DE10029256A1 - Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former - Google Patents
Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template formerInfo
- Publication number
- DE10029256A1 DE10029256A1 DE2000129256 DE10029256A DE10029256A1 DE 10029256 A1 DE10029256 A1 DE 10029256A1 DE 2000129256 DE2000129256 DE 2000129256 DE 10029256 A DE10029256 A DE 10029256A DE 10029256 A1 DE10029256 A1 DE 10029256A1
- Authority
- DE
- Germany
- Prior art keywords
- drilling template
- model
- drilling
- artificial teeth
- working model
- 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.)
- Withdrawn
Links
Classifications
-
- 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
Abstract
Description
Das Implantieren von künstlichen Zähnen kann, was das Material als solches betrifft, als ausgereifte Technik bezeichnet werden. Probleme bestehen jedoch bei dem Bohren der Löcher für die Implantateinsätze. Hier ist viel Erfahrung und fachmännisches Gespür des Zahnarztes erforderlich. Trotzdem gelingt nicht jede Bohrung, was sehr nachteilige Folgen für den Patienten hat.The implantation of artificial teeth can be what the material as such concerns, can be referred to as mature technology. However, there are problems when drilling the holes for the implant inserts. There's a lot of experience here and professional expertise of the dentist required. Still succeed not every hole, which has very disadvantageous consequences for the patient.
Aus diesem Grunde wurden schon die verschiedensten Bohrschablonen entwickelt, die dem Zahnarzt die Bohrtiefe und die Bohrrichtung vorgeben. Beispiele solcher Bohrschablonen finden sich in der EP-A-0 774 238, der US- A- 5 800 168 oder der FR-A- 2 645 733. Diese Schablonen gewährleisten zwar das Bohren entsprechend den vorher eingestellten Winkeln, sodaß handwerkliche Fehler vermieden werden können. Eine Gewähr, daß die gebohrten Löcher an der richtigen Stelle sitzen, ist jedoch damit nicht gegeben.For this reason, a wide variety of drilling templates have been developed developed, which dictate the drilling depth and the drilling direction to the dentist. Examples of such drilling templates can be found in EP-A-0 774 238, the US A- 5 800 168 or FR-A- 2 645 733. Ensure these templates drilling according to the previously set angles, so that technical mistakes can be avoided. A guarantee that the drilled holes in the right place, however, is not given.
Eine andere Überwachung der Bohrerstellung wird in der EP-A-0 834 292 gelehrt. Hier kann der Zahnarzt auf einem Bildschirm verfolgen, ob er den Bohrer, dessen Stellung durch Sensoren und einen Computer überwacht wird, in der richtigen Lage hält. Auch bei diesem Stand der Technik geht es nur darum, den Bohrer in einer vorher eingestellten Lage zu halten.Another drill position monitoring is described in EP-A-0 834 292 taught. Here the dentist can monitor on a screen whether he has the Drill, the position of which is monitored by sensors and a computer, holds in the right position. This state of the art is also only possible to keep the drill in a pre-set position.
Aus der FR-A- 2 687 947 ist ein CAD/CAM-Verfahren zur Herstellung einer Bohrschablone bekannt, bei dem dem Patienten ein Schablonenrohling in den Mund appliziert wird und mittels Röntgenstrahlen eine Aufnahme des Kieferknochens mit aufgestecktem Schablonenrohling gemacht wird. Zur Feststellung der genauen Lage auf dem Röntgenbild besitzt der Schablonenrohling mindestens einen Markierungspunkt aus radioopakem Material. Das Röntgenbild wird digitalisiert, sodaß mit den ansich bekannten CAD/CAM-Methoden die Richtung des Bohrkanals festgelegt werden kann. Entsprechend wird in dem Schablonenrohling die Bohrung vorgenommen. Die so erhaltene Schablone soll gewährleisten, daß im Inneren des Kieferknochens keine Nerven, Wurzeln oder Arterien angebohrt werden. Der wesentliche Nachteil diese Verfahrens ist es, daß auf dem Bildschirm nur ein zweidimensionales Bild erzeugt werden kann.FR-A-2 687 947 describes a CAD / CAM method for producing a Known drilling template, in which the patient a template blank in the Mouth is applied and an X-ray image of the Jaw bone is made with attached template blank. For The exact location on the x-ray image has the Template blank at least one marking point made of radio-opaque Material. The x-ray image is digitized so that it is known per se CAD / CAM methods the direction of the drill channel can be set. Accordingly, the hole is made in the template blank. The template thus obtained is intended to ensure that inside the No nerves, roots or arteries are pierced in the jawbone. The The main disadvantage of this method is that there is only one on the screen two-dimensional image can be generated.
Ein ähnliches, aber noch komplizierteres Verfahren zur Herstellung einer Bohrschablone wird in der US-A-5 967 777 offenbart. Bei diesem Verfahren wird das zu digitalisierende Bild in einem Computertomographen erstellt. Der in den Mund des Patienten eingesetzte Schablonenvorläufer besitzt bereits die Form der zu implantierenden Zähne. In der US-A- 5 967 777 ist auch ausgeführt, daß mit diesem Verfahren Bilder des Kieferknochens im Querschnitt und Längsschnitt erzielt werden können. Alleine wegen der hohen Kosten dürfte sich ein CT-Verfahren in der Praxis jedoch nicht durchsetzten.A similar, but even more complicated process for making one A drilling template is disclosed in US-A-5,967,777. With this procedure the image to be digitized is created in a computer tomograph. The Template precursors inserted into the patient's mouth already have the Shape of the teeth to be implanted. In US-A-5,967,777 is also stated that with this procedure images of the jawbone in the Cross-section and longitudinal section can be achieved. Alone because of the high In practice, however, a CT procedure should not be cost-effective.
Es ist daher Aufgabe der im Anspruch 1 angegebenen Erfindung, mittels des CAD/CAM-Verfahrens ein Verfahren zur Herstellung einer Bohrschablone anzugeben, das einerseits einfach ist, andrerseits eine optimalere Festlegung der Bohrung mit größter Sicherheit erlaubt.It is therefore an object of the invention specified in claim 1, by means of CAD / CAM process is a process for producing a drilling template to specify, which is simple on the one hand, and on the other hand a more optimal definition the drilling with the greatest security.
Vorteilhafte Weiterbildungen der Erfindung sind in den Unteransprüchen beschrieben.Advantageous developments of the invention are in the subclaims described.
Einzelheiten der Erfindung ergeben sich aus der nachstehenden Beschreibung anhand der Zeichnungen.Details of the invention emerge from the description below based on the drawings.
Hierin zeigen:Show here:
Fig. 1 ein Arbeitsmodell eines Kiefers in Draufsicht; Figure 1 is a working model of a jaw in plan view.
Fig. 2 das Arbeitsmodell nach Fig. 1 mit einem angegossenen Bohrschablonenrohling; FIG. 2 shows the working model according to FIG. 1 with a cast-on drilling template blank;
Fig. 3 einen Querschnitt durch das Arbeitsmodell gemäß Schnitt M-M in Fig. 2. Fig. 3 shows a cross section through the working model according to section MM in Fig. 2.
Von einem Kiefer eines Patienten wird zunächst ein Arbeitsmodell angefertigt, das in Fig. 1 mit 1 bezeichnet ist. Mit 2 ist die Lücke bezeichnet, in die ein Zahn implantiert werden soll. Die Herstellung solcher Arbeitsmodelle ist notorischer Stand der Technik und braucht nicht weiter beschrieben werden.A working model, which is denoted by 1 in FIG. 1, is first produced from a patient's jaw. 2 denotes the gap into which a tooth is to be implanted. The production of such working models is notoriously state of the art and need not be described further.
Zur Erstellung eines digitalen Modells von diesem Arbeitsmodell wird es mit einem Laserstrahl abgetastet und die topographische Form in einem Computer gespeichert. Zum Abtasten des Modells wird zweckmäßigerweise ein Verfahren benutzt, daß als konoskopisches Messen bezeichnet wird, das auf dem Prinzip der konoskopischen Holographie beruht. Zur digitalen Erfassung der Oberfläche existiert eine Flächenrückführungssoftware mit dem Namen SurfaceExplorer.To create a digital model of this working model, it is used scanned with a laser beam and the topographical shape in a computer saved. A is expediently used to scan the model Method used that is referred to as conoscopic measurement based on is based on the principle of conoscopic holography. For digital capture Surface retraction software with the name exists on the surface SurfaceExplorer.
Das digitale, Modell läßt sich prinzipiell auch durch Abtasten der Negativform (Abdruck) des Kiefers erzeugen. Von einer direkten Abtastung des Gebisses des Patienten aber wird wegen der zu erwartenden Schwierigkeiten abgesehen.In principle, the digital model can also be found by scanning the negative form Create (impression) of the jaw. From a direct scan of the bit of the patient because of the expected difficulties aside.
Im Bereich der Zahnlücke 2 wird am Arbeitsmodell 1 anschließend der Rohling einer Bohrschablone angegossen. Als Material kann ein in der Dentaltechnik üblicher Prothesenkunststoff verwendet werden. Wichtig dabei ist, daß auch benachbarte festsitzende Zähne mit eingegossen werden, damit die Lage der Schablone genau fixiert ist.In the area of the tooth gap 2 , the blank of a drilling template is then cast on the working model 1 . A prosthesis plastic customary in dental technology can be used as the material. It is important that adjacent, stuck teeth are also cast in so that the position of the template is precisely fixed.
Alternativ herzu ist das Herausfräsen aus dem Vollen mittels der gespeicherten Daten möglich.Alternatively, milling out of solid is possible using the stored data possible.
Falls es für erforderlich gehalten wird, kann die Form des fertigen Rohlings 3 ebenfalls digital erfaßt werden, sodaß ein Bild eines Arbeitsmodelles mit aufgesetztem Bohrschablonenrohling auf dem Bildschirm erstellt werden kann.If it is deemed necessary, the shape of the finished blank 3 can also be recorded digitally, so that an image of a working model with a drilling template blank attached can be created on the screen.
Mit einem zur Verfügung stehenden 3D-Graphikprogramm lassen sich nun durch das Kiefermodell beliebige Schnitte legen. Ein solches Bild ist mit aufgesetztem Bohrschabonenrohling in Fig. 3 schematisch dargestellt. Mit 5 ist der Kieferkochen bezeichnet, in den die Bohrung 4 für den Implantateinsatz eingebracht werden soll.With an available 3D graphics program, any cuts can now be made through the jaw model. Such an image is shown schematically in FIG. 3 with the drilling template blank attached. 5 denotes the jaw cooking into which the bore 4 is to be made for the implant insert.
Bei der Herstellung des Bohrkanals 4 im Kieferknochen 5 muß größte Sorgfalt darauf gelegt werden, daß im Inneren des Knochens keine Nervenstränge, Arterien, Wurzeln benachbarter Zähne oder Hohlräume (hiatus maxilaris) angebohrt werden, da dies fatale Folgen für den Patienten hat. Zu diesem Zwecke ist es empfehlenswert, auf das virtuelle Bild des Implantatbereiches eine Röntgenaufnahme kongruent abzubilden. Daher sollte eine Röntgenaufnahme des Implantatbereiches zusammen mit einem aufgesetztem Bohrschablonenrohling gemacht werden, der mindestens einen radioopaken Marker, z. B. in Form einer 3 mm starken Stahlkugel, besitzt. Dieser Marker erlaubt auf dem Bildschirm eine genaue Einstellung der Größenverhältnisse.When making the drilling channel 4 in the jawbone 5 , great care must be taken to ensure that no nerve strands, arteries, roots of adjacent teeth or cavities (hiatus maxilaris) are drilled inside the bone, since this has fatal consequences for the patient. For this purpose it is advisable to map an X-ray image congruently to the virtual image of the implant area. Therefore, an x-ray of the implant area should be taken together with a blank template that has at least one radiopaque marker, e.g. B. in the form of a 3 mm thick steel ball. This marker allows you to set the exact size on the screen.
Auf dem Bildschirm kann nun ein Bild erzeugt werden, das schematisch der Fig. 3 entspricht.An image can now be generated on the screen, which schematically corresponds to FIG. 3.
Der Zahntechniker legt nun den zunächst nur virtuell vorhandenen Bohrkanal 4 hinsichtlich Durchmesser und Lage optimal in den Kieferknochen 5, wobei er den Bereich 6, der auf keinen Fall verletzt werden darf, ausspart. Durch Herstellung verschiedener Schnitte auf dem Bildschirm ist dann auch zu erkennen, ob in jedem Bereich genügend Knochenmaterial vorhanden ist, insbesondere, ob die Abstände zum Zahnfleisch auf beiden Seiten des Kieferknochens und zu den gefährlichen Bereichen ausreichend sind. Nachdem die Lage des Bohrkanals endgültig festgelegt ist, wird mittels der CAM-Technik dieser im Bohrschablonenrohling ausgebohrt, wobei der Rohling zweckmäßigerweise auf dem Arbeitsmodell aufsitzt, sodaß auch im Arbeitsmodell eine Bohrung erzeugt wird, die genau der späteren Bohrung im Kieferknochen des Patienten entspricht. Diese Arbeitsweise ermöglicht dann auch das Durchsägen des Arbeitsmodelles im Bereich der Bohrung als letzte Kontrolle.The dental technician now optimally places the drill channel 4, which is initially only available virtually, in terms of diameter and position in the jawbone 5 , thereby leaving out the area 6 , which in no case may be injured. By making various cuts on the screen, it can then also be seen whether there is sufficient bone material in each area, in particular whether the distances to the gums on both sides of the jawbone and to the dangerous areas are sufficient. After the position of the drilling channel has been finally determined, it is drilled out in the blank template using the CAM technique, the blank expediently sitting on the working model, so that a hole is also created in the working model that exactly corresponds to the later drilling in the patient's jawbone. This way of working then enables the sawing through of the working model in the area of the bore as a final check.
Da das Material der Bohrschablone relativ weich ist, wird empfohlen, die Bohrung in der Schablone mit einer Metallhülse (nicht gezeigt) auszukleiden, damit eine absolut exakte Führung des vom Zahnarzt zu bedienenden Bohrers gewährleistet ist. Ebenfalls kann ein Anschlag (nicht gezeigt) an der Bohrschablone vorgesehen werden, der auf den Bohrer des Zahnarztes abgestimmt ist und der die Bohrtiefe begrenzt.Since the material of the drilling template is relatively soft, it is recommended that Line the hole in the template with a metal sleeve (not shown), thus an absolutely exact guidance of the drill to be operated by the dentist is guaranteed. A stop (not shown) on the Drilling template should be provided on the dentist's drill is coordinated and which limits the drilling depth.
Mit der erfindungsgemäß hergestellten Bohrschablone wird folglich auch weniger erfahrenen Zahnärzten ein Hilfsmittel an die Hand gegeben, was der Implanierungstechnik zu einen weiteren Durchbruch verhelfen kann.Consequently, with the drilling template produced according to the invention Less experienced dentists are given a tool to help them Implantation technology can help to make another breakthrough.
Claims (4)
daß durch Laserabtastung eines Arbeitsmodells (1) oder dessen Negativform ein digitales Modell des Gebisses erzeugt wird,
daß entweder durch Angießen an das Arbeitsmodell (1) ein Bohrschablonenrohling (3) erzeugt wird,
oder daß mittels der gespeicherten Daten der Bohrschablonenrohling (3) aus dem Vollen gefräst wird,
und daß durch Erzeugen mehrere Querschnittsbilder des digitalisierten Kieferknochens (5) die optimale Lage des Bohrkanals (4) festgelegt wird.1. A method for producing a drilling template for implanting artificial teeth using the CAD / CAM technique, the position of the drilling channel ( 4 ) being determined on the basis of an image of the jawbone on a screen, characterized in that
that a digital model of the dentition is generated by laser scanning of a working model ( 1 ) or its negative form,
that either a drilling template blank ( 3 ) is produced by casting on the working model ( 1 ),
or that the drilling template blank ( 3 ) is milled from the solid using the stored data,
and that by generating several cross-sectional images of the digitized jawbone ( 5 ) the optimal position of the drilling channel ( 4 ) is determined.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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DE2000129256 DE10029256A1 (en) | 2000-06-14 | 2000-06-14 | Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former |
PCT/DE2001/002099 WO2001095824A1 (en) | 2000-06-14 | 2001-06-02 | Method for producing a boring jig for implanting artificial teeth |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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DE2000129256 DE10029256A1 (en) | 2000-06-14 | 2000-06-14 | Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former |
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DE10029256A1 true DE10029256A1 (en) | 2000-11-30 |
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DE2000129256 Withdrawn DE10029256A1 (en) | 2000-06-14 | 2000-06-14 | Manufacture of drilling template for implanting artificial teeth involves laser scanning working model or negative shape to produce digital model, making drilling template former |
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DE (1) | DE10029256A1 (en) |
WO (1) | WO2001095824A1 (en) |
Cited By (21)
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WO2003007835A1 (en) | 2001-07-13 | 2003-01-30 | Degudent Gmbh | Method and device for the there-dimensional determination and digitisation of a plaster- or positive-model |
WO2003060825A3 (en) * | 2002-01-16 | 2004-05-06 | Andrei Feldman | Oral implant template |
EP1486900A1 (en) * | 2003-06-12 | 2004-12-15 | Materialise, Naamloze Vennootschap | Method and system for manufacturing a surgical guide |
WO2007028260A1 (en) * | 2005-09-07 | 2007-03-15 | Lukas Kamer | Method for producing guiding members for guiding a surgical tool and a guiding member produced according thereto |
DE102009003183A1 (en) * | 2009-05-18 | 2010-11-25 | Gäßler, Guido | Method for manufacturing dental template, involves providing volume and position of tooth form according to digital control data, where tooth form or structure corresponding to tooth form is produced within x-ray-transparent material |
US8185224B2 (en) | 2005-06-30 | 2012-05-22 | Biomet 3I, Llc | Method for manufacturing dental implant components |
US8206153B2 (en) | 2007-05-18 | 2012-06-26 | Biomet 3I, Inc. | Method for selecting implant components |
US8221121B2 (en) | 2008-04-16 | 2012-07-17 | Biomet 3I, Llc | Method for pre-operative visualization of instrumentation used with a surgical guide for dental implant placement |
US8257083B2 (en) | 2005-10-24 | 2012-09-04 | Biomet 3I, Llc | Methods for placing an implant analog in a physical model of the patient's mouth |
US8651858B2 (en) | 2008-04-15 | 2014-02-18 | Biomet 3I, Llc | Method of creating an accurate bone and soft-tissue digital dental model |
US8777612B2 (en) | 2007-11-16 | 2014-07-15 | Biomet 3I, Llc | Components for use with a surgical guide for dental implant placement |
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US8926328B2 (en) | 2012-12-27 | 2015-01-06 | Biomet 3I, Llc | Jigs for placing dental implant analogs in models and methods of doing the same |
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US10449018B2 (en) | 2015-03-09 | 2019-10-22 | Stephen J. Chu | Gingival ovate pontic and methods of using the same |
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