WO2019027108A1 - Procédé de fabrication d'une prothèse dentaire complète pour un patient édenté - Google Patents

Procédé de fabrication d'une prothèse dentaire complète pour un patient édenté Download PDF

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Publication number
WO2019027108A1
WO2019027108A1 PCT/KR2017/015197 KR2017015197W WO2019027108A1 WO 2019027108 A1 WO2019027108 A1 WO 2019027108A1 KR 2017015197 W KR2017015197 W KR 2017015197W WO 2019027108 A1 WO2019027108 A1 WO 2019027108A1
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WIPO (PCT)
Prior art keywords
patient
image
occlusal
complete denture
midline
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PCT/KR2017/015197
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English (en)
Korean (ko)
Inventor
조득원
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서울대학교병원
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Publication of WO2019027108A1 publication Critical patent/WO2019027108A1/fr

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    • 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
    • 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
    • A61B6/03—Computed tomography [CT]
    • 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
    • A61B6/03—Computed tomography [CT]
    • A61B6/032—Transmission computed tomography [CT]
    • 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
    • A61B6/5205—Devices using data or image processing specially adapted for radiation diagnosis involving processing of raw data to produce diagnostic data
    • 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
    • A61C13/08—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
    • A61C13/34—Making or working of models, e.g. preliminary castings, trial dentures; Dowel pins [4]
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T15/00—3D [Three Dimensional] image rendering

Definitions

  • the present invention relates to a method of manufacturing a complete denture for edentulous patients, and more particularly, to a method of manufacturing a complete denture for a edentulous patient,
  • the present invention relates to a method for manufacturing a complete denture having high durability.
  • the main model is made and the upper and lower jaw relations are made by making the recording image and the occlusion agent on the main model. Arrangement of artificial teeth in the occlusion agent is performed to demonstrate the value of lead, and finally the total denture is completed.
  • Such a conventional method of preparing a complete denture requires an average of 3 to 5 months, and it is inconvenient to visit the denture at least five times in order to visit the denture. This manufacturing process depends on the experience and skill of the dentist and it is very difficult to predict the outcome of the treatment. In addition, in order to produce a complete denture suitable for a patient, it is necessary to reflect the whole patient information of the patient's face, head and neck, upper and lower mandible.
  • a method of manufacturing a complete denture for an edentulous patient comprising the steps of: Generating an image; Displaying a soft tissue image and a hard tissue image from the 3D image on a screen; Setting a reference line connecting the soft tissue image displayed on the screen and the anatomical landmark of the patient on the hard tissue image; Setting an occlusal plane and a midline on the 3D image with reference to the reference line; Designing recording, occlusal or artificial teeth between the maxilla and mandible on the 3D image with reference to the occlusal plane and the midline; And outputting the three-dimensional structure according to the design file of the recording image, the occlusion agent, or the artificial teeth.
  • the spacing member can separate the upper and lower soft tissues in the oral cavity of the patient and determine the occlusal height and horizontal relationship between the upper and lower mandible through height adjustment.
  • the spacing member may include a top end stop tray, a mandibular tray, and a connecting member for adjusting a distance between the trays.
  • the reference line may be a midline, a pupil trunk, or a Camper's plane.
  • the patient can visit only three times at least, thereby significantly reducing the inconvenience of dentures. That is, if a tomographic image is taken and an occlusion agent or an occlusal prosthesis is obtained through the occlusion or denture, the patient can visit the hospital to finally mount the denture.
  • the treatment period can be shortened. In some cases, it may be possible to omit the poetic and discontinuity phases.
  • a correct denture can be designed because a complete denture is manufactured using tomography, for example, cone beam CT using oral and external anatomical information.
  • FIG. 1 is a flowchart sequentially illustrating a method of manufacturing a complete denture according to an embodiment of the present invention.
  • Fig. 2 is a cross-sectional view schematically showing the spacer in Fig. 1.
  • Figs. 3 to 5 are views showing exemplary reference line setting of Fig.
  • FIG. 6 is a view illustrating a process of determining the position of an artificial tooth in FIG.
  • Figure 7 illustrates an exemplary occlusion agent output in Figure 1
  • a complete denture design system is a system for providing a complete denture using a 3D image of a head of an edentulous patient.
  • the system includes an imaging device for photographing a head of a patient, And a 3D output device for producing a structure necessary for complete denture based on the final design file from the designing device.
  • the imaging device is a device for generating a 3D image of a patient's head, specifically the internal and external soft tissues of the patient, the teeth, and the facial bone structure using tomography.
  • the imaging device may be configured with, for example, Cone Beam Computerized Tomography (CT).
  • CT Cone Beam Computerized Tomography
  • the cone beam CT detects the cone-shaped transmission X-ray two-dimensionally using an area detector and obtains the three-dimensional volume information by using it to generate a 3D image by only one rotation scan of the object.
  • Cone beam CT is a device that accurately generates hard tissue images of the head, such as the maxilla, mandible, ridge, alveolar bone, and root. However, it can also generate soft tissue images of the contour of the patient's face. Further, when the patient is taking a cone beam CT in a state where the separation member is held between the upper and lower mandibles, the soft tissues can be accurately represented because the upper and lower soft tissues are separated from each other by the spacing member and the
  • the design apparatus receives a 3D image, i.e., a soft tissue image and a hard tissue image, from the imaging device and displays each or a combination thereof on the screen. Because the 3D image contains all of the patient's anatomical information to create a complete denture, the dentist can produce accurate, wear-friendly dentures based on this.
  • the dentist connects to the design device through the user terminal and sets a reference line on the soft tissue image, hard tissue image, or a combined image thereof displayed on the screen.
  • the reference line is a reference line for the design of a complete denture, and includes a line on the face and head and neck, a camper's plane, a Frankfort horizontal plane, a pupil trunk, (Upper eyelid), upper eyelid (upper eyelid), upper eyelid, lower eyelid, or a combination thereof.
  • the dentist can determine the position of the recording, occlusal or artificial teeth by checking the soft tissue images and hard tissue images based on these reference lines.
  • the designing device can display simulation of the change of the face or facial according to the position change of the artificial tooth.
  • the design of the occlusal agent or the artificial tooth the designing device stores the image of the structure (recording image, occlusion agent, or artificial tooth) in a STL (STeroLithography) file format.
  • STL STeroLithography
  • the 3D output device includes a milling machine, a 3D printer, and the like, which receives a design file from a designing device and manufactures a structure such as a recording material, an occlusion material, or an artificial tooth.
  • FIG. 1 is a flowchart sequentially illustrating a method of manufacturing a complete denture according to an embodiment of the present invention.
  • Fig. 2 is a cross-sectional view schematically showing the spacer in Fig. 1.
  • Fig. Figs. 3 to 5 are illustrations showing the reference line setting of Fig. 1 by way of example.
  • FIG. 6 is a view illustrating a process of determining the position of an artificial tooth in FIG.
  • Figure 7 illustrates an exemplary occlusion agent output in Figure 1;
  • a separation member 10 is inserted between a maxilla 20 and a mandible 30 of a patient before performing a tomography of a 3D image of the patient's head using the imaging device (S10) .
  • the spacing member 10 includes a top deformation tray 12, a mandible tray 14, and a connecting member 16 for adjusting the distance between these trays.
  • the upper deformation tray 12 and the lower tray 14 each have a tray shape for pulling up and have an impression material for forming a pattern on the inside.
  • This impression material and spacing member 10 serve to more clearly reveal the intraoral soft tissue of the patient in subsequent tomography.
  • the connecting member 16 is configured to adjust the distance between two trays by connecting the upper and lower tails 12 and 14 to each other.
  • the connecting member 16 may be provided with threads on the outer circumference thereof to adjust the tray interval by rotating movement. It is very important to determine the horizontal or vertical relationship between occlusal height or vertical height and malocclusion in an edentulous patient. In the present invention, before designing the complete shape of the complete denture, Is determined.
  • a 3D image of the patient's head is generated using tomography of the imaging device (S20).
  • the imaging device generates soft tissue images and hard tissue images as 3D images.
  • the soft tissue image includes the soft tissue image in the oral cavity as well as the facial appearance.
  • the soft tissue image as well as the impression material and the soft tissue image separated by the spacing member 10 can be obtained as well as the hard tissue image .
  • the method of obtaining the soft tissue image in the oral cavity is not limited to this, and the soft tissue image can be obtained by scanning the inside of the oral cavity by optical scanning or scanning the impression material with the soft tissue in the oral cavity.
  • the design apparatus displays a soft tissue image, a hard tissue image, or a combination thereof on the screen using the 3D image photographed from the imaging device (S30). Through this, the dentist can confirm the soft tissue, skull and mandible, and upper and lower jaw relationship of the patient's face.
  • the dentist accesses the design apparatus through the user terminal and sets a reference line on the 3D image displayed on the screen (S40).
  • the reference line is information on the basis of the occlusal plane and the midline for making the complete denture, and refers to a line or a plane connecting the anatomical landmark.
  • the reference line is referred to as a reference line for simplicity of the term, but it should be understood as a concept including a plane on a 3D image as well as a line connecting landmarks.
  • FIG. 3 shows an example in which a pupil trunk line and a camper's plane are set as reference lines on a soft tissue image.
  • the camber plane means a plane connecting the apical portion of the nasal wing and the upper part of the tragus.
  • the outline of the face is represented by a soft tissue image, but the intraoral soft tissue may be separately imaged.
  • FIG. 4 illustrates an example in which a soft tissue image and a hard tissue image are displayed together, and a pupil trunk line and a camper plane are set as reference lines. It can be confirmed that a part of the spacing member is displayed in the oral cavity.
  • the reference line includes the midline of the face and the head and neck, or the Frankfort Horizontal plane, and includes a wing (nostril), an ankle (anterior mouth), an ankle (a dorsal line) ), A line connecting the anatomical landmarks of the lower and upper mandibles (lower jaw), eyebrows, upper and lower lips, and the like.
  • the Frankfort horizontal plane means the horizontal plane determined by looking sideways between the lowest point of the orbit edge and the highest point of Lee, Yeon-yeon.
  • An anatomical reference line or reference point plays a very important role in dental prosthetic treatment.
  • a person's dentition is caused by many causes such as malocclusion, growth pattern, loss of teeth, movement of teeth due to tooth loss, congenital defect, remnant of toothpick, malpractice such as dry mouth, jaw face anomaly, jaw face defect, Have various arrangements.
  • a treatment plan is established considering these causes. If the tooth is partially defective, the treatment plan such as the length of teeth or occlusion can be made with reference to the remaining dental condition.
  • the complete denture must be designed by relying on reference points or reference lines based on the soft tissue, skull, and mandible of the face.
  • an occlusal plane and a midline are set on the 3D image displayed on the screen with reference to the reference line (S50).
  • the occlusal plane and midline are important factors in the complete denture design of edentulous patients, on which records, occlusal or artificial teeth are arranged.
  • the occlusal plane refers to the horizontal virtual plane formed by the occlusal surface of the teeth as the entire dentition, preferably the occlusal plane is set substantially parallel to the pupil trunk line or camper plane.
  • the midline is the line representing the center of the tooth, and is set to match the center of the head and neck because there is no standard tooth for the edentulous patient.
  • a recording image, an occlusion agent, or an artificial tooth is designed between the upper and lower jaws based on the occlusal plane and the midline (S60). Since the 3D image of the present invention is photographed while the patient is holding the spacer member 10, the occlusion diameter has already been determined. Therefore, recording, occlusal, or artificial teeth can be designed while referring to the patient's soft and hard tissues based on the occlusal plane and the midline shown in the 3D image. 6, the position of the artificial tooth can be determined based on the occlusal plane, the midline, the reference line, etc. while referring to the soft tissue image and the hard tissue image of the patient's head, i.e., anatomical information.
  • the dentist can determine the ratio of the face, the esthetics of the facial feature, the relation between the upper and lower mandible, the relation between the tongue and the ball in the mouth, The three-dimensional position of the artificial tooth can be arranged while checking the horizontal relation of the preparation. Therefore, clinical errors such as errors in the occlusal plane can be significantly reduced. In addition, since such 3D images and design data are transmitted to the technician, the possibility of failure of treatment due to communication difficulties between the dentist and the technician can be significantly reduced.
  • the result of the treatment can be easily predicted when the change of the patient's face is displayed on the screen by simulation.
  • the images of these structures are stored as design files in the STL file format.
  • the three-dimensional structure is output according to the design file of the recording material, the occlusion agent, or the artificial tooth using the 3D output device (S70).
  • the above design file can have the STL file format, and can output a three-dimensional structure using a milling machine, a 3D printer, and the like.
  • the occlusal plane 52 and the midline 50 referenced in the previous design step are directly transferred to the occlusion agent 40 output as a three-dimensional structure, and are displayed and utilized in the tooth arrangement.
  • the occlusion agent is output as a three-dimensional structure.
  • the present invention is not limited thereto.
  • the patient can obtain the finished denture even if he visits only three times.
  • the edentulous patient records the cone beam CT at the door, and the dentist uses the anatomical reference line from the photographed 3D image to output the recording, occlusal or artificial values.
  • the dentist uses the anatomical reference line from the photographed 3D image to output the recording, occlusal or artificial values.
  • the dentist will arrange the teeth to complete the dentures.
  • the patient is finally fitted with a denture.
  • the patient's convenience can be maximized by reducing the number of visits to the patient.
  • it can contribute to increase productivity by lowering doctor's time and frequency of treatment.

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Abstract

La présente invention concerne un procédé de fabrication d'une prothèse dentaire complète sur la base d'une image 3D de la tête d'un patient édenté. Le procédé de fabrication d'une prothèse dentaire complète consiste à : capturer un CT à faisceau conique dans un état dans lequel le patient mord un élément d'espacement entre leur maxillaire et la mandibule pour obtenir une image de tissu dur et une image de tissu mou de la tête du patient ; et définir un plan occlusal et une ligne médiane sur l'image 3D, ce qui permet de concevoir la prothèse complète l'utilisant. Selon la présente invention, il est possible de réaliser une prédiction visuelle, de simplifier un processus de traitement et d'augmenter la prévisibilité d'un résultat de traitement.
PCT/KR2017/015197 2017-08-01 2017-12-21 Procédé de fabrication d'une prothèse dentaire complète pour un patient édenté WO2019027108A1 (fr)

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KR1020170097512A KR102057671B1 (ko) 2017-08-01 2017-08-01 무치악 환자를 대상으로 한 완전틀니의 제조 방법
KR10-2017-0097512 2017-08-01

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Cited By (3)

* Cited by examiner, † Cited by third party
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CN110063807A (zh) * 2019-05-09 2019-07-30 同济大学 具备前牙美学考量的无牙颌个性化托盘装置及其使用方法
WO2020162730A1 (fr) * 2019-02-09 2020-08-13 이우형 Système dentaire ayant une ligne de base permettant de fusionner un modèle de dent numérique tridimensionnel avec un emplacement anatomique et une analyse de plan de corps humain
WO2021162220A1 (fr) * 2020-02-11 2021-08-19 부산대학교 산학협력단 Prothèse dentaire pour patient édenté, comprenant un élément détachable de prothèse dentaire remplaçable de façon répétée, et son procédé de fabrication

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KR102484790B1 (ko) * 2020-09-21 2023-01-05 주식회사 메디트 의치 제작을 위한 교합고경 재현 방법
WO2022059929A1 (fr) * 2020-09-21 2022-03-24 주식회사 메디트 Procédé de reproduction de dimension verticale occlusale pour la fabrication de dents artificielles
KR102538681B1 (ko) * 2021-02-18 2023-05-31 오스템임플란트 주식회사 무치악 환자의 데이터를 이용하는 치아 배열 시스템 및 그 동작 방법

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020162730A1 (fr) * 2019-02-09 2020-08-13 이우형 Système dentaire ayant une ligne de base permettant de fusionner un modèle de dent numérique tridimensionnel avec un emplacement anatomique et une analyse de plan de corps humain
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CN110063807A (zh) * 2019-05-09 2019-07-30 同济大学 具备前牙美学考量的无牙颌个性化托盘装置及其使用方法
WO2021162220A1 (fr) * 2020-02-11 2021-08-19 부산대학교 산학협력단 Prothèse dentaire pour patient édenté, comprenant un élément détachable de prothèse dentaire remplaçable de façon répétée, et son procédé de fabrication

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