WO2016142407A1 - Procédé pour produire une prothèse dentaire - Google Patents

Procédé pour produire une prothèse dentaire Download PDF

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Publication number
WO2016142407A1
WO2016142407A1 PCT/EP2016/054985 EP2016054985W WO2016142407A1 WO 2016142407 A1 WO2016142407 A1 WO 2016142407A1 EP 2016054985 W EP2016054985 W EP 2016054985W WO 2016142407 A1 WO2016142407 A1 WO 2016142407A1
Authority
WO
WIPO (PCT)
Prior art keywords
denture
flask
teeth
modified
acrylate
Prior art date
Application number
PCT/EP2016/054985
Other languages
English (en)
Inventor
Brian SCHOTTLANDER
Original Assignee
Davis, Schottlander & Davis Ltd
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 Davis, Schottlander & Davis Ltd filed Critical Davis, Schottlander & Davis Ltd
Publication of WO2016142407A1 publication Critical patent/WO2016142407A1/fr

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Classifications

    • 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
    • A61C13/10—Fastening of artificial teeth to denture palates or the like
    • A61C13/1003—Fastening of artificial teeth to denture palates or the like by embedding in base material
    • A61C13/1013—Arch forms
    • A61C13/1016—Methods or apparatus for mounting, holding or positioning a set of teeth
    • 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
    • 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
    • A61C13/0006—Production methods
    • A61C13/0019—Production methods using three dimensional printing
    • 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
    • A61C13/01—Palates or other bases or supports for the artificial teeth; Making same
    • 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
    • A61C13/01—Palates or other bases or supports for the artificial teeth; Making same
    • A61C13/04—Palates or other bases or supports for the artificial teeth; Making same made by casting
    • 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
    • A61C13/12—Tools for fastening artificial teeth; Holders, clamps, or stands for artificial teeth
    • A61C13/16—Curing flasks; Holders therefor
    • 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 present invention relates to a new process for producing a denture utilising digital techniques to produce a modified type of denture flask, which is characterised in that it includes a hollow section having a shape and size corresponding to both the denture base and the individual teeth of the denture. Subsequently, individual teeth may be placed within the hollow section of the flask, and finally traditional techniques may be used to form the denture.
  • Dentures are prosthetic devices constructed to replace missing teeth. They are supported by the surrounding soft and hard tissues of the oral cavity. Complete dentures replace all of the teeth in the upper and/or the lower jaw, whereas partial dentures only replace some of the teeth in the jaw concerned. For example, partial dentures may replace one or more front teeth and/or one or more of the posterior teeth. Conventional dentures are removable as and when required.
  • the tooth distribution in each quadrant of the mouth consists of three front teeth, and four or five posterior teeth including two pre-molars and two or three molars.
  • the number of teeth used depends on factors such as the number of remaining natural teeth and the space available.
  • the third molar tooth is not always present in the natural human dentition, and is not usually included in dentures.
  • Dentures should be retentive, comfortable and provide support for the cheeks and lips. They should allow effective mastication, acceptable aesthetics, clear phonetics, and contribute to the wearer's confidence and self-esteem.
  • technicians at a dental laboratory pour a material, such as plaster, to form a model representing the shape and contours of the soft and hard tissue area of the jaws concerned as well as any remaining natural teeth. Once solidified, this forms a model of the upper and/or lower jaws of the individual patient.
  • the dental technician makes on the model a bite rim out of wax with a wax rim/block on it, positioned to replicate the position of the missing teeth. This is made of solid wax to approximately the correct dimensions but without any anatomical modelling and is sent to the clinician to make various adjustments so as to give information to the technician about facial height, lip support etc, and to mark various anatomical landmarks.
  • an articulator is a hinged metal piece of equipment used to represent the movements of the jaws in the dental laboratory
  • the dental technician then models in wax the plate that will form the denture itself and teeth are added to it in the functionally and aesthetically correct positions.
  • This wax model with teeth is referred to as a denture try-in.
  • the clinician checks the try-in in the patient's mouth against either the denture or the try-in of the opposing arch or the existing teeth in the opposing arch, with regard to the appearance, phonetics, and function. Adjustments are made by the clinician where necessary. Once the try-in has been returned to the dental laboratory, the dental technician then finishes any modelling work on the try- in that may be needed in order to get a true representation of the finished denture.
  • the technician then takes the wax denture with teeth attached and invests it into plaster contained in a metal flask, taking care to put a separator film between the two halves of the flask in order that it may be opened when set.
  • the dental technician opens the two halves of the flask and, using boiling water, removes the wax from the flask leaving the teeth embedded into one half.
  • the teeth remain in the flask where they are held in position by the plaster and there is hollow space corresponding to where the wax has been removed.
  • An acrylate dough is then packed into the hollow space in the flask, and it is closed tight in a conventional manner and heated to cure the acrylate dough forming the denture base material. Once cured, the plaster is broken away and the denture is cleaned and polished before sending back to the clinician to fit into the patient's mouth.
  • an impression of a patient's jaw can be scanned into a computer in the dental laboratory.
  • the impression may be scanned directly at the chairside and the data transmitted electronically to the dental laboratory.
  • a model may be produced from this impression and may be scanned into a computer either in the laboratory or directly at the chairside.
  • the components of the denture are then positioned digitally, by inputting additional information including measurements of the anatomical features and dimensions of the patient's mouth into the computer, and using specialist software to design the denture.
  • specialist software to design the denture.
  • the denture plate is then milled out of wax, leaving space for precisely fitting teeth to be inserted into the wax to form the try-in.
  • both the denture plate and teeth can be milled out of wax. This is then sent to the clinician for checking in the patient's mouth, following which the try- in can be invested into plaster contained in a metal flask, as in the traditional manner described above.
  • the step of producing and fitting a try-in is completely omitted, and the denture is produced directly from the digital design by milling the denture plate from prepolymerised plastic, leaving space for the individual teeth to be fixed in with an adhesive, such as an acrylic adhesive material.
  • an adhesive such as an acrylic adhesive material.
  • both the individual teeth themselves as well as the denture base are produced by milling, and the teeth and base are fixed together using adhesives.
  • US 2013/0326878 describes a method of production of a dental prosthesis involving digital design of the denture base, teeth shape, and occlusion, and production of the complete denture using various automated methods, such as inkjet printing.
  • the denture base and teeth are produced separately using the automated method, e.g. by using two inkjet printing machines, one with red material (for the gingiva) and one with white material (for the teeth), and then fixed together using an adhesive.
  • US 2013/0326878 describes a method of production of a dental prosthesis involving CAD/CAM and rapid manufacturing techniques.
  • the denture base and the teeth are formed from two different coloured materials and using different techniques, which may include three- dimensional printing, and the teeth and base are then bonded together.
  • the separate three-dimensional printing of both a denture base and artificial teeth, which are then assembled to form a denture by adhesion of the teeth to the base is also described in WO 2014/098956, which relates to photo-curable resin compositions that may be used in three-dimensional printing for manufacturing artificial teeth and denture bases.
  • the present invention seeks to design an improved process for producing a denture utilising digital techniques to produce a modified type of denture flask, which is characterised in that it includes a hollow section having a shape and size corresponding to both the denture base and the individual teeth of the denture. Subsequently, individual teeth may be placed within the hollow section of the flask, and finally traditional techniques may be used to form the denture.
  • the present invention provides a process for producing a denture utilising digital techniques to produce a modified type of denture flask, which is characterised in that it includes a hollow section having a shape and size corresponding to both the denture base and the teeth of the denture. Subsequently, teeth may be placed within the hollow section of the flask, and finally traditional techniques may be used to form the denture.
  • the teeth are individual teeth or the teeth are joined together, optionally wherein they are loosely joined together.
  • This process provides a number of advantages relative to both the existing traditional techniques for denture production, as well as the recent techniques incorporating digital technologies.
  • the shape of the hollow section in the denture flask allows for the precise positions of the individual teeth relative to the base to be fixed, and avoids the problem of the individual teeth twisting relative to the base as may occur with processes which involve the separate production of the denture base and teeth and adhesive bonding together of the components.
  • the process allows for the digital design of the denture that avoids the laborious steps of physically setting up the teeth and also enables different occlusal schemes to the tried out using the software.
  • the process allows for the use of high quality factory- manufactured individual teeth, which generally have better aesthetics, higher strength, and greater wear-resistance than those produced by inkjet (three- dimensional) printing or other digital processes.
  • the process may, if required, eliminate the need for a try-in to be produced, thus reducing the number of processing steps and overall manufacturing time compared with traditional processes.
  • An additional benefit of the present process is that the exact volume of the part of the hollow section corresponding to the denture base is known, allowing calculation of the exact weight of material required to fill the denture flask and produce the denture base. Therefore the precise amount of material required to produce the denture base can be mixed, thus avoiding wastage and reducing costs.
  • the try-in may be produced from either plastic or wax.
  • the teeth on this try-in may then be adjusted in the mouth and the adjusted try-in may be rescanned before producing the denture flask, thus providing a more accurately fitting denture or dentures.
  • the teeth on this try-in may then be trimmed in the mouth and the adjusted try-in may be rescanned before producing the denture flask.
  • Software may combine the original and new scans so that the denture teeth are their pre-trimmed sizes thus enabling the original teeth to be fitted into the digitally produced flask.
  • the trimming of the same teeth that had been carried out on the try-in can be carried out by milling the denture teeth using the data from the rescanned try-in, thus providing a more accurately fitting denture or dentures.
  • Figure 1 shows one half of the flask with the hollow section of the denture flask with the teeth in position.
  • Figure 2 shows the second half of the flask that provides the shape of the denture that fits to the patient's gum.
  • Figure 3 shows the half of the flask as depicted in Figure 1 with one potential position where hard stops might be applied if required (outer dashed and dotted line) and one potential position for the sealing means formed from a soft or flexible material (inner dashed line).
  • the present invention provides a process for producing a denture utilising digital techniques to produce a modified type of denture flask, which is characterised in that it includes a hollow section having a shape and size corresponding to both the denture base and the individual teeth of the denture. Subsequently, individual teeth may be placed into those positions in the hollow section of the flask corresponding to their sizes and shapes, and finally both traditional and digital techniques may be used to form the denture.
  • both traditional and digital techniques may be used to form the denture.
  • the term "about” means plus or minus 20%; more preferably plus or minus 10%; even more preferably plus or minus 5%; most preferably plus or minus 2%.
  • denture means a prosthetic device constructed to replace missing teeth; a denture consists of a denture base that is supported by the soft and hard tissues of the oral cavity, and artificial denture teeth that restore aesthetics and function for a patient.
  • digital techniques are used to produce the modified type of denture flask.
  • the digital techniques used to produce the modified type of denture flask comprise an initial step of using denture design software to digitally design the denture.
  • the denture design software will be used to firstly digitally position individual teeth relative to the digital model of the jaw after which the denture base is itself digitally designed to fit the digital model of the jaw and the denture teeth themselves to provide for an appropriate occlusion and aesthetics.
  • the data used by the denture design software may be obtained using any appropriate method.
  • the data of the patient's jaws is obtained by taking impressions.
  • the data of the patient's jaws is obtained by scanning.
  • a three dimensional facial image is obtained by photographic and/or scanning means.
  • three- dimensional laser or optical scanning either of the patient's jaws directly or models thereof may be used to obtain the necessary data of the patient's jaws.
  • the digital techniques used to produce the modified type of denture flask may comprise any known method for fabricating the flask.
  • the modified denture flask is fabricated using one or more methods selected from cutting technology, milling technology, stereolithography, selective laser melting, selective laser sintering, fused deposition modelling, and three-dimensional printing.
  • the digital techniques used to produce the modified denture flask comprise three-dimensional printing of the flask.
  • other processes for the production of dentures using digital techniques may use three-dimensional printing methods to directly produce a denture base and/or individual teeth
  • the present inventor has developed a novel process in which a modified denture flask is produced using a digital technique, such as three-dimensional printing.
  • a digital technique such as three-dimensional printing.
  • a number of different materials may be used in the step of three-dimensional printing of the modified denture flask.
  • the material used to produce the modified denture flask by three-dimensional printing should be a material that does not stick to or adversely react with the material that is to be used to form the denture base.
  • the material used to produce the modified denture flask by three- dimensional printing is a plastics material.
  • the material may be a thermoplastic plastics material or a thermosetting plastics material.
  • a combination of materials may be used to produce the modified denture flask.
  • this combination of materials comprises a plastics material together with one or more additional materials, such as a filler.
  • the material used to produce the modified denture flask by three-dimensional printing is a thermoplastic material, such as nylon. Nylon is particularly preferred because it is compatible with the use of an acrylate or methacrylate denture base material, which are the most commonly used materials for fabricating the denture base, without the use of a separator.
  • the material used to produce the modified denture flask by three-dimensional printing is a thermosetting plastics material, such as an epoxy resin, a polyurethane, melamine, a polyester, an acrylate, or a methacrylate. In a particularly preferred embodiment, the material is an acrylate or a methacrylate.
  • an acrylate monomer may be any suitable derivative of acrylic acid and a methacrylate monomer may be any suitable derivative of methacrylic acid, with ester derivatives of acrylic acid or methacrylic acid, such as a methyl acrylate, ethyl acrylate, butyl acrylate, methyl methacrylate, ethyl methacrylate, and butyl methacrylate being particularly suitable.
  • Acrylates or methacrylates are particularly preferred because they are compatible with the use of nylon as the denture base material, without the use of a separator. In some cases, nylon or another suitable thermoplastic material is used for fabricating the denture base, usually by injecting the nylon or other thermoplastic material into the denture flask.
  • two or more materials may be used to produce the modified denture flask by three-dimensional printing.
  • a first material may be used to produce a thin inner layer of the modified denture flask. This inner layer is the layer that would be in direct contact with the material being used to form the denture base in the subsequent steps of the process of the invention.
  • the first material should preferably be a material that does not stick to or adversely react with the material that is to be used to form the denture base. Therefore, the first material is preferably either nylon or another suitable thermoplastic material, or an acrylate or a methacrylate.
  • one or more additional materials may be used to produce the remainder of the modified denture flask.
  • the additional materials may comprise one or more backing materials with or without a filler.
  • These additional materials should ideally be low-cost materials and be rigid so as to support and strengthen the first material. Since these additional materials would not come into contact with the material that is to be used to form the denture base, the issue of compatibility does not arise, and therefore there is no restriction on the type of material used, since if this material does not chemically adhere to the inner material then the assembly can be designed so that there is a physical lock between them. It is not essential that this/these additional materials should be produced by three- dimensional printing.
  • the modified denture flask preferably comprises two portions.
  • the two portions are preferably of approximately equal sizes.
  • the two portions of the flask will be referred to as the upper portion and the lower portion.
  • the actual external shape and design of the modified denture flask may be varied according to preference, but should ensure precise positioning together of the two portions of the flask.
  • the modified denture flask preferably includes means to prevent under closure or over closure of the two portions of the flask.
  • the two portions of the modified denture flask comprise one or more positive stops which prevent under closure or over closure of the two portions of the flask.
  • the positive stops are preferably formed from a rigid material.
  • the modified denture flask further comprises sealing means on one or both portions of the flask.
  • the sealing means is preferably formed from a material that is sufficiently soft or flexible to distort under pressure to form a seal between the two halves of the flask without affecting the positive stops mentioned above.
  • the sealing means is provided around the edge of one or both portions of the flask. The provision of the sealing means will allow the two portions of the flask to compress slightly when they are closed together to the positive stops, providing a seal around the flask.
  • This sealing means may be produced by three dimensional printing or else may have been preformed from a material such as a silicone and affixed to the edge of one or both portions of the flask as above.
  • the modified denture flask includes a hollow section having a shape and size corresponding to both the denture base and the individual teeth of the denture.
  • a traditional denture flask from which the wax that has modelled the denture base has been removed by a means such as boiling water already contains the individual teeth embedded in the plaster and simply has a hollow section corresponding to the denture base
  • the modified denture flask has a hollow section which has individual indentations for accommodating the individual teeth of the denture rather than already containing the denture teeth.
  • the process preferably further comprises a step of placing individual teeth within the hollow section of the flask.
  • the individual teeth are slotted into the individual indentations of the hollow section. Since the individual teeth can easily be added to the spaces for them in the modified denture flask and aligned in their correct positions, the problem of twisting/rotation of the teeth relative to the denture base is avoided. It is also possible to use high quality factory-manufactured teeth, in order to avoid the problems of low strength and wear, and poor aesthetics resulting from direct three-dimensional printing or milling of teeth.
  • the process of the present invention preferably further comprises a step of using traditional techniques to form the denture using the modified denture flask.
  • One preferred technique used to form the denture comprises packing an acrylate or a methacrylate material into the modified denture flask, pressing the halves of the modified denture flask together under pressure, and subsequently curing the acrylate or methacrylate material to polymerise.
  • the acrylate or methacrylate material is prepared by mixing the acrylate or methacylate monomer with suitable polymers and/or other reactants directly prior to the packing step. Mixing of the acrylic acid or methacrylic acid monomer with suitable polymers and/or other reactants can be by hand or using a mechanical mixer.
  • the acrylate or methacrylate material may comprise one or more additives, for example, a filler.
  • a pourable or injectable acrylate or methacrylate material may be used to form the denture base.
  • another technique used to form the denture comprises pouring or injecting an acrylate or methacrylate material into the modified denture flask, and allowing it to self cure or cure by means of heat, light or another suitable method of curing. For instance, if the flask is manufactured from a clear or translucent material, the acrylate or methacrylate material may be cured by means of light.
  • a further technique utilising a pourable acrylic material comprises injecting an acrylate or methacrylate material into the modified denture flask through one or more holes in the flask, and allowing it to polymerise.
  • the pourable acrylate or methacrylate material may comprise one or more additives, for example, a filler.
  • nylon or another suitable thermoplastic material may alternatively be used to form the denture base. Therefore, in another embodiment of the invention, the technique used to form the denture comprises injecting nylon or another suitable thermoplastic material into the modified denture flask through one or more holes in the flask, and allowing it to set by cooling.
  • the nylon or other thermoplastic material may comprise one or more additives, for example, a filler.
  • the amount of material required to produce the denture base is also calculated utilising the denture design software.
  • the denture is milled from a puck, which is preferably of plastics material.
  • the puck is a disc of typically pink plastics and it is generally about 100mm in diameter and about 25mm deep.
  • a teeth facing surface of a denture is produced in a first stage and a fitting surface, which faces away from the teeth, is produced in a separate stage of the process.
  • the denture is initially formed on only its teeth facing surface and instead of producing a final fitting surface at this stage, the denture has a base in the form of a disc which fits into a milling machine.
  • a clinician may, at the denture try in stage (with the try in material in wax or plastic), grind down the teeth and especially the cusps so that they fit together better for an individual patient.
  • the revised try in is then scanned and used as the basis for the top side of the denture with the base of the denture in the form of a disc which fits into a milling machine.
  • the denture with only the teeth facing surface finished, is fitted into the milling machine.
  • the sides of the puck are held by the milling machine and the denture teeth are milled down to correspond to the scan of the revised try in.
  • the base of the denture is then milled from the puck to provide a fitting surface which corresponds with a scanned fitting surface.
  • the finished denture is cut away from the sides of the puck.

Abstract

Un procédé pour produire une prothèse dentaire comprend les étapes consistant à (i) produire un moufle pour prothèse dentaire modifié au moyen d'une ou de plusieurs techniques numériques, le moufle comprenant une section creuse ayant une forme et une taille correspondant à la fois à la base de la prothèse dentaire et aux dents de la prothèse dentaire, (ii) placer les dents à l'intérieur de la section creuse du moufle, et (iii) former la prothèse dentaire.
PCT/EP2016/054985 2015-03-09 2016-03-09 Procédé pour produire une prothèse dentaire WO2016142407A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB1503953.0A GB2536231A (en) 2015-03-09 2015-03-09 Process for producing a denture
GB1503953.0 2015-03-09

Publications (1)

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WO2016142407A1 true WO2016142407A1 (fr) 2016-09-15

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Cited By (2)

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Publication number Priority date Publication date Assignee Title
EP3517073A1 (fr) * 2018-01-30 2019-07-31 DGSHAPE Corporation Procédé de fabrication d'une prothèse dentaire
DE102018125083A1 (de) * 2018-10-10 2020-04-16 Binder Dental Gmbh Verfahren zur Herstellung einer Zahnprothese

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IT202100018344A1 (it) * 2021-07-12 2023-01-12 Gian Carlo Mortara Procedimento di realizzazione di una protesi odontoiatrica e muffola configurata per realizzare detto procedimento

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EP2465465A1 (fr) * 2010-12-20 2012-06-20 Laboratoire Bienfait Ensemble et procédé pour fabriquer une prothèse dentaire
WO2014053549A1 (fr) * 2012-10-02 2014-04-10 3Shape A/S Moule pour une restauration dentaire

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CN101548911A (zh) * 2008-04-03 2009-10-07 北京大学口腔医学院 一种基于cad/rp技术的全口义齿设计制作方法
EP2465465A1 (fr) * 2010-12-20 2012-06-20 Laboratoire Bienfait Ensemble et procédé pour fabriquer une prothèse dentaire
WO2014053549A1 (fr) * 2012-10-02 2014-04-10 3Shape A/S Moule pour une restauration dentaire

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3517073A1 (fr) * 2018-01-30 2019-07-31 DGSHAPE Corporation Procédé de fabrication d'une prothèse dentaire
DE102018125083A1 (de) * 2018-10-10 2020-04-16 Binder Dental Gmbh Verfahren zur Herstellung einer Zahnprothese

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GB2536231A (en) 2016-09-14

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