferably additional information specific to the patient, and determine the value of the dental attribute from said additional information;

the analysis computer is programmed, in step c), to determine a three-dimensional numerical model of the dental arch, referred to as the "updated reference model", observable according to a view superimposed in register with the updated image then determine the value of the dental attribute from measurements on the updated reference model;

preferably, preferably, preferably

by means of an optimization method, preferably metaheuristic, preferably evolutionary, preferably by simulated annealing, and / or

- by means of a network of neurons, the reference model updated by deformation of an initial reference model, preferably generated by a scan of the dental arch;

the value of the dental attribute qualifies or quantifies the general dental situation of the target patient and / or an orthodontic situation;

the value of the dental attribute qualifies or quantifies a state of an orthodontic appliance represented on the updated image and / or a state of a tooth of the target patient represented on the updated image and / or oral hygiene; dental patient;

before step e), the dental professional selects the composition protocol in a parameterized protocol base and / or creates the composition protocol by selecting a composition protocol in a parameterized protocol base and then modifying it;

before step e), the dental professional configures the composition protocol so as to select a region of the patient's mouth for the analysis in step c) and / or the selection of the standard response relevant in step (d) relate only to that region;

in step d), the computer selects at least one standard response as a function of data relating to the target patient that can not be determined by analyzing the dental situation of step c);

before step d), the composition computer evaluates

the reaction of the target patient, in particular according to the first main aspect of the invention, and / or

the reaction of the dental professional, in particular according to the second main aspect of the invention,

following the sending of an earlier composite response generated in a previous step g), then, in step d), selecting said standard response according to the evaluation of said reaction;

the prior composite response is a response generated during a previous cycle of steps a) to g), from a previous updated image, or is a response generated during a previous step g) relating to said image updated;

at least one composition rule is configured to act on said composition as a function of said at least one relevant type response selected in step d), and / or based on data on the target patient and / or on data relating to the dental professional;

the composition rule is configured to act on said composition according to data relating to the target patient that can not be determined by analyzing the dental situation of step c);

at least one composition rule is chosen from the group formed by:

a filter determining whether a standard response can be integrated or not in the composite response;

a composition rule imposing a format on the relevant standard answer, preferably imposing a page background and / or a font and / or a character size and / or a color of characters and / or a translation in a language or a language register;

- a composition rule determining a position of each relevant standard answer according to its content or a category to which it belongs;

- a conditional composition rule;

- the conditional composition rule:

- has an effect that depends on the dental situation of the target patient, and / or

- has an effect that depends on the standard answer to which it applies, and / or

- modifies the relevant standard answer or the composite answer as a whole, and / or

- takes into account past events, and / or

- applies to compound response and depends on patient data, and / or

- has an effect that depends on previous exchanges with the target patient, and / or

- has an effect which depends on an arbitrary choice, in particular of the dental professional who follows the target patient or of an insurance professional;

before step e),

- a dental professional following the target patient, or

- an insurance professional, in particular an insurance company or

an enterprise having a centralized computer programmed to execute at least steps d) and e) from a plurality of requests each containing a value of said at least one dental attribute, preferably sent by a plurality patients followed by a plurality of dental professionals, preferably using their mobile phones,

selects the dialing protocol from said protocol template database and / or creates the dialing protocol by selecting a protocol template from a protocol template database and modifying it;

in step f), the controller is a dental professional identical or different from the dental professional who follows the target patient;

in one embodiment, the analysis computer and / or the composition computer are integrated into the mobile telephone;

in one embodiment, the analysis computer and / or the composition computer are remote from the mobile telephone, and in particular may be in an evaluation center with which the mobile phone communicates, the center of the evaluating computer-based, preferably, requests from patients over 1, more than 5, more than 50, more than 100, preferably more than 1000 dental professionals;

according to the first main aspect of the invention, the composition computer preferably composes, according to a protocol of identical or different composition from that implemented in step d) and in step e), a medical check-up according to said value of said at least one dental attribute, and presents said medical report to the dental professional.

Of course, the different main aspects of the invention are not incompatible. In particular, the method can be used, for the same dental situation, to generate a composite response intended for the target patient and another composite response intended for the dental professional, preferably according to two different composition protocols. For the sake of clarity, in this description, the composition protocol used to generate a composite response intended for the dental professional is described as "professional".

The invention also relates to a system comprising a mobile phone, an analysis computer and a composition computer configured to implement steps a) and b) and optionally g), step c), and steps d). and e), respectively.

The invention also relates to: a computer program, and in particular a specialized application for a mobile telephone, comprising program code instructions for the execution

steps a) and b) and optionally g), and / or

of step c), and / or

steps d) and e),

when said program is executed by a computer,

a computer medium on which is recorded such a program, for example a memory or a CD-ROM, and

a computer, in particular a personal device, in particular a mobile phone or a tablet or a computer, in which such a program is loaded.

The invention further provides a method for preparing a response based on a value for at least one dental attribute relating to the dental situation of a target patient, particularly a target patient followed by a care professional. dental procedures, said method comprising the following steps:

d) selecting, by a composition computer, in a base of standard responses and depending on said value of said at least one dental attribute, at least one relevant standard response, preferably of several relevant standard-answers; e ') composing, by the composition computer, a compound response from said at least one relevant type response;

g ') presentation of the composite answer, optionally validated and / or modified, preferably on a mobile phone;

the selection in step d) and the composition in step e ') being determined in accordance with composition rules of a composition protocol.

Steps d) to g ') may have one or more optional or optional features, steps d) to g), respectively. Steps d) to g ') may be identical to steps d) to g), respectively. The invention also relates to a system comprising a computer composition configured to implement the steps d) and e '). This system may also include a mobile phone configured to implement step g ').

The invention also relates to:

a computer program, and in particular a specialized application for a mobile telephone, comprising program code instructions for the execution

of step g '), and / or

steps d) and e '),

when said program is executed by a computer,

Definitions

The "representation of a dental arch" is a representation of all or part of said arch.

Unless otherwise indicated, "model" refers to a three-dimensional numerical model. By "model of an archway" is meant a representation of all or part of said arch.

By "target patient" is meant any person for whom a method according to the invention is implemented to assess the dental situation, whether the person is sick or not.

By "mobile phone" is meant any portable device for taking pictures or movies and communicating via a mobile phone network.

By "computer" is meant a computer processing unit. This unit can be included in particular in the mobile phone or be a PC-type computer or a server of an "evaluation center", for example a computer located at the dental professional, or a tablet. The mobile phone and the computer then comprise communication means for exchanging with each other, in particular for transmitting the request comprising the updated image and / or the composite response.

Conventionally, a computer comprises in particular a processor, a memory, a human-machine interface, conventionally comprising a screen, an internet communication module, by WIFI, by Bluetooth® or by the telephone network. Software configured to implement step c) is loaded into the memory of the analysis computer. Software configured to implement steps d) and e) is loaded into the memory of the composition computer. A computer can also be connected to a printer.

By "image" is meant a two-dimensional image, such as a photograph or an image of a video. An image is formed of pixels.

A "neural network" or "artificial neural network" is a set of algorithms well known to those skilled in the art. A "learning base" is a base of computer records adapted to the training of a neural network.

To be operational, a neural network is typically driven by a learning process called "deep learning", from a learning base.

The learning base conventionally contains information on the two types of objects that the neural network must learn to match.

The training can be done from a learning base consisting of records each comprising a first object of a first type and a second corresponding object of a second type. The first objects at the input of the neural network and the second objects at the output of the neural network are presented, which enables the neural network to learn to supply, from any object of the first type, a corresponding object of the neuron network. second type.

For example, the neural network may be provided with a set of records each containing an image (first object) and the value for a dental attribute for that image (second object), so that it determines the values of its images. parameters so that when presented with an updated image, it provides, as output, a value for this dental attribute in this updated image. The training of a neural network is adapted to the goal pursued and does not pose any particular difficulty to those skilled in the art.

For example, each record of the training database may include an image of a dental arch and a description identifying, in this image, the representations of the teeth, or "tooth areas", and the corresponding tooth numbers. After being trained, the neural network will be able to identify, on an image presented to it, the representations of the teeth and the corresponding tooth numbers.

"Understand", "include" and "present" should be interpreted in a broad and non-limiting manner unless otherwise indicated.

Brief description of the figures

Other features and advantages of the invention will become apparent on reading the following detailed description and on examining the appended drawing in which:

FIG. 1 illustrates the implementation of a method according to the invention in an embodiment in which the analysis of the request and the composition of the composite answer are carried out remotely from the mobile telephone, and

FIG. 2 illustrates the use of a spacer;

FIG. 3 illustrates the implementation of a method according to the invention in an embodiment in which the analysis of the request and the composition of the composite answer are carried out in the mobile telephone.

Detailed description of a first embodiment

A method according to the invention comprises the steps mentioned above. This method is described in detail within the scope of the first main aspect of the invention, to present a compound response to the target patient.

The method then aims to automatically generate responses to patient requests. For this purpose, the method uses a composition protocol, applicable to the target patient or to a group of patients of the dental professional, and which sets the composition rules governing step e).

Preferably, the group of patients, or "cohort", comprises more than 20, more than 50, more than one hundred, more than three hundred, more than five hundred, even more than one thousand patients. In one embodiment, the patient group includes all patients followed by the professional dental care. Advantageously, the dental professional can thus apply the same procedure regardless of the patient considered.

The cohort can also include patients with the same pathologies, for example all patients with sleep apnea.

The composition protocol includes a set of composition rules that determine the selection of the relevant standard-responses, as well as how the selected relevant standard-responses are modified and / or arranged to compose the composite response.

The standard response database in which relevant standard responses are selected may have more than 100, more than 500, or more than 1000 standard responses.

In particular, it may include messages providing information on the dental situation of the target patient, messages providing a recommendation, for example relating to the brushing of a particular tooth, messages of congratulation or encouragement, warning messages. , reassuring messages or messages asking the patient to make an appointment with the dental professional.

For the selection of the relevant standard answers, a composition rule can be a simple filter determining whether or not an associated standard response can be integrated into the composite response.

For the modification of the relevant standard answers, for example, a composition rule may impose a particular format for a selected standard response, for example imposing a page background, a font, a character size or a color of characters. or impose a translation into a particular language, for example in a language known to the target patient, or impose a particular language register.

For the arrangement of the relevant standard answers, possibly modified, a composition rule can be to simply display all the relevant standard answers, for example in an email. A composition rule can also determine the position of each relevant standard answer according to its content or the category to which it belongs. A composition rule can be applied to an associated standard response, to a set of associated standard responses, ie to a "category" of standard responses, to all selected standard responses, or to the compound answer.

A composition rule can be conditional or unconditional.

In particular, its action may depend on data relating to the target patient, and in particular his dental situation, particularly orthodontic (or "clinical situation").

Its action may also depend on one or more other standard responses selected to respond to receipt of the refreshed image and / or one or more selected standard responses to compose a compound response that has been previously sent to the target patient. and / or the reaction of the target patient to one or more earlier compound responses previously sent to him, preferably in the same orthodontic setting (same period between two orthodontic treatments or even orthodontic treatment).

In one embodiment, said reaction can be evaluated by analyzing the updated images. In particular, a modification in the monitoring of orthodontic treatment and / or in compliance with oral hygiene recommendations can be visually detectable by analysis of successive updated images.

In one embodiment, said reaction can be evaluated by an independent analysis of the updated images, for example by examining whether the target patient has read the response he received during the last implementation of the method.

The action of a compositional rule may also depend on the reactions of one or more other "historical" patients to one or more of the earlier compound responses generated in accordance with the invention that have been previously sent to them, preferably in the framework of orthodontic treatments substantially identical to that of the target patient.

The action of a compositional rule may still depend on characteristics of the target patient independent of his dental situation, for example, his age or sex, or the emotional proximity between the target patient and the dental professional, in particular to determine whether the familiarity should be used. The action of a composition rule can still depend on the history of the target patient, ie, for example, the treatments he has undergone, or the requests he has sent in the past, or his behavior during treatments. It may in particular depend on the value, determined in at least one prior step c), for at least one dental attribute relating to the dental situation of the target patient, that is to say of the image analysis. updated other cycles of steps a) to f).

The action of a composition rule can also depend on data independent of the target patient, or "external data". For example, it may depend on the time of year when the target patient's request was received, for example to wish a happy new year in early January.

It may also depend on an arbitrary choice of the dental professional, in particular his / her own choice to communicate about a particular dental situation or region of the patient's mouth.

The following examples illustrate the variety of possible composition rules:

A composition rule that depends on the dental situation of the target patient, that is to say the value of at least one dental attribute, can be for example: "if the dental attribute value is" orthodontic splint detached of the tooth n ° 13 ", select the following relevant standard answer: 'The images that you transmitted to us allowed us to detect a detachment of your orthodontic gutter on a canine of right, on the upper arch'".

A composition rule whose effect depends on the standard answer to which it applies can be for example: "to impose a red color for the only relevant standard answers relating to warnings".

A composition rule that modifies a relevant standard response or the composite response as a whole can be for example: "if the target patient is English, use only standard answers in English", or "if the target patient is English, translate the compound answer in English ".

Other conditional composition rules that take into account past events may be, for example: "if the target patient did not respond to the previous reminder, this standard response can not be selected as the relevant standard response" or "if the standard answer # 8 has been selected as the relevant standard response for composing the previous composite response, the standard answer # 9 can not be selected as the relevant standard response ".

A compositional rule that applies to composite response and depends on patient data can be, for example: "If the target patient is a male, enter the compound answer with 'Dear Sir' followed by the name of the target patient, in lower case, with a first letter capitalized ".

A composition rule whose effect depends on previous exchanges with the target patient may be, for example, "if the target patient has not made an appointment despite two successive retries, select the relevant standard answer. essential that you make a quick appointment. Your dental situation is getting worse.

A compositional rule whose effect depends on an arbitrary choice of the dental professional can be for example: "not to integrate, in the composite response, an alert concerning occlusal interferences", or "not to integrate, in the composite response, alert for tooth # 12 ".

In one embodiment, the composition protocol is unique and fixed. Preferably, however, the dental professional may choose it from a protocol template database and / or modify the parameter values of the composition rules.

In one embodiment, at least a portion of the protocol templates are pre-parameterized and the dental professional modifies the values of the parameters, for example depending on the type of patient and / or choices that are specific to him and / or specificities of the patient. For example, it can use a preset protocol template for an adult and change parameter values to make it child-friendly.

The choices may be specific to the dental professional. For example, according to dental professionals, the dialing protocol will have to signal the appearance of malocclusion or not. Parameter values may therefore be independent of the patient and the treatment and may be an arbitrary decision of the dental professional. To set the parameter values, a check box can be associated with each standard response of the standard response database, with the activation or deactivation of this box defining whether or not the standard response can be used as a response. relevant type. The value of this check box is an example of the value of a parameter in a composition rule that defines the ability or the prohibition to use the standard response.

More preferably, the standard answers are classified into categories. Preferably, at least one parameter concerns all the standard responses of a category, that is to say that the value of this parameter is applicable to all the standard responses of this category. The setting by the dental professional is advantageously simplified.

Preferably, when the dental professional can choose the dialing protocol in a protocol template database, the protocol templates have default values for each of the settings and the dental professional can change the parameter values.

Preferably, the dental professional can set the composition protocol to select a region of the mouth on which the analysis in step c) and / or the composition in step e) should carry. In particular, preferably, the composition protocol is configured to allow selection of the teeth.

Advantageously, the composite response will therefore not include information on other part of the mouth that said region. In addition, the analysis in step c) will be accelerated.

Prior to step a), a reminder preferably informs the target patient of the need to acquire a refreshed image. This reminder is sent to his mobile phone, for example in the form of an email, an alert or an SMS.

In step a), an updated image of the dental arch of the target patient is acquired by means of a mobile phone. Step a) is preferably performed by the target patient or a close relative of the target patient. Step a) can advantageously be carried out remotely from the evaluation center, in particular more than 1 km, or more than 5 km from the evaluation center, in particular outside the orthodontic practice.

Preferably, the updated image is a photograph, in particular a panoramic photograph. In one embodiment, the updated image is extracted from a film.

The updated image is preferably an extra-oral image. Preferably, a spacer is used in step a), as shown in FIG. 2. A spacer is a well-known device, having chutes 12 extending around an opening 14. The target patient has his lips in the troughs, which allows to remove them and improve the observation of the dental arches through the opening. Preferably, a retractor is delivered to the target patient, for example during an appointment with his orthodontist.

In one embodiment, no spacer is used in step a).

In step b), a request is prepared by an application loaded into the mobile phone. This request includes a updated image acquired in step a), but also information to identify the origin of the request, that is to say a target patient identifier "patient_ID".

The request is processed by an "analysis computer", which can in particular be a processing module integrated in the mobile phone or be a computer of a remote evaluation center of the mobile phone.

In the latter case, the request is transmitted to the analysis computer by the mobile phone. All known communication means can be used for this purpose. The transmission can be in particular carried out by a mobile telephone network to which the mobile phone is subscribed.

The analysis computer may receive requests from a plurality of target patients of the dental professional, and in particular when in an assessment center, preferably from several dental professionals. Preferably, it receives requests of more than 1000, more than 10,000, preferably more than 50,000, more preferably more than 100,000 target patients.

In step c), the analysis computer analyzes the request. In particular, it analyzes the updated image in order to evaluate the dental situation of the target patient. In one embodiment, the assessment of the dental situation of the target patient is validated and / or modified, in particular completed, by a dental professional. The dental professional may also act accordingly, for example to order a new orthodontic gutter when the assessment indicates that the one worn by the target patient is no longer suitable. The refreshed image analysis may include a measure of the value of a dental attribute directly on the refreshed image. The updated image being taken by the patient, however, the analysis computer generally can not immediately perform such a measurement.

The analysis of step c) therefore preferably comprises prior treatment of segmentation of the updated image to determine the elements (or "segments") that are represented, for example the tooth areas, the gum areas , or orthodontic appliance areas.

The value of the attribute can then be measured on the corresponding zone. For example, after identifying the tooth area of tooth # 3, that is the area of the updated image that represents that tooth, the analysis computer can measure the color (dental attribute) of this tooth, and determine that it is "normal" (value of the dental attribute).

In a preferred embodiment, the analysis computer searches, from the updated image, for additional information, preferably additional information specific to the patient, and then uses the additional information, preferably in combination with the measured information. on the updated image, optionally after segmentation, to determine a value for the dental attribute.

Preferably, the analysis computer determines, from the updated image, a theoretical configuration that corresponds to the updated image, then uses the theoretical configuration to determine the value of the attribute for the updated image.

In particular, it can search for a three-dimensional numerical model offering a view that can be superimposed in register with the updated image, that is to say which makes it possible to observe the three-dimensional numerical model as the updated image. He can then use additional information from this model, called the "updated reference model", to determine a value for the unmeasurable dental attribute on the updated image.

For example, if the updated reference model represents the roots of the teeth, not visible on the updated image, the analysis computer can measure an abnormal approximation of the roots of two adjacent teeth, the dental attribute being "approximation of the roots adjacent teeth "and its value being" abnormal ". The analysis of the updated image can in particular implement optimization methods.

To find the updated reference model, it is possible, in particular, to iteratively modify an initial reference model to obtain an updated reference model that corresponds to the updated image. Ideally, the updated reference model is therefore a three-dimensional numerical reference model from which the updated image could have been taken if this model had been real.

The initial reference model is a three-dimensional digital model of the patient's dental arch, preferably acquired by means of a scanner, preferably from a dental professional. It has a high precision.

Preferably, the search of the updated reference model comprises

a first optimization operation making it possible to search for a view of the reference model to be tested which best corresponds ("best fit") to the updated image; and

a second optimization operation making it possible to search, by testing a plurality of said reference models to be tested, the reference model to be tested which, among all the reference models to be tested, provides, following a said first operation of optimization, a view that best corresponds to the updated image.

Preferably, a first optimization operation is performed for each test of a reference model to be tested during the second optimization operation.

Preferably, the first optimization operation and / or the second optimization operation, preferably the first optimization operation and the second optimization operation implement a metaheuristic method, preferably an evolutionary method, preferably a simulated annealing. .

To modify the initial reference model, a succession of reference models "to be tested" is tested, the first reference model to be tested being the initial reference model.

Preferably, the choice of a reference model to be tested depends on the level of correspondence of the reference models "to be tested" previously tested with the updated image. This choice is preferably made by following a known optimization method, in particular chosen from metaheuristic optimization methods, preferably evolutionary methods, in particular in simulated annealing processes. All known optimization methods can be used. The analysis of the updated image is preferably carried out by means of a metaheuristic method, preferably an evolutionary method, preferably by simulated annealing, preferably by means of a method described in PCT / EP2015 / 074896.

Metaheuristic methods are known optimization methods. They are preferably chosen from the group formed by:

evolutionary algorithms, preferably chosen from: evolution strategies, genetic algorithms, differential evolution algorithms, distribution estimation algorithms, artificial immune systems, Shuffled Complex Evolution path recomposition, simulated annealing, ant colony algorithms, particle swarm optimization algorithms, taboo research, and the GRASP method;

- the kangaroo algorithm,

- the method of Fletcher and Powell,

- the sound effects method,

- stochastic tunneling,

- climbing hills with random re-starts,

- the method of cross entropy, and

- the hybrid methods between the metaheuristic methods mentioned above.

The analysis of the updated image can in particular implement metaheuristic methods, as described in PCT / EP2015 / 074896. The method described in this document allows it in particular to determine the possible displacements of the teeth represented on the updated image, and / or changes in their shape or their appearance, and then to define attribute values accordingly, for example the "abnormal" value for the attribute "position of tooth # 13".

The analysis can also use artificial intelligence algorithms, and in particular one or more neural networks using a learning base. These algorithms are well known.

A neural network may in particular be chosen from: networks specialized in the classification of images, called "CNN"("Convolutional neural network"), for example

- AlexNet (2012)

- ZF Net (2013)

- VGG Net (2014)

- GoogleNet (2015)

- Microsoft ResNet (2015)

- Caffe: BAIR CaffeNet Reference, BAIR AlexNet

- T orch: VGG CNN S, V GG CNN M, V GG CNN M 2048, V GG CNN M 1024, V GG_CNN_M_ 128, V GG CNN F, V GG ILSVRC-2014 l6-layer, VGG ILSVRC-2014 l9- layer, Network-in-Network (Imagenet & CIFAR-10)

- Google: Inception (V3, V4).

networks specialized in the localization, and detection of objects in an image, the Object Detection Network, for example:

- R-CNN (2013)

- SSD (Single Shot MultiBox Detector: Object Detection Network), Faster R- CNN (Faster Region-based Convolutional Network Method: Object Detection Network)

- Faster R-CNN (2015)

- SSD (2015)

The list above is not exhaustive.

Preferably, the neural network is driven by means of a learning base typically having more than 10,000, preferably more than 50,000, preferably more than 100,000 records, each record containing a historical image, preferably one photo, a "historic" dental arch, and a "historical" description providing values for attributes of the historical image, and in particular for attributes to evaluate the patient's dental situation.

In one embodiment, the analysis uses only the information provided by the refreshed image.

In a preferred embodiment, the analysis performed in step c) uses not only the information contained in the updated image, but also data relating to the target patient, extracted from a database "BD_patients" from the target patient identifier determined from the request. The analysis is advantageously more precise.

The database of patient data "BD_patients" can in particular contain general information on each patient, for example his age, information on the treatment in progress or treatments in the past, and information on previous exchanges between the patient and the analysis computer.

The analysis of the updated image makes it possible to determine a value for at least one attribute relating to the dental situation of the target patient, or "dental attribute".

The dental attribute can be relative to the general dental situation, and for example take the values "satisfactory dental situation" or "unsatisfactory dental situation", relating to a state of an orthodontic appliance represented on the updated image, and take by for example, the values "intact device" or "damaged device", relating to the state of a tooth, and take for example the values "abraded tooth", "broken tooth", or "decayed tooth".

The values of a dental attribute can also be quantitative. For example, a value of an attribute can define the extent to which a tooth has moved, has been abraded, or has changed in appearance.

The values of the dental attributes are then transmitted by the analysis computer to a "composition computer", which may be the same or different from the analysis computer. All known communication means can be used for this purpose.

The composition computer can also be integrated into the mobile phone.

In step d), the composition computer selects one or more standard answers relevant to the dental situation. For this purpose, it searches in a base of standard responses, "BD standard responses", one or more standard responses responding to the dental attribute values determined in step c) and the composition rules.

The composition rules preferably allow selection based on data relating to the target patient, and in particular relating to the treatment of the target patient.

For example, if a dental attribute value indicates a detachment of an orthodontic splint, such detachment can be interpreted differently depending on the effectiveness of the current treatment. For example, if the target patient data indicates that the detachment appeared very quickly, the computer can also select the appropriate standard response: "We thank you for making an urgent appointment". If, on the contrary, this detachment follows a very slow evolution of the position of the teeth, the computer can select the relevant standard answer: "We thank you for making an appointment with the orthodontist within two months".

Several relevant standard answers can be selected for the same aspect of the dental situation. For example, a first relevant standard response may relate to the detachment of the gutter and a second relevant standard response may relate to an abnormal deformation of this gutter.

Different relevant standard answers can be selected for different aspects of the dental situation. For example, a relevant standard answer may relate to the detachment of the orthodontic gutter and a second relevant standard answer may be related to the appearance of a caries.

In step e), a response is composed by the composition computer, according to the composition protocol, from the relevant standard answer (s) determined in step d).

The composition step may be limited to the preparation of a message, for example an SMS or an email literally repeating the relevant standard answer (s).

The composition of the composite response may also include formatting or formatting operations, for example, to introduce a courtesy formula or the signature of the dental professional who follows the target patient.

The composition of the composite response may also include an arrangement operation of the different relevant standard responses received, and the introduction of linking sentences between these different relevant standard-answers.

The target patient data may also be used to modify the standard response (s) so that they are better adapted to the target patient, eg translated into a target patient's target language. Preferably, step e) provides a response similar to that which a dental professional could have written, preferably in a language register adapted to the target patient.

In step f), the response composed by the composition computer is preferably subjected to a controller so that it validates or modifies it, for example by completing it. The controller is a dental professional who may be the same or different from the one who follows the target patient. In particular, in a preferred embodiment, the controller controls and / or modifies composite responses for patients of more than 1, more than 5, more than 10, or even more than 50 dental professionals. In one embodiment, the controller has no patient on its own.

In one embodiment, the relevant standard response is or is not verified by a controller, depending on the relevant standard response.

In step g), if the dialing computer is not integrated in the mobile phone, the composite reply is sent to the mobile phone by the dialing computer, preferably by means of a mobile telephone network.

The compound answer is then presented on the mobile phone. Advantageously, the target patient therefore quickly receives a response to his request, well adapted to his dental situation.

Preferably, a compound response is systematically presented to the patient for each occurrence of step a).

More preferably, an informational message is also presented to the dental professional who follows the patient. The information message may be a copy of the compound response or be personalized, according to the second main aspect of the invention. A method according to the invention thus advantageously allows the professional to systematically obtain a report of the dental situation of the patient and act accordingly.

The method can also be used to inform the patient to improve his oral hygiene, for example to teach him to brush his teeth better.

As it is clear now, the composite response therefore depends on:

- the analysis of the updated image; - the list of standard answers available in the standard answer database;

- the composition protocol.

A method according to the invention thus makes it possible to answer a question concerning the dental situation of a target patient in a rapid manner, without any constraint for the dental professional, and specifies.

The method may in particular be implemented to control the course of orthodontic treatment, after the installation of an apparatus for correcting the positioning of the teeth of the target patient, called "active orthodontic appliance".

The method can also be implemented after orthodontic treatment, to check that the positioning of the teeth does not evolve unfavorably ("recurrence"), especially after the installation of an apparatus for keeping the teeth in position, said " passive orthodontic appliance ".

Example

In a preferred embodiment, a pre-parameterized protocol template is presented to the dental professional when he wants to apply a dialing protocol to compose and address a compound response to a specific target patient.

Preferably, the protocol model lists standard responses classified, for example, according to the frame in which the target patient is followed, for example according to the orthodontic appliance possibly worn by the patient (orthodontic splint, arc appliance and fasteners, restraint apparatus ...) or out of orthodontic treatment (general intra-oral evaluation).

Preferably, the standard answers are further classified within these categories in subcategories, for example according to the element of the orthodontic appliance concerned. For example, in the category of orthodontic appliances with bows and attachments, the standard answers can be classified in subcategories "bow" and "fasteners" depending on whether they relate to the bow or the fasteners, respectively .

Preferably, the standard responses are still classified within these subcategories in items, for example depending on the nature of the anomaly. For example, in the fasteners sub-category, standard answers can be classified in headings "loose fastener" and "damaged fastener" depending on whether they relate to a detachment or damage to the fastener, respectively.

For each standard answer, the dental professional may preferably:

- choose the level of alert, for example choose to do nothing, inform the target patient, or alert the patient with the addition of an indicator of high importance; and or

- choose the teeth to exclude from the analysis in step c), and therefore for which the composite answer will not include information; and or

- choose a message for the target patient, preferably in a predefined list; and or

- choose a message for the dental professional, preferably in a predefined list.

Preferably, regardless of the standard responses, the pre-parameterized protocol model also allows the dental professional to:

- define the frequency with which scans will be requested from the patient in the absence of specific instructions addressed to the target patient by the dental professional (step a));

define the frequency with which scans will be requested from the patient in the case of specific instructions addressed to the target patient by the dental professional, for example to indicate to him that he must change the orthodontic gutter (step a)).

Detailed description of a second embodiment

A method according to the second main aspect of the invention may comprise one or more of the optional features of the method according to the first main aspect of the invention described above, except incompatibility.

A method according to the second main aspect of the invention is intended to present to the dental professional a composite response through a protocol of "professional" composition identical or, preferably, different from that used to compose the composite response intended to the target patient.

Preferably, the professional composition protocol makes it possible to define thresholds from which a composite response must be composed and transmitted to the professional of dental care. For example, the professional dialing protocol makes it possible to determine whether a dental situation, for example a non-pathological malocclusion, should be reported to the dental professional or not.

Preferably, the professional composition protocol makes it possible to define a level of detail for the composite response, for example to specify displacement or deformation values of the teeth.

Preferably, the professional composition protocol makes it possible to determine whether the composite response must include medical recommendations, for example to advise a particular procedure such as tomography imaging, or modification of an orthodontic appliance, or change target patient's orthodontic appliance, or more generally the modification of the treatment.

In one embodiment, the composite response intended for the dental professional does not provide a diagnosis and / or involves no medical recommendation.

Preferably, the professional dialing protocol makes it possible to determine whether the composite response must include recommendations for modifying the schedule of appointments with the target patient and / or modifying the dialing protocol used to compose the compound responses for the target patient. and / or changing the frequency of the reminders addressed to the target patient to implement a step a).

Preferably, the professional dialing protocol also makes it possible to determine the format of the composite response, as described above.

Preferably, the professional dialing protocol also makes it possible to define a list of recipients of the composite answer, or even to define specific documents to be sent to the recipients.

Preferably, the professional dialing protocol also allows the dental professional to be informed that he / she must undertake new tasks. For example, it may lead to composing a compound response to inform a dental assistant that she must prepare the next care session as a result of the dental attribute values determined in step c). For example, the medical assistant may be informed that she needs to prepare a tray for the next treatment session, in particular to have the consumable care material needed for this session. Preferably, the professional dialing protocol also makes it possible to automatically start new tasks. For example, the professional dialing protocol can lead to the generation of a mail or an email to a prosthetist to make a prosthesis, or to the target patient to make an appointment. The professional composition protocol can also, for example, lead to the generation of a command of orthodontic appliance parts, for example fasteners, and / or an orthodontic appliance, for example a gutter.

The method can be used to provide control of the target patient, especially outside the periods of orthodontic treatment or dental care. Dental problems, for example an early caries or necrosis of a soft tissue or infection, can therefore be detected early or even anticipated, especially if the analysis in step c) implements of artificial intelligence.

The implementation of a professional composition protocol allows the dental professional to save time, but also to obtain a medical assessment well adapted to his preferences.

Detailed description of a third embodiment

A method according to the third main aspect of the invention may include one or more of the optional features of the method according to the first and second main aspects of the invention described above, except for incompatibility.

A method according to the third main aspect of the invention is intended to present to a third party, in particular an insurance professional, a composite response through a composition protocol. Preferably, this composition protocol is determined by the third party. If an answer is also composed for the target patient or the dental professional, the "third party" composition protocol, that is, used to prepare the composite response intended for the third party, may be identical or, preferably, different from the one used to compose composite responses for the target patient and the dental professional.

A method according to the invention is particularly useful so that a target patient can, without constraint, and in particular without having to go to a health care professional. provide the professional with information relating to his dental situation.

The dental professional can then, depending on the situation:

- prepare an insurance contract;

- determine a treatment of the target patient's teeth;

- check that a treatment of the target patient's teeth is followed and / or is effective and / or is supported by an insurance contract subscribed by the target patient;

- based on a treatment of the target patient's teeth, determine and recommend to the target patient a dental professional;

- check that the target patient's statements are consistent with his dental situation.

In one embodiment, the composition protocol is determined to compose both a composite response for the target patient and / or a composite response to the insurance professional and / or a composite response to the dental professional. .

In one embodiment, the composition protocol results in the insertion of an advertisement in the compound response, particularly in the compound response intended for the target patient. Preferably, the composition protocol determines the advertisement based on data relating to the target patient that can not be determined by the analysis of the dental situation of step c).

In one embodiment, the composition protocol results in the insertion, in the composite response intended for the target patient, of a recommendation for a dental professional.

Of course, the invention is not limited to the embodiments described above and shown.

In general, a composite response and / or an information message may be presented to the target patient and / or to any third party, for example an insurance professional and / or a dental professional, for example on an interface web.

In addition, the target patient is not limited to a human being. A method according to the invention can be used for another animal. A method according to the invention is not necessarily used for diagnostic purposes. It can for example be used for educational or informational or commercial purposes.

Claims

A method of preparing a compound response from a value for at least one dental attribute relating to the dental situation of a target patient, said method comprising the steps of:

d) selecting, by a composition computer, in a base of standard responses and according to said value of said at least one dental attribute, at least one relevant standard response;

e) composing, by the composition computer, a composite response from said at least one relevant standard response;

g) presentation of the composite answer, optionally validated and / or modified; the selection in step d) and the composition in step e) being determined in accordance with composition rules of a composition protocol,

a method in which, prior to step e), the composition protocol is selected in a protocol template database and / or is created by selecting a protocol template in a protocol template database and then modifying it.

The method of the immediately preceding claim, wherein the composition rule is configured to act on said composition based on non-determinable target patient data by analyzing the dental situation of the target patient.

The method of any one of the preceding claims, including a step f), wherein in step f), the controller is a dental professional different from a dental professional who follows the target patient, and wherein the controller controls and / or modifies compound responses for patients of more than 5 dental professionals.

4. Method according to any one of the preceding claims, wherein before step e),

- a dental professional following the target patient, or

- an insurance professional, or an enterprise having a centralized computer programmed to execute at least steps d) and e) from a plurality of requests each containing a value of said at least one dental attribute,

selects the composition protocol from said protocol template database and / or creates the composition protocol by selecting a protocol template from a protocol template database and modifying it.

The method according to any of the preceding claims, wherein at least one composition rule is selected from the group consisting of:

- a compositional rule imposing a format for the relevant standard answer,;

- a composition rule determining the position of each relevant standard answer according to its content or a category to which it belongs;

- a conditional composition rule.

The method of the immediately preceding claim, wherein the conditional composition rule:

- takes into account past events, and / or

- applies to the composite response and depends on data related to the target patient, and / or

- has an effect that depends on an arbitrary choice of a dental professional who follows the target patient or an insurance professional.

The method of any of the preceding claims, wherein at least one composition rule is configured to act on said composition based on said at least one relevant type response selected in step d), and / or according to data relating to the target patient and / or data relating to a dental professional who follows the patient and / or data related to an insurance professional.

8. Method according to any one of the preceding claims, wherein the composition computer composes, according to a composition protocol identical to or different from that implemented in step d) and in step e), a balance sheet. according to said value of said at least one dental attribute, and present said medical report to a dental professional according to the target patient.

9. A method of evaluating a dental situation of a target patient, optionally followed by a dental professional, said method comprising the following steps:

a) acquiring, by means of a mobile phone, at least one updated image representing a dental arch of the target patient;

b) preparing, by the mobile phone, a request comprising the updated image, and transmitting the request to an analysis computer;

d) - g) preparing a compound response according to a method according to any one of the preceding claims.

The method according to the immediately preceding claim, wherein, in step g), the composition computer transmits the composite response, optionally validated and / or modified,

- to the mobile phone, and the mobile phone presents the composite answer, optionally validated and / or modified, and / or

- to a dental professional who follows the patient, and / or

- to an insurance professional.

The method of any one of the two immediately preceding claims, wherein the target patient is followed by a dental professional and the Composition protocol is common to all patients of a group of patients of the dental professional.

The method of any one of the three immediately preceding claims, wherein the analysis computer is programmed to, in step c):

- measuring the value of the dental attribute on the updated image; and or

- Search, from the updated image, additional information specific to the patient, and determine the value of the dental attribute from said additional information.

Method according to the immediately preceding claim, wherein the analysis computer is programmed to, in step c), determine a three-dimensional numerical model of the dental arch, referred to as the "updated reference model", observable next a view in register with the updated image, then determine the value of the dental attribute from measurements on the updated reference model.

The method of the immediately preceding claim, wherein the analysis computer is programmed to determine the updated reference model by deformation of an initial reference model.

The method according to any of claims 9 to 14, wherein in step c) the value of the dental attribute qualifies or quantifies the general dental situation of the target patient and / or an orthodontic situation.

The method of the immediately preceding claim, wherein, in step c), the value of the dental attribute qualifies or quantifies a state of an orthodontic appliance represented on the refreshed image and / or a state of a target patient's tooth represented on the updated image and / or oral hygiene of the target patient.

The method of any one of claims 9 to 16, wherein in step c) said analysis is performed by means of one or more neural networks.

The method according to any one of claims 9 to 17, wherein, prior to step d), the composition computer evaluates the target patient's response following the sending, to the target patient, of a compound response. previous step generated in a step g) before, then, in step d), selects said at least one standard response based on the evaluation of said reaction.

The method of any one of claims 9 to 18, wherein the target patient is followed by a dental professional, and wherein, prior to step e), the dental professional configures the composition protocol of selecting a region of the target patient's mouth for the analysis in step c) and / or the selection of the relevant standard response in step d) to relate only to said region.

The method according to any one of claims 9 to 19, wherein in step d), the composition computer selects at least one standard response based on data relating to the target patient that can not be determined by the analysis. of the dental situation of step c).

The method of any one of claims 9 to 20, wherein the analysis computer and the composition computer are integrated in the mobile phone, or in which the analysis computer and / or the computer of composition are remote from the mobile phone.

22. The method according to any one of claims 9 to 21, wherein the composite response is transmitted to a third party, then the third:

- prepares an insurance contract; and or

determines a treatment of the teeth of the target patient; and or

- verifies that a treatment of the target patient's teeth is followed and / or is effective and / or is supported by an insurance contract subscribed by the target patient; and or

- according to a treatment of the teeth of the target patient, determines and recommends, to the target patient, a dental professional; and or

- verifies that statements of the target patient are consistent with his dental situation.