WO2022170928A1 - Système de diagnostic et de traitement microscopique dentaire - Google Patents

Système de diagnostic et de traitement microscopique dentaire Download PDF

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Publication number
WO2022170928A1
WO2022170928A1 PCT/CN2022/072541 CN2022072541W WO2022170928A1 WO 2022170928 A1 WO2022170928 A1 WO 2022170928A1 CN 2022072541 W CN2022072541 W CN 2022072541W WO 2022170928 A1 WO2022170928 A1 WO 2022170928A1
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Prior art keywords
module
data
display
digital image
image
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PCT/CN2022/072541
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English (en)
Chinese (zh)
Inventor
李剑月
杜雷
王吉龙
何进
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苏州速迈医学科技股份有限公司
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Publication of WO2022170928A1 publication Critical patent/WO2022170928A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/06—Implements for therapeutic treatment
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition

Definitions

  • the invention relates to the technical field of dental diagnosis and treatment, in particular to a dental microscopic diagnosis and treatment system.
  • the microscopic field of view is narrow, the equipment is difficult to locate under the microscope, and the external communication between patients and nurses is inconvenient.
  • the field of view of a surgical microscope is small, especially when viewing at high magnifications. When the surgical instruments are moved from the field of view outside the scope into the field of view under the scope, the positioning is difficult, and the doctor needs to grope and try, or remove the head to observe directly.
  • the cavity in the middle of the tooth contains soft tissue called the pulp.
  • the upper part of the cavity is wide, called the pulp cavity, and the lower part has a tubular root canal, which leads to the blood vessels of the tooth nerve and the nutrient nerve. Infection of the dental pulp can cause pain, infection of the jawbone, and eventually weaken the tooth due to the death of the dental nerve.
  • root canal treatment the doctor needs to completely open the pulp cavity, find and treat all the root canals.
  • Humans generally have 1-4 root canals per tooth, with the most root canals in the posterior teeth. Multiple root canal teeth are often difficult to find due to ageing changes or the deposition of reparative dentin, or pulp stone, or pulp cavity calcification, or root canal morphological variation, etc.
  • Stereoscopic anatomy understand and see the anatomy of the pulp cavity from all directions and positions; and use the X-ray films taken by various angle projection methods to understand and indicate the number, shape, position and direction of the root and root canal and curvature; root-to-crown relationship; possible variations in root and root canal anatomy.
  • the root canal needs to be estimated.
  • the essential collar is used to expose the position of the root canal orifice, that is, if there is calcification of the root canal orifice, it is even more necessary for the doctor to repeatedly test the possible positions, which will inevitably remove too much healthy tooth tissue.
  • preoperative dental films are often used to help doctors judge and determine the number and shape of root canals.
  • doctors need to devote part of their energy to memorizing the shape of root crowns, and even suspend the operation to look at the dental films.
  • the dental film is only a two-dimensional plane image, it cannot accurately reflect the three-dimensional shape of the root canal.
  • many root canals have multiple bends in the direction, which cannot be accurately positioned by the dental film.
  • the application proposes a dental microscopic diagnosis and treatment system, and the specific scheme is as follows:
  • a dental microscopic diagnosis and treatment system comprising a microscopic observation module, a 3D imaging module and an AR display module, the microscopic observation module is used to observe a target object to be observed; the 3D imaging module is used to collect the display in real time.
  • the micro-observation module observes the optical image under the microscope in the field of view, and converts the optical image under the microscope into a three-dimensional digital image;
  • the AR display module is worn on the operator's head and is used to receive the three-dimensional image output by the 3D imaging module. digital images, and convert the three-dimensional digital images into optical images for presentation in the operator's field of vision.
  • the storage module stores a digital image of the radiation imaging three-dimensional structure of the target object
  • the image split-screen display module is used to digitally display the radiation imaging three-dimensional structure of the target object.
  • the image is displayed in the set position in the display area of the AR display module in the form of an optical image.
  • the digital image switch of the radiation imaging three-dimensional structure is controllable, and the operator can choose to view the layered two-dimensional image or the 3D image of the target object as required.
  • the image recognition processing module is used to identify the biological features in the three-dimensional digital image, and through the comparison of the biological features, it is displayed at a set position in the display area of the AR display module.
  • the microscopic observation module is provided with a large zoom objective lens and a magnification system, and the detection module is used to detect the focus position of the large zoom objective lens and the zoom system respectively.
  • the image recognition processing module determines the depth position of the radiation imaging three-dimensional structure digital image according to the focus position of the zoom large objective lens detected by the detection module, and the image recognition processing module determines the depth position of the digital image of the radiation imaging three-dimensional structure according to the detection module.
  • the detected magnification of the zoom system determines the depth range in which the radiographic three-dimensional structure digital image displays the current layer region.
  • the radiation imaging three-dimensional structure digital image is displayed at the edge of the display area of the AR display module, or the radiation imaging three-dimensional structure digital image and the three-dimensional digital image are overlapped and displayed, and the radiation imaging three-dimensional structure digital image is displayed.
  • the transparency is adjustable.
  • the positioning and navigation detection module is used to detect the depth and spatial position data of the surgical instrument in real time
  • the image recognition processing module Compare the depth and spatial position data collected by the positioning navigation detection module with the biological features in the three-dimensional digital image to obtain real-time relative position data between the surgical instrument and the target object, and display it on the AR display The set position within the module display area.
  • the depth and spatial position data of the surgical instrument and the status data of the surgical instrument are stored in the storage module in real time, and the status data of the surgical instrument can be displayed in the display area of the AR display module. Set the location.
  • the storage module also stores patient information data, root tester data, oral scanner data, electronic periodontal probe data and pulp vitality data.
  • the required data is displayed at a set position within the display area of the AR display module.
  • each data is displayed in the set position in the display area of the AR display module in the form of a text symbol, a data table, a two-dimensional curve or a three-dimensional topographic map, and each data is divided into screens in the display area of the AR display module. Display, or switch the display in the same window, the display transparency of each data and the size and position of the display window of each data can be adjusted.
  • the switch of the AI-assisted analysis module is controllable, the operator can choose to turn on or off the AI-assisted function according to needs, and the AI-assisted analysis module is used for the 3D imaging module.
  • the three-dimensional digital image is analyzed to identify the lesion condition of the target object, and mark or remind the target object according to the lesion condition.
  • the data stored in the storage module is summarized and analyzed to form additional AI auxiliary information displayed on the AR. Displays the set position within the display area of the module.
  • the camera module is used to collect the facial expression image data of the patient
  • the AI assisted analysis module analyzes the facial expression image data collected by the camera module, judges the comfort of the patient, and displays it in real time. The set position in the display area of the AR display module.
  • the dental microscopic diagnosis and treatment system of the present application has one or more of the following beneficial effects:
  • the dental microscopic diagnosis and treatment system of the present application displays the optical images under the microscope in the operating microscope in the form of AR optical images in the field of vision of the operator, and the operator (such as a doctor) can move freely
  • the head no longer limited by the position of the operating microscope, can observe the magnified field of view under the microscope and the normal field of view outside the microscope at the same time, the position of the surgical instrument is continuously visible, and can be accurately moved from outside the microscope to the designated position under the microscope, and can also be observed at the same time.
  • the dental microscopic diagnosis and treatment system of the present application is provided with an image split-screen display module.
  • the operator can call up and view the 3D structure of the target object at any time as needed, and can choose to view specific layered images to determine the tissue under the microscope. the internal structure;
  • the dental microscopic diagnosis and treatment system of the present application is provided with an AI auxiliary module to realize AI-assisted diagnosis and display.
  • FIG. 1 is a schematic diagram of the installation position of the operating microscope provided in Embodiment 1 of the application;
  • FIG. 2 is a schematic diagram of the connection between the operating microscope and the AR device provided in Embodiment 1 of the application;
  • FIG. 4 is a schematic diagram of an area that can be observed by an operator in an AR device according to Embodiment 1 of the present application;
  • FIG. 5 is a schematic diagram of the location of the additional information display area provided in Embodiment 1 of the present application.
  • Embodiment 9 is a flowchart of the dental microscopic diagnosis and treatment system provided in Embodiment 5 of the present application.
  • 1-surgical microscope 11-photosensitive element, 12-imaging mirror group, 13-magnification lens group, 14-zoom large objective lens, 2-AR equipment, 3-AR display module display area, 4-real image display area, 5- Surgical instruments, 6- Additional information display area.
  • This embodiment provides a dental microscopic diagnosis and treatment system, which includes a microscopic observation module, a 3D imaging module and an AR display module.
  • the microscopic observation module is an operating microscope 1. As shown in FIG. 1, the operating microscope 1 can be installed on a bracket to facilitate the operator to quickly move the operating microscope 1 as required.
  • the operating microscope 1 is designed with dual optical paths, and is used to observe the target object to be observed.
  • the 3D imaging module is used to collect in real time the optical image under the microscope in the observation field of the operating microscope 1, and convert the optical image under the microscope into a three-dimensional digital image.
  • the 3D imaging module includes left and right photosensitive elements 11 , a magnification variable system and a large zoom objective lens 14 .
  • the AR display module is worn on the operator's head, and is used for receiving the three-dimensional digital image output by the 3D imaging module, and converting the three-dimensional digital image into an optical image for display in the operator's field of vision.
  • the AR display module may be an AR device 2 such as a protective mask, a helmet, and glasses with an augmented reality function, and AR glasses are preferably used, as shown in FIG. 2 .
  • the dental microscopic diagnosis and treatment system of this embodiment mainly acquires a three-dimensional digital image by adding a 3D imaging module to the optical image under the microscope in the observation field of the operating microscope 1, and uses the head-mounted AR display device to display the optical image.
  • the form is displayed in the operator's field of vision, and the system flow is shown in Figure 3.
  • Operators such as doctors wearing AR glasses and other head-mounted AR display devices can move their heads freely and are no longer limited by the position of the operating microscope 1 .
  • the magnified field of view under the microscope and the normal field of view outside the microscope can be observed at the same time.
  • the position of the surgical instrument 5 is continuously visible, and can be accurately moved into the designated position under the microscope from outside the microscope.
  • the enlarged field of view under the microscope is the AR display module.
  • Display area 3 the normal field of view outside the mirror, that is, the real image display area 4 displayed by the non-AR display module.
  • the patient status outside the mirror can be observed or the nurse can be instructed to confirm that the instruments or materials are correct.
  • the dental microscopic diagnosis and treatment system of the present embodiment adds a corresponding digital image of the three-dimensional structure of radiation imaging to the edge position of the display area of the AR glasses and other head-mounted AR display devices by adding an image split-screen display module, that is, In the additional information display area 6 shown in FIG. 5 , the system flow is shown in FIG. 6 .
  • the digital image of the three-dimensional structure of radiation imaging is preferably a CBCT digital image, and the following embodiments all take the CBCT digital image as an example to illustrate the technical solution.
  • the dental microscopic diagnosis and treatment system includes a storage module, and the CBCT digital image data of the target object can be imported into the storage module by means of external input or retrieval.
  • the image split-screen display module is used to display the CBCT digital image of the target object in the form of an optical image at the edge of the display area 3 of the AR display module, so as to provide real-time reference for the operator.
  • the CBCT digital image switch is controllable, the operator can manually choose to view the layered two-dimensional image or 3D image of the target object according to needs, and the operator can select and view the specific layered two-dimensional image to determine the internal structure of the tissue under the microscope. In this embodiment, the operator needs to manually compare and register the CBCT digital image with the three-dimensional digital image of the operating microscope 1 .
  • the dental microscopic diagnosis and treatment system of this embodiment recognizes the biological features in the three-dimensional digital image by adding an image recognition processing module, and compares the CBCT digital image with the three-dimensional digital image by comparing the biological features.
  • the images are automatically compared and registered, and then the CBCT digital image matching the three-dimensional digital image is displayed on the edge of the AR display module display area 3.
  • the system flow is shown in FIG. 7 .
  • the dental microscopic diagnosis and treatment system of this embodiment further includes a detection module.
  • the detection module is used to detect the focus position of the large zoom objective lens 14 and the magnification of the variable magnification system respectively.
  • the detection module preferably adopts a position sensor, that is, a position sensor is respectively added to the position of the large zoom objective lens 14 and the variable magnification lens group 13 of the operating microscope 1 .
  • the image recognition processing module determines the depth position of the CBCT digital image according to the focal position of the zoom large objective lens 14 detected by the position sensor, and the image recognition processing module determines the depth position of the CBCT digital image according to the variable magnification detected by the detection module.
  • the magnification of the system determines the depth range in which the CBCT digital image displays the current slice region.
  • the focal depth position of the operating microscope 1 is automatically registered with the layered depth of the CBCT digital image, that is, a certain plane structure is observed under the microscope, and the CBCT digital image automatically displays the CT digital image of the
  • the dental microscopic diagnosis and treatment system of this embodiment is based on the third embodiment, and the CBCT digital image and the three-dimensional digital image are displayed in superposition.
  • the CBCT digital image transparency is adjustable.
  • the dental microscopic diagnosis and treatment system of this embodiment further includes a positioning, navigation and detection module, and the positioning, navigation and detection module is installed on a surgical instrument 5, such as a dental handpiece.
  • the positioning and navigation detection module is used to detect the depth and spatial position data of the surgical instrument 5 in real time, and the image recognition processing module automatically compares the depth and spatial position data collected by the positioning and navigation detection module with the data in the three-dimensional digital image. Comparing biological features, such as root canal orifice position, shape and root canal depth, direction and other tissue features, obtain real-time relative position data between the surgical instrument 5 and the target object, and display them on the AR
  • the setting position in the display area 3 of the display module such as the additional information display area 6 shown in FIG.
  • the state data of the surgical instrument 5 such as the rotational speed of the mobile phone, the torque value, etc.
  • the state data of the surgical instrument 5 can also be introduced, and can also be simultaneously displayed in the additional information display area 6 as shown in FIG. 5 .
  • the position sensor disposed at the position of the large zoom objective lens 14 and the variable magnification lens group 13 detects a change, the real-time data of the surgical instrument 5 is automatically displayed at the set position in the display area 3 of the AR display module, which is convenient for doctors Confirm the operation in time and improve the efficiency.
  • the depth and spatial position data of the surgical instrument 5 and the state data of the surgical instrument 5 can be stored in the storage module in real time.
  • the dental microscopic diagnosis and treatment system of this embodiment is based on any one of the first to fourth embodiments, and introduces more relevant data, such as patient information data, root tester data, oral scanner data, and electronic periodontal probe.
  • Multiple data information such as data and pulp vitality data can be stored in the storage module through external input or retrieval.
  • Each data is provided with a display switch, which can be controlled individually. The operator can display the required data in the set position in the AR display module display area 3 as needed.
  • the system flow is shown in FIG. 9 .
  • Oral scanner data high-resolution 3D morphology of oral structures.
  • Pulp vitality data The pulp is located in the pulp cavity surrounded by dentin, and is connected to the periapical tissue by a narrow apical foramen, which cannot be viewed directly, resulting in the inability to visually judge its specific state in clinical practice. .
  • Clinically, temperature and electrical stimulation of the nerve fibers of the pulp are used to judge its vitality state, and help doctors to choose, completely remove the necrotic pulp, or perform amputation to preserve the healthy part.
  • the dental microscopic diagnosis and treatment system in this embodiment adds an AI-assisted analysis module on the basis of any one of Embodiments 1 to 5, so as to realize AI-assisted diagnosis and display.
  • the AI auxiliary analysis module switch is controllable, and the switch can be a main switch or a separate function switch, and the operator can choose to turn on or off the corresponding AI auxiliary function according to needs.
  • the AI-assisted analysis module is used to analyze the three-dimensional digital images collected by the 3D imaging module, identify the lesion condition of the target object, and mark or remind the target object according to the lesion condition.
  • Various data are summarized and analyzed to generate additional AI auxiliary information.
  • the operator can display the additional AI auxiliary information in the set position in the display area 3 of the AR display module as required.
  • the system flow is shown in FIG. 10 .

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Epidemiology (AREA)
  • Dentistry (AREA)
  • Robotics (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Endoscopes (AREA)

Abstract

Système de diagnostic et de traitement microscopique dentaire, comprenant un module d'observation microscopique, un module d'imagerie en trois dimensions (3D) et un module d'affichage à réalité augmentée (RA). Le module d'observation microscopique est utilisé pour observer un objet cible à observer ; le module d'imagerie 3D est utilisé pour acquérir une image optique microscopique dans un champ d'observation du module d'observation microscopique en temps réel et convertir l'image optique microscopique en une image numérique 3D ; le module d'affichage à RA est porté sur la tête d'un opérateur et est utilisé pour recevoir l'image numérique 3D produite par le module d'imagerie 3D et convertir l'image numérique 3D en une image optique à afficher dans le champ de vision de l'opérateur. En utilisant le système de diagnostic et de traitement microscopique dentaire, pendant une intervention chirurgicale, l'opérateur peut observer commodément et de manière flexible l'objet cible, et peut également visualiser rapidement des informations de données relatives à l'intervention chirurgicale.
PCT/CN2022/072541 2021-02-10 2022-01-18 Système de diagnostic et de traitement microscopique dentaire WO2022170928A1 (fr)

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CN117562678B (zh) * 2024-01-08 2024-04-12 华中科技大学同济医学院附属协和医院 一种用于神经外科手术显微镜的辅助系统

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