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WO2019192032A1 - Plaque de guidage d'implantation de chirurgie dentaire pour édentement complet et son procédé de fabrication - Google Patents

Plaque de guidage d'implantation de chirurgie dentaire pour édentement complet et son procédé de fabrication Download PDF

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Publication number
WO2019192032A1
WO2019192032A1 PCT/CN2018/083529 CN2018083529W WO2019192032A1 WO 2019192032 A1 WO2019192032 A1 WO 2019192032A1 CN 2018083529 W CN2018083529 W CN 2018083529W WO 2019192032 A1 WO2019192032 A1 WO 2019192032A1
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WO
WIPO (PCT)
Prior art keywords
module
planting
guide
dental
guide plate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2018/083529
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English (en)
Chinese (zh)
Inventor
光寒冰
唐宝
谢海波
金亚鸣
庞恩林
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Nanjing Profeta Intelligent Technology Co Ltd
Original Assignee
Nanjing Profeta Intelligent Technology Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Nanjing Profeta Intelligent Technology Co Ltd filed Critical Nanjing Profeta Intelligent Technology Co Ltd
Publication of WO2019192032A1 publication Critical patent/WO2019192032A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00—Products made by additive manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/225—Fastening prostheses in the mouth
    • A61C13/265—Sliding or snap attachments
    • A61C13/2653—Sliding attachments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0048—Connecting the upper structure to the implant, e.g. bridging bars
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y10/00—Processes of additive manufacturing

Definitions

  • the invention belongs to the technical field of oral cosmetic plastic surgery, and particularly relates to a dental full-mouth dentition surgery implant guiding plate and a manufacturing method thereof.
  • the initial implant surgery did not have the aid of effective equipment.
  • the doctor's sensory experience relied on the manual visual inspection to determine the position of the artificial root, and the blind implant method increased the risk of surgery.
  • doctors have developed surgical guides to reduce the risk of surgery.
  • the existing surgical guides are mainly positioned in three ways: dental support, jaw support and mucosal support.
  • Dental support refers to the use of the remaining teeth in the oral cavity as a positioning reference and support for the surgical guide, and the position of the implant is determined based on the remaining tooth position and shape information.
  • jaw support is the use of the jaw support as the positioning guide and support for the surgical guide to determine the position of the implant.
  • the mucosa needs to be opened up to a large extent, and the patient is traumatized; the mucosal support is the use of the patient's mucosa.
  • the tissue is used as the positioning reference and support for the surgical guide to determine the position of the implant. Compared with the way of the jaw support, the patient has less trauma. Therefore, many patients with full-mouth loss use mucosal support for the operation, but at the same time Need to solve the problem of accurate positioning.
  • the traditional dental implant guides are mostly wrapped plastic materials, and the dental surgery guide plates are required to be deformed, not easy to bend, can be cooled, and have large operation space and visual range during the implementation of dental implant surgery. Wide range of features.
  • the traditional plastic guide material has these drawbacks, which directly affects the implementation of implant surgery.
  • Surgical implant guide plates include:
  • a guide tube module comprising a guide tube of the same number as the implant, the guide tube being coaxial with the implant to be assembled, the inner diameter of which is adapted to the diameter of the drill bit used by the doctor;
  • the planting retention tube module comprises at least two retention tubes evenly distributed on both sides of the planting guide tube, the retention tube being coaxial with the retention nails to be driven into the bone;
  • the bridge module is connected, and the overall shape is adapted to the curve of the patient's arch, the section is trapezoidal or approximately trapezoidal, and the short bottom edge of the trapezoid is a curve, and the shorter bottom surface of the connecting bridge module corresponds to the auxiliary positioning plate;
  • the auxiliary positioning plate module has the lower side precisely matched with the surgical planting guide plate and the dental and maxillofacial data, and is used for assembling the surgical planting guide plate to the patient's dental and maxillofacial mucosa, so that the doctor can perform the operation of implanting the fixing nail. ;
  • the latch module includes a plurality of plugs between the surgical planting guide plate and the auxiliary positioning plate module, and is used for fixing the position between the surgical planting guide plate and the auxiliary positioning plate module.
  • additive Manufacturing commonly known as 3D printing
  • 3D printing is a combination of computer-aided design, material processing and forming manufacturing technology, based on digital model files, and dedicated metal materials are stacked in layers by software and numerical control system. Manufacturing technology for physical goods.
  • CAD guide plate planting uses three-dimensional reconstruction software to measure the bone density of the patient's gum bed, the height and width of the alveolar bone itself, and design the best mechanical planting point. In the operation, it avoids important nerves and blood vessels, greatly improving the safety of the operation; the planting guide plate is very suitable for the additive manufacturing method because of its high precision requirements and strong product customization requirements.
  • the wall thickness of the fixing hole of the implanting conduit is increased, and finally the outer tube wall of the guiding tube is parallel to the z-axis, and the z-axis is perpendicular to the gum Direction
  • the fitting surface between the connecting bridge body and the auxiliary positioning plate module may be provided with a groove or a protrusion.
  • the protrusions are axially parallel cylindrical protrusions or axially parallel circular tables, and the purpose is: the grooves and the protrusions can strengthen the position of the auxiliary positioning plate and the planting guide, and the doctor fixes the position. Provides additional retention when nailed.
  • At least two pins are present between the plurality of pins, and the angle in the axial direction is greater than 90°, which is to increase the connection stability and the force balance between the two.
  • a connecting rod is arranged between the two ends of the connecting bridge body, which can further prevent deformation, and the connecting rod can provide additional supporting force when the doctor hits the fixing nail.
  • the cross-sectional area of the connecting body can be reduced, or the heat treatment can be omitted, and the advantage of not performing the heat treatment is that the surface oxide layer of the sample is thin, has a metallic luster, and the patient feels good.
  • the connecting body may be a cross bar or a curved bar.
  • the upper jaw portion adopts a cross bar
  • the lower jaw adopts a curved bar to avoid the patient tongue
  • the connecting body has a rectangular cross section for convenient matching.
  • the joint between the connecting bridge body and the planting retention pipe is provided with a concave water tank, which not only has a good vision of the doctor, but also facilitates flushing and cooling in the operation, and the water flow can flow out of the oral cavity along the water tank.
  • the auxiliary positioning plate module and the planting guide plate module are provided with a pin hole for inserting the pin, and the pin hole is designed with the lip side and the buccal side as a starting point, and the auxiliary positioning plate module and the planting guide plate are penetrated. Module.
  • the plug is slightly longer than the depth of the pin hole, and it is recommended to be 2 mm longer than the plug.
  • the tip of the pin is designed to be conical, which is convenient for assembly and retention. It is recommended to use standard parts.
  • S1 patient data acquisition, obtaining patient oral treatment plan data by measurement, including CT data, dental and maxillofacial data and denture design template data;
  • step S2 planting a template design, and preparing a dental implant guide module and an auxiliary positioning plate module according to the data obtained in step S1;
  • step S3 digital model printing, printing out the dental implant guide module and the auxiliary positioning plate module designed in step S2;
  • step S4 the print model measurement confirms that the dental implant guide module and the auxiliary positioning plate module printed in step S3 are assembled together, and if there is no movement between the two, it is qualified, otherwise it is not qualified, and step S1 or S2 is performed again;
  • the step S1 is specifically: obtaining the patient oral treatment plan data from the doctor, including the physical denture design model, the planting guide tube module, and the position information of the three-dimensional model of the planting retention tube module; obtaining the denture by scanning
  • the 3D model data of the model is designed; the patient denture design template data, the dental and maxillofacial data, and the CT data are simultaneously imported into the software, and the doctor and the designer cooperate to confirm the position information of the planting guide tube module and the planting retention tube module.
  • Step S2 is specifically to confirm the position information of at least two retention tube modules, and the designer designs the inner diameter to match the diameter of the retention nail at the confirmed position, and the outer diameter is at least larger than the inner diameter of 1 mm and the length is 5 mm or more.
  • Step S3 is specifically required to perform sand blasting treatment: removing metal particles on the printing surface without affecting precision, and ensuring accurate matching of the planting guide plate and the auxiliary positioning plate
  • the metal powder for the production of the surgical planting guide plate shall be purchased from the denture raw materials approved by the food and drug supervision and administration department for registration or filing, and the technical indicators shall comply with the mandatory standards or the technical requirements for the products registered or filed;
  • the planting guide tube module confirms the corresponding position information of the planting guide tube module. If the axial direction of the planting guide tube has a sharp inclination angle with the z-axis, increase the wall thickness of the retaining hole in the outer side of the planting guide tube, and finally reach the outer tube. The effect of the wall parallel to the z-axis;
  • Step S4 is specifically as follows: S4.1 Auxiliary guide plate and surgical guide plate matching verification: the auxiliary positioning plate module and the planting guide plate module are installed together, the pressing is not moved, and then the two are precisely matched by the bolt, and combined with the denture design model, Pressing without swaying; if there is any swaying phenomenon, it is necessary to re-create the dental pedicle missing implant guide.
  • the auxiliary positioning plate and the bolt are fixed on the dental jaw and the gypsum plaster model by planting the fixing nail, and the measuring rod is inserted into the planting guiding tube to obtain the angle and position information of the implant implantation in the surgical plan by using the scanner; S4 .2.2
  • the design data and the physical data fit verification based on the design data and the physical data fitting verification, further verify whether the surgical guide plate meets the allowable error value, If the data is within the error value, the dental full-tooth dentition is missing the implant guide and can be used for surgery.
  • the patient is implanted with the fixation hole and then CT scan again to ensure that the surgical guide and the patient's mouth are in accordance with Preoperative planning is precisely matched.
  • a method of assembling a denture is carried out as follows:
  • the doctor After the doctor obtains the planting template, including the planting guide module, the auxiliary positioning plate module and the plug module, after the three modules are combined into the implanting template, the doctor must ensure that the patient implants the template to try on: the mucosal support is tight; the bite is stable and accurate. ;
  • the planting guide module, the auxiliary positioning plate module and the latch module are combined into a planting template, and the doctor allows the patient to wear the implanting template, after the accurate biting, the planting retaining nail, and then the plug module and the auxiliary positioning plate module are removed. Finally, the implant guide module fixed by the planting retention nail is retained in the patient's mouth;
  • the implant is implanted with the help of the implant guide module
  • the denture module can be assembled on the same day; the soft tissue can also be sutured to ensure the assembly of the denture module after a certain period of time after the implant is stabilized.
  • the present invention has the following beneficial effects:
  • the skeletal metal dental implant guide made by the method of the present invention has the difference in material properties such as deformation and difficulty in bending, and the invention is in the form of the invention.
  • the skeletal guide structure design also has obvious advantages compared with the traditional wrap design: during the implementation of the dental implant surgery, it not only provides the doctor with more operation space, wider visibility range, and near the planting retention tube.
  • the concave sink design also enables flushing and cooling during the operation.
  • Figure 1 is a gypsum model of the upper and lower jaw mucosa
  • FIG. 2 is a positional relationship between a planting guide tube module, a planting retention tube module and a maxillary mucosa model
  • Figure 3 is a planting guide module
  • FIG. 4 Inclined planting guide tube before and after thickening correction
  • Figure 5 is a cross-sectional design of the connecting bridge module
  • Figure 6 is a planting guide with a reinforcing connecting rod
  • Figure 7a denture design template data A
  • Figure 7c denture design template data A" ⁇ "dental mucosa data B", from the mucosal front view;
  • Figure 8 is an auxiliary positioning plate with a simulated hole
  • Figure 9 is a planting guide module with an auxiliary guide plate retention hole and an auxiliary positioning plate module
  • Figure 10 is a verification drawing of the auxiliary positioning plate and the planting guide assembly.
  • 1 mucosal gypsum model 2 is used to generate a cylindrical model of planting guide tube
  • 3 is used to generate a cylindrical model of planting retention tube
  • 4 planting guide tube module 5 planting retention tube module
  • 6 connection bridge body Module 7 concave sink
  • 8 retaining bulges 9 auxiliary guide retaining holes
  • 10 thickened modified inclined planting guide tube 11 reinforced connecting rod
  • 12 denture design template data A 13 "denture design model A” ⁇ "Dental and maxillofacial model B”
  • 14 auxiliary positioning plate module D 15 auxiliary positioning plate module central part
  • 16 auxiliary positioning plate module edge part 17 planting simulation hole
  • 18 bolt 19 auxiliary positioning with auxiliary guide plate retaining hole Board module.
  • the method for manufacturing the dental full-tooth dentition surgery implant guide plate of the present invention, and the above-mentioned jaw surgery planting guide plate is taken as an example, the production steps are as follows:
  • the patient's oral treatment plan data is obtained from the doctor, and the position information of the three-dimensional model including the physical denture design model, the planting guide tube module, and the planting retention tube module is shown in FIGS. 1 and 2.
  • the three-dimensional model data of the denture design model is obtained by scanning.
  • the patient's denture design template data, the dental and maxillofacial data, and the CT data are simultaneously imported into the software, and the doctor and the designer cooperate to confirm the position information of the planting guide tube module 4 and the planting retention tube module 5. ⁇ figure 2 ⁇
  • the doctor and the designer jointly confirmed the position information of the three planting retention tube modules 5. It is known that the doctor uses a 2.0 mm drill bit when planting the retention tube module 5 by the planting retention tube module 5, and the designer is A planting retention tube module with an inner diameter of 2 mm, an outer diameter of 4 mm and a length of 5 mm was designed at a common confirmation position. ⁇ image 3 ⁇
  • the doctor and the designer jointly confirmed the position information of the four planting guide tube modules 4, wherein the axial direction of one of the planting guide tubes has a significant inclination angle with the z-axis (the vertical direction of the gums), and the tilting axis of the retaining hole is fixed.
  • the outer direction of the oblique angle of the xy plane (the gum plane) is increased, and the wall thickness of the retaining hole is increased, and finally the outer wall is parallel to the z-axis.
  • the planting guide tubes are combined by connecting the bridge modules.
  • the cross-section of the connecting bridge body is as shown in Fig. 5.
  • the width of the trapezoidal cross-section is 3 mm and the height is 4 mm.
  • the angles ⁇ and ⁇ on both sides are both It is 6°.
  • a crossbar with a cross-section of 2 mm*2 mm is added between the two ends of the connector, and the entire device is not deformed when the retaining nail is inserted during surgery.
  • the portion where the connecting bridge body is combined with the planting retention tube is designed as a concave water tank 7. ⁇ Figure 6 ⁇
  • the central portion is adjusted to 2 mm, and the edge portion of the wrapped gum is adjusted to 3 mm.
  • the “simulated implant” hole position is designed on the four tooth models to facilitate the doctor to simulate before surgery.
  • the auxiliary guide plate retaining hole size is set to 2.05 mm, which is slightly larger than the bolt size.
  • the four auxiliary guide plate retaining holes are separated on the denture design model, and the maximum angle of the axial direction of the two auxiliary guide retaining holes is about 120° [Fig. 9]
  • the generated auxiliary positioning board module print data is imported into the slicing software, and after the slicing is completed, the slice file is imported into the resin printing device for printing.
  • Post-treatment of resin printing including the support surface and the polished layer.
  • the generated dental implant guide base module slice is then introduced into the slicing software, and the bonding surface of the metal model and the plastic part is placed as the upper surface, and the support is added. After the slicing is completed, the slice file is introduced into the metal melting printing device for printing.
  • the dental implant guide base module removes the support after removing the equipment, performing sand blasting and simple car gold.
  • the retaining holes were ground using a 2.0 mm milling drill, and the 2.0 mm pins were used to insert the auxiliary guide retaining holes and retaining holes with slight resistance.
  • the auxiliary positioning plate module and the planting guide plate are installed together, the pressing is not moved, and the two are precisely matched by the bolt, and combined with the three-dimensional solid model of the maxillary denture design model, and the pressing is not moved.
  • the doctor After the doctor obtains the planting template, including the planting guide module, the auxiliary positioning plate module and the plug module, after the three modules are combined into the implanting template, the doctor must ensure that the patient implants the template to try on: the mucosal support is tight; the bite is stable and accurate. .
  • the planting guide module, the auxiliary positioning plate module and the latch module are combined into a planting template, and the doctor allows the patient to wear the implanting template, after the accurate biting, the planting retaining nail, and then the plug module and the auxiliary positioning plate module are removed. Finally, the implant guide module fixed by the planting retention nail is retained in the patient's mouth.
  • the patient performs a CT scan again after planting the retention hole, and finally ensures that the surgical guide and the patient's mouth are precisely matched according to the preoperative planning.
  • the implant is implanted with the help of the implant guide module.
  • the denture module can be assembled on the same day; the soft tissue can also be sutured to ensure the assembly of the denture module after a certain period of time after the implant is stabilized.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Manufacturing & Machinery (AREA)
  • Materials Engineering (AREA)
  • Dental Prosthetics (AREA)

Abstract

L'invention concerne une plaque de guidage d'implantation de chirurgie dentaire pour un édentement complet, installée de manière fixe dans la cavité buccale d'un patient pour aider à l'implantation et au positionnement d'une prothèse dentaire, et principalement composée d'une plaque de guidage d'implantation chirurgicale et d'une plaque de positionnement auxiliaire, la plaque de guidage d'implantation chirurgicale comprenant : des modules de cylindre de guidage d'implantation (4), des modules de cylindre de rétention d'implantation (5), un module de pont de connexion (6), un module de plaque de positionnement auxiliaire (14) et des modules de boulon (18), la plaque de guidage d'implantation chirurgicale et le module de plaque de positionnement auxiliaire (14) étant reliés de manière fixe au moyen des modules de boulon (18). Pendant une chirurgie d'implantation dentaire, la plaque de guidage d'implantation chirurgicale offre aux médecins un plus grand espace de travail et une plus grande portée visuelle, tandis que la conception d'une rainure d'eau concave (7) à proximité du module de cylindre de rétention d'implantation (5) permet également le refroidissement par irrigation pendant une chirurgie.
PCT/CN2018/083529 2018-04-04 2018-04-18 Plaque de guidage d'implantation de chirurgie dentaire pour édentement complet et son procédé de fabrication Ceased WO2019192032A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201810295982.X 2018-04-04
CN201810295982.XA CN108478299A (zh) 2018-04-04 2018-04-04 齿科全口牙列缺失手术种植导向板及其制作方法

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WO2019192032A1 true WO2019192032A1 (fr) 2019-10-10

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CN115531010B (zh) * 2022-09-23 2025-10-17 罗穗锋 一种下颌无牙合的种植导向装置及种植体定位种植方法

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US20120183922A1 (en) * 2009-09-30 2012-07-19 Sang Choon Cho Guide Block For A Dental Implant Procedure And Guide Block Assembly, And Implant Procedural Technique Using Same
CN203619704U (zh) * 2013-12-04 2014-06-04 杭州六维齿科医疗技术有限公司 全牙缺失的牙种植手术导板
CN206548620U (zh) * 2016-09-22 2017-10-13 杭州六维齿科医疗技术有限公司 带有对颌咬合记录的牙种植导向模板
CN206548621U (zh) * 2016-11-04 2017-10-13 杭州口腔医院有限公司 即刻拔牙精确定位备孔的牙种植手术导板
CN106943200A (zh) * 2017-05-05 2017-07-14 云南增材佳维科技有限公司 一种种植牙导板

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