KR20150040508A - Method of making customized dental implant for immediate implanting after extraction of tooth using virtual 3D image of teeth - Google Patents

Abstract

Disclosed is a manufacturing method of a patient customized dental implant using a 3D virtual tooth structure. The dental implant is manufactured by the steps of extracting a patient′s intra-oral as a three-dimensional (3D) data by using a scan technology and then manufacturing a virtual tooth; and manufacturing an actual tooth including a fixture and an abutment by using zirconia ceramics. According to the invention, it is possible to implant a dental implant immediately without drilling right after extracting the tooth through a special device and an optimized surface treatment for an initial fixing since the dental implant is manufactured to be most similar with a patient′s original tooth.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method and apparatus for preparing a dental implant using a three-dimensional virtual tooth structure,

The present invention relates to a method of manufacturing a dental restoration, and more particularly, to a method of manufacturing a patient-customized dental restoration using a three-dimensional image of teeth.

Implant is an artificial tooth, which is a dental treatment method that restores the function of the natural teeth through surgery to the defect of the tooth. It can be used semi-permanently, and it is firmly fixed to the gum bone, so it does not interfere with food intake because it has excellent masticatory power. In addition, when the implant is placed, it is possible to prevent the tooth from moving into the hollow space of the gum after loss of the tooth, and it is possible to maintain the health and the preservation of the gum like a natural tooth. Dental implant technology has grown rapidly after the concept of the 1960s has been established and has become a representative technology of dental restorative treatment nowadays, and it has become so common that it is designated as a salary item of National Health Insurance.

Currently, the shape of the dental implant can be classified as threaded or cylindrical. However, these implants are standardized and very different from the natural tooth form. For example, in the case of the molar region, a large crown is connected to a root shape that is much thinner than the root of a natural tooth, thereby forming a space at a joint site, which may cause a food problem such as food impaction.

A method of drilling or the like is involved in placing the implant fixture. The drilling makes space for the implant, which requires several drilling until it reaches the size of the implant, and if the position, angle and depth of the implant are not correct, they cause malocclusion, tooth movement and pain. . Therefore, it is necessary to substitute natural tooth type implant implant technique.

The main material of the implant is titanium or titanium alloy, which is due to the excellent biocompatibility of the oxide formed on the surface of the titanium alloy. However, recent studies have reported inconveniences such as hypersensitivity reactions to titanium, elution of titanium from long-term human use, accumulation of lymph nodes, and electrical conduction. In addition, as the period of use of the titanium implant becomes longer, the aesthetic problem that the dark color of the metal appears in the lower part of the restoration tooth frequently occurs along with the retraction of the gingiva frequently, resulting in aesthetic problem. Furthermore, there is considerable difficulty in recovering from the occurrence of such side effects, which is perceived to be a serious problem for patients and dentists.

Korean Patent No. 1235320 relates to an implant using zirconia, which is useful for restoration of an implant using CT scan data, and discloses an esthetically superior implant by using zirconia. However, this is a conventional screw type implant and is not related to restoration of natural tooth shape.

Considering these problems, there is a need for an implant system that maintains natural tooth shape, improves the treatment process, and exhibits excellent aesthetic effect.

The present invention provides a method of manufacturing a patient-customized dental restoration using a three-dimensional image.

In one aspect, the present disclosure provides a method of making a patient-customized dental restoration. In one embodiment, the method comprises: obtaining an image of a tooth structure requiring restoration of the patient; Extracting three-dimensional virtual teeth of a tooth requiring restoration using the image; And producing a patient-specific dental restoration comprising a fixture and abutment using the three-dimensional virtual teeth.

The dental restoration manufactured according to the method of the present invention is characterized in that the dental restoration is instantly placed after tooth removal, which requires restoration of the patient.

Fixtures and abutments made according to the method of the present invention, such as fixtures and abutments, may be fabricated in one piece or in separate form, and suitable materials may be used, for example tooth restoration may be made of zirconia, ceramic, But are not limited to, those described above.

Obtained by using at least one of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), 3 Dimensions Scanner and Intraoral Scanner according to the present invention , Way.

In order to obtain a three-dimensional virtual tooth according to the present invention, the image of the tooth or the tooth structure to be restored can be obtained as a two-dimensional or three-dimensional image, and the image of the structure can be obtained from the teeth, tooth roots, gingiva, A tooth structure including a dentio-enamel junction, a tooth structure adjacent to a tooth to be placed, an opposing tooth structure of the tooth to be placed, and an alveolar bone and a jawbone structure image of the tooth to be implanted.

The method according to the present invention may further comprise the step of surface roughing the fixture of the restoration, for example, the surface roughness treatment may include grit blasting, acid treatment, anodization, laser irradiation, ultraviolet irradiation, And / or < / RTI >

A dental restoration manufactured according to the present invention, for example, an implant is a dental restoration custom-made to an implant patient that is the same as that of a natural tooth, and restoration of the patient's teeth can be perfectly restored to prevent the usual side effects that may occur after restoration treatment. In addition, by using the image data taken before the procedure, if the implant of another patient's teeth is needed in the future, the implant can be immediately implanted and the period of tooth loss can be minimized.

1 is a process for fabricating a dental restoration according to an embodiment of the present invention.
Figure 2 is a photograph of two CT images taken according to one embodiment of the present invention.
3 is a photograph of a 3D virtual tooth prepared according to one embodiment of the present invention.
4 is a side and front view photograph of a zirconia implant fabricated in accordance with one embodiment of the present application.
FIG. 5 is a photograph of a dog-customized tooth restoration (a) according to an embodiment of the present invention, (b), (c), and (d, e).

Hereinafter, the configuration and the names thereof will be described as an example, but the present invention is not limited thereto, and the understanding and interpretation of the invention should be construed as a corresponding configuration.

We need restoration by means such as computed tomography. The present invention relates to a method of manufacturing a personalized restoration of a natural tooth type using an image of a tooth after obtaining an image of the tooth and specifically obtaining a virtual tooth data using a three- The present invention relates to a dental restoration which can be implanted immediately after extraction without drilling.

Accordingly, in one aspect, the present invention provides a method of manufacturing a patient-customized dental restoration using a three-dimensional virtual tooth structure, comprising: obtaining an image necessary for extracting the three-dimensional virtual tooth structure; Extracting a three-dimensional virtual tooth structure of a tooth requiring restoration using the image; And preparing a patient-customized dental restoration comprising the fixture and abutment using the three-dimensional virtual tooth structure.

The term "dental restoration" as used herein refers to a structure that can replace a tooth in a deficient tooth space including an implant, a bridge restoration, a crown restoration, an inlay, an onlay, and a denture.

As used herein, the term "tooth structure" refers to a portion of the oral cavity requiring acquisition of an image for extraction of a virtual tooth for the preparation of a restoration of teeth. The tooth structure of the teeth to be implanted, tooth root, gingiva, an enamel junction, and an adjacent tooth structure and an opposed tooth structure including the tooth to be placed, and alveolar bone and jaw bone structure of the tooth position to be placed.

The structures of teeth that require restoration herein can be obtained using basic laser scanning, photographic imaging and mechanical sensing scanning techniques, such as computed tomography (CT), magnetic resonance imaging (MRI) Imaging, 3Dimensions Scanner, and / or Intraoral Scanner, but is not limited thereto.

The structure of the teeth obtained according to the present invention is converted into a three-dimensional image for extraction of virtual teeth. The 3D image data may be transferred to a CAD system for manipulating the electronic data by conventional means. [Choi, Won-Jun et al., A contour-based algorithm for generating 3D models of teeth and jaws in CT images, 2003 ) Korean Information Science Society Fall Fall Conference 30 (2): 619-621]. In one embodiment of the present invention, three-dimensional data is extracted after a CT scan of the inside of a patient's mouth, and a virtual tooth, i.e., a tooth structure is formed into a three-dimensional image using a CAD (Computer Aided Design) [See, for example, Huhun et al., Dental Separation in CT Images of Adaptive Optimal Thresholding (2002) Korean Society for Multimedia, Fall, pp. 89-92). Fig. 3 is a diagram showing a 3D virtual tooth extracted from a photographed CT data using a CAD program.

As used herein, the term "implant" refers to a restoration that rests on or in the jawbone for restoration of a missing tooth, including fixtures and abutments, and may further include a crown connected to the abutment. In one embodiment of the invention, the fixture and abutment are constructed as an integral or separate structure, and the crown is a crown structure commonly used in dental treatment and is not limited to any one.

The fixture of the implant manufactured according to the method of the present application includes an abutment capable of connecting the fixture with a crown such as a root-shaped fixture and a crown of the same shape as a natural tooth of an individual.

Implants can be classified according to the time of implantation. According to the implantation time, the implantation is performed immediately after the extraction, immediately after the implantation, at 6 to 10 weeks after the extraction, and at 3 to 6 months after the implantation There is a late method of operation. Typically, the implant procedure involves an incision on the gum to reveal the bones before implantation.

However, the implant treatment of the present invention is an immediate extraction procedure in which there is no incision step for the gum and a tooth-like fixture or fixture and abutment of a natural tooth is immediately placed after the patient's tooth extraction. Therefore, the method of the present invention does not require a drilling step necessary for a typical implant procedure, and the implant procedure can be completed in a time shorter than the time until completion of the conventional implant procedure.

Furthermore, the implant has one operation or two operations depending on the implantation method. In one operation, implant root and upper tooth are simultaneously placed and restored. In the second operation, fixture of implant root is placed first and then waited for adhesion with bone. Abutment and crown, . The method according to the present invention is also applicable to a double operation in a specific case including a case in which a single operation is generally performed but a residual alveolar bone is in a poor state.

In the case of using a scanning technique for manufacturing an implant, the inside of a patient's mouth can be scanned without using a dental impression material or a mold, and this can be used for manufacturing a dental restoration, which is convenient.

A series of steps for the method of manufacturing the dental restoration of the present application is shown in Fig. In one embodiment of the present invention, the patient's existing CT data or newly taken CT data is obtained after the patient's tooth extraction decision is made. If necessary, additional angles can be imaged at a single point of exposure using a single system for intraoral scanning, virtual tooth models and implants. The virtual tooth after the photographing is designed, for example, as a root implant in the shape of a natural tooth, and has a groove shape having an optimum taper at a portion connected to the upper crown, After the implantation of the root root implant is completed, the angle of the connecting groove of the root portion is made into CAD by setting a corresponding connection key by taking a digital or analog impression using a dedicated impression pin.

The fabrication of the implant using the manufactured CAD image can be made by making a cast using a prototyping mechanism or by using a milling method. The milling method is used here, but the present invention is not limited thereto.

The materials used to make the restoration herein are zirconia, ceramic, or titanium or a combination of one or more thereof, and in one embodiment, fixtures and abutments are made using zirconia. FIG. 4 is a view showing an integrated implant of a fixture and an abutment manufactured by using zirconia, which is obtained by preparing the implants from three-dimensional virtual teeth derived as described above.

The fabricated implants of the present application use devices such as threads, microelevations, microthreads or vertical fins for initial fixation at the time of implantation and are restored by immediate implantation.

The fixture of the present application may further include a surface roughness processing step. The above-mentioned "surface roughness treatment" is carried out to improve the osseointegration phenomenon between the fixture and the jawbone. The surface roughness treatment is a physical or chemical treatment such as grit blasting, acid treatment, anodizing, laser irradiation, ultraviolet irradiation, The roughness of the surface of the fixture can be adjusted. [Wennerberg A et al. On Implant Surfaces: A Review of Current Knowledge and Opinions 2009; 24: 63-74] In one embodiment of the present invention, the surface roughness treatment of the root roots is performed by the particle spraying method after the milling step and the acid treatment with hydrofluoric acid, but the present invention is not limited thereto.

Hereinafter, embodiments are provided to facilitate understanding of the present invention. However, the following examples are provided only for the purpose of easier understanding of the present invention, and the present invention is not limited to the following examples.

<Examples>

Example 1 CT photographing

A tailored restoration was made on a dog according to a series of steps of the embodiment described below. Dogs used in this example used 12-month-old beagle dogs (9 to 12 kg). Before the CT scan, anesthesia was maintained with isoflurane after intravenous induction anesthesia with atropine and ketamine, and vital signs including blood pressure were checked. CT images (Siemens emotion 16, Forchheim, Germany) Images are shown in FIG.

Example 2 Extraction of a virtual tooth structure

(DICOM) image of a CT image of a beagle dog of Example 1 using a commercially available program (OnDemand 3D, Cybermed, Korea), a task of zoning a three-dimensional image model for a tooth (Segmentation procedure). In summary, the threshold value of the optimal difference of the radial blackening degree obtained by repeated preliminary analysis and trial and error was input, and the image of the corresponding region was subjected to the first regionization. At this stage, a threshold value of a tooth to be extracted is set, and only a specific point is specified in the corresponding tooth and only a portion having a value corresponding to the degree of blackening of these points is left. In additional, more detailed secondary sagittalization, the subject is magnified using the axial, coronal, and sagittal views of the tomographic image and the 3D Zoom function in the stereoscopic image, then viewed locally, using a semi-automatic tool (smart pen) More accurate tooth extraction was performed with the side surface minimized. The virtual teeth of the STL file, which is 3D data, are obtained as shown in FIG. 3 through 3D reconstruction of the data obtained as described above.

Example 3 Implant preparation

The virtual tooth data of the second embodiment was converted into a file in the STL (STereoLithography) format and then transferred to a milling center. Using a medical grade zirconia block in the milling center (Dentime, Seoul), a real zirconia implant Respectively.

Example 4 Implant placement

For implant placement in the beagle dog of Example 1, anesthesia was performed in the same manner as in Example 1, and a local anesthetic was further administered. The teeth were placed at the site for implant placement, immediately implanted, and waited for 2 months. Pull out test and histomorphometric analysis were performed to evaluate the degree of osseointegration. [Wennerberg A. et al. Nanostructures and hydrophilicity influence osseointegration: a biomechanical study in the rabbit tibia (2013) Clinical Oral Implants Research 19 June 2013, 1600-0501 and Park YS et al. The effects of ion beam-assisted deposition of hydroxyapatite on the grit-blasted surface of endosseous implants in rabbit tibiae. Int J Oral Maxillofac Implants (2005) 20 (1): 31-8)

As a result of the experiment according to the present embodiment, it showed faster recovery ability than the conventional drilling method, and showed complete healing of the soft tissue after 1 to 2 weeks. Bone-to-implant contact (BIC) Pull-out force values were 57.5 ± 8.8% and 52.3 ± 12.1 N, respectively, in the initial experiment. Referring to Fig. 5, in the integrated implant shown in Fig. 4, an initial load is applied at the time of implantation using the x-ray photograph (a), the x-ray photographs (b and c) before implantation, and the x- In order to avoid that, the crown was removed and placed.

While the present invention has been described in connection with what is presently considered to be the preferred embodiments, it is to be understood that the invention is not limited to the disclosed embodiments, but, on the contrary, .

All technical terms used in the present invention are used in the sense that they are generally understood by those of ordinary skill in the relevant field of the present invention unless otherwise defined. The contents of all publications referred to herein are incorporated herein by reference.

Claims (8)

A method of manufacturing a patient-customized dental restoration,
Obtaining an image of a tooth structure requiring restoration of the patient;
Extracting three-dimensional virtual teeth of a tooth requiring restoration using the image; And
And using the three-dimensional virtual tooth to produce a patient-customized dental restoration comprising a fixture and abutment.
2. The method of claim 1, wherein the dental restoration is immediately implanted after tooth extraction where the patient is required to have restoration.
2. The method of claim 1, wherein the fixture and abutment are fabricated in an integral or discrete manner.
The method of claim 1, wherein the tooth restoration is made of zirconia, ceramic, or titanium or a combination of one or more of the foregoing.
The method according to claim 1,
Wherein the image is obtained using at least one of computed tomography (CT), magnetic resonance imaging (MRI), a 3-dimensional scanner, and an intraoral scanner. Way.
The method according to claim 1,
The image of the tooth structure includes a tooth structure including a crown, a root, a gingiva, a gingival, a dentio-enamel junction of a tooth to be placed, a tooth structure adjacent to a tooth to be placed, a contour tooth structure of the tooth to be placed, Wherein the image includes an alveolar bone and a jawbone structure image of the tooth.
The method of claim 1, wherein the method further comprises the step of treating the fixture with a surface finish.
The method of claim 7, wherein the surface roughness treatment is performed by at least one of grit blasting, acid treatment, anodizing, laser irradiation, ultraviolet irradiation or plasma treatment.

Images