Intraoral scanner with dental diagnostic capabilities

Abstract

To provide methods and apparatuses for scanning both external and / or internal structures of teeth.SOLUTION: Described herein are intraoral scanning methods and apparatuses for generating a three-dimensional model of a subject's intraoral region (e.g., teeth) including both surface features and internal features. These methods and apparatuses may be used for identifying and evaluating lesions, caries and cracks in the teeth. Any of these methods and apparatuses may use minimum scattering coefficients and / or segmentation to form a volumetric model of the teeth.SELECTED DRAWING: Figure 1A

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This patent application claims priority to U.S. Provisional Patent Application No. 62 / 367,607, entitled "INTRAORAL SCANNER WITH DENTAL DIAGNOSTICS CAPABILITIES," filed July 27, 2016, U.S. Provisional Patent Application No. 62 / 477,387, entitled "INTRAORAL SCANNER WITH DENTAL DIAGNOSTICS CAPABILITIES," filed March 27, 2017, and U.S. Provisional Patent Application No. 62 / 517,467, entitled "MINIMAL VALUE LIFTING TO FORM A VOLUMETRIC MODEL OF AN OBJECT," filed June 9, 2017, each of which is incorporated herein by reference in its entirety. Literature citations

[0002] All publications and patent applications mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.

[0003] The methods and devices described herein may relate to optical scanners, and in particular to optical scanners that generate three-dimensional representations of objects. In particular, methods and devices are described herein that may be useful for scanning (including 3D scanning) and analyzing the oral cavity for diagnosis, treatment, longitudinal tracking, dental metrology, and detection of dental caries and cracks. These methods and devices may generate volumetric models of the internal structure of the teeth and / or may include color scanning. [Background technology]

[0004] Many dental and orthodontic procedures can benefit from an accurate three-dimensional (3D) depiction of a patient's tooth-like structure and the interior of the mouth. In particular, it would be useful to provide a 3D depiction of both the surface and internal structure of the tooth (including enamel and dentin, as well as caries), as well as a rough internal composition of the tooth volume. Although a surface representation of the 3D surface of a tooth alone has proven very useful in designing and fabricating dental prostheses (e.g., crowns and bridges) and in treatment planning, it would be very useful to be able to image the internal structure, including caries and crack growth in the enamel and underlying dentin, especially when combined with surface topography mapping.

[0005] Historically, ionizing radiation (e.g., x-rays) have been used to image the interior of teeth. For example, bitewing radiographs are often used to obtain non-quantitative images of the interior of a tooth. However, in addition to the risks of ionizing radiation, such images are typically limited in their ability to show shape and can be time-consuming and costly to obtain. Other techniques, such as cone-beam computed tomography (CBCT), can provide tomographic images but also require ionizing radiation.

[0006] Thus, it would be useful to provide methods and apparatus (including devices and systems (e.g., intraoral scanning systems)) that can be used to model one or more teeth of a subject using non-ionizing radiation, including both the external (surface) and internal (within the enamel and dentin) structure and composition. The model of the subject's teeth may be a 3D volumetric model or a panoramic image. In particular, it would be useful to provide methods and apparatus that can provide this functionality in a single device. Improved methods and systems for scanning a patient's intraoral cavity and / or automating the identification and analysis of dental caries are needed. Summary of the Invention [Problem to be solved by the invention]

[0007] The present invention has been made to solve the problems of the prior art. [Means for solving the problem]

[0008] Generally, described herein are methods and apparatus (e.g., devices and systems) for scanning both the external and / or internal structures of teeth that are capable of generating a model of a subject's teeth, including both the surface topography features and the internal features (e.g., dentin, dental fillings, cracks, and / or caries). Any of these devices may include an intraoral scanner that scans inside or around the subject's oral cavity, the intraoral scanner comprising one or more light sources capable of illuminating in two or more spectral ranges, i.e., a spectral range that illuminates the surface topography (e.g., visible light) and a penetrating spectral range (e.g., infrared range, and particularly "near infrared" (including but not limited to 850 nm). The scanning device may further include one or more sensors that detect the emitted light and one or more processors that control the operation of the scan and analyze the light received in both the first and second spectral ranges to generate a model of the subject's teeth, including the tooth surfaces and the internal topography (including within the enamel and dentin). The generated model may be a 3D volumetric model or a panoramic image.

[0009] As used herein, a volumetric model may include a three-dimensional virtual representation of an object, in which an internal region (such as a structure) is located in a physical three-dimensional volume in a proportional and relative relationship to other internal and surface shapes of the object being modeled. For example, a volumetric representation of a tooth may include an external surface that is located proportionally to the tooth, as well as internal structures within the tooth (below the tooth surface), such that a cross-section of the volumetric model approximately matches a cross-section of the tooth showing the location and size of the internal structures, and the volumetric model may be cross-sectional from any (e.g., any) direction and represent an equivalent cross-section of the object being modeled. A volumetric model may be electronic or physical. A physical volumetric model may be formed, for example, by 3D printing, etc. The volumetric models described herein may extend completely within a volume (e.g., extend throughout the entire volume (e.g., a tooth volume)) or may extend partially within a volume (e.g., extend within the volume being modeled to a certain minimum depth (e.g., 2 mm, 3 mm, 4 mm, 5 mm, 6 mm, 7 mm, 8 mm, 9 mm, 10 mm, 12 mm, etc.)).

[0010] The methods described herein typically include methods for generating a model of the subject's teeth, which typically generate a 3D model or rendering of the teeth, including both surface and internal features. Non-ionizing methods of imaging and / or detecting internal structures may be used, such as observing internal structures by illuminating the structures within the tooth using one or more penetrating spectral ranges (wavelengths) and acquiring images with the penetrating wavelengths, including using trans-illumination (illuminating from one side and capturing light from the other side after passing through an object) and / or using low-angle penetration imaging (e.g., reflectance imaging, capturing light reflected / scattered from the internal structures when illuminated with a penetrating wavelength). In particular, multiple penetration images may be acquired from the same relative position. While conventional penetrating imaging techniques (e.g., trans-illumination) may be used where the angle between the light emitter's illumination direction and the detector's (e.g., camera) viewing angle is 90 degrees or 180 degrees, methods and apparatus are also described herein where the angle is much smaller (e.g., 0-25 degrees, 0-20 degrees, 0-15 degrees, 0-10 degrees, etc.). Smaller angles (e.g., 0-15°) can be particularly advantageous as they allow the illumination (light source) and detection (detector (e.g., camera, etc.)) to be closer together, and allow the scanning wand for the intraoral scanner to be more easily positioned and moved around the patient's teeth. Such small angle penetrating images and imaging techniques may be referred to herein as reflected illumination and / or imaging, or reflected / scattering imaging. In general, penetrating imaging may refer to any appropriate type of penetrating imaging, including trans-illumination, small angle penetrating imaging, etc., unless otherwise specified. However, small angles can also cause direct reflections from the surface of an object (eg, a tooth) that can obscure internal structures.

[0011] The methods and apparatus described herein are particularly useful in combining a 3D surface model of one or more teeth with imaged internal features such as damage (caries, cracks, etc.) detectable by using penetration imaging, by using an intraoral scanner adapted to detect both surface and internal features separately but simultaneously (or nearly simultaneously). Combining surface scanning and penetration imaging can be performed by alternating or switching between these different modalities to allow both to use the same coordinate system. Alternatively, the surface scan and the penetration scan may be observed simultaneously, which may be done, for example, by selectively filtering the imaging wavelengths to separate infrared light (near infrared light) from visible light. The 3D surface data can thus provide important reference and angle information for internal structures and may enable interpretation and analysis of penetration images that may otherwise be difficult or impossible to interpret.

[0012] For example, described herein is a method for generating a model of a subject's teeth, the method including capturing three-dimensional (3D) surface model data of at least a portion of the subject's teeth using an intraoral scanner, obtaining a plurality of images of the interior of the teeth using near-infrared wavelengths with the intraoral scanner, and using the 3D surface model data and the plurality of images to form a 3D model of the teeth, including their internal shape.

[0013] One method of generating a model of a subject's teeth may include capturing three-dimensional (3D) surface model data of at least a portion of the subject's teeth with an intraoral scanner operating in a first imaging modality, the 3D surface model data having a first coordinate system, acquiring a plurality of images of the interior of the teeth with an intraoral scanner operating in a second modality using a penetrating wavelength, the plurality of images being referenced to the first coordinate system, and using the 3D surface model data and the plurality of images to form a 3D model of the teeth, including the internal structure. Generally, capturing the first wavelength does not necessarily capture an image, but a 3D surface scan can be captured directly. The second penetrating modality may be captured as images that are processed as described herein.

[0014] In general, capturing the 3D surface model data may include determining the 3D surface topology in any suitable manner. For example, determining the 3D surface topology may include using confocal focusing. Capturing the 3D surface model data may include using one or more of confocal scanning, stereoscopic vision, or structured light triangulation.

[0015] Any of the methods and devices described herein may be used to model, image, and / or render 3D images of a single tooth or tooth area, multiple teeth, teeth and gums, or other intra-oral structures, particularly from inside a subject's mouth.

[0016] Generally, the methods and devices described herein for implementing them include a 3D color intraoral scan / scanner. For example, the methods may include capturing color intraoral 3D data.

[0017] As described in more detail below, the methods and apparatus can control switching between collecting surface data and collecting penetrating imaging (penetrating) data. For example, any of the methods may include acquiring images using a penetrating wavelength while the 3D surface model data is being captured (e.g., by switching between a first imaging modality and a second (penetrating) imaging modality).

[0018] The same sensor may be used to collect the surface shape data and the internal shape data, or different sensors may be used. For example, acquiring multiple images may include using the same sensor on an intraoral scanner to capture the 3D surface model data and multiple images with penetrating wavelengths. Alternatively, one or more separate sensors may be used.

[0019] As mentioned above, acquiring images of teeth using a penetrating wavelength (or penetrating spectral range) may include acquiring a penetration image at any angle between the illumination source and a sensor (e.g., a detector or camera). In particular, internal shape (e.g., reflectance imaging) data may be imaged using a low-angle configuration, where one, or preferably two or more penetration images are acquired at various orientations relative to one or more teeth. For example, acquiring multiple images may include illuminating the teeth at an angle of 0° to 15° relative to a sensor (e.g., a detector, camera, etc.) that receives illumination from the teeth that is reflected from the internal composition of the one or more teeth. Acquiring multiple images (e.g., penetration images such as these low-angle penetration images) generally involves acquiring one or more (e.g., multiple including two or more, three or more, etc.) penetration images over the same region of the tooth and at various angles of the intraoral scanner relative to the tooth. Thus, the same internal region of the tooth is displayed in multiple different scans from various angles.

[0020] In general, any number of sensors may be included on an intraoral scanner (e.g., the wand of an intraoral scanner). Any suitable sensor may be used to detect and record (e.g., light) in the appropriate spectral range. Sensor may refer to and include detectors, cameras, etc. For example, obtaining multiple images may include capturing multiple images using penetrating wavelengths using multiple sensors on the intraoral scanner.

[0021] The illumination used to acquire the penetrating images is generally penetrating and thus capable of penetrating or penetrating at least a portion of the enamel and dentin of the tooth. The penetrating wavelength of light may primarily include infrared light, particularly near infrared light. For example, light in the range of 700-1090 nm (e.g., 850 nm) may be used. Other wavelengths or wavelength ranges may also be used, including wavelengths shorter than the visible spectrum. Thus, acquiring the multiple images may include illuminating the tooth with infrared light. Acquiring the multiple images (e.g., penetrating images) may include illuminating the tooth with one or more of white light (including but not limited to white light transillumination), UV / blue fluorescence, and red light fluorescence.

[0022] The illumination used to acquire the penetration images can be considered semi-penetrating in the sense that the interior regions (e.g., points or voxels) of the tooth may be visible only from a few camera positions and orientations. That is, the points may be obscured by other structures in some images that have the volume point in their field of view. In that sense, images that have the volume point in their field of view cannot image the volume point. Thus, the methods and apparatus described herein are able to take into account high masking of the volume points, unlike other penetration scanning techniques (e.g., CT) that use X-ray imaging where no masking occurs.

[0023] In general, any suitable technique may be used to create a 3D model of the tooth including (a combination of) the surface structure and the internal structure obtained by penetration imaging. These 3D models may be referred to as combined 3D surface / volume models, 3D volumetric surface models, or simply "3D models", etc. As mentioned above, both the surface data and the penetration imaging data may generally be in the same coordinate system. The two may be combined by using a common coordinate system. In some variations, the surface data may be represented as a surface model and an internal shape added to this model. In some variations, this data may be reconstructed into a three-dimensional model at the same time (after being added together). One or both data sets may be modified separately (e.g., filtered, subtracted, etc.). For example, creating a 3D model of the tooth including the internal structure may include combining 3D surface model data and internal structure data (including volumetric data). Creating a 3D model of the tooth including the internal structure may include combining multiple penetration images thereof, which may be obtained from various angles using an intraoral scanner.

[0024] In any of the methods and devices configured to implement these methods described herein, the data may be analyzed automatically by the system or manually. In particular, the methods and devices described herein may include examining internal features and / or identifying features of interest, including cracks and caries. Features may be recognized based on feature recognition criteria (e.g., dark or light areas in the penetrant image), pattern recognition, machine learning, etc. Features may be marked, including color-coded, labeled, etc. Features may be marked directly in the 3D model, or on the penetrant image, or in a data structure referenced to (e.g., sharing a coordinate system with) the 3D tooth model formed by the methods and devices described herein.

[0025] Further described herein are devices configured to perform any of the described methods. For example, one intraoral scanning system for generating a model of a subject's teeth described herein includes a handheld wand having at least one sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being penetrative, and one or more processors operatively connected to the handheld wand configured to: generate a three-dimensional (3D) surface model of at least a portion of the subject's teeth using light in the first spectral range; and generate a 3D model of the subject's teeth, including the internal structure, based on the 3D surface model and a plurality of images of the internal structure acquired in the second spectral range.

[0026] One intraoral scanning system for generating a model of a subject's teeth may include a handheld wand having at least one sensor and a number of light sources configured to emit light in a first spectral range and a second spectral range, where the second spectral range is penetrative; and one or more processors operatively connected to the handheld wand configured to: identify surface information using light in the first spectral range detected by the handheld wand using a first coordinate system; use the surface information to generate a three-dimensional (3D) surface model of at least a portion of the subject's teeth; acquire a number of images in the second spectral range referenced to the first coordinate system; and generate a 3D model of the subject's teeth, including internal structures, based on the 3D surface model and the number of images.

[0027] Further described herein is a method for generating a model of a subject's teeth, including both surface and internal structures, where the same intraoral scan cycles between different modalities, e.g., surface scanning and penetration, and further modalities (e.g., laser fluorescence, etc.) may alternatively be included. In general, the examples described herein focus on combining surface and penetration, but alternative internal scanning techniques (e.g., laser fluorescence) may be used as an alternative or in addition to the internal geometry imaging described herein.

[0028] For example, described herein is a method for generating a model of a subject's teeth, including both surface and internal structures, the method including: scanning a portion of the subject's teeth with a handheld intraoral scanner using a first modality that captures three-dimensional (3D) surface model data of the teeth; scanning a portion of the subject's teeth with the handheld intraoral scanner using a second modality that images the interior of the teeth using a penetrating wavelength to capture internal data of the teeth; and cycling between the first and second modalities, where the cycling rapidly switches between the first and second modalities such that images using the penetrating wavelength share a coordinate system with the 3D surface model data captured by the first modality.

[0029] Any of the methods described herein may include automatically adjusting the duration spent scanning in a first modality, the duration spent in a second modality, or the duration spent in a first modality and a second modality when cycling between the first and second modalities. For example, any of the methods may include automatically adjusting the duration spent scanning in a first modality, the duration spent in a second modality, or the duration spent in a first modality and a second modality when cycling between the first and second modalities based on the captured 3D surface model data, internal data, or both the 3D surface model data and internal data. Thus, one method of generating a model of a subject's teeth may include scanning a portion of the subject's teeth with a handheld intraoral scanner using a first modality that captures three-dimensional (3D) surface model data of the teeth; scanning the portion of the subject's teeth with the handheld intraoral scanner using a second modality that images the interior of the teeth using a penetrating wavelength to capture internal data of the teeth; cycling between the first and second modalities using a scanning strategy that rapidly switches between the first and second modalities in a cycle such that the internal data uses the same coordinate system as the 3D surface model data captured with the first modality; and adjusting the scanning strategy based on the captured 3D surface model data, the internal data, or both the 3D surface model data and the internal data.

[0030] Adjusting the scan modality may include adjusting based on a determination of a quality of the captured 3D surface model data. Adjusting the scan modality may include automatically adjusting the scan modality and / or adjusting a duration of the scan in the first modality and / or adjusting a duration of the scan in the second modality.

[0031] Any of these methods may involve combining 3D surface model data with internal tooth data to form a 3D model of the tooth.

[0032] As described above, capturing the 3D surface model data may include determining the 3D surface topology using confocal focusing / confocal scanning, stereoscopic vision, or structured light triangulation.

[0033] In general, cycling may include cycling between a first modality, a second modality, and a third modality, where cycling rapidly switches between the first modality, the second modality, and the third modality such that images using a penetrating wavelength share a coordinate system with the 3D surface model captured with the first modality. The third modality may be another penetrating modality or a non-penetrating modality (e.g., color, a visible image of the subject's teeth, etc.).

[0034] Scanning a portion of the subject's teeth with a handheld intraoral scanner in a second modality may include illuminating the teeth at an angle of 0° to 15° relative to a viewing direction of a sensor receiving the illumination (small angle illumination). Scanning a portion of the subject's teeth with an intraoral scanner in a second modality may include acquiring penetration images at different angles between the illumination source and the sensor and / or at different positions or angles relative to the teeth such that the same interior region of the tooth is imaged from various angles relative to the tooth.

[0035] As discussed above, any suitable penetrating wavelength may be used, including infrared wavelengths (e.g., near-infrared wavelengths). For example, scanning a portion of the subject's teeth with an intraoral scanner according to a second modality may include illuminating the teeth with one or more of white light trans-illumination, UV / blue fluorescence, and red light fluorescence.

[0036] Also described herein is an intraoral scanning system for generating a model of a subject's teeth, configured to cycle through multiple scanning modes. For example, one intraoral scanning system described herein includes a handheld intraoral wand having at least one sensor and multiple light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being penetrative, and one or more processors operatively connected to the handheld intraoral wand, the one or more processors configured to cycle the wand between a first mode and a second mode, where in the first mode the wand emits light in the first spectral range for a first duration and the one or more processors receive three-dimensional (3D) surface data in response, and in the second mode the wand emits light in the second spectral range for a second duration and the one or more processors receive image data in response.

[0037] One intraoral scanning system for generating a model of a subject's teeth may include a handheld intraoral wand having at least one sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being penetrative, and one or more processors operatively connected to the wand, the one or more processors configured to cycle the wand between a first mode and a second mode, where in the first mode the wand emits light in the first spectral range for a first duration and the one or more processors receive three-dimensional (3D) surface data in response, and where in the second mode the wand emits light in the second spectral range for a second duration and the one or more processors receive image data in response, the one or more processors configured to adjust the first duration and the second duration based on the received 3D surface data, the received image data, or both the 3D surface data and the image data. In any of the devices described herein, one mode can be surface scanning (3D surface), which can be, for example, 680 nm. Another mode can be penetrant scanning, which can be, for example, using near infrared light (e.g., 850 nm). Another mode can be color imaging, which can be using white light (e.g., approximately 400-600 nm).

[0038] A penetration imaging method for visualizing internal structures using a handheld intraoral scanner is also described. Thus, any of the general methods and devices described herein may be configured to use penetration imaging data to model one or more teeth to detect internal features such as cracks and caries, among others. For example, one method for imaging the interior of a tooth to detect cracks and caries may include: acquiring multiple penetration images of the tooth at various orientations using a handheld intraoral scanner at a first position and emitting light at a penetration wavelength; identifying surface location information using the intraoral scanner at the first position; and generating a three-dimensional (3D) model of the tooth using the multiple penetration images and the surface location information.

[0039] Generating a 3D model of the tooth may include repeating the steps of obtaining a number of penetration images and generating 3D models corresponding to different positions.

[0040] Obtaining multiple penetration images of the teeth at various orientations may include obtaining the penetration images, each of which is obtained using one or both of a different illumination source or combination of illumination sources on the intraoral scanner that emit a penetration wavelength, or a different image sensor on the intraoral scanner that obtains the images.

[0041] In some variations, acquiring a plurality of penetration images may include acquiring three or more penetration images.

[0042] Obtaining multiple penetration images of the tooth surface at various orientations may include, for example, obtaining penetration images with low angle illumination / observation, where in each penetration image, the angle between the light emitted and the light received by the image sensor is between 0-15 degrees. For example, one method of imaging the inside of a tooth to detect cracks and caries may include scanning the tooth from multiple positions, where the intraoral scanner obtains multiple penetration images of the tooth at various orientations, where the intraoral scanner emits light at a penetration wavelength, where in each penetration image, the angle between the light emitted and the light received by the image sensor is between 0-15 degrees, and determining surface location information using the intraoral scanner, including repeating the steps of obtaining the multiple penetration images at each position, and generating a three-dimensional (3D) model of the tooth using the penetration images and the surface location information.

[0043] In addition to scanning and modeling devices (e.g., scanning devices, tooth modeling devices, etc.) and methods, and methods of operating the scanning and / or modeling devices, as described above, this specification also describes methods of reconstructing volumetric structures using images generated from one or more penetrating wavelengths.

[0044] For example, described herein is a method for reconstructing volumetric structure from an object that includes regions that are semi-transparent to a range of radiation wavelengths and highly scattering (e.g., teeth). The method may include illuminating the object with a light source that emits (e.g., exclusively or primarily) at a penetrating wavelength, acquiring multiple images of the object with a camera that is sensitive to the penetrating wavelength (e.g., recording in the range of radiation wavelengths), receiving position data representing the position of the camera relative to the object in each of the multiple images, generating an upper limit of the scattering coefficient from the multiple images and position data for each point in the volume, and generating an image of the object from the upper limit of the scattering coefficient at each point. The penetrating wavelength light that is applied to the object may be emitted from approximately the same direction as the camera. The generated image or images may show the shape of the object within the volume, and the image may further include (or be modified to include) the external boundary of the object as well as the internal structure.

[0045] Although teeth may be described herein as objects that include one or more regions that are translucent and strongly scattering, in general, teeth may also include regions that are strongly scattering (e.g., dentin) and regions that are weakly scattering and highly transparent (e.g., enamel) at near infrared wavelengths. Teeth may also include regions with intermediate or mixed scattering properties, such as caries. The methods and apparatus for performing volumetric scanning described herein are suitable for mapping these various regions of one or more teeth.

[0046] One method for reconstructing volumetric structure from an object that includes regions that are semi-transparent to a range of radiation wavelengths and strongly scattering may include acquiring a plurality of images of the object with a camera in the range of radiation wavelengths, where illumination for the plurality of images is projected approximately from the direction of the camera; receiving position data representing a position of the camera relative to the object in each of the plurality of images; generating an upper limit of the scattering coefficient from the plurality of images and the position data for each point in the volume; and generating an image of the object from the upper limit of the scattering coefficient at each point.

[0047] The radiation wavelength range may be infrared or near infrared wavelengths.

[0048] Any of these methods may include receiving surface data representing an exterior surface of the object, and the generating step is performed for each point in the volume, within the exterior surface of the object.

[0049] The object may include a tooth having an external enamel surface and an internal dentin surface. A tooth is only one type of object that includes translucent, strongly scattering regions, but in other examples may include both other tissues (including soft and / or hard tissues) (e.g., spine, etc.). These objects that include translucent, strongly scattering regions may typically include translucent, strongly scattering regions for penetrating wavelengths (e.g., infrared or near infrared wavelengths) as described herein.

[0050] The position data typically includes data on the position and orientation of the camera at the time each of the multiple images is captured. For example, the position data may include three numerical coordinates in three-dimensional space, as well as the pitch, yaw, and roll of the camera.

[0051] The step of generating an upper limit for the scattering coefficient at each point of the volume may include projecting each point of a 3D point cloud grid corresponding to the volume of the object onto each of the multiple images using the first calibration, generating a list of intensity values ​​for each projected point, converting each intensity value in the list of intensity values ​​to a scattering coefficient according to the volume response, and storing, for each grid point, the minimum scattering coefficient value in the list of scattering coefficient values.

[0052] For example, the first calibration may include a fixed pattern noise calibration to calibrate out sensor issues and image ghosting in the camera. The first calibration may include a camera calibration to determine a transformation of the camera that projects known points in space to points on the image.

[0053] Further described herein is a method for reconstructing volumetric structures from a tooth that is translucent in a radiation wavelength range, the method comprising the steps of receiving in a processor a representation of the tooth surface in a first coordinate system; receiving in the processor a plurality of images of the tooth in the radiation wavelength range, the plurality of images being acquired with illumination projected approximately from the direction of the camera; receiving in the processor position data representing a position of the camera in each of the plurality of images; projecting each point of a point cloud grid corresponding to a volume within the tooth surface onto each of the plurality of images using a first calibration; generating a list of intensity values ​​for each projected point; converting each intensity value on the list of intensity values ​​to a scattering coefficient according to the volume response; and storing the minimum scattering coefficient at each point in a minimum scattering coefficient list.

[0054] Any of these methods may further include generating an image from the minimum scattering coefficient list.

[0055] The position data may include position and orientation data for one or more cameras at the time each of the multiple images is captured.

[0056] The first calibration may include a fixed pattern noise calibration to calibrate for camera sensor issues and image ghosting. In some embodiments, the first calibration may include a camera calibration to determine a transformation of the camera that projects known points in space to points on the image.

[0057] The method may further include receiving surface data representing an exterior surface of the object, the projecting being performed within the exterior surface of the object for each point within the volume.

[0058] The point cloud grid may include a cubic grid.

[0059] Any of the methods described herein may be implemented as software, firmware, and / or hardware, for example, any of the methods may be configured as a non-transitory computing device readable medium having instructions stored thereon for implementing the method.

[0060] For example, a non-transitory computing device readable medium having stored thereon instructions for reconstructing a volumetric structure from a tooth that is semi-transparent in a radiation wavelength range is described, the instructions may be executable by a processor to cause a computing device to perform the following steps: receive a representation of the tooth surface in a first coordinate system, receive a plurality of images of the tooth in the radiation wavelength range, the plurality of images being acquired with illumination projected approximately from the direction of the camera, receive position data representing a position of the camera in each of the plurality of images, project each point of a point cloud grid corresponding to the tooth volume onto each of the plurality of images using a first calibration, generate a list of intensity values ​​for each projected point, convert each intensity value on the list of intensity values ​​to a scattering coefficient according to a volume response, store a minimum scattering coefficient at each point in a minimum scattering coefficient list, and generate an image from the minimum scattering coefficient list.

[0061] The position data may include position and orientation data of the camera at the time each of the plurality of near-infrared images is captured, and may include three numerical coordinates in three-dimensional space, as well as pitch, yaw, and roll of the camera.

[0062] The first calibration may include a fixed pattern noise calibration to calibrate for sensor issues and image ghosting of the camera. The first calibration may include a camera calibration to determine a transformation of the camera that projects known points in space to points on the image.

[0063] The point cloud grid may be inside the tooth, and as mentioned above, the point cloud grid may comprise a cubic grid.

[0064] As an alternative or in addition to using scattering coefficients, any suitable method of forming the internal structure of a patient's tooth using a penetration wavelength image. For example, any of the apparatus (e.g., systems, devices, software, etc.) and methods described herein can use the two-dimensional penetration image together with information about the position and / or orientation of the scanner relative to the object (e.g., tooth) being imaged to form a three-dimensional model of the tooth, including the internal structure within the tooth, by segmenting the 2D penetration image. As mentioned above, a penetration image may refer to a penetration image of the interior of an object acquired with near-infrared and / or infrared wavelengths. The position and / or orientation of the scanner may be a proxy for the position and / or orientation of a camera on the scanner (e.g., on a handheld wand) that acquires the image.

[0065] For example, the present specification describes a method for modeling a subject's teeth, the method including capturing multiple images of the interior of the subject's teeth with an intraoral scanner and a position and orientation of the intraoral scanner specific to each of the multiple images, segmenting the multiple images to form internal structures corresponding to structures within the subject's teeth, projecting the internal structures onto a three-dimensional model of the subject's teeth using the positions and orientations of the multiple images, and displaying the three-dimensional model of the subject's teeth including the internal structures.

[0066] In any of these methods and devices, it is possible to capture a 3D surface model using non-penetrating wavelengths (e.g., surface scanning) while simultaneously capturing penetrating images. For example, capturing may include capturing surface images of the subject's teeth while capturing multiple images of the interior of the subject's teeth. The method may also include forming a three-dimensional model of the subject's teeth from the captured surface images. For example, forming the three-dimensional model of the subject's teeth may include identifying the three-dimensional surface topology using confocal focusing. Capturing the surface images of the subject's teeth may include using confocal scanning, stereoscopic vision, or structured light triangulation.

[0067] Generally, the same device (e.g., scanner) may model and / or display the 3D representation of the teeth including the internal structures, or alternatively or additionally, a separate processor (e.g., remote to the scanner) may be used. Any of these methods may include storing and / or transmitting the penetration images and the position and orientation of the intraoral scanner while capturing the multiple two-dimensional images, including to a remote processor that performs the steps following segmentation.

[0068] In any of the methods and apparatus described herein, the 3D model including the internal structure may be displayed during the operation of the scanner. This may advantageously allow a user to view the internal structure of the subject's teeth in real time or near real time. Thus, any of these methods may include displaying the three-dimensional model as the image is captured.

[0069] Segmenting the multiple images may include applying edge detection to the multiple images to identify closed boundaries in the multiple images. Segmenting the multiple images may include forming a volumetric density map from the multiple images to identify internal structures. Segmenting the volumetric density map may include performing segmentation by identifying one or more isosurfaces in the volumetric density map to identify internal features. Any of these methods may include segmenting the volumetric density map to identify internal features (e.g., cracks, caries, dental fillings, dentin, etc.).

[0070] For example, one intraoral scanning device configured to generate a model of a subject's teeth may include an intraoral scanner having a plurality of light sources and position and orientation sensors, the light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being penetrative, and one or more processors operatively connected to the intraoral scanner, the processors configured to cause the scanner to capture a plurality of images and a position and orientation of the intraoral scanner corresponding to each of the plurality of images when the intraoral scanner emits light in the second spectral range, the processors further configured to segment the plurality of images to form internal structures corresponding to structures within the subject's teeth, and display or transmit a three-dimensional model of the subject's teeth including the internal structures.

[0071] The processor may be configured to segment the plurality of images by applying edge detection to the plurality of images to identify closed boundaries in the plurality of images. The processor may be configured to identify internal structures by forming a pixel density map from the plurality of images to segment the plurality of images. The processor may be configured to identify internal structures by identifying closed partitions in the pixel density map.

[0072] Further described herein is a non-transitory computing device readable medium having stored thereon instructions executable by a processor to cause an intraoral scanning device to perform the steps of capturing a plurality of images using penetrating wavelength light and a position and orientation of the intraoral scanner specific to each of the plurality of images, segmenting the plurality of images to form internal structures corresponding to structures within the subject's teeth, projecting the internal structures onto a three-dimensional model of the subject's teeth using the position and orientation of the intraoral scanner specific to each image, and displaying the three-dimensional model of the subject's teeth including the internal structures.

[0073] The non-transitory computing device readable medium having instructions may be further configured to cause the intraoral scanning device to perform the steps of segmenting the plurality of images by applying edge detection to the plurality of images to identify closed boundaries in the plurality of images. The non-transitory computing device readable medium having instructions may be further configured to cause the intraoral scanning device to perform the steps of forming a pixel density map from the plurality of images to segment the plurality of images to form an internal structure. The non-transitory computing device readable medium having instructions may be further configured to cause the intraoral scanning device to perform the steps of identifying closed partitions in the pixel density map to segment the plurality of images to form an internal structure.

[0074] Further described herein is a non-transitory computing device readable medium having stored thereon instructions executable by a processor that cause the computing device to perform the steps of receiving three-dimensional surface model data of the subject's teeth from the scanner; receiving from the scanner a plurality of images of the interior of the subject's teeth and a position and orientation of the intraoral scanner specific to each image of the plurality of images; segmenting the plurality of images to form the internal structure of the subject's teeth; projecting the internal structure of the subject's teeth onto the three-dimensional surface model; and displaying the three-dimensional surface model showing the internal structure.

[0075] For example, described herein is a method for generating a three-dimensional (3D) volumetric model of a subject's tooth using an intraoral scanner, the method including: capturing 3D surface model data of at least a portion of the tooth using the intraoral scanner while moving the intraoral scanner over the subject's tooth; acquiring multiple images of the interior of the tooth using near-infrared wavelengths with the intraoral scanner while moving the intraoral scanner over the tooth such that multiple images of the same interior region of the tooth are imaged; for each of the multiple images of the interior of the tooth, identifying a position of the intraoral scanner relative to the subject's tooth using the 3D surface model data; and forming the 3D volumetric model of the subject's tooth, including its internal shape, using the multiple images and the position of the intraoral scanner relative to the subject's tooth.

[0076] One method of generating a three-dimensional (3D) volumetric model of a subject's teeth using an intraoral scanner includes the steps of: capturing 3D surface model data of at least a portion of the teeth using the intraoral scanner while moving the intraoral scanner over the teeth of the subject; acquiring a plurality of images of the interior of the teeth using near-infrared wavelengths while moving the intraoral scanner over the teeth, by emitting near-infrared light from the intraoral scanner at a first polarization and detecting the near-infrared light returning to the intraoral scanner with an image sensor within the intraoral scanner, wherein the near-infrared light returning to the intraoral scanner is filtered and mirrored. The method may include the above steps of acquiring a plurality of images of the interior of the tooth, with surface reflections removed by filtering near-infrared light of a first polarization from the near-infrared light returning to the intraoral scanner before it reaches the image sensor; for each of the plurality of images of the interior of the tooth, determining the position of the intraoral scanner relative to the subject's tooth using the 3D surface model data at the time each of the plurality of images was captured; and forming a 3D volumetric model of the subject's tooth, including its internal shape, using the plurality of images and the position of the intraoral scanner relative to the subject's tooth.

[0077] In any of these methods and devices, the near-infrared light returning to the intraoral scanner may be filtered to remove specular reflections by filtering all or substantially all of the near-infrared light of the first polarization from the near-infrared light returning to the intraoral scanner before it reaches the image sensor.

[0078] Further described herein is an intraoral scanner that scans both surface and internal structures. For example, one intraoral scanning system for generating a three-dimensional (3D) volumetric model of a subject's teeth may include a handheld wand having at least one image sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being in the near-infrared wavelength range, and one or more processors operatively connected to the handheld wand configured to perform the steps of: capturing 3D surface model data of at least a portion of the subject's teeth while moving the intraoral scanner over the teeth; acquiring multiple images of the interior of the teeth using light in the second spectral range while moving the intraoral scanner over the teeth such that multiple images of the same interior region of the teeth are imaged; identifying a position of the handheld wand relative to the subject's teeth using the 3D surface model data for each of the multiple images of the interior of the teeth; and forming the 3D volumetric model of the subject's teeth including their internal shape using the multiple images and the position of the intraoral scanner relative to the subject's teeth.

[0079] One intraoral scanning system for generating a three-dimensional (3D) volumetric model of a subject's teeth includes a handheld wand having at least one image sensor and a plurality of light sources, the light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being within the near-infrared wavelength range; a filter in front of the image sensor configured to filter light in the second spectral range and in the first polarization; and one or more processors operatively connected to the handheld wand for performing the steps of: capturing 3D surface model data of at least a portion of the teeth while moving the intraoral scanner over the subject's teeth; and acquiring a plurality of images of the interior of the teeth using light in the second spectrum while moving the intraoral scanner over the teeth. the one or more processors configured to perform the steps of: acquiring a plurality of images of the interior of the tooth by emitting light at a first polarization and detecting the near-infrared light returning to the intraoral scanner with an image sensor within the intraoral scanner, where the near-infrared light returning to the intraoral scanner is filtered to remove specular reflections by filtering the near-infrared light of the first polarization from the near-infrared light returning to the intraoral scanner before it reaches the image sensor; for each of the plurality of images of the interior of the tooth, using the 3D surface model data to identify a position of the handheld wand relative to the subject's tooth; and forming a 3D volumetric model of the subject's tooth including its internal shape using the plurality of images and the position of the intraoral scanner relative to the subject's tooth.

[0080] Further, methods of imaging tooth cracks and caries are described herein. For example, one method of imaging the inside of a subject's tooth to detect cracks and caries using an intraoral scanner described herein includes: scanning the intraoral scanner over the subject's tooth; using an intraoral scanner that emits both near-infrared and non-penetrating wavelengths to obtain multiple near-infrared images of the inside of the subject's tooth in various orientations; for each image location of the multiple near-infrared images, using the non-penetrating wavelength to determine the position of the intraoral scanner relative to the subject's tooth; and using the multiple near-infrared images and the position of the intraoral scanner relative to the subject's tooth in each near-infrared image of the multiple near-infrared images to generate a three-dimensional (3D) volumetric model of the subject's tooth.

[0081] Any of these methods may include analysing the volumetric model to identify cracks or caries (or other internal regions of the tooth).

[0082] For example, one method of performing transillumination imaging of a subject's tooth to detect cracks and caries may include repeating the steps of: scanning the subject's tooth from a plurality of positions, where at each of the positions, using an intraoral scanner to obtain a plurality of near-infrared images of the interior of the tooth at various orientations, where the intraoral scanner emits light at a near-infrared wavelength at a first polarization, where in each near-infrared image, the angle between the emitted light and the light received by the image sensor is between 0 degrees and 15 degrees, and further where the received near-infrared light is filtered to block the near-infrared light of the first polarization; and determining a position of the intraoral scanner relative to the subject's tooth for each image location of the plurality of near-infrared images; and generating a three-dimensional (3D) volumetric model of the tooth using the penetration image and surface position information.

[0083] Also described herein is a method for generating an internal image of a tooth based on a penetration image and a camera sensor position using the scattering coefficients. For example, one method for forming a three-dimensional (3D) volumetric model of a subject's tooth may include acquiring a plurality of near-infrared images of the subject's tooth with a camera sensor, where near-infrared illumination for the plurality of near-infrared images is projected from approximately the direction of the camera sensor, receiving position data for each of the plurality of near-infrared images representing a position of the camera relative to the subject's tooth, generating an upper limit of the scattering coefficient from the plurality of near-infrared images and the position data for each point in the volume, combining the upper limit of the scattering coefficient for each point in the volume to form a 3D volumetric model of the subject's tooth, and outputting the 3D volumetric model of the subject's tooth.

[0084] Any of these methods may include forming an iso-surface from the 3D volumetric model of the subject's tooth. Forming the iso-surface may be done by selecting a threshold or range of values ​​of the scattering coefficient. The sub-ranges may correspond to different interior regions (e.g., structures). For example, the outputting step may include forming an iso-surface from the 3D volumetric model of the subject's tooth that corresponds to an interior dentin surface.

[0085] One method for reconstructing volumetric structures from teeth that are translucent in a radiation wavelength range may include receiving in a processor a representation of the tooth surface in a first coordinate system; receiving in the processor a plurality of images of the tooth in the radiation wavelength range acquired by a camera, the plurality of images being acquired with illumination projected approximately from the direction of the camera; receiving in the processor position data representing the position of the camera in each of the plurality of images; projecting each point of a point cloud grid corresponding to a volume within the tooth surface onto each of the plurality of images using a first calibration; generating a list of intensity values ​​for each projected point; converting each intensity value on the intensity value list to a scattering coefficient according to the volume response; and storing the minimum scattering coefficient at each point in a minimum scattering coefficient list.

[0086] Any of these methods may be implemented in a device including software, hardware, and / or firmware for carrying out the method. For example, a non-transitory computing device readable medium having stored thereon instructions for reconstructing a volumetric structure from a tooth that is semi-transparent in a radiation wavelength range, the instructions being executable by a processor to cause a computing device to perform the following steps: receive a representation of the tooth surface in a first coordinate system, receive a plurality of images of the tooth in the radiation wavelength range acquired by a camera, the plurality of images being acquired with illumination projected approximately from the direction of the camera, receive position data representing a position of the camera in each of the plurality of images, project each point of a point cloud grid corresponding to the tooth volume onto each of the plurality of images using a first calibration, generate a list of intensity values ​​for each projected point, convert each intensity value on the list of intensity values ​​to a scattering coefficient according to the volume response, store a minimum scattering coefficient of the scattering coefficients at each point, and output the image generated from the minimum scattering coefficient list.

[0087] Further described herein are methods of using the segments to create internal structures. For example, one method of modeling a subject's teeth may include capturing with an intraoral scanner a plurality of images of the interior of the subject's teeth and a position and orientation of the intraoral scanner specific to each of the plurality of images, segmenting the plurality of images to create internal structures corresponding to structures within the subject's teeth, projecting the internal structures onto a three-dimensional model of the subject's teeth using the positions and orientations of the plurality of images, and displaying the three-dimensional model of the subject's teeth including the internal structures.

[0088] Also described herein is an intraoral scanning device configured to generate a model of a subject's teeth, the device including: an intraoral scanner having a plurality of light sources and position and orientation sensors, the light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being penetrative; and one or more processors operatively connected to the intraoral scanner, the processors configured to cause the scanner to capture a plurality of images and a position and orientation of the intraoral scanner corresponding to each of the plurality of images when the intraoral scanner emits light in the second spectral range, the processor further configured to segment the plurality of images to form internal structures corresponding to structures within the subject's teeth, and display or transmit a three-dimensional model of the subject's teeth including the internal structures.

[0089] Further described herein is a non-transitory computing device readable medium having stored thereon instructions executable by a processor that cause an intraoral scanning device to perform the steps of capturing a plurality of images using penetrating wavelength light and a position and orientation of the intraoral scanner specific to each of the plurality of images, segmenting the plurality of images to form internal structures corresponding to structures within the subject's teeth, projecting the internal structures onto a three-dimensional model of the subject's teeth using the position and orientation of the intraoral scanner specific to each image, and displaying the three-dimensional model of the subject's teeth including the internal structures.

[0090] Further described herein are methods of forming a 3D volume (including a volumetric volume) of a tooth. For example, one method described herein includes receiving data associated with an intraoral scan of a subject, identifying from the received data at least a portion of a volume of a first internal shape of the subject's tooth, identifying from the received data at least a portion of a volume of a second internal shape of the subject's tooth, the second internal shape being different from the first internal shape, mapping together the portion of the volume of the first internal shape and the portion of the volume of the second internal shape, and outputting together the portion of the volume of the first internal shape and the portion of the volume of the second internal shape as a 3D volume.

[0091] The received data may include data from a tooth surface penetrating intraoral scan of the subject. The received data may further include data from a tooth surface intraoral scan of the subject.

[0092] The method may further include identifying a surface of the subject's tooth from the received data, mapping the tooth surface together with a portion of the first internal shape volume and a portion of the second internal shape volume, and outputting the tooth surface together with a portion of the first internal shape volume and a portion of the second internal shape volume as a 3D volume.

[0093] The received data may further include data from a tooth surface color intraoral scan of the subject.

[0094] The method may further include identifying a tooth surface color of the subject from the received data, mapping the tooth surface color to the tooth surface, and outputting a 3D volume having the tooth surface and the tooth surface color.

[0095] The first internal shape of the tooth may include dentin of the tooth and the second internal shape of the tooth includes enamel of the tooth. The intraoral scan may include a second intraoral scan of the subject, and the method further includes receiving data associated with a previous intraoral scan of the subject, identifying at least a portion of an enamel or dentin volume from the received data associated with the previous intraoral scan of the subject, identifying a volume change in the enamel or dentin by comparing the portion of the enamel or dentin volume identified from the received data associated with the second intraoral scan with the portion of the enamel or dentin volume identified from the received data associated with the previous intraoral scan, and outputting the identified volume change.

[0096] The method may further include detecting dental caries of the tooth by comparing the second internal shape to the first internal shape, and outputting a signal to the user associated with the detected dental caries. Comparing the second internal shape to the second internal shape may include analyzing whether a volume of the second internal shape extends from a surface of the volume of the first internal shape. The analyzing step may include determining whether the volume of the second internal shape extends from a surface of the volume of the first internal shape to a portion of the second internal shape associated with dentin.

[0097] The method may further include calculating a volume of a second internal shape extending from a surface of the volume of the first internal shape, and outputting a signal associated with the calculated volume.

[0098] Further described is a method including receiving data associated with an intraoral scan of a subject, identifying a dental caries volume of the subject's tooth from the received data, quantifying the dental caries volume of the subject's tooth, and outputting a signal associated with the quantified volume of dental caries of the subject's tooth.

[0099] The method may further include identifying an enamel volume of the subject's tooth from the received data, mapping the enamel volume to the tooth caries volume, and outputting a 3D volume of the mapped enamel and tooth caries volumes to a user. For example, the method may further include identifying a dentin volume of the subject's tooth from the received data, mapping the dentin volume to the enamel volume and the tooth caries volume, and outputting the mapped enamel and tooth caries volumes together with the dentin volume as a 3D volume.

[0100] The intraoral scan of the subject may include a second intraoral scan of the subject, and the method may further include receiving data associated with a previous intraoral scan of the subject, identifying a pre-dental caries volume of the subject's tooth from the received data associated with the previous intraoral scan of the subject, and outputting a signal associated with a volumetric difference between the dental caries volume and the pre-dental caries volume. The method may further include outputting a 3D model of the dental caries volume of the subject's tooth.

[0101] Also described herein is a trans-illumination adapter sleeve apparatus for an intraoral scanner, the apparatus including a sleeve body configured to fit over a wand of an intraoral scanner, the sleeve body including a light pass-through region at a distal end configured to allow near-infrared light to pass through the sleeve, a first wing region extending from the distal end of the sleeve body adjacent the light pass-through region, and a near-infrared light source configured to emit near-infrared light from the first wing region. The near-infrared light source may be configured to emit near-infrared light traversing the light pass-through region.

[0102] The device may further include a second wing region extending from the distal end of the sleeve body adjacent the light passing region, the second wing region having a second near-infrared light source configured to emit near-infrared light from the second wing region. The device may further include electrical contacts at the proximal end of the sleeve body configured to apply electrical energy to the near-infrared light source. The device may further include a flexible circuit coupling the electrical contacts to the near-infrared light source. Any of these devices may include a camera sensor operatively connected to the second wing extending from the distal end of the sleeve body adjacent the light passing region.

[0103] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and by reference to the accompanying drawings, in which: [Brief description of the drawings]

[0104] [Figure 1A] FIG. 1 shows an example of a 3D (color) intraoral scanner that may be adapted for use as described herein to generate a model of a subject's teeth, having both surface and internal shapes. [Figure 1B] FIG. 1 illustrates a schematic diagram of an example of an intraoral scanner configured to generate a model of a subject's teeth, having both surface and internal geometries. [Figure 2A]FIG. 1 shows transillumination imaging through a tooth at 180°. [Figure 2B] FIG. 1 shows transillumination imaging through a tooth at 90°. [Figure 2C] ~ [Figure 2D] 1A and 1B are side and top perspective views, respectively, of an example of a distal end of a wand of an intraoral scanner configured to provide trans-illumination imaging through teeth at 90° and 180°. [Figure 2E] FIG. 1 shows a schematic of an intraoral scanner configured to perform both surface scanning (e.g., visible light, non-penetrating) and penetrating scanning with near-infrared (IR) wavelengths. The scanner includes polarizers and filters that block near-infrared light reflected from the tooth surfaces while collecting near-infrared light reflected from internal structures. [Figure 3A] ~ [Figure 3C] FIG. 2C and FIG. 2D show exemplary penetration by orientation of low angle illumination imaging using an intraoral scanner wand as shown in FIGS. [Figure 3D] FIG. 3B shows another example (similar to that shown in FIG. 3A) in which illumination with a light source (e.g., a near-infrared light source) is performed from the right and imaging is performed on the left (the orientation may be reversed) to obtain 180° trans-illumination, with strong and weak scattering indicated by arrows. [Figure 4A] FIG. 1 shows an example of a penetration imaging (e.g., small angle penetration imaging) configuration consisting of a sensor and light (illumination) source, where the line of sight vector between the sensor and light source is 0° to 15° at various positions around the tooth, representing different positions adopted at different times (e.g., by moving the wand / scanner around the tooth so that penetration images can be obtained at various relative angles to the tooth). [Figure 4B] ~ [Figure 4F] Figure 4B shows an example of a multi-camera multi-source scanner. Figures 4C-4F show alternative low-angle configurations. [Figure 5A] ~ [Figure 5I] 5A-5C show nine alternative orientations of penetration imaging that can be used as part of an intraoral scanner such as that shown in FIG. 1A-1B. In FIG. 5A-5C, the center sensor is active and the right (FIG. 5B) or left (FIG. 5A) or both (FIG. 5C) light sources are illuminating the teeth. Similarly, in FIG. 5D-5F, the right sensor is active, and in FIG. 5G-5I, the left sensor is active. [Figure 6] FIG. 1 illustrates generally one method of generating a model of one or more teeth of a subject, having both surface and internal shapes. [Figure 7] FIG. 1 illustrates one variation of a method for generating a model of a subject's teeth, having both surface and internal geometries, by cycling through various scanning modalities (e.g., surface scanning, penetration imaging, etc.). [Figure 8] FIG. 8 shows a graphical example of a timing diagram for scanning a sample (e.g., a tooth) as it cycles through various scanning modalities (surface scanning, laser fluorescence, viewfinder, and penetrant imaging modalities are shown) to generate a model having both surface and internal features. In FIG. 8, the y-axis indicates the lens position (scan amplitude) of the 3D confocal scanner. The duration of each scan (e.g., scan time for each mode) may be fixed or adjustable. For example, the duration (d) of a penetrant scan may be dynamically adjusted (e.g., increased or decreased) during a scan based on the quality of the received images, the completeness of the 3D reconstruction of the internal structures, etc. Similarly, the duration of a surface scan may be dynamically adjusted during a scan based on the quality of the images (e.g., previous and / or current images, etc.) being scanned, the completeness of the 3D surface model of the area being scanned, etc. [Figure 9A] FIG. 13 shows an example of an overlay of penetration images on a 3D tooth surface model; and FIG. 14 shows a penetration image panorama (where the penetration images are stitched together to form a panorama). [Figure 9B]9B shows a portion of the model reconstruction of FIG 9A, including the surface and internal features, Note that in FIG 9A and 9B, the overlay showing the internal structure is not a volumetric reconstruction. [Figure 10A] FIG. 1 illustrates an example of a front view of an example front end of an intraoral scanner. [Figure 10B] FIG. 2 illustrates an example of a bottom view of an intraoral scanner showing multiple sensors and light sources. [Figure 11A] ~ [Figure 11C] FIG. 13 shows a projected image taken in transmission looking down onto the top of the tooth using a penetrating wavelength (eg, near-infrared wavelength). [Figure 11D] ~ [Figure 11F] FIG. 13 illustrates using a penetrating wavelength and moving the light source in the z-direction relative to the teeth. [Figure 11G] ~ [Figure 11I] 11A, 11D, and 11G correspond to a first depth position, while FIGS. 11B, 11E, and 11H correspond to a second depth position (above the teeth), and FIGS. 11C, 11F, and 11I correspond to a third depth position (further up). [Figure 12] FIG. 1 illustrates an example of a penetrating light source (e.g., a penetrating spectral range light source) and camera configuration that can be used as part of an intraoral scanner wand. [Figure 13] FIG. 1 shows a flow chart illustrating one method for reconstructing volumetric structure in the emission wavelength range from an object that contains semi-transparent and strongly scattering regions. [Figure 14] FIG. 13 shows another flowchart illustrating method steps for reconstructing volumetric structures from teeth. [Figure 15A] ~ [Figure 15E] FIG. 13 shows an example of image fixed pattern noise calibration and illumination non-uniformity calibration that gives a constant response for a homogenous flat target. [Figure 16]FIG. 1 illustrates a simplified block diagram of a data processing system that may be used to implement the methods and techniques described herein. [Figure 17A] FIG. 1 illustrates an example of a method for scanning teeth with an intraoral scanner using penetrating wavelengths (e.g., infrared and / or near infrared wavelengths) to identify internal structures. [Figure 17B] 17A shows an example of a method for scanning teeth with an intraoral scanner using penetrating wavelengths (e.g., infrared and / or near infrared wavelengths) to identify internal structures. [Figure 18A] ~ [Figure 18C]

[0033] Figure 18A shows one method of automated segmentation of near-infrared images. Figure 18A shows edge detection from a penetration scan through a tooth acquired by an intraoral scanner at a near-infrared wavelength (e.g., 850 nm). Figures 18B and 18C show segmentation based on the edge detection of Figure 18A plotted on the penetration scan. [Figure 19A] ~ [Figure 19C] Figure 19A shows further sections of the near infrared images of Figures 18A-18C. Figure 19A shows edge detection from a near infrared image acquired of the subject's teeth shown in Figure 19C. Figure 19B shows sections of the image of Figure 19C, with multiple sections (5 sections) painted onto the near infrared image shown in Figure 19C. [Figure 20A] ~ [Figure 20C] Figure 20 shows segments of a near infrared image of a patient's teeth. Figure 20A shows edge detection in a near infrared image. Figure 20B shows segments of the near infrared image, showing 18 (overlapping) segments. Figure 20C shows a further segment of the near infrared image shown in Figure 20B. [Figure 21A] ~ [Figure 21C] 21A and 21B show sections of a near infrared image of a patient's teeth, respectively, illustrating edge detection of the near infrared image of FIG. 21C. FIG. 21B shows edge detection of the near infrared image shown in FIG. 21C. [Figure 22A] ~ [Figure 22C]Figure 22A shows segments of a near infrared image of a patient's teeth. Figure 22A shows edge detection in a near infrared image. Figure 22B shows segments of the near infrared image, showing eight (overlapping) segments. Figure 22C shows a further segment of the near infrared image shown in Figure 22B. [Figure 23A] ~ [Figure 23C] Figure 23A shows a section of a near infrared image of a patient's teeth, and Figure 23B shows edge detection of the near infrared image of Figure 23C. [Figure 24A] FIG. 23 shows a partial three-dimensional model of a patient's teeth formed from sectioned images including those shown in FIGS. 18A-23C. [Figure 24B] FIG. 24B is a cross-sectional view of the 3D model of FIG. 24A showing the internal structure including dentin. [Figure 25A] FIG. 1 illustrates an example of a volumetric (or "voxel") model of a patient's jaw and teeth, including internal structures, which are shown as density maps within a 3D surface model. [Figure 25B] FIG. 25B is an enlarged view of the volumetric model of FIG. 25A. [Figure 26A] ~ [Figure 26C] FIG. 1 illustrates a method for creating a 3D surface that can be used to generate a volumetric model (showing both surface and internal structures) of a patient's teeth. [Figure 27A] ~ [Figure 27G] FIG. 1 illustrates how near-infrared scanning can be performed in addition to surface scanning to generate a volumetric model of a patient's teeth. [Figure 28A] ~ [Figure 28B] 1 shows a volumetric model of a patient's teeth, created using an intraoral scanner, showing both the surface geometry (e.g., enamel) and the internal (segmental) geometry (e.g., dentin). [Figure 29A] FIG. 13 is a partially transparent perspective view of a removable / disposable cover configured as a trans-illumination sleeve with electrical connections. [Figure 29B] 29A is a perspective view showing, in solid fill, the sleeve of FIG. 29A configured for use with the wand portion of an intraoral scanner and adapted to accommodate the wand to include trans-illumination with penetrating wavelengths (e.g., near-infrared wavelengths). [Figure 30A] ~ [Figure 30C]

[0036] Figures 30A and 30B show an example of a trans-illumination sleeve with electrical coupling. Figure 30A shows an example of a support frame for the sleeve, Figure 30B shows the support frame with a flex circuit and connector coupled to the support frame, and Figure 30C shows the sleeve of Figures 30A-30B fully assembled. [Figure 31A] FIG. 29C shows an example of a flexible circuit and connector that may be used as part of the sleeve shown in FIGS. 29A-30B. [Figure 31B] FIG. 31B illustrates an example of a distal end portion of the flexible circuit shown in FIG. 31A including an LED housing. [Figure 31C] 13A and 13B are diagrams showing an example of a connector portion of a sleeve. [Figure 32A] ~ [Figure 32B] FIG. 29C shows an example of an LED positioner and shader portion of the distal end of the sleeve as shown in FIGS. 29A-30B. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0105] Described herein are intraoral scanners that generate a three-dimensional (3D) model (which may include the internal geometry of the teeth and may also include a model of the surfaces) of a subject's intraoral region (e.g., one or more teeth, gums, jaw, etc.), as well as methods of using such scanners. For example, FIG. 1A shows an example of an intraoral scanner 101 that may be configured or adapted as described herein to generate a 3D model having both the surface geometry and the internal geometry. As shown generally in FIG. 1B, an exemplary intraoral scanner may include a wand 103 that may be handheld by an operator (e.g., dentist, dental hygienist, technician, etc.) and moved over one or more teeth of the subject to scan both the surface and internal structures. The wand may include one or more sensors 105 (e.g., a camera such as a CMOS, a CCD, a detector, etc.) and one or more light sources 109, 110, 111. In FIG. 1B, three light sources are shown, namely, a first light source 109, a second light source (color light source), and a third light source 111, the first light source 109 configured to emit light in a first spectral range (e.g., visible light, monochromatic visible light, etc., which may not be visible light) for detecting the surface shape, the second light source (color light source) is white light, for example, between 400 and 700 nm (e.g., about 400 to 600 nm), and the third light source 111 configured to emit light in a second spectral range for detecting the internal shape of the tooth (e.g., by trans-illumination, sometimes collectively referred to as penetrating imaging (e.g., in the near infrared), low angle penetrating imaging, laser fluorescence, etc.). Although the illumination sources are shown separately in FIG. 1B, in some variations, switchable light sources may be used. The light sources may be any suitable light sources, including LEDs, optical fibers, etc. The wand 103 may include one or more controls (buttons, switches, dials, touch screen, etc.) to aid in control (e.g. turning the wand on and off, etc.), alternatively or in addition, one or more controls not shown may be present in another part of the intraoral scanner, for example a foot pedal, keyboard, console, touch screen, etc.

[0106] In general, any suitable light source may be used, in particular a light source that is compatible with the mode to be detected. For example, any of these devices may include a visible light source or other (including non-visible) light source for surface detection (e.g., at or around 680 nm, or other suitable wavelengths). A color light source, typically a visible light source (e.g., a "white light" light source), for color imaging may also be included. Additionally, a penetrating light source (e.g., an infrared light source, e.g., specifically, a near-infrared light source) for penetrating imaging may also be included.

[0107] The intraoral scanner 101 may include one or more processors, including linked or remote processors, to control the operation of the wand 103, including the coordination of the scan, and the scanning and generation of a 3D model including surface and internal geometry during review and processing. As shown in FIG. 1B, the one or more processors 113 may include or be coupled to a memory 115 for storing scan data (surface data, internal geometry data, etc.). Communications circuitry 117, including wireless or wired communications circuitry, may also be included for communicating with components of the system (including the wand) or external components (including external processors). For example, the system may be configured to receive and transmit scans or 3D models. One or more additional outputs 119 may be included for outputting or presenting information, such as a display screen, printer, etc. As mentioned above, an input 121 (buttons, touch screen, etc.) may be included, and the device may allow or require user input for controlling scanning and other operations.

[0108] Any of the devices and methods described herein may be used to scan for and / or identify internal structures such as enamel and / or dentin cracks, caries, lesions, etc. Accordingly, any of the devices described herein may be configured to perform scans that can be used to detect internal structures using a penetrating wavelength or a spectral range of penetrating wavelengths. Also described herein are methods for detecting cracks, caries, and / or lesions, or other internal features (e.g., dental fillings, etc.). Various penetrating scanning techniques (penetrating imaging) may be used or incorporated into the device, including, but not limited to, trans-illumination and low-angle penetrating imaging, both of which detect the passage of light at a penetrating wavelength from or through tissue (e.g., from or through one or more teeth).

[0109] Transillumination is a technique that may be used to learn the internal shape of a tooth. Traditionally, there are two basic configurations for transillumination of teeth. Figures 2A and 2B show these configurations: 180° and 90°. Both configurations can be used to visualize the inside of a tooth, primarily through the enamel. As shown in Figure 2A, in the 180° configuration, penetrating wavelengths (including one or more penetrating wavelength spectral ranges) are emitted from a light source 203 and transmitted from one side of the tooth 201, and a sensor 205 (e.g., a camera) on the opposite side detects the light that is transmitted through the tooth. This light is neither scattered nor absorbed. Similarly, in Figure 2B, the tooth 201 is illuminated on both sides with light from light sources (203, 203'), and a camera 205 oriented at 90° to both sources detects the light at a right angle to the light sources. Transillumination has typically been limited to single-projection use to capture images of the inside of a tooth (similar to using x-rays). Described herein are methods and apparatus for visualizing the enamel-dentin region using a penetrating wavelength (e.g., 700-1300 nm, 700-1090 nm, etc., e.g., 850 nm) to obtain multiple projections or orientations from a single position of the scanner relative to one or more teeth and / or for multiple angles of the sensor relative to the teeth (specifically, three or more orientations or projections may be employed for each internal region imaged). Employing multiple (e.g., three or more) projections can provide better imaging because multiple (e.g., three or more) images can be generated through the tooth from a particular position of the wand relative to one or more teeth. While taking one or more 180° projections can be useful when the light travels a short distance and there is little light scattering, combining different projections (orientations) from the same location (e.g., within milliseconds of each other and at approximately the same scan time) can allow the system to build a volumetric model of the enamel-dentin region.

[0110] In variants where projection is performed in a 90° configuration and / or a 180° configuration, the intraoral scanner may be adapted to perform trans-illumination imaging in this configuration. For example, Figures 2C and 2D show an example of a distal end of an intraoral scanner wand adapted to collect trans-illumination images at 90° and 180°, where the wand 213 includes a pair of protrusions or wings 215, each housing a light source (LED) and camera combination 217. In Figures 2C and 2D, both wings and the base of the wand may include a light source and a sensor (camera), allowing at least three trans-illumination images to be acquired from a single position of the wand relative to the tooth, as shown in Figures 3A-3C. In Figure 3A, a first orientation is shown, where the LED 303 on the right side is turned on to illuminate through the tooth for detection / capture (180°) by the camera 305 on the left side. FIG. 3D, similar to FIG. 3A, shows light being applied from the right side and traveling into the interior of the tooth (arrows) and either penetrating the tooth to a camera sensor 305 (also referred to herein as an image sensor, camera, or simply "sensor") or scattering from the interior region. The orientation of the camera sensor and illumination source may be swapped. In FIG. 3B, the LED 303' on the left side is turned on to provide trans-illumination through the tooth for detection / capture (180°) by the camera 305' on the right side. In FIG. 3C, both LEDs 303, 303' are turned on to provide illumination from both the right and left side, and a trans-illumination image is captured by camera 305'', which is 90° off-axis from the LEDs.

[0111] In general, transillumination imaging data as described above may be combined with and collected simultaneously with 3D tooth surface data (e.g., 3D surface model data), allowing for an additional layer of data over internal structures such as caries, cracks, etc. Additionally, the use of multiple projections (taken from multiple orientations) as described above may allow for the reconstruction of a volumetric model of the internal structure of the tooth enamel, thereby showing features that would not otherwise be visible.

[0112] While 90° and 180° configurations of dental trans-illumination can be useful, it can be particularly useful to provide penetrant imaging configurations where the angle between the emitted light beam (vector) and the received light beam (vector) is very small (e.g., 0-30°, 0-25°, 0-20°, 0-15°, 0-10°, etc.), and in particular angles of 0-15° (or 0-15° not including 0°) can be useful.

[0113] Transillumination in the 180° and 90° configurations may limit the range of motion of the intraoral scanner wand to the periphery of the tooth due to the angle limitations of the camera relative to the light source in those configurations (as shown in FIGS. 2C and 2D). Thus, methods and apparatus for penetration imaging / visualization (e.g., of the enamel-dentin region) using small angles, including 0-15°, are also described herein. In one example, a light source (LED) emitting in the penetrating spectral range (e.g., 850 nm) is used with a line of sight vector at a small angle of 0-15° relative to the camera's viewing angle. As mentioned above, this penetration imaging may be combined with simultaneous 3D surface modeling of the tooth. The relative positions of the light source and camera are typically known, and one or more penetration images can be acquired at each position of the wand. Due to the small angle of the gaze vector available with the wand, the intraoral scanner wand may be configured with only a slight curve, allowing it to fit within the oral cavity and move easily around the oral cavity, unlike wands configured to measure 90° and 180° trans-illumination (such wands may use a device shape that includes side wings to hold the LEDs and sensors so that the wand can wrap around the teeth for imaging (see, e.g., FIG. 2C ). The use of small angle reflected imaging may enable buccal and lingual scanning, whereas the 90° (trans-illumination) scanning described herein would be limited to occlusal scanning.

[0114] Penetration imaging with a small angle may include imaging the inside of a tooth using a wand with unlimited movement around the tooth, allowing for capturing internal structural data while also scanning for 3D (surface) model data without the need for dedicated structures and / or modes of operation. However, reducing the angle between the emitted light and the detector can be complicated by direct reflections. For example, direct reflections can occur in areas of the tooth surface where the angles of illumination and imaging are nearly equal (e.g., in the light cone and imaging NA). Such direct reflections can be problematic if they saturate the sensor or if they indicate surface information but obscure deeper structural information. To overcome such problems, the devices and methods described herein that use them can capture and use multiple illumination orientations obtained from the same position. In this specification, in the context of a handheld wand, capturing multiple images from the same position may effectively mean capturing multiple images at nearly the same time, whereby no significant amount of movement occurs. For example, multiple images may be acquired within a few milliseconds of each other (less than 500 ms, less than 400 ms, less than 300 ms, less than 200 ms, less than 100 ms, less than 50 ms, etc.) and / or small movements may be corrected.

[0115] Alternatively or additionally, the apparatus and / or method may reduce or eliminate problems arising from saturation due to direct reflections by using only non-saturated pixels. In some variations, surface information may be subtracted from the penetration image as part of the processing. For example, a visible light image ("viewfinder image") or surface imaging may be used to remove direct surface reflections.

[0116] In general, the devices (e.g., systems) described herein can always know the location of the wand based on the surface scan, even when images are acquired at different (and even small) angles. Thus, if surface and penetrating scans are performed simultaneously or nearly simultaneously (e.g., within 600 ms, 500 ms, 400 ms, etc. of each other), including interleaving these scans with other scan types, the location of the wand relative to the object being scanned may be known. Based on this information, the device can estimate which portions of the images or signals are coming from the surface and what is coming from deeper structures.

[0117] FIG. 4A shows an example of a configuration of penetrating light sources 403, 403′ (e.g., light sources in a penetrating spectral range) and one or more cameras 405 that can be used as part of an intraoral scanner wand, shown at different positions around the target object (tooth 401). In FIG. 4A, three camera positions are shown, each with a pair of LEDs (e.g., 403 and 403′) flanking each camera, which emit light in a penetrating spectral range (penetrating wavelength). Alternatively, a single light source (e.g., LED) may be used instead of a pair. Different images with penetrating modalities may be acquired at various wand positions relative to the tooth. Alternatively, the wand may be configured with multiple imaging sensors (cameras) and multiple light sources to allow multiple penetrating images to be acquired at approximately the same time (e.g., by turning on multiple sensors when illuminating from the direction of one or more LEDs (e.g., FIGS. 5G and 5E, etc.). 5A-5I, as shown, penetration images may be acquired in at least nine different orientations. Alternatively or additionally, multiple orientations may be used sequentially, such as over a very short period of time (e.g., within less than 500 ms, within less than 400 ms, within less than 300 ms, etc.).

[0118] Figures 4B-4F show other emitters and detectors used at any penetrating wavelength that can be used to obtain internal images of objects with semi-transparent and strongly scattering regions (e.g., teeth). These images typically collect reflectance modes (e.g., light at penetrating wavelengths that can travel inside the tooth and be scattered / reflected from the internal structures and collected by the detector). In Figure 4B, a classical (e.g., 90°, 180°) transillumination angle is combined with a small angle illumination angle. In Figures 4C-4F, the emitted and collected light rays have a very small angle (e.g., about 0°) and may be collected by placing the emitter 403, 403' and detector 405 assemblies (e.g., CMOS, CCD, etc.) adjacent to one another as shown in Figure 4C, interdigitated with one another as shown in Figure 4D, or simply sharing a common or near-common beam path as shown in Figures 4E and 4F (in which case reflection or wave guides may be used to direct the emitted and / or received light, including the use of beam splitters (dichroic beam splitters) and / or filters).

[0119] As mentioned above, any suitable sensor may be used, including a CMOS or CCD camera, or any other sensor capable of detecting wavelengths of interest (eg, a near-infrared wavelength detector).

[0120] Penetrating illumination from very close to the sensor (camera) can result in the strongest illumination in the area closest to the camera, and therefore in an uneven distribution of illumination, but this is surprisingly less of a problem than one might expect. In penetrating imaging situations, the light that produces the captured image propagates through the object, and the longer the path, the longer the scattering that occurs, resulting in a more gentle illumination compared to direct illumination. In the case of forward illumination, the strongest amount of light is the area closest to the illumination source (e.g., LED), as a result of low-angle illumination, which causes back scattering. This nearby area (e.g., the first 1-2 mm) is the critical area for caries detection. However, it may be desirable to compensate for the unevenness of the resulting illumination profile distribution, as described above.

[0121] By using penetration imaging, and particularly low angle illumination / imaging (sometimes called reflectance imaging), it is possible to obtain information about the interior regions of the tooth (e.g., cracks, caries, damage, etc.) that would not be obtainable otherwise. The internal shape (or internal region) information may be incorporated into the 3D model, which can be particularly powerful when combined with surface information (e.g., 3D surface model or depth information). This may allow the user to seamlessly capture diagnostic data during the 3D scanning procedure, while allowing unlimited movement around the tooth to capture data from various angles to give a 3D model of the tooth's interior.

[0122] Combining surface data and internal shape data As mentioned above, it may be particularly useful to combine and / or coordinate 3D surface data with any internal shape data (including but not limited to penetration imaging data). For example, internal shape data, such as penetration imaging data, may be combined with surface data collected from the same or nearly the same location on the intraoral scanner (surface imaging data) so that the same coordinate system can be applied to both types of data.

[0123] As mentioned above, a color 3D intraoral scanner such as that shown in FIG. 1A may be equipped with an illumination device that emits light in two or more different spectral ranges to capture various surface and internal geometries. The collected data (e.g., surface data and internal geometry data) can be correlated and combined to form a 3D model that includes information on the internal structure of the tooth as well as damage, deterioration, enamel incomplete fractures, etc. The internal geometry data may be collected by any suitable penetrant imaging technique, such as the reflected (e.g., low angle) illumination and imaging techniques described above, trans-illumination imaging techniques, or other techniques known in the art, such as, but not limited to, UV / blue fluorescence and red light fluorescence.

[0124] The internal shape data may be collected together with the surface data, including color 3D surface model data of the teeth (and may include images of the lesions and internal tooth structure), and may be combined with those surface data. The combination of surface and internal data may be represented as a 3D model or 3D rendering, which may include full color 3D data (including models and renderings) of the lesions and tooth internal structure, as well as the surfaces of the teeth, gums, and any other scanned portions of the intra-oral region. However, in some variations, the extent of the internal and surface data may be the same, and in some variations, the extent of the surface data may be greater than the extent of the internal data, for example, the 3D model may include internal data for only a portion of the 3D model, while other regions may not include the internal shape (or may only include an incomplete internal shape).

[0125] In operation, the 3D model of one or more teeth, including both surface and internal features, may be automatically or manually analyzed and internal features may be identified and / or marked. For example, damage, caries, and / or cracks may be labeled, including color-coded, depending on the type and risk of damage, caries, and / or cracks, for example, which may be represented in one or more images that may be provided and / or as part of the data file generated to display those images. Alternatively or additionally, meanings / explanations of these findings may be written.

[0126] An intraoral scanner that generates a 3D model including both surface and internal structures as described herein may include one or more image sensors. For example, the image sensor may be configured to capture color 3D (surface) images or data, and may also capture images of lesions and tooth internal structures. Optionally or additionally, the system may have multiple sensors. Surface data may be acquired using an intraoral scanner in any suitable manner. Intraoral scanners are generally configured to scan (with a wand) in both surface imaging mode and internal imaging mode (e.g., simultaneously). For example, surface data capture may be performed using a color intraoral 3D scanner with confocal stereoscopic vision, or structured light triangulation, or any other 3D surface scanning technology capable of intraoral scanning.

[0127] As shown in FIGS. 10A and 10B, illumination sources (including a light source for a first modality (e.g., surface scanning), a light source for a second modality (e.g., penetrative imaging such as penetrative imaging), and / or a light source for a third modality (e.g., color scanning)) may be located at the front tip of the intraoral scanner wand (e.g., near the object being scanned or inside the scanner head). The illumination configuration at the front tip may be configurable by modifying the front tip with or without any particular light source suitable for the desired diagnostic function, depending on the needs of the application. The light sources and sensors (e.g., cameras) may be arranged in any suitable manner, including those shown in FIGS. 10A-10B and 4. For example, the light sources and cameras may be side-by-side. In some variations, the systems and methods use miniature sensors 1005, 1007 (e.g., wrapped around the front tip) to capture volumetric 3D internal shape data (e.g., images) and / or facilitate penetrative imaging in a more efficient manner.

[0128] As mentioned above, in some variations, the damage / internal tooth structure capture method may be any combined penetrant imaging through the tooth, including one or more of trans-illumination, red light laser fluorescence, blue / UV laser fluorescence, etc. In general, the internal shape data may be used in combination with the surface data, including the coordinate system of the surface data, to reconstruct a 3D representation of the tooth structure. For example, a 3D reconstruction of the tooth data may be reconstructed by an algorithm that combines several (e.g., multiple) 2D images, typically acquired at several different angles or orientations, using any of the internal shape imaging techniques described herein.

[0129] In particular, data captured by the intraoral scanner, including a 3D model of one or more teeth, both with surface and internal geometry, may be stored by the device and / or sent to a doctor, medical records, dentist, etc. For example, all data captured by the intraoral scanner, i.e., a color 3D model combining the topography of dental damage and the internal tooth structure, may be kept in a designated patient database for the long-term monitoring and preservation of the patient's oral health. These data may or may not be annotated (including date and / or markings referencing the internal geometry).

[0130] For example, comparisons over time may be performed at one or more levels using the 3D models described herein, such as by comparing surface changes, visual color changes, internal / volumetric changes, or any combination thereof across time. For example, each may be shown as a before and after (e.g., by manual evaluation or automatic difference comparison). In some embodiments, two or more 3D models may be overlaid on one another on the display to highlight differences between the 3D models. Overlaid models may help to highlight, for example, changes in enamel thickness, dentin volume, color, opacity, and / or increases or decreases in caries size. Optionally, a 3D model of the patient's dental condition at an earlier time may be morphed to a 3D model of the patient's dental condition at a later time, which helps to highlight any changes in the patient's dental condition over time. In some embodiments, a time series of 3D models may be progressively morphed from one model to the next to provide a movie or animation of the changes in the patient's dental condition. An automated comparison may be performed by applying or transforming to a common coordinate system, which may in particular be performed using surface information (e.g., based on 3D surface model data included as part of the generated 3D volumetric model). Typically, all three types of data (surface, color, volumetric, etc.) may be interconnected by the same coordinate system, as previously described. The methods and apparatus described herein, including the 3D model, may generally be used to predict a patient's future dental or orthodontic condition (e.g., as described in U.S. Patent Application Publication No. 2016 / 0135925, the entire contents of which are incorporated herein by reference).

[0131] When comparing scans including 3D volumetric scans, the scans may be adjusted or normalized relative to each other for automatic, semi-automatic, or manual comparison. For example, one or more tooth scans (e.g., full jaw scan, partial scan, etc.) may not be 100% reproducible, especially not reproducible to an accuracy greater than the voxel resolution. When performing a voxel-by-voxel comparison, matching and / or morphing functions may be applied to one or both scans to allow a more direct comparison. For example, matching and / or morphing functions may be used. Morphing functions may allow voxel-by-voxel comparison by matching external surfaces against each other. This may also allow comparison of full and partial scans.

[0132] As mentioned above, in general, the captured data may be stored and saved in the same coordinate system. Thus, the surface data (including the 3D surface model data) may use one coordinate system (e.g., x, y, z, so the 3D surface model is S(x,y,z)) and the internal shape data may use or reference the same coordinate system (so, for example, the internal shape data is I(x,y,z)). Thus, common shapes or structures will have the same address (coordinates) between both data sets.

[0133] FIG. 6 illustrates an example of a method for generating a 3D model or 3D rendering of one or more teeth using surface data and internal shape data. In this example, a handheld intraoral scanner wand (scanner) may first be positioned adjacent to a target intraoral region to be scanned (601). Once scanning begins, the device may collect surface data (e.g., 3D model surface data) including depth information in a first coordinate system (603). The surface data may typically be collected while the sample is illuminated using a first illumination spectrum (e.g., visible light (e.g., monochromatic or broadband light)). Internal shape data may also be collected, for example, using a second illumination spectrum (which may include only a single wavelength or a small range of wavelengths) that penetrates the interior of one or more teeth (605). This data may use the same coordinate system as the surface data, which may be accomplished as described in more detail below. Once collected, the data may be analyzed and / or filtered (including differencing, smoothing, etc.) and combined to form a 3D model rendering of the intra-oral cavity (e.g., one or more teeth, gums, jaws, etc.) using both the surface data and the internal shape data (607). For example, when constructing a 3D geometry of the internal shape data (which is typically two-dimensional in nature), the algorithm may refine the internal shape data using reference to a known 3D surface scan.

[0134] In general, in any of the devices and methods described herein, the internal shape data collected at 605 can be used to reconstruct a volumetric model of one or more teeth, including the internal shape. In particular, tomographic reconstruction (e.g., optical tomography) can be used. Full volumetric modeling can be performed. Typically, refraction, reflection, scattering, and / or absorption (including combinations of these) of all penetrating rays can be performed, depending on the material properties and the light used. In some variations, the method and / or the device can divide the tooth volume into small voxels and estimate these four parameters (refractive index, reflection, scattering, absorption) for each voxel based on the collected imaging data, using a coordinate system corresponding to that of the surface data. More complex models (e.g., based on anisotropic scattering or complex surface scattering) can also be used. After a set of parameters for each voxel has been estimated, the method or the device can compare how well the captured image fits this model. Thus, in some variations, the apparatus and / or method may attempt to minimize the difference between the captured image and the modeled and predicted image.An initial guess, including estimates of enamel parameters and width, may be constructed from the 3D surface capture.

[0135] Alternatively or additionally, multi-surface modeling may be used, which assumes a set of (possibly homogenous) optical properties of materials, e.g., for air, dentin, and enamel (but may include more than these three). This approach may attempt to find the boundaries between materials. There are several ways to achieve this, for example, similar to the approach described above for full volumetric modeling, but without using a voxel representation. Alternatively or additionally, a contour method may be used, in which a first (e.g., air-enamel) boundary is given from the 3D surface capture, and then a smooth 3D surface that best fits this silhouette can be approximated by finding the edges of the region in the 2D penetration image. See, for example, "3D Shape from Silhouette Points in Registered 2D Images Using Conjugate Gradient Method," (Andrzej Szymczaka, William Hoffb, Mohamed Mahfouzc, et al.), the entire contents of which are incorporated herein by reference. Besides contours, other shapes, similarities, corners may be used as known in the art. These shapes may be detected from different viewpoints and located in 3D by triangulation, and are part of the boundary.

[0136] In practice, recording surface data and internal topography data in the same coordinate system can be achieved by scanning both surface topography and internal topography at the same location and / or time. As mentioned above, with a user-controlled handheld intraoral scanning device (e.g., a wand), it may be difficult to scan the same area at different times and with different wavelengths. Thus, any of the devices and methods described herein can coordinate scanning in different modalities or modes (e.g., surface data scanning, and / or internal topography / penetration data scanning).

[0137] For example, FIG. 7 illustrates one method in which an intraoral scanner alternates between surface scanning and one or more other scanning modalities (e.g., internal shape scanning, such as a penetration imaging scan). In FIG. 7, the scanner is positioned adjacent to a target intraoral structure to be modeled (701), and then the wand may be moved over the target while the device automatically scans the target for both surface and internal data (703). As part of the method, the system may alternate (switch) between scanning a portion of a tooth using a first modality (e.g., a surface scan with emission of an appropriate wavelength or range of wavelengths) to collect surface data (e.g., 3D surface model data) (705) and scanning with a second modality (e.g., a penetrating wavelength) (707). After a suitable duration in the first modality, the method and apparatus may briefly switch to a second modality (e.g., a penetrating wavelength or range of penetrating wavelengths) to collect internal shape data for a short period (second duration) over approximately the same area of ​​the object as was scanned in the surface mode (707). As long as the second duration is appropriately short (e.g., less than 500 ms, less than 400 ms, less than 300 ms, etc., less than 200 ms, less than 100 ms, less than 50 ms, etc.), the coordinate systems between the two modalities are approximately the same and the wand is in approximately the same position when switching. Alternatively or additionally, the method and apparatus may extrapolate the relative position of the wand with respect to the surface based on surface data information collected immediately before and after the collection of the internal data. Thus, in any of the methods described herein, including that shown in step 703 of FIG. 7, the device may interpolate positions between each scan (e.g., a first modality scan (e.g., a surface scan), a second modality scan (e.g., a penetrant, e.g., one or more near-infrared scans), and a third modality scan (e.g., a color scan), etc.). This interpolation can compensate for small, but potentially significant, movements of the wand during the scan.In particular, when making adjustments between surface and internal structures, the scans are performed manually, and each scan image is interpolated (and / or extrapolated) to more accurately approximate the 3D position of the tooth (or the 3D relative position of the tooth with respect to the scanner wand). Thus, the portion of the tooth scanned using the penetrating wavelength may be proportionally interpolated between the surface scans performed before and after the penetrating scan. See, for example, FIG. 8, described below. FIG. 8 shows an exemplary relative timing of the scans in each mode. Alternatively or additionally, the position of the tooth and / or the wand / scanner during the scan may be extrapolated from the previous surface scan position based on the speed of movement of the scanner wand (e.g., estimated from the rate of change across the surface from the previous surface scan and / or from a motion sensor in the wand). Correcting the coordinate system (e.g., x, y, z position and azimuth) of each scan in this way may allow images of different modalities to be closely aligned with each other, regardless of how the scanner is steered by the user. In a penetration scan, multiple scans may be taken from the same relative position and used to reconstruct the internal shape, and the precision of this coordinate system may allow for higher resolution modeling of the internal shape.

[0138] In general, when collecting a penetrating wavelength image, the emitted and received light may have different polarizations. In reflected light mode, for example when using low angle penetrating imaging, some of the energy is penetrating, but some is also reflected from the surface. It may be preferable to block this direct surface reflection, which may be done in any suitable way, including using polarized light. For example, to block surface reflections, a sample (e.g., a tooth) may be illuminated with a penetrating wavelength of a particular polarization, and this polarization can be blocked in the imaging path. This polarization may also be useful to block direct light from the illumination source in trans-illumination (where there is a direct line of sight to the illuminator, for example as in 180° trans-illumination).

[0139] Many of the methods and devices described herein involve mode switching to distinguish between surface and internal structures, but in some variations they may be detected at exactly the same time, which may be done, for example, using dichroic beam splitters and / or filters. Thus, by separating the wavelengths and / or polarizations that are penetrative and involve internal reflection and / or scattering from those that involve only (or mainly) surface features, surface data may be collected and processed separately from the internal features, and these two data sets may be recombined later. This approach may inherently use the same coordinate system.

[0140] For example, FIG. 2E shows a schematic of an intraoral scanner configured to perform both surface scans (e.g., visible light, non-penetrating) and penetrating scans using near-infrared (NIR) wavelengths (850 nm in this example). In FIG. 2E, the scanner includes a near-infrared illumination source 289 and a first polarizer 281, and a second polarizer 283 in front of an image sensor 285 to block near-infrared light (P-polarized light) reflected from the surfaces of the teeth 290 while collecting near-infrared light (S-polarized light) scattered from the internal tooth structures / regions. The near-infrared light source illuminates the teeth with P-polarized light, and the specular light reflected from the tooth surfaces (e.g., enamel) is reflected with specular reflection since its P-polarized state is preserved. Near-infrared light penetrating internal tooth features such as dentin is scattered to random polarization (S and P). The wavelength-selective quarter wave plate 293 does not change the polarization of the near-infrared light (e.g., it leaves the polarization state of the delivered near-infrared light unchanged), but changes the polarization of the returning scanning light from P to S so that only surface reflections are captured at the scanning wavelength. The returning near-infrared light is a mixture of S and P polarization and is first filtered through a polarizing beam splitter (PBS) 294 and a polarizing filter 283 to send only S polarization to the image sensor. Thus, only near-infrared S polarized light coming from the tooth internal structures is captured at the image sensor and the specular light with the original P polarization is blocked. Other intraoral scanner configurations may also be used as part of the probe, with or without a polarizing filter as shown in FIG. 2E.

[0141] In FIG. 2E, a surface scan may be performed by illuminating the surface (using the scanner illumination unit 297) with P-polarized light, the polarization of which is reversed by a wavelength-selective quarter-wave plate 293 (which transmits S-polarized light to the image sensor).

[0142] As shown in FIG. 7, the scanning regime may be adjusted (709) manually or automatically, including the duration of the scanning modality (e.g., the second scanning modality) for calculating the internal shape data. For example, the scanning procedure (time sharing and sequence) may be changed for each case, and the system may automatically optimize the scanning resources to obtain a higher quality scan and / or a more complete reconstruction. The method or apparatus may identify (709) the quality of the scan data (e.g., the quality of the surface scan data) and adjust the scan duration (e.g., the second duration) accordingly. The quality estimation may be performed automatically, for example, based on blur, oversaturation, or undersaturation, etc. For example, the duration of the scanning regime may be dynamically adjusted (e.g., increased or decreased) based on the quality of the scan with this modality, and the scan duration d for this modality may be increased or decreased if the previous x scans with this modality are below a first (e.g., minimum) quality threshold (quantifying one or more of blur, oversaturation, undersaturation, etc.). imay be increased. If the duration of the scan is longer than the minimum duration and the quality is above a second quality threshold (which may be the same as or higher than the first quality threshold), the scan time may be decreased. Reducing the scan duration may allow for increasing the duration of other scan modalities and / or increasing the switching speed of scan modalities. Alternatively or additionally, the scan duration of a modality may be adjusted based on the completeness of the 3D model to be reconstructed. For example, when scanning an area of ​​the 3D model that has a more complete surface model (e.g., an area where a surface model has already been created), the duration of the surface scan may be decreased and the duration of the penetration scan (e.g., a reflectance scan using near-infrared wavelengths or a trans-illumination scan using near-infrared wavelengths) may be increased to increase the resolution and / or range of internal structures. Similarly, the frequency of scans in each mode may be dynamically adjusted by the device. Any of the methods and devices described herein may be configured to display these missing areas or angles on a 3D graphical display, providing feedback to the user to slow down the scan or add an additional scan from a particular angle.

[0143] As shown in FIG. 7 (e.g., optional step 708) and FIG. 8, more than two scanning modalities may be used. FIG. 8 illustrates an exemplary method of operating an intraoral scanner to switch between different scanning modalities, such as surface scan 801, laser fluorescence 803, color visible light scan (viewfinder) 805, penetration scan 807, UV scan, etc. The system may initially switch between scanning modalities using a default scanning strategy. The system may then analyze (in real time) the defaults coming from each scanning modality as described above, and prioritize scanning modalities with lower data completeness, for example by increasing the frequency and / or duration (d) of the scans. In some embodiments, the system may compare collected data from one or more of the scanning modalities to a predefined data resolution threshold to determine which scanning modality should be prioritized. For example, the system may increase the frequency or duration of surface penetration imaging once it determines that sufficient surface data has been collected by the surface imaging modality, and that the resolution of the internal shape data is still insufficient. Alternatively or additionally, in some variations, scans may be performed simultaneously for the various modalities. Once sufficient scan areas have been scanned, the scan data may be used to assemble a 3D model of the entire intraoral region (711). Alternatively, the 3D model may be assembled continuously as the scan progresses. The frequency of the scan 809 is shown as the frequency of the scan amplitude in FIG. 8, with the surface scan occurring at the maximum of the scan amplitude and the penetration scan occurring at the minimum of the scan amplitude as the confocal scan depth increases and decreases. The frequency of the depth scan 809 may be dynamically increased or decreased during the course of the scan, for example to allow for a scan with a longer scan duration, or to accommodate a user moving the wand / scanner faster.In some variations, the wand may include a motion sensor (eg, an accelerometer, etc.) to detect the rate of motion, and the scan speed and duration may be adjusted based on the detected scanner motion.

[0144] 6, the resulting 3D model, including surface and internal structures, may be utilized in various manners to benefit the health care of a subject (e.g., a patient). For example, the 3D model may be used to identify (automatically or manually) and analyze dental damage, caries, and / or cracks. The 3D model may be used, for example, to measure the size, shape, and location of damage, including cavities, assess the type of caries based on translucency, color, shape, and / or assess the type of surface problem (e.g., cracks, cavities, etc.) based on surface illumination (609).

[0145] This 3D data (or data derived from it) may be monitored over time for a particular patient 611. For example, the 3D data may be checked visually or algorithmically for changes in shape, size, and type over time.

[0146] In general, the 3D data can be annotated. For example, the clinician may mark areas of interest after the initial scan, which may then be manually or automatically evaluated in subsequent scans. Additionally, the 3D data may be used to assist in treatment or provide treatment guidance and monitoring (613). For example, if the clinician decides to restore a tooth, the 3D data generated as described herein showing the surface and interior areas may be used to guide reduction of the tooth to ensure removal of the decayed portions. During the course of treatment, additional (e.g., intermediate) scans may be taken to provide further instructions and immediate feedback to the practitioner regarding reduction.

[0147] 9A and 9B show an example of a rendering of a 3D model 900 of a subject's intra-oral region, including both the surface (the entire surface is shown in the projection of FIG. 9A) and the internal structure (a magnified area is shown in FIG. 9B). In FIG. 9B, the dark area 903 revealed by the combination of the 3D surface data and the penetration imaging using 850 nm light indicates an area of ​​interest. The area of ​​interest may be an area of ​​caries, a dental filling, etc. By manipulating the image in this manner, the ability to rotate, zoom, cross-section, or otherwise view the 3D model or areas of the 3D model can greatly enhance treatment and understanding of the subject's dental needs.

[0148] Depth Scan 11A-11I show an example of volumetric modeling of internal tooth structure using penetrating wavelengths such as near infrared trans-illumination ("TI"). In this example, there is a lesion in the tooth and it is possible to detect the lesion if the light is below or at the level of the lesion. If the light is below the lesion, the lesion will absorb the light and will appear as a dark spot in the image. In FIG. 11D, a tooth with a lesion is shown with a scanner sensor 1101 above the tooth (positioned above the occluding surface of the tooth). The scanner includes one or two light sources (emitters) 1105, 1105' (as shown in FIGS. 11D-11F), which emit near infrared light as indicated by the arrows. The light penetrates the tooth and the sensor 1101 detects the obstruction of the light by the lesion, as shown in FIG. 11A.

[0149] As the scanner is moved upwards with the light source (i.e., the scanner wand is raised higher in the longitudinal direction of the tooth), the lesion image changes as shown in FIG. 11B. The corresponding relative position of the light source with respect to the tooth is shown diagrammatically in FIG. 11E and illustrated in FIG. 11H. As the scanner is moved further up the tooth, the dark spot 1113 representing the lesion begins to shrink and eventually disappears completely as the light saturates. Eventually, when the light source 1105, 1105' is higher than the lesion, the dark spot is no longer present (e.g., FIG. 11C) and only the central occluded area (dentin) is shown. As already mentioned above, the external surfaces of the tooth and gingiva may be scanned simultaneously using separate light sources, which gives the 3D external surface of the tooth and therefore the distance from the tooth to the scanner. This information may be used to map the depth and / or shape of the lesion as described above.

[0150] Such depth scans may be performed manually or automatically and may be useful in providing a backup and / or alternative to volumetric modeling of one or more teeth (e.g., 0 degree volumetric modeling). Indeed, this longitudinal scan of the teeth (which may be performed in any orientation (bottom to top, top to bottom, etc.) of the tooth) may be used as a type or subtype of volumetric scan that may provide information regarding the shape and location of dentin and / or lesions.

[0151] For example, a longitudinal (z-axis) scan of one or more teeth with an intraoral scanner, particularly one with both penetrating (e.g., near-infrared) and surface scanning wavelengths, may be an alternative to a volumetric scan. In general, data may be acquired by scanning one or more teeth upwards or downwards (in the z-axis).

[0152] As mentioned above, one configuration of the described scanning device is capable of optically imaging the interior regions of one or more teeth, for example by using trans-illumination (through the side) at an angle (e.g. 90°) between the light source and the camera. If dental caries are present in the tooth, then by observing the tooth from above (occlusion observation) with a penetrating wavelength (e.g. in trans-illumination), the caries can be shown as occluded regions. Depending on the relative z (depth) position of the light source with respect to the caries, occluded regions corresponding to the caries will appear in the x,y image. Thus, a scan through the z axis (depth) may be performed as described above to identify the z position and / or shape of the caries. In some variations, the method of scanning using penetrating wavelengths (or penetrating and surface scanning) may begin by illuminating from both sides, imaging from above, and placing the light source as close to the gum line as possible. The method may then proceed by moving upward along the z axis of the tooth and away from the occluded surface of the tooth. This may allow light to be directed at the lesion from various depths (in the z-axis). As shown in Figures 11A-11C, the caries may be initially present, but as the scanner is pulled upwards it shrinks in the imaging plane (x,y) until it no longer blocks the light. Either of these methods may also calculate or determine the longitudinal z-position of the tooth as the scanner moves upwards, which gives the relative depth to the tooth and therefore the depth of the lesion from the enamel layer. From this information the dimensions of the lesion may also be determined (e.g. an estimate of how far the lesion extends in the z-position direction), as well as the width and extent (e.g. how far it extends in the x,y directions). This information may be used together with a surface 3D model of the tooth's outer shape to provide a model of the entire tooth and lesion.

[0153] Thus, it is possible to determine models of both the external and internal structures of the tooth using both penetrating (e.g., near-infrared) and non-penetrating (surface scanning) wavelengths. A z-axis depth scan (or even a discontinuous scan) of the tooth may be particularly useful for identifying the depth and / or dimensions of one or more internal tooth structures. In any of the methods described herein, a 3D scan of the tooth may be performed simultaneously with a penetration scan (including depth), as described above.

[0154] Thus, in any of the tooth scanning methods described herein, the method may include determining a depth (z) dimension for each scan to indicate the relative depth of the light source (e.g., near-infrared light source) with respect to the tooth. This information may be provided by a 3D surface scan that corresponds / correlates with the penetration scan. The depth information (e.g., indicating how far the scanner has moved in the z-axis) can provide substantial volumetric information.

[0155] As mentioned above, the depth (z) scan described herein may be performed manually or automatically. For example, the scan may be performed by manually scanning a wand up along the tooth. During the scan, both 3D surface modeling and internal modeling / imaging may be performed simultaneously and continuously. The scan may be performed at any suitable rate (e.g., 20 scans per second). Thus, the user may scan at a reasonable speed and the output may be in real time, including displaying the damage, and / or the damage (and any other internal structures) may be later analyzed by software and then displayed. In one example, simultaneous scans may be performed such that a surface scan (by laser) may be performed over a period of about 35 milliseconds, followed by a 15 millisecond window for other types of imaging, including color, near infrared, etc., and this may be repeated during the scan period. In some examples, a near infrared scan may be performed over 5 milliseconds within the 15 millisecond window. It may be advantageous to have shorter sampling times (e.g., less than 20 ms, less than 15 ms, less than 12 ms, less than 10 ms, less than 7 ms, less than 5 ms, etc.), as this can reduce smearing of the image. However, shortening the scan time may require more energy, e.g., more power / current may be required for the penetrating light source. Imaging data may be collected throughout. Alternatively, scans (e.g., surface scans, near-infrared scans, color scans, etc.) may be performed over longer or shorter periods and / or simultaneously (e.g., laser surface scans and near-infrared scans may be performed simultaneously using separate emitters / detectors). In this way, for example, surface scans and penetrating scans, or any other different types of scans, may be performed simultaneously or switched between them for short periods of time (within 200 ms, 150 ms, 100 ms, 50 ms, etc.), allowing for coordination between surface (e.g., 3D) type structures and internal structures, as described above.

[0156] Using Scattering Coefficients to Image Internal Structures Further described herein are methods and apparatus for generating images of the internal structure of a tooth or other translucent, highly scattering object based on multiple penetrant images (also referred to herein as "penetrant images") taken through the object, given a camera position (relative to the object). These methods and apparatus are thus capable of generating images (including three-dimensional models) of the internal structure without requiring a model of the external surface.

[0157] For example, methods and apparatus (including computing device readable media) are described herein for reconstructing the volumetric structure of an object that includes semi-transparent, strongly scattering regions, such as a tooth. More specifically, these apparatus (e.g., systems) and methods can provide a technique for reconstructing the internal structure of an object, such as the dentin in a tooth.

[0158] In general, any object that is semi-transparent and highly scattering for a particular wavelength can be imaged by the methods described herein (as well as using either apparatus). If the position and orientation of the camera relative to the object is known, the internal structure of the object can be reconstructed with low computational complexity proportional to the volume and number of images reconstructed.

[0159] Any intraoral scanner as described herein that captures images through an intraoral region of a subject (e.g., one or more teeth, gums, jaw, etc.) and also provides information regarding the relative position of the scanner (e.g., the camera of the scanner that captures the images) may be used. For example, returning to FIGS. 1A and 1B, FIG. 1A illustrates an example of an intraoral scanner 101 that may be configured or adapted as described herein to generate a 3D model having both surface and internal shapes. As shown generally in FIG. 1B, an exemplary intraoral scanner may include a wand 103 that may be handheld by an operator (e.g., dentist, dental hygienist, technician, etc.) and moved over one or more teeth of a subject to scan both surface and internal structures. The wand may include one or more sensors 105 (e.g., a camera such as a CMOS, a CCD, a detector, etc.) and one or more light sources 109, 110, 111.

[0160] In FIG. 1B, two separate light sources are shown, a first light source 109 and a second light source 111, the first light source 109 configured to emit light in a first spectral range (e.g., visible light, monochromatic visible light, etc.) for detection of the surface topography, and the second light source 111 configured to emit light in a second spectral range for detection of the internal topography of the tooth (e.g., by trans-illumination, low angle penetrative imaging, laser fluorescence, etc., sometimes collectively referred to as penetrative imaging). Although FIG. 1B shows multiple illumination sources separately, in some variations, switchable light sources may be used. The light sources may be any suitable light source, including LEDs, optical fibers, etc. The wand 103 may include one or more controls (buttons, switches, dials, touch screen, etc.) to aid in control (e.g., turning the wand on and off, etc.), alternatively or additionally, one or more controls not shown may be present in another part of the intraoral scanner, such as a foot pedal, keyboard, console, touch screen, etc.

[0161] Additionally, the wand 103 may include one or more position and / or orientation sensors 123, such as an accelerometer, a magnetic field sensor, a gyroscope sensor, a GPS, etc. Alternatively or additionally, the wand may include an optical sensor, a magnetic sensor, or some other combination thereof, for detecting the relative position of the wand (particularly the camera) with respect to the object being imaged (e.g. one or more teeth). Alternatively or additionally, the device may detect the relative position of the wand based on a surface image (e.g. a surface scan) and / or a discovery scan acquired as described above.

[0162] In general, any suitable light source may be used, particularly one that is compatible with the mode to be detected. For example, any of these devices may include a visible light source or other light source for surface detection (e.g., at or around 680 nm or other suitable wavelength), a visible light source (e.g., a white light source) for conventional imaging, including color imaging, and / or a penetrating light source (e.g., an infrared light source and / or a near infrared light source) for penetrating imaging.

[0163] The relative positions of the light source and camera are typically known, and one or more penetration images may be acquired at each position of the wand. The positions of the light source and camera may include three numerical coordinates in three-dimensional space (e.g., x, y, z), as well as the pitch, yaw, and roll of the camera.

[0164] The intraoral scanner 101 may include one or more processors, including linked or remote processors, to control the operation of the wand 103, including the coordination of the scan, and the scanning and generation of a 3D model including surface and internal geometry during review and processing. As shown in FIG. 1B, the one or more processors 113 may include or be coupled to a memory 115 for storing scan data (surface data, internal geometry data, etc.). Communications circuitry 117, including wireless or wired communications circuitry, may also be included for communicating with components of the system (including the wand) or external components (including external processors). For example, the system may be configured to receive and transmit scans or 3D models. One or more additional outputs 119 may be included for outputting or presenting information, such as a display screen, printer, etc. As mentioned above, an input 121 (buttons, touch screen, etc.) may be included, and the device may allow or require user input for controlling scanning and other operations.

[0165] Any of the devices and methods described herein may be used to perform scans to locate and / or identify internal structures such as enamel and / or dentin cracks, caries, lesions, etc. Accordingly, any of the devices described herein may be configured to perform scans to detect internal structures using penetrating wavelengths or a spectral range of penetrating wavelengths. A variety of penetrating scanning techniques (penetrating imaging) may be used or incorporated into the device, of particular interest being trans-illumination and low angle penetrating imaging, both of which detect the path of penetrating wavelength light that penetrates tissue (e.g., through one or more teeth).

[0166] The methods and apparatus described herein for visualizing the enamel-dentin region using a penetrating wavelength (e.g., 850 nm, etc.) may acquire multiple projections or orientations from a single position of the scanner relative to one or more teeth, and in particular, three or more orientations or projections may be acquired at each position. By acquiring multiple (e.g., three or more) projections, better imaging can be achieved because multiple (e.g., three or more) images can be generated through the tooth from a particular position of the wand relative to one or more teeth.

[0167] FIG. 12 shows an example of a portion of a scanner configured to include a penetrating light source 1202, 1202′ (e.g., a penetrating spectral range light source) and a camera that can be used as part of an intraoral scanner wand. In FIG. 12, a camera 1200 is shown flanked by a pair of LEDs 1202, 1202′ that emit light in the penetrating spectral range in approximately the same direction that the camera is pointing toward the target T (e.g., tooth 1201). A single light source 1202 (e.g., LED) may be used instead of a pair. Generally, according to the present disclosure, the wand light source projects in approximately the same direction as the camera, although in some embodiments the light source may be offset by up to ±15 degrees relative to the direction of the camera, as described above.

[0168] 13 shows a flowchart 1300 illustrating one method for reconstructing volumetric structure in a range of emission wavelengths from an object having semi-transparent, strongly scattering regions, which may be, for example, a tooth that includes an outer enamel surface and an inner dentin surface.

[0169] At step 302 of flowchart 1300, the method includes acquiring a plurality of images of an object with a camera in a range of radiation wavelengths, with illumination for the plurality of images projected from approximately the direction of the camera. In some embodiments, the radiation wavelength range is infrared or near infrared wavelengths. Infrared or near infrared wavelengths can be used, for example, to penetrate semi-transparent objects. In one embodiment, illumination for the plurality of images may be offset by up to ±15 degrees with respect to the direction of the camera. The plurality of images may be stored in a computer memory coupled to the camera.

[0170] Both of these methods require the acquisition of position data representing the relative position of the camera with respect to the object in each of the multiple images. 304 In general, the location data may include receiving the location data. 304 contains the position and orientation of the camera relative to the object. 304 can be calculated from the multiple images, or alternatively or additionally, the position and orientation can be measured with sensors 123 on the wand (e.g., gyroscope sensors, accelerometers, GPS, etc.). Alternatively or additionally, the position and orientation can be calculated by alignment of the scanned surface data. In some embodiments, the position data 304 The position data includes three numerical coordinates in three-dimensional space (e.g., x, y, and z in a Cartesian coordinate system) and the pitch, yaw, and roll of the camera. 304 may be quantified as a vector metric (eg, a rotation metric and a vector position).

[0171] At step 306 of flowchart 1300, the method further includes generating an upper bound on the scattering coefficient for each point in the volume from the multiple images and position data. Each of the multiple images may be a projection from the real world (the 3D environment) onto a 2D plane (the image), with depth being lost in the process. Each 3D point corresponding to a particular image point may be constrained to be on the line of sight of the camera. The real world location of each 3D point can be found as the intersection of two or more projection lines through a process of triangulation.

[0172] In step 306, an upper limit for the scattering coefficient at each point of the volume representing the scanned object is calculated. The upper limit is selected from the multiple images by triangulating the position of each point using position data from the camera. The multiple images generate an intensity for each point that is a result of the amount of light reflected by the object. This intensity for each point is used to generate a scattering coefficient for each point. The upper limit for the scattering coefficient for each point may be stored in a memory coupled to the camera.

[0173] The step of generating an upper limit for the scattering coefficient at each point of the volume may include projecting each point of a 3D point cloud grid corresponding to the volume of the object onto each of the multiple images using a first calibration, generating a list of scattering coefficient values ​​for each projected point, correcting each scattering coefficient value in the list of scattering coefficient values ​​according to the volume response, and storing, for each grid point, a minimum scattering coefficient value in the list of scattering coefficient values.

[0174] To facilitate projecting each point of the 3D point cloud grid onto each of the multiple images, several calibrations may be performed. For example, in one embodiment, the first calibration may include a fixed pattern noise calibration to calibrate for camera sensor issues and image ghosting. In another embodiment, the first calibration includes a camera calibration to determine a transformation of the camera that projects a known point in space onto a point on the image. In some embodiments, all of the above calibrations may be performed prior to projecting the points onto the image.

[0175] When generating the upper scattering coefficient limit from the penetration image and position data, the upper scattering coefficient limit may be determined only for points within the external surface of the object being imaged. For example, the methods described herein may further include receiving surface data representing the external surface of the object (e.g., scan data representing the external or enamel surface of a tooth). With the external surface data, it is possible to generate the scattering coefficient using only points within this external surface (e.g., internal points). This may allow, for example, imaging to be focused only on the dentin surface within the enamel surface of the tooth.

[0176] Finally, any of these methods may include generating 308 images of the object from the upper bounds of the scattering coefficients at each point. Examples of generating these images are provided herein, which may include forming lines and / or surfaces based on a threshold value of the scattering coefficient, or a value based on the scattering coefficient.

[0177] 14 is a flow chart 400 illustrating a method for reconstructing volumetric structures from teeth. Teeth may be semi-transparent in the radiation wavelength range. In optional step 402, the method includes receiving in a processor a representation of the tooth surface in a first coordinate system. The representation of the tooth surface may be a 3D model of the tooth, for example, generated by scanning the tooth or by taking an impression of the tooth.

[0178] The method may further include receiving 404 a plurality of images of the teeth in a range of radiation wavelengths at a processor, the plurality of images being acquired with illumination projected from approximately the direction of the camera. In some embodiments, the wavelength is a penetrating wavelength in the infrared or near infrared range, or a range of penetrating wavelengths within the infrared or near infrared range. Infrared (IR) or near infrared wavelengths may be used, for example, for penetrating teeth. The illumination for the plurality of images may be offset by up to ±15 degrees with respect to the direction of the camera. The plurality of images may be stored in a computer memory coupled to the camera.

[0179] At step 406, the method further includes receiving, at the processor, position data representative of the position of the camera in each of the multiple images. Typically, the position data includes the position and orientation of the camera relative to the object. This position data can be calculated from the multiple images, or alternatively, the position and orientation can be measured with sensors on the camera (e.g., gyroscope sensors, accelerometers, GPS, etc.). Alternatively or additionally, the position and orientation can be calculated by alignment of scanned surface data. In some embodiments, the position data includes three numerical coordinates in three-dimensional space (e.g., x, y, and z in a Cartesian coordinate system) and the pitch, yaw, and roll of the camera. The position data may be quantified as a vector metric (e.g., a rotation metric and a vector position).

[0180] The method may further include projecting 408 each point of a point cloud grid corresponding to a volume within the tooth surface onto each of the multiple images using a first calibration. The generated point cloud grid may be within the external tooth surface. The grid may be located, for example, on a cubic grid. Each grid point may be projected onto each of the multiple images using a calibration. To facilitate projecting each point of the grid onto each of the multiple images, some calibration may be performed. For example, the calibration may include a fixed pattern noise calibration to calibrate for camera sensor issues and image ghosting. In another embodiment, the calibration may include a camera calibration to determine a transformation of the camera that projects a known point in space onto a point on the image. In some embodiments, all of the above calibrations may be performed before projecting the points onto the image.

[0181] The method may further include generating 410 a list of brightness values ​​for each projected point. The multiple images generate a brightness for each point that is a result of the amount of light reflected by the object. The brightness values ​​for each point may be stored.

[0182] In step 412, the method may further include converting each luminance value in the list of luminance values ​​into a scattering coefficient according to the volume response. This step may be performed to calibrate the luminance value of each pixel. In this process, for each point relative to the camera position, the scattering coefficient that would result in such a luminance value is calculated. The result is a scattering coefficient that normalizes the luminance according to the volume response.

[0183] 14, the method may further include storing the minimum scattering coefficients at each point in a minimum scattering coefficient list 414. The method may further include generating an image from the list of minimum scattering coefficients at each point.

[0184] As mentioned above, the method and technique may include multiple calibrations for projecting points from the real world onto its multiple images. One such calibration is image fixed pattern noise calibration (PRNU), which addresses sensor issues and system ghosting unrelated to the object being scanned. Figures 15A-E show an example of image fixed pattern noise calibration, which gives a constant response for a homogeneous, flat target. Figure 15A shows an original image of a flat, homogeneous target, which contains two particles 1501, 1502 in the middle of the image. Figure 15B shows an intermediate image after moving the target parallel to its plane, which causes the two particles to "disappear" from the image. Figure 15C shows the image after applying a bias factor value to each pixel, which introduces strong electronic noise into the image. In Figure 15D, a slope is applied to each pixel, resulting in a smooth pattern being imparted by the optical system. Finally, Figure 15E shows the final image after response equalization.

[0185] Another calibration that can be applied is called camera calibration, which allows projecting real-world (3D) points onto 2D image pixels. Camera calibration determines the transformation of the camera that projects known points in space onto points on the image.

[0186] A volumetric response calibration may also be applied, which gives a scattering coefficient for every point in the world that has a given intensity in the image that is in the camera's field of view, giving a standard scattering coefficient for a constant response anywhere in the field of view.

[0187] Finally, a scan-to-world camera calibration may be applied, which is a rigid body transformation that transforms from the scan coordinate system (of the 3D scan of the object) to the camera calibration coordinate system (of the 2D image of the object).

[0188] Other techniques may be used to calculate the volumetric scattering coefficients from the penetration image and the camera position. For example, in some variants, backpropagation may be used. Backpropagation may involve estimating (e.g., tracing) the rays that penetrate the tooth volume and enter the camera. The actual intensity of each ray reaching the sensor may be obtained from the penetration image and the camera position and orientation. For each ray, the attenuation of the intensity due to scattering in the volume through which the ray passes may be estimated. For example, the transmission of light through a strongly scattering and weakly absorbing material may be modeled with a hybrid Monte Carlo scattering computational scheme to obtain the time evolution of the light transmission through the material. A series of projection data may be estimated by extrapolating in time the difference in optical density between the absorbing object and a non-absorbing reference to the shortest time of flight. This technique can therefore give the difference in the absorption coefficient. See, e.g., Yamada et al., "Simulation of fan-beam-type optical computed-tomography imaging of strongly scattering and weakly absorbing media," Appl. Opt. 32, 4808-4814 (1993). Volumetric scattering may then be estimated by determining the actual radiance reaching the sensor.

[0189] Any of the methods described herein may be performed by an apparatus including a data processing system (or subsystem), which may include hardware, software, and / or firmware for performing many of the steps described above, including the processor of the intraoral scanner (see, for example, FIG. 1B). For example, FIG. 16 is a simplified block diagram of a data processing subsystem 500. The data processing system 500 typically includes at least one processor 502 that communicates with several peripheral devices via a bus subsystem 504. These peripheral devices may typically be a storage subsystem 506 (memory subsystem 508 and file storage subsystem 514), a set of user interface input / output devices 518, an interface 516 to an external network such as the public switched telephone network, etc. This interface is shown diagrammatically as a "modem and network interface" block 516, which is coupled to a corresponding interface device in another data processing system via a communication network interface 524. The data processing system 500 may be a terminal or low-end personal computer, or a high-end personal computer, a workstation, a mainframe, etc.

[0190] The user interface input device may be a keyboard, etc., or may be a pointing device, scanner, etc. The pointing device may be an indirect pointing device, such as a mouse, trackball, touchpad, graphics tablet, etc., or may be a direct pointing device, such as a touch screen integrated into the display. Other types of user interface input devices (e.g., a voice recognition system) may also be used.

[0191] The user interface output device may be a printer or a display subsystem, which includes a display controller and a display device coupled to the controller. The display device may be a cathode ray tube (CRT), a flat panel device (e.g., a liquid crystal display (LCD)), or a projection device. The display subsystem may also provide non-visual displays, such as audio output.

[0192] The storage subsystem 506 may hold the basic programming and data constructs that provide the functionality of the present invention. The methods described herein may be implemented as software, firmware, and / or hardware, and those methods (implemented as software / firmware) may be stored in the storage subsystem 506. The storage subsystem 506 typically includes a memory subsystem 508 and a file storage subsystem 514.

[0193] The memory subsystem 508 typically includes several memories, including a main random access memory (RAM) 510 for storage of instructions and data during program execution, and a read only memory (ROM) 512 in which fixed instructions are stored. In the case of Macintosh-compatible personal computers, the ROM contains part of the operating system, and in the case of IBM-compatible personal computers, the ROM contains the BIOS (basic input / output system).

[0194] The file storage subsystem 514 provides for persistent (non-volatile) storage of program files and data files and may include at least one hard disk drive and at least one floppy disk drive (and associated removable media). Other devices such as CD-ROM drives and optical drives (and all associated removable media) may also be present. In addition, the system may include a type of drive that has removable media cartridges. One or more of these drives may be located at a remote location, for example, a server on a local area network or a site on the Internet's World Wide Web.

[0195] In this context, the term "bus subsystem" may be used as a generic term encompassing any mechanism that allows the various components and subsystems to communicate with each other as intended. With the exception of the input devices and displays, the other components need not be in the same physical location. Thus, for example, portions of a file storage system may be connected via a variety of local or wide area network media, including telephone lines. Similarly, the input devices and displays need not be in the same location as the processor, although it is anticipated that the invention will most often be practiced in the context of PCSs and workstations.

[0196] Although bus subsystem 504 is shown diagrammatically as a single bus, a typical system will have several buses, such as a local bus and one or more expansion buses (e.g., ADB, SCSI, ISA, EISA, MCA, NuBus, or PCI), as well as serial and parallel ports. Network connections are typically established through devices such as a network adapter on one of these expansion buses and a modem on a serial port. The client computers may be desktop or portable systems.

[0197] The scanner 520 may represent a wand and other components responsible for scanning an impression of a patient's teeth obtained from a patient or an orthodontist and passing the scanned digital data set information to the data processing system 500 for further processing. In a distributed environment, the scanner 520 may be located at a remote location and communicate the scanned digital data set information to the data processing system 500 via the network interface 524.

[0198] Various alternatives, modifications, and equivalents may be used in place of the components described above. Furthermore, the techniques described herein may be implemented in hardware or software, or a combination of both. These techniques may be implemented as computer programs executed on programmable computers, each of which includes a processor, a processor-readable storage medium (such as volatile and non-volatile memory and / or storage elements), and suitable input / output devices. The program code is applied to data entered at the input device to perform the described functions and generate output information. The output information is applied to one or more output devices. Each program may be implemented in a high-level programming language, procedural or object-oriented, to operate in conjunction with a computer system. However, the programs may be implemented in assembly or machine language, if desired. In any case, the language may be a compiled or interpreted language. Each such computer program may be stored on a general-purpose or dedicated programmable computer-readable storage medium or storage device (e.g., CD-ROM, hard disk, or magnetic diskette) for configuring and operating the computer when the computer reads the storage medium or storage device to perform the described procedures. The system may be implemented as a computer-readable storage medium configured with a computer program, the storage medium so configured causing the computer to operate in a specific and predetermined manner.

[0199] 26A-26C and 27A-27G show steps that may be part of a method for creating a 3D volumetric model of a patient's teeth, which may be used in one or more treatments using the methods and devices described above. In any of these methods, an intraoral scanner 2801 capable of measuring both surface and internal structures (including color, e.g., RGB color, in some variations) may be used to scan the patient's teeth (e.g., obtain images and scans of the jaw, including the teeth). The device may perform scans in a variety of modalities, including surface wavelengths (non-penetrating or substantially non-penetrating, e.g., visible light, white light) and penetrating wavelengths (e.g., near infrared / infrared). Scanning typically involves performing scans from multiple positions around the oral cavity and stitching together the resulting images to generate a three-dimensional model of the teeth, for example by resolving the relative position of the scans with respect to the jaw (FIG. 26C). The surface scan may be used to construct a model (eg, a 3D digital model and / or rendering) of the external surfaces of the jaw / teeth 2803, as shown in FIG. 26C.

[0200] In any of these methods and apparatus described herein, the internal structure of the tooth may be formed or modeled to form a volumetric model of the tooth including the internal structure extracted by a penetration scan (e.g., near-infrared and / or infrared scan), as shown in Figs. 27A-27G. Figs. 26A-27G show one way of reconstructing the internal structure using scattering coefficients (alternatively or additionally, other methods may be used). In Fig. 27A, a grid of points is constructed that represents the internal volume of the jaw / tooth. All grid points are projected onto the acquired penetration (e.g., near-infrared) image, and for each grid point, all pixel locations may be saved, as shown in Fig. 27B. For each pixel location and each grid location, the apparatus may calculate a scattering coefficient that results in the gray level of the observed pixel, as shown graphically in Fig. 27C. In these figures (e.g., Fig. 27C), the eye may be considered to represent the viewing angle of the sensor (e.g., camera). The apparatus may obtain the minimum scattering coefficient calculated for each grid point (Fig. 27D). The point cloud grid, along with the corresponding minimum scattering coefficient, can then provide a sampleable volume 2909 at the grid points based on a threshold or correlation (e.g., an isosurface) of the minimum scattering coefficient, as shown in Figure 27E. Figure 27G shows an isosurface 2911 generated by identifying constant values ​​of the sampled density function. Figure 27F is a close-up of the same region of the tooth, showing both the isosurface of Figure 27G and a (partially transparent) ghost image 2915 of the enamel around the isosurface. This isosurface can represent the dentin and the caries of the tooth extending from the outer surface of the tooth towards the dentin (as described below).

[0201] In the example shown in FIG. 27F, the isosurface shows the dentin-enamel junction 2911 visible under the enamel 2915. The example in FIG. 27F further shows the tooth caries seen in the circled region 2913. In this example, the tooth caries appears as an isosurface within or surrounded by the enamel (as well as the dentin). The tooth caries is identifiable by extending from the inner dentin region to the outer surface of the tooth. The methods and apparatus described herein are capable of accurately reconstructing both the outer surface and the inner structure, and therefore are able to identify the tooth caries from this characteristic morphology (showing an arm or extension extending from the outer surface through the infrared / near infrared transparent enamel). In FIG. 27F, a similar tooth caries region is circled 2913, showing an extension or bridge between two teeth where the surface scan shows that they are in fact separate. Thus, combining surface scans with internal scans (e.g., from infrared / near infrared images) may allow correction of internal data for possible errors due to limited viewing angles, etc. Any of the devices and methods described herein may be configured to automatically or semi-automatically identify these regions or irregularities corresponding to dental caries, etc. They may be highlighted in the tooth model, image, or representation, and / or a flag, alert, or other notification may be presented, transmitted, and / or stored along with the estimated location. Alternatively or additionally, the threshold used to determine the isosurface may be selected to distinguish one or more internal features, such as dentin, caries, fillings, cracks, etc.

[0202] Alternatively or additionally, the device can automatically (or semi-automatically) identify and distinguish the internal structures of the tooth based on the shape of the isosurfaces and / or their relative location within the tooth. As mentioned above, caries may have a density (e.g., scattering coefficient) similar to dentin. However, caries can be distinguished from dentin by its morphology. The device can detect "arms" or appendages that are materials with a density (e.g., scattering coefficient) similar to dentin but that extend from the external surface of the enamel. Since the external surface of the tooth can be well characterized along with the internal structure, the extent of the caries can be identified by mapping the external surface of the iso-density map of the area extending from the external surface to the larger, defined internal dentin pattern. The boundary between the dentin and the internal extent of the caries can be identified by approximating the continuous surface of the dentin, including the area around the "projected" area, and / or by examining the rate of change of the surface orientation of the dentin. Other internal structures (e.g., infills, cracks, etc.) can be distinguished based on their scattering coefficient value ranges and / or based on their location or morphology. The device can display them with color coding, annotations, etc.

[0203] Thus, in any of these methods and devices, the scanner can look inside the enamel and reconstruct the margin line. Additionally, it may be possible to use additional wavelengths (e.g., green light) or even other flesh-penetrating radiation modalities (e.g., ultrasound) imaging, which may allow construction of the margin line and even the tooth root, and / or help differentiate structures, such as distinguishing dental caries from dentin or other internal structures.

[0204] The resulting volumetric 3D model of the tooth may be used to reconstruct the tooth based on the histological tooth. As mentioned above, the volumetric model may be used to create a more realistic looking and / or more comfortable dental prosthesis (such as an implant).

[0205] Furthermore, the methods and apparatus described herein may enable a user (e.g., dentist, physician, dental technician, etc.) to track the tooth over time, including tracking dentin, caries, etc., as well as the overall health of the tooth, by comparing models acquired over time. For example, a time-lapse video (images) may be constructed. FIG. 28A shows an example of a first acquired volumetric reconstruction, showing dentin 3001 (filled in) and enamel 3003 (slightly transparent). FIG. 28B shows another example of a volumetric model of a tooth showing dentin 3001 and enamel 3003.

[0206] The volumetric model may include width information and may also provide an estimate of wear over time. For example, it is easily possible to track the change in enamel width over time and across different regions of the tooth. Knowing the enamel width allows the wear of the tooth to be estimated, providing a snapshot of the severity of wear.

[0207] Divisions and classifications Any suitable method and apparatus (e.g., systems, devices, software, etc.) may be used to generate an image of the internal structure of a tooth (or other translucent, highly scattering object). For example, as an alternative or in addition to using the scattering coefficients described above, any of the apparatus and methods described herein may use a two-dimensional penetration image together with information about the relative position and / or orientation of the intraoral scanner with respect to the object (e.g., tooth) being imaged to segment the two-dimensional penetration image and generate a three-dimensional model of the tooth including one or more internal structures of the object. A penetration image may refer to an image acquired with near-infrared and / or infrared wavelengths that reveals the internal structure of the object (e.g., tooth). The position and / or orientation of the scanner may be a proxy for the position and / or orientation of a camera on the scanner (e.g., on a handheld wand) that acquires the image.

[0208] The devices and methods described herein are capable of constructing a three-dimensional (3D) volumetric model of the teeth from segmented two-dimensional (2D) images. The methods and devices are also capable of segmenting the 3D model of the teeth.

[0209] In general, the methods and apparatus described herein allow for direct segmentation of penetration images, which may allow for identification of dentin within the tooth, including dentin location and morphology, and identification and localization of cracks, damage, and / or caries within the tooth, including within the dentin. Segmentation may allow for reconstruction of a volumetric model based on the penetration image and information of the camera position corresponding to the penetration image. The volumetric model of the tooth may be segmented, and these segments (related to various internal structures of the tooth) may be back-projected onto the image and / or combined with a surface model of the tooth (e.g., the external surface of the tooth) to allow for projection onto a surface image and better segmentation of the internal structures of the tooth.

[0210] Thus, the penetrating images of the teeth acquired by penetrating wavelengths (e.g., near-infrared and / or infrared wavelengths) may include internal tooth structures and / or 3D data. These images may be acquired using any of the dental scanners described herein, and the tooth volume may be segmented into different regions depending on the opacity, color, and other properties of the images and 3D data. These regions may be, for example, healthy enamel, dentin, lesions, dental fillings, etc. Segmentation may be performed on 2D images or volumetric models. Segmentation may be performed on the images and / or 3D models to classify them according to the presence of different segments. This segmentation may enable the user to manually or automatically (or semi-automatically) detect and classify different internal structures, e.g., dental caries, enamel erosion, and other dental problems. Furthermore, these images or models may be used to measure the internal regions of one or more tooth segments to perform better dental treatment, including tooth alignment or other treatment planning. For example, precise localization of dental damage may enable a user to plan precise fillings that minimize enamel extraction. Thus, segmentation as described herein may enable capture of internal tooth structures without the ionizing radiation currently used by X-rays. Dental problems may be presented on 3D volumetric models. Furthermore, segmentation and classification of internal structures may be automated, as will be described in more detail below. Finally, precise measurements of internal structures may be made for better treatment planning.

[0211] 17A, 17B show an example of data flow when scanning teeth with an intraoral scanner to identify internal structures. The method shown in FIG. 17A, 17B includes three parts. First, the teeth may be scanned with an intraoral scanner 1701 (or any other scanner) configured to perform a penetration scan of the interior of the teeth using optical (e.g. infrared, near infrared, etc.) wavelengths or optical wavelength ranges. Any of these scanners may also perform simultaneous scans to identify surface topography (e.g. with one or more non-penetrating wavelengths), color, etc., as described above. Multiple penetration scans 1703, 1703' may be performed during the scan, and for each penetration image, the camera position 1705, 1705' (e.g. x, y, z positions and / or pitch, roll, yaw angles) may be identified and / or recorded. In some variations, the tooth surface may also be imaged simultaneously, as described above, and a 3D surface model 1707 of the tooth may also be determined simultaneously. In this example, a scan of the patient's teeth may be performed, for example, by an intraoral 3D scanner 1702 capable of imaging the internal tooth structure (e.g., by near-infrared imaging). The position and orientation of the camera may be determined, in part, from the 3D scan data and / or the 3D tooth surface model 1707.

[0212] The penetration image may then be segmented (1711). In this example, segmentation may be done in one of two ways. On the internal tooth structure image, the image may be segmented by contour finding 1713, 1713'. Machine learning methods may be applied to further automate this process. Alternatively or additionally, a close-up image (close camera position) may be used to determine the close-up shape and further back-project the shape from the 3D model onto the image to precisely locate the segment such as the enamel. The method may further include back-projecting the pixels of the internal tooth image onto the teeth and calculating a density map of the internal tooth reflectance coefficients. The enclosing surface of the various segments can be found or estimated by using isosurfaces or thresholds of the density map and / or by machine learning methods. Furthermore, by segmenting the image and back-projecting the segments onto a model (e.g. a 3D surface model (e.g. back-projected onto the world)), the segments can be found from the intersection of the projection of the segment with the tooth surface.

[0213] The results may be displayed (1717), transmitted, and / or stored. For example, the results may be displayed by the scanning system during the intraoral scanning procedure. The results may be shown in images with encircling contours of the various sections, 3D density maps, etc. In the example shown in FIG. 17, a density map 1715 is shown, which represents the dentin under the outer surface enamel. The image may be color-coded to show the different sections. In this example, the internal sections (structures) are shown in the 3D surface model (shown as transparent), but only some are shown because not all teeth were scanned with penetration images. Alternative views, cross sections, slices, projections, etc. may be provided. The image in the example of FIG. 17 includes artifacts 1716 present on the outside of the teeth, which may be removed or trimmed based on the surface model 1718.

[0214] Each pixel of the image may be marked with a segment. Internal structures such as dentin, enamel, cracks, damage, etc. may be automatically identified by the segments and may be manually or automatically identified (e.g., based on machine learning of 3D structures, etc.). Each segment may be displayed separately or together (e.g., in different colors, shades, etc.), with or without a surface model (e.g., a 3D surface model).

[0215] Thus, in Fig. 17, the patient is first scanned with a 3D scanner capable of both surface and penetrant scanning (e.g., near-infrared imaging), and the orientation and / or position of the camera is known (based on the position and / or orientation of the wand and / or surface scan). This position and orientation may be relative to the tooth surface. Thus, the method and apparatus may include an estimate of the camera position (where the camera is, e.g., the x, y, z position of the camera, and its rotational position).

[0216] In general, a penetration image (e.g., a near-infrared or infrared image) may be automatically segmented. Figures 18A-18C show a first example of automatic segmentation of a near-infrared image. Figure 18A shows a first automatic segmentation of an external tooth surface (e.g., identified by edge detection). In Figure 18A, a circumferential edge 1803 is shown. In this example, only a first level of edge detection searching for the periphery is performed. In Figures 18B and 18C, a continuous edge region 1805 is shown, which is derived by edge detection and mapped to the near-infrared image (original image). Figures 19A-19C show the identification and mapping of other edges in the same image. Figure 19A shows only the edges detected using a threshold setting from the near-infrared image (e.g., Figure 19C). In Figure 19B, five (overlapping (1905)) segments 0-4 are traced from the detected edges by forming continuous lines. The different segments are shown color coded and a color legend identifying the segments is shown on the right. From the near infrared image, the device is able to automatically segment the image. In Figs. 18A-18C and 19A-19C, different segments are marked which may correspond to different regions (or different internal structures) on the image. If multiple images are analyzed, these estimated segments may be back projected onto the 3D model and / or shown in the image. Figs. 20A-20C and 21A-21C show another example of near infrared images from the same patient as shown in Figs. 18A-19C, showing segmentation based on edge detection and identification of estimated continuous line regions from the detected edges. In Figs. 21A-21C, another region of the teeth of the same patient is shown, where 8 segments (0-7) are identified as shown in Fig. 21B. Fig. 21A shows edge detection from the original image shown in Fig. 21C. Figures 22A-22C show segmentation of different regions of the patient's teeth. Figure 22A shows edges detected from the original near-infrared image. Figures 22B and 22C show eight segments (0-7) identified on the near-infrared image. Similarly, Figures 23A-23C show segmentation of different regions of the patient's teeth, with Figure 23A showing edge detection, Figure 23B showing segments identified from these edges, and Figure 23C showing the original near-infrared image.

[0217] Sectional images such as those shown in Figs. 18A-23C may be used to form a model of the internal structure of the scanned object (e.g., tooth). Surface 3D models may also be used. For example, Figs. 24A-24B show a three-dimensional model of a region of a patient's tooth formed by sectional images including those shown in Figs. 18A-23C. In Fig. 24A, the 3D reconstruction includes the outer surface of the tooth (partially shown transparent), and various internal sections may be shown in different colors and / or transparencies. For example, in Fig. 24A, dentin (inner part of the tooth) 2404 is shown within the boundaries of tooth 2405. In Fig. 24A, the section showing the dentin is a surface (in Fig. 24B, a volume), but may also be shown as a density map, as shown later in Figs. 25A and 25B. The resulting 3D volume containing the segmented image may then be used iteratively to obtain images transmitted through the resulting volume, which may be "projections" that can be directly compared to the original near-infrared image, which may be used to modify the model. This process may be repeated (iterated) to refine the model, which may result in better image segmentation.

[0218] As mentioned above, the segmentation may include edge detection. Any suitable edge detection method may be used, including machine learning. The segmentation of the near infrared images may be used in combination with the camera position information to reconstruct the volume. Since the different cross sections (different cones) are known and segmented, the inner segments of all the projections of the cones resulting from the various positions can be known and therefore the intersections of these segments can be identified. This process can be made easier by using the outer surface boundaries of the tooth, which may be provided by surface imaging and / or a 3D model. As mentioned above, the process may be iterative, and the method may use the 3D data to project a simulated penetration (e.g., near infrared) image, which can be compared with the original image to refine the segmentation and derive the next evolved internal structure model. Similarly, the outer segments or segmented regions 2407 of the tooth surface may be removed.

[0219] The tooth model, including the internal structure, may be displayed in a variety of ways, as described above: Figure 24B shows a cross section of a tooth, showing the internal structure, including the dentin 2404 and the thickness of the enamel between the outer surface 2405 and the dentin 2404.

[0220] Figures 25A and 25B show a reconstruction of a tooth including internal structures (already shown in Figures 17A, 17B). In this example, the internal structures are shown by density mapping (e.g., segments). For example, dentin 2505 is shown in detail in portion 2503 of the surface model in Figure 25B. The external surface of the tooth can also be identified as segments (as shown in Figures 25A and 25B), and in this example there is a near perfect match between the segmented external surface and the external surface identified by surface imaging.

[0221] Sleeve for intraoral scanner with transillumination Any of the devices described herein may include one or more sleeves configured to protect the intraoral scanner wand, but also to extend its functionality and / or adapt the scanner for penetrating wavelength applications, such as trans-illumination. The sleeve shown in Figs. 29A-31B is an example of a sleeve that may be used as a barrier (e.g., hygiene barrier) to prevent contamination of the wand portion of the intraoral scanner, as the scanner may be used with a variety of patients and may also be used as an adapter to provide trans-illumination with infrared / near-infrared wavelength imaging. The sleeve in these figures is configured as a trans-illumination sleeve with electrical connections. For example, the sleeves described herein may include both penetrating wavelength illumination (e.g., near-infrared and / or infrared LEDs) and one or more sensors (e.g., CCDs) or may use the same camera already on the wand.

[0222] In FIG. 29A, the wand of the intraoral scanner Wand 3101 is shown with a sleeve 3101 disposed around the end of the sleeve 3101 3105 for the intraoral scanner (wand) is shown in solid color. In general, the sleeve 3105 is slid onto the end of the wand because the light source and camera (sensors) already on the wand are inserted into the sleeve. 3105 Electrical contacts 3123 are provided on the sleeve 3124 so that the LEDs and / or sensors 3125 can be visible through the sleeve and can provide control, power, and / or data transmission to the LEDs and / or sensors 3125. 3105 Inner or sleeve 3105 The sleeve is attached to the top. 3105 The sleeve includes a pair of wing regions 3103 on opposite sides. 3105 When the wand is placed over the wand, the wing regions 3103 face each other and extend from the distal end of the wand.

[0223] The sleeve 3101 may be held to the end of the wand by friction or a connecting mechanism (not shown). Thus, the sleeve can be easily removed from the wand and a new sleeve can be placed over the wand each time the scanner is used on a different patient. In this example, the sleeve may be configured to transmit infrared (e.g., near infrared) light and thus may include one or more protrusions 3103 (e.g., for trans-illumination) as shown in FIG. 29B. Electrical contacts and connectors integrated with the sleeve may make the scanner compatible for infrared / near infrared trans-illumination.

[0224] Thus, the sleeve may include circuitry (e.g., flexible circuitry) connected to an LED illumination (infrared / near infrared) source and / or one or more sensors, particularly for trans-illumination. See, e.g., Figs. 30A-30C. Fig. 30A shows an example of a sleeve frame 3201, which may be rigid or semi-rigid. The frame may support a flexible circuit 3203 (shown in Fig. 30B) and / or a connector 3205, and may also provide shielding (e.g., light blocking). Over the frame and circuitry may be a flexible outer sleeve 3207, as shown in Fig. 30C.

[0225] The sleeve may be assembled by injection molding each of the component parts, including the entire sleeve, the windows for illumination and image capture, the connectors for the circuitry, and one or more LED holding areas (e.g., by injecting an infrared and visible light transparent material that forms a window through the sleeve, and then injecting the rigid sleeve material). A molded part positioning device may then be used to position the flexible circuitry and place the LED encapsulation mechanism. The flexible outer sleeve may then be injected.

[0226] Figures 31A-31C show the flex circuit 3301, connector 3303, and LED holder / shield 3305 in more detail. Figures 32A-32B show examples of the LED positioner and light shield portion at the distal end of the sleeve. The example shown in Figure 32A includes a support frame or arm 3404 that includes a light shroud or light shielding region 3406 that extends downwardly and encloses a portion of the LED. Example dimensions are shown.

[0227] In this specification, when a feature or element is referred to as being "on" another feature or element, the feature or element may be directly adjacent to the other feature or element, or there may be intervening features and / or elements. In contrast, when a feature or element is referred to as being "directly on" another feature or element, there are no intervening features and / or elements. It should also be understood that when a feature or element is referred to as being "connected," "attached," or "coupled" to another feature or element, the feature or element may be directly connected, attached, or coupled to the other feature or element, or there may be intervening features or elements. In contrast, when a feature or element is referred to as being "directly connected," "directly attached," or "directly coupled" to another feature or element, there are no intervening features or elements. Features and elements so described or illustrated may be described or illustrated with respect to one embodiment, but may also apply to other embodiments. Also, as will be understood by those skilled in the art, when a structure or feature is referred to as being "adjacent" to another feature, the reference may include portions that overlap or underlie the adjacent feature.

[0228] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the disclosure. For example, the singular forms "a," "an," and "the" as used herein are intended to encompass the plural forms as well, unless the context clearly contradicts otherwise. It is further understood that the words "comprises" and / or "comprising," as used herein, specify the presence of stated features, steps, operations, elements, and / or components, and do not exclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term "and / or" includes any combination of one or more of the associated listed items and may be abbreviated as " / ."

[0229] Spatially relative terms such as "under," "below," "lower," "over," "upper," and the like may be used herein for ease of description when describing the relationship of one element or feature to another element or feature as depicted in the figures. It should be understood that these spatially relative terms are intended to encompass other orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures were inverted, an element described as being "under" or "beneath" another element or feature would be oriented "over" that other element or feature. Thus, for example, the term "under" may encompass both an orientation of "over" and "under." The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, terms such as "upwardly," "downwardly," "vertical," and "horizontal" are used herein for descriptive purposes only, unless otherwise specified.

[0230] The terms "first" and "second" may be used herein to describe various features / elements (including steps), but these features / elements should not be limited by these terms unless the context indicates otherwise. These terms may be used to distinguish one feature / element from another. Thus, a first feature / element may be referred to as a second feature / element below, and similarly, a second feature / element may be referred to as a first feature / element below, without departing from the teachings of the present invention.

[0231] Throughout this specification and the claims that follow, unless otherwise stated, the term "comprise" and its variations "comprises," "comprising," and the like, mean that various components may be used in conjunction with one another in methods and articles (e.g., devices and method-containing compositions and apparatus). For example, the word "comprising" should be understood to imply the inclusion of all stated elements or steps, but not the exclusion of any other elements or steps.

[0232] As used in the present specification and claims, including in the examples, and unless otherwise specified, any numerical value may be read as being preceded by the term "about" or "approximately", even if the term is not explicitly present. The term "about" or "approximately", when describing a size and / or location, may be used to indicate that the stated value and / or location falls within a reasonable expected range of values ​​and / or locations. For example, a numerical value may be ±0.1% of the stated value (or range of values), ±1% of the stated value (or range of values), ±2% of the stated value (or range of values), ±5% of the stated value (or range of values), ±10% of the stated value (or range of values), or other such values. Any numerical value given herein should be understood to encompass the approximate values ​​before and after that value, unless the context contradicts. For example, if the value "10" is disclosed, "about 10" is also disclosed. Any numerical range described herein is intended to encompass all subranges encompassed therein. It should also be understood that when a value is disclosed, values ​​"less than" that value, values ​​"greater than" that value, and possible ranges therebetween, as would be properly understood by one of ordinary skill in the art. For example, when a value "X" is disclosed, values ​​"less than" X and values ​​"greater than or equal to X" (e.g., where X is a number) are also disclosed. It should also be understood that throughout this application, data is provided in several different formats, and that this data represents endpoints and starting points, with ranges covering any combination of these data points. For example, if a specific data point "10" and a specific data point "15" are disclosed, values ​​between 10 and 15 are considered to be disclosed, as well as values ​​greater than, equal to, less than, less than, and equal to 10 and 15. It is also understood that each number between the two specific numbers is also disclosed.For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0233] Although various exemplary embodiments have been described above, any of a number of modifications may be made to the various embodiments without departing from the scope of the invention as set forth in the claims. For example, the order in which the various method steps described are performed may often be changed in alternative embodiments, and in some alternative embodiments, one or more method steps may be skipped altogether. Optional features of the various embodiments of the apparatus and systems may be included in some embodiments and not included in other embodiments. Thus, the above description is primarily for illustrative purposes and should not be construed as limiting the scope of the invention as set forth in the claims.

[0234] The examples and specific examples contained herein are illustrative, not limiting, of specific embodiments in which the subject matter may be practiced. As noted, other embodiments may be utilized or derived, and structural or logical substitutions or changes may be made without departing from the scope of the present disclosure. Such embodiments of the subject matter may be referred to individually herein or collectively under the term "the present invention," which is merely for convenience and is not intended to spontaneously limit the scope of the present application to any one invention or inventive concept, even if more than one is actually disclosed. Thus, although specific embodiments have been shown and described herein, the specific embodiments shown may be substituted with any configuration designed to achieve the same purpose. The present disclosure is intended to encompass any adaptations or variations of the various embodiments. Combinations of the above-described embodiments, as well as other embodiments not specifically described herein, will become apparent to those skilled in the art upon review of the above description. [Appendix 1] 1. A method for generating a three-dimensional (3D) volumetric model of a subject's teeth using an intraoral scanner, comprising: capturing 3D surface model data of at least a portion of the subject's teeth using an intraoral scanner while moving the intraoral scanner over the subject's teeth; acquiring multiple images of the interior of the tooth using near infrared wavelengths with the intraoral scanner while moving the intraoral scanner over the tooth such that multiple images of the same interior area of ​​the tooth are imaged; for each of the plurality of images of the interior of the teeth, determining a position of the intraoral scanner relative to the subject's teeth using the 3D surface model data; generating a 3D volumetric model of the subject's teeth, including an internal shape, using the plurality of images and the position of the intraoral scanner relative to the subject's teeth; The method includes: [Appendix 2] 1. A method for generating a three-dimensional (3D) volumetric model of a subject's teeth using an intraoral scanner, comprising: capturing 3D surface model data of at least a portion of the subject's teeth using an intraoral scanner while moving the intraoral scanner over the subject's teeth; acquiring a plurality of images of the interior of the tooth using near infrared wavelengths while moving the intraoral scanner over the tooth by emitting near infrared light from the intraoral scanner at a first polarization and detecting the near infrared light returning to the intraoral scanner with an image sensor within the intraoral scanner, wherein the near infrared light returning to the intraoral scanner is filtered to remove specular reflections by filtering the near infrared light of the first polarization from the near infrared light returning to the intraoral scanner before it reaches the image sensor; for each of the plurality of images of the interior of the teeth, determining a position of the intraoral scanner relative to the subject's teeth at the time each of the plurality of images was captured using the 3D surface model data; generating a 3D volumetric model of the subject's teeth, including an internal shape, using the plurality of images and the position of the intraoral scanner relative to the subject's teeth; The method includes: [Appendix 3] 2. The method of claim 1, wherein the step of acquiring the multiple images of the inside of the teeth includes emitting near-infrared light from the intraoral scanner at a first polarization and detecting the near-infrared light returning to the intraoral scanner with an image sensor within the intraoral scanner, wherein the near-infrared light returning to the intraoral scanner is filtered to remove specular reflections, the removal being achieved by filtering the near-infrared light of the first polarization from the near-infrared light returning to the intraoral scanner before it reaches the image sensor. [Appendix 4] 3. The method of claim 2, wherein the near-infrared light returning to the intraoral scanner is filtered to remove specular reflections, the removal being accomplished by filtering all or substantially all of the near-infrared light of the first polarization from the near-infrared light returning to the intraoral scanner before it reaches the image sensor. [Appendix 5] 3. The method of claim 1 or 2, wherein the step of capturing the 3D surface model data includes identifying a 3D surface topology using confocal focusing. [Appendix 6] 3. The method of claim 1 or 2, wherein the step of capturing the 3D surface model data includes using confocal scanning, stereoscopic vision. [Appendix 7] 3. The method of claim 1 or 2, wherein the step of capturing the 3D surface model data includes using structured light triangulation. [Appendix 8] 3. The method of claim 1 or 2, wherein the step of capturing 3D surface model data includes capturing a model of the teeth and gums. [Appendix 9] 3. The method of claim 1 or 2, further comprising capturing a 3D color model of the teeth while moving the intraoral scanner over the teeth. [Appendix 10] 3. The method of claim 1 or 2, further comprising alternating between capturing 3D surface model data and obtaining the plurality of images of the interior of the tooth while moving the intraoral scanner over the tooth. [Appendix 11] 3. The method of claim 1 or 2, wherein the step of acquiring the plurality of images includes capturing the 3D surface model data and the plurality of images of the interior of the tooth using a same sensor on the intraoral scanner. [Appendix 12] 3. The method of claim 1 or 2, wherein the step of acquiring a plurality of images of the interior of the tooth includes low angle penetration imaging. [Appendix 13] 3. The method of claim 1 or 2, wherein obtaining the plurality of images of the interior of the tooth includes using a separate sensor on the intraoral scanner to capture 3D surface model data and the plurality of images of the interior of the tooth. [Appendix 14] 3. The method of claim 1 or 2, wherein the step of forming the 3D volumetric model of the subject's teeth comprises combining the 3D surface model data with a 3D model of the internal structures. [Appendix 15] 3. The method of claim 1 or 2, further comprising marking the internal structure. [Appendix 16] 1. An intraoral scanning system that generates a three-dimensional (3D) volumetric model of a subject's teeth, comprising: a handheld wand having at least one image sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being within a near infrared wavelength range; one or more processors operatively connected to the handheld wand, capturing 3D surface model data of at least a portion of the subject's teeth while moving an intraoral scanner over the teeth; acquiring multiple images of the interior of the tooth using light in the second spectral range while moving the intraoral scanner over the tooth such that multiple images of the same interior area of ​​the tooth are imaged; for each of the plurality of images of the interior of the teeth, determining a position of the handheld wand relative to the subject's teeth using the 3D surface model data; generating a 3D volumetric model of the subject's teeth, including an internal shape, using the plurality of images and the position of the intraoral scanner relative to the subject's teeth; the one or more processors configured to implement A system including: [Appendix 17] 1. An intraoral scanning system that generates a three-dimensional (3D) volumetric model of a subject's teeth, comprising: a handheld wand having at least one image sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, the second spectral range being within a near infrared wavelength range; a filter in front of the image sensor configured to filter light in the second spectral range and in the first polarization; one or more processors operatively connected to the handheld wand, capturing 3D surface model data of at least a portion of the subject's teeth while moving an intraoral scanner over the teeth; acquiring a plurality of images of the interior of the tooth using light of the second spectrum while moving the intraoral scanner over the tooth by emitting near infrared light from the intraoral scanner at a first polarization and detecting the near infrared light returning to the intraoral scanner with an image sensor within the intraoral scanner, wherein the near infrared light returning to the intraoral scanner is filtered to remove specular reflections by filtering the near infrared light of the first polarization from the near infrared light returning to the intraoral scanner before it reaches the image sensor; for each of the plurality of images of the interior of the teeth, determining a position of the handheld wand relative to the subject's teeth using the 3D surface model data; generating a 3D volumetric model of the subject's teeth, including an internal shape, using the plurality of images and the position of the intraoral scanner relative to the subject's teeth; the one or more processors configured to implement A system including: [Appendix 18] 18. The system of claim 16 or 17, wherein the handheld wand further includes at least one secondary image sensor in addition to the image sensor. [Appendix 19] 18. The system of claim 16 or 17, wherein the one or more processors are configured to identify surface information by using confocal focusing. [Appendix 20] 18. The system of claim 16 or 17, wherein the one or more processors are configured to identify surface information by using confocal scanning, stereoscopic vision, or structured light triangulation. [Appendix 21] 18. The system of claim 16 or 17, wherein the handheld wand is configured to cycle between emitting light in the first spectral range to perform the surface scan and emitting light in the second spectral range to detect internal structures by switching between the first spectral range and the second spectral range such that an image acquired with the second spectral range shares a coordinate system with the surface scan. [Appendix 22] 18. The system of claim 16 or 17, wherein the image sensor is configured to capture both the 3D surface model data and the internal data of the teeth. [Appendix 23] 18. The system of claim 16 or 17, wherein the plurality of light sources includes a white light source. [Appendix 24] 18. The system of claim 16 or 17, further comprising: the plurality of light sources and the image sensor positioned such that light emitted in the second spectral range is reflected off the teeth and received by the one or more sensors at an angle between 0° and 15°. [Appendix 25] 1. A method of generating a model of a subject's teeth, comprising the steps of: scanning a portion of a subject's teeth with an intraoral scanner using a first modality to capture three-dimensional (3D) surface model data of the teeth; scanning the portion of the subject's teeth with the intraoral scanner using a second modality to image the interior of the teeth using a penetrating wavelength to capture internal data of the teeth; cycling between the first modality and the second modality, the cycling rapidly switching between the first modality and the second modality such that images using the penetrating wavelength share a coordinate system with the 3D surface model data captured with the first modality; The method includes: [Appendix 26] 1. A method of generating a model of a subject's teeth, comprising the steps of: scanning a portion of a subject's teeth with a handheld intraoral scanner using a first modality to capture three-dimensional (3D) surface model data of the teeth; scanning the portion of the subject's teeth with the handheld intraoral scanner with a second modality that images the interior of the teeth using a penetrating wavelength to capture internal data of the teeth; cycling between the first modality and the second modality using a scanning scheme in which the first modality and the second modality are rapidly switched in a cycling manner such that the internal data uses the same coordinate system as the 3D surface model data acquired with the first modality; adjusting the scanning strategy based on the captured 3D surface model data, the internal data, or both the 3D surface model data and the internal data; The method includes: [Appendix 27] 27. The method of claim 25 or 26, further comprising combining the 3D surface model data with the internal data of the tooth to form a 3D model of the tooth. [Appendix 28] 27. The method of claim 25 or 26, further comprising combining the 3D surface model data with the internal data of the tooth to form a 3D model of the tooth and marking internal structures. [Appendix 29] 27. The method of claim 25 or 26, wherein the step of capturing the 3D surface model data includes identifying a 3D surface topology using confocal focusing. [Appendix 30] 27. The method of claim 25 or 26, wherein the step of capturing the 3D surface model data includes using confocal scanning, stereoscopic vision, or structured light triangulation. [Appendix 31] 27. The method of claim 25 or 26, further comprising scanning the subject's teeth and gums. [Appendix 32] 27. The method of claim 25 or 26, further comprising cycling between the first modality, the second modality, and a third modality, wherein the cycling rapidly switches between the first modality, the second modality, and the third modality such that images using the penetrating wavelength share a coordinate system with the 3D surface model captured by the first modality. [Appendix 33] 27. The method of claim 25 or 26, further comprising scanning the portion of the subject's teeth with the intraoral scanner using a third modality to capture a color image of the subject's teeth. [Appendix 34] 27. The method of claim 25 or 26, further comprising capturing both the 3D surface model data and the internal data of the teeth using a sensor on the intraoral scanner. [Appendix 35] 27. The method of claim 25 or 26, wherein the step of scanning the portion of the subject's teeth with the intraoral scanner using the second modality includes illuminating the teeth at an angle of 0° to 15° relative to a sensor receiving the illumination. [Appendix 36] 27. The method of claim 25 or 26, wherein the step of scanning the portion of the subject's teeth with the intraoral scanner using the second modality includes acquiring a plurality of trans-illumination images or low-angle penetration images at a plurality of different angles between an illumination source and a sensor. [Appendix 37] 27. The method of claim 25 or 26, further comprising capturing the 3D surface model data and the internal data of the teeth using a separate sensor on the intraoral scanner. [Appendix 38] 27. The method of claim 25 or 26, further comprising capturing internal data of the teeth using a plurality of sensors on the intraoral scanner. [Appendix 39] 27. The method of claim 25 or 26, wherein the step of scanning the portion of the subject's teeth with the intraoral scanner using the second modality includes illuminating with one or more of white light transillumination, UV / blue fluorescence, and red light fluorescence. [Appendix 40] 32. The method of claim 30 or 31, wherein the step of scanning the portion of the subject's teeth with the intraoral scanner using the second modality includes illuminating with infrared light. [Appendix 41] 26. The method of claim 25, further comprising automatically adjusting the duration spent scanning in the first modality, the duration spent in the second modality, or the duration spent in the first modality and the second modality when cycling between the first modality and the second modality. [Appendix 42] 26. The method of claim 25, further comprising automatically adjusting the duration spent scanning in the first modality, the duration spent in the second modality, or, when cycling between the first and second modalities, the duration spent in the first and second modalities based on the captured 3D surface model data, the internal data, or both the 3D surface model data and the internal data. [Appendix 43] 27. The method of claim 26, wherein adjusting the scanning strategy includes adjusting based on a quality determination of the captured 3D surface model data. [Appendix 44] 27. The method of claim 26, wherein adjusting the scan strategy includes automatically adjusting the scan strategy. [Appendix 45] 27. The method of claim 26, wherein the step of adjusting the scan modality includes adjusting a duration of a scan in the first modality. [Appendix 46] 27. The method of claim 26, wherein the step of adjusting the scan modality includes adjusting a duration of a scan with the second modality. [Appendix 47] 1. An intraoral scanning system for generating a model of a subject's teeth, comprising: a handheld intraoral wand having at least one sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, and further wherein the second spectral range is penetrative; one or more processors operatively connected to the handheld intraoral wand, the one or more processors configured to cycle the wand between a first mode, in which the wand emits light in the first spectral range for a first duration, and the one or more processors receiving three-dimensional (3D) surface data in response, and in which the wand emits light in the second spectral range for a second duration, and the one or more processors receiving image data in response; A system including: [Appendix 48] 1. An intraoral scanning system for generating a model of a subject's teeth, comprising: a handheld intraoral wand having at least one sensor and a plurality of light sources configured to emit light in a first spectral range and a second spectral range, and further wherein the second spectral range is penetrative; one or more processors operatively connected to the wand, the one or more processors configured to cycle the wand between a first mode, in which the wand emits light in the first spectral range for a first duration, and the one or more processors receive three-dimensional (3D) surface data in response, and in which the wand emits light in the second spectral range for a second duration, and the one or more processors receive image data in response; the one or more processors are configured to adjust the first duration and the second duration based on the received 3D surface data, the received image data, or both the 3D surface data and the image data. system. [Appendix 49] 49. The system of claim 47 or 48, wherein the wand includes a plurality of sensors. [Appendix 50] 49. The system of claim 47 or 48, wherein the one or more processors are configured to identify surface information from the three-dimensional (3D) surface data using confocal focusing. [Appendix 51] 49. The system of claim 47 or 48, wherein the one or more processors are configured to responsively identify surface information from the three-dimensional (3D) surface data by using confocal scanning, stereoscopic vision, or structured light triangulation. [Appendix 52] 49. The system of claim 47 or 48, wherein the first duration and the second duration are set such that the image data acquired in the second spectral range shares a coordinate system with the 3D surface data acquired in the first spectral range. [Appendix 53] 49. The system of claim 47 or 48, wherein the first duration and the second duration are less than 100 milliseconds, whereby the image data acquired in the second spectral range shares a coordinate system with the 3D surface data acquired in the first spectral range. [Appendix 54] 49. The system of claim 47 or 48, wherein the at least one sensor is configured to capture both the 3D surface model data and the internal data of the teeth. [Appendix 55] 49. The system of claim 47 or 48, wherein the at least one sensor includes a first sensor configured to capture the 3D surface model data from light in the first spectral range and a second sensor configured to capture the internal data of the tooth from light in the sensor spectral range. [Appendix 56] 49. The system of claim 47 or 48, further comprising a plurality of sensors adjacent to the plurality of light sources. [Appendix 57] 49. The system of claim 47 or 48, wherein the light source configured to emit light in the second spectral range is configured to emit one or more of white light trans-illumination, UV / blue fluorescence, and red light fluorescence. [Appendix 58] 49. The system of claim 47 or 48, wherein the light source configured to emit light in the second spectral range is configured to emit infrared light. [Appendix 59] 49. The system of claim 47 or 48, further comprising: the plurality of light sources and the at least one sensor arranged on the handheld wand such that light emitted in the second spectral range is reflected off the teeth and received by the one or more sensors at an angle between 0° and 15°. [Appendix 60] 49. The system of claim 47 or 48, wherein the processor is configured to generate a 3D model of the teeth from the three-dimensional (3D) surface data and the image data. [Appendix 61] 49. The system of claim 47 or 48, wherein the one or more processors are configured to automatically adjust the first duration and the second duration based on the received 3D surface data, the received image data, or both the 3D surface data and the image data. [Appendix 62] 1. A method for imaging the interior of a subject's teeth to detect cracks and caries using an intraoral scanner, comprising: scanning the subject's teeth with the intraoral scanner; acquiring a plurality of near-infrared images of the interior of the subject's teeth at various orientations using the intraoral scanner emitting both near-infrared and non-penetrating wavelengths; determining, for each image location of the plurality of near infrared images, a position of the intraoral scanner relative to the subject's teeth using the non-penetrating wavelength; generating a three-dimensional (3D) volumetric model of the subject's teeth using the plurality of near-infrared images and the position of the intraoral scanner relative to the subject's teeth in each near-infrared image of the plurality of near-infrared images; The method includes: [Appendix 63] 63. The method of claim 62, further comprising analyzing the volumetric model to identify cracks or caries. [Appendix 64] 63. The method of claim 62, wherein the step of acquiring a plurality of near-infrared images of the interior of the subject's teeth at various orientations includes acquiring low-angle images. [Appendix 65] 63. The method of claim 62, wherein the step of acquiring a plurality of near-infrared images of the inside of the subject's teeth at various orientations includes acquiring low-angle images, wherein the angle between the near-infrared light emitted and received by the intraoral scanner is between 0 degrees and 15 degrees. [Appendix 66] 63. The method of claim 62, wherein the intraoral scanner emits light at a wavelength of 850 nm. [Appendix 67] 63. The method of claim 62, further comprising emitting near-infrared light from the intraoral scanner to acquire the plurality of near-infrared images at a first polarization; and filtering the infrared light returning from the patient's teeth to remove specular reflections by filtering the infrared light returning from the patient's teeth to remove light having the first polarization. [Appendix 68] 1. A method for imaging through a subject's teeth to detect cracks and caries, comprising: Scanning the subject's teeth from a plurality of positions, wherein at each position: acquiring a plurality of near infrared images of the interior of the tooth at various orientations using an intraoral scanner, the intraoral scanner emitting light at a near infrared wavelength at a first polarization, the angle between the emitted light and the light received by the image sensor in each near infrared image being between 0 and 15 degrees, and further wherein the received near infrared light is filtered to block near infrared light of the first polarization; determining a position of the intraoral scanner relative to the subject's teeth for each image location of the plurality of near infrared images; the scanning step including repeating generating a three-dimensional (3D) volumetric model of the tooth using the penetration image and the surface position information; The method includes: [Appendix 69] 70. The method of claim 68, further comprising the step of capturing 3D surface model data of the subject's teeth. [Appendix 70] 70. The method of claim 69, wherein the step of capturing the 3D surface model data includes using confocal scanning, stereoscopic vision, or structured light triangulation. [Appendix 71] 70. The method of claim 68, wherein the scanning step includes switching between the near-infrared wavelength and a non-penetrating wavelength. [Appendix 72] 1. A method for forming a three-dimensional (3D) volumetric model of a subject's teeth, comprising: acquiring a plurality of near-infrared images of the subject's teeth with a camera sensor, where near-infrared illumination for the plurality of near-infrared images is projected from approximately the direction of the camera sensor; receiving, for each of the plurality of near infrared images, position data representative of a position of the camera relative to the subject's teeth; generating an upper bound on a scattering coefficient from the plurality of near infrared images and the position data for each point within the volume; combining the upper bounds of scattering coefficients for each point within a volume to form a 3D volumetric model of the subject's teeth; outputting the 3D volumetric model of the subject's teeth; The method includes: [Appendix 73] 73. The method of claim 72, wherein the outputting step includes generating an isosurface from the 3D volumetric model of the subject's teeth. [Appendix 74] 73. The method of claim 72, further comprising the step of receiving surface data representing an exterior surface of the subject's teeth, and wherein the generating step is performed within the exterior surface of the subject's teeth for each point within the volume. [Appendix 75] 73. The method of claim 72, wherein the outputting step includes generating an iso-surface corresponding to an internal dentin surface from the 3D volumetric model of the subject's teeth. [Appendix 76] 73. The method of claim 72, wherein the location data includes position and orientation data of the camera at a time when each of the plurality of near-infrared images is captured. [Appendix 77] 73. The method of claim 72, wherein the position data includes three numerical coordinates in three dimensional space, the pitch, yaw, and roll of the camera. [Appendix 78] The step of generating the upper limit of the scattering coefficient for each point in the volume comprises: projecting each point of a 3D point cloud grid corresponding to the volume of teeth of the subject onto each of the plurality of near infrared images using a first calibration; generating a list of luminance values ​​for each projection point; converting each intensity value on the list of intensity values ​​into a scattering coefficient according to a volume response; storing, for each grid point, a minimum scattering coefficient value of said scattering coefficients; Including, 73. The method of claim 72. [Appendix 79] 80. The method of claim 78, wherein the first calibration includes a fixed pattern noise calibration to calibrate for sensor issues and image ghosting of the camera. [Appendix 80] 79. The method of claim 78, wherein the first calibration includes a camera calibration that determines a transformation of the camera that projects known points in space to points on an image. [Appendix 81] 1. A method for reconstructing volumetric structures from a tooth that is translucent in a radiation wavelength range, comprising: receiving in a processor a representation of the tooth surface in a first coordinate system; receiving in the processor a plurality of images of the teeth in the radiation wavelength range acquired by a camera, the plurality of images being acquired with illumination projected generally from the direction of the camera; receiving, at the processor, position data representative of a position of the camera in each of the plurality of images; projecting each point of a point cloud grid corresponding to a volume within the surface of the tooth onto each of the plurality of images using a first calibration; generating a list of intensity values ​​for each projected point; converting each intensity value on the list of intensity values ​​into a scattering coefficient according to a volume response; storing the minimum scattering coefficient at each point in a minimum scattering coefficient list; The method includes: [Appendix 82] 82. The method of claim 81, further comprising the step of outputting an image generated from the minimum scattering coefficient list. [Appendix 83] 82. The method of claim 81, wherein the position data includes position and orientation data of the camera at the time each of the plurality of images is captured. [Appendix 84] 82. The method of claim 81, wherein the first calibration includes a fixed pattern noise calibration to calibrate for sensor issues and image ghosting of the camera. [Appendix 85] 82. The method of claim 81, wherein the first calibration includes a camera calibration that determines a transformation of the camera that projects known points in space to points on an image. [Appendix 86] 82. The method of claim 81, further comprising the step of receiving surface data representing an exterior surface of the subject's teeth, and wherein the projecting is performed within the exterior surface of the subject's teeth for each point within the volume. [Appendix 87] 82. The method of claim 81, wherein the point cloud grid comprises a cubic grid. [Appendix 88] 82. The method of claim 81, wherein the camera includes a camera sensor. [Appendix 89] 1. A non-transitory computing device readable medium having stored thereon instructions for reconstructing volumetric structures from teeth that are translucent in a radiation wavelength range, the instructions comprising: receiving a representation of the tooth surface in a first coordinate system; receiving a plurality of images of the tooth in the radiation wavelength range acquired by a camera, the plurality of images being acquired with illumination projected from approximately the direction of the camera; receiving position data representative of a position of the camera in each of the plurality of images; projecting each point of a point cloud grid corresponding to the tooth volume onto each of the plurality of images using a first calibration; generating a list of intensity values ​​for each projected point; converting each intensity value on the list of intensity values ​​into a scattering coefficient according to a volume response; storing a minimum scattering coefficient at each point among the scattering coefficients; outputting an image generated from the minimum scattering coefficient list; Executable by a processor to cause a computing device to perform A computing device readable medium. [Appendix 90] 90. The device of claim 89, wherein the location data includes position and orientation data of the camera at a time each of the plurality of near-infrared images is captured. [Appendix 91] 90. The device of claim 89, wherein the position data includes three numerical coordinates in three-dimensional space of the camera: pitch, yaw, and roll. [Appendix 92] 90. The device of claim 89, wherein the first calibration includes a fixed pattern noise calibration to calibrate for sensor issues and image ghosting of the camera. [Appendix 93] 90. The device of claim 89, wherein the first calibration includes a camera calibration that determines a transformation of the camera that projects known points in space to points on an image. [Appendix 94] 90. The device of claim 89, wherein the point cloud grid is inside the tooth. [Appendix 95] 90. The device of claim 89, wherein the point cloud grid comprises a cubic grid. [Appendix 96] 1. A method of modeling a subject's teeth, comprising: capturing with an intraoral scanner a plurality of images of the interior of the subject's teeth and a position and orientation of the intraoral scanner specific to each image of the plurality of images; segmenting the plurality of images to generate internal structures corresponding to internal structures of the subject's teeth; using the positions and orientations of the plurality of images to project the internal structures onto a three-dimensional model of the subject's teeth; displaying the three-dimensional model of the subject's teeth, including the internal structure; The method includes: [Appendix 97] 97. The method of claim 96, wherein the capturing step includes capturing surface images of the subject's teeth while capturing the multiple images of the interior of the subject's teeth. [Appendix 98] 98. The method of claim 97, further comprising generating the three-dimensional model of the subject's teeth from the captured surface images. [Appendix 99] 97. The method of claim 96, further comprising storing the position and orientation of the intraoral scanner while capturing the plurality of two-dimensional images. [Appendix 100] 97. The method of claim 96, wherein segmenting the plurality of images includes applying edge detection to the plurality of images to identify closed boundaries within the plurality of images. [Appendix 101] 97. The method of claim 96, wherein segmenting the plurality of images includes forming a volumetric density map from the plurality of images to identify the internal structure. [Appendix 102] 102. The method of claim 101, further comprising partitioning the volumetric density map to identify the internal structure. [Appendix 103] 103. The method of claim 102, further comprising segmenting the volumetric density map to identify the internal structure by identifying isosurfaces in the volumetric density map. [Appendix 104] 104. The method of claim 103, wherein the step of forming the three-dimensional model of the subject's teeth includes identifying a three-dimensional surface topology using confocal focusing. [Appendix 105] 98. The method of claim 97, wherein the step of capturing an image of the subject's dental surface includes using confocal scanning, stereoscopic vision, or structured light triangulation. [Appendix 106] 97. The method of claim 96, wherein the step of capturing a plurality of images includes using a penetrating wavelength with the intraoral scanner. [Appendix 107] 97. The method of claim 96, wherein the step of capturing a plurality of images includes capturing an infrared image. [Appendix 108] 97. The method of claim 96, further comprising displaying the three-dimensional model as the image is captured. [Appendix 109] 1. An intraoral scanning device configured to generate a model of a subject's teeth, comprising: an intraoral scanner having a plurality of light sources and a position and orientation sensor, the light sources configured to emit light in a first spectral range and a second spectral range, and further wherein the second spectral range is penetrative; a processor operatively connected to the intraoral scanner, the one or more processors configured to cause the scanner to capture a plurality of images and a position and orientation of the intraoral scanner corresponding to each of the plurality of images when the intraoral scanner emits light in the second spectral range; Including, The processor is further configured to segment the plurality of images to form internal structures corresponding to structures within the subject's teeth, and display or transmit a three-dimensional model of the subject's teeth including the internal structures. Device. [Appendix 110] 110. The apparatus of claim 109, wherein the processor is configured to segment the plurality of images by applying edge detection to the plurality of images to identify closed boundaries within the plurality of images. [Appendix 111] 110. The apparatus of claim 109, wherein the processor is configured to identify the internal structure by forming a pixel density map from the plurality of images to segment the plurality of images. [Appendix 112] 110. The apparatus of claim 109, wherein the processor is configured to identify the internal structure by identifying closed partitions within the pixel density map. [Appendix 113] 1. A non-transitory computing device readable medium having stored thereon instructions executable by a processor, the instructions causing an intraoral scanning device to: capturing a plurality of images using penetrating wavelength light and a position and orientation of the intraoral scanner specific to each image of the plurality of images; segmenting the plurality of images to generate internal structures corresponding to structures within the subject's teeth; projecting the internal structures onto a three-dimensional model of the subject's teeth using the position and orientation of the intraoral scanner specific to each image; displaying the three-dimensional model of the subject's teeth, including the internal structure; To carry out the following: A computing device readable medium. [Appendix 114] 114. The device of claim 113, wherein the non-transitory computing device readable medium having instructions is further configured to cause the intraoral scanning device to perform the step of segmenting the plurality of images by applying edge detection to the plurality of images to identify closed boundaries within the plurality of images. [Appendix 115] 114. The device of claim 113, wherein the non-transitory computing device readable medium having instructions further configured to cause the intraoral scanning device to perform the step of forming a pixel density map from the plurality of images and segmenting the plurality of images to form the internal structure. [Appendix 116] 114. The device of claim 113, wherein the non-transitory computing device readable medium having instructions is further configured to cause the intraoral scanning device to perform the step of identifying closed partitions in the pixel density map to partition the plurality of images to form the internal structure. [Appendix 117] A non-transitory computing device readable medium having stored thereon instructions executable by a processor, the instructions being configured to cause a computing device to: receiving three-dimensional surface model data of the subject's teeth from a scanner; receiving from a scanner a plurality of images of the interior of the subject's teeth and a position and orientation of the intraoral scanner specific to each image of the plurality of images; segmenting the plurality of images to form an internal structure of the subject's teeth; projecting the internal structure of the subject's tooth onto the three-dimensional surface model; displaying the three-dimensional surface model showing the internal structure; To carry out the following: A non-transitory computing device readable medium. [Appendix 118] receiving data associated with an intraoral scan of a subject; identifying from the received data at least a portion of a volume of a first internal shape of the subject's teeth; identifying from the received data at least a portion of a volume of a second internal shape of the tooth of the subject, the second internal shape being different from the first internal shape; mapping together the portion of the volume of the first internal shape and the portion of the volume of the second internal shape; outputting the portion of the volume of the first internal shape and the portion of the volume of the second internal shape together as a 3D volume; The method includes: [Appendix 119] 19. The method of claim 118, wherein the received data includes data from a tooth surface penetration intraoral scan of the subject. [Appendix 120] 120. The method of claim 119, wherein the received data further includes data from an intraoral scan of the subject's dental surfaces. [Appendix 121] 121. The method of claim 120, further comprising the steps of: identifying a surface of the subject's tooth from the received data; mapping the surface of the tooth together with the portion of the volume of the first internal shape and the portion of the volume of the second internal shape; and outputting the surface of the tooth together with the portion of the volume of the first internal shape and the portion of the volume of the second internal shape as the 3D volume. [Appendix 122] 122. The method of claim 121, wherein the received data further includes data from a tooth surface color intraoral scan of the subject. [Appendix 123] 123. The method of claim 122, further comprising the steps of: identifying a color of the surface of the tooth of the subject from the received data; mapping the color of the surface of the tooth to the surface of the tooth; and outputting the 3D volume having the surface of the tooth and the color of the surface of the tooth. [Appendix 124] 19. The method of claim 118, wherein the first internal feature of the tooth comprises dentin of the tooth and the second internal feature of the tooth comprises enamel of the tooth. [Appendix 125] 125. The method of claim 124, wherein the intraoral scan includes a second intraoral scan of the subject, the method further comprising the steps of receiving data associated with a previous intraoral scan of the subject; identifying at least a portion of the enamel or dentin volume from the received data associated with the previous intraoral scan of the subject; identifying a volume change in the enamel or dentin by comparing the portion of the enamel or dentin volume identified from the received data associated with the second intraoral scan to the portion of the enamel or dentin volume identified from the received data associated with the previous intraoral scan; and outputting the identified volume change. [Appendix 126] 125. The method of claim 124, further comprising detecting dental caries of the tooth by comparing the second internal shape to the first internal shape, and outputting a signal to a user associated with the detected dental caries. [Appendix 127] 127. The method of claim 126, wherein comparing the second internal shape to the first internal shape includes analyzing whether the volume of the second internal shape extends from a surface of the volume of the first internal shape. [Appendix 128] 128. The method of claim 127, wherein the analyzing step includes determining whether the volume of the second internal shape extends from the surface of the volume of the first internal shape to a portion of the second internal shape associated with the dentin. [Appendix 129] 128. The method of claim 127, further comprising the steps of calculating a volume of the second internal shape extending from the surface of the volume of the first internal shape, and outputting a signal associated with the calculated volume. [Appendix 130] receiving data associated with an intraoral scan of a subject; determining a dental caries volume of the subject's tooth from the received data; quantification of the volume of dental caries in the teeth of the subject; outputting a signal associated with the quantified volume of dental caries in the tooth of the subject; The method includes: [Appendix 131] 131. The method of claim 130, further comprising the steps of identifying a volume of the subject's tooth enamel from the received data, mapping the volume of enamel to the volume of tooth caries, and outputting a 3D volume of the mapped volumes of enamel and tooth caries to a user. [Appendix 132] 132. The method of claim 131, further comprising identifying a volume of dentin of the subject's teeth from the received data; mapping the volume of dentin to the volume of enamel and the volume of caries of the teeth; and outputting the mapped volumes of enamel and caries of the teeth together with the volume of dentin as the 3D volume. [Appendix 133] 131. The method of claim 130, wherein the intraoral scan of the subject includes a second intraoral scan of the subject, the method further comprising the steps of receiving data associated with a previous intraoral scan of the subject; determining a previous volume of dental caries of the subject's teeth from the received data associated with the previous intraoral scan of the subject; and outputting a signal associated with a volume difference between the volume of dental caries and the previous volume of dental caries. [Appendix 134] 131. The method of claim 130, further comprising outputting a 3D model of the volume of the dental caries of the tooth of the subject. [Appendix 135] 1. A transillumination adapter sleeve device for an intraoral scanner, comprising: a sleeve body configured to fit over a wand of an intraoral scanner, the sleeve body including a light passing region at a distal end configured to allow near infrared light to pass through the sleeve; a first wing region extending from the distal end of the sleeve body adjacent the light passing region; a near-infrared light source configured to emit near-infrared light from the first wing region; An apparatus comprising: [Appendix 136] 136. The apparatus of claim 135, wherein the near-infrared light source is configured to emit near-infrared light that traverses the light passing area. [Appendix 137] 136. The device of claim 135, further comprising a second wing region extending from the distal end of the sleeve body adjacent to the light passing region, the second wing region having a second near-infrared light source configured to emit near-infrared light from the second wing region. [Appendix 138] 136. The device of claim 135, further comprising an electrical contact at a proximal end of the sleeve body configured to apply electrical energy to the near-infrared light source. [Appendix 139] 139. The apparatus of claim 138, further comprising a flexible circuit coupling the electrical contacts to the near infrared light source. [Appendix 140] 139. The apparatus of claim 138, further comprising a camera sensor operatively connected to a second wing extending from the distal end of the sleeve body adjacent to the light passing area.

Claims

1. 1. A method for detecting caries, comprising: Scanning the teeth from a plurality of positions and orientations with an intraoral scanner, said scanning comprising: receiving scan data of the patient's dentition, the scan data including a first set of surface data representative of the external surfaces of the teeth, the first set being acquired with the intraoral scanner using structured light to capture surface topology; receiving a plurality of 2D near infrared (near IR) images of the patient's dentition acquired with the intraoral scanner while acquiring the first set of surface data representative of external surfaces of the teeth, the plurality of 2D near infrared images including internal shape data; the scanning step including: detecting one or more caries from the plurality of 2D near-IR images including the internal shape data; generating a three-dimensional (3D) model of the tooth based on the captured surface topology and the internal shape data; displaying the 3D model of the tooth with the one or more caries marked on the 3D model; The method includes:

2. The step of detecting one or more caries comprises using machine learning to: The method of claim 1 , comprising recognizing the one or more caries from the plurality of 2D near-IR images.

3. The method of claim 1 , wherein detecting the one or more caries comprises segmenting the plurality of 2D near-IR images.

4. The method of claim 1 , further comprising displaying the one or more caries.

5. The method of claim 1 , wherein the scanning step further comprises receiving a plurality of white light images while acquiring the first set of 2D images.

6. The method of claim 1 , wherein detecting one or more caries from the plurality of 2D near-IR images is performed simultaneously with scanning the teeth.

7. The method of claim 1 , further comprising the step of comparing the one or more caries to one or more second caries determined from a previous intraoral scan of the tooth.

8. The method of claim 1 , wherein the plurality of 2D near-IR images of the patient's dentition are acquired with an angle between an illumination source and a sensor of less than 15 degrees.

9. 1. An intraoral scanning system comprising: a wand having at least one image sensor, a visible light source, and a near infrared (near IR) light source; one or more processors operatively connected to the wand, receiving scan data of the patient's dentition including a first set of surface data representative of external surfaces of the teeth acquired with the at least one sensor that captures surface topology using structured light; receiving a plurality of 2D near infrared (near IR) images of the patient's dentition acquired with the at least one sensor while acquiring the first set of surface data representative of external surfaces of the teeth, the plurality of 2D near infrared images including internal shape data; detecting one or more caries from the plurality of 2D near-IR images including the internal shape data; generating a three-dimensional (3D) model of the tooth based on the captured surface topology; displaying the 3D model of the tooth with the one or more caries marked on the 3D model; the one or more processors configured to A system comprising:

10. 10. The system of claim 9, wherein the one or more processors are configured to segment the 3D model or the one or more 2D near-IR images to detect the one or more caries.

11. 10. The system of claim 9, wherein the wand is configured to cycle between emitting visible and near infrared light such that images captured with visible and near infrared light share a common coordinate system.

12. 10. The system of claim 9, wherein the one or more processors are further configured to image the patient's dentition with white light to capture color information of the patient's dentition during scanning of the patient's dentition with visible light.

13. 10. The system of claim 9, wherein the one or more light sources and the image sensor are positioned such that emitted light is reflected from the teeth and received by the one or more sensors at an angle between 0° and 15°.

14. 10. The system of claim 9, wherein the one or more caries are detected by using machine learning to recognize the one or more caries from the plurality of 2D near-IR images.

15. 10. The system of claim 9, wherein the one or more processors are further configured to display the one or more caries.

16. 10. The system of claim 9, wherein the one or more processors are further configured to detect one or more caries from the plurality of 2D near-IR images simultaneously with scanning the teeth.

17. 10. The system of claim 9, wherein the one or more processors are further configured to compare the one or more caries to one or more second caries determined from a previous intraoral scan of the tooth.

18. 10. The system of claim 9, wherein the plurality of 2D near-IR images of the patient's dentition are acquired with an angle between an illumination source and a sensor of less than 15 degrees.

19. 1. A method for tracking caries over time, comprising: receiving a first scan data set of the patient's dentition acquired at a first time, the first scan data set including a first set of surface data representing external surfaces of the teeth acquired with an intraoral scanner that captures surface topology using structured light; receiving a first plurality of 2D near infrared (near IR) images of the patient's dentition acquired with the intraoral scanner while acquiring the first set of surface data representative of external surfaces of the teeth, the plurality of 2D near infrared images including internal shape data; detecting one or more first caries from the first plurality of 2D near-infrared (near-IR) images including the internal shape data; comparing the one or more first caries to one or more second caries determined from a previous intraoral scan taken at a second time different from the first time; generating a three-dimensional (3D) model of the tooth based on the captured surface topology and the internal shape data; outputting a comparison of the one or more first caries lesions to the one or more second caries lesions to indicate a comparison over time; The method includes:

20. 20. The method of claim 19, wherein the outputting step includes outputting the comparison with the 3D model of the teeth.

21. 20. The method of claim 19, wherein detecting the one or more first caries comprises using machine learning to recognize the one or more caries from the first plurality of 2D near-IR images.

22. The method of claim 19, wherein the step of detecting the one or more first caries includes a step of segmenting the plurality of 2D near-infrared images.

23. 20. The method of claim 19, further comprising displaying the one or more caries.

24. 20. The method of claim 19, wherein the first plurality of 2D near-IR images of the patient's dentition are acquired with an angle between an illumination source and a sensor of less than 15 degrees.

25. 1. An intraoral scanning system comprising: a wand having at least one image sensor, a visible light source, and a near infrared (near IR) light source; one or more processors operatively connected to the wand, receiving a first scan data set of the patient's dentition acquired at a first time, said first scan data set including a first set of surface data representing external surfaces of the teeth acquired with an intraoral scanner that captures surface topology using structured light; receiving a first plurality of 2D near infrared (near IR) images of the patient's dentition acquired with the intraoral scanner while acquiring the first set of surface data representative of external surfaces of the teeth, the plurality of 2D near infrared images including internal shape data; Detecting one or more first caries from the first plurality of 2D near infrared (near IR) images including the internal shape data; comparing the one or more first caries to one or more second caries determined from a previous intraoral scan taken at a second time different from the first time; generating a three-dimensional (3D) model of the tooth based on the captured surface topology and the internal shape data; outputting a comparison of the one or more first caries lesions to the one or more second caries lesions to indicate a comparison over time; the one or more processors configured to A system comprising:

26. 26. The system of claim 25, wherein the one or more processors are configured to output the comparison using the 3D model of the teeth.

27. 26. The system of claim 25, wherein the one or more processors are configured to detect the one or more first caries and recognize the one or more caries from the first plurality of 2D near-IR images using machine learning.

28. 26. The system of claim 25, wherein the one or more processors are configured to detect the one or more first caries by segmenting the plurality of 2D near-infrared images.

29. 26. The system of claim 25, wherein the one or more processors are configured to display the one or more caries.

30. 26. The system of claim 25, wherein the first plurality of 2D near-IR images of the patient's dentition are acquired with an angle between an illumination source and a sensor of less than 15 degrees.

Images