WO2022060017A1 - Dispositif et procédé pour déterminer la précision d'un guide de chirurgie d'implant - Google Patents

Dispositif et procédé pour déterminer la précision d'un guide de chirurgie d'implant Download PDF

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Publication number
WO2022060017A1
WO2022060017A1 PCT/KR2021/012365 KR2021012365W WO2022060017A1 WO 2022060017 A1 WO2022060017 A1 WO 2022060017A1 KR 2021012365 W KR2021012365 W KR 2021012365W WO 2022060017 A1 WO2022060017 A1 WO 2022060017A1
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WIPO (PCT)
Prior art keywords
image data
implant
implant surgery
surgery guide
accuracy
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PCT/KR2021/012365
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English (en)
Korean (ko)
Inventor
김종은
임정화
Original Assignee
연세대학교 산학협력단
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Publication of WO2022060017A1 publication Critical patent/WO2022060017A1/fr

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    • 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
    • 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
    • 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
    • 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
    • A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
    • 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
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
    • 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
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • 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 an apparatus and method for determining accuracy of an implant surgical guide.
  • it relates to an apparatus for determining the accuracy of an implant surgery guide and a method for determining the accuracy of an implant surgical guide while omitting the actual placement process of the implant.
  • the implant surgery guide is a tool that helps to move the ideal implant placement position to the actual implant surgery site. It can be created using In addition, as 3D printers are widely used in recent years, the production of implant surgical guides using a lamination method has become popular, making it possible to produce them quickly compared to the existing production methods.
  • the present invention relates to this.
  • the technical problem to be solved by the present invention is to provide an apparatus and method for determining accuracy of an implant surgery guide that can determine the accuracy while omitting the actual placement process of the implant in determining the accuracy of the manufactured implant surgery guide.
  • Another technical problem to be solved by the present invention is to dramatically reduce the time required to determine the accuracy of the manufactured implant surgery guide and simplify the research process by determining the accuracy while omitting the actual placement process of the implant. It is to provide an implantable surgical guide accuracy determination device and determination method.
  • Another technical problem to be solved by the present invention is to eliminate the scattering according to the specificity of the CBCT data by not using the CBCT data taken after actually completing the implant placement for the patient as the actual placement process of the implant is omitted. It is to provide an apparatus and method for determining the accuracy of an implant surgery guide in which distortion of the result value may not occur.
  • Another technical problem to be solved by the present invention is that by determining the accuracy while omitting the actual placement process of the implant, various factors that can bias the research results, such as differences according to the physiological characteristics of the patient and the clinician's experience It is to provide an implant surgical guide accuracy determination device and determination method that can be removed.
  • Another technical problem to be solved by the present invention is to determine in advance the possibility of implant placement in a direction that the clinician does not want due to manufacturing error of the implant surgery guide by determining the accuracy while omitting the actual placement process of the implant. It is to provide an apparatus and method for determining the accuracy of an implant surgery guide.
  • the implant surgery guide accuracy determination method for achieving the above technical problem is (a) the implant surgery guide accuracy determination device is a first scan body (Scan Body) is inserted into the sleeve Performing an alignment to match the reference image data and three-dimensional position information with respect to the first image data scanned on the teeth mounted with the implanted surgical guide, (b) the implant surgery guide accuracy determination device is the reference image data and Generating second image data in which the first scan body image data included in the first image data matched with the three-dimensional position information is replaced with either the second abutment image data or the second implant fixture image data, (c) ) performing, by the implant surgery guide accuracy determination device, best-fit alignment based on the coordinate values of the teeth with respect to the second image data and the reference image data, and (d) the implant surgery guide accuracy determination device is the best and determining the accuracy of the implant surgical guide by analyzing the second image data and the reference image data on which the fit alignment is performed.
  • the implant surgery guide accuracy determination device is a first scan body (Scan Body)
  • the teeth may be any one of a patient's real teeth and a tooth model manufactured by imitating the patient's real teeth.
  • the first image data and the second image data are in any one of STL (STereoLithography), DCM, OBJ, and PLY format that holds 3D position information for each of all objects included It may be a single data file.
  • STL STereoLithography
  • DCM DCM
  • OBJ OBJ
  • PLY format that holds 3D position information for each of all objects included It may be a single data file.
  • the reference image data is image data of a state in which the first abutment image data indicating the implant placement position clinically determined by the doctor for the tooth generated on the implant planning program is designed and the implant planning program
  • the first implant fixture image data indicating the implant placement position clinically determined by the doctor with respect to the generated tooth may be any one of the image data in the designed state.
  • the implant surgery guide accuracy determination device 3D modeling the first abutment 3D modeled image data, and (a) ⁇ 0′) may further include any one or more of the step of storing, by the implant surgery guide accuracy determination device, image data obtained by 3D modeling the first implant fixture as the second implant fixture image data.
  • the implant surgery guide accuracy determination device is any one of the second abutment image data or the second implant fixture image data on the first image data loading, (b-2) of the first scan body image data and the second abutment image data or the second implant fixture image data included in the first image data from the user by the implant surgery guide accuracy determination device Receiving a point for any one alignment, (b-3) the first scan body image data included in the first image data based on the received point by the implant surgery guide accuracy determination device; Aligning and replacing any one of the second abutment image data or the second implant fixture image data, and (b-4) the implant surgical guide accuracy determination device is the second abutment image data or the second implant fixture image It may include any one or more of the steps of generating second image data in which the implant surgery guide image data included in the first image data in which any one of the data is substituted is deleted.
  • the implant surgery guide accuracy determination device performs the implant surgery based on the three-dimensional position information of the second abutment image data included in the second image data. Based on the three-dimensional position information of the third implant fixture to be implanted using the guide and the three-dimensional position information of the first abutment image data included in the reference image data, the fourth implant planned according to the clinical judgment of the clinician Calculating the three-dimensional position information of the implant fixture and (d-2) the three-dimensional position information of the third implant fixture and the fourth implant fixture calculated by the implant surgery guide accuracy determination device It may include any one or more of the steps of analyzing items for determining the accuracy of the implant surgery guide using
  • the item for determining the accuracy of the implant surgery guide may be any one or more of a deviation of an angle between the axes of the third implant fixture and the fourth implant fixture, a distance between points, and a depth.
  • the implant surgery guide accuracy determination device further comprises the step of transmitting the accuracy determination result of the implant surgery guide to an implant planning program or implant surgery guide production program can do.
  • the first scan body includes a stopper part having a predetermined diameter, disposed on one surface of the stopper part, an upper body part having a diameter less than the predetermined diameter, and the other surface of the stopper part, and a lower body portion having a diameter less than the diameter.
  • the stopper part may include a plurality of grooves disposed on one surface to a predetermined depth.
  • the upper body part may include a flat part perpendicular to one surface of the stopper part.
  • Implant surgery guide accuracy determination device for achieving the above technical problem is one or more processors, a network interface, a memory and large-capacity network data for loading a computer program performed by the processor, and Including storage for storing the computer program, wherein the computer program is a first image scanned by the one or more processors (A) a first scan body (Scan Body) of a dental implant surgery guide inserted into the sleeve An operation of performing alignment to match the reference image data and 3D position information on the data, (B) first scan body image data including the first image data matching the reference image data and 3D position information 2 An operation of generating second image data substituted with either the abutment image data or the second implant fixture image data, (C) Best based on the coordinate values of the teeth with respect to the second image data and the reference image data An operation for performing fit alignment and (D) an operation for determining the accuracy of the implant surgery guide by analyzing the second image data and reference image data on which the best-fit alignment is performed are executed.
  • A a first scan
  • a computer program stored in a medium according to another embodiment of the present invention for achieving the above technical problem is combined with a computing device, (AA) a first scan body (Scan Body) mounted with an implant surgical guide inserted into the sleeve Aligning the first image data of scanned teeth with reference image data and three-dimensional position information, (BB) the first image data including the reference image data and three-dimensional position information matching the first image data 1 generating second image data in which the scan body image data is substituted with either the second abutment image data or the second implant fixture image data, (CC) of the tooth with respect to the second image data and the reference image data Performing the best-fit alignment based on the coordinate value and (DD) analyzing the second image data and the reference image data on which the best-fit alignment is performed to determine the accuracy of the implant surgery guide.
  • a computing device a computing device, (AA) a first scan body (Scan Body) mounted with an implant surgical guide inserted into the sleeve Aligning the first image data of scanned teeth with
  • the first scan body scans the patient's teeth with the implant surgery guide inserted into the sleeve, the first image data scanned and the patient's teeth generated on the implant planning program. Since the first abutment image data indicating the implant placement position clinically determined by the doctor or the first implant fixture image data is used only the reference image data, which is the image data in the designed state, the actual placement process of the implant can be omitted. , it can dramatically shorten the time required to determine the accuracy of the implant surgical guide and at the same time simplify the research process. It has the effect of being able to check.
  • the CBCT data taken after the implant placement is actually completed in the patient is not used, and at the same time, the second abutment image data, which is image data obtained by 3D modeling the second abutment, or image data obtained by 3D modeling the second implant fixture, is not used. 2
  • the implant fixture image data it has the effect of removing the distortion caused by scattering due to the specificity of the CBCT data and fundamentally blocking the factors that interfere with the accuracy determination of the implant surgery guide, so that an accurate determination can be made.
  • the determined accuracy of the implant surgery guide is transmitted to the implant planning program or implant surgery guide production program, it is treated as a kind of big data related to the production of the implant surgery guide and can be used as data contributing to the production of an ideal implant surgery guide. .
  • FIG. 1 is a view showing the overall configuration included in the implant surgery guide accuracy determination device according to a first embodiment of the present invention.
  • FIG. 2 is a flowchart illustrating representative steps of a method for determining accuracy of an implant surgical guide according to a second embodiment of the present invention.
  • FIG. 3 is a diagram exemplarily illustrating a first scan body.
  • FIG. 4 is a view exemplarily showing first image data including the implant surgery guide and the first scan body mounted on the patient's tooth model.
  • 5 and 6 are diagrams exemplarily illustrating a state in which three-dimensional position information of the first image data and the reference image data are matched.
  • step S220 is a flowchart illustrating specific steps included in step S220.
  • FIGS. 8 to 10 are diagrams exemplarily illustrating a process of generating second image data.
  • FIG. 11 is a diagram exemplarily illustrating second image data.
  • step S240 is a flowchart illustrating specific steps included in step S240.
  • 13 is an exemplary view attached to contribute to the explanation of the principle of calculating the three-dimensional position of the implant fixture to be implanted from the three-dimensional position information of the scan body.
  • FIG. 14 is an exemplary view of determining the accuracy of the implant surgery guide using the three-dimensional position information of the third implant fixture and the three-dimensional position information of the fourth implant fixture together with the items for determining the accuracy of the implant surgery guide It is a drawing shown as
  • FIG. 1 is a view showing the overall configuration included in the implant surgery guide accuracy determination apparatus 100 according to a first embodiment of the present invention.
  • the implant surgery guide accuracy determination apparatus 100 includes a processor 10 , a network interface 20 , a memory 30 , a storage 40 , and a data bus 50 connecting them can do.
  • the processor 10 controls the overall operation of each component.
  • the processor 10 may be any one of a central processing unit (CPU), a micro processor unit (MPU), a micro controller unit (MCU), or a type of processor widely known in the art to which the present invention pertains.
  • the processor 10 may perform an operation for at least one application or program for performing the implant surgery guide accuracy determination method according to the second embodiment of the present invention.
  • the network interface 20 supports wired/wireless Internet communication of the implant surgery guide accuracy determination apparatus 100 according to the first embodiment of the present invention, and may support other known communication methods. Accordingly, the network interface 20 may be configured to include a corresponding communication module.
  • the memory 30 stores various data, commands and/or information, and loads one or more computer programs 41 from the storage 40 to perform the implant surgery guide accuracy determination method according to the second embodiment of the present invention. can do.
  • RAM is illustrated as one of the memories 30 in FIG. 1 , it goes without saying that various storage media can be used as the memory 30 .
  • the storage 40 may non-temporarily store one or more computer programs 41 and large-capacity network data 42 .
  • the storage 40 is a non-volatile memory, such as a read only memory (ROM), an erasable programmable ROM (EPROM), an electrically erasable programmable ROM (EEPROM), a flash memory, a hard disk, a removable disk, or in the art to which the present invention pertains. It may be any one of widely known computer-readable recording media.
  • the computer program 41 is loaded into the memory 30, and (A) a first scan body scans a tooth equipped with an implant surgical guide inserted in a sleeve by one or more processors 10 An operation of performing an alignment to match the reference image data and the three-dimensional position information on the image data, (B) the first scan body image data included in the first image data aligned with the reference image data to the second abutment An operation for generating second image data substituted with either image data or second implant fixture image data, (C) Best-fit alignment based on the coordinate values of the teeth with respect to the second image data and the reference image data and (D) an operation for determining the accuracy of the implant surgery guide by analyzing the second image data and the reference image data on which the best-fit alignment is performed.
  • the data bus 50 serves as a movement path for commands and/or information between the processor 10 , the network interface 20 , the memory 30 , and the storage 40 described above.
  • the implant surgery guide accuracy determination apparatus 100 may be an independent device, and more specifically, may be a tangible physical server or an intangible cloud server.
  • the computer program 41 will be a core configuration for executing the above-mentioned operation, and the server may have a known implant planning program, an implant surgery guide production program, etc. installed together, and the above-mentioned operation It may be implemented as a function of the known implant planning program, implant surgery guide production program, and the like.
  • the implant surgery guide accuracy determination apparatus 100 includes a display unit (not shown) itself or an external display device (not shown). ) to output image data.
  • FIG. 2 is a flowchart illustrating representative steps of a method for determining accuracy of an implant surgical guide according to a second embodiment of the present invention.
  • reference image data for the first image data in which the guide accuracy determination apparatus 100 scans a tooth equipped with an implant surgery guide 300 in which the first scan body 200 is inserted into the sleeve 350 and alignment are performed to match the 3D position information (S210).
  • the first scan body 200 is a dental tool used for digital image data acquisition by connecting to an implant fixture to be placed on the patient's gums. Using the location information, the implant placement location, direction, and depth information can be guided.
  • the first scan body 200 is illustrated in FIG. 3 by way of example. Referring to FIG. 3 , the first scan body 200 is disposed on one surface of the stopper part 220 and the stopper part 220 having a predetermined diameter. , is disposed on the other surface of the upper body portion 240 and the stopper portion having a diameter less than a predetermined diameter, the lower body portion 260 having a diameter less than a predetermined diameter can be confirmed.
  • the stopper unit 220 includes a plurality of grooves 222 disposed on one surface to a predetermined depth.
  • the grooves 222 are six. It may be one, and by having the longest diameter among the components of the first scan body 200, when inserted into the sleeve 350 included in the implant surgical guide 300, only the lower body part 260 is inserted and the upper body part ( 240) serves as a stopper that prevents the insertion.
  • the upper body 240 is a configuration that is exposed to the outside when the first scan body 200 is inserted into the sleeve 350. Since it is a part exposed to the scanner for imaging, when it is made of metal, it is polished by sandblasting. can be removed, and it can be implemented as a material with excellent abrasion resistance, deformation, strength, etc.
  • the upper body portion 240 includes a flat portion 242 perpendicular to one surface of the stopper portion 220, and the existence of the flat portion 242 determines the alignment of scan and second scan body image data to be described later. It may serve as a guide for confirming the insertion direction of the first scan body 200 while increasing the accuracy.
  • the lower body part 260 is configured to be inserted into the sleeve 350 without being exposed to the outside when the first scan body 200 is inserted into the sleeve 350 , and is exposed to the outside while being inserted into the sleeve 350 .
  • the material can also be implemented with a different material, but in consideration of the convenience of manufacture, the upper body part 240 and the lower body part ( 260) can be implemented integrally, and in this case, the lower body part 260 is also sandblasted to remove gloss or abrasion resistance, deformation, such as pecton, which is a new material of a photocurable polymer or high molecular polymer series. It can be implemented with a material with excellent strength and the like.
  • the diameters of the upper body part 240 and the lower body part 260 described above are less than the diameter of the stopper part 220 , and the diameter of the upper body part 240 and the diameter of the lower body part 260 are the same. In a state not to do so, for example, if the diameter of the upper body part 240 exceeds the diameter of the lower body part 260 or vice versa, it is irrelevant if it is less than the diameter of the stopper part 220. will be.
  • the length of the upper body part 240 and the stopper part 220 is not limited, but in the case of the lower body part 260, the first scan body 300 can be fixed to the sleeve 350 in a state in which the patient If it is not long enough to contact the gingiva of the tooth model or the gingiva of the tooth model, it will be sufficient.
  • the stopper part 220 when the upper body part 240 and the lower body part 260 are integrally implemented, the stopper part 220 must be disposed near the center of the integrally implemented body part, so the stopper part 220 is the upper body part ( 240) and a separate hole (not shown) through which the lower body part 260 can be penetrated, and the diameter of the hole is a state in which the upper body part 240 and the lower body part 260 are penetrated. It will have to approximate the diameter of the upper body 240 and the lower body 260 to the extent that it does not move in the .
  • the first image data is image data obtained by scanning teeth in which the first scan body 200 is mounted with the implant surgery guide 300 inserted into the sleeve 350, and more specifically, each of the objects included therein. It may be a data file of any format that holds three-dimensional position information about It may be any one of dental models manufactured by imitating real teeth.
  • the first image data can be obtained through the intraoral scanner. After scanning the area to be implanted and the surrounding teeth, the first scan body 200 is inserted into the implant surgery guide 300 . After mounting and scanning the surroundings including the first scan body 200 once more, it takes a certain amount of time to finish by scanning the antagonist and occlusal state. It will be said that it is desirable to acquire the first image data using a table-top scanner for a tooth model manufactured by imitating a patient's actual teeth as shown in FIG.
  • the implant surgery guide 300 may be a pre-fabricated implant surgery guide 300 designed through a known implant planning program or an implant surgery guide production program before step S210 and manufactured through any one of various methods, FIG. 4 . It can be seen that the first image data including the implant surgery guide 300 and the first scan body 200 mounted on the patient's tooth model is shown as an example.
  • the first image data of the first scan body 200 scanning the teeth with the implant surgery guide 300 inserted into the sleeve 350 must match the reference image data and the three-dimensional position information, where the reference image
  • the data is image data of a state in which the first abutment image data indicating the implant placement position determined clinically by the doctor for the tooth generated on the known implant planning program is designed, and the implant surgery guide 300 is based on the accuracy determination It can be seen as data that becomes this data, and unlike the first image data, the implant surgery guide 300 is not included, but the STL that holds three-dimensional position information for each of all objects that are included in the same way as the first image data. , DCM, OBJ, and PLY format.
  • the reference image data is used by the doctor for the tooth generated on the known implant planning program.
  • the first implant fixture image data indicating the implant placement position determined by The implant fixture image data will be determined, and the following reference image data will continue the description on the premise that the first abutment image data is the image data of the designed state.
  • the guide accuracy determination apparatus 100 When loading the first image data (red, ⁇ shape) and reference image data (yellow, ⁇ shape), the direction and arrangement angle may be different as shown in FIG. 5 due to the characteristics of a three-dimensional image, In this state, proceeding with a subsequent process for accuracy determination is likely to reduce the accuracy of determination, so the three-dimensional position information of the first image data and the three-dimensional position information of the reference image data, more specifically, the reference image data
  • the state as shown in FIG. 6 is created by matching the 3D position information of the first image data based on .
  • matching the 3D position information can be understood as a kind of alignment in which all objects included in the first image data and all objects included in the reference image data are facing the same direction and arrangement angle. There will be.
  • the guide accuracy determination apparatus 100 compares the first scan body image data included in the first image data that matches the reference image data and the three-dimensional position information Generates second image data substituted with the second abutment image data (S220).
  • the second image data may be a data file of any one of STL, DCM, OBJ, and PLY formats that holds three-dimensional position information for each of the objects that are included in the same way as the first image data and reference image data, , although both the first image data and the second image data are data, since the substance is to output a specific object as a three-dimensional image, the first scan body image data output on the first image data is converted into the second abutment image data in some way The question is whether to convert to .
  • the second abutment image data means the image data in which the guide accuracy determination device 100 stores the image data obtained by 3D modeling the second abutment bar, Accordingly, before the step S210, the guide accuracy determination apparatus 100 stores the image data obtained by 3D modeling the second abutment as the second abutment image data (205) may be performed.
  • the first scan body image data output on the first image data is a scan image of a state in which the first scan body 200 is inserted into the sleeve 350 included in the implant surgery guide 300, the second abutment image
  • the data is image data obtained by 3D modeling the second abutment, and the reason why it needs to be replaced is because the first scan body image data is image data obtained through the actual scanning process, so there may be an incompletely scanned area. 2
  • the abutment image data is image data completed through 3D modeling rather than scanning, so there is no possibility that an incomplete area exists.
  • step S220 is a flowchart illustrating specific steps included in step S220.
  • the guide accuracy determination apparatus 100 loads the second abutment image data on the first image data (S220-1).
  • Fig. 8 shows an exemplary view in which the second abutment image data is loaded on the first image data
  • the first image data refers to the first image data in which the reference image data and the three-dimensional position information are matched in step S210 and the loaded second abutment image data may be loaded at an arbitrary point on the first image data, for example, on the opposite side of the vicinity of the right molar in which the first scan body 200 is disposed as shown in FIG. 8 .
  • the guide accuracy determination device 100 receives a point (Point, P) for aligning the first scan body image data and the second abutment image data included in the first image data from the user do (S220-2).
  • step S210 the alignment of the three-dimensional position information is required to replace the image data, and the first image data and the second abutment image data differ from the first image data and the reference image data because the objects they contain are different. This is because a point (P) that can be a reference point for alignment is required.
  • This point P can be received from the user, and the reception from the user is through an input unit (not shown) included in the guide accuracy determination apparatus 100 or an external input means (not shown) connected thereto, for example, It can be received through a mouse, keyboard, etc., and when the processor 10 included in the guide accuracy determination device 100 is an artificial intelligence image processing processor, the processor 100 itself aligns the point P without receiving from the user. ) can be selected.
  • FIG. 9 can confirm that the point P received from the user is additionally shown on the exemplary drawing in which the second abutment image data is loaded on the first image data shown in FIG. 8 .
  • the guide accuracy determination apparatus 100 aligns and replaces the first scan body image data and the second abutment image data included in the first image data based on the received point (P) ( S220-3).
  • the second abutment image data may be aligned and replaced on the first scan body image data included in the first image data by the point P received in step S220-2, where the substitution is the first scan body image data It may mean both the deletion of , or the overwriting of the second abutment image data on the first scan body image data.
  • FIG. 10 is a view showing a state in which the first scan body image data is aligned with the second abutment image data based on the point P shown in FIG. 9 and is substituted. Compared with FIG. 9, the second abutment image data 1 It can be seen that the scan body has moved to the location of the image data.
  • the guide accuracy determination device 100 If the replacement was performed, the guide accuracy determination device 100 generates second image data in which the implant surgery guide image data including the first image data in which the second abutment image data is replaced is deleted (S220-4).
  • the implant surgery guide 300 is a dental tool for maintaining the inserted state of the scan body in the sleeve 350 in order to move the ideal implant placement position to the actual surgical site. If the 3D position information is confirmed, it may be deleted from the first image data, and only when it is deleted, the operation S240, which will be described later, can be easily performed.
  • the reason why the patient's tooth model is not removed is because the reference image data includes the image data of the patient's teeth, which will be described later in step S230.
  • the second image data generated by removing the implant surgery guide image data from the drawing shown in FIG. 11 is exemplarily shown in FIG. It can be seen that a second abutment is placed on the gum.
  • the above description is based on the premise that the reference image data is image data in a state in which the first abutment image data is designed, and the first implant fixture image data, not the first abutment image data, on the known implant planning program. If it can be loaded immediately, the reference image data may be image data in a state in which the image data of the first implant fixture is inserted, and in this case, the second abutment mentioned in the above description is the second implant fixture, and the second abutment image data may be changed to the second implant fixture image data.
  • the guide accuracy determining apparatus 100 performs Best Fit alignment with respect to the second image data and the reference image data based on the coordinate values of the teeth (S230).
  • Best-fit alignment is one of the well-known algorithms used in analysis programs, and refers to alignment that automatically sets the position where the error between two pieces of data is minimal.
  • the second image data and the reference image data commonly include the image data of the patient's teeth, and the object that both data individually includes through the second image data and the reference image data, more specifically, the second image data. Since it is necessary to compare the second abutment image data included in the image data and the first abutment image data included in the reference image data, it is preferable to perform best-fit alignment based on the coordinate values of the image data of the patient's teeth that are included in common. , if the best-fit alignment is performed based on this, the two data may be arranged in a state in which the error between the second image data and the reference image data is minimized.
  • the guide accuracy determination apparatus 100 analyzes the second image data and the reference image data on which the best-fit alignment is performed to determine the accuracy of the implant surgery guide 300 (S240).
  • the reference image data outputs the first abutment image data indicating the implant placement position determined clinically by the doctor, and the second image data is a second abutment that can present the ideal implant placement position through the implant surgery guide 300 . Since the image data is output, it is possible to determine the accuracy of the implant surgery guide 300 by analyzing it. Hereinafter, it will be described with reference to FIGS. 12 to 14 .
  • step S240 is a flowchart illustrating specific steps included in step S240.
  • the guide accuracy determination device 100 is based on the three-dimensional position information of the second abutment image data included in the second image data, the three-dimensional position information and reference of the third implant fixture to be implanted using the implant surgery guide. Based on the three-dimensional position information of the first abutment image data included in the image data, the three-dimensional position information of the fourth implant fixture, which is planned to be implanted, is calculated according to the clinical judgment of the clinician (S240-1).
  • both the second image data and the reference image data contain only the abutment image data, not the image data of the implant fixture to be placed the actual implant, the three-dimensional position information of the implant fixture to be placed is determined based on the abutment image data. can be calculated.
  • the three-dimensional position of the implant fixture is inevitably related to the three-dimensional position of the scan body, and shares the central axis and the central axis of the scan body, but It is possible to calculate a three-dimensional position for this in consideration of the diameter, height, and the like, and the implant fixture is not actually output on the guide accuracy determination apparatus 100 .
  • step S240-1 does not allow direct extraction of implant fixture image data from a known implant surgery guide production program, for example, an implant studio, but the position of the abutment that can be made from the implant placed in that location. This is because only the implemented shape is allowed to be extracted, and if the implant surgery guide production program that allows to directly extract the shape of the implant fixture, for example, the reference image data includes the first implant fixture image data, a separate Without calculating the 3D position information, the 3D position information of the corresponding implant fixture may be used as it is.
  • step S240-1 can be expressed as projecting the three-dimensional position information of the scan body onto the gum part, because it is possible to calculate the three-dimensional position information that can reproduce the virtual implant fixture, as shown in FIG. As such, it will not separately output the actual implant fixture.
  • the guide accuracy determination device 100 calculates the three-dimensional position information of the third implant fixture and the fourth implant height.
  • An item for determining the accuracy of the implant surgery guide 300 is analyzed using the three-dimensional position information of the stasis (S240-2).
  • the three-dimensional position information of the third implant fixture indicates the ideal implant placement position presented through the guide 300 for implant surgery
  • the three-dimensional position information of the fourth implant fixture includes an implant planning program or an implant surgery guide production program. Since the clinical decision by the clinician indicates the planned implant placement position, when the 3D position information of the third implant fixture and the 3D position information of the fourth implant fixture are analyzed, the accuracy of the implant surgery guide 300 is can be determined. This is because it is possible to confirm the degree of difference from the clinically determined placement position by the doctor.
  • the item for determining the accuracy of the implant surgical guide may be any one or more of the angle ( ⁇ ) between the axes of the third implant fixture and the fourth implant fixture, the distance between points (d), and the deviation (v) of the length. And, as shown in FIG. 13 for better understanding in FIG. 14, these items are shown together with the implant fixture.
  • the guide accuracy determination device 100 transmits the accuracy determination result of the implant surgery guide 300 to the implant planning program or the implant surgery guide production program (S250).
  • step S240 the smaller the angle ⁇ between the axes of the third implant fixture and the fourth implant fixture, the closer the distance d between the points, the smaller the deviation v of the implant.
  • the accuracy of the surgical guide 300 is determined to be high, and in the opposite case it is determined to be low. you will be able to use
  • the first scan body 200 scans the patient's teeth equipped with the implant surgery guide 300 inserted into the sleeve and the implant planning program.
  • the actual implantation process of the implant because only the first abutment image data or the first implant fixture image data indicating the implant placement position determined clinically by the doctor with respect to the patient's teeth created in the above image data is used, which is the image data in the designed state. can be omitted, dramatically shortening the time required to determine the accuracy of the implant surgical guide, and at the same time simplifying the research process.
  • the possibility of implantation can be confirmed in advance.
  • the implant by omitting the actual placement process of the implant, it is possible to block the occurrence of differences due to the inability to correct the implantation direction due to the bone density or anatomical structure of the patient's gums or the clinician's experience performing implant surgery. Accuracy may be considered in determining the accuracy of the surgical guide 300 .
  • the CBCT data taken after the implant placement is actually completed in the patient is not used, and at the same time, the second abutment image data, which is image data obtained by 3D modeling the second abutment, or image data obtained by 3D modeling the second implant fixture, is not used.
  • the implant fixture image data By using the implant fixture image data, it is possible to make an accurate decision by removing the distortion caused by scattering due to the specificity of the CBCT data and fundamentally blocking the factors that interfere with the accuracy determination of the implant surgery guide.
  • the accuracy of the determined implant surgery guide 300 is transmitted to the implant planning program or the implant surgery guide production program, which is treated as a kind of big data related to the implant surgery guide 300 production, making the ideal implant surgery guide 300 It can be used as a material that contributes to
  • the implant surgery guide accuracy determination apparatus 100 according to the first embodiment of the present invention and the implant surgery guide accuracy determination method according to the second embodiment of the present invention are the same technical It can be implemented as a computer program stored in the medium according to the third embodiment of the present invention including features.
  • the computer program stored in the medium is combined with the computing device, (AA) the reference image data and the first image data for scanning the teeth with the implant surgical guide inserted in the sleeve with the first scan body (Scan Body) inserted into the sleeve.

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Abstract

Conformément à un mode de réalisation, la présente invention concerne un procédé pour déterminer la précision d'un guide de chirurgie d'implant, lequel procédé comprend les étapes dans lesquelles un dispositif pour déterminer la précision d'un guide de chirurgie d'implant : (a) effectue un alignement pour mettre en correspondance des données d'image de référence et des informations de position tridimensionnelle avec des premières données d'image obtenues à la suite du balayage, par un premier corps de balayage, d'une dent sur laquelle est monté un guide chirurgical d'implant inséré dans un manchon ; (b) génère des secondes données d'image dans lesquelles des premières données d'image de corps de balayage incluses dans les premières données d'image correspondant aux données d'image de référence et aux informations de position tridimensionnelle sont remplacées soit par des secondes données d'image de pilier, soit par des secondes données d'image de corps d'implant ; (c) effectue un alignement de meilleur ajustement pour les secondes données d'image et les données d'image de référence sur la base des coordonnées de la dent ; et (d) détermine la précision du guide de chirurgie d'implant en analysant les secondes données d'image et les données d'image de référence sur lesquelles l'alignement de meilleur ajustement a été effectué.
PCT/KR2021/012365 2020-09-18 2021-09-10 Dispositif et procédé pour déterminer la précision d'un guide de chirurgie d'implant WO2022060017A1 (fr)

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