WO2021025355A1 - 임플란트 수술을 계획하는 방법, 장치 및 컴퓨터 프로그램 - Google Patents
임플란트 수술을 계획하는 방법, 장치 및 컴퓨터 프로그램 Download PDFInfo
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Definitions
- the present invention relates to a computer program for planning dental implant surgery and designing an implant procedure guide according to the surgery plan. More specifically, the present invention relates to a method, an apparatus, and a computer program for reducing an operation preparation time by establishing an implant surgery plan using a guide stent made in advance with a certain standard.
- the dental implant procedure involves placing an implant fixture into the alveolar bone.
- a guide device called a guide stent or a surgical guide is commonly used.
- the guide stent currently used in the procedure site is Korean Patent Registration No. 10-1473192 (Prior Document 1, name of the invention: Method of manufacturing a guide stent for implants, announcement date: 2014.12.16.), Korean Patent No. 10-1554157 (Prior Document 2, a reference marker for intraoral attachment and a method of manufacturing a guide stent for an implant procedure using the same, announcement date: 2015.09.21.) It is manufactured by a method similar to that disclosed.
- FIG. 1A of the present specification The guide stent manufacturing method described in Prior Document 2 is illustrated in FIG. 1A of the present specification, and a brief description of the conventional guide stent manufacturing method is as follows with reference to FIG. 1A.
- the operator acquires a three-dimensional image of the inside of the oral cavity (periodontal tissue in the oral cavity) through the CT scan of the person being treated, and acquires a three-dimensional external shape image corresponding to the three-dimensional image through an oral scan (s1). .
- CT scans can only confirm the hard tissue in the oral cavity, so it is necessary to confirm the shape of the gums or the crown of the child.
- oral scanning is performed by the operator inserting the scanner into the oral cavity of the person to be treated, and since it must be scanned along the oral cavity, the problem of image distortion frequently occurs.
- the obtained three-dimensional image and external shape image of the patient's oral cavity are image-matched based on the characteristics or markers of teeth included in each image, and a three-dimensional procedure guide image is generated through image registration (s2).
- the operator establishes an implant procedure plan using the 3D procedure guide image (s3), and a guide stent with a guide hole formed according to the procedure guide image is manufactured.
- a guide stent is manufactured using a 3D printer with equipment such as a 3D printer in dentistry.
- 3D printing takes a lot of time.
- a guide stent is made of a soft material, and a separate metal member is installed in the hole portion of the guide stent where the implant sleeve is to be placed.
- the guide stent formed of a soft material is twisted in the process of processing the metal member in the guide hole, there is a problem that an error occurs when the patient attaches the completed guide stent.
- the present invention is to solve the above-described problem, and an object of the present invention is to shorten the preparation time for implant surgery by using a guide stent made in advance with a certain standard. More specifically, according to the present invention, as in the prior art, a guide stent is not separately manufactured based on the patient's oral image, but an implant surgery plan is established using a standardized guide stent, and a standardized guide stent is used according to the surgery plan. It aims to shorten the preparation time for surgery by processing.
- an object of the present invention is to provide a surgical guide designed to be stably mounted inside the oral cavity of an operator without error, and designed to show the implant placement position and angle during surgery.
- the method of supporting implant surgery is made according to a certain standard to group human teeth into an arbitrary range so as to belong to at least one or more groups, and to cover the tooth positions of the group.
- B step of generating a library-matched CT image by matching and it may include the step c of planning the implant surgery of the patient using the library-matched CT image.
- the guide stent there is an effect of improving the convenience of the patient and the operator by shortening the time for establishing an implant surgery plan and manufacturing the guide stent. More specifically, according to the embodiment of the present invention, since the guide stent is not separately manufactured for each patient, but the standardized guide stent is processed according to the surgery plan, there is an effect of shortening the preparation time for implant surgery. Furthermore, the guide stent according to the embodiment of the present invention can be manufactured quickly and easily, and can be stably mounted inside the oral cavity of the person to be treated without error.
- 1A is a flow chart for explaining a method of manufacturing a conventional guide stent for an implant
- FIG. 1B is a view for explaining the configuration of an implant surgery planning system according to an embodiment of the present invention
- FIG. 2 is a view for explaining a pre-guide device according to an embodiment of the present invention
- FIG. 3 is a flow chart illustrating a process of planning an implant surgery and processing a surgical guide according to an embodiment of the present invention
- FIG. 4 is a flowchart illustrating a process of processing an oral image of a subject to be treated according to an embodiment of the present invention
- FIG. 5 is a flow chart for explaining a process of generating a surgical guide for a corresponding procedure by processing a preguide according to an embodiment of the present invention
- FIG. 6 is a view for explaining an example of a user interface for selecting a tooth to be treated in an implant planning service server according to an embodiment of the present invention and loading a CT image and a surgical guide library
- FIG. 7 is a view for explaining an example of a user interface for matching a CT image and a surgical guide library in an implant planning service server according to an embodiment of the present invention
- FIG. 8 is a view for explaining an example of a user interface for segmenting a maxillary image and a mandible image in an implant planning service server according to an embodiment of the present invention
- FIG. 9 is a diagram for explaining an example of a user interface for placing a crown at an implant placement position in an implant planning service server according to an embodiment of the present invention
- FIG. 10 is a view for explaining an example of a user interface for generating a panoramic image by setting an oral curve in an implant planning service server according to an embodiment of the present invention
- FIG. 11 is a view for explaining an example of a user interface for setting a mandibular neural tube in an implant planning service server according to an embodiment of the present invention
- FIG. 12 is a diagram for explaining an example of a user interface for setting implant types, positions, depths, and angles on a CT image in an implant planning service server according to an embodiment of the present invention, and setting a handpiece insertion path
- FIG. 13 is a view for explaining an example of a user interface for setting an etching area for processing a surgical guide in an implant planning service server according to an embodiment of the present invention
- FIG. 14 is a view for explaining an example of a user interface for setting an etch depth of a preguide in an implant planning service server according to an embodiment of the present invention
- FIG. 1B is a view for explaining the configuration of an implant surgery planning system 100 according to an embodiment of the present invention.
- the implant planning system includes a guide stent set 110 made in advance with a certain standard, a CT imaging device 120, a service server 130 performing implant surgery planning and guide design functions as shown in FIG. 1B, and a guide. It may include a milling machine 140 for processing the stent.
- FIG. 1B illustrates the CT imaging device 120, the guide design service server 130, and the milling machine 140 as separate and independent devices, but this is only an example.
- the implant planning system refers to a device or a set of devices that perform a CT image capture function, an implant planning and guide design function, and/or a guide milling function, each function being an independent hardware device or a cloud-based device. It may be implemented in software of, or software and hardware may be integrally formed.
- the implant planning and guide design service function 130 according to the embodiment of the present invention may be implemented as software, and may be executed by installing the software on a general-purpose server.
- the guide stent set 110 is not individually manufactured based on the patient's oral image, but is a ready-made product made in advance with a certain standard according to the implant placement position, and is prescribed by the milling machine 140 according to the design of the implant planning service server. After processing, it can perform the function of a surgical guide that can be applied to the patient's surgery.
- the guide stent in the state before being processed is referred to as a free guide.
- FIG. 2 is a view for explaining a pre-guide device according to an embodiment of the present invention.
- the preguide may be formed into a maxillary (upper jaw) model and a mandible (lower jaw) model according to an implant placement position.
- the pre-guide set according to an embodiment of the present invention is, when numbering human teeth as shown in FIG. 2A, max. 18 to 14, 16 to 22, 15 to 25, 28 to 24, It may include at least one maxillary model formed to group the maxillary teeth in an arbitrary range, such as No. 26 to No. 11, and cover the tooth position of the group.
- At least formed to group the maxillary teeth in an arbitrary range such as mandible 48-43, 46-31, 45-35, 38-34, 36-42, and cover the tooth position of the group. It may include one or more mandibular models.
- the maxillary model may be formed in a shape such as 210, 220, 230, 240, 250, 260 of FIG. 2B, and 215, 225, 235, 255, and 265 of FIG. 2B are 210, 220, 230, 250, respectively.
- the pre-guide according to the embodiment of the present invention is formed of a guide tray in the shape of 280 in FIG. 2C, an impression material such as resin that is formed inside the guide tray to obtain an impression inside the oral cavity, and a radiopaque material. More than one marker (270 to 276) may be included. Further, in the pre-guide according to an embodiment of the present invention, a vinyl film may be formed on one surface of an impression material such as a resin that emulates a tooth.
- a person to be treated holds a model covering an implant target position among the preguide sets in his mouth, and the implant placement site is modeled through the impression material. That is, the implant placement site of the person to be treated is modeled on the impression material in the preguide.
- the impression material is resin
- it may be cured through light polymerization or self-curing.
- the preguide according to the embodiment of the present invention has a vinyl film formed on the surface of the impression material that mirrors the implant placement site of the recipient, the preguide is easily detached from the oral cavity even when the impression material is cured through light polymerization or self polymerization. can do.
- it is appropriate for the preguide to harden the impression material in the oral cavity to prevent contraction.
- the surgical guide and the implant placement of the recipient It can be used as a means of physical matching of the part.
- the implant placement site is modeled on the impression resin included in the preguide according to the embodiment of the present invention, and since the surgical guide completed through the processing of the preguide also includes the impression resin modeled on it.
- the pre-guide is a ready-made product, it can function as a surgical guide tailored to a specific implant for the patient to be treated.
- the operator holds the preguide in his mouth and takes an oral image with the CT imaging device 120, and the markers 270 to 276 are radiopaque or radio-transmissive, so they are displayed on a 3D image obtained through CT scan. Can be.
- the marker displayed on the CT image may be used as a registration criterion for the preguide image in the process of processing the CT image.
- the pre-guide according to the embodiment of the present invention is processed as a surgical guide in the milling machine 140 as described above. At this time, one side of the pre-guide is accurately positioned and processed at the preset coordinates in the milling machine 140. A jig holder that can be physically coupled with the mill jig may be formed.
- the pre-guide device according to the embodiment of the present invention is a ready-made product made in advance with a certain standard according to the implant target position, and includes an impression material so that the implantation site can be modeled, and a marker that can be displayed in a CT image.
- the marker may not be formed at positions 270 to 276 shown in FIG. 2C, but may be formed at the handle portion 290 of FIG. 2D, or may be preferably formed at three or more positions among positions 270 to 276 of FIG. 2C.
- the marker since the marker is used as a matching reference between the preguide library and the preguide image, it suffices if it can be used as a matching reference by forming a dot, line, or plane. It should be noted that it is limited to and cannot be interpreted.
- the CT imaging device 120 takes a CT image in which the preguide 110 is inserted in the oral cavity of the patient, and the implant planning server 130 receives the CT image generated by the CT imaging device 120.
- the implant planning and guide design service server 130 may include a preguide library 131, an image processing module 132, an implant planning module 133, a guide design module 134, a reporting module, and a file management module 136.
- the preguide library 131 is not separately illustrated in FIG. 1B, but may be stored in the storage unit of the service server 130.
- the preguide library 131 is a database for a set of information on the preguide 110 and may include information on the shape, size, image, material, and position of a marker of a corresponding model of the preguide.
- the service server 130 may identify a preguide model mounted by a patient to be treated through a CT image or, when a preguide model is identified through a user input, may load data for the corresponding model from the preguide library 131.
- the image processing module 132 may perform a function of matching the CT image 125 with the loaded preguide data.
- the image of the inside of the oral cavity obtained through a CT scan shows information on internal tissues such as the crown (the upper side of the tooth appearing outside the gum), the root (the lower side of the tooth hidden in the gum as a part that is joined to the alveolar bone), and the alveolar bone. It includes, and may include a marker image of the preguide 110.
- the image processing module 132 may match data of the preguide library in the CT image based on the marker image.
- CT images do not accurately provide information on the gums, and conventionally, in order to solve this problem, a 3D external shape image was obtained through an oral scan, and the 3D image inside the oral cavity and the external shape image were image-matched.
- a separate oral scan is not required.
- the preguide 110 according to the embodiment of the present invention is a standard product, and information on the shape is pre-stored in the planning server 130 as preguide library 131 data, and the preguide library 131 is added to the CT image 125 in the image processing module 132. This is because it can be matched as a standard. More specific details of matching the CT image and preguide library data according to an embodiment of the present invention will be described later in the description of the accompanying FIGS. 6 to 7.
- the image processing module 132 may perform a function of segmenting the maxillary image and the mandible image from the CT image.
- the CT image according to the embodiment of the present invention is obtained with the upper and lower jaws open by the thickness of the pre-guide since the person to be treated was photographed with the pre-guide 110 in the mouth. Therefore, the image processing module 132 separates the maxillary image and the mandible image based on an arbitrary line, reconstructs the separated maxillary image and the mandibular image so that they can be occluded, and compensates for errors due to the thickness of the preguide. have.
- the image processing module 132 may perform a function of displaying tooth curves and neural tube positions in the corrected CT image.
- the image processing module 132 may perform a function of separating and correcting the maxillary and mandible images so as to be occluded, and recording information on the tooth curve and neural tube positions. More specific details of adding data to the CT image will be described later in the accompanying description of FIGS. 8, 10 and 11.
- the implant planning module 133 may perform a function of planning implant placement by setting a position and/or orientation of an implant using the CT image processed by the image processing module 132. For example, the implant planning module 133 may place a crown object at an implant placement site in a CT image by setting an angle and a size. Thereafter, the implant planning module 133 may place the implant object apart from the arranged crown object by a predetermined distance. Furthermore, implant surgery can be planned by setting the size, length, position, and placement angle of the implant object. Information on the implant surgery plan generated by the implant planning module 133 is stored as implant planning information 138, and may be provided to the operator in the reporting module 135.
- the implant planning module 133 may perform a function of providing a guide to a practitioner while arranging an implant object.
- the implant planning module may provide a guide so that the implant position is located at a depth of 0.5 to 1 mm from the bone, or may provide a guide to secure a gap of 2 mm or more with the root of an adjacent tooth.
- the implant planning module may provide a guide such that a gap between the implant and a nerve is secured at least 3mm, or a guide may be provided such that the gap between the implant and a sinus is secured by at least 2mm.
- the implant planning module may provide a guide so that the implant axis and the center of the prosthesis coincide, or may provide a guide as to whether or not sufficient bones exist at the implant placement position.
- the implant planning module may provide a guide as to whether the sleeve has invaded teeth or gingiva.
- the implant planning module 133 may perform a function of setting an insertion direction of an implant treatment tool, that is, a handpiece, together with an implant placement plan.
- the guide design module 134 may perform a function of generating processing information of the preguide 110 according to an implant placement plan set in the implant planning module 133. For example, the guide design module 134 may set a guide hole area to be etched in the preguide by applying an offset of a preset range based on the type, size, and/or length of the implant sleeve determined in the implant planning module 133. Furthermore, the guide design module 134 may apply the implant surgical tool, that is, the insertion angle and position information of the handpiece in the preguide, to set the etching area of the flat surface above the preguide for insertion of the handpiece.
- the processing information of the free guide generated by the guide design module 134 is provided to the milling machine 140 in the form of a guide file 145, and the milling machine 140 refers to the machining file.
- the free guide can be processed.
- the milling machine 140 may generate a surgical guide for implant surgery by etching the depth, diameter area, and handpiece insertion area of the guide hole recorded in the processing file in the corresponding preguide.
- the pre-guide processing information may include guide hole depth information. If there is no guide hole depth information, the milling machine 140 operates for an arbitrary time even after the guide hole is etched in the preguide in the milling machine 140. According to an embodiment of the present invention, since the guide hole depth information is reflected, the milling machine 140 There is an effect of shortening the time consumed in processing the preguide into a surgical guide.
- the guide design module may display a user interface as shown in FIG. 14.
- FIG. 14 is an example of a user interface for setting an etch depth of a preguide in an implant planning and guide design service server 130 according to an embodiment of the present invention.
- the 1410 of FIG. 14 is an area displaying an implant object
- 1420 is an etching area of a guide hole.
- the user may set the length of the guide hole 1420 object by using the pointer object 1430.
- information on the guide hole etching depth may be generated by reflecting the length.
- the reporting module 135 of the service server 130 can perform a function of providing information on the type, size, location and/or orientation of the CT image processed by the image processing module 132 and the implant set by the implant planning module 133 to the practitioner. have.
- the reporting module 135 may perform a function of analyzing the CT image to generate information about the patient's bone density, the implant placement position, and the distance of the neural tube, and provide the information to the operator.
- the file management module 136 may perform a function of reading and writing files necessary in the implant surgery planning system 100 according to an embodiment of the present invention. More specifically, the file management module 136 executes and stores a CT image file generated by the CT device 120, a file recording implant planning and guide design information generated by the service server 130, and/or a file necessary for the milling machine 140 to operate. Can perform the function
- the file management module 136 may perform a function of loading the CT image file 125 generated by the CT imaging apparatus in a preguide mounted state as a Dicom file in the service server 130. Furthermore, the file management module 136 may process a CT image based on the loaded Daicom file and generate implant planning data generated based on the processed CT image in STL & XML file format. Furthermore, the file management module 136 can convert the STL file into an NC file so that it can be loaded on the milling machine 140.
- the NC file may include milling position coordinate information.
- Figure 3 is a flow chart for explaining a process of generating a surgical guide by planning an implant surgery in the implant surgery planning system 100 according to an embodiment of the present invention and processing a preguide accordingly.
- the implant planning system 100 may establish an implant plan for the patient while registering information on the patient who is the subject to be treated. Furthermore, the planning system can check the teeth to be operated on among all human teeth. (Step 315) At this time, the planning system displays an image of all human teeth as shown in FIG. 6A, and the operator may obtain information on the teeth to be treated by selecting among them the teeth 605 to be treated.
- the implant planning system 100 may process the oral image of the patient.
- Step 320 More specifically, the operator may take a CT image with a pre-guide device made in advance with a predetermined standard by matching to the implant placement position.
- the planning system may acquire a CT image of the preguide mounted state, and may match the CT image with the preguide library based on the image of a marker included in the preguide device from the CT image.
- a more detailed description of step 320 will be described later in the accompanying description of FIG. 4.
- FIG. 4 is a flowchart illustrating a detailed process of step 320 of FIG. 3 for processing an oral image of a person to be treated according to an embodiment of the present invention.
- the implant planning system 100 may load a CT image of a preguide mounted state and a library for the preguide. (Step 410) At this time, the implant planning system may display a user interface as in the example of 6b. 6B is an example of a user interface for loading a CT image and a preguide library.
- Reference numeral 615 of FIG. 6B is an area indicating the position of a tooth to be implanted
- 617 and 619 are user-selected areas
- 630 and 640 are preguide library areas that display information about the preguide.
- a CT image may be displayed as 610.
- a pre-guide area such as 620 is displayed, and the operator can select a pre-guide model mounted on the subject at 620.
- a form in which the free guide is mounted on the oral cavity as shown in 630 may be displayed, and a three-dimensional image of the free guide may be displayed at 640.
- the implant planning system 100 may match the CT image and the preguide image.
- the implant planning system may display a user interface as in the example of FIG. 7. 7 is a view for explaining an example of a user interface for matching a CT image and a preguide library according to an embodiment of the present invention.
- the preguide library may include information on the shape, size, image, material, and location of the marker of the corresponding model, and 714 is the preguide. The form of is displayed.
- FIG. 716 of FIG. 7A is a CT image taken with a preguide in the mouth.
- the image of the inside of the oral cavity acquired through CT scan includes information on internal tissues such as the crown (the upper side of the tooth appearing outside the gum), the root (the lower side of the tooth covered in the gum as a part that is joined to the alveolar bone), and the alveolar bone. And, it may include a marker image of the preguide. Since the preguide according to the embodiment of the present invention includes a marker formed of a radiopaque material or a radiosemitransmissive material, the implant planning system 100 matches the marker positions recorded in the preguide library based on the marker displayed on the CT image. You can create an image in the form of
- the CT image can be transformed as shown in 727 of FIG. 7B. Thereafter, when the operator selects an object corresponding to the marker 726 displayed on 727 in the preguide library 724, the image may be matched as shown in 728 based on the selected marker.
- a 2D CT image may be displayed at various angles, and images may be matched by adjusting the position of the preguide shape 730 at the corresponding angle.
- Image registration may be performed automatically without a separate user input or may be performed manually by receiving a user input.
- the degree of matching of the markers may be displayed in colors (731 to 736) for each marker. For example, if a specific marker is correctly matched, green, red if the preguide is inward based on the CT image, and purple if the freeguide rises above the CT image, the user can see the position of the preguide shape 730. Can be finely tuned, and the System 100 can perfectly match the preguide library and CT images.
- the markers of the preguide may be formed at positions 731 to 736 in FIG. 7D, but this is only an example. That is, the pre-guide device according to the embodiment of the present invention is a ready-made product made in advance with a certain standard according to the target position of the implant, and includes an impression material so that the implantation site can be modeled, and a marker that can be displayed on a CT image is included. It is sufficient, and is not limited to its form.
- the marker may be formed on the handle 740 of FIG. 7E, and in that case, the preguide library and the CT image may be matched with respect to the handle portion.
- the maxillary image and the mandible image may be segmented.
- the CT image according to the embodiment of the present invention is obtained with the upper and lower jaws open by the thickness of the pre-guide since the person to be treated was photographed with the pre-guide in the mouth.
- the system 100 according to the embodiment of the present invention separates the maxillary image and the mandible image based on an arbitrary line 810 as illustrated in FIG. 8, and reconstructs the separated maxillary image and the mandible image so that they can be occluded, and free guide Errors due to thickness can be corrected.
- the system 100 according to an embodiment of the present invention may display information on the average position of the reference line and perform correction in such a manner that the user adjusts it.
- the planning system 100 separates the maxillary image and the mandible image in advance without receiving a user input for the reference line 810, and if the tooth to be treated is located in the maxilla, the maxillary image, and if it is located in the mandible You can also display only images.
- the planning system 100 may place a crown (step 425) and set a tooth curve and a neural tube (step 430).
- the planning system 100 provides the user interface as shown in FIG. 9, and the user can place the crown object 910 at the treatment position, adjust the angle of the crown using the 920 object, and use the 930 object to adjust the size of the crown. You can also adjust. Furthermore, the planning system 100 provides a user interface as shown in 1000 in FIG. 10 so that the user can set a tooth curve by clicking on a curve in the middle of the bone, and provides user interfaces as shown in 1110 and 1120 in FIG. You can set up a neural tube like 1130 by rotating the scroll to check the neural tube and selecting it.
- the planning system may establish an implant plan in step 330.
- the planning system 100 may plan implant placement by setting the position and/or orientation of the implant using the oral image processed in step 320.
- the implant planning module 133 may arrange the crown object 1210 by setting an angle and size at the implant placement site in the CT image. Thereafter, the implant planning module 133 may place the implant object 1220 apart from the arranged crown object by a predetermined distance.
- implant surgery can be planned by setting the size, length, position, and placement angle of the implant object.
- the planning system 100 may perform a function of providing a guide to a practitioner while placing an implant object.
- the planning system 100 may provide a guide so that the implant position is located at a depth of 0.5 to 1 mm from the bone, or may provide a guide to secure a gap of 2 mm or more with the root of an adjacent tooth.
- the planning system 100 may provide a guide such that a gap between the implant and a nerve is secured by 3mm or more, or a guide may be provided such that the gap between the implant and a sinus is secured by 2mm or more.
- the planning system 100 may provide a guide so that the axis of the implant coincides with the center of the prosthesis, or may provide a guide as to whether the bone is sufficiently present at the implant placement position. As another example, the planning system 100 may provide a guide as to whether the sleeve has invaded teeth or gingiva. Furthermore, along with the implant placement plan, as shown in 1230 of FIG. 12B, the insertion direction of the implant treatment tool, that is, the handpiece may be set.
- the planning system 100 may generate pre-guide processing information to process the pre-guide according to the implant placement plan and process it into a surgical guide for a corresponding surgery.
- the planning system 100 may set a guide hole area to be etched in the preguide by applying an offset of a preset range based on a predetermined type, size and/or length of the implant sleeve.
- guide processing information may be generated by applying the implant surgical tool, that is, the insertion angle and position information of the handpiece in the preguide, to set the etching area of the flat surface above the preguide for insertion of the handpiece.
- the generated guide processing information can be saved in STL & XML file format.
- the planning system 100 may process the preguide into a surgical guide for a corresponding procedure by etching the set etching area in the preguide.
- the planning system includes a milling machine, and the processing information of the free guide, that is, information on the guide hole area and/or the handpiece insertion area, is generated in the form of a file for guide processing and can be applied to the milling machine. have.
- the milling machine can process the free guide by referring to the processing file.
- the milling machine may generate a surgical guide for implant surgery by etching the depth, diameter area, and handpiece insertion area of the guide hole recorded in the processing file in the corresponding preguide.
- the planning system sets the guide hole etching area, and the operator provides a 3D user interface such as 1320.
- the flat surface etching area is set by using, as shown in 1330, the guide hole and the flat surface are etched in the preguide and processed into a surgical guide for the corresponding procedure.
- the water outlet region may be set to partially overlap the guide hole region.
- the injection port area is an area for injecting water into an implant treatment area of the oral cavity, is formed to have a diameter smaller than the guide hole diameter, and may be set to partially overlap the guide hole area. Furthermore, since the spout diameter is formed to be less than 1/2 of the guide hole diameter, even if the spout area partially overlaps the guide hole area, the guide hole area can be clearly specified.
- the etching area on the flat surface is formed according to the arbitrary handpiece insertion path as shown in 1340 of FIG. 13B. Can be set.
- the teeth to be implanted are adjacent.
- the first guide hole and the second guide hole are disposed adjacent to each other, but do not overlap.
- the first handpiece region for the handpiece insertion path for the first guide hole and the second handpiece region for the handpiece insertion path for the second guide hole may overlap each other.
- the first handpiece region and the second handpiece region may be distinguished by a stepped method.
- the planning system may report the operation plan while visually providing information on the type, size, location and/or direction of the CT image, crown and implant in which the preguide is matched.
- the planning system may analyze the CT image of the person to be treated to generate and report information on the person's bone density, implant placement location, and distance of the neural tube.
- FIG. 5 is a flowchart illustrating a series of procedures in which a random implant procedure plan is established for a preguide according to an embodiment of the present invention and processed into a surgical guide for the procedure.
- a pre-guide set made in advance with a predetermined standard may be prepared according to the implant placement position.
- the preguide according to the embodiment of the present invention may include a maxillary (upper jaw) model and a mandible (lower jaw) model according to an implant placement position.
- the pre-guide set according to an embodiment of the present invention is formed to group human teeth in an arbitrary range so that they belong to at least one or more groups, and at least one maxillary model and a mandibular model formed to cover the tooth positions of the group.
- a preguide according to an embodiment of the present invention may include a guide tray, an impression material such as resin formed inside the guide tray to obtain an impression of the oral cavity, and at least one marker formed of a radiopaque or semi-transparent material.
- step 520 the operator acquires an impression of the implant site through the impression material of the preguide. That is, the person to be treated puts an arbitrary model covering the target position of the implant in his mouth, and the implant site is imitated through the impression material.
- the impression material is resin, it can be cured through light polymerization.
- the surgical guide (step 530) that is finally completed by processing the preguide in a milling machine (step 520) according to an embodiment of the present invention
- the surgical guide It is used as a means of physical matching of the implant placement site of the recipient.
- the implant placement site is modeled on the impression resin included in the preguide according to the embodiment of the present invention, and since the surgical guide completed through the processing of the preguide also includes the impression resin modeled on it.
- the pre-guide is ready-made, it can function as a customized surgical guide for the procedure.
- the preguide may be processed according to the implant procedure plan.
- the preguide is not a model manufactured according to the oral shape of a person to be treated, but is made in advance with a certain standard. Accordingly, information on the standard of each model of the preguide, that is, information on the shape, size, image, material, and location of the marker may be previously stored in the service server in the form of a preguide library.
- the preguide library may be matched with the CT image based on the preguide marker included in the oral CT image taken with the preguide.
- the image of the inside of the oral cavity acquired through CT scan includes information on internal tissues such as the crown (the upper side of the tooth appearing outside the gum), the root (the lower side of the tooth covered in the gum as a part that is joined to the alveolar bone), and the alveolar bone
- the marker image of the preguide is included. This is because in the preguide according to the embodiment of the present invention, since the marker is formed of a radiopaque or semi-transparent material, it is recorded on a CT image. Accordingly, markers can be identified in the CT image, and since marker information is included in the pre-stored pre-guide library, the CT image and the pre-guide library can be matched based on the marker.
- the operator can establish an implant plan using the CT image matched with the preguide library.
- a crown object can be placed at the implant placement site by setting the angle and size, and the implant object can be placed at an arbitrary distance apart from the crown object, and the size, length, position and By setting the placement angle, implant surgery can be planned.
- processing information of the preguide may be generated in the service server according to the implant placement plan, and accordingly, the preguide may be processed by the milling machine.
- the guide hole area to be etched in the preguide is set by applying an offset in a preset range based on the type, size and/or length of the implant sleeve, and the implant surgical tool, that is, the insertion angle and position information of the handpiece.
- the preguide may be processed accordingly.
- the processed free guide can act as a surgical guide for the corresponding surgery.
Abstract
Description
Claims (32)
- 서버에서, 임플란트 수술을 지원하는 방법에 있어서,인간의 치아를 적어도 하나 이상의 그룹에 속하도록 임의의 범위로 그루핑하고, 해당 그룹의 치아 위치를 커버하도록 일정한 규격에 따라 제작되며, 방사선 불투과성 또는 반투과성 물질로 형성된 마커를 포함하는 가이드 모델을 피시술자의 구강 내에 삽입한 상태에서 촬영한 상기 피시술자의 구강 CT 이미지를 획득하는 a 단계;상기 가이드 모델의 규격에 대한 정보인 라이브러리를 로딩하고, 상기 구강 CT 이미지에서 상기 마커를 식별하고, 상기 라이브러리에 포함된 마커와 상기 구강 CT 이미지에서 식별된 마커를 기준으로 상기 구강 CT 이미지와 상기 라이브러리를 정합하여 라이브러리 정합 CT 이미지를 생성하는 b 단계; 및상기 라이브러리 정합 CT 이미지를 이용하여 상기 피시술자의 임플란트 수술을 계획하는 c 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 1항에 있어서, 상기 c 단계 이후에,상기 피시술자의 임플란트 수술 계획에 따라, 상기 가이드 모델을 상기 임플란트 수술에 대한 서지컬 가이드로 가공하기 위하여, 상기 가이드 모델의 가공 영역에 대한 정보를 생성하는 d 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 2 항에 있어서, 상기 b 단계는,상기 정합 CT 이미지에서 구강의 상악 이미지와 하악 이미지를 임의의 기준에 따라 분리하는 단계;분리된 상악 이미지와 하악 이미지가 교합될 수 있도록 재구성하여, 상기 정합 CT 이미지에서 상기 가이드 모델의 삽입에 따른 오차를 보정하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 1항에 있어서, 상기 b 단계는,상기 정합 CT 이미지에서, 치아 커브를 설정하는 단계; 및상기 정합 CT 이미지에서, 하악 신경관을 설정하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 2항에 있어서,상기 가이드 모델은, 구강 내부의 인상을 취득하는 인상 재료를 포함하며, 상기 인상 재료를 통해 상기 피시술자의 임플란트 식립 부위에 대한 구강 본이 형성되며,상기 서지컬 가이드는, 상기 가이드 모델을 가공하여 형성되며, 상기 구강 본이 포함되며, 상기 구강 본은 상기 피시술자의 임플란트 식립 부위와 상기 서지컬 가이드의 물리적인 정합 수단으로 기능하는 것을 특징으로 하는 수술 지원 방법.
- 제 5항에 있어서,상기 인상 재료는 치과용 광중합형 레진 또는 자가중합형 레진으로, 상기 피시술자의 구강 내에서 중합되는 것을 특징으로 하는 수술 지원 방법.
- 제 6항에 있어서,상기 가이드 모델은, 상기 인상 재료의 상기 구강 본이 형성되는 일면에 형성되는 비닐막을 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 5항에 있어서,상기 d 단계는,상기 가이드 모델의 가이드홀 영역 및 임플란트 수술 도구인 핸드피스 삽입 영역 중 적어도 하나 이상을 설정하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 5항에 있어서,제 c 단계는,상기 정합 CT 이미지의 임플란트 식립 부위에 크라운 객체를 각도 및 크기를 설정하여 배치하는 단계;배치된 크라운 객체를 기준으로 임의의 거리를 이격하여 임플란트 객체를 배치하는 단계; 및상기 임플란트 객체의 종료, 크기, 길이, 위치 및 식립 각도 중 적어도 하나 이상을 설정하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 9항에 있어서,상기 정합 CT 이미지에 배치된 상기 임플란트 객체로부터 뼈까지의 위치, 상기 임플란트 객체로부터 상기 임플란트 식립 부위에 인접된 치아의 뿌리까지의 위치 및 상기 임플란트 객체로부터 신경 사이의 간격 중 적어도 하나 이상에 대한 가이드 정보를 제공하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 10항에 있어서,상기 임플란트 객체의 축과 보철의 중심와의 일치 여부에 대한 가이드 정보 및 상기 임플란트의 슬리브가 치아 또는 치은을 침범했는지 여부에 대한 가이드 정보 중 적어도 하나 이상을 제공하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 1항에 있어서, 상기 c 단계 이후에,상기 정합 CT 이미지를 이용하여 계획된 상기 수술에 사용되는 임플란트의 종류, 크기, 위치 및 방향 중 적어도 하나 이상에 대한 정보를 레포팅하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 제 1항에 있어서, 상기 c 단계 이후에,상기 구강 CT 이미지 또는 상기 정합 CT 이미지를 분석하여 추정한 상기 피시술자의 골밀도 정보 및 상기 임플란트 식립 위치와 신경관의 거리에 대한 정보 중 적어도 하나 이상을 레포팅하는 단계를 포함하는 것을 특징으로 하는 수술 지원 방법.
- 임플란트 수술을 지원하는 시스템에 있어서,인간의 치아를 적어도 하나 이상의 그룹에 속하도록 임의의 범위로 그루핑하고, 해당 그룹의 치아 위치를 커버하도록 일정한 규격에 따라 제작되며, 방사선 불투과성 또는 반투과성 물질로 형성된 마커를 포함하는 가이드 모델;상기 가이드 모델을 피시술자의 구강 내에 삽입한 상태에서 상기 피시술자의 구강 CT 이미지를 촬영하는 CT 촬영 장치; 및상기 가이드 모델의 규격에 대한 정보인 라이브러리를 로딩하고, 상기 구강 CT 이미지에서 상기 마커를 식별하고, 상기 라이브러리에 포함된 마커와 상기 구강 CT 이미지에서 식별된 마커를 기준으로 상기 구강 CT 이미지와 상기 라이브러리를 정합하여 라이브러리 정합 CT 이미지를 생성하며, 상기 라이브러리 정합 CT 이미지를 이용하여 상기 피시술자의 임플란트 수술을 계획하는 서버를 포함하는 것을 특징으로 하는 수술 지원 시스템.
- 제 14항에 있어서, 상기 서버는,상기 피시술자의 임플란트 수술 계획에 따라 상기 가이드 모델을 상기 임플란트 수술에 대한 서지컬 가이드로 가공하기 위하여, 상기 가이드 모델의 가공 영역에 대한 정보를 설정하는 것을 특징으로 하는 수술 지원 시스템.
- 제 15항에 있어서,상기 가이드 모델의 가공 영역에 대한 정보에 따라, 상기 가이드 모델에서 상기 가공 영역을 식각하여 상기 서지컬 가이드로 가공하는 밀링 머신을 더 포함하는 것을 특징으로 하는 수술 지원 시스템.
- 제 14항에 있어서, 상기 서버는,상기 정합 CT 이미지에서 구강의 상악 이미지와 하악 이미지를 임의의 기준에 따라 분리하고, 분리된 상악 이미지와 하악 이미지가 교합될 수 있도록 재구성하여, 상기 정합 CT 이미지에서 상기 가이드 모델의 삽입에 따른 오차를 보정하며,상기 정합 CT 이미지에서, 치아 커브를 설정하고, 하악 신경관을 설정하는 것을 특징으로 하는 수술 지원 시스템.
- 제 14항에 있어서,상기 가이드 모델은, 구강 내부의 인상을 취득하는 인상 재료를 포함하며, 상기 인상 재료를 통해 상기 피시술자의 임플란트 식립 부위에 대한 구강 본이 형성되며,상기 서지컬 가이드는, 상기 가이드 모델을 가공하여 형성되며, 상기 구강 본이 포함되며, 상기 구강 본은 상기 피시술자의 임플란트 식립 부위와 상기 서지컬 가이드의 물리적인 정합 수단으로 기능하는 것을 특징으로 하는 수술 지원 시스템.
- 제 18항에 있어서,상기 가이드 모델은 치과용 광중합형 레진 또는 자가중합형 레진으로 상기 피시술자의 구강 내에서 중합되는 상기 인상 재료를 포함하는 것을 특징으로 하는 수술 지원 시스템.
- 제 18항에 있어서,상기 가이드 모델은, 상기 인상 재료의 상기 구강 본이 형성되는 일면에 형성되는 비닐막을 포함하는 것을 특징으로 하는 수술 지원 시스템.
- 임플란트 수술을 지원하는 서버에 있어서,인간의 치아를 적어도 하나 이상의 그룹에 속하도록 임의의 범위로 그루핑하고, 해당 그룹의 치아 위치를 커버하도록 일정한 규격에 따라 제작되며, 방사선 불투과성 또는 반투과성 물질로 형성된 마커를 포함하는 가이드 모델의 규격에 대한 정보인 라이브러리를 저장하는 저장부;상기 가이드 모델을 피시술자의 구강 내에 삽입한 상태에서 촬영한 상기 피시술자의 구강 CT 이미지에서 상기 가이드 모델의 상기 마커를 식별하고, 상기 라이브러리에 포함된 마커와 상기 구강 CT 이미지에서 식별된 마커를 기준으로 상기 구강 CT 이미지와 상기 라이브러리를 정합하여 라이브러리 정합 CT 이미지를 생성하는 이미지 프로세싱 모듈;상기 라이브러리 정합 CT 이미지를 이용하여 상기 피시술자의 임플란트 수술을 계획하는 임플란트 플래닝 모듈을 포함하는 것을 특징으로 하는 수술 지원 서버.
- 제 21항에 있어서,상기 피시술자의 임플란트 수술 계획에 따라, 상기 가이드 모델을 상기 임플란트 수술에 대한 서지컬 가이드로 가공하기 위하여, 상기 가이드 모델의 가공 영역을 설정하고, 상기 가이드 모델의 가공용 파일을 생성하는 가이드 설계 모듈을 포함하는 것을 특징으로 하는 수술 지원 서버.
- 제21항에 있어서,상기 구강 CT 이미지, 상기 정합 CT 이미지를 이용한 임플란트 플래닝 정보, 및 상기 가이드 모델의 가공용 파일을 미리 설정된 형식으로 변환하는 기능을 수행하는 파일 관리 모듈을 포함하는 것을 특징으로 하는 수술 지원 서버.
- 제 21항에 있어서, 상기 이미지 프로세싱 모듈은,상기 정합 CT 이미지에서 구강의 상악 이미지와 하악 이미지를 임의의 기준에 따라 분리하고, 분리된 상악 이미지와 하악 이미지가 교합될 수 있도록 재구성하여, 상기 정합 CT 이미지에서 상기 가이드 모델의 삽입에 따른 오차를 보정하는 것을 특징으로 하는 수술 지원 서버.
- 제 21항에 있어서,상기 가공용 파일은 상기 가이드 홀의 식각 깊이에 대한 정보가 포함되는 것을 특징으로 하는 수술 지원 서버.
- 제 25항에 있어서, 상기 이미지 프로세싱 모듈은,상기 정합 CT 이미지에서, 치아 커브를 설정하고, 하악 신경관을 설정하는 것을 특징으로 하는 수술 지원 서버.
- 제 22항에 있어서, 상기 가이드 설계 모듈은,상기 가이드 모델의 가이드홀 영역 및 임플란트 수술 도구인 핸드피스 삽입 영역 중 적어도 하나 이상을 설정하는 것을 특징으로 하는 수술 지원 서버.
- 제 21항에 있어서, 상기 임플란트 플래닝 모듈은,상기 정합 CT 이미지의 임플란트 식립 부위에 크라운 객체를 각도 및 크기를 설정하여 배치하고, 배치된 크라운 객체를 기준으로 임의의 거리를 이격하여 임플란트 객체를 배치하고, 상기 임플란트 객체의 종료, 크기, 길이, 위치 및 식립 각도 중 적어도 하나 이상을 설정하는 것을 특징으로 하는 수술 지원 서버.
- 서버에서, 임플란트 수술을 지원하는 기능을 수행하기 위하여 컴퓨터 판독가능한 매체에 저장된 컴퓨터 프로그램에 있어서,인간의 치아를 적어도 하나 이상의 그룹에 속하도록 임의의 범위로 그루핑하고, 해당 그룹의 치아 위치를 커버하도록 일정한 규격에 따라 제작되며, 방사선 불투과성 또는 반투과성 물질로 형성된 마커를 포함하는 가이드 모델을 피시술자의 구강 내에 삽입한 상태에서 촬영한 상기 피시술자의 구강 CT 이미지를 획득하는 기능;상기 가이드 모델의 규격에 대한 정보인 라이브러리를 로딩하고, 상기 구강 CT 이미지에서 상기 마커를 식별하고, 상기 라이브러리에 포함된 마커와 상기 구강 CT 이미지에서 식별된 마커를 기준으로 상기 구강 CT 이미지와 상기 라이브러리를 정합하여 라이브러리 정합 CT 이미지를 생성하는 기능; 및상기 라이브러리 정합 CT 이미지를 이용하여 상기 피시술자의 임플란트 수술을 계획하는 기능을 수행하는 것을 특징으로 하는 컴퓨터 프로그램.
- 제 29항에 있어서,상기 피시술자의 임플란트 수술 계획에 따라, 상기 가이드 모델을 상기 임플란트 수술에 대한 서지컬 가이드로 가공하기 위하여, 상기 가이드 모델의 가공 영역을 설정하는 기능을 수행하는 것을 특징으로 하는 컴퓨터 프로그램.
- 제 29항에 있어서,상기 정합 CT 이미지에서 구강의 상악 이미지와 하악 이미지를 임의의 기준에 따라 분리하는 기능;분리된 상악 이미지와 하악 이미지가 교합될 수 있도록 재구성하여, 상기 정합 CT 이미지에서 상기 가이드 모델의 삽입에 따른 오차를 보정하는 기능을 수행하는 것을 특징으로 하는 컴퓨터 프로그램.
- 제 30항에 있어서,상기 정합 CT 이미지에서, 치아 커브를 설정하는 기능;상기 정합 CT 이미지에서, 하악 신경관을 설정하는 기능;상기 가이드 모델의 가이드홀 영역 및 임플란트 수술 도구인 핸드피스 삽입 영역 중 적어도 하나 이상을 설정하는 기능을 수행하는 것을 특징으로 하는 컴퓨터 프로그램.
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