CN111803235B - Periodontal acceleration bone formation auxiliary orthodontic treatment operation guide plate system and forming method thereof - Google Patents

Abstract

The present invention discloses a surgical guide plate system for periodontal accelerated osteogenesis and auxiliary orthodontic treatment and its forming method, including an ultrasonic positioning alarm device and a guide plate body printed by 3D, the guide plate body including a tooth surface retention plate that can be fitted and fixed on the crown and an alveolar bone retention plate opposite to the alveolar bone cortex, the ultrasonic positioning alarm device including an ultrasonic probe and an alarm, the tooth surface retention plate is provided with a crown fitting surface that fits the crown, and the alveolar bone retention plate is provided with a guide hole for drilling the alveolar bone cortex and a probe jack for plugging the ultrasonic probe and facing the drilling position. The present invention can achieve the purpose of accurate positioning of the bone removal cortex area and reducing surgical complications; further, in the process of drilling, ultrasonic positioning monitoring and alarming of the drilling depth can be achieved to prevent the purpose of excessive drilling to cause damage to the tooth root, nerves and important tissue structures, thereby further improving the safety of the operation.

Description

Periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system and forming method thereof

Technical Field

The present invention belongs to the technical field of medical auxiliary equipment, and specifically relates to a 3D printed periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system and a forming method with an ultrasonic positioning alarm function.

Background Art

Malocclusion affects the patient's aesthetic, periodontal and mental health. With the development of the economy, more and more adults are undergoing orthodontic treatment, but the treatment time and cost of 2-3 years are a major challenge for adult orthodontics. How to shorten the tooth movement time and thus shorten the entire orthodontic treatment time is the research focus of many clinicians and researchers. In recent years, periodontal accelerated osteogenic orthodontics (PAOO) can effectively accelerate orthodontic tooth movement. This technology purposefully cuts the alveolar bone cortex through surgery to reduce the resistance of natural bone to orthodontic tooth movement, thereby shortening the entire orthodontic course. This technology can also reduce traditional complications of orthodontic treatment such as root resorption and demineralization; at the same time, this technology can effectively improve the quantity and quality of periodontal tissues because bone transplantation obtains more bone support.

Removing the bone cortex around the tooth root is the key to PAOO. The surgeon should stay 2-3mm away from the alveolar ridge and avoid important anatomical structures such as the maxillary sinus, inferior alveolar nerve canal, mental foramen and tooth root to avoid iatrogenic damage. Many times, due to crowded dentition, the tooth roots are very close to each other, so extreme caution must be taken to avoid unnecessary iatrogenic damage.

However, the location of cortical bone removal in PAOO surgery is currently determined by periodontists based on experience and the patient's CBCT. They lack a very accurate understanding of the anatomical structure of the surgical area, resulting in low surgical efficiency and high risks. Especially for novice doctors who are just starting to perform this surgery, the probability of iatrogenic injuries such as root damage is high.

Summary of the invention

The purpose of the present invention is to provide a surgical guide plate system and a shaping method for accelerating periodontal osteogenesis and assisting orthodontic treatment, so as to solve the above-mentioned problems.

To achieve the above-mentioned objectives, the present invention first discloses a periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system, including a 3D printed guide body, wherein the guide body includes a tooth surface retention plate that can be fitted and fixed on a tooth crown and an alveolar bone retention plate opposite to the alveolar bone cortex, the tooth surface retention plate is provided with a crown fitting surface that fits the tooth crown, and the alveolar bone retention plate is provided with a guide hole for drilling the alveolar bone cortex.

Furthermore, it also includes an ultrasonic positioning alarm device, which includes an ultrasonic probe and an alarm. The alveolar bone retention plate is also provided with a probe jack for plugging in the ultrasonic probe. The ultrasonic probe corresponds to the guide hole and faces the drilling position, and the ultrasonic probe is connected to the alarm.

Furthermore, it also includes a roller card locator installed on the alveolar bone retention plate, the roller card locator includes an I-shaped guide rail and a U-shaped slider, the two side surfaces of the I-shaped guide rail are provided with vertically extending slide grooves, the slide grooves are provided with slide groove teeth, rollers are pivotally connected on both sides of the U-shaped slider, the rollers are provided with roller teeth that can engage with the slide groove teeth, the I-shaped guide rail is provided with a through hole that can penetrate to the alveolar bone cortex, and the probe jack and guide hole are provided on the U-shaped slider.

Furthermore, it also includes a roller card locator installed on the alveolar bone retention plate, the roller card locator includes an I-shaped guide rail and a U-shaped slider, the two side surfaces of the I-shaped guide rail are provided with vertically extending slide grooves, the slide grooves are provided with slide groove teeth, rollers are pivotally connected on both sides of the U-shaped slider, the rollers are provided with roller teeth that can engage with the slide groove teeth, the I-shaped guide rail is provided with a through hole that can penetrate to the alveolar bone cortex, and the guide hole is provided on the U-shaped slider.

Furthermore, the guide holes are evenly arranged along the vertical direction of the teeth.

Furthermore, the guide hole is located between the roots of two teeth, the upper end of the guide hole is 2-3 mm away from the top of the alveolar ridge, the lower end is 2-4 mm below the root apex, and the distance between the guide holes in the vertical direction is 2-3 mm.

Furthermore, a rubber layer is provided on one side of the roller to increase the friction with the slide groove.

Furthermore, the ultrasonic positioning alarm device also includes a wireless sensor and a single chip microcomputer, the ultrasonic probe is connected to the wireless sensor, the wireless sensor is connected to the single chip microcomputer, and the single chip microcomputer is connected to the alarm.

Then, the present invention discloses a method for forming a surgical guide plate system for periodontal accelerated osteogenesis-assisted orthodontic treatment, comprising the following steps:

Step 1: Obtain the patient's oral CBCT data and import it into E3D 3D design software;

Step 2: Use the iTero intraoral scanner to scan the patient's mouth and obtain a three-dimensional digital model of the dentition including part of the mucosa;

Step 3: Use microCT to scan the drill bit used for dental ultrasonic bone cutter to remove cortical bone and obtain accurate three-dimensional data of the drill bit;

Step 4: Import the CBCT data and the 3D dentition digital model data into the E3D software for precise matching to obtain a mandibular CT model that integrates high-precision 3D dentition and alveolar bone data;

Step 5: Determine the drill bit position and drilling direction for cortical bone removal;

Step 6: Use rapid prototyping technology to print out a surgical guide device for accelerated periodontal osteogenesis and assisted orthodontic treatment.

Furthermore, in step 5, the drill bit position and hole entry direction for cortical bone removal should avoid anatomical structures that are prone to iatrogenic injury.

Compared with the prior art, the advantages of the present invention are:

The present invention achieves the purpose of accurate positioning of the bone removal cortical area and reducing surgical complications through a 3D printed periodontal accelerated osteogenesis assisted orthodontic treatment (PAOO) surgical guide system and its design method with ultrasonic positioning and alarm functions; further, during the drilling process, ultrasonic positioning monitoring and alarm of the drilling depth can be realized to prevent damage to the tooth root, nerves and important anatomical structures caused by excessive drilling, thereby further improving the safety of the operation.

The present invention will be further described in detail below with reference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings constituting a part of this application are used to provide a further understanding of the present invention. The exemplary embodiments of the present invention and their descriptions are used to explain the present invention and do not constitute an improper limitation of the present invention. In the drawings:

FIG1 is a schematic structural diagram of a tooth portion of a periodontal accelerated osteogenesis-assisted orthodontic treatment operation disclosed in the present invention;

FIG2 is a schematic structural diagram of a surgical guide system for accelerated periodontal osteogenesis and assisted orthodontic treatment disclosed in preferred embodiments 1 or 2 of the present invention (excluding the roller card positioner);

3 is a schematic diagram of the structure of a surgical guide system for accelerated periodontal osteogenesis and assisted orthodontic treatment disclosed in Embodiment 3 of the present invention;

4 is a side view of the structural diagram of the periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system disclosed in the fourth embodiment of the present invention;

FIG. 5 is a schematic block diagram of an alarm for a surgical guide system for accelerated periodontal osteogenesis and assisted orthodontic treatment disclosed in Embodiments 2, 3 and 4 of the present invention.

Legend:

1. Guide plate body; 2. Tooth crown; 3. Tooth surface retention plate; 4. Alveolar bone cortex; 5. Alveolar bone retention plate; 6. Guide hole; 7. I-shaped guide rail; 8. U-shaped slider; 9. Slide groove; 10. Roller; 11. Through hole; 12. Probe jack; 13. Drill bit; 14. Ultrasonic probe; 15. Wireless sensor; 16. Single chip microcomputer; 17. Alarm.

DETAILED DESCRIPTION

The embodiments of the present invention are described in detail below with reference to the accompanying drawings, but the present invention can be implemented in many different ways as defined and covered by the claims.

Embodiment 1:

As shown in Figures 1, 2 and 5, the present invention first discloses a periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system, including a guide body 1 printed by 3D printing of a transparent polymer material, the guide body 1 including a tooth surface retention plate 3 that can be fitted and fixed on a tooth crown 2 and an alveolar bone retention plate 5 opposite to the alveolar bone cortex 4, the tooth surface retention plate 3 is provided with a crown fitting surface fitted with the tooth crown 2, the alveolar bone retention plate 5 is provided with a guide hole 6 for drilling the alveolar bone cortex 4, so that the drill bit 13 is guided by the guide hole 6, thereby improving the drilling efficiency and positioning accuracy, thereby achieving the purpose of reducing surgical complications.

In this embodiment, during the specific setting, the guide holes 6 are evenly arranged along the vertical direction of the tooth roots. The guide holes 6 are located between the roots of two teeth. The upper end of the guide holes 6 is 2-3 mm away from the top of the alveolar ridge, and the lower end is 2-4 mm below the root apex. The distance between the guide holes 6 in the vertical direction is 2-3 mm. This setting method can better perform osteogenesis-assisted orthodontic treatment on the teeth.

Then, the present invention discloses a method for forming a surgical guide plate system for periodontal accelerated osteogenesis-assisted orthodontic treatment, comprising the following steps:

Step 1: Obtain the patient's oral CBCT data and import it into E3D 3D design software;

Step 2: Use the iTero intraoral scanner to scan the patient's mouth and obtain a three-dimensional digital model of the dentition including part of the mucosa;

Step 3: Use microCT to scan the dental ultrasonic bone cutter cortical bone removal drill to obtain accurate drill bit 13 three-dimensional data;

Step 4: Import the CBCT data and the 3D dentition digital model data into the E3D software for precise matching to obtain the jaw CT model integrated with high-precision 3D dentition data;

Step 5: Determine the drill bit 13 position and hole direction for cortical bone removal;

Step 6: Use rapid prototyping technology to print out a surgical guide device for periodontal accelerated osteogenesis and assisted orthodontic treatment;

In this embodiment, in step 5, the position and direction of the drill bit 13 for cortical bone removal should avoid anatomical structures that are prone to iatrogenic injury, such as the maxillary sinus, inferior alveolar nerve canal, mental foramen, tooth root, etc.

Embodiment 2:

In this embodiment, an ultrasonic positioning alarm device is added on the basis of the first embodiment, and the ultrasonic positioning alarm device includes an ultrasonic probe 14 and an alarm 17. Specifically, one side of the guide hole 6 is matched with a probe jack 12 for inserting the ultrasonic probe 14, and the ultrasonic probe 14 faces the position of the drill hole. The ultrasonic positioning alarm device also includes a wireless sensor 15 and a single-chip microcomputer 16, the ultrasonic probe 14 is connected to the wireless sensor 15, the wireless sensor 15 is connected to the single-chip microcomputer 16, and the single-chip microcomputer 16 is connected to the alarm 17. Among them, the ultrasonic probe 14 uses Ultrasonix#C5-2, the wireless sensor 15 uses NRF24L07 wireless sensor, and the single-chip computer 16 uses STC-51 series STC89C52 single-chip computer as the main control chip, and the alarm 17 uses HYR1704U type, wherein the single-chip computer 16 can distinguish the level and position of the drill bit 13 according to the acoustic properties of the cortical bone, cancellous bone, periodontal membrane, and cementum; thus, after step 6 of the first embodiment, step 7 is added: the ultrasonic probe 14 can generate ultrasonic waves to the drill bit 13, and judge the tissue and depth contacted by the drill bit 13 according to the change of frequency, and trigger the alarm system when approaching the periodontal membrane and the root of the tooth, wherein step 7 only exists in the system equipped with the ultrasonic positioning alarm device. Then, the relevant data of the entire surgical process are recorded and analyzed, and there will be a first prompt alarm when breaking through the cortical bone, and a serious alarm will be issued when contacting the periodontal membrane to prevent the drill bit 13 from going deeper and damaging the root of the tooth. In the present invention, ultrasound refers to a mechanical wave with a frequency higher than 20kHz. The ultrasonic sensor uses the principle of piezoelectric effect to convert electrical energy and ultrasonic energy into each other, that is, when emitting ultrasonic waves, the electrical energy is converted to emit ultrasonic waves; and when receiving echoes, the ultrasonic vibration is converted into an electrical signal. The ultrasonic alarm principle in the present invention is similar to the ultrasonic flaw detector widely used in the engineering field. Ultrasonic waves will be reflected at the interface of two media with different acoustic impedances. The amount of energy reflected back is related to the difference in acoustic impedance of the media on both sides of the interface and the orientation and size of the interface. Therefore, the present invention will utilize the different acoustic impedances of the tooth root, periodontal membrane, and alveolar bone, and use single-chip microcomputer 16 control, signal recognition, ultrasonic ranging and other technologies to improve the existing ultrasonic bone knife system, design an ultrasonic bone knife with ultrasonic positioning alarm function, and cooperate with 3D printed periodontal accelerated osteogenesis assisted orthodontic treatment (PAOO) surgical guide to more accurately perform surgical positioning and bone removal, and minimize surgical complications such as root damage and neurovascular damage.

Embodiment three:

In this embodiment, on the basis of embodiment 1, as shown in Figures 3 and 4, it also includes a roller card locator installed on the alveolar bone retention plate 5, the roller card locator includes an I-shaped guide rail 7 and a U-shaped slider 8, vertically extending slide grooves 9 are arranged on both sides of the I-shaped guide rail 7, and slide groove teeth are arranged in the slide groove 9. Rollers 10 are pivotally connected on both sides of the U-shaped slider 8, and roller teeth that can engage with the slide groove teeth are arranged on the roller 10. The I-shaped guide rail 7 is provided with a through hole 11 that can penetrate into the alveolar bone cortex. The I-shaped guide rail 7 is provided with a through hole 11, and the guide hole 6 is arranged on the U-shaped slider 8. Therefore, during the process of the surgeon drilling a hole in the vertical direction of the tooth root, the roller 10 can quickly insert the drill bit 13 to drill a hole every time it moves a position, thereby simplifying the drilling operation process. A rubber layer that increases the friction with the slide groove is provided on one side of the roller 10, and the rubber layer fits the I-shaped guide rail 7.

Embodiment 4:

In this embodiment, on the basis of the third embodiment, an ultrasonic positioning alarm device is further provided on the U-shaped slider 8. Similarly, the ultrasonic positioning alarm device includes an ultrasonic probe 14 and an alarm 17, wherein a probe socket 12 for plugging in the ultrasonic probe 14 is provided on the U-shaped slider 8, and similarly, the ultrasonic probe 14 corresponds one-to-one with the guide hole 6 and faces the drilling position.

The above are only preferred embodiments of the present invention and are not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included in the protection scope of the present invention.

Claims (5)

1. A periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system, characterized in that it comprises a 3D printed guide body (1), the guide body (1) comprising a tooth surface retention plate (3) that can be fitted and fixed on a tooth crown (2) and an alveolar bone retention plate (5) that is opposite to the alveolar bone cortex (4), the tooth surface retention plate (3) being provided with a tooth crown fitting surface that fits the tooth crown (2), and the alveolar bone retention plate (5) being provided with a tool for drilling the alveolar bone cortex (4). The invention also includes an ultrasonic positioning alarm device, the ultrasonic positioning alarm device including an ultrasonic probe (14) and an alarm (17), the alveolar bone retention plate (5) is also provided with a probe jack (12) for plugging the ultrasonic probe (14), the ultrasonic probe (14) corresponds to the guide hole (6) and faces the drilling position, and the ultrasonic probe (14) and the alarm (17) are connected; and also includes a probe installed on the alveolar bone retention plate (5). A roller card positioner, the roller card positioner comprising an I-shaped guide rail (7) and a U-shaped slider (8), the two side surfaces of the I-shaped guide rail (7) being provided with vertically extending slide grooves (9), the slide grooves (9) being provided with slide groove teeth, the two sides of the U-shaped slider (8) being pivotally connected with rollers (10), the rollers (10) being provided with roller teeth capable of meshing with the slide groove teeth, the I-shaped guide rail (7) being provided with a through hole (11) capable of penetrating to the alveolar bone cortex (4) The probe jack (12) and the guide hole (6) are arranged on the U-shaped slider (8); a rubber layer for increasing friction with the slide groove is arranged on one side of the roller (10); the ultrasonic positioning alarm device also includes a wireless sensor (15) and a single-chip microcomputer (16); the ultrasonic probe (14) is connected to the wireless sensor (15), the wireless sensor (15) is connected to the single-chip microcomputer (16), and the single-chip microcomputer (16) is connected to the alarm (17). 2. The periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system according to claim 1, characterized in that the guide holes (6) are evenly arranged along the vertical direction of the tooth root. 3. The periodontal accelerated osteogenesis assisted orthodontic treatment surgical guide system according to claim 1 is characterized in that the guide hole (6) is located between the roots of two teeth, the upper end of the guide hole (6) is 2-3 mm away from the top of the alveolar ridge, the lower end is 2-4 mm below the root apex, and the distance between the guide holes (6) in the vertical direction of the tooth root is 2-3 mm. 4. A method for forming a surgical guide system for accelerated periodontal osteogenesis and orthodontic treatment, comprising the surgical guide system for accelerated periodontal osteogenesis and orthodontic treatment as claimed in any one of claims 1 to 3, characterized in that it comprises the following steps: Step 1: Obtain the patient's oral CBCT data and import it into E3D 3D design software; Step 2: Use the iTero intraoral scanner to scan the patient's mouth and obtain a three-dimensional digital model of the dentition including part of the mucosa; Step 3: Using microCT, scan the drill bit (13) used for dental ultrasonic bone cutter to remove cortical bone, and obtain accurate three-dimensional data of the drill bit; Step 4: Import the CBCT data and the 3D dentition digital model data into the E3D software for precise matching to obtain a mandibular CT model that integrates high-precision 3D dentition and alveolar bone data; Step 5: Determine the position and drilling direction of the drill bit (13) for cortical bone removal; Step 6: Use rapid prototyping technology to print out a surgical guide device for accelerated periodontal osteogenesis and assisted orthodontic treatment. 5. The forming method of the surgical guide system for accelerated periodontal osteogenesis and assisted orthodontic treatment according to claim 4 is characterized in that, in step 5, the drill bit position and hole entry direction for cortical bone removal should avoid anatomical structures that are prone to iatrogenic damage.