EP4734872A1 - Non-invasive monitoring of dental implant surgical placement - Google Patents

Abstract

System and methods to provide accurate and reliable 3D tracking of osteotomy sites using known key structures used during the pre- and intra-operative procedures. Based on the pre-determined 3D position of the implant generated during the planning phase, a known implant 3D position will be available as a reference associated to key structures obtained from, e.g., cone-beam computed tomography (CBCT) and intra-oral scanners (IOS) files. During the surgical procedure, a matching 3D implant placement based on the planned position will favor the restorative procedures, minimizing costs and the need for adjustments.

Description

NON-INVASIVE MONITORING OF DENTAL IMPLANT

SURGICAL PLACEMENT

CROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims priority to U.S. Provisional Patent Application No. 63/510,729, filed June 28, 2023, entitled “NON-INVASIVE MONITORING OF DENTAL IMPLANT SURGICAL PLACEMENT,” the disclosure of which is expressly incorporated herein by reference in its entirety.

BACKGROUND

[0002] Dental implants are widely used to replace missing teeth and/or to provide support for artificial teeth or dental prostheses. Dental implants are generally surgically placed into the jawbone and integrated with the surrounding bone tissue to form a secure foundation for dental restoration. Traditionally, dental implants have been made of biocompatible materials, such as titanium, which are capable of osseointegrating with the patient’s bone. The current clinical practice to track implant placement during surgery utilizes X-ray radiation to generate two-dimensional images of the surgical site, which can lead to frequent interruptions of the surgical procedure for imaging, higher likelihood of misinterpretation of the 2D X-ray images, and increased radiation exposure for the patient.

SUMMARY

[0003] System and methods to provide accurate and reliable 3D assessments of osteotomy sites using known key structures used during the pre- and intra- operative procedures as reference, according to various implementations. Based on the pre-determined 3D position of the implant generated during the planning phase, a known implant 3D position will be available as a reference associated to key structures obtained from cone-beam computed tomography (CBCT) and intra-oral scan files. During the surgical procedure, a 3D implant position will be generated based on tracking features added to surgical drills, embedded on surgical drills, or as a standalone device to be placed in the osteotomy sites between surgical drills, which will favor the restorative procedures, minimizing costs and the need for adjustments. [0004] In accordance with aspects of the present disclosure, a method of monitoring dental implant placement during a surgical procedure is disclosed. The method includes obtaining a first file comprising a first preoperative digital model aligned on the patient’s CBCT; obtaining a second file comprising of a digital model captured with the dental surgery implement positioned in the patient’s mouth; aligning the first file preoperative digital model , or CBCT scan, with the second file to generate a digital model of the dental surgery implement positioned in relation to the planned implant position; and presenting, via a user interface, a virtual position of computer- aided file of the used drill will automatically simulated in a three-dimensional (3D) model of the patient’s scans showing a positioning of the dental surgery implement in relation to the anatomical structure(s) of interest.

[0005] This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter.

BRIEF DESCRIPTION OF THE DRAWINGS

[0006] The foregoing summary, as well as the following detailed description of illustrative embodiments, is better understood when read in conjunction with the appended drawings. For the purpose of illustrating the embodiments, there is shown in the drawings example constructions of the embodiments; however, the embodiments are not limited to the specific methods and instrumentalities disclosed. In the drawings:

[0007] FIG. l is a block diagram of a system for non-invasively monitoring the placement of dental implants during surgery, according to some implementations;

[0008] FIG. 2 is a flow diagram of a process for non-invasively monitoring the placement of dental implants during surgery, according to some implementations;

[0009] FIG. 3 illustrates a representation of components used to generate alignment and measurements of a dental surgical implement;

[0010] FIG. 4 shows example of oral scan used during surgery to provide a position of the dental surgical implement using a virtual drill file;

[0011] FIGS. 5 A and 5B illustrate an example step-wise procedure showing a sequence of drills; [0012] FIG. 6 illustrates a preoperative digital model for the patient’s mouth.

[0013] FIG. 7 illustrates an example of cone-beam computed tomography (CBCT) data;

[0014] FIG. 8 illustrates alignment of preoperative digital model to the CBCT data.

[0015] FIG. 9 illustrates the inferior alveolar nerve (IAN) and teeth identified from CBCT image data of FIG. 7

[0016] FIG. 10 illustrates an example of digital model obtained during the surgery with a first drill.

[0017] FIG. 11 illustrates an example of a digital model obtained during surgery with a first drill aligned with preoperative digital model;

[0018] FIG. 12 illustrates a virtual position of the first drill in relation to anatomical structures of interest;

[0019] FIG. 13 illustrates an example of a digital model obtained during surgery with a second drill;

[0020] FIG. 14 illustrates an example of a digital model obtained during surgery with a second drill aligned with preoperative digital model;

[0021] FIG. 15 illustrates a virtual position of the second drill in relation to anatomical structures of interest;

[0022] FIG. 16 illustrates a virtual comparison of the first and second drills in relation to anatomical structures;

[0023] FIG. 17 illustrates an example of a digital model obtained during surgery with a third drill;

[0024] FIG. 18 illustrates an example of a digital model obtained during surgery with a third drill aligned with preoperative digital model;;

[0025] FIG. 19 illustrates a virtual position of the third drill in relation to anatomical structures of interest;

[0026] FIG. 20 illustrates a virtual comparison of the first, second and third drills in relation to anatomical structures;

[0027] FIGS. 21 and 22 illustrate different views of the relationship of the drills to the teeth and IAN with the anatomical structures;

[0028] FIG. 23 illustrates an example alternatives that may be used in the methods of the present disclosure embedded in the drills; [0029] FIG. 24 illustrates example alternatives of surgical implements that may be used between the drills to indicate osteotomy sites; and

[0030] FIG. 25 illustrates separate surgical instruments with added features to be processed.

DETAILED DESCRIPTION

[0031] Disclosed herein is a system and methods for non-invasively monitoring the placement of dental implants during surgery, according to various implementations. As mentioned above, current implant surgical placement monitoring techniques that rely on X-ray images are time-consuming, requiring frequent interruption of the surgical procedure and requiring a new patient set-up for each X-ray image obtained. In addition, these current techniques expose patients to X-ray radiation are limited to two-dimensional (2D) images.

[0032] In contrast, the disclosed system and methods provide accurate and reliable 3D assessments of osteotomy sites using known key structures used during the pre- and intraoperative procedures. Based on the pre-determined 3D position of the implant generated during the planning phase, a known implant 3D position will be available as a reference associated to key structures obtained from cone-beam computed tomography (CBCT) and oral scan files. Additionally or alternatively, the scan files may be computed tomography (CT) or other equivalent to the above that includes scans of the jaws or other structures of the mouth. During the surgical procedure, a matching 3D implant placement based on the planned position will favor the restorative procedures, minimizing costs and the need for adjustments. Main advantages to be considered include 3D procedural monitoring radiation-free technique; no need to acquire additional hardware(s); improved surgical accuracy; ability to correct osteotomy site before final implant placement; decreased surgical time; facilitated restoration (crown) placement; and improved surgeon and patient experience.

[0033] At a high level, reference points/surfaces of interest in surgical components used during implant placement are determined to improve the accuracy of the surgical procedure, protecting key structures of interest. There is no need to buy extra surgical components or dedicated equipment. The implementations of the present disclosure can be incorporated to existing oral scanners software without any major hardware changes or updates. The implementations of the present disclosure improve the overall experience for both surgeon and patient, decreasing intra-operative stress. Measurements can be generated during surgery with an oral scanner. A set of computer-aided design pieces will be available to match the structures available during the surgery to determine the actual position of the osteotomy site, confirm positioning, or suggest adjustment of the position. Thus, the disclosed system and methods provide for a non-invasive 3D technique that will result in higher accuracy of the final implant position, provide a step-by-step 3D position of the surgical site, allow intraoperative adjustments, and prevent temporary and permanent damage to critical structures.

[0034] According to the present disclosure, a 3D dental implant surgical procedural monitoring technique may include the following, non-limiting, processes: i) a process to combine the digital models to the CBCT, highlighting key structures of interest to match the surgical components to the patients’ key structures of interest; ii) an integrated approach to determine reference points of the surgical guide and surgical drill structures, including the sleeve and drill shafts; iii) a minimum number of surfaces at the surgical guide and surgical drills to be considered by the implementations of the present disclosure to calculate the 3D position of the osteotomy sites pre-, intra- and post-operative; iv) an internal check to indicate errors during measurement to inform the operator the need to redo the scan enabling scans optimal alignment; v) a set of computer-aided design pieces to link the resulting osteotomy sites based on the surgical components and it’s relation to the key structures selected; and/or vi) a real- time interactive tool to support the adjustment of the surgical procedure.

[0035] A three-dimensional (3D) measuring technique utilizes intra oral scan to capture the position of key components used for surgical implant placement. An automated process will calculate the position of the components during the procedure to confirm the optimal osteotomy position and suggest adjustments when required. The following 3D measurements will be performed to monitor the surgical procedure: surgical guide; drills; implants. By calculating the 3D position of the previous components, it is possible to: adjust the surgical guide to ensure optimal position; monitor the position of the drills in relation to the planned implant position and in relation to key structures of interest, such as: bone, nerves, roots and sinus; and ensure the final 3D position of the implant is aligned with the planned implant position to facilitate restorative procedures. [0036] The optimal alignment is obtained is obtained by adding a sleeve acting as an alignment features to the drills, but it is still possible to process the drills without adding alignment features using the original drill design.

[0037] Generally, the disclosed system and methods can determine accurate positioning information of the osteotomy site in relation to the neighboring structures along the surgical procedure allowing adjustments to match the planned position and to avoid damage to critical anatomical structures. The current clinical practice to track surgical implant placement utilizes x- ray radiation that generates the position limited to 2D images of the site of interest, requiring the interruption of the surgical procedure and patient set-up for the exam. The disclosed system and methods offer a radiation-free 3D tracking alternative that can be performed with or without the surgical guide in place, decreasing surgical time, increasing the precision of the surgical placement, and improving the surgeon and patient’s experience.

[0038] Referring now to FIG. 1, a block diagram of a system for non-invasively monitoring the placement of dental implants during surgery is shown, according to some implementations. Generally, the system shown in FIG. 1 is configured to implement the non- invasive monitoring technique described above. However, it should be appreciated that the illustrated system is only one example configuration for implementing the disclosed technique; thus, the present disclosure is not intended to be limited to only a single configuration, and other implementations of the disclosed technique are contemplated herein. Notwithstanding, as shown in FIG. 1, the system generally includes a computing device 100 and a scanner 130, such as an intraoral scanner. Alternatively, the scanner 130 may be any device adapted to scan a subject’s teeth, jaws, and/or gums.

[0039] Computing device 100 is shown to include a processing circuit 102 that includes a processor 104 and a memory 106. Processor 104 can be a general-purpose processor, an ASIC, one or more FPGAs, a group of processing components, or other suitable electronic processing structures. In some embodiments, processor 104 is configured to execute program code stored on memory 106 to cause computing device 100 to perform one or more operations, as described below in greater detail. It will be appreciated that, in embodiments where computing device 100 is part of another computing device, the components of computing device 100 may be shared with, or the same as, the host device. For example, if computing device 100 is implemented via a server, then computing device 100 may utilize the processing circuit, processor(s), and/or memory of the server to perform the functions described herein.

[0040] Memory 106 can include one or more devices (e.g., memory units, memory devices, storage devices, etc.) for storing data and/or computer code for completing and/or facilitating the various processes described in the present disclosure. In some embodiments, memory 106 includes tangible (e.g., non-transitory), computer-readable media that stores code or instructions executable by processor 104. Tangible, computer-readable media refers to any physical media that is capable of providing data that causes computing device 100 to operate in a particular fashion. Example tangible, computer-readable media may include, but is not limited to, volatile media, non-volatile media, removable media and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Accordingly, memory 106 can include RAM, ROM, hard drive storage, temporary storage, non-volatile memory, flash memory, optical memory, or any other suitable memory for storing software objects and/or computer instructions. Memory 106 can include database components, object code components, script components, or any other type of information structure for supporting the various activities and information structures described in the present disclosure. Memory 106 can be communicably connected to processor 104, such as via processing circuit 102, and can include computer code for executing (e.g., by processor 104) one or more processes described herein.

[0041] While shown as individual components, it will be appreciated that processor 104 and/or memory 106 can be implemented using a variety of different types and quantities of processors and memory. For example, processor 104 may represent a single processing device or multiple processing devices. Similarly, memory 106 may represent a single memory device or multiple memory devices. Additionally, in some embodiments, computing device 100 may be implemented within a single computing device (e.g., one server, one housing, etc.). In other embodiments, computing device 100 may be distributed across multiple servers or computers (e g., that can exist in distributed locations). For example, computing device 100 may include multiple distributed computing devices (e.g., multiple processors and/or memory devices) in communication with each other that collaborate to perform operations. For example, but not by way of limitation, an application may be partitioned in such a way as to permit concurrent and/or parallel processing of the instructions of the application. Alternatively, the data processed by the application may be partitioned in such a way as to permit concurrent and/or parallel processing of different portions of a data set by two or more computers. For example, virtualization software may be employed by computing device 100 to provide the functionality of a number of servers that is not directly bound to the number of computers in computing device 100.

[0042] Memory 106 is shown to include an implant monitoring engine 108 configured to generate a 3D model of a patient’s mouth that includes a visual indication of the position of a surgical implement (e.g., a drill bit) within the patient’s mouth. In some implementations, implant monitoring engine 108 is configured to obtain a digital model of a surgical implement of interest, e.g., from a database and/or a user input. For example, a user (e.g., a dentist) may select a model of the surgical implement from a database of pre-generated 3D models of various surgical implements. Implant monitoring engine 108 is also configured to obtain a 3D model of the inside of a patient’s mouth, e.g., via scanner 130. For example, scanner 130 may be used to scan the patient’s mouth and, from the scan data, implant monitoring engine 108 constructs a 3D model of the patient’s mouth. Generally, the oral scan is captured during a surgical procedure, e.g., when the surgical implement is in use. Then, implant monitoring engine 108 aligns the model of the surgical implement and the model of the patient’s mouth (e.g., by overlaying the models) to form a composite 3D model indicating the position of the surgical implements within the patient’s mouth. In some implementations, implant monitoring engine 108 can display this composite 3D model via a user interface.

[0043] Computing device 100 is also shown to include a communications interface 120 that facilitates communications between computing device 100 and any external components or devices. For example, communications interface 120 can provide means for transmitting data to, or receiving data from, other remote (e.g., external) computers. In addition, communications interface 120 can act as an input/output (I/O) to provide direct communications with external devices, such as scanner 130. Accordingly, communications interface 120 can be or can include a wired or wireless communications interface (e.g., jacks, antennas, transmitters, receivers, transceivers, wire terminals, etc.) for conducting data communications, or a combination of wired and wireless communication interfaces. In some embodiments, communications via communications interface 120 are direct (e.g., local wired or wireless communications) or via a network (e.g., a WAN, the Internet, a cellular network, etc ). For example, communications interface 120 may include one or more Ethernet ports for communicably coupling computing device 100 to a network (e g., the Internet). In another example, communications interface 120 can include a Wi-Fi transceiver for communicating via a wireless communications network. In yet another example, communications interface 120 may include cellular or mobile phone communications transceivers.

[0044] In some implementations, computing device 100 includes a user interface 122 configured to display images, text, and other graphical elements (e.g., video, 3D renderings, etc.). User interface 122 generally includes one or more components that allow a user to interact with computing device 100. For example, user interface 122 typically includes at least a display screen, but can also include a user input device. In particular, user interface 122 can include a display screen (e.g., an LED or LCD display) and, optionally, a user input device such as a mouse, a keyboard, a number pad, a joystick, etc. In some implementations, user interface 122 can include a touchscreen that implements the functionality of both a display and a user input device. While shown as a component of computing device 100, it should be appreciated that user interface 122 may be remote from computing device 100 - and therefore may be in communication with computing device 100.

[0045] Scanner 130, as mentioned above, can be any suitable oral scanning device. Generally, scanner 130 is configured to capture a 3D image of the inside of a patient’s mouth and/or to capture multiple 2D images that are combined together to generate a 3D image. In some implementations, scanner 130 includes at least one image capture device, such as a CMOS sensor or the like, for capturing images. It will be appreciated that oral scanners are known in the art and therefore are not described in detail herein.

[0046] Referring now to FIG. 2, a flow diagram of a process 200 for non-invasively monitoring the placement of dental implants during surgery is shown, according to some implementations. In some implementations, process 200 is implemented by computing device 100, as described above. It will be appreciated that certain steps of process 200 may be optional and, in some implementations, process 200 may be implemented using less than all of the steps. It will also be appreciated that the order of steps shown in FIG. 2 is not intended to be limiting.

[0047] At 202, a baseline digital model of the inside of a patient’s mouth is obtained. In some implementations, the first digital model is a three-dimensional (3D) model. In some such implementations, the baseline digital model is formatted as a stereolithography (STL) file; however, other formats are contemplated herein such as, but not limited to, OBJ, 3MF, AMF, DAE, PLT, WRL, SMESH, IGS, IGES, STP, STEP, GIF and, 3DPDF. At 204, a digital model is generated from an oral scan of a patient’s mouth with the surgical implement comprising of 302 and 306. In some implementations, the surgical implement is a dental drill bit. In some implementations, the digital model is obtained from a database based on information associated with the dental surgery implement. At 206, the baseline digital models of the patient’s mouth and the digital model of the surgical implement (e.g., digital model of patient’s mouth with the surgical implement positioned therein) are aligned to generate the virtual position of the drill. In some implementations, the alignment step includes determining a plurality of first reference points for the dental surgery implement in the digital model of the surgical implement and aligning the first digital with the digital model of the patient’s mouth. At 208, a 3D model of the patient’s mouth, showing the positioning of the surgical implement, is displayed via a user interface.

[0048] The construction and arrangement of the systems and methods as shown in the various implementations are illustrative only. Although only a few implementations have been described in detail in this disclosure, many modifications are possible (e.g., variations in sizes, dimensions, structures, shapes, and proportions of the various elements, values of parameters, mounting arrangements, use of materials, colors, orientations, etc.). For example, the position of elements may be reversed or otherwise varied, and the nature or number of discrete elements or positions may be altered or varied. Accordingly, all such modifications are intended to be included within the scope of the present disclosure. The order or sequence of any process or method steps may be varied or re-sequenced according to alternative implementations. Other substitutions, modifications, changes, and omissions may be made in the design, operating conditions, and arrangement of the implementations without departing from the scope of the present disclosure.

[0049] Further details of the methods of the present disclosure will now be described. As noted above, an aspect of the disclosure is based on the matching of the file of the surgical guide or the drill bit (e.g., stored and available during surgery) and the oral scanning of the shaft of the drill bit during surgery with the oral scanner. The representation of the components used to generate the alignment and measurements are shown in FIG. 3, which shows a sleeve used as an alignment device 302 and a drill bit 304. A computer-aided file of the drill bit 304 (or drills) is virtually added to scans that incorporates the sleeve 302 to support the alignment. This is virtually placed into the device 100. In FIG. 3, a shaft section 306 (outside the bone) and a twist section 308 (inside the bone) of the drill bit 304 is shown in combination with the sleeve 302. This combination of the drill bit 304 and sleeve 302 is collectively herein a dental surgical implement 310. The dental surgical implement 310 may be either virtual or physical depending on whether it is a digital representation used in the methods below or actually being used drill into a patient’s jaw.

[0050] For the purpose of description, a sequence of drills with different depths is described; however, it should be understood that the disclosed system and methods can be implemented with any other size and/or type of surgical instrument, (e.g. Figs. 24 and 25). Measurements can be made to determine the accuracy of each step, and the distance to key structures of interest. In some implementations, the drill bit or other surgical implement is manufactured with identifying features (e.g., on the shaft in the case of a drill bit, or any available structure in the drill) to assist with alignment. In other words, the surgical implement may have a unique feature, such as a collar or ridge, that can be easily identified to determine a positioning of the surgical implement, which in turn is used to determine alignment. Such identifying features can include, for example, pits, pins, circles, squares, pentagon, hexagon, etc., or any combination thereof, e.g., with a particular angle. However, it should be appreciated that the present disclosure is not limited in this aspect; rather, the surgical implements as described herein can include any identifying features for assisting with alignment. In addition, identifying features can be added to existing drills, e.g., as an add-on device placed on the drill shaft. For example, a collar can be attached to an existing drill bit to serve as an identifying feature for alignment purposes.

[0051] FIG. 4 shows a digital model obtained during surgery (502) providing the position of the drill bit 304 in the osteotomy site.

[0052] FIGS. 5A and 5B illustrate an example step-wise procedure 500 showing a sequence of drills with reference to FIGS. 6-20 during surgery. While the example described is a sequence with three drills, the method is not limited to three drills.

[0053] At 501, cone-beam computed tomography (CBCT) image data is downloaded, processed, and aligned to preoperative scan in the system for non-invasively monitoring the placement of dental implants (e.g., computing device 100). An example of the preoperative scan is shown in FIG. 6. CBCT image data is shown in FIG. 5. Alignment is shown if FIG. 8 [0054] At 502, the key anatomical structure(s) (e.g., inferior alveolar nerve (IAN) and teeth) are identified from CBCT image data. An example is shown in FIG. 9. At 503, a scan is obtained during surgery with a first drill. An example is shown in FIG. 10. At 504, a scan of the first drill without the inside section is aligned with preoperative scan or CBCT image data. An example is shown in FIG. 11. At 505, a computer-aided design (CAD) file of the first drill is added to generate a virtual position in relation to anatomical structures of interest. An example is shown in FIG. 12.

[0055] At 506, a scan is obtained during surgery with the second drill. An example is shown in FIG. 13. At 507, a scan of a second drill without the inside section aligned with the preoperative scan or CBCT image data. An example is shown in FIG. 14. At 508, a CAD file of the second drill is added to generate a virtual position in relation to anatomical structures of interest. An example is shown in FIG. 15. At 509, a virtual comparison of the first and second drills is made in relation to anatomical structures. An example is shown in FIG. 16.

[0056] At 510, a scan is obtained during surgery with a third drill. An example is shown in FIG. 17. At 511, a scan of the third without the inside section is aligned with CBCT. An example is shown in FIG. 18. At 512, a CAD file of the third drill is added to generate virtual position in relation to anatomical structures of interest. An example is shown in FIG. 19. At 513, a virtual comparison of the first, second and third drill drills is made in relation to anatomical structures. An example is shown in FIG. 20.

[0057] FIGS. 21 and 22 illustrate different views of the relation of the drills to the teeth and IAN with the anatomical structures. For example, FIG. 21 shows a Frontal -Coronal view. FIG. 22 shows a Frontal -Apical view. FIG. 23 illustrated a view of the position of the drills in relation to anatomical structures and the planned implant position;

In addition to the example(s) described above, the process can use alternatives such as shown in FIG. 24 to add features embedded into surgical drills, or as shown in FIG. 25 to use separate surgical instruments with added features to be processed. Added features embedded in the drill represented as an added round peak, added circle, or a rectangle groove to be used as a reference for file processing, or any tracking feature(s) compromising of a shape, or a combination of different shapes.

[0058] The present disclosure contemplates methods, systems, and program products on any machine-readable media for accomplishing various operations. The implementations of the present disclosure may be implemented using existing computer processors, or by a special purpose computer processor for an appropriate system, incorporated for this or another purpose, or by a hardwired system. Implementations within the scope of the present disclosure include program products including machine-readable media for carrying or having machine-executable instructions or data structures stored thereon. Such machine-readable media can be any available media that can be accessed by a general purpose or special purpose computer or other machine with a processor. By way of example, such machine-readable media can comprise RAM, ROM, EPROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to carry or store desired program code in the form of machine-executable instructions or data structures, and which can be accessed by a general purpose or special purpose computer or other machine with a processor.

[0059] When information is transferred or provided over a network or another communications connection (either hardwired, wireless, or a combination of hardwired or wireless) to a machine, the machine properly views the connection as a machine-readable medium. Thus, any such connection is properly termed a machine-readable medium. Combinations of the above are also included within the scope of machine-readable media. Machine-executable instructions include, for example, instructions and data which cause a general-purpose computer, special purpose computer, or special purpose processing machines to perform a certain function or group of functions.

[0060] Although the figures show a specific order of method steps, the order of the steps may differ from what is depicted. Also, two or more steps may be performed concurrently or with partial concurrence. Such variation will depend on the software and hardware systems chosen and on designer choice. All such variations are within the scope of the disclosure. Likewise, software implementations could be accomplished with standard programming techniques with rule-based logic and other logic to accomplish the various connection steps, processing steps, comparison steps and decision steps.

[0061] It is to be understood that the methods and systems are not limited to specific synthetic methods, specific components, or to particular compositions. It is also to be understood that the terminology used herein is for the purpose of describing particular implementations only and is not intended to be limiting. [0062] As used in the specification and the appended claims, the singular forms “a,” “an” and “the” include plural referents unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, another implementation includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another implementation. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint.

[0063] “Optional” or “optionally” means that the subsequently described event or circumstance may or may not occur, and that the description includes instances where said event or circumstance occurs and instances where it does not.

[0064] Throughout the description and claims of this specification, the word “comprise” and variations of the word, such as “comprising” and “comprises,” means “including but not limited to,” and is not intended to exclude, for example, other additives, components, integers or steps. “Exemplary” means “an example of’ and is not intended to convey an indication of a preferred or ideal implementation. “Such as” is not used in a restrictive sense, but for explanatory purposes.

[0065] Disclosed are components that can be used to perform the disclosed methods and systems. These and other components are disclosed herein, and it is understood that when combinations, subsets, interactions, groups, etc. of these components are disclosed that while specific reference of each various individual and collective combinations and permutation of these may not be explicitly disclosed, each is specifically contemplated and described herein, for all methods and systems. This applies to all aspects of this application including, but not limited to, steps in disclosed methods. Thus, if there are a variety of additional steps that can be performed it is understood that each of these additional steps can be performed with any specific implementation or combination of implementations of the disclosed methods.

Claims

WHAT IS CLAIMED IS:

1. A method of monitoring dental implant placement during a surgical procedure, the method comprising: obtaining a pre-operative digital model of the patient’s mouth comprising of oral scan; obtaining a pre-operative CBCT scan data of the patient’s jaws; obtaining an intra-operative fde comprising a digital model of a patient’s mouth, wherein the digital model is captured with the dental surgery implement combined with the alignment device positioned in the patient’s mouth; aligning the pre-operative digital model with the CBCT scan data; aligning the intra-operative file with the file comprising a digital model of a dental surgery implement including the sleeve and the drill bit to generate a digital model of the dental surgery implement positioned in the patient’s mouth; presenting, via a user interface, a three-dimensional (3D) model of the patient’s mouth showing a positioning of the dental surgery implement with the twist section inside the bone in relation to key anatomical structures; and presenting, via a user interface, a three dimensional numerical evaluation of the distance of the dental surgery implement to anatomical structures of interest

2. The method of claim 1, wherein the pre-operative and intra-operative digital models are a three-dimensional (3D) model of the patient’s mouth.

3. The method of claim 2, wherein the pre-operative and intra-operative digital models are a computer-aided design file.

4. The method of claim 1, wherein the dental surgery implement digital model is a three- dimensional (3D) model.

5. The method of claim 4, wherein the dental surgery implement digital model is a computer-aided design file.

6. The method of claim 1 , wherein the dental surgery implement is a dental drill bit with combined sleeve as alignment device.

7. The method of claim 1, wherein the dental surgery implement is a standard dental bit without added alignment features.

8. The method of claim 1, wherein the dental surgery implement is a dental drill bit with embedded alignment features.

9. The method of claim 1, wherein the dental surgery implement is a standalone device to be placed in the osteotomy sites between surgical drills.

10. The method of claim 1, wherein the pre-operative or intra-operative fdes are digital model of the patient’s mouth captured using a scanner for capturing digital data.

11. The method of claim 1, further comprising determining a plurality of first reference points for the dental surgery implement in the intra-operative file, wherein the plurality of first reference points are used to align the intra-operative file with the dental surgery implement including the sleeve and the drill bit.

12. The method of claim 1, wherein the dental surgery implement file is obtained from a database.

13. The method of claim 1, further comprising obtaining subsequent files comprising subsequent scans of a patient’s mouth, wherein the subsequent scans are captured with additional dental surgery implements positioned in the patient’s mouth.

14. The method of claim 12, further comprising virtually aligning the pre-operative file, the dental surgery implement file, and subsequent scans of the patient’s mouth with the dental surgery implement in the patient’s mouth.

15. The method of claim 13, further comprising presenting, via the user interface, a three-dimensional (3D) model of the patient’s mouth showing a positioning of the dental surgery implement and additional dental surgery implements.

16. A computer implemented system for monitoring dental implant placement during a surgical procedure, comprising: a processor; and a memory that stores computer executable instructions that when executed by the processor: receives a pre-operative digital model of the patient’s mouth comprising of oral scan; receives a pre-operative CBCT scan data of the patient’s jaws; receives intra-operative file comprising a digital model of a patient’s mouth, wherein the digital model is captured with the dental surgery implement combined with the alignment device positioned in the patient’s mouth; receives a file comprising of a digital model of a dental surgery implement including the sleeve and the drill bit; aligns the pre-operative digital model with the CBCT scan data; aligns the intra-operative file with the file comprising of a digital model of a dental surgery implement including the sleeve and the drill bit to generate a digital model of the dental surgery implement positioned in the patient’s mouth; presents, via a user interface, a three-dimensional (3D) model of the patient’s mouth showing a positioning of the dental surgery implement; and presents, via a user interface, a three dimensional numerical evaluation of the distance of the dental surgery implement to anatomical structures of interest.

17. The system of claim 16, wherein the pre-operative and intra-operative digital models are a three-dimensional (3D) model of the patient’s mouth.

18. The system of claim 16, wherein the pre-operative and intra-operative digital models are a computer-aided design fde.

19. The system of claim 16, wherein the dental surgery implement digital model is a three-dimensional (3D) model.

20. The system of claim 16, wherein the dental surgery implement is a dental drill bit with combined sleeve as alignment device.

21. The system of claim 16, wherein the dental surgery implement is a standard dental bit without added alignment features.

22. The system of claim 16, wherein the dental surgery implement is a dental drill bit with embedded alignment features.

23. The system of claim 16, wherein the dental surgery implement is a standalone device to be placed in the osteotomy sites between surgical drills.

24. The system of claim 16, wherein the pre-operative or intra-operative files are digital model of the patient’s mouth captured using a scanner for capturing digital data.

25. The system of claim 16, wherein the dental surgery implement digital model is a computer-aided design file.

26. The system of claim 16, further comprising determining a plurality of first reference points for the dental surgery implement in the intra-operatory file, wherein the plurality of first reference points are used to align the intra-operatory file with the dental surgery implement including the sleeve and the drill bit.

27. The system of claim 16, wherein the system further obtains subsequent files comprising subsequent scans of a patient’s mouth, wherein the subsequent scans are captured with additional dental surgery implements positioned in the patient’s mouth.

28. The system of claim 16, further comprising virtually aligning the pre-operative file, the dental surgery implement file, and subsequent scans of the patient’s mouth with the dental surgery implement in the patient’s mouth.

29. The system of claim 16, wherein the system further presents, via the user interface, a three-dimensional (3D) model of the patient’s mouth showing a positioning of the dental surgery implement and additional dental surgery implements.