JP4468871B2 - Dental care support method and system - Google Patents

Description

  The present invention enables a member dentist to explain a patient's occlusion and / or disease status through a monitor, and allows the patient to understand past / present / future occlusion and / or disease status and treatment plan and risk for it. In addition, the present invention relates to a dental care support method and system capable of receiving treatment after understanding.

Conventionally, the field of dentistry includes preservation, prosthesis, periodontal, orthodontics, internal jaw disorders, and the like. For example, orthodontic dentistry will be described as an example of the prior art.
Align Technology Inc. (ALIGN TECHNOLOGY INC. USA) provides video information to dentists by connecting terminals owned by dentists and servers that provide predetermined services through communication networks such as the Internet. There is an invisa line to be provided ("INVISALIGN" product name) and video information provided accompanying it. The invisa line is a transparent plate-like orthodontic attachment device that is directly attached to the dentition in the oral cavity and moves the teeth little by little over a long period of time to finally obtain a beautiful tooth arrangement. The server virtually creates a transparent plate-shaped orthodontic appliance for each patient and applies it to the images obtained by CT scanning from each patient's dentition model to determine the movement of the teeth. Process the process. And after producing this as many kinds of variations, it is transmitted from the server to the terminal owned by each dentist.

  In this system, the digital information transmitted to the terminal owned by the dentist can be displayed as an image on the monitor, and the moving image can be recognized visually by rotating or shortening the time and moving the teeth step by step. Provide as information. The company that manages the system manufactures transparent plates according to orders from dentists, drops plate-shaped orthodontic appliances (“Invisaline” product name) as image information into the CAD-CAM process, A plate for use is cut out, polymerized and sanitized, and mailed to each dentist. Note that programming can be easily changed by transmitting information from the terminal owned by the dentist to the server as information on the movement of the teeth when actually attached to the patient. If it is determined that the transmitted tooth movement is different from the planned movement, it can be appropriately corrected by, for example, producing a new plate for correcting the movement.

  On the other hand, three-dimensional panoramas, cephalos, etc. are manufactured and sold by several dental manufacturers. Yokogawa Materials Co., Ltd. sells a navigation system that can image implant procedures on a personal computer. A similar, inexpensive and compact implant placement surgical navigation system, the “Artma Virtual Implant System” is available from Baumgartner & Rath GmbH, Germany (CT images). Can be used to navigate implant placement in real time, and panoramic radiographs can simulate the distance to the lower alveolar canal and maxillary sinus. Then, it is taken into a computer and constructed into a three-dimensional image, and a treatment plan is made while examining the condition of the bone and the implantation position with the three-dimensional image. The actual operation is performed in the handpiece and the oral cavity. While tracking the positional relationship of each attached sensor with infrared, In this device, surgery can be performed while synchronizing with the treatment plan on the screen.This device can simulate the implant placement depth and mesial / centrifugal angle from a single panoramic photograph. Using this device, it is possible to perform a preliminary examination with a panoramic X-ray before taking a CT, and this device can be operated while communicating with a remote dentist by an attached web camera. It is also possible to communicate with a dental technician about the prosthetic plan, which is not approved in Japan, but is gaining attention among clinical dentists.

As patent documents related to the present invention, Japanese Patent Laid-Open Nos. 2000-20633 and 2004-24639 have been discovered.
The invention described in Japanese Patent Application Laid-Open No. 2000-20633 allows the patient to easily understand the treatment method by using the explanation method according to the patient's temperament, and is convinced of the treatment by the treatment method that the patient thinks best. In the explanation when selecting one treatment method from a plurality of treatment methods, the temperament of the patient is classified according to a predetermined method, and an explanation corresponding to this classification is provided. In addition, the present invention relates to an explanation method for selecting a treatment method characterized by sequentially explaining by visual means and / or auditory means. The present invention accumulates a plurality of treatment means as a plurality of explanations classified according to a predetermined temperament, a selection means for selecting a corresponding temperament from the explanations according to a plurality of temperaments, and an explanation means selected by the selection means. It is an explanation system for selecting a treatment method, characterized by adding transmission means for transmission by auditory means and / or visual means, and if necessary, tactile means (see FIG. 14).

Prior to this invention, it was common for doctors or assistants to explain treatment policies in dentistry and medical departments to patients based on printed matter, graphics, and the like. And the patient actually listened to the explanation and the fact was that there was no option than to agree with the doctor's recommendation.
However, in such explanation methods and contents, there are many technical explanations, insurance coverage, necessary treatment costs are the limit of understanding, treatment methods that can be received and their benefits, methods for preventing illness, etc. Compared to treatment methods, there are many contents beyond understanding even if explained, and it was normal to follow the explanations of doctors without fully understanding.
Although it is known that the degree of understanding varies greatly depending on the patient's temperament, etc., the fact is that little consideration has been given to selecting an explanation method depending on the temperament.

  The invention described in Japanese Patent Application Laid-Open No. 2004-24639 provides appropriate medical information by image / sound to a patient seated in a dental medical unit. An image display device 120 to be provided; a display control computer 130 for controlling a display image of the image display device 120 corresponding to a patient seated on the dental care unit 110; and detecting that the patient is seated on the dental care unit 110; The present invention relates to a dental care system comprising: a patient detection unit 111 that outputs to a display control computer 130; and an image selection unit 125 that enables a patient to select a display image displayed by the image display device 120 ( FIG. 15).

  In dental practice, patient anxiety is significant, and recently, the need for patient explanations regarding medical care and treatment content, so-called informed consent has been recognized. Therefore, every time a doctor accepts a patient, he / she presents general explanatory materials and individual patient materials to explain the progress of treatment and future treatment methods. In this explanation, the patient's intraoral image is also displayed on the monitor.

  However, in the explanation for the first visit patient, it is necessary to make the main complaint of the patient and judgment of injury from the questionnaire, prepare appropriate explanation materials, and in the case of a reexamination patient, Since it was necessary to prepare treatment materials after judging the course of treatment, preparation of the materials was complicated and time consuming.

On the other hand, the patient feels anxiety during the waiting time until the start of medical treatment, the waiting time for anesthesia, and the waiting time for equipment preparation after being guided to and seated by the medical unit. It was hoped to do.
The invention described in Japanese Patent Laid-Open No. 2004-24639 has been made in consideration of such problems, and by providing appropriate medical information with images and sounds to a patient seated in a dental medical unit, We provide a dental care system that can eliminate the complexity of treatment and the anxiety of patients.

JP 2000-20633 A JP 2004-24639 A

  In the case of the invisa line provided by the Align Technology Inc. and the video information provided accompanying it, a virtual plate-shaped orthodontic appliance for each patient is virtually created and each patient's teeth are created. It can be applied to images obtained by CT scanning from a row model, and the process of determining tooth movement can be viewed as an image. Therefore, dentists and patients can fully recognize the patient's current disease status and what happens when they purchase and apply the invisa line, and understand the content dramatically compared to the past and As such, it has the advantage that it can be taken with peace of mind about the treatment and its consequences.

  However, in this prior art, information is exchanged only from the viewpoint of correction, so even if the desired dentition with the desired clean teeth can be obtained as a result of treatment, the basic role of the teeth and mouth The current situation is that there has not been sufficient examination of food chewing, that is, occlusion of the upper and lower dentition. In other words, the patient's dentition to which the invisa line is applied is numerically calculated as a model from the hinge point centered on the standard condylar axis of the maxilla and mandible, and the occlusion is treated separately if necessary The method was taken. Therefore, the invisaline orthodontic device has received a great response because it has excellent aesthetics that can be removed from the one that moves the tooth while adhering and fixing to the tooth as before, and it has been installed. It can be said that it is a breakthrough treatment system in terms of hygiene that can be eaten as is. However, it is difficult to say that plates made using this system are based on models that are defective in functionality, and therefore based on authentic information. It is just a system that can be used only to realize the treatment plan desired by the doctor, that is, the beautiful dentition.

  Also, 3D panoramas, cephalos and the like require a large computer, and therefore the space and cost are considerably large. Therefore, it is not easy to install in an individual dental clinic, and it is difficult to say that precious equipment is being used effectively. Although these devices are devices that can visualize and image the patient's oral cavity in three dimensions, their use depends largely on the skills of individual dentists, and since this device is used, occlusion is achieved. The system does not provide any information that suggests how to improve the system automatically or suggests it.

  In the case of the navigation system of Yokogawa Materials, Inc. and Altoma Virtual Implant System, the use of intraoral images related to the patient depends on the skills of the individual dentist, and the patient's accurate and objective The current situation is that it does not contribute substantially to comprehensive diagnosis.

  The invention described in Japanese Patent Application Laid-Open No. 2000-20633 allows the patient to easily understand the treatment method by using the explanation method according to the patient's temperament, and is convinced of the treatment by the treatment method that the patient thinks best. Although it has the advantage that the patient can fully understand the treatment methods that can be received and their benefits, methods for preventing morbidity, comparison with other treatment methods, etc. It only presupposes the traditional dental treatment that depends on the dentist's arm. Therefore, if it is a prosthesis, it is treated for the problem of correction if it is orthodontic, and the basic role of the teeth and mouth is mastication of food, that is, the occlusion of the upper and lower dentition is sufficient. The point not examined is the same in the present invention.

  The invention described in Japanese Patent Application Laid-Open No. 2004-24639 provides appropriate medical information by image / sound to a patient seated in a dental medical unit. By providing the patient with appropriate medical and medical information during the time, waiting time for anesthesia, and equipment preparation, it is possible to eliminate the complexity of the procedure and the patient's anxiety. Although it has an advantage, the actual treatment has the same problems as the invention described in Japanese Patent Application Laid-Open No. 2000-20633 in that it depends on the dentist's arm.

  On the other hand, the appearance of a face to a person is very important. The face that embodies one's own image has a great influence on the patient's quality of life as a more beautiful appearance has been demanded. The purpose of orthodontic treatment is to improve abnormalities in the jaw function, dentition, and maxillofacial morphology and ensure oral hygiene, as well as the physical and psychological aspects of the patient. It is also about restoring, maintaining and improving health. Therefore, it is very advantageous if a more accurate dentition can be obtained after sufficient examination of the occlusion of the upper and lower dentitions.

  The present invention has been made in consideration of such problems, and it is said that the present invention is based on the premise after thorough examination even if it is not said that it has been left behind. Dental treatment support method capable of urging treatment by comprehensive diagnosis based on the upper and lower dentition and jaw bone information of patients obtained in connection with general medical treatment of dental treatment, and gill bite and disease factors resulting therefrom The purpose is to provide a system.

  The present invention solves the above-mentioned problems of the prior art. The invention according to claim 1 enables a member dentist to explain a patient's occlusion situation and disease state through a monitor, It is a dental care support method that allows you to receive a treatment act after understanding and understanding the future bite status, disease status and treatment plan and risk for it. Step of connecting, 3D digital image information (X-ray photograph, Cephalo, MRI, dental panoramic photograph, etc.) or dental radiograph (dental panorama, Cephalo, etc.), dental CT including the patient's maxilla and mandible Transmitting the patient information including the two-dimensional image information of the head including the information from the member dentist's terminal to the server via the communication network; In this case, a three-dimensional digital image of the dentition including the patient's maxilla and mandible is formed from the transmitted patient information, and the twin stage method is virtually executed on the three-dimensional digital image, thereby the patient himself Classifying the potential problems related to the current occlusal situation of the patient and the image processing by compressing the expected progress when the treatment is performed, and pre-classifying according to the disease situation specified for general dental practice Selecting an organized therapy and a jig to be used for the therapy, virtually performing it on the patient's three-dimensional digital image, and compressing the expected course of time to perform image processing; From the server to the member dentist's terminal, the patient's current occlusion situation and / or the specified disease situation, the treatment method implemented in accordance therewith and the jig used for the treatment method The step of transmitting information on the image processing about the use effect, and the dentist explaining the information transmitted from the server to the monitor to the patient in a state that can be recognized at the visual level in the member dentist's terminal And a dental care support method comprising the steps of enabling.

  The member dentist's terminal and the server are connected by a communication network, and three-dimensional digital image information (X-ray photograph, Cephalo, MRI, dentition panorama photograph, etc.) of the dentition including the patient's maxilla and mandible or X-ray photograph (dental Patient information consisting of two-dimensional image information of the head including the column panorama, cephalo, etc., and dental CT is transmitted from the member dentist's terminal to the server via the communication network. When the three-dimensional digital image information is transmitted, the server uses the image information as it is to construct a three-dimensional digital image of the patient. When other information such as X-ray photographs, cephalos, dentition panoramic photographs, dental CT, etc. are transmitted after being processed into various forms such as digital data after being read by a scanner as image information Then, a three-dimensional digital image of the dentition including the patient's maxilla and mandible is constructed using predetermined software on the server side.

  The feature of the present invention is that these image information that has been transmitted as a problem in general dental practice is used, and a potential problem regarding the occlusal situation simultaneously with or in preference to the problem in general dental practice. The point is that the treatment method and image processing are performed by compressing the time expected when the treatment is performed. Therefore, it is possible to remove the bite and the morbidity factor resulting from the problem by the time when the problems caused in the general dental practice are completely cured by the treatment. In other words, the twin stage method is virtually executed on this three-dimensional digital image built in the server, and thereby, potential problems regarding the current occlusion situation of the patient himself, the treatment method thereof, and the implementation thereof. In this case, the expected progress is time-compressed and image processing is performed. Various models are manufactured and sold by various companies as actual tools for implementing the twin stage method. In the present invention, a virtual tool that is digitized so as to be processed on a computer is used. Specifically, the virtual tool of the twin hobby articulator is virtually applied to a three-dimensional digital image of a dentition including the patient's maxilla and mandible.

Similarly, for a disease specified for general dental practice, an appropriate treatment method and a jig used for the treatment method are selected from treatment methods classified and arranged in advance according to the disease state. The jig used here is also a virtual tool obtained by digitizing the real thing. Using this virtual tool, a treatment method is virtually performed on a three-dimensional digital image of a patient, and the progress and expected progress are time-compressed and image processing is performed.
Information regarding image processing regarding the current occlusion situation and / or specified disease situation of the patient obtained in this way, the treatment method performed in accordance therewith, and the effect of using the jig used in the treatment method, and Is transmitted from the server to the member dentist's terminal via the communication network. The information in this case is digitally processed electronic data.
Then, the dentist will explain on the member dentist terminal side while copying the information transmitted from the server to the monitor to the patient in a state where it can be recognized at the visual level.

  The invention according to claim 2 solves the above-mentioned problems of the prior art, and a three-dimensional digital image of a dentition including a patient's upper and lower jaw bones formed in a server is based on the cusp inclination angle of the tooth. The dental care support method according to claim 1, wherein the dental care support method is formed.

  Recent electronic measurements and kinematic analyzes have revealed that the molar dislocation is composed of three factors: condylar tract, incisor tract, and cusp inclination. Of these, the condylar path, which is the first factor, has been inherently unique to the living body and has not been changed. However, the condyle path is blurred due to the difference between the forward path and the return path (return path), and it is clear that the influence on the amount of posterior separation is relatively small, about one-third compared to the incisal path and cusp angle. Became. Traditionally, the condyle path has been emphasized as a standard for occlusion. And although it was measured by a pantogram and reproduced on a fully-adjustable articulator, it was a natural consequence that the effort to reproduce the molar occlusion was not rewarded. According to recent electronic measurement data, the second factor, the incisal tract, has been found to vary greatly between individuals and cannot serve as a standard for occlusion. The third factor, the tilt angle of the cusp, has not been studied in prosthetic dentistry. However, anatomically measured occlusal surface data by the moire method (Sekikawa et al., 1983 “Stereoscopic measurement of the first mandibular first occlusal surface of the Japanese mandible,” 25: 737-744) As a result of analysis, it was found that the inclination angle of the cusp has very little variation, and it has four times the reliability compared to the condylar path with blur and the incisal path with variation. As a result, it is concluded that the standard for new occlusion in prosthetic clinics is not the condylar or incisal tract, but the standard value of the cusp inclination angle of natural molars with little variation from a developmental point of view. Yes. Also in the present invention, a three-dimensional digital image of a dentition including the patient's upper and lower jawbones is formed on the basis of the cusp inclination angle of the teeth.

  The invention described in claim 3 solves the above-mentioned problems of the prior art, and is a treatment virtually implemented on a three-dimensional digital image of a dentition including a patient's maxilla and mandible formed in a server. The dental care support method according to claim 1 or 2, wherein the instrument is a twin hobby articulator.

  As for the twin stage method, immediately after its development, “how to give treatment occlusion (in temporomandibular joint treatment) using a twin hobby articulator (manufactured by Shioda Co., Ltd., sold by Morita Co., Ltd.)” and “new concept” Since various reports have been made, such as “PARCO system using provisional restoration by”, and the ratio in general distribution is large, in the present invention, 3 of the dentition including the patient's maxilla and mandible A virtual tool of a twin hobby articulator was used as a jig that is virtually implemented on a three-dimensional digital image.

  The invention according to claim 4 solves the above-mentioned problems of the prior art, and the server stores data for each member dentist and / or patient and makes the data available as necessary. The dental care support method according to any one of claims 1 to 3, wherein the dental care support method is provided.

  The invention according to claim 5 solves the above-mentioned problems of the prior art, and virtually executes the twin stage method on the three-dimensional digital image, thereby enabling the potential regarding the current occlusion situation of the patient. In the step of performing image processing by temporally compressing the problems that are expected to occur and the treatment method when the problem is implemented, the dentition and / or facial morphology is taken into account.

  The invention according to claim 6 solves the above-described problems of the prior art, and is a dental care support system in which a plurality of member dentist terminals and a server are connected by a communication network such as the Internet, The server can store 3D digital image information (X-rays, cephalos, MRI, dentition panorama, etc.), X-rays (dental panorama, cephalos, etc.) and dental CT Including patient information consisting of two-dimensional captured image information of the head from the member dentist's terminal via the communication network, and the patient's current occlusion status and / or identified disease status, in response Digital data transmission / reception means for transmitting image processing information about the treatment method to be performed and the effect of using the jig used in the treatment method; for member dentists 3D digital image forming means for forming a 3D digital image of a dentition including a patient's maxilla and mandible from patient information transmitted from the end, and a twin for virtually executing the twin stage method on the 3D digital image Stage method virtual implementation means, occlusion problem identification means for identifying potential problems related to the current occlusion situation of the patient, occlusion treatment selection means for selecting the treatment method, and 3D digital image of the patient Occlusal treatment virtual implementation means that compresses the image of the expected progress when the treatment method is performed, image processing, disease identification means that identifies the disease status discovered in relation to the patient's general dental practice, patient's general dentistry Disease treatment method selection means for selecting an appropriate treatment method from treatment methods classified and arranged in advance for each disease state discovered in relation to medical treatment, and 3D data of the patient A CPU provided with a disease treatment method virtual execution means for performing image processing by temporally compressing an expected progress when the treatment method is performed on a tall image; and a virtual treatment used when the twin stage method is executed Digital data of tools, data on the types of problems related to biting, digital data on virtual treatment tools according to the problems related to biting, data on types of disease states discovered in general dental practice of patients, general dental care And a recording means storing various arithmetic programs, and a dental treatment support system configured to include:

  The invention according to claim 7 solves the above-described problems of the prior art, and the three-dimensional digital image forming means includes a three-dimensional digital image of a dentition including the upper and lower jaw bones of the patient formed in a server. The dental care support system according to claim 5, wherein the dental care support system is formed on the basis of a cusp inclination angle of a tooth.

  The invention described in claim 8 solves the above-mentioned problems of the prior art, and the twin stage method is virtually applied to a three-dimensional digital image of a dentition including the patient's maxilla and mandible formed in a server. The dental care support system according to claim 5 or 6, wherein the jig for carrying out is a twin hobby articulator.

The invention described in claim 9 solves the above-mentioned problems of the prior art, and the recording device stores data for each member dentist and / or patient and can use the data as necessary. A dental care support system according to any one of claims 5 to 7 is provided.
Invention of Claim 10 solves the subject of the prior art mentioned above, The occlusion problem specific | specification means considers the aesthetics in a dentition and / or a facial form, It is characterized by the above-mentioned. A dental care support system according to any one of -8 is provided.

  The invention described in claim 11 is an invention related to the sub-combination of the invention described in claim 1 described above, and allows the member dentist to explain the patient's own bite status through the monitor, so that the patient can see the past, present, and future. A dental care support method capable of receiving a treatment act after understanding and understanding the bite situation of the patient and the treatment plan and risk for the bite, and connecting the member dentist terminal and the server via a communication network; and , 3D digital image information (X-ray, Cephalo, MRI, dental panorama, etc.) or X-ray image (dental panorama, Cephalo, etc.) of the dentition including the patient's maxilla and mandible, head including dental CT Transmitting the patient information including the two-dimensional image information of the member dentist's terminal to the server via the communication network, and the server , A three-dimensional digital image of the dentition including the patient's maxilla and mandible is formed from the transmitted patient information, and the twin stage method is virtually performed on the three-dimensional digital image, thereby A time-compressed image processing of the potential problems related to the current occlusal situation, the treatment method and the expected course of the treatment, and the server to the member dentist terminal. The step of transmitting information on the current occlusion status and the dentist explaining the image information transmitted from the server to the monitor in a state that can be recognized at the visual level in the member dentist's terminal. And a dental care support method comprising the steps of enabling.

  The invention described in claim 12 is an invention related to the sub-combination of the invention described in claim 5 described above, and a dental care support system in which a plurality of member dentist terminals and a server are connected by a communication network such as the Internet. The server can store 3D digital image information of the dentition including the patient's maxilla and mandible (X-ray photograph, cephalo, MRI, dentition panorama photograph, etc.) or radiograph (dental panorama, cephalo etc.), dental Patient information consisting of two-dimensional image information of the head including CT for the patient is received from the member dentist's terminal via the communication network, and there are potential problems related to the current occlusal situation of the patient, and its treatment method And digital data transmission / reception means for transmitting image processing information about the effects of using the jig used in the treatment method; Three-dimensional digital image forming means for forming a three-dimensional digital image of a dentition including the patient's upper and lower jaw bones from the transmitted patient information, and a twin stage method for virtually executing the twin stage method on the three-dimensional digital image Virtual implementation means, occlusion problem identification means for identifying potential problems related to the current occlusion situation of the patient, occlusion treatment selection means for selecting the treatment method, and three-dimensional digital image of the patient A CPU provided with an occlusal treatment method virtual execution means for performing image processing by compressing the expected progress when the treatment method is performed; and digital data of a virtual jig used when performing the twin stage method, bite Data on the types of problems related to alignment, digital data of virtual treatment devices according to problems related to biting, and various calculation programs Providing dental support system is configured to include a; and accumulated recording means.

  Using image information obtained in connection with general dental care, potential problems regarding the occlusal situation, the treatment method, and the treatment method at the same time as or prior to the problem related to general dental treatment. Treatment can be promoted by performing time-compressed image processing on an expected progress when it is carried out and providing this to the terminal for the member dentist. Therefore, it is possible to remove the bite and the morbidity factor resulting from the problem by the time when the problems caused in the general dental practice are completely cured by the treatment. This has the advantage that the patient can be treated with an understanding and understanding of past, present and future bite and / or disease conditions and treatment plans and risks associated therewith.

Hereinafter, a dental care support method and system according to the present invention will be described in detail with reference to the drawings.
FIG. 1 is a schematic view of an embodiment of a dental care support method according to the present invention.

  The illustrated dental care support method according to the present invention generally includes a step (step 1) of connecting a member dentist's terminal and a server via a communication network, and patient information via the communication network as a member dentist. Transmitting to the server from the terminal for use (step 2), and forming a 3D digital image of the patient in the server and visualizing the case where the twin stage method is virtually performed on the 3D digital image (Step 3), a step (Step 4) of visualizing a case where a predetermined treatment method is performed even for a disease state specified for general dental practice (Step 4), and the obtained video information from the server to a member dentist Transmitting to the terminal for use via the communication network (step 5), and at the member dentist terminal, the dentist sends the patient Is configured to include a step (step 6) to allow explained Projected monitoring the image information visually level to.

There are two types of patient information in Step 2; three-dimensional digital image information of the dentition including the patient's upper and lower jaw bones, and other forms such as X-ray photographs, cephalos, dental CT, and dentition panoramic photographs. Exists (see FIG. 2). Therefore, it is determined which type of information (step 2a), and when the 3D digital image information is transmitted, the server uses the image information as it is to obtain the 3D digital image of the patient. Build (step 3c). In determining which type of information, for example, in the case of three-dimensional digital image information, predetermined code information in the image information is given, and whether or not the code information exists in the server It can comprise so that it may judge by detecting.
However, in order to send the three-dimensional digital image information, the member dentist as the transmission source needs to have an expensive three-dimensional digital image photographing device. Rather, the dental care support method is characterized in that even a member dentist who cannot afford such a device can obtain information equivalent to or higher than that of the member dentist. Therefore, in many cases, the transmitted patient information includes patient information obtained by equipment already provided as equipment by many member dentists, for example, X-ray photographs, cephalos, dentition panoramic photographs, dental use CT etc. Such patient information includes X-ray photographs and panoramic photographs, digital data obtained by reading them with a scanner, digital X-ray photographing apparatus, digital dental panoramic photographing apparatus, cephalo, or The data is transmitted from the member dentist's terminal to the server in various forms such as electronic data of images taken by the dental CT. As described above, when the transmitted patient information is transmitted in a form other than the three-dimensional digital image information, predetermined software is started on the server side (step 2b), and the upper and lower sides of the patient are used by using this software. A three-dimensional digital image of the dentition including the jawbone is constructed (step 2c).

  In step 3, predetermined software is called from the recording device, and is started and executed (step 3a). First, the software calls a virtual tool for virtually executing the twin stage method, for example, a virtual tool that converts the twin hobby articulator into electronic data (step 3b), and this is executed by the patient constructed in the server. The twin stage method is virtually executed by applying to a three-dimensional digital image (step 3c). As a result, potential problems related to the current occlusal situation of the patient and the expected progress when the treatment is performed are time-compressed and image processed (step 3d). As described above, each function means can call up predetermined software from the recording device each time and start up and execute it, or it can be built in the CPU with a single software. Of course, it can also be set.

  Various models are manufactured and sold by various companies as actual tools for carrying out the twin stage method, and many dentists have already used experience. In the present invention, any articulator capable of adjusting the condyle path and the incisal path can be used, but it is used as an electronic virtual tool so that it can be processed on a computer. Specifically, the virtual tool of the twin hobby articulator is virtually applied to a three-dimensional digital image of a dentition including the patient's maxilla and mandible.

  Here, regarding the clinical method of the twin stage method, first, an outline will be described, and then each step will be described in detail. As described above, in the present invention, the actual twin hobby articulator is not used, but it is digitized so that it can be processed on a computer and used as a virtual tool. It is the same as that of the twin hobby articulator. Therefore, how to use an actual twin hobby articulator will be described here.

  The clinical procedure of the twin stage method is to adjust the twin hobby articulator to “Condition 1” in the first step and give the standard cusp inclination angle by waxing the posterior cusp form to fully balanced occlusion In the second step, the twin hobby articulator is adjusted to “Condition 2” to provide anterior guidance of the reference angle (Anterior Guidance) (Table 1, FIG. 5). Thus, a two-stage system is used to express a standard molar separation amount. In the illustrated preferred embodiment, the twin stage method is further modified by adding two steps. In the third step of this embodiment, the upper and lower jaw models were rotated 180 degrees and mounted on a twin hobby articulator adjusted to “Condition 3” in Table 2 upside down (limited to metal thin type rings). Furthermore, in the fourth step, in order to reproduce the original backward movement, the upper and lower jaw models were returned to the original, and the adjustment values of the condylar tract inclination angle and the incisor guidance plate inclination angle were changed. As the articulator used in this step, the Gilbach articulator (sold by Hakusui Trading Co., Ltd.) is the articulator with the most reproducible function at present, but there is a limit to the reproduction of the backward movement. Accordingly, the present inventor has discovered that the “condition 4” of the fourth step can be reproduced by improving the twin hobby articulator, and filed a patent application (Japanese Patent Application Laid-Open No. 2004-136072). Therefore, the dental articulator according to Japanese Patent Application Laid-Open No. 2004-136072 can be used in this step.

  The reason why the third step and the fourth step were added to the conventional twin stage method and amended was the result of more than 450 clinical trials, adjustment by the conventional twin stage method, and comprehensive treatment for all teeth. This is because it has been found that there is a risk of temporomandibular joint injuries (clicks) occurring on the side matched with the forward movement of Condition 1. Then, the correspondence was examined, and the reference value of the angle of the posterior guidance (posterial guidance) of the last molar expressed in Condition 3 (Table 2) and Condition 4 (Table 4) was derived. Table 3 shows that the posterior cusp inclination angle can be reproduced at 45 ° and 35 °.

Subsequently, each step will be described in detail.
First step (Condition 1) is provision of molar cusp inclination (Table 1, FIG. 4 (b)). First, as an adjustment value of Condition 1, sagittal condyle inclination angle is 25 °, Bennett angle ( Horizontal lateral condyle path angle) is set to 15 °. Further, the sagittal incision guide plate is adjusted to have a sagittal inclination angle of 25 ° and a side wing angle of 10 °. In the twin hobby articulator, the adjustment value of Condition 1 is printed with a red mark (hereinafter referred to as red).
At that time, the front tooth part of either dentition model of the upper or lower jaw is made in a removable structure in advance, and this is removed to be in a state of “no front tooth guidance (no front tooth)”.
The molar part is waxed to reproduce the balanced occlusion occlusion pattern so that the upper and lower molars slide evenly during the eccentric movement. As a result, an occlusal surface having a standard cusp inclination angle is obtained.

In the second step (condition 2), anterior guidance (anterior guidance) is given (Table 1, FIG. 5). First, as an adjustment value, the sagittal condylar inclination angle is 40 ° and the Bennett angle (condition 1). Is set to 15 °. Moreover, the sagittal inclination angle of the saddle-shaped incisor guidance plate is adjusted to 45 °, and the side wing angle is adjusted to 20 °. In the twin hobby articulator, the adjustment value of Condition 2 is printed with a blue mark (hereinafter referred to as blue).
The front tooth part is attached to the dentition model, and the state is “with front tooth guidance (with front tooth)”.
In the case of having a normal cover, the palatal surface of the maxillary front tooth is waxed so that the upper and lower jaw incisors slide in contact with each other in the forward movement and the working side upper and lower canines in the lateral movement. This provides ideal anterior guidance and a standard amount of molar separation. Incidentally, the standard value of the amount of molar separation in the twin stage method is 1.0 mm in the forward motion, 1.0 mm on the non-working side of the side motion, and 0.5 mm on the working side.

The third step (Condition 3) is the provision of the last molar guide (posterial guidance) (Table 2, Fig. 6). As the adjustment values for Condition 3, the sagittal condylar inclination angle is 40 ° and the Bennett angle Is set to 15 °. Further, the sagittal inclination angle of the metal saddle-shaped incisor guidance plate is adjusted to 48 ° and the side blade angle is adjusted to 25 °.
Remove the front teeth of the removable model and replace the upper and lower jaw models upside down and upside down ("no front teeth", "with the last molar").
It is determined whether or not the last molar slides in contact. This is a reproduction of the movement of the posterior molar anterior region and the posterior molar lateral region on the drawing. As shown in FIGS. 7A to 7C, the posterior molar guide can be divided into a forward motion region and a backward motion region in the sagittal plane.

  The fourth step (Condition 4) is the provision of posterior molar guidance (Table 5, FIGS. 7 (a) to (c)), but the original guide surface when the condyle is guided posteriorly is the rearmost. Reproduced in molars. This is condition 4. On the other hand, as described above, there is no reliable articulator. However, in order to solve this problem, the present inventor improved a twin hobby articulator (Japanese Patent Laid-Open No. 2004-136072). ) Can be used.

  Steps 3a to 3d are steps for performing image processing on a computer after shortening the time after using the twin stage method as described above with a virtual tool. Such digitized data is once recorded in a recording device.

  Next, a problem that the patient sent from the member dentist's terminal has with regard to occlusion is identified from the image obtained by virtually executing the above-described twin stage method. By launching predetermined software from the recording device, a problem identifying means for biting is created in the CPU. The occlusal problem specifying means specifies the classification into which the patient's occlusion is classified from the classification of the occlusion situation recorded in the recording device and the problem database peculiar to the classification. In the problem database, an effective treatment method and treatment jig data used for the treatment method are recorded in association with each problem.

FIG. 11 shows treatment methods according to the bite status of patients diagnosed by the twin stage method.
Then, predetermined software is started up, and occlusion treatment selection means is created in the CPU. The occlusal treatment method selecting means is one treatment method, and if there are a plurality of treatment methods, the treatment method (or treatment virtual jig with the highest priority among the treatment methods according to the patient's occlusion situation). ) In order. For example, an appropriate one is selected by inputting the conditions of a university / specialized dentist, patient, or member dentist who has a contract with the server administrator. And the occlusal treatment method virtual execution means created in the CPU is expected when the treatment method is executed virtually on the three-dimensional digital image of the patient constructed in the server. The image is processed with time compression.

Next, the method of guiding the lower jaw to the proper occlusal position will be described by taking the case of jaw position guidance by sprinting as an example.
When performing occlusal diagnosis by applying the twin stage method, in cases where the jaw position is unstable, such as temporomandibular joint injuries or low-level occlusions, the jaw position may be guided to the appropriate occlusal position by sprinting in advance. is necessary. The inventor of the present invention has theoretically considered “Onset process of temporomandibular joint internal injury (FIG. 8)” (Hoyasu Yaya Kan, Takayama Toshio, “Occlusion Studies”, first edition, pages 666--1995, Inspired by Quintessence Publishing), “Sprint jaw position guidance procedure (FIG. 9)” was applied to treatment, and extremely good results were obtained. Therefore, this treatment method can be adopted as one of the treatment methods virtually implemented in order to solve a potential problem related to the current occlusion situation of the patient in the present invention.

Each of the “temporomandibular joint manifestation process (FIG. 8)” related to the above-mentioned Takayama's consideration and the “manual position induction procedure by splint” related to the idea of the present inventor will be briefly described below. Takayama made a biomechanical drawing analysis of the occlusal state of the lower occlusion person, and the mandibular bone centered around the incisal point I as shown in FIG. Hinge Rotation occurs, and as a result, the inclination angle of the anterior wall of the mandible is 54 ° due to the action of the vector force acting on the contact point between the condylar upper end and the anterior wall of the mandible (FIG. 8). A conclusion was drawn that resulted in a posterior superior displacement of the condyle of 1.5-3.0 mm.

With this as a hint, the “procedure for chin position guidance by splint” developed by Ito, the present inventor, is as follows. Conventionally, the first step of prosthetic treatment has been to set or reproduce the "center position or proper condylar position", but this is the "position where the patient bites everyday", that is, the state where there is no sense of incongruity Was the initial goal of treatment. This is presumed to be close to the so-called “cusp fitting position”. On top of that, at the end of the treatment, “the goal was to reach the occlusal position where the upper and lower jaw teeth contact in the largest area. The procedure to reach that final goal is as follows:
(1) Setting of the horizontal reference plane using the golden face division ratio (FIG. 10)
In general, low occlusion cases are adapted for occlusal elevation, but in order to perform occlusal elevation, it is necessary to set the horizontal reference plane and determine the amount of occlusal elevation using the Willis method.
(2) Occlusal lifting using a Michigan sprint (Fig. 9)
For cases where diagnosis by the twin stage method is deemed necessary, raise the bite as follows. However, we refrained from deleting the guides coming from the distal pits of the posterior teeth of the molar part to the marginal ridge (this part is the so-called early contact part, which plays the role of posteria guidance in the posterior molar part. Table 6).

  From the above results, the thickness of the sprint can be set. Next, the manufactured sprint is sequentially attached to the oral cavity and adjusted. The thickness of the occlusal paper actually adjusted is 50-100 μm, and the facet gradually increases toward the back, with the tip of the cusp slightly raised from the premolar to the molar (posterior molar). If the adjustment of observation is performed at intervals of about 5 minutes, a hit occurs from the left and right canines to the canines. This indicates that the mandibular anterior tooth has moved anteriorly and downwardly with the condyle, and the amount of condylar movement when the vicinity of the first and second molars of the mandibular molar is 1 mm higher is It becomes 1.5-3.0 times as an analysis result. The occlusal adjustment usually ends around here.

  Thus, in the method of the present invention, the above-mentioned stent is manufactured from the average value of the special laminating technique and the mandibular movement theory formula. However, as an actual work, there is no jaw model from the three-dimensional digital image of the patient. Also, it can be automatically manufactured by dropping numerical information used in a computer into CAD-CAM. This is expected to dramatically reduce the work of dental technicians. A jig / tool actually manufactured in connection with the method of the present invention, for example, a plate similar to an invisa line, can also be automatically manufactured by dropping predetermined numerical information into CAD-CAM.

  Since the tool for treating a potential problem related to occlusion is also performed on a computer in the same manner as the virtual implementation of the twin stage method, a virtual tool digitized so as to be processed by a computer is used. Specifically, for example, the horizontal reference plane is set on the monitor using the patient's image using the golden section ratio of the face, or the Michigan type sprint is used as the digitized data, and this is converted into the three-dimensional digital of the patient. Video processing is performed by shortening the time when the effect is applied to an image.

  By the way, when the occlusion and the like of the upper and lower dentitions are studied as described above, aesthetics in the dentition and / or face form can be taken into consideration. Normal occlusion not only achieves a beautiful dentition, but also deeply affects the impression of the entire face. This can be determined, for example, based on the longitudinal relationship of the upper and lower first molars. In other words, it can be divided into maxillary protrusion and mandibular protrusion (anteroposterior factor) and overbite and open bite (vertical factor), and these factors are reflected in the patient's three-dimensional digital image to create beautiful teeth. As a result, it becomes possible to acquire a beautiful facial form (appearance).

After the image processing of the potential problems related to occlusion and the treatment method therefor is completed, a disease state related to general dental practice is next identified using a 3D digital image of the patient built in the server.
The primary purpose of the patient information sent from the member dentist's terminal is to identify and treat disease conditions related to general dental care such as storage, correction, and prosthesis. It is specified by a disease specifying means constructed by predetermined software. The identification of disease conditions, selection of treatments, and virtual implementation of treatments in general dental practice basically identify problems related to occlusion, select the treatment method, and select the treatment method. It is exactly the same as the flow of implementation. It can be said that only the contents to be processed are different.

That is, the disease identification means classifies the disease status of the patient from the classification of the disease status related to general dental practice recorded in the recording device and the treatment database for the disease of that category. Is identified. FIG. 12 is a list of treatment methods according to disease states specified by the treatment method database according to disease states.
The introduction to the treatment method will be described. Regarding the prosthesis in FIG. 12, from the altitude of the mandibular movement theory of Takayama, condition 1 (red): molar part (first molar)
Condition 2 (blue): front tooth (canine, side wing angle)
(Incisor: Sagittal Incisor Road Angle)
Condition 3: Anterior region of backward movement From each angle according to each condition, A: contact part and non-contact part in the eccentric position of upper and lower teeth, B: diagnosis from the viewpoint of being higher or lower than a reference value Look at the (space) and look comprehensively. In the contact of A, it is judged that it is fitted, and the maximum shearing effect can be obtained only when the height of B is high, but in the contact state of A and B, wear and discoloration of the teeth , Fracture lines, cracks, and the like. In addition, various oncology such as X-ray, alveolar hard line, periodontal stenosis and the like are observed.

  Regarding non-contact in FIG. 12, if storage is caries and filling treatment, foods that do not satisfy the above-mentioned conditions have food residues and are likely to get caught, for example, the efficiency with which the upper and lower pressures are in contact There is a risk that a significant moment may be applied compared to the good shear force. Therefore, since the masticatory effect and the masticatory force are reduced, the tendency that the mixture of food and saliva is not good and easily becomes caries becomes strong. In other words, the result is that adhesion of plaque, cigarettes, tea astringency, and the like are easily adhered to a reference value or less.

In addition, if the cause of the internal jaw disorder in FIG. 12 is lower than the reference value of condition 3, it often appears as an objective present syndrome and a prominent symptom. In the case of orthodontics, the physical effect of the crown / root ratio even when fitting and building up after the difference in the amount of movement in the eccentric position of the upper and lower teeth exceeds the limit of restoration As long as you deviate from the above, it may happen that you will be forced to rely on surgical procedures. However, even if it can be completely cured only by grinding, it is considered that a partial adhesive coating method using a laminate is also necessary in order to maximize the occlusion (joining) of the opposing relationship in order to heal correctly and correctly. . However, it is desirable that conditions 1 to 3 be sufficiently satisfied even in a low occlusal position. However, if emphasis is placed on the maintenance of the jaw, balanced masticatory power, maxillofacial symmetry, and aesthetic sensation It is considered best to be necessary. The golden section ratio and sprint, correction of corrective force, reinforcement of prosthesis, and the theme of biting are the most essential conditions in preventive dentistry, so Takayama's mandibular movement theory formula is the best from a clinical point of view. It can be asserted that the calculation formula is based on scientific grounds.
Therefore, the disease treatment method selection means constructed in the CPU by the predetermined software is classified into the pre-classified and organized treatment methods and the treatment methods related to the disease state specified from the treatment method database. Select the jig to be used.
Subsequently, the disease treatment method virtual execution means constructed in the CPU virtually executes the virtual tool used for the selected treatment method on the three-dimensional digital image of the patient, and predicts the process. The elapsed time is compressed and processed.

  In step 4, information regarding the current biting status of the patient, information regarding the treatment method and image processing effect regarding the use effect of the jig used in the treatment method are identified and / or specified from the server to the member dentist terminal. Information on the image processing about the disease state, the treatment method implemented in accordance therewith, and the effect of using the jig used in the treatment method is transmitted. Various treatment information supplied to the dentist along with the image information can be attached. It is also possible to include information primarily for the dentist but for the patient.

  In step 5, the member dentist terminal allows the dentist to explain the various information transmitted from the server to the monitor to the patient in a state where it can be recognized at the visual level. As a member dentist's terminal, a general-purpose PC having sufficient processing capability to process a monitor and a moving image, and therefore a PC that can be purchased without difficulty by a general dentist is sufficient.

Next, an embodiment of a dental care support system according to the present invention as a system for carrying out the above-described dental care support method will be described in detail with reference to the drawings.
FIG. 13 is a schematic configuration diagram of an embodiment of a dental care support system according to the present invention.
The dental care support system 1 according to the present invention is generally capable of transmitting and receiving moving image images between the plurality of member dentist terminals 2 and the server 3 and between the plurality of member dentist terminals 2 and the server 3. For example, the communication network 4 such as the Internet is provided. Although not shown in the figure, professional consultation and new diagnostic methods for dental care from dentists, potential problems and treatment methods related to the current occlusal situation of patients, disease status related to general dental care, and treatment methods University hospitals / specialized dentists who are in charge of the development of jigs used for the treatment, or specialized trading companies that manufacture and sell the developed treatment jigs are referred to as so-called attached institutions, and the attached engine terminals are attached to these attached institutions. The system can be tied up by installing the apparatus and connecting it to the server 3 via the communication network 4.

The member dentist's terminal 2 can send and receive image information including moving images and still images, for example, via the communication network 4, and use the transmitted various information (including moving image information) as a monitor. Since it is a general-purpose PC that has the ability to project, and its basic configuration is well known, description thereof is omitted here. The member dentist's terminal 2 creates an electronic medical record including the member dentist's ID number, the member doctor's name, address information for communicating with the server 3, the patient's name, image data as patient information, and other information. The data is recorded and stored in a storage device (not shown) of the member dentist's terminal 2 and transmitted to the server 3. In the server 3, the electronic medical records are sequentially recorded and stored in the recording device 40 as the electronic medical record database 48.
The server 3 includes a communication unit 10 capable of transmitting and receiving image information including moving images and still images via the communication network 4, a CPU 20 for expressing various functional units by executing software (programs), and software And a recording device 40 for recording various data. This system is constructed as a fully automatic system by software, but a monitor and keyboard device (not shown) are installed so that the operator can input / output various data and select as required. You can also

  The communication means 10 is a three-dimensional digital image information (X-ray photograph, cephalo, MRI, dentition panorama photograph, etc.) or an X-ray photograph (dentation panorama, cephalo etc.) of dental dentition including the patient's maxilla and bone, dental CT An electronic medical record including patient information consisting of two-dimensional captured image information of the head including is received from the member dentist's terminal 2 via the communication network 4, and the patient's current occlusion status and / or specified Digital information such as sending information about the image processing when the disease status, the treatment method implemented according to the disease condition, and the effect of using the jig used in the treatment method are virtually implemented to the terminal 2 for the member dentist A data transmitting / receiving device. As patient information transmitted from the member dentist's terminal 2 to the server 3 via the communication network 4, two types of three-dimensional digital image information and other forms of information are assumed. In addition, it can be said that the latter can be used as a feature of the system of the present invention. When determining which type of information is, for example, in the case of 3D digital image information, predetermined code information is given to the image information, and the server 3 has the code information. The determination can be made depending on whether or not to perform, but various methods can be adopted, and the present invention is not limited to this.

  When the three-dimensional digital image information is transmitted, the server 3 uses the image information as it is to start software for forming the three-dimensional digital image forming means 22 stored in the recording device 40, and A 3D digital image of a patient is read as it is to construct a 3D digital image. When other information such as X-ray photographs, cephalos, dentition panoramic photographs, dental CT, etc. are processed after being processed into various forms such as image information or as digital data after being read by a scanner. The three-dimensional digital image forming means 22 is configured to be able to construct a three-dimensional digital image of a dentition including the patient's maxilla and mandible based on such a two-dimensional image.

  The above-mentioned theory of mandibular movement (occupational appendix) of Takayama quantifies the sagittal plane, frontal plane, and horizontal plane, condylar point, incisor point, and tooth cusp inclination values, and the movement and rotational force in each plane. (The equation of motion called three-axis six-degree-of-freedom based on the Eurano theorem). This theoretical formula is calculated by setting the numerical value in the skull within the standard. However, the numerical value of the maxillofacial face is different for each individual. For example, if the teeth are reflected in images such as the upper and lower jaw model, panorama, Cephalo X-ray photograph, and dental CT, there is no upper and lower jaw model. 3D image processing should be able to calculate accurately (Occlusal Appendices Calculation and Takayama's Dissertation (Toshio Takayama, “Kinematic and Experimental Analysis of Human Mandibular Movement for Clinical Applications) Research, The University of Tokyo Degree Review Paper, No. 8203, 1987 ”).

In addition, there are various dentistry reference planes in the cranium. For example, in the past, the front reference point was defined as 43 mm on the Axis plane based on a drawing trace assuming a golden division ratio of 70 mm. However, this is only defined so that the size of the articulator, that is, the size of each patient is different, so the Frankfurt plane or the Axis orbital plane is selected as the reference plane, and the three-dimensional If each numerical value is introduced into the digital image-processed mathematical formula and calculated, using the alpine mandibular movement theory formula, which is a calculation formula with three axes and six degrees of freedom, one by one from the position and angle of each tooth. The three-dimensional cusp inclination angle of the tooth can also be calculated, and can be the basis of comprehensive dentistry.
Based on clinical results using about 700 twin hobby articulators over the past 10 years using the twin stage method, it is possible to save, prosthetic, periodontal, orthodontic, internal jaw disorders, etc. It has been demonstrated that it has a good therapeutic effect on diseases belonging to dental practice. These therapeutic effects have been clarified from many clinical findings such as prognosis determination, and this has been published in the papers and others related to the author's work.
It is the place where Lambert Kessler, a Belgian mathematician and astronomer in 1835, teaches the trend of an entire set with a set standard value. Kessler measured the height of the French soldiers, which could be represented by a regular curve in statistics, indicating that any set of soldiers was within a certain range (beginning of the concept of mean value). Deviations from the average were natural omissions, and small omissions occurred more than big omissions. Diagnosis starts from the fact that a specific reference value (average value) can be set, and it can be said that the insight from many clinical knowledge cases embodies the average factor. A paper with the same purpose is also published in the Journal of Prosthodontic Society (Kawazoe, “Clinical Evidence and Dental Prosthetics”).

As described above, the jaw movement of each patient can be calculated by data processing. Here, the important thing is to select the item that causes the least change as the reference value. In the present invention, to calculate the altitude mandibular movement theory, the most universal of condylar head, incisal tract, and cusp inclination angle, ie, the cusp inclination angle of the tooth (the last molar) is used as a reference. Selected as
The twin stage method virtual execution means 24 constructed in the CPU 20 calls, for example, a virtual tool of a twin hobby articulator from the virtual jig digital data 41 for execution of the twin stage method of the recording device 40, and the patient's three-dimensional Applied to digital images, the four steps of the actual twin stage method described above are virtually implemented. In the computer, the size of the virtual tool of the twin hobby articulator is synchronized with the size of the patient's 3D digital image, and the reference point of the patient's 3D digital image, for example, the reference point of the cusp inclination angle (maxillary jaw) A coordinate axis is formed by using the origin (0, 0, 0) as the origin (0, 0, 0) and the corresponding origin when the virtual tool of the twin hobby articulator is attached. Is calculated. The specific processing contents are omitted here as described above.

  Similarly, the mathematical formula of the backward motion virtually executed in the correction step of the twin stage method according to the inventor's idea is also based on the altitude of the mandibular motion theoretical formula of the alpine, for example, with a certain reference point in the sagittal plane ( If the positive direction is the forward motion region with the setting of (0, 0, 0), it can be obtained by setting the backward motion region as the negative direction as a hypothesis and putting the rotational force (from the occlusion study appendix). In other words, the formula for backward movement is also calculated in the craniofacial face because the arrangement of the positional relationship in the same movement is different even if the reference point and reference plane are changed. If introduced into the jaw movement theory formula, it can be derived by comprehending the data analysis of 3D digital image processing by a computer (examination of jaw function of Sirona graph and Axio graph) There is a vessel, etc.).

As a result of the virtual implementation of the twin stage method on the three-dimensional digital image of the patient constructed as described above, potential problems related to the patient's current bite situation are represented as numerical data in the server 3 and / or Since it appears as an image on the monitor, the numerical data and / or image data is temporarily recorded and stored in the recording device 40 as potential problem data. On the other hand, the recording apparatus 40 records and stores a problem database 42 in which potential problems related to biting are classified and organized based on numerical values and / or images.
The occlusion problem specifying means 26 constructed in the CPU 20 is sequentially classified from the problem data database 42 regarding the occlusion of the numerical data and / or image data obtained by executing the twin stage method virtual execution means 24 and the recording device 40. The problem data relating to the occlusion that has been arranged are compared with each other, and it is specified to which problem the problem relating to the occlusion of the patient that has become apparent belongs. In the problem database 42, effective treatment methods and treatment jig data used for the treatment methods are recorded in association with each problem.
In addition, the occlusal problem specifying means 26 may be configured to specify a potential problem in consideration of aesthetics in the dentition and / or face form. The normal occlusal state not only achieves a beautiful dentition but also deeply affects the impression of the entire face. This can be determined based on, for example, the front and back relationship of the upper and lower first molars. In other words, the facial form is divided into numerical values for maxillary protrusion and mandibular protrusion (anteroposterior factor), overbite and open bite (vertical factor), and these factors are numerical values obtained from the 3D digital image of the patient. By reflecting the data and / or the image data, it is possible to obtain a beautiful tooth arrangement and eventually a beautiful facial form (appearance).

The occlusal treatment method selection means 28 constructed in the CPU 20 is a single treatment method from the problem database 42 recorded and stored in the recording device 40 in advance. Appropriate ones are selected by entering the conditions of the university / professional dentist, patient, or member dentist who has a contract with the third manager.
The occlusal treatment method virtual execution means 30 constructed in the CPU 20 is selected from the treatment jig database 43 for each occlusion problem in the recording device 40 in order to virtually execute the treatment method selected by the occlusion treatment method selection means 28. The virtual tool is called, and the image is processed by temporally compressing an expected progress when the treatment method is implemented by virtually applying to the three-dimensional digital image of the patient. Specifically, it can be performed by performing a predetermined calculation process as in the case of the twin stage method virtual execution means 24 described above. Since this image is a large amount of data that uses a considerable amount of memory, it is preferable to record the image in the recording device 40 once. In addition, about the result of having implemented the obtained numerical data and / or image, the twin stage method virtual implementation means 24, and the occlusion treatment method virtual implementation means 30, the electronic chart of the member dentist is stored in the electronic medical record. It is specified and recorded from predetermined information such as an ID number, a member doctor's name, and a patient's name.

When the processing on the potential problems related to the current occlusal situation of the patient and the treatment method thereof is completed, the disease identification means 32 is built in the CPU 20, and the disease identification means 32 is discovered with respect to general dental practice of the recording device 40. The problem data relating to the disease situation sequentially classified and arranged from the disease database 44 classified and arranged in advance for each disease situation is called, and the problem to which the problem relating to the general dental practice of the patient belongs is specified. . For example, the disease specifying means 32 is constructed by generating processing end information when the processing is completed in the occlusal treatment virtual execution means 30, and in the software in the recording device 40 based on the processing end signal. The disease specifying means 32 can be started by programming in advance to start software for constructing the disease specifying means 32. Of course, it is needless to say that the operation can be ensured by configuring similarly when sequentially starting other software.
The disease specifying means 32 is almost the same as the occlusal problem specifying means 26 for specifying a problem related to occlusion, but the operation itself is almost the same, and the basic configuration is substantially the same. As an example, in the case of the above-described prosthesis in FIG. 12, the disease database 44 is preliminarily stored in condition 1 ((red): (molar part (first molar)), condition 2 ((blue): anterior tooth (canine). , Side wing angle)), (incisor: sagittal incision road angle), and condition 3 (anterior region of backward motion), each angle data and the disease state, By comparing this with the data of the respective angles under the conditions 1, 2 and 3 obtained from the 3D digital image of the patient constructed by the 3D digital image forming means 22, that is, A: The positional relationship between the contact part and the non-contact part in the eccentric position of the upper and lower teeth, B: From the viewpoint of whether it is higher or lower than the reference value, the disease state is determined by looking at the upper and lower spaces (space) .
In the disease database 44, data relating to effective treatment methods and treatment jigs used in the treatment methods are recorded in association with each problem. As described above, these diagnoses are performed at the numerical level (based on the data) in the server 3, but also by visual inspection by a university / specialist dentist who has a contract with the administrator of the server 3. You can also

The disease treatment method selection means 34 built in the CPU 20 specifies data relating to the treatment method associated with the disease determined by the disease identification means 32 and the treatment jig used for the treatment method from the disease database 44. As a result, an appropriate treatment method is selected from treatment methods classified and arranged in advance for each disease state discovered in relation to general dental practice of the patient. In that case, if there is only one treatment method, if there are multiple treatment methods, select the appropriate one by entering the conditions of the patient, member dentist, or university / professional dentist who has a contract with the server. Will be.
The disease treatment method virtual execution means 36 constructed in the CPU 20 performs image processing by temporally compressing the expected progress when the treatment method is performed on the three-dimensional digital image of the patient. Specifically, as in the case of the twin stage method virtual execution unit 24 and the occlusal treatment method virtual execution unit 30 described above, based on the coordinate position data of a predetermined part in the patient's three-dimensional digital image, they are calculated according to a predetermined calculation formula. This can be done by performing arithmetic processing according to In addition, about the result of having implemented the disease treatment method virtual implementation means 36, the electronic medical chart preserve | saved at the recording apparatus 40 is the same as the case where the twin stage method virtual implementation means 24 and the occlusion treatment method virtual implementation means 30 are implemented. It is specified and recorded from information such as the ID number of the member dentist, the name of the member doctor, and the name of the patient.

  In the recording device 40, various program recording units 46 for recording software for executing the present system and various data are recorded. Various types of data include the digital data 41 of the virtual jig used when performing the twin stage method, the data 42 regarding the types of problems related to occlusion, the digital data 43 of virtual treatment tools according to the problems related to occlusion, the patient There are data 44 relating to the type of disease status discovered in relation to general dental practice, digital data 45 of virtual treatment tools classified by disease situation found relating to general dental practice, and the like.

  The recording device 40 is also provided with an electronic medical record database 48 for storing data for each member dentist and / or patient, and the data can be used as necessary. Thereby, the existing patient data and the diagnosis according to the present invention can be linked. Each dental material manufacturer has data collection for each individual that combines various information such as period (periodontal), insurance, X-ray digital images, intraoral photographs, and examinations. However, there is no collected data that can be used for comprehensive diagnosis of patients, and therefore, there is no system for performing diagnostic processing using such data. The system of the present invention forms a three-dimensional digital image of a dentition including the patient's maxilla and mandible from the collected data of each individual and the patient information transmitted from the terminal 2 for the member dentist. . As a result, potential problems related to the patient's current occlusion situation and their treatment methods are selected, and further, the expected progress when the treatment method is performed on the three-dimensional digital image of the patient is time-compressed. In the same way, with regard to general dental practice of patients, the disease status is similarly identified, an appropriate treatment method is selected, and further, the disease treatment method is performed on a three-dimensional digital image of the patient. In this case, image processing is performed by time-compressing the expected progress.

  Since the system of the present invention has the above-described configuration, the server 3 itself must use an expensive computer, but the member dentist terminal 2 can use a general-purpose PC, The dentist has the advantage of being able to obtain advanced dentistry information without spending enormous expenses. The system of the present invention is a communication network system capable of comprehensive diagnosis. Since it can be constructed using computers of any manufacturer, the system can be constructed at low cost, and the equipment already used in general dental clinics is used. The information is captured by the 3D digital image analyzer of the server 3 and the face is measured and the jaw bone is projected (projected so that it can be processed as a 3D image), and various articulator virtual tools are combined. can do. The member dentist can use various image information transmitted through the communication network 4 in this manner with a slight burden.

  On the other hand, the member dentist can enjoy the benefits of comprehensive dental diagnosis that is completed through the virtual implementation and utilization of the twin stage method (conditions 1-4, mechanisms such as internal jaw disease). It is possible to confirm clinically how the actual patient's treatment progresses. It should be possible to reconfirm that the patient's current symptom log and chief complaint are correctly encoded. The system of the present invention can embody all the findings of a specialized course at a general dental university within a category. Since all judgments can be explained in a comprehensive and comprehensive way, the best way to treat can be found, so the dentist and patient can discuss and fully understand It has the advantage of being able to provide a diagnosis for a high-dimensional treatment with certainty that can be done and is satisfactory. Specifically, the dentist, in the actual medical treatment, the information transmitted from the server 3 regarding the inspection, the interview, the present symptom, the past history, and the future prospect, that is, the reference value of the numerical value of each patient. Can be done by comparing.

It can be suggested that it is likely to become a decayed tooth, but it is highly likely to recur even after treatment. Alternatively, when a problem such as water spilling even if it is not a decayed tooth or easy filling can be taken out, it is possible to present on a video using a monitor how to solve the problem. Teeth are easily dislocated, broken, discolored, cracked, what is the cause of wear and the cause, whether the face is symmetric or asymmetrical, whether it is biting on the back teeth, tartar It can answer all kinds of questions that the patient complains about, such as why the astringent tea is confined to the region of the tooth in a certain area, why it is easy to bleed, and why the gums are swollen.
Furthermore, if the patient's own information can be programmed instantaneously, for example, the selection and medical history of the medicine or the like can be transmitted from the fingerprint, eyes, vein plexus, etc. to the server 3 via the communication network 4.

  As described above in detail, the system of the present invention can present accurate information to each member dentist from the certainty and logic of the underlying theory. Then, various treatment measures are processed on the server using various patient information transmitted from the terminal for the member dentist to construct a three-dimensional digital image of the patient. Regardless of the presence or absence of the mandible model, the virtual tool of the prescribed articulator is taken into the computer, the treatment process is projected on each tooth, and the patient's face is seen through, and the jaw bone image is seen through The history of the current symptom, past history, future treatment plan, and the expected result can be visually recognized in front of the patient.

It is the schematic of one Embodiment of the dental care assistance method which concerns on this invention. It is a flowchart for demonstrating the detail of step 2 of FIG. It is a flowchart for demonstrating the detail of step 3 of FIG. It is a perspective view which shows the twin hobby articulator used for the twin stage method. It is the schematic which shows the 1st step of the twin stage method. It is the schematic which shows the 2nd step of a twin stage method. It is the schematic which shows the 3rd step of a twin stage method. It is a figure for demonstrating the relationship between an articulator and a cusp inclination | tilt angle, (a) is a description which shows the movement path | route of each part, such as a mandibular head, a large, and an anterior tooth, on the basis of an axis plane in a sagittal surface FIG. 4B is a partially enlarged view of the upper and lower maxillary molars in FIG. 5A, and FIG. 5C is a specific view of FIG. It is the schematic for demonstrating the expression principle of the temporomandibular joint internal injury by a high mountain. It is the schematic of the Michigan type | mold sprint improved based on the expression principle of the temporomandibular joint internal lesion by Takayama. It is the schematic for demonstrating the setting method of a horizontal reference plane, (a) is explanatory drawing about golden division ratio, (b) is explanatory drawing of the occlusal high diameter determination method at the time of complete denture production, ( (c) is explanatory drawing for demonstrating the analysis result regarding the golden division ratio in a face aperture. It is a treatment method according to the bite situation of patients diagnosed by the twin stage method. It is a table | surface of the treatment method according to the disease condition specified by the treatment method database according to disease condition. 1 is a schematic configuration diagram of an embodiment of a dental care support system according to the present invention. It is the block diagram of the treatment method selection explanatory method to the patient which considered the predetermined method about the conventional patient's temperament. It is the schematic of the dental treatment unit which can provide suitable medical treatment information with the image and sound to the conventional seated patient.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Dental care support system 2 Member dentist's terminal 3 Server 4 Communication network 10 Communication means 20 CPU
22 three-dimensional digital image forming means, 24 twin stage method virtual implementation means 26 occlusion problem identification means, 28 occlusion treatment selection means 30 occlusion treatment virtual implementation means, 32 disease identification means 34 disease treatment method selection means, 36 disease treatment method Virtual implementation means 40 Recording device 41 Virtual jig digital data, 42 Problem database 43 Treatment jig database by occlusion problem, 44 Disease database 45 Digital data of virtual treatment tool by disease status 46 Various program recording units 50 Monitor 60 Keyboard apparatus

Claims (3)

A dental practice support for servers that end a plurality of end connected via a communication network,
Receiving means for receiving patient information including image information related to a patient's skull from a predetermined terminal of the plurality of terminals ;
A problem database for storing potential problems related to occlusion and treatments associated with the potential problems;
A disease database for storing disease states based on general dental practice and treatments associated with the disease states;
3D image construction means for constructing 3D image information related to the patient's skull based on the patient information received by the reception means ;
On the basis of the three-dimensional three-dimensional digital image constructed by the image construction unit, and the twin-stage method virtual means for executing with a virtual tool articulator twin stage method,
By comparing the potential problems related to the occlusion manifested by the twin stage method performed by the twin stage method virtual execution means and the potential problems stored in the problem database, the patient's Occlusal problem identification means for identifying potential problems,
Occlusal therapy selecting means for selecting the treatment associated with the potential problems of the patient identified by said occlusal problems specifying means,
Based on a three- dimensional digital image of a patient, a virtual occlusion treatment method that obtains first image information obtained by performing time compression on an expected progress when the treatment method selected by the occlusion treatment method selection unit is performed is obtained. and the means of implementation,
Based on the three-dimensional digital image information on the cranium of the patient, and disease specifying means for specifying a disease situation about the common dental practice of the patient,
And disease conditions specified by the disease specific means, by comparing the disease status stored in the disease database, and disease treatments selecting means for selecting a therapy associated with the disease status of the patient,
A second image obtained by performing time-compressed image processing on an expected progress when a treatment method selected by the disease treatment method selection unit is virtually executed based on three-dimensional digital image information relating to the patient's skull; A disease treatment virtual implementation means for obtaining information ;
E Bei and transmission means for transmitting said second image information obtained by the occlusion therapy virtual embodiment the first image information and said disease therapies virtual execution means obtained by means to the predetermined terminal ,
The twin stage method virtual implementation means calculates the jaw movement of the patient on the basis of the cusp inclination angle of the tooth in the three-dimensional digital image.
Dental support medical server. The dental care support server according to claim 1, wherein the occlusal problem specifying unit specifies the potential problem in consideration of aesthetics in a dentition and / or a facial form.   The twin stage method virtual execution means performs the twin stage method in a state where the upper jaw and the lower jaw constituting the virtual tool are in a normal position, and further, in the state where the upper jaw and the lower jaw are reversed upside down and upside down, The dental treatment support server according to claim 1 or 2, wherein a twin stage method is performed.