Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C5/00—Filling or capping teeth
  • A61C5/007—Dental splints; teeth or jaw immobilisation devices; stabilizing retainers bonded to teeth after orthodontic treatments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/002—Orthodontic computer assisted systems
• • 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
  • 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
  • A61C11/02—Dental articulators, i.e. for simulating movement of the temporo-mandibular joints; Articulation forms or mouldings characterised by the arrangement, location or type of the hinge means ; Articulators with pivots
• • 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]
• • 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
  • A61C19/05—Measuring instruments specially adapted for dentistry for determining occlusion
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/36—Devices acting between upper and lower teeth
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
  • A61F5/56—Devices for preventing snoring
  • A61F5/566—Intra-oral devices
• • 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
  • A61C13/0013—Production methods using stereolithographic techniques
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
  • A61F5/56—Devices for preventing snoring
  • A61F2005/563—Anti-bruxisme

Definitions

• the invention relates to a method for producing a guided bite splint for a supporting jaw comprising at least one guide for a counter-jaw.
• DE 20 2010 006 250 U1 discloses a device for producing a guide rail for correcting the condylar position of a temporomandibular joint, the device having a position-variable platform on which a lower jaw model is arranged and changed in its position relative to the upper jaw model by means of a control device ,
• DE 10 2013 112 032 AI discloses a method for constructing a bite splint, wherein 3D data of the two jaws are detected and the position of the patient's jaws and temporomandibular joints are detected relative to each other, whereby an occlusion is simulated, wherein dental interfering contacts of one In the craniomandibular system, a bite splint is constructed using the acquired 3D data and from the simulation of the acquired data so that the identified spurious contacts are eliminated become.
• a series of multiple bite bars are designed to interactively approximate the physiological location of the temporomandibular joints, the bite splints of the series differing only slightly in shape and thus the temporomandibular joints in small discrete steps over a longer period of time into their physiological Able to be brought.
• a disadvantage of the known methods is that the guides of a guided bite rail are subsequently added by a manual reworking.
• the object of the present invention is therefore to provide a method for producing a guided bite bar, which allows a precise and time-saving production of a guided bite splint, whereby manual manufacturing errors, in particular the guides of the bite bar, should be avoided.
• the invention relates to a method for producing a guided bite splint for a supporting jaw comprising at least one guide for a counter-jaw.
• a 3D model of an upper jaw and / or a 3D model of a lower jaw are already present, wherein the 3D models of the upper jaw and the lower jaw are arranged in an occlusal position to each other.
• a 3D model of the bite splint is then constructed, whereby the at least one guide for the opposing jaw is automatically constructed on the 3D model of the bite splint computer-assisted.
• the guided bite splint is on the upper jaw as a support jaw and thus the lower jaw as opposed jaw or constructed on the lower jaw as a support jaw and thus the maxilla as opposed jaw.
• a guided bite splint is also used as a mouthguard in the dental and orthodontic treatment of teeth grinding, bruxism and craniomandibular dysfunctions.
• a guided splint for example, can be a Mi ⁇ chiganschiene, which is used to prevent muscle aches and joint pain, as well as an uncertain final bite position. Above all, the Michigan railing acts as a relaxation rail. The leadership of the mandible on the bite ⁇ rail is mostly carried out in the canine.
• the guided bite splint can also be a DROS bite splint, which serves in particular for mandibular stabilization.
• the guided bite splint thus serves as a relaxation splint to prevent occlusal dysfunctions and to relax the masticatory muscles (reduction of muscle tone).
• the guided Ausbissschiene should also protect against the destruction of ZahnhartSubstanz, which is caused by teeth grinding.
• a guided bite splint may be treated to treatment ⁇ Kunststoffaji malocclusion positions as a malocclusion with a previous lower jaw or a malocclusion with a protruding jaw.
• the jaw anomalies can be either innate or acquired.
• the extent of the malocclusion becomes clear only at the time of jaw closure and manifests itself, for example, as an open bite or because the maxillary teeth bite behind the lower jaw teeth instead of the other way round.
• the position of the jaw zuei ⁇ Nander and facial skeleton has a decisive Influence on the facial profile. Depending on whether overdevelopment or underdevelopment is localized in the upper jaw and / or in the lower jaw, different facial profiles result paral ⁇ lel to Friedbiss.
• the guide of the bite splint is usually arranged in the anterior region and / or in the canine region and can have a specific angle of inclination relative to a insertion axis of the bite splint between 20 and 40 degrees usually in the lateral direction and / or the protrusive direction of a jaw movement.
• the 3D model of the upper jaw and / or the lower jaw are already present for carrying out the method, and were measured, for example, by means of an intraoral 3D camera.
• the 3D model of the two jaws are arranged in the occlusal position and integrated into a virtual actuator model.
• a mallli ⁇ che 3D image of both the patient's jaw may be used in the final bite position for arrangement of the two SD models relative to each other.
• the at least one guide for the counter-jaw is designed compu ⁇ tergeform automatically, wherein the guide of the bite splint exerts in the final ⁇ bite position, a force in a desired direction on the opposing jaw to correct the malocclusion position.
• Another advantage of the present method is that the at least one guide of the guided bite splint can be accurately positioned and adapted precisely to the opposing jaw.
• the complex stepwise removal of the material for the production of the guides is thereby saved in comparison to the known manufacturing ⁇ lungsclar.
• the 3D models of the upper jaw and the lower jaw can be integrated into a virtual Artikulatormodell that simulates an articulation movement of the Un ⁇ terkiefers relative to the upper jaw.
• an articulator is simu ⁇ lines that mimics the temporomandibular joint movement.
• the movement of the jaws to each other is simulated, the jaw joint can perform both rotational movements (opening and Sch thoroughlybewe ⁇ conditions around the hinge axis), as well as sliding (advancing movements).
• the TMJ best ⁇ hen from a cartilage-covered joint head, also a cartilage-covered fossa and fibrocartilaginous intermediate joint disc.
• the guided bite splint is then computer-aided using the two 3D models of the jaws and taking into account the simulated movements of the temporomandibular joints in the virtual articulator model.
• the virtual Artikulatormodell the Be ⁇ movements of the two jaws can be calculated also by so-called heuristics or simulated another, for example a translational movement of the two 3D models of the jaws to each other.
• the extent of the guided bite splint on the upper jaw or on the lower jaw can be determined as a support jaw computer-aided automatically or by a user.
• the extent of the guided bite splint is determined relative to the supporting jaw.
• the extent can be determined by using a virtual tool by the user by the border of the guided bite splint is drawn on the 3D model of the support jaw.
• the expansion of the bite block ⁇ rail can be automatically determined with computer assistance, in ⁇ the odels on a database of different 3D is accessed by support jaws and a suitable 3D model of a supporting jaw is selected for the extent of the occlusal splint is already defined.
• a minimum thickness of the bite splint can run computer-aided automatically or be defined by ei ⁇ NEN user.
• the minimum thickness of the bite rail can be determined.
• the user may manually enter the value for the minimum thickness.
• the minimum thickness can be automatically determined by computer-assisted ⁇ who by the measured 3D model of the support jaw is compared with the database of different supporting jaw, for the minimum thicknesses have already been set.
• the guided splint has to everywhere have the specified differently bene minimum thickness along an axis of insertion of the splint.
• the insertion axis is defined by an insertion direction when placing the bite splint on the supporting jaw.
• the predetermined minimum thickness can be undershot to the edge of the bite splint who ⁇ .
• the distance can for example be entered by a Be ⁇ user or computer-assisted automatically by comparison with a database of different support jaw and opposing jaw with known Okissesionsöff- voltages are compared.
• the spacing of the Okissesionsö réelle can be defined genkiefer for example, by the distance between the entspre ⁇ sponding occlusal contacts of the supporting jaw and the overall.
• the 3D model of the guided bite splint can be automatically calculated computer-aided, wherein the conditions are to be met that the guided bite splint covers a defined contact area on the supporting jaw, that at least one local cusp tip is defined as a resting point for at least one tooth of the opposing jaw.
• the 3D is calculated odell the guided Aufbissschiene computerized automatically, that the conditions are met ⁇ gen.
• the defined contact point for the individual teeth ensures a stable mechanical support of the bite splint on the supporting jaw.
• At least one guide point of the guide to be constituted on the opposing jaw computerge ⁇ supports can be defined by a user automatically or manually.
• the guidance point is automatically defined manually by means of a virtual tool by the user or computer-assisted by comparison with a database under ⁇ different support jaw and opposing jaw with fixed guide points.
• At least one movement profile can be defined for each guide point.
• the movement profile is defined as a function of the jaw opening as a function of a jaw movement distance.
• the movement profile thus defines a desired course of movement of the opposing jaw in reducing the jaw opening to a closed occlusal position, in which the opposing jaw bites on the on ⁇ bite rail.
• a force is exerted on the lower jaw in a distal direction and, in the case of a preceding lower jaw, a force is exerted in a mesial direction for the desired motion course.
• the movement profile goes through a defined plane that passes through the guide point and, for example, runs along one direction of the insertion axis.
• several motion profiles can also be defined in different levels.
• the surface shape of the lead in response to the at least ei ⁇ nem motion profile, can be automatically calculated computer- tergeKey.
• the surface shape of the guide is automatically calculated as a function of at least one defined movement profile com ⁇ computer-supported.
• the surface of the 3D model of the guided bite splint in the areas of the guides can be guided adjusted accordingly relationship ⁇ example, wherein a gap between the predetermined motion profiles may be interpolated so that a smooth transition of the surface shape of the guide is formed.
• the surface shape of the guide is thus calculated that the constructed guide leads to the desired course of movement of the opposing jaw relative to the bite splint and relative to the supporting jaw according to the defined movement profiles.
• At least two movement profiles can be defined in two different levels for each guide point, wherein the surface shape of the guide is interpolated between the two planes of the two motion profiles so that a smooth transition arises.
• a first level of a first motion profile can, for example, in a lateral (side) direction of movement and a second level of a second motion profile may be arranged for example in a protrusionalen (pre- and ⁇ back) direction of movement.
• the surface of the 3D virtual model of the overall led occlusal splint can be reduced to the extent that no surface point of the 3D is penetrated virtually Odell the opposing jaw, so long as the opposing jaw along at least one guide within the virtual articulator - Moved model within a defined range of motion.
• the guided bite splint can be fully automated according to the constructed 3D model of the bite splint. table by means of a subtractive manufacturing method, such as a CAM manufacturing machine, or by means of an additive manufacturing method, such as a 3D printer forth ⁇ made.
• the guided bite splint is produced fully automatically according to the constructed 3D model.
• the designed bite bar is printed.
• the 3D printer can be based on an SLS (Selective Laser Sintering) process, which enables the printing of three-dimensional objects without binders or additional assembly steps.
• SLS Selective Laser Sintering
• the present 3D model of the bite rail is broken down into many horizontal planes by means of a special slicing software and forwarded as control commands to the 3D printer. The 3D printer then prints the object
• the 3D printer can also be based on a stereo lithography method, wherein a laser is used, which polymerizes a composite of lichtempfind ⁇ lichem resin and material particles mass.
• the material of the bite splint may be carried out, for example, a plastic with a matching Här ⁇ te. The hardness and elasticity of the plastic are The chosen so that a precise guidance of the counter ⁇ jaw along the constructed guides is made possible.
• the bite splint can also be made of different plastics.
• Another object of the invention is the guided on ⁇ bite rail produced using the above method, wherein the at least one guide for the Ge ⁇ jaw is computer-aided automatically constructed.
• the guide for the opposing jaw can be constructed using the at least one movement profile at at least one guidance point.
• the guide is constructed using the defined movement profile, so that the guide leads to the desired course of movement of the opposing jaw.
• the bite splint can run after the constructed 3D model of the bite splint fully automatic ⁇ table by means of a subtractive manufacturing method, such as a CAM-making machine, or by means of an additive manufacturing process, such a 3D printer, be set forth ⁇ .
• a subtractive manufacturing method such as a CAM-making machine
• an additive manufacturing process such as a 3D printer
• the guided bite rail is produced fully automatically and thus in a time-saving manner, whereby possible manufacturing errors of a manual production of the guides are avoided.
• Fig. 1 shows a sketch to illustrate the pine procedural ⁇ proceedings for the manufacture of a guided Aufbissschiene 1 for a support jaw 2, in the present case for the upper, comprising at least one guide 3.
• the bite splint 1 a plurality of guides 3 with the opposing jaw 4, in the present case for the lower jaw, on.
• a 3D model 5 of the upper jaw and a 3D model 6 of the lower jaw are already present and were measured on the patient by means of an intraoral 3D camera.
• the 3D model of the upper jaw 5 and the 3D model 6 of the Un ⁇ terkiefers are arranged in a Okklusal too 7 to each other and inte grated in a virtual ⁇ Artikulatormodell. 8
• the Artikulatormodell 8 simulates an articulation motion of the temporomandibular joint 9, which is illustrated for clarity as a cross, and thus the sub ⁇ jaw 6 relative to the upper jaw 5.
• the articulation motion of the temporomandibular joint 9 may consist of a Rotationsbe ⁇ movement 10, a feed motion 11 in the horizontal direction, a movement 12 in the vertical direction relative to the 3D model 5 of the upper jaw and an unillustrated sideways movement in a rotational axis direction of the temporomandibular joint 9 be composed.
• a 3D model 13 of the guided on ⁇ bite rail 13 is constructed, wherein the simulated movement ⁇ course of the lower jaw 4 relative to the upper jaw 2 from the Articulator model 8 is used.
• a first guide point 14, a second guide point 15 and a third guide point 16 are manually set by a user or computer-assisted on the 3D model 13 of the release rail 1 automatically.
• the guide points 14, 15 and 16 on the 3D model 13 of the bite splint are determined in relation to their positions on the opposing jaw 4.
• the extension of the 3D model 13 of the bite rail 1 relative to the 3D model 5 of the support jaw 2 is thereby automatically determined by the user or computer-based so Festge ⁇ sets that at least a defined support area of the support jaw 2 is covered and an opening of the jaw defines a Value.
• the 3D model 13 is on ⁇ bite rail 1 so constructed that a local cusp tip geddling as a Aufla ⁇ is defined 18 for each tooth 17 of the opposing jaw. 4
• the support points 18 are shown as crosses on the opposing teeth 17.
• For the second guide point 15 also several motion profiles 22 are set in different levels.
• two motion profiles 23 are also set in different planes.
• a first diagram 24 is an example of a first function 25 of the first movement profile 19 as a function of an opening 26 of the opposing jaw 4, namely a distance of the jaw from each other, in dependence on a distance 27 of the respective sliding contact point of the opposing jaw in the guide plotted relative to the respective guide point in the plane of the respective movement profile.
• the first function 25 for the first movement profile 19 has a linear course.
• a second function 28 of the second movement profile 20 has an exponential shape.
• the third guide 31 is calculated.
• the surface shape of the guide 3, 30, 31 is interpolated in an intermediate region 32 between adjacent motion profiles, so that a smooth transition of the surface shape of the guide is formed.
• the construction of the guided bite splint is virtual by means of a computer 33 wherein the computer 33 is a assivorrich ⁇ tung 34, such as a monitor, as well as control elements such as egg ⁇ ne keyboard 35 and a mouse 36 are connected.
• the construction of the 3D model 13 of the bite rail 1 can be computer-assisted automatically and / or manually by a user using a virtual tool 37, such as a cursor.
• the design data to a CAM manufacturing machine are passed 38th In the CAM production machine 38, the produced bite rail 1 with the guides 3 is then ground out of a pipe 39 which may be made of a special plastic. Alternatively, the guided bite rail 1 can also be produced by means of a 3D printer.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Epidemiology (AREA)
• Engineering & Computer Science (AREA)
• General Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Otolaryngology (AREA)
• Pulmonology (AREA)
• Nursing (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Biophysics (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
• Dental Prosthetics (AREA)
• Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

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• 2017
  • 2017-10-02 DE DE102017217558.3A patent/DE102017217558A1/de not_active Withdrawn
• 2018
  • 2018-10-02 US US16/648,099 patent/US11583367B2/en active Active
  • 2018-10-02 JP JP2020539145A patent/JP2020535934A/ja active Pending
  • 2018-10-02 WO PCT/EP2018/076780 patent/WO2019068703A1/de not_active Ceased
  • 2018-10-02 CN CN201880064556.3A patent/CN111182853B/zh active Active
  • 2018-10-02 EP EP18786242.0A patent/EP3691566B1/de active Active
  • 2018-10-02 KR KR1020207007199A patent/KR102580303B1/ko active Active
• 2023
  • 2023-12-07 JP JP2023206767A patent/JP2024023588A/ja active Pending

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