Tooth root type dental implanting method using oral cavity CBCT image

Abstract

A method of using an oral cavity CBCT image for designing a one-stage tooth root type dental implant having a fixation device, comprising: before oral cavity CBCT imaging for an affected tooth (1), inserting a metal wire (5) into the gingival sulcus (9) of the gingival margin of the affected tooth, and acquiring CBCT image data of the emergence portion from the gingival margin to the alveolar bone margin of the affected tooth (1), the intercuspal occlusion relationship, and the tooth root and the alveolar socket of the affected tooth, so as to provide CBCT image data of the intercuspal occlusion relationship that satisfies the design of the tooth root type dental implant; then converting the CBCT image data into the three-dimensional patch model and performing repeated processing on the surface to obtain a final dental implant model; and on the basis of the final dental implant model, performing 3D printing to manufacture a dental implant.

Description

A root-type dental implant method using oral CBCT images

[0001] Related applications

[0002] This application claims priority to Chinese invention patent application No. 202311370922.7 filed on October 20, 2023, entitled “A method for root-type dental implantation using oral CBCT images”. Technical Field

[0003] The present application relates to the technical field of oral medicine, and in particular to a root-type dental implant method using oral CBCT images. Background Art

[0004] With the increasing perfection of pure titanium 3D printing technology in the field of oral medicine, as well as the improvement of oral imaging technology and related computer software technology, personalized root-type dental implants have been developed in the field of oral implant medicine in recent years. Due to their minimal invasiveness, retention of the original tooth alveolar bone shape, preservation of the original tooth mucosa shape without losing aesthetic requirements, and comparable mechanics and corresponding functional structures of the original tooth, they are currently highly praised by doctors and patients in the field of oral implants who need the technology of extracting and implanting the affected teeth immediately.

[0005] However, the design of personalized root-type dental implants requires high-quality CBCT imaging data of the affected tooth's root, alveolar socket, socket edge, gingival margin, the height and width of the alveolar bone edge from the gingival margin to the root, and any irregular shapes, as well as the spatial relationship between the affected tooth's adjacent teeth, opposing teeth, and the intercuspal position. Only with accurate imaging data can a precise root-type dental implant be designed and produced. Current problems:

[0006] First, because soft tissue does not block X-rays, CBCT imaging technology cannot obtain accurate imaging data of the gingival part (from the edge of the alveolar bone to the gingival margin). First, inaccurate data may cause the gingival part to be not smooth enough, and bacteria may attach and cause peri-implantitis; second, the data of the gingival margin will affect the design of the position of the porcelain abutment. The position of the porcelain abutment will affect the aesthetics and oral health of the final crown after it is completed. ① The abutment is too far away from the gums, resulting in insufficient aesthetics; ② The abutment enters the gingival sulcus too deeply, causing gingivitis.

[0007] Second, the spatial relationship between the adjacent teeth and the opposing teeth in the intercuspal state will affect the spatial position and size of the root-type dental implant restoration base and the final porcelain tooth. The current method of superimposing oral CBCT images with oral scan images has many shortcomings: ① cumbersome operation; ② multiple equipment is required; ③ high cost and time; ④ inconsistent data results from different equipment sources; ⑤ low standardization of the root-type dental implants produced, resulting in a high implant failure rate.

[0008] Third, since the teeth that need to be extracted often have complex conditions such as shallow alveolar sockets, buccal, lingual or palatal bone defects, and curved tooth roots, root-type dental implants are prone to loosening after implantation and cannot produce initial stability, resulting in implant failure.

[0009] Therefore, only when root-type dental implants are precisely designed and have initial stability can the indications of this type of dental implants be expanded, and can they be truly popularized and applied in oral clinics to serve humanity.

[0010] Summary of the Invention

[0011] The purpose of this application is to provide a root-type dental implant method using oral CBCT images, so that personalized root-type dental implants are simple and easy to operate during design and production, and the wound healing time after implantation and installation is short, the initial stability is good, the bioaffinity is good, and the clinical success rate of implantation is high.

[0012] The technical solution of the present application is to provide a root-type dental implant method using oral CBCT images, the method comprising:

[0013] Step 1: Insert a circle of wire into the gingival sulcus at the edge of the patient's gums. The wire is wrapped around the gingival sulcus, and then the excess wire is cut off with scissors.

[0014] Step 2: Take a CBCT image of the affected tooth in the patient's oral cavity, and obtain spatial position relationship image data of the affected tooth, adjacent teeth, opposing teeth, and distal adjacent teeth in the state of cusp interdigitation based on the CBCT image data of the occlusal relationship; obtain transgingival image data by photographing the area between the gingival margin and the alveolar bone top, so as to provide a numerical basis for designing and manufacturing the position of the tooth shoulder of the root-type implant, the spatial position of the implant, and the shape and size of the implant, wherein the transgingival image includes an image of the metal wire 5;

[0015] Step 3, converting the CBCT image data obtained in step 2 into a root surface model of the affected tooth;

[0016] Step 4: Perform fine processing and detail restoration on the surface of the root film model of the affected tooth, and export the three-dimensional model;

[0017] Step 5: Perform surface treatment on the three-dimensional model obtained in step 4, and add a table for installing braces on the top of the model;

[0018] Step 6: Design a threaded bolt channel from the top of the restoration abutment to the retention device. The bolt channel should intersect with the tooth root to ensure a cross-locking connection. However, the bolt channel must exit from the root within the alveolar socket. The retention device should be located in an area with ample alveolar bone at the root to ensure stability and strength after the retention screw is inserted.

[0019] Step 7: After obtaining the final dental implant model, the dental implant is 3D printed according to the final dental implant model, and the doctor performs the dental implant surgery on the patient.

[0020] The required implant retention screws are standardized according to the size of the personalized root implant and the designed bone volume of the alveolar bone, and enter the alveolar bone at least 2MM after exiting the implant bolt channel.

[0021] In any of the above technical solutions, further, in step 1, the metal wire is a thin silver wire with strong plasticity or a medical barium sulfate wire, and its length is greater than the visual circumference of the gingival sulcus of the patient's oral teeth.

[0022] In any of the above technical solutions, further, the step of converting the CBCT image data into a root surface model of the affected tooth in step 3 includes:

[0023] The CBCT images in three directions are read, an overlay template is established, and the affected tooth part is simulated to obtain a nearly complete root surface model of the affected tooth.

[0024] In any of the above technical solutions, further, the step of converting the CBCT image data into a root surface model of the affected tooth in step 3 further includes: extracting the position coordinates of the affected tooth.

[0025] The beneficial effects of this application are:

[0026] The technical solution in this application is to place a circle of silver wire with high radiopacity and strong plasticity around the gingival sulcus of the affected tooth to obtain CBCT image data of the gingival margin of the affected tooth and the occlusal relationship between the gingival part of the alveolar bone margin and the interdigitation of the tooth cusps; use medical design software and industrial design software to design a 3D printable root implant model through virtual fitting; realize customized implant extraction image simple, fast and accurate, and in terms of model design, the base position is more in line with the patient's own tooth structure. The retaining screw designed and installed on the implant can form a cross-locking knot with the implant, firmly locking the implant in the alveolar socket. After installation, the wound healing time is short, the implant is stable and has good bioaffinity. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] The advantages of the above and / or additional aspects of the present application will become apparent and readily understood from the description of the embodiments in conjunction with the following drawings, in which:

[0028] FIG1 is a schematic flow chart of a root-type dental implant method using oral CBCT images according to one embodiment of the present application;

[0029] FIG2 is a schematic diagram of the spatial adjacent relationship of teeth according to one embodiment of the present application;

[0030] FIG3 is a schematic diagram of a tooth structure according to an embodiment of the present application;

[0031] FIG4 is a three-directional CBCT schematic diagram of an affected tooth according to one embodiment of the present application;

[0032] FIG5 is a schematic diagram of a three-dimensional patch model according to an embodiment of the present application;

[0033] FIG6 is a schematic diagram of a preliminary treatment model of an affected tooth according to an embodiment of the present application;

[0034] FIG7 is a schematic diagram of a fine-processing model of an affected tooth according to an embodiment of the present application.

[0035] FIG8 is a schematic diagram showing the positions of the restoration abutment bolt channel and the retention screw according to one embodiment of the present invention.

[0036] Among them, 1-affected tooth, 2-mesial adjacent tooth, 3-opposing tooth, 4-distal adjacent tooth, 5-metal wire, 6-alveolar bone top, 7-alveolar bone, 8-gingival soft tissue, 9-gingival sulcus, 10-tooth crown, 11-tooth root. DETAILED DESCRIPTION

[0037] In order to more clearly understand the above-mentioned objectives, features and advantages of the present application, the present application is further described in detail below in conjunction with the accompanying drawings and specific embodiments. It should be noted that the embodiments of the present application and the features therein can be combined with each other in the absence of conflict.

[0038] In the following description, many specific details are set forth to facilitate a full understanding of the present application. However, the present application may also be implemented in other ways different from those described herein. Therefore, the scope of protection of the present application is not limited to the specific embodiments disclosed below.

[0039] This embodiment provides a method for extracting image data required for a root-type dental implant method using oral CBCT images. Based on CBCT images and design software, a method for designing a 3D-printable root-type dental implant image is provided through virtual fitting.

[0040] It's important to note that CBCT imaging, also known as cone-beam CT, uses X-rays to reconstruct slices of the entire dentition, obtaining multi-layer images of the alveolar bone and teeth, creating 3D images. Design software includes both medical and industrial design software, such as Mimics Medical, Geomagic Wrap, Geomagic DesignX, and Solidworks. Mimics Medical is specialized software for simulating and extracting medical CT images, widely used in orthopedics, internal medicine, and related research, experiments, and treatments. Geomagic is a powerful suite of industrial data design and processing software, primarily used in industrial design, reverse engineering, and scanning inspection.

[0041] A method for extracting image data of a 3D-printed root-type dental implant is designed, including:

[0042] Step 1: As shown in FIG2 and FIG3 , a circle of metal wire 5 is inserted into the gingival sulcus at the gingival margin of the patient before taking oral CBCT images of the patient, utilizing the radiopacity of the metal wire 5 to X-rays.

[0043] Among them, the metal wire 5 in step 1 is a thin silver wire with strong plasticity or a medical barium sulfate wire with a diameter of 0.3 mm and a length greater than the visual circumference of the gingival sulcus 9 of the patient's oral teeth; the metal wire 5 is inserted into the gingival sulcus 9 around a circle, and the excess metal wire 5 is cut off with scissors; because the metal wire 5 is soft and the diameter is limited to 0.3 mm, it is easy to place in the gingival sulcus 9 during operation.

[0044] Step 2. After the metal wire 5 is installed in the affected tooth's mouth through the operation of step 1, a CBCT image of the affected tooth's mouth is taken, and the spatial adjacent relationship image data of the affected tooth 1, the adjacent tooth 2, the opposing tooth 3, and the distal adjacent tooth 4 in the state of cusp interdigitation is obtained based on the CBCT image data of the occlusal relationship of the cusp interdigitation; the transgingival part image data is obtained by photographing the part between the gingival edge and the alveolar bone top 6, specifically the junction of the crown 10 and the root 11 surrounded by the gingival soft tissue 8 from the alveolar bone top 6 to the gingival edge, which provides a digital basis for designing and producing the position of the tooth shoulder of the root-type implant, the spatial position of the implant, and the shape and size of the implant. In addition, the transgingival part image includes the image of the metal wire 5.

[0045] It should be noted that spatial neighbor relationship refers to the arrangement relationship between different teeth, especially when there is not enough space between teeth. The spatial neighbor relationship can be used to describe the relative positions of the upper and lower teeth in the mouth.

[0046] Step 3: Convert the CBCT image data obtained in step 2 into a root surface model of the affected tooth. In this embodiment, the CBCT image is read using Mimics Medical software, and three views are created and superimposed on the template to analyze and edit the read image. The affected tooth part is simulated to extract a nearly complete root surface model of the affected tooth.

[0047] 3.1. As shown in Figure 4, the CBCT image data from steps 1 and 2 were imported into the Mimics Medical software. After obtaining data from different angles of superior, anterior, and left sides, three views were created.

[0048] 3.2. As shown in Figure 5, an overlay template is created in the view, and the image data is overlaid and displayed and then edited to create a triangular facet model of the patient's target tooth. The model of the target tooth and the location of the tooth are obtained; the location of the target tooth is important data for locating the fixation method of the dental implant and the position of the retention pin.

[0049] It should be noted that a triangular patch is a mesh composed of many connected triangles and is used to represent the surface of a three-dimensional object.

[0050] Step 4: Repeatedly process the surface of the root film model of the affected tooth to eventually obtain a dental implant model with a smooth surface that fits the oral cavity.

[0051] 4.1. As shown in Figure 6, the triangular patch model exported from Mimics in step 3 was further processed in Geomagic Wrap software. The irregular surface of the triangular patch model was edited and repaired to obtain a smooth surface model of the affected tooth with good fit to the original tooth.

[0052] 4.2. As shown in Figure 7, the main mechanical parts of the tooth root are designed and processed using the machining principles of the affected tooth model in step 4.1 in Geomagic DesignX software; the outer surface and alveolar socket of the affected tooth model are added and modified to obtain the implant model including the abutment. At this time, the abutment of the implant model is ready for the installation of braces.

[0053] The above describes in detail the technical solution of the present invention application in combination with the accompanying drawings. The present invention application proposes a root-type dental implant method using oral CBCT images, including: placing a circle of silver wire with high radioblocking and strong plasticity around the gingival sulcus of the affected tooth, obtaining CBCT image data of the gingival edge of the affected tooth and the gingival part to the alveolar bone edge and the occlusal relationship of the tooth cusp; using medical design software and industrial design software, through virtual fitting, designing a 3D-printable root-type dental implant model; realizing customized dental implant extraction effect is simple, fast and accurate. In terms of model design, the abutment position is more in line with the patient's own tooth structure, the wound healing time after installation is short, the dental implant is stable and has good biological affinity.

[0054] The steps in this application can be adjusted in order, combined, and deleted according to actual needs.

[0055] The units in the device of the present application can be combined, divided and deleted according to actual needs.

[0056] Although the present application is disclosed in detail with reference to the accompanying drawings, it should be understood that these descriptions are merely exemplary and are not intended to limit the application of the present application. The scope of protection of the present application is defined by the appended claims and may include various modifications, alterations and equivalents made to the invention without departing from the scope and spirit of the present application.

Claims

1. A root-type dental implant method using oral CBCT images, characterized in that: The method comprises the following steps: Step 1: insert a circle of metal wire (5) into the gingival sulcus at the gingival margin of the patient, the metal wire (5) surrounds the gingival sulcus (9), and then cut off the excess metal wire (5) with scissors; Step 2, take a CBCT image of the patient's oral cavity, and obtain the image data of the spatial position relationship of the affected tooth (1), the mesial adjacent tooth (2), the opposing tooth (3), and the distal adjacent tooth (4) in the state of cusp occlusion based on the CBCT image data of the occlusal relationship of the cusp occlusion; obtain the image data of the transgingival part by photographing the part between the gingival edge and the alveolar bone top (6), so as to provide a digital basis for the design and production of the position of the tooth shoulder of the root-type implant, the spatial position of the implant, and the shape and size of the implant, wherein the transgingival part image includes the image of the metal wire (5); obtain the image data of the spatial position relationship between the root of the affected tooth and the alveolar socket and the size of the alveolar bone around the alveolar socket through the CBCT image, so as to provide the shape and size data of the root implant of the root-type implant and the position of the retention device and the depth of the retention screw entering the alveolar bone for the design; Step 3, converting the CBCT image data obtained in step 2 into a root surface model of the affected tooth; Step 4: Perform fine processing and detail repair on the surface of the root film model of the affected tooth, and export the three-dimensional model; Step 5: performing surface treatment on the three-dimensional model obtained in step 4, and adding a restoration base for installing the braces on the top of the model; Step 6. After obtaining the final dental implant model, a threaded bolt channel is designed from the top of the restoration base to the retention device site, and the bolt channel crosses the tooth root to ensure the formation of a cross-locking knot. However, the bolt channel outlet at the tooth root must be in the alveolar socket, and the retention device site is selected as much as possible at a position with more alveolar bone at the root to ensure the stability and strength of the retention screw after it is screwed in. The dental implant is 3D printed according to the final dental implant model, and the doctor performs dental implant surgery on the patient.

2. A root-type dental implant method using oral CBCT images as claimed in claim 1, characterized in that: The metal wire (5) in step 1 is a thin silver wire or a medical barium sulfate wire with strong plasticity, and its length is greater than the visually measured circumference of the gingival sulcus (9) of the patient's oral teeth.

3. The root-type dental implant method using oral CBCT images as claimed in claim 1, characterized in that: The step of converting the CBCT image data into a root surface model of the affected tooth in step 3 includes: The CBCT images in three directions are read, an overlay template is established, and the affected tooth part is simulated to obtain a nearly complete root surface model of the affected tooth.

4. A root-type dental implant method using oral CBCT images as claimed in claim 3, characterized in that: The step of converting the CBCT image data into a root surface model of the affected tooth in step 3 also includes: extracting the position coordinates of the affected tooth.

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