HK1229677A1

HK1229677A1 - System and method for recording a bite of an edentulous individual

Info

Publication number: HK1229677A1
Application number: HK17103548.2A
Authority: HK
Inventors: 埃林．勒诺．德拉劳; 史蒂夫．考伯恩; 乔治．考伯恩
Original assignee: 特里斯佩拉牙科公司
Priority date: 2013-12-19
Filing date: 2014-12-19
Publication date: 2017-11-24

Description

System and method for recording occlusion of an edentulous individual

Cross Reference to Related Applications

This application claims priority from U.S. provisional patent application No.61/917,987, filed 2013, 12, month 19, which is incorporated herein by reference.

Technical Field

The present disclosure relates generally to recording the bite of an edentulous individual.

Background

The relative positions of the individual's maxillary (upper) and mandibular (lower) dental arches are in a maxillo-mandibular relationship. The maxillomandibular relationship includes occlusions (interdigitation) between some or all of the individual's teeth, commonly referred to as the "bite", the location of the central occlusions or the location of the central relationship. Various methods are used to register the bite of a fully or partially toothed individual. The static positions of the teeth, the implant or both need to be reliably and repeatably in contact with each other.

Occlusion may be recorded using registration materials or optical scanners. Optical scanners can be used to scan the dental arch separately, as well as to scan the teeth or implants in one or more locations where they contact each other. The dental arches are aligned with each other using modeling software that generates a model of the individual's maxillomandibular relationship and is used for diagnostic and/or dental restoration and/or prosthesis design purposes. The scanner may be, for example, a three-body intraoral scanner (3Shape triosinral scanner).

U.S. publication No.2013/0218530 discloses a method in which a two-dimensional extraoral image is superimposed onto a three-dimensional intraoral model for analyzing existing dentition and visualizing proposed restorative and prosthetic designs. The present disclosure relates to capturing natural dentition and creating visualizations of possible restorations and corrections.

U.S. publication No.2013/0209962 discloses a method of creating an aesthetically-oriented replica and recording the relationship of the upper and lower jaws using an individual's existing denture. Arch information is obtained from an impression of the gums, either in a denture or separately in an impression tray. The maxillomandibular relationship is recorded by securing two denture pieces together using bite registration material placed over the teeth in the bite position. The denture is removed from the mouth and scanned, held as a unit by the bite registration material. Alternatively, the upper denture, lower denture and bite registration material may be scanned separately and the resulting digital model is in accordance with the software.

U.S. publication No.2013/0209962 describes a technique for using impression material inside an individual's existing denture to stabilize the denture and restore proper load distribution on the gums. Following this, much like the method described in U.S. publication No.2012/0322031, an arch impression is combined with maxillomandibular registration. The impression-based recording of the maxillomandibular relationship is more random than the pin tracing method because the material is injected on top of an existing denture and then the individual bites down until the material hardens. This bite registration material is then removed from the denture and separately scanned by a desktop scanner. The upper and lower dentures are removed and scanned independently. In the rendering software, the upper and lower dentures are gridded to scan the bite registration material, and a composite model is created.

Intra-and extra-oral gothic pin tracings are described in many issued patents, published patent applications, scientific publications, commercial journals and textbooks. The earliest examples dates back to more than 100 years ago. Intraoral tracing, also known as intraoral gothic arch enrollment devices, is disclosed in U.S. patent No.1,764,115, U.S. patent No.2,447,287, U.S. patent No.2,582,104, U.S. patent 5,186,624, and U.S. patent 6,152,730. More recent examples are shown in U.S. publication No.2013/0280672 and U.S. publication No. 2012/0322031. Extraoral tracing follows similar principles and is described in U.S. patent No.5,722,828.

Pin tracing would include custom seats on the upper and lower arches, including on any combination of teeth, implants or gums. The pin is secured to one arch and the recording plate is secured to the opposite arch. The movement of the person is illustrated by the markings made by the pins on the recording plate. The markers can be used to identify and record certain maxillomandibular relationships. The resulting trace is used to determine the upper and lower jaw positions of the individual in a central relationship. The center relationship position is then locked in the pair position and the device removed. Traditionally, pin tracking is used to physically hold the dental cast, which is then fixed in place to the articulator.

The central position is defined in Nallaswamy, Deepak (2011) dental prosthesis prosthodontics Textbook (ISBN 81-8061-. This position is independent of tooth contact. This position is clinically discernable when the mandible is pointing up-front. It is constrained to move rotationally entirely about a transverse horizontal axis. "

The gothic track conveys position information (e.g., how to open or close the chin, etc.) as well as the desired maxillomandibular relationship. This information aids in diagnosis, analysis, or repair and prosthesis design. Essentially, the pin tracer remains discrete between arches and allows partially or fully edentulous individuals to bite and perform jaw movements with minimal contact and without interfering with identifying the desired maxillomandibular position.

Due to the different shapes and sizes of the soft tissue of the individual in which the pin tracer device is located, an intervening material is used to improve the fit and stability of the tissue-engaging portion of the pin tracer device. Impression materials or intraoral putty may be used. The tissue-engaging side of the pin tracer device may be perforated to allow for mechanical retention of these intermediary materials. During the application of the stamp and hardening of the material, it flows through the perforations and engages with the pin tracer device. As a result, the material must be torn to remove it, which provides resistance to additional removal of material from the pin tracing.

Using pin tracking includes adjusting the pin up and down to obtain an maxillomandibular relationship in the central relationship. From this position, jaw movement is tracked by a pin contacting the recording plate. Apart from the pathology, this process often leads to a triangular arrow shape. The tip of the aforementioned arrow is used to identify the center relationship position. In this position, the upper and lower portions of the device should be connected to each other to transfer the desired maxillomandibular relationship to the articulator. For example, the pin is secured to the recording plate in the centered relationship position by securing the recording plate with a hole therein to the recording plate portion of the device. The holes in the attached recording plate are the same size as the pins and only allow complete closure of the bite in the centric relationship of the maxillomandibular position. The pin may also be fixed to the recording plate by injecting a bite registration material into the space between the upper and lower portions of the apparatus. When the material hardens, the individual maintains the central relationship position. This allows two parts of the device to be removed, either together in one piece or separately, and then reassembled and readjusted for subsequent removal. The pin may also be secured to the recording plate by bridging the upper and lower portions of the pin track to each other with a mechanical connection.

Once the pin and recording plate are secured to each other, the pin track is removed from the mouth and the pin track is used to transmit maxillomandibular information to the articulator (physically or virtually). To place the cast in a virtual environment, the process involves scanning pin tracking using a three-dimensional scanner, either by scanning the upper and lower portions while they are locked together, or by scanning both the upper and lower portions separately, and then aligning the two halves in software. The tissue-engaging side of the device is used to align the existing virtual models of the upper and lower gums. Alternatively, the single step method involves scanning the impression material in the upper and lower portions of the device to create the upper and lower models. These models are then aligned in the virtual environment as previously described.

The Dental model and pin tracer device may be scanned using a desktop three-dimensional scanner (e.g., a Dental Wings scanner, a three-body desktop scanner, etc.). The three-dimensional rendered model is input into software for modeling and design of dental restorations, prostheses, and dentures, as described in application U.S. publication No.2013/0218532 and international publication No. wo 2012/041329. These techniques use traditional impressions of the upper and lower arches, which are then scanned, or by pouring tartar/plaster onto the impressions, a model can be created and the resulting cast can also be scanned. The method described in U.S. publication No.2012/0322031 combines an arch impression with a pin tracing device. U.S. publication No.2013/0280672 describes a method of recording maxillomandibular information using two separate processes: a conventional impression for recording an impression of the dental arch and a separate pin tracer device. Both data sources are scanned and the resulting model is rendered, combined or gridded in software and used for diagnosis and/or design of dentures and/or other dental restorations.

Disclosure of Invention

Establishing a maxillomandibular relationship corresponding to a bite position in an edentulous individual by previous methods often includes obtaining a bite registration cast of the individual's dental arch and three-dimensional scanning of the registration material. Such methods include the inherent inaccuracies of bite registration and it is therefore desirable to mitigate these inaccuracies.

Disclosed herein are methods and systems for recording data of the maxillomandibular relationship corresponding to the bite position of an edentulous individual. The data facilitates preparation of a model that includes empirical data of the individual's maxillomandibular relationship at the bite position. The method includes and the system facilitates scanning an individual's dental arch to provide first data for modeling the dental arch and scanning the dental arch in a bite position to provide second data for modeling a relative position of the dental arch in the bite position based on empirical data. The bite position is established by including a pair of trays in the mouth of the individual during acquisition of the second data. When applying the methods and systems disclosed herein, it is not necessary to prepare a cast from bite registration material.

The tray is shaped to receive an arch of teeth and includes a complementary bite establishing component, such as a dentition, or a pin and registration plate, to provide a pin tracing function to define a bite location. The tray may, for example, be a replica of an individual's denture, or a pin tracer or other bite registration device that may include some dentition, some or all of which are included on an individual's existing denture dentition. The tray includes openings to expose each of the dental arches, providing a continuous scanning channel between the dental arches when the tray is held in the mouth of an individual. The visible portion of the dental arches, and the continuous channel between the dental arches, are scanned to provide second data. The second data is combined with the first data to create a single composite model of the two dental arches with empirical data of bite positions.

The methods and systems disclosed herein facilitate the design or modification of dentures and the obtaining of maxillomandibular relationships without the use of impressions or bite registration materials. The advantages that can be obtained include: reduce the inherent inaccuracies of the impression material, reduce cost, shorten the time required or reduce the experience required to establish the bite position.

In a first aspect, the present disclosure provides methods and systems for determining the bite of an edentulous individual. An individual's maxillary and mandibular dental arches are scanned to provide first data for preparing a model of the dental arch. The method includes the steps of holding a pair of trays in the mouth of the individual such that the dental arches are received in the trays to define an maxillomandibular relationship corresponding to a bite position, wherein a bite establishing component is located on each of the trays. The tray includes openings for exposing each of the dental arches to provide a continuous scanning channel between the dental arches. While the tray is held in the mouth of the individual, the dental arches and the continuous channel between the dental arches are each scanned to provide second data for preparing a model of the relative position of the dental arch in the bite position. The first data and the second data can be combined to prepare a model of the dental arch using empirical data of bite position.

In another aspect, the present disclosure provides a method of obtaining data for preparing a model of an edentulous individual, the method comprising: obtaining first data of a person's maxillary dental arch and first data of a person's mandibular dental arch for modeling the maxillary dental arch and the mandibular dental arch; providing a pair of components for receiving the maxillary and mandibular dental arches in an maxillo-mandibular relationship defining a bite position, the pair of components defining an opening on each of the components for exposing a continuous passage between the maxillary and mandibular dental arches; and acquiring second data along successive paths of the maxillary and mandibular arches in the bite position for modeling the relative positions of the maxillary and mandibular arches in the bite position.

In an embodiment, the openings are aligned on a respective surface of each of the components.

In one embodiment, the method comprises: the first data and the second data are combined to prepare a model that includes empirical data of the bite position.

In one embodiment, the method comprises: providing dental data for a pair of dentures and combining the first data, the second data and the dental data to prepare a model including empirical data of a bite position. In one embodiment, providing the dental appliance data includes scanning a pair of dentures suitable for the individual.

In one embodiment, the method includes providing dental data for a pair of dentures and combining the first data, the second data, and the dental data to prepare a model that includes empirical data for a bite position. In an embodiment, providing the mouthpiece data comprises accessing a library of mouthpiece data.

In one embodiment, the method includes obtaining third data for a pair of components for modeling the pair of components. In one embodiment, the method includes combining the first data, the second data, and the third data to prepare a model that includes empirical data for the bite position and empirical data for a pair of components.

In an embodiment, the method comprises obtaining fourth data of the appearance of the person for modeling the appearance. In one embodiment, the method includes combining the first data, the second data, and the fourth data to prepare a model that includes empirical data of the bite position and empirical data of the external feature at the bite position.

In an embodiment, the method comprises obtaining fourth data of the appearance of the person for modeling the appearance. In an embodiment, the obtaining the fourth data further comprises: fourth data is acquired while the individual maintains the selected facial expression to prepare the model with empirical data of the external features at the selected facial expression.

In an embodiment, the second data further comprises data of external features of the individual for modeling the relative position of the maxillary arch and the external features.

In one embodiment, acquiring the second data includes exposing the opening with a cheek retractor.

In one embodiment, providing a pair of components includes preparing a replica of a denture prepared for an individual, and the opening is defined on the replica.

In one embodiment, the method includes locking a pair of components in an engaged position.

In one embodiment, the pair of components includes a recorder and a recording surface. In one embodiment, the method includes defining the bite position with reference to markings made by the recorder on the recording surface.

In one embodiment, the method includes providing a bridge between the pair of components proximate the opening for providing a frame of reference along a portion of the continuous channel between the pair of components. In one embodiment, providing a bridge between a pair of components proximate to the opening includes: a pair of components is attached to a non-deformable material.

In one embodiment, the method includes providing a bridge between the pair of components proximate the opening for providing a frame of reference along a portion of the continuous channel between the pair of components. In one embodiment, providing a bridge between a pair of components proximate to the opening includes: moving a bridging member connected to a pair of members from a closed position to a bridging position.

In an embodiment, acquiring the first data comprises scanning the dental arch with an intraoral scanner.

In an embodiment, acquiring the first data includes scanning the dental arch with an extraoral scanner.

In an embodiment, acquiring the first data comprises scanning the dental arch with an optical scanner.

In an embodiment, acquiring the first data comprises scanning the dental arch with ultrasound.

In an embodiment, acquiring the second data includes scanning the dental arch along a continuous path with an intraoral scanner.

In one embodiment, acquiring the second data includes scanning the dental arch along a continuous path with an extraoral scanner.

In one embodiment, acquiring the first data includes scanning the dental arch with an optical scanner along a continuous path.

In an embodiment, acquiring the first data includes scanning the dental arch with ultrasound along a continuous path.

In another aspect, provided herein is a bite registration device comprising: a maxillary component shaped to receive a maxillary dental arch; a mandibular assembly shaped to receive a mandibular dental arch; a bite-establishing component positioned on opposing portions of the upper and lower jaw components for defining a bite between the upper and lower jaw components; and a maxillary opening defined in the maxillary component and a mandibular opening defined in the mandibular component for exposure to scan a continuous channel between a maxillary dental arch received in the maxillary component and a mandibular dental arch received in the mandibular component.

In one embodiment, the maxillary and mandibular openings are defined on respective surfaces of the maxillary and mandibular components. In one embodiment, the respective surfaces are located on the facial walls of the maxillary component and the mandibular component.

In one embodiment, the maxillary and mandibular openings are defined on respective surfaces of the maxillary and mandibular components. In one embodiment, the respective surfaces are located on the buccal walls of the maxillary component and the mandibular component.

In one embodiment, the maxillary and mandibular openings are defined on respective surfaces of the maxillary and mandibular components. In one embodiment, the respective surfaces are located on the lingual walls of the maxillary component and the mandibular component.

In one embodiment, the device includes a bridge extending between the upper jaw component adjacent the upper jaw opening and the lower jaw component adjacent the lower jaw opening for providing a frame of reference along the continuous path between the upper jaw component and the lower jaw component. In one embodiment, the bridge includes a bridge assembly movable between a closed position and a bridging position. In one embodiment, the bridge assembly is hingedly, pivotally or slidably connected to the bite registration device.

In one embodiment, the device includes a bridge extending between the upper jaw component adjacent the upper jaw opening and the lower jaw component adjacent the lower jaw opening for providing a frame of reference along the continuous path between the upper jaw component and the lower jaw component. In one embodiment, the bridge includes a bridge assembly movable between a closed position and a bridging position. In one embodiment, the bridge comprises a single bridge component connected to the upper jaw component or connected to the lower jaw component.

In one embodiment, the device includes a bridge extending between the upper jaw component adjacent the upper jaw opening and the lower jaw component adjacent the lower jaw opening for providing a frame of reference along the continuous path between the upper jaw component and the lower jaw component. In one embodiment, the bridge includes a bridge assembly movable between a closed position and a bridging position. In one embodiment, the bridge includes a first bridge component extending from the upper jaw component and a second bridge component extending from the lower jaw component.

In one embodiment, the device includes a bridge extending between the upper jaw component adjacent the upper jaw opening and the lower jaw component adjacent the lower jaw opening for providing a frame of reference along the continuous path between the upper jaw component and the lower jaw component. In one embodiment, the bridge includes a bridge assembly movable between a closed position and a bridging position. In an embodiment, the bridge component reversibly covers at least one of the openings.

In one embodiment, the supplemental bite establishing component includes dentition extending from the maxillary component and extending from the mandibular component.

In one embodiment, the supplemental nip creating assembly includes a recording surface and an opposing register for marking the recording surface. In one embodiment, the recorder extends from the lower jaw assembly and the recording surface is located on the upper jaw assembly.

In one embodiment, the supplemental nip creating assembly includes a row of teeth.

In another aspect, the present disclosure provides a method of obtaining data for preparing a model of an edentulous individual, the method comprising: obtaining first data of a person's maxillary dental arch and first data of a person's mandibular dental arch for modeling the maxillary dental arch and the mandibular dental arch; providing a pair of components for receiving the maxillary and mandibular dental arches in an maxillo-mandibular relationship defining a bite position, the pair of components defining an opening on each of the components for exposing a continuous passage between the maxillary and mandibular dental arches; and acquiring second data along successive paths of the maxillary and mandibular dental arches in the bite position for modeling the relative positions of the maxillary and mandibular dental arches in the bite position. The pair of components includes a bite registration device comprising: a maxillary component shaped to receive a maxillary dental arch; a mandibular assembly shaped to receive a mandibular dental arch; a bite-establishing component positioned on opposing portions of the upper and lower jaw components for defining a bite between the upper and lower jaw components; and a maxillary opening defined in the maxillary component and a mandibular opening defined in the mandibular component for exposure to scan a continuous channel between a maxillary dental arch received in the maxillary component and a mandibular dental arch received in the mandibular component.

In another aspect, the present disclosure provides a method of obtaining data for preparing a model of an edentulous individual, the method comprising: obtaining first data of a person's maxillary dental arch and first data of a person's mandibular dental arch for modeling the maxillary dental arch and the mandibular dental arch; providing a pair of components for receiving the maxillary and mandibular dental arches in an maxillo-mandibular relationship defining a bite position, the pair of components defining an opening on each of the components for exposing a continuous passage between the maxillary and mandibular dental arches; and acquiring second data along successive paths of the maxillary and mandibular arches in the bite position for modeling the relative positions of the maxillary and mandibular arches in the bite position, the pair of components including a recorder and a recording surface. The pair of components includes a bite registration device comprising: a maxillary component shaped to receive a maxillary dental arch; a mandibular assembly shaped to receive a mandibular dental arch; a bite-establishing component positioned on opposing portions of the upper and lower jaw components for defining a bite between the upper and lower jaw components; a maxillary opening defined in the maxillary component and a mandibular opening defined in the mandibular component for exposure to scan a continuous channel between a maxillary dental arch received in the maxillary component and a mandibular dental arch received in the mandibular component; and a recording surface and an opposing recorder for marking the recording surface.

Other aspects and features of the present disclosure will become apparent to those ordinarily skilled in the art upon review of the following description of specific embodiments in conjunction with the accompanying figures.

Drawings

Embodiments of the present disclosure will now be described, by way of example only, with reference to the accompanying figures in which features assigned reference numerals having the same last two digits correspond to like features of the various figures (e.g., maxillary sinus openings 42, 142, 242, 342, 442, 542, 642, 742, 842, 942, 1042, etc.).

FIG. 1 is a person with an edentulous tooth;

FIG. 2 is the individual of FIG. 1 having a pair of trays in their mouth to define a bite;

FIG. 3 is a flow chart of a scanning method for acquiring data;

FIG. 4 is a schematic illustration of data acquired by the method of FIG. 3;

FIG. 5 is a flow chart of a processing method for assembling data acquired by applying the method of FIG. 3 into a three-dimensional model;

FIG. 6 is a schematic of components of the three-dimensional model of FIG. 5;

fig. 7 is a replica of a denture;

FIG. 8 is a reproduction of FIG. 7 in the mouth of the individual of FIG. 1;

FIG. 9 is a flow chart of a scanning method for acquiring data;

FIG. 10 is a schematic illustration of data acquired by the method of FIG. 9;

FIG. 11 is a flow chart of a processing method for assembling data acquired by applying the method of FIG. 9 into a three-dimensional model;

FIG. 12 is a schematic of components of the three-dimensional model of FIG. 11;

FIG. 13 is a pin tracer with buccal openings;

fig. 14 is a pin track with a bridge between the pin tracked maxillary and mandibular components;

FIG. 15 is a pin tracer with a mandibular bridge assembly;

FIG. 16 is the pin tracer of FIG. 15 with the maxillary and mandibular bridge assemblies in the bridging position;

fig. 17 is the pin track of fig. 16 with the mandibular bridge assembly removed;

FIG. 18 is a pin tracer with maxillary and mandibular bridge components;

fig. 19 is the pin tracer of fig. 18 with a mandibular bridge assembly in the bridging position;

fig. 20 is the pin track of fig. 18 with the mandibular bridge assembly removed;

FIG. 21 is a pin track with maxillary and mandibular bridge components in a bridging position;

FIG. 22 is a pin tracer with maxillary and mandibular bridge components;

fig. 23 is the pin track of fig. 22 with a mandibular bridge assembly in the bridging position;

fig. 24 is the pin track of fig. 22 with the mandibular bridge assembly removed;

fig. 25 is the pin tracer of fig. 13 with material between the maxillary and mandibular components;

FIG. 26 is a custom pin tracer including custom tooth rows;

FIG. 27 is a flow chart of a scanning method for acquiring data;

FIG. 28 is a schematic illustration of data acquired by the method of FIG. 27;

FIG. 29 is a flow chart of a processing method for assembling data acquired by applying the method of FIG. 27 into a three-dimensional model;

FIG. 30 is a schematic of components of the three-dimensional model of FIG. 29;

fig. 31 is a replica of a denture;

FIG. 32 is a pin tracer with buccal openings;

FIG. 33 is a pin tracer with buccolingual openings;

FIG. 34 is a pin tracer with a lip face opening; and

FIG. 35 is a pin tracer with a labial-lingual opening.

Detailed Description

Establishing the maxillomandibular relationship often includes obtaining a bite registration and three-dimensional scanning of the registration material, or intraoral scanning of the maxillary and mandibular teeth at a given occlusal condition or contact. Any static intraoral structure may be used as these registered landmarks (e.g., natural teeth, restorative dentition, restorations supporting dental implants, etc.). Without these structures, it is complicated to obtain meaningful bite registration. This is particularly evident in individuals with complete loss of dentition or loss of posterior dentition, where the individual lacks premolars and/or molars. Establishing maxillomandibular positions based solely on anterior tooth contact may result in maxillomandibular relationships that are undesirable for analysis and design. For individuals who are completely edentulous (individuals without teeth; the teeth are either natural, prosthetic or supportive implant), there is no static reference point to align the maxillary and mandibular structures. In some cases, the maxillomandibular relationship is recorded using pin tracing and impression materials, or placing an intervening structure on the gums.

There is a need for a method to record the maxillomandibular relationship of edentulous individuals without, or substantially without, teeth or implants because such individuals do not have a stable or static reference point to align the maxillary and mandibular dental arches with one another. The method should facilitate positioning the individual's lower jaw in a selected maxillomandibular relationship, such as a bite position. Data of the relative positions of the maxillary and mandibular arches is then recorded, for example by an optical or ultrasound scanner.

Methods and systems are provided herein for obtaining data in an maxillomandibular relationship defining a bite position that facilitates modeling of an edentulous individual. The maxillary and mandibular dental arches of an individual are scanned, providing first data that can be used to model each arch.

The snap-in position may be established using a pair of trays having snap-in establishing components located on opposing portions of each tray for establishing the snap-in position. By tray, it is meant any shaped or formed component to receive either a maxillary or mandibular dental arch. The bite-establishing component can include dentition based on an existing denture, a pin and recording plate combination that together provide a pin track, other recorders combined with a recording surface, or any suitable features that contact each other in the bite position. When the tray is received into the mouth of the individual, opposing portions of the tray oppose each other, e.g., the maxillary buccal lingual surface may face the mandibular buccal lingual surface. The tray includes openings for exposing maxillary and mandibular dental arches received in the tray. The openings provide a continuous channel between the dental arches received within the tray, facilitating data acquisition of both dental arches in a single continuous data acquisition sweeping from one of the dental arches to the other along the continuous channel without interrupting data acquisition. The opening may include a window, and may also include other transparent covers if the scanning technique used will remain active through the transparent cover. However, many scanning systems may give better performance when giving free views of the maxillary and mandibular arches. As a result, leaving the opening without any transparent cover will improve the performance of the scanner in which the tray is used, in addition to simplifying the architecture of the tray.

For example, first data is acquired for each of the maxillary and mandibular dental arches with an intraoral scanner (e.g., an optical scanner, an ultrasonic scanner, etc.). The first data may be used to model each dental arch. A trisomy scanner is an example of an intraoral scanner that can be applied in these methods.

Second data of the maxillary and mandibular dental arches is obtained along a continuous path between the maxillary and mandibular dental arches when the maxillo-mandibular relationship is in the bite position for modeling the relative positions of the maxillary and mandibular dental arches at the bite position. Scanning can be accomplished using an intraoral scanner or an extraoral scanner (e.g., an optical scanner, an ultrasound scanner, etc.). Three-dimensional MDynamic 4D system extraoral scanners are also applicable to these methods and systems.

Scanning can provide benefits over the use of impression materials in terms of accuracy and time efficiency. Intraoral scanners often record many data captures that can be used to create a three-dimensional model. The scanner is then removed and an overlay of the previously created three-dimensional model is created. A new data capture is recorded and both the first three-dimensional model and the new three-dimensional model are mated to each other to create a single composite model. The first data includes sufficient data capture of the maxillary and mandibular dental arches to model the surface of the dental arch that the denture or other tray will sit on when used by an individual. The second data includes sufficient data capture of the maxillary and mandibular arches through the opening and sufficient data capture of the continuous channel between the maxillary and mandibular arches to provide empirical data of the bite position. An extraoral scanner may be similarly used, possibly in conjunction with a cheek retractor or other instrument to provide a clear depth of field for the maxillary and mandibular dental arches, and may additionally be used to scan an individual's external features that may reflect smiling and other facial expressions that may accompany bite positions or other maxillo-mandibular relationships.

A replica of an existing denture can be used as a tray. The replica is prepared by scanning an existing denture and three-dimensionally printing the replica with the appropriate material. Openings will be included in the replica. The bite-establishing component will include some or all of the dentition in the denture and the exposed portions of the maxillary and mandibular arches may be scanned along a continuous path to establish the relationship of the maxillary and mandibular arches at the bite position.

The tray may include a recorder and a recording surface (e.g., pin recording plate, digital recorder and recording surface, etc. used in pin tracking), effectively allowing the tray to act as a pin track to define a bite position or other maxillo-mandibular relationship position. The bite set assembly will include a pin and a registration plate.

Scanning the dental arch provides advantages over using traditional impression materials. Techniques based on impression materials have known drawbacks including tissue compression, errors caused by improper size/shape of the impression tray, deformation of the impression material caused by movement during the impression process, deformation of the material during the set-up or hardening process, and regional loss of data caused by air bubbles in the material. If the cast is prepared by pouring tartar/gypsum into the impression, the cast-based model will undergo the same deformation and the dimensional proportion of the gypsum dental model will be further affected by the moisture content. The dimensional fidelity of the dental arch is affected by these compounding errors caused by impression materials, impression making techniques, stone/plaster material properties, and the inherent inaccuracies of the table scan process, among others. Thus, techniques involving scanning rather than impression materials would be an improvement over existing industry practices.

Determining occlusion of an edentulous individual

Fig. 1 is an edentulous individual 10 having an upper maxillary arch 12 and a lower mandibular arch 14 in their mouth 16. Neither the maxillary arch 12 nor the mandibular arch 14 has any dentition, although the methods and systems disclosed herein are applicable to partially toothed individuals. The external facial features of the individual 10 are features of the face, particularly around the mouth 16, that reflect changes in the facial expression of the individual (e.g., when the individual 10 is smiling, unpleasant, whistling, etc.), and may include the mouth, nose, eyes, or other external features.

Fig. 2 shows an edentulous individual 10 having an upper maxillary tray assembly 17 and a lower mandibular tray assembly 19 in their mouth 16. The maxillary tray 17 receives the maxillary arch 12 and the mandibular tray 19 receives the mandibular arch 14. The maxillary tray 17 and the mandibular tray 19 together are a pair of trays. A maxillary opening 09 is defined in the maxillary tray 17 to expose the maxillary arch 12 and a mandibular opening 11 is defined in the mandibular tray 19 to expose the mandibular arch 14.

The maxillary occlusion establishing component 13 extends from the maxillary tray 17 and the mandibular occlusion establishing component 15 is located on the mandibular tray 19. In the trays 17, 19 the maxillary occlusion establishing component 13 is a pin and the mandibular occlusion establishing component 15 is a registration plate, providing a pin tracing function. Other suitable maxillary and mandibular occlusion establishing components 13, 15 (e.g., partially toothed, etc.) may also be used. The maxillary and mandibular occlusion establishing components 13 and 15 together allow the edentulous individual 10 to define the occlusion. The maxillary tray 17 and the mandibular tray 19 may be locked in one position to maintain the bite position when the trays 17, 19 are placed in the mouth 16 and removed from the mouth 16.

Fig. 3 is a flow chart of a scanning method 05 for scanning an individual 10 to model a maxillary arch 12 and a mandibular arch 14.

Fig. 4 is an illustration of a scanning method 05 performed on a person 10. At part 01 of the method 05, first data 85 is obtained by scanning the maxillary arch 12 and the mandibular arch 14 with the intraoral scanner 57. The first data 85 facilitates preparation of a three-dimensional model of the maxillary arch 12 and the mandibular arch 14. The first data 85 includes sufficient coverage of the maxillary and mandibular dental arches 12, 14 to model the surface on which the denture or other dental appliance may sit (e.g., the first data 85 may include substantially all of the data for each of the maxillary and mandibular dental arches 12, 14, less data for all but one of the two dental arches 12, 14, etc.). In fig. 4, first data 85 is shown as being collected by the intraoral optical scanner 27 at portion 01. Other suitable scanners may also be used (e.g., external optical scanners, extraoral optical scanners with cheek retractors, ultrasound, etc.).

At part 02 of method 05, the individual 10 is provided with a maxillary tray 17 and a mandibular tray 19. When the maxillary tray 17 and the mandibular tray 19 are placed in the mouth of the individual 10, the individual 10 is in an maxillomandibular relationship defining a bite position. The maxillary tray 17 and the mandibular tray 19 may be locked in a position defining a bite position so that the maxillary tray 17 and the mandibular tray 19 maintain that position when removed from the mouth 16.

At part 03 of method 05, second data 86 is acquired by scanning arch 12, arch 14, and continuous channel 56 between maxillary arch 12 and mandibular arch 14. The second data 86 is acquired when the maxillary tray 17 and the mandibular tray 19 are in the mouth 16 and the maxillo-mandibular relationship is in the bite position. The second data 86 includes empirical data of the maxillomandibular relationship at the bite position. Since the bite is defined by the maxillary tray 17 and the mandibular tray 19 and the second data 86 is acquired at the bite position, portion 02 precedes portion 03. Portion 01 may be performed before or after portions 02 and 03.

The continuous channel 56 provides an unbroken path between the upper and lower dental arches 12, 14. The continuous channel 56 may begin at the mandibular arch 14 as viewed through the mandibular opening 11 (as indicated by the beginning of the continuous channel 56 in fig. 4). Starting from the mandibular arch 14 at the mandibular opening 11, a continuous channel continues through the material 50 (e.g., impression material, bite registration material, mouth putty, etc.) connecting the maxillary tray 17 and the mandibular tray 19. Starting with material 50, a continuous channel 56 reaches the maxillary arch 12, as viewed through the maxillary opening 09. At this point, the continuous channel 56 has passed through both the maxillary and mandibular arches 12, 14, and the second data 86 may be prepared. However, the second data 86 may benefit from an increased amount of data along the continuous channel. To provide a greater amount of second data 86, the continuous channel 56 then passes through the maxillary tray 17 to the other maxillary opening 11 where another portion of the maxillary arch 14 is visible and from there down through more of the material 50 to the mandibular tray 19 where the mandibular arch 14 is visible through the other opening of the mandibular opening 11.

The continuous channel 56 includes two points of contact with each of the maxillary and mandibular arches 12 and 14. However, the continuous channel may follow any path including each of the maxillary and mandibular arches 12, 14. The material 50 is provided to allow the continuous channel 56 to include each of the maxillary and mandibular dental arches 12 and 14 without losing the frame of reference in the space between the maxillary and mandibular trays 17 and 19. The depth of field of current scanners is often typically too shallow for acquiring reliable second data 86 across the gap between the maxillary tray 17 and the mandibular tray 19, and therefore, without the material 50, the maxillary tray 17 and the mandibular tray 19 cannot provide a frame of reference along the portion of the continuous channel 56 between the maxillary tray 17 and the mandibular tray 19. It is expected that future improvements in the depth of field of the optical scanner will facilitate acquisition of the second data 86 along a continuous channel that does not include the material 50 or any other feature (e.g., the bridge 148 and other examples of bridges shown below, etc.) that is directed to providing a frame of reference within a shallow depth of field. However, with the latest optical scanners (intraoral or extraoral), the material 50 or other feature bridging the maxillary tray 17 and the mandibular tray 19 facilitates the acquisition of the second data 86 along the continuous channel 56.

Non-fading inks or other temporary marking techniques may be applied to the maxillary and mandibular dental arches 12 and 14 to make visible markings (not shown) on the maxillary and mandibular dental arches 12 and 14 that may be used as an aid in meshing and aligning the first data 85 with the second data 86 when preparing the first model 21. The temporal marker is present in both the first data 85 and the second data 86. With the temporal markers, the size of the continuous channel 56 providing the selected amount or quality of the second data 86 may be reduced.

Fig. 5 is a flow chart of a process 90 for assembling first data 85 and second data 86 into a first model 21 of an individual 10 for designing or optimizing a denture or other dental appliance.

Fig. 6 is an illustration of data used in method 90. At part 91 of method 90, first data 85 and second data 86 are combined to prepare first model 21. The first model 21 includes models of the maxillary and mandibular dental arches 12 and 14 based on the first data 85 and includes empirical data of the maxillo-mandibular relationship at the bite position based on the second data 86. As a result, the maxillo-mandibular relationship in the first model 21 reflects the actual maxillo-mandibular relationship of the individual 10 in the bite position defined by the maxillo-tray 17 and the mandible tray 19.

At part 92 of the method 90, dental appliance data 89 for a denture 29 or other dental appliance or feature may be added to the first model 21 to provide the second model 23. The dental appliance data 89 is shown to facilitate modeling of the denture 29. The denture 29 may be a previous denture of the individual, in which case the dental data 89 may be obtained by scanning the previous denture of the individual. Alternatively, the denture 29 may be selected from a library, in which case the dental appliance data 89 may be derived from the library. The denture 29 may also be adjusted or changed by the modeling software (e.g., to select particular features of the dentition that will remain in occlusion from the second data 86, so that changes to the denture 29 result in changes in the occlusion of the individual 10, etc.).

At part 93 of the method 90, the maxillomandibular relationship defined by the denture 29 is updated in response to introduction of the denture 29 or changes to the denture 29, as described with respect to part 92.

In the case where the denture 29 is an existing denture for the individual 10, the dental data 89 may be obtained by scanning the existing denture for the individual 10. In some cases, the splint material may be applied to the maxillary denture, the mandibular denture, or both dentures to restore a more appropriate bite position before continuing with method 05. For example, wax, prosthetic acrylic or bite registration material may be placed over the teeth on the maxillary tray 17 and the mandibular tray 19 to restore perpendicularity of the bite of the individual 10. When the denture teeth are broken, the bite of the individual 10 can be moved out of position to optimize function, which can be moved with the splint material. In the case of excessive bone loss or tooth wear, the mandible can be advanced so that the bottom teeth project well beyond the top teeth. If a previous denture is used for design purposes in this case, the position of the denture can be corrected using the splint to design a new denture.

In some embodiments, the temporary material may be applied to the top denture, the bottom denture, or both the top denture and the bottom denture to restore more appropriate lip support before continuing with method 05. For example, wax may be added to the outer surface of the denture to provide customized facial support, and the resulting denture with temporary material may be scanned and incorporated into a new prosthesis.

Older dentures often do not properly load the gums because the shape of the gums on which the dentures sit is constantly shrinking and changing. Additionally, as the denture teeth break down, the individual's bite can be moved out of position to optimize function. U.S. publication No.2013/0209962 details a method in which denture fit shortcomings are addressed by taking an impression on the denture tissue fit side and recording the bite using bite registration material, and then scanning the resulting denture, impression material and bite registration. The method 05 does not rely on registering materials to obtain the first data 85 and the second data 86. Pin tracing may be used to record occlusion where use of an existing denture is inappropriate.

False tooth replica

Fig. 7 shows a replica 20 of a denture for an individual 10.

Fig. 8 shows a reproduction 20 in the mouth 16 of an individual 10. Unlike an individual denture, the replica 20 includes an opening 22 on each buccal side of the replica 20 to expose a portion of the maxillary arch 12 and the mandibular arch 14. When placed in the mouth 16, the replica 20 provides a continuous channel between the upper and lower dental arches 12, 14 to register the maxillo-mandibular relationship. The anterior dentition 24 and the posterior dentition 26 proximate the opening 22 provide a frame of reference within the depth of field for a commonly used scanner that passes between the upper and lower dental arches 12 and 14.

The replica 20 may include other openings similar to the opening 22 at several locations to facilitate accurate scanning (not shown). Adding more openings or increasing the size of the openings increases the amount of second data 86 acquired by scanning by exposing more of the maxillary arch 12, the mandibular arch 14, or both. The larger the resolution and depth of field of the scanner used, the smaller the opening 22 may be. The opening 22 may be exposed, for example, about one square centimeter on each of the upper and lower dental arches 12, 14. However, if too many openings of too large a size are placed at the wrong part of the replica 20, the individual 10 may not be able to bite down effectively on the replica 20 without the replica 20 slipping out from between the maxillary and mandibular dental arches 12, 14 due to uneven loading.

When selecting the size, number and location of the openings on the replica, competitive considerations of sufficient exposure of the maxillary and mandibular arches 12, 14 along the continuous pathway must be balanced with the stability of the replica 20 in the mouth 16 when the individual 10 bites down on the replica 20. To facilitate stable occlusion at the replica 20, an opening 22 is placed between the maxillary tubercle and the maxillary canine ridge on the maxillary arch. Similarly, on the mandibular arch, the opening 22 is placed between the mandibular cuspid ridge and the mandibular molar back pad.

The operation of the scanner is limited by the available tolerance of the depth of field. For example, some current intraoral optical scanners are unable to record depths of more than about 4mm, with about 16mm being the depth tolerance of current intraoral optical scanners. For example, some current extraoral optical scanners are unable to accurately record depths of more than about 1500 mm.

The replica 20 may be prepared by any suitable method (e.g., using a previous casting process, three-dimensional printing, etc.). Scanning the denture of the individual 10 to provide the dental data 29 allows for the rapid creation of an embryonic form of the replica 20 and modeling the denture of the individual 10 at portion 92 for modification at portion 92. In addition, the molded denture tray can be removed from the second model 23 for analysis, diagnosis, and/or designing a new prosthesis on the model 21 at the bite position.

Fig. 9 illustrates a method 105, the method 105 including scanning the maxilla tray 17 and the mandible tray 19 to provide third data 187 at portion 104 of the method 105. The maxillary tray 17 and the mandibular tray 19 are scanned using an extraoral scanner 59.

Fig. 10 is an illustration of data acquired by method 105. Third data 187 may include data for all sides of each tray 17, 19 to facilitate preparation of an accurate model of the tray 17, 19 for the second model 125 (see below). Alternatively, the third data 187 may include data of a denture (not shown) of the individual to prepare the replica 20, similar to the dental data 89 being based on data from the denture of the individual. In this case, the second data 186 would be obtained while the replica 20 was in the mouth of the individual (not shown; in fig. 9 and 10, the maxillary tray 17 and the mandibular tray 19 were scanned for the third data 187, and thus the second data 186 is based on the bite established with the maxillary tray 17 and the mandibular tray 19, which can also be used to prepare the replica 20). Since the bite is defined by the maxillary tray 17 and the mandibular tray 19 and the second data 186 is acquired at the bite position, the portion 102 precedes the portion 103. Portion 101 and portion 104 may be performed before or after portion 102 and portion 103, respectively, or before or after each other.

Fig. 11 illustrates a method 190 of making the first model 121 and the second model 125.

Fig. 12 is an illustration of data used in method 190. At step 194, the third data 187 is combined with the first model 121 to provide a second model 125 of the individual at the bite position and wearing the maxillary tray 17 and the mandibular tray 19. The maxillary tray 17 and the mandibular tray 19 may be useful starting points for designing new dental appliances at sections 194 and 193. The maxillary tray 17 and the mandibular tray 19 may be removed from the second model 125 to analyze, diagnose and/or design a new prosthesis on the model 121 at the bite position.

In the case where the bite of the individual 10 is unlikely to be changed, the duplicate 20 or the denture of the individual 10 may be used as a starting point of the third data 187 or as the dental data 89. This may be the case if the dentures of the individual 10 are cosmetically renewed. In the event that the bite of the individual 10 may change significantly from that provided by an existing denture, a pin tracer may be used to establish a new bite.

Pin tracer

FIG. 13 is a pin tracer 30 for use in determining a bite position for a central occlusal relationship with respect to an upper and lower jaw in some embodiments of the method 05. The maxillary component 32 is shaped to receive a maxillary dental arch and the mandibular component 34 is shaped to receive a mandibular dental arch. A pin 36 extends from the upper jaw assembly 32 and a recording plate 38 is secured to the lower jaw assembly 34 (alternatively, the pin may be placed on the lower jaw assembly and the recording plate may be placed on the upper jaw assembly). The pins 36 mark the registration plate 38 as the upper jaw assembly 32 moves relative to the lower jaw assembly 34. The marking of the pins 36 on the register plate 38 allows the position of the bite to be identified. The upper jaw assembly 32 and the lower jaw assembly 34 may be positionally locked relative to one another in the occluded position (or any other position). The pin tracer 30 can then be placed in the individual's mouth and the individual's dental arch and pin tracer 30 scanned together (this would apply, for example, to portion 103 of scanning method 105).

The maxillary buccal wall 40 of the maxillary component 32 includes a maxillary opening 42. Chin cheek wall 44 of chin assembly 34 includes a chin opening 46. In addition to or instead of the cheek walls 40, 44, openings similar to the maxillary opening 42 and the mandibular opening 46 may be included on the maxillary lip wall 52 and the mandibular lip wall 54. Other possible locations for the openings are described below with reference to fig. 32-35.

The maxillary opening 42 and the mandibular opening 46 provide clear views of the dental arch, exposing portions of both the maxillary dental arch 12 and the mandibular dental arch 14. Where portions of the maxillary and mandibular arches 12, 14 can be captured in a single continuous channel (e.g., continuous channel 56, etc.), it is convenient to use an intraoral scanner to record the maxillomandibular relationship. Depending on the type of scanner used, it may be possible to capture both the maxillary arch 12 and the mandibular arch 14 in a single field of view. Previous pin tracing and dentures cover almost all of the maxillary and mandibular dental arches 12 and 14 and do not provide useful openings for scanning the maxillary and mandibular dental arches 12 and 14 simultaneously while scanning the pin tracing, and therefore do not facilitate modeling based on empirical scan data of bite position. In contrast, the methods and systems disclosed herein facilitate modeling based on empirical scan data of the dental arch at the bite location.

To facilitate stable occlusion on the pin tracer 30, the maxillary opening 42 is placed between the maxillary tubercle and the maxillary canine ridge on the maxillary arch. Similarly, on the mandibular arch 14, a mandibular opening 46 is placed between the mandibular cuspid ridge and the mandibular molar back pad.

Most denture or pin tracing devices have a gap between the upper and lower arch components, allowing contact only between the pin and the recording plate (see, e.g., U.S. publication No.2013/0280672 or U.S. publication No.2012/0322031) to prevent contact between portions of the upper and lower arch components during tracing and not between the pin and the recording plate. Such gaps often occur at the rear of the pin track. These gaps prevent most intraoral scanners (having a relatively small depth of field) from recording pinned maxillary and mandibular components with the same depth of field, complicating the recording of maxillomandibular relationships. Pin tracer 30 lacks a structure that provides a continuous frame of reference for a continuous scan channel (e.g., continuous channel 56, etc.). As shown in fig. 4, 10, 25 and 31, the material 50 can be used to provide a frame of reference for portions of the continuous channel between the maxillary component 32 and the mandibular component 34. Alternatively, a structure may be included with the pin tracer to provide a frame of reference.

Bridge with a bridge body

Fig. 14 shows the pin tracer 130 with a bridge 148 (e.g., a short metal or other rigid material, etc.) connecting the upper jaw component 132 and the lower jaw component 134 of the pin tracer 130. Bridge 148 provides a frame of reference for the continuous scan path between maxillary and mandibular arches 12, 14 provided by openings 142, 146.

As described above, some scanners have limitations in depth scan tolerance that is shallower than the distance between the left and right portions of the maxillary buccal wall 40 and the left and right portions of the mandibular buccal wall 44 (e.g., in some commercial intraoral scanners, more than 4mm of scan cannot be completed from the scanner). To address this problem, the space between the maxillary and mandibular portions of the pin tracer device is bridged with a mechanical device such as bridge 148 or filled with a material (e.g., material 50 in fig. 4 and 25). Any gaps or voids between the components 132, 134 that are deeper than the tolerance of the scanner are bridged or filled, which provides a continuous channel between the exposed maxillary and mandibular dental arches (particularly the maxillary and mandibular gingiva). The bridge 148 allows the scanner to create a path between the upper and lower dental arches along a continuous path with a constant frame of reference to register the upper and lower jaw relationship. As above, openings may be included at multiple locations, and bridges may be included at each location to increase the accuracy of data acquisition. The bridge 148 provides a constant frame of reference along the continuous channel between the openings 142, 146 that can be easily scanned within the depth of field of most optical scanners and can be contacted by an ultrasonic scanner or other touch-based scanner.

Fig. 15-17 illustrate the pin tracer 230 with an articulated bridge 260, the articulated bridge 260 including a maxillary articulation bridge assembly 262 and a mandibular articulation bridge assembly 264. In the closed position, such as bridge assembly 264 of fig. 15, the bridge assembly does not pass through the gap between the upper jaw assembly 232 and the lower jaw assembly 234. When the bridge assemblies 262, 264 are each in the open bridge position (fig. 16), the bridge assemblies 262, 264 contact one another, which provides a bridge between the upper jaw assembly 232 and the lower jaw assembly 234, and a constant frame of reference for a continuous passage. Alternatively, a single bridge component may be employed that bridges the upper and lower jaw components 232, 234 and may be placed on either the upper and lower jaw components 232, 234 (not shown). Hinged bridge assemblies 262, 264 are connected to upper jaw assembly 232 and lower jaw assembly 234 by hinges 266. Hinge 266 is removable (fig. 17).

Fig. 18-20 illustrate pin tracer 330 with pivot bridge 370, pivot bridge 370 including a maxillary pivot bridge assembly 372 and a mandibular pivot bridge assembly 374. When one of bridge assemblies 372, 374 is in the open bridge position (fig. 19), bridge assemblies 372, 374 contact one another, which provides a constant frame of reference for the continuous channel between upper jaw assembly 332 and lower jaw assembly 334. Hinged bridge assemblies 372, 374 are connected to the upper jaw assembly 332 and the lower jaw assembly 334 by pivots 376.

Fig. 21 shows pin tracer 430 with pivot bridge 471, the pivot bridge 471 including bridge components 473, 475 that are smaller than bridge components 372, 374. Both bridge assemblies 473, 475 are in an open position (as shown) to provide a connection between the upper jaw assembly 432 and the lower jaw assembly 434.

Fig. 22-24 show the pin tracer 530 with a sliding bridge 580, the sliding bridge 580 including a maxillary sliding bridge assembly 582 and a mandibular sliding bridge assembly 584. When each of the bridge assemblies 582, 584 is in the open bridge position (fig. 23), the bridge assemblies 582, 584 contact each other, which provides a connection between the upper jaw assembly 532 and the lower jaw assembly 534. The sliding bridge assemblies 582, 584 are slidably connected to the upper and lower jaw assemblies 532, 534.

The examples of bridge assemblies shown herein are located on the openings 242, 246, 342, 346 and 542, 546, respectively, in the closed position (fig. 15, 18, 22). By placing the bridge assembly close to the opening, scanning is facilitated. However, the bridge assembly may be placed away from the opening and need not cover the opening when in the closed position.

An example of a bridge assembly may be used by the replica 20 if the dentition 24, 26 used in a given replica 20 does not bridge the maxillary and mandibular portions of the replica 20. Otherwise, the dentitions 24, 26 may provide a bridge between the maxillary and mandibular portions of the replica 20.

All examples of pin tracking shown herein may include a securing and locking feature to secure and lock the upper jaw assembly 32 and the lower jaw assembly 34 in a given maxillomandibular relationship.

In addition to the illustrated example, the bridge assembly may further include a ratchet feature, a piston and cylinder assembly, or otherwise.

Fig. 25 shows a material 50 (e.g., impression material, bite registration material, mouth putty, etc.) used to connect the maxillary and mandibular components 32, 34 of the pin tracer 30. The bridge 148 or material 50 is placed close enough to the cheek walls 40, 44 to provide a continuous channel, at least within the depth of field of a typical scanner. Where openings similar to openings 42, 46 are placed in the maxillary lip wall 52 and the mandibular lip wall 54 in addition to or instead of the buccal walls 40, 44, the bridge 148 or material 50 may be placed close enough to the lip walls 52, 54 to provide a continuous channel within the depth of field of a typical scanner (see fig. 34-35).

Fig. 26 is a customized pin tracer 630. In addition to the features of the pin tracer 30, the customized pin tracer includes a leading row of teeth 624. The anterior dentition 624 may be used to guide the maxillomandibular relationship of the central dentition or to assist the individual 10 in selecting the appropriate cosmetic effect of the dentition 624. The customized pin tracer 630 shows the first six teeth. However, other variations of the anterior 624 or posterior dentition may also be included in the customized pin tracer 630 (e.g., maxillary, molar, etc. only). The anterior dentition 624 provides a frame of reference for the continuous passage between the maxillary openings. The customized pin tracer 630 can include any of the bridges and bridge assemblies shown in fig. 15-24, and the material 50 can be used for the customized pin tracer 630, as shown in fig. 25.

In some embodiments, the customized pin tracer 630 can be conventionally manufactured or manufactured using rapid prototyping techniques (three-dimensional printing). The customized pin tracer 630 may, for example, incorporate some or all of the following features: (a) creating a customized fit of the desired tissue-fitting surface by using an intraoral scan model, (b) accommodating a portion of an individual's existing denture, (c) accommodating natural teeth, dental implants or other restorations, (d) providing a hypothetical tooth arrangement. These are features that may also be included in the replica 20.

The replica 20 may be used when the bite is unlikely to change as a result of molding or processing. In case a new bite is to be defined, the pin tracer 30 or one of its variants may be used. In the event that a new bite is to be defined and the individual 10 chooses to maintain a consistent dental appearance, the custom pin tracer device 730 facilitates determination of the central occlusal maxillomandibular relationship and provides an associated cosmetic landmark.

External scanning of facial information

The second model 23 includes dental appliance data 89 for a denture or other dental appliance of the individual 10, or dental appliance data for a denture or dental appliance from a library. The second model 123 comprises third data 187 of the denture of the individual 10, or third data 187 of the maxillary tray 17 and the mandibular tray 19. Each of these second models 23, 123 may be viewed without the data of the external features 18. However, in some cases, the data of the external features 18 may provide additional facial information for modeling, diagnosis, and design. By recording common facial expressions (e.g., mouth closed in relaxed state, mouth open in relaxed state, high smile, etc.), this may provide aesthetic information that may be recorded and used to assist in visualization of the proposed design of the prosthesis or prosthesis. The visualization may be done entirely digitally on the model, or the suggested design may be digitally visualized in real time directly on the person using an exaggerated reality.

Fig. 27 shows a method 205, the method 205 comprising scanning the external features 18 at the portion 206 to provide fourth data 288. The fourth data is acquired by scanning the external feature 18 with an extraoral scanner 59.

FIG. 28 is an illustration of data acquired by method 205. The fourth data 288 is obtained by extraoral scanning of the external features 18 of the individual 10, such as the area around the mouth 16. The fourth data 288 may include data of external features at the bite position, such as when the individual 10 is smiling or otherwise unpleasant. However, the dental arches 12, 14 will generally not be visible in the fourth data 288.

Capturing empirical data of the external features 18 facilitates modeling the individual 10 at a selected facial expression based on the empirical data while the individual 10 is at that facial expression. In addition, acquiring data of other external features, such as the location of the external ear canal, other landmarks, facilitates more accurate modeling of jaw movements. Facial information may be captured in the fourth data 288 and, if the second data 286 is captured with an extraoral scanner, also in the second data 286, the capturing of the second data 286 with the extraoral scanner may involve the use of a cheek retractor. Additionally, the information obtained by scanning portions of the personal denture (e.g., via the dental appliance data 89), the revised replica (e.g., replica 20), or the maxillary tray 17 and mandibular tray 19 (e.g., third data 187) may provide aesthetic information that may be useful in the secondary design of the denture or other dental appliance, particularly when used in combination with the data of the external features 18.

FIG. 29 is a flow chart of a processing method 290 for assembling first data 285, second data 286, and fourth data 288 into fourth model 227 including data of external feature 18.

FIG. 30 is a schematic of the components of the fourth model 227. As the mandible relationship or molded tray of the fourth mold 227 is updated, the external features are updated accordingly at 296. Facial information is recorded with an extraoral three-dimensional scan of the individual's head. Useful information for aesthetic and prosthetic design of dental restorations includes, but is not limited to: a resting lip position with mouth open, a resting lip position with chin immobilized and mouth closed, a resting lip position in mouth closed bite, a lip line with high smile. Because the denture incorporates a support flange that covers the maxillary gingiva and provides labial support, the denture has a more pronounced effect on labial position than the natural dentition. The anterior teeth, and their bone and tissue supporting structures are lost, the lips are insufficiently supported and often have a completely collapsed appearance. Extraoral scanning of individuals without dentures may lead to a poor image of future designs, since the lack of lip support, compared to software visualized designs, leads to a dissimilar appearance of the new prosthesis.

Facial information may include, but is not limited to, the following landmarks:

A. sagittal or median plane-an imaginary plane passing longitudinally through the middle of the head and dividing the head into right and left halves

B. The position of the auditory canal, also known as the external auditory canal

C. Boundaries of the nose wings

D. Boundaries of tragus of ear

E. Orbit of eye

F. Track marked with visual mark on skin

G. Submental point marked with visual indicia on skin

H. In a threshold marked by a visible mark on the skin

I. Nasion marked with visual marks on skin

J. Submental site marked with visual indicia on the skin

K. Mandibular corner points marked by visual marks on the skin

L, submandibular points marked by visual marks on the skin

M, the position of the lips in a relaxed state, known as the "lip line

N, the position of the lips during a smile, known as the "smile line

O, position of occluded lips

P, side profile: straight, concave or convex

Q, face contour: square, round and conical

After identifying relevant landmarks from the above, the following points may be established:

beyron point-approximately 13mm in front of the rear edge of the tragus of the ear, on a line extending from the center of the tragus to the canthus

Bergstrom point-about 10mm anterior to the center of the spherical insertion of the external ear canal and about 7mm below the Frankfort horizontal plane

Gysi Point-on line to the external orbit of the eye, about 13mm anterior to the uppermost part of the external ear canal

Frankfort horizontal plane-a plane passing through the inferior border of the orbit (referred to as the orbital point) and the upper border of each ear canal or external auditory canal

Campers plane-a line from the inner boundary of the alar nose to some defined point on the tragus of the ear (usually the midpoint or upper boundary of the tragus). Which is often used for the purpose of establishing the plane of the alar tragus. Theoretically, the plane of the alar tragus of the nose is considered parallel to the occlusal plane. When viewed in the midsagittal plane, the occlusal plane is at an angle of about 10 degrees relative to the Frankfort horizontal plane.

Replica with bridging tooth rows

Fig. 31 is a replica 120 of a denture. The front row of teeth 124 and the rear row of teeth 126 extend across the opening 122, which provides a frame of reference proximate the opening 122 for the continuous channel.

Position of opening

The openings providing a view of the arch may be placed at various locations on the pin tracer or other tray for establishing occlusion and scanning of the arch. Some examples follow below.

Fig. 32 is a pin tracer 700 with a single maxillary buccal opening 742 and a single mandibular buccal opening 746. The maxillary and mandibular buccal openings 742, 746 are on opposite sides of the respective maxillary and mandibular components 732, 734. A continuous channel will extend a greater distance between openings 742, 746 than in pin tracer 30. In general, placing the openings on corresponding sides of the respective maxillary and mandibular dental arches facilitates scanning more than placing the openings on non-corresponding surfaces. For example, the openings 42, 46 of the pin tracer 30 are placed on the left and right sides of both the upper jaw assembly 32 and the lower jaw assembly 34. This provides a simpler continuous channel than pin tracer 700.

Fig. 33 is a pin tracer 830 with a maxillary bucco-lingual opening 851 and a mandibular bucco-lingual opening 853. The pin tracer 830 would likely have to be used with an intraoral scanner because the extraoral scanner would not have a clear view of the openings 851, 853.

Fig. 34 is a pin tracer 930 with a maxillary labial face opening 941 and a mandibular labial face opening 943. These positions of the openings 941 and 943 may be easier to scan than the face openings 42, 46, but may also make the pin tracer 930 unstable relative to the pin tracer 30.

Fig. 35 is a pin tracer 1030 with a maxillary labial-lingual opening 1045 and a mandibular labial-lingual opening 1047. With pin tracing 830, the tongue opening may need to be scanned with an intraoral scanner as compared to an extraoral scanner.

Are given by way of example only

In the previous description, for purposes of explanation, numerous details were set forth in order to provide a thorough understanding of the embodiments. However, it will be apparent to one skilled in the art that these specific details are not required. In some instances, specific details are not provided as to whether the embodiments described herein are implemented as a software routine, hardware circuit, firmware, or a combination thereof.

Embodiments of the present disclosure may be represented as a computer program product stored in a machine-readable medium (also referred to as a computer-readable medium, a processor-readable medium, or a computer-usable medium having a computer-readable program code embodied therein). The machine-readable medium may be any suitable tangible, non-transitory medium including magnetic, optical, or electrical storage medium including a diskette, compact disk read only memory (CD-ROM), storage device (volatile or non-volatile), or similar storage mechanism. The machine-readable medium may contain various sets of instructions, code sequences, configuration information, or other data, which when executed, cause a processor to perform portions of the methods according to embodiments of the disclosure. Those of ordinary skill in the art will appreciate that other instructions and operations necessary to implement the described embodiments may also be stored on the machine-readable medium. Instructions stored on a machine-readable medium may be executed by a processor or other suitable processing device and may interface with circuitry to perform the described tasks.

The above described embodiments are intended to be examples only. Alterations, modifications and variations may be effected to the particular embodiments by those of skill in the art without departing from the scope, which is defined solely by the claims appended hereto.

Claims

1. A method of obtaining data for preparing a model of an edentulous individual, comprising:

obtaining first data of a maxillary dental arch of the individual and first data of a mandibular dental arch of the individual for modeling the maxillary dental arch and the mandibular dental arch;

providing a pair of components for receiving the maxillary and mandibular dental arches in an maxillo-mandibular relationship defining a bite position, the pair of components defining an opening on each of the components for exposing a continuous passage between the maxillary and mandibular dental arches; and

second data is acquired along the continuous channel of the maxillary and mandibular dental arches in the bite position for modeling the relative positions of the maxillary and mandibular dental arches in the bite position.

2. The method of claim 1, wherein the openings are aligned on respective surfaces of each of the components.

3. The method of claim 1, further comprising: combining the first data and the second data to prepare the model, the model including empirical data of the bite position.

4. The method of claim 1, further comprising: providing dental appliance data for a pair of dental appliances and combining the first data, the second data and the dental appliance data to prepare the model, the model including empirical data of the bite position.

5. The method of claim 4, wherein providing the mouthpiece data comprises: a pair of dentures appropriate for the individual is scanned.

6. The method of claim 4, wherein providing the mouthpiece data comprises: a library of dental appliance data is accessed.

7. The method of claim 1, further comprising: third data for the pair of components is obtained for modeling the pair of components.

8. The method of claim 7, further comprising: combining the first data, the second data, and the third data to prepare the model, the model including empirical data of the bite position and empirical data of the pair of components.

9. The method of claim 1, further comprising: fourth data of an external feature of the person is obtained for modeling the external feature.

10. The method of claim 9, further comprising: combining the first data, the second data, and the fourth data to prepare the model, the model including empirical data of the bite position and empirical data of the external feature at the bite position.

11. The method of claim 9, wherein obtaining the fourth data further comprises: acquiring the fourth data while the person maintains the selected facial expression to prepare a model with empirical data of the external features at the selected facial expression.

12. The method of claim 1, wherein the second data further comprises data of external features of the individual for modeling the relative positions of the maxillary arch and the external features.

13. A method as in claim 1, wherein acquiring the second data comprises exposing the opening with a cheek retractor.

14. The method of claim 1, wherein providing the pair of components includes preparing a replica of a denture prepared for the individual, and the opening is defined on the replica.

15. The method of claim 1, further comprising: locking the pair of components in the occluded position.

16. The method of claim 1, the pair of components further comprising a recorder and a recording surface.

17. The method of claim 16, further comprising: the bite position is defined with reference to markings made by the register on the recording surface.

18. The method of claim 1, further comprising: a bridge is provided between the pair of components proximate the opening for providing a frame of reference along a portion of the continuous channel between the pair of components.

19. The method of claim 18, wherein providing a bridge between the pair of components proximate to the opening comprises: connecting the pair of components with a non-deformable material.

20. The method of claim 18, wherein providing a bridge between the pair of components proximate to the opening comprises: moving a bridging member connected to the pair of members from a closed position to a bridging position.

21. The method of claim 1, wherein acquiring the first data comprises: the arch is scanned with an intraoral scanner.

22. The method of claim 1, wherein acquiring the first data comprises: scanning the dental arch with an extraoral scanner.

23. The method of claim 1, wherein acquiring the first data comprises: the arch is scanned with an optical scanner.

24. The method of claim 1, wherein acquiring the first data comprises: the arch is scanned ultrasonically.

25. The method of claim 1, wherein obtaining the second data comprises: scanning the arch along the continuous channel with an intraoral scanner.

26. The method of claim 1, wherein obtaining the second data comprises: scanning the arch along the continuous channel with an extraoral scanner.

27. The method of claim 1, wherein acquiring the first data comprises: scanning the arch along the continuous channel with an optical scanner.

28. The method of claim 1, wherein acquiring the first data comprises: ultrasonically scanning the arch along the continuous channel.

29. A bite registration device comprising:

a maxillary component shaped to receive a maxillary dental arch;

a mandibular assembly shaped to receive a mandibular dental arch;

a bite-establishing component on opposing portions of the upper and lower jaw components for defining a bite between the upper and lower jaw components; and

a maxillary opening defined on the maxillary component and a mandibular opening defined on the mandibular component for exposure to scan a continuous channel between a maxillary dental arch received in the maxillary component and a mandibular dental arch received in the mandibular component.

30. A bite registration device as in claim 29 wherein the maxillary opening and the mandibular opening are defined on respective surfaces of the maxillary component and respective surfaces of the mandibular component.

31. A bite registration device as in claim 30 wherein the respective surfaces are located on the facial walls of the upper jaw component and the lower jaw component.

32. A bite registration device as in claim 30 wherein the respective surfaces are located on buccal walls of the upper jaw component and buccal walls of the lower jaw component.

33. A bite registration device as in claim 30 wherein the respective surfaces are located on a lingual wall of the upper jaw component and a lingual wall of the lower jaw component.

34. A bite registration device as in claim 30 wherein the respective surfaces are located on a lingual wall of the upper jaw component and a lingual wall of the lower jaw component.

35. A bite registration device as defined in claim 29, further comprising: a bridge extending between the upper jaw component proximate the upper jaw opening and the lower jaw component proximate the lower jaw opening for providing a frame of reference along the continuous channel between the upper jaw component and the lower jaw component.

36. A bite registration device as defined in claim 35 wherein said bridge includes a bridge member movable between a closed position and a bridging position.

37. The bite registration device of claim 36, wherein the bridge assembly is hingedly, pivotally, or slidably connected to the bite registration device.

38. A bite registration device as in claim 36 wherein the bridge comprises a single bridge component connected to the upper jaw component or connected to the lower jaw component.

39. A bite registration device as in claim 36 wherein the bridge comprises a first bridge component extending from the upper jaw component and a second bridge component extending from the lower jaw component.

40. A bite registration device as defined in claim 36 wherein said bridge assembly reversibly covers at least one of said openings.

41. A bite registration device as in claim 29 wherein the supplemental bite establishing component comprises rows of teeth extending from the upper jaw component and extending from the lower jaw component.

42. A bite registration device as in claim 29 wherein the supplemental bite establishing component comprises a recording surface and an opposing register for marking the recording surface.

43. A bite registration device as in claim 42 wherein the recorder extends from the lower jaw component and the recording surface is located on the upper jaw component.

44. A bite registration device as in claim 29 wherein the supplemental bite establishing component comprises a dentition.

45. A method according to claim 1 using a bite registration device according to claim 29.

46. A method according to claim 16 using a bite registration device according to claim 42.