WO2002089692A1 - Method and device for guiding the movement of at least one reference point in relation to a body - Google Patents

Method and device for guiding the movement of at least one reference point in relation to a body Download PDF

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Publication number
WO2002089692A1
WO2002089692A1 PCT/FR2001/001355 FR0101355W WO02089692A1 WO 2002089692 A1 WO2002089692 A1 WO 2002089692A1 FR 0101355 W FR0101355 W FR 0101355W WO 02089692 A1 WO02089692 A1 WO 02089692A1
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WO
WIPO (PCT)
Prior art keywords
3d image
body
means
image
characterized
Prior art date
Application number
PCT/FR2001/001355
Other languages
French (fr)
Inventor
Raymond René DERYCKE
Original Assignee
Areall
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Areall filed Critical Areall
Priority to PCT/FR2001/001355 priority Critical patent/WO2002089692A1/en
Publication of WO2002089692A1 publication Critical patent/WO2002089692A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08Machine parts specially adapted for dentistry
    • A61C1/082Positioning or guiding, e.g. of drills
    • A61C1/084Positioning or guiding, e.g. of drills of implanting tools
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/103Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • A61C9/004Means or methods for taking digitized impressions
    • A61C9/0046Data acquisition means or methods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072Reference field transducer attached to an instrument or patient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364Correlation of different images or relation of image positions in respect to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/373Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/376Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/45For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4504Bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • A61C9/004Means or methods for taking digitized impressions
    • A61C9/0046Data acquisition means or methods
    • A61C9/0086Acoustic means or methods

Abstract

The invention relates to methods that are used to guide the movement of at least one reference point Pr in relation to a body K. Said method is characterised essentially in that it consists in: producing a first 3D image of body K using a radiation beam, a second 3D image of body K defined by numerous, but finite, image points corresponding to the sample points of the surface of body K which are defined in relation to a given reference system R; indexing the first 3D image in relation to the second 3D image in order to obtain a third 3D image which is referenced in reference system R, (means 8); producing an image of point Pr in reference system R; and guiding point Pr in relation to body K in reference system R using the third 3D image and the image of point Pr. The invention also relates to the device using said method and is particularly, although not exclusively, suitable for the medical field, for example, in dentistry to help dentists implant replacement teeth.

Description

METHOD AND DEVICE FOR GUIDING THE MOVEMENT OF AT LEAST ONE POINT OF REFERENCE IN RELATION TO A BODY

The present invention relates to methods for guiding movement of at least one reference point relative to a body, which find an advantageous application in the medical field and in particular in the dental field for example, help dentists achieve dental implants.

The present invention also relates to devices for implementing these methods, for guiding movement of at least one reference point relative to a body.

The modern dental techniques can replace damaged teeth with artificial teeth that are implanted, for example by means of pivots. To implement these teeth, it is necessary to perform, in the bony portion of the maxilla, a pilot hole in which is arranged the pivot of the replacement tooth.

It is obvious that for the replacement tooth is perfectly positioned such relative to the remaining teeth and surrounding relative to the maxilla, it is necessary that the axis of the pilot hole is perfectly defined. But where must be made the pilot hole is often difficult to access and not generally has excellent visibility, which does not allow the practitioner to realize for sure and accurately a conveniently located pilot hole.

It is already known, particularly from US-A-5,230,623, a method for guiding the movement of at least one reference point relative to a body, which consists essentially in performing a 3D image from the outer points body in a given reference, to produce an image of the reference point in this reference, and guiding the reference point relative to the body in the repository, by means of the 3D image taken from the body and image the reference point.

This solution may be acceptable when the body is relatively accessible and has a good homogeneity.

However, that is not the case where the body consists for example of a jaw with its teeth, having enamel, dentin, flesh, amalgam or the like. Under these conditions, the 3D image is not perfectly representative of the body and it is impossible to accurately guide the reference point relative to the body, which can be a serious disadvantage when this method is used for example in the field of dental surgery or similar.

Also, the present invention does is to implement a method for guiding the movement of at least one reference point relative to a body, which enables, in particular in the dental field but not exclusively, to overcome the drawbacks of the prior art and thus to more easily work very fine quality, while reducing the intervention time on patients. More specifically, the present invention relates to a method for guiding the movement of at least one reference point relative to a body, comprising: providing a 3D image from said body in a given reference, to produce an image of said reference point in said reference system, and guiding said reference point relative to said body in said repository through said 3D image produced from said body and the image of said reference point, characterized in that said 3D image made of said body in the given reference frame is obtained by: performing the one hand a first 3D image of the body by means of a first radiation beam, and secondly a second 3D image of said body, said second image 3D being defined by a plurality of image points in a finite number of sample points corresponding to the surface of said body, said sample points being defined by relative to the given reference frame, then indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in the given reference frame, the said third 3D image is the 3D image formed from said body.

The present invention also relates to a device for implementing the method defined above for guiding the movement of at least one reference point relative to a body characterized in that it comprises: means for performing a first 3D image of the body by means of a first radiation beam, means for performing a second 3D image of said body, said second 3D image being defined by a plurality of image points corresponding to a finite number of sample points of the surface of said body, these sample points being defined with respect to a given reference frame, means for indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in said reference, means for imaging said point in said reference, and means for guiding said point relative to said body in said repository through said tro isième 3D image and the image of that point.

Other features and advantages of the invention will emerge during the following description given in the attached drawings for illustration but in no way limiting, in which:

Figure 1 is a block diagram implementation of the method according to the invention for guiding the movement of at least one reference point relative to a body, and

2 shows the block diagram of a device for implementing the method according to the invention, in an application in the dental field.

The present invention relates to a method for guiding the movement of at least one reference point P r with respect to a body K which finds advantageous applications in the medical field, in particular dental. An exemplary embodiment of the method is described below in a dental application to establish very precisely artificial teeth by means of pins or the like, it being understood that this method can also be applied without any difficulty to other fields of application and regardless of the nature of the body K. the block diagram of the method according to the invention is shown in Figure 1.

Referring to this diagram, the method comprises firstly providing a first 3D image of the field K, three-dimensional image (image I, Figure 1), by means of a first radiation beam. In the case of applying the method in the dental field, the first 3D image is that of the part of the jaw 1 with slot 2 of the tooth to be replaced and all the teeth 3 which are in the vicinity of this slot 2, as well as that of the portion 4 of the maxillary bone which carries the teeth 3 and the first 3D image is obtained by means of at least one of the following beams of radiation: X-ray beam, beam light radiation, ultrasonic beam or the like. In the implementation mode shown in Figure 1, the first radiation beam used is an X-ray beam (RAY.X) which advantageously allows to penetrate the enamel and dentin of the teeth, as well as in the bone in which are implanted the teeth.

This 3D image is obtained in a manner well known in itself. It may be obtained for example by means of a source 5 of X-rays, Figure 2, a scintillator 6 which receives X-rays that have passed through the body and converts them into light signals and a converter 7, as a CCD sensor or the like, which converts the light signals into analogue or digital electrical signals. These electrical signals are then processed by a processing unit 8 controlled by a programmer 28 of computer type or the like, known in itself, to form a video image 9 displayed on a video screen 10 or the like. The method then consists in producing (BRAS AR "1) a second 3D image of the body (picture II, Figure 1), the second 3D image being defined by a plurality of image points in a finite number corresponding to samples of the surface point K body, these sample points being defined with respect to a given reference. This second 3D image can be obtained in a manner known in itself, eg by means of a multi-articulated measurement arm robot, shown schematically at 12 in Figure 2. The signals delivered by the poly- articulated arm each once it is pointed at a sample point on the surface of the body K are applied to an input of the processing unit 8 which converts them into signals which are processed to provide image points, for example video, which, Due to the structure of the robot arm 12, are perfectly determined and referenced by an address in a reference frame R (e.g., X, Y and Z), figure 2, for example bonded to the robot itself.

When this second 3D image was obtained, the method comprises (INDEX. Figure 1) then to index the first 3D image relative to the second 3D image for example, in the processing module 8, Figure 2, in a manner known it -even for example by means of image motion control software that are commonly found in trade and that can move on a video screen a video image, in this case the first 3D image for the overlay to another video image, in this case the second 3D image, so that the maximum points images of the sample points coincide with the points corresponding images of the first 3D image. In theory, three sample points are sufficient to achieve this superposition, but it is obvious that the result will be easier to obtain and more reliable if the number of sample points is greater.

When both first and second 3D images are superimposed, one obtains a third 3D picture (III, Figure 1) identical to the first but referenced in the reference frame R defined above, each point being defined by its address in this repository.

The method then consists in producing a Pr point of the image in the same reference frame R, (BRAS MAN., Figure 1), for example with a robot articulated arm 13 of the same type as that described above, which is displayed in the image 9 on the video screen 10, Figure 2. at this stage of the process, it is easy to guide the point P r with respect to K in the same reference frame R by means of the third 3D image and image of the point P r which are combined in the same image 9 on the video screen 10, as shown in Figure 2.

In this representation, the K is the jaw 1 of a patient P and the point r is for example a point related to the bit 16 drilling the jaw bone 4 in preparation for the implantation of a replacement tooth in slot 2. the wick 16 being connected to the processing unit 8 by the articulated arm 13, it is easy for the practitioner to be positioned exactly at the desired location of the body 2 K, by simple observation of the 9 picture on the video screen without having to observe in situ the displacement of the drill itself.

The method described above can be implemented, provided that K is stationary relative to the reference A.

However, it is obvious that, in the case of a body Ktel the teeth of a patient, it can never be absolutely still. Accordingly, to compensate for displacements due to patient movement and constantly know the position of K compared to R repository, it is very advantageous for the method according to the invention further comprises the index K to the R repository . also, the device for implementing the method according to the invention may further comprise means for indexing the body relative to K repository A. These means may be of any type, for example an arm 22 of the same type those referenced 12 or 13. this indexing allows positioning the third 3D image based on the K body movements and for obtaining at any instant, on the screen 10, a perfect correlation between this third image 3 and the position D real patient.

The method described above works well in himself. However, in the case where the first radiation beam is an X-ray beam, the resulting image may have dark portions or residual images due in particular to the scattering of X rays which limit its quality. Such is the case of the first 3D image.

Indeed, it is not unusual that the X-rays used for the realization of the first 3D image meet, for example in a teeth or the like, opaque material to X-rays, for example amalgam, ceramics or the like, which s preclude penetration and which reflect and diffuse into the surrounding space. The first 3D image obtained thus has often known ghosting technicians to as artifacts.

Also, advantageously, the method comprises in addition the phases described above, to produce a fourth 3D image of the field K by means of a second radiation beam at least partially reflective on the surface of the body.

However, particularly when the part of the body K, for example, part 1, 3, 21, 4 of the dentition of a patient to be treated is difficult to access, the fourth 3D picture (IV, Figure 1) can be indirectly formed on a hollow recess (technical negative) of this section of teeth, carried out previously (empty CAM., Figure 1). It is also possible to make the fourth 3D image on a full molding (technical positive) obtained from the indentation. Advantageously, this fourth 3D image is obtained by scanning the portion of the teeth to be treated by means of a light beam of radiation, for example one that is issued by a laser generator 11 or the like. This technique called the technicians' image obtained by scanner "is well known in itself and will not be described further here. The method then consists in treating the first 3D image by the fourth 3D image to obtain a first 3D image corrected artifacts (COR, Figure 1). In this way, the first 3D image corrected artifacts displayed on the video screen 10 is completely and volume, K to be analyzed, that is to say in the case of the application incorporated by for example, the entire portion of the relevant dentition for implanting a replacement tooth, this representation of the body K having a minimum number of defects that could disturb the observation of the practitioner.

However, it is specified that, for the fourth 3D image of a body which is for example covered with a surface layer of a material such as flesh 21 of the gums, it is advantageous to use a radiation passing through this material but which is reflected by the material constituting the main body, for example the jaw bone. In the range of above-mentioned application example, such radiation is for example that given by an ultrasound source 18.

Thus, in the example of preferred implementation described above, the fourth 3D image can be obtained in situ, by means of two beams, a light beam of radiation for the crown of the teeth and an ultrasound beam for the collar teeth and jawbone. The skilled person knows the types of sensors needed to receive the reflected light rays (sensor 19) or the ultrasound reflected (sensor 20) and for outputting the signals to be transmitted to the processing unit 8 controlled by the controller 28.

When this fourth 3D image is obtained from an impression or the like, it can, also, have defects. As a result, advantageously, it is possible to verify the fourth 3D image through the second, and possibly subjecting it to corrections based on the definition of this second image, it is certain, as obtained directly from the body itself.

The practitioner who wants to implant a tooth can view, on the third 3D image, the pin 15 which will be implanted replacement tooth axis he perfectly defined against other 3 teeth and bones maxillary 4. It can then position the bit 16 of the drill 14 and control its movement so that the axis of the wick is perfectly coincident with the implantation axis 15 and constantly remains as and that it enters into the bone for achieving the pilot hole 17. This operation is always possible, even if the patient moves because, by being indexed in the same reference frame R via the means 22, the third image moves correlation with the patient's movements, which allows constantly practitioner to position the wick 16 correctly relative to the patient.

The example given above is an application in the dental field, but it is understood that such a method is equally advantageous applications, for example in the field of surgery or microsurgery including endoscopy.

Claims

1. A method for guiding the movement of at least one reference point (Pr) with respect to a body (K), comprising: providing a 3D image from said body (K) in a given reference, to produce an image said reference point (Pr) in said repository, and guiding said reference point (Pr) relative to said body in said repository through said 3D image produced from said body and the image of said reference point (Pr ), characterized in that said 3D image produced from said body (K) in the given reference frame is obtained by: performing the one hand a first 3D image of the body (K) by means of a first radiation beam , and secondly a second 3D image of said body (K), said second 3D image being defined by a plurality of image points in a finite number of sample points corresponding to the surface of said body, said sample points being defined with respect to ref erential given, then indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in the given reference frame, the said third 3D image is the 3D image formed from said body.
2. Method according to claim 1, characterized in that said first radiation beam is at least one of the following beams of radiation: X-ray beam, bright radiation beam, ultrasound beam.
3. A method according to one of claims 1 and 2, characterized in that said second 3D image is obtained by means of a multi-articulated measurement arm robotics.
4. A method according to one of claims 1 to 3, characterized in that it consists in producing said first, second and third 3D images under videographic form so as to be capable of being viewed on a video screen.
5. A method according to one of claims 1 to 4, characterized in that it consists in producing a fourth 3D image of said body by means of a second radiation beam at least partially reflective on the surface of said body, and processing the first 3D image by the fourth 3D image to obtain a first 3D image corrected artifacts.
6. A method according to claim 5, characterized in that it consists in carrying out the fourth 3D image from an impression of said body, said cavity being designed according to one of the following techniques: "Technical negative" and " technical positive.
7. Method according to one of Claims 5 and 6, characterized in that it consists of verifying the fourth 3D image from the second 3D image.
8. Method according to one of Claims 5 to 7, characterized in that the second radiation beam at least partially reflective on the surface of said body is at least one of the following beams: light beam of radiation, beam ultrasound.
9. A method according to one of claims 1 to 8, characterized in that it comprises indexing said body (K) relative to said reference frame (R).
10. Device for implementing the method according to one of the preceding claims, characterized in that it comprises: means (5, 6, 7, 8, 9, 10) for performing a first 3D image from the body
(K) by means of a first radiation beam, means (8, 12, 10) for performing a second 3D image of said body (K), said second 3D image being defined by a plurality of image points in a finite number corresponding to the sample points of the surface of said body (K), these sample points being defined with respect to a given reference frame (R), means (8) for indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in said frame of reference (R), means (8, 13, 10) for imaging said point (Pr) in said frame of reference (R), and means (13, 14, 15) for guiding said point ( Pr) relative to said body (K) in said repository (R) by means of said third 3D image and the image of said point (Pr).
11. Device according to claim 10, characterized in that it further comprises: means (8, 10, 11, 19, 18, 20) for providing a 3D image of said fourth body (K) by means of a second radiation beam at least partially reflective on the surface of said body, and means (8) for processing the first 3D image by the fourth 3D image to obtain a first 3D image corrected artifacts.
PCT/FR2001/001355 2001-05-04 2001-05-04 Method and device for guiding the movement of at least one reference point in relation to a body WO2002089692A1 (en)

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