JP4738152B2 - Simulation program to support dental treatment - Google Patents

Description

The present invention relates to simulation to support the dental treatment, in particular, for each available surgery buried implant body in the jaw bone, on the simulation program to perform the simulation to support the treatment planning in line with the wishes of the patient to the computer.

  In recent years, in dental treatment, a simulation for supporting a treatment method using an image obtained by CT scanning of a patient's jawbone has become widespread. For example, there is a treatment (implant) in which a screw-type part for a base is embedded in a jawbone to form a base such as a denture. Conventionally, the placement position was determined by a doctor's visual inspection using a radiographic image of the jawbone, but even if the placement position is slightly shifted, the jawbone sinus may be penetrated or nerves may be damaged. As a result, there is a possibility that a fatal accident will occur, and a simulation has been carried out so that it is possible to easily examine the placement position with higher safety.

With regard to such a technique, for example, as an invention related to denture orthosis attachment work, it has been proposed to perform a simulation using an image relating to a jaw and an image relating to an attachment part.
JP-T-2004-522489

  The simulation supporting the conventional dental treatment shows how the implant is placed in the jawbone based on the treatment method determined by the doctor before the operation. Therefore, in the treatment, although the doctor or patient is told verbally about the treatment and the contents of the operation before the operation, the doctor decides the operation method, and the patient's intention may not be considered much. there were. Implant treatment is an expensive operation in which one implant is 300,000 yen or more, and the treatment period may be long. In the conventional simulation, since there is no mechanism for taking into account the patient's financial or physical burden, it has not been possible to use the simulation to examine the contents of the operation in consideration of the patient's burden.

  Accordingly, an object of the present invention is to provide a simulation method for supporting dental treatment for enabling the creation of a treatment plan reflecting the wishes of a patient.

To solve the above problems, the present invention is a simulation program for causing the simulation to help implant body implantation surgery to jawbone computer, in the computer, at least the patient an acceptable cost of treatment, treatment A patient desired information storage procedure for acquiring a period and storing it in a storage area as patient desired information, a setting procedure for setting the maximum number of patients that can be treated within the treatment cost of the patient desired information as a processing number, and the processing number An arrangement procedure for placing an implant body on a model showing a jawbone shape, and determining whether an area where the implant body placed so as to be embedded in the jawbone of the model is in contact with the jawbone has a predetermined surface area or more and determining the intensity determining step whether strength to support the implant body is sufficient by, the intensity determining step If the strength for supporting the implant body I is determined not to be sufficient, the intensity compensation procedure for performing a simulation to determine the mass of bone augmentation material required for bone augmentation to compensate for the strength on the basis of the treatment period, the process number the intensity is executed estimated cost of the bone augmentation is a procedure treatment cost determination for determining whether the at subtherapeutic cost of patient desired information to compensate for, the patient would like information by the cost of treatment determination procedure treatment costs by subtracting the processing number for each being determined not less, until subtherapeutic cost of patient desired information, and the deployment procedure, and the intensity determination procedure is repeated to execute the said reinforcing compensation procedure Configured to be

  In such a simulation method, since it is possible to make a treatment plan that reflects the wishes of the patient, it is possible to support an implant body placement operation in the jawbone.

As a means for solving the above problems, the present invention is a simulation method that perform the procedure computers, and may be a simulation apparatus for performing the simulation method.

  The present invention makes it possible to make a treatment plan that reflects the wishes of the patient and support dental treatment.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  A simulation apparatus for supporting dental treatment according to an embodiment of the present invention has a functional configuration as shown in FIG. FIG. 1 is a diagram illustrating a functional configuration example of a simulation apparatus for supporting dental treatment according to an embodiment of the present invention.

  A simulation apparatus 100 shown in FIG. 1 is a computer controlled by a CPU (Central Processing Unit) and capable of executing a CAD system. In order to realize the present invention, at least a dentition shape acquisition unit 101 and The patient preference information acquisition unit 102, the treatment method adjustment unit 103, the treatment method output unit 104, the installer 19, and the storage area 16.

  The dentition shape acquisition unit 101 uses the CT model of the jaw bone obtained by CT scan and the 3D data of the 3D scan of the jaw bone shape made of gypsum (hereinafter also referred to as a gypsum model) to obtain the shape of the patient's jaw bone. As a processing unit for determining an optimal CT value.

  The patient request information acquisition unit 102 is a processing unit that calculates a treatment cost based on a cost desired by the patient and a treatment period. For example, the cost is an amount including a charge for the number of implant bodies to be implanted, and the treatment period is a treatment period that is acceptable to the patient.

  The treatment method adjusting unit 103 performs a simulation in which an implant body model (hereinafter simply referred to as an implant body) of an artificial tooth arranges an implant body based on an interference state with a jawbone shape and a mandibular canal shape. It is a processing unit that verifies whether or not the above conditions are satisfied and determines a treatment method that satisfies the patient's desire.

  Based on the treatment method determined by the treatment method adjustment unit 103, the treatment method output unit 104 includes a simulation screen showing a state in which the implant body is embedded, treatment contents showing treatment period, cost, etc., and treatment method. The consent form for the operation based on the screen is output on the screen. Moreover, it prints out as needed.

  The storage area 16 is an area in a storage device such as a hard disk unit, and stores programs for executing various processes, data necessary for processing by the CPU, tables, and the like. In the storage area 16, at least a CT model 121 for each patient that manages a CT model acquired by CT scanning in correspondence with patient identification information, and a three-dimensional solid model acquired by 3D scanning of a plaster that models the jawbone shape of the patient. Patient-specific plaster model 122 that manages patient identification information in association with the patient identification information, and patient preference information 131 that manages the expense, treatment period, and the like desired by the patient input based on the interview with the patient in association with the patient identification information DB 141 showing the standard pain tolerance and limit values based on stress concentration (Ng: Newton gram) corresponding to the patient's age based on patient identification information, gender, region, and the like, The patient pain DB 142 indicating the allowable value and limit value of pain based on the past patient treatment results in correspondence with the patient identification information, and the treatment method adjustment unit 103 The treatment method determined I and a patient per treatment methods DB143 shown to correspond to the patient identification information.

  When the storage medium 20 storing the program for realizing the processing in the simulation apparatus 100 is set in the driver, the installer 19 reads the program from the storage medium 20 and installs it in the storage apparatus. Execution of the processing in the simulation apparatus 100 is realized by the CPU performing according to a program installed in the storage device. Any medium can be used as long as the program can be read by a computer. For example, it is a CD-ROM (Compact Disc Read-Only Memory). Alternatively, it may be downloaded via a network and installed in the storage device.

  Although not shown, the simulation apparatus 100 includes an output control unit that controls output data and controls output to a printer or the like according to an instruction from the CPU, and input control that controls input data input by a keyboard, a mouse, or the like. And a display control unit that controls display data to control display on a monitor or the like. The simulation apparatus 100 may input the CT model acquired by the CT scan by being directly connected to the CT scan apparatus, or may be input from an external storage device as necessary. good. Furthermore, you may make it have a communication control part for connecting to a network.

  In the present invention, the dentition shape acquisition unit 101, the patient desired information acquisition unit 102, the treatment method adjustment unit 103, and the treatment method output unit 104 are executed in this order. Each of these processing units will be described below.

  FIG. 2 is a diagram illustrating a CT model based on a difference in CT values. FIG. 2A and FIG. 2B are CT models relating to the same jawbone. FIG. 2A shows a CT model of the jawbone when the CT value is 150. FIG. 2B shows a CT model of the jawbone when the CT value is 500. The tooth shape is shown in the circled part, but the tooth shape in the CT model shown in FIG. 2 (A) is shown gently, whereas the CT shown in FIG. 2 (B). The tooth shape in the model is projected with a sharper shape. CT forms a model based on the moisture content, and the smaller the CT value, the greater the moisture content. Comparing meat and bone, the meat portion has a high water content, so the CT value is small, and the bone portion has a low water content, so the CT value is greatly expressed.

  The boundary between bone and meat is a portion where bone fibers and meat are intertwined with each other, and is a portion having a large apparent water content. The portion represented by the sharp shape in FIG. 2 (B) is represented by the gentle shape in FIG. 2 (A) because the portion having a low moisture content in FIG. In Fig. 2 (A), where the CT value is low, the bone content of the bone and meat, which have a high apparent water content, is not included. This is because even the boundary between the bone and meat having a large amount is represented as a bone.

  As described above, even models related to the same jawbone are different in shape depending on which CT value is used.

  Now, when verifying the implant location, the implant body in the jaw bone has sufficient strength, and in order to prevent it from penetrating through the jaw bone, the implant body is placed according to the bone thickness at the placement position. The place will be different. In addition, when the insertion position is pointed, a surgical method may be changed because a drill for making a hole for implanting an implant body is difficult to enter.

  In the conventional simulation, the shape of the patient's jawbone was obtained using a standard CT model with a CT value applied as a standard. However, as described above, CT calculates the CT value based on the water content, and since there are individual differences in the water content in the body and bones, the individual patient whose standard CT value is the treatment target It may not fit. In that case, even if the implant placement location is verified by simulation using a CT model with standard CT values, the shape of the jawbone is different from the CT model used in the simulation during actual surgery. In some cases, a more accurate simulation according to the patient could not be performed.

  In the present application, first, a process for acquiring an optimal (more accurate) jawbone shape is performed by the dentition shape acquisition unit 101.

  FIG. 3 is a flowchart for explaining processing performed by the dentition shape acquisition unit. In this process, using the fact that the CT value of the tooth is close to the CT value of the bone, the CT model is compared with the plaster model taken from the actual tooth type, and the tooth type matches the plaster model as much as possible. By obtaining the CT value, the CT value in consideration of individual differences among patients is obtained.

  In FIG. 3, the doctor first creates the patient's jawbone shape with plaster (step S0). Then, the dentition shape obtaining unit 101 creates a 3D solid model by using a CAD function from a surface model obtained by taking the finished gypsum jawbone shape with a 3D scanner (step S1). The generated 3D solid model is stored in the gypsum model 122 for each patient.

  Next, the dentition shape acquisition unit 101 creates a jaw bone model (solid model) with a predetermined CT value lower than the standard CT value using the CAD function from the CT model of the patient's jaw bone shape obtained by the CT scan. (Step S2). Here, the dentition shape acquisition unit 101 sets a predetermined value as the previous volume difference. For example, set the volume value calculated from the gypsum model as the value that maximizes the volume difference between the volume of the overlapped part of the gypsum model and the jawbone model and the volume of the gypsum model, or 1/2 the volume value. To do.

  Then, the dentition shape acquisition unit 101 arranges the gypsum model and the solid model of the jawbone model so as to coincide with each other in the 3D space, obtains the volume of the overlapping portion by Boolean calculation (step S3), and determines the overlapping portion of the overlapping portion. The absolute value of the volume difference between the volume and the volume of the gypsum model is calculated (step S4).

  The dentition shape acquisition unit 101 determines whether or not the volume of the overlapping portion and the volume of the gypsum model match based on the calculated volume difference (step S5). When the volume difference calculated in step S4 indicates zero, it is determined that the volumes coincide with each other, and the CT value in this case is regarded as the optimal CT value of the patient, and the CT value is associated with the patient identification information, and the CT value is determined for each patient. Setting is performed by storing in the DB 123 (step S8).

  Here, when it does not correspond, the dentition shape acquisition unit 101 determines whether or not the volume difference is minimized (step S6). That is, it is determined whether or not the volume difference in step S4 calculated this time has increased compared to the previous volume difference. When it determines with increasing, it determines with the previous volume difference having been the minimum, and applies the last CT value. The previous CT value may be obtained by subtracting the predetermined value used in step S7 from the current CT value, or stored in a predetermined storage area every time the CT value is updated in step 7, You may read from. The dentition shape acquisition unit 101 sets the previous CT value as the patient's optimal CT value by associating it with the patient identification information and storing the CT value in the patient-specific optimal CT value DB 123 (step S8).

  On the other hand, if the volume difference is neither zero nor a value suggesting a minimum CT value (the current volume difference has decreased from the previous volume difference), the dentition shape acquisition unit 101 determines the CT value being processed. Is added with a predetermined CT value to create a jawbone model (solid model) (step S7), the process returns to step S3, and the same processing as described above is repeated.

  The CT values set in the patient-specific optimal CT value DB 123 in this way are used when the patient's jawbone is displayed in three dimensions in the process described below.

  FIG. 4 is a diagram illustrating an example of a screen for acquiring patient desired information displayed on the display unit by the patient desired information acquiring unit. In FIG. 4, the patient desired information acquisition unit 102 displays a patient desired information screen 40 on the display unit. The patient request information screen 40 has a table area 40a for displaying the date on which treatment details are input, a display area 40b for displaying patient names, a display area 40c for displaying CT model names, and a display for displaying items of treatment contents. An area 40e, a display area 40e for displaying doctor findings information, and a setting area 40f for setting patient desired information are provided.

  For example, “November 30, 2005” is automatically displayed in the table area 40a that displays the date on which the treatment content is input. In the display area 50b for displaying the patient name, for example, the patient is based on the patient identification information or the patient name selected in advance or selected using the patient information in which the patient identification information and the patient name are managed correspondingly. In the display area 50c for displaying the CT model name, the CT model identification information corresponding to the patient identification information from the patient-specific CT model 121 is displayed as the CT model name.

  In the display area 40e for displaying the treatment content items, items such as the number of implant bodies to be implanted, bone replacement, treatment period, and cost are displayed. Corresponding to these items, in the display area 50e for displaying information on doctor findings, for example, “3”, “Yes”, and “6 months” are displayed as information input from the doctor. “1 million yen” automatically calculated based on the information is displayed. For example, “2”, “None”, “6 months” are displayed in the setting area 40f for setting the patient desired information as the information inputted regarding the patient's wishes, and the expense that the patient has declared as payable. “700,000 yen” is set. In this patient-desired example, the patient wants to reduce the number of implants as much as possible and save the effort of bone replacement, etc., but he wants a smaller number than the number of doctor findings. In this case, the information entered when the cost and the treatment period for some reinforcement are allowed.

  The patient request information set on the patient request information screen 40 is stored in the patient request information 131 together with the doctor finding information in correspondence with the patient identification information.

  The patient can confirm the result of the interview with the doctor while viewing the patient request information screen 40, and can confirm the patient's request in light of the doctor's findings. Therefore, the patient can recognize in advance the difference from the doctor's findings.

  Next, a mechanism for adjusting the treatment method while referring to the patient request information 131 will be described with reference to FIG.

  FIG. 5 is a flowchart for explaining processing performed by the treatment method adjustment unit. This process is characterized in that, in addition to the conventional simulation method, information on the upper limit (budget) of the treatment and the treatment period are used as information on the patient's desire as input. Based on the information on the cost, the upper limit of the number of implants to be implanted is determined, and on the basis of the information on the treatment period, it is determined whether or not to perform bone replacement for reinforcing the bone strength.

  In FIG. 5, first, the treatment method adjustment unit 103 acquires the optimal CT value set in the optimal CT value DB 123 for each patient using the patient identification information, and calculates the jaw bone model based on the optimal CT value from the CT model 121 for each patient. Acquired and placed in a predetermined display area (step S101). Similarly, a mandibular canal model based on this optimal CT value is acquired from the CT model 121 for each patient, and is superimposed on the jawbone model placed in the predetermined display area. (Step S102).

  The treatment method adjustment unit 103 refers to the cost desired by the patient from the patient preference information 131, calculates the maximum number of implants that can be implanted within the cost, and inputs the implant body data for that number (step S103). ), The implant body is arranged on the jawbone model along the dentition shape (step S104). Here, if the cost desired by the patient is 700,000 yen, and the cost of one implant body is 300,000 yen, 2 is the number obtained by dividing 700,000 yen by 300,000 yen. The implant body is arranged on the jawbone model along the dentition shape. The calculated maximum number is stored in the storage area 16 as the processing number.

  Then, the treatment method adjustment unit 103 checks the interference between the placed implant body and the jaw bone model, and further checks the interference between the implant body and the mandibular canal model (step S105), and the placement of the implant body is appropriate. It is determined whether or not (step S106). If it is determined that the arrangement is not appropriate, the arrangement position is reset (step S106-2).

  In the resetting of the placement position, the treatment method adjustment unit 103 identifies the dentition shape from the jawbone model based on the optimal CT value, and sets the angle of each placed implant body in the dentition direction and the upper surface of the implant body head toward the back side. Change to tilt. Here, the dentition shape is specified by comparing with a dentition pattern of about 2 to 5 prepared in advance. Further, the angle of the implant body is changed particularly when the implant body is disposed above the mandibular canal.

  After resetting the arrangement position, the process returns to step S104. In this case, the treatment method adjustment unit 103 performs shape arrangement based on the information indicating the angle changed in step S106-2. Thereafter, the above processing is repeated.

  On the other hand, when it is determined in step S106 that there is no problem in the placement by the interference check, the treatment method adjustment unit 103 checks the thickness of the jawbone on which the implant body is placed (step S107). In the thickness check, the thickness of the jawbone at the position where the implant body is arranged is calculated from the jawbone model based on the optimum CT value, and is compared with a predetermined thickness required when implanting. The treatment method adjustment unit 103 determines whether or not a predetermined thickness is satisfied (step S108). If the thickness does not meet the specified thickness, the bone around the implanted implant is thin, and when the denture is attached to the implant and the force is actually applied, the bone will not be able to support the force and will crack or chip. This means that there is a high possibility that problems such as the above will occur, so the arrangement position needs to be changed. Therefore, the treatment method adjustment unit 103 proceeds to reset the arrangement position in step S106-2 and repeats the same processing as described above.

  On the other hand, if it is determined in step S108 that the predetermined thickness is satisfied, the treatment method adjustment unit 103 analyzes the stress applied to the jawbone by the implantation of the implant body (step S109). Based on the stress analysis result, the treatment method adjustment unit 103 determines whether or not the maximum stress value is equal to or greater than a predetermined stress value (step S110). If there is stress concentration, i.e. greater than or equal to the predetermined stress value, when a denture is attached to the implant and force is actually applied, a large force concentrates on the bone, causing damage to the bone, This means that there is a high possibility that the situation will cause a strong pain, so the arrangement position needs to be changed. Therefore, the treatment method adjustment unit 103 proceeds to reset the arrangement position in step S106-2 and repeats the same processing as described above.

  On the other hand, if there is no stress concentration (less than a predetermined stress value) in step S110, the treatment method adjustment unit 103 determines whether or not the patient feels pain (step S111). The treatment method adjustment unit 103 uses the patient identification information to acquire the limit value of the patient's pain from the patient-specific pain DB 142, and determines whether or not the degree of stress (Ng) is greater than or equal to the limit value. . Here, when there is no patient identification information that matches the patient-specific pain DB 142, the treatment method adjustment unit 103 acquires a standard limit value from the standard pain DB 141, and the degree of stress (Ng) is the standard limit. It is determined whether or not the value is greater than or equal to the value. In addition, when referring to a standard limit value from the standard pain DB 141, a limit value corresponding to the age and sex of the patient and the position of the tooth to be treated may be referred to.

  When it is determined that the patient feels pain, the treatment method adjustment unit 103 proceeds to reset the arrangement position in step S106-2 and repeats the same processing as described above.

  On the other hand, when it is determined in step S111 that the patient does not feel pain, the treatment method adjustment unit 103 determines whether there is sufficient strength to support the implant body (step S112). That is, the treatment method adjustment unit 103 determines whether or not the surface area in which the implant body is embedded is equal to or greater than a predetermined surface area.

  When it is determined that there is not sufficient strength, the treatment method adjustment unit 103 determines whether or not the treatment period desired by the patient is equal to or longer than a predetermined period necessary for bone formation (bone replacement) (step S113). . If it is longer than the predetermined period, it is determined that the treatment period is sufficient. In this case, bone formation is simulated in a portion with insufficient strength (step S113-2). The treatment method adjustment unit 103 uses a jaw bone model with an optimum CT value, for each implant body, for example, the volume from the upper surface of the insufficiently strong part such as a bone defect to the height of the jaw bone (if the jaw bone is originally The volume (g) of the bone forming agent necessary for bone formation is calculated by calculating the volume of a certain part) and multiplying the predetermined mass of the bone building agent from the volume. Then, the treatment method adjustment unit 103 holds the result obtained by multiplying the calculated mass of the bone formation part by a predetermined fee in the storage area 16 as the cost for bone formation. After the simulation of bone formation, the treatment method adjustment unit 103 returns to step S109, executes stress analysis again, and thereafter repeats the same processing as described above.

  In step S113, when it is determined that the treatment period desired by the patient is insufficient for the predetermined period for bone formation, the treatment method adjustment unit 103 changes the type of the implant body (step S113-4). That is, the implant body is changed to a thicker implant body than the currently simulated implant body. By changing to a thick implant body, the contact area with the jawbone can be increased, and the strength can be improved. The change in thickness may be appropriately set by a doctor. The changed implant body type is stored in the storage area 16.

  In step S112, when it is determined that there is sufficient strength, the treatment method adjustment unit 103 calculates the cost desired by the patient from the patient preference information 131, and the cost (estimated cost) calculated using the patient-specific treatment method DB 143. To determine whether it is within the patient's budget (step S114). If it is not within the budget (exceeds the cost desired by the patient), the treatment method adjustment unit 103 performs a change to reduce the number of implants by one (subtract 1 from the number of treatments) in order to reduce treatment costs ( In step S114-2), the process returns to step S104, and the same processing is repeated.

  On the other hand, if the budget is within the budget (below the cost desired by the patient) in step S114, the treatment method output unit 104 displays the simulation result, treatment details, consent form, etc. on the display unit, and prints as necessary. Is output (step S115). The treatment method output unit 104 acquires records for the number of patient implants in the patient treatment method DB 143, stores the number of treatments stored in the storage area 16, and the mass of the bone forming portion material for each implant. (G) Based on the type of implant body, patient identification information, the number, the number identifying the implant body, the type of implant body, the presence or absence of bone compensation, the mass of bone compensation calculated in step S113-2, etc. Set.

  FIG. 6 is a diagram showing an example of a simulation screen showing the degree of stress concentration based on the stress analysis result in the processing flow shown in FIG. FIG. 6 (A) shows an example in which stress is concentrated at the contact portion between the bone and the implant body because the implant body is embedded with the missing portion of the jawbone as it is. FIG. 6B shows an example in which after the bone replacement goods are packed in the defect portion, the implant body is embedded, and the entire jawbone absorbs stress and is stable. 6A and 6B, the degree of the degree of stress is indicated by brightness, and a brighter portion indicates that the degree of stress is higher.

  In FIG. 6 (A), there is a locally bright portion in the defect portion of the jawbone, whereas in FIG. 6 (B), it can be seen that the stress is moderately distributed over the entire surface of the defect portion. The treatment method adjusting unit 103 shown in FIG. 5 is in a state where stress as shown in FIG. 6 (A) is concentrated, such as changing the placement position of the implant body, changing the type of the implant body, By changing the number of bodies, bone formation of the defect portion, etc., it is possible to simulate a state in which the stress is dispersed and stable as shown in FIG. 6B.

  FIG. 7 is a diagram illustrating an example of a screen showing the treatment content displayed on the display unit by the treatment method output unit. In FIG. 7, the treatment method output unit 104 displays a treatment content screen 50 on the display unit. The treatment content screen 50 includes a table region 50a that displays the date on which the treatment content is presented, a display region 50b that displays the patient name, a display region 50c that displays the CT model name, and a display region that displays items of the treatment content. 50e, a setting area 50e for displaying doctor findings information, a display area 50f for displaying patient desired information, a display area 50g for displaying calculation results, and a display for displaying the time required to calculate the calculation results An area 50h and a display area 50i for displaying the operation difficulty level are provided.

  For example, “November 30, 2005” is automatically displayed in the table area 50a that displays the date on which the treatment content is presented. In the display area 50b for displaying the patient name, for example, the patient is based on the patient identification information or the patient name selected in advance or selected using the patient information in which the patient identification information and the patient name are managed correspondingly. In the display area 50c for displaying the CT model name, the CT model identification information corresponding to the patient identification information from the patient-specific CT model 121 is displayed as the CT model name.

  Items such as the number, bone replacement, treatment period, and cost are displayed in the display area 50e for displaying treatment content items. Corresponding to these items, for example, “3”, “Yes”, and “6 months” are displayed in the display area 50e for displaying doctor findings information, and are automatically calculated based on the doctor findings information. “1 million yen” is displayed. Similarly, for example, “2”, “None”, and “6 months” are displayed in the display area 50f for displaying the patient desired information corresponding to these items, and the expenses that the patient can pay for are displayed. “700,000 yen” is displayed. Further, similarly, in the display area 50g displaying the calculation result by the processing flow of FIG. 5 corresponding to these items, for example, “2”, “Yes”, “6 months”, and automatic calculation are performed. “680,000 yen” is displayed.

  For example, “0:15:45” is displayed in the display area 50h that displays the time required to calculate the calculation result, and the display area 50i that displays the surgical difficulty is displayed according to a predetermined algorithm, for example. “30%” calculated using the calculation result displayed in the display area 50g for displaying the calculation result is displayed.

  The treatment content screen 50 displays information acquired from the patient-specific treatment method DB 143 corresponding to the patient identification information. In this example, for example, when one standard implant body is 300,000 yen, it is two desired by the patient, but the amount of bone is changed in step S113-2 in FIG. Is 680,000 yen.

  In this case, the patient initially wanted a treatment with only two implants, although the treatment period and cost were somewhat acceptable, whereas the simulation results showed sufficient strength. This indicates that bone replacement by bone formation was necessary to maintain. If necessary, the doctor shows the patient a three-dimensional image showing the stress concentration before and after packing the bone grafting material as shown in FIG. 6 and explains the validity of the surgical plan as a simulation result. You may make it do.

  Next, the data structure of the database and the like will be described with reference to FIGS.

  FIG. 8 is a diagram illustrating an example of a data configuration of patient request information. In FIG. 8, information set and displayed on the patient desired information screen 40 shown in FIG. 4 is stored in correspondence with patient identification information for identifying a patient.

  The patient desired information 131 shown in FIG. 8 mainly includes patient identification information, doctor findings, and patient desired items. The doctor findings and patient desired items further include the number of implants (pieces) and bone replacement (present). / None), treatment period (months), cost (10,000 yen), etc. Here, the parentheses indicate units.

  In the example shown in FIG. 8, in correspondence with the patient identification information “001”, the items of the doctor findings are “3 implants”, “bone replacement”, treatment period “6” (month), and cost 100 (10,000). Yen) information is stored, and in the item desired by the patient, information on the implant body “2”, bone replacement “none”, treatment period “6” (month), and cost 70 (10,000 yen) is stored.

  FIG. 9 is a diagram illustrating an example of a data configuration of the standard pain DB and the patient pain DB. In the standard pain DB 141 shown in FIG. 9A, a pain tolerance value (Ng) and a pain limit value (Ng) are associated with each combination of sex, age (age), and region.

  In the combination, for example, for each sex “male” and “female”, it is divided into age ranges of “-10”, “11-20”, “21-60”, “61”, etc. Furthermore, for each of these age ranges, “middle incisors”, “side incisors”, “canine teeth”, “first premolars”, “second premolars”, “first premolars”, “second majors” “Molar”, “third molar”, etc., or a portion of information (number, alphabet, etc.) that can specify a tooth corresponds. In specifying the part, it may be further classified into the upper jaw, the lower jaw, the right side, the left side, etc., or may be classified in a rough range along the dentition.

  For each of these combinations, a standard pain tolerance (Ng) range is associated with a standard pain limit (Ng).

  The pain DB 142 for each patient shown in FIG. 9B stores the degree to which the patient feels pain set by the doctor during the past treatment. In each patient pain DB 142, sex, age (age), region, pain tolerance (Ng), and pain limit value (Ng) are associated with patient identification information.

  In the example shown in FIG. 9B, the gender “male”, the age “23”, the part “first molar”, and the patient's allowable pain values “a1 ′ to a2” are associated with the patient identification information “001”. “” (Ng), the pain limit value “A1 ′ to A2 ′” (Ng) of the patient is shown.

  In the determination of whether or not to feel pain in step S111 in FIG. 5, the treatment method adjustment unit 103 first refers to the patient-specific pain DB 142 and the patient-specific pain DB 142 does not store past pain information of the patient. In this case, the standard pain DB 141 is referred to.

  FIG. 10 is a diagram illustrating a data configuration of the patient-by-patient treatment method DB. The patient-by-patient treatment method DB 143 shown in FIG. 10 is a database for managing the results of the simulated treatment method, and includes patient identification information, the number of implant bodies (number), a number for identifying the implant body (the first number), an implant It has items such as body type, bone filling (with / without), and bone filling mass (g) in the case of bone filling.

  The treatment method output unit 104 extracts a record indicating the treatment method using the patient identification information in the simulation result output in step S115 of FIG. 5, calculates the cost, and lays out the treatment content screen 50 shown in FIG. Based on, display as calculation results. The doctor findings 50e and the patient wishes 50f are obtained and displayed by referring to the patient wish information 131 using the patient identification information, respectively.

  In the example shown in FIG. 10, the cost of the patient having the patient identification information “001” is, for example, the sum of the amount of money of the first thickness “4 mm” and the amount of money of the second thickness “4 mm”. Calculate as the amount of money, and further calculate the amount of bone replacement by multiplying the total mass of the first bone replacement mass G1 (g) and the second bone replacement mass G2 (g) by the unit price of the bone replacement material To do. Then, the sum of the amount of the implant body and the amount of bone replacement is displayed on the treatment content screen 50 of FIG. 7 as the cost of the calculation result. In this example of the treatment method, the cost is calculated as 680,000 yen, and it can be understood that the treatment can be performed within 700,000 yen desired by the patient.

  In the determination as to whether or not the calculation as described above is within the budget in step S114 in FIG. 5, when the treatment method adjustment unit 103 calculates the cost, or in the output of the simulation result in step S115 in FIG. This is executed when the treatment method output unit 104 calculates the cost.

  As described above, in the simulation apparatus 100 according to the present invention, it is possible to set the patient's wishes such as the number of implants desired by the patient, the presence or absence of bone filling, the treatment period that the patient can tolerate, and the expense that the patient can pay. It becomes possible to adjust the treatment method within the range desired by the patient.

Regarding the above description, the following items are further disclosed.
(Appendix 1)
In a simulation method for supporting an implant body placement operation in a jawbone, a computer includes:
A patient request information storage procedure for acquiring at least a treatment cost acceptable by the patient and a treatment period and storing it in the storage area as patient request information;
A setting procedure for setting the maximum number that can be operated within the treatment cost of the patient desired information as a processing number;
An arrangement procedure for arranging the number of implants for the number of treatments in a model showing a jawbone shape,
Strength for determining whether or not the strength of the implant body is sufficient by judging whether or not the area where the implant body placed so as to be embedded in the jaw bone of the model is in contact with the jaw bone has a predetermined surface area or more Judgment procedure;
When it is determined that the strength of the implant body is not sufficient by the strength determination procedure, a strength compensation procedure for performing a simulation related to a treatment for supplementing the strength based on the treatment period;
A treatment cost determination procedure for determining whether an estimated cost related to the treatment number and the treatment for supplementing the intensity is equal to or less than a treatment cost of the patient desired information;
Each time it is determined that the treatment cost is not less than the treatment cost of the patient desired information by the treatment cost judgment procedure, the placement procedure, the strength determination procedure, A simulation method characterized by repeatedly executing the reinforcement compensation procedure.
(Appendix 2)
The intensity compensation procedure is:
When the treatment period of the patient desired information is equal to or longer than a predetermined period for the treatment of bone formation, it has a bone formation mass calculation procedure for calculating the mass of the material of the bone formation part and storing it in the storage area,
2. The simulation method according to claim 1, wherein the estimated cost is a sum of a result obtained by multiplying the number of processes by a predetermined fee and a result obtained by multiplying the mass by a predetermined fee.
(Appendix 3)
The intensity compensation procedure is:
If the treatment period of the patient desired information is less than a predetermined period for the treatment of bone formation, the type information indicating the type after the change by changing the type of the implant body so that the contact area with the jawbone is widened The simulation method according to supplementary note 2, further comprising a type change procedure for storing the information in a storage area.
(Appendix 4)
The computer is
A stress analysis procedure for analyzing the stress exerted by the implant body on the placement position of the jawbone by the placement procedure;
The patient's pain tolerance value and pain limit value are acquired from the patient-specific pain database in which the patient's pain tolerance value and the pain threshold value are managed in correspondence with the patient identification information. Determining whether the patient feels pain by determining whether the maximum stress value calculated by the stress analysis procedure corresponds to either an allowable value of pain or a limit value of pain Pain judgment procedure to
4. The simulation method according to claim 1, further comprising a placement resetting procedure for resetting a placement position of the implant body when the pain judgment procedure determines that the patient feels pain.
(Appendix 5)
The computer is
A stress analysis procedure for analyzing the stress exerted by the implant body on the placement position of the jawbone by the placement procedure;
A stress concentration determination procedure for determining whether or not there is a stress concentration by determining whether or not the maximum stress value calculated by the stress analysis procedure is equal to or greater than a predetermined stress value;
4. The simulation method according to claim 1, wherein when the stress concentration determination procedure determines that there is no stress concentration, the strength determination procedure is executed.
(Appendix 6)
The computer is
A gypsum model creation procedure for storing, as a gypsum model, a 3D solid model created on the basis of the jawbone shape of gypsum collected from the patient to be operated;
For the CT model of the patient's jaw bone acquired by CT scan for the patient, the CT value is changed for each predetermined CT value, and the CT value that minimizes the volume of the non-polymerized portion between the CT model and the plaster model is obtained. 6. The simulation method according to any one of appendices 1 to 5, further comprising a CT value acquisition procedure to be acquired.
(Appendix 7)
A computer-executable program for causing a computer to perform a simulation that supports an operation of implanting an implant in a jawbone, the computer comprising:
A patient request information storage procedure for acquiring at least a treatment cost acceptable by the patient and a treatment period and storing it in the storage area as patient request information;
A setting procedure for setting the maximum number that can be operated within the treatment cost of the patient desired information as a processing number;
An arrangement procedure for arranging the number of implants for the number of treatments in a model showing a jawbone shape,
Strength for determining whether or not the strength of the implant body is sufficient by judging whether or not the area where the implant body placed so as to be embedded in the jaw bone of the model is in contact with the jaw bone has a predetermined surface area or more Judgment procedure;
When it is determined that the strength of the implant body is not sufficient by the strength determination procedure, a strength compensation procedure for performing a simulation related to a treatment for supplementing the strength based on the treatment period;
A treatment cost determination procedure for determining whether an estimated cost related to the treatment number and the treatment for supplementing the intensity is equal to or less than a treatment cost of the patient desired information;
Each time it is determined that the treatment cost is not less than the treatment cost of the patient desired information by the treatment cost judgment procedure, the placement procedure, the strength determination procedure, A computer-executable program for repeatedly executing the reinforcement compensation procedure.
(Appendix 8)
A simulation device that supports an implant operation in a jawbone,
Patient preference information storage means for acquiring at least a treatment cost acceptable by the patient and a treatment period and storing it in the storage area as patient preference information;
A setting means for setting the maximum number that can be operated within the treatment cost of the patient desired information as a processing number;
Arranging means for arranging the implant bodies for the number of treatments in a model showing a jawbone shape;
Strength for determining whether or not the strength of the implant body is sufficient by judging whether or not the area where the implant body placed so as to be embedded in the jaw bone of the model is in contact with the jaw bone has a predetermined surface area or more A determination means;
When it is determined that the strength of the implant body is not sufficient by the strength determination means, strength compensation means for performing a simulation related to the treatment for supplementing the strength based on the treatment period;
A treatment cost judging means for judging whether or not an estimated cost related to the treatment number and the treatment for supplementing the intensity is equal to or less than a treatment cost of the patient desired information;
Each time it is determined that the treatment cost is not less than the treatment cost of the patient desired information by the treatment cost judgment means, the placement means, the strength determination means, The simulation apparatus characterized by repeatedly executing the reinforcement compensation means.
(Appendix 9)
In a simulation method for supporting an implant body placement operation in a jawbone, a computer includes:
At least the treatment cost acceptable to the patient and the treatment period are acquired and stored in the storage area as patient preference information, and the maximum number of patients that can be operated within the treatment cost of the patient preference information is calculated. , A procedure for setting the maximum number as the upper limit value of the number of implants embedded;
Determining whether or not to perform treatment for supplementing the strength of the jawbone according to whether or not the treatment period of the patient desired information is equal to or longer than a predetermined period;
A step of simulating the position and number of implants in the jawbone based on the upper limit of the number of implants set and whether or not a treatment for supplementing the determined strength is performed. Simulation method.

  The present invention is not limited to the specifically disclosed embodiments, and various modifications and changes can be made without departing from the scope of the claims.

It is a figure which shows the function structural example of the simulation apparatus for assisting the dental treatment which concerns on one Example of this invention. It is a figure which shows the CT model by the difference in CT value. It is a flowchart figure for demonstrating the process performed by a dentition shape acquisition part. It is a figure which shows the example of a screen for acquiring the patient desired information displayed on a display unit by a patient desired information acquisition part. It is a flowchart figure for demonstrating the process performed by the treatment method adjustment part. It is a figure which shows the example of a simulation screen which shows the degree of the stress concentration based on the stress analysis result in the processing flow shown in FIG. It is a figure which shows the example of a screen which shows the treatment content displayed on a display unit by the treatment method output part. It is a figure which shows the example of a data structure of patient desired information. It is a figure which shows the example of a data structure of standard pain DB and patient pain DB. It is a figure which shows the data structure of treatment method DB for every patient.

Explanation of symbols

DESCRIPTION OF SYMBOLS 16 Storage area 19 Installer 20 Storage medium 100 Simulation apparatus 101 Dental row shape acquisition part 102 Patient desired information acquisition part 103 Treatment method adjustment part 104 Treatment method output part 121 CT model for every patient 122 Plaster model for every patient 123 Optimal CT value DB for every patient
131 Patient Request Information 141 Standard Pain DB
142 Pain DB for each patient
143 Treatment method DB for each patient

Claims (5)

A simulation program for causing the simulation to help implant body implantation surgery to jawbone computer, in the computer,
A patient request information storage procedure for acquiring at least a treatment cost acceptable by the patient and a treatment period and storing it in the storage area as patient request information;
A setting procedure for setting the maximum number that can be operated within the treatment cost of the patient desired information as a processing number;
An arrangement procedure for arranging the number of implants for the number of treatments in a model showing a jawbone shape,
It is determined whether or not the strength of supporting the implant body is sufficient by determining whether or not the area where the implant body arranged to be embedded in the jaw bone of the model has a predetermined surface area or more is in contact with the jaw bone. Intensity judgment procedure;
If it is determined that the strength supporting procedure for the implant body is not sufficient by the strength determination procedure, a strength compensation procedure for performing a simulation to determine the mass of the bone formation material necessary for bone formation to supplement the strength based on the treatment period;
To execute the steps treatment cost determination estimated cost of the bone augmentation to compensate for the strength and the processing number is equal to or less than the treatment costs of the patient desired information,
Each time it is determined that the treatment cost is not less than the treatment cost of the patient desired information by the treatment cost judgment procedure, the placement procedure, the strength determination procedure, simulation program characterized Rukoto was repeatedly execute and said reinforcing compensation procedure. The intensity compensation procedure is:
When the treatment period of the patient desired information is equal to or longer than a predetermined period for the treatment of bone formation, it has a bone formation mass calculation procedure for calculating the mass of the material of the bone formation part and storing it in the storage area,
The simulation program according to claim 1, wherein the estimated cost is a sum of a result of multiplying the number of processes by a predetermined fee and a result of multiplying the mass by a predetermined fee. The intensity compensation procedure is:
If the treatment period of the patient desired information is less than a predetermined period for the treatment of bone formation, the type information indicating the type after the change by changing the type of the implant body so that the contact area with the jawbone is widened have a kind change procedure to store in the storage area,
The simulation program according to claim 2 , wherein the computer executes the arrangement procedure, the intensity determination procedure, the intensity compensation procedure, and the treatment cost determination procedure after executing the type change procedure . The computer is
A stress analysis procedure for analyzing the stress exerted by the implant body on the placement position of the jawbone by the placement procedure;
The patient's pain tolerance value and pain limit value are acquired from the patient-specific pain database in which the patient's pain tolerance value and the pain threshold value are managed in correspondence with the patient identification information. Determining whether the patient feels pain by determining whether the maximum stress value calculated by the stress analysis procedure corresponds to either an allowable value of pain or a limit value of pain Pain judgment procedure to
If the patient by the pain judging procedure is determined to feel pain, further executes a placement reconfiguration procedure by changing the angle of the implant body Ru is rearranged in the arrangement procedure,
The simulation according to any one of claims 1 to 3, wherein when the pain determination procedure determines that the patient does not feel pain, the intensity determination procedure, the intensity compensation procedure, and the treatment cost determination procedure are executed. Program . A simulation program for causing the simulation to help implant body implantation surgery to jawbone computer, in the computer,
At least the treatment cost acceptable to the patient and the treatment period are acquired and stored in the storage area as patient preference information, and the maximum number of patients that can be operated within the treatment cost of the patient preference information is calculated. , A procedure for setting the maximum number to the number of implants embedded;
Whether or not to perform treatment for supplementing the strength of the jawbone depending on whether the treatment period of the patient desired information is longer than a predetermined period required for bone formation for supporting the implant body at the implant body placement position of the jawbone Procedures to determine the
Said implant body implantation number, the implant body implantation number as therapeutic whether the so based rather estimated cost performed by a fall within the cost of treatment of the patient desired information to supplement the strength and the determined change simulation program characterized Rukoto to execute a procedure for simulating the implant body implantation position to the jaw bone.

Images