WO2019231116A1 - Procédé de conception d'un guide chirurgical dentaire, appareil associé et support d'enregistrement sur lequel celui-ci est enregistré - Google Patents

Procédé de conception d'un guide chirurgical dentaire, appareil associé et support d'enregistrement sur lequel celui-ci est enregistré Download PDF

Info

Publication number
WO2019231116A1
WO2019231116A1 PCT/KR2019/005130 KR2019005130W WO2019231116A1 WO 2019231116 A1 WO2019231116 A1 WO 2019231116A1 KR 2019005130 W KR2019005130 W KR 2019005130W WO 2019231116 A1 WO2019231116 A1 WO 2019231116A1
Authority
WO
WIPO (PCT)
Prior art keywords
surgical guide
guide
shape
image
oral cavity
Prior art date
Application number
PCT/KR2019/005130
Other languages
English (en)
Korean (ko)
Inventor
최규옥
조상형
김효정
Original Assignee
오스템임플란트 주식회사
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 오스템임플란트 주식회사 filed Critical 오스템임플란트 주식회사
Publication of WO2019231116A1 publication Critical patent/WO2019231116A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • 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
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • 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
    • 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
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides

Definitions

  • the present invention relates to a method for designing a dental surgical guide, an apparatus for the same, and a recording medium recording the same, and more particularly, a method for digitally designing a surgical guide for guiding an implant procedure, an apparatus for the same, and recording the same. It relates to a recording medium.
  • An implant procedure for replacing a tooth involves dissecting a gingiva to expose the alveolar bone, and using a drill to form a hole in which a fixture is placed.
  • the surgeon guide is used as an auxiliary device for guiding the position of the hole formed in the alveolar bone and the implantation direction of the fixture when the operator forms the hole.
  • the surgical guide is designed on a software program, and is actually generated by outputting it to a 3D printer or the like according to the design result.
  • FIG. 1 is a view showing a schematic structure of a surgical guide.
  • the surgical guide covers a guide hole in which a drill is inserted when forming a hole in an alveolar bone, a drill guide 1b for guiding a position of the drill, and a gingiva or tooth, and a surge And a guide support 1c serving as a main body of the curl guide.
  • the guide support may be formed to cover the entire tooth, but may be partially formed to cover only the peripheral teeth and the surrounding gingival surfaces positioned close to the target tooth according to the number and position of the implant target tooth.
  • the shape of the surgical guide is determined according to the position of the target tooth.
  • the user manually determines the area in which the surgical guide is generated around the target tooth. According to this, even for patients with the same tooth number, the user needs to repeat the series of procedures for setting the surgical guide area, shape, height, width, and the like, and the design time is not only large. According to the degree of experience or knowledge, there is a problem in that the deviation between users is large in the design accuracy.
  • the surgical guide is mounted on the patient from the top of the crown to the bottom direction to cover the crown (Crown) and gingival during implantation.
  • the crown has a shape that gradually increases as it goes down from the top end and then narrows again from the point where the maximum convexity, which is the thickest part, passes. Therefore, if the width of the surgical guide is set according to the circumference of the cervical, which is the boundary between the gingiva and crown, the width of the surgical guide takes into account the entire circumference of the crown because the guide may be damaged at the maximum air melting part during installation. Should be determined.
  • the user rotates the dental image to determine the overall circumference of the crown with the eyes, and roughly determines the width of the surgical guide accordingly.
  • the width of the surgical guide is too large, there is a space between the surgical guide, the crown and the gingival, so it is loosely mounted, so it is difficult to insert the implant in the correct position because the surgical guide is not properly fixed when drilling for the implant procedure. Lose.
  • the width of the surgical guide is too small, there is a risk that the guide will be damaged when mounted in the oral cavity.
  • Surgical guides are important because they may be directly related to the success or failure of the implant procedure.
  • the design accuracy is greatly reduced due to the high dependency on the user's intuitive judgment or experience when designing the surgical guide.
  • the efficiency is greatly reduced because the user has to repeat a series of operations for the design of the surgical guide.
  • the present invention not only reduces design accuracy by determining specific properties such as surgical guide area, height, and shape depending on the user's judgment or experience in digital design of the surgical guide, but also repeats a series of complicated processes for each patient. It is proposed to solve the problems of the prior art that the design efficiency is lowered, dental surgical guide design method that can design a surgical guide optimized for the dental structure of the patient while minimizing manual input by the user, An object of the present invention is to provide an apparatus and a recording medium recording the same.
  • the above object is a dental surgical guide design method performed by a dental surgical guide design apparatus for providing a digital design of a surgical guide according to an aspect of the present invention, the method comprising: obtaining an oral image of a patient; Determining a shape of the surgical guide corresponding to the missing tooth number in the oral cavity image based on a guide library which holds the shape information of the surgical guide according to the implant target tooth number; And generating the surgical guide according to the determined shape.
  • the method may further include generating an arch arch line in the oral cavity image.
  • the generating of the surgical guide may include generating the surgical guide at a position where a center line of the surgical guide corresponds to the arch arch line. Can be generated.
  • the method may further include determining a position of a guide hole into which a drill for drilling the alveolar bone formed in the surgical guide is inserted in correspondence with the fixture placement position according to the implant planning performed in advance.
  • the calculating of the undercut area may include determining an oral insertion direction of the surgical guide based on a slope of the gingival plane; Generating a plurality of straight lines corresponding to the oral cavity insertion direction in the oral cavity image; And determining the undercut area based on the position of the contact point between the straight line and the surface of the oral cavity object of the oral cavity image.
  • the guide library may further include position information of a text bar into which text is inserted corresponding to the shape of the surgical guide and position information of a guide window corresponding to an opening formed to determine a mounting state of the surgical guide during the procedure. It may include.
  • the guide library may be subdivided to include shape information of the surgical guide according to at least one of age, gender, race, and form of an arch form of a patient.
  • the method may further include generating an arch form line in the oral image, and the generating of the surgical guide may include the shape of the surgical guide according to the guide library based on the length or curvature of the arch line. Correcting; And generating the surgical guide according to the corrected shape.
  • a dental surgical guide design apparatus for providing a digital design of a surgical guide, comprising: an image acquisition unit generating an oral image of a patient; A guide library which holds the shape information of the surgical guide according to the implant target tooth number; And a guide generation unit configured to determine a shape of the surgical guide corresponding to the tooth number lost in the oral cavity image based on the guide library, and to generate the surgical guide according to the determined shape. It can also be achieved by the device.
  • the plane generating unit for generating a gingiva plane corresponding to the upper boundary of the gingiva based on the oral image;
  • an undercut calculator configured to calculate an undercut area to which a gap is applied between the surgical guide and the surface of the oral object of the oral cavity image based on the slope of the gingival plane, wherein the guide generator reflects the undercut area.
  • the internal shape of the surgical guide can be determined.
  • a separate user input for determining the basic shape of the surgical guide through the guide library and determining the guide shape by providing a surgical guide shape in which the undercut area is reflected is omitted.
  • the user's convenience is greatly improved.
  • the present invention by diversifying the guide library according to the sex, age, race, and arch form of the patient, as well as the missing tooth number case, it is possible to increase the applicability to various patients and to provide a surgical guide suitable for the dental structure of each patient. Can be designed.
  • FIG. 1 shows a schematic structure of a surgical guide
  • Figure 2 is a block diagram showing the configuration of a dental surgical guide design apparatus according to an embodiment of the present invention
  • FIG. 3 is a reference diagram for explaining the gingival plane generated by the plane generating unit according to an embodiment of the present invention
  • FIG. 4 is an example of an oral scan image in which a gingival plane and an arch line are generated according to an embodiment of the present invention
  • FIG. 5 is a reference diagram for explaining an undercut area of a surgical guide
  • FIG. 7 is a reference diagram for explaining a method for determining the position of a surgical guide
  • FIG. 8 is a flowchart showing an example of a method for calculating an undercut area according to an embodiment of the present invention.
  • FIG. 9 is a reference view for explaining a method of determining the oral insertion direction of the surgical guide according to an embodiment of the present invention.
  • FIG. 10 is a reference diagram for explaining a method for determining an undercut area according to an embodiment of the present invention.
  • 11 is an example of a screen displaying a calculated undercut area on an oral cavity image
  • FIG. 13 is a diagram illustrating an example in which a surgical guide is generated in an oral image.
  • the dental surgical guide design apparatus performs the computer-aided design of the surgical guide as an aid for guiding the drilling position, the drilling depth, the fixture placement direction of the drill during the alveolar bone drilling operation for the implant procedure.
  • FIG. 2 is a block diagram showing the configuration of a dental surgical guide design apparatus according to an embodiment of the present invention.
  • the dental surgical guide design apparatus 100 includes a user interface 10, an image acquisition unit 20, a plane generation unit 30, and an arch form generator ( 40), a planer 50, a guide library 60, an undercut calculator 70, and a guide generator 80.
  • the user interface unit 10 receives necessary information from the user and displays the information.
  • the user interface unit 10 includes input means for inputting information such as a mouse, a keyboard, a button, a keypad, input menus and processing results, and various images and information. It can be implemented as a variety of input and output means, including a display means for displaying a display, a touch screen for providing input and output through one device.
  • the image acquisition unit 20 acquires an oral image of the patient.
  • the oral image refers to a multi-dimensional image such as two-dimensional or three-dimensional image in which the tooth arrangement of the patient is displayed, such as CT (Computed Tomography), X-ray, MRI (Magnetic Resonance Imaging), tooth panoramic image, oral scan image, etc. It includes not only the images themselves obtained by a photographing apparatus (not shown) but also the images generated through image processing such as reconstruction, registration, segmentation, and the like.
  • the image acquisition unit 20 incorporates various algorithms for reconstructing, matching, and dividing the data obtained through the photographing apparatus, and generates an oral image using the algorithm.
  • the image acquisition unit 20 reconstructs or multi-faces the 3D image by using a Fast Furier Transform (FFT) on the image data acquired through the CT imaging apparatus for generating the oral image.
  • FFT Fast Furier Transform
  • Sectional images can be reconstructed based on planar reforamtion (MPR) and curved-planar reformation (CPR) algorithms.
  • a matching process for matching the coordinate systems of the two images may be performed based on corresponding feature points in different types of images, such as a CT image and an oral scan image.
  • image processing algorithms which process image data obtained through a photographing apparatus to reconstruct, match, or segment a specific region based on brightness or color values of the image are widely known. The description will be omitted.
  • the plane generator 30 generates a gingival plane based on the oral cavity image.
  • gingival plane is meant a plane corresponding to the gingival upper boundary.
  • the type of the oral cavity image that creates the gingival plane is not particularly limited, it is preferable that the oral cavity image is generated based on the oral cavity scan image in which soft tissue including the gingiva is clearly visible.
  • the coordinate system is matched through image registration to share the position of the gingival plane generated in another type of oral image.
  • 3 is a reference view for explaining the gingival plane generated by the plane generating unit 30 according to an embodiment of the present invention.
  • Margin gingiva 301 is a collar-shaped gingiva surrounding a cervical margin of a tooth
  • Papillary gingiva 303 is a tooth and a tooth among free gingiva.
  • Pyramid-shaped gingiva filling the triangle between (Embrasure).
  • the upper gingival boundary which is a reference for generating the gingiva plane, may be a boundary b1 where the tooth and the free gingiva contact or a boundary b2 of the nipple gingiva.
  • the gingival plane may be created so that a part of the plane is in contact with at least some gingival upper boundary even though it is not exactly in contact with all the gingival upper boundaries. Can be.
  • the gingival plane may be determined at an appropriate slope such that it is in contact with the upper boundary of the gingiva close to the missing tooth to be implanted and the other gingiva is as close as possible to the upper boundary.
  • the gingival plane can be usefully used when performing implant planning to determine the position or angle of implant objects such as abutments, fixtures, crowns, or designing surgical guides.
  • the plane generating unit 30 recognizes a point on the upper gingival boundary that distinguishes the crown from the gingiva based on an algorithm for analyzing brightness, color, and shape of an image of the oral cavity, or the upper part of the gingiva through machine learning.
  • a point on the boundary can be automatically recognized to create a gingival plane that includes or is in close proximity to the points.
  • the plane generation unit 30 may receive the points on the gingival boundary, which is a reference for the gingival plane generation, through the user interface unit 10, and generate the gingival plane based on this.
  • the number of points to be recognized or input is not particularly limited to generate the gingival plane, but it is preferable to input three points to generate one plane. If less than three points are input or recognized, a plane including the corresponding points is generated, and the specific slope of the plane may be determined by applying statistical data or reference data regarding the position or angle of the gingiva. In addition, when more than three points are defined, a plane including all points may not exist. In this case, one plane that is closest to the most defined points may be determined by interpolating based on the positions of the points. . To this end, the plane generator 30 may store reference data or an interpolation algorithm for generating the gingival plane.
  • the arch generating unit 40 generates an arch form line, which is a curve formed by a patient's dentition based on the oral image.
  • the arch line is a curve that is also used to generate a panoramic image by reconstructing the CT image and various algorithms for generating the arch line are known.
  • the arch line is an automatic generation method that generates the arch line by recognizing the isolation of the anterior teeth, the peak of the canine, and the peak of the buccal cusp of the molar tooth through an image recognition algorithm based on brightness, color, and shape, or entirely user.
  • the manual method may be generated based on a user input through the interface unit 10, or may be generated in a semi-automatic method of receiving a partial input from a user and generating an entire dental arch line using the same.
  • FIG. 4 shows an example of an oral scan image in which a gingival plane and an arch form line are generated according to an embodiment of the present invention.
  • the area A on the screen is a mandibular scan image in which the gingival plane (GP) and the dental arch line (DL) are overlapped, and the area B is a mandibular scan image according to various angles.
  • the position of (P1, P2, P3) can be grasped.
  • the gingival plane is formed to include three points P1, P2, and P3. It can be seen that P1, P2, and P3 are located on the upper gingival boundary, respectively.
  • FIG. 4 shows an example in which the gingival plane is generated to be in contact with the papillary gingiva, but as described above, the gingival plane may be generated to be in contact with the boundary between the tooth and the free gingiva.
  • the point for creating the gingival plane is not particularly limited as long as it exists on or near the upper gingival boundary, but the gingival plane is located at a plurality of points spaced apart from each other as shown in FIG. 4 to reflect the entire gingival boundary as much as possible. It is desirable to.
  • the arch line DL shows an example generated by using three points as the points P4 between the anterior teeth and the points P5 and P6 between the molar teeth.
  • the present invention is not necessarily limited thereto, and the arch form may be determined manually or automatically at an appropriate position and number so that the arch form line is formed close to the patient's arch form.
  • the arch arch generating unit 40 may arrange a control point (CP) on the arch line line generated as shown in FIG. 4 to allow the user to adjust the shape or length of the arch line.
  • CP control point
  • an arch line is generated based on an oral scan image, but the arch line may be generated based on a CT image.
  • the same may be generated through the automatic generation method, the manual generation method, or the semi-automatic generation method through image recognition.
  • the arch line when generating the arch line on the CT image, the arch line may be generated on the gingival plane. As such, the process of finding a slice for generating the arch line in the CT image data may be omitted by generating the arch line on the gingival plane.
  • the dental arch line is generated based on the oral cavity image of the oral cavity scan image and the CT image, the position of the dental arch line generated in one image is shared in another image when the coordinate system is matched with each other through image registration. Of course it can be.
  • the planning unit 50 may determine the size, position, and angle of the implant object based on an oral image, for example, a CT image including a reconstructed image, such as an oral scan image, a panoramic image, a multi-faceted reconstruction image, and an image obtained by matching two images. Perform implant planning to determine the like.
  • Implant objects include fixtures, crowns, abutments, and the like, which constitute the implant.
  • the planning unit 50 may perform a series of planning processes for determining the position, size, angle, and the like of the implant object based solely on the input through the user interface unit 10, but the planning unit 50 may have lost a tooth.
  • color or brightness is different in the oral image to detect the missing region based on the pixel or voxel value of the image and automatically place the implant object in the detected missing region. It may be.
  • the attenuation of X-rays is different so that the brightness is different in the CT image. The missing part will appear relatively dark.
  • medically validated and recommended surgical guide information or information from the user such as the distance between crowns and fixtures, the distance between adjacent fixtures, the size of each tooth, and information for selecting the appropriate implant object for the missing tooth number.
  • Empirically validated and entered reference information or statistical information can be utilized.
  • the planning unit 50 may utilize a gingival plane and an arch line when implant planning.
  • the planning unit 50 may generate the crown in the tooth loss region of the oral image so that the center of the crown lies on the arch line.
  • the planning unit 50 may generate the lower portion of the crown so that the gingival plane does not exceed a predetermined reference, and even when the position of the crown is changed based on an input through the user interface unit 10. You can limit the scope of the change. This is because the crown is virtually above the gingival and cannot invade much of the gingival area. In addition, when the gingival plane is created to contact the gingival upper boundary of the lost tooth to be implanted, the lower portion of the crown may be created to contact the gingival plane.
  • the planning unit 50 may utilize the gingival plane to determine the generation position or the movement range of the crown, thereby minimizing the correction work as compared to the prior art in which the user determines the position of the gingiva and arranges the crown. As a result, the position of the crown can be determined more accurately.
  • the planning unit 50 determines the position and implantation angle of the fixture, abutment, etc. based on the preceding crown planning result.
  • the planning unit 50 is one such as the implantation angle of the fixture relative to the crown's central axis, such as the distance between the crown-fixture and the distance between the crown-abutment, such as placing the fixture so that the center axis of the crown and the fixture's center axis coincide.
  • Preliminary information about the distance between homogeneous objects placed in adjacent locations, such as the distance between objects constituting the implant and the distance between adjacent fixtures, may be stored in advance, and the position and implantation angle of the fixture and abutment may be determined based on the information. .
  • the guide library 60 holds the shape information of the surgical guide according to the implant target tooth number.
  • the surgical guide has a shape that covers a part of the mandible near the tooth 36, rather than the entire mandible. It can be formed to be.
  • the surgical guide needs to have a shape corresponding to the entire lower jaw arch so as to cover both the left side and the right side.
  • the guide library 60 is a shape of the surgical guide corresponding to the tooth number case to which the tooth is lost and subjected to implantation, for example, the area covered, such as the overall shape or a partial shape, the guide size, the shape curvature. Information about the guide height, guide thickness, guide width, and the like.
  • the shape of the surgical guide may be largely divided into a whole shape covering a mandible or the entire upper part or a part covering a part, and the curvature of the area and shape of the surgical guide may vary according to the tooth number to be treated.
  • the guide library 60 may maintain shape information by dividing the upper and lower jaw, respectively, and may be provided according to the sex, age, and race of the patient. This reflects the difference in curvature and length of the dental arch according to gender, age, and race.
  • the guide library 60 may hold surgical guide shape information corresponding to the tooth number case according to the shape of the dental arch.
  • the arch form can be divided into square, tapered, and oval forms, and the arch form reflects a close relationship with the curvature of the surgical guide. .
  • the guide library 60 may be constructed based on statistical and experimental data accumulated through various clinical cases, and new shape information is continuously added or continuously added to the guide library 60 by reflecting the user's surgical guide design history. Of course, it may be updated.
  • the guide library 60 may include text bars and location information generated on the surgical guide corresponding to the shape of the surgical guide.
  • the text bar is a kind of label in which various text data necessary for managing the surgical guide, such as patient name, hospital name, chart number, and the like are written, and the guide window is used to determine the mounting state of the surgical guide during implantation.
  • the opening is formed around the target area.
  • the text bar may be positioned where the left and right cross across the tongue when the surgical guide has an overall shape covering the entire mandible or maxilla, and in the case of a partial shape, does not interfere with the procedure. It may be located off the tooth to be treated.
  • the guide window may be located where it is possible to grasp between two consecutive teeth adjacent to the target tooth.
  • the undercut calculator 70 calculates an undercut region of the surgical guide.
  • FIG. 5 is a reference diagram for explaining an undercut area of a surgical guide, and shows a cross section in the lingual / buccal direction for one tooth on which the surgical guide is mounted.
  • the tooth since the tooth has a shape that gradually narrows toward the neck 501, which is a neck portion, when the surgical guide S is manufactured according to the tooth shape, the tooth may be damaged when mounted in the oral cavity.
  • the undercut area UC refers to an area in which a predetermined gap Gap is provided between the surgical guide and the surface of the oral cavity object for smooth installation in the oral cavity.
  • the undercut calculator 70 determines the oral insertion direction of the surgical guide based on the inclination of the gingival plane generated by the planar generation unit 30, and generates a straight line in the oral insertion direction in the oral image to produce a straight line and an oral image.
  • the undercut area may be calculated based on the position of the contact point where the surface of the oral cavity object corresponding to the inner image object contacts.
  • the guide generator 80 determines the shape of the surgical guide corresponding to the tooth number lost in the oral cavity image from the guide library 60, and generates a surgical guide according to the determined shape.
  • the internal shape in which the surgical guide is in direct contact with the gingiva or teeth is generated by reflecting the undercut area calculated by the undercut calculator 70.
  • the undercut area a portion of the internal shape is removed to provide a gap spaced from the oral object by a predetermined distance so that the surgical guide is smoothly mounted to the oral cavity of the patient during the procedure.
  • the undercut area is reflected in the inner shape, only the inner shape may be changed while leaving the outer shape as it is.
  • the outer thickness may be thinner than other parts, so the outer shape may be maintained evenly. Of course, it may be changed together.
  • the lost tooth number is directly input to the user through the user interface unit 10 or electronic medical record (EMR) for managing chart data in which the patient's medical information and the dental condition are recorded according to the patient's visit. It may be linked with a server, etc. to receive information about the missing tooth number. Alternatively, at the boundary between teeth, color or brightness values are changed to divide each tooth region, and then the tooth number is assigned to each divided tooth region, and the difference in color or brightness between the lost tooth region and other regions where the tooth is present is divided. The missing tooth number may be detected based on the missing tooth number.
  • the tooth region includes the clustering method, the compression-based method, the histogram-based method, the edge detection method, and the region growing method. It can be divided using various known image segmentation techniques.
  • the position of the surgical guide is the center line of the surgical guide and the dental arch formed by the dental arch generating unit 40.
  • the arch line may be determined to correspond.
  • the height of the surgical guide is important in the implant procedure, for example, if the guide height is too low, there is a risk that the surgical guide is not fixed to the patient's mouth and the guide may move when drilling. May cause pain in the gingiva.
  • the guide generation unit 80 determines the height of the surgical guide based on the position of the gingiva plane generated by the plane generation unit 30 to the oral cavity of the patient compared to the prior art that the user arbitrarily determines the guide height. Customized surgical guides can be designed.
  • the guide generator 80 determines the basic shape of the surgical guide based on the guide library 60, and the guide hole formed in the surgical guide is planned by the planning unit 50. Determine the placement position of the fixture.
  • the guide hole refers to a hole into which a drill and an implant object are inserted for drilling the alveolar bone during implantation.
  • the guide generation unit 80 may determine the position of the guide hole to correspond to the fixture insertion position by the planning unit 50, and the diameter of the guide hole may be determined by the width of the fixture.
  • the dental surgical guide design apparatus 100 does not need to repeat a series of processes for designing the area or shape of the surgical guide for each patient by utilizing the guide library 60. As a result, user convenience is greatly improved, and design time is shortened.
  • the guide library 60 is generated based on the oral cavity size or shape of the general public, and there may be a case in which the shape or shape of the guide library 60 does not exactly fit the patient.
  • the guide generator 80 corrects the guide shape based on the length, curvature, and the like of the patient's dental arch line, without using the guide shape according to the guide library 60 before the surgical guide is finally generated. This can be customized to better suit the patient.
  • the length of the guide shape may be reduced as compared to the length of the arch form as the reference shape of the guide library 60. Longer than the reference value may extend the length of the guide shape.
  • the curvature of the guide shape may be adjusted accordingly.
  • the surgical guide finally generated by the guide generator 80 is displayed on the oral cavity image, and the user may modify or supplement the surgical guide on the oral cavity image.
  • FIG. 6 is a flowchart illustrating a method for designing a dental surgical guide according to an embodiment of the present invention.
  • FIG. 6 the organic operation of the above-described dental surgical guide design apparatus 100 will be described.
  • the image acquisition unit 10 acquires an oral image showing a tooth arrangement of a patient who needs an implant procedure through imaging equipment such as a CT device or an oral scanner (S10).
  • the image preprocessing process such as processing noise or correcting the tilt in the captured image, matching different images such as CT image and oral scan image, and reconstructing the image into 3D image and cross-sectional image This may be accompanied.
  • the gingival plane and the arch form line are generated in the obtained oral image (S20).
  • the plane generating unit 30 may generate a gingival plane corresponding to the upper boundary of the gingiva based on a point input through the user interface unit 10, or based on brightness, color or object shape in the oral cavity image. It may be implemented to recognize points on the gingival upper boundary and automatically create a gingival plane.
  • the gingival plane is generated to contact the boundary of the gingiva close to the lost tooth to be implanted.
  • the plane generating unit 30 recognizes the area where the tooth is lost, and displays a guide box for guiding the area where the point is to be input around the corresponding area so that a point serving as a reference for generating the gingival plane around the tooth loss area is input. You might be able to induce it.
  • weights may be differently applied depending on whether the distance to the tooth loss region is close.
  • the arch generating unit 40 may generate the arch line by applying various known algorithms for generating the arch line.
  • the dental arch line may be automatically generated through a process such as hole filling, connected component analysis, thinning, curve fitting, and the like.
  • hole peeling is a process for filling empty areas such as a missing tooth or a root canal area
  • a connection component analysis is a process for extracting a connection component of an individual tooth
  • the thinning operation is a thinning of the connection component.
  • an arch form line can be generated based on the centerline of the connecting component.
  • Curve fitting is a process for applying a predetermined function to the arch line produced primarily through thinning to obtain a smooth curved arch line.
  • the arch form generating unit 40 may manually generate the arch form line based on a user input through the user interface unit 10.
  • Implant planning for determining the position, size, and angle of the implant object constituting the implant, such as a crown, fixture, or abutment, is performed through the planning unit 50 (S30).
  • Implant planning may be based on oral scan images, 3D images reconstructed from CT data, cross-sectional images, registration images, and the like.
  • the planning may be performed based on a CT image in which hard tissues such as alveolar bones appear well when planning for crowns, abutments, and fixtures, but planning for crowns is important considering the relationship between the gingival boundary and adjacent tooth boundary. It can also be done on oral scans that show good tooth boundaries or soft tissue.
  • the planning may be performed on different types of images for each object, and the result of planning on different images may be shared through image registration.
  • Implant planning proceeds in such a way that the position and size of the crown are first determined in accordance with the tooth loss area, and then the position and implantation angle of the fixture and abutment are determined corresponding to the crown.
  • the above process is performed manually according to a user input through the user interface unit 10 or by using an image recognition algorithm, the tooth loss area is detected, and the distance between each object constituting an implant is placed in an adjacent position.
  • the reference information regarding the distance between homogeneous objects and the like may be stored in advance and the planning may be automatically performed based on the same.
  • the planning unit 50 generates a crown on the dental arch line generated during the planning process, so that the lower portion of the crown does not go beyond the gingival plane above a predetermined reference, and the upper portion of the crown is above the predetermined reference You can restrict it from going over.
  • the occlusal plane is a plane formed by the occlusal surface where the upper and lower dents meet.
  • the occlusal plane receives a point on the occlusal surface through the user interface unit 10 and generates a plane including the corresponding points or insulates the mandibular incisor through image recognition. It may be automatically generated as a plane connecting the upper points by recognizing the buccal centrifugal cusps of the left and right second molar of the lower jaw.
  • the planning unit 50 provides an alarm message to the user when the crown position is modified below the gingival plane or above the occlusal plane by over the predetermined reference value through the user interface unit 10 to provide a more successful implant planning. You can plan.
  • the guide library 60 may include the text bar and the position of the guide window according to the basic shape of the surgical guide and determine the position of the text bar and the guide window together with the basic shape.
  • additional information such as the patient's gender, age, race, patient's specific arch form, etc. may be used together in determining the basic shape of the surgical guide.
  • the guide basic shape may be determined through the guide library 60, and the position of the guide hole, the position of the surgical guide, and the height of the surgical guide may be determined together.
  • the position of the guide hole may be determined corresponding to the placement position of the fixture according to implant planning. For example, the position of the guide hole may be determined to coincide with the center of the fixture and the center of the guide hole, and the size of the guide hole may be determined based on the width of the fixture. Meanwhile, the position of the surgical guide may be determined as a position where the center line of the surgical guide corresponds to the arch line.
  • FIG. 7 is a reference diagram for explaining a method for determining a position of a surgical guide.
  • the generation position of the surgical guide may be determined such that predetermined points 701 and 703 on the center line OL of the surgical guide are positioned on the arch line DL.
  • the position or number of points serving as a reference for positioning the surgical guide relative to the arch line may be changed depending on the setting in addition to the example of FIG. 7.
  • the height of the surgical guide may be applied to the default height set as the default (Default) in the guide library 60, the specific height of the surgical guide can be determined based on the position of the gingiva plane. For example, the height of the surgical guide may be determined to cover the gingival to the same height as the position of the gingival plane, or may be generated to cover the gingival by a predetermined distance more than the position of the gingival plane, or the tooth direction is greater than the gingival plane. You can also create it in a higher position.
  • the height of the surgical guide may be generated based on the location of the gingival plane, but a specific height relative to the location of the gingival plane may be determined differently according to a user or device setting.
  • the undercut calculator 70 calculates the undercut area of the surgical guide and reflects it in the surgical guide shape (S50).
  • FIG. 8 is a flowchart illustrating an example of a method of calculating an undercut area according to an exemplary embodiment of the present invention
  • FIGS. 9 and 10 are reference diagrams for explaining a method of calculating an undercut area according to FIG. 8.
  • the oral insertion direction of the surgical guide is determined based on the slope of the gingival plane (S501).
  • FIG. 9 is a reference diagram for describing a method of determining the oral insertion direction of a surgical guide.
  • the oral insertion of the surgical guide is basically inserted from the occlusal plane OP toward the gingival plane GP.
  • the specific direction is determined so as to be inserted in a direction perpendicular to the gingival plane GP and consequently is determined according to the inclination of the gingival plane.
  • the determined insertion direction may be displayed on the oral cavity image, and the user may confirm and correct the direction.
  • the undercut area is determined based on the position of the contact point between the generated straight line and the surface of the oral cavity object (S505).
  • FIG. 10 is a diagram illustrating a method of determining an undercut area according to an exemplary embodiment of the present invention and shows a maxillary tooth object cross section in a lingual / buccal direction.
  • the straight line L1 is a tooth object. It has a contact point CP1 with the surface of T1
  • the straight line L3 has a contact point CP2 with the surface of the tooth object T1.
  • the undercut calculator 70 may calculate a region corresponding to a position lower than the positions of the contacts CP1 and CP2 as the undercut region UC based on the insertion direction of the surgical guide.
  • FIG. 11 illustrates an example of a screen on which the calculated undercut area is displayed on the oral cavity image. As shown in FIG. 11, an undercut area in which a gray portion of an image is calculated is calculated. In this way, the undercut area may be displayed and provided on the oral image, and the user may be given an opportunity to check and correct it.
  • the guide generation unit 80 reflects the undercut area calculated in this way to the internal shape of the surgical guide (S507).
  • the internal shape S IN of the surgical guide S corresponding to the position lower than the positions of the contacts CP1 and CP2 calculated as the undercut regions in FIG. 10 corresponds to the contacts CP1 and CP2. It shows the removed shape to correspond to the width of the inner shape (S IN ).
  • the removed portion has a predetermined gap with the oral cavity object T1, where the size of the gap may be determined based on the distance between the contact point and the straight line contacting the oral cavity object.
  • the undercut area is reflected in the internal shape of the surgical guide to give a free space so that the surgical guide can be easily inserted without being caught in the maximum fusion part of the tooth when the surgical guide is actually inserted in the oral cavity.
  • FIG. 12 shows an example in which the outer shape S OUT is also changed outward so that a part of the inner shape is removed according to the undercut area while the guide thickness is thinner than other parts so that the overall uniform thickness is maintained.
  • the undercut area may be reflected only in the inner shape without changing the outer shape.
  • FIG. 13 shows an example in which a surgical guide is generated on an oral cavity image.
  • the surgical guide S may be displayed in a form covering the oral cavity object of the oral image as if the surgical guide S is actually mounted on the oral cavity of the patient.
  • the shape of the surgical guide S according to the guide library 60, the text bar 1301, and the position of the guide window 1303 may be checked.
  • PMS system Patient Management System
  • necessary text information such as the patient's name, chart number, etc. in the text bar.
  • the user may modify the shape or height of the surgical guide generated through the user interface unit 10.
  • the shape of the surgical guide finally completed according to the user modification may be added to the guide library 60 or updated to existing information according to the user's selection.
  • the step of correcting by reflecting the curvature or shape of the specific dental arch of the patient may be further added.
  • the dental surgical guide design apparatus 100 and method according to the present invention by providing the basic shape through the guide library 60, each patient by automatically reflecting and providing the undercut area Since it is not necessary to repeat a series of processes for determining specific properties including the surgical guide shape for each, it is possible to greatly improve the guide design efficiency and design a surgical guide suitable for the patient's dental structure.
  • the method for designing a dental surgical guide according to the present invention may be implemented as a program that can be executed in a computer, and may be implemented as various recording media such as magnetic storage media, optical reading media, and digital storage media.
  • Implementations of the various techniques described herein may be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations of them. Implementations may be implemented for processing by, or to control the operation of, a data processing device, eg, a programmable processor, a computer, or multiple computers, a computer program product, ie an information carrier, for example a machine readable storage. It may be embodied as a computer program recorded on a device (computer readable medium).
  • Computer programs, such as the computer program (s) described above may be written in any form of programming language, including compiled or interpreted languages, and may be written as standalone programs or in modules, components, subroutines, or computing environments. It can be deployed in any form, including as other units suitable for use.
  • the computer program can be deployed to be processed on one computer or multiple computers at one site or distributed across multiple sites and interconnected by a communication network.
  • processors suitable for the processing of a computer program include, by way of example, both general purpose and special purpose microprocessors, and any one or more processors of any kind of digital computer.
  • a processor will receive instructions and data from a read only memory or a random access memory or both.
  • Elements of a computer may include at least one processor that executes instructions and one or more memory devices that store instructions and data.
  • a computer may include one or more mass storage devices that store data, such as magnetic, magneto-optical disks, or optical disks, or receive data from, transmit data to, or both. It may be combined to be.
  • Information carriers suitable for embodying computer program instructions and data include, for example, semiconductor memory devices, for example, magnetic media such as hard disks, floppy disks, and magnetic tape, compact disk read only memory. ), Optical media such as DVD (Digital Video Disk), magneto-optical media such as floppy disk, ROM (Read Only Memory), RAM , Random Access Memory, Flash Memory, Erasable Programmable ROM (EPROM), Electrically Erasable Programmable ROM (EEPROM), and the like.
  • the processor and memory may be supplemented by or included by special purpose logic circuitry.
  • the computer readable medium may be any available medium that can be accessed by a computer, and may include both computer storage media and transmission media.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dentistry (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Robotics (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

La présente invention concerne un procédé pour la conception d'un guide chirurgical dentaire, un appareil associé et un support d'enregistrement sur lequel celui-ci est enregistré. Le procédé de conception d'un guide chirurgical dentaire selon la présente invention consiste à déterminer et à fournir une forme pour le guide sur la base d'une bibliothèque de guides. Par conséquent, le procédé permet d'omettre une entrée utilisateur séparée pour déterminer la forme du guide, ce qui permet de raccourcir la durée de conception d'un guide et d'améliorer considérablement la commodité pour l'utilisateur.
PCT/KR2019/005130 2018-05-31 2019-04-29 Procédé de conception d'un guide chirurgical dentaire, appareil associé et support d'enregistrement sur lequel celui-ci est enregistré WO2019231116A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2018-0062335 2018-05-31
KR1020180062335A KR101985919B1 (ko) 2018-05-31 2018-05-31 치과용 서지컬 가이드 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체

Publications (1)

Publication Number Publication Date
WO2019231116A1 true WO2019231116A1 (fr) 2019-12-05

Family

ID=66844731

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2019/005130 WO2019231116A1 (fr) 2018-05-31 2019-04-29 Procédé de conception d'un guide chirurgical dentaire, appareil associé et support d'enregistrement sur lequel celui-ci est enregistré

Country Status (2)

Country Link
KR (1) KR101985919B1 (fr)
WO (1) WO2019231116A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110353723A (zh) * 2019-07-30 2019-10-22 深圳市倍康美医疗电子商务有限公司 组合式放射导板的制作方法及组合式放射导板
CN113855291A (zh) * 2021-12-01 2021-12-31 极限人工智能有限公司 种植体辅助规划方法、装置、电子设备及存储介质
CN116090117A (zh) * 2022-12-05 2023-05-09 高峰医疗器械(无锡)有限公司 基于口腔模型的导板设计方法、装置、设备及存储介质

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102378382B1 (ko) * 2019-08-22 2022-03-25 오스템임플란트 주식회사 의료영상 정합 방법 및 그 장치
KR20210079715A (ko) * 2019-12-20 2021-06-30 오스템임플란트 주식회사 임플란트 수술용 가이드 디자인 방법 및 그 장치
KR102482953B1 (ko) 2020-11-06 2023-01-02 오스템임플란트 주식회사 덴탈 아치를 획득하는 방법, 디바이스 및 기록매체에 저장된 컴퓨터 프로그램
KR102350098B1 (ko) * 2020-12-18 2022-01-11 오스템임플란트 주식회사 악궁라인 생성 방법 및 이를 위한 치과영상 처리장치
KR102601540B1 (ko) * 2021-10-19 2023-11-13 오스템임플란트 주식회사 치과 수술용 가이드 디자인 방법, 그리고 이를 구현하기 위한 장치

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5322621B2 (ja) * 2008-12-19 2013-10-23 京セラメディカル株式会社 ステント作製用口腔模型の製造装置およびステント作製用口腔模型の製造システム
US8714975B2 (en) * 2009-12-22 2014-05-06 Lambert J. STUMPEL Surgical guide and method
KR20170013678A (ko) * 2015-07-28 2017-02-07 주식회사 디오 정렬기준이 표시된 치아 임플란트 시술용 서지컬 가이드 및 그의 제조방법
KR101738924B1 (ko) * 2015-12-15 2017-05-24 오스템임플란트 주식회사 치과용 스텐트 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체
KR101797154B1 (ko) * 2016-09-02 2017-12-12 주식회사 디오 치과 임플란트용 서지컬 가이드 제조방법

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR101769332B1 (ko) * 2016-10-06 2017-08-18 오스템임플란트 주식회사 치과용 서지컬 가이드 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5322621B2 (ja) * 2008-12-19 2013-10-23 京セラメディカル株式会社 ステント作製用口腔模型の製造装置およびステント作製用口腔模型の製造システム
US8714975B2 (en) * 2009-12-22 2014-05-06 Lambert J. STUMPEL Surgical guide and method
KR20170013678A (ko) * 2015-07-28 2017-02-07 주식회사 디오 정렬기준이 표시된 치아 임플란트 시술용 서지컬 가이드 및 그의 제조방법
KR101738924B1 (ko) * 2015-12-15 2017-05-24 오스템임플란트 주식회사 치과용 스텐트 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체
KR101797154B1 (ko) * 2016-09-02 2017-12-12 주식회사 디오 치과 임플란트용 서지컬 가이드 제조방법

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110353723A (zh) * 2019-07-30 2019-10-22 深圳市倍康美医疗电子商务有限公司 组合式放射导板的制作方法及组合式放射导板
CN113855291A (zh) * 2021-12-01 2021-12-31 极限人工智能有限公司 种植体辅助规划方法、装置、电子设备及存储介质
CN116090117A (zh) * 2022-12-05 2023-05-09 高峰医疗器械(无锡)有限公司 基于口腔模型的导板设计方法、装置、设备及存储介质
CN116090117B (zh) * 2022-12-05 2023-09-26 高峰医疗器械(无锡)有限公司 基于口腔模型的导板设计方法、装置、设备及存储介质

Also Published As

Publication number Publication date
KR101985919B1 (ko) 2019-06-05

Similar Documents

Publication Publication Date Title
WO2019231116A1 (fr) Procédé de conception d'un guide chirurgical dentaire, appareil associé et support d'enregistrement sur lequel celui-ci est enregistré
KR102122034B1 (ko) 치과용 서지컬 가이드 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체
US10898077B2 (en) Identification of intraoral areas of interest
US11872102B2 (en) Updating an orthodontic treatment plan during treatment
WO2021025355A1 (fr) Procédé, appareil et programme d'ordinateur pour programmer une opération chirurgicale d'implantation
WO2019112301A2 (fr) Appareil et procédé de désignation de région d'implantation d'implant
KR102248604B1 (ko) 최적화된 어버트먼트 및 보철물 수복 유형 설계를 위한 임플란트 식립 설계장치 및 그 방법
KR20190142080A (ko) 치과용 임플란트 플래닝 방법, 이를 위한 장치, 및 이를 기록한 기록매체
KR102013667B1 (ko) 치과용 서지컬 가이드 설계 방법, 이를 위한 장치, 및 이를 기록한 기록매체
WO2021025296A1 (fr) Procédé de recommandation automatique d'un modèle de couronne et appareil de cao de prothèse pour sa mise en œuvre
US11399917B1 (en) Systems and methods for determining an orthodontic treatment
KR102350098B1 (ko) 악궁라인 생성 방법 및 이를 위한 치과영상 처리장치
CN113057733B (zh) 一种基于三维模型确定颧骨种植体种植位置的方法和装置
Paoli et al. A CAD-based methodology for dental implant surgery

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 19810276

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205A DATED 20/04/2021)

122 Ep: pct application non-entry in european phase

Ref document number: 19810276

Country of ref document: EP

Kind code of ref document: A1