Devices and methods for simulating dental procedures

Abstract

A dental surgical simulator (1) includes a support structure and a linkage device (40) suspended from the support structure. The linkage device (40) is controlled by a computer (80) configured to simulate dental surgery or treatment. A handpiece (30) is coupled to the linkage device (40) and is configured to be held in a user's hand and manipulated by the user within a workspace (W) in the real space. A phantom head (10) is provided with a phantom maxilla (13) and a phantom mandible (14) and is supported by the support structure and arranged within the workspace (W). The phantom mandible (14) is arranged to be movable relative to the phantom maxilla (13).

Description

Technical Field

[0001] The present disclosure relates to devices and methods for simulating medical and dental procedures and methods, in particular devices and methods for simulating the activities of physicians, dentists, dental / oral / maxillofacial surgeons, dental hygienists or dental therapists using virtual, mixed and / or augmented reality. Background Art

[0002] Dentistry, also known as dental and oral medicine, is a branch of medicine that includes the study, diagnosis, prevention and treatment of oral diseases, disorders and conditions, which are typically in the dentition, but also in the oral mucosa, as well as adjacent and related structures and tissues, particularly in the maxillofacial (jaw and face) region. Dentistry includes oral-related practices, which are carried out by dentists, dental surgeons, oral surgeons, maxillofacial surgeons, dental hygienists and dental therapists in the form of dental procedures and treatments.

[0003] Dental students require training facilities, and using real patients has significant drawbacks.

[0004] Dental simulators for simulating dental procedures are known in the art. These simulators are used to train dental students, thus reducing the need for training on plastic mannequin heads with plastic mannequin teeth (which do not provide accurate simulation, do not allow objective assessment or tracking of work, and are not environmentally friendly) and reducing the need for training on real patients. Known dental simulators include a computer that controls the simulation and hosts a virtual environment, a display screen that displays the simulation environment, and one or two handpieces connected to the computer to provide input. The simulation environment includes objects, virtual tooth sets, virtual versions of tools controlled by the handpieces, and virtual versions of the handpieces themselves. The tools can be surgical instruments (scalpels, syringes, etc.) or other devices (such as mirrors or probes). The handpieces are connected to sensors that determine their position and orientation, which are used to control (display) the position of the tools in the virtual environment. Typically, one of the handpieces is mounted on a haptic feedback system through which the computer controls the force that the user feels through the handpiece.

[0005] Stationary U-shaped guides and the like are used as handrests for the hands / fingers of dental students (users). In real dental procedures or treatments, dentists typically place their fingers on the patient's teeth and jaws, and the simulation using a single fixed U-shaped guide in known dental simulators is not a realistic simulation.

[0006] The visual display screen is arranged between the user's eyes and the handheld member and the guide rail, and presents a virtual environment showing a virtual tooth group on a virtual jaw. Known simulators include a computer that controls the simulation and hosts the virtual environment, a display screen that displays the simulated environment, and one or two handheld members connected to the computer to provide input / output. The simulated environment includes objects and a virtual version of a tool controlled by the handheld member. The tool can be a surgical instrument (scalpel, syringe, etc.) or other devices (such as a mirror or a probe). The handheld member is connected to a sensor that determines its position for controlling the position of the tool in the virtual environment. One of the handheld members is mounted on a haptic feedback system that allows the computer to control the force felt by the user through the handheld member, making a more realistic simulation possible. However, the virtual version of the handheld member is displayed on the display screen, but the user cannot see his or her own fingers or hands, which is a drawback because it prevents the user from making important visual inputs. Summary of the Invention

[0007] The aim is to provide a dental simulator that overcomes or at least reduces at least one of the above problems.

[0008] The foregoing and other aims are achieved by the features of the independent claims. Further implementations are apparent in the dependent claims, the description, and the drawings.

[0009] According to a first aspect, there is provided a dental surgery simulator, comprising: a support structure, a display screen, a computer configured to simulate a dental surgery or treatment, a linkage device suspended from the support structure, the linkage device being controlled by the computer to simulate a medical surgery or treatment by providing haptic force feedback, a handheld member operably coupled to the linkage device and configured to be held in the user's hand and manipulated by the user in a workspace in the real space, a phantom maxilla and a phantom mandible supported by the support structure and arranged in the workspace, the phantom mandible preferably being arranged to be movable relative to the phantom maxilla, the computer being configured to display a virtual environment on the display screen, the virtual environment including at least one virtual tooth co-located with the phantom maxilla or the phantom mandible.

[0010] By providing the phantom maxilla and mandible, the computer simulation of dental surgery becomes more realistic for the user, which is caused by the mixed reality resulting from the presence of the upper and / or lower jaws. With the presence of the phantom jaws, the user can support their hand / fingers thereon in a manner closely simulating the way a dentist supports their hand / fingers on a real patient, enhancing the computer simulation experience. In addition, the visual presence of the upper and lower jaws provides a more realistic representation of the working environment with a real patient, thus providing a more realistic simulation.

[0011] According to a possible implementation of the first aspect, the upper dental mold and the lower dental mold are movable relative to the support structure. The dental surgical simulator includes one or more sensors configured to sense the position and orientation of the upper dental mold and the lower dental mold relative to the support structure. Wherein the computer receives the position and orientation of the upper dental mold and the lower dental mold through the one or more sensors, and the computer is configured to adjust the orientation and position of at least one virtual tooth according to the movement of the upper dental mold or the lower dental mold, such that when the upper dental mold or the lower dental mold moves, the at least one virtual tooth remains co-located with the upper dental mold or the lower dental mold on the display screen.

[0012] According to a possible implementation of the first aspect, the upper dental mold and the lower dental mold can be manually moved by the user.

[0013] According to a possible implementation of the first aspect, the computer is configured to at least display a part of the virtual upper jaw and a part of the virtual lower jaw. The computer is configured to co-locate the virtual upper jaw with the upper dental mold and the virtual lower jaw with the lower dental mold on the display screen, and this is also the case when the upper dental mold or the lower dental mold moves.

[0014] According to a possible implementation of the first aspect, the lower dental mold is suspended from the upper dental mold by a hinge mechanism, such as a four-bar kinematic chain, preferably a hinge mechanism that simulates the movement of the human jaw.

[0015] According to a possible implementation of the first aspect, the lower dental mold is suspended from the upper dental mold to allow movement between an open position and a closed position.

[0016] According to a possible implementation of the first aspect, the dental surgical simulator includes a position sensor configured to generate a signal indicating the position of the lower dental mold relative to the upper dental mold.

[0017] According to a possible implementation of the first aspect, the closed position corresponds to a position for checking occlusal reduction.

[0018] According to a possible implementation of the first aspect, the computer is configured to display a virtual upper tooth set for the upper dental mold and a virtual lower tooth set for the lower dental mold on the display screen, thereby allowing a visual occlusal check of the virtual tooth sets in the closed position.

[0019] According to a possible implementation of the first aspect, the upper dental mold is suspended from the support structure to allow rotation with one, two, or three rotational degrees of freedom, preferably with the center of rotation of each degree of freedom located between the upper dental mold and the lower dental mold.

[0020] According to a possible implementation of the first aspect, preferably one, two or three degrees of freedom of rotation are manually imparted, and wherein the dental surgical simulator includes one or more rotational position sensors for sensing the rotation of the upper jaw of the phantom for each of one to three degrees of freedom.

[0021] According to a possible implementation of the first aspect, the computer receives signals from one or more rotational position sensors, and wherein the computer (80) is configured to adjust the simulation of the dental surgery or treatment according to the signals from the rotational position sensors.

[0022] According to a possible implementation of the first aspect, the upper jaw of the phantom is suspended from the support structure by a first mechanism, the first mechanism allowing the upper jaw to rotate about a first horizontal axis Y disposed in the working space, and the first mechanism not intruding into the working space, the first mechanism preferably including a remote center linkage, preferably two spaced-apart parallel remote center linkages.

[0023] According to a possible implementation of the first aspect, the upper jaw of the phantom is suspended from the support structure by a second mechanism, the second mechanism allowing the upper jaw of the phantom to rotate about a second horizontal axis disposed in the working space, and the second mechanism not intersecting the working space.

[0024] According to a possible implementation of the first aspect, the upper jaw of the phantom is suspended from the support structure by a third mechanism, the third mechanism allowing the upper jaw of the phantom to rotate about a vertical axis Z, and the third mechanism not intersecting the working space.

[0025] According to a possible implementation of the first aspect, the upper jaw of the phantom includes an upper support member having a detachable upper jaw element detachably attached thereto, and wherein the lower jaw of the phantom includes a lower support member having a detachable lower jaw element detachably attached thereto.

[0026] According to a possible implementation of the first aspect, the detachable upper jaw element is a universal upper jaw element, the universal upper jaw element preferably not having / defining teeth, and wherein the detachable lower jaw element is a universal lower jaw element, the detachable lower jaw element preferably not having / defining teeth.

[0027] According to a possible implementation of the first aspect, the detachable upper jaw element is a specific upper jaw element provided with phantom teeth, the phantom teeth being preferably detachably attached to the specific upper jaw element, the specific upper jaw element with its phantom teeth being preferably an exact replica of a part of a real human upper jaw with its teeth, and wherein the detachable lower jaw element is a specific lower jaw element provided with phantom teeth, the phantom teeth being preferably detachably attached to the specific lower jaw element, and the specific lower jaw element with its phantom teeth being preferably an exact replica of a part of a real human lower jaw with its teeth.

[0028] According to a possible implementation of the first aspect, the computer is provided with a virtual model of the specific upper jaw element and / or the specific lower jaw element.

[0029] According to a possible implementation of the first aspect, the phantom upper jaw and the phantom lower jaw are part of a phantom head, and the phantom head with its phantom lower jaw and phantom upper jaw is preferably configured to move in unison with each other.

[0030] According to a possible implementation of the first aspect, the computer is configured to guide the user to mount / remove the specific upper or lower jaw element on / from the support member, and the computer is preferably further configured to guide the user to mount / remove the phantom teeth on / from the specific jaw element.

[0031] According to a possible implementation of the first aspect, the computer is coupled to a display screen, and wherein the dental surgery simulator is configured to project an image from the display screen onto the user's eyes through a partially transparent reflective element, while allowing the user to view the workspace, the handpiece, the phantom upper jaw, and the phantom lower jaw through the partially transparent reflective element.

[0032] According to a possible implementation of the first aspect, the computer is configured to simulate a medical or dental surgery or treatment by force feedback in response to the user's manipulation of the handpiece in the workspace.

[0033] According to a possible implementation of the first aspect, the phantom upper jaw and / or the phantom lower jaw is a segmented phantom jaw, wherein at least one segment is detachable.

[0034] By using a segmented phantom jaw, wherein at least one or more or all of the segments can be removed and of course reinstalled, adjacency between the haptic arm and the phantom jaw can be avoided, which may occur especially when simulating activities related to virtual teeth of the lower jaw. In other words, in some cases, a part of the phantom jaw blocks the haptic arm, and by removing the segment of the relevant segmented phantom jaw, space is made for the haptic arm while most of the phantom jaw remains for the user to use as a support for the hand and to provide a sense of realism for the simulation.

[0035] According to a second aspect, there is provided a dental surgical simulator, comprising:

[0036] a support structure, a computer configured to simulate a dental surgery or treatment,

[0037] a linkage suspended from the support structure, the linkage being controlled by the computer to simulate a medical procedure or treatment by providing a haptic force feedback configured to simulate a dental surgery or treatment, a handpiece operably coupled to the linkage and configured to be held in a user's hand and manipulated by the user in a workspace in the real space, a maxillary phantom movably supported by the support structure and disposed in the workspace, wherein the maxillary phantom is suspended from the support structure by a mechanism that allows the maxillary phantom to rotate about at least one axis disposed in the workspace, and the mechanism does not intersect the workspace.

[0038] By providing a linkage that does not intrude into the workspace, the phantom head can be used in a computer simulation of a dental surgery or treatment without disturbing the workspace required for the movement of the handpiece.

[0039] According to a possible implementation of the second aspect, the maxillary phantom is suspended from the support structure by a first mechanism that allows the maxilla to rotate about a horizontal axis disposed within the workspace, and the first mechanism does not intrude into the workspace. The first mechanism preferably includes at least one spaced parallel remote center linkage.

[0040] According to a possible implementation of the second aspect, the maxillary phantom is suspended from the support structure by a second mechanism that allows the maxillary phantom to rotate about a horizontal axis, and the second mechanism does not intersect the workspace. The second mechanism preferably includes an L-shaped plate extending between the phantom head and the maxillary phantom.

[0041] According to a possible implementation of the second aspect, the maxillary phantom is suspended from the support structure by a third mechanism that allows the maxillary phantom to rotate about a vertical axis, and the third mechanism does not intersect the workspace. The third mechanism preferably includes a hinge pin that connects the first mechanism to the L-shaped plate and allows the L-shaped plate to rotate about the vertical axis.

[0042] According to a third aspect, there is provided an apparatus for simulating or training a dental surgery or treatment, the apparatus comprising: a handpiece configured to be held in a user's hand and manipulated by the user in a workspace in the real space, a haptic arm controlled by a computer configured to simulate a dental surgery or treatment, the handpiece being mechanically connected to the haptic arm, a powered dental handpiece having a motor for driving a dental drill, a support for supporting at least one phantom tooth in a workpiece space.

[0043] By providing both a handpiece for computer simulation of dental procedures or treatments and a handpiece for physical simulation of dental procedures, both types of training can be carried out by a single machine, thus significantly saving costs and space.

[0044] According to a possible implementation of the third aspect, the powered dental handpiece provides electrical power or pneumatic power through a cable connected to the powered dental handpiece.

[0045] According to a possible implementation of the third aspect, the device includes at least one phantom jaw for supporting at least one phantom tooth.

[0046] According to a possible implementation of the third aspect, the phantom tooth is at least partially made of a polymeric material.

[0047] According to a possible implementation of the third aspect, the computer has at least a first operating mode for simulating dental procedures or treatments using the handpiece and a second operating mode for training dental procedures or treatments using the powered dental handpiece.

[0048] According to a possible implementation of the third aspect, the handpiece is a passive handpiece that does not include any motors and is not configured to operate a dental drill.

[0049] According to the fourth aspect, there is provided a medical procedure simulator including: a handpiece configured to be held in a user's hand and manipulated by the user in a workspace in the real space, and a linkage controlled by a computer configured to simulate a medical procedure or treatment, the linkage including an elongate main link, a first crank, a second crank, and a third crank, a first actuator driving the first crank, a second actuator driving the second crank, a third actuator driving the third crank, the handpiece being connected to the end of the main link by a mechanical joint, the first crank being arranged to actuate the main link in a longitudinal direction, the second crank being arranged to actuate the main link in a first transverse direction, and the third crank being arranged to actuate the main link in a second transverse direction different from the first transverse direction, the first crank being directly coupled to the main link by a second mechanical joint, the second crank being coupled to the main link by a first link, the first link being coupled to the second crank at a first end and the first link being coupled to the main link at a second end, and the third crank being coupled to the main link by a second link, the second link being coupled to the third crank at a first end and the second link being coupled to the main link at a second end.

[0050] The linkage of the medical procedure simulator is not complex and is thus reliable and inexpensive because it contains a relatively small number of components. In addition, the linkage is suitable for providing a cuboid workspace with vertical and horizontal sides.

[0051] In a first possible implementation of the fourth aspect, the first crank is connected to the main coupling at a first axial position, the first link is coupled to the main coupling at a second axial position between the end and the first axial position, and the second link is coupled to the main coupling at a third axial position between the end and the first position, and the second and third axial positions are preferably substantially the same.

[0052] In a second possible implementation of the fourth aspect, the main coupling includes a three-dimensional force sensor for sensing three-dimensional forces applied by a user to the handpiece, the three-dimensional force sensor is disposed between the end position and the second and / or third axial positions, and the three-dimensional force sensor is preferably an integral part of the main coupling.

[0053] In a third possible implementation of the fourth aspect, the first, second, and / or third cranks are coupled to a rotational position sensor or encoder.

[0054] In a fourth possible implementation of the fourth aspect, the first, second, and / or third actuators are rotational actuators.

[0055] In a fifth possible implementation of the fourth aspect, the respective rotational axes of the first, second, and third cranks are arranged orthogonally to each other.

[0056] In a sixth possible implementation of the fourth aspect, the first link extends substantially horizontally, the second link extends substantially vertically, and the rotational axis of the first crank extends substantially vertically.

[0057] In a seventh possible implementation of the fourth aspect, the computer is configured to simulate a medical operation or treatment by utilizing the haptic feedback of the linkage mechanism, preferably haptic force control feedback, and by utilizing the visual feedback of the display screen.

[0058] In an eighth possible implementation of the fourth aspect, the medical operation simulator includes a reference member, on which the first, second, and third cranks are mounted.

[0059] In a ninth possible implementation of the fourth aspect, the medical operation simulator includes a reference member, relative to which the linkage mechanism provides at least six independent degrees of freedom for the handpiece.

[0060] In a tenth possible implementation of the fourth aspect, the linkage mechanism connects the handpiece to the reference member.

[0061] In an eleventh possible implementation of the fourth aspect, the handpiece includes an inertial measurement unit, which is preferably configured to generate direction data indicating the rotational direction of the handpiece, preferably the rotational direction of the handpiece in real space and / or relative to the reference member.

[0062] In a twelfth possible implementation of the fourth aspect, the free end of the first crank is coupled to the main coupling, preferably by a mechanical joint providing relative movement with at least two degrees of freedom between the main coupling and the first crank, such as, for example, a universal joint.

[0063] In a thirteenth possible implementation of the first aspect, the second lateral direction is substantially perpendicular to the first lateral direction.

[0064] In a fourteenth possible implementation of the fourth aspect, the computer is configured to simulate a medical operation or treatment by using the signal from the three-dimensional force sensor as an input and controlling the speed of the end accordingly.

[0065] According to the fifth aspect, there is provided a medical operation simulator including a handpiece coupled to a haptic force feedback system providing haptic force feedback, the force feedback system including at least one actuator, a control system including: a virtual model configured to calculate a virtual force and a force sensor configured to sense the force applied to the handpiece, the virtual model receiving a signal representing the speed of the handpiece, a summing point summing the virtual force and the sensed force, a lead-lag compensator receiving the output of the summing point, a PI or PID controller receiving the output of the lead-lag compensator, a motor driver receiving the speed command from the PI or PID controller, and at least one actuator electrically driven by the motor driver.

[0066] By using a lead-lag compensator in the medical operation simulator, high frequencies caused by contact instability or system resonance are eliminated from the input signal of the PI or PID controller, thereby making the operation of the medical operation simulator more stable and smooth, with a realistic feeling.

[0067] In a possible implementation of the fifth aspect, the virtual model receives a signal indicating the direction of the handpiece 30.

[0068] In another possible implementation of the second aspect, the virtual model receives a signal indicating the rotational speed of the virtual drill.

[0069] According to the sixth aspect, there is provided a dental operation simulator including a computer configured to simulate a dental operation or treatment, a handpiece configured to be held in a user's hand and manipulated by the user in a workspace in the real space, the computer being configured to generate an image of the simulated dental operation to be displayed on a display screen, a partially transparent reflecting element configured to reflect the image on the display screen to the user's eyes, and a workspace configured to be visible to the user through the partially transparent reflecting element.

[0070] By providing a partially transparent reflective screen, the user can see their hands during medical surgery training. This is important visual feedback that greatly enhances the user experience. The resulting mixed reality enhances the overall user experience.

[0071] According to a sixth possible implementation of the first aspect, the dental surgery simulator is configured to reflect an image from the display screen to the user's eyes by reflection on a partially transparent reflective element, and is configured to blend the image with the view of the workspace (W) that the user sees through the partially transparent reflective element.

[0072] According to a first possible implementation of the sixth aspect, the image on the display screen is reflected to the user's eyes, and the workspace can be simultaneously visible to the user through the partially transparent reflective element when the user views the partially transparent reflective element from the viewing space.

[0073] According to a third possible implementation of the sixth aspect, the display screen is a stereoscopic display screen.

[0074] According to a fourth possible implementation of the sixth aspect, the computer is configured to send stereoscopic images to the stereoscopic display screen.

[0075] According to a fifth possible implementation of the sixth aspect, the stereoscopic display screen is an autostereoscopic display screen.

[0076] According to a sixth possible implementation of the sixth aspect, the computer is configured to generate an image of a virtual handpiece that is co-located with the handpiece, and the image is preferably a stereoscopic image.

[0077] According to a seventh possible implementation of the sixth aspect, the computer is configured to provide a three-dimensional virtual environment that includes a first virtual tool having a first virtual position and a first virtual orientation, the first virtual tool corresponding in size and shape to the handpiece, and the first virtual tool being co-located with the handpiece.

[0078] According to an eighth possible implementation of the sixth aspect, the partially transparent reflective element is a partially transparent mirror or a semi-transparent mirror.

[0079] According to a ninth possible implementation of the sixth aspect, the dental surgery simulator is provided with adjustable lighting in the workspace.

[0080] According to a tenth possible implementation of the sixth aspect, the dental surgery simulator is provided with a phantom maxilla and a phantom mandible, both of which are disposed in the workspace.

[0081] According to the eleventh possible implementation of the sixth aspect, the dental surgery simulator is provided with a phantom head, which is arranged in the working space and preferably includes a phantom maxilla and a phantom mandible.

[0082] According to the seventh aspect, a method for simulating a dental surgery or treatment is provided, including: providing a dental surgery simulator, which includes a handpiece configured to be held in the user's hand and manipulated by the user in the working space of the real space, generating an image of a virtual environment with a simulated dental surgery or treatment on a display screen, reflecting the image to the user through a partially transparent reflective element, and allowing the user to view the working space and the image of the virtual environment reflected through the partially transparent reflective element simultaneously through the partially transparent reflective element.

[0083] According to the first possible implementation of the seventh aspect, the working space includes at least one movable phantom jaw and / or a movable phantom head, and the virtual environment includes at least one virtual jaw with virtual teeth, and the method includes adjusting the position of the virtual jaw with virtual teeth to maintain co - localization with the phantom jaw.

[0084] According to the eighth aspect, a dental surgery simulator is provided, including: a computer configured to simulate a dental surgery or treatment, a parallel robot controlled by the computer, the parallel robot providing at least three translational degrees of freedom, the parallel robot being controlled by the computer to simulate a dental surgery or treatment by providing haptic force feedback via the parallel robot, a handpiece operably coupled to the parallel robot through a mechanism providing at least three rotational degrees of freedom, the handpiece being configured to be held in the user's hand and manipulated by the user in the working space of the real space, and an autostereoscopic display screen, the computer being configured to generate a stereoscopic image of a simulated dental surgery to be displayed on the autostereoscopic display screen, and the computer being configured to generate a stereoscopic image of a virtual handpiece co - located with the handpiece.

[0085] By providing a dental surgery simulator with a force - feedback parallel robot, combined with an autostereoscopic display, a highly realistic training can be provided for dentists or students without the trainees having to use 3D (shutter) glasses.

[0086] According to a possible implementation of the eighth aspect, the dental surgery simulator includes a parallel robot controlled by a computer, the parallel robot providing at least three translational degrees of freedom, the parallel robot being controlled by the computer to simulate a dental surgery or treatment by providing haptic force feedback via the parallel robot, and the handpiece is operably coupled to the parallel robot through a mechanism providing at least three rotational degrees of freedom.

[0087] According to a possible implementation of the eighth aspect, the parallel robot includes one actuator for each translational degree of freedom.

[0088] According to a possible implementation of the eighth aspect, the dental surgery simulator includes a sensor for sensing the orientation of the handpiece.

[0089] According to a possible implementation of the eighth aspect, the dental surgery simulator includes a partially transparent reflective element arranged to reflect an image from an autostereoscopic display to the user's eyes, and the workspace is arranged to be visible to the user through the partially transparent reflective element.

[0090] According to a possible implementation of the eighth aspect, the computer is configured to generate a three-dimensional virtual environment including a first virtual tool having a first virtual position and a first virtual orientation, the first virtual tool preferably corresponding in size and shape to the handpiece, and the computer is configured to co-locate the first virtual tool with the handpiece.

[0091] According to the ninth aspect, there is provided a dental surgery simulator including: a computer configured to simulate a dental surgery or treatment, a reference member, a first handpiece simulating a dental drill, the first handpiece being configured to be held in a user's hand and manipulated by the user in a real-space workspace, a linkage coupled to the reference member, the linkage being controlled by the computer, the computer being configured to simulate a dental surgery or treatment by providing haptic feedback via the linkage, a second handpiece simulating a dental mirror, the second handpiece being configured to be held in a user's hand and manipulated by the user in a real-space workspace, a main coupling member coupled to the reference member by one or more joints providing first and second degrees of freedom, a secondary coupling member coupled to the main coupling member by one or more joints providing third and fourth degrees of freedom, the second handpiece being connected to the secondary coupling member by one or more joints providing fifth and sixth degrees of freedom to form a serial chain connecting the second handpiece to the reference member with six degrees of freedom, a first sensor for sensing movement in a first degree of freedom, a second sensor for sensing movement in a second degree of freedom, a third sensor for sensing movement in a third degree of freedom, the first, second, and third position sensors being in data connection with the computer, and an inertial measurement unit arranged in the second handpiece, the inertial measurement unit being in data connection with the computer and being configured to sense movement in at least the fourth, fifth, and sixth degrees of freedom.

[0092] The combination of the three position sensors and the inertial measurement unit in the handpiece provides a relatively simple but still accurate system for determining the accurate position of the handpiece relative to the reference member, since the signals from the position sensors can be used to compensate the inertial measurement unit.

[0093] In a first possible implementation of the ninth aspect, the handpiece is connected to the secondary coupling member by one or more joints providing a sixth degree of freedom, which allows the handpiece to rotate about the axis of the handpiece and the inertial measurement unit is configured to sense the sixth degree of freedom.

[0094] In a second possible implementation of the ninth aspect, the first sensor, the second sensor, or the third sensor is a rotational position sensor.

[0095] In a third possible implementation of the ninth aspect, the primary coupling member is an elongate coupling member that is coupled to the reference member by a third pivot joint that allows the primary coupling member to rotate about its longitudinal axis to achieve the first degree of freedom.

[0096] In a fourth possible implementation of the ninth aspect, the first sensor is a rotational position sensor that is configured to sense rotation about the longitudinal axis of the primary coupling member.

[0097] In a fifth possible implementation of the ninth aspect, the primary coupling member is an elongate coupling member that is coupled to the reference member by a hinge that allows the primary coupling member to rotate about a transverse axis to obtain the second degree of freedom.

[0098] In a sixth possible implementation of the ninth aspect, the second position sensor is a rotational position sensor that is configured to sense rotation of the primary coupling member about the transverse axis.

[0099] In a seventh possible implementation of the ninth aspect, the secondary coupling member is an elongate coupling member that is coupled to the primary coupling member by a third hinge that allows the secondary coupling member to rotate about a transverse axis to obtain the third degree of freedom.

[0100] In an eighth possible implementation of the ninth aspect, the third sensor is a rotational position sensor that is configured to sense the rotational movement of the secondary coupling member about the transverse axis.

[0101] In a ninth possible implementation of the ninth aspect, the secondary coupling member is an elongate coupling member that is coupled to the primary coupling member by a second pivot joint that allows the secondary coupling member to rotate about its longitudinal axis to obtain the fourth degree of freedom.

[0102] In a tenth possible implementation of the ninth aspect, the medical surgical simulator includes a tertiary coupling member coupled to a quaternary coupling member, the tertiary coupling member being coupled to the primary coupling member or the secondary coupling member, and the quaternary coupling member being coupled to the third sensor to form a serial chain that converts rotation of the secondary coupling member about the transverse axis of the secondary coupling member into rotational movement of the third sensor.

[0103] In an eleventh possible implementation of the ninth aspect, the medical surgical simulator includes a second hinge that provides a fifth degree of freedom to the handpiece.

[0104] In a twelfth possible implementation of the ninth aspect, the medical surgical simulator includes a fourth pivot joint that allows the handpiece to rotate about the axis of the handpiece to provide a sixth degree of freedom.

[0105] In a thirteenth possible implementation of the ninth aspect, the medical surgical simulator includes a rotational position sensor within the handpiece for sensing rotation of the handpiece about the axis of the handpiece.

[0106] In a fourteenth possible implementation of the ninth aspect, the inertial measurement unit is configured to sense rotation of the handpiece about the axis of the handpiece.

[0107] In a fifteenth possible implementation of the ninth aspect, the inertial measurement unit is configured to sense movement of up to six degrees of freedom, preferably three rotational degrees of freedom, and wherein the computer is configured to use signals from the first, second, and / or third sensors as a reference for calibrating the inertial measurement unit.

[0108] According to a tenth aspect, there is provided a medical surgical simulator comprising: a handpiece configured to be held in a user's hand and manipulated by the user in a workspace in the real space, a linkage controlled by a computer configured to simulate a medical operation or treatment, the handpiece including an inner portion extending into an outer portion, wherein the outer portion is configured to rotate about the inner portion, a part of the inner portion protruding from the outer portion, the part being coupled to the linkage by a joint having at least two degrees of freedom, an inertial measurement unit mounted to the inner portion and coupled to the computer, and a rotational position sensor for sensing rotational movement of the outer portion relative to the inner portion, the rotational position sensor being coupled to the computer, at least a first part of the rotational position sensor being mounted on the inner portion, and the first part being connected to the computer by a cable guided or supported by the inner portion.

[0109] The inner and outer portions of the handpiece are arranged such that the degrees of freedom of the handpiece that the user can operate with his or her hand are increased. The arrangement in which at least a first part of the rotational sensor is mounted on the inner portion allows the outer portion to rotate infinitely relative to the inner portion, thereby providing non-limited rotation of the handpiece about its longitudinal axis. Since the rotational position sensor can be at least partially arranged on the inner portion, the rotational sensor can be connected to the computer by a cable without the need for slip rings or the like to allow rotation, because the cable is not exposed to rotation. The absence of slip rings or the like in the connection between the rotational position sensor and the computer provides a more reliable connection between the rotational position sensor and the computer.

[0110] In a first possible implementation of the tenth aspect, the inertial measurement unit is configured to generate orientation data indicating the direction of rotation of the handpiece.

[0111] In a second possible implementation of the tenth aspect, the inertial measurement unit is coupled to the computer by a cable guided or supported by the inner part.

[0112] In a third possible implementation of the tenth aspect, the medical surgical simulator includes a first rotary bearing located between the inner part and the outer part, and preferably includes a second rotary bearing axially spaced from the first rotary bearing.

[0113] In a fourth possible implementation of the tenth aspect, the outer part is arranged to rotate about the longitudinal axis of the inner part.

[0114] In a fifth possible implementation of the tenth aspect, the inner part is elongate and is connected to a joint at a first end of the inner part, and a rotational position sensor is arranged at or near a second end of the inner part, the second end being located inside the outer part.

[0115] In a sixth possible implementation of the tenth aspect, the inertial measurement unit is configured to generate position and / or orientation data of the handpiece in real space, preferably relative to a reference piece.

[0116] In a seventh possible implementation of the tenth aspect, the coupling of the inertial measurement unit to the computer includes a data link from the inertial measurement unit to the computer for transmitting position and / or orientation data.

[0117] In an eighth possible implementation of the tenth aspect, the coupling of the rotational position sensor to the computer includes a data link from the rotational position sensor to the computer for transmitting rotational position data.

[0118] In a ninth possible implementation of the tenth aspect, the outer part has an unrestricted rotation relative to the inner part.

[0119] In a tenth possible implementation of the tenth aspect, the longitudinal extent of the outer part includes a proximal part and a distal part extending at an angle to the proximal part, wherein the inner part projects from the outer part through the distal part.

[0120] According to the eleventh aspect, there is provided a dental surgical simulator having a front and a back, the dental surgical simulator comprising: a computer configured to simulate a dental operation or treatment, a linkage controlled by the computer, a handpiece coupled to the linkage and configured to be held in a user's hand and manipulated by the user in a workspace in the real space, a display screen coupled to the computer for displaying images generated by the computer, a base, a main structure having a substantially flat bottom, wherein the linkage is at least partially received in the main structure, and a column supporting the main structure above the base, having a distance between the substantially flat bottom and the base to create a space between the substantially flat bottom and the base, the column being height-adjustable to change the distance between the surface on which the base is placed and the substantially flat bottom to a range preferably including a distance of at least 70 to 80 cm, more preferably at least including a distance of 65 to 85 cm, the column (3) being laterally offset relative to the base and relative to the substantially flat bottom, the column extending from a position adjacent to the front of the base, preferably at the front of the base, to a position adjacent to the front of the main structure, preferably at the front of the main structure.

[0121] The space between the substantially flat bottom and the base allows the dental surgical simulator to occupy less space as it can be easily adapted to different room settings. In particular, the substantially flat bottom of the main housing and the height-adjustability of the column allow the main housing to be arranged, for example, on a workbench or a tabletop, thus saving valuable room space.

[0122] In a first possible implementation of the eleventh aspect, the space between the base and the flat bottom is an empty space that only intersects the column.

[0123] In a second possible implementation of the eleventh aspect, the space can be accessed from all lateral directions, except where access is blocked by the column.

[0124] In a third possible implementation of the eleventh aspect, the dental surgical simulator includes two or more columns, and the two or more columns are all laterally offset and arranged on the same side of the base and the main housing.

[0125] In a fourth possible implementation of the eleventh aspect, the main housing is supported by only one column.

[0126] In a fifth possible implementation of the eleventh aspect, the space is open to the environment, except where the space is blocked by the base, the substantially flat bottom, or the column.

[0127] In a sixth possible implementation of the eleventh aspect, the column is height-adjustable for changing the distance between the base and the substantially flat bottom, preferably a motorized height-adjustable column.

[0128] In a seventh possible implementation of the eleventh aspect, the column includes a linear actuator for height adjustment.

[0129] In an eighth possible implementation of the eleventh aspect, the display screen is disposed in a display housing provided above the main housing, and the display housing is preferably supported above the main housing by an arm connected to the column or the main housing.

[0130] In a ninth possible implementation of the eleventh aspect, the base includes a lower housing.

[0131] In a tenth possible implementation of the eleventh aspect, the main housing includes a reference member for supporting the linkage.

[0132] In an eleventh possible implementation of the eleventh aspect, the base is configured to be placed on the floor, and preferably the base is wheeled.

[0133] In a twelfth possible implementation of the eleventh aspect, the computer is configured to generate images of a simulated dental procedure or treatment for display on the display screen.

[0134] In a thirteenth possible implementation of the eleventh aspect, the column extends from the base to the main housing.

[0135] In a fourteenth possible implementation of the eleventh aspect, the column extends from a position adjacent to the side of the base to a position adjacent to the side of the main housing.

[0136] These and other aspects will become apparent from the embodiments described below. Description of the Drawings

[0137] In the following detailed part of the present disclosure, aspects, embodiments, and implementations will be explained in more detail with reference to the exemplary embodiments shown in the drawings, wherein:

[0138] Figure 1 is a top (elevated) view of a dental procedure simulator according to an embodiment,

[0139] Figure 2 is Figure 1 a side view of the dental procedure simulator of

[0140] Figure 3 is Figure 1 a side view of the dental procedure simulator of

[0141] Figure 4 shows Figure 1 a front view of the display housing of the dental procedure simulator of

[0142] Figure 5 is a cross-sectional view of a display housing that passes through Figure 4 and also illustrates the working space, the user's eyes, and the visual space,

[0143] Figure 6 is Figure 1 a top view of a dental surgery simulator from the user's perspective through a translucent mirror in the display housing to the working space, and also shows a virtual environment by reflection from the translucent mirror,

[0144] Figure 7 is by Figure 1 a dental surgery simulator showing an image of a mixed reality virtual environment,

[0145] Figures 8 to 11 is Figure 1 a top view of a specific phantom jaw used in a dental surgery simulator,

[0146] Figure 12 is a top view of a phantom head and its mounting system using a specific mandible and a specific phantom maxilla,

[0147] Figure 13 is Figure 12 a side view of the phantom head,

[0148] Figure 14 and 15 is Figure 1 a top view of a general phantom jaw used in a dental surgery simulator,

[0149] Figure 16 is Figure 12 a top view of a phantom head showing the three rotational axes of the phantom head relative to the dental surgery simulator, on which a general phantom jaw is mounted,

[0150] Figure 17 and 18 is Figure 16 a top view of a phantom head illustrating rotations about the Z-axis and the X-axis,

[0151] Figure 19 and 20 is Figure 12 a side view of a phantom head illustrating different positions of the phantom mandible relative to the phantom maxilla,

[0152] Figure 21 and 22 is Figure 16 a side view of a phantom head illustrating rotation about the Y-axis,

[0153] Figures 23 to 26 are respectively a top view and an isometric view of an embodiment of a linkage with its drive system and a handpiece connected to the linkage,

[0154] Figure 27 is a cross-sectional view of a handpiece according to an embodiment,

[0155] Figure 28 and 29 is Figure 27 a side view of the handpiece,

[0156] Figure 30 is a top view of a dental surgery simulator including an auxiliary tool according to another embodiment,

[0157] Figure 31 is a top view of an embodiment of the auxiliary tool,

[0158] Figure 32 and 33 are respectively Figure 31 an end view and a side view of the auxiliary tool,

[0159] Figure 34 is Figure 1 a schematic diagram of the dental surgery simulator, further showing the user's eyes and visual space,

[0160] Figure 35 is a schematic diagram of an embodiment of a control system that can be used in a dental surgery simulator,

[0161] Figure 36 showing another embodiment of a dental surgery simulator having an additional function of training to drill into plastic phantom teeth, and

[0162] Figure 37 and 38 illustrate an embodiment of a segmented phantom jaw for a dental surgery simulator. DETAILED DESCRIPTION

[0163] Referring to the accompanying drawings, and in particular Figures 1 to 734, which shows a first embodiment of a medical surgical simulator 1, particularly a dental surgical simulator 1 for simulating dental surgeries and treatments. The medical surgical simulator 1 is intended for training the skills and capabilities of medical professionals or students. In the case of the dental surgical simulator 1, the dental surgical simulator is intended for training the skills and capabilities of dentists, dental surgeons, oral surgeons, maxillofacial surgeons, dental hygienists, and dental therapists. The users receiving training on the dental surgical simulator can be students or professionals. The dental surgical simulator 1 generally includes: a first handpiece 30, which, in this embodiment, represents a dental drill handle; a base 2, which, in this embodiment, has a lower housing that houses a computer 80; a column 3, which is height-adjustable in this embodiment; a main housing 4 that houses a linkage device 40 connecting the first handpiece 30; a mold head 10; and a support arm 5 that supports a display housing 6.

[0164] The base 2 is a wheeled base in the embodiment, for allowing the user to easily roll the medical surgical simulator 1 to another location. The column 3 extends from the base 2 to the main housing 4 and supports the main housing 4 above the base 2, with a distance between the substantially flat bottom of the main housing 4 and the base 2 to create a space R between the substantially flat bottom and the base 2. The column 3 is laterally offset relative to the base 2 and relative to the substantially flat bottom, to allow access to the space R from all sides (except the side where the column 3 is arranged). In the embodiment, the column 3 extends from a position adjacent to the side (front side) of the base 2 to a position adjacent to the side (front side) of the main housing 4.

[0165] The space R between the base 2 and the flat bottom is an empty space R that only intersects with the column 3. The space R can be accessed from all lateral directions except where the column 3 blocks the access.

[0166] In an embodiment (not shown), the dental surgical simulator 1 includes two or more columns 3, and these columns 3 are all laterally offset and arranged on the same side of the base 2 and the main housing 4. In the shown embodiment, the main housing 4 is supported by only one column 3. The space R is open to the environment except where the space R is shielded by the base 2, the substantially flat bottom, or the column 3.

[0167] As Figure 2 and 3As shown by the double-headed arrow in [Fig. 0], the height of the main housing 4 can be adjusted by the operation of the column 3, which in an embodiment is motorized, for example by an electric linear actuator. The column 3 supports the main structure above the base 2 with a distance between the substantially flat bottom of the main housing 4 and the base 2, thereby forming a space between the substantially flat bottom and the base 2. The height of the column is adjustable to vary the distance between the surface on which the base is placed (such as the floor) and the substantially flat bottom to a range preferably including a distance of at least 70 to 80 cm, more preferably at least 65 to 85 cm. The column 3 is laterally offset with respect to the base 2 and with respect to the substantially flat bottom. The column 3 extends from a position adjacent to the front face of the base 2, preferably at the front face of the base 2, to a position adjacent to the front face of the main structure 101, preferably at the front face of the main structure 101.

[0168] The mannequin head 10 is suspended from the front face of the main housing 4, and the display housing 6 is suspended from the main housing 4 by the support arm 5 such that when the height of the main housing 4 is adjusted, the mannequin head 10, the display housing 6, and the first handpiece 30 move synchronously with the main housing 4. The main housing 4 together with the support arm 5 and the display housing 6 form the main structure 101, to which the mannequin head 10 is also attached.

[0169] As Figure 2 shown, the main housing 4 has a substantially flat bottom, which together with the height adjustability allows the main housing 4 to be arranged above a workbench or tabletop 85, thereby saving valuable training room space. Figure 3 The main outer housing in the lower position is shown. The height adjustability also allows the working height of the dental surgical simulator 1 to be adjusted according to the individual user, since the mannequin head 10 and the handpiece 30 will move up and down simultaneously with the main outer housing 4.

[0170] The medical surgical simulator 1 includes a lower housing located on the base 2, in which a computer 80 and a power supply for the computer 80 and other electrical components of the medical surgical simulator 1 are arranged. In an embodiment, the medical surgical simulator 1 includes more than one computer.

[0171] The computer 80 has a memory and a processor. The processor is arranged to execute software stored on the memory, in particular software configured to simulate a medical operation or treatment, especially in a training or teaching environment.

[0172] The computer 80 is connected to a display screen 9, a model in the workspace W, a linkage 40 mounted to the main housing 4, and a first handpiece 30 also arranged in the workspace W. The linkage 40 (hereinafter referred to with reference to Figures 23 to 26is mechanically connected to the first handpiece 30 (described in detail). The workspace W is a three-dimensional space in the real world, and the first handpiece 30 can be manipulated by the user within this space without being restricted by the linkage 40 (the restriction caused by the range of the end of the linkage connected to the first handpiece 30 in the orthogonal directions in the real space is limited).

[0173] This model represents a part of the object (e.g., the maxilla 13 and mandible 14 of the phantom with or without the phantom tooth set and with or without the phantom head 10) and provides the necessary mechanical environment for the medical operation or treatment to be performed. For example, the surgeon / dentist can place his / her hand on the phantom jaw / tooth / head 10, 13, 14, 22 during the operation and thus place his / her hand in the same way as when treating a real patient.

[0174] The speed of the handpiece 30 is adjusted in response to the force applied by the user to the first handpiece 30 and the interaction of the virtual drill 30' with the virtual teeth of the virtual model of the jaw with teeth 29. The virtual environment includes algorithms for determining how the speed of the virtual drill 30' should change in response to the sum of the x, y, z forces applied by the user to the first handpiece 30 (from the 3DOF sensor 50) and any reaction forces from the virtual contact between the virtual drill or handpiece 30' and the virtual teeth. The virtual environment uses Newtonian physics in some aspects (i.e., force = spring constant × deflection) to mimic the reaction force between the virtual drill 30' and the virtual teeth, while using a PID control loop to determine the speed change of the handpiece 30. The virtual teeth are given hardness and stiffness. The stiffness is related to the spring constant provided by the teeth when in contact, and the hardness is related to how much work the virtual drill has to do to drill off the volume of the virtual teeth. The position of the real drill (the first handpiece) 30 is used to determine whether there is contact with the virtual teeth.

[0175] Once the virtual environment calculates the virtual force acting on the virtual drill 30', it commands this force to the PID control loop, which controls the speed of the actuator in the system (described in further detail below) to change the real-world speed of the first handpiece 30. The user senses the movement of the first handpiece 30. Although the speed of the first handpiece 30 is controlled by the dental surgery simulator 1, the direction of the first handpiece 30 is controlled by the user. The system measures the direction of the first handpiece 30 controlled by the user and, in response, updates the direction of the virtual drill 30' in the virtual environment. The computer 80 is also configured to update the position of the virtual drill 30' in the virtual environment.

[0176] The movable and suspendable phantom head 10 is used to adjust the orientation of the virtual environment displayed on the display 9. The orientation of the phantom head 10 can be adjusted manually, and a sensor (not shown) coupled to the computer 80 that measures the rotation of the phantom head 10 is used to correspondingly adjust the orientation of the virtual model. Thus, the phantom head 10 and the phantom jaw are co-located and connected to the virtual phantom head and the virtual jaw. When the user turns the phantom head 10, the virtual head rotates in the scene, and when the user changes the opening degree of the lower jaw, the virtual lower jaw correspondingly adjusts its position in the virtual environment. The phantom head 10 is an intuitive control for the orientation of the virtual model.

[0177] The computer 80 provides an interface for the user to select different virtual environment surgeries and treatments to be simulated and to run various training software applications for surgeries. The training applications monitor the user's interaction with the virtual environment and the first handheld member 30 and measure various criteria to evaluate the user's performance.

[0178] Now referring specifically to Figures 4 to 7 , the visual housing 6 is provided with a display screen 9 disposed towards the rear of the display housing 6. A viewing opening or window 8 towards the front end of the display housing 6 in the upper side of the display housing 6 allows the user to view the partially transparent reflective element 7 from the viewing area V. The partially transparent reflective element 7 is disposed on the lower side of the display housing 6 towards the front end of the display housing 6 and allows the user to see the workspace W from the viewing area V through the partially transparent reflective element 7. The partially transparent reflective element 7 is arranged to reflect the image displayed on the display screen 9 to the user's eyes, and the workspace W can be simultaneously visible to the user through the partially transparent reflective element 7 (assuming the user's eyes are located in the viewing area V and the user is looking towards the partially transparent reflective element 7). Thus, in the user's view, the virtual image of the virtual environment is mixed with the real image of the workspace W.

[0179] The display screen 9 and the partially transparent reflective element 7 are positioned such that the view is co-located with the position of the first handheld member 30. This allows the system to generate images of the virtual drill 30' that are aligned with the real-world first handheld member 30 in the user's line of sight.

[0180] The dental surgery simulator is configured to reflect the image from the display screen 9 to the user's eyes by reflection on the partially transparent reflective element 7, and is configured to mix the image of the virtual environment with the view of the workspace (W) that the user sees through the partially transparent reflective element 7.

[0181] Thus, the image on the display screen 9 is reflected to the user's eyes, and when the user views the semi-reflective element 7 from the viewing space V, the workspace W is simultaneously visible to the user through the partially transparent reflective element 7.

[0182] In an embodiment, the display screen 9 is a stereoscopic display screen, and the computer 80 is configured to send stereoscopic images to the stereoscopic display screen 9. In an embodiment, the stereoscopic display screen 9 is an autostereoscopic display screen 9. In an embodiment, the display screen 9 is a stereoscopic display screen, where the stereoscopic level is adjustable such that it can be adjusted to an optimal level for a particular user.

[0183] The computer 80 is configured to provide a three-dimensional virtual environment including a first virtual tool 30' having a first virtual position and a first virtual orientation. The first virtual tool 30' corresponds in size and shape to the handheld member 30, and the first virtual tool 30' is co-located with the handheld member 30. A virtual drill 99 and at least one virtual tooth are displayed as part of the three-dimensional virtual environment. In Figure 7 an example, a complete virtual mandible 29 is shown. In an embodiment, both the virtual mandible 29 and the virtual maxilla are shown.

[0184] The computer 80 sends images of a simulated dental procedure or treatment to the display screen 9. The images on the display screen are reflected to the user's eyes (assuming the user's eyes are within the visual space V and the user is facing the semi-transparent reflective element 7) by the semi-transparent reflective element 7 (such as, for example, a semi-transparent mirror). The visual space is a three-dimensional space in which the user can simultaneously observe the images from the display screen 9 through the reflection of the semi-transparent reflective element 7 and observe the objects in the working space W through the semi-transparent reflective element 7.

[0185] The software is configured to present a virtual environment including at least one virtual object (such as a virtual tooth), all of which are observed by the user through the partially transparent reflective element 7. The virtual environment includes a virtual tool, which in this embodiment corresponds to a virtual dental drill 30' of a real-world haptic drill handle 30.

[0186] In an embodiment, the dental surgery simulator 1 is provided with adjustable lighting (not shown) in the working space W. In an embodiment, the lighting is mounted on the lower side of the display housing 6 and is directed towards the working space W. The adjustable lighting facilitates generating an appropriate balance of the image of the working space W seen through the partially transparent reflective element 7 and the image of the virtual environment reflected from the pressure transparent reflective element 7 for a given user.

[0187] Now referring specifically to Figures 8 to 22 , the phantom maxilla 13 and the phantom mandible 14 are supported by the structure of the dental surgery simulator 1 and are arranged in the working space W. The phantom mandible 14 is arranged to be (manually) movable relative to the phantom maxilla 13. The phantom mandible 14 is suspended from the phantom maxilla 13 by a hinge mechanism 15 (a four-bar kinematic chain in an embodiment). Preferably, the hinge mechanism 15 mimics the movement of the human jaw to make the model realistic.

[0188] The phantom mandible 14 is suspended from the phantom maxilla 13 to allow (manually imparted) movement between a fully open position and a closed position as shown respectively in Figure 19 and 20 . A position sensor (not shown) is configured to generate a signal indicative of the position of the phantom mandible 14 relative to the phantom maxilla 13 and is connected to a computer 80. Software is configured to adjust the position of the virtual mandible based on the signal from the sensor.

[0189] The closed position of the phantom mandible 14 corresponds to a position for checking occlusal reduction. The software is configured to display on a display screen 9 a virtual upper tooth set for the virtual maxilla and a lower virtual tooth set for the virtual mandible, thereby allowing an occlusal check of the virtual tooth sets.

[0190] The phantom maxilla 13 is suspended from a support structure to allow rotation in three degrees of freedom, with the center of rotation for each degree of freedom located between the phantom maxilla 13 and the phantom mandible 14, i.e., at the center of the working space W, such that the phantom maxilla 13 does not leave the working space W when it is rotated. The X, Y, Z rotation axes are as shown in Figure 16 . The rotation is manually imparted and preferably conforms to the phantom head 10. Three rotational position sensors (not shown) for sensing the rotation of the maxilla 13 are provided for sensing the rotation in each of the three degrees of freedom. The computer 80 receives signals from the three rotational position sensors. The software is configured to adjust the simulation of a dental procedure or treatment based on the signals from the rotational position sensors. In particular, the software adjusts the orientation and position of the virtual maxilla and the orientation and position of the virtual mandible.

[0191] The phantom maxilla 13 is suspended from the support structure by a first mechanism 11. The first mechanism allows the maxilla to rotate about a first horizontal axis Y extending through the center of the working space W, and the first mechanism 11 does not intersect the working space W. The mechanism includes a remote center linkage 11, preferably two spaced parallel remote center linkages 11, to make the mounting structure of the phantom head 10 more rigid and stable. The linkage 11 is connected to the main housing 4 by a bracket 17.

[0192] The phantom maxilla 13 is suspended from the support structure by a second mechanism. The second mechanism allows the phantom maxilla 13 to rotate about a second horizontal axis X provided in the working space W, and the second mechanism does not intersect the working space W. The second mechanism includes an L-shaped plate 12 extending between the phantom head 10 and the phantom maxilla 13. The phantom maxilla 13 is connected via the L-shaped plate 12 by a hinge pin (not visible in the figure), and the hinge pin allows the phantom maxilla 13 and the phantom head 10 to rotate consistently about the second horizontal axis X.

[0193] The upper dental mold 13 is suspended from the support structure by a third mechanism 16, which allows the upper dental mold 13 to rotate about a vertical axis Z extending through the center of the working space W, and the third mechanism 16 does not intersect the working space W. The third mechanism 16 includes a hinge pin that connects the first mechanism 11 to the L-shaped plate 12 and allows the L-shaped plate 12 to rotate about the vertical Z axis.

[0194] The upper dental mold 13 includes an upper support member 19 to which detachable upper dental mold elements 21, 25 are detachably attached, and the lower dental mold 14 includes a lower support member 18 to which detachable lower dental mold elements 20, 24 are detachably attached. In an embodiment, the detachable dental mold elements 20, 21, 24, 25 are releasably attached to the upper or lower support elements 18, 19 by magnetic forces from a combination of permanent magnets and magnetic material members associated with the support elements and the dental mold elements, respectively.

[0195] The universal upper dental mold element 25 and the universal lower dental mold element 24 do not have mold teeth, but are still considered to constitute the upper and lower dental molds, respectively. Thus, the lower or upper dental mold can be formed by a simple U-shaped member that is substantially similar in shape and size to a human lower or upper jaw, preferably that of an average person, but without teeth and without grooves for receiving teeth. The universal upper and lower dental molds can be made of a polymeric material such as plastic, natural, and / or synthetic rubber.

[0196] The specific upper dental mold element 20 and the specific lower dental mold element 21 are provided with mold teeth 22. The mold teeth 22 are detachably attached by inserting them into specific grooves 23 in the specific upper or lower dental mold elements 20, 21. In an embodiment, the specific upper and lower dental mold elements 20, 21 with their mold teeth 22 are exact models of parts of a real human upper and lower jaw with their upper teeth. One or more mold teeth 22 to be subjected to dental surgery or treatment are removed to provide space for the first handpiece 30 to move without being obstructed by the relevant mold teeth 22. In Figures 8 to 11 this case, one mold tooth 22 has been removed as an example and the grooves 23 in the relevant mold teeth 20, 21 are empty. The user can use the remaining mold teeth 22 to support the user's hand and / or fingers. Virtual teeth will be displayed, connected, and co-located with the empty positions / grooves of the relevant teeth in the (upper or lower) dental mold 13, 14 (or specific lower dental mold element 20 / specific upper dental mold element 21). Since the computer 80 is notified of the orientation and position of the corresponding upper and lower dental molds 13, 14 by sensors, the computer 80 adjusts the position and orientation of the virtual teeth accordingly, and in an embodiment also adjusts the position and orientation of the virtual jaws in the virtual model accordingly.

[0197] When using specific upper and / or lower modular jaw elements 20, 21, the computer 80 is provided with a virtual model of the specific lower jaw element 20 and / or the specific upper jaw element 21. Such a virtual model may include virtual models of all the teeth of the associated jaw or only one or more teeth corresponding to the positions / grooves in the respective modular jaw where the modular teeth 22 are not provided.

[0198] The computer 80 is configured to display a virtual environment on the display screen 9, which virtual environment includes at least one virtual tooth co-located with the modular upper jaw 13 or the modular lower jaw 14.

[0199] The modular upper jaw 13 and the modular lower jaws 14, 20 are movable relative to the support structure. The computer 80 receives the position and orientation of the modular upper jaw 13, 21 and the modular lower jaws 14, 20 via one or more sensors, and the computer 80 is configured to adjust the orientation and position of at least one virtual tooth according to the movement of the modular upper jaw 13, 21 or the modular lower jaws 14, 20 such that when the modular upper jaw 13, 21 or the modular lower jaws 14, 20 move, at least one virtual tooth remains co-located with the modular upper jaw 13, 21 or the modular lower jaws 14, 20 on the display screen 9.

[0200] In an embodiment, the computer 80 is configured to display at least a portion of a virtual upper jaw and a portion of a virtual lower jaw 29, and the computer is configured to co-locate the virtual upper jaw with the modular upper jaw 13 and the virtual lower jaw 29 with the modular lower jaw 14 on the display screen 9, and this is also the case when the modular upper jaw 13, 21 or the modular lower jaw 14, 20 moves relative to the support structure.

[0201] In an embodiment, the computer 80 is configured to co-locate the virtual teeth with the modular upper jaw 13, 21 or the modular lower jaws 14, 20. Thus, regardless of what movement the user may impose on the modular jaws 13, 14, the computer will co-locate the virtual teeth with the modular jaws 13, 14.

[0202] In an embodiment, the computer 80 is configured to display more than one virtual tooth and is configured to co-locate the virtual teeth with the corresponding upper or lower modular jaws 13, 14.

[0203] The computer 80 guides the user as to which jaw element (generic or specific) to install for a given exercise. Thus, the computer 80 is configured to guide the user to install the generic upper or lower jaw elements 25, 24 or specifically the specific upper or lower jaw elements 20, 21.

[0204] In Figures 12 to 21In the embodiment shown, the phantom upper jaw 13 and the phantom lower jaw 14 are part of the phantom head 10. The phantom head 10, its phantom lower jaw 14 and phantom upper jaw 13 are arranged to be movable relative to the dental surgical simulator 1 and the support structure of the phantom head 10, and its phantom lower jaw 14 and phantom upper jaw 13 move in unison with each other.

[0205] Figure 37 and 38 An embodiment of a segmented upper jaw 22 is shown. In this embodiment, the phantom upper jaw 21 and / or the phantom lower jaw 20 are segmented phantom jaws, where at least one segment is removable. In the embodiment shown, the segmented phantom jaw has five segments 21a, 21b, 21c, 21d, and 21e. Preferably, at least one segment is removable. Figure 38 A phantom jaw with the central segment 21c removed is shown. In an embodiment, all the segments are removable, i.e., they can be taken out without using tools and reinstalled without using tools. These segments can slide into guide rails, be magnetically attached, attached but using Velcro or other suitable releasable attachment means.

[0206] By using a segmented phantom jaw where at least one or more or all of the segments can be removed, adjacency between the haptic arm and the phantom jaw can be avoided, which may occur particularly when simulating the movement of virtual teeth related to the lower jaw. In other words, in some cases, a part of the phantom jaw blocks the haptic arm, particularly the handpiece coupler 31, and by removing the segments 21a, 21b, 21c, 21d, or 21e of the relevant segmented phantom jaw, a position is left for the haptic arm while most of the phantom jaw remains for the user to use as a support for the hand and to provide a sense of realism for the simulation.

[0207] Now referring particularly to Figures 23 to 26 , which illustrates a linkage device 40 controlled by a computer 80 to simulate a medical operation or treatment. The linkage device 40 includes a main coupler 41 (a long straight member in the embodiment), and a first handpiece 30 is connected to the front end of the main coupler 41 through a mechanical joint having at least two degrees of freedom, which will be explained in more detail below. The linkage device 40 has a first crank 42 driven by a first rotary actuator 47, a second crank 44 driven by a second rotary actuator 48, and a third crank 46 driven by a third rotary actuator 49. The respective rotational axes of the first, second, and third cranks 42, 44, 46 can be arranged orthogonally to each other in an embodiment (not shown).

[0208] The rotational axis of the first crank 42 extends substantially vertically. The first crank 42 is directly (i.e., without an intermediate coupling member therebetween) coupled to the main coupling member 41 at a first position located at or near the rear end of the main coupling member 41 by a hinge having two degrees of freedom, such as a universal joint.

[0209] The second crank 44 is directly (i.e., without an intermediate coupling member therebetween) coupled to the main coupling member 41 by a first horizontally extending connecting rod 43, preferably by a universal joint allowing rotation about two axes, and the third crank 46 is coupled to the main coupling member 41 by a second vertically extending connecting rod 45. The first crank 42 is arranged to actuate the main coupling member 41 in a first (horizontal) axial direction X. The second crank 44 is arranged to actuate the main coupling member 41 in a second (horizontal) transverse direction Y, and the third crank 46 is arranged to actuate the main coupling member 41 in a second (vertical) transverse direction Z.

[0210] The first connecting rod 43 is coupled to the main coupling member 41 at a second axial position between the front end and the first position, and the second connecting rod 45 is coupled to the main coupling member 41 at a third axial position between the front end and the first position. In an embodiment, the second and third axial positions substantially coincide.

[0211] The main coupling member 41 includes a three-dimensional force sensor (3DOF sensor) 50 for sensing the forces applied by the user to the first handpiece 30 in three dimensions. The three-dimensional force sensor 50 is provided between the front end position and the second and / or third axial positions, and the three-dimensional force sensor 50 is preferably an integral part of the main coupling member 41. The three-dimensional force sensor 50 is coupled (data connection) to a computer 80, for example, by a signal cable.

[0212] The first, second, and third cranks 42, 44, 46 are coupled (directly or to the rotary motors driving the respective cranks) to respective first, second, and third rotary position sensors or encoders 26, 27, 28 that are data-connected to the computer 80. In the illustrated embodiment, the rotational axes of the second crank 44 and the third crank 46 both extend horizontally and parallel to each other. However, in the main embodiment, the rotational axes of the second crank 44 and the third crank 46 also extend horizontally and are angled with respect to each other, for example, at a right angle.

[0213] The first, second, and third cranks 42, 44, 46 are mounted on a reference member 51, such as a frame or a base. The reference member 51 is supported by the main housing 4 or by the support structure of the dental surgical simulator 1. The linkage 40 connects the handpiece 30 to the reference member 51, and with respect to the reference member 51, the linkage 40 provides six independent degrees of freedom for the handpiece 30.

[0214] When the first handpiece 30 is not in use, the handpiece holder 32 provides a parking position for the first handpiece 30. A parking sensor 59 is associated with the handpiece holder 32 to detect the parking position of the first handpiece 30.

[0215] The arrangement of the linkage 40 creates a workspace W in which the first handpiece 30 can be manipulated by the user, which is shaped as a cuboid with a horizontal top and bottom.

[0216] Now referring specifically to Figures 27 to 29 , which more particularly illustrates the first handpiece 30. The first handpiece 30 includes an inner portion 38 that extends to an outer portion 37, the outer portion being configured to rotate about the inner portion 38. The outer portion 37 forms the housing of the first handpiece 30 and is configured to rotate about the inner portion 38 about the longitudinal axis L of the handpiece 30. A portion 57 of the inner portion 38 projects from the outer portion 37 and the portion 57 is coupled to the front end of the linkage 40 by a joint having at least two degrees of freedom. The joint includes a handpiece coupler 31 that is coupled to the inner portion 38 by a first pivot hinge 34 at one of its ends to provide one degree of freedom. The other end of the handpiece coupler 31 is attached to a connecting element 56 by a first pivot joint 36 to provide a second degree of freedom. The connecting element 56 is rigidly connected to the end of the main coupler 41.

[0217] A first inertial measurement unit 52 is mounted to the inner portion 38. A fourth rotational position sensor 53 senses the rotational movement of the outer portion 37 relative to the inner portion 38. The fourth rotational position sensor 53 is mounted on the inner portion 38 and is arranged to measure the rotational position of the outer portion 37 relative to the inner portion 38. At least a first portion of the fourth rotational position sensor 53 is mounted on the inner portion 38, and the first portion is connected to a computer 80 by a cable 58 that is guided or supported by the inner portion 38.

[0218] The first inertial measurement unit 52 and the fourth rotational position sensor 53 are coupled to the computer 80 by a cable 58 that is received in a cable channel 35 that extends through the inner portion 38. The cable 58 exits the inner portion 38 near the first hinge 34, and then enters a cable channel 33 that extends through the handpiece coupler 31. The cable 58 establishes a data link between the inertial measurement unit 52 and the computer 80 to transmit position and / or orientation data, and a data link between the fourth rotational position sensor 54 and the computer 80 to transmit rotational position data.

[0219] A cap 39 forms the free end of the first handpiece 30. A first rotary bearing 54 and an axially spaced second rotary bearing 55 are arranged between the inner portion 38 and the outer portion 37. Due to the absence of a limiting structure, the outer portion 37 has an unrestricted roll relative to the inner portion 38.

[0220] The inner part 38 is elongate and is connected to the handpiece coupler 31 at a first end of the inner part 38. A fourth rotational position sensor 53 is disposed at or near a second end of the inner part 38, the second end being located inside the outer part 37.

[0221] The longitudinal extent of the outer part 37 includes a proximal part (near the user) and a distal part (away from the user). The distal part extends at an angle to the proximal part and the inner part 38 projects from the outer part 37 through the distal part.

[0222] The first inertial measurement unit 52 is positioned within the housing 37 of the handpiece 30 and is mounted on the inner part 38. The first inertial measurement unit 52 is configured to measure translational acceleration, rotational velocity, and magnetic fields. Accordingly, the first inertial measurement unit 52 is also capable of determining the velocity and displacement of the first handpiece 30 using data processing techniques known in the art. In an embodiment, the first inertial measurement unit 52 has nine sensors, which include a three-axis gyroscope, a three-axis accelerometer, and a three-axis magnetometer. The first inertial measurement unit 52 is provided with an embedded digital motion processor, which obtains data from the accelerometer, gyroscope, and magnetometer and processes the data. The inertial measurement unit chip outputs a quaternion, which describes the orientation in space relative to a reference, such as in real space. This data output is transmitted along the cable 58 to the computer 80 together with the signal from the fourth rotational position sensor 53.

[0223] The inertial measurement unit 52 is calibrated prior to use by: placing the handpiece 30 in a defined orientation such that the environmental reference is aligned. This embodiment uses Figure 28 the parking position on the handpiece holder 32 shown for calibration.

[0224] Now with particular reference to Figures 30 to 33 , which illustrates another embodiment of the dental surgery simulator 1. In this embodiment, for simplicity, structures and features that are the same as or similar to the corresponding structures and features previously described or shown herein are denoted by the same reference numerals as previously used.

[0225] In this embodiment, an auxiliary tool 60 with a second handpiece 61 is added, for example, to simulate a mirror tool used by a dentist. Different from the first handpiece 30 whose real-world position is controlled by the dental surgery simulator 1, the real-world position of the second handpiece 61 is controlled by the user (the auxiliary tool 60 is not actuated and is manually moved without haptic feedback). The auxiliary tool 60 is suspended from the support arm 5 and includes a second handpiece 61 that the user can manipulate in the workspace W. The auxiliary tool 60 is suspended from the main structure of the dental surgery simulator by a linkage. The computer 80 is configured to display a corresponding virtual auxiliary tool in the virtual environment, such as a virtual dental mirror corresponding to the real-world dental mirror handle. The position and movement of the virtual second handpiece are adjusted to directly match the real-world position of the second handpiece 61.

[0226] The auxiliary tool 60 includes a main coupling member 63 coupled to the structure of the dental surgery simulator 1 by one or more joints providing the first and second degrees of freedom and a secondary coupling member 66 coupled to the main coupling member 63 by one or more joints providing the third and fourth degrees of freedom. The second handpiece 61 is connected to the secondary coupling member 66 by one or more joints providing the fifth and sixth degrees of freedom to form a serial chain connecting the handpiece 61 to the main structure of the dental surgery simulator 1 in six degrees of freedom. A fifth rotational position sensor 68 senses the movement of the first degree of freedom, a sixth rotational position sensor 72 is used to sense the movement of the second degree of freedom, and a seventh rotational position sensor 73 is used to sense the movement of the third degree of freedom. The fifth, sixth, and seventh position sensors 68, 72, 73 are in data connection with the computer 80.

[0227] A second inertial measurement unit 74 is disposed in the second handpiece 61 and moves in unison with the second handpiece 61. The second inertial measurement unit 74 is in data connection with the computer 80, and the second inertial measurement unit 74 is configured to sense the movement of at least the fourth, fifth, and sixth degrees of freedom. In an embodiment, the second inertial measurement unit 74 is technically the same as the first inertial measurement unit 52.

[0228] The second handpiece 61 is connected to the secondary coupling member 66 by a fourth pivot joint 69 providing the sixth degree of freedom. The sixth degree of freedom allows the second handpiece 61 to rotate about the (longitudinal) axis of the second handpiece 61. The second inertial measurement unit 74 is configured to sense the sixth degree of freedom.

[0229] The fourth pivot joint 69 is connected to the end of the secondary coupling member by a second hinge 62 providing the fifth degree of freedom of the second handpiece 61.

[0230] The second handpiece 61 can move in three translational degrees of freedom, and the second handpiece 61 itself can move in three rotational degrees of freedom.

[0231] The main connector 63 is an elongate connector, such as, for example, a rod or a tube. The main connector 63 is coupled to a reference member (such as the support structure of the dental surgery simulator 1) by a fourth hinge 75, which allows the main connector 63 to rotate about a transverse axis (transverse to the longitudinal extent of the main connector 63) to obtain a second degree of freedom.

[0232] The main connector 63 is coupled to the fourth hinge 75 by a third pivot joint 67, which allows the main connector 63 to rotate about its longitudinal axis to achieve a first degree of freedom.

[0233] A fifth rotational position sensor 68 is arranged to sense rotation about the longitudinal axis of the main connector 63, and a second rotational position sensor 72 is arranged to sense rotation about the third hinge 75.

[0234] The secondary connector 66 is an elongate connector, which is coupled to the main connector 63 by a third hinge 65, which allows the secondary connector 66 to rotate about a transverse axis (transverse to the longitudinal axis of the secondary connector 66) to obtain a third degree of freedom.

[0235] A seventh rotational position sensor 73 is configured to sense the rotational movement of the secondary connector 66 about the third hinge 65. The secondary connector 66 is coupled to the third hinge 65 by a second pivot joint 64, which allows the secondary connector 66 to rotate about its longitudinal axis to obtain a fourth degree of freedom.

[0236] The tertiary connector 70 is coupled to the quaternary connector 71. The tertiary connector 70 is coupled to the main connector 63 or the secondary connector 66, and the quaternary connector 71 is coupled to the seventh rotational position sensor 73 to form a series chain, which converts the rotation of the secondary connector 66 about the transverse axis of the secondary connector 66 (about the third hinge 65) into the rotational movement of the seventh rotational position sensor 73.

[0237] A second inertial measurement unit 74 is configured to sense the rotation of the handpiece 61 about the (longitudinal) axis of the handpiece 61, i.e., to sense the movement of the sixth degree of freedom. The second inertial measurement unit 74 communicates data with a computer 80, preferably via a wireless (RF) data connection.

[0238] In an embodiment (not shown), a rotational position sensor is arranged within the second handpiece 61 for sensing the rotation of the handpiece 61 about the longitudinal axis of the handpiece 61.

[0239] In an embodiment, the second inertial measurement unit 74 is configured to sense the movement of all six degrees of freedom, and the computer 80 is configured to use the signals from the fifth, sixth, and / or seventh sensors 68, 72, 73 as references to calibrate the second inertial measurement unit 74.

[0240] Typically, the computer 80 is configured to: receive information indicating the rotational positions of the first, second, and third cranks, and control the actuation of the first, second, and third cranks (the global linear motion of the first handpiece 30), to receive information indicating the actuation of the first handpiece 30 and the second handpiece 61, and to receive from the first inertial measurement unit 52 information indicating the direction (rotational position) of the first handpiece 30, and to receive from the second inertial measurement unit 74 information indicating the direction (rotational position) of the second handpiece 61. Using a control scheme, the position, direction, and actuation of the first handpiece 30 are sensed by the computer 80, which is also capable of providing haptic feedback to the first handpiece 30 via actuators 47, 48, 49, as determined by the characteristics of the virtual model. The position of the virtual tool in the virtual environment is displayed on the display screen 9.

[0241] By using data from the rotational position sensors 26, 27, 28, 68, 72, 73 associated with the first linkage 40 and the second linkage 60, and from the first and second inertial measurement units 52, 74 and the rotational position sensor 53, the position and direction of the virtual tool in the virtual environment are displayed on the display screen 9 so as to co - locate with the position and direction of the real tool.

[0242] In an embodiment, the computer 80 is configured to simulate a medical operation or treatment by utilizing the haptic feedback, preferably haptic force feedback, of the linkage 40 and its associated actuators 47, 48, 49, and by utilizing the visual feedback of the display screen 9. Thus, the computer 80 is configured to use the signal from the three - dimensional force sensor 50 as an input and accordingly control the position of the end of the linkage 40.

[0243] In an embodiment, the computer 80 includes software applications for providing a training platform, providing teaching materials and videos, recording, playing back, and evaluating user performance; providing audio, video, and text communication with a remote instructor via a computer network; providing the ability for the remote instructor to provide force input to the haptic system; and providing different virtual objects (such as teeth, jaws, or a complete head), tools, and physical rules to the virtual environment.

[0244] In an embodiment, the computer 80 is configured to detect collisions between the drills of a virtual dental drill (using the real position of the first tool 30) to determine the mutual forces to be applied to the virtual drill based on the virtual drill position, the virtual drill model, and the virtual tooth model. The computer 80 is also configured to calculate the virtual drill speed based on the mutual forces and user input (such as from a foot pedal).

[0245] In an embodiment, the tooth model volume is represented as a set of three-dimensional pixels or voxels. Each voxel has a hardness value associated with it, representing the type / quality of the tooth material (i.e., dentin, enamel, pulp). A conventional marching cube algorithm is used to generate a triangular mesh of the isosurface of the tooth model voxel set.

[0246] The virtual handpiece is modeled analytically or by voxels. Therefore, the physical model of the handpiece is a finite number of voxels, or by a fully analytically defined shape. The handpiece model also has vector parameters for the three-dimensional velocity of the handpiece. The virtual tool is provided with a virtual drill. The virtual drill or the virtual handpiece can be in virtual contact with the virtual teeth. To this end, the shape of the virtual drill is rendered for the voxels of the virtual teeth. The real position of the first handpiece 30 is used to determine the position of the virtual drill and to determine the contact between the virtual drill and the virtual teeth.

[0247] Now special reference Figure 35, The control loop is used to control the speed in one direction at the end of the main connector 41 and thus control the speed of the first handpiece 30. A total of 3 of these force control loops are activated to control three directions of movement (3DOF). The force control loop uses the difference between the virtual force calculated by the virtual environment 90 and the real force in one direction calculated from the force measured by the 3DOF force sensor 50 at the summing point 86. The output at the summing point 86 is the input to a lead-lag compensator 87 that is used to remove high frequencies and is connected to a standard PI or PID controller 88. The PI or PID controller calculates the speed command for the motor driver 89. The motor driver 89 also receives signals from the rotational position sensors (encoders) 26, 27, 28 and determines the actual speed of the handpiece 30 based on the position signals. The motor driver 89 electrically drives the first rotary actuator 47, (the motor drivers of the other two control loops drive the second rotary actuator 48 and the third rotary actuator 49). The motor driver uses the difference between the speed command of the PI or PID controller and the actual speed calculated from the actual positions measured by the position sensors (encoders) 26, 27, 28 on the respective rotary actuators 46, 47, 48. A differentiator 92 that receives the position signal provides the actual speed as an output signal. The output of the differentiator 92 is provided to the motor driver 89 and the virtual environment 90. In an embodiment, the differentiator 92 is an integral part of the motor driver 89. The first, second, and third rotary actuators 47, 48, 49 are connected to the first handpiece 30 via a linkage 40 that is connected to the above-described different sensors (force, position, and orientation). The input from the foot pedal sensor 91 (connected to the dental surgery simulator 1 via a data cable and connected to the computer 80) is used to determine the rotational speed of the virtual drill. The virtual environment receives signals from the IMU 52 to be informed of the orientation of the first handpiece 30. The virtual environment 90 includes a drill model, a tooth model, and a jaw model, and uses the real position and real orientation of the first handpiece 30 to determine the position and orientation of the virtual drill. The virtual drill model and the virtual tooth model or jaw model are used to calculate the resulting virtual force, which is sent back as a command to the force control loop and applied to the handpiece 30.

[0248] When starting to use the dental surgery simulator 1, the user positions himself / herself on a chair (not shown) in front of the dental surgery simulator 1. If the display screen 9 is an autostereoscopic display screen, the user does not need to use shutter glasses or glasses with polarizing lenses. The height of the main housing 4 is appropriately adjusted to the ideal working height of the relevant user. The chair height can also be adjusted according to the needs of the user.

[0249] In an embodiment, the dental surgery simulator is provided with a connection via a network (such as LAN, WAN) of the computer 80.

[0250] Figure 36Another embodiment is shown, in which the functionality of the dental surgery 1 simulator is enhanced by increasing the possibility of training the user by drilling into plastic teeth using a conventional dental handpiece 130 including a motor-driven drill. In this embodiment, at least the upper or lower mold body jaw is provided with one or more mold body teeth 22 made of a polymer (plastic) material suitable for being drilled into with a dental drill. The mold body teeth 22 are detachably attached by inserting them into specific grooves 23 in specific mold upper or lower jaw elements 20, 21. Thus, the polymer material teeth 22 can be replaced after they have been drilled into, or they can be replaced to provide another exercise with different teeth 22. In this embodiment, the specific upper and lower jaw elements 20, 21 with their mold body teeth 22 are preferably an exact model of a part of a real human upper and lower jaw with its teeth made of a suitable polymer (plastic) material. The mold body teeth 22 to be subjected to dental surgery or treatment for training (aspiring) dentists are drilled into using the conventional dental handpiece 130. The conventional dental handpiece 130 is powered (electrically or pneumatically) by a cable 133 that connects the conventional dental handpiece 130 to the main housing 4 for powering the pneumatic or electric motor in the conventional dental handpiece 130. The pneumatic or electric motor drives a dental drill (not shown) for drilling into the plastic teeth 22. The cable 133 also supplies pressurized water to the conventional dental handpiece 130 for spraying water onto the working space.

[0251] In a variant of this embodiment, the device 1 is configured to operate in another mode when the user drills into the plastic teeth using the conventional dental handpiece 130. Thus, the computer 80 runs a specific training program suitable for training by drilling into the plastic teeth 22 with the conventional dental handpiece 130.

[0252] The computer 80 can be programmed to enhance the user experience when drilling into the plastic teeth 22 with the conventional dental handpiece 130 by means of graphics on the display screen 9 and / or by means of audio information via the speaker. Thus, the training experience can be enhanced by providing instructions or feedback on the user's performance on the display screen 9 or via the speaker.

[0253] The computer 80 has at least a first operating mode for simulating dental surgery or treatment using the handpiece 30 and a second operating mode for training dental surgery or treatment using the conventional power dental handpiece 130.

[0254] In the present disclosure, any reference to a body part such as a tooth, mandible, maxilla, or head generally refers to the human version of these body parts. Thus, in the present disclosure, for example, a phantom mandible is a physical model of a human mandible, and for example, a virtual mandible is a virtual model of a human mandible. The similarity between the phantom body part and the real body part is preferably at such a level that at least the shape of the phantom body part is very similar to the shape of the real body part to the extent that the phantom body part provides the user with a true impression of the body part.

[0255] Various aspects and implementations have been described in connection with the various implementations herein. However, other variations of the disclosed implementations can be understood and effected by those skilled in the art in practicing the claimed subject matter, by study of the drawings, the disclosure, and the appended claims. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" does not exclude a plurality. A single processor or other unit may implement the functions of several items recited in the claims. The fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. A computer program may be stored / distributed on a suitable medium, such as an optical storage medium or a solid-state medium provided together with or as part of other hardware, but it may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.

[0256] Reference signs used in the claims should not be construed as limiting the scope. Unless otherwise stated, the drawings are intended to be read in conjunction with the description (e.g., cross-hatching, arrangement of components, scale, degree, etc.) and will be regarded as part of the whole written description of the present disclosure. As used in the description, the terms "horizontal", "vertical", "left", "right", "up" and "down", and their adjectival and adverbial derivatives (e.g., "horizontally", "rightward", "upward", etc.), refer only to the orientation of the illustrated structure when the particular drawing is facing the reader. Similarly, the terms "inward" and "outward" generally refer to the direction of a surface relative to its elongation axis or axis of rotation, as the case may be.

Claims

1. A dental surgery simulator, comprising: A support structure, A display screen, A computer configured to simulate a dental surgery or treatment, A linkage device suspended from the support structure, the linkage device being controlled by the computer to simulate a medical surgery or treatment by providing haptic force feedback, A handpiece, the handpiece being operatively coupled to the linkage device and configured to be held in a user's hand and manipulated by the user in a workspace in the real space of the dental surgery simulator, A phantom maxilla and / or a phantom mandible movably supported by the support structure and disposed in the workspace, wherein the phantom maxilla and / or the phantom mandible are configured to support the user's hand / fingers in a manner closely simulating the way a dentist supports his / her hand / fingers on a real patient, The computer is configured to display a virtual environment on the display screen, the virtual environment including at least one virtual tooth co-located with a view of the phantom maxilla or the phantom mandible.

2. A dental surgery simulator, comprising: A support structure, A display screen, A computer configured to simulate a dental surgery or treatment, A linkage device suspended from the support structure, the linkage device being controlled by the computer to simulate a medical surgery or treatment by providing haptic force feedback, A handpiece, the handpiece being operatively coupled to the linkage device and configured to be held in a user's hand and manipulated by the user in a workspace in the real space of the dental surgery simulator, A phantom maxilla and / or a phantom mandible movably supported by the support structure and disposed in the workspace, The computer is configured to display a virtual environment on the display screen, the virtual environment including at least one virtual tooth co-located with a view of the phantom maxilla or the phantom mandible, wherein the phantom maxilla is suspended from the support structure to allow rotation with one, two or three rotational degrees of freedom.

3. The dental surgical simulator according to claim 1 or 2, wherein, The computer is configured to generate a virtual environment including a virtual handpiece, a virtual maxilla and a virtual mandible, the computer being configured to display the virtual environment on the display screen, and the computer is configured to: Co-locate the virtual handpiece with the handpiece, Co-locate the virtual maxilla with a view of the phantom maxilla, and / or Co-locate the virtual mandible with a view of the phantom mandible.

4. The dental surgical simulator according to any one of claims 1 to 3, wherein, The phantom mandible is arranged to be movable relative to the phantom maxilla.

5. The dental surgical simulator according to claim 1 or 2, wherein The phantom maxilla and the phantom mandible are provided with one or more grooves for receiving at least one phantom tooth, and wherein the at least one virtual tooth is co-located with the at least one phantom tooth on the display screen; and wherein the phantom maxilla and the phantom mandible together with the at least one phantom tooth are configured to support the user's hand / fingers in a manner closely simulating the way a dentist supports his / her hand / fingers on a real patient.

6. The dental surgical simulator according to claim 1 or 2, wherein The phantom maxilla is movable relative to the support structure in unison with the phantom mandible, The dental surgery simulator includes one or more sensors configured to sense the position and orientation of the phantom maxilla and the phantom mandible relative to the support structure, The computer receives the positions and orientations of the phantom maxilla and the phantom mandible via the one or more sensors, and the computer is configured to adjust the orientation and position of the at least one virtual tooth according to the movements of the phantom maxilla and the phantom mandible such that when the phantom maxilla or the phantom mandible moves, the at least one virtual tooth remains co-located with the phantom maxilla or the phantom mandible on the display screen.

7. The dental surgical simulator according to claim 3, wherein, The computer is configured to display at least a portion of the virtual maxilla and a portion of the virtual mandible, and the computer is configured to co-locate the virtual maxilla with the phantom maxilla and the virtual mandible with the phantom mandible on the display screen, and this also holds when the phantom maxilla or the phantom mandible moves.

8. The dental surgical simulator according to claim 1 or 2, wherein The phantom mandible is suspended from the phantom maxilla by a hinge mechanism.

9. The dental surgical simulator according to claim 8, wherein, The phantom mandible is suspended from the phantom maxilla by a four-bar kinematic chain.

10. The dental surgical simulator according to claim 8, wherein, The phantom mandible is suspended from the phantom maxilla by a hinge mechanism that mimics human jaw movement.

11. The dental surgical simulator according to claim 1 or 2, wherein, The phantom mandible is suspended from the phantom maxilla to allow movement between an open position and a closed position.

12. The dental surgical simulator according to claim 1 or 2, comprising a position sensor configured to generate a signal indicative of the position of the phantom mandible relative to the phantom maxilla.

13. The dental surgical simulator according to claim 11, wherein, The closed position corresponds to a position for checking bite reduction, and wherein the computer is configured to display a virtual upper tooth set for the phantom maxilla and a virtual lower tooth set for the phantom mandible on the display screen, thereby allowing a visual bite check of the virtual tooth sets in the closed position.

14. The dental surgical simulator according to claim 2, wherein, The rotation of one, two or three degrees of freedom is manually imparted, and wherein the dental surgical simulator includes one or more rotational position sensors for sensing the rotation of each of the one to three degrees of freedom of the phantom maxilla.

15. The dental surgical simulator according to claim 1 or 2, wherein, The phantom maxilla is suspended from the support structure by a first mechanism that allows the maxilla to rotate about a first horizontal axis Y disposed in the workspace, and the first mechanism does not intrude into the workspace.

16. The dental surgical simulator according to claim 15, wherein, The first mechanism includes a remote center linkage, or two spaced-apart parallel remote center linkages.

17. The dental surgical simulator according to claim 1 or 2, wherein The phantom maxilla is suspended from the support structure by a second mechanism that allows the phantom maxilla to rotate about a second horizontal axis X disposed in the workspace, and the second mechanism does not intersect the workspace.

18. The dental surgical simulator according to claim 1 or 2, wherein, The phantom maxilla is suspended from the support structure by a third mechanism that allows the phantom maxilla to rotate about a vertical axis Z, and the third mechanism does not intersect the workspace.

19. The dental surgical simulator according to claim 1 or 2, wherein, The phantom maxilla includes an upper support member to which a detachable maxilla element is detachably attached, and wherein the phantom mandible includes a lower support member to which a detachable mandible element is detachably attached.

20. The dental surgical simulator according to claim 19, wherein, The detachable maxillary element is a universal maxillary element that does not have / define teeth, and wherein the detachable mandibular element is a universal mandibular element that does not have / define teeth.

21. The dental surgical simulator according to claim 19, wherein, The detachable maxillary element is a specific maxillary element provided with phantom teeth, the teeth being detachably attached to the specific maxillary element, and the specific maxillary element with its teeth being an exact replica of a part of a real human maxilla with its teeth, and wherein the detachable mandibular element is a specific mandibular element provided with phantom teeth, the teeth being detachably attached to the specific mandibular element, and the specific mandibular element with its teeth being an exact replica of a part of a real human mandible with its teeth.

22. The dental surgical simulator according to claim 1 or 2, wherein The phantom maxilla and / or the phantom mandible is a segmented phantom jaw, wherein at least one segment is arranged to be detachable.

23. The dental surgical simulator according to claim 1 or 2, wherein The computer is configured to generate an image of the simulated dental procedure for display on the display screen, the dental procedure simulator comprising a partially transparent reflective element arranged to reflect the image from the display screen into the user's eyes, and the workspace being arranged to be visible to the user through the partially transparent reflective element.

24. A dental procedure simulator, comprising: A support structure, A display screen, A computer configured to simulate a dental procedure or treatment, A linkage suspended from the support structure, the linkage being controlled by the computer to simulate a medical procedure or treatment by providing haptic force feedback, A handpiece operably coupled to the linkage and configured to be held in the user's hand and manipulated by the user in a workspace in the real space of the dental procedure simulator, A phantom maxilla and / or a phantom mandible movably supported by the support structure and arranged in the workspace, wherein the phantom maxilla and / or the phantom mandible is configured to support the user's hand / fingers in a manner closely simulating the way a dentist supports his / her hand / fingers on a real patient, The computer is configured to generate a virtual environment including at least one virtual tooth, a virtual handpiece, a virtual maxilla, and a virtual mandible, the computer being configured to display the virtual environment on the display screen, And the computer is configured to: Co - locate the virtual tooth with the virtual maxilla or the virtual mandible; Co - locate the virtual handpiece with the position of the handpiece in the workspace, Co - locate the virtual maxilla with the position of the phantom maxilla in the workspace, and Co - locate the virtual mandible with the position of the phantom mandible in the workspace.

25. A dental procedure simulator, comprising: A support structure, A display screen, A computer configured to simulate a dental procedure or treatment, A linkage suspended from the support structure, the linkage being controlled by the computer to simulate a medical procedure or treatment by providing haptic force feedback, A handpiece, the handpiece being operably coupled to the linkage device and configured to be held in a user's hand and manipulated by the user within a workspace in the real space of the dental surgery simulator, A phantom maxilla and / or a phantom mandible movably supported by the support structure and disposed within the workspace, The computer being configured to generate a virtual environment including at least one virtual tooth, a virtual handpiece, a virtual maxilla, and a virtual mandible, the computer being configured to display the virtual environment on the display screen, And the computer being configured to: Co-locate the virtual tooth with the virtual maxilla or the virtual mandible; Co-locate the virtual handpiece with the position of the handpiece within the workspace, Co-locate the virtual maxilla with the position of the phantom maxilla within the workspace, and Co-locate the virtual mandible with the position of the phantom mandible within the workspace, Wherein the phantom maxilla is suspended from the support structure to allow rotation with one, two, or three rotational degrees of freedom.

26. The dental surgical simulator according to claim 24 or 25, wherein, The phantom mandible is arranged to be movable relative to the phantom maxilla.

27. The dental surgical simulator according to claim 24 or 25, wherein, The phantom maxilla and the phantom mandible are provided with one or more grooves for receiving at least one phantom tooth, and wherein the at least one virtual tooth is co-located with the at least one phantom tooth on the display screen; and wherein the phantom maxilla and the phantom mandible, together with the at least one phantom tooth, are configured to support the user's hand / fingers in a manner closely simulating the way a dentist supports their hand / fingers on a real patient.

28. The dental surgical simulator according to claim 24 or 25, wherein, The phantom maxilla is movable relative to the support structure in unison with the phantom mandible, The dental surgery simulator includes one or more sensors configured to sense the position and orientation of the phantom maxilla and the phantom mandible relative to the support structure, Wherein the computer receives the position and orientation of the phantom maxilla and the phantom mandible via the one or more sensors, and The computer is configured to adjust the orientation and position of the at least one virtual tooth according to the movement of the phantom maxilla and the phantom mandible such that when the phantom maxilla or the phantom mandible moves, the at least one virtual tooth remains co-located with the phantom maxilla or the phantom mandible on the display screen.

29. The dental surgical simulator according to claim 24 or 25, wherein, The computer is configured to display at least a portion of the virtual maxilla and a portion of the virtual mandible, the computer being configured to co-locate the virtual maxilla with the phantom maxilla and the virtual mandible with the phantom mandible on the display screen, and this is also the case when the phantom maxilla or the phantom mandible moves.

30. The dental surgical simulator according to claim 24 or 25, wherein, The phantom mandible is suspended from the phantom maxilla by a hinge mechanism.

31. The dental surgical simulator according to claim 30, wherein, The phantom mandible is suspended from the phantom maxilla by a four-bar kinematic chain.

32. The dental surgical simulator according to claim 30, wherein The phantom mandible is suspended from the phantom maxilla by a hinge mechanism simulating human jaw movement.

33. The dental surgical simulator according to claim 24 or 25, wherein, The phantom mandible is suspended from the phantom maxilla to allow movement between an open position and a closed position.

34. The dental surgery simulator according to claim 24 or 25, comprising a position sensor configured to generate a signal indicative of the position of the mandible of the phantom relative to the maxilla of the phantom.

35. The dental surgical simulator according to claim 33, wherein, The closed position corresponds to a position for checking occlusal reduction, and wherein the computer is configured to display a virtual upper tooth set for the maxilla of the phantom and a virtual lower tooth set for the mandible of the phantom on a display screen, thereby allowing a visual occlusal check of the virtual tooth sets in the closed position.

36. The dental surgical simulator according to claim 33, wherein, The rotation in one, two or three degrees of freedom is manually imparted, and wherein the dental surgery simulator includes one or more rotational position sensors for sensing the rotation of the maxilla of the phantom in each of the one to three degrees of freedom.

37. The dental surgical simulator according to claim 24 or 25, wherein, The maxilla of the phantom is suspended from the support structure by a first mechanism that allows the maxilla to rotate about a first horizontal axis Y disposed in the workspace, and wherein the first mechanism does not intrude into the workspace.

38. The dental surgical simulator according to claim 37, wherein, The first mechanism includes a remote center linkage, or two spaced-apart parallel remote center linkages.

39. The dental surgical simulator according to claim 38, wherein, The maxilla of the phantom is suspended from the support structure by a second mechanism that allows the maxilla of the phantom to rotate about a second horizontal axis X disposed in the workspace, and wherein the second mechanism does not intersect the workspace.

40. The dental surgical simulator according to claim 24 or 25, wherein The maxilla of the phantom is suspended from the support structure by a third mechanism that allows the maxilla of the phantom to rotate about a vertical axis Z, and wherein the third mechanism does not intersect the workspace.

41. The dental surgical simulator according to claim 24 or 25, wherein, The maxilla of the phantom includes an upper support member to which a detachable maxillary element is detachably attached, and wherein the mandible of the phantom includes a lower support member to which a detachable mandibular element is detachably attached.

42. The dental surgical simulator according to claim 41, wherein, The detachable maxillary element is a universal maxillary element that does not have / define teeth, and wherein the detachable mandibular element is a universal mandibular element that does not have / define teeth.

43. The dental surgical simulator according to claim 41, wherein, The detachable maxillary element is a specific maxillary element provided with phantom teeth, the teeth being detachably attached to the specific maxillary element, and the specific maxillary element with its teeth being an exact replica of a part of a real human maxilla with its teeth, and wherein the detachable mandibular element is a specific mandibular element provided with phantom teeth, the teeth being detachably attached to the specific mandibular element, and the specific mandibular element with its teeth being an exact replica of a part of a real human mandible with its teeth.

44. The dental surgical simulator according to claim 24 or 25, wherein, The maxilla of the phantom and / or the mandible of the phantom are segmented phantom jaws, wherein at least one segment is arranged to be detachable.

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