Method and system for generating a model for use in intra-oral navigation of a patient

Abstract

A computer-implemented method for generating, by one or more computer processors, a three dimensional model for use in assisted navigation of a patient's oral cavity is provided.SOLUTION: Receiving 302 a first dataset comprising surface boundary information, generating 304 a digital patient model from at least a portion of the first dataset, performing 306 a 3D surface scan of a portion of an intraoral cavity using a 3D scanner, the 3D surface scan comprising a region of interest, aligning 308 the acquired 3D surface scan to at least a portion of the digital patient model, determining 310 a spatial transformation configured to align or register the acquired 3D surface scan and the 3D digital patient model, and using at least the transformation: Determining 312 position and orientation information of the 3D scanner relative to the digital patient model and generating 314 a second dataset comprising the position and orientation information of the 3D scanner relative to the 3D patient model.SELECTED DRAWING: Figure 2A

Description

[Technical Field]

[0001] The present invention relates to a method and system for generating models for use in intraoral navigation of a patient, particularly but not exclusively for use in planning dental procedures. [Background technology]

[0002] Digital software tools for dental treatment and planning use precise scans of the oral cavity, which may include not only anatomical objects of interest (e.g., teeth) and biological structures such as bone and gum tissue, but also artificial structures such as dental prostheses, abutments, and anchoring systems. The precise scans of the oral cavity facilitate the construction and positioning of dental prostheses and anchoring systems.

[0003] In the field of digital dentistry, scan data of biological structures is typically determined optically or radiologically. Optical scanners (i.e., those using visible, and sometimes infrared and / or UV, wavelengths) for three-dimensional measurements directly from intraoral surface structures or from extraoral impressions of oral surface structures are widespread and economical. Surface data is typically represented by a surface mesh containing triangular elements, which is routinely stored and exchanged between systems in STL or similar digital surface definition formats.

[0004] Radiation scanners, such as digital volume tomographs (DVTs) or computed tomographs (CTs), use x-rays to generate volumetric datasets of biological structures. Surface representations can also be determined from these datasets by applying thresholding techniques, which analyze the intensity values ​​(e.g., measured in Hounsfield units) of individual scan elements (voxels) to determine whether they exceed or fall below a certain threshold. Radio-dense structures (hereafter referred to as "volume-dense" structures or objects), such as teeth, can be identified in this way, and the boundaries of identified volume-dense scan structures can be modeled as triangular surface data (e.g., triangular surface meshes), which can also be stored and exchanged between systems in STL or similar digital surface definition formats.

[0005] Calculations using MRI (Magnetic Resonance Imaging) scan data are more complex and preferably involve contour analysis methods that operate based on the gradients of adjacent scan elements. However, even in these cases, volumetric structures or objects such as gums, gingiva, and other tissues, primarily soft tissues, can be identified, and their interfaces can be modeled as triangular surface data for further processing.

[0006] For the above-mentioned scanning methods, such as surface scanning using infrared, visible, or UV radiation, as well as radiological methods such as DVT or CT, and also volumetric methods such as MRI, there are so-called marker elements that are designed to be clearly visible (sometimes with features that help determine their position and orientation with greater precision) in one or more three-dimensional measurement data of the respective surface or volumetric scanning method. Thus, when placed and fixed in a predetermined position relative to the patient's dentition or jawbone before the scan is taken, they can be used to define precise landmarks in the data set. In this way, the marker elements can make it possible to define a reference frame in the respective scan data with high precision.

[0007] In the context of the present disclosure, the term dental restoration includes all types of tooth replacement, partial or complete, of single or multiple teeth. The term virtual dental restoration (hereinafter more simply referred to as dental restoration) should be understood to include a suitable electronic representation of a dental restoration, i.e., a digital three-dimensional representation, preferably a surface representation with sufficient accuracy of the jawbone, gingival tissue, marker elements, anchoring systems, and the like.

[0008] When designing a customer's prosthesis, the prosthesis is often designed to replace an anatomical object that has been removed from the existing oral situation. In addition to the importance of precision in manufacturing a dental prosthesis (e.g., a crown), preparation steps (e.g., drilling sockets for anchoring systems) must be performed with extremely high precision, and the patient's anatomical situation must be accurately modeled for proper planning of the prosthesis. Similarly, the positioning of any elements, such as anchoring systems, placed on the model of the patient's anatomical situation during the planning step must be reproduced with extremely high accuracy in both position and orientation to the corresponding location in the patient's actual anatomy.

[0009] To help achieve the latter, existing technologies use the placement and affixation of marker elements in dental templates and / or to the patient's dentition or jawbone to allow for a frame of reference for a digital model of the patient's dental condition. This frame of reference provides the basis for digital implant planning and the subsequent fabrication of a drill guide (such as a 3D-printed, molded, or thermoformed template) that can be placed over the patient's remaining teeth, screwed into the jawbone, or otherwise secured in place, and includes one or more guide holes for dental pins to control the correct orientation and location of the drill and subsequently secure the dental prosthesis. This process is highly complex and therefore expensive, typically requires the patient to visit the clinic multiple times, and, despite the accuracy achieved, still contains many sources of error.

[0010] There is an increasing demand for more immediate and less costly dental treatment. New methods are needed to shorten the planning and implementation of dental treatment, particularly for treatments that can be completed in a single visit or fewer visits than previously possible. It is therefore an object of the present invention to alleviate at least some of the shortcomings of known dental restorative procedures. Summary of the Invention

[0011] The object is at least partly solved by a computer-implemented method for generating a three-dimensional model for use in navigating a patient's oral cavity. One embodiment comprises a method for generating such a three-dimensional model according to independent claim 1. Another embodiment provides a system for generating a three-dimensional model according to independent claim 16.

[0012] Dependent claims 2 to 15 present various embodiments of the invention.

[0013] According to one aspect of the present invention, there is provided a computer-implemented method for generating, by one or more computer processors, a three-dimensional model for use in assisted navigation of a patient's oral cavity, the method being based on at least a first scan of an anatomical region of the patient's oral cavity, the method comprising:

[0014] receiving a first data set including surface boundary information from a first scan (which, notably, may include surface scan data obtained from a surface scan or generated from volume density scan data);

[0015] generating a three-dimensional digital patient model from at least a portion of the first dataset;

[0016] performing a three-dimensional surface scan of a portion of the oral cavity with a three-dimensional surface scanner, thereby obtaining the three-dimensional surface scan, the three-dimensional surface scan including the region of interest;

[0017] aligning the acquired three-dimensional surface scan to at least a portion of a three-dimensional digital patient model;

[0018] Using the acquired three-dimensional surface scan and the digital patient model, determining a spatial transformation configured to align or register the acquired three-dimensional surface scan and the three-dimensional digital patient model to a predetermined degree;

[0019] determining position and orientation information of the three-dimensional surface scanner relative to the three-dimensional digital patient model using at least the transformation;

[0020] generating a second data set including position and orientation information of the three-dimensional surface scanner relative to the three-dimensional digital patient model.

[0021] An anatomical region typically includes at least one type of tissue of a patient. The tissue types within the patient's anatomical region may include soft tissue (e.g., gingival tissue) as well as bone and / or dental tissue (i.e., enamel, dentin, and / or cementum). Similarly, the three-dimensional digital patient model may include one or more portions of a jawbone, gingival tissue, and one or more teeth.

[0022] The present invention recognizes that a patient's tooth surfaces represent a very unique and highly detailed topology that can be used to precisely position objects relative to them with great accuracy. Thus, once a detailed three-dimensional digital model of the patient's anatomy has been created, a navigation assistance system can inform a user or robotic dental treatment system of the precise position and orientation of the three-dimensional surface scanner's field of view (and thus the device itself) relative to the patient's dentition (or its imprint), based on a surface scan acquired by said three-dimensional surface scanner of the patient's anatomy, or a dental imprint thereof, respectively.

[0023] Furthermore, the first data set may include surface boundary information of the patient's jawbone, and therefore, if the digital patient model also represents the jawbone in an accurate manner relative to the patient's dentition, the method of the present invention also serves to inform the position and orientation of the field of view of the 3D surface scanner relative to such jawbone of the patient, even if the bony structures are not visible in the field of view of the 3D surface scanner.

[0024] Thus, using the present invention, the use of marker elements can be avoided, or at least significantly reduced, and no longer need to be used to aid in the digital treatment planning process of a dental procedure or to create drill guides for placing dental anchoring systems, which can provide more immediate feedback and treatment assistance by allowing the user, or alternatively a robotic navigation and treatment system, to determine its exact location relative to the patient's dentition or oral anatomy. Indeed, under certain circumstances, even exposure to x-rays can be minimized using the system of the present invention.

[0025] In one embodiment, the second data set further includes at least a portion of a three-dimensional digital patient model.

[0026] In one embodiment, the surface boundary information of the first data set includes surface segments, the surface segments having labels associated therewith identifying a tissue type, each surface segment representing a tissue type selected from the group including gingival tissue, bone tissue, and dental tissue.

[0027] This may include, in the context of performing the method of the present invention, by a user or by a suitably trained artificial neural network, identifying elements of anatomical regions of the patient's oral cavity in the three-dimensional digital patient model, but may also include retaining labels associated with surface segments that identify tissue types in the process of generating the three-dimensional digital patient model, i.e., retaining previously assigned labels associated with such surface segments when, for example, the first dataset is based on a previously acquired volume density scan and is post-edited.

[0028] The surface boundary information of the first data set is generated from a set of density scan segments from the second data set that are cross-mounted with a corresponding set of surface scan segments from the surface scan in a common 3D coordinate system. Cross-mounting may be performed by using the correspondingly labeled surface scan segments to align them with the volume density scan segments, for example, by determining surface scan segments and volume density scan segments of similar shape and volume. Thus, in the prior art, such cross-mounting may have relied on position and orientation information of one or more marker elements in the three-dimensional measurement data, and the use of such marker elements may be avoided in the application of the present invention. The present invention may include applying scaling, translational, and rotational transformations to the surface scan segments and / or volume density scan segments to achieve the best possible alignment of the surface scan segments and volume density scan segments in the common 3D coordinate system. In particular, elements from both the surface scan and the volume scan showing tooth surfaces of a person's dentition may be used in the process of cross-mounting the surface scan segments and volume density scan segments, i.e., closely aligning the segments of both scans so that, for example, there is geometric overlap.

[0029] The second data set may include a digital representation of the three-dimensional surface scanner within a common reference frame, the digital representation of the three-dimensional surface scanner positioned and oriented according to the position and orientation. The digital representation of the three-dimensional surface scanner may be schematic, i.e., by including a three-dimensional surface model of the geometry of the three-dimensional surface scanner, the three-dimensional surface model of the surface scanner positioned and oriented corresponding to the position and orientation of the three-dimensional surface scanner at the time the three-dimensional surface scan of the area of ​​interest was performed.

[0030] In one embodiment, the second data set may be transferred to a visualization system configured to visualize at least a portion of the second data set to a user in a two-dimensional, pseudo-three-dimensional, or three-dimensional image representation. The visualization system may be further configured to augment or overlay a display of the portion of the second data set with a view of the patient's oral cavity.

[0031] These embodiments allow the user to have a very smooth and natural view of the patient's oral cavity (either via image representation or live view), while simultaneously giving the user visual feedback of the position and orientation of the 3D surface scanner inside the patient's oral cavity and relative to the patient's technique and jaw.

[0032] In one embodiment, the second data set may be generated as a three-dimensional output model, allowing for simplified post-processing of the information contained in the second data set, for example, in the process of designing a dental prosthesis or when generating a treatment or examination plan for a dental procedure that includes the placement of a dental anchoring system.

[0033] In one embodiment, regions of interest may be determined in the three-dimensional output model based on a dental treatment or examination plan, and the regions of interest may be identified in the three-dimensional output model, for example, by applying specific labels to portions of the three-dimensional output model that lie within the regions of interest, thus allowing, for example, easier highlighting of such portions in the output of a visualization system, or definition of "difficult-to-treat" (no-go) zones when the three-dimensional output model is loaded into a robotic navigation and treatment system for performing a dental procedure through a robotic (assisted) system.

[0034] In one embodiment, the method includes generating the second data set as a three-dimensional output model. For example, the method may include transferring the second data set to a navigation system configured to display the three-dimensional output model. The navigation system may receive the dental treatment or examination plan in addition to the three-dimensional patient model, determine one or more deviations of the three-dimensional output model from the dental treatment or examination plan, and identify the deviations in the three-dimensional output model.

[0035] In one embodiment, the method includes continuously or real-time acquiring and updating the three-dimensional surface scan. This ensures immediate or near-immediate updates in the generation of the second data set, thus, for example, in conjunction with such an embodiment, helping to make the experience of using a (robotic) visualization and navigation system nearly realistic for the user. In this way, the barriers to using such systems can be reduced, thereby making the benefits to patients particularly noticeable due to the increased navigation accuracy that can be achieved using the inventive system.

[0036] In one embodiment, the 3D surface scanner may include, be integral with, or be mounted on a dental instrument, such as a dental drill, a dental probe, or any other dental instrument suitable for determining the condition of a patient's teeth or manipulating a patient's teeth, gums, or jawbone. Such an embodiment is particularly useful when the invention is used as a navigational aid system for a user during a dental examination or treatment procedure, as it ensures that the field of view of the 3D surface scanner always accurately "sees" the area with which the dental instrument engages.

[0037] In a further embodiment, as described above, the invention includes transferring the second data set to a robotic navigation system configured to control or assist in the control of the navigation of a dental instrument, such as a dental drill, a dental probe, or another type of dental instrument, based on the position and orientation information included in the second data set.

[0038] In one embodiment, aligning at least a portion of the three-dimensional digital patient model to the acquired three-dimensional surface scan uses only the tooth surfaces of the three-dimensional digital patient model. Such alignment may be performed, for example, by applying a least-squares method to determine the best fit of the surface structure (topology) encoded in the three-dimensional digital patient model to the three-dimensional surface scan. Alternative known methods for determining the best fit of the topology are known in the art and therefore will not be described in further detail.

[0039] In a further embodiment, matching at least a portion of the three-dimensional digital patient model to the acquired three-dimensional surface scan uses only surface boundary information of the first data set that includes segments labeled as dental tissue. This may enhance the determination of the best fit between the three-dimensional digital patient model and the acquired three-dimensional surface scan, as the patient's tooth surfaces represent a unique, highly detailed, static topology that may be used as the basis for highly accurate matching of the acquired three-dimensional surface scan to the three-dimensional digital patient model.

[0040] In one embodiment, the first data set includes labeled surface scan segments, each surface scan segment including a three-dimensional surface model of a corresponding object recognized and segmented from the surface scan data, each surface scan segment having an associated label that identifies the surface scan segment. In such an embodiment, the method includes receiving a third data set of labeled volume density scan segments, each volume density scan segment including a three-dimensional volume density model of a boundary surface of a corresponding object recognized and segmented from the volume density scan data of a volume density scan of an anatomical region, each volume density scan segment having an associated label that identifies the volume density scan segment;

[0041] cross-mounting labeled surface scan segments from the first data set with labeled volume density scan segments from a third data set in a common 3D coordinate system;

[0042] generating a three-dimensional digital patient model from at least a portion of the first data set cross-mounted with the labeled volumetric density scan segments.

[0043] According to this aspect, there is also provided a computer-implemented method for planning a dental procedure, the method comprising:

[0044] a method for generating, by one or more computer processors, a three-dimensional model for use in navigating a patient's oral cavity, as described above;

[0045] generating a registration data set comprising a registration of at least a portion of the digital patient model and at least a portion of the three-dimensional surface scan.

[0046] In one embodiment, the dental procedure includes implantation of a dental prosthesis or a dental prosthesis support structure, for example, a dental anchoring system.

[0047] According to another aspect, the present invention provides a system for generating a three-dimensional model for use in assisted navigation of a patient's oral cavity, the system including at least one computer processor, a storage device, a three-dimensional surface scanner for performing a three-dimensional surface scan of a portion of the patient's oral cavity to obtain a three-dimensional surface scan including a region of interest, and optionally at least one visualization device and / or robotic navigation (assistance) system, the storage device storing instructions that, when executed by the computer processor, perform the method of the present invention according to any of the above aspects and / or embodiments.

[0048] In particular, such a system includes: a three-dimensional digital patient model generator configured to generate a three-dimensional digital patient model from at least a portion of a first dataset of surface boundary model data from an intraoral scan of an anatomical region of the patient's oral cavity;

[0049] a surface scan aligner configured to align the acquired three-dimensional surface scan to at least a portion of a three-dimensional digital patient model;

[0050] a spatial transformation determination engine configured to determine, using the acquired three-dimensional surface scan and the digital patient model, a spatial transformation configured to align or register the acquired three-dimensional surface scan and the three-dimensional digital patient model;

[0051] a scanner position and orientation determination engine configured to determine a position and orientation of the three-dimensional surface scanner relative to the three-dimensional digital patient model using at least the transformation;

[0052] an output generator configured to output a second data set comprising at least a portion of the three-dimensional digital patient model and position and orientation information of the three-dimensional surface scanner relative to the three-dimensional digital patient model.

[0053] In one embodiment, the system output generator is configured to generate the second data set in such a way that the portion of the three-dimensional digital patient model and the digital representation of the three-dimensional surface scanner are transformed into a common frame of reference, and the digital representation of the three-dimensional surface scanner can be positioned and oriented according to the position and orientation determined by the scanner position and orientation determination engine.

[0054] In one embodiment, the system is configured to read further three-dimensional surface scan information continuously or in real time from the three-dimensional surface scanner and to update the three-dimensional surface scan and thus the second data set continuously or in real time.

[0055] In one embodiment, the three-dimensional surface scanner includes, is integral with, or is attached to a dental instrument such as a dental drill, a dental probe, or any other dental instrument suitable for determining the condition of a patient's teeth or manipulating the patient's teeth, gums, or jawbone.

[0056] The present invention takes advantage of the recognition that the geometry and specific locations of a person's tooth surfaces are highly unique and can therefore be considered as a highly accurate three-dimensional topology that can itself be considered to define a specific reference frame. This avoids the use of marker elements in the process of obtaining any of the three-dimensional measurement data and generating a data set based thereon. Accordingly, in one embodiment, the digital patient model of the present invention does not include digital representations of marker elements.

[0057] In yet another aspect, the present invention comprises computer program code which, when loaded into a storage device and executed by a computer processor communicatively connected to a three-dimensional surface scanner for performing a three-dimensional surface scan of a portion of a patient's oral cavity, performs, in a suitably configured computer, the inventive method of any of the above aspects and / or embodiments to create a system for generating a three-dimensional model for use in assisted navigation of a patient's oral cavity. [Brief explanation of the drawings]

[0058] The present invention is further described by the following detailed description taken in conjunction with the drawings, in which like reference numerals refer to like elements unless otherwise indicated.

[0059] Although the following detailed description describes particular embodiments of the invention in more detail, it should be noted that it is intended that any feature described in connection with only one of the embodiments, whether or not described in the detailed description, may also be used in or in combination with any other embodiment of the invention (except where such a combination of features would lead to non-sensical results).

[0060] The following detailed description is not intended to limit the invention to the particular embodiments and combinations of features therein; rather, the present invention is limited and defined only by the appended claims.

[0061] [Figure 1A] FIG. 1A is an architecture diagram of a system for generating a model for use in intra-oral navigation of a patient, according to one embodiment of the present disclosure. [Figure 1B] FIG. 1B is an architecture diagram of the processor and memory of the system of FIG. 1A according to one embodiment of the present disclosure. [Figure 2] 2A and 2B show an exemplary flow diagram of a method for generating a model for use in intra-oral navigation of a patient, according to an embodiment of the present disclosure. [Figure 3] 3A-3O illustrate an exemplary embodiment of a method for generating a model for use in intra-oral navigation of a patient, according to an embodiment of the present disclosure. [Figure 4] 4A and 4B illustrate a first exemplary graphical user interface implementation of various aspects of the disclosure. [Figure 5] 5A and 5B illustrate a first exemplary graphical user interface implementation of various aspects of the present disclosure. [Figure 6] 6A-6J illustrate a second exemplary graphical user interface implementation of various aspects of the present disclosure. [Figure 7] 7A-7T illustrate a third exemplary graphical user interface implementation of various aspects of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0062] One aspect of the present invention is the generation of three-dimensional models for use in navigating a patient's oral cavity. One embodiment includes a method for generating such a three-dimensional model.

[0063] Figure 1A is an architecture diagram of a computer-enabled system 100 for generating a model for use in intra-oral navigation of a patient according to one embodiment of the disclosure, shown together with an external or remote service 102. Figure 1B is an architecture diagram of a processor 104 and memory 106 of the system 100 of Figure 1A according to one embodiment of the disclosure.

[0064] 1A and 1B, system 100 includes at least one processor 104, memory 106 (including local memory 108 and bulk memory 110), one or more input devices 112 (including an intraoral scanner in the form of a 3D surface scanner 114), one or more output devices 116 (including at least one display 118 upon which a graphical user interface (GUI) 120 is generated), and one or more network adapters 122. System 100 also includes a bus 124 for facilitating communication between processor 104, memory 106, input devices 112, output devices 116, and network adapter 122. It should be noted that 3D surface scanner 114 is in data communication with bus 124, which may be wired or wireless, in the latter case being facilitated by a wireless protocol (not shown) such as Bluetooth™ or Wi-Fi™.

[0065] The remote services 102 include a surface scanning service 130 , a volumetric density scanning service 132 , a segmentation service 134 , and a dental planning service 136 .

[0066] The processor 104 executes programs and applications read from the memory 106 that implement various functions of the system 100, as described below. The processor 104 thus includes a scan segment cross-mounter 230, a 3D digital patient model generator 232, a 3D surface scan updater 234, a surface scan aligner 236 (including, for example, an object recognizer 238 that performs object recognition), a spatial transformation determiner 240, a scanner position and orientation determiner 242, a navigation system 244 (including a display manipulator 246 and a deviation determiner 248), a display generator 250, and an output generator 252.

[0067] The memory 106 includes program and application code 260 configured to be read and executed by the processor 104 such that the processor 104 implements the various functions described above.

[0068] The memory 106 also includes a surface boundary model 262 (which may include labeled surface scan segments) received from the surface scanning service 130 or the volume density scanning service 132 of the remote service 102, volume density scan data 264 (which may include labeled volume density scan segments) received from the volume density scanning service 132 of the remote service 102, cross-mounted surface and volume density scan segments 266 (generated and output by the scan segment cross-mounter 230), an acquired 3D surface scan 268 (received from the 3D surface scanner 114), a 3D scanner position and orientation 270 (generated and output by the scanner position and orientation determiner 242), a dental treatment or examination plan 272 (received from the external dental planning service 136), and a display 274 (generated and output by the display generator 250).

[0069] The network adapter 122 facilitates communication between the system 100 and the remote service 102 .

[0070] 2A and 2B show exemplary flow diagrams of methods 300 and 320, respectively, for generating a model for use in intraoral navigation of a patient, according to an embodiment of the present disclosure. Method 300 of FIG. 2A may be considered a simple method for generating such a model, while method 320 of FIG. 2B may be considered a complex method for generating such a model, although it should be understood that methods 300 and 320 have some common steps and embody the same core technology.

[0071] 2A, method 300 is a method for automatically generating, by processor 104, a three-dimensional model for use in navigating a patient's oral cavity. To do so, method 300 uses at least an intraoral surface scan of an anatomical region of the patient's oral cavity, the anatomical region including at least one tissue of the patient.

[0072] At step 302, the system 100 receives a first data set of surface boundary model data from an intraoral scan. The first data set may be surface scan data that may be obtained from a surface scan and may be received from a remote surface scanning service 130 of the remote service 102. Alternatively, the first data set may be generated from volume density scan data received by and from a volume density scanning service 132 of the remote service 102.

[0073] Step 302 may include saving a first data set of the surface boundary model 262 .

[0074] In this embodiment, the first data set includes one or more labeled surface scan segments, each including an individual segment corresponding to an object and / or feature recognized via an image recognition and segmentation process (e.g., by segmentation service 134) in the surface scan of the oral cavity, particularly the anatomical region of interest. In this embodiment, the surface scan data is generated by a remote surface scanning service 130, which may perform any one or any combination of the following: collecting the surface scan data collected from a surface scanner (e.g., an optical scanner or a camera); converting the surface scan data into a three-dimensional model that can be accessed and read by the processor 104 of the system 100; manipulating or converting it to another format, as needed, so that it can be displayed on the display 118; and storing it in a computer-readable file as a surface boundary model 262 in memory 106. In alternative embodiments, the system 100 includes the surface scanning service 130, and in such embodiments, the method 300 includes steps performed by the surface scanning service 130.

[0075] The remote service 102 may also include a segmentation service 134 configured to receive scan data (either surface (IOS) or volume density (CBCT or CT) scan data) and use image processing, extraction, and classification to segment the received scan image containing anatomical regions of interest into various identified objects and associate classification tags with each of the segments. The segmentation service 134 may provide the segments in the form of individual virtual 3D segment models, each of which (also referred to herein simply as a “segment model”) is a digital 3D representation of an actual anatomical part or feature of the patient's anatomy. In one embodiment, the segmentation service 134 provides each segment as an individual digital 3D model, preferably (but not limited to) in STL format as a triangular mesh or point cloud.

[0076] In an alternative embodiment, the system 100 includes a segmentation service 134. In such an embodiment, the method 300 includes steps performed by the segmentation service 134.

[0077] In step 304, the 3D patient model generator 232 generates a 3D digital patient model from at least a portion of the first data set.

[0078] The GUI 120 may include a 3D model view pane for displaying a three-dimensional digital patient model (based in this embodiment on a surface scan of the region of interest). The GUI 120 includes various user controls that enable a user to instruct the display generator 250 to perform various operations, such as, but not limited to, selecting and loading a patient's scan records, selecting and manipulating display views, selecting content for display in the GUI 120, selecting objects of interest and / or identifiers of objects of interest that may be included in the patient's scan data, selecting and displaying identifiers associated with the patient's dental treatment plan, descriptions and images of implants, prostheses, materials, etc.

[0079] In step 306, a three-dimensional surface scan of at least a portion of the patent's oral cavity is performed using the three-dimensional surface scanner 114, thereby obtaining a three-dimensional surface scan that includes a region of interest. The region of interest may be or include, for example, a diseased tooth or a proposed site for a dental implant or prosthesis.

[0080] In step 308, the surface scan matcher 236 matches the three-dimensional surface scan acquired in step 306 to at least a portion of the three-dimensional digital patient model generated in step 304, such as by using object or feature recognition to identify features common to both (performed by the object recognizer 238). The surface scan matcher 236 outputs the results of this process, such as in the form of data relating pixels or voxels of the three-dimensional surface scan acquired in step 306 that are found to match with pixels or voxels of the three-dimensional digital patient model.

[0081] In step 310, the spatial transformation determiner 240 uses as inputs the 3D surface scan acquired in step 306, the 3D digital patient model generated in step 304, and the output of the surface scan aligner 236 to determine a spatial transformation configured to align or register the acquired 3D surface scan and the 3D digital patient model.

[0082] In step 312, the scanner position and orientation determiner 242 uses at least this transformation to determine the position and orientation of the 3D surface scanner 114 relative to the 3D digital patient model. In step 314, the generator 252 generates a second data set including the position and orientation of the 3D surface scanner 114 relative to the 3D digital patient model. The second data set may be output to a storage device, such as a memory or non-transitory storage device. The storage device may be remote from the system 100 or may comprise a graphics memory of the system 100 (or a remote system) so that the position and orientation can be used to generate a display.

[0083] It should be noted that method 300 uses only surface scan data about the patient (obtained from surface scan service 130) when generating the three-dimensional digital patient model. Method 320 of FIG. 2B is also a method for automatically generating, by processor 104, a three-dimensional model for use in navigating the patient's oral cavity using intraoral surface scans of anatomical regions of the patient's oral cavity. However, method 320 additionally uses volumetric density scan data (e.g., from a CT or CBCT scan) from volumetric density scan service 132 when generating the three-dimensional digital patient model.

[0084] 2B, the system 100 receives a first dataset of surface scan data (in the form of labeled surface scan segments) of an intraoral surface from the surface scan service 130 of the remote service 102. Each segment includes a three-dimensional surface model of a corresponding object recognized and segmented from the surface scan data. This step may include saving the first dataset of surface boundary models 262. The first dataset is as described above in the context of method 300.

[0085] In step 324, the system 100 receives a dataset of labeled volumetric density scan segments of the intraoral surface from the volumetric density scan service 132 of the remote service 102. Each volumetric density scan segment includes a three-dimensional volumetric density model of the boundary of a corresponding object recognized and segmented from the volumetric density scan data of the volumetric density scan of the patient's intraoral cavity. This step may include saving the dataset of volumetric density scan data 264.

[0086] The dataset of labeled volumetric density scan segments typically includes individual segments corresponding to objects and / or features recognized via image recognition and segmentation processes (e.g., by segmentation service 134) in one or more CT or CBCT volumetric density scans of the oral cavity and surrounding tissues, including the region of interest. The labeled volumetric density scan segments are generated by and received from a remote volumetric density scanning service 132. The volumetric density scanning service 132 may perform any one or combination of the following: collect volumetric density scan data collected from a volumetric density scanner (using a volumetric scanning device such as a cone beam computed tomography (CBCT) scanner), convert the volumetric density scan data into a three-dimensional model that can be accessed and read by the processor 104 of the system 100, manipulate or convert it into another format as needed so that it can be displayed on the display 118, and save it in a computer-readable file that can be received by the system 100 and stored as volumetric density scan data 264 in memory 106.

[0087] In certain alternative embodiments, system 100 includes volumetric density scanning service 132 , and in such embodiments, method 320 includes steps performed by volumetric density scanning service 132 .

[0088] Similarly, in embodiments in which the system 100 includes a segmentation service 134 , the method 320 includes steps performed by the segmentation service 134 .

[0089] In step 326, the scan segment cross-mounter 230 cross-mounts the labeled surface scan segments and the labeled volume density scan segments into a common three-dimensional coordinate system. The received surface scan segments and volume density scan segments are generally acquired using different modalities (and thus using different, typically independent, scanning machines / equipment), and the scan data generated by each scanning modality is collected and stored according to a 3D coordinate system specific to the particular scanning machine / equipment that collected the data. Thus, because they each represent the same object or feature, it is important to align the resulting scan data from each scanner into a common three-dimensional coordinate system so that similar objects from each scan can be aligned and displayed as occupying the same spatial volume, as they should.

[0090] As a result of cross-mounting to a common 3D coordinate system, for each pair of surface scan and volume density scan segments corresponding to the same patient object or feature from the scanned anatomical region of interest, there will be one or more respective points in the 3D space of the common 3D coordinate system that "match" (i.e., the points from each segment of the segment pair will substantially or exactly coincide). These matching points will correspond to corresponding points on the actual object / feature of the patient's actual anatomy. Matching points will only be displayed for regions of the patient's anatomy that were imaged with a particular scanning modality.

[0091] Thus, because surface scan data includes only surface visible image data, while volume scan data includes both surface and subsurface image data, point matching can only occur for points in volume density scan segments that correspond to visible points on the surface of the scanned object (because surface scan segments do not include subsurface data points). Ideally, points in each corresponding (or jointly represented) pair of surface scan segments and associated volume density scan segments should be precisely aligned in a common three-dimensional coordinate system; however, due to differences in accuracy between scanning modalities and differences in the resolution and generation accuracy of the three-dimensional scan segment models generated for each scanning modality, the points may only substantially align (i.e., match within a margin of error). Nevertheless, as a result of cross-mounting step 326, surface scan segments that correspond (or jointly represented) to the scanned object should occupy approximately the same space in the three-dimensional coordinate system as similar regions of the associated object represented by the corresponding volume density scan segments.

[0092] Thus, step 326 causes the two sets of segments (surface and volume) to be viewable, eg, in a common three-dimensional coordinate system, superimposed, or otherwise combined as desired.

[0093] In step 328, the 3D patient model generator 232 generates a 3D digital patient model from at least a portion of the first data set cross-mounted with the labeled volumetric density scan segments. In step 330, a 3D surface scan of at least a portion of the patent's intra-oral cavity is performed using the 3D surface scanner 114, thereby obtaining a 3D surface scan including a region of interest. The region of interest may be or may include, for example, a diseased tooth or a proposed site for a dental implant or prosthesis. Optionally, in step 332, the 3D surface scan is repeated or updated continuously or in real time using the 3D surface scanner 114, such as to capture changing surface scans as the 3D surface scanner 114 moves in position or orientation.

[0094] The 3D model view pane of GUI 120 may be used to display a three-dimensional digital patient model (in this embodiment, based on surface scan and volume density scan data of the region of interest).

[0095] In step 334, the surface scan matcher 236 matches the 3D surface scan acquired in step 330 (or updated in step 332) to at least a portion of the three-dimensional digital patient model generated in step 328, such as by using object or feature recognition to identify features common to both. The surface scan matcher 236 outputs the results of this process, such as in the form of data relating pixels or voxels of the 3D surface scan acquired in step 330 or 332 that were found to match with pixels or voxels of the 3D digital patient model.

[0096] In step 336, the spatial transformation determiner 240 uses as inputs the 3D surface scan acquired in steps 330 / 332, the 3D digital patient model generated in step 328, and the output of the surface scan aligner 236 to determine a spatial transformation configured to align or register the acquired 3D surface scan and the 3D digital patient model.

[0097] In step 338, the scanner position and orientation determiner 242 uses at least this transformation to determine the position and orientation of the 3D surface scanner 114 relative to the 3D digital patient model.

[0098] In step 340, the generator 250 generates a second data set including at least a portion of the digital patient model and a digital representation of the 3D surface scanner 114 in a common frame of reference, the digital representation of the 3D surface scanner being positioned and oriented according to the position and orientation determined in step 338.

[0099] The second data set may be stored or output (such as by output generator 252) to display 274 in memory 106 and is suitable for display on the screen of a computer or other computing device (such as in a 3D model view pane of GUI 120 on display 118) so that a user can inspect that the three-dimensional digital patient model and the digital representation of the three-dimensional surface scanner 114 are correctly positioned and oriented relative to one another. Display generator 250 may optionally generate the second data set as a manipulable three-dimensional model.

[0100] The second data set is particularly useful in embodiments in which the 3D surface scanner 114 includes, is integral with, or is attached to a dental drill, dental probe, or other dental instrument, because it allows the user to determine whether the 3D surface scanner 114 (and therefore the dental instrument) is positioned and oriented as desired relative to the intraoral region of interest.

[0101] In step 342, the display generator 250 outputs the second data set (e.g., in the form of a manipulatable three-dimensional model) to the navigation system 244. The navigation system 244 is configured to convert the second data set into a display for viewing and manipulating in a 3D model view pane of the GUI 120. The display manipulators 246 of the navigation system 244 provide user control for the GUI 120, allowing a user to control the GUI 120 to perform various operations, such as, but not limited to, selecting and loading a patient's scan records, selecting and manipulating display views (e.g., rotating, zooming in and out of the display), selecting content for display in the GUI 120, selecting objects of interest and / or identifiers of objects of interest that may be included in the patient's scan data, and selecting and viewing identifiers, descriptions and images of implants, prostheses, materials, etc., associated with the patient's dental treatment plan. As a result, the user can navigate the 3D digital patient model while viewing the 3D surface scanner 114 model in the correct position and orientation relative to the 3D digital patient model, including as the position and orientation changes in response to user manipulation of the 3D surface scanner 114 and / or movements of the patient's head or jaw.

[0102] The dental treatment or examination plan is received from the system 100 from the remote dental planning service 136 and stored by the system 100 in a dental treatment or examination plan 272 in the memory 106. The deviation determiner 248 of the navigation system 244 is configured to retrieve the dental treatment or examination plan from the dental treatment or examination plan 272 or from the dental planning service 136, determine one or more deviations of the second data set from the dental treatment or examination plan, and alter the display to identify those deviations. The deviations may be detected by the surface scan aligner 236 using the respective dental treatment or examination plan and the three-dimensional digital patient model as inputs. Altering the display to identify the deviations may be achieved by overlaying the deviations on the manipulable three-dimensional model, such as by labeling or coloring the areas of the deviations.

[0103] 3A-3O illustrate an exemplary embodiment of one aspect of the present invention, whereby method 320 of FIG. 2B is used to generate a three-dimensional socket model from three-dimensional surface scan segments (3D surface models of corresponding objects recognized and segmented from surface scan data of the surface scan) and volume density scan segments (3D volume density models of corresponding object boundaries recognized and segmented from volume density scan data of the volume density scan) associated with an object. In the illustrated embodiment, the object is a tooth, and the generated socket model is a tooth socket corresponding to the outer shape of the portion of the tooth below the gum line, i.e., the root.

[0104] FIG. 3A shows an example of a 3D surface boundary model 1a generated based on a volume density scan. Individual structures in model 1a correspond to actual structures in a patient's oral cavity. As shown, 3D surface boundary model 1a embodies an anatomical representation of the patient's actual gingival tissue 2, bone 3, and teeth (labeled 11, 12, 13, 14, 15, 16, and 17 according to the Federation of Dental International (FDI) notation (a tooth numbering system commonly used in the dental industry)), among other individual teeth (not labeled). In one embodiment, surface boundary model 1a is generated from the 3D volumetric structures represented in the volume density scan and extracted by image recognition and segmentation techniques, such as thresholding the intensity values ​​(measured in Hounsfield units) of individual scan elements in a radiograph stack. In one embodiment, surface boundary model 1a includes a point cloud, a triangular or other polygonal mesh, or other 3D digital model.

[0105] FIG. 3B shows an example of a 3D surface model 1b generated based on a surface scan of the same anatomical region as FIG. 3A. The individual structures in model 1b correspond to actual structures in a patient's oral cavity. As shown, 3D surface model 1b embodies a representation of the patient's actual gingival tissue 2 and the anatomy of the teeth (labeled 11, 12, 13, 14, 15, 16, and 17 according to FDI notation). Because the bone in the patient's oral cavity lies below the surface of the gingiva and teeth, bone information will typically not be present in surface scan model 1b.

[0106] Because the surface scan and volume density scan are obtained from scans of the same oral region of interest, both Model 1a and Model 1b include respective model anatomy representing the same particular anatomy of the patient (e.g., teeth 11, 12, 13, 14, 15, 16, and 17, and gums 2). Model 1b includes a point cloud, triangular or other polygonal mesh, or other 3D digital model generated from the 3D surface structure represented in the surface scan.

[0107] As shown in Figures 3A and 3B, both the volume density scan model 1a and the surface scan model 1b are surface models of (generally the same) anatomical region. The 3D surface models 1a and 1b do not include representations of internal anatomy. This means that neither model includes information about the socket or other structures beneath the visible outer surface of the object in the model. In an illustrative example, if the object is a tooth, this means that the anatomy of the tooth socket that houses the tooth cannot be seen, because the socket is not visible in either the 3D volume density scan model (Figure 3A) or the 3D surface scan model (Figure 3B).

[0108] In both Model 1a of FIG. 3A and Model 1b of FIG. 3B, only the crown portion of the tooth is modeled, and neither scan model includes the root or the anatomy of the socket that houses the tooth. While surface details are useful when planning a patient's dental treatment, planning the patient's surgical treatment, and designing the patient's prosthesis, the lack of available subsurface information in Models 1a and 1b about the patient's anatomy below the visible surface of the patient's oral cavity can hinder accurate planning and design.

[0109] To facilitate the generation of accurate 3D socket models, in one embodiment, each of the respective volumetric density scan data and surface scan data from which the respective 3D surface models 1 a and 1 b are generated is submitted to a segmentation application. The segmentation application may be a remote service 244 or may be a local application (which may be stored in local memory 204 and executed by one or more processors 201). The segmentation processor processes each of the received surface scan data and volumetric density scan data to automatically recognize (via image recognition functions) and extract and classify (via segmentation functions) individual recognized objects into labeled categories or classes.

[0110] For example, in embodiments where the objects are teeth in a patient's mouth, a segmentation processor receives each of the intraoral surface scan data and CBCT or other volumetric density scan data, processes each of the scan data sets to recognize and label the recognized objects as individually identified teeth, gums, bone, and potentially other objects such as fillings, implants, etc. that are recognized in the received scan data, and tags the recognized objects with a corresponding object type label associated with the object type (or classification) of the recognized object.

[0111] For example, the segmentation processor may recognize an object in the 3D model or scan data that corresponds to tooth type 16 and assign the recognized object the object type label "16" (or any unique label that classifies the recognized object as being of a unique object type that corresponds to the patient's actual tooth 16). The segmentation processor recognizes and classifies (i.e., "labels") the recognized data segments in the scan data into a plurality of individual segments and corresponding various recognized object types.

[0112] Each segment preferably comprises a 3D surface model representing the actual scanned object (e.g., a scanned tooth, a portion of gum, bone, an implant, etc.). In one embodiment, each segment corresponds to an individual object within the patient's oral cavity and is labeled as such with an associated label. Each segment comprises its own independent 3D model represented as a three-dimensional triangular (or other polygonal) mesh.

[0113] 3C , a segmentation processor may recognize representations of individual teeth 11, 12, 13, 14, 15, 16, and 17 in a patient's volumetric density scan and segment each recognized representation of any of teeth 11, 12, 13, 14, 15, 16, and 17, gums 2, and bone 3 into corresponding independent segments 11 a, 12 a, 13 a, 14 a, 15 a, 16 a, 17 a, 2 a, and 3 a, collectively forming a segmented volumetric density scan surface model 10 a. Each segment is converted into an independent surface mesh, e.g., a 3D triangular mesh, and each segment may be independently selected (e.g., when presenting the segmented model in a graphical user interface (GUI) as discussed below).

[0114] In particular, because segments 11a-17a, 2a, and 3a were extracted from volumetric scan data, each segment contains the complete information available from the volumetric density scan. This means that objects (e.g., nerve canals) and portions of objects (e.g., tooth roots) that cannot be imaged in a surface scan because they lie beneath the visible surfaces inside and outside the patient's mouth are still modeled in the volumetric density scan segments. Each volumetric density scan segment contains the complete object information (based on what is imaged in the volumetric scan data), even if it is beneath the surface of the scanned anatomical region of the patient. Thus, each of teeth 11a-17a includes root information, which is clearly visible in the segmented model.

[0115] 3D , the segmentation processor may recognize representations of individual teeth 11, 12, 13, 14, 15, 16, and 17 in the patient's surface scan and segment each recognized representation of any of teeth 11, 12, 13, 14, 15, 16, and 17 and gingiva 2 into corresponding independently selectable segments 11 b, 12 b, 13 b, 14 b, 15 b, 16 b, and 17 b and 2 b to collectively form segmented surface scan surface model 10 b. Each segment is converted into an independent surface mesh, for example, a 3D triangular mesh.

[0116] The segmented model 10b includes all of the segments of the patient's scanned anatomical region, with each segment being an independently selectable 3D model of the corresponding scanned object. Thus, each segment 11b-17b, and 2b, can be viewed by itself, as shown, for example, in FIG. 3I (which shows only tooth segment 16b, corresponding to the patient's tooth 16). Tooth segment 16b includes only the portion of tooth 16 present in the surface scan. Thus, tooth segment 16b represents only the crown of tooth 16, since only the crown (the portion of tooth 16 above the gum line) is visible during the surface scan.

[0117] Figure 3E shows a segmented volumetric density scan surface model 10a and a segmented surface scan surface model 10b cross-mounted to a common three-dimensional coordinate system. Separate imaging systems are typically used to capture each of the surface scan data and the volumetric density scan data. For example, an intraoral scanner (IOS) may be used to capture a surface scan of a patient's oral region of interest, while a CBCT scanner may be used to capture a volumetric density scan of the patient. Both scans are valuable in providing important information and complement each other to provide a more complete picture of the patient's actual oral condition. While surface scanners (such as optical scanners) can capture very high-resolution details of the visual topography of a patient's dentition, they can only capture surface details, not internal details.

[0118] In contrast, a volumetric density scan (such as a CT or CBCT scan) can capture details of the internal volume and density of a patient's dentition, such as the dimensions and density of the jaw, complete teeth (including roots), and nerve pathways. Together, surface and volumetric density scans can form the basis of dental treatment planning and the prosthetic manufacturing process.

[0119] Because independent imaging systems capture image data relative to the specific 3D coordinate system of the imaging system that captures the scan, in order to cross-mount the scans into a single view pane with its own 3D coordinate system, both scans must be aligned with each other. This process is often called scan matching or registration. Methods exist for aligning 3D meshes to a single 3D coordinate system.

[0120] In one embodiment, each of the surface scan data and volume density scan data is segmented into 3D triangular mesh segments corresponding to individual teeth and jaws, followed by keypoint determination of corresponding tooth segments from each of the surface scan and volume density scan for each tooth, followed by alignment of the keypoints in a common 3D coordinate system. This process may be performed, for example, using CoDiagnostix™ dental implant planning software from Dental Wings, Inc. (a Straumann Group company).

[0121] In particular, in FIG. 3E , the location of each segment (11a, 12a, 13a, 14a, 15a, 16a, 17a, 2a and 11b, 12b, 13b, 14b, 15b, 16b, and 17b and 2b) from each segmented model 10a and 10b corresponds to the same respective actual anatomical structure (11, 12, 13, 14, 15, 16, 17, and 2) within the patient's mouth. As can be seen, it is very important that segments corresponding to portions of the same actual anatomical structure from each scan type (e.g., interior or surface) be mounted in the same three-dimensional coordinate system. When properly cross-mounted, as shown, the segments representing the same actual anatomical structure substantially coincide.

[0122] In one embodiment, the segmentation processor processes the scan data to identify and classify portions of the scan data into individual segments classified by anatomical structure type based on a set of labeled training data containing multiple instances of each of the anatomical structure types. In one embodiment, the segmentation processor is a trained convolutional neural network (CNN) that has been trained on a large dataset of scan images obtained from many different people with different anatomical conditions, including or lacking different teeth, gums, bones, and other natural and artificial (e.g., implants, prosthetics, etc.) anatomical structures.

[0123] FIG. 3F illustrates the problem encountered when tooth scan segment 16b (see FIG. 3D) is removed from the surface scan. As shown, removing tooth crown segment 16b results in a hole 16c in model 10b where crown 16b previously was. This is expected because segmented surface scan 3D model 10b is generated based solely on surface scan data, which does not include bone or other subsurface information, such as tooth root information. Thus, when tooth segment 16b is selected and removed from segmented surface scan model 10b (see FIG. 3D), no socket information is available, and surface scan model 10b only has hole 16c where tooth segment 16b was before removal.

[0124] Figure 3G shows the segmented surface scan 3D model with tooth segment 16a from the segmented volume density scan 3D model (of Figure 3C) co-mounted in the same 3D coordinate system after tooth segment 16b has been removed. Figure 3H shows tooth segment 16a separate and apart from the other segments of volume density scan model 10b. Tooth segment 16a is separated from crown portion 16a. c and root portion 16a r In particular, the root portion 16a of the tooth 16 r Trunk 16a t and three individual roots (Lingual root 16a r_l , mesio-buccal root 16a r_mbs(not visible in Fig. 3H ), and distal buccal root 16a r_dbr The tooth 16 may have three individual roots, while other teeth may have only one root, or may have two or additional roots. For simplicity, the trunk and individual roots of any given tooth may be collectively referred to herein as the "roots" of the tooth. Crown 16a c Only the root portion 16a is visible above the gum line in the surface scan. r are not visible above the gum line with the naked eye or with the camera of an intraoral scanner.

[0125] Figure 3I shows an individual tooth segment 16b (from the segmented surface-scan 3D model 10b of Figure 3G). As shown, tooth segment 16b represents only the crowns of teeth 16, as only the crowns of the teeth are visible to the surface-scan camera (because they are above the gum line and visible to both the naked eye and the camera lens).

[0126] In particular, because both the surface scan and the volume density scan image the same region of interest, both scans contain surface information about the same actual corresponding anatomy (assuming each scan scanned the same region). This means that for a visible surface, such as a tooth crown, both the surface scan and the volume density scan will each contain surface or surface boundary information about the tooth crown.

[0127] Surface scans using optical sensors tend to produce much higher resolution images, resulting in highly detailed surface 3D models. Volumetric density scans typically use modalities that are not as accurate as optical scans or are not medically safe to be as accurate as optical scans. For example, volumetric density scans generated using X-ray technology, including CT or CBCT modalities, are based on X-ray radiation and can obtain highly accurate images using high doses of X-rays, but doing so is not medically safe for patients. Therefore, CT and CBCT modalities used on patients must be set to very low levels of X-ray radiation, making them safer for humans. The tradeoff is lower image accuracy. Therefore, crown surface data from surface scans generally contain more detail than crown surface data from volumetric density scans.

[0128] To generate a 3D model of the patient's oral situation after tooth removal, the application uses a volume density scan of the root portion 16a of the tooth segment 16a. r Hold the crown part 16a c To do this, the application determines the gum line around the volume density scan tooth segment 16b based on points along the bottom edge of the surface scan tooth segment 16b.

[0129] FIG. 3J shows a surface scan tooth segment 16a and a cross-mounted volume density scan tooth segment 16b (both displayed in the same 3D coordinate system). As shown, the gum line 16b gl is the set of points corresponding to the lower edge of the surface scan tooth segment 16b. gl Since the position of the crown part 16a is known, c is calculated in the application specific 3D coordinate system as all points on the same side of the gum line (also called the cut line) where the surface scan tooth segment 16b lies.

[0130] Briefly, the application removes all points of the volume density scan tooth segment 16a that coincide with or fall within substantially the same volumetric 3D coordinate system region as the surface scan tooth segment 16b (i.e., crown), i.e., the corresponding portions of the volume density scan tooth segment and the surface scan tooth segment are jointly represented. r is obtained by subtracting 16b from 16a (and removing any outlier points if necessary).

[0131] FIG. 3K shows a volume density scan of tooth segment 16a to crown portion 16a. c Root 16a removed r Since this is a surface model, only the outer points of the segment are present in the 3D model, and therefore the crown portion 16a c When the segment 16a is removed, the inner r_内部 is empty. Root part 16a r The shape and morphology of the root 16a is defined from surface models of the individual segments obtained from the volume density scan. r is defined only by points on the outer surface of the

[0132] Thus, the inner contour of the root follows the contour of the outer surface of the root itself. The remaining root 16ar can then be displayed along with the surface model 10a of FIG. 3F (with the crown segment 16a removed) to generate a surface 3D model 10d that represents the patient's oral situation with the tooth 16 extracted. This is shown in FIGS. 3L, 3M, and 3N. FIG. 3L presents the 3D model 10d in a lingual view, substantially along a horizontal plane, to show the cavity 16c and socket contour 16s. FIG. 3M shows the model 10d from a different orientation along the same horizontal plane as FIG. 3L, as seen from the rear of the model. The socket contour is better visible from this perspective. FIG. 3N shows yet another view of the model 10d, looking into the socket from which the tooth 16 was virtually extracted. The contour of the socket 16s is visible, indicating where two of the three individual root projections were located before the virtual extraction of the tooth 16.

[0133] The socket 16s includes the contours of the trunk and where each of the individual roots was located prior to the virtual extraction. As shown, the socket 16s follows the contours of the roots of the extracted tooth, including the trunk-socket portion 16a. t and tongue base 16a r_l , mesio-buccal root 16a r_mbr , and distal buccal root 16a r_dbr Corresponding tongue sockets 16s r_l , mesial buccal root socket 16s r_mbr , and distal buccal root socket 16s r_dbr and three individual root sockets containing

[0134] The tooth volume density scan segment model contains only the outer (boundary) surface of the tooth object, and therefore does not contain information about the interior of the tooth itself. That is, for segmentation, the segmentation processor generates a 3D mesh of the outer surface of the tooth without including any modeling of the interior of the tooth. For closed objects such as teeth, the 3D mesh model is also a closed triangular mesh (the number of edges and triangular faces associated with any given vertex is equal). Thus, the truncated root segment 16a r the inside of the crown portion 16a c Since the segment 16) from which the root segment 16a was removed is empty, r The inner surface of the root segment 16a r The inner surface follows the same contour as the outer surface of the root segment 16a. r This is the same exterior wall, seen from the inside of the wall.

[0135] Crown portion 16a from volume density scan segment 16a c Removal of the vertex produces an open mesh (i.e., there is at least one vertex in the mesh where the number of edges associated with the vertex exceeds the number of triangular faces associated with that vertex). As used herein, an edge face is a face where the number of adjacent faces (that share an edge) is not equal to the number of edges of the face. Crown portion 16a of volume density scan segment 16a cIn the context of the removal of the remaining part of the volume density scan segment 16a, i.e., the cut root segment 16a r includes a set of marginal surfaces along the margin line (where the crown meets the gingiva) and results in an open mesh. r Since there is no information inside the open mesh, the inner surface of the cut root segment 16a r It is identical to the exterior of

[0136] At any point after the segmented volumetric density scan surface model 10a and the segmented surface scan surface model 10b are cross-mounted in a common three-dimensional coordinate system (see FIG. 3E), the user may inspect or actually intervene in the patient's oral cavity (e.g., by removing dental tissue with a dental drill). To do so, the user inserts the head of an appropriate dental tool into the oral cavity. The surface scanner 114 of the system 100 scans the oral cavity, and as described above with reference to FIG. 2B, the system 100 generates a display environment on the GUI 120 of both the second data set (i.e., at least a portion of the digital patient model) and a digital representation of the surface scanner 114, with the surface scanner 114 positioned and oriented according to its real-world position and orientation relative to the digital patient model.

[0137] 3O is a schematic diagram of a display environment 400 of the GUI 120, including a depiction of a digital patient model 402 and a digital representation 404 of the surface scanner 114. In this example, the surface scanner 114 is integrated into or includes a dental drill (shown without a drill bit for clarity). Because the surface scanner 114 in this example includes a pair of lateral protrusions on either side of the dental drill's head, these are also illustrated (at 406a, 406b) on the digital representation 404 of the surface scanner 114. (This arrangement maximizes the three-dimensional sensitivity of the optics (i.e., light source and photodetector) of the surface scanner 114.)

[0138] As the user manipulates the surface scanner 114 within the oral cavity, the system 100 updates the view shown in the display environment 400 of the GUI 120 based on the scan data continuously received by the system 100 from the surface scanner 114. As a result, the user can see exactly where the surface scanner 114 is located within the oral cavity, including the position and orientation of the drill bit.

[0139] 4A, 4B, 5A, and 5B illustrate an exemplary embodiment of a display environment 500 of GUI 120 during various steps in a dental treatment planning workflow. GUI display environment 500 may be displayed on the electronic display 118 of system 100 implementing a dental treatment planning application. GUI display environment 500 includes controls 501 (not shown separately) that allow a user to select and load patient scan data into memory 106 of system 100 or onto an external memory device (not shown) accessible through system 100 or accessible by remote service 102 via network adapter 122.

[0140] In the context of the described aspects of the invention, scan data includes surface scan data and volume density scan data of the patient's anatomical region of interest. In one embodiment, both the surface scan and the volume density scan are acquired prior to dental treatment planning, while in other embodiments, one or both of the surface scan data and the volume density scan data are acquired in conjunction with use of dental treatment planning.

[0141] For example, the remote surface scanning service 130 may include an optical scanner application in communication with an optical scanner, which communicates optical scan data to the system 100 during or after completion of an intraoral scan of a region of interest in a patient's oral situation. Similarly, the volumetric density scanning service 132 may include a volumetric density scanner application in communication with a volumetric density scanner, which communicates volumetric density scan data to the system 100 during or after completion of an intraoral scan of a region of interest in a patient's oral situation.

[0142] As described above, system 100 manages the display of graphical content in GUI display environment 500 of GUI 120, including monitoring user input to graphical controls received through user input devices 112, such as a mouse, keyboard, joystick, voice recognition, etc. User input may correspond to actions to be taken, such as invoking various application functions specific to the application or essential features of the GUI functionality to change the layout or content of features displayed on the display. More specifically, the front-end GUI displays user input controls and monitors user input associated with the function controls. Upon receiving user input associated with a user input control, the GUI invokes the appropriate function corresponding to the particular user input control and the type and content of the user input. The GUI is also responsive to back-end processes that communicate with the back-end GUI, which in turn communicate with the front-end GUI to display, remove from display, and / or modify the display of information on the electronic display.

[0143] Such user-selected functions may result in the display, removal from display, modification of display of models, views, segments, and / or annotations, the display, removal from display, and updating of the appearance of various user controls and information displayed in the GUI display environment 500, and the receipt and return of information to facilitate essential functional features of the system 100, including, but not limited to, essential treatment evaluation, essential treatment planning, virtual execution of treatment or surgery (such as tooth extraction, implant placement, prosthesis design and placement, etc.).

[0144] 4A, GUI display environment 500 includes global controls 501 such as file management, general display controls, and other controls common to the GUI display environment. For example, controls 501 may include a file selection control, a file save / export control, a view pane formatting control, etc. GUI display environment 500 also includes patient data specific controls 502 such as dental arch and individual tooth model controls.

[0145] The GUI display environment 500 includes functional controls 503, including a tooth extraction control 512. While tooth extraction control 512 is generally shown as a single control, it may include multiple controls, such as a pop-up display panel guided dialog or other well-known GUI interactive techniques, for displaying information and requests for information and for receiving user input. The GUI 500 also includes at least one view pane 503 for displaying therein a three-dimensional model of a selected patient's 3D anatomical model of the patient's oral situation (or a selected portion thereof) obtained from the patient's scan data and selected via a selection control in control 502.

[0146] Control 501 includes one or more controls (not shown) that, when selected, allow a user to select the patient's surface and volume density scan data from memory 106 of system 100. In one embodiment, when patient scan data is initially loaded, GUI display environment 500 may display one or more view panes 503 (only one shown) to present a visual overview of the patient's oral condition on the display. In FIG. 4A , view pane 503 is shown displaying a 3D model of the volume density scan. Environment 500 may also include various additional views of the patient's oral condition based on the volume density scan data. For example, environment 500 may include a panoramic view pane, an axial view pane, a cross-sectional view pane, and a tangential view pane (not shown).

[0147] An important purpose of the virtual tooth extraction tool accessible via control 512 is to virtually represent the patient's oral situation upon virtual removal of one or more teeth or other objects selected for extraction. For example, when a tooth is virtually removed and displayed within GUI display environment 500, the resulting displayed 3D model should include a representation of the tooth socket that will become visible to the naked eye upon removal of the targeted extracted tooth. This ensures that system 100 generates a digital patient model for display in display environment 500 using the digital representation of surface scanner 114 that is faithful to reality but that can be modified, for example, by the virtual extraction procedure to reflect the planned tooth extraction.

[0148] As shown in Figure 4A, a user can activate the virtual tooth extraction tool by selecting the tooth extraction control 512 via a mouse (not shown) by moving a graphical cursor 520 over the control 512 and mouse-clicking the control 512. Figure 4B shows an embodiment of a pop-up dialog 513 that is displayed in the GUI environment 500 when the tooth extraction control 512 is activated. As shown, the dialog may include a tooth selection map that allows a user of the system 100 to select one or more individual teeth for virtual extraction.

[0149] In one embodiment, the user may select teeth, such as target extracted teeth, by clicking on individual teeth in the chart. Optionally, the user may select a respective selection click box or radio button, or other such selection feature, to save the socket model generated by the tool upon socket generation and / or to extract the extracted tooth model (which includes in the view pane 503 a model minus the target extracted tooth and plus the socket models generated for such target extracted tooth). Once the user has selected the target extracted tooth and selected the save / extract option, the user may click the select button 517 to invoke the tooth extraction tool.

[0150] FIG. 5A shows a posterior view of the 3D extracted tooth model 10D (looking from the patient's back toward the front into the maxillary dental arch), which better shows the 3D socket model 16s corresponding to the socket from which the tooth 16 will be extracted. The socket model 16s is displayed along with the 3D surface scan model from which the tooth 16 was extracted. FIG. 5B shows the same model 10D from a bottom view (looking up from below toward the maxilla). As shown, the tooth 16 is missing, but the interior 16c of the socket 16s is visible, following the contours of the root of the extracted tooth 16.

[0151] FIG. 6A depicts a GUI display environment 700 generated by system 100 (e.g., by display generator 250 of FIG. 1B ) after a patient's surface and volume density scans have been imported and loaded into memory 106 of system 100. FIG. 6A illustrates the state of the patient's teeth after a dental professional has selected and virtually placed an implant. Techniques for virtually placing an implant in a virtual model of a patient's dentition are already known in the art, such as through the use of CoDiagnostix® dental implant planning software. In FIG. 6A , a virtual implant post 710 is positioned and shown in various types of views in corresponding view panes of graphical environment 700. In the illustrated example, the implant post 710 is shown virtually positioned in a cross-sectional view (view pane 703 d), an axial view (view pane 703 c), a panoramic view (view pane 703 b), a tangential view (view pane 703 e), and a 3D view (view pane 703 a).

[0152] As shown in the various views of panes 703a-703e, the placement of the implant is represented by the placement of an implant post or screw 710, which is the base of a full implant. The full implant includes the implant post 710, an abutment (not shown) that attaches to the implant post 710, and an abutment for a prosthesis or dental restoration (not shown), which may be a crown, bridge, or denture.

[0153] During the initial planning stage, only the implant post 710 needs to be virtually placed. The implant planning software application provides a virtual implant placement guide 711, which does not correspond to a physical component; it is merely a visual indicator to assist the dental professional in placing the implant at the correct angle. In FIG. 6A , the virtual guide 711 appears in the 3D view pane 703a as a long, cylindrical rod whose central axis coincides with the central axis of the implant post 710 and whose diameter corresponds to the diameter of the abutment attachment socket inside the implant post. The cylinder of the virtual implant placement guide 711 preferably extends along its central axis above the occlusal plane of the tooth, such that the cylindrical length is much longer than the cylindrical diameter. The guide 711 is preferably displayed in a color that contrasts with the colors used in the 3D model and other view panes so that the application user can immediately see the guide in relation to the content of each view pane.

[0154] The GUI display environment 700 includes a tooth extraction control 712 that is accessed in the exemplary embodiment by selecting a control from the view pane display control 702 that corresponds to the portion of the patient's dentition where the implant under consideration will be placed. In the embodiment shown, the dental professional selects the mandibular dental arch control, right-clicks on it to bring up a context menu, and selects the tooth extraction control 712 from the context menu. Selecting the tooth extraction control may instruct the dental treatment planning application to automatically perform a virtual tooth extraction (using the principles described above). There are many ways to implement a control that invokes the automatic virtual tooth extraction tool; the key is to provide one or more controls that allow the user to invoke the tooth extraction workflow.

[0155] FIG. 6B illustrates a pop-up window 713 that appears in the GUI display environment 700 when a user selects the tooth extraction control 712. The pop-up window presents several options and user input controls for obtaining input required by the virtual tooth extraction tool, including a tooth selection control 713 and a mode control 714. In the embodiment shown in FIG. 6B, the tooth selection control 713 displays a set of selectable tooth icons corresponding to the teeth in the selected portion of the patient's dentition selected by the user in FIG. 6A. The user (i.e., dental professional) may select the tooth corresponding to the tooth on which the virtual implant post 710 is placed. In this example, the user selects tooth 35, which corresponds to the tooth on the left side of the mandibular dental arch on which the virtual implant post 710 is placed. For the mode, the user selects "Mode: Alveolar Resection" 715 from the options drop-down menu 714, checks the checkbox control 716 to indicate that the extracted tooth should be saved as a separate file for future planning, and invokes the virtual tooth extraction tool by clicking the extraction control 717.

[0156] FIG. 6C shows a 3D surface model of the patient's dentition in the view pane 703a. Upon completion, the virtual tooth extraction tool adds two 3D model files to the list of available model scans and 3D models in the control section 702 of the GUI display environment 700. The user can select these files to display in the pane. One file is an extracted tooth model (indicated at 721 in the file list). The extracted tooth model was created by the virtual tooth extraction tool according to the techniques described in connection with FIGS. 1 and 4 , and is a 3D surface model of the patient's dentition (including the previously placed implant post 310) with the selected tooth 35 removed from the model and a socket generated and included in its place in the model. The second file is an extracted tooth model (indicated at 722) in the file list, which is a model of the tooth 35 with the crown removed from the root.

[0157] Once these files have been created, the user clicks on the Plan menu 723 in the GUI display environment 700 and selects the Virtual Plan export control 724, as shown in FIG. 6D. In a next step, as shown in FIG. 6E, the user can then select the format of the export file in the format selection control 727 of a pop-up window 726. In this example, the user selects the STL format option 728 and clicks Next 729 to move to the next menu. In the next step, shown in FIG. 6F, the user selects the button control 732 to activate the option to export the selected model scan or segmentation without further processing.

[0158] Clicking the Next button 733 in FIG. 6G selects the tooth extraction file 731 from the Export File Selection pop-up window 730. Clicking the Next button 732 displays the Implant Selection pop-up window 735 shown in FIG. 6H, which provides a scanbody selection control 736. The scanbody selection control 736 includes a scan selection control 737 that allows the user to view and select a suitable scanbody from a set of possible scanbody types. The user can select a scanbody from a menu of scanbodies and add the selected scanbody to the model for export. The scanbody will enable verification of the correct postoperative positioning of the implant (or other anchor element) relative to the tooth surfaces of the patient's dentition after its implantation and, potentially, during the healing period. This can be achieved by aligning the three-dimensional measurement data of a surface scan obtained from the person's postoperative oral cavity with a three-dimensional digital patient model containing the selected scanbody.

[0159] The user then clicks the Next button 738. In Figure 6I, the user can select additional options, such as selecting the 3D coordinate system in which to export the model and whether the exported objects should be exported as individual files that share a coordinate system. Clicking on the Export Plan line 741 invokes the export function based on the selected options and the parameters selected by the user on the previous screen. The export file is saved to a known location in computer-readable memory.

[0160] In Figure 6J, the same process may be followed to export the surface scan crown segment of the virtually extracted tooth (and optionally the antiocclusal crown segment, i.e., the crown segment from the tooth in the opposite jaw that contacts the target extracted tooth in the occlusal plane when the jaws are closed). It is important to ensure that the surface scan tooth segment is exported in the same coordinate system as the exported virtual extracted tooth model.

[0161] The resulting exported file contains a 3D model of the patient's dentition with the virtual extraction of the tooth where the intended implant replacement will be placed. In place of the extracted tooth is a virtual socket where the virtual tooth once was. The model also includes a virtual implant post placed in the socket where the dental professional placed it during the implant planning process.

[0162] 7A-7T illustrate a GUI display environment 900 for a prosthetic design application, such as a computer-aided design (CAD) or computer-aided manufacturing (CAM) tool. In one embodiment, the prosthetic design tool is an application operating on the system 100 described above with reference to FIGS. 1A and 1B.

[0163] FIG. 7A shows a GUI display environment 900 displayed on the GUI 120 of the electronic display 118, including user input controls and display areas, as discussed below. To design a prosthesis, a user clicks control 901 (FIG. 7A) to start a new case, enters case information (e.g., the case ID, patient ID, and dentist ID associated with the new case in the text boxes), and selects and loads into memory a 3D model generated from the patient scan data for use in the system 100. In this example, a dental crown is being designed. The user enters file names for the virtual extraction file (in this case, as the mandibular tooth model input) and the extracted tooth file (as the mandibular wax-up), and loads the files into the system by, for example, clicking the Save button (FIG. 7B). The system 100 displays the 3D model from the selected virtual extraction file in the view pane 903 (FIG. 7C). If desired, system 100 provides controls in environment 900 to clean the scan (e.g., to fill holes where the scan data is imperfect, smooth scan lines, remove noise, etc.). System 100 may then provide tools to adjust the orientation of the model relative to the occlusal plane, if desired (FIG. 7D).

[0164] Before proceeding with the design, the user tags tooth positions in the displayed model to indicate to the system 100 the tooth positions for which the prosthesis will be designed and which teeth are adjacent to the tooth for which the prosthesis will be designed (see FIG. 7E). Next, in FIG. 7F, the user selects the platform (implant manufacturer, implant type and connection) and scanbody. These selections should match the implants and scanbody selected in the dental implant or treatment planning application, and the virtual extraction file has also been generated accordingly.

[0165] Once the setup is complete, the user can proceed to design the prosthesis. In FIG. 6J, the surface scan crown segments from the 3D model were exported as individual segments in a 3D coordinate system aligned with the virtual extracted tooth model. Because the surface scan crown model was generated from an optical scan of the patient's original tooth (before the actual tooth was actually extracted), the surface scan crown segments can be used as a digital wax-up model without having to re-scan the patient's mouth. Because the surface scan crown segments were exported as individual segments aligned with the same 3D coordinate system as the virtual extracted tooth model, the surface scan crown segments of the virtually extracted tooth can be mounted in the view pane along with the virtual extracted tooth model and directly used by the system 100 as the top portion of the prosthetic crown. By importing the surface scan crown segment file as a wax-up file (FIG. 7B), the designer can select the Clone Waxup control (FIG. 7G) to instruct the prosthetic design application of the system 100 to clone the wax-up model from the wax-up model file to serve as the prosthetic crown surface. Once the wax-up cloning tool has cloned the wax-up model as a prosthesis, the user can then fine-tune the prosthesis shape via the fitting, shaping, and sculpting controls available in the GUI viewing environment 900. The environment 900 also includes controls for rotating and changing the view of the model displayed in the view pane 903 so that the user can view the prosthesis 904 from all angles. For example, in FIG. 7H , the model 905 has been rotated so that the prosthesis 904 can be viewed buccally. This allows the designer to make adjustments to the prosthesis by viewing it in situ within the virtual extracted tooth model 905.

[0166] Once the visible surface of the crown has been designed based on the extracted surface scan crown segment acquired during the tooth extraction process, the user can then design the bottom of the prosthesis. The system 100 may provide controls for the designer to input restoration specifications, such as material type, color, and what should be output (e.g., output an STL file, output an order (which may be direct communication to a remote manufacturing facility)) (FIG. 7I).

[0167] In FIG. 7J, a virtual extraction model 905 is displayed in the view pane 903. The example case of FIGS. 7A-7T is a new case for implant prosthesis design, and the virtual extraction model 905 includes a virtual implant post because it was exported with the implant placed in the model (e.g., using the process described with respect to FIGS. 6A-6J). In this example, a temporary abutment is selected and automatically virtually connected to the implant post and displayed as shown. The user can then select the cement gap thickness (FIG. 7K), set the material thickness (FIG. 7L), and display the prosthesis 904 within the model 905, including the socket contour (or "emergence profile") (FIG. 7M). The user can then also turn off the display of the model 905 to display only the prosthesis (FIG. 7N).

[0168] Figure 7O shows the display of model 905 turned on again (see the on / off buttons for the various models in Figure 7O) and rotated to get a better side view of socket 910. With the anatomy transparency set low to see the implant post and abutment inside socket 910, it becomes clear that an anatomically correct prosthesis 904 can be designed to match the patient's oral anatomy by using the socket contour to guide the design of the lower crown portion of the prosthesis to fit the inner contour of socket 910. In this regard, the prosthesis design application provides controls for adjusting the shape and fit of the lower crown portion.

[0169] Once the base of the crown prosthesis is shaped to fit the contours of the socket 910, the designer can proceed to specify the prosthesis shell. The application can automatically calculate proximity distance information between the prosthesis surface (when the prosthesis is virtually attached to the virtual implant post 906) and the teeth on either side of the prosthesis (Figure 7P) and generate shell surfaces (viewed buccally in Figure 7Q and looking down the occlusal plane in Figure 7R). Figure 7S shows the final prosthesis design in a model with both the upper and lower jaws, with the anatomical model set partially transparent to partially visualize the implant post 906, abutment, and prosthetic crown. The user can easily check the placement and shape of the prosthesis through visual inspection of the model. Figure 7S. Figure 7T shows the same model and orientation as Figure 7S, but with the anatomy completely opaque. The workflow continues through the usual steps before sending the crown for manufacturing.

[0170] Once the prosthetic design is complete, the design file can be exported and used to manufacture the design. In one embodiment, the exported design file may be sent to a manufacturing facility or remote manufacturing service. In one embodiment, the exported prosthetic design file may be used to generate 3D printer instructions to send to a 3D printer that is responsive to such instructions to 3D print the prosthetic.

[0171] The above-described aspects and embodiments of the present invention provide multiple advantages in virtual socket visualization, anatomical treatment planning, and anatomical prosthetic design. According to one advantage, anatomical treatment specialists and prosthetic designers can plan treatment and design anatomically accurate prostheses based on an accurate three-dimensional model of the socket, which is the site of treatment planning and prosthetic design and which models the patient's specific socket anatomy.

[0172] The model may be generated prior to the removal of the anatomical object from the patient, allowing for accurate treatment planning and design of the prosthesis prior to or simultaneously (i.e., in parallel) with the actual surgical removal of the anatomical object from the patient. This means that the patient may require only a single visit with a treating specialist. In as few as one or two visits, the patient's anatomical region of interest, including the anatomical object targeted for removal, may be scanned. The scan data may be imported into digital treatment planning tools, including a virtual socket model generation tool and / or a virtual object removal tool, each of which generates a virtual socket model that is included in a representation of the virtual anatomical model of the patient's anatomical region of interest (i.e., the region including the target removal object and adjacent anatomical objects or features).

[0173] With the virtual socket model included in the displayed virtual anatomical model, the treating professional can more accurately virtually place implants or other treatment bodies in the virtual socket model, design and print 3-D printable surgical guides, and export the virtual anatomical and virtual socket models for use in a separate prosthetic design software tool to design an anatomically accurate prosthesis. If the treating professional has access to immediate prosthetic manufacturing equipment, the prosthesis can be manufactured while the patient is in the office. Otherwise, the prosthesis can be sent to a lab for manufacturing, and the patient can return when the anatomical area surrounding the implant has healed sufficiently to fit the prosthesis onto the implant.

Claims

1. 1. A computer-implemented method (100) for generating, by one or more computer processors, a three-dimensional model (10D) for use in assisted navigation of a patient's oral cavity, said method being based on at least a first scan of an anatomical region of the patient's oral cavity, said method comprising: receiving a first data set including surface boundary information from the first scan and generating a three-dimensional digital patient model from at least a portion of the first data set; performing a three-dimensional surface scan of a portion of the oral cavity using a three-dimensional surface scanner, thereby obtaining a three-dimensional surface scan, the three-dimensional surface scan including a region of interest; registering the acquired three-dimensional surface scan to at least a portion of the three-dimensional digital patient model; using the acquired three-dimensional surface scan and the digital patient model to determine a spatial transformation configured to align or register the acquired three-dimensional surface scan and the three-dimensional digital patient model to a predetermined degree; determining position and orientation information of the 3D surface scanner relative to the 3D digital patient model using at least the transformation; generating a second data set including the position and orientation information of the 3D surface scanner relative to the 3D digital patient model.

2. The method of claim 1 , wherein the second data set further comprises at least a portion of the three-dimensional digital patient model.

3. 3. The method of claim 1 or claim 2, wherein the surface boundary information of the first data set includes surface segments, the surface segments having labels associated therewith identifying a tissue type, each surface segment representing a tissue type selected from the group including gingival tissue, bone tissue, and dental tissue.

4. 4. The method of claim 3, further comprising identifying elements of the anatomical region of the patient's oral cavity in the three-dimensional digital patient model, including retaining labels associated with surface segments that identify the tissue types in the process of generating the three-dimensional digital patient model.

5. 5. The method of claim 1, wherein the second data set further comprises a digital representation of the three-dimensional surface scanner in a common frame of reference, the digital representation of the three-dimensional surface scanner being positioned and oriented according to the position and orientation information.

6. The method of any one of claims 1 to 5, comprising generating the second data set as a three-dimensional output model.

7. 7. The method of claim 6, further comprising: the navigation system receiving a dental treatment or examination plan; determining a region of interest in the three-dimensional output model based on the dental treatment or examination plan; and identifying the region of interest in the three-dimensional output model.

8. 8. The method of any one of claims 1 to 7, comprising transferring the second dataset to a visualization system configured to visualize at least a portion of the second dataset using a three-dimensional or pseudo three-dimensional display device.

9. The method of claim 8 , wherein the visualization system includes augmenting or overlaying a display of the portion of the second data set with a view of the patient's oral cavity.

10. The method of any one of claims 1 to 9, comprising acquiring and updating the three-dimensional surface scan continuously or in real time.

11. 11. The method of any one of claims 1 to 10, comprising transferring the second data set to a robotic navigation system configured to control navigation of a dental instrument, such as a dental drill, a dental probe, or another type of dental instrument, based on the position and orientation information included in the second data set.

12. 12. The method of any one of claims 1 to 11, wherein the 3D surface scanner comprises, is integral with, or is mounted on a dental instrument, such as a dental drill, a dental probe, or another type of dental instrument.

13. 13. The method of any one of claims 1 to 12, wherein aligning at least a portion of the three-dimensional digital patient model to the acquired three-dimensional surface scan uses only surface boundary information of the first data set that includes segments labeled as dental tissue.

14. The method of any one of claims 1 to 13, wherein the surface boundary information from the first scan is determined from a surface scan and / or a volume density scan of the anatomical region of the patient's oral cavity.

15. The method of any one of claims 1 to 14, wherein the digital patient model does not include digital representations of marker elements.

16. 1. A system for generating a three-dimensional model for use in assisted navigation of a patient's oral cavity, the system comprising: at least one computer processor (104); A storage device (106); a 3D surface scanner (114) for performing a 3D surface scan of a portion of the patient's oral cavity, and optionally a display device and / or a robotic navigation (assistance) system; A system, wherein the storage device (106) stores instructions that, when executed by the computer producer (104), implement the method of any one of claims 1 to 15.

17. 16. Computer program code for performing the method of any one of claims 1 to 15 when executed by a computer processor (104) communicatively connected to a 3D surface scanner (114) for performing a 3D surface scan of a portion of a patient's oral cavity.

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