JP6261231B2 - Dental dentition measuring device - Google Patents

Description

  The present invention relates to a dentition measuring device suitable for use in malocclusion treatment and implant treatment.

In denture base treatment and implant treatment for edentulous jaw disease and multiple tooth defects, it is extremely important to provide an ideal occlusion to a denture and a construction tooth. Conventionally, this occlusion is applied to the anatomical form of the hard tissue around the oral cavity and around the oral cavity, and the average value, and combined with several virtual reference lines and planes to capture the universal chewing movement of the mandible. I've been trying. In actual treatment, doctors and technicians reconstruct the occlusion of each patient based on such a universal mastication movement.

    In a normal human dentition, teeth are arranged so as to draw a generally U-shaped curve (called a dental arch) slightly open on the back side, and the occlusal line between the upper and lower teeth is a three-dimensional curve. ing. It is known that the occlusion curve by this dentition is on a spherical surface centered on a specific point on a vector representing the resultant force at the time of occlusion. In the case of a normal dentition, the upper and lower molars contact mechanically correctly at the time of occlusion, but normal occlusion cannot be obtained when the dentition is shifted to the left or right.

  Conventionally, since there is no standard for the direction and magnitude of the strong clamping force during actual occlusion, it is extremely difficult to quantitatively construct an individual ideal occlusion of a patient, for example, edentulous When producing a denture base for a patient with jaw disease, there is a problem that it takes a considerable amount of time and labor to produce a denture base that satisfies the patient. In order to improve this problem, the present inventor focused on the resultant force of actual occlusion, developed a face bow that can easily obtain an ideal occlusion in a short time, applied for a patent, and has already patented it. (See Patent Document 1 below). By using this face bow (called “Oral Compass”), it is much easier and quicker to construct an ideal occlusion than the conventional method. ing.

  However, even if this face bow (oral compass) is used, it is difficult to specify an ideal dentition, and there is a problem that considerable time and skill are required. That is, when the patient's dentition is deformed, it is visually difficult to determine the left and right position and height of the last molar where the most occlusal pressure is applied, especially for high precision for vocalists and sports athletes. It is very difficult to specify the occlusal contact position. For this reason, it is difficult to construct a dentition so that proper mastication can be performed, and treatment that is completely convinced by the patient is generally very difficult, depending on the superiority and skill of the doctor's spatial knowledge. Met. If correct occlusion is not performed, mastication is not performed well, and it is known that the growth of children has a negative impact on brain development. is there.

     To correct a patient's deformed dentition, a mouthpiece (reference piece) serving as a dentition reference is inserted into the patient's oral cavity in consideration of the patient's age and physique, and the reference piece and the actual dentition are inserted. If the difference is measured, the dentition suitable for the patient can be reconstructed. However, the patient's dentition has individuality, and when the amount of deformation is large, it is difficult to grasp the correct dentition.

International Publication Number WO2004 / 082511

Therefore, the present invention has an object to provide a dentition measuring device capable of accurately grasping a deformation amount (deviation) in order to correct a patient with a deformed dentition curve to a normal state. Yes.

In order to solve the above problems, the present invention employs the following configuration.
That is, teeth measuring apparatus according to the present invention (1),
A base frame having a pair of left and right side frames along both sides of the patient's head and a horizontal frame in the left and right direction connecting the pair of left and right side frames to each other;
A rotatable frame supported by the rotatably the base frame in a direction toward and away from to the patient's face inside of said side frame,
Earpieces attached to the base frame and locked near the left and right ear holes of the patient,
A dental face bow comprising a reference point indicating tool attached to the base frame and indicating an occlusal force concentration part set near a patient's nadion;
And an imaging device attached to the rotatable frame of the face bow for dental,
The rotating frame includes a pair of shafts rotatably supported by the base frame, and a horizontal frame connecting the pair of shafts;
The imaging device is
A support frame attached in a direction opposite to the pair of axes from a lateral frame of the rotating frame;
One or more cameras attached to the support frame,
The one or more cameras are provided in a direction for photographing a dentition in the oral cavity of a patient wearing the dental face bow.
Moreover, the dentition measuring apparatus (2) according to the present invention is the above dentition measuring apparatus (1),
The support frame is
A support arm attached from the horizontal frame of the rotating frame toward the opposite direction to the pair of shafts;
A camera support frame attached to the tip of the support arm,
The camera support frame is characterized by a curved shape centered on the center of curvature of the patient's occlusal curved surface.
Moreover, the dentition measuring apparatus (3) according to the present invention is the dentition measuring apparatus (2),
The camera support frame is
A cylinder attached to the tip of the support arm;
It is characterized by comprising a rectangular frame that is slidably inserted into the cylinder.
Moreover, in the dentition measuring apparatus (4) according to the present invention, any one of the dentition measuring apparatuses (1) to (3),
The one or more cameras are arranged toward the center of curvature of the patient's occlusal curved surface.
Moreover, in the dentition measuring device (5) according to the present invention, any one of the dentition measuring devices (1) to (4),
A dental measurement mouthpiece to be inserted into the oral cavity of the patient is attached to the rotating frame,
The dentition measuring mouthpiece is formed in a curved shape along an ideal occlusal sphere,
The one or more cameras are characterized in that the mouthpiece and a patient's actual dentition are photographed together.

Moreover, in the dentition measuring apparatus (6) according to the present invention, any one of the dentition measuring apparatuses (1) to (4),
The one or more cameras are constituted by a pair of left and right cameras arranged at intervals on the left and right.
Moreover, in the dentition measuring device (7) according to the present invention, any one of the dentition measuring devices (1) to (4),
It said one or more cameras, and arranged left and right of the camera in the horizontal direction at intervals, that is composed of a camera arranged vertically spaced than pair of right and left cameras It is a feature .

A dentition measuring apparatus according to the present invention is an imaging apparatus provided on a rotating frame of a dental face bow that is positioned by an indicator and an earpiece and is mounted on a patient's face so as to follow the patient's occlusal vector. Since a dentition is photographed with a camera, a rational dentition can be constructed by analyzing this image. For example, by comparing the actual dentition of the patient imaged by the camera of this imaging apparatus with the ideal dentition stored in the mouthpiece or computer as a reference piece, the actual dentition deformation amount ( (Deviation) can be accurately grasped, so by constructing the dentition so that this deviation does not occur,
An ideal dentition can be obtained.

As an imaging device, a mouse is used to image a patient's dentition using an apparatus that images the patient's oral cavity with a pair of left and right cameras arranged at predetermined intervals in the left and right direction, and analyzing the image with a computer. Even if there is no piece, an ideal dentition can be constructed. In addition, if an image is taken using an imaging device that includes a pair of left and right cameras and a third camera that is spaced vertically relative to the pair of left and right cameras, the actual dentition is measured in three dimensions. It is more convenient to construct a three-dimensional dentition curve.

It is a perspective view showing the state which mounted | wore the patient's face with the dentition measuring apparatus concerning this invention. It is a perspective view of an imaging device. It is a perspective view of an imaging device provided with a pair of left and right cameras. It is a perspective view of an imaging device provided with the 3rd camera arranged at intervals in the up-and-down direction in addition to a pair of left and right cameras. It is a front view of the face bow except an imaging device. It is the bottom view (a) and front view (b) showing the dentition of the upper jaw which deform | transformed. It is a front view of the skull showing an occlusal muscle. It is a side view of the skull which represents the resultant force of the occlusal force two-dimensionally. It is a side view of the skull which represents the resultant force of the occlusal force two-dimensionally.

  Hereinafter, the present invention will be described in detail based on embodiments of the present invention shown in the drawings. First, the face bow (oral compass) 2 constituting the dentition measuring apparatus according to the present invention is used for examining the direction of the occlusal force by attaching it to the patient's face, as shown in FIG. An imaging device 3 described later is attached to this.

  The oral compass 2 includes a base frame 101 made of a material having a certain degree of rigidity and strength, such as metal or plastic. The base frame 101 is a schematic gate including a pair of left and right side frames 102 and 102 disposed on the left and right sides of the patient's head, and a horizontal frame 103 that connects the upper ends of the left and right side frames to each other. It is formed into a mold. The side frame 102 is used as a side vector axis that represents the direction of force during occlusion in a side view.

  An approximately U-shaped rotation frame 105 is attached to the base frame 101 by shafts 106 and 106 so that the rotation is possible and the angle can be set.

  An attachment member 110 for fixing the mouthpiece is fixed to the oral compass 2 at the center of the horizontal frame 105b of the rotation frame 105. A dentition curve reference piece 112 (mouthpiece) is attached to the attachment member 110 by a fixing means such as a bolt. The dentition curve reference piece 112 is selectively attached in various shapes and dimensions according to the patient's physique and the like.

  The rotating frame 105 is attached to a position adapted to the patient by a shaft attached to a plurality of screw holes provided in the brackets 115 and 115 fixed to the base frame 101. Further, on both sides of the rotation frame 105, a rotation frame height indicator that is rotatable with respect to the rotation frame 105 is attached. An indicator pin is provided at the tip of the indicator. By attaching the rotation frame 105 to the base frame so that the movement locus of the instruction pin is within a predetermined range of the patient's temporal region, that is, between the ear hole and the joint head when the indicator is rotated. An appropriate dentition curve can be measured.

  A bracket 130 is fixed to the central portion of the horizontal frame 103 of the base frame 101. The bracket 130 includes a reference point indicating tool 131 whose protrusion length can be adjusted to correctly attach the base frame 101 to the patient's head, and a vertical position that supports the base frame 101 in the vicinity of the patient's eyebrows. An adjustable pad member 132 is attached. As the pad 132, a loosely curved plate-shaped pad that touches the patient's skin can be used. However, such a pad touches the patient's skin when worn on the patient's face, Since there is a risk of scratching, it is preferable to use a pad made of a rotating spherical body as in the illustrated example.

  The reference point indicating tool 131 is for indicating the point (N point) at which the resultant force axis at the time of biting of the patient intersects the frontal bone surface of the patient. As shown in FIG. It has been found that it starts from the middle point of the left and right mandibular angles and is located near the top of the human head Nadion, so in practice the base frame should be shown to the patient to indicate the middle point of the left and right eyebrows Just install it.

  Further, earpiece support members 135 protruding in a direction perpendicular to the side frames are attached to the side frames 102, 102 on both sides of the base frame 101. The protrusion length of the earpiece support member 135 can be adjusted, and an earpiece 140 that extends in a direction perpendicular to the support member 135 is attached to the tip of the earpiece support member 135. The earpiece 140 has a smooth tip, and the base frame 101 can be supported on the patient's head by inserting the earpiece 140 into the ear hole of the patient.

  The oral compass 2 is attached to the patient's head by the pad member 132 and the earpiece 140. In this attached state, the side frame 102 of the base frame 101 is a projection line viewed from the side of the occlusal force vector axis. It becomes a state that overlaps. In this state, the rotating frame 105 is attached to the base frame 101, and the mouthpiece 5 attached to the rotating frame 105 is inserted into the patient's oral cavity by rotating the rotating frame 105. The wax rim held by the patient can be fixedly held on the face bow 2 via the rotating frame when the dentition is examined or when the occlusion of the total denture is collected. By determining the angle of the rotating frame 105 with the wax rim fixedly held with respect to the base frame 102, the occlusal state optimum for occlusal engineering can be reproduced. This angle measurement can be read with a protractor or the like.

  FIG. 6 shows a state in which the reference mouthpiece 5 is inserted into the patient's oral cavity and arranged along the upper dentition 200, and the mouthpiece 5 is a support member provided at the base side end. 6 is attached to the rotating frame 105. The reference mouthpiece 5 is formed in a substantially convex bell shape in which the base side end is formed into a rounded convex curved surface, and the left and right sides are slightly wider on the back side (the lower side in FIG. 6A). ing. Moreover, as shown in FIG.6 (b), the cross section which follows the line of the left-right direction and the cross section which follows the front-back direction (longitudinal direction) is formed in the mouthpiece 5 in the curved shape. This curved surface is a curved surface along an ideal occlusal sphere, and the radius of curvature of the curved surface is about 65 mm to 75 mm in patients 10 to 10 years old who have poor occlusion. In this case, the resorption of the jawbone is increased, so that it is approximately 65 mm regardless of race. What is necessary is just to select an appropriate thing according to a patient's age, physique, etc. The mouthpiece 5 is arranged inside the patient's dentition 200 with a slight gap t. If there is a deviation in the patient's dentition, a large gap as shown by T in the figure is formed, There is also a deviation of H in the direction.

  Next, the photographing device 3 used by being attached to the face bow 2 will be described. As shown in FIG. 2, the photographing apparatus 3 includes a support frame 9 and a camera 20. The support frame 9 is fixed to the left and right center part of the rotating frame 105, and includes support arms 11 and 11 fixed to the rotating frame 105, and a camera support frame 12 attached to the tip of the support arm. I have. The camera support frame 12 is a rectangular frame composed of a vertical frame 12a slidably inserted in a cylinder 13 attached to the support arm 11 and upper and lower horizontal frames 12b. The vertical frame 12a has a curved shape centered on the patient's occlusal curvature center O.

  A camera 20 is attached to the camera support frame 12. The camera 20 is a CCD camera similar to a small camera provided in a smartphone, a mobile phone, or the like, and transmits a captured image as an electrical signal to a computer or the like. In the figure, reference numeral 21 denotes a code for transmitting an electrical signal representing an image, and the leading end of the code 21 is connected to the computer 25 of the management device 24. A plurality of types of standard dentition images are recorded in the memory 26 of the management device 24 according to the age and physique of the patient, and the standard images can be appropriately displayed on the display device 27. Therefore, if the curvature center of this standard image (or the mouthpiece photographed at the same time as the dentition) and the center of curvature of the actual patient photographed by the camera 20 are combined on the same condition and displayed on the same screen, the patient's The abnormal part of the dentition can be clearly seen on the screen. For example, the right bite, left bite, and anterior tooth bite can be easily confirmed, so the “twist” and “bend” of the cervical spine can be almost identified without X-ray imaging, and many related whole body Complications can be predicted with high accuracy by collating with data. Then, by sending and receiving images using the Internet, a smartphone or the like, it is possible to treat and respond to a specialist doctor and a remote patient.

  FIG. 3 shows an example in which two cameras 20 are provided on the left and right with an interval (several centimeters). The pair of left and right cameras are arranged toward the center of curvature O of the occlusal curved surface, and both are provided so as to photograph the dentition in the patient's oral cavity. As described above, when photographing a dentition with a pair of left and right cameras, the actual dentition can be grasped more accurately without a mouthpiece. In particular, wear and deterioration of the occlusal surface can be compared with the standard state with higher accuracy, so it is possible to adjust the occlusion with simple operations. Will point out problems at the micron level, which will lead to dramatic problem solving.

  FIG. 4 shows an example in which another camera is provided in the vertical direction in addition to the pair of left and right cameras. In this example, a pair of left and right cameras are attached to a pair of left and right projecting arms 15 projecting downward from the camera support frame 12, and the upper camera is mounted on the left and right sides of the camera support frame 12 in the same manner as in FIG. It is provided in the center (on the midline of the patient's face). As described above, when three or more cameras are used, it is possible to obtain a three-dimensionally superior image during inspection of systemic complications due to poor occlusion and application to a dental CADCAM. As dental prostheses and artificial teeth made with dental geared cams, it is possible to make a patient having an engineering function unique to a patient in a short time, and to develop dream dental care. A pair of left and right cameras may be provided on the upper side, and a third camera may be provided on the lower side.

The occlusion treatment using this dentition measuring device is characterized in that the occlusion is constructed by paying attention to the resultant force at the time of occlusion by mastication. That is, the muscles acting at the time of occlusion are the masseter Mm and the temporal muscle Mt, as shown in FIGS. 7, 8, and 9. The force generated by these is a vector having a predetermined direction and magnitude. According to the study of the present inventor, these resultant forces F are slightly different depending on individual patients. As shown in FIG. 5, it is known that the head is directed to a point (referred to as “N point”) near the front edge of the frontal sinus (immediately above the nadion).

  7, 8, and 9 representing the head two-dimensionally, Pa represents the occlusal point of the front tooth, Pb represents the occlusal point of the back tooth, and Pc represents the point of the joint head. In the figure, the occlusal force acting on the back tooth occlusion point Pb and the occlusal force acting on the joint head point Pc are vectors having directions indicated by L in the figure, and the relationship between these forces and the resultant force F is Although it can be expressed by a simple formula, it is omitted here. In the figure, O represents the N point. The occlusal curve is on a spherical surface centered at this point O.

  In addition, the resultant force at the time of occlusion of all patients does not necessarily go to O (N point). Due to aging and resorption of bone by aging, the point at which the resultant force at the time of occlusion is It is also known that the line L connecting to the point P (referred to as “force line” or “vector axis”) gradually approaches the point P side. Thus, even if the point where the resultant force at the time of occlusion changes due to aging or the like, the occlusion curve of each patient can be grasped by visually observing the remaining teeth, gums, etc. .

  Therefore, if a circular arc (actually a spherical surface) centered on a point on the resultant force line L (the position is slightly different depending on the patient) is drawn, each occlusal point in an ideal occlusion should be aligned on the circular arc. . The present invention has been completed based on such knowledge, and an ideal occlusion is obtained by manufacturing a denture base based on the arc.

That is, when the deviation of the patient's dental dentition is measured using the dentition measuring apparatus of the present invention, a new dentition may be constructed so as to eliminate this deviation. Since this construction method is well-known, description is abbreviate | omitted.

  The dentition measuring apparatus according to the present invention can be industrially produced, and is suitable for use in dental treatment and implant treatment for edentulous jaw disease, multiple tooth defects and the like in the field of dentistry.

1 Dental dentition measuring device 2 Face bow (Oral compass)
3 Imaging Device 20 Camera 101 Base Frame 102 Side Frame 103 Horizontal Frame 105 Rotating Frame 140 Earpiece

Claims (7)

A base frame having a pair of left and right side frames along both sides of the patient's head and a horizontal frame in the left and right direction connecting the pair of left and right side frames to each other;
A rotatable frame supported by the rotatably the base frame in a direction toward and away from to the patient's face inside of said side frame,
Earpieces attached to the base frame and locked near the left and right ear holes of the patient,
A dental face bow comprising a reference point indicating tool attached to the base frame and indicating an occlusal force concentration part set near a patient's nadion;
And an imaging device attached to the rotatable frame of the face bow for dental,
The rotating frame includes a pair of shafts rotatably supported by the base frame, and a horizontal frame connecting the pair of shafts;
The imaging device is
A support frame attached in a direction opposite to the pair of axes from a lateral frame of the rotating frame;
One or more cameras attached to the support frame,
The dentition measuring apparatus, wherein the one or more cameras are provided in a direction for photographing a dentition in a mouth of a patient wearing the dental face bow. The support frame is
A support arm attached from the horizontal frame of the rotating frame toward the opposite direction to the pair of shafts;
A camera support frame attached to the tip of the support arm,
The dentition measuring apparatus according to claim 1, wherein the camera support frame has a curved shape centered on a curvature center of a patient's occlusal curved surface. The camera support frame is
A cylinder attached to the tip of the support arm;
The dentition measuring device according to claim 2, wherein the dentition measuring device is configured by a rectangular frame that is slidably inserted into the cylindrical body. The dentition measuring apparatus according to any one of claims 1 to 3, wherein the one or more cameras are arranged toward a center of curvature of a patient's occlusal curved surface. A dental measurement mouthpiece to be inserted into the oral cavity of the patient is attached to the rotating frame ,
The dentition measuring mouthpiece is formed in a curved shape along an ideal occlusal sphere,
It said one or more cameras, dental measuring apparatus according to any one of claims 1 to 4, characterized in that for imaging in conjunction with the actual teeth of the mouthpiece and the patient. The dentition measuring apparatus according to any one of claims 1 to 4, wherein the one or more cameras are constituted by a pair of left and right cameras arranged at an interval on the left and right. It said one or more cameras, and arranged left and right of the camera in the horizontal direction at intervals, that is composed of a camera arranged vertically spaced than pair of right and left cameras The dentition measuring apparatus according to any one of claims 1 to 4, characterized in that:

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