Dental x-ray imaging system

Abstract

To provide a dental X-ray imaging system that is capable of outputting medical examination information suitable for a patient based on an occlusal force of the patient measured in an X-ray room and an X-ray image.SOLUTION: A dental X-ray imaging system 1 comprises: a rotation arm 21 including an X-ray generator 25 and an X-ray detection unit 26 at opposite positions with a fixed interval therebetween; a control unit 120 which performs operation control and X-ray irradiation control of the rotation arm 21; a bite plate 10 which positions the dentation of a patient; occlusal force detection means 30 which is installed at the bite plate 10 and can detect at least an occlusal force of the patient; a storage unit 140 which stores information on the detected occlusal force and X-ray image information in association with each other; an arithmetic unit 150 which creates medical examination information suited for a target patient by calculation using the X-ray image information and the information on the occlusal force stored in the storage unit 140 with respect to the target patient; and medical examination information output means 160 which outputs the medical examination information onto a network 200.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] The present invention relates to a dental X-ray imaging system. [Background technology]

[0002] Conventionally, bite force sensor sheets have been put into practical use to detect the bite force of teeth as an electrical signal by being inserted into the oral cavity. Measurements using bite force sensor sheets have been performed chairside in dental treatment equipment. Furthermore, a dental X-ray imaging apparatus has been put into practical use (see, for example, Patent Document 1) that uses a bite plate for positioning to irradiate and photograph the oral cavity in a predetermined position. Traditionally, dentistry has used X-ray CT devices that use cone beams and panoramic X-ray devices that can take cross-sectional images of the dentition and left and right temporomandibular joints. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2014-124287 Summary of the Invention [Problem to be solved by the invention]

[0004] However, despite the fact that teeth are primarily used for biting and chewing food, there was no X-ray equipment that could capture images of a patient's teeth while occlusal force was being applied. Furthermore, there was no X-ray equipment that could confirm how a patient's teeth, jawbone, temporomandibular joint, etc., change and are affected by differences in the patient's occlusal force. Furthermore, there was a need to select the best prosthesis for each patient from among artificial prostheses made of zirconia, hybrid resin, etc., with information useful for the patient's treatment (clinical information), such as combined information on occlusal force, jaw movement, and upper and lower occlusion.

[0005] The present invention has been made in consideration of the above-mentioned problems, and its objective is to provide a dental X-ray imaging system that can output treatment information tailored to the patient based on the patient's bite force and X-ray images measured in the X-ray room. [Means for solving the problem]

[0006] The dental X-ray imaging system of the present invention is characterized by comprising an X-ray generator and an X-ray detection unit arranged opposite each other at a fixed distance, a rotating arm supported by a support column and a slide main body so that it can rotate around a vertical rotation center axis, a control unit that controls the operation of the rotating arm and the emission of X-rays, a bite plate that positions the patient's dentition within the rotation area of ​​the X-ray generator and X-ray detection unit, an occlusal force detection means that is installed on the bite plate and is capable of detecting at least the patient's occlusal force, a memory unit that links and stores the detected occlusal force information and X-ray image information, a calculation unit that creates medical information tailored to the patient by performing calculations using the X-ray image information and occlusal force information stored in the memory unit for the target patient, and a medical information output means that outputs the medical information onto a network.

[0007] According to this configuration, the dental X-ray imaging system is equipped with an occlusal force detection means on the bite plate, and can perform X-ray imaging while occlusal force is applied to the patient's teeth positioned using the bite plate. The memory unit associates the detected occlusal force information with X-ray image information and stores them. The calculation unit generates patient medical information through calculations using this information. The medical information output means outputs the generated medical information to a network. Therefore, for example, a display device on an information terminal outside the X-ray room can display the patient's medical information via the network. Furthermore, for example, a dentist can select a prosthesis suitable for the patient's occlusal force based on this medical information. [Effects of the Invention]

[0008] According to the present invention, it is possible to output medical information suited to a patient based on the patient's occlusal force and X-ray images measured in an X-ray room. [Brief explanation of the drawings]

[0009] [Figure 1] 1A and 1B are schematic diagrams illustrating the configuration of a dental X-ray imaging system according to a first embodiment, in which (a) shows the periphery of a rotating arm, and (b) shows a bite plate. [Figure 2] FIG. 10 is a diagram showing an example of a head fixation device used together with a bite plate. [Figure 3] 1 is a functional block diagram showing the configuration of a dental X-ray imaging system according to a first embodiment. [Figure 4] 10 is a flowchart showing the flow of processing in the dental X-ray imaging system. [Figure 5] 10 is a flowchart showing a process flow using images stored under different occlusal forces. [Figure 6] 10 is a flowchart showing the flow of processing using images stored under conditions where the occlusal force is constant and the images are taken at different times. [Figure 7] FIG. 10 is a functional block diagram showing the configuration of a dental X-ray imaging system according to a second embodiment. [Figure 8] FIG. 10 is a schematic diagram showing a process of calculating a deflection by the dental X-ray imaging system according to the second embodiment. [Figure 9] FIG. 1 shows the main prosthetic materials and their hardness. [Figure 10] FIG. 10 is a schematic diagram showing bite force distribution characteristics relative to deflection area. [Figure 11] FIG. 1 is a diagram showing an example of an image captured by a dental X-ray imaging system. [Figure 12] FIG. 10 is a schematic diagram showing bite force distribution characteristics relative to gray value. [Figure 13] FIG. 1 is a diagram showing an example of an image captured by a dental X-ray imaging system. [Figure 14] FIG. 1 is a schematic diagram showing bite force distribution characteristics relative to the thickness of the mandibular lower edge cortical bone. [Figure 15]Schematic diagrams of the position of the articular disc when the mouth is closed, (a) showing the normal state and (b) showing temporomandibular joint disorder. [Figure 16] FIG. 10 is a schematic diagram showing bite force distribution characteristics relative to the coincidence probability of articular disc positions. [Figure 17] FIG. 10 is a schematic diagram illustrating the configuration of a dental X-ray imaging system according to a third embodiment. [Figure 18] FIG. 2 is a schematic diagram showing an example of a lower jaw three-dimensional position data input means. [Figure 19] FIG. 10 is a functional block diagram showing the configuration of a dental X-ray imaging system according to a third embodiment. [Figure 20] 1A and 1B are schematic diagrams of the three-dimensional position of the mandible before and after opening, where (a) shows the xy plane and (b) shows the zx plane. [Figure 21] FIG. 10 is a schematic diagram showing bite force distribution characteristics relative to the amount of lower jaw position movement. [Figure 22] 10A and 10B are schematic diagrams of modified bite plates, in which (a) shows the state before placing the impression material, (b) shows the state after placing the impression material, and (c) shows the state after taking a dental impression. [Figure 23] FIG. 10 is a schematic side view showing a modified example of the occlusion detection means. [Figure 24] FIG. 10 is a schematic plan view showing a modified example of the occlusion detection means. DETAILED DESCRIPTION OF THE INVENTION

[0010] The following describes in detail an embodiment of a dental X-ray imaging system according to the present invention with reference to the drawings. The sizes and positional relationships of components shown in the drawings may be exaggerated for clarity. Three embodiments and modifications corresponding to three functional blocks will be described below. The following description will be formally divided into sections 1-1 to 1-4, 2-1 to 2-6, 3-1 to 3-6, and 4-1 to 4-4.

[0011] (First embodiment) [Outline of dental X-ray imaging system] A dental X-ray imaging system according to a first embodiment will be described with reference to Figs. 1 to 3. Fig. 1 is a schematic diagram of the dental X-ray imaging system according to this embodiment, where (a) shows the periphery of a rotating arm and (b) shows a bite plate. Fig. 2 is a diagram showing an example of a head fixture used together with the bite plate. Fig. 3 is a block diagram showing the configuration of the dental X-ray imaging system according to this embodiment.

[0012] The dental X-ray imaging system 1 shown in FIG. 1(a) is configured as, for example, a CT device. The dental X-ray imaging system 1 includes a rotating arm 21. The rotating arm 21 is supported by a support column 13 and a slide body 14 so as to be rotatable around a vertical rotation center axis 23. The support column 13 stands vertically from a flat base (not shown). The support column 13 supports the slide body 14 so as to be movable up and down. The slide body 14 is integrally configured with a slide base 15, an upper slide body 16, and a lower slide body 17. The upper slide body 16 is attached to protrude horizontally forward from the upper end of the slide base 15. The lower slide body 17 is attached to protrude horizontally forward from the lower end of the slide base 15.

[0013] The upper slide body 16 rotatably supports the horizontal arm portion 22 of the rotating arm 21. Although not shown, the horizontal arm portion 22 incorporates a rotating arm drive unit that rotates the rotating arm 21 around a vertical rotation center axis 23. The dental X-ray imaging system 1 also includes a vertical drive unit (not shown) that drives the slide main body portion 14 up and down while supporting it on the support column 13.

[0014] On the rotating arm 21, an X-ray generator 25 and an X-ray detection unit 26 are arranged facing each other at a fixed distance, respectively, downward from both ends of the horizontal arm unit 22. The X-ray generator 25 emits, for example, cone beam X-rays. The X-ray detection unit 26 is made up of, for example, a CCD (Charge Coupled Device) sensor. The area between the X-ray generator 25 and the X-ray detection unit 26 is the X-ray imaging area for the patient's dentition, etc.

[0015] A chin rest 27 is disposed on the protruding end side of lower slide body 17. Chin rest 27 vertically supports head fixture 40. Bite plate 10 is attached horizontally to head fixture 40 via attachment piece 11 (see Figure 2).

[0016] The bite plate 10 is a fitting for positioning the patient's dentition, and positions the patient's dentition within the rotational range of the X-ray generator 25 and the X-ray detection unit 26. The bite plate 10 shown in FIG. 1(b) is formed with a dentition positioning unit 12. Note that the attachment piece unit 11 is not shown in FIG. 1(b). The bite plate 10 is provided with an occlusal force detection means 30. The occlusal force detection means 30 is capable of at least detecting the occlusal force of the patient.

[0017] The occlusal force detection means 30 includes, for example, a sheet portion 31, a pressure-sensing portion 32, and a connection portion 33. The sheet portion 31 is formed, for example, from a flexible sheet. The pressure-sensing portion 32 has a pair of electrodes arranged facing each other in the thickness direction of the sheet portion 31. The connection portion 33 is a wiring portion for connecting the electrodes of the pressure-sensing portion 32 to a control portion of the occlusal force detection means (not shown). The connection portion 33 is formed on the sheet portion 31 (flexible sheet). This occlusal force detection means 30 can properly detect occlusal pressure even when the upper and lower teeth are fitted three-dimensionally. As such occlusal force detection means 30, a known product, such as an oral function monitor manufactured by Sumitomo Riko, product name "Oramo-bf," can be used.

[0018] Head fixation device 40 fixes the patient's head within the X-ray imaging area. As shown in Figure 2, head fixation device 40 includes a lower support member 41, a pair of vertical support pieces 42, a front head contact member 43, and a head fixation belt 44.

[0019] The lower support 41 is mounted on the chin rest 27 so as to be horizontally movable. A pair of vertical support pieces 42 are erected vertically upward from both corners of the lower support 41. The forehead contact body 43 is a pad that contacts the patient's forehead and is attached to the pair of vertical support pieces 42 through which it is inserted so as to be vertically movable. The head fixing belt 44 is attached to the forehead contact body 43 so as to contact the sides and occipital parts of the patient's head. Between the lower support 41 and the forehead contact body 43, the bite plate 10 is attached horizontally to the pair of vertical support pieces 42 via the attachment piece 11. The bite plate 10 is attached so as to be vertically movable relative to the pair of vertical support pieces 42. The dental X-ray imaging system 1 is not limited to a CT device, but can also be configured as a panoramic X-ray imaging device.

[0020] As shown in FIG. 3, the dental X-ray imaging system 1 includes an occlusal force detection means 30, a control unit 120, a memory unit 140, a calculation unit 150, a medical information output means 160, a communication unit 170, a display unit 180, and an operation input / display unit 190.

[0021] The control unit 120 controls the operation of the rotary arm 21 and the irradiation of X-rays. The control unit 120 includes a rotating arm control unit 121 and an X-ray irradiation control unit 122. Predetermined control signals, such as those for starting or stopping operation, are input to the rotating arm control unit 121 from the operation input / display unit 190. The rotating arm control unit 121 outputs a drive control signal to a rotating arm drive unit (not shown), such as a motor, built into the horizontal arm unit 22, based on the input control signal. Predetermined control signals, such as those for starting or stopping operation, are input to the X-ray irradiation control unit 122 from the operation input / display unit 190. The X-ray irradiation control unit 122 outputs a drive control signal to the X-ray generator 25 based on the input control signal.

[0022] The control unit 120 acquires a detection signal (X-ray image information) detected by the X-ray detection unit 26 and outputs the detection signal to the calculation unit 150. The control unit 120 acquires a measurement signal (measurement value) of the occlusal force from the control means of the occlusal force detection means 30 and outputs the measurement signal to the calculation unit 150. The calculation unit 150 stores the measurement value of the occlusal force together with the X-ray image information in the memory unit 140.

[0023] The detected occlusal force information and the X-ray image information are linked and stored in the storage unit 140. The storage unit 140 includes a ROM (Read Only Memory), a RAM (Random Access Memory), an HDD (Hard Disk Drive), etc., and stores various programs.

[0024] The calculation unit 150 generates medical information suitable for a target patient by performing calculations using the X-ray image information and occlusal force information stored in the storage unit 140. The calculation unit 150 includes a CPU (Central Processing Unit) and the like. Note that a GPU (Graphics Processing Unit) and the like may be used as a processor in addition to the CPU.

[0025] The calculation unit 150 has an AI calculation unit 151. The AI ​​calculation unit 151 creates current medical information using a learning model created by performing machine learning using past medical information of the target patient and other patients. The learning model is a trained model that can be stored and shared in the cloud 210 via the network 200. The past medical information includes, for example, medical record data from when the patient visited a dentist, and progress and outcome information of diagnostic treatment, etc. Alternatively, the past medical information may include statistical information created by calculation using at least one of X-ray image information and occlusal force information stored in the memory unit 140. The current medical information is information output from the medical information output means 160.

[0026] The medical information output means 160 outputs the medical information onto the network 200. The medical information output means 160 is, for example, an output interface, and outputs the information output from the calculation unit 150 to the communication unit 170 or the display unit 180.

[0027] The communication unit 170 acquires the medical information from the medical information output means 160 and outputs the medical information to other devices, the cloud 210, etc. via the network 200. The network 200 may be a communication network within the dental clinic or an external communication network such as the Internet.

[0028] The display unit 180 is a display device installed in a treatment unit or server outside the X-ray room of a dental clinic. In this embodiment, the display unit 180 is, for example, a display device installed in a treatment unit for treating patients. The display unit 180 is configured, for example, with a liquid crystal display or the like. The display unit 180 displays an X-ray image of a patient positioned on the bite plate 10. The display unit 180 displays treatment information output from the treatment information output means 160. As shown in FIG. 3, the display unit 180 can be connected to a network 200 to display information related to dental treatment on the network. Note that the display unit 180 may display treatment information input directly from the treatment information output means 160 without going through the network 200. The display unit 180 may also display treatment information input from the treatment information output means 160 via the communication unit 170.

[0029] The operation input / display unit 190 is an input / display unit of a dental X-ray imaging device installed in an X-ray room of a dental clinic. The operation input / display unit 190 sets, for example, a desired value of occlusal force. The operation input unit includes, for example, a mouse and a keyboard. The display unit includes, for example, a liquid crystal display. This display unit may be a display unit attached to an operating device that allows the operator to control the dental X-ray imaging device. Alternatively, the operation input / display unit 190 may be configured as a touch panel.

[0030] [Dental X-ray system operation] Next, the operation of the dental X-ray imaging system 1 according to the first embodiment will be described with reference to FIG. 4 (and also with reference to FIGS. 1 to 3 as appropriate). First, the dental X-ray imaging system 1 is prepared for startup (step S10). Here, the operator guides the patient into the X-ray room and sets the rotating arm 21, X-ray generator 25, etc. to standby. The operator also sets the occlusal force (step S20). Here, the control means of the occlusal force detection means 30, etc. are set to standby, and a desired value of the occlusal force is set.

[0031] Next, a patient measurement information acquisition process is performed (Step S30). In the patient measurement information acquisition process, first, the patient is positioned on the bite plate 10, and the patient bites the occlusal force detection means 30, and the occlusal force is measured (Step S31). Then, the operator determines whether the measured value matches the set value (Step S32). If the measured value does not match the set value (Step S32: No), the process returns to Step S31, and the patient is asked to bite the occlusal force detection means 30 again, and the occlusal force is measured.

[0032] On the other hand, if the operator determines that the measured value matches the set value (step S32: Yes), X-rays are irradiated with the patient applying occlusal force (step S33). X-rays that pass through the patient's teeth are detected as X-ray image information by the X-ray detection unit 26, and the detection signal is output to the calculation unit 150. Furthermore, the storage unit 140 stores the X-ray image information together with the occlusal force (step S34).

[0033] Then, following the patient measurement information acquisition process (step S30), the calculation unit 150 creates medical information for the patient using the stored information (X-ray image information and occlusal force) stored in the storage unit 140 (step S40). Then, the medical information output means 160 outputs the medical information for the patient, for example, onto the network 200 (step S50). For example, the display unit 180 of a treatment unit outside the X-ray room can display the medical information via the network 200. By referring to the medical information, dentists and the like can select a prosthesis suitable for the occlusal force of the patient whose X-ray has been taken.

[0034] 1-1. 4 may be performed at least twice. In this case, the calculation unit 150 acquires a plurality of pieces of X-ray image information corresponding to at least two imaging sessions of the target patient and stores the acquired information in the storage unit 140. The calculation unit 150 calculates difference image data from the plurality of pieces of X-ray image information stored in the storage unit 140, and creates medical information using the difference image data.

[0035] For example, when there are two pieces of X-ray image information, the calculation unit 150 calculates image data consisting of the absolute values ​​of the differences between each pixel information (brightness value) of one piece of X-ray image information and each pixel information (brightness value) of the other piece of X-ray image information as differential image data. In this differential image data, the pixel values ​​of pixels whose pixel information (brightness values) of the two pieces of X-ray image information match are set to 0 (transparent), and an image consisting of the pixel values ​​of pixels that do not match is displayed.

[0036] 1-2. 4 is performed multiple times on the same day, the occlusal force setting value set in step S20 may be different. In this case, the calculation unit 150 obtains multiple pieces of X-ray image information with the occlusal force of the target patient set to different values ​​in at least two imaging sessions, and stores the information in the storage unit 140. The calculation unit 150 calculates differential image data from the multiple pieces of X-ray image information with different occlusal forces to create medical information.

[0037] FIG. 5 is a flowchart showing the flow of processing using images stored under different occlusal force conditions. As shown in FIG. 5, the operator sets a first occlusal force (step S20A) and performs patient measurement information acquisition process 1. At this time, the first occlusal force may be set to, for example, 100 [N], and the patient may be asked to gently bite down on the occlusal force detection means 30 in a relaxed state. Since patient measurement information acquisition process 1 is similar to the process of step S30 shown in FIG. 4, a description thereof will be omitted. The calculation unit 150 associates the X-ray image information obtained in patient measurement information acquisition process 1 with the first occlusal force and stores them in the storage unit 140.

[0038] Then, on the same day of treatment as the patient measurement information acquisition process 1, the operator sets a second occlusal force (step S20B) and performs the patient measurement information acquisition process 2. At this time, the second occlusal force may be set to, for example, 300 [N], and the patient may bite down hard on the occlusal force detection means 30. Note that the occlusal position in the occlusal force detection means 30 is set to be consistent between the occlusal position in the patient measurement information acquisition process 1 and the occlusal position in the patient measurement information acquisition process 2. The patient measurement information acquisition process 2 is similar to the process of step S30 shown in FIG. 4, and therefore its description will be omitted. Note that the calculation unit 150 associates the X-ray image information obtained in the patient measurement information acquisition process 2 with the second occlusal force and stores them in the storage unit 140.

[0039] Then, following patient measurement information acquisition process 2, the calculation unit 150 generates subtraction image data using the two X-ray image information stored in the storage unit 140 (step S40A). The subtraction image data itself may be used as the patient's medical information, or the results of analyzing the subtraction image data may be used as the medical information. Then, the medical information output means 160 outputs the subtraction image (medical information) of the patient, for example, onto the network 200. For example, the display unit 180 of the medical unit outside the X-ray room displays the subtraction image via the network 200 (step S50A).

[0040] 1-3. 4 is performed multiple times across several medical treatment days, the occlusal force setting value set in step S20 may be the same. In this case, the calculation unit 150 acquires multiple pieces of X-ray image information with the occlusal force of the target patient set to be the same in at least two imaging sessions, and stores the information in the storage unit 140. The calculation unit 150 calculates differential image data from the multiple pieces of X-ray image information with the same occlusal force, and creates medical treatment information.

[0041] FIG. 6 is a flowchart showing the process flow using stored images taken at different times with a constant occlusal force. As shown in FIG. 6, the operator sets the occlusal force (step S20) and refers to the imaging history (step S21). The operator then determines whether this is the first X-ray imaging for the patient (step S22). If this is the first X-ray imaging for the patient (step S22: Yes), the operator performs patient measurement information acquisition process 1. At this time, the occlusal force may be set to, for example, 300 [N], and the patient may bite down hard on the occlusal force detection means 30. The patient measurement information acquisition process 1 is similar to the process of step S30 shown in FIG. 4, and therefore its description is omitted. The calculation unit 150 associates the X-ray image information obtained in the patient measurement information acquisition process 1 with the occlusal force (for example, 300 [N]) and stores them in the storage unit 140. If this is the first X-ray imaging for the patient, once the patient measurement information acquisition process 1 is completed, no further X-ray imaging will be performed for this consultation day.

[0042] On the other hand, when X-ray imaging is performed on the patient on a later consultation day, since it is determined in step S22 that this is the second or subsequent X-ray imaging of the patient (step S22: No), the operator performs patient measurement information acquisition process 2. At this time, the occlusal force is set to the same value as the previous time (e.g., 300 [N]), and the patient is asked to bite down firmly on the occlusal force detection means 30. Note that the occlusal position in the occlusal force detection means 30 is ensured to be consistent between the occlusal position in patient measurement information acquisition process 1 and the occlusal position in patient measurement information acquisition process 2. Since patient measurement information acquisition process 2 is the same as the process of step S30 shown in FIG. 4, its description will be omitted. Note that the calculation unit 150 associates the X-ray image information obtained in patient measurement information acquisition process 2 with the occlusal force (e.g., 300 [N]) and stores them in the storage unit 140.

[0043] If this is the second or subsequent X-ray imaging of the patient, following patient measurement information acquisition process 2, the calculation unit 150 generates differential image data using the two pieces of X-ray image information stored in the storage unit 140 based on the history (step S40B). Then, the medical information output means 160 outputs the differential image (medical information) of the patient onto, for example, the network 200. For example, the display unit 180 of the medical unit outside the X-ray room displays the differential image via the network 200 (step S50B). In this modified example, a previously captured image and a currently captured image are output as a differential image, allowing the progress of treatment to be observed.

[0044] If the X-ray imaging is the third or subsequent time, the subtraction image data may be generated using the X-ray image information acquired this time and the X-ray image information acquired on the immediately preceding examination day, or the subtraction image data may be generated using the X-ray image information acquired this time and the X-ray image information acquired the first time.

[0045] 1-4. In a modified example of the dental X-ray imaging system 1, the control unit 120 is configured not to start the operation of the rotating arm 21 or the irradiation of X-rays if the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within a predetermined range. In other words, if the occlusal pressure due to proper occlusion cannot be obtained during X-ray imaging, X-ray imaging for that day of treatment may be suspended. Alternatively, the control unit 120 may include an alarm unit that, if the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within a predetermined range, notifies information about the abnormality by displaying a warning and / or sounding a warning to prompt the patient to reposition. If X-rays are applied when the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within a predetermined range, the resulting X-ray image will be unreliable and useless. Therefore, it is necessary to take another X-ray image when the pre-measurement value is within the predetermined range. In contrast, the above-described modified example has the effect of preventing exposure to radiation from being caused by retaking the image by interrupting the image taking or issuing a warning.

[0046] (Second embodiment) Next, a dental X-ray imaging system 1B according to the second embodiment will be described with reference to Fig. 7. Dental X-ray imaging system 1B differs from the first embodiment in a storage unit 140B and a calculation unit 150B. The schematic configuration diagram and processing flow of dental X-ray imaging system 1B are the same as those of the first embodiment, so the drawings and description will be omitted.

[0047] 2-1. As shown in Fig. 7, in this embodiment, the storage unit 140B includes a characteristic storage unit 141. In this embodiment, the medical information includes information on prosthetic materials that are compatible with the patient's oral cavity. The characteristic storage unit 141 stores distribution characteristics of hardness application ranges that are previously determined for the prosthetic materials. Details of the distribution characteristics of hardness application ranges will be described later.

[0048] In this embodiment, the calculation unit 150B creates medical information for the target patient, including information about the jawbone deflection. Alternatively, the calculation unit 150B creates medical information for the target patient, including information about the temporomandibular joint. As shown in FIG. 7, the calculation unit 150B has an AI calculation unit 151, a prosthetic material selection means 152, and a determination unit 153. The prosthetic material selection means 152 refers to the distribution characteristics of the hardness application range stored in the characteristic storage unit 141, and selects a prosthetic material that is suitable for the jawbone deflection (or information about the temporomandibular joint) and occlusal force information measured for the target patient. The determination unit 153 is not a required component and is used when a prior determination is required before selecting a prosthetic material. The AI ​​computing unit 151 creates current medical information using a learning model created by performing machine learning using past medical information of the target patient and other patients. In this embodiment, the current medical information includes at least one of information on jawbone deflection, information on prosthetic materials, and information on the temporomandibular joint, as information output from the medical information output means 160.

[0049] 2-2. Next, a specific example in which the medical information includes information about the bending of the jawbone will be described. The calculation unit 150B calculates difference image data in the axial plane from multiple X-ray image information about the target patient stored in the storage unit 140B. The calculation unit 150B estimates the location and amount of bending of the jawbone from the position and area where the difference image is displayed. The calculation unit 150B creates medical information including the location and amount of bending of the jawbone as information about the bending of the jawbone.

[0050] The amount of deflection will now be described with reference to Figures 8(a) to 8(c). The dashed line in Figure 8(a) is a schematic diagram showing the lingual line of the dentition in the mandibular axial section before treatment. Before treatment, the patient is unable to bite hard on the occlusal force detection means 30 and bites the occlusal force detection means 30 gently. The solid line in Figure 8(b) is a schematic diagram showing the lingual line of the dentition in the mandibular axial section after treatment. After treatment, the patient is able to bite hard on the occlusal force detection means 30. Figure 8(c) is a diagram in which Figures 8(a) and 8(b) are superimposed.

[0051] The calculation unit 150B quantitatively grasps the anterior-posterior uniformity, lateral uniformity, and bending of the jawbone as images, areas, and positions based on the positional relationship and magnitude of the bending amounts A and A' of the molars and the bending amounts B and B' of the front teeth. For example, in FIG. 8(c), if the sum of the bending amount A of the left molar and the bending amount A' of the right molar is greater than the sum of the bending amount B of the left front tooth and the bending amount B' of the right front tooth (A+A'>B+B'), the calculation unit 150B can create medical information indicating that the bending on the back tooth side is greater. Also, for example, if the sum of the bending amount A of the left molar and the bending amount B of the left front tooth is greater than the sum of the bending amount A' of the right molar and the bending amount B' of the right front tooth (A+B>A'+B'), the calculation unit 150B can create medical information indicating that the bending on the left side is greater. The calculation unit 150B calculates the deflection area D defined by, for example, the following formula (1). D=A+A'+B+B' … (1)

[0052] 2-3. Fig. 9 is a diagram showing major prosthetic materials and their hardness. Here, α, β, γ, and δ shown in Fig. 9 respectively represent the regions α, β, γ, and δ shown in Fig. 10 as a first example. The characteristic storage unit 141 shown in Fig. 7 stores, for example, the information shown in Fig. 9.

[0053] Figure 10 is a schematic diagram showing the occlusal force distribution characteristics relative to the deflection area. The horizontal axis of the graph in Figure 10 represents occlusal force. The unit of occlusal force is N. The vertical axis of the graph represents the deflection area. The smaller the deflection area of ​​the jawbone in the difference image, the better, and the larger it is, the worse, so the origin of the vertical axis is set to "small." The unit of the deflection area is [mm 2 In this case, the minimum value of the vertical axis is 0 [mm 2 ], and the maximum value of the vertical axis is, for example, 100 [mm 2 Alternatively, the unit of the deflection area may be the number of pixels of the image.

[0054] The characteristic storage unit 141 shown in FIG. 7 stores, for example, the distribution characteristics of the hardness application range shown in FIG. 10. The distribution characteristics of the hardness application range shown in FIG. 10 are calculated in advance according to the type of prosthetic material for the first and second indices, with the bite force measurement value as the first index and the deflection area of ​​the jawbone in the subtraction image of the X-ray image as the second index. For example, of the measurement areas 301 and 302 when biting hard, measurement area 302 is located in the δ region and has a relatively large deflection area D. If a hard prosthetic material is used for a patient whose measurement area is in the δ region, it will have a significant impact on the jawbone. A material that is too hard can lead to oral cavity collapse. On the other hand, measurement area 301 is located in the α region and has a relatively small deflection area D. If a hard prosthetic material is used for a patient whose measurement area is in the α region, it will have a small impact on the jawbone. For example, hard zirconia can be used for a patient whose measurement area is in the α region when biting hard. For patients whose measurement range when biting down hard is in the δ region, it is desirable to use a hard resin with low hardness. Note that a material that can be processed with a 3D printer may also be selected as the prosthetic material.

[0055] The prosthetic material selection means 152 refers to the distribution characteristics shown in Fig. 10 and selects a prosthetic material that is suited to the information on the jawbone deflection area and the bite force information measured for the target patient. For example, the prosthetic material selection means 152 refers to the distribution characteristics shown in Fig. 10 and to Fig. 9, and thereby creates clinical information indicating that all of the prosthetic materials in Fig. 9 are suited to patients whose measurement range is in the α region. For example, the prosthetic material selection means 152 refers to the distribution characteristics shown in Fig. 10 and to Fig. 9, and thereby creates clinical information indicating that only hard resin is suited to patients whose measurement range is in the δ region. Therefore, the prosthetic material selection means 152 can select a prosthetic material that is suited to the patient's oral cavity.

[0056] The medical information output means 160 outputs the medical information of the patient, including information on the prosthetic material selected by the prosthetic material selection means 152 and information on the deflection area (information on the deflection of the jawbone). When the distribution characteristics of the hardness application range shown in Fig. 10 are used, prior determination by the determination unit 153 is not required.

[0057] The graph in Figure 10 is a schematic diagram, and the division into four regions by three straight lines passing through the origin is merely an example; the number of divisions and the slope of the lines can be any. The graph can be created from subject data acquired in advance. The distribution characteristics of the hardness application range can be created in various patterns, and may be created using AI.

[0058] 2-4. Next, an example of medical information when a patient's X-ray image is a case image of osteoporosis will be described with reference to Figs. 11 and 12. Fig. 11 is a diagram showing an example of an image captured by dental X-ray imaging system 1B. In Fig. 11, a part of the cortical bone at the lower edge of the mandible is set as an extracted region 311 as an example. Note that α, β, γ, and δ shown in Fig. 9 respectively represent regions α, β, γ, and δ shown in Fig. 12 as a second example.

[0059] FIG. 12 is a schematic diagram showing bite force distribution characteristics relative to gray value. The horizontal axis of the graph in FIG. 12 represents bite force. The vertical axis of the graph represents gray value of an X-ray image. When bone density is low due to osteoporosis, X-rays are more likely to penetrate, and the X-ray image of the bone appears darker (darker). When bone density is normal and high, X-rays are more likely to be absorbed, and the X-ray image of the bone appears whiter (lighter). The gray value of the extracted portion 311 is better as it becomes lighter (whiter), and worse as it becomes darker (blacker), so the origin of the vertical axis is set to "light." The gray value is dimensionless, and when expressed in 8 bits, the minimum gray value (pure black) may be 0 and the maximum gray value (pure white) may be 255.

[0060] The characteristic storage unit 141 shown in Fig. 7 stores, for example, the distribution characteristic of the hardness application range shown in Fig. 12. The distribution characteristic of the hardness application range shown in Fig. 12 is determined in advance according to the type of prosthetic material for the first index and the second index, with the bite force measurement value as the first index and the shading value of a predetermined extracted portion 311 of the patient's X-ray image as the second index.

[0061] If a hard prosthetic material is used for a patient whose measurement range is in the δ region, the impact of osteoporosis on the jawbone will be large. If a hard prosthetic material is used for a patient whose measurement range is in the α region, the impact of osteoporosis on the jawbone will be small. Therefore, as with the deflection area, when the shading value is dark, it is desirable to select a prosthetic material with cushioning power that has little impact on the jawbone (see Figure 9).

[0062] It has been reported that the cortical bone of the lower border of the mandible reflects the bone density of the lumbar vertebrae and femur. The extraction site 311 is preferably the cortical bone of the lower border of the mandible. Since the dental X-ray imaging system 1B of this embodiment is configured as, for example, a CT device, CT values ​​may be used instead of gray values. When using CT values, it is preferable to use an X-ray generator that emits fan-beam X-rays. Furthermore, by simultaneously capturing a part that serves as a reference for the grayscale values ​​somewhere on the shooting screen, the grayscale values ​​can be calibrated, improving the accuracy of the measured grayscale values. For example, if the grayscale value of the reference part is calibrated to 100, the grayscale value of a location on the screen with the same brightness as the reference part will also be 100. In this case, it can be seen that the X-ray transmittance at a location on the screen with the same brightness as the reference part is the same as the X-ray transmittance of the reference part. The part that serves as the reference for the grayscale values ​​can be set anywhere on the shooting screen.

[0063] When using the distribution characteristics of the hardness application range shown in Fig. 12, a prior determination by the determination unit 153 is required. If the grayscale value of the extracted portion 311 of the patient's X-ray image is darker than a predetermined threshold, the determination unit 153 determines that the image is a case image of osteoporosis. If it is determined that the image is a case image of osteoporosis, the prosthetic material selection means 152 refers to the distribution characteristics shown in Fig. 12 and selects a prosthetic material that matches the grayscale value and occlusal force information of the extracted portion 311 of the X-ray image taken of the patient. The medical information output means 160 outputs the medical information of the patient, including information on the selected prosthetic material and the grayscale value of the extracted portion 311 (information on jawbone deflection).

[0064] 2-5. Next, another example of medical information when the patient's X-ray image is a case image of osteoporosis will be described with reference to Figs. 13 and 14. Fig. 13 is a diagram showing an example of an image captured by dental X-ray imaging system 1B. Note that α, β, γ, and δ shown in Fig. 9 respectively represent regions α, β, γ, and δ shown in Fig. 14 as a third example.

[0065] FIG. 14 is a schematic diagram showing bite force distribution characteristics relative to mandibular lower border cortical bone thickness. The horizontal axis of the graph in FIG. 14 represents bite force. The vertical axis of the graph represents mandibular lower border cortical bone thickness. Since the larger the value of mandibular lower border cortical bone thickness, the better, and the smaller the value, the worse, the origin of the vertical axis is set to "large." The unit of mandibular lower border cortical bone thickness may be [mm] or the like. In this case, "small" on the vertical axis may be 0 [mm], and "large (origin)" on the vertical axis may be 6 [mm], for example. The unit of mandibular lower border cortical bone thickness may also be the number of pixels in the image.

[0066] The characteristic storage unit 141 shown in Fig. 7 stores, for example, the distribution characteristic of the hardness application range shown in Fig. 14. The distribution characteristic of the hardness application range shown in Fig. 14 is determined in advance according to the types of prosthetic materials for the first and second indexes, with the bite force measurement value as the first index and the thickness t0 of the cortical bone at the lower edge of the mandible at a predetermined extracted site in the patient's X-ray image as the second index.

[0067] If a hard prosthetic material is used for a patient whose measurement range is in the δ region, the impact of osteoporosis on the jawbone will be large. If a hard prosthetic material is used for a patient whose measurement range is in the α region, the impact of osteoporosis on the jawbone will be small. Therefore, if the thickness t0 of the mandibular lower border cortical bone is small, it is desirable to select a prosthetic material with cushioning properties that has little impact on the jawbone (see Figure 9).

[0068] When using the distribution characteristics of the hardness application range shown in Fig. 14, a prior determination by the determination unit 153 is required. When the thickness t0 of the cortical bone at the lower edge of the mandible in the X-ray image of a patient is smaller than a predetermined threshold, the determination unit 153 determines that the image is a case of osteoporosis. Conventionally, it is known as a screening method for osteoporosis that when the cortical bone at the lower edge of the mandible becomes thin and is about 3 mm or less, osteoporosis is present (see the references below). Reference: "Japanese Society of Dental Radiology, Osteoporosis Screening Materials, June 2021" Therefore, the threshold value of the thickness t0 of the cortical bone at the lower edge of the mandible is preferably 3 mm.

[0069] If the image is determined to be a case image of osteoporosis, the prosthetic material selection means 152 selects a prosthetic material that matches the thickness t0 of the cortical bone at the lower edge of the mandible and the information on occlusal force in the X-ray image taken of the patient, with reference to the distribution characteristics shown in Fig. 14. The medical information output means 160 outputs the medical information of the patient, including information on the selected prosthetic material and the thickness of the cortical bone at the lower edge of the mandible (information on the bending of the jawbone).

[0070] 2-6. Next, a specific example of the case where the medical information includes information related to the temporomandibular joint will be described with reference to Figures 15(a), 15(b) and 16. Note that here, α, β, γ and δ shown in Figure 9 respectively represent the regions α, β, γ and δ shown in Figure 16 as a fourth example.

[0071] Figures 15(a) and 15(b) are schematic diagrams showing the position of the articular disc 323 when closing the mouth. In Figures 15(a) and 15(b), the person is facing left. As shown in Figure 15(a), under normal circumstances, when closing the mouth, the articular disc 323 is in the appropriate position between the temporal bone 321 and the mandible 322. The tip of the mandible 322 opens and closes the mouth while resting on the articular disc 323.

[0072] 15(b), in an abnormal case (in the case of temporomandibular joint disorder), when closing the mouth, the tip of the mandible 322 comes off the articular disc 323. When the tip of the mandible 322 comes off the articular disc 323, it becomes difficult to open the mouth until the tip of the mandible 322 rests on the articular disc 323, and a clicking sound occurs when the tip of the mandible 322 rests on the articular disc 323.

[0073] Figure 16 is a schematic diagram showing bite force distribution characteristics versus the probability of matching of articular disc positions. The horizontal axis of the graph in Figure 16 represents bite force, and the vertical axis of the graph represents the probability of matching of articular disc positions. Since 100% is good and 0% is poor, the origin of the vertical axis is set to 100%.

[0074] The characteristic storage unit 141 shown in FIG. 7 stores, for example, the distribution characteristic of the hardness application range shown in FIG. 16. The distribution characteristic of the hardness application range shown in FIG. 16 is calculated in advance based on the type of prosthetic material for the first and second indices, with the bite force measurement value as the first index and the matching probability of the articular disc position as the second index. The matching probability of the articular disc position is calculated by pattern recognition of an X-ray image, so that the probability is 100% when the articular disc is in the correct position and the probability decreases when the articular disc is not in the correct position. In this embodiment, the normal positional relationship between the tip of the mandible 322 and the articular disc 232 and the abnormal positional relationship between the tip of the mandible 322 and the articular disc 323 are pattern-recognized as image shapes, and the matching probability of the features is calculated in advance.

[0075] When using the position coordinates of the tip of the mandible 322 and the articular disc 232 instead of pattern recognition, it is possible to determine that the relative positional relationship between them is normal if it is within an appropriate range using relative coordinates, and abnormal if it is outside the appropriate range. Also, a learning model may be created by performing machine learning to understand the characteristics of normal and abnormal ranges, and the AI ​​may be allowed to distinguish between normal and abnormal ranges.

[0076] If a hard prosthetic material is used on a patient whose measurement range is in the δ region, it will have a large effect on the temporomandibular joint. If a hard prosthetic material is used on a patient whose measurement range is in the α region, it will have a small effect on the temporomandibular joint. Therefore, if the articular disc is not in the correct position, it is desirable to select a prosthetic material with cushioning properties that will have little effect on the temporomandibular joint (see Figure 9).

[0077] When the distribution characteristics of the hardness application range shown in FIG. 16 are used, prior determination by the determination unit 153 is not required. The prosthetic material selection means 152 calculates the match probability of the articular disc position by pattern recognition of the X-ray image of the target patient. The prosthetic material selection means 152 refers to the distribution characteristics shown in FIG. 16 and selects a prosthetic material that matches the match probability calculated for the patient and the occlusal force information. The medical information output means 160 outputs the medical information of the patient, including information on the selected prosthetic material and the match probability (information on the temporomandibular joint). This makes it possible to observe the effect of occlusal force on the temporomandibular joint during the treatment process, etc.

[0078] (Third embodiment) Next, a dental X-ray imaging system 1C according to a third embodiment will be described with reference to FIGS. 17 to 20. In the dental X-ray imaging system 1C of FIG. 17, the same components as those in the dental X-ray imaging system 1 of FIG. 1 are designated by the same reference numerals, and their descriptions will be omitted. The dental X-ray imaging system 1C differs from the first embodiment in that it further includes a lower jaw three-dimensional position data input means 50. FIG. 18 is a schematic diagram showing an example of a lower jaw three-dimensional position data input means. In the dental X-ray imaging system 1C of FIG. 19, the same components as those in the dental X-ray imaging system 1B of FIG. 7 are designated by the same reference numerals, and their descriptions will be omitted.

[0079] 3-1. The lower jaw three-dimensional position data input means 50 is a means capable of acquiring the three-dimensional position data of the lower jaw in a state where the patient's upper jaw is placed on the bite plate 10. The three-dimensional position data of the lower jaw is output to the calculation unit 150C via the control unit 120. In this embodiment, the calculation unit 150C stores the three-dimensional position data of the lower jaw in the memory unit 140C. The memory unit 140C stores the detected occlusal force information and the three-dimensional position data of the lower jaw in association with each other. In this embodiment, the calculation unit 150C creates medical information for the target patient that includes at least one of the lower jaw position information and the bite registration information.

[0080] Here, the occlusion registration information included in the medical information is information on the occlusion position of each tooth obtained by determining the position where the upper and lower teeth are aligned. In other words, the occlusion registration information is information on the occlusion position obtained by adjusting the occlusal surfaces of each tooth so that the centric occlusion and the centric position are equal. Here, the centric occlusion position indicates the occlusion position when biting firmly. Furthermore, the centric position indicates the occlusion position when biting relaxed.

[0081] When creating medical information including occlusion registration information, it is preferable that the occlusal force detection means 30 be capable of detecting the load ratio for each tooth. By using such a modified occlusal force detection means 30, the dental X-ray imaging system 1C can display the occlusal balance of the jawbone and temporomandibular joint relative to the load ratio for each tooth. Furthermore, when the occlusal force detection means 30 is capable of detecting the load ratio for each tooth, the detected information can be used to obtain a stable state in which the upper and lower dentitions are in contact at the most locations. The occlusal registration information is used to adjust the prosthesis by changing or grinding it to achieve such a stable state. The occlusal force detection means 30 capable of detecting the load ratio for each tooth can be a known product, such as an occlusal contact inspection device manufactured by Nitta Corporation, product name "T-Scan III" (registered trademark).

[0082] 3-2. In the following, the calculation unit 150C will be described as creating medical information including mandibular position information, as an example. The mandibular three-dimensional position data input means 50 is equipped with a chip 51 that can be attached directly or indirectly to the mandibular teeth. The chip 51 can detect the three-dimensional position of the mandible optically, electromagnetically, by acceleration, or ultrasonically.

[0083] As an example, the lower jaw three-dimensional position data input means 50 shown in Fig. 18 is fabricated by incorporating a chip 51 into a lower jaw mouthpiece created using a 3D scanner and a 3D printer. For example, when detecting the three-dimensional position of the lower jaw electromagnetically, a magnet is provided in the chip 51. Also, as shown by the dashed lines in Fig. 17, the X-ray generator 25 and the X-ray detection unit 26 are provided with a camera and a coil for detecting magnetic force, and the three-dimensional position of the lower jaw is detected by the camera and the coil.

[0084] When detecting the three-dimensional position of the lower jaw in terms of acceleration, an acceleration sensor is provided on chip 51. The acceleration sensor measures acceleration in three axes: left and right, front and back, and up and down. The calculation unit 150C performs a calculation to integrate the measurement value (acceleration) twice, thereby detecting the three-dimensional position of the lower jaw. The lower jaw three-dimensional position data input means 50 shown in FIG. 18 may detect the three-dimensional position of the lower jaw in terms of acceleration, or may detect the three-dimensional position of the lower jaw electromagnetically.

[0085] When optically detecting the three-dimensional position of the lower jaw, a two-dimensional barcode is provided on the chip 51. A barcode reader is also provided on the frame or bracket (indirect articulator), and the barcode reader detects the three-dimensional position of the lower jaw. As the optical three-dimensional lower jaw position data input means 50, a known product, such as the "Freecoder" manufactured by Orange Dental, can be used.

[0086] When ultrasonically detecting the three-dimensional position of the lower jaw, a bracket (indirect articulator) can be used in which multiple chips 51, each equipped with an ultrasonic microphone, are fixed to the patient's upper jaw, and multiple chips 51, each equipped with an ultrasonic transmitter, are fixed to the patient's lower jaw. The ultrasonic three-dimensional lower jaw position data input means 50 can be a known product, such as the product name "Arcus Digma II" manufactured by Cabo Planmeca Japan Co., Ltd.

[0087] 3-3. In the dental X-ray imaging system 1C, an X-ray imaging operation (patient measurement information acquisition process: step S30) including bite force measurement and X-ray irradiation is performed at least twice, and the three-dimensional position of the mandible is detected during each X-ray imaging operation. The two required X-ray imaging operations are performed before and after opening the mouth of the target patient. At the timing before opening in the mouth opening sequence, bite force, three-dimensional position of the mandible, and an X-ray imaging image are each obtained. In addition, at the timing after opening in the mouth opening sequence, bite force, three-dimensional position of the mandible, and an X-ray imaging image are each obtained.

[0088] In this embodiment, the memory unit 140C stores information including the bite force, the three-dimensional position of the lower jaw, and the X-ray image before opening the mouth, and the bite force, the three-dimensional position of the lower jaw, and the X-ray image after opening the mouth. Furthermore, the calculation unit 150C calculates the difference information of the bite force, the three-dimensional position of the lower jaw, and the difference information of the X-ray image obtained before and after opening the mouth from the information stored in the memory unit 140C, and creates medical information including the difference information.

[0089] Here, the three-dimensional position of the lower jaw before and after opening the mouth will be described with reference to Figures 20(a) and 20(b). In Figures 20(a) and 20(b), the dashed lines indicate the three-dimensional position of the lower jaw before opening the mouth. The solid lines indicate the three-dimensional position of the lower jaw after opening the mouth. Here, the three-dimensional position coordinates of the lower jaw before opening the mouth are set to (0,0,0). After opening the mouth, the lower jaw shifts by x in the positive direction of the x-axis, by y in the positive direction of the y-axis, and by z in the negative direction of the z-axis. In other words, the amount of movement of the lower jaw position in the x-direction is x, the amount of movement of the lower jaw position in the y-direction is y, and the amount of movement of the lower jaw position in the z-direction is "-z". Hereinafter, as an example, the amount of movement of the lower jaw position is represented by the root mean square of the deviation in each axial direction (vector magnitude).

[0090] 3-4. The three-dimensional mandibular position data input means 50 can acquire three-dimensional position information of the mandibular during mouth opening, which is the period from before mouth opening to after mouth opening in a series of mouth opening movements. The three-dimensional mandibular position data input means 50 has output information capable of displaying the trajectory of the mandibular during mouth opening based on the acquired three-dimensional position information of the mandibular during mouth opening. Alternatively, the three-dimensional mandibular position data input means 50 has output information capable of analyzing mandibular movement based on the acquired three-dimensional position information of the mandibular during mouth opening. Alternatively, the three-dimensional mandibular position data input means 50 has both output information capable of displaying the trajectory of the mandibular during mouth opening and output information capable of analyzing mandibular movement. Examples of such three-dimensional mandibular position data input means 50 include known products, such as the "Freecorder" manufactured by Orange Dental and the "Arcus Digma II" manufactured by Cabo Planmeca Japan Co., Ltd.

[0091] 3-5. The dental X-ray imaging system 1C transmits and receives data to and from at least one of the facial 3D scanner 220, the intraoral 3D scanner 230, the intraoral observation camera 240, the CAD / CAM device 250, the CT device 260, and the swallowing movement analysis device 270, which are on the network 200. Note that any of the facial 3D scanner 220, the intraoral 3D scanner 230, the intraoral observation camera 240, the CAD / CAM device 250, the CT device 260, and the swallowing movement analysis device 270 can be a conventionally known device, existing product, or web service.

[0092] 3-6. Next, a specific example of selecting a prosthetic material based on the amount of mandibular position movement in this embodiment will be described with reference to Fig. 21. Note that here, α, β, γ, and δ shown in Fig. 9 respectively represent the regions α, β, γ, and δ shown in Fig. 21 as a fifth example.

[0093] FIG. 21 is a schematic diagram showing bite force distribution characteristics relative to the amount of mandibular position movement. The horizontal axis of the graph in FIG. 21 represents bite force. The vertical axis of the graph represents the amount of mandibular position movement. Since the smaller the amount of mandibular position movement, the better, and the larger the amount of mandibular position movement, the worse, the origin of the vertical axis is set to "small." In this case, the "origin (small)" of the vertical axis may be 0 [mm], and the "maximum value (large)" of the vertical axis may be, for example, 6 [mm]. The unit of the amount of mandibular position movement may also be the number of pixels of the image.

[0094] The characteristic storage unit 141 shown in Fig. 19 stores, for example, the distribution characteristic of the hardness application range shown in Fig. 20. The distribution characteristic of the hardness application range shown in Fig. 21 is determined in advance according to the types of prosthetic materials for the first and second indexes, with the bite force measurement value as the first index and the amount of mandibular position movement measured by the mandibular three-dimensional position data input means 50 as the second index.

[0095] For example, when biting down hard, the measurement area 341 is located in the δ region, and the amount of movement of the mandibular position is relatively large. Patients with large amounts of mandibular position movement tend to have a high incidence of bruxism (teeth grinding) due to bite force, for example. If a hard prosthetic material is used for a patient with a measurement area in the δ region, the impact on the opposing teeth is large. If a hard prosthetic material is used for a patient with a measurement area in the α region, the impact on the opposing teeth is small. Therefore, when the amount of mandibular position movement is large, it is desirable to select a soft prosthetic material (see Figure 9) taking into account the impact on the opposing teeth.

[0096] When using the distribution characteristics of the hardness application range shown in Fig. 21, there is no need for prior determination by the determination unit 153. The prosthetic material selection means 152 selects a prosthetic material that matches the information on the mandibular position movement amount measured for the target patient, with reference to the distribution characteristics shown in Fig. 21. The medical information output means 160 outputs the medical information of the patient, including information on the selected prosthetic material and the mandibular position movement amount (mandibular position information).

[0097] The calculation unit 150C shown in FIG. 19 includes an AI calculation unit 151. The AI ​​calculation unit 151 generates current medical information using a learning model created by performing machine learning using past medical information of the target patient and other patients. In this embodiment, the past medical information can include statistical information created by calculation using at least one of X-ray image information, bite force information, and three-dimensional position information of the mandible stored in the storage unit 140C. In this embodiment, the current medical information includes at least one of information output from the medical information output means 160, such as information on prosthetic materials, mandibular position information, bite registration information, mandibular trajectory information, and mandibular movement analysis information. If the mandibular three-dimensional position data input means 50 has output information capable of displaying the mandibular trajectory, the medical information output means 160 can output information on the mandibular trajectory. Also, if the mandibular three-dimensional position data input means 50 has output information capable of analyzing mandibular movement, the medical information output means 160 can output information on the analysis of mandibular movement.

[0098] The dental X-ray imaging system 1C of this embodiment can measure the position of the mandible (height and position on the interdigital plane) before and after opening the mouth and before and after prosthetic treatment, as well as the occlusal force during interdigital engagement. Furthermore, the dental X-ray imaging system 1C can confirm the position of the mandible based on differences in occlusal force. Furthermore, it can measure and predict wear due to bruxism (teeth grinding).

[0099] Furthermore, if the occlusal force detection means 30 in the dental X-ray imaging system 1C is capable of detecting the load ratio for each tooth, it is possible to obtain occlusion registration information (occlusion information) for prosthetic treatment. This makes it possible to remove premature contact areas that occur before the entire upper and lower dentitions come into contact properly during occlusion. This also makes it possible to adjust the shape of the prosthetic appliance to alleviate pain and discomfort and enable appropriate chewing movements.

[0100] Although the dental X-ray imaging system according to each embodiment of the present invention has been described above, the scope of the present invention is not limited to these descriptions and should be broadly interpreted based on the claims. Furthermore, it goes without saying that various changes and modifications based on these descriptions are also included in the scope of the present invention.

[0101] 4-1. For example, the occlusal force detection means 30 is not limited to the configuration shown in FIG. 1(b), and an impression material may be laminated on a sheet portion 31 shown in FIG. 22(a). The occlusal force detection means 30B shown in FIG. 22(b) has impression materials 34 arranged on both sides of the sheet portion (flexible sheet) 31 so as to cover the surface of the sheet portion (flexible sheet) 31. Examples of the impression material 34 that can be used include alginate impression materials, silicone rubber impression materials, and polyether rubber impression materials. The patient bites down on the occlusal force detection means 30B shown in FIG. 22(b), and the impression material 34 is removed from the oral cavity after it hardens. As shown in FIG. 22(c), the occlusal force detection means 30C with the hardened impression material 34 has a tooth-shaped portion 35 that reflects the shape of the patient's dentition. Since the occlusal force detection means 30C can be positioned to match the patient's dentition, it is possible to improve reproducibility by preventing deviation between the occlusal position during patient measurement information acquisition process 1 and the occlusal position during patient measurement information acquisition process 2.

[0102] 4-2. Furthermore, occlusal force detection means 30 may be fixed to slide main body 14, or may be detachable from slide main body 14. Bite plate 10D shown in Figures 23 and 24 is detachably attached to slide main body 14, on which chin rest 27 is formed, via attachment piece 11D and head fixture 40. In this way, occlusal force detection means 30D can be removed from the main body of the dental X-ray imaging system and used as a standalone unit.

[0103] In addition, in the occlusal force detection means 30, the flexible sheet (sheet portion 31, connection portion 33) may be fixed to the control unit, or may be detachable from the control unit. The flexible sheet (sheet portion 31D, connection portion 33D) of the occlusal force detection means 30D shown in Figures 23 and 24 is detachably attached to the control unit 37 of the occlusal force detection means 30D. In this way, the sheet portion 31D of the occlusal force detection means 30D can be replaced for each patient, which is hygienic. The two-dot chain line in Figure 23 indicates that the bite plate 10D is attached so that it can move up and down.

[0104] 4-3. The AI ​​calculation unit 151 of the calculation unit 150B may select a prosthetic material or create a distribution characteristic of the hardness application range using the distribution characteristic of the hardness application range (FIGS. 10, 12, 14, and 16) stored in the characteristic storage unit 141. Similarly, the AI ​​calculation unit 151 of the calculation unit 150C may select a prosthetic material or create a distribution characteristic of the hardness application range using the distribution characteristic of the hardness application range (FIG. 21) stored in the characteristic storage unit 141. The AI ​​calculation unit 151 of the calculation unit 150C may determine the shape of the prosthetic appliance taking into account the optimal occlusion using mandibular position information or bite registration information.

[0105] The prosthetic material selection means 152 of the calculation units 150B and 150C can also be realized by the AI ​​calculation unit 151 selecting a prosthetic material suited to the patient's oral cavity using the distribution characteristics of the hardness application range. The AI ​​learning model for selecting prosthetic materials can create statistically learned distribution characteristics of various hardness application ranges by allocating prosthetic materials empirically selected by multiple dentists to various distributions (Figures 10, 12, 14, 16, and 21). Furthermore, in the dental X-ray imaging systems 1B and 1C, clinical information regarding the prosthetic material selected by the prosthetic material selection means 152 may be fed back. Specifically, first, the clinical information output means 160 outputs the patient's clinical information, including information on the prosthetic material selected by the prosthetic material selection means 152 with reference to the distribution characteristics of various hardness application ranges. Next, the dentist treats the patient using the prosthetic material selected by the prosthetic material selection means 152. Then, the dentist obtains clinical information, such as information on the suitability or unsuitability of the prosthetic material and progress information, as the treatment results. Then, for example, the dentist inputs the clinical information of multiple patients thus obtained into the AI ​​calculation unit 151. Then, the AI ​​calculation unit 151 performs machine learning to correct the threshold value of the distribution characteristics of the hardness application range and improve the accuracy of the distribution characteristics of the hardness application range. Furthermore, the AI ​​calculation unit 151 may create clinical information using the updated learning model.

[0106] 4-4. For example, the dental X-ray imaging system 1 can refer to the medical record data of the dental clinic where it is installed. If a target patient is receiving ongoing treatment at this dental clinic and past medical record data for the patient exists, the AI ​​calculation unit 151 may compare the past medical record data of the target patient with the status of prostheses such as opposing teeth, taking into account bite force and occlusion data, and suggest a suitable prosthesis based on statistical patterns. On the other hand, when selecting a prosthesis for a patient with no past treatment history, a dentist may first determine the condition of the patient's teeth by visual inspection or touch and manually input necessary data such as the status of the prostheses for opposing teeth into the dental X-ray imaging system 1. The AI ​​calculation unit 151 of the dental X-ray imaging system 1 may suggest a prosthesis that fits the patient's oral cavity by taking into account the bite force and occlusion data in addition to the manually input data. [Explanation of symbols]

[0107] 1,1B,1C Dental X-ray System 13 Posts 14 Slide body 21 Rotating arm 23 Rotation axis 25 X-ray generator 26 X-ray detection unit 10,10D Bite Plate 11,11D Mounting piece 12 Tooth positioning part 30, 30B, 30C, 30D Bite force detection means 31,30D seat section 32 Pressure-sensing part 33,33D Connection 37 Control unit of bite force detection means 50 Mandibular three-dimensional position data input means 51 chips 120 control section 140,140B,140C Storage section 141 Characteristics memory unit 150,150B,150C calculation section 151 AI calculation section 152 Prosthetic Material Selection Method 153 Judgment section 160 Medical information output means 170 Communications Department 180 Display section 190 Operation input and display unit 200 Network 210 Cloud 220 Facial 3D Scanner 230 Intraoral 3D Scanner 240 Intraoral Observation Camera 250 CADCAM equipment 260 CT device 270 Swallowing motion analysis device

Claims

1. a rotating arm that has an X-ray generator and an X-ray detection unit disposed opposite each other with a fixed distance between them, and that is supported by a support column and a slide main body unit so as to be rotatable around a vertical rotation center axis; a control unit that controls the operation of the rotary arm and the irradiation of X-rays; a bite plate for positioning the patient's dentition within a rotational area of ​​the X-ray generator and the X-ray detector; a bite force detection means that is installed on the bite plate and is capable of detecting at least the bite force of the patient; a storage unit that stores the detected occlusal force information and the X-ray image information in association with each other; a calculation unit that generates medical information suitable for a patient by performing calculations using the X-ray image information and occlusal force information stored in the storage unit for the patient; a medical information output means for outputting the medical information onto a network; A dental X-ray imaging system comprising:

2. The calculation unit has an AI calculation unit, and the AI ​​calculation unit generates current medical information using a learning model created by performing machine learning using past medical information of the target patient and other patients.

10. The dental x-ray imaging system according to claim 1.

3. The control unit issues a warning or does not start the operation of the rotary arm and the irradiation of X-rays when the bite force measured by the bite force detection means before the X-ray irradiation is not within a predetermined range.

10. The dental x-ray imaging system according to claim 1.

4. The calculation unit calculates difference image data from a plurality of pieces of X-ray image information obtained by at least two imaging sessions for the target patient and stored in the storage unit, and creates the medical information using the difference image data. Characterized by 4. The dental X-ray imaging system according to claim 1.

5. The calculation unit calculates difference image data from a plurality of pieces of X-ray image information obtained by at least two imaging sessions under conditions in which the bite force of the subject patient is set to be different and stored in the storage unit, and creates the medical information.

5. The dental X-ray imaging system according to claim 4.

6. The calculation unit calculates difference image data from a plurality of pieces of X-ray image information that are obtained under the condition that the occlusal force of the subject patient is set to be the same in at least two photographs and are stored in the storage unit, and creates the medical information.

5. The dental X-ray imaging system according to claim 4.

7. The calculation unit generates medical information for the patient, the medical information including information on the bending of the jawbone.

5. The dental X-ray imaging system according to claim 4.

8. The calculation unit calculates subtraction image data in the axial plane from a plurality of X-ray image information of the target patient stored in the storage unit, estimates the bending location and amount of bending of the jawbone from the position and area where the subtraction image is displayed, and creates medical information including the bending location and amount of bending of the jawbone as information about the bending of the jawbone.

8. The dental radiography system according to claim 7.

9. a characteristic storage unit that stores distribution characteristics of hardness application ranges that are previously determined according to the type of prosthetic material for the first index and the second index, the bite force measurement value being a first index and the jawbone deflection area in a subtraction image of X-ray images being a second index; the calculation unit has a prosthetic material selection means for selecting a prosthetic material that matches information on the jawbone deflection area and information on the bite force measured for a target patient, by referring to the distribution characteristics; The medical information output means outputs the medical information of the patient including at least information on the selected prosthetic material.

9. The dental radiography system according to claim 8.

10. a characteristic storage unit that stores distribution characteristics of hardness application ranges that are determined in advance according to the type of prosthetic material for the first index and the second index, the bite force measurement value being a first index and the shading value of a predetermined extracted portion of an X-ray image of a patient being a second index; The calculation unit a determination unit that determines that the X-ray image of the patient is a case image of osteoporosis when the gray value of the extracted portion of the X-ray image of the patient is darker than a predetermined threshold value; a prosthetic material selection means for selecting a prosthetic material that matches the gray value and occlusal force information of the extracted portion of the X-ray image taken of the patient when the image is determined to be a case image of osteoporosis, by referring to the distribution characteristics; The medical information output means outputs the medical information of the patient including at least information on the selected prosthetic material.

4. The dental X-ray imaging system according to claim 1.

11. a characteristic storage unit that stores distribution characteristics of hardness application ranges that are determined in advance according to the type of prosthetic material for the first index and the second index, the bite force measurement value being a first index and the thickness of the mandibular lower edge cortical bone of a predetermined extracted site of an X-ray image of a patient being a second index; The calculation unit a determination unit that determines that the X-ray image of the patient is a case image of osteoporosis when the thickness of the mandibular lower edge cortical bone in the X-ray image is smaller than a predetermined threshold; a prosthetic material selection means for selecting a prosthetic material that matches the information on the thickness of the cortical bone of the lower edge of the mandible and the occlusal force of the X-ray image taken of the patient when the image is determined to be a case image of osteoporosis, by referring to the distribution characteristics; The medical information output means outputs the medical information of the patient including at least information on the selected prosthetic material.

4. The dental X-ray imaging system according to claim 1.

12. The calculation unit generates medical information for the target patient, the medical information including information on the temporomandibular joint.

4. The dental X-ray imaging system according to claim 1.

13. a characteristic storage unit for storing distribution characteristics of hardness application ranges calculated in advance according to the type of prosthetic material for the first index and the second index, the bite force measurement value being a first index, the coincidence probability calculated by pattern recognition of the X-ray image so that the probability when the articular disc is in the correct position is 100% and the probability when the articular disc is not in the correct position is reduced; the calculation unit has a prosthetic material selection means for calculating a coincidence probability of the articular disc position by pattern recognition of the X-ray image of the target patient, and selecting a prosthetic material that matches the calculated coincidence probability and occlusal force information for the patient by referring to the distribution characteristics; The medical information output means outputs the medical information of the patient including at least information on the selected prosthetic material.

13. The dental radiography system of claim 12.

14. a lower jaw three-dimensional position data input means for acquiring three-dimensional position data of the lower jaw while the patient's upper jaw is placed on the bite plate; the storage unit stores the detected bite force information and the three-dimensional position data of the lower jaw in association with each other; The calculation unit generates medical information for the target patient, the medical information including at least one of mandibular position information and bite registration information.

4. The dental X-ray imaging system according to claim 1.

15. The mandibular three-dimensional position data input means is characterized by comprising a chip that can be attached directly or indirectly to the mandibular teeth and that can be detected optically, electromagnetically, by acceleration, or by ultrasonic waves.

15. The dental radiography system of claim 14.

16. the storage unit stores information including the bite force, the three-dimensional position of the lower jaw, and the X-ray image before opening, and the bite force, the three-dimensional position of the lower jaw, and the X-ray image after opening, which are obtained by taking at least two photographs before opening and after opening in a series of mouth opening movements of the target patient; The calculation unit calculates difference information of bite force obtained before and after opening, difference information of the three-dimensional position of the lower jaw, and difference information of the X-ray image from the information stored in the storage unit, thereby creating the medical information including the difference information.

15. The dental radiography system of claim 14.

17. The lower jaw three-dimensional position data input means is capable of acquiring three-dimensional position information of the lower jaw during opening, which is an intermediate period from before opening to after opening in the series of mouth opening movements, and has output information capable of displaying the trajectory of the lower jaw and / or output information capable of analyzing the lower jaw movement based on the acquired information.

17. The dental radiography system of claim 16.

18. Sending and receiving data to and from at least one of a facial 3D scanner, an intraoral 3D scanner, an intraoral observation camera, a CAD / CAM device, a CT device, and a swallowing movement analysis device on a network; 17. The dental radiography system of claim 16.

19. a characteristic storage unit that stores distribution characteristics of hardness application ranges that are previously determined according to the type of prosthetic material for the first index and the second index, the bite force measurement value being a first index and the amount of mandibular position movement measured by the mandibular three-dimensional position data input means being a second index, the calculation unit has a prosthetic material selection means for selecting a prosthetic material that matches information on the amount of mandibular position movement measured for a target patient, by referring to the distribution characteristics; The medical information output means outputs the medical information of the patient including at least information on the selected prosthetic material.

15. The dental radiography system of claim 14.

20. The bite force detection means includes a flexible sheet, The flexible sheet is provided with a pressure-sensing section in which a pair of electrodes are arranged opposite each other in the thickness direction of the sheet.

4. The dental X-ray imaging system according to claim 1.

21. The bite force detection means includes impression materials arranged on both sides of the flexible sheet so as to cover the surface of the flexible sheet.

21. The dental radiography system of claim 20.

22. The bite force detection means is provided detachably from the slide body.

21. The dental radiography system of claim 20.

23. The flexible sheet is provided so as to be detachable from the control unit of the bite force detection means.

21. The dental radiography system of claim 20.

24. The bite force detection means is characterized in that it is possible to detect the load ratio for each tooth.

4. The dental X-ray imaging system according to claim 1.

Images