Impression for repairing complete denture, complete denture and preparation method

Abstract

The invention relates to an impression for repairing a complete denture, the complete denture and a preparation method. The impression terminator capable of being used for controlling the thickness of the impression material is designed by adopting computer modeling software, and the thickness of the impression material is limited by designing a bulge structure which is matched with the shape of an intraoral mucosa and has a certain thickness on an individual tray tissue surface, so that the intraoral impression of a patient has uniform thickness; the preparation precision of the edentulous jaw final impression is ensured; meanwhile, the individual tray and the diagnosis denture are designed into an integrated structure, so that a doctor can be assisted in acquiring the occlusion relation of a patient while the edentulous jaw final impression is acquired, the two steps of preparing the final impression and recording the jaw position relation in the traditional process are combined into one step, the clinical process is simplified, and the working efficiency is improved. And the experience dependence and the technical sensitivity of the operation process are reduced, so that the accuracy of the two key steps in the edentulous jaw repair process is improved.

Description

Technical Field

[0001] The present application relates to the field of oral restoration, and in particular to an impression for full denture restoration, a full denture and a preparation method thereof. Background Art

[0002] Edentulous jaw is a common and frequently occurring disease in oral rehabilitation. With the aging of our society, we will face more and more edentulous jaw patients. At present, mucosa-supported full dentures are still the main method of restoring edentulous jaws. However, the traditional full denture restoration clinical process is complicated and technically sensitive. From the initial diagnosis to the final denture wearing, patients need to visit the doctor many times, which brings great inconvenience to patients, especially elderly patients.

[0003] Making an accurate impression of the edentulous jaw is the key to ensuring good retention and stability of the complete denture, and it is also the first step to ensure the treatment effect. Traditional edentulous jaw impressions are usually obtained using the "two-step method", that is, the finished tray is used to make the initial impression and the plaster model is reproduced. Then the edge line is drawn on the plaster model, and a light-cured resin sheet is used to make individual trays on the plaster model that fully match the edentulous jaw tissue surface for making a more accurate final impression. However, the operation process of manually making individual trays is complicated, and the thickness and edge extension of the trays are difficult to standardize; and when using individual trays to make the final impression, the pressure applied to the tray cannot be accurately controlled, and the thickness of the impression material on the tray tissue surface cannot be guaranteed to be uniform; at the same time, the mucosa in some areas may also be deformed due to excessive force, resulting in reduced impression accuracy, affecting the accuracy of making and wearing effects of the complete denture. Summary of the invention

[0004] In order to solve the problem that the pressure molding using individual trays cannot be accurately controlled and the thickness of the impression material on the tray tissue surface cannot be guaranteed to be uniform, the present application provides an impression, a full denture and a preparation method for full denture restoration.

[0005] In a first aspect, the present application provides a method for making an impression for full denture restoration, comprising: The digital initial impressions of the upper and lower jaws were obtained through intraoral scanning to obtain the oral mucosal tissue morphology; Obtain maxillomandibular and mandibular relationship; Import the digital initial impressions of the upper and lower jaws and the jaw position relationship of the upper and lower jaws into the engineering software, and complete the jaw position relationship matching of the upper and lower jaw models through the engineering software; Import the matching results into dental modeling software to complete the preliminary design of digital individual trays and diagnostic denture complexes; The complex is imported into the engineering software, and multiple impression stoppers with uniform thickness and close to the mucosa are added to the corresponding tissue surface of the complex using the engineering software; A composite model with an impression stopper added is prepared; The composite model was repositioned in the mouth and the margins were reshaped; All impression stoppers of the composite model are removed extraorally, and a light silicone rubber body is applied to the area where the impression stoppers are located. When in place, the individual trays are accurately repositioned by edge-molding the initial silicone rubber impression, and the light silicone rubber body is removed after it is completely solidified to obtain a final impression of the edentulous jaw with uniform tissue surface thickness.

[0006] Optionally, each of the impression stoppers has a thickness of 1 mm and is evenly distributed on the alveolar ridge top and upper palate corresponding to the tissue surface of the composite model.

[0007] Optionally, at least three of the impression terminators are respectively provided in the maxillary model and the mandibular model of the composite model.

[0008] Optionally, obtaining the maxillary and mandibular position relationship includes: The vertical distance of occlusion was preliminarily determined using the stop jaw gap method and recorded using a centric maxillary tray. The impression material was evenly applied to the maxillary and mandibular tissue surfaces of the centric maxillary tray and placed in the patient's mouth. The centric maxillary tray was pressed against the mandibular alveolar ridge, and after the silicone rubber was completely solidified, the midline, corner of mouth line, and jaw plane were marked intraorally. The centric maxillary tray was scanned using an extraoral scanning device to obtain the maxillary and mandibular position relationship.

[0009] Optionally, the preliminary design of the complex of the completed digital individual tray and diagnostic denture comprises: According to the maxillary and mandibular models and occlusal relationship data in the matching results, the anatomical landmarks are calibrated, and the position of the occlusal plane is determined according to the jaw position relationship. The edges of individual trays are drawn, the height, width and upper lip convexity of the jaw bank are determined, and the preliminary design of the digital individual trays and diagnostic denture complex is completed and exported in STL format.

[0010] In a second aspect, the present application provides an impression for full denture restoration, which is obtained by the impression making method as described above.

[0011] In a third aspect, the present application provides a method for preparing a complete denture, comprising: The final impression of the edentulous jaw was obtained as described above; Design impressions and diagnostic denture occlusal complexes based on final impressions of the edentulous jaw and individual trays and diagnostic denture complexes; Denture design is performed using the data of impressions and diagnostic denture occlusal complexes, and the designed dentures are digitally processed to obtain the final full denture.

[0012] In a fourth aspect, the present application also provides a complete denture, which is produced by the method for producing a complete denture as described above.

[0013] In summary, this application at least includes the following beneficial technical effects: 1. An impression terminator that can be used to control the thickness of the impression material was designed using computer modeling software. A protrusion structure with a certain thickness that fits the shape of the intraoral mucosa was designed on the tissue surface of individual trays to limit the thickness of the impression material, so that the patient's intraoral impression has a uniform thickness, ensuring the accuracy of the final impression of the edentulous jaw. At the same time, the individual trays and diagnostic dentures are designed as an integrated structure. While obtaining the final impression of the edentulous jaw, it can assist the doctor in obtaining the patient's occlusal relationship, combining the two steps of making the final impression and recording the jaw position relationship in the traditional process into one, simplifying the clinical process and reducing the experience dependence and technical sensitivity of the operation process, thereby improving the accuracy of the two key steps in the edentulous jaw restoration process. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] Figure 1 This is a flow chart of an impression making method for full denture restoration in an embodiment of the present application; Figure 2 This is a schematic diagram of the structure of the digital initial impression of the upper and lower jaws scanned in the embodiment of the present application; Figure 3 This is a schematic diagram of the process of using a centric jaw tray to record jaw position relationship in an embodiment of the present application; Figure 4 This is a schematic diagram showing the relationship between the upper and lower jaw digital initial impressions and the upper and lower jaw positions in the embodiment of the present application; Figure 5 It is a schematic diagram of the preliminary design structure of the digital individual tray and the diagnostic denture complex in the embodiment of the present application; Figure 6 This is a schematic diagram of the arrangement structure of the stamp terminator in the embodiment of the present application; Figure 7 This is a schematic diagram of the final impression structure obtained in the embodiment of the present application; Figure 8 This is a flow chart of a method for preparing a complete denture in an embodiment of the present application; Fig. 9 This is a schematic diagram of the structure of the impression and diagnostic denture occlusal complex model in the embodiment of the present application; Fig.10 Schematic diagram of the impression and diagnostic denture occlusal complex scan in the embodiment of the present application; Fig.11 This is a schematic diagram of the denture design and wearing effect in the embodiment of the present application. DETAILED DESCRIPTION

[0015] In order to make the purpose, technical solution and advantages of the present application more clearly understood, the present application is further described in detail below in conjunction with the accompanying drawings and embodiments. 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.

[0016] The terms used in the following embodiments of the present application are only for the purpose of describing specific embodiments, and are not intended to be used as limitations to the present application. As used in the specification and the appended claims of the present application, the singular expressions "one", "a kind of", "said", "above", "the" and "this" are intended to also include plural expressions, unless there is a clear contrary indication in its context. It should also be understood that the term "and / or" used in the present application refers to and includes any or all possible combinations of one or more listed items. The term "exemplary" means "used as an example, embodiment or illustrative", and any embodiment described as "exemplary" here does not need to be interpreted as being superior to or better than other embodiments. The terms "first" and "second" are only used for descriptive purposes, and cannot be understood as implying or implying relative importance or implicitly indicating the number of indicated technical features. Thus, the features defined as "first" and "second" can expressly or implicitly include one or more of these features, and in the description of the embodiments of the present application, unless otherwise specified, the meaning of "multiple" is two or more.

[0017] An embodiment of the present application provides a method for making an impression for full denture restoration.

[0018] refer to Figure 1 , a method for making an impression for full denture restoration, comprising the following steps: S101: Obtain the digital initial impressions of the upper and lower jaws through intraoral scanning to obtain the oral mucosal tissue morphology; In this embodiment, the digital initial impressions of the upper and lower jaws can be obtained by scanning with existing intraoral scanning equipment. Figure 2 As shown. The intraoral scanning device can quickly scan and model the patient's mouth, which is more efficient than the traditional method (selecting the finished tray and placing it in the patient's mouth to take the impression), and can significantly reduce the patient's discomfort. Oral mucosal tissue includes the edentulous upper and lower alveolar ridges and surrounding soft and hard tissues. The initial impression obtains the basic morphology and structure of the patient's mouth, providing a basis for the subsequent production of individual trays and diagnostic denture complexes.

[0019] S102: Obtain the maxillary and mandibular position relationship; A key step in the full denture treatment process for edentulous patients is to determine the jaw relationship. The jaw relationship includes the vertical height (bite vertical distance) between the upper and lower jaws and the horizontal position relationship. When a stable natural dentition exists, the jaw relationship is maintained by the uniform and extensive contact between the upper and lower teeth after occlusion; when the dentition is missing, the mandibular bone without restrictions can move in all directions, resulting in the loss of a stable jaw relationship. Therefore, re-determining the appropriate jaw relationship is crucial to the success of full denture restoration.

[0020] In the traditional process, the jaw relationship is usually recorded at the next follow-up visit after the final impression is made (this solution can collect the jaw relationship at the first visit, reducing the consultation process). The vertical distance of the occlusion requires making a wax ridge of a certain height on the plaster model, and then trying it in the mouth. By observing the rest gap of the upper and lower wax ridges, supplemented by observation of the lower 1 / 3 height of the face, nasolabial groove and other anatomical landmarks, the height of the wax ridge is repeatedly adjusted to the appropriate vertical distance. This process is relatively cumbersome and technically sensitive; in addition, the wax ridge needs to be shaped after being softened at high temperature, and the use of fire sources such as alcohol lamps has certain safety risks. The wax ridge with too high temperature entering the patient's mouth also poses a risk of scalding the patient. At the same time, the horizontal jaw relationship of edentulous patients is usually established in the centric relationship. The centric relationship, that is, the mandibular condyle is located in the unrestricted physiological posterior position in the articular fossa, is also the only position with the highest repeatability that can be obtained for edentulous jaws. In clinical practice, the mandible is retracted using bimanual guidance to achieve centric relationship, or the patient is asked to repeatedly open the mouth slightly and bite quickly to achieve centric relationship. Both methods require a high level of technical skills and clinical experience from the physician.

[0021] In view of the above problems, after the digital initial impression is made, the vertical distance of the occlusion is initially determined by the stop jaw gap method, and the centric jaw tray is used for recording; see Figure 3 As shown in the figure, the impression material is evenly applied to the upper and lower mandibular tissue surfaces of the median maxillary tray and placed in the patient's mouth; the tray is pressed against the mandibular alveolar ridge, and the patient is asked to swallow saliva and bite gently to avoid mandibular protrusion. At the same time, the maxillary lip silicone rubber is observed and adjusted to determine the appropriate upper lip convexity. After the silicone rubber is completely solidified, the midline, corner of mouth line, and jaw plane are marked in the mouth to achieve horizontal position relationship records; the median maxillary tray is scanned by an extraoral warehouse scanning device to obtain a preliminary digital jaw position relationship record.

[0022] S103: Importing the upper and lower mandibular digital initial impressions and the upper and lower mandibular jaw position relationship into the engineering software, and completing the jaw position relationship matching of the upper and lower mandibular models through the engineering software; In this embodiment, the upper and lower jaw digital initial impression and the upper and lower jaw jaw position relationship (see Figure 4) can be imported into the engineering software magics in STL format. When the centric maxillary tray takes the occlusal relationship, the silicone rubber material will take out the surface information of the intraoral mucosal tissue. At this time, the software can match the mucosa without occlusal information in the oral scan to the centric maxillary tray with occlusion according to the mucosal feature points in the centric maxillary tray and the mucosal feature points in the oral scan data, so that the oral scan mucosal data contains occlusal data.

[0023] S104: Import the matching results (i.e., the oral scan mucosal data with occlusal relationship) into the dental modeling software to complete the preliminary design of the digital individual trays and diagnostic denture complex; In this embodiment, the oral scan mucosa data with occlusal relationship is imported into the dental modeling software 3Shape, and the anatomical landmarks such as the maxillary tuberosity, canine point, incisor mastoid, lip frenulum, and molar retrocusp are marked in turn, and the occlusal plane position is determined according to the preliminary jaw position relationship. Then, the model is observed, the undercut is filled, the edge of the individual tray is drawn, the height, width and upper lip convexity of the jaw bank are determined, and the preliminary design of the digital individual tray and the diagnostic denture complex is completed (see Figure 5 ), and export in STL format.

[0024] It should also be noted that the dental modeling software can automatically design and generate individual trays and diagnostic denture complexes based on the oral scan mucosal data with occlusal relationships, but in this embodiment, the complex tissue surface needs to be 1mm away from the mucosa, so that bubbles are not easily generated when fluid silicone rubber is used later. Fluid silicone rubber has strong fluidity, but if the distance is too large, bubbles are easily generated, or the mold is incomplete (this is different from conventional denture design, where the denture and mucosa need to be close together). In this embodiment, this gap is used to design the impression terminator.

[0025] S105: importing the complex into the engineering software, and using the engineering software to add multiple impression terminators that fit the mucosa and have uniform thickness on the corresponding tissue surface of the complex; Import the digital individual trays and the corresponding jaw support data of the diagnostic denture complex in STL format into the engineering software for further detailed design and then add impression terminators that fit the mucosal thickness uniformly (see Figure 6 ).

[0026] Specifically, magics engineering software is used to mark the tissue surface of individual trays and preliminary designs of diagnostic denture complexes in a decentralized manner. The marking positions are the alveolar ridge top and the upper palate, not the edge of the assembly, because the edge position needs to be reshaped later. The number of impression terminators should not be too many to prevent excessive subsequent grinding and uneven thickness. For example, 3 to 6 impression terminators are respectively set in the maxillary model and the mandibular model of the composite model. And the distribution of the impression terminators must be evenly dispersed, so that the stop points can be better used for resetting in the patient's mouth. The composite occlusion can only be accurately expressed in the mouth. Using the offset function in the Magics software, the marked area can be directly offset 1mm away from the tissue surface. At the same time, the offset impression terminator can form a mortise and tenon structure with the tissue surface for easy insertion and removal.

[0027] S106: preparing a composite model after adding an impression stopper; In this embodiment, the composite model can be prepared by 3D printing. After the composite model is prepared, clinical operation can be performed to assemble, inspect, and adjust individual trays.

[0028] S107: Reposition the composite model in the mouth and perform edge shaping; Before starting the operation, teach the patient to practice sucking, swallowing, and making "ah" sounds, etc., to fully dry the edges and tissue surfaces of the composite model equipped with the impression stopper to prevent the edge shaping silicone rubber from falling off. When performing edge shaping, in addition to adding enough silicone rubber to the edge of the tray and the maxillary posterior embankment area, a small amount of edge shaping silicone rubber can be placed on the tissue surface of the tray except for the impression stopper. Then reposition the individual tray in the mouth, press, and complete the edge shaping action; at the same time, use the thickness of the impression stopper (about 1 mm) to support and ensure that a uniform thickness of impression material can be left on the tissue surface of the tray except for the impression stopper area.

[0029] S108: Remove all impression stoppers of the composite model outside the mouth, and apply a light silicone rubber body to the area where the impression stoppers are located. When in place, accurately reposition the individual trays by shaping the initial impression of the edge of the silicone rubber without applying additional force. After the light silicone rubber body is completely solidified, remove it to obtain a final impression of the edentulous jaw with uniform tissue thickness (see Figure 7 ).

[0030] In this embodiment, a protrusion structure (i.e., impression terminator) having a certain thickness and matching the shape of the intraoral mucosa is designed on the tissue surface of individual trays to limit the thickness of the impression material. The impression material can flow freely in the gap between the mucosa and the tissue surface to achieve pressure-free impression taking, so that the patient's oral impression has a uniform thickness, avoiding the possibility that the mucosal morphology will change and affect the impression taking accuracy due to pressure applied by biting and pressing, thereby ensuring the accuracy of making the final impression of the edentulous jaw. At the same time, the individual trays and the diagnostic denture are designed as an integrated structure, which can assist the doctor in obtaining the patient's occlusal relationship while obtaining the final impression of the edentulous jaw, thereby combining the two steps of making the final impression and recording the jaw position relationship in the traditional process into one, simplifying the clinical process, and reducing the experience dependence and technical sensitivity of the operation process, thereby improving the accuracy of the two key steps in the edentulous jaw restoration process.

[0031] The diagnosis and treatment process of edentulous patients not only needs to restore the occlusal function, but also needs to have a good aesthetic effect. In the traditional edentulous denture production process, the doctor relies on the secondary impression to make a model, and after making a wax ridge on the model, the model is repeatedly tried in the patient's mouth to determine the aesthetic signs such as the convexity and incisal edge of the patient's restoration. This process is highly technically sensitive and requires multiple adjustments in the patient's mouth, resulting in a poor patient experience. In the solution of this embodiment, when the patient is first diagnosed, the centric jaw tray or the patient's old denture is used to obtain the patient's jaw position and occlusion relationship, and then the centric jaw tray is scanned and the patient's intraoral scan mucosa is matched with it using digital software, so that the mucosal data with occlusion can be initially obtained. The data can then be used to design a diagnostic denture based on the individual tray designed above. As a result, a structure that combines the individual tray and the diagnostic denture can be designed - a diagnostic denture individual tray complex. Mucosal shaping can be performed in the mouth to obtain accurate mucosal information, and the diagnostic denture can also be used to confirm the occlusion and aesthetic effect. The steps of impression making, occlusion acquisition, and aesthetic effect confirmation can be completed at one time, and digital technology can be applied to traditional processes, thereby reducing the technical sensitivity of the operation process, helping to simplify the experience-based dependence of clinical operations, reduce the number of patient visits, improve production efficiency, and improve restoration accuracy.

[0032] Based on the above embodiment, the present application also provides an embodiment, that is, an impression for full denture restoration obtained by using the impression making method provided in the above embodiment. The specific process will not be repeated here.

[0033] Based on the above embodiments, the present application also provides a method for preparing a complete denture, see Figure 8 ,include: S801, designing the impression and diagnostic denture occlusal complex based on the final impression of the edentulous jaw and the individual trays and diagnostic denture complex prepared by the method described above; In this embodiment, the diagnostic denture can be first inspected, adjusted and the vertical distance can be determined, and then the aesthetic factors such as occlusion can be confirmed to obtain a complete impression and a diagnostic denture occlusal complex. Since the occlusion is obtained by the central jaw tray, the accuracy cannot be guaranteed. Therefore, in this embodiment, individual trays and diagnostic denture complexes are used. With the help of face workers, electronic face bows and other equipment, the occlusion can be adjusted on the individual trays of the diagnostic denture and the diagnostic denture complex. The adjusted occlusion is fixed with occlusal silicone rubber to the upper and lower jaws. At the same time, the midline, incisal position, convexity and other aesthetic factors are determined and observed. For example, if the midline is offset, a line mark can be made directly on the complex. Thus, the impression and the diagnostic denture occlusal complex are designed (reference Fig. 9 as shown).

[0034] S802. Design a denture using the impression and the data of the diagnostic denture occlusal complex, and digitally process the designed denture to obtain the final full denture.

[0035] In this embodiment, the complete impression and the diagnostic denture occlusal complex are scanned by the warehouse (see Fig.10 ), use the acquired data to design dentures, digitally process the designed dentures, and obtain the final permanent restoration full denture (see Fig.11 ).

[0036] Based on the above embodiment, the present application also provides an embodiment, that is, a full denture obtained by using the full denture preparation method provided in the above embodiment. The specific process is referred to the above content and will not be repeated here.

[0037] As described above, the above embodiments are only used to introduce the technical solution of the present application in detail, but the description of the above embodiments is only used to help understand the method and core idea of ​​the present application and should not be understood as limiting the present application. Any changes or substitutions that can be easily thought of by technicians in this technical field within the technical scope disclosed in the present application should be included in the protection scope of the present application.

Claims

1. A method for making an impression for full denture restoration, characterized in that: The impression making method comprises: The digital initial impressions of the upper and lower jaws were obtained through intraoral scanning to obtain the oral mucosal tissue morphology; Obtain maxillomandibular and mandibular relationship; Import the digital initial impressions of the upper and lower jaws and the jaw position relationship of the upper and lower jaws into the engineering software, and complete the jaw position relationship matching of the upper and lower jaw models through the engineering software; Import the matching results into dental modeling software to complete the preliminary design of digital individual trays and diagnostic denture complexes; The complex is imported into the engineering software, and multiple impression stoppers with uniform thickness and close to the mucosa are added to the corresponding tissue surface of the complex using the engineering software; A composite model with an impression stopper added is prepared; The composite model was repositioned in the mouth and the margins were reshaped; All impression stoppers of the composite model are removed extraorally, and a light silicone rubber body is applied to the area where the impression stoppers are located. When in place, the individual trays are accurately repositioned by edge-molding the initial silicone rubber impression, and the light silicone rubber body is removed after it is completely solidified to obtain a final impression of the edentulous jaw with uniform tissue surface thickness.

2. The method for making an impression according to claim 1, characterized in that: The thickness of each impression stopper is 1 mm, and they are evenly distributed on the alveolar ridge top and upper palate corresponding to the tissue surface of the composite model.

3. The method for making an impression according to claim 2, characterized in that: At least three impression terminators are respectively arranged in the maxillary model and the mandibular model of the composite model.

4. The method for making an impression according to any one of claims 1 to 3, characterized in that: The obtaining of the maxillary and mandibular position relationship comprises: The vertical distance of occlusion was preliminarily determined using the stop jaw gap method and recorded using a centric maxillary tray. The impression material was evenly applied to the maxillary and mandibular tissue surfaces of the centric maxillary tray and placed in the patient's mouth. The centric maxillary tray was pressed against the mandibular alveolar ridge, and after the silicone rubber was completely solidified, the midline, corner of mouth line, and jaw plane were marked intraorally. The centric maxillary tray was scanned using an extraoral scanning device to obtain the maxillary and mandibular position relationship.

5. The method for making an impression according to any one of claims 1 to 3, characterized in that: The preliminary design of the completed digital individual tray and diagnostic denture complex includes: According to the maxillary and mandibular models and occlusal relationship data in the matching results, the anatomical landmarks are calibrated, and the position of the occlusal plane is determined according to the jaw position relationship. The edges of individual trays are drawn, the height, width and upper lip convexity of the jaw bank are determined, and the preliminary design of the digital individual trays and diagnostic denture complex is completed and exported in STL format.

6. An impression for full denture restoration, obtained by the impression making method as claimed in the preceding claims.

7. A method for preparing a complete denture, characterized in that: The method comprises obtaining a final impression of the edentulous jaw according to any one of claims 1 to 5; Design impressions and diagnostic denture occlusal complexes based on final impressions of the edentulous jaw and individual trays and diagnostic denture complexes; Denture design is performed using the data of impressions and diagnostic denture occlusal complexes, and the designed dentures are digitally processed to obtain the final full denture.

8. A complete denture, obtained by the method for preparing a complete denture as claimed in claim 7.

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