FR3033245A1 - STANDARD RADIOLOGICAL GUIDE FOR DENTAL IMPLANTOLOGY, CUSTOMIZABLE AND TRANSFORMABLE IN A SURGICAL GUIDE - Google Patents
STANDARD RADIOLOGICAL GUIDE FOR DENTAL IMPLANTOLOGY, CUSTOMIZABLE AND TRANSFORMABLE IN A SURGICAL GUIDE Download PDFInfo
- Publication number
- FR3033245A1 FR3033245A1 FR1500405A FR1500405A FR3033245A1 FR 3033245 A1 FR3033245 A1 FR 3033245A1 FR 1500405 A FR1500405 A FR 1500405A FR 1500405 A FR1500405 A FR 1500405A FR 3033245 A1 FR3033245 A1 FR 3033245A1
- Authority
- FR
- France
- Prior art keywords
- grids
- guide
- spacers
- axis
- customizable
- 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.)
- Granted
Links
- 125000006850 spacer group Chemical group 0.000 claims abstract description 14
- 210000002455 dental arch Anatomy 0.000 claims abstract description 5
- 239000000463 material Substances 0.000 claims description 4
- 239000007943 implant Substances 0.000 abstract description 10
- 239000011347 resin Substances 0.000 abstract description 7
- 229920005989 resin Polymers 0.000 abstract description 7
- 239000011505 plaster Substances 0.000 abstract description 4
- 210000001847 jaw Anatomy 0.000 abstract 1
- 238000005259 measurement Methods 0.000 description 2
- 210000000988 bone and bone Anatomy 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 239000004053 dental implant Substances 0.000 description 1
- 210000004513 dentition Anatomy 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 238000003754 machining Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000005245 sintering Methods 0.000 description 1
- 230000036346 tooth eruption Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
- A61C1/08—Machine parts specially adapted for dentistry
- A61C1/082—Positioning or guiding, e.g. of drills
- A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3966—Radiopaque markers visible in an X-ray image
Landscapes
- Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Epidemiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Dental Prosthetics (AREA)
Abstract
Guide radiologique standard pour l'implantologie dentaire, personnalisable et transformable aisément par le praticien ou son prothésiste en guide chirurgical. Ce Guide est constitué par 2 grilles (1) parallèles entre elles, placées l'une au-dessus de l'autre et dont la forme est celle d'une arcade dentaire entière ou partielle. Elles sont réunies entre elles de manière rigide par des entretoises (2). Une ou deux autres grilles (4) peuvent être placées entre les deux grilles (1) précédentes et perpendiculairement à elles. Les grilles (1)(4) et les entretoises (2) sont visibles radiologiquement. Les grilles (1) peuvent être indépendantes l'une de l'autre, non reliées par des entretoises (2). On prend une empreinte de la mâchoire du patient on réalise un modèle en plâtre sur lequel on positionne le guide. On coule de la résine sur les parties dentées et édentées en préservant l'espace entre les grilles(1). Une fois la résine durcie, on démoule l'ensemble. On obtient un guide radiologique personnalisé. Le patient passe un scanner en portant ce guide. On détermine l'axe d'un implant. La droite matérialisant cet axe coupe chaque grille (1a) (1b) en 1 point que l'on reporte sur le guide. A chaque point on fait un trou par lequel on passe une tige dans un tube placé entre les 2 grilles (1), matérialisant l'axe de l'implant. On répète l'opération s'il y a plusieurs implants. On solidarise le ou les tubes aux grilles, puis on ôte les tiges des tubes qui deviennent des canons de forage. On obtient un guide chirurgical.Standard radiology guide for dental implantology, customizable and easily transformed by the practitioner or his technician into a surgical guide. This Guide is constituted by 2 grids (1) parallel to each other, placed one above the other and whose shape is that of an entire dental arch or partial. They are joined together rigidly by spacers (2). One or two other grids (4) can be placed between the two grids (1) above and perpendicular to them. Grids (1) (4) and spacers (2) are radiologically visible. The grids (1) can be independent of one another, not connected by spacers (2). We take an impression of the jaw of the patient we realize a plaster model on which we position the guide. Resin is poured onto toothed and toothless parts, preserving the space between the grids (1). Once the resin has hardened, the assembly is demolded. We obtain a personalized radiological guide. The patient passes a scanner while wearing this guide. The axis of an implant is determined. The line materializing this axis intersects each grid (1a) (1b) in 1 point that is reported on the guide. At each point, a hole is made through which a rod is placed in a tube placed between the two grids (1), materializing the axis of the implant. We repeat the operation if there are several implants. The tube (s) is secured to the grids, and the rods are removed from the tubes which become drill guns. We obtain a surgical guide.
Description
- 1 - La présente invention destinée à l'implantologie dentaire concerne un dispositif faisant office de guide radiologique standard, personnalisable et aisément transformable en guide chirurgical par un praticien ou son prothésiste.The present invention intended for dental implantology concerns a device serving as a standard radiological guide, customizable and easily transformable into a surgical guide by a practitioner or his prosthetist.
Elle permet un guidage précis du puits de forage d'un implant dentaire. L'axe de ce puits ou de l'implant est déterminé en fonction du positionnement des futures dents prothétiques, de l'orientation, de la morphologie et des dimensions de la crête osseuse. Sachant que l'axe prothétique est aussi important que l'axe de la crête, on 10 calcule à partir des coupes radiographiques l'axe idéal. Il est donc important de reproduire avec précision, en bouche, le point et l'axe de forage d'un implant, déterminé à partir des images radiologiques issues d'un scanner ou d'un appareil de tomographie volumique numérisée par faisceau conique ( « cone beam »). 15 La présente invention répond à cette exigence en présentant un guide radiologique, standard, préfabriqué, qui s'adapte à tous les patients et qui se transforme aisément par le praticien ou son prothésiste en un guide chirurgical précis, sans aucun intermédiaire. Les guides radiologiques classiques sont souvent des guides artisanaux 20 difficilement transformables en guides chirurgicaux. D'autres guides font appel à des techniques plus sophistiquées et plus onéreuses. Autre avantage, les repères normés de ce guide permettent de valider les mesures faites sur un scanner ou un « cone-beam ». 25 Les dessins annexés illustrent l'invention : La Fig.1 montre une vue d'ensemble du guide. La Fig.2 montre une forme de l'entretoise. La Fig.3 montre le dispositif auquel on a rajouté une grille latérale. 3033245 - 2 - Ce guide radiologique, Fig. 1, est constitué de 2 grilles (1) parallèles entre elles, placées l'une au-dessus de l'autre dont la forme en fer à cheval est celle de l'arcade dentaire. Le guide radiologique peut aussi avoir la forme d'une ou plusieurs sections 5 d'arcade. Ces sections d'arcades peuvent s'emboiter entre elles. Les grilles (1) sont reliées entre elles de manière rigide par des entretoises(2). Les entretoises (2), Fig.1 et 2, se fixent en s'emboitant dans des orifices (3) situés sur la grille, de préférence sur la ligne médiane du quadrillage des grilles. Les entretoises sont de longueurs différentes. Les orifices sont équidistants entre eux. En un autre mode de réalisation, en lieu et place des orifices (3), on a des « pins », des petites tiges qui affleurent des faces internes des grilles(1) et 15 dans lesquels s'emboitent les entretoises qui présentent, à cette fin, un logement dans leur axe. Les grilles(1) peuvent être indépendantes l'une de l'autre, non reliées par des entretoises(2). On les positionne alors librement sur le modèle en plâtre. 20 Dans une autre configuration une ou deux grilles (4), ayant la forme d'une arcade dentaire, sont placées perpendiculairement aux deux précédentes grilles (1). Elles sont positionnées entre ces dernières, latéralement ou de façon médiane. Ces grilles (4) peuvent ne pas être quadrillées, mais simplement constituées 25 de barres très fines à la manière des « dents » d'un peigne. Le quadrillage des grilles(1) permet de faire des mesures précises. Les grilles (1) (4) et les entretoises(2) sont visibles radiologiquement. 3033245 - 3 - La fabrication de ce guide radiologique standard peut se faire par injection d'un matériau radio opaque dans un moule, par usinage, frittage ou à l'aide d'une imprimante 3D. Principe du guide: 5 L'une des 2 grilles (1) est au contact de la gencive, elle est dite grille gingivale (lb), l'autre est située au niveau de la face occlusale (face masticatrice) des dents, elle est nommée grille occlusale (la). L'axe d'un implant sur les coupes radiologique va passer par les 2 grilles (1) déterminant 2 points. 10 Un point d'intersection avec la grille gingivale (lb) et un autre avec la grille occlusale (la). Par ces 2 points passe une droite qui reproduit l'axe de l'implant, déterminé après étude des coupes du scanner. L'utilisation de ce guide se fait de la manière suivante : On prend une empreinte de la denture du patient, à partir de laquelle on 15 réalise un modèle en plâtre. Sur ce modèle, on positionne le guide radiologique ou un segment de celui-ci, selon que l'on a un patient totalement ou partiellement édenté. Puis toujours sur ce modèle, on dépose une couche de résine fluide sur la partie édentée et sur la grille gingivale (lb). On fait de même sur la face 20 occlusale des dents et sur la grille occlusale (la). Sur les 2 grilles (1) la couche de résine sera la plus fine possible afin de maintenir un espace libre de matériau entre les 2 grilles(1). Mais cette couche sera tout de même suffisamment épaisse pour maintenir la rigidité de l'ensemble. 25 Quand la résine a durci, on démoule le guide pour le séparer du modèle en plâtre. Le guide radiologique standard au départ devient guide personnalisé, adapté au patient. 3033245 - 4 - Le praticien ou l'opérateur radio place en bouche ce guide personnalisé, au moment de passer un scanner ou un « cone-beam ». Sur les images du scanner on repère sur chacune des grilles, comme indiqué ci-dessus, les points par où passe la droite qui matérialise l'axe 5 d'un implant. Aux points repérés radiologiquement sur la grille gingivale (lb) et sur la grille occlusale (la), on fait un trou. Au niveau de la zone à implanter, dans l'espace libre entre les grilles et après avoir déboité ou sectionné les entretoises, on place un tube dont le 10 diamètre interne permet le passage, sans jeu, d'un foret guide d'implantologie. Une tige d'un diamètre égal à ce foret est glissée dans les 2 trous et à travers le tube. La tige et le tube matérialise l'axe de l'implant. On répète l'opération s'il y a plusieurs implants.It allows precise guidance of the wellbore of a dental implant. The axis of this well or implant is determined according to the positioning of the future prosthetic teeth, the orientation, the morphology and the dimensions of the bone crest. Knowing that the prosthetic axis is as important as the axis of the ridge, the ideal axis is calculated from the X-ray sections. It is therefore important to accurately reproduce, in the mouth, the point and the axis of drilling of an implant, determined from the radiological images obtained from a scanner or from a conical beam scanned volume computed tomography machine (" cone beam "). The present invention meets this requirement by presenting a standard, prefabricated, radiological guide which is adaptable to all patients and which is easily transformed by the practitioner or his prosthetist into a precise surgical guide without any intermediary. Conventional radiological guides are often handicraft guides that are difficult to transform into surgical guides. Other guides use more sophisticated and expensive techniques. Another advantage is that the standardized references in this guide validate the measurements made on a scanner or a cone-beam. The accompanying drawings illustrate the invention: Fig.1 shows an overview of the guide. Fig.2 shows a shape of the spacer. Fig.3 shows the device to which we added a side gate. 3033245 - 2 - This radiological guide, Fig. 1, consists of 2 grids (1) parallel to each other, placed one above the other whose horseshoe shape is that of the dental arch. The X-ray guide may also be in the form of one or more arcade sections. These sections of arcades can fit together. The grids (1) are interconnected rigidly by spacers (2). The spacers (2), Fig.1 and 2, are fixed by nesting in orifices (3) located on the grid, preferably on the center line of the grids grid. The spacers are of different lengths. The orifices are equidistant from each other. In another embodiment, in place of the orifices (3), there are "pins", small rods which are flush with the inner faces of the grids (1) and 15 in which the spacers which this end, a housing in their axis. The grids (1) can be independent of one another, not connected by spacers (2). They are then positioned freely on the plaster model. In another configuration one or two grids (4), having the shape of a dental arch, are placed perpendicular to the two previous grids (1). They are positioned between them, laterally or medially. These grids (4) may not be squared, but simply consist of very thin bars in the manner of the "teeth" of a comb. The grid grid (1) allows accurate measurements. Grids (1) (4) and spacers (2) are radiologically visible. The manufacture of this standard radiological guide can be done by injecting an opaque radio material into a mold, by machining, sintering or using a 3D printer. Principle of the guide: 5 One of the two grids (1) is in contact with the gum, it is called gingival grid (lb), the other is located at the occlusal surface (masticatory face) of the teeth, it is called occlusal grid (the). The axis of an implant on the radiological sections will go through the two grids (1) determining 2 points. 10 A point of intersection with the gingival grid (1b) and another with the occlusal grid (1a). Through these 2 points passes a line that reproduces the axis of the implant, determined after study of the CT sections. The use of this guide is as follows: An impression is taken of the dentition of the patient, from which a plaster model is made. On this model, we position the radiological guide or a segment of it, depending on whether we have a patient totally or partially edentulous. Then always on this model, one deposits a layer of fluid resin on the edentée part and on the gingival grid (lb). The same is done on the occlusal surface of the teeth and on the occlusal grid (1a). On the 2 grids (1) the resin layer will be as thin as possible to maintain a free space of material between the 2 grids (1). But this layer will still be thick enough to maintain the rigidity of the whole. When the resin has hardened, the guide is demolded to separate it from the plaster model. The standard radiological guide at the beginning becomes a personalized guide adapted to the patient. 3033245 - 4 - The practitioner or the radio operator places this personalized guide in the mouth, when passing a scanner or a "cone-beam". On the images of the scanner are marked on each of the grids, as indicated above, the points through which the line that materializes the axis 5 of an implant. At radiologically marked points on the gingival grid (lb) and on the occlusal grid (la), a hole is made. At the level of the zone to be implanted, in the free space between the grids and after disbanding or cutting the spacers, a tube is placed, the internal diameter of which allows the clearance-free passage of an implantology guide drill. A rod of a diameter equal to this drill is slid into the 2 holes and through the tube. The stem and the tube materialize the axis of the implant. We repeat the operation if there are several implants.
Ensuite on relie, par de la résine, ou tout autre matériau, ce ou ces tubes au guide radiologique personnalisé. Quand la résine a durci on ôte les tiges, libérant les tubes. On obtient ainsi un guide chirurgical adapté au patient, les tubes servant de canons de forage. 25Then we connect, by resin, or any other material, this or these tubes to the personalized radiological guide. When the resin has hardened, the stems are removed, releasing the tubes. This produces a surgical guide adapted to the patient, the tubes serving as drill guns. 25
Claims (9)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR1500405A FR3033245B1 (en) | 2015-03-03 | 2015-03-03 | STANDARD RADIOLOGICAL GUIDE FOR DENTAL IMPLANTOLOGY, CUSTOMIZABLE AND TRANSFORMABLE INTO SURGICAL GUIDE |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR1500405A FR3033245B1 (en) | 2015-03-03 | 2015-03-03 | STANDARD RADIOLOGICAL GUIDE FOR DENTAL IMPLANTOLOGY, CUSTOMIZABLE AND TRANSFORMABLE INTO SURGICAL GUIDE |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| FR3033245A1 true FR3033245A1 (en) | 2016-09-09 |
| FR3033245B1 FR3033245B1 (en) | 2020-12-18 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR1500405A Active FR3033245B1 (en) | 2015-03-03 | 2015-03-03 | STANDARD RADIOLOGICAL GUIDE FOR DENTAL IMPLANTOLOGY, CUSTOMIZABLE AND TRANSFORMABLE INTO SURGICAL GUIDE |
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| Country | Link |
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| FR (1) | FR3033245B1 (en) |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20060251220A1 (en) * | 2005-05-06 | 2006-11-09 | Young Matthew D | Diagnostic kit, device, and method of using same |
| US20080199827A1 (en) * | 2005-09-07 | 2008-08-21 | Lukas Kamer | Method for Producing a Guiding Member for Guiding a Surgical Tool, and Guiding Member Produced According to This Method |
| US20090176182A1 (en) * | 2007-09-11 | 2009-07-09 | Roberto Carrillo Fuentevilla | Systems and processes for dental implant placement |
| EP2361584A1 (en) * | 2010-02-22 | 2011-08-31 | Mariusz Duda | Method for producing a drilling guide |
| KR101074463B1 (en) * | 2010-04-29 | 2011-10-17 | 경희대학교 산학협력단 | Method for forming guide-hole of surgical guiding instrument and surgical guide member for the same |
| US20140221819A1 (en) * | 2013-02-01 | 2014-08-07 | David SARMENT | Apparatus, system and method for surgical navigation |
-
2015
- 2015-03-03 FR FR1500405A patent/FR3033245B1/en active Active
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20060251220A1 (en) * | 2005-05-06 | 2006-11-09 | Young Matthew D | Diagnostic kit, device, and method of using same |
| US20080199827A1 (en) * | 2005-09-07 | 2008-08-21 | Lukas Kamer | Method for Producing a Guiding Member for Guiding a Surgical Tool, and Guiding Member Produced According to This Method |
| US20090176182A1 (en) * | 2007-09-11 | 2009-07-09 | Roberto Carrillo Fuentevilla | Systems and processes for dental implant placement |
| EP2361584A1 (en) * | 2010-02-22 | 2011-08-31 | Mariusz Duda | Method for producing a drilling guide |
| KR101074463B1 (en) * | 2010-04-29 | 2011-10-17 | 경희대학교 산학협력단 | Method for forming guide-hole of surgical guiding instrument and surgical guide member for the same |
| US20140221819A1 (en) * | 2013-02-01 | 2014-08-07 | David SARMENT | Apparatus, system and method for surgical navigation |
Also Published As
| Publication number | Publication date |
|---|---|
| FR3033245B1 (en) | 2020-12-18 |
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