Preparation method of mixed support type multi-angle visual self-adaptive orthodontic implant anchorage guide plate

Abstract

The invention discloses a preparation method of a mixed support type multi-angle visual self-adaptive orthodontic implant anchorage guide plate. The preparation method comprises the following steps: S1, data acquisition; s2, data fitting is carried out; s3, designing an orthodontic planting nail; s4, designing a mixed support type multi-angle visual self-adaptive orthodontic implant guide plate: obtaining a dental crown-tooth root-mucosa model, designing a tooth-mucosa-occlusion triple mixed support type multi-angle visual self-adaptive implant guide plate, and further generating a mixed support type multi-angle visual self-adaptive orthodontic implant guide plate STL (Standard Template Library) file; s5, 3D printing is carried out; and S6, finished product preparation: removing the supporting rod from the printed guide plate, grinding and polishing, and sterilizing to finish the preparation. The anti-rotation displacement force of the guide plate is improved, and extra instrument fixation is not needed in the operation; the visual track and the head end opening expose the drill bit and the nail point in the whole process, guide plate dislocation is facilitated, a doctor can avoid tooth roots, maxillary sinus and neural tubes under direct vision, and the damage rate of the tooth roots is reduced.

Description

TECHNICAL FIELD

[0001] The application belongs to the field of manufacturing oral orthodontic implant anchorage guide plates, in particular to a digital design and manufacturing method of a mixed support type multi-angle visualized self-adaptive orthodontic implant anchorage guide plate, which is suitable for high-risk cases that require absolute anchorage and have narrow interradicular spaces or are adjacent to important anatomical structures. BACKGROUND

[0002] Orthodontic implant anchorage (TAD, Temporary Anchorage Device) or micro implant anchorage (MIA, Micro Implant Anchorage) is a micro screw anchorage technology that is born from the intersection of orthodontics and implantology. It is a titanium alloy or stainless steel micro screw with a diameter of 1-2 mm and a length of 6-12 mm, which is temporarily implanted into the alveolar bone or jaw bone to provide a "thread-unmoving anchor point" for orthodontic force, so as to accurately move the target teeth without displacement of the teeth that should not be moved. However, when implanting the orthodontic micro implant anchorage, there are cases with small interradicular space, adjacent nerve canal, limited visual field, or the need for immediate high stability. Therefore, the existing technology uses digital preoperative CBCT + oral scan registration to lock the implant site in the software and generate a rigid solid guide plate. During the operation, the implant pin is implanted through the guide plate to mechanically reproduce the pre-set path. Compared with the traditional orthodontic implant pin, which requires the doctor to judge the implant position and direction based on experience, the existing technology fundamentally reduces the risk of root damage, shortens the operation time, and improves patient comfort. However, in clinical work, the traditional guide plate technology for orthodontic implant anchorage often has the following problems:

[0003] · Registration and positioning accuracy problem: In the existing technology, the CBCT data registration error of oral scan data is large, and manual adjustment is required, so that the implant position of the anchorage pin cannot accurately avoid the tooth root and key anatomical structures.

[0004] · Guide plate structure design defect problem: The existing technology cannot adapt to different handle diameters, and multiple sets of instruments need to be customized. In addition, the intraoperative observation is limited, and the implantation path cannot be monitored in real time. After the operation, it is difficult to dislocate the guide plate when the pin head is protruding.

[0005] · Inadequate intraoperative stability problem: The existing technology only relies on tooth support and is easily displaced by mucosa or oral angle traction. When rotating the anchorage pin, it is easy to roll into the surrounding mucosa, causing the implantation path to deviate, and the oral angle contraction force causes the guide plate angle to deviate. SUMMARY

[0006] The purpose of the present application is to overcome the deficiencies in the prior art, provide a mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate manufacturing method, the implant anchorage guide plate manufacturing method of the present application is based on digital data, designed through professional 3DSlicer, Blender software, combined with 3D printing or other ways to process and manufacture mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate, the present application optimizes the design process of traditional orthodontic implant nail guide plate, improves the operation precision, initial stability and safety, and the implant guide plate made by the present application has the advantages of high precision, stability, universality and visualization.

[0007] Technical scheme:

[0008] A preparation method of a mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate, comprising the following steps:

[0009] S1, data acquisition: acquiring the CBCT automatic segmented tooth STL file of the implant anchorage nail planned implantation, and the three-dimensional data STL file of the working side obtained by model scanning or model scanning;

[0010] S2, data fitting: registering and fitting the three-dimensional data STL file of the working side and the CBCT automatic segmented tooth STL file to obtain the positions and relationships of the orthodontic implant nail to be placed, the angle, the depth, and the gum soft tissue and bone tissue;

[0011] S3, design of orthodontic implant nail: simulate the three-dimensional position relationship of the orthodontic anchorage nail implantation in the data fitting and matching file, and avoid the anatomical structure and implant bone marrow;

[0012] S4, design of mixed support type multi-angle visual adaptive orthodontic implant guide plate: design a tooth-mucosa-bite triple mixed support type multi-angle visual adaptive implant guide plate, obtain a crown-root-mucosa model, and further generate a mixed support type multi-angle visual adaptive orthodontic implant guide plate STL file;

[0013] S5, 3D printing: import the mixed support type multi-angle visual adaptive orthodontic implant guide plate STL file into the layout software of 3D printing, and perform 3D printing;

[0014] S6, finished product: remove the support rod from the printed guide plate, polish and polish, and after sterilization, the manufacturing is completed.

[0015] Preferably, in S4, in the design of the tooth-mucosa-bite triple mixed support, the tooth support surface uses the crown shape to design a rigid positioning part; the mucosa support surface is designed to fit the gum elastic structure to disperse the pressure; and the bite support surface is designed to have a bite support structure at the corresponding position of the lower jaw to form a triple mixed support.

[0016] Preferably, the mucosa support surface is located at the bottom of the main body of the implant guide plate; the tooth support surface is connected to the mucosa support surface and comprises a support structure wrapping the bottom of the tooth; and the occlusion support surface is arranged on the back of the support structure.

[0017] Preferably, in S4, the main body of the implant guide plate is designed as a C-shaped elastic conduit, which is in a hollow cylindrical shape, and one side of the body is provided with a longitudinal opening to form a through-type visualized track, and the cross section of the C-shaped elastic conduit is in a C shape.

[0018] Preferably, the inner diameter of the C-shaped elastic conduit is matched with the size of the handle, and the inner diameter of the C-shaped elastic conduit is slightly smaller than the outer diameter of the size of the handle.

[0019] Preferably, in S4, an observation hole is arranged at the bottom of the front surface of the main body of the implant guide plate, and the top end of the observation hole is in a circular through-hole structure, which can be used for the axial passing of the nail head protruding from the bone surface when the guide plate is withdrawn after the operation, to realize non-damage dislocation, and can also be used for the vertical placement of the self-tapping implant nail through the hole to the bone surface in the initial implantation stage, to complete the pre-punching of the cortical bone, and then to be taken out, and then to be implanted along the preset angle in the C-shaped conduit for formal implantation, so as to improve the cortical penetration efficiency and reduce the risk of nail channel deviation.

[0020] Preferably, in S4, a slope is additionally arranged on the other side of the body of the implant guide plate relative to the visualized track, the slope is wide at the bottom and narrow at the top, and a groove is additionally arranged on the slope, the groove serves as a distal pressure point to prevent soft tissue from being rolled in and to offset the corner pulling force.

[0021] Preferably, the body of the implant guide plate below the observation hole is cut off by 1 mm of material to form two left and right double-arm clamps, which are used for pressing the free gingiva in the use process to prevent the free gingiva from being rolled into the surrounding mucosa when the anchorage nail is rotated.

[0022] Preferably, in the step S4, a Blender software is used to generate a mixed support type multi-angle visualized self-adaptive orthodontic implant guide plate STL file.

[0023] Preferably, the operation steps of the Blender software are as follows:

[0024] The crown-root-mucosa model after registration by 3D Slicer is imported, the C-shaped elastic conduit is established along the virtual nail channel, and a through-type visualized track is formed by cutting off a 1 mm wide observation window; then, a three-fold support structure is integrally generated by using Boolean operation, and a gingival pressing elastic double arm and a distal pressure point are added, and finally, the guide plate STL is exported after merging the grids.

[0025] Advantages of the present application

[0026] The mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate provided by the application takes CBCT and intraoral scanning data as the starting point, is rigidly registered through 3D Slicer, and is integrally designed in Blender: the C-shaped elastic catheter can adapt to TAD handles of different diameters; the tooth-mucosa-bite triple mixed support structure forms multi-point retention in the mouth, so that the anti-rotation displacement force of the guide plate is improved, and no additional instrument is needed to fix during the operation; the visual track and the head opening expose the drill bit and the nail tip throughout, so that the doctor can avoid the tooth root, the maxillary sinus and the nerve tube under direct vision, the tooth root damage rate is reduced, and the guide plate is especially suitable for high-risk areas such as tooth root spacing <2mm, low sinus floor and close nerve tube; and can be seamlessly embedded in digital orthodontic schemes such as early treatment of teenagers, invisible treatment of adults and lingual treatment. With the popularity of chair-side 3D printing and AI automatic segmentation, the guide plate is expected to be widely promoted in primary hospitals and specialist clinics across the country, become a standardized and replicable technical paradigm for precise implantation of micro-implants, and has significant clinical value and broad market prospects. BRIEF DESCRIPTION OF DRAWINGS

[0027] Figure 1 It is a schematic diagram of the orthodontic implant nail and the tooth root catheter in the embodiment.

[0028] Figure 2 It is one of the stereograms of the orthodontic implant guide plate in the embodiment.

[0029] Figure 3 It is the second stereogram of the orthodontic implant guide plate in the embodiment.

[0030] Figure 4 It is the third stereogram of the orthodontic implant guide plate in the embodiment.

[0031] Figure 5 It is a reference diagram for use of the orthodontic implant guide plate in the embodiment. DETAILED DESCRIPTION

[0032] The application will be further described below in conjunction with the embodiments, but the protection scope of the application is not limited thereto:

[0033] In combination Figures 1-4 , the technical scheme adopted by the application is:

[0034] A mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate manufacturing method is applied to the manufacturing of implant anchorage guide plates for high-risk patients who need absolute anchorage and have narrow tooth root gaps or adjacent important anatomical structures at the implant site; the manufacturing method comprises:

[0035] S1, data acquisition: acquiring the tooth STL file automatically segmented by CBCT when the implant anchorage nail is planned to be implanted, and the three-dimensional data STL file of the working side obtained by oral scanning or model scanning;

[0036] S2, data fitting: automatically register the three-dimensional data STL file of the working side and the tooth STL file automatically segmented by CBCT to obtain the position and relationship of the orthodontic implant pin to be placed, angle, depth, and gingival soft tissue, bone tissue three;

[0037] S3, design orthodontic implant pin: simulate the three-dimensional position relationship of the orthodontic anchorage pin implant in the data fitting matching file, and pay attention to avoid anatomical structures such as tooth roots and implant bone marrow;

[0038] S4, design mixed support multi-angle visual adaptive orthodontic implant guide plate: design a tooth-mucosa-bite triple mixed support multi-angle visual adaptive implant guide plate;

[0039] S5, 3D printing: import the mixed support multi-angle visual adaptive orthodontic implant guide plate STL file into the 3D printing layout software and perform 3D printing;

[0040] S6, finished product: remove the support rod after printing, polish and polish, and after disinfection, the production is completed.

[0041] Further, in the data fitting step, the CBCT is preprocessed and data registration is completed using 3D Slicer software; the registration principle is: taking the three-dimensional shape of the hard tissue teeth in the two data sources as the reference, ensuring that the tooth crown and root position completely coincide and the outline is clear.

[0042] Further, the data fitting step is: automatically segmenting the CBCT data to obtain the STL model of the teeth and the upper and lower jaw bones; then automatically registering the tooth crown and mucosa STL obtained by intraoral scanning according to the tooth STL obtained by CBCT segmentation.

[0043] Further, in the step of designing the orthodontic implant pin, the registered model is imported into the Blender software, as shown in Figure 1 , using a model with a diameter of 1-2mm and a length of about 6-12mm Figure 1 (medium green cylinder), placing the implant pin at the preset implant position, adjusting the implant angle, and avoiding the tooth root and nerve canal Figure 1 (medium blue part).

[0044] In combination Figures 2-5 , the orthodontic implant guide plate designed by the application has tooth-mucosa-bite triple mixed support, the tooth support surface 6 uses the crown shape to design a rigid positioning part; the mucosa support surface 7 designs an elastic structure that fits the gum and disperses the pressure; the occlusion support surface 8 designs an occlusion support structure at the corresponding position of the lower jaw, forming a triple mixed support.

[0045] The mucosa support surface 7 is located at the bottom of the main body 1 of the implant guide plate; the tooth support surface 6 is connected to the mucosa support surface and comprises a support structure wrapping the bottom of the tooth; and the occlusion support surface 8 is arranged on the back of the support structure.

[0046] The main body 1 of the implant guide plate is designed as a C-shaped elastic conduit, which is a hollow cylinder 2, one side of the body of which is provided with a longitudinal opening to form a through-type visualization track 3, and the cross section of the C-shaped elastic conduit is in the shape of a C.

[0047] The inner diameter of the C-shaped elastic conduit is matched with the size of the handle, and the inner diameter of the C-shaped elastic conduit is slightly smaller than the outer diameter of the size of the handle.

[0048] An observation hole 5 is arranged at the bottom of the front surface of the main body of the implant guide plate.

[0049] A slope 10 is arranged on the other side of the body of the implant guide plate relative to the visualization track, the slope 10 is wide at the bottom and narrow at the top, and a groove 9 is arranged on the slope 10, the groove 9 serves as a distal pressure point to prevent soft tissue from being rolled in and offset the pulling force of the corner of the mouth.

[0050] The body of the implant guide plate below the observation hole is cut off by 1 mm of material to form two left and right arms 4, the arms 4

[0051] In the use process, the arms are used to press the free gingiva to prevent the free gingiva from being rolled into the surrounding mucosa when the abutment pin is rotated.

[0052] Further, in the self-adaptive step of designing the orthodontic implant guide plate, the size of the handle is first measured in Blender, and a corresponding C-shaped elastic conduit is made on the guide plate according to the size, so as to ensure that the conduit can be elastically held tightly to prevent shaking, and different diameter handles can share the same guide plate to realize self-adaptation.

[0053] Further, in the mixed support type multi-angle step of designing the orthodontic implant guide plate, a tooth-mucosa-occlusion triple mixed support is designed in Blender. The tooth support surface uses the shape of the crown to design a rigid positioning part; the mucosa support surface designs an elastic structure that fits the gum to disperse the pressure; and the occlusion support surface designs an occlusion support structure at the corresponding position of the lower jaw to form a triple mixed support.

[0054] Further, in the visualization step of designing the orthodontic implant guide plate, an open track is designed in Blender to facilitate the observation of the pin body entering process during the operation, and a head channel is reserved to facilitate the smooth removal of the guide plate after the operation.

[0055] Further, in the mixed support type multi-angle visualization self-adaptive orthodontic implant guide plate step, a pressure mucosa elastic arm and a distal pressure point are designed in Blender to prevent soft tissue from being rolled in and offset the pulling force of the corner of the mouth.

[0056] Further, in combination with Figure 5 Finally, the integrated design of the mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate is completed in Blender, and the whole process can realize the continuous operation of design-printing-sterilization within 30 minutes.

[0057] The mixed support type multi-angle visual adaptive orthodontic implant anchorage guide plate designed based on the application can support two clinical implant strategies: one-step preparation-free implantation, that is, the implant nail is directly guided into the inclined hollow cylinder and the operation is completed, but there is a risk of nail body slipping along the bone surface; two-step pre-drilling implantation, first, the observation hole 5 is used to vertically drill the bone surface to form an initial cortical bone channel, and then the C-shaped hollow cylinder-shaped 2 of the same guide plate is rotated into the implant nail at a preset inclination angle. Thus, the same guide plate can realize the multi-angle conversion of "vertical pre-punching-inclined formal implantation", significantly expanding the application scenarios and improving the implant precision and safety.

[0058] The problems that can be solved by the application include:

[0059] (1) Surgical accuracy advantage

[0060] The 3D Slicer automatically registers the STL of the oral cavity scanning and the STL of the CBCT segmented teeth, so as to ensure that the anchorage nail implantation position is accurately avoided from the tooth root and the key anatomical structure.

[0061] (2) Surgical convenience advantage

[0062] The handle size of the pre-designed Blender matches the guide plate and the designed C-shaped elastic multi-size adaptive guide pipe, which can tightly wrap and adapt to the anchorage nail handle of different diameters, reducing the intraoperative adjustment steps.

[0063] (3) Surgical safety advantage

[0064] Through the straight open visual track and the visual opening above the anchorage nail head channel, the whole nail entering process is visualized, and the anchorage nail head channel is reserved, allowing the guide plate to be smoothly removed when the nail head protrudes, avoiding tissue damage caused by intraoperative violent dislocation.

[0065] (4) Surgical stability advantage

[0066] Through the adoption of tooth-mucosa-bite triple mixed support, the stress is dispersed and the guide plate stability is enhanced, the pressure mucosa elastic double arms are additionally added, the free gingiva is actively pressed and pasted, the surrounding mucosa is prevented from being rolled in when the rotating anchorage nail, and the distal mucosa pressure point is designed, the guide plate is fixed on the mucosa with additional instruments, and the displacement of the guide plate caused by the mouth corner traction is offset to ensure the constant implantation angle.

[0067] The specific embodiments described herein are merely illustrative of the spirit of the application. Various modifications or changes in the specific embodiments described herein can occur to those skilled in the art to which the application pertains without departing from the spirit of the application, and it is understood that such modifications or changes are to be considered as within the scope of the application as defined by the appended claims.

Claims

1. A method for preparing a hybrid supportive, visual, multi-angle adaptive orthodontic implant anastomosis guide plate, characterized in that... It includes the following steps: S1. Data Acquisition: Acquire the STL file of teeth automatically segmented by CBCT during implant anchorage screw planning, and the STL file of three-dimensional data of the working side obtained by intraoral scan or model scan. S2. Data Fitting: The three-dimensional STL data file of the working side and the tooth STL file automatically segmented by CBCT are registered and matched to obtain the position, angle, depth of the orthodontic implant, as well as the position and relationship of the gingival soft tissue and bone tissue. S3. Design of orthodontic implant screws: Simulate and design the three-dimensional positional relationship of orthodontic anchorage screws in the data fitting and matching file, avoiding anatomical structures and implanting cancellous bone; S4. Design a hybrid support-multi-angle visualization adaptive orthodontic implant guide: Obtain a crown-root-mucosa model, design a tooth-mucosa-occlusion triple hybrid support-multi-angle visualization adaptive implant guide, and further generate a hybrid support-multi-angle visualization adaptive orthodontic implant guide STL file. S5, 3D printing: Import the STL file of the hybrid support-type multi-angle visualization adaptive orthodontic implant guide plate into the 3D printing layout software, add support rods and short crossbars, and perform 3D printing; S6. Finished product: Remove the support rods from the printed guide plate, polish it, disinfect it, and the production is complete.

2. The method according to claim 1, characterized in that... In S4, the tooth-mucosa-occlusion triple hybrid support design utilizes the crown shape to design a rigid positioning part; the mucosa support surface is designed with an elastic structure that conforms to the gingiva to disperse pressure. The occlusal support surface is designed with an occlusal support structure at the corresponding position of the mandible, forming a triple hybrid support.

3. The method according to claim 2, characterized in that... The mucosal support surface is located at the bottom of the main body of the implant guide; the tooth support surface is connected to the mucosal support surface and includes a support structure that wraps around the bottom of the tooth; the occlusal support surface is located on the back of the support structure.

4. The method according to claim 1, characterized in that... In S4, the main body of the planting guide plate is designed as a C-shaped elastic conduit. The C-shaped elastic conduit is hollow and has a longitudinal opening on one side to form a through-type visual track. The cross-section of the C-shaped elastic conduit is C-shaped.

5. The method according to claim 4, characterized in that... The inner diameter of the C-shaped flexible catheter is matched with the handle size, and the inner diameter of the C-shaped flexible catheter is slightly smaller than the outer diameter of the handle size.

6. The method according to claim 4, characterized in that... In S4, an observation hole is provided on the bottom front section of the main body of the planting guide plate.

7. The method according to claim 4, characterized in that... In S4, an inclined surface is added to the other side of the implantation guide plate relative to the visualization track. The inclined surface is wider at the bottom and narrower at the top. A groove is added to the inclined surface. The groove serves as a distal pressure point to prevent soft tissue from being drawn in and to counteract the traction force at the corner of the mouth.

8. The method according to claim 6, characterized in that... Cut a 1 mm section of material from the implant guide plate body below the observation hole to form two double-arm clamps on the left and right. These double-arm clamps are used to press the free gingiva during use to prevent the free gingiva from being rolled into the surrounding mucosa when the anchorage screw is rotated.

9. The method according to claim 1, characterized in that... In step S4, a hybrid support-based multi-angle visualization adaptive orthodontic implant guide STL file is generated using Blender software.

10. The method according to claim 9, characterized in that... The steps for using Blender software are as follows: Import the crown-root-mucosa model registered with 3D Slicer, establish a C-shaped elastic conduit along the virtual screw path, and simultaneously remove a 1mm diameter observation window to form a through-type visualization track; then add gingival elastic arms and distal compression points; subsequently, use Boolean operations to generate a triple support structure, and finally merge the mesh and export the guide plate STL.

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