A method for manufacturing a digital guide plate for temporomandibular joint cavity injection

Abstract

The application discloses a manufacturing method of a digital guide plate for temporomandibular joint cavity injection, and the CT and MRI data of a patient are subjected to image segmentation, three-dimensional reconstruction and image registration in a computer software, so that the models of the condylar process, the articular disc and the articular tubercle of the temporomandibular joint are obtained and the relative position relationship is confirmed, and thus the positions of the upper cavity and the lower cavity of the joint are determined. According to the patient's condition, the drug is injected into the upper cavity or the lower cavity of the joint, and the needle insertion position, angle and depth of the injector are simulated in the software. On the basis of the soft tissue of the maxillofacial part reconstructed by the CT of the patient, a 3D printing guide plate which can be attached to the surface of the soft tissue is designed individually, and the guide hole is determined on the guide plate in combination with the needle insertion position, angle and depth. The guide plate comprises a positioning wing for assisting installation and positioning and a preset needle insertion guide hole, and can be used for guiding the needle insertion of the injector and the drug injection in the joint cavity injection treatment.

Description

TECHNICAL FIELD

[0001] The application belongs to the technical field of medical treatment, and particularly relates to a manufacturing method of a digital guide plate for temporomandibular joint cavity injection. BACKGROUND

[0002] Temporomandibular joint osteoarthritis (TMJOA) is a common joint degenerative disease characterized by synovial inflammation, progressive cartilage destruction and bone resorption. TMJOA can cause pain, joint damage and functional disorders such as difficulty in chewing and speaking, which seriously affects the quality of life of patients. TMJOA is difficult to treat, and there are very limited effective treatment methods. Among the conservative treatment methods for TMJOA, joint cavity injection therapy is a relatively safe and effective method, which can reduce pain and improve joint movement dysfunction by injecting drugs directly into the upper or lower cavity of the joint. However, due to the complex anatomy of the temporomandibular joint region, the joint cavity is divided into upper and lower cavities by the articular disc. During treatment, doctors usually choose to inject drugs into the upper or lower cavity of the temporomandibular joint according to the osteoarthritis condition of the patient, so the accurate positioning of the upper and lower cavities and the avoidance of articular disc damage are the key to the success of joint cavity injection therapy.

[0003] Prior art: At present, doctors mainly perform joint cavity injection by experience, and the depth of needle insertion is not easy to control. The positioning accuracy of the articular disc and the joint cavity is poor, and during the injection process, the syringe often pierces the articular disc or the condyle, causing damage and pain to the articular tubercle surface. At the same time, since the articular disc is located between the upper and lower cavities of the joint and is deep, it cannot be directly operated to select the exact injection site. SUMMARY

[0004] The purpose of the present application is to provide a manufacturing method of a digital guide plate for temporomandibular joint cavity injection, which solves the technical problems of complex anatomy of the temporomandibular joint region of patients, large individual differences, poor visibility, poor positioning accuracy of doctors when injecting by experience, and inability to accurately control the depth and position of needle insertion. The operation often needs to be repeated to find the best angle and depth of needle insertion, which is time-consuming and easy to cause poor treatment effect.

[0005] The technical scheme adopted by the present application to solve the technical problems is:

[0006] A manufacturing method of a digital guide plate for temporomandibular joint cavity injection, comprising the following steps:

[0007] S1, obtaining the spiral CT and MRI data of the patient's maxillofacial region: first determine the condyle horizontal axis during shooting, and then determine the oblique sagittal position scanning line according to the condyle horizontal axis, and store the temporomandibular joint MRI image in DICOM format;

[0008] S2, determine the position of the upper cavity and the lower cavity of the temporomandibular joint: import the DICOM data of CT and MRI of the patient into the computer software, separate the temporomandibular joint tubercle, mandibular condyle and articular disc from the background and establish a new mask, and separate the mandible and teeth, articular fossa and articular disc by Boolean operation, and the model of the temporomandibular joint tubercle, mandibular condyle and articular disc is reconstructed by the region growing function, and the model is stored as STL format; the positional relationship of each STL model can be determined through the image registration function, that is, the relative positional relationship of the condyle of the temporomandibular joint, the articular disc and the articular tubercle is determined, so that the position of the upper cavity and the lower cavity of the joint is determined, and the maxillofacial soft tissue model of the patient is reconstructed according to the CT and saved as an STL file for standby;

[0009] S3, design of joint cavity injection guide plate: import the STL model file in step S2 into the computer software, convert the surface data of the soft tissue surface region of interest into volume data with a periphery of 1-3mm based on the maxillofacial soft tissue STL model reconstructed from the CT of the patient, design a 3D printing guide plate that can fit the soft tissue surface, and determine the positioning wing and guide hole, and save it as an STL model format;

[0010] S4, 3D printing of personalized joint cavity injection guide plate: import the STL model file formed in step S3 into the 3D printer to print the joint cavity injection guide plate entity.

[0011] The method for manufacturing the digital guide plate for temporomandibular joint cavity injection of the application comprises the following steps: S1, obtaining the MRI image of the temporomandibular joint; S2, determining the position of the upper cavity and the lower cavity of the temporomandibular joint; S3, designing the joint cavity injection guide plate; and S4, 3D printing the personalized joint cavity injection guide plate.

[0012] The method for manufacturing the digital guide plate for temporomandibular joint cavity injection of the application comprises the following steps: S1, obtaining the MRI image of the temporomandibular joint; S2, determining the position of the upper cavity and the lower cavity of the temporomandibular joint; S3, designing the joint cavity injection guide plate; and S4, 3D printing the personalized joint cavity injection guide plate.

[0013] The method for manufacturing the digital guide plate for temporomandibular joint cavity injection of the application comprises the following steps: S1, obtaining the MRI image of the temporomandibular joint; S2, determining the position of the upper cavity and the lower cavity of the temporomandibular joint; S3, designing the joint cavity injection guide plate; and S4, 3D printing the personalized joint cavity injection guide plate.

[0014] The method for manufacturing the digital guide plate for temporomandibular joint cavity injection of the application comprises the following steps: S1, obtaining the MRI image of the temporomandibular joint; S2, determining the position of the upper cavity and the lower cavity of the temporomandibular joint; S3, designing the joint cavity injection guide plate; and S4, 3D printing the personalized joint cavity injection guide plate.

[0015] In step S4, the printer nozzle is preheated to 70 degrees before printing, test paper is placed on the tray and printing marks are checked through the Pattern Test mode, and after meeting the requirements, formal printing is performed.

[0016] The present application has the beneficial effects that: a method for manufacturing a digital guide plate for temporomandibular joint cavity injection is proposed, CT and MRI data of a patient are image segmented, three-dimensionally reconstructed and image registered in computer software, models of condylar process, disc and tubercle of the temporomandibular joint are obtained and their relative position relationship is confirmed, so as to determine the positions of the upper cavity and the lower cavity of the joint. According to the patient's condition, the drug is injected into the upper cavity or the lower cavity of the joint, the needle insertion position, angle and depth of the syringe are simulated in the software. On the basis of the maxillofacial soft tissue reconstructed by the CT of the patient, a 3D printed guide plate that can fit the surface of the soft tissue is designed individually, and the guide hole is determined on the guide plate in combination with the needle insertion position, angle and depth. The guide plate includes a positioning wing for assisting installation and a preset needle insertion guide hole, and can be used to guide the needle insertion of the syringe and the injection of the drug in the joint cavity injection treatment. BRIEF DESCRIPTION OF DRAWINGS

[0017] The present application will be further described below in conjunction with the drawings and embodiments, wherein:

[0018] Figure 1 is a structural schematic diagram of an embodiment of the present application. DETAILED DESCRIPTION

[0019] To make the objectives, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be described clearly and completely below in conjunction with the drawings of the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, rather than all the embodiments of the present application. It should be understood that the specific embodiments described herein are only used to explain the present application, and are not used to limit the present application. Based on the embodiments in the present application, all other embodiments obtained by those of ordinary skill in the art without creative work belong to the scope of protection of the present application.

[0020] As shown in Figure 1 A method for manufacturing a digital guide plate for temporomandibular joint cavity injection, comprising the following steps:

[0021] S1, obtain the patient's maxillofacial spiral CT and MRI data: when shooting, first determine the condyle horizontal axis, then determine the oblique sagittal position scanning line according to the vertical condyle horizontal axis, store the MRI image of the temporomandibular joint as DICOM format; CT layer thickness 0.5mm, working voltage 120kV, current 7700mA. The MRI is shot using a 1.5T imaging system and a special coil for the temporomandibular joint. Select fast spin echo sequence T1WI (parameter settings: repetition time TR 2300 ms, echo time TE 47 ms), T2WI (parameter settings: TR 2500 ms, TE 47 ms), image acquisition matrix: 288x256, DICOM: Digital imaging and communications in Medicine.

[0022] S2, determine the position of the upper cavity and the lower cavity of the temporomandibular joint: import the DICOM data of the patient's CT and MRI into the computer software Mimics Research 19.0, the threshold value of the maxillofacial skeleton is 0-1600, the threshold value of the disc is 0-235, separate the temporomandibular joint tubercle, mandibular condyle and disc from the background and establish a new mask, separate the mandible from the teeth, joint fossa and disc by Boolean operation, and reconstruct the model of the temporomandibular joint tubercle, mandibular condyle and disc by region growing function, the model is in STL format. The positional relationship of each STL model can be determined through image registration function, i.e. the relative position relationship of the temporomandibular joint condyle, disc and tubercle is determined, so as to determine the position of the upper cavity and the lower cavity of the joint, and the patient's maxillofacial soft tissue model is reconstructed according to CT and saved as STL file for standby use;

[0023] S3, design of joint cavity injection guide plate: import the STL model file in step S2 into computer software 3-Matic11.0, convert the surface data of the soft tissue surface of interest region to body data with a periphery of 1-3mm based on the maxillofacial soft tissue STL model reconstructed by the patient's CT, design a 3D printing guide plate that can fit the soft tissue surface, and determine the positioning wing and guide hole, and save it as an STL model format;

[0024] S4, 3D printing of personalized joint cavity injection guide plate: import the STL model file formed in step S3 into the 3D printer to print the joint cavity injection guide plate entity.

[0025] In the preferred embodiment of the application, at least 5 MRI images of the temporomandibular joint disc can be seen in step S1.

[0026] In the preferred embodiment of the application, in step S2, in the preferred embodiment of the application, in step S3, the soft tissue surface of interest region is the region from the nasal bridge to the front and rear edges and the upper edge of the auricle.

[0027] In the preferred embodiment of the present application, the determination of the positioning wing and the guide hole in step S3 is achieved by importing the process STL file into Mimics Research 19.0, selecting to inject the drug into the upper cavity or the lower cavity of the joint according to the patient's condition, simulating the needle position, angle and depth of the personalized syringe, and designing a cylindrical model matching the syringe needle by using the Medcad function to design the guide hole on the guide plate.

[0028] In the preferred embodiment of the present application, in step S4, the printer nozzle is preheated to 70 degrees before printing, test paper is placed on the tray and the printing trace is checked by the Pattern Test mode, formal printing is performed after meeting the requirements, the printing software is opened, the guide plate STL data is imported by Insert, the guide plate position is placed and optimized by Placement, and the guide plate file is checked for errors, and if there is no error, the printing task is started. The non-toxic resin material which can be high-temperature and high-pressure sterilized is used, the support material is cleaned after printing, and the joint cavity injection guide plate entity is obtained.

[0029] Instructions: After 3D printing the guide plate, it is attached to the patient's nasal bridge and the upper edge of the auricle, and the positioning wing assists in fixation. When the fit is good and there is no instability such as tilting, it is considered to be fully in place. Based on the guide hole when the guide plate is fixed, the syringe is injected into the joint cavity at the preset position, angle and depth, which can accurately avoid the surface of the articular disc, condyle and joint tubercle, prevent damage to the surface cartilage and cause pain. After the syringe reaches the preset position, the drug is injected, the syringe is withdrawn and the guide plate is removed, and the injection treatment is completed.

[0030] In the description of the present application, it should be noted that the terms "center", "longitudinal", "transverse", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer" and the like indicate the orientation or positional relationship based on the orientation or positional relationship shown in the drawings, and are only for the convenience of describing the present application and simplifying the description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore cannot be understood as limiting the present application. In addition, the terms "first", "second" are only for descriptive purposes and cannot be understood as indicating or implying relative importance.

[0031] In the description of the application, it is necessary to point out that, unless otherwise explicitly specified and limited, the terms "mounting", "connection", "connecting" should be understood broadly, for example, can be fixed connection, can also be detachable connection, or integrally connected; can be mechanical connection, can also be electrical connection; can be directly connected, can also be indirectly connected through an intermediate medium, can be the communication inside two elements. For those skilled in the art, the specific meaning of the above terms in the application can be understood according to the specific circumstances. In addition, in the description of the application, unless otherwise specified, the meaning of "a plurality of" is two or more.

[0032] It should be understood that for those skilled in the art, improvements or changes can be made according to the above description, and all these improvements and changes shall belong to the protection scope of the appended claims of the present application.

Claims

1. A method for manufacturing a digital guide for temporomandibular joint cavity injection, characterized by, The method comprises the following steps: S1, obtaining the spiral CT and MRI data of the patient's maxillofacial part: when shooting, first determine the condyle horizontal axis, then determine the oblique sagittal position scanning line according to the vertical condyle horizontal axis, and store the MRI image of the temporomandibular joint as a DICOM format; S2, determining the position of the upper cavity and the lower cavity of the temporomandibular joint: importing the DICOM data of the CT and MRI of the patient into the computer software, separating the temporomandibular joint tubercle, mandibular condyle and articular disc from the background and establishing a new mask, separating the mandible and teeth, articular fossa and articular disc by Boolean operation, and reconstructing the model of the temporomandibular joint tubercle, mandibular condyle and articular disc through the region growing function, and storing the model as an STL format; the positional relationship of each STL model can be determined through the image registration function, i.e. the relative positional relationship of the condyle, articular disc and articular tubercle of the temporomandibular joint is determined, so that the position of the upper cavity and the lower cavity of the joint is determined, and the CT is reconstructed to obtain the maxillofacial soft tissue model of the patient and saved as an STL file for standby; S3, design of joint cavity injection guide plate: importing the STL model file in step S2 into the computer software, converting the surface data of the soft tissue surface region of interest to the body data of the surrounding 1-3mm based on the maxillofacial soft tissue STL model reconstructed by the CT of the patient, designing a 3D printing guide plate that can fit the soft tissue surface, and determining the positioning wing and guide hole, and saving it as an STL model format; S4, 3D printing of personalized joint cavity injection guide plate: importing the STL model file formed in step S3 into the 3D printer to print the joint cavity injection guide plate entity.

2. The method of claim 1, wherein the method further comprises: The MRI image of the temporomandibular joint in step S1 can be at least 5 temporomandibular disc images.

3. The method of claim 1, wherein the method further comprises: determining a position of the digital guide plate in the temporomandibular joint cavity of the patient; and adjusting the digital guide plate based on the determined position. In step S2, the threshold value of the maxillofacial bone is 0-1600, and the threshold value of the articular disc is 0-235.

4. The method of claim 1, wherein the method further comprises: In step S3, the soft tissue surface region of interest is the region from the nasal bridge to the front and upper edges of the auricle.

5. The method of claim 1, wherein the method further comprises: In step S3, the positioning wing and guide hole are determined by importing the process STL file into Mimics Research 19.0, selecting the drug injection into the upper cavity or lower cavity of the joint according to the patient's condition, simulating the needle position, angle and depth of the syringe, and designing a cylindrical model matching the syringe needle to design the guide hole on the guide plate.

6. The method of claim 1, wherein the method further comprises: In step S4, the printer nozzle is preheated to 70 degrees before printing, a test paper is placed on the tray, and the printing trace is checked through the PatternTest mode, and the formal printing is carried out after meeting the requirements.

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