WO2019172476A1

WO2019172476A1 - Oral occlusion analysis method and device on basis of patient's temporomandibular joint motion

Info

Publication number: WO2019172476A1
Application number: PCT/KR2018/002880
Authority: WO
Inventors: 김진사
Original assignee: 주식회사 쓰리디산업영상
Priority date: 2018-03-08
Filing date: 2018-03-12
Publication date: 2019-09-12

Abstract

An oral occlusion analysis device, which operates by means of at least one processor, comprises: an image matching unit for generating a matched image by means of matching three-dimensional oral scan image and CT image of a patient; a mandibular joint movement model generating unit for separating the mandible comprising the temporomandibular joint from the matched image or the CT image, and generating a mandibular joint movement model which is a motion range of the mandible modelled in a three-dimensional space by means of movement parameters determining the movement range of the temporomandibular joint; and a collision simulating unit for simulating the mandibular motion of the patient by means of applying the mandibular joint movement model to a mandibular area of the matched image, and measuring the collision state of a tooth occlusal surface of the patient by means of the simulation.

Description

Method and Apparatus for Oral Occlusion Analysis Based on Patients' Temporomandibular Joint Movement

The present invention relates to patient temporomandibular joint movement analysis.

Recently, digital occlusion analysis is being activated by the development of digital equipment for the prosthesis design and oral device manufacturing in the dental field. Among them, there is a method of analyzing the oral occlusion of a patient using a virtual articulator digitizing a physical articulator. However, the virtual articulator uses statistically quantified movement parameters instead of per-temporal Temporal Mandibular Joint (TMJ) movements, and thus cannot reflect the characteristics of the jaw joint structure and movement of each patient. In particular, it is difficult to analyze the geometric movement of the temporomandibular joint, so that the oral device can be manufactured without considering the structure of the jaw joint.

On the other hand, in order to analyze the temporomandibular joint movement of the patient wearing a device with a marker or sensor attached to the oral cavity, CT imaging can be secured data. However, a separate stadium wearing device is expensive and has a disadvantage of complicated data acquisition procedure.

The problem to be solved by the present invention is to generate a mandibular joint motion model of the patient using a 3D oral scan image and CT image of the patient, and to analyze the oral occlusion based on the mandibular movement simulated by the mandible joint motion model and To provide a device.

An oral occlusal analysis device operated by at least one processor according to an embodiment, comprising: an image registration unit for generating a registration image by registering a 3D oral scan image and a CT image of a patient, a temporal image in the registration image or the CT image Mandibular joint that separates the mandible including the temporomandibular joint and creates a mandible joint model that models the range of motion of the mandible in three-dimensional space using motion parameters that determine the range of motion of the temporomandibular joint. An exercise model generator, and a maneuver simulation model for applying the mandible joint motion model to the mandibular region of the registration image to simulate the mandibular movement of the patient and measuring the collision state of the tooth occlusal surface of the patient through the simulation; do.

The image matching unit may generate the registration image by matching common registration points of the 3D oral scan image and the CT image.

The mandibular joint motion model generator may determine each of the left temporal mandibular joint, the right temporal mandibular joint, and the mandibular tooth center as motion reference points, and determine the motion range of the motion reference points based on the motion parameters. The exercise parameters may include a maximum left movement range, a maximum right movement range, and a maximum protrusion range of the jaw at each exercise reference point.

The mandible joint motion model generator sets a mandatory movement axis in the mandibular condyle of the left temporal mandibular joint and the right temporal mandibular joint, and limits the range of mandibular movement based on the center of the mandibular tooth. You can decide.

The collision simulation unit may further measure the collision state of the temporomandibular joint region of the patient through the simulation.

The image registration unit may match the 3D oral scan image and the CT image, and generate the registration image by adding a virtual prosthesis to the procedure position of the matched image.

The collision simulation unit may output the oral occlusal state of the patient by the virtual prosthesis by measuring the collision state of the occlusal surface of the patient through the simulation.

An oral occlusal analysis method of a device operated by at least one processor according to another embodiment, comprising: separating a mandible including a temporomandibular joint from a CT image of a patient, and adjusting the range of motion of the temporomandibular joint 3 Generating a mandibular joint motion model modeled in a dimensional space, matching the 3D oral scan image and the CT image of the patient and simulating mandibular motion of the patient by applying the mandibular joint motion model to a registration image; And outputting an oral occlusal state of the patient by measuring a collision state of the occlusal surface of the patient through the simulation.

The generating of the mandibular joint motion model may include determining the left temporal mandibular joint, the right temporal mandibular joint, and the mandibular tooth center as motion reference points, and determining the range of motion of the left temporal mandibular joint and the right temporal mandibular joint. The motion range of the mandible may be modeled in three-dimensional space using the motion parameters.

The method may further include generating the matched image by matching common matched points of the 3D oral scan image and the CT image.

The outputting of the oral occlusal state of the patient may further measure the collision state of the temporomandibular joint region of the patient through the simulation to output the oral occlusal state of the patient.

According to an embodiment, patient-specific oral occlusion may be analyzed using a 3D oral scan image and a CT image. In particular, according to the embodiment it is possible to simulate the jaw joint movement and occlusion of the patient simply and conveniently without a separate mouth wearing device.

1 is a block diagram of a device for mandibular movement based oral occlusal analysis according to an embodiment.

2 is a view illustrating registration of a 3D oral cavity scan image and a CT image according to an exemplary embodiment.

3 is a view illustrating the temporal mandibular joint separation according to the embodiment.

4 is a diagram illustrating an example of setting an exercise reference point for generating a mandibular joint motion model according to an embodiment.

5 is an illustration of a mandible joint motion model according to an embodiment.

6 is a view for explaining the principle of mandibular movement according to an embodiment.

7 is a diagram illustrating a mandible motion simulation and collision analysis using a mandible joint motion model according to an embodiment.

8 illustrates a collision and occlusion analysis according to an embodiment.

9 is a flowchart illustrating a method of analyzing oral occlusion based on patient temporomandibular joint movement according to an embodiment.

DETAILED DESCRIPTION Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings so that those skilled in the art may easily implement the present invention. As those skilled in the art would realize, the described embodiments may be modified in various different ways, all without departing from the spirit or scope of the present invention. In the drawings, parts irrelevant to the description are omitted in order to clearly describe the present invention, and like reference numerals designate like parts throughout the specification.

Throughout the specification, when a part is said to "include" a certain component, it means that it can further include other components, without excluding other components unless specifically stated otherwise. In addition, the terms “… unit”, “… unit”, “module”, etc. described in the specification mean a unit that processes at least one function or operation, which may be implemented by hardware or software or a combination of hardware and software. have.

1 is a block diagram of a device for analyzing mandibular movement based oral occlusion according to an embodiment, FIG. 2 is a view illustrating registration of a 3D oral scan image and CT image according to an embodiment, and FIG. It is a figure explaining mandibular joint separation.

Referring to FIG. 1, a patient mandibular movement-based oral occlusal analysis apparatus (hereinafter, simply referred to as an “oral occlusal analysis apparatus”) 100 is operated by at least one processor and uses a 3D oral scan image and a CT image of a patient. The mandibular joint movement model of the patient is generated, and the oral occlusion is analyzed based on the mandibular movement simulated by the mandibular joint movement model. To this end, the oral occlusal analysis apparatus 100 includes an image registration unit 110, a mandibular joint motion model generator 130, and a collision simulation unit 150.

The image matching unit 110 acquires a 3D oral scan image and a CT image of the patient. The image matching unit 110 may include three-dimensional oral scan data (eg, STL files) acquired by the dental oral scanner 10 and CT data (eg, obtained by the dental CT imaging apparatus 20). For example, three-dimensional oral scan images and CT images may be obtained from DICOM files. In this case, the CT image may be a conebeam computed tomography (CBCT) image.

The dental oral scanner 10 images the oral cavity surface through imaging. Therefore, the three-dimensional oral scan image obtained by the dental oral scanner 10 is a tooth root (parts coupled with the alveolar bone) that is not clearly revealed in the shape of the crown (upper teeth shown outside the gums) of the periodontal tissue in the oral cavity. And the shape of the gum around the lower tooth side). Therefore, the oral cavity surface information about the crown and the gum of the tooth can be obtained from the 3D oral scan image.

The CT imaging apparatus 20 images bone tissue such as teeth and periodontal tissue in the oral cavity through the imaging. Therefore, the CT image acquired by the CT imaging apparatus 20 includes bone tissues such as crown, root, alveolar bone and teeth among the periodontal tissues in the oral cavity.

When the matching points of the 3D oral scan image and the CT image are determined, the image matching unit 110 matches the matching points of the two images to match the 3D oral scan image and the CT image. In this case, the image matching unit 110 may initially match by matching the matching points, and may precisely match based on detailed information such as teeth. The registration point may be selected by the user or automatically determined by the same points that are commonly expressed in the 3D oral scan image and the CT image. In this case, the registration point may be determined as a specific position on the surface of the reference teeth.

Referring to FIG. 2, matching points p11, p12, and p13 are determined in the 3D oral cavity scan image 11. Points p21, p22, and p23 that are matched with registration points p11, p12, and p13 of the 3D oral cavity scan image 11 in the CT image 21 are determined. The image matching unit 110 matches the registration points of the two images and overlaps the 3D oral scan image 11 and the CT image 21. Then, an image 30 in which the 3D oral scan image 11 and the CT image 21 are matched is generated.

When designing various prostheses, such as implants, the patient's maxillary / mandibular bone tissue and oral surface structure must be accurately represented. Although the CT image 21 expresses hard bone tissue well, there is a limit in that it cannot express soft tissues such as gums, tongues, muscles, and the like. In order to compensate for this, by matching the oral scan image 11 and the CT image 21 providing 3D oral surface data, the registration image 30 can accurately represent the bone tissue and the oral surface structure.

The mandibular joint motion model generator 130 separates the mandible and the skull including the temporal mandibular joint (TMJ) using a CT image.

Referring to FIG. 3, since the CT image superimposed on the registration image 31 represents bone tissue, the maxillary / mandible may be separated by a region growing method by setting a threshold of the CT image. The mandible joint motion model generation unit 130 may convert the maxillary / mandible separated from the 3D volume data into a 3D mesh image.

The mandibular joint motion model generation unit 130 sets the center points of the left and right temporal mandibular joint (TMJ) and the lower jaw tooth, which are the axes of the mandibular movement, as exercise reference points. The mandibular joint motion model generator 130 sets motion parameters that determine the range of motion of the left and right temporal mandibular joints, and models the mandibular joint motion model that models (displays) the motion range of the temporomandibular joint (TMJ) in three-dimensional space. Create

The collision simulation unit 150 applies the mandibular joint motion model of the patient to the registration image to simulate the mandibular movement of the patient. Since the 3D oral scan image is matched with the CT image, the collision simulation unit 150 may measure the collision state between the maxillary / mandibular tooth occlusal surface and the temporomandibular joint region through mandibular motion simulation. The collision simulation unit 150 outputs collision state information in the patient's mouth. The prosthesis can be designed based on the crash state information in the patient's mouth.

According to another exemplary embodiment, the collision simulation unit 150 may determine a collision state between the maxillary and mandibular dental occlusal surface and the temporomandibular joint region by the virtual prosthesis based on the registration image further including virtual prosthetic data. It can be measured. That is, the user (doctor) adds (synthesizes) a virtual prosthesis to the procedure position of the registration image, and measures the collision state between the tooth occlusal surface and the temporomandibular joint region before the procedure of various prosthetics such as an implant. Through this, the user (doctor) can check the tooth occlusion effect by the virtual prosthesis in advance, and can modify the prosthesis design according to the collision state information in the patient's mouth.

FIG. 4 is a diagram illustrating an example of setting an exercise reference point for generating a mandible joint motion model according to an embodiment, FIG. 5 is an illustration of a mandible joint motion model according to an embodiment, and FIG. 6 is a diagram illustrating a mandatory movement principle according to an embodiment. It is a figure.

Referring to FIG. 4, the temporomandibular joint (TMJ) is a joint between two bones located between the mandible (mandibular bone) and the temporal bone (temporal bone). The temporomandibular joint acts as the central axis of the mandibular movement and is supported by the jaw muscles and ligaments.

Mandibular movement is determined by the structure of the mandibular condyle (mandibular condyle) and concave mandibular fossa in the TMJ region. Therefore, in order to analyze the geometric motion of the mandible, the left and right temporal mandibular joints (TMJ_R, TMJ_L) are set as the motion reference points. A three-dimensional movement axis is set for each of the joint protrusions of the left and right temporal mandibular joints TMJ_R and TMJ_L.

In addition, in order to limit the range of movement of the lower jaw, the center of the lower jaw teeth (Centric Relation, CR) is also set as the reference point of movement.

Referring to FIG. 5, the mandibular joint motion model generation unit 130 uses left and right temporal mandibular joints TMJ_R and TMJ_L, and mandibular tooth center CR, respectively, using motion parameters that determine a range of motion of each exercise reference point. Set the range of motion. The exercise parameters are shown in Table 1.

운동 파라미터Exercise parameters	설명Explanation
CO(Centric Occlusion)Centric Occlusion	교합치(상악)의 중심위Center position of occlusal teeth
LL(Left Lateral)Left Lateral (LL)	최대 왼쪽 움직임 범위Max left movement range
RL(Right Lateral)Right Lateral (RL)	최대 오른쪽 움직임 범위Maximum right-hand movement range
P(Protrusive)P (Protrusive)	턱의 최대 돌출범위Maximum protrusion of the jaw
R(Rest Position)R (Rest Position)	하악 안정 위치Mandible stable position
E(Maximum Opening)Maximum opening (E)	최대 개방 위치Open position

The area that connects the maximum left movement range (LL), the maximum right movement range (RL), and the maximum protrusion range (P) with respect to the mandibular tooth center (CR) or occlusal center (CO) is defined in the mandibular movement range. Corresponding. In addition, the mandible stable position (R), the maximum opening position (E) can be used to model the mandibular movement in the three-dimensional space.

Here, the method of setting the maximum left movement range LL, the maximum right movement range RL, and the maximum protrusion range P for each of the left and right temporal mandibular joints TMJ_R and TMJ_L may vary. For example, the range of mandibular movement of the patient may be set based on a reference value measured according to age or gender. Alternatively, a specially designed measuring device for radiography can be inserted into the patient's mouth and moved to the front, left and right of the jaw to the maximum, and the position values of the maximum left movement point, maximum right movement point and maximum protrusion point can be measured. The mandible joint motion model generator 130 generates a mandible joint motion model that models (displays) a mandible movement range according to the movement of the left and right temporal mandibular joints TMJ_R and TMJ_L in three-dimensional space.

FIG. 5A is a motion model showing a sagittal plane, ie, a range of mandibular movement seen from the side. The horizontal axis is the position in the direction from the back to the front of the face, and the vertical axis is the position in the direction from the bottom to the top.

FIG. 5B is a motion model showing a coronal plane, that is, the range of mandible movement seen from above. The horizontal axis is the position in the direction from the right to the left of the face, and the vertical axis is the position in the direction from the bottom to the top.

FIG. 5C is a motion model showing a transverse plane, that is, a range of mandibular movement seen from above. The horizontal axis is the position in the direction from the right to the left of the face, and the vertical axis is the position in the direction from the front to the back.

Referring to Figure 6, it is a diagram illustrating the principle of mandibular movement according to the movement of the temporomandibular joint. Referring to (a) of FIG. 7, in the horizontal plane, when the right joint protrusion moves from C to W, the left joint protrusion opposite to the balance of the jaw moves along the line B in C, and a BG called Bennett Angle Generated and extruded from C to P.

The right mandible movement is a horizontal plane connecting the maximum left movement range (LL), the maximum right movement range (RL), and the maximum protrusion range (P) with respect to the mandibular tooth center (CR) / occlusal center (CO). It can be represented graphically as the movement of a point at (CR, LL, P, RL) and the position (W, C, B, P) of the articular process.

Referring to (b) of FIG. 6, the maximum protrusion range (F), the rest position (Rest Position, R), and the maximum opening position (Maximum) based on the center of mandibular tooth center CR and occlusal tooth center CO. It is possible to graphically express the range of mandibular movement in the sagittal plane connecting the opening, E).

7 is a diagram illustrating a mandible motion simulation and collision analysis using a mandibular joint motion model according to an embodiment, and FIG. 8 is a diagram illustrating a collision and occlusion analysis according to an embodiment.

Referring to FIG. 7, the collision simulation unit 150 applies the mandibular joint motion model of the patient to the matched image to simulate the mandibular movement.

The collision simulation unit 150 analyzes various collision states of the oral data in the matched image through the mandibular motion simulation to analyze the occlusal state of the collided upper and lower jaw.

For example, as shown in (a), the collision simulation unit 150 may analyze the movement of the temporomandibular joint (TMJ). As a result, as shown in (b), the impact region of the temporal mandibular joint (TMJ) with the mandible may be analyzed, and as shown in (c), the collision region of the joint protrusion may be analyzed.

Referring to FIG. 8, the collision simulation unit 150 analyzes the collision of the upper and lower teeth of the occlusal surface through the mandibular motion simulation and outputs the oral occlusal state according to the mandibular motion.

The collision simulation unit 150 checks the mandibular movement due to the patient's own temporomandibular joint, and performs a prosthesis design based on the temporal mandibular joint (TMJ) and the occlusal surface collision through the mandibular movement.

The prosthesis may be designed based on the patient's oral occlusal state, or the prosthetic design may be modified based on the oral occlusion by the virtual prosthesis.

9, the oral occlusal analysis apparatus 100 obtains a 3D oral scan image and a CT image of a patient (S110).

The oral occlusal analysis apparatus 100 generates a matched image in which the 3D oral scan image and the CT image are matched by matching registration points and / or teeth of the 3D oral scan image and the CT image (S120).

The oral occlusal analysis apparatus 100 separates the mandible and the skull including the temporal mandibular joint (TMJ) from the registration image or the CT image using the CT image (S130).

The oral occlusal analysis apparatus 100 sets the center points of the left and right temporal mandibular joint (TMJ) and the lower jaw teeth as exercise reference points (S140).

The oral occlusal analysis apparatus 100 sets motion parameters for determining a range of motion of the left and right temporal mandibular joint (TMJ), and generates a mandibular joint motion model modeling the motion range of the temporal mandibular joint (TMJ) in three-dimensional space. (S150).

The oral occlusal analysis apparatus 100 applies the mandibular joint motion model of the patient to the registration image of the patient to simulate the mandibular movement of the patient (S160).

The oral occlusal analysis apparatus 100 measures a collision state of the maxillary / mandibular tooth occlusal surface and the temporomandibular joint region through the mandibular motion simulation of the patient (S170).

The oral occlusal state, including the maxillary / mandibular tooth occlusal surface and the collision state of the temporomandibular joint site, is reflected in the prosthetic design.

As described above, according to the embodiment, the patient-specific oral occlusion may be analyzed using the 3D oral scan image and the CT image. In particular, according to the embodiment it is possible to simulate the jaw joint movement and occlusion of the patient simply and conveniently without a separate mouth wearing device.

The embodiments of the present invention described above are not only implemented through the apparatus and the method, but may be implemented through a program for realizing a function corresponding to the configuration of the embodiments of the present invention or a recording medium on which the program is recorded.

Although the embodiments of the present invention have been described in detail above, the scope of the present invention is not limited thereto, and various modifications and improvements of those skilled in the art using the basic concepts of the present invention defined in the following claims are also provided. It belongs to the scope of rights.

Claims

An oral occlusal analysis device operated by at least one processor,

An image registration unit for generating a registration image by matching the 3D oral scan image and the CT image of the patient;

The mandible including the temporal mandibular joint (Temporomandibular joint) is separated from the registration image or the CT image, and the motion range of the mandible is modeled in a three-dimensional space by using motion parameters for determining the motion range of the temporomandibular joint. A mandible joint motion model generator for generating a mandible joint motion model, and

Collision simulation unit for applying the mandible joint motion model to the mandible region of the registration image to simulate the movement of the mandible of the patient, and measuring the collision state of the tooth occlusal surface of the patient through the simulation

Oral occlusal analysis device comprising a.
In claim 1,

The image matching unit

And oral occlusion analysis device for generating the registration image by matching common registration points of the 3D oral cavity scan image and the CT image.
In claim 1,

The mandible joint model generation unit

Determine the left temporal mandibular joint, the right temporal mandibular joint, and each of the mandibular tooth centroids as exercise reference points, and determine the range of motion of the exercise reference points based on the exercise parameters,

And the exercise parameters include a maximum left movement range, a maximum right movement range, and a maximum protrusion range of the jaw at each movement reference point.
In claim 3,

The mandible joint model generation unit

Oral occlusal analysis device for setting the mandibular movement axis in the mandibular condyle of the left temporal mandibular joint and the right temporal mandibular joint and limiting the range of mandibular movement based on the center of the mandibular tooth .
In claim 1,

The collision simulation unit

Oral occlusal analysis device for further measuring the collision state of the temporomandibular joint region of the patient through the simulation.
In claim 1,

The image matching unit

And the 3D oral scan image and the CT image, and adding the virtual prosthesis to the procedure position of the matched image to generate the registration image.
In claim 6,

The collision simulation unit

The oral occlusal analysis device for measuring the collision state of the occlusal surface of the patient through the simulation to output the oral occlusal state of the patient by the virtual prosthesis.
An oral occlusal analysis method of a device operated by at least one processor,

Separating the mandible including the temporomandibular joint from the CT image of the patient and generating a mandible joint motion model modeling the range of motion of the temporomandibular joint in three-dimensional space;

Simulating the mandible movement of the patient by applying the mandible joint motion model to the matched image by matching the 3D oral scan image and the CT image of the patient, and

Outputting the oral occlusal state of the patient by measuring a collision state of the occlusal surface of the patient through the simulation

Oral occlusal analysis method comprising a.
In claim 8,

Generating the mandible joint motion model

The mandibular joint, the right temporal mandibular joint, and the mandibular tooth centroid are respectively determined as motion reference points, and the motion of the mandible using the motion parameters that determine the range of motion of the left temporal mandibular joint and the right temporal mandibular joint. Oral occlusion analysis method, which models the range in three-dimensional space.
In claim 8,

And matching the common registration points of the 3D oral cavity scan image and the CT image to generate the registration image.
In claim 8,

Outputting the oral occlusal state of the patient

The oral occlusal analysis method of outputting the oral occlusal state of the patient by further measuring the collision state of the temporomandibular joint region of the patient through the simulation.