CN110200714A - A method of for making the pallet and production plantation guide plate of plantation guide plate - Google Patents

Abstract

The invention discloses a tray for making a planting guide plate and a method for making a planting guide plate. The tray includes a bottom plate, buccal wing plates and lingual wing plates; grid lines are arranged on the lower surface of the bottom plate, and radial positioning is arranged in the center of each grid The eye; the buccal wing is fixedly arranged along the outer edge of the bottom plate; one side of the lingual wing is fixedly arranged along the inner edge of the bottom plate; an accommodating groove is formed between the buccal wing and the lingual wing. The method is as follows: prepare a physical model; use the tray to take dental impressions; wear the tray to take oral CT; perform software simulation for implant design; S5. Fill the tray with a temporary guide plate material and form a guide straight hole in the temporary guide plate material ; S6. Replace the temporary guide plate material with the guide plate material, and the planting guide plate is completed. Or the method is to use the tray to take the dental model and wear it to take a CT scan, and use the CT data to 3D print the implant guide plate. The invention is beneficial to the precise positioning of planting dens, is suitable for non-flap minimally invasive implantation surgery, has low production requirements and low cost.

Description

A tray for making a planting guide plate and a method for making a planting guide plate

technical field

The invention belongs to the technical field of dental medical instruments, and in particular relates to a tray for making a planting guide plate and a method for making the planting guide plate.

Background technique

In clinical stomatology, dental implant is a common treatment method for repairing missing teeth. In order to achieve the purpose of accurately implanting the implant in the alveolar bone, the method of implant surgery guide plate can be used to assist in surgical implant implant placement. At present, the methods for making implant surgery guide plate include simple compression molding method and oral CT scanning 3D printing method.

The simple compression molding method can only determine the implant placement site, but not the direction and depth of the implant placement, which can easily lead to nerve damage and implant lateral penetration of the alveolar bone, and is now basically eliminated.

The 3D printing method of oral CT scanning is to obtain the three-dimensional image data of the alveolar bone through oral CT scanning, and use computer-aided design and 3D printing to make the implantation guide plate. The implantation guide plate made by this method can accurately locate the direction of implant placement And depth, not easy to cause nerve damage and alveolar bone perforation. The disadvantages of this method are:

(1) When using the guide plate in clinical operations, the gingiva and periosteum need to be peeled off from the alveolar bone in a large area and turned over to expose the bone surface, and then the implant guide plate can be used after being fixed on the bone surface (that is, flap implantation). Leading to large surgical trauma, heavy bleeding, obvious postoperative pain, complex surgery, difficult to popularize;

(2) The software and hardware requirements are high, and specific design software and 3D printers are required to design the planting guide and 3D printing;

(3) The production cost is high.

The root cause of these shortcomings is that the existing oral CT scanning method can accurately display the three-dimensional dimensions of the alveolar bone, but cannot display the outline of the gingiva, and it is difficult to measure the thickness of the gingiva in the edentulous area. Therefore, the 3D printed implant guide plate designed by computer It is only suitable for alveolar bone surface implantation, that is, flap implantation, that is, the gingival mucoperiosteal flap is turned up from the bone surface to implant the implant, and it cannot be used to make an implant guide plate for non-flap implantation surgery.

The reason why the existing oral CT scanning methods cannot display the outline of the gums and measure the thickness of the gums in the edentulous area is that, under natural conditions, soft tissues such as the human lips, cheeks, and tongue are in contact with the teeth and gums. Taken together, since the X-ray densities of soft tissues such as lips, cheeks, and tongue are basically the same as those of gums, and the density difference is not large, the existing oral CT scanning methods do not separate soft tissues such as lips, cheeks, and tongue from teeth and gums. Therefore, it is difficult to distinguish gums from soft tissues such as the adjacent lips, cheeks, and tongue on oral CT images, while alveolar bone and teeth are hard tissues, and their X-ray density is significantly higher than that of soft tissues such as lips, cheeks, and tongue. Oral CT images are clearly identified and identified.

Therefore, a new technology is needed to solve the problems in the prior art that the implant guide plate needs to be flapped for implantation, the operation is complicated, the trauma is large, the software and hardware requirements are high, and the cost is high.

Therefore, during oral CT scanning, the key to solving this problem is to use a method to separate soft tissues such as lips, cheeks, and tongue from the gums so that the outline of the gums can be clearly displayed and the thickness of the gums can be measured through oral CT images.

Contents of the invention

In order to solve the surgical problems in the prior art, the present invention provides a tray for making a planting guide plate and a method for making a planting guide plate. The planting guide plate made by this method can accurately locate the planting position and is suitable for non-flap minimally invasive surgery. Implantation operation, low production requirements and low cost.

The present invention adopts following technical scheme:

A tray for making an implantation guide plate, comprising a base plate, a buccal wing plate and a lingual wing plate; the shape of the base plate is adapted to the shape of the dental arch, and the lower surface of the base plate is provided with uniform grid lines, the Each grid of the grid line is a square grid, and the center of each grid is provided with a sunken radiation positioning eye; one side of the buccal wing is fixedly connected with the outer edge of the base plate, and the buccal wing is fixed along the outer edge of the base plate. Along the arrangement; one side of the lingual wing is fixedly connected to the inner edge of the bottom plate and the lingual wing is arranged along the inner edge of the bottom plate; the buccal wing and the lingual wing are formed to accommodate teeth and Accommodating groove for the alveolar bone.

As a further improvement of the technical solution of the present invention, the buccal wing includes a plurality of buccal flaps, and the plurality of buccal flaps are sequentially arranged along the outer edge of the bottom plate.

As a further improvement of the technical solution of the present invention, the lingual wing plate includes a plurality of lingual flaps, and the plurality of lingual flaps are sequentially arranged along the inner edge of the bottom plate.

As a further improvement of the technical solution of the present invention, the side of the buccal wing and/or the lingual wing close to the bottom plate is provided with recessed grid scale numbers corresponding to the grid lines.

As a further improvement of the technical solution of the present invention, the base plate, the buccal wing plate and the lingual wing plate are all made of X-ray transparent materials.

The method for making the planting guide plate is based on the above-mentioned tray for making the planting guide plate, comprising the following steps:

S1. Take a full-mouth dental impression including the edentulous area and prepare it into a physical model;

S2. Filling radiopaque materials into the radiolocating eye corresponding to the edentulous area on the tray, and using the tray to take tooth impressions;

S3. Put the tray on the dental case in the mouth, and take a CT of the oral cavity;

S4. Carry out software simulation implant design, and use the radiation positioning eyepoint on the tray as a reference to determine the simulated implant data of the implant. The data include implant implant position, implant depth, buccolingual inclination angle, mesiodistal inclination angle;

S5. Fill the temporary guide plate material on the tray corresponding to the edentulous area, and form a guide straight hole in the temporary guide plate material through the bottom plate according to the data, and the buccal-lingual inclination angle of the guide straight hole , The mesial-distal inclination angle is equal to the simulated buccolingual inclination angle and the simulated mesial-distal inclination angle;

S6. Put the tray on the solid model, and drill a simulated implant hole on the solid model through the guide straight hole, insert a rod from the guide straight hole until the simulated implant hole, The diameter of the rod body is equal to the diameter of the guiding straight hole; the guide plate material is used to replace the temporary guide plate material, and the rod body is taken out, then the planting guide plate is completed.

As a further improvement of the technical solution of the present invention, in the above S5, the material of the temporary guide plate is a thermoplastic material, a through hole is drilled on the tray bottom plate corresponding to the implantation position, and a hot metal rod is inserted into the through hole And extend into the thermoplastic material to form the guide straight hole, the diameter of the metal rod is equal to the diameter of the through hole.

As a further improvement of the technical solution of the present invention, in the above S6, the buccal flap or the lingual flap corresponding to the edentulous area is removed first, and then the material of the guide plate is replaced.

As a further improvement of the technical solution of the present invention, in the above S2, when the radiopaque material is filled, the radiopaque material is also filled into the grid scale numbers corresponding to the edentulous area.

The method for making the planting guide plate is based on the above-mentioned tray for making the planting guide plate, comprising the following steps:

S01. Take a full-mouth dental impression including the edentulous area and prepare it into a physical model;

S02. Using the tray to take tooth impressions on the solid model;

S03. Put the tray on the dental case in the mouth, take a CT scan of the oral cavity to obtain CT data of the oral cavity;

S04. Perform 3D printing according to the oral CT data to make a guide plate for implantation.

Compared with prior art, the beneficial effect of the present invention is:

1. In the method for making the planting guide plate of the present invention, the tray used when making the planting guide plate is provided with a radiation positioning eye, and the tray is worn during CT scanning, which can play the role of precise positioning; the implantation of the planting guide plate made The position, implantation depth, buccolingual tilt angle, and mesial-distal tilt angle are equal to the software's simulated implant position, simulated buccolingual tilt angle, and simulated mesial-distal tilt angle, with high precision and suitable for non-flap implementation Minimally invasive and precise implant surgery, the implant cavity can be prepared without opening the gingival mucoperiosteal flap, the surgical trauma and blood loss are greatly reduced compared with flap surgery, and the postoperative is almost painless; this method is less difficult and can be performed by a dentist Make the planting guide plate by yourself without using 3D printing, effectively reducing the cost;

2. In another method of making a planting guide plate of the present invention, the patient wears a tray to perform a CT scan of the oral cavity, and transmits the obtained oral CT data to a processing factory for 3D printing to make a planting guide plate. The produced guide plate is suitable for non-transplantation Minimally invasive valve implantation surgery.

3. The tray of the present invention is provided with grid lines, grid scale numbers and radiation positioning eyes. When in use, radio-blocking materials can be filled in the grid scale numbers and radiation positioning eyes at the corresponding positions of the edentulous area. It can play the role of precise positioning when wearing a tray for CT scanning, and can be used to make implant guides with low manufacturing difficulty; the manufactured implant guides are suitable for non-flap minimally invasive implantation surgery, which is conducive to reducing the difficulty of surgery and reducing surgery Trauma, effectively reduce costs.

Description of drawings

The technology of the present invention will be further described in detail below in conjunction with the accompanying drawings and specific embodiments:

Fig. 1 is the structural representation of tray of the present invention;

Fig. 2 is the top view of tray of the present invention;

Fig. 3 is the bottom view of pallet of the present invention;

Fig. 4 is the schematic diagram that metal rod is inserted in the guide hole in the method of the present invention;

Fig. 5 is a partial longitudinal sectional view of a metal rod inserted into a guide hole;

Fig. 6 is a partial transverse sectional view of a metal rod inserted into a guide hole.

Reference signs:

1-tray; 11-bottom plate; 12-buccal wing; 13-lingual wing; 111-grid; 112-radiation positioning eye; 121-buccal flap; 131-lingual flap; 14-handle; 15-accommodating tank; 16-grid scale number; 113-through hole;

2-solid model; 21-simulation of planting hole;

3-thermoplastic material; 31-guide straight hole;

4- Metal pole.

Detailed ways

The idea, specific structure and technical effects of the present invention will be clearly and completely described below in conjunction with the embodiments and accompanying drawings, so as to fully understand the purpose, scheme and effect of the present invention. It should be noted that, in the case of no conflict, the embodiments in the present application and the features in the embodiments can be combined with each other. The same reference numbers are used throughout the drawings to indicate the same or similar parts.

It should be noted that, unless otherwise specified, when a feature is called "fixed" or "connected" to another feature, it can be directly fixed and connected to another feature, or indirectly fixed and connected to another feature. on a feature. In addition, descriptions such as up, down, left, and right used in the present invention are only relative to the mutual positional relationship of the components of the present invention in the drawings.

Referring to FIGS. 1 to 3 , a tray 1 for making a planting guide includes a bottom plate 11 , a buccal wing 12 and a lingual wing 13 . The buccal wing 12 is also provided with a handle 14 protruding outward. The base plate 11 , the buccal wing 12 and the lingual wing 13 are all made of X-ray transparent material.

Wherein, the shape of the bottom plate 11 adapts to the shape of the dental arch, and is U-shaped or horseshoe-shaped. The lower surface of the bottom plate 11 is provided with uniform grid lines 111, and each grid of the grid lines 111 is a square grid with a side length of 2 mm. A sunken radiation positioning eye 112 is provided in the center of each grid. The radiation positioning eye 112 is cylindrical, with a diameter of 1 mm and a depth of 1 mm. The radiation positioning eye 112 is used to place X-ray radiation-resistant materials for precise positioning during CT shooting.

One side of the buccal wing 12 is fixedly connected to the outer edge of the base plate 11 and the buccal wing 12 is arranged along the outer edge of the base 11 and is slightly inclined to the outside; the buccal wing 12 includes a plurality of buccal flaps 121, A plurality of the buccal flaps 121 are sequentially arranged along the outer edge of the bottom plate 11, and two adjacent buccal flaps 121 are partially connected and fixed, so that the buccal flaps 121 can be disassembled in sections when the implant guide plate is subsequently manufactured. .

One side of the lingual wing plate 13 is fixedly connected to the inner edge of the base plate 11 and the lingual wing plate 13 is arranged along the inner edge of the base plate 11, and is slightly inclined inwardly; the lingual wing plate 13 includes a plurality of lingual flaps 131, A plurality of the lingual flaps 131 are sequentially arranged along the inner edge of the bottom plate 11, and two adjacent lingual flaps 131 are partially connected and fixed, so that the lingual flaps 131 can be disassembled in sections when the planting guide is subsequently manufactured.

An accommodating groove 15 capable of accommodating teeth and alveolar bone is formed between the buccal wing 12 and the lingual wing 13 , and the two sides of the accommodating groove 15 are slightly inclined to the outside for easy wearing.

As preferably, the side of the buccal wing plate 12 and/or the lingual wing plate 13 close to the bottom plate 11 is provided with a concave grid scale number 16 corresponding to the grid line 111, and the grid scale number 16 is concavely arranged, and can be recessed The X-ray blocking material is filled inside to identify and facilitate positioning during CT shooting.

The above-mentioned X-ray blocking material may be gutta-percha.

The method for making the planting guide plate is based on the above-mentioned tray 1 for making the planting guide plate, comprising the following steps:

S1. Take the patient's full-mouth dental impression including the edentulous area in a conventional manner and prepare a physical model 2, which is usually a plaster model.

S2. Fill the radiation-resistant material (such as gutta-percha) in the radiation positioning eye 112 and the grid scale number 16 corresponding to the edentulous area on the tray 1, and fill the non-edentulous area in the accommodating groove 15 of the tray 1 Fill the impression material in the area (the impression material is silicone rubber, dental model paraffin, self-setting plastic, or alginate impression material, etc.), and immediately place the tray 1 on the above-mentioned plaster model after filling the impression material. On the dental arch, the tray 1 is used to take tooth impressions.

S3. Put the tray 1 with the tooth impressions taken in S2 into the patient's oral cavity, make sure that the tray 1 is in place and fixed well, and keep wearing it to take oral CT. The radioactive positioning eye 112 and the radio-blocking material filled in the grid scale number 16 will generate high-density images, and these high-density images will be used as position references for subsequent simulated planting designs, while the buccal wings of the tray 1 12 and lingual wing 13 can separate it from teeth and gums due to supporting soft tissues such as the lip, buccal and tongue, and there is an air gap between the buccal wing 12 and lingual wing 13 and the teeth and gums, so that the edentulous area The gums are surrounded by air, and the density of the air is lower than that of the gums. Therefore, the lips, cheeks, tongue, teeth, gums, and alveolar bone can be clearly distinguished on the captured CT images, which is convenient for precise positioning.

S4. Utilize the oral CT data analysis software to carry out simulated implant design on the image data obtained in S3, and use the radiation positioning point on the tray 1 and the grid scale number 16 as a reference to determine the simulated implant data, which includes the patient's teeth Groove bone width and height, gingiva thickness, simulated implant position, implant depth, buccolingual inclination angle, and simulated mesial-distal inclination angle.

S5. Fill in the temporary guide plate material on the tray 1 in S2 corresponding to the edentulous area, the temporary guide plate material is thermoplastic material 3 (such as: paraffin), adopt the drill bit on the tray 1 bottom plate 11 to match the simulated implant in S4 Drill a through hole 113 at a position consistent with the position, insert a hot metal rod 4 into the through hole 113 and extend into the thermoplastic material 3 to form a guiding straight hole 31, according to the buccal-lingual inclination angle in S4, the near Distal inclination angle is used to adjust the direction of the metal rod 4, so that the buccolingual inclination angle and the mesio-distal inclination angle of the guiding straight hole 31 are consistent with the buccolingual inclination angle and the simulated mesio-distal inclination angle simulated in S4, wherein , the diameter of the metal rod 4 is equal to the diameter of the through hole 113 .

S6. After the guide straight hole 31 is made, take out the metal rod 4, put the tray 1 on the solid model 2, use the drill bit in S5 to drill out the simulated implant socket hole on the solid model 2 through the guide straight hole 31 21. The diameter of the simulated planting hole 21 is equal to the diameter of the metal rod 4, and then the metal rod 4 is inserted into the simulated planting hole 21 through the guiding straight hole to ensure that the simulated planting hole 21 is coaxial with the guiding straight hole 31 , as shown in Figure 4, Figure 5 and Figure 6; remove the buccal wing 12 or lingual wing 13 corresponding to the edentulous area, keep the tray 1 worn on the solid model 2, and keep the metal rod 4 inserted in the In the guiding straight hole 31 and the planting socket hole 21, the thermoplastic material 3 is replaced with a guide plate material (for example: self-curing plastic), and after solidification, the metal rod 4 is taken out to polish the tray 1, and the planting guide plate is completed. The planting guide plate includes The tray and the solidified body of self-curing plastic, the solidified body and the tray have a guiding straight hole 31.

Since the tray 1 is worn in this method for CT shooting, the lips, cheeks, and tongue can be distinguished from the teeth, gums, and alveolar bone on the CT image, and the implant guide plate including the outline and thickness of the gums can be accurately produced. Surgery without flap, suitable for non-flap minimally invasive precision implant surgery, without opening the gingival mucoperiosteal flap, the implant cavity can be prepared through the guiding straight hole 31, the surgical trauma and blood loss are greatly reduced compared with flap surgery , almost painless after surgery.

When making the planting guide plate, the tray 1 and the physical model 2 are used to prepare the guiding straight hole 31 and the simulated planting socket hole 21, so as to ensure the accuracy of the subsequent planting socket.

The manufacturing difficulty of this method is low, and the implantation guide plate can be made by the dentist himself, which effectively reduces the cost.

The present invention also provides another method for making a planting guide plate, comprising the following steps:

S01. Take a full-mouth dental impression of the patient including the edentulous area in a conventional manner and prepare a physical model 2, which is usually a plaster model.

S02. Fill the impression material in the non-edentulous area of the accommodating groove 15 of the tray 1 (the impression material is silicone rubber, dental model paraffin, self-setting plastic, or alginate impression material, etc.), Immediately after molding the material, the tray 1 is positioned on the dental arch of the above-mentioned plaster model, and the tray 1 is used to take tooth impressions.

S03. Put the tray 1 with tooth marks taken in S02 into the patient's oral cavity, make sure that the tray 1 is in place and fixed well, and keep wearing it for oral CT shooting. Since the tray 1 is worn for CT shooting, and the tray The buccal wing 12 and the lingual wing 13 of 1 can support soft tissues such as the lips, cheeks, and tongue to separate them from the teeth and gums, and between the buccal wing 12 and the lingual wing 13 and the teeth and gums There is an air gap, so the gums in the edentulous area are surrounded by air, and the density of the air is lower than that of the gums. Therefore, the lips, cheeks, and tongue can be clearly distinguished from the teeth, gums, and alveolar areas on the CT image. bone, can obtain very detailed CT data.

S04. According to the oral CT data, 3D printing is used to make the implant guide plate. The implant guide plate produced in this way is suitable for non-flap minimally invasive implant surgery, which is conducive to reducing the difficulty of surgery, reducing surgical trauma and less bleeding. Flap surgery is greatly reduced and there is almost no postoperative pain.

Other contents of the tray for making the planting guide plate and the method for making the planting guide plate according to the present invention refer to the prior art, and will not be repeated here.

The above is only a preferred embodiment of the present invention, and is not intended to limit the present invention in any form. Therefore, any modification, Equivalent changes and modifications all still belong to the scope of the technical solutions of the present invention.

Claims (10)

1. a kind of for making the pallet of plantation guide plate, it is characterised in that: including bottom plate, cheek side wing and tongue side wing plate；

The shape of the bottom plate and the shape of dental arch are adapted, and the lower surface of the bottom plate is equipped with uniform grid lines, the net Each grid of ruling is grid square, and the center of each grid is equipped with the radiation positioning eye of recess；

Cheek side wing side is fixedly connected with the outer of the bottom plate and cheek side wing is arranged along the outer of the bottom plate；

Tongue side wing plate side is fixedly connected with the interior edge of the bottom plate and tongue side wing plate is along the interior along setting of the bottom plate；

The accommodation groove that can accommodate tooth and alveolar bone is formed between the cheek side wing and the tongue side wing plate.

2. according to claim 1 for making the pallet of plantation guide plate, it is characterised in that: the cheek side wing includes more A cheek side lobe piece, multiple cheek side lobe pieces are successively arranged along the outer of the bottom plate.

3. according to claim 1 for making the pallet of plantation guide plate, it is characterised in that: the tongue side wing plate includes more A tongue side limb, multiple tongue side limbs are successively along the interior along setting of bottom plate.

4. it is according to claim 1 for make plant guide plate pallet, it is characterised in that: the cheek side wing and/or Tongue side wing plate corresponds to the grid scale number that the grid lines is equipped with recess close to the side of the bottom plate.

5. according to claim 1 for making the pallet of plantation guide plate, it is characterised in that: the bottom plate, cheek side wing It is made with tongue side wing plate of X-ray transmission material.

6. the method for production plantation guide plate, based on the support for being used to make plantation guide plate as described in any one of claims 1 to 5 Disk, which comprises the following steps:

S1. it takes the denture stamp including edentulous region and is prepared into physical model；

S2. the radiation positioning at position corresponding with edentulous region intraocularly inserts radiation resistance and penetrates material on the pallet, and uses institute It states pallet and takes tooth mark；

S3. the pallet is worn into entrance interior tooth example, shoots oral cavity CT；

S4. it carries out software and simulates Planting Design, using the radiation positioning eyespot on pallet as reference, determine the simulation plantation of planting body Data, the data include the implantation position of planting body, implantation depth, cheek-tongue direction tilt angle, the near and far inclination angle of simulation Degree；

S5. interim guide plate material is inserted at position corresponding with edentulous region on the pallet, and according to the data across described Bottom plate forms a guidance straight hole, the cheek-tongue direction tilt angle of the guidance straight hole, near and far inclination angle in interim guide plate material It spends equal with the cheek-tongue direction tilt angle of simulation, the near and far tilt angle of simulation；

S6. the pallet is worn on the physical model, and drills out simulation on the physical model by the guidance straight hole Socket bore is planted, a body of rod is inserted into from guidance straight hole up to socket bore, the diameter of the body of rod and the guidance are planted in the simulation The diameter of straight hole is equal；The interim guide plate material is replaced using guide plate material, takes out the body of rod, then plants guide plate completion.

7. the method for production plantation guide plate according to claim 6, which is characterized in that in the S5, the interim guide plate Material is thermoplastic material, and the implantation position is corresponded on tray substrate and drills out a through-hole, and one is inserted into the through-hole and is burnt The metallic rod of heat simultaneously protrudes into the thermoplastic material and forms the guidance straight hole, the diameter of the metallic rod and the through-hole Diameter is equal.

8. it is according to claim 6 production plantation guide plate method, it is characterised in that: in the S6, first remove and agomphosis The corresponding cheek side lobe piece in area or tongue side limb, then carry out the replacement of guide plate material.

9. the method for production plantation guide plate according to claim 6, which is characterized in that in the S2, in filling radiation resistance When penetrating material, also material is penetrated in filling radiation resistance in the grid scale number at position corresponding with edentulous region.

10. the method for production plantation guide plate, based on as described in any one of claims 1 to 5 for making and planting guide plate Pallet, which comprises the following steps:

S01. it takes the denture stamp including edentulous region and is prepared into physical model；

S02. tooth mark is taken on the physical model using the pallet；

S03. the pallet is worn into entrance interior tooth example, shooting oral cavity CT obtains oral cavity CT data；

S04. 3D printing production plantation guide plate is carried out according to the oral cavity CT data.