1239829 五、發明說明（1) 【技術領域】 本發明係為一種以斷層放射線影像及逆向工程技術製 作外科手術導引裝置之方法，特別是關於一種使用在骨科 鲁療手術前，利用斷層放射線影像及逆向工程技術製作一 導引裝置，以便讓骨科醫師決定骨科手術進行之位置、轴 線及深度的方法。 【先前技術】 按，一般牙科醫師在進行植牙手術前，會以植牙位置 相鄰之真齒製作出一植牙模具，再以該植牙模具定位出欲 鑽孔之位置，以便能將假牙植入口腔上下顎骨頭中，然而 該種植牙手術之定位方式皆是人為的臨床判斷，經常無法 以最適宜角度與長度將植體植入口腔上下顎骨頭中。 又，在外科手術時如口腔下顎加長或縮減手術，醫師 會先以傳統斷層放射線影像技術如X光，照射病患之口腔 骨格，再以X光片決定外科手術切割或鑽孔的位置，然而χ 光片僅能猜測手術大約的位置，並無法精確地決定出手術 正確位置，且亦無法得知切割或鑽孔之深度，及轴線是否 垂直骨格等等。 、 在習知技藝方面，如本國專利公告號48〇166號發明專 利’係為『牙齒觀察系統』，其係揭露一種利用斷層掃描 (Computed Tomography)儀器取得病患牙齒之三維（3D)田 影像，以變化3D影像之視點觀察牙齒之矯正視點。然而 用3D影像之斷層掃描必須長時間照射病患，其幅射線對病1239829 V. Description of the invention (1) [Technical Field] The present invention relates to a method for manufacturing a surgical guide device using tomographic radiography and reverse engineering technology, and particularly relates to a method for using tomographic radiography before orthopedic surgery. And reverse engineering technology to make a guide device to allow orthopedic doctors to determine the position, axis, and depth of orthopedic surgery. [Previous technology] According to the general practice, before performing dental implant surgery, a dentist will make a dental implant mold from the real teeth adjacent to the implant position, and then use the dental implant mold to locate the position to be drilled, so that Dentures are implanted into the upper and lower jaw bones of the oral cavity. However, the positioning methods of this dental implant surgery are artificial clinical judgments. Often it is impossible to implant the implants into the upper and lower jaw bones at the optimal angle and length. In addition, during surgery, such as lengthening or reducing the oral jaw, the physician will first use traditional tomography techniques such as X-rays to illuminate the patient's oral bones, and then use X-rays to determine the location of the surgical cut or drilling. However, X-rays can only guess the approximate location of the operation, and cannot accurately determine the correct location of the operation, nor can they know the depth of the cut or drilling, and whether the axis is perpendicular to the bone grid. In terms of know-how, for example, National Patent Publication No. 48〇166 is the "Dental Observation System", which discloses a three-dimensional (3D) field image of a patient's teeth using a computed tomography instrument. Observe the corrective viewpoint of the teeth by changing the viewpoint of the 3D image. However, tomography using 3D images must illuminate the patient for a long time.
1239829 五、發明說明（2) 患造成的潛在傷害’反不如傳統之X光機只需瞬間的照 射，對人體之傷害較小。 ” 【内容】 職是，本案發明人即為解決上述現有骨科或牙科手貧 中無法正確決定手術切割或鑽孔位置之不便與缺失，乃= 潛心研究並配合學理之運用，提出一種以斷層放射線3像 及逆向工程技術製作外科手術導引裝置之方法，&以= 之斷層放射線影像裝置製作出一導引裝置，再藉=談 裝置精綠定位手術切割或鑽孔之位置。 而本發明係提供以下之技術手段來達成 引裝置以利外科手術之目的·· 衣作出精確¥ 公傻^ ^ =之主要技術特徵係在於提供一種以斷層放射線 ΐΪίΪ:工：技術製作外科手術導引裝置之方法，該方 ti t 預估定位標示之模具施加於該病患、之手術 = 計進行手術之大約位置，再以X光機照射 射i习德，I杈具及預估定位標示之複數骨骼切面斷層放 之複=典叹士以Γ電腦裝置分析該含模具及預估定位標示 位置' ϋ口 :=斷層放射線影像，以決定手術進行之正確 之結果/，、： ：、、: f於骨骼之模擬軸線，最後配合電腦分析 即可i# &; I圯向工程技術製作出精確之導引裝置，如此 ^達成讓外科醫師依精確之導引裝置來進行手術之功1239829 V. Description of the invention (2) Potential harm caused by the disease ’In contrast to the traditional X-ray machine, which requires only instantaneous irradiation, the harm to the human body is small. [Content] The inventor of this case is to solve the inconvenience and lack of the surgical cutting or drilling position in the existing orthopedic or dental hand poverty mentioned above. He has devoted himself to studying and cooperating with the application of science to propose a tomographic radiation 3 image and reverse engineering technology to make a surgical guidance device, & using a tomographic imaging device = to create a guidance device, and then borrow = to talk about the device fine green to locate the position of surgical cutting or drilling. And the invention The following technical methods are provided to achieve the purpose of guiding the device to facilitate surgery. The main technical feature of making clothes is accurate. The main technical feature is to provide a tomographic radiation method. Method, the square ti t predictive positioning mark of the mold is applied to the patient, the surgery = the approximate position of the operation, and then X-ray machine is used to illuminate i, Germany, and the plurality of bones Resection of section tomography = Dian Shishi analyzed the containing mold and estimated positioning mark position with a Γ computer device. Ϋ 口: = Tomography image to determine the operation. The correct result / ,, ::: ,,: f in the simulated axis of the bone, and finally with computer analysis, i # &; I 圯 direction engineering technology to produce an accurate guidance device, so ^ reach the surgeon Performing surgical operations with precise guidance
五、發明說明（3) 【實施方法】 為了使貴審查委員能更進—牛 定目的所採取之技術、手段及功效:本發明為達成特 明之詳細說明與附圖，相信本發:> 閱以下有關本發 當可由此得—深人且具體之瞭解，=的、特徵與特點， 考與說明帛，並非用來對本發明加：限：：圖式僅提供參 由於植牙手術為外科手術之—種，（且^ 完全一樣，故而本發明先以植牙手術 進行之方式 曰月。首先請參閱第—圖所示，係為本發==^加以說 施例鑽孔之立體示剖視圖，而第二 =手術為實 流程示意圖。在植牙手術進行前皆必需：：士發明之定位 至該病患之手術位置處（100)，該模且上、入拉具施加 位標示用以初步決定手術鑽孔之大略位置二有-二估定 為-種以聚合材料配合病患植牙 以 定位模型，-般稱之為植牙軟骨模型。U1所製成之V. Description of the invention (3) [Implementation method] In order to make your review committee more advanced-the technology, means and effects adopted by Niu's intended purpose: The present invention is to achieve a specific detailed description and drawings, I believe this issue: > Read the following about this book when you can get a deep and specific understanding, =, characteristics and characteristics, test and explanation, not to add to the present invention: Limitation :: The diagram is only provided for reference because the dental implant surgery is surgical The type of surgery (and ^ are exactly the same, so the present invention first uses the method of dental implant surgery to say the month. First, please refer to the figure-is a three-dimensional illustration of the drilling of the embodiment == ^ Sectional view, and the second = surgery is a schematic diagram of the actual process. Before the dental implant surgery is performed, it must be: The invention of the patient is positioned at the surgical position of the patient (100). Based on the preliminary determination of the approximate location of the surgical drill hole, there are two-estimated to be a type of polymer material to cooperate with the patient's dental implant to locate the model, which is generally called a dental implant cartilage model. Made by U1
當製作完成該模具10後，本發明利 ,產生裝i，如X光機照射欲進行手術之位：處層 妝射一橫切面及一縱切面等不同的角度，產生含 V 估定位標示之複數張骨骼切面之斷層放射線影像，、^ 、 包腦裝置（1 0 2 )，若該斷層放射線影像產生裝置Η 光機’則所產生之骨絡切面斷層放射線影像=類比 圖像，尚需藉一掃描機輸入至該電腦裝置中，但若該 放射線影像產生装置是使用數位X光機，則可直接^ 曰 該電腦裝置上。 月11 至 -1239829 五、發明說明（4) 僳心Ϊ”的骨路斷層放射線影像使用斷層放射線影 =衣=論是續光機或數位χ光機)都侧清晰 =如像仁縱切面的骨骼斷層放射線影像可使用一 體層綜合技術（Dlgltal TQmQsynthesys，DT=得種^位 疋傳統斷J攝影法的延續，本發明利用該DTS技術將縱切 =之骨路圖像以複數個不同角度之U骨路支 ί:ί::ΐ:Γ利用DTS技術可產生在同-支點面觀 看至夕二個先軸角度和距離的參考平面之 個參考平面影像轉換為一預測影像圖素之 利用母 重建一新的影像。 從町踝不源來 請t閱第三圖及第四圖所示，係為一病患口腔之牙齒 月如圖像之k切面及縱切面之示意圖。本發明利用 裝置分析該含模具丨〇及預估定位標示之複數張骨叹= 層放射線影像之相對位置(1。4)，以決定出手術：鑽孔之 位置、鑽孔至㈣之垂直軸線、或 當深度等等（106) 〇 王月月口之過 置、定出該模具10上精確之鑽孔位 置軸線及冰度後，本發明即依該模具丨0及預估 示，利用逆向工程技術並結合該模具之圖像資訊，^ 成手術之導引裝置12(1 08)，而該導引裝置上形 孔13，因此牙科醫師再將該導引裝置12裝設於病来之 位置處，利用該導引裝置12之導引孔13即可輕易=術 之鑽孔動作（11 0 )。 進彳丁手術 而手術導引裝置之逆向工程流程示意圖，如第五圖所 1239829 五、發明說明（5) · -— ----- - 示。本發明將作完斷層放射線影 位標示），利用接觸式或非接觸匕，二模具（含預估定 模具之三維點群資料擷取（201)， 靡知晦設備’作植牙 模具之三維點群資料編修(203 )，腦軟體作植牙 體模型⑵5)，之後，、結合植牙模具之三維實 建構植牙模具及精確定位標示孔之三㈤奋雕貝/ ’ ‘正亚 然後，利用快速原型加工設備，二St，20”， 定位標示之手術導引裝置（2 〇 9 )。 凡 旲具及精確 請參閱第六圖所示，係為本發明 統方塊圖，本發明是利用一斷層；射線影像系 射該病患之骨絡，產生複數照 像，並利用一影像擷取器22將該骨！^ ^ 衫 像輸入-電腦裝置3。，該影像擷；：;=斷層放射線影 線影像產生裝置20，用以擷d二2;接於；；層放射 3。則連接於該影像擷取器22，。::；像：=電腦装置 m L /、鬥5又有一定位分析程式， 用以決定該斷層放射線影像上之鑽孔軸線及深产。 其中該電腦裝置3G則又至少由—處理單元3=、-記憶 =32…輸人介面單元33、—顯示單頑、—儲存單元 3:C所組成。其中該處理單元31是用以執行 :疋位分析程式，以分析出手術鑽孔之位置、轴線及深 f。而該記憶單元32連接該處理單切，是用以儲存該模 具圖像、該斷層放射線影像及該定位分析程式。 、 其中該輸入介面單元33連接該處理單元31，用以 該電腦裝置30至該影像擷取器22，而該顯示單元％連接於 1239829 五、發明說明（6) 該處理單元31 ’用以顯示該處理單 ! f:該儲存單元35連接至該處理單“析之定位結 單元3 1所分析之定位結果，以及兮 二用以儲存該處理 元31，用以列印該處理單 =歹印單兀36連接處理單 師藉該電腦裝置3〇提供各種精“定斤：ί位結果，牙科醫 用逆向工程技術製作出外科手術 =矾，將該模具利 藉此導引裝置精確地施行手術。衣置，以便使醫師可 本發明之第二實施例則應用 割手術上。請參閱第七圖所示， =二領加長或縮減切 手術之橫切面示意圖，而第俜為^ =以下顎切割 樹示意圖，在下顎切割手二 =面；1 術位置處，同樣地該模Hi:;預 ίϋί Γ 步決定手術切割之大略位置，該 极具1 4可以為一種以聚合材料 上之真#16所製成。 料配口病患下顆15欲切割位置 =編該模具14後，本實施例利用-斷層放射線 =一 I置恥射該模具14之位置處，產生含模具14及預 位標示15之複數骨絡斷層放射線影像，並輸入至一電 ^I置]如第九圖係為牙齒骨骼圖像縱切面之示意圖，而 1十圖係為第九圖縱切面之局部放大示意圖。同樣地利用 ，切面及縱切面之骨骼切面斷層放射線影像輸入至該電腦 衣置，再利用該電腦裝置分析該模具及骨骼圖像之相對位 置，如此即可決定出手術欲切割之精確位置、骨骼之垂直 軸線、或切割深度等等，最後利用逆向工程技術製作出外 ΗΪ 第10頁 1239829 五、發明說明（7) 科手術導引裝置’而該導引裝置上形成有導引槽口，可讓 外科醫師依導引槽口可精確地進行手術。 職是，本發明確能藉上述所揭露之技術，提供一種迥 然不同於習知者的設計，堪能提高整體之使用價值，又其 申請前未見於刊物或公開使用，誠已符合發明專利之要 件，爰依法提出發明專利申請。 惟’上述所揭露之圖式、說明，僅When the mold 10 is completed, the present invention is advantageous. For example, an X-ray machine irradiates a position to be operated: a layer of makeup is shot at a different angle, such as a cross-section and a longitudinal section, and a V-shaped positioning mark is generated. Multiple radiographic images of skeletal sections, ^, brain-enclosed device (102), if the tomographic image generating device Η light machine ', the radiographic images of osteoprosthetic sections = analog images, need to borrow A scanner is input into the computer device, but if the radiographic image generating device uses a digital X-ray machine, it can be directly on the computer device. Month 11 to -1239829 V. Explanation of the invention (4) The tomographic radiographic image of "Xin Xinxuan" uses tomographic radiography = clothing = on a continuous light machine or digital X-ray machine) both sides are clear = as in the longitudinal section of the image Skeleton tomographic radiography can use integrated layer synthesis technology (Dlgltal TQmQsynthesys, DT = Get the seed ^ position 的 Continuation of the traditional tomography J photography method, the present invention uses the DTS technology to cut the longitudinal image of the bone path = U bone road branch ί: ί :: ΐ: Γ The use of DTS technology can generate a reference plane image that is viewed on the same-fulcrum plane and has two reference planes with two angles and distances of the first axis. Reconstruction of a new image. Please refer to the third and fourth figures from the source of the ankle. It is a schematic diagram of the k-section and longitudinal section of a dental month image of a patient's mouth. The invention uses a device Analyze the multiple bone sighs containing the mold and the estimated positioning mark = the relative position of the radiographic image (1.4) to determine the operation: the position of the hole, the vertical axis of the hole to the radon, or the depth Wait (106) 〇 Wang Yueyue mouth transposed, After the precise drilling position axis and ice degree on the mold 10 are obtained, the present invention uses reverse engineering technology and combines the image information of the mold according to the mold 丨 0 and the prediction to form a surgical guide 12 (1 08), and the guide device is formed with a hole 13, so the dentist installs the guide device 12 at the location where the disease comes, and can easily use the guide hole 13 of the guide device 12 = surgery The drilling operation (110). Schematic diagram of the reverse engineering process of the surgical guidance device during the operation of the diarrhea, as shown in the fifth figure 1239829 V. Description of the invention (5) ·--------Shown. The present invention The tomographic radiographic mapping will be completed), using contact or non-contact daggers, two molds (including 3D point group data extraction of the estimated molds (201), and the best known equipment to make 3D point groups of dental implant molds Data editing (203), brain software as a dental implant model (5), and then, combined with the three-dimensional actual construction of the dental implant mold to construct the dental implant mold and accurately positioning the marked holes of the three-shoulder carved shell / '' 正 亚 Then, use the rapid Prototype processing equipment, two St, 20 ", positioning guide for surgical guide (2 square 9). Please refer to the sixth figure for the tools and precision, which is a block diagram of the present invention. The present invention uses a tomography; the radiographic image is used to shoot the bones of the patient to generate multiple photographs and use an image to capture them. Device 22 will the bone! ^ ^ Shirt like input-computer device 3. , The image capture;:; = tomographic radiation image generating device 20, for capturing d2 2; then ;; layer radiation 3. It is connected to the image capture device 22 ′. ::; like: = computer device m L /, Dou 5 has a positioning analysis program to determine the drilling axis and deep production on the fault radiographic image. The computer device 3G is at least composed of-processing unit 3 =,-memory = 32 ... input interface unit 33,-display unit,-storage unit 3: C. Wherein, the processing unit 31 is used to execute a position analysis program to analyze the position, axis and depth f of the surgical drilling. The memory unit 32 is connected to the processing single cut to store the model image, the tomographic image, and the positioning analysis program. The input interface unit 33 is connected to the processing unit 31 for the computer device 30 to the image capture device 22, and the display unit is connected to 1239829 V. Description of the invention (6) The processing unit 31 'is used for displaying The processing order! F: The storage unit 35 is connected to the positioning result analyzed by the positioning unit 31 of the processing order, and the second is used to store the processing element 31 for printing the processing order = 处理 印The unit 36 connected to the processing unit uses the computer device 30 to provide a variety of "determining the weight: the result, the dental medical reverse engineering technology to produce surgical surgery = alum, and this mold is used to guide the device to accurately perform the operation . The garment is placed so that the physician can use the second embodiment of the present invention for a cutting operation. Please refer to the seventh figure, = schematic diagram of the cross-section of the two-collar lengthening or reduction surgery, and the second one is ^ = the diagram of the lower jaw cutting tree, the second hand is the plane of the lower jaw cutting; 1 at the surgery position, the same Hi: Preliminary steps determine the approximate position of the surgical cut. The pole 1 4 can be made of a polymer material # 16. The position of the next 15 cutting positions of the patient with the material distribution = After the mold 14 is edited, this embodiment uses-tomographic radiation = a position where the mold 14 is irradiated to generate a plurality of bones including the mold 14 and the preposition mark 15 The tomographic radiographic image is input to an electronic device] For example, the ninth figure is a schematic diagram of a longitudinal section of a tooth and bone image, and the tenth figure is a partial enlarged schematic diagram of a longitudinal section of the ninth figure. Similarly, the tomographic radiation images of the skeletal section of the cut surface and longitudinal section are input to the computer clothing, and then the computer device is used to analyze the relative positions of the mold and the skeletal image, so as to determine the precise position and bone to be cut during surgery. Vertical axis, or cutting depth, etc., and finally using reverse engineering technology to produce the outer shell. Page 10 1239829 V. Description of the invention (7) Surgical guidance device 'and the guide device is formed with a guide slot, which allows The surgeon can precisely perform the operation with the guiding notch. The purpose is that the present invention can indeed provide a design that is quite different from those of the learners by the technology disclosed above, which can improve the overall use value, and it has not been seen in publications or public use before its application. It has already met the requirements of the invention patent. , Filed an application for an invention patent according to law. But the schemes and descriptions disclosed above are only
式、說明’僅為本發明之實施例 當可依據上述之說明作其他種種 於本發明之發明精神及以下界定 1239829 圖式簡單說明 【圖式簡單說明】 (一）圖式說明： 第一圖係為以植牙手術鑽孔之立體示意圖； 第二圖係為本發明之流程示意圖； 第三圖係為口腔牙齒骨骼圖像之橫切面示意圖； 第四圖係為口腔牙齒骨骼圖像之縱切面示意圖； 第五圖係為手術導引裝置之逆向工程流程示意圖； 第六圖係為本發明之斷層放射線影像系統方塊圖； 第七圖係為下顎切割手術之橫切面示意圖； 第八圖係為第六圖橫切面之局部放大示意圖； 第九圖係為牙齒骨骼圖像縱切面之示意圖；及 第十圖係為第八圖縱切面之局部放大示意圖。 (二）主要部分之代表符號： 模具 10 真齒 11 導引裝置 12 導引孔 13 模具 14 預估定位標示 15 真齒 16 斷層放射線影像產生裝置 20 影像擷取器 22 電腦裝置 30Formulas and descriptions are only examples of the present invention. According to the above description, other kinds of invention spirits and the following definitions can be made. 1239829 Brief description of the drawings [Simplified description of the drawings] (I) Illustration of the drawings: The first diagram It is a three-dimensional schematic diagram of drilling a dental implant; the second diagram is a schematic diagram of the process of the present invention; the third diagram is a schematic cross-sectional view of an oral tooth bone image; the fourth diagram is a longitudinal view of an oral tooth bone image Sectional schematic diagram; the fifth diagram is a schematic diagram of the reverse engineering process of the surgical guidance device; the sixth diagram is a block diagram of the tomographic imaging system of the present invention; the seventh diagram is a schematic diagram of the cross-section of the mandibular cutting operation; the eighth diagram It is a partial enlarged schematic diagram of the cross section of the sixth figure; FIG. 9 is a schematic diagram of the longitudinal section of the dental bone image; and the tenth figure is a partially enlarged schematic diagram of the vertical section of the eighth figure. (II) Representative symbols of the main part: mold 10 true tooth 11 guide device 12 guide hole 13 mold 14 estimated positioning mark 15 true tooth 16 tomographic image generating device 20 image capture device 22 computer device 30
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