EP3899959A1 - Method for creating, processing, maintenance and using database of maxillofacial statuses - Google Patents

Method for creating, processing, maintenance and using database of maxillofacial statuses

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Publication number
EP3899959A1
EP3899959A1 EP19806092.3A EP19806092A EP3899959A1 EP 3899959 A1 EP3899959 A1 EP 3899959A1 EP 19806092 A EP19806092 A EP 19806092A EP 3899959 A1 EP3899959 A1 EP 3899959A1
Authority
EP
European Patent Office
Prior art keywords
images
patient
database
maxillofacial
statuses
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP19806092.3A
Other languages
German (de)
French (fr)
Inventor
Lubomir Georgiev Petrov
Petar Lyubomirov Petrov
Georgi Lyubomirov Petrov
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP3899959A1 publication Critical patent/EP3899959A1/en
Pending legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/002—Orthodontic computer assisted systems

Definitions

  • the invention relates to a method for creating, processing, maintaining and using a database of maxillofacial statuses to be used in dental treatment, for restorative procedures and for carrying out scientific researches.
  • U.S. Patent Application No. US2018/0184891A1 discloses a method for creating and maintaining a dental status database, as well as its usage.
  • the method according to the said application includes intra-oral panoramic capture by a medical professional of at least a portion of a patient’s mouth by using an intraoral mirror fitted with a camera. Capturing is done before and after each dental treatment.
  • the shots taken are three-dimensional and are stored on a remote server (e.g.“a cloud”), and subsequent three-dimensional images from subsequent capturing at each subsequent visit to the health care professional are also saved.
  • the method also includes the attachment of an X-ray image (Cone beam computed tomography— CBCT) to the panoramic three-dimensional image of the same area of the patient’s mouth.
  • CBCT X-ray image
  • the database retains historical information about the patient’s condition, including historical panoramic three- dimensional images of the patient’s mouth. Access to the database is granted through a detector for recognizing the face of the healthcare professional or at least his/her eyes, thus making the patient’s information file available only to his/ her healthcare professional. Using a user-name and a an access password is also provided.
  • the use of the database consists of conducting dental treatment for subsequent restoration of dental status, including prosthetics, orthodontics, restorative dentistry, maxillofacial prosthetics, restorative, diagnostic and oral, and maxillofacial surgery.
  • the known solution forms a database which contains incomplete information and does not allow for high accuracy restoration of the patient’s maxillofacial status, and does not create conditions for the use of the data in other areas beyond the specific restorative work.
  • the problem to solve with the invention is to provide a method for creating, processing, maintaining and using a database of maxillofacial statuses, which allows efficient processing of the necessary images, allows for high precision of the produced parts for restorative dentistry or prosthetics, as well as allowing for conducting a wide range of researches.
  • the method for creating, processing, maintaining, and using database of maxillofacial statuses includes capturing the patient’s teeth by a medical professional with intraoral scanner, as the capturing is carried out at selected intervals, where the medical professional creates a patient’s file.
  • the file records the images of each capture, which also includes computed tomography (CBCT) of the patient’s mouth, and the patient’s file is supplemented by captures of both types at each subsequent dental manipulation. All images are stored and used for subsequent restoration of the dental status.
  • CBCT computed tomography
  • the first capturing for a patient file by an intraoral scanner is when occlusion of the first permanent teeth is established, whereas the capturing by computed tomography (CBCT) is set individually by the medical professional.
  • the maxillofacial status of each patient is created by adding a photo of his face to the patient’s file.
  • All files are stored in a database of maxillofacial statuses, and from the captured images by the intraoral scanner, the CBCT and the photo image, combined images are produced at the interval determined by the medical professional. Meanwhile intermediate images are also produced, presenting overlay of selected images from at least one of the devices used - the intraoral scanner, CBCT and camera, which updates and maintains the database of maxillofacial statuses.
  • the combined images and the intermediate images are produced by created specialized software, and the database of maxillofacial statuses, in addition to being used for restoration of dental status A, is also used for at least one of the following: diagnosing other diseases B, manufacturing dental sets C, creating a market for dental anatomies D, identification of individuals E, scientific research F.
  • Diagnosing other diseases B is achieved by comparing several previous records of the maxillofacial status of the patient’s file, thus determining whether there is accelerated tooth wear present or any other change, and if so, a recommendation to the patient for consults a suitable specialist in another field is given.
  • Creating a market for dental anatomies D involves offering at least one set of dental anatomies through an electronic catalogue, whereby, after a customer purchases the images, a respective type of restorations are made based on them.
  • Identification of individuals E is carried out by capturing the unrecognizable person with at least an intraoral scanner and then by comparing the obtained images with those available in the database of maxillofacial statuses’ three- dimensional images taken through the same means until identification is done.
  • Scientific research F is carried * out by scientific organizations in the field of anthropometric, etiological and other studies through measurements and comparisons of three-dimensional images from the database of maxillofacial statuses.
  • the created specialized software includes the following steps: connecting to the database of maxillofacial statuses from which a particular patient’s file is selected, followed by selection making from the available images for which reference points identical to each image are determined. Registration is performed based on these reference points, resulting in a cumulative image, which is also stored in the database of maxillofacial statuses followed by the next step which is to determine the differences between the last and the previous images, after which analysis is performed and then the diagnosis is determined.
  • the selection from the available images in the database of maxillofacial statuses depends on the particular application and includes at least one of the following groups: a series of captured images with an intraoral scanner only; a series of images taken with the CBCT only; a series of intermediate images from the intraoral scanner and the CBCT; a series of combined images taken with the intraoral scanner, CBCT and the digital camera.
  • a method for manufacturing denture teeth has been created using the database of maxillofacial statuses, in which a three-dimensional image of patient’s teeth is downloaded from the database in their optimal entirety and then the dentin and the enamel portions of each tooth are printed individually by a 3D-printer with the respective color, thus obtaining two components that are bonded by a composite mediator, after which a positioning splint is produced that corresponds to the exact position of the teeth in the dental arches, according to the 3D-image and an occlusal splint is printed.
  • the advantages of the invention are that a database is created containing images of the maxillofacial status of individuals for a long period of time, beginning with their childhood, which presents an opportunity for efficient processing of the necessary images and achieving high precision of the produced details of restorative dentistry, prosthetics and orthodontic intervention, as well as an opportunity to carry out a wide range of studies— diagnostic, scientific, criminal, as well as the possibility of creating a market for dental anatomies.
  • FIG. 1 is a flowchart of a method according to the invention
  • FIG. 2 is a flowchart of created specialized software used according to the invention.
  • FIG. 3 is a combined image obtained by overlapping of images taken with intraoral scanner, computed tomography and face photo;
  • each individual’s teeth are unique per se.
  • the anatomy of permanent teeth is extremely important for maintaining the proper function of the masticatory apparatus. The method was designed to achieve high accuracy in restoring the integrity of those teeth in shape and function when lost or damaged, as well as to provide sufficient information for various researches.
  • FIG. 1 presents a flowchart of the method according to the invention.
  • the first step in creating a maxillofacial status is to have a medical professional 1 capture an image with an intraoral scanner of the teeth of a patient 2.
  • the patients, as shown in FIG. 1, are usually multiple, therefore there is also a single patient indicated by 2n.
  • the capturing is performed immediately after occlusion of the first permanent teeth is established. This capture produces a 3D-image 3.
  • the capturing continues at intervals set by the medical professional 1, or only at visits by patient 2, 2n.
  • the uneven intervals between recordings formed by the patient’s visits would adversely affect the accuracy and objectivity of using the recordings later.
  • the 3D-images of the teeth can also be obtained by initially producing an impression which is then scanned.
  • the next step is creating a file 4, 4n of patient 2, 2n, in which file 4, 4n the 3D- image received from each capturing is recorded.
  • the file 4, 4n of the patient 2, 2n is supplemented by capturing/recording each subsequent manipulation performed in his/ her mouth.
  • computed tomography CBCT
  • the 3-D CBCT image 6, 6n obtained by computed tomography is also recorded in the created file 4, 4n of patient 2, 2n.
  • the starting point for capturing through computed tomography (CBCT) is determined individually by the medical professional 1. It is recommended that this happens after the eruption of all permanent teeth of the patient 2, 2n.
  • the resulting 2D-image 7, 7n of the face of the patient 2, 2n is also recorded in the file 4, 4n of the patient 2, 2n at the intervals set by the medical professional 1.
  • Each patient file 4, 4n is stored in a centralized database of maxillofacial status 5, preferably in a cloud by giving it, for example, a unique identification number.
  • the created file 4, 4n is accessed with the unique identification number through a password and a code available to the patient 2, 2n and to his/her medical professional 1. It is appropriate to also use other, different forms of identification and access control, which does not restrict and does not go beyond the scope of the invention.
  • the 3D-images taken with the intraoral scanner 3, 3n and computed tomography 6, 6n, as well as the photo-images 7, 7n taken with the digital camera, are processed by superimposing one another, thus receiving a combined image 8, 8n.
  • a current combined image 8, 8n is added to the patient file 4, 4n at the relevant time, which forms the maxillofacial status of the patient 2, 2n at that moment. This maintains the created database of maxillofacial status 5.
  • the created specialized software 9 includes the following steps: SI - connecting to the centralized database of maxillofacial statuses 5 from which the file 4, 4n of the specific patient 2, 2n with its unique number is selected, after which in the next step S2 - a selection is made from the available images 3, 6, 7, and depending on the particular application, it is possible to choose from:
  • step S3 is made - determining reference points identical for each of the images and S4 - registration on these reference points, after which in the next step S5 an overlaid cumulative image 8, 8n is obtained, referred to as combined or intermediate in the method. It shows the changes that have taken place over time.
  • the resulting images are also stored in the database of maxillofacial statuses 5.
  • step S6 of the created specialized software 9 the differences between the last and the previous images are determined, the step S7 is analysing and then the step S8 is diagnosing, i.e. on the basis of the changes that have taken place, the opinion of the medical professional 1 is formed.
  • database 5 it is recommended that database 5 be globally accessible, but regional status would not go beyond the scope of the present invention.
  • Case 1 - Caries In case of a need for caries treatment, the medical professional 1“prepares” the cavity and scans the tooth with an intraoral scanner or takes an impression that is also scanned. Then he/she retrieves from the database the image of the corresponding tooth from the last intact image, overlaying it with the image after preparation and sending the data to a 3D-printer 10, which produces a filling of appropriately specified material. Then the medical professional 1 adapts it to the tooth, thus restoring its proper function and aesthetics.
  • Case 2 Abrasion Treatment - A 3D-image 3,3n, of the non-abrasive dentition made with an intraoral scanner is retrieved from the database and tooth restoration is performed, similar to the use of the database in case 1. This will make the teeth look just as they looked before the abrasion.
  • Case 3 Missing Tooth Restoration - From the 3D-image 3, 3n, captured with the intraoral scanner and stored in the patient file 4, 4n prior to tooth loss, the corresponding tooth or group of teeth needed for the restoration are separated and, based on this 3D-image, a crown, a bridge or other is made in the image of intact teeth before the loss in order to preserve the function and aesthetics.
  • restoration of the jaw bone is also possible, e.g. a removal of a tumour or recovery after an accident.
  • the bone can be restored by downloading the images from the CBCT image 6, 6n prior to the pathology, these images are then sent to the 3D-printer 10, which produces them after which by way of surgery, they are inserted in the affected area.
  • the medical professional 1 assess that an implant or a series of implants will be used, it is best to use the intermediate combined image or the combined image 8, 8n saved in the corresponding file 4, 4n.
  • Case 4 Dentures in cases of edentulism.
  • An intraoral scan is taken of the patient’s current intraoral status.
  • the resulting 3D-image is overlaid with the previous intermediate and/or combined image 8, 8n, in which all the teeth are present, and by using a 3D-printer, the teeth, which are an exact copy of the teeth existing before occurrence of the changes, are printed one by one; the material of the prosthesis underneath has a height and thickness that compensates for the lost bone and mucous membrane.
  • the prosthesis corresponds to the individual intraoral status of the particular patient, rather than using theoretically constructed dental arches, which achieves maximal comfort when using the prosthesis.
  • Case 5 - Implant recovery The available combined image 8, 8n from the scanner, tomography and photo image taken before the loss of teeth is retrieved and the toothless jaw is scanned and this image is overlaid with the available combined image.
  • a surgical guide is printed using a dedicated software available on the market, which determines the exact position of the implants, corresponding to the placement of the teeth before their loss.
  • the crowns themselves are produced as described in case 3.
  • Case 7 Orthodontic Treatment— assists in the early detection, diagnosis and treatment of pathologies before they worsen.
  • the information captured and stored in file 4, 4n of the patient 2, 2n who needs an orthodontic intervention and included in the intermediate and/or combined image 8, 8n at the time of the intervention, is sent to specialized software 11 of those available on the market, which calculates and digitally visualizes the stages required to achieve alignment in the dental arches after which on the basis of these stages, orthodontic appliances are made.
  • Such treatment is significantly more accurate and shorter than the existing one.
  • medical professional 1 Periodically, medical professional 1 compares several previous dental status records from file 4, 4n of the patient 2, 2n stored in database of maxillofacial statuses 5. If, for example, accelerated tooth wear or other change is detected, the medical professional 1 makes a recommendation to the patient 2, 2n to consult an suitable specialist 12 in another field. Examples: If the medical professional 1 notices on the 3D-image 6, 6n of CBCT pathological formations, it is recommended to refer the patient to a maxillofacial surgeon. In another case, if the medical professional 1 notices an accelerated tooth movement, it is advisable to refer the patient 2, 2n to an orthodontist. The examples given are non- exhaustive.
  • Individual dental teeth are made as follows: - 3D-image 3, 3n is retrieved from database of maxillofacial statuses 5 of the teeth of the patient 2, 2n in their optimal entirety.
  • the dentin and enamel parts of each tooth with the respective colour are printed with 3D printers, thus obtaining two components.
  • the two components are extracted from the 3D-image 3, 3n by software available on the market.
  • a positioning splint is made that corresponds to the exact position of the teeth in the dental arches.
  • An occlusal bite registration is printed with the 3D-printer.
  • the sets made are embedded in a denture plaque according to the known technologies and a total or partial denture construction is obtained as a final product.
  • the proposed dental anatomies are chosen by another patient, referred to herein as “customer 13” X or Y, if he/she does not like his/her teeth, and may request from his/her other medical professional 14 the chosen dental shapes for replacement. This is accomplished as the customer 13X, 13 Y chooses with their other medical professional 14 the appropriate dental anatomy, purchasing it from the virtual market after which dental veneers from the chosen anatomies are produced. Subsequently the veneers are placed on the patient’s teeth until he/she approves them. When approved, suitable types of restorations are made, including provisional or permanent ones.
  • the created database of the maxillofacial statuses 5 of patients 2, 2n is made available to scientific organizations conducting anthropometric, etiologic or other studies through measurements and comparisons of the recorded 3D-images 2, 6, 8, 2n, 6n, 8n in this database 5, including analyses of representatives of different races and communities, as patients 2, 2n are not burdened with directly participating in these researches.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Primary Health Care (AREA)
  • Public Health (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

The invention will find use in dental treatment, for restorative procedures and for carrying out scientific researches. The method includes capturing the patient's teeth (3, 3n) for the file (4, 4n) of a patient (2, 2n) by an intraoral scanner at the time of established occlusion of the first permanent teeth. The capturing being carried out at selected intervals, where a medical professional (1) creates the patient's file, (4, 4n). The method also includes computed tomography (CBCT).The 3-D CBCT image (6, 6n) obtained by computed tomography, is also recorded in the created file (4, 4n) of patient. A photo image (7, 7n) of the patient's face, taken with a suitable digital camera, is also created. All files (4, 4n) are stored in a database of maxillofacial statuses (5). The combined images and the intermediate images are made by using created specialized software (9), and the database of maxillofacial status, apart from restoration of dental status (A), is used for at least one of: Diagnosing other diseases (B), Manufacturing dental sets (C), Creating a market for dental anatomies (D), Identification of individuals (E), Scientific researches (F). Also is created a method for manufacturing denture teeth by using the database of the maxillofacial statuses.

Description

METHOD FOR CREATING, PROCESSING, MAINTENANCE AND USING DATABASE OF MAXILLOFACIAL STATUSES
FIELD OF THE INVENTION
The invention relates to a method for creating, processing, maintaining and using a database of maxillofacial statuses to be used in dental treatment, for restorative procedures and for carrying out scientific researches.
BACKGROUND OF THE INVENTION
U.S. Patent Application No. US2018/0184891A1 discloses a method for creating and maintaining a dental status database, as well as its usage. The method according to the said application includes intra-oral panoramic capture by a medical professional of at least a portion of a patient’s mouth by using an intraoral mirror fitted with a camera. Capturing is done before and after each dental treatment. The shots taken are three-dimensional and are stored on a remote server (e.g.“a cloud”), and subsequent three-dimensional images from subsequent capturing at each subsequent visit to the health care professional are also saved. The method also includes the attachment of an X-ray image (Cone beam computed tomography— CBCT) to the panoramic three-dimensional image of the same area of the patient’s mouth. The database retains historical information about the patient’s condition, including historical panoramic three- dimensional images of the patient’s mouth. Access to the database is granted through a detector for recognizing the face of the healthcare professional or at least his/her eyes, thus making the patient’s information file available only to his/ her healthcare professional. Using a user-name and a an access password is also provided. The use of the database consists of conducting dental treatment for subsequent restoration of dental status, including prosthetics, orthodontics, restorative dentistry, maxillofacial prosthetics, restorative, diagnostic and oral, and maxillofacial surgery.
The known solution forms a database which contains incomplete information and does not allow for high accuracy restoration of the patient’s maxillofacial status, and does not create conditions for the use of the data in other areas beyond the specific restorative work.
SUMMARY OF THE INVENTION
The problem to solve with the invention is to provide a method for creating, processing, maintaining and using a database of maxillofacial statuses, which allows efficient processing of the necessary images, allows for high precision of the produced parts for restorative dentistry or prosthetics, as well as allowing for conducting a wide range of researches.
The method for creating, processing, maintaining, and using database of maxillofacial statuses includes capturing the patient’s teeth by a medical professional with intraoral scanner, as the capturing is carried out at selected intervals, where the medical professional creates a patient’s file. The file records the images of each capture, which also includes computed tomography (CBCT) of the patient’s mouth, and the patient’s file is supplemented by captures of both types at each subsequent dental manipulation. All images are stored and used for subsequent restoration of the dental status. According to the invention, the first capturing for a patient file by an intraoral scanner is when occlusion of the first permanent teeth is established, whereas the capturing by computed tomography (CBCT) is set individually by the medical professional. As such the maxillofacial status of each patient is created by adding a photo of his face to the patient’s file. All files are stored in a database of maxillofacial statuses, and from the captured images by the intraoral scanner, the CBCT and the photo image, combined images are produced at the interval determined by the medical professional. Meanwhile intermediate images are also produced, presenting overlay of selected images from at least one of the devices used - the intraoral scanner, CBCT and camera, which updates and maintains the database of maxillofacial statuses. In addition, the combined images and the intermediate images are produced by created specialized software, and the database of maxillofacial statuses, in addition to being used for restoration of dental status A, is also used for at least one of the following: diagnosing other diseases B, manufacturing dental sets C, creating a market for dental anatomies D, identification of individuals E, scientific research F.
Diagnosing other diseases B is achieved by comparing several previous records of the maxillofacial status of the patient’s file, thus determining whether there is accelerated tooth wear present or any other change, and if so, a recommendation to the patient for consults a suitable specialist in another field is given.
Creating a market for dental anatomies D involves offering at least one set of dental anatomies through an electronic catalogue, whereby, after a customer purchases the images, a respective type of restorations are made based on them.
Identification of individuals E is carried out by capturing the unrecognizable person with at least an intraoral scanner and then by comparing the obtained images with those available in the database of maxillofacial statuses’ three- dimensional images taken through the same means until identification is done.
Based on the established identity of the three-dimensional image, from the database the corresponding combined image of the face photo is displayed thus directly visualizing the person.
Scientific research F is carried* out by scientific organizations in the field of anthropometric, etiological and other studies through measurements and comparisons of three-dimensional images from the database of maxillofacial statuses.
The created specialized software includes the following steps: connecting to the database of maxillofacial statuses from which a particular patient’s file is selected, followed by selection making from the available images for which reference points identical to each image are determined. Registration is performed based on these reference points, resulting in a cumulative image, which is also stored in the database of maxillofacial statuses followed by the next step which is to determine the differences between the last and the previous images, after which analysis is performed and then the diagnosis is determined.
The selection from the available images in the database of maxillofacial statuses depends on the particular application and includes at least one of the following groups: a series of captured images with an intraoral scanner only; a series of images taken with the CBCT only; a series of intermediate images from the intraoral scanner and the CBCT; a series of combined images taken with the intraoral scanner, CBCT and the digital camera.
According to the invention, a method for manufacturing denture teeth has been created using the database of maxillofacial statuses, in which a three-dimensional image of patient’s teeth is downloaded from the database in their optimal entirety and then the dentin and the enamel portions of each tooth are printed individually by a 3D-printer with the respective color, thus obtaining two components that are bonded by a composite mediator, after which a positioning splint is produced that corresponds to the exact position of the teeth in the dental arches, according to the 3D-image and an occlusal splint is printed.
The advantages of the invention are that a database is created containing images of the maxillofacial status of individuals for a long period of time, beginning with their childhood, which presents an opportunity for efficient processing of the necessary images and achieving high precision of the produced details of restorative dentistry, prosthetics and orthodontic intervention, as well as an opportunity to carry out a wide range of studies— diagnostic, scientific, criminal, as well as the possibility of creating a market for dental anatomies.
BRIEF EXPLANATION OF THE ATTACHED DRAWINGS
FIG. 1 is a flowchart of a method according to the invention; FIG. 2 is a flowchart of created specialized software used according to the invention.
FIG. 3 is a combined image obtained by overlapping of images taken with intraoral scanner, computed tomography and face photo;
EMBODIMENTS OF THE INVENTION
Just like fingerprints, each individual’s teeth are unique per se. On the other hand, the anatomy of permanent teeth is extremely important for maintaining the proper function of the masticatory apparatus. The method was designed to achieve high accuracy in restoring the integrity of those teeth in shape and function when lost or damaged, as well as to provide sufficient information for various researches.
For higher clarity of the method, FIG. 1 presents a flowchart of the method according to the invention.
The method for creating, processing, maintaining and using a database of maxillofacial statuses is as follows:
The first step in creating a maxillofacial status is to have a medical professional 1 capture an image with an intraoral scanner of the teeth of a patient 2. The patients, as shown in FIG. 1, are usually multiple, therefore there is also a single patient indicated by 2n. The capturing is performed immediately after occlusion of the first permanent teeth is established. This capture produces a 3D-image 3. Over the years, the capturing continues at intervals set by the medical professional 1, or only at visits by patient 2, 2n. The uneven intervals between recordings formed by the patient’s visits would adversely affect the accuracy and objectivity of using the recordings later. Alternatively, the 3D-images of the teeth can also be obtained by initially producing an impression which is then scanned.
The next step is creating a file 4, 4n of patient 2, 2n, in which file 4, 4n the 3D- image received from each capturing is recorded. The file 4, 4n of the patient 2, 2n is supplemented by capturing/recording each subsequent manipulation performed in his/ her mouth. In addition to intraoral scanning, computed tomography (CBCT) is also performed of the mouth of the respective patient 2, 2n. The 3-D CBCT image 6, 6n obtained by computed tomography; is also recorded in the created file 4, 4n of patient 2, 2n. The starting point for capturing through computed tomography (CBCT) is determined individually by the medical professional 1. It is recommended that this happens after the eruption of all permanent teeth of the patient 2, 2n.
A photo image 7, 7n of the patient’s face, taken with a suitable digital camera, is also created. The resulting 2D-image 7, 7n of the face of the patient 2, 2n is also recorded in the file 4, 4n of the patient 2, 2n at the intervals set by the medical professional 1.
Each patient file 4, 4n is stored in a centralized database of maxillofacial status 5, preferably in a cloud by giving it, for example, a unique identification number. The created file 4, 4n is accessed with the unique identification number through a password and a code available to the patient 2, 2n and to his/her medical professional 1. It is appropriate to also use other, different forms of identification and access control, which does not restrict and does not go beyond the scope of the invention.
At the time period determined by the medical professional 1, the 3D-images taken with the intraoral scanner 3, 3n and computed tomography 6, 6n, as well as the photo-images 7, 7n taken with the digital camera, are processed by superimposing one another, thus receiving a combined image 8, 8n. Thus a current combined image 8, 8n is added to the patient file 4, 4n at the relevant time, which forms the maxillofacial status of the patient 2, 2n at that moment. This maintains the created database of maxillofacial status 5.
In the various cases of using the created database of maxillofacial status 5, it is also accepted to create an intermediate image at a certain point, which consists of overlaying the 3D-images captured only with the intraoral scanner, only with computed tomography or both. The combined image 8, 8n, like any intermediate image, is obtained by using created specialized software 9, the schematic flowchart of which is shown in FIG.2.
The created specialized software 9 includes the following steps: SI - connecting to the centralized database of maxillofacial statuses 5 from which the file 4, 4n of the specific patient 2, 2n with its unique number is selected, after which in the next step S2 - a selection is made from the available images 3, 6, 7, and depending on the particular application, it is possible to choose from:
- series of images 3, 3n, made only with an intraoral scanner;
- series of images 6, 6n, made with CBCT only;
- series of intermediate images with the intraoral scanner and the CBCT;
- series of combined 8, 8n images taken with the intraoral scanner, CBCT and the digital camera.
Afterward, for each of the selected groups of images, step S3 is made - determining reference points identical for each of the images and S4 - registration on these reference points, after which in the next step S5 an overlaid cumulative image 8, 8n is obtained, referred to as combined or intermediate in the method. It shows the changes that have taken place over time.
The resulting images are also stored in the database of maxillofacial statuses 5.
In the next step S6 of the created specialized software 9, the differences between the last and the previous images are determined, the step S7 is analysing and then the step S8 is diagnosing, i.e. on the basis of the changes that have taken place, the opinion of the medical professional 1 is formed.
When the maxillofacial status of the patient 2, 2n needs to be restored, up-to-date capturing is performed, for example with an intraoral scanner, which is overlaid with the available images at the selected reference points, after which analysis is performed and the differences are determined, which are then produced by appropriate technical means, for example, 3D-printer, CNC machine, etc. When the created database of maxillofacial status 5 is used, for example, for identification of individuals E, a current image of the unrecognizable person 17 is first taken, for example with an intraoral scanner. Then a comparison is made between the obtained images 16 and those available in the database 5. Then, if there is a match, the last available combined image 8, 8n of the individual is downloaded and the identification is thus completed.
The maintenance of the created database of maxillofacial status 5 by capturing with the three devices continues over the years, and at any moment, it contains current information on each individual patient 2, 2n at the time of the last capturing.
It is recommended that database 5 be globally accessible, but regional status would not go beyond the scope of the present invention.
The following exemplary cases demonstrate the use of the database of maxillofacial status 5, not exhaustively specified:
A. In the dental treatment for the subsequent restoration of individual intraoral status:
Case 1 - Caries - In case of a need for caries treatment, the medical professional 1“prepares” the cavity and scans the tooth with an intraoral scanner or takes an impression that is also scanned. Then he/she retrieves from the database the image of the corresponding tooth from the last intact image, overlaying it with the image after preparation and sending the data to a 3D-printer 10, which produces a filling of appropriately specified material. Then the medical professional 1 adapts it to the tooth, thus restoring its proper function and aesthetics.
Case 2 - Abrasion Treatment - A 3D-image 3,3n, of the non-abrasive dentition made with an intraoral scanner is retrieved from the database and tooth restoration is performed, similar to the use of the database in case 1. This will make the teeth look just as they looked before the abrasion. Case 3 - Missing Tooth Restoration - From the 3D-image 3, 3n, captured with the intraoral scanner and stored in the patient file 4, 4n prior to tooth loss, the corresponding tooth or group of teeth needed for the restoration are separated and, based on this 3D-image, a crown, a bridge or other is made in the image of intact teeth before the loss in order to preserve the function and aesthetics. In case of need, from the CBCT image 6, 6n, restoration of the jaw bone is also possible, e.g. a removal of a tumour or recovery after an accident. When the bone is affected, it can be restored by downloading the images from the CBCT image 6, 6n prior to the pathology, these images are then sent to the 3D-printer 10, which produces them after which by way of surgery, they are inserted in the affected area. Should the medical professional 1 assess that an implant or a series of implants will be used, it is best to use the intermediate combined image or the combined image 8, 8n saved in the corresponding file 4, 4n.
Case 4 - Dentures in cases of edentulism. An intraoral scan is taken of the patient’s current intraoral status. Then, the resulting 3D-image is overlaid with the previous intermediate and/or combined image 8, 8n, in which all the teeth are present, and by using a 3D-printer, the teeth, which are an exact copy of the teeth existing before occurrence of the changes, are printed one by one; the material of the prosthesis underneath has a height and thickness that compensates for the lost bone and mucous membrane. Thus, the prosthesis corresponds to the individual intraoral status of the particular patient, rather than using theoretically constructed dental arches, which achieves maximal comfort when using the prosthesis.
Case 5 - Implant recovery: The available combined image 8, 8n from the scanner, tomography and photo image taken before the loss of teeth is retrieved and the toothless jaw is scanned and this image is overlaid with the available combined image. On this basis, a surgical guide is printed using a dedicated software available on the market, which determines the exact position of the implants, corresponding to the placement of the teeth before their loss. The crowns themselves are produced as described in case 3.
Case 6— Bone Pathologies - The image 6, 6n of the bone from the last recorded tomography (CBCT) is retrieved, a study for early detection of tumours, cysts, etc. is conducted, which makes it possible to take the necessary therapy measures. In the case of fractures, it is possible to restore the position of the bones before the injury.
Case 7— Orthodontic Treatment— assists in the early detection, diagnosis and treatment of pathologies before they worsen. The information captured and stored in file 4, 4n of the patient 2, 2n who needs an orthodontic intervention and included in the intermediate and/or combined image 8, 8n at the time of the intervention, is sent to specialized software 11 of those available on the market, which calculates and digitally visualizes the stages required to achieve alignment in the dental arches after which on the basis of these stages, orthodontic appliances are made. Such treatment is significantly more accurate and shorter than the existing one.
B. Other diseases - diagnosing
Periodically, medical professional 1 compares several previous dental status records from file 4, 4n of the patient 2, 2n stored in database of maxillofacial statuses 5. If, for example, accelerated tooth wear or other change is detected, the medical professional 1 makes a recommendation to the patient 2, 2n to consult an suitable specialist 12 in another field. Examples: If the medical professional 1 notices on the 3D-image 6, 6n of CBCT pathological formations, it is recommended to refer the patient to a maxillofacial surgeon. In another case, if the medical professional 1 notices an accelerated tooth movement, it is advisable to refer the patient 2, 2n to an orthodontist. The examples given are non- exhaustive.
C. Manufacture of complete sets and dentures in cases of edentulism
Individual dental teeth are made as follows: - 3D-image 3, 3n is retrieved from database of maxillofacial statuses 5 of the teeth of the patient 2, 2n in their optimal entirety. The dentin and enamel parts of each tooth with the respective colour are printed with 3D printers, thus obtaining two components. The two components are extracted from the 3D-image 3, 3n by software available on the market.
- The two components are bonded with a composite mediator.
- A positioning splint is made that corresponds to the exact position of the teeth in the dental arches.
- An occlusal bite registration is printed with the 3D-printer.
The sets made are embedded in a denture plaque according to the known technologies and a total or partial denture construction is obtained as a final product.
D. Creating a market for dental anatomies and denture teeth
When capturing the maxillofacial status of the patient 2, 2n, he/she is offered that his/her tooth anatomies become part of an e-commerce market which offers a paid set of dental anatomies or denture teeth from an electronic catalogue. The proposed dental anatomies are chosen by another patient, referred to herein as “customer 13” X or Y, if he/she does not like his/her teeth, and may request from his/her other medical professional 14 the chosen dental shapes for replacement. This is accomplished as the customer 13X, 13 Y chooses with their other medical professional 14 the appropriate dental anatomy, purchasing it from the virtual market after which dental veneers from the chosen anatomies are produced. Subsequently the veneers are placed on the patient’s teeth until he/she approves them. When approved, suitable types of restorations are made, including provisional or permanent ones.
E. Use for identification
In the case of a crime or serious incident where the face of the patient 2, 2n is unrecognizable 17, the government of the country whose nationality the patient 2, 2n is, is provided, to use through its specialized structures 15, the information from the database of maxillofacial statuses 5 for recognition based on the maxillofacial status, because as described above, the teeth of each individual are unique and one of a kind. In order to achieve this comparison, three-dimensional intraoral imaging is first performed using an intraoral scanner or CBCT of the unrecognizable person (17), and then the obtained images 16 are compared with the available in the database 5 31 images 3, 3n, 6, 6n created by the same means. When the identity of the 3D-image is established, the corresponding combined image 8, 8n with face capture is displayed from the database of the maxillofacial statuses 5, which directly visualizes the person. This is how the individual is identified with precision.
F. Scientific research
The created database of the maxillofacial statuses 5 of patients 2, 2n is made available to scientific organizations conducting anthropometric, etiologic or other studies through measurements and comparisons of the recorded 3D-images 2, 6, 8, 2n, 6n, 8n in this database 5, including analyses of representatives of different races and communities, as patients 2, 2n are not burdened with directly participating in these researches.

Claims

1. Method for creating, processing, maintaining and using a database of maxillofacial statuses, including capturing the patient’s teeth by a medical professional with intraoral scanner, the capturing being carried out at selected intervals, where the medical professional creates a patient’s file, in which the images of each capturing are recorded, which also includes computed tomography (CBCT) of the mouth of the respective patient, whereas patient’s file is supplemented by capturing of both types of each subsequent tooth manipulation performed, the images being stored and used for the subsequent restoration of dental status, characterized by that first capturing (3, 3n) for the file (4, 4n) of a patient (2, 2n) by an intraoral scanner is at the time of established occlusion of the first permanent teeth, whereas the computed tomography (CBCT) imaging (6, 6n) is set individually by the medical professional (1), thereby creating the maxillofacial status of each patient (2, 2n) by adding to the file (4, 4n) of the patient a photo image (7, 7n) of his/her face; all files (4, 4n) are stored in a database of maxillofacial statuses (5), and combined images (8, 8n) are produced from the captured images (3, 3n) by the intraoral scanner, from CBCT (6, 6n) and from the photo image (7, 7n) at the interval of time determined by the medical professional (1), while also producing intermediate images representing the overlay of selected images from at least one of the devices used — the intraoral scanner, the CBCT and the camera, with which the database of maxillofacial status (5) is updated and maintained; wherein the combined images (8, 8n) and the intermediate images are made by using created specialized software (9), and the database of maxillofacial status (5), apart from restoration of dental status (A), is used for at least one of: Diagnosing other diseases (B), Manufacturing dental sets (C), Creating a market for dental anatomies (D), Identification of individuals (E), Scientific researches (F).
2. Method according to claim 1, characterized by that the diagnosing of other diseases (B) is made by comparing several previous records of the maxillofacial status of the patient’s file (4, 4n), to determine whether there is accelerated tooth wear present or any other change, and if so, a recommendation is made that the patient consult an suitable specialist (12) in another field.
3. Method according to claim 1, characterized by that the creation of a market for dental anatomies (D) involves the offering of at least one set of dental anatomies through an electronic catalogue, whereby, after purchasing the images from customer 13X, 13Y, respective type of restoration structures are made based on them.
4. Method according to claim 1, characterized by that the identification of individuals (E) is carried out by capturing at least with an intraoral scanner of the unrecognizable person (17) and then the obtained images (16) are compared with those available in the database of the maxillofacial status (5) 3D-images taken with the same means until identification is done.
5. Method according to claim 4, characterized by that based on the established identity of the 3D-image, from the database (5), the corresponding combined image (8, 8n) with face image is displayed, directly visualizing the person.
6. Method according to claim 1, characterized by that the scientific researches (F) are carried out by scientific organizations in the field of anthropometric, etiological and other studies by measuring and comparing the three-dimensional images (3, 3n), (6, 6n ), (7, 7n), (8, 8n) from the database of maxillofacial statuses (5).
7. Method according to claim 1, characterized by that the created specialized software (9) includes the steps: connecting to a database of maxillofacial statuses from which a particular patient’s file is selected (SI), and then selecting from the available images (S2) for which reference points are determined (S3), identical for each of the images and registration (S4) is performed based on these reference points, resulting in a cumulative image (S5), which is also stored in the database of maxillofacial statuses (5), and in the next step the differences between the latest and the previous images are determined (S6), analysis is performed (S7), followed by diagnosis (S8).
8. Method according to claim 7, characterized by that the selection from the available images in the database of the maxillofacial statuses (5) is dependant of the particular application and includes at least one of the following groups: a series of captured images (3, 3n) with an intraoral scanner only; a series of images (6, 6n) taken with CBCT only; a series of intermediate images from the intraoral scanner and the CBCT; a series of combined images (8, 8n) taken with the intraoral scanner, CBCT and the digital camera.
9. Method for manufacturing denture teeth by using the database of the maxillofacial statuses created according to claim 1, characterized by that a three- dimensional image of the patient's teeth is downloaded from the database in their optimal entirety, and then the dentin and enamel portions of each tooth are printed with a 3D-printer (10) one by one with the respective colour, thus obtaining two components that are bonded with a composite mediator, and then a positioning splint is produced corresponding to the exact position of the teeth in the dental arches, according to the 3D-image and an occlusal splint is printed.
EP19806092.3A 2018-12-19 2019-10-29 Method for creating, processing, maintenance and using database of maxillofacial statuses Pending EP3899959A1 (en)

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BG112853A BG67398B1 (en) 2018-12-19 2018-12-19 Method of creating, processing, support and use of oral and maxillofacial database and method for dental veneers thereof
PCT/BG2019/000026 WO2020124171A1 (en) 2018-12-19 2019-10-29 Method for creating, processing, maintenance and using database of maxillofacial statuses

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US7717708B2 (en) * 2001-04-13 2010-05-18 Orametrix, Inc. Method and system for integrated orthodontic treatment planning using unified workstation
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US20160124920A1 (en) * 2014-10-31 2016-05-05 Douglas A. Golay Combination web browser based dental practice management software system with embedded web browser based dental imaging software
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