Computerized dental system with software suite for pathology analysis, treatment selection, prosthesis design and preparation, and prosthesis manufacturing machine and tooth preparation robot.

Abstract

A complete computerized system for performing dental care with interventions for partial or total coronal-peripheral preparations, comprising: on the one hand, a software suite installed in a computer system (I), the first part of which, designed using a specific form of Artificial Intelligence based on the creation of several successive databases with the development of precise and reliable rules, allows for the analysis of dental pathologies, the establishment of diagnoses, the selection and recommendation of appropriate treatments, and the second part of which performs, based on the data obtained by the first part,This involves designing fixed prostheses and defining tooth preparation, as well as developing the 3D scanning and exchange files necessary for manufacturing the required fixed prostheses and preparing teeth appropriately directly in the patient's mouth. Furthermore, it includes the associated hardware consisting of the manufacturing machine (M) for prosthesis fabrication and the robot (R) for preparing teeth directly in the patient's mouth. Figure to be published for the abstract: Fig 1,

Description

Title of the invention: Computerized dental system with software package for pathology analysis, treatment selection, prosthesis design and cutting and prosthesis manufacturing machine and tooth cutting robot. Technical field of the invention

[0001] The present invention relates to the field of dental care and more particularly to the most common acts carried out by practitioners as well as the production of the necessary fixed prostheses, in particular the crown, the bridge, the veneer and the inlay or onlay. State of the prior art

[0002] In recent years we have seen significant technical developments aimed at increasingly frequent and extensive use of IT in the dental field as in many other medical fields. Partial devices are used to assist the practitioner in certain specific tasks, such as, for example, taking 3D images of the oral cavity using miniature 3D cameras or programming 3D printers or milling machines for the manufacture of prostheses. However, there are no complete devices with a high level of integration and automation to successively and completely analyze pathologies, define complete cycles of dental care and actually carry out said dental care. All the more or less automated processes and devices implemented to date require manual interventions, even if these are sometimes relatively short. None of the solutions proposed in the prior art allows, in the context of dental care with interventions for partial or total coronary-peripheral, to successively carry out in a continuous process: the analysis of the dental pathology, the establishment of the diagnosis, the selection and recommendation of appropriate dental treatments and all the operations linked to the care concerned, namely the definition of the necessary prosthesis, the definition of the cutting of the tooth, the automatic manufacture of the prosthesis and the more or less automated cutting of the tooth in the patient's mouth.

[0003] It should be noted that the level of automation possible for cutting the tooth depends on whether or not it is necessary to go through an impression-taking phase after cutting to allow the definition and production of the prosthesis. This impression-taking phase also has a certain number of disadvantages: • Firstly for the patient who must have in his mouth materials with an unpleasant taste and consistency. • Then for the practitioner who must carry out frequent cleaning and rinsing. • And then on the hygiene level by increasing the risks of soiling and even infection. • Finally, in terms of the duration of the intervention, since the multiplication of these manual operations, some of which are very delicate due to the precision required, require numerous retouches. Presentation of the invention

[0004] The aim of the present invention is to significantly improve the range of tools available to practitioners by proposing a complete computerized system for carrying out dental care with interventions for partial or total coronal-peripheral preparations. Said complete computerized system comprising: • On the one hand, a software package, the first part of which, designed using a particular form of Artificial Intelligence based on the creation of several successive databases with the development of precise and reliable rules, allows the analysis of dental pathologies, the establishment of diagnoses, the selection and recommendation of appropriate dental treatments, and the second part of which is made up of programs to, based on the preceding elements, firstly carry out the design of prostheses and the definition of the cutting of teeth and then develop the 3D scanning files and the exchange files necessary to allow the production of prostheses by the associated manufacturing machine and the cutting of teeth directly in the patient's mouth in a more or less automated manner by the robot also associated. • On the other hand, the associated hardware elements consisting of said prosthesis manufacturing machine and said robot for cutting teeth in the patient's mouth, each containing their own control and piloting system and being directly connected to the computer equipment in which the system's software package is installed.

[0005] As indicated, the first part of the software package of the system, developed by means of a particular form of Artificial Intelligence based on the constitution of several successive databases with the development of precise and reliable rules, includes the functions of analysis of dental pathologies, establishment of diagnoses and selection and recommendation of appropriate dental treatments, allows the practitioner firstly to considerably reduce the time he usually spends on these three activities and secondly to have before him, presented by the system, a wider range of possibilities than he would probably have imagined. We know, firstly, that practitioners are often subject to time constraints that are difficult to manage and secondly that the possibilities of computerized systems allow for the storage of a very large amount of information, information which is thus made immediately available. But of course, as will be specified in the remainder of the description of the invention, the practitioner will always retain control of the whole since he will have the possibility at any time to intervene and correct, modify and accept the proposals or recommendations made by the system. The second part of the system's software package operates from the data developed in the first part. It includes programs dedicated to the design of prostheses and the definition of tooth cutting and programs for developing 3D scanning files and exchange files necessary to enable the production of prostheses by the associated manufacturing machine and the cutting of teeth directly in the patient's mouth by the robot also associated. Finally, the associated hardware elements of the invention consist precisely of said prosthesis manufacturing machine and said robot for cutting teeth in the patient's mouth. Detailed description of the invention

[0006] Necessary computer equipment. Before describing the system of the invention in detail, it is appropriate to provide some details on the computer equipment necessary for implementing the system, even if many of these details are obvious. Such computer equipment consists of standard hardware with a relatively high level of performance. The computer must have a large storage capacity with a substantial hard drive, one (or more) high-capacity processor(s) and one (or more) high-performance graphics card(s). The equipment is first completed by one (or preferably two) screen(s). These screens must also have a certain level of performance in the various criteria relating to screens such as: size, response time, display and refresh rate, brightness and contrast, viewing angle, co- lorimetric and color reproduction. A printer is also needed for scanning and printing documents or images. Of course, an ergonomic keyboard and a user-friendly mouse are essential. Finally, the furniture set on and in which the different elements of the IT system are installed must also have a good level of ergonomics. The practitioner's position when sitting at or standing next to the desk should be as comfortable and practical as possible.

[0007] The description which now follows details the elements which constitute the system of the invention itself. • The two already mentioned parts of the software package of the system of the invention are first described: • The first part concerns the development of the program which subsequently allows the determination of the pathology, the issuance of a diagnosis and the selection and recommendation of appropriate dental treatments. • The second part is divided into two phases. The first phase consists of having the previously developed program process the patient's data and obtaining, for the specific case, the determination of the pathology, the issuance of a diagnosis and the selection and recommendation of appropriate dental treatments. The second phase consists first of all in carrying out, from the previous elements, the design of the prosthesis and the definition of the tooth cutting and then in developing the necessary 3D scanning and exchange files. • Then the two material entities which complete the invention are presented, namely the prosthesis manufacturing machine and the robot for cutting teeth in the patient's mouth.

[0008] Description of the first part of the software of the system which is the subject of the invention 1. The method of developing this first part of the system software is detailed here, which then allows the determination of the pathology, the issuing of a diagnosis and the selection and recommendation of dental treatments. As indicated, this development is based on a particular form of Artificial Intelligence consisting of the creation of several databases and the development of precise and reliable rules. It is the optimization of complex systems which includes the following steps: 1. Constitution of the initial database in the form of general descriptors, called primary descriptors, introduced into the system in the form of numeric, alphanumeric or even Boolean indications, these general descriptors can be made up of: 1. Concrete and precise examples of pathologies and associated dental treatments noted in the literature, in the various information bodies of the profession and in training cycles. 2. As many specific cases as possible (made anonymous) already treated in the dental practice. 3. Laws, standards, professional concepts, rules and general recommendations relating to the profession issued by experts and authorities and which more specifically recommend certain dental treatments and certain practices for certain pathologies. 4. Known assessments of best practices. 2. Constitution of the test base by selection, by the practitioner(s), from among these primary general descriptors, of a limited number of particularly significant and representative cases, this test base is intended to subsequently verify that the application of the rules which will be established in the following stages, thanks to the implementation of this particular Artificial Intelligence system, indeed generate the expected diagnostic and associated dental treatment proposals. 3. Generation of new descriptors, by recombination of parameters from the largest number of general descriptors in the initial base in order to generate the working base or reference base made up of a smaller number of descriptors which are thus qualified as intelligent and significant descriptors. 4. Generation, by means of a Machine Learning system, from these intelligent and meaningful descriptors, of a set of precise rules which firstly make it possible to establish the correct diagnoses according to the different pathologies and then to propose the appropriate dental treatments for the different types of pathology. 5. Verification on the initial concrete examples of the test base (point 1.2) that the application of the rules defined previously generates results which are consistent with the said examples and which remain in line with the experts' recommendations (point 1.1.3). 6. Return to point 1.1 to supplement the initial database in the event of a mismatch between the results of applying the generated rules and both the recommendations of experts and practices (point 1.1.3 and point 1.1.4) and the examples selected for the test base (point 1.2).

[0009] Description of the second part of the software of the system which is the subject of the invention. 1. The second part of the system software detailed below is broken down, as a reminder, into a first phase of computer processing of the data coming from the first part in order to establish, for the actual case concerned, the pathology, the diagnosis and the selection and recommendation of dental treatments and into a second phase of designing the appropriate prosthesis and defining the cutting of the tooth with development of the 3D scanning files and exchange files necessary for introduction into the piloting and control program integrated into each of the hardware elements of the system, namely the prosthesis manufacturing machine and the tooth cutting robot in the patient's mouth. 1. Phase of computer processing of data from the first part and establishment of proposals. 1. Computer processing of data from the first part of the software. 2. Proposal for defining the patient's pathology, taking into account possible modifications by the practitioner. 3. Proposed diagnosis taking into account any possible modifications made by the practitioner. 4. Proposal for dental treatment taking into account any possible modifications made by the practitioner. 5. Taking into account any corrections made by the practitioner. 2. Phase of designing the prosthesis and defining the cutting of the tooth. 1. Computer processing of the data necessary for the design of the prosthesis and the definition of the cutting of the tooth coming from the first part of the software. 2. Development of the prosthesis design, creation of the 3D modeling file by the software section dedicated to this function and transmission of the exchange file (STL or other) to the prosthesis manufacturing machine. 3. Development of the tooth cutting definition, creation of the 3D modeling file by the software section dedicated to this function and transmission of the exchange file (STL or other) to the tooth cutting robot. 4. Taking into account any corrections made by the practitioner. 2. Description of the system hardware associated with the software package, the two parts of which have been detailed previously. 1. Description of the prosthesis manufacturing machine. This machine is an automatic 3D manufacturing machine that automatically machines the prosthesis in the material selected and installed by the practitioner and / or the prosthetist. This machine is equipped at least with its own control unit with its piloting and control program that operates from the exchange file containing the 3D model transmitted in point 2.2.2. In addition to its machining head equipped with the necessary tool, this machine integrates in particular a scanner that projects a laser beam onto the block of material in which the prosthesis is machined and that continuously records the distance that separates it from each point of the block of material in order to carry out the machining of the prosthesis with great precision.The structure of the machine is entirely mechanical, so there is no interface with a human being during the manufacturing operation and therefore no risk of parasitic movement on this level, which contributes to achieving a high level of precision. 2. Description of the robot for automatic tooth trimming in the patient's mouth. As with the previous machine, the robot is equipped at least with its own control unit with its piloting and control software which operates from the exchange file containing the 3D modeling of the pre-established trimming and transmitted in point 2.2.3. In terms of its electromechanical structure, it consists of a base positioned not far from the chair in which the patient is installed and robotic arms provided with several segments and end members for holding the trimming tool and the stirrup intended to be positioned on the patient's tooth to be treated, or on a neighboring tooth, and which constitutes a base for controlling the movements of the trimming tool.

[0010] Finally, considering the point raised in the last paragraph relating to the state of the art on the page concerning fully automated interventions with robots, it can be noted that two cases may arise within the framework of the invention, cases which have different consequences on the progress and duration of an intervention on a patient. • The case where the precision of the tooth cutting carried out by the robot is not sufficient to reproduce with a sufficient level of accuracy the shape of the cutting produced by the system. The cutting of the tooth must therefore be carried out before the manufacture of the prosthesis so that a digital impression of the cutting as it was actually carried out can then be recorded. This digital impression is then introduced into the system (point 2.2.2) to carry out the definition of the prosthesis, in particular in its interface part with the cut tooth, and the definition thus produced is then entered into the prosthesis manufacturing machine for manufacturing. It is only after this manufacture of the prosthesis, after the cutting of the tooth, that the practitioner can proceed to place it in the patient's mouth. • The preferred case where the precision characteristics of the tooth cutting robot allow for cutting with only minimal and acceptable deviations from the definition established by the system, the passage through the phase of developing an optical impression from the actual cutting, which is therefore not approximate, is no longer necessary. The manufacture of the prosthesis by the automatic machine can then be anticipated and thus be carried out before or during the cutting of the tooth by the robot. The prosthesis is therefore available as soon as the cutting operation by the robotic system is finished and can be fixed immediately by the practitioner in the patient's mouth. This results in a considerable saving of time in the progress of the entire intervention. It is obvious that it is very difficult to design and produce a robot with such a level of precision. Nevertheless, the present invention integrates this case into its possibilities of use.

[0011] After the preceding detailed description and in order to better specify the possibilities and advantages of the system of the invention, the progress, using the proposed system, of the different operations linked to a concrete intervention on a patient are described below. A. Installation of the patient on the intervention chair by the practitioner. B. Complete clinical examination of the patient by the practitioner. C. Introduction into the system of previous and current data relating to the patient and their pathology. D. Implementation by the practitioner of the first part of the system of the invention. E. Definition by the system of the patient's pathology taking into account possible modifications by the practitioner. F. Diagnostic proposal by the system taking into account possible modifications by the practitioner. G. Proposal for dental treatment by the system, taking into account any corrections made by the practitioner. H. Automatic updating and consolidation of this part of the system by incorporating the case being treated. I. Complete design, by the system, of the necessary prosthesis, creation of the 3D modeling file and transmission of the exchange file to the manufacturing machine. J. Detailed definition, by the system, of the shape of the tooth cutting, creation of the 3D modeling file and transmission of the exchange file to the robot. K. Positioning, by the practitioner, of the robot elements near the patient's mouth, placement of the stirrup in the patient's mouth and positioning of the camera. L. Cases where the precision level of the tooth cutting robot is not sufficient to accurately reproduce the cutting shape developed by the system.

[0012] - Launch by the practitioner of the automatic cutting of the tooth by the robot.

[0013] - Automatic cutting of the tooth by the robot.

[0014] - Taking, by the practitioner after cutting, of a digital impression of the cut tooth as it is after actual cutting. Given the insufficient level of precision of the robot, the cutting does not quite correspond to the initial definition, it is therefore necessary to review the design of the prosthesis, in particular at the level of the interface with the cut tooth.

[0015] - Introduction by the practitioner of the digital impression of the tooth cut into the system for modifying the definition of the prosthesis, in particular in its interface part with the cut tooth.

[0016] - Revision of the design of the prosthesis by the system and creation of the new modeling file and transmission of the exchange file to the manufacturing machine.

[0017] - Launch of the automatic manufacturing of the prosthesis by the fa machine brication.

[0018] - Fixing of the prosthesis in the patient's mouth by the practitioner. A. Preferred case where the precision characteristics of the tooth cutting robot allow for cutting with only minimal and acceptable deviations from the definition established by the system, therefore the passage through the phase of developing a digital impression from the actual cutting is no longer necessary. The sequence of operations thus takes place as follows: next.

[0019] - Launch by the practitioner of the automatic manufacture of the prosthesis by the manufacturing machine.

[0020] - Automatic manufacturing of the prosthesis by the manufacturing machine.

[0021] - Launch by the practitioner of the automatic cutting of the tooth by the robot.

[0022] - Automatic cutting by the robot.

[0023] - Checking the tooth cutting.

[0024] - Recovery of the prosthesis by the practitioner.

[0025] - Fixing of the prosthesis in the patient's mouth by the practitioner.

[0026] It can be seen that in this preferred case, the manufacture of the prosthesis by the automatic machine can then be anticipated and therefore carried out before or during the cutting of the tooth by the robot. The prosthesis is thus available as soon as the cutting operation by the robot is finished and can be fixed immediately by the practitioner in the patient's mouth.

[0027] As already mentioned, this results in a considerable saving of time in the progress of the entire intervention.

[0028] The following figures 1 to 9 which illustrate the entire system which is the subject of the invention make it possible to complete the description.

[0029] [Fig.l] constitutes a simplified general view of the entire system of the invention with, around the practitioner in front of his desk, on the one hand the necessary computer equipment (I) which contains the system software and on the other hand the hardware entities consisting of the tooth cutting robot (R) with the chair on which the patient is installed and the prosthesis manufacturing machine (M).

[0030] [Fig.2] shows an example of a robot (R) with a double robot arm (1a) and (2a). The arm (1a) constitutes the manipulator of the stirrup (1b) which is fixed on the patient's tooth to be treated or on a neighboring tooth and the arm (2a) constitutes the manipulator of the cutting tool (2b) of the tooth to be treated.

[0031] [Fig. 3] shows an example of fixing the holding stirrup (1b) on the patient's tooth to be treated by means of the arm (1a).

[0032] [Fig.4] shows an example of the start of cutting the patient's tooth to be treated by the cutting tool (2b) as well as the holding stirrup (1b) carried by the arm (1a).

[0033] [Fig.5] illustrates in flowchart form the prior actions of the practitioner necessary to enable the process of the system of the invention to start.

[0034] [Fig.6] shows the beginning of the general flowchart of the system of the invention, this beginning relates to the first part, based on the particular form of AI previously described, which ensures the creation or consolidation of databases and the development or updating of rules for proposing pathology definition, proposing diagnosis and selecting and recommending dental treatment.

[0035] [Fig.7] shows the continuation of the flowchart relating to the second part - phase 1 of the system which, by applying the previously established rules, establishes the proposals for pathology, diagnosis and dental treatment, under the control of the practitioner who has the possibility of making corrections if necessary.

[0036] [Fig.8] shows the continuation of the flowchart relating to the second part - phase 2 of the system where, following the diagnosis and the proposed and approved dental treatment, the system proceeds to the design of the prosthesis and the definition of the tooth cutting and establishes, after possible corrections and approval by the practitioner, the necessary 3D modeling and exchange files to send them respectively to the prosthesis manufacturing machine and to the cutting robot.

[0037] [Fig.9] shows the software / machine interface in the two possible cases: the case of the cutting robot not having a high level of precision and the case of the cutting robot having a high level of precision.

Claims

Claims

1. : Complete computerized system for performing dental care with interventions for partial or total coronary-peripheral preparations characterized by the fact that it includes: • on the one hand, a software set installed in computer equipment (I), a software set of which a first part, designed using Artificial Intelligence techniques based on the creation of several successive databases with the development of precise and reliable rules, allows an analysis of dental pathologies, an establishment of diagnoses, a selection and a recommendation of appropriate treatments and of which a second part carries out, from the data obtained by said first part, a design of fixed prostheses and a definition of the cutting of teeth as well as a development of the 3D scanning files and the exchange files necessary to allow a manufacture of fixed prostheses and an adequate cutting of teeth directly in the patient's mouth • on the other hand, an associated hardware set consisting of the manufacturing machine (M) for said manufacturing of prostheses and a robot (R) for cutting teeth directly in the patient's mouth.

2. : Complete computerized system for performing dental care with interventions for partial or total coronary-peripheral preparations according to claim 1 characterized by the fact that the development of said first part of the software set, which uses Artificial Intelligence techniques, is based on the constitution of several successive databases with development of rules according to the following steps:

1. constitution of the initial database in the form of general descriptors, called primary descriptors, introduced into the system in the form of numeric, alphanumeric or even Boolean indications, these general descriptors can be made up of:

1. concrete and precise examples of pathologies and 3.

4.

5. associated dental treatments noted in the literature, in the various information bodies of the profession and in training cycles, 2. as many specific cases as possible (made anonymous) already treated in the dental practice, 3. laws, standards, regulations and general recommendations relating to the profession issued by experts and authorities and which more specifically recommend certain dental treatments for certain pathologies, constitution of the test base by selection, by the practitioner, from among said first general descriptors, of a limited number of particularly significant and representative cases, this test base is intended to subsequently verify that the application of the rules which will be established in the following stages thanks to the implementation of this particular Artificial Intelligence system indeed generate the expected associated diagnostic and dental treatment proposals, generation of new descriptors, by recombination of parameters from the largest number of general descriptors of the initial base in order to generate the working base or reference base made up of a more limited number of descriptors which are thus qualified as intelligent and significant descriptors, generation, by means of a Machine Learning system, from said intelligent and significant descriptors,of a set of precise rules which allow on the one hand to establish the correct diagnoses according to the different pathologies and on the other hand to propose the appropriate dental treatments for the different types of pathology, verification on the initial concrete examples of the test base (§2a) that the application of the rules defined previously generates results which are in accordance with the said examples and which remain in accordance with the recommendations of the experts, return to point 1 to complete the database, initial in case of inconsistency between the previous results of application of the generated rules and both the laws, standards, regulations and recommendations of the experts and the examples retained for the test base.

3. : Complete computerized system for carrying out dental care with interventions for partial or total coronal-peripheral preparations according to claims 1 and 2, characterized in that said 3D prosthesis manufacturing machine associated with the system is provided at least with its own control unit with a piloting and control program operating from said exchange files containing said 3D modeling pre-established by said second part of the software of the invention.

4. : Complete computerized system for carrying out dental care with interventions for partial or total coronal-peripheral preparations according to claims 1 and 2 characterized in that said robot associated with the system for cutting teeth in the patient's mouth is equipped at least with its own control member with its piloting and control software which operates from said exchange files containing said 3D modeling of the cutting pre-established by said second part of the software of the invention.

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