JP2018126559A - Periodontal disease diagnosis support apparatus, and method and program for the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a periodontal disease diagnosis support apparatus and a method for the same, which can obtain quantified/digitized criteria for examination for making it possible to objectively determine the degree of progress of periodontal disease in examination for periodontal disease, and which can significantly improve the examination property and safety of the examination, as well as can significantly improve the objectivity of diagnosis.SOLUTION: The periodontal disease diagnosis support apparatus includes: a tooth part shape detecting section for detecting a tooth part shape including at least the position of the apex of alveolar bone from a dental image photographed by an imaging device; and an alveolar bone resorption degree calculating section for calculating the degree of alveolar bone resorption using information on the detected tooth part shape including the apex of alveolar bone.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a periodontal disease diagnosis support apparatus using dental images, a method thereof, and a program, and in particular, a tooth that can be used for diagnosis of periodontal disease by processing detection data from a dental X-ray image. BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a peripheral disease diagnosis support apparatus, a method thereof, and a program.

  Periodontal disease is a disease in which chronic gingivitis has progressed and inflammation has spread to periodontal tissues other than gingiva, with progressive destruction of periodontal tissue. Clinically, chronic inflammation of the gingiva, bleeding from the periodontal pocket, and alveolar bone retraction occur, and the teeth are shaken and moved due to the progress of destruction, eventually the teeth naturally drop or need to be extracted Is known to occur.

  In the treatment of periodontal disease, it is necessary to first check how much the current symptoms are progressing and then diagnose what kind of symptoms are caused. Test items for periodontal disease are roughly classified into tests related to bacterial infection and inflammation, tests related to tissue destruction, tests related to occlusion and risk factors, and the like. The present application is an invention relating to a technical idea related to a probing pocket depth test in a test related to tissue destruction and an alveolar bone resorption test using dental X-rays.

Hereinafter, the probing pocket depth inspection method will be described regarding the progress of periodontal disease.
FIG. 1 is a conceptual cross-sectional view schematically showing lower jaw teeth in periodontal disease. As shown in FIG. 1, a tooth has a root 4 supported by an alveolar bone 8 and a gum (gum) 6, and a space between the root 4 and the gum 6 is called a periodontal pocket (gingival crevice) 10. When suffering from periodontal disease, the gums are swollen red, the periodontal ligament is ruptured, blood and pus come out from the periodontal pocket, and the alveolar bone 8 begins to melt. The depth of the pocket from the gingival crest 7 to the lower end of the periodontal pocket 11 is about 0 to 1 mm in a healthy tooth, but in the case of a tooth affected by periodontal disease, the depth depends on the progression of periodontal disease. It gets deeper.

  In the probing pocket depth inspection method, a periodontal probe (inspection needle, specifically, a needle with a scale called a pocket probe) 15 is inserted into the periodontal pocket between the gingiva and the tooth root to the lower end of the periodontal pocket. This is the simplest method to find the condition of the symptom while measuring the depth. About 4 to 6 points are measured for one tooth, but it may be accompanied by bleeding, causing pain to the patient and taking time. Further, as will be described later, there is a problem that it cannot be said to be sufficient as an objective index of periodontal disease. In the probing pocket depth inspection method, the periodontal pocket is generally determined to be mild periodontitis if the periodontal pocket depth is 3 mm or less, moderate periodontitis if it is 4 to 6 mm, and severe periodontitis if it is 7 mm or more. .

  Next, an alveolar bone resorption inspection method will be described. The alveolar bone resorption is the distance from the alveolar bone (the length from the cement-enamel boundary 3 to the alveolar crest 9) to the root length (the length from the cement-enamel boundary 3 to the root apex 5 (E + D)) (E )). In periodontal disease, the alveolar bone begins to melt as described above, and the alveolar crest gradually decreases, the periodontal pocket depth increases, and the absorbed alveolar bone distance (the length from the cement-enamel border to the alveolar crest) E also increases. The ratio of the absorbed alveolar bone distance E to the root length (D + E) is defined as the alveolar bone resorption rate.

  Judgment by the alveolar bone resorption test method is generally mild periodontitis if the alveolar bone resorption is less than 30%, moderate periodontitis if the alveolar bone resorption is less than 30% to less than 50%, 50% or more (alveolar bone resorption Severe periodontitis when the degree is ½ or more of the root length. However, since the alveolar bone resorption is measured by reading from a dental image using a dental X-ray, there is a drawback that it greatly depends on the skill level and judgment criteria of a doctor.

  Conventionally, various proposals have been made on the periodontal disease inspection methods including the above-described probing pocket depth inspection method and alveolar bone resorption degree inspection method by the following literatures.

  For example, in Patent Document 1, a technical idea of processing a tomographic image of the periphery of a tooth obtained using an OCT apparatus to create a two-dimensional image and measuring the height of the alveolar bone and the outline of the periodontal pocket. It is disclosed. However, this technique using a laser light source has a problem that the depth of the periodontal pocket hidden in the gingiva is an estimated value and cannot be measured accurately. In addition, the measuring method has a drawback that optical adjustment is very difficult.

  Patent Document 2 discloses a technical idea for measuring the amount of autoinducer-2 substance collected from plaque in the oral cavity of a patient and diagnosing the progress of periodontal disease correlated with the amount of autoinducer. Has been. However, even in this case, there are disadvantages that an effective result cannot be obtained in judging whether there is variation in the result depending on the plaque collection position and whether the progress of periodontal disease is the whole tooth or local. ing.

JP 2009-131313 A JP 2010-256190 A JP 2010-218562 A

  In the diagnosis of periodontal disease, the probing pocket depth method is painful because the periodontal probe having a sharp tip is inserted into all gums and the depth thereof is measured visually. There is much bleeding and the patient suffers a lot of pain and mental burden. In order to examine the degree of periodontal disease progression of the entire gum, it is necessary to diagnose the probing pocket depth of the entire tooth, which is troublesome and not easy.

  The probing pocket depth method is not only painful, but also damages the teeth and periodontal tissue, worsens the disease, and is also a contact type, so the periodontal pocket causing microorganisms are infected in different periodontal pockets. is there. There is also a problem that it is not sufficient as an objective index of periodontal disease. That is, even if the depth of the periodontal pocket is the same, the volume of the tooth below the periodontal pocket varies from tooth to tooth and from person to person, so the force to support the tooth is determined solely by the depth of the periodontal pocket. I can't do it.

  As described above, the diagnosis of periodontal disease by measuring the alveolar bone resorption rate is based on the absorbed alveolar bone distance (cement-enamel boundary 3) relative to the root length (distance from the cement-enamel boundary 3 to the root apex 5 (E + D)). To the alveolar bone crest 9 (distance (E)) is measured as the alveolar bone resorption rate. However, the alveolar bone resorption is actually very difficult to measure. Since the root apex is not visible, a dental X-ray image is taken. Although the root apex can be confirmed from the dental X-ray image, the cement-enamel boundary is unclear on the image and the position cannot be determined. Since the cement-enamel boundary is visually confirmed, the image data and the visual data need to be matched, which is extremely difficult to understand.

  Alveolar bone resorption is shown as a ratio to the root length, but there is no strict definition on the image for measuring the ratio to the root length. The actual situation is that "flame", "moderate periodontitis" and "severe periodontitis" are identified. For this reason, when mild, moderate, and severe are mixed when diagnosed by a single tooth unit, it is determined whether to describe the disease name based on the most severe tooth or the disease name with the most number of affected teeth. It may be different.

  As described above, the diagnosis of periodontal disease depends on the skill of a doctor, and it has been difficult to obtain and diagnose quantitative and objective alveolar bone resorption data. In conventional examination and diagnosis of periodontal disease, there are various problems such as the examination judgment varies depending on the examiner, and certain objective data cannot be obtained, and a diagnostic method that can objectively judge the degree of progression of periodontal disease In addition, a support device that obtains quantified and quantified examination criteria has been desired.

  The present invention is intended to solve such problems in the prior art, and the periodontal that can improve the objectivity of measurement data while improving the testability and safety in periodontal disease diagnosis. It is an object of the present invention to provide a disease diagnosis support apparatus, method, and program.

In order to solve such a problem, the periodontal disease diagnosis support device according to the present invention,
From a dental image photographed by the imaging device, a tooth shape detector that detects the shape of the tooth including at least the position of the alveolar bone crest, and
An alveolar bone resorption degree calculating unit that calculates alveolar bone resorption degree using information on the shape of the tooth part including the detected alveolar bone crest.

  That is, the periodontal disease diagnosis support apparatus according to the present invention detects the shape of a tooth part such as the alveolar crest by comparing a dental X-ray image of a periodontal disease patient with a typical periodontal disease X-ray image. Then, necessary dimensions are measured from the shape information, and the alveolar bone resorption is calculated. Since measurement by human visual judgment is not involved, an objective and non-uniform alveolar bone resorption rate can be calculated. In addition, objective alveolar bone resorption data can be presented, so that there is no difference in the diagnosis results of the examiner, and support for realizing accurate diagnosis judgment can be provided.

  The periodontal disease diagnosis support apparatus according to the present invention further detects the position of the tip of the tooth bone (the root apex) and the position of the tip of the crown, and the alveolar bone resorption degree calculation unit provides information on the shape of the tooth part. As another example, the alveolar bone resorption can be calculated using information on the position of the alveolar bone apex, the position of the tip of the dental bone (root apex), and the position of the tip of the crown.

  As described above, the alveolar bone resorption is defined by the distance between the alveolar bone (the distance from the cement-enamel boundary 3 to the alveolar crest 9) to the root length (the distance from the cement-enamel boundary 3 to the root apex 5 (E + D)). (E)). However, since the cement-enamel boundary is identified on the surface of the same tooth bone, it is difficult to judge the position from a dental X-ray image. On the other hand, in the periodontal disease diagnosis support apparatus according to the present invention, the alveolar bone resorption is provisionally defined as the ratio of the length from the root apex to the alveolar bone crest with respect to the tooth length (D / C in FIG. 1). To do. This provisionally defined alveolar bone resorption value has a correlation with the value of the alveolar bone resorption rate (E / (D + E) in FIG. 1) according to the conventional definition, and can be used instead.

  The provisional definition of alveolar bone resorption is easy to identify from the dental apex (tip of the dental bone), the occlusal part (tip of the crown), and the alveolar crest from the dental X-ray image. The calculated bone resorption value is an objective value with no variation. The periodontal disease diagnosis support device according to the present invention detects the tooth length from the position of the root apex and the position of the tip of the crown, and detects the length from the position of the alveolar crest and the root apex, and the alveolar bone In the absorptivity calculator, the alveolar bone absorptivity according to the provisional definition is calculated.

  Therefore, the calculated value of the alveolar bone resorption degree by the periodontal disease diagnosis support apparatus according to the present invention accurately represents the same concept as the original alveolar bone resorption degree, and is presented as a value having no variation. As a result, there is no difference in the diagnosis results of the examiner, and it is possible to provide support for realizing accurate diagnosis judgment.

  The alveolar bone resorption degree by the periodontal disease diagnosis support device according to the present invention is the average of the position of the alveolar crest, the position of the tip of the alveolar bone, and the position of the tip of the crown for a plurality of adjacent tooth portions. It is also possible to adopt a configuration to make it.

  Since individual positions of a plurality of adjacent tooth portions vary, by calculating the alveolar bone resorption from a value obtained by averaging the respective positions, in the present invention, the alveoli averaged for each adjacent tooth portion Bone resorption is calculated and presented. Thereby, the examiner can diagnose the progress of periodontal disease in units of groups of adjacent tooth portions. Similarly, since the number of measurement positions and the number of measurements can be averaged and calculated, a more reliable value of alveolar bone resorption can be presented.

  The periodontal disease diagnosis support apparatus according to the present invention may have a configuration including a display unit that displays at least one of a dental image, information on the shape of a tooth, and a calculation result of alveolar bone resorption.

  That is, since the photographed image of the tooth part is displayed on a display or the like, the examiner can visually recognize the shape of the tooth part, for example, the position and shape of the tip of the crown, the root apex, and the alveolar crest. In addition, since the calculated value of the calculated alveolar bone resorption rate is displayed in the same manner, the examiner can make a diagnosis by considering the value of the alveolar bone resorption rate while visually recognizing each tooth shape.

  The periodontal disease diagnosis support apparatus according to the present invention provides at least one information of the position of the alveolar bone apex, the position of the tip of the dental bone, and the position of the tip of the crown as information on the shape of the tooth. It is also possible to adopt a configuration in which a plurality of matching tooth portions are connected and displayed on the display portion. Further, the connection may be approximated by a curve and displayed.

  In the present invention, the position of the alveolar crest of the tooth shape displayed on the display or the like, the position of the tip of the tooth, and the position of the tip of the crown are connected and displayed as a line. Further, the connection line is displayed as a smooth approximate curve. Therefore, the examiner can examine periodontal disease and determine the degree of progression in the whole tooth part or a part of the tooth group group. Similarly, the examiner can examine periodontal disease and determine the degree of progression while considering the calculated value of the alveolar bone resorption displayed on the whole tooth part or a part of the tooth group group. In particular, it is very effective for an examiner who is aiming for accurate and objective examination judgment to make a diagnosis while visually recognizing the connection line of each tooth part displayed superimposed on the tooth part image.

  The dental photographed image related to the periodontal disease diagnosis support apparatus according to the present invention is not limited to the X-ray photographed image, and may be a CT photographed image. In addition, since the tooth shape detection unit that detects the shape of the tooth portion including the position of the alveolar bone crest has a plurality of typical periodontal disease tooth imaging data, the shape of the tooth portion is determined from the dental imaging image to be examined. If it cannot be detected, typical periodontal diseased tooth imaging data is compared to select the most approximated periodontal diseased tooth imaging data, and the shape of the tooth is detected from the data.

  As described above, in the diagnosis of periodontal disease, it is possible to obtain and diagnose quantitative and objective alveolar bone resorption data without relying only on the skill of a doctor. There is no variation in examination judgment by the examiner, and accurate examination judgment of periodontal disease can be made based on certain objective data and tooth image.

  ADVANTAGE OF THE INVENTION According to this invention, the objectivity of measurement data is also improved significantly, improving testability and safety in periodontal disease examination. Instead of the conventional inspection method, periodontal disease diagnosis that significantly improves reliability, safety, and economical efficiency becomes possible.

It is a section conceptual diagram showing typically a mandibular tooth in periodontal disease. It is a functional block diagram which comprises the periodontal disease diagnosis assistance apparatus, method, and program which concern on one Embodiment of this invention. It is a timing flowchart for demonstrating operation | movement of the periodontal disease diagnosis assistance apparatus, method, and program which concern on one Embodiment of this invention. It is a dental X-ray image (an individual tooth part of a lower jaw part) of typical periodontal disease. It is the figure which showed the concept of the averaging method of the alveolar bone resorption degree measured value of the periodontal disease diagnosis assistance apparatus which concerns on one Embodiment of this invention. It is the figure which showed the dental panoramic X-ray image and tooth part line which were displayed on the periodontal disease diagnosis assistance apparatus which concerns on one Embodiment of this invention. It is the figure which showed the dental X-ray image displayed on the periodontal disease diagnosis assistance apparatus which concerns on one Embodiment of this invention. It is the figure which showed the dental panoramic X-ray image and alveolar bone top line which were displayed on the periodontal disease diagnosis assistance apparatus which concerns on one Embodiment of this invention.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. In the following, the range necessary for the description for achieving the object of the present invention is schematically shown, and the range necessary for the description of the relevant part of the present invention will be mainly described. According to a known technique.

  FIG. 2 is a functional block diagram of the alveolar bone resorption measurement support apparatus according to an embodiment of the present invention. As shown in the figure, the apparatus 1 is roughly configured to include at least an X-ray image data acquisition unit 100, an X-ray image data storage server 101, a control device 102, and a display device 103. The control apparatus 102 includes an image analysis unit 104 that reads and analyzes data transmitted from the X-ray image data acquisition unit, an approximate data extraction unit 105 that extracts approximate image data from the X-ray image data storage server 101, and an approximation with image data. A collation measurement unit 106 that collates image data and measures each part, an arithmetic analysis processing unit 107 that performs arithmetic processing on the measurement data, a storage unit 108 that stores each processing data, and a display processing unit 109 that transmits display data to the display device 103 It is configured with.

  The X-ray imaged image data acquisition unit 100 is connected to a dental X-ray imaging apparatus or is in a state where information data can be transmitted and received. Alternatively, the X-ray captured image data obtaining unit 100 may be configured integrally with the dental X-ray image capturing device 110.

  The X-ray image data storage server 101 stores and stores various periodontal disease X-ray images as well as typical dental X-ray images in periodontal diseases. The display device 103 displays X-ray captured image data and various calculation analysis processing data processed and displayed by the display processing unit 109 of the control device 102, and displays information useful for doctor's treatment determination.

  Next, the operation of the present apparatus configured as described above will be described. FIG. 3 is a timing flowchart for explaining the operation of the alveolar bone resorption measurement support apparatus according to an embodiment of the present invention.

  For example, when a dental X-ray image of a periodontal disease patient is taken by a dentist, the X-ray image data is transferred to the X-ray image data acquisition unit 100 by the X-ray imaging device 110 (step H101). Hereinafter, the X-ray image data is referred to as “image data”. The imaging data may be imaging data obtained by the 10-dental X-ray photography method or the 14-dental X-ray photography method, or may be individual tooth imaging data.

  The approximate data extraction unit 105 in the control device 102 analyzes the imaging data, and extracts dental X-ray image data that is closest to the image from the X-ray image data storage server (step H102). Hereinafter, the extracted dental X-ray image data is referred to as “image data”. The approximate data extraction unit sends the imaging data and the image data to the collation measurement unit 106. The collation measurement unit 106 collates the imaged data with the image data, and measures dental part data necessary for the examination diagnosis of periodontal disease. Here, the measurement refers to, for example, specifying the crown position and the apex position from the imaging data and measuring the length of the teeth. In addition, collation and measurement, for example, when the position of the alveolar crest is unclear in the imaging data, the image data that is approximate data is collated so that the image is superimposed, and the position of the alveolar crest is determined from the superimposed image data. This means specifying the distance from the root apex position of the imaging data to the alveolar crest position as an alternative measurement. That is, the position of dental site data that is difficult to measure from the imaging data is read from the image data that is approximate data, and the length or the like is measured by superimposing the imaging data and the approximate image data (step H103).

  The arithmetic analysis processing unit 107 performs arithmetic processing to describe the measured dental part data later according to a prescribed program (step H104). As will be described later, for example, when calculating the alveolar bone resorption rate in periodontal disease, the arithmetic analysis processing unit 107 measures the distance from the root apex to the alveolar crest, which is the measurement data from the verification measurement unit, and the tooth length. Measurement data is obtained, and the alveolar bone resorption is calculated by performing arithmetic processing according to a defined formula. In addition, in order to output information necessary for dental diagnosis, the calculation analysis processing unit 107 has a function for processing various calculation programs for calculating a defined formula. For example, calculation processing such as the area and volume of a medical condition location is also included.

  The display device 103 has a display function that displays information for dental examination diagnosis and supports a doctor's diagnosis. The display device 103 displays, for example, dental image data of a patient that has been X-rayed in accordance with an instruction (step H105) of the display processing unit 109 in the control device 102. Then, information necessary for the dental diagnosis calculated by the calculation analysis process 107 is also displayed. It is also possible to display the calculation analysis data superimposed on the image data (step H106). For example, a curve connecting the occlusal positions of each tooth, a curve connecting the alveolar crest, a curve connecting the apex, and the like can be displayed superimposed on the dental image. The type and display method of the display data are displayed in accordance with instructions from the display processing unit 109 such as numerical display, list display, three-dimensional image display, virtual cut surface display, and back side display (step H106). Also, printout to a sheet including a specific recording sheet or chart sheet is executed (step H107).

  The in-device information is recorded and saved in the storage unit 108, and can be extracted and used sequentially (step H108).

  Next, a specific inspection method for measuring alveolar bone resorption in periodontal disease periodontal disease diagnosis using the periodontal disease diagnosis support device according to the present invention and the movement of the periodontal disease diagnosis support device will be described.

  During the examination, a dental X-ray image of the subject is taken, and the imaging data is transmitted to the X-ray imaging image data acquisition unit 100 of the periodontal disease diagnosis support apparatus. The kind of X-ray imaging image used for the periodontal disease diagnosis support apparatus 1 according to the present invention is not limited, and 10 dental X-ray images, 14 dental X-ray images, and a dental panorama. Any image such as an X-ray photograph image may be used. Further, it may be a dental CT image. About the following concrete description and drawing, the image using the dental X-ray photography 10 sheet method is demonstrated to an example. These dental image capturing devices may be devices incorporated in the periodontal disease diagnosis support device according to the present invention, or may be a side device capable of transmitting and receiving data.

  The control device 102 of the periodontal disease diagnosis support apparatus 1 according to the present invention analyzes the acquired imaging data and reads all the information and numerical values that can be detected in the imaging information. For example, the detectable information necessary for calculating the alveolar bone resorption rate such as the tooth length C from the crown tip to the root apex and the absorbed alveolar bone distance D from the alveolar crest to the root apex is read.

  In the case where there is an image data information that is unclear and cannot be detected such as the position of the alveolar crest, the image data that is most approximated from the typical periodontal disease image data stored in the X-ray image data storage server 101 is approximate. It is selected and extracted by the data extraction unit 105. For example, the case where the position of the alveolar crest is unclear and cannot be detected will be described below.

  FIG. 4 is an example of typical periodontal disease image data (individual teeth of the lower jaw) stored in the X-ray image data storage server 101. The Normal image in FIG. 4 is normal, the Mild image is an initial periodontal disease, the Moderate image is a typical periodontal disease, and the Severe image is an image showing severe periodontal disease. The approximate data extraction unit 105 extracts the image data that is most approximate to the imaging data while sequentially collating them. In this extraction operation, a known algorithm in the technical concept such as the fingerprint authentication system disclosed in Patent Document 3 can be used. As shown in one image data in FIG. 4, the left and right roots 4 appearing white and the black triangle portion located on the upper portion of the alveolar bone 8 located therebetween are the characteristics of the periodontal disease dental image. The lower end is the alveolar crest. For example, by designating the lower end of the black triangular portion as the alveolar crest, the position of the alveolar crest can be identified, and the length D from there to the root apex can be measured.

  In this way, the collation measuring unit 106 collates the approximate image data extracted from the typical periodontal disease image data with the imaging data of the examinee, and identifies the position of the unclear alveolar bone crest. And has a function of calculating the length to the root apex. In this way, not only the alveolar crest, but all the information that can be detected by collation between the imaging data and the approximate image data can be detected and calculated.

  The calculation analysis processing unit 107 calculates and calculates alveolar bone resorption according to, for example, a defined formula (definition formula) based on the detected data. As shown in FIG. 1, the definition of alveolar bone resorption is originally based on the absorbed alveolar bone distance (from cement-enamel boundary 3 to the root length (distance from cement-enamel boundary 3 to root apex 5 (E + D))). It is the ratio of the distance (E) to the alveolar bone crest 9. That is, E / (E + D). However, since the position of the cement-enamel boundary is the same tooth bone surface, the position is unclear and difficult to judge from the dental X-ray image. Therefore, the periodontal disease diagnosis support device according to the present invention uses the alveolar bone. The degree of absorption is provisionally defined as the ratio of the length from the root apex to the alveolar crest with respect to the tooth length (D / C in FIG. 1).

The provisional definition of alveolar bone resorption is shown.
Alveolar bone resorption = 1 / n Σ (length from root apex to alveolar crest / tooth length) [%]
= 1 / n Σ (D / C) [%]
Tooth length: Length C from root apex to crown tip
n: Number of measurement points

  According to this definition, it can be calculated based on positional information of the root apex (tooth tip), occlusal part (crown tip), and alveolar crest that can be clearly detected from dental X-ray imaging. Further, there is no error in the alveolar bone resorption value, and variations in the calculated value can be prevented, which serves the purpose of objective quantification. This provisionally defined alveolar bone resorption value has a correlation with the value of the alveolar bone resorption rate (E / (D + E) in FIG. 1) according to the conventional definition, and can be used instead.

  That is, the periodontal disease diagnosis support device according to the present invention detects the length of the tooth from the position of the root apex and the position of the crown tip, and detects the length from the position of the alveolar crest and the root apex, The bone resorption degree calculation unit is characterized in that the alveolar bone resorption degree according to the provisional definition is calculated. However, the definition of alveolar bone resorption is not limited to this provisional definition, and it goes without saying that the formula to be defined can be changed. It is also part of the technical idea of the present application to define and formulate other diagnostic determination parameters related to periodontal disease based on imaging data and other information detected from the image data, and to formulate and calculate the parameters.

  In this tentative definition, alveolar bone resorption is quantified as an average ratio of the number of measurement points n to one site. The existing definition is “diagnosis for one tooth” and “integration of evaluation for one tooth” to perform “individual level diagnosis”. As in the present application, one tooth site or one tooth group On the other hand, the idea of measuring and averaging the alveolar bone resorption rate at a plurality of locations and quantifying them has never existed.

  FIG. 5 is a diagram illustrating a concept of an averaging method of alveolar bone resorption measurement values of the periodontal disease diagnosis support apparatus according to an embodiment of the present invention. The broken line alveolar in this figure is the length D from the root apex to the alveolar crest in FIG. The straight line etheth is the tooth length C in FIG. FIG. 5 shows an operation of averaging the alveolar bone resorption calculated values at the number of measurement points n. For example, n is 3 when the positional information of the root apex (tooth tip), the occlusal part (crown tip), and the alveolar crest is detected in three locations and the alveolar bone resorption is calculated in three ways. The three alveolar bone resorptions are divided by 3 and averaged. As a result, the alveolar bone resorption rate in the above one tooth part is shown as an average value without variation, and becomes effective information by diagnosing the periodontal disease progress of the examiner. Diagnosis in one tooth can be made accurately without being confused by partial narrow local assessment.

  Similarly, a case where periodontal disease is diagnosed in a group of six lower anterior teeth in the ten dental X-ray photograph method will be described. The position information of the root apex (tooth tip), the occlusal part (crown tip), and the alveolar crest of six teeth is detected in a total of 18 locations, for example, 3 locations per tooth, and 18 types of alveolar bone resorption are calculated. In this case, n is 18 and the alveolar bone resorption is divided by 18 and averaged. As a result, the alveolar bone resorption at the lower anterior teeth is shown as an average value without variation, and is more effective information for diagnosing the periodontal disease progression of the entire lower anterior teeth of the examiner. It becomes. This is a diagnosis method suitable for the characteristics of periodontal disease in which the disease state easily progresses in units of adjacent tooth groups.

  Similarly, it can be applied to the entire tooth. In addition, the average value by n is calculated as the weighted average value of the alveolar bone resorption rate in the adjacent tooth group including the tooth by increasing the number n of times of measurement of only one tooth portion in which the periodontal disease symptom has progressed remarkably. It is also possible to do. In this case, the information is effective for diagnosis judgment of the entire group tooth portion including the tooth portion where the medical condition is extremely advanced. Calculation processing instructions such as specifying the measurement site, specifying the number of measurements, changing the official calculation, and executing the weighted average process are performed by the operator operating the operation unit of the periodontal disease diagnosis support device. Sent to the unit 107.

  Next, the display device 103 will be described. FIG. 6 is a diagram showing a dental panoramic X-ray image and a tooth line displayed on the periodontal disease diagnosis support apparatus according to an embodiment of the present invention. The root apex line shown in the figure indicates the root apex line 14 (FIG. 1) in which the root apex is smoothly connected. Alveolar line indicates an alveolar crest line 13 (FIG. 1) in which alveolar crests are smoothly tied. Occlusion line shows the occlusion line 12 (FIG. 1) which connected smoothly the upper end of the occlusion part of the tooth.

  The display device 103 displays the dental imaging data as shown in FIG. 6, and the position data detected by the collation measurement unit 106 is subjected to, for example, a connection line processing by the display processing unit 109 and is superimposed on the dental imaging image. To display. For example, in the case of a crown line, the connection line forming process is performed by connecting individual positions of the crown of each tooth, and by approximating the line as a smooth curve and superimposing it on the image. It means to display. Thus, the examiner can grasp the level of the alveolar crest position with respect to the tooth length through the entire tooth image, which is very useful for diagnosis of periodontal disease. The alveolar bone resorption degree calculated by the periodontal disease diagnosis support apparatus can be displayed in a line, or the alveolar bone resorption value can be displayed numerically. The line that smoothly connects the alveolar bone resorption is approximated to the alveolar crest line, but useful diagnostic information different from the alveolar crest line can be provided by applying a method such as weighted averaging as described above.

  Assuming that the condition where the tooth part is averaged and progressing uniformly on the whole is regarded as horizontal bone resorption, the technique of quantifying alveolar bone resorption based on three smooth lines like this Effectively shows the condition to the examiner mainly in horizontal bone resorption. Regarding the drawing of three lines and the process of quantifying alveolar bone resorption based on the three lines, it is possible to perform the connection line processing as described above and display the same on a dental image in the same manner. The person can easily evaluate the medical condition while visually confirming the alveolar bone resorption data that does not depend on the subjectivity.

  Contrary to the above, if the root apex, alveolar crest, and occlusion are superimposed on the dental imaging image for each tooth measurement point and displayed as a point (plot display), periodontal disease diagnosis for each tooth It is effective for the diagnosis of periodontal disease in the adjacent tooth group.

  FIG. 7 is a view showing a dental X-ray image displayed on the periodontal disease diagnosis support apparatus according to an embodiment of the present invention. This figure is an X-ray image of the upper left molar region of the upper jaw. As shown in the figure, among the seven adjacent tooth parts, there is a tooth part in which periodontal disease remarkably progresses and bone resorption occurs. If the pathology is progressing to some of the teeth in the whole tooth, it can be regarded as "vertical bone resorption". In this way, simple connection line display or dot display (plot display) of the alveolar crest Is valid for diagnosis.

  Based on this image information, the examiner takes various approaches for diagnosis, such as increasing the number of measurement points in the period where the periodontal disease progress is significant, or adding a weighted average process to the alveolar bone resorption calculation formula. It becomes possible to try. If the difference between the maximum value and the minimum value is calculated, or the amount of change in piecewise alveolar bone resorption is calculated, it is useful information for evaluation of the vertical resorption.

  Connection lines such as root apex, alveolar crest, and occlusal part are not limited to being displayed as smoothly connected lines, but can be displayed with a smoother approximate curve by simply connecting the plot points. The display is also performed by the display processing unit 109. For example, data such as impacted wisdom teeth (parental wisdom) that interfere with the smooth connection creation of site lines such as the apex, alveolar crest, and occlusal portion can be ignored and displayed. This is because the shape and position of the embedded wisdom teeth are clearly different from the shape and position of the other teeth, and therefore a favorable line for accurate diagnosis cannot be obtained if smooth connection processing is performed.

  FIG. 8 is a diagram showing a dental panoramic X-ray image and an alveolar bone crest line displayed on the periodontal disease diagnosis support apparatus according to an embodiment of the present invention. As shown in the figure, for example, an alveolar crest line that smoothly connects alveolar crests is changed to a line that has been processed and calculated as required by the examiner. The process which omits the above-mentioned impact wisdom tooth and the curve process using a specific template can be performed. For example, if the detection unit information of the same subject's aged dental image data is displayed in a superimposed line so that the secular change can be understood, the age-related progression of periodontal disease of the subject can be clearly visually diagnosed. It becomes possible. As shown in FIG. 8, as the display method of the tooth line, the examiner may select the display method most suitable for the diagnosis.

  As described above, the periodontal disease diagnosis support apparatus according to an embodiment of the present invention and the dental image using the method / program thereof, the specific part information, the data such as the alveolar bone resorption information, and the like are displayed and displayed. By converting the method as necessary as described above, the examiner can obtain information that can be visually recognized that is very meaningful for diagnosis of tooth disease such as periodontal disease. The information for diagnosis is highly reliable because it is read from dental imaging data, and is extremely valuable information for judgment of diagnosis as objective data that does not contain human subjectivity.

  Note that the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention. For example, a dental imaging image can be handled as CT (computer tomography) image data.

  The dental imaging image has been described mainly for dental X-ray imaging data as described above. However, if CT image data is used, the above-described tooth detection lines, alveolar bone resorption display, and the like are superimposed and displayed. In addition, the information can be displayed from various angles or converted into a tomographic plane. Furthermore, it becomes possible by utilizing the same mechanism for the examination diagnosis of the tooth disease not limited to the periodontal disease. These are all part of this technical idea.

  Moreover, although the aspect at the time of implement | achieving the technical idea of this invention as a periodontal disease diagnosis assistance apparatus was demonstrated above, it can also implement | achieve as a computer program which algorithmized all or one part of each function, or as a method It can also be realized.

  As described above, according to the invention according to the present application, the diagnosis of periodontal disease can be made by obtaining quantitative and objective alveolar bone resorption data without relying only on the skill of a doctor. It becomes possible to make an accurate diagnosis of periodontal disease based on objective data and tooth images.

  The present invention remarkably improves the objectivity and reliability of measurement data while greatly improving the examination property and safety in periodontal disease diagnosis. Therefore, the present invention is not limited to individual periodontal disease diagnosis support by a dentist, but is useful for all industries related to dental imaging equipment, information processing equipment, and display devices, and related industries. Industrial value and availability are extremely large.

1 Periodontal disease diagnosis support device 2 Crown 3 Cement-enamel border 4 Tooth root 5 Tooth root 6 Gingiva (gum)
7 Gingival crest 8 Alveolar bone 9 Alveolar bone crest 10 Periodontal pocket 11 Periodontal pocket lower end 12 Occlusal line 13 Alveolar bone crest line 14 Apical line 15 Periodontal probe A Probing pocket depth (PD)
B Attachment level C Tooth length D Length from root apex to alveolar crest E Distance absorbed from alveolar bone (length from cement-enamel boundary to alveolar crest)
D + E root length

Claims (15)

A storage device storing typical periodontal disease images;
At least the position of the alveolar crest and the tip of the tooth bone from the dental image, which is image data extracted by the image capturing device that captures a dental image or image data extracted from the storage device as data approximate to the image capturing data. A tooth shape detecting unit for detecting a plurality of positions of a tooth part including a position and a position of a crown tip part with respect to one tooth part or one tooth group;
The position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown as information on the shape of the tooth detected at a plurality of positions for the one tooth part or one tooth group Calculating alveolar bone resorption for the plurality of places using information, and obtaining alveolar bone resorption that is quantified by averaging the calculated alveolar bone resorption for the plurality of places; Periodontal disease diagnosis support apparatus having   The tooth according to claim 1, wherein the position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown are averaged for a plurality of adjacent teeth. Peripheral diagnosis support device.   The periodontal disease diagnosis according to claim 1 or 2, further comprising a display unit that displays at least one of the dental image, information on the shape of the tooth portion, and the quantified alveolar bone resorption rate. Support device.   As information on the shape of the tooth part, any one or more information of the position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown is adjacent to each other. The periodontal disease diagnosis support apparatus according to claim 3, wherein the tooth part is connected and displayed on the display unit.   The periodontal disease diagnosis support apparatus according to claim 4, wherein the connection is approximated by a curve and displayed. Computer
At least alveolar bone from a dental image that is image data extracted by an imaging device that captures a dental image or image data extracted as data approximating the imaging data from a storage device in which a typical periodontal disease image is stored A tooth shape detection unit for detecting a plurality of positions of a tooth part including a position of a top part, a position of a tooth tip part and a position of a tooth crown part with respect to one tooth part or one tooth group;
The position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown as information on the shape of the tooth detected at a plurality of positions for the one tooth part or one tooth group Calculating alveolar bone resorption for the plurality of places using information, and obtaining alveolar bone resorption that is quantified by averaging the calculated alveolar bone resorption for the plurality of places; Periodontal disease diagnosis support program, characterized by functioning.   The tooth according to claim 6, wherein the position of the alveolar crest, the position of the tip of the dental bone, and the position of the tip of the crown are averaged for a plurality of adjacent tooth portions. Perinatal diagnosis support program.   The periodontal disease diagnosis according to claim 6 or 7, further comprising a display unit that displays at least one of the dental image, information on the shape of the tooth portion, and the quantified degree of alveolar bone resorption. Support program.   As information on the shape of the tooth part, any one or more information of the position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown is adjacent to each other. The periodontal disease diagnosis support program according to claim 8, wherein the tooth part is connected and displayed on the display unit.   The periodontal disease diagnosis support program according to claim 9, wherein the connection is approximated by a curve and displayed. At least alveolar bone from a dental image that is image data extracted by an imaging device that captures a dental image or image data extracted as data approximating the imaging data from a storage device in which a typical periodontal disease image is stored A first step of detecting a plurality of positions of a tooth part including a position of the apex part, a position of a tooth tip part, and a position of a tooth crown part with respect to one tooth part or one tooth group;
The position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown as information on the shape of the tooth detected at a plurality of positions for the one tooth part or one tooth group A second step of calculating alveolar bone resorption for the plurality of locations using information and obtaining the quantified alveolar bone resorption by averaging the calculated alveolar bone resorption for the plurality of locations; and Periodontal disease diagnosis support method to do.   The tooth according to claim 11, wherein the position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown are averaged for a plurality of adjacent teeth. Peripheral diagnosis support method.   The periodontal disease diagnosis support method according to claim 11 or 12, wherein at least one of the dental image, information on the shape of the tooth part, and the quantified alveolar bone resorption rate is displayed on a display part. .   As information on the shape of the tooth part, any one or more information of the position of the alveolar crest, the position of the tip of the tooth, and the position of the tip of the crown is adjacent to each other. The periodontal disease diagnosis support method according to claim 13, wherein the tooth part is connected and displayed on the display part.   The periodontal disease diagnosis support method according to claim 14, wherein the connection is approximated by a curve and displayed on the display unit.

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