WO2016079071A1 - Procédé de création d'un articulateur numérique - Google Patents

Procédé de création d'un articulateur numérique Download PDF

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Publication number
WO2016079071A1
WO2016079071A1 PCT/EP2015/076721 EP2015076721W WO2016079071A1 WO 2016079071 A1 WO2016079071 A1 WO 2016079071A1 EP 2015076721 W EP2015076721 W EP 2015076721W WO 2016079071 A1 WO2016079071 A1 WO 2016079071A1
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data
person
digital
record
data record
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PCT/EP2015/076721
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German (de)
English (en)
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Franz Xaver Wack
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Franz Xaver Wack
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C11/00—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
    • A61B5/0035—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0088—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for oral or dental tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1073—Measuring volume, e.g. of limbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
    • A61B5/4542—Evaluating the mouth, e.g. the jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/025—Tomosynthesis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4417—Constructional features of apparatus for radiation diagnosis related to combined acquisition of different diagnostic modalities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/51—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for dentistry
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/24—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the mouth, i.e. stomatoscopes, e.g. with tongue depressors; Instruments for opening or keeping open the mouth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5235—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/04—Measuring instruments specially adapted for dentistry
    • A61C19/045—Measuring instruments specially adapted for dentistry for recording mandibular movement, e.g. face bows
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2210/00—Indexing scheme for image generation or computer graphics
    • G06T2210/41—Medical
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture

Definitions

  • the invention relates to a method for creating a digital articulator. Furthermore, the invention relates to a system for carrying out the method.
  • a known method for producing and inserting a dental prosthesis proceeds as follows: First, the upper jaw and the lower jaw, in particular the teeth, are molded by means of an impression jig. Thereafter, models of the upper jaw and lower jaw made of gypsum from a dental technician, who usually sits not in the dental office, made. In a further step, the lower jaw movement and lower jaw relation to the upper jaw in the dental practice is determined, for example by means of an arbitrary facebow and a bite registration. The models are inserted by the dental technician in an articulator, whereby their connection is made so that the determined lower jaw movement can take place and the bite registration is correct.
  • a model of the veneer is waxed in the model in the articulator.
  • the wax model of the veneer is then scanned, for example, and the data obtained is used to produce the insertable veneer with the exact same dimensions as the wax model from a blank.
  • the dental technician After the dental technician has made the veneer, this must be brought back to the dental office - for example, by courier. There, the person is summoned to a new appointment, in which this person the veneer is glued to the intended location of the dentition. Since elaborate plaster models of a mostly not in the dental office This procedure takes a very long time and the person must be summoned to the dental office for at least two appointments.
  • US 2014/0294273 A1 has proposed a digitized method for designing a dental application.
  • a model of the maxillary teeth and a model of the mandibular teeth of the person from a deformation material, e.g. Plaster formed.
  • An optical camera then scans the plaster models everywhere to make the 3D images of the models ("3D Digital Mode") Positioning of the positions of the teeth of the person and the corresponding positions of the teeth on the plaster models is positioned on the reference plane of the facial skeleton and the resulting digital data is now changed with a computer program to simulate, for example, the possible effects of the dental application on other teeth It remains imperative to create the plaster models, so that the associated time or cost is inevitable.
  • a method for producing a digital articulator comprising the following steps: A method for the integrated production of dental prostheses for a person consisting of: creating a digital volume tomogram of the midface and the lower face of the person by means of an X-ray device and transferring the first data set thus obtained to a computer unit; Creation of an intraoral scan of the maxillary teeth and the mandibular teeth of the person by means of an intraoral scanning camera and transmission of the second data set thus obtained to the computer unit; digital pantographic recording of the person's trajectory and transmission of the third data record thereby obtained to the computer unit; and using the first data set, the second data set and the third data set to create the digital articulator by means of a computer program.
  • both a digital volume tomogram of the person's midface and lower face and an intraoral scan of the person's maxillary and mandibular teeth as well as digital pantographic recording of the subject's lane can be created as digital files and combined with each other by a computer program to form a fully digital articulator to create.
  • the technical bias is overcome that of two-dimensional image files (preferably an STL or XML data set) due to limitations in positioning an intraoral camera limited parts of maxillary and mandibular teeth, no 3D model can be built with sufficient accuracy.
  • a digital volume tomogram (preferably a DICOM data set) with a usually lower resolution (eg with a voxel size of 100/1000 mm) with an intraoral scan of the maxillary teeth and the mandibular teeth with a higher resolution (eg with a pixel size of 19 / 1000 mm), so that a resulting 3D Model that fully represents the midface and the lower face, so that the movement of the teeth and joints can be fully simulated by the pantographic record of the joint track, and at the same time precisely shows the current, detailed position of the maxillary and mandibular teeth.
  • a digital volume tomogram preferably a DICOM data set
  • a usually lower resolution eg with a voxel size of 100/1000 mm
  • an intraoral scan of the maxillary teeth and the mandibular teeth with a higher resolution eg with a pixel size of 19 / 1000 mm
  • the latter information may be essential, in particular, for the manufacture of dental prostheses, in particular a veneer or one or more crowns, in order to create a perfectly fitting denture, by the creation of an intraoral scan of the person's maxillary and mandibular teeth by means of an intraoral scanning camera and transmission the thus obtained third data set to the computer unit, for example, the prepared tooth stumps even more accurate - here with 19/1000 mm - can be detected.
  • the current dental situation of the person e.g. of temporomandibular joints or teeth in a dental treatment, e.g. the preparation of the denture and the insertion of the denture (such as a veneer) are included in a dentition of the person by e.g. using these currently created files the dentures is also currently produced.
  • the data of the first data record are preferably brought into the correct relation on the basis of the performed imaging method by means of the digital volume tomogram with measured individual temporomandibular joint data , this is realized by the application of person-specific, anatomical conditions. It can be explained more concretely that the corner points of the Bonwill triangle and the condylar path inclination can be represented and measured simply by means of the digital volume tomogram by rotation of the sagittal section plane.
  • An advantageous development of the invention provides that bringing into the correct relation of first data set and third data set by the definition of the Frankfurt horizontal or other anatomical crankshaft individual dimension of the patient on the basis of the first data set in relation to the recorded data of the lower jaw movement of the third record is done. Only the digital volume tomogram can easily represent and measure the corner points of the Bonwill triangle and the condylar path inclination by turning the sagittal section plane. By tilting the horizontal plane on the two condyles and the lower incision, the Bonwill triangle is shown from an axial viewpoint, whereby the actual basis, the individual Interkondylardistanz of the patient becomes readable.
  • a further advantageous development of the invention provides that, as a further step before the creation of the digital articulator, a digital acquisition of the face by static records and the dynamic movements by means of a face scanner and transmission of the fourth data set obtained thereby to the computer unit.
  • the detection of the face by the face scan takes place both statically and dynamically.
  • the aesthetic conditions for example in the length design of the anterior teeth when introducing soft tissue ratios, smile lines, lip dynamics, etc. in the middle and lower face individually.
  • the creation of the digital articulator preferably takes place in that the second and / or third and / or fourth data record is superimposed onto the first data record using the computer program specialized for data record transfer.
  • the second and / or third and / or fourth data record can be superimposed on the first data record in that at least three anatomically identical points of the first data record and the second and / or third and / or fourth data record are superimposed.
  • dentures can be made in a denture of a person, in particular a veneer, which preferably takes place as follows: Calculation of the shape of the denture and the location in the dentition of the person to which the dentures are applied should, from the data of the digital articulator as a fifth data set and transmission of the fifth data set to a manufacturing device; and manufacturing the denture in the manufacturing device from a blank by means of the data of the fifth data set.
  • a further advantageous development of the invention provides that the three-dimensional bone and tooth ratios of the person are determined during the creation of the digital volume tomogram. This can be done together with the pantograph data more accurate determination of the required shape of the denture, as if, for example, only the tooth conditions by an impression by means of impression material - as is done in the prior art - are determined.
  • a further advantageous development of the invention provides that the first data record is a DICOM data record and / or the third data record is an STL or XML data record and / or the second data record is an STL data record and / or the fourth data record is an OBJ data record is.
  • standard devices can be used to create the records and the resulting records can be used within a standard software for a digital articulator.
  • a further advantageous development of the invention provides that in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt triangle, individual anterior guidance. Based on these measurements, a reliable creation of the digital articulator is possible.
  • a further advantageous embodiment of the invention provides that in the digital detection of the face, the static recordings include a face photograph and / or a profile photo and / or a smile photo and / or wherein in the digital detection of the face, the dynamic movements recording a mimic action and / or an opening of the mouth and / or a laughing process. Based on these values, an ideal setting of the virtual model in the digital articulator is possible.
  • the digital articulator contains the data for the individual values of the person and its anatomical hinge axis. Thus, the dentures can be even better adapted to the circumstances of the person, since not only the static values - such as teeth clenched - - flow, but also the dynamic values eg when chewing.
  • a further advantageous embodiment of the invention provides that an insertion of the denture takes place in the person by sticking at the predetermined location on the dentition of the person. This step can be done immediately after the preparation of the denture on site, so that no further appointment with the dentist is necessary.
  • a further advantageous development of the invention provides that between the steps of the production of the dental prosthesis and the insertion of the dental prosthesis, the dental prosthesis is fired in a zirconia furnace. As a result, special zirconium restorations can also be carried out.
  • a further advantageous embodiment of the invention provides that all data of the person are transferred to a tablet computer and there the teeth and the veneer are displayed in selectable states. With this, the person can still be visualized on the dental chair, as the denture with the glued veneer will look like.
  • a further advantageous embodiment of the invention provides that a milling machine, preferably a five-axis milling machine is used as a manufacturing device for the production of the dental prosthesis.
  • a milling machine preferably a five-axis milling machine is used as a manufacturing device for the production of the dental prosthesis.
  • Such milling machines are reliable and can easily produce all kinds of dentures and veneers or crowns.
  • Such a system can be set up eg in a fully digital dental practice.
  • a digital volume tomogram of the middle and lower face is created by the person to whom a veneer is to be adhered to the dentition;
  • the three-dimensional bone and tooth conditions of the person are recorded.
  • the device ORTHOPANTOMOGRAPH OP300 of the manufacturer KaVo Dental GmbH is used.
  • the first record thus obtained is in a DICOM format.
  • DICOM stands for Digital Imaging and Communications in Medicine and is a standard format for medical data.
  • the first data record is transmitted by means of known transmission methods - for example wirelessly via WLAN or Bluetooth or wired via a USB interface - to a computer unit and stored there and can be used by means of a - for example - Dicom viewer in the design software.
  • the oral situation can be determined by means of an intraoral scan of the maxillary and mandibular teeth. This is done by means of a suitable scan camera, for example the CEREC Omnicam from the manufacturer Sirona Dental GmbH.
  • a second data record is obtained in an STL or XML format. STL stands for STereoüthography.
  • the second record is - like the other two records - transmitted by known transmission paths to the computer unit and stored there.
  • a digital acquisition of the face can be performed.
  • This provides that by means of the face scanner both the static states - for example by a face photograph, a frontal photo or a smile photo - and the dynamic states - for example, the facial expressions, an opening process of the mouth or a laughing process - recorded and recorded.
  • This is done by means of a known from the prior art face scanner, such as the model FACE HUNTER ZIRKONZAHN GmbH.
  • an individual adjustment of the virtual model into the digital articulator is possible.
  • a fourth record in an OBJ format is obtained.
  • OBJ stands for "object” and is a file format for the description of geometric objects.
  • the fourth data set is - as the other three records - by means of known Transfer paths to the computer unit and stored there.
  • steps of the creation of the volume tomogram, the creation of the intraoral scan and the pantographic recording of the joint track and the other for the realization of the invention only optionally possible step and the creation of the facial scan can in any order respectively. They are performed regularly one after the other as long as the person is in the dental office.
  • the measured individual temporomandibular joint data of the same person must be placed in the correct relation to the virtual person who is obtained from the above-described data records after the imaging measures (digital volume tomogram). This can be realized by the application of person-specific, anatomical conditions.
  • the Frankfurt horizontal and the individual Interkondylarachse can be clearly defined as the actual reference basis based on the recording of the digital volume tomogram and brought after introduction of the scan data of the individual jaw the recorded data of the lower jaw movements of the third record of pantographischen record the aforementioned data of the digital volume tomogram in relation by taking the record of the first record (Dicom record) as well as the third record (STL or XML record) of the pantography - the articular record;
  • This allows the lower jaw to be virtually separated from the skull. Because the lower jaw movements are unambiguous through the pant
  • the digital articulator has all individual values of the person including their anatomical hinge axis.
  • the shape of the veneer directly on the screen for example by means of the above-mentioned design software exocad DentalCAD, set and the resulting fifth dataset are used for the production of the ceramic veneer.
  • This fifth data set is transferred by means of known transmission methods - wirelessly or by cable - to a five-axis milling machine, for example the model inLab MC X5 from the manufacturer Sirona Dental GmbH.
  • the milling and grinding process as known from the prior art, by machining a selected blank - for example, a ceramic zirconia. In this case, the data of the fifth data record is used.
  • the veneer After a short time, the veneer is ready and can be immediately glued into the dentition of the person.
  • Another advantage of the method according to the invention is that the person can be shown on the screen before creating the veneer, as the veneer looks in the dented state in the dentition. All that is required is to transfer all the data of the person obtained from the first, second, third and optionally fourth data sets and additionally the fifth data set representing the veneer to a tablet computer. There, the dentition and the veneer can then be displayed in selectable states. The person can then stop this production even before the transmission of the fifth data set to the milling machine and the beginning of the production of the veneer, if he does not like the virtual result displayed on the tablet computer. A new fifth record can then be created that results in a different shape of the veneer. This result can then be shown to the person again on the tablet computer. This process can be repeated until the person is satisfied with the result presented - there is then no "rude awakening" when the veneer is glued in and the overall impression of the dentition does not match the person's imagination.
  • CAI Computer Aided Imaging
  • CAD computer aided design
  • CAM Computer Aided Manufacturing
  • the equipment required for this purpose can all be readily available in the dental practice, so that no additional time is required due to the involvement of a foreign dental technician laboratory
  • a system according to the invention ie a fully digital dental practice with an individual articulator, and a fully digitized workflow to be realized thereby
  • the data which are respectively generated by a component of the system, can in the context of fully digitized workflow from one component of the system to another component without Further, for example, the design of a dental prosthesis by means of CAD on the basis of the digital articulator, which is created from CAI generated data, can be made in order to then produce the tooth replacement by means of CAM He goes to the dentist and, immediately after taking his data and creating the data for the veneer, he glues the veneer made in the dental office.
  • the invention thus enables a "fully digitalized dental practice" with a digital workflow in an interdisciplinary treatment concept.
  • the inventor has thus realized that digital networking of digital single dental devices by means of communicating interfaces within a single dental practice or spatially separate cooperating dental / dental units That is, a completely digital workflow for a dental-functional technical / therapeutic and / or prosthetic care of a patient can be realized.
  • the purpose is, among others:
  • Reproducibility 1 1 without re-treatment on Dental chair.
  • Proposed is the networking of all of a dental scientifically recognized, functionally and aesthetically-oriented digital workflow necessary individual devices for enabling a fully digital anatomy and functionally accurate dental practice.
  • the invention makes it possible to provide a method for using an electronic technique (CAI-CAD-CAM) for producing a patient-specific, functionally and anatomically exact prosthesis by means of an electronically-based articulator.
  • CAI-CAD-CAM electronic technique
  • the invention also makes it possible to provide a virtual electronic patient-specific articulator, which is also referred to below as the “individual virtual articulator”, in short "IVA”.
  • the invention provides an absolutely true patient-specific articulator, which can also be designated as a purely patient-specific genuine virtual or digital plaster model-free articulator.
  • the IVA according to the invention is distinguished by the fact that none with an arbitrary - i.
  • the individual patient hinge axis only needs to be scanned in to approximated facebow models and inserted into the Exocad software as an STL or XML dataset.
  • the temporomandibular joint anatomy may also show an arthritic change in the condyle and yet this condyle may be in the correct centric position.
  • the CBCT should be at maximum maximum point contact of both jaws when created. This is realized by the so-called “habitual maximum intercuspidation", that is a slightly open jaw retention would not be value-altering until about 2mm since the condyles are still in pure rotation at the initial mouth opening.
  • the spatial patient-specific movement of the lower jaw e.g. the transverse condylar path inclination or latero- / protrusion, as well as the mouth opening shown.
  • the models can be scanned using a digital scan camera, such as the Omnicam scan camera.
  • the individual jaws can be molded in 1-2 minutes and at the same time as a 3D image on the monitor represent.
  • the facial presentation can be prepared by using a digital video camera in a short video or single photos to create an aesthetically matched dentures, the individual face conditions, e.g. Lips, smile line etc. of the patient can be displayed.
  • Scan models with STL data set e.g. Upper jaw lower jaw digital impression.
  • DVT with Dicom record e.g. KaVo OP300.
  • the true patient-specific virtual articulator can be simulated by matching all 3 (and optionally 4) above-mentioned records and programming the individual movement of the mandible by software in 3D space, by, e.g. digital imaging techniques, e.g. a DVT with digital surveying techniques such. Zebris - pantographic facebow recorder by means of ultrasound transmitter / receiver - can be linked together.
  • the patient after the imaging measures the measured individual temporomandibular joint data (zebris) of the same patient, which is referred to as "matching".
  • the matching can be done as follows:
  • data can be brought into the resolution of the other by the transfer by means of algorithmic application, eg by using the program Aadva-Manager specialized for the transfer of data records with the application DICOM Viewer, which is activated from the software EXOCAD, DICOM data of DVT's, for example from KaVo software CliniView exported.
  • the best fit adaptation is selected.
  • the complete parameters of the patient-specific anatomy of his jaws, teeth and bone structures can be defined by the DVT recording and the recorded data of the lower jaw movements, for example from the functional registration system - here Zebrissystem - brought into relation by, among others, the data set of the DVT -Dicom data set eg exported from the KaVo software Cliniview, as well as the STL or XML data set eg the pantography - Gelenkbahnen recording or the maxilla coupling tray, which allows the maxillae assignment - here zebris JMA - into the interfaces (again Aadva manager , Dicom-Viewer, best fit), the designer software provided here - here Exocad - brings, and these with the so-called "matching" correlated and thus has matched exactly.
  • the invention will be explained below with reference to the figures based on embodiments.
  • Fig. 1 shows schematically an inventively arranged system according to an embodiment.
  • FIG. 2 schematically shows how, in one embodiment of a method according to the invention, a second data record is superimposed on a first data record.
  • FIG. 3 shows schematically how in the embodiment of FIG.
  • a digital articulator can be created using a first data set, a second data set, a third data set.
  • Figure 2 shows in a perspective view of the upper jaw diagonally from below and from the inside of the mouth, as a second set of data from an intraoral scan of a person's maxillary teeth on a first data set, i. a digital volume tomogram of the person's midface can be superimposed. From the volume tomogram, the posterior sides of the teeth are visible along with tooth roots and bones. For example, four points of the scan model formed from the second data record can be equated with the anatomically exactly identical points of the digital volume tomogram for the overlay.
  • FIG. 3 shows on the left side an exemplary individualized SD model in a lateral view, which is formed by the overlay illustrated above.
  • the model can then be correlated with digital pantographic recording of the articular and other values of the subject to simulate, for example, upper jaw movements relative to the lower jaw.
  • On the right side of Figure 3 shows the upper jaw and the lower jaw of the 3D model when simulating the state in which the mouth is closed.
  • a 3D model can be provided which includes both the precise positions of all intraoral parts and relevant facial parts, such as teeth and teeth Bones or temporomandibular joints as well as the dental health status regarding, for example, malocclusions, tooth replacement or already existing dentures as well as possible movements of the intraoral parts and relevant facial parts in relation to each other (eg temporomandibular joint movement).
  • a method for producing and inserting a veneer into a denture of a person with the following steps:
  • the first data set and the second data set for creating a digital articulator by means of a computer program, wherein the data of the first data set by means of the performed imaging process by means of the digital volume tomogram with the measured individual temporomandibular joint data in the right relation, said by the Application of person-specific, anatomical conditions is realized; Calculating the shape of the veneer and the location in the dentition of the person to whom the veneer is to be applied, from the data of the digital articulator as the fifth data set, and transmitting the fifth data set to a milling machine; Milling the veneer in the milling machine from a blank by means of the data of the fifth record.
  • Method according to one of the preceding objects wherein an insertion of the veneer takes place at the person by sticking to the predetermined location on the dentition of the person.
  • the method of item 5 wherein between the steps of milling the veneer and inserting the veneer, the veneer is fired in a zirconia furnace.
  • Method according to one of the preceding objects wherein in the production of the digital volume tomogram the three-dimensional bone and tooth ratios of the person are determined.
  • the first data record is a DICOM data record and / or the third data record is an STL or XML data record and / or the second data record is an STL data record and / or the fourth data record is an OBJ data record.
  • Method according to one of the preceding objects wherein in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt's triangle, individual anterior guidance.
  • Method according to one of the preceding objects wherein in the digital acquisition of the face the static recordings comprise a face photograph and / or a profile photo and / or a smile photo.
  • the method of any preceding item, wherein the digital articulator includes the data for the individual values of the subject and the anatomical hinge axis thereof. 13. The method according to any one of the preceding objects, wherein a five-axis milling machine is used as a milling machine.
  • a method for producing and inserting a veneer into a denture of a person with the following steps:
  • Method according to one of the preceding objects wherein in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt's triangle, individual anterior guidance.
  • Method according to one of the preceding objects wherein in the digital acquisition of the face the static recordings comprise a face photograph and / or a profile photo and / or a smile photo.
  • a method for the integrated production of dental prostheses for a person consisting of:
  • a radiological imaging device for example, such as an X-ray device, and transmission of the resulting first data set to a computer unit;
  • Method according to item 2 wherein the bringing into the correct relation of first data set and second data set by the definition of the Frankfurt horizontal or other anatomical crankshaft personal dimension of the person based on the first data set in relation to bring the recorded data of the lower jaw movement of the second data set , Method according to one of the preceding objects, wherein, as a further step prior to the creation of the digital articulator, an intraoral scan of the maxillary teeth and the mandibular teeth of the person takes place by means of an intraoral scanning camera and transmission of the thereby obtained third data set to the computer unit.
  • a method according to item 7 or 8 wherein between the steps of producing the dental prosthesis and inserting the dental prosthesis, the dental prosthesis is fired in a zirconia oven.
  • STL or XML record and / or the second record is an STL record and / or the fourth record is an OBJ record.
  • the dental prosthesis comprises a veneer, a crown, a bridge, a partial implant, a full implant, a prosthesis or a combination thereof.
  • the preparation of the dental prosthesis by milling the denture from a blank and / or by sintering a blank for example using a laser and / or made by 3D printing from a blank and / or grinding a blank becomes.
  • a milling machine preferably a five-axis milling machine is used as a manufacturing device for producing the dental prosthesis.
  • a digital virtual articulator for use in the system of item 21 and in the method of any one of items 1 to 20.

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Abstract

L'invention concerne un procédé de création d'un articulateur numérique individualisé d'une personne, lequel procédé comprend les étapes suivantes consistant à : créer un tomogramme numérique de volume de la partie centrale du visage et de la partie inférieure du visage de la personne au moyen d'un appareil à rayons X et transmettre le premier ensemble de données obtenu à une unité de calcul ; créer un balayage intra-buccal des dents maxillaires et des dents mandibulaires de la personne au moyen d'une caméra à balayage intra-buccal et transmettre le deuxième ensemble de données obtenu à l'unité de calcul ; enregistrer au pantographe numérique la pente condylienne de la personne et transmettre le troisième ensemble de données obtenu à l'unité de calcul ; et utiliser le premier ensemble de données, le deuxième ensemble de données et le troisième ensemble de données pour créer l'articulateur numérique au moyen d'un programme informatique.
PCT/EP2015/076721 2014-11-17 2015-11-16 Procédé de création d'un articulateur numérique WO2016079071A1 (fr)

Applications Claiming Priority (8)

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DE102014016947.2 2014-11-17
DE102014016947 2014-11-17
DE102015000014 2015-01-07
DE102015000014.4 2015-01-07
DE102015001716.0 2015-02-13
DE102015001716 2015-02-13
DE102015208882.0A DE102015208882A1 (de) 2014-11-17 2015-05-13 Verfahren zur Herstellung von Zahnersatz
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018077653A1 (fr) 2016-10-31 2018-05-03 Sicat Gmbh & Co. Kg Articulateur virtuel

Citations (4)

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Publication number Priority date Publication date Assignee Title
US20070190492A1 (en) * 2006-02-15 2007-08-16 Dental Implant Technologies, Inc. Computer machined dental tooth system and method
US20090316966A1 (en) * 2008-05-16 2009-12-24 Geodigm Corporation Method and apparatus for combining 3D dental scans with other 3D data sets
US20110276159A1 (en) * 2010-05-05 2011-11-10 Hankookin, LLC Computer-aided Fabrication Of A Removable Dental Prosthesis
US20140294273A1 (en) 2011-08-31 2014-10-02 Maxime Jaisson Method for designing an orthodontic appliance

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070190492A1 (en) * 2006-02-15 2007-08-16 Dental Implant Technologies, Inc. Computer machined dental tooth system and method
US20090316966A1 (en) * 2008-05-16 2009-12-24 Geodigm Corporation Method and apparatus for combining 3D dental scans with other 3D data sets
US20110276159A1 (en) * 2010-05-05 2011-11-10 Hankookin, LLC Computer-aided Fabrication Of A Removable Dental Prosthesis
US20140294273A1 (en) 2011-08-31 2014-10-02 Maxime Jaisson Method for designing an orthodontic appliance

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018077653A1 (fr) 2016-10-31 2018-05-03 Sicat Gmbh & Co. Kg Articulateur virtuel
DE102016120762A1 (de) * 2016-10-31 2018-05-03 Sicat Gmbh & Co. Kg Virtueller Artikulator
DE102016120762B4 (de) * 2016-10-31 2021-05-20 Sicat Gmbh & Co. Kg Virtueller Artikulator

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