JP3625278B2 - Implant planting jig and manufacturing method thereof - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a jig used for implanting an implant, and more particularly to improving the safety and accuracy of implant implantation.
[0002]
[Prior art]
When orthodontic treatment is performed for malocclusions and the like, reaction is always caused when force is applied to the teeth intended for correction. A structure that receives this reaction is called a fixed source. Conventionally, teeth for correction purposes are generally moved using a tooth, skull or neck as a fixed source.
[0003]
However, when the teeth are used as a fixing source as in the conventional art, even if the number of teeth serving as the fixing source is increased, not only the teeth intended for correction but also the teeth serving as the fixing source are moved. In addition, when the skull or neck is used as a fixed source, it is necessary to use a device that can be removed by the patient for daily life. In this case, the ideal tooth movement cannot be performed unless the patient's cooperation is obtained so as to secure a sufficient apparatus wearing time. In addition, the use of a device having a fixed source such as the skull or neck places a heavy burden on the patient.
[0004]
For this reason, recently, a safe part (alveolar bone) that does not move between teeth and that does not affect the anatomical structure of the teeth and jawbone has a diameter of 1.2 mm, for example. It has been put into practical use by implanting an orthodontic implant made of a metal screw such as titanium and using this as a fixed source. After about 3 months after the orthodontic implant is implanted, the implant in the bone adheres to the bone and does not fall off during the orthodontic treatment even if a corrective force is applied. By using this orthodontic implant as a fixed source, as described above, teeth that are not desired to move do not move, and the success or failure of treatment does not depend on patient cooperation. The teeth can be moved and the burden on the patient is small.
[0005]
On the other hand, a prosthetic implant is used for the purpose of prosthetic treatment of a tooth defect portion instead of “denture”. This implant is implanted in the vicinity of the apex of the alveolar bone of the maxilla or mandible of the defect so that the alveolar bone and structure are not broken even when an occlusal force is applied. After about 3 months have passed since the implant was implanted, the implant in the bone adheres to the bone, and even if an occlusal force is applied, the implant remains stable. After confirming the stable state of the implant, a prosthesis such as a crown or bridge is mounted on the base, and the prosthetic treatment is completed.
[0006]
[Problems to be solved by the invention]
As described above, the orthodontic implant needs to be accurately planted in a safe site. For example, if a tooth root is damaged during planting, the tooth may have to be extracted. If the maxillary sinus is punctured, infection may occur. If the mandibular canal is punctured, bleeding or nerve paralysis may occur. There is a serious impact such as.
[0007]
However, when implanting orthodontic implants, the anatomical structures of the teeth and jawbone, such as the root, maxillary sinus and mandibular canal, are present inside the invisible to the practitioner. Since the accurate position cannot be grasped sufficiently, there is a problem that it is difficult to accurately set the orthodontic implant in a safe site.
[0008]
On the other hand, in the case of prosthetic implants, as in the case of the orthodontic implants described above, it is difficult to accurately set up in a safe area that does not affect the anatomical structures of the teeth and jawbone. There was a problem of being.
[0009]
An object of the present invention is to solve the above-mentioned problems and to provide an implant planting jig and a method for producing the same that can accurately and easily plant an implant in a safe site.
[0010]
[Means for Solving the Problems]
In order to achieve the above object, a method for producing an implant planting jig according to the present invention is configured such that an external shape of an impression model reproducing a patient's teeth and ridge is non-contacted by a three-dimensional measuring device using light irradiation. External shape acquisition step for obtaining three-dimensional electronic data obtained in step 3, and an internal shape acquisition step for obtaining the internal shape of the patient's teeth and jawbone in a non-contact manner by means of a computed tomography apparatus (CT) to obtain three-dimensional electronic data A synthesizing step of synthesizing the three-dimensional data obtained from the external shape acquiring step and the internal shape acquiring step, and a solid model representing the external and internal shapes of the patient's teeth and jawbone based on the synthesized three-dimensional data And a jig used when implanting an implant, having an impression of the external shape of the teeth and the jaw ridge including the occlusal surface obtained from the entity model, And a jig preparing step of preparing a jig implant insertion with anatomical structures in effect guide the planting elevation of the implant so as not to guide holes of the bone.
[0011]
According to the above configuration, a solid model that accurately reproduces the external and internal shapes of the patient's teeth and jawbone is prepared, and the impression of the external shape of the teeth including the occlusal surface and the external ridge obtained from the solid model is obtained. An implant placement jig having a guide hole for guiding the placement of the implant so as to hold it and not to affect the anatomical structure of the teeth and jawbone is prepared. Therefore, when implanting an implant on a patient's teeth, it can be accurately restored to the patient's teeth and through the guide hole, the implant is safe and does not affect the anatomical structures of the teeth and jawbone It is possible to easily produce an implant planting jig that can be accurately planted on a site.
[0012]
An implant planting jig according to the present invention is a jig produced based on a solid model or three-dimensional data representing the external and internal shapes of a patient 's teeth and jawbone, and includes a patient's occlusal surface. and has an impression of the external shape of the alveolar ridge, Chi lifting the guide hole for guiding the plant standing orthodontic implant so as not to affect the anatomical structures of teeth and jaw bone, the guide hole adjacent 2 Opposite the alveolar bone between the two teeth.
[0013]
According to the above configuration, when implanting an implant on the patient's teeth, the implant can be accurately restored to the patient's teeth by using the implant planting jig, and the implant is inserted into the teeth and jawbone via the guide hole. Can be planted accurately in a safe area that does not affect the anatomical structure of
[0015]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
FIG. 1 shows a method for producing an orthodontic implant planting jig according to a first embodiment of the present invention. FIG. 2 is a side view showing a part of the patient's jaw 10. A maxillary sinus 13 covered with the maxillary bone mucosa is located above the maxilla 11, and a mandibular canal 14 and a mandibular canal 14 through which the inferior alveolar vein and inferior alveolar nerve pass are located below the mandible 12. In the first embodiment, for example, the orthodontic implant 16 is implanted between the roots R of the first molar M1 and the second molar M2 of the upper jaw 11. First, an impression model is taken from the patient's oral cavity using plaster of teeth and ridges that specifically shows the intraoral information three-dimensionally. In this embodiment, the impression of the first molar M1 and the second molar M2 is emphasized.
[0016]
In the external shape acquisition step of step S1, the external shape of the impression model reproducing the patient's teeth (crown and neck) and the chin is obtained by a non-contact method using a three-dimensional measuring device using light irradiation. Dimensional electronic data.
[0017]
For the three-dimensional measuring device, for example, a pattern projection method (light cutting method) measuring device that measures an impression model in a non-contact manner by a laser slit light cutting method based on triangulation is used. Laser light is generated from a laser light source such as a semiconductor laser, and a polygon mirror is rotated to irradiate an impression model with slit light. The impression model is moved to a predetermined position by the driving means, and a slit light image irradiated on the impression model is photographed by, for example, an imaging unit having two CCD cameras. This slit pitch is, for example, a minimum of 0.05 mm. In addition, a multiple exposure high-speed measuring device using a multi-slit laser and a CCD camera, a point measuring device using a laser spot, or the like may be used.
[0018]
In the internal shape acquisition step of step S2, the internal shape including the maxillary sinus and the mandibular canal of the patient's teeth and jawbone is obtained in a non-contact manner by a computer tomography apparatus (CT) and converted into three-dimensional electronic data. For example, a well-known X-ray CT is used for the CT, and the X-ray CT reconstructs a tomographic image of the internal shape of the patient's teeth and jawbone from computerized X-ray projection images from multiple directions. . This slice pitch is usually 0.5 to 1 mm. In addition, MRI (Magnetic Resonance Imaging) that visualizes a tomographic distribution of a specific substance in a living body using nuclear magnetic resonance (NMR), which is spin resonance of atomic nuclei, may be used.
[0019]
Next, the synthesis process of step S3 synthesizes the three-dimensional data obtained from the external shape acquisition process of step S1 and the internal shape acquisition process of step S2. That is, both data are synthesized on a three-dimensional coordinate using a computer to obtain three-dimensional data representing the external and internal shapes of the patient's teeth and jawbone. The three-dimensional data is displayed as a three-dimensional image on a two-dimensional plane of the monitor using computer graphics (CG) technology as necessary. Since the slice pitch of X-ray CT is usually 0.5-1 mm and is sparse, accurate data on the surface shape of teeth, gums, etc. cannot often be obtained from data from X-ray CT. To compensate for this, by synthesizing highly accurate 3D measuring device data with a minimum slit pitch of 0.05 mm, the precise positional relationship between the surface shape and the internal shape can be obtained, and the accuracy of the entire data and It is possible to improve reproducibility.
As a result, accurate three-dimensional data representing the external and internal shapes of the patient's teeth and jawbone can be obtained even if the internal shape is complex.
[0020]
The model production process of step S4 produces a solid model representing the external and internal shapes of the patient's teeth and jawbone based on the synthesized three-dimensional data. FIG. 3A shows an example of a solid model that reproduces a part of the upper jaw of a patient. This solid model 2 is made of a transparent resin, and for example, hollow root Ra and maxillary sinus 13a are colored. This is to make these parts easy to see. For example, an NC machine tool, a three-dimensional modeling apparatus, or the like is used for manufacturing the entity model. The three-dimensional modeling apparatus includes an ultraviolet curable resin optical modeling apparatus, a thermoplastic resin laminating apparatus, and the like.
When using an NC machine tool, the three-dimensional data is converted into NC machining data such as G code data. When using a three-dimensional modeling apparatus, the three-dimensional data is converted into modeling data such as STL data.
[0021]
The jig manufacturing step of step S5 is a jig that serves as a guide when implanting an implant, and has an impression of the external shape of the teeth and jaw ridge including the occlusal surface obtained from the entity model, A jig having a guide hole for implant implantation having a position and an angle that does not affect the anatomical structure of the jawbone is created.
[0022]
As shown in FIG. 3 (A), first, the first first molar M1a and the second adjacent first molar M1a and the second are visually observed on the body model 2 at a safe position and angle that does not damage the root Ra and do not pierce the maxillary sinus 13a. An orthodontic implant 16 such as a 1.2 mm titanium screw is screwed (planted) directly into the alveolar bone ALa between the molars M2a (about 4 mm). Then, a pipe through which this can be inserted is fitted into the orthodontic implant.
[0023]
A dental immediate polymerization resin used by mixing powder and liquid with the pipe projecting from the body model 2 is pressed against the body model 2 to take an impression of the teeth and the jaw crest including the occlusal surface. This impression is used for an implant planting jig. As shown in FIG. 3 (B), the impression 3 has a pipe 4, and when the impression 3 is solidified, the impression 3 with the pipe 4 is pulled off from the entity model 2. At this time, the orthodontic implant 16 is screwed into the substantive model 2 (FIG. 3A). Next, when the pipe 4 is pulled out from the solid impression 3, this portion becomes the guide hole 6 as shown in FIG. 3C, and the implant planting jig 5 is manufactured. The guide hole 6 of the implant planting jig 5 faces a safe part of the alveolar bone AL between the first and second molars M1 and M2 adjacent to each other in the upper jaw 11 shown in FIG. Yes. Accordingly, the occlusal surface of the patient's teeth and the jaw crest are impressed, the patient's root R is not injured, and the maxillary sinus 13 is not drilled. An implant planting jig 5 having a guide hole 6 that guides the planting of the corrective implant 16 is produced.
[0024]
Thereafter, when the orthodontic implant is planted, the produced implant planting jig 5 is actually applied to the teeth and jaw ridge including the patient's occlusal surface, and the implant planting jig 5 is obtained. Since it can be accurately restored to the patient's teeth, a safe part of the patient's alveolar bone AL can be drilled from the guide hole 6 with a drill. At this time, when heat is generated by drilling, the bone is denatured. Therefore, a hole 7 for water injection is made in the implant planting jig 5, and water is injected with a syringe and cooling is performed. The titanium screw 16 is screwed into the drilling hole 21 to finish planting the orthodontic implant.
[0025]
Thus, when the orthodontic implant 16 is implanted in the patient's teeth, the anatomical structure of the teeth and jawbone is not affected by drilling using the implant implantation jig 5. Can be planted accurately and easily in a safe area.
[0026]
Next, a method for producing an implant planting jig for prosthesis according to the second embodiment will be described.
FIG. 4 is a side view showing a part of the lower jaw 12 of the patient. In the second embodiment, for example, the first molar M1 of the lower jaw 12 is missing, and the prosthetic implant 18 is provided in the missing portion (M1). To plant. First, as in the first embodiment, an impression model is taken from the patient's oral cavity by using plaster of teeth and ridges that specifically show the intraoral information three-dimensionally. In the second embodiment, the impression of the second molar M2 and the second premolar B2 adjacent to the missing part (M1) is preferentially taken.
[0027]
As in the first embodiment, the external shape of the impression model that reproduces the patient's teeth and jaw ridge by the external shape acquisition step is converted into three-dimensional electronic data, and the internal shape of the patient's teeth and jawbone is acquired by the internal shape acquisition step. Is converted into three-dimensional electronic data, and the three-dimensional data of both is synthesized by the synthesis step. Then, in the model making process, a solid model representing the external and internal shapes of the patient's teeth and jawbone is created based on the synthesized three-dimensional data. Finally, it is a jig used when implanting a prosthetic implant in the jig manufacturing process, and has an impression of the external shape of the teeth and jaw ridge, including the occlusal surface taken from the body model, and the root of the tooth An implant placement jig having a guide hole having a position, depth, and angle that does not pierce the lower jaw and does not pierce the mandibular canal is produced. In this case as well, as in the first embodiment, the prosthetic implant is screwed (planted) directly into the substantial model, and the pipe is fitted to this to take an impression, and the pipe is removed from the impression to form a guide hole. To make a jig.
[0028]
Thus, as shown in FIG. 5, the guide hole facing the safe portion near the top of the alveolar bone AL between the second molar M2 and the second premolar B2 on both sides of the defect (M1) in FIG. A prosthetic implant planting jig 5A on which 6A is formed is produced. Since the implant implantation jig 5A can be accurately restored to the patient's teeth by simply fitting the produced implant implantation jig 5A to the teeth and jaw ridge including the patient's occlusal surface, the guide hole From 6A, it is possible to drill in a safe part of the alveolar bone AL of the patient. Thereafter, as shown in FIG. 4, the prosthetic implant 18 is screwed into the drilling hole 22 to complete the implantation of the prosthetic implant 18. With this prosthetic implant 18 as a base, a prosthesis 24 such as a crown or a bridge is mounted.
[0029]
As described above, in the case of the prosthetic implant 18, similarly to the above-described orthodontic implant 16, the drill and the anatomical structure of the teeth and jawbone are affected by drilling using the implant setting jig 5 </ b> A. It can be planted accurately and easily in a safe area that does not give any damage.
[0030]
In each of the above embodiments, the implant is directly screwed (planted) into the body model, and the impression is taken after fitting the pipe into it, and the jig is made by removing the pipe from the impression and forming a guide hole. However, based on the three-dimensional data showing the external and internal shapes of the patient's teeth and jawbone, a drilling hole is formed in a safe part of the alveolar bone on the computer, and the drilling hole is simultaneously created when creating the solid model. After producing and taking an impression of a solid model, a guide hole may be formed in an impression (jig) based on this drilling hole.
[0031]
【The invention's effect】
According to the present invention, a solid model that accurately reproduces the external and internal shapes of the patient's teeth and jawbone is prepared, and the impression of the external shape of the teeth and the jaw crest, including the occlusal surface, obtained from the solid model is obtained. An implant placement jig having a guide hole for guiding the placement of the implant so as to hold it and not to affect the anatomical structure of the teeth and jawbone is prepared. Therefore, when implanting an implant on a patient's teeth, it can be accurately restored to the patient's teeth and through the guide hole, the implant is safe and does not affect the anatomical structures of the teeth and jawbone It is possible to easily produce an implant planting jig that can be accurately planted on a site.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a method for producing an implant planting jig according to a first embodiment of the present invention.
FIG. 2 is a side view showing a part of a patient's jaw.
FIGS. 3A to 3C are perspective views showing a solid model and an implant planting jig according to the first embodiment. FIGS.
FIG. 4 is a side view showing a part of a lower jaw of a patient.
FIG. 5 is a perspective view showing an implant planting jig according to a second embodiment.
[Explanation of symbols]
2 ... Solid model 5, 5A ... Jig for implant implantation, 6, 6A ... Guide hole, 16 ... Orthodontic implant, 18 ... Prosthetic implant, S1 ... External shape acquisition step, S2 ... Internal shape acquisition step, S3 ... Synthesis process, S4 ... Model production process, S5 ... Jig production process.

Claims (2)

An external shape acquisition step in which the external shape of the impression model reproducing the patient's teeth and ridge is obtained in a non-contact manner by a three-dimensional measuring device using light irradiation and converted into three-dimensional electronic data;
An internal shape acquisition step of determining the internal shape of the patient's teeth and jawbone in a non-contact manner by means of a computed tomography apparatus (CT) and converting it into three-dimensional electronic data;
A synthesis step of synthesizing the three-dimensional data obtained from the external shape acquisition step and the internal shape acquisition step;
Based on the synthesized three-dimensional data, a model creation process for creating a solid model representing the external and internal shapes of the patient's teeth and jawbone,
A jig used when implanting an implant, having an impression of the external shape of a tooth and a ridge including an occlusal surface taken from the entity model, and the entity model or the synthesized three-dimensional data A jig preparation step for producing an implant planting jig having a guide hole for guiding the implantation of the implant so as not to affect the anatomical structure of the teeth and jawbone,
A method for producing an implant planting jig comprising: A jig created based on a solid model or three-dimensional data representing the external and internal shapes of the patient 's teeth and jawbone,
Have the impression of the external shape of the tooth and alveolar ridge including occlusal surface of the patient, Chi lifting the guide hole for guiding the plant standing orthodontic implant so as not to affect the anatomical structures of teeth and jaw bone, The guide hole is a jig for implant implantation facing the alveolar bone between two adjacent teeth .

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