New method for producing dental prostheses and corresponding system for assisting the production of dental prostheses

Abstract

A method for producing dental prostheses is disclosed, through the steps of providing a preformed arch (16) which represents a dental arch model of a patient, for example formed starting from a digital model, applying the preformed arch (16) to a support located in the patient's mouth, for example to an impression tray or a pre-existing prosthesis, orienting the preformed arch (16) in the patient's mouth so as to obtain the parallelism between the occlusal plane and the Camper's plane, performing the occlusal registration between the preformed arch (16) and an opposing reference in the patient's mouth, and finally producing the prostheses after the performed registration. A corresponding system is also disclosed.

Description

[0001] New method for producing dental prostheses and corresponding system for assisting the production of dental prostheses

[0002] DESCRIPTION

[0003] Field of application

[0004] The present invention refers to a method for producing dental prostheses and to a corresponding system for assisting the production of dental prostheses, for example for producing total prostheses starting from preexisting total prostheses or starting from an edentulous oral cavity. The following description is made with the reference to this field of application with the sole purpose of simplifying the presentation thereof.

[0005] Prior art

[0006] As is known, the design of a complete oral rehabilitation of one dental arch or of two dental arches at the same time, both for the purpose of a traditional mobile rehabilitation (and therefore for the purpose of the design of a total prosthesis) and for the purpose of a rehabilitation aided by implants (either fixed or removable), involves a standardized technical clinical path consisting of at least four (generally five) appointments with the patient. In particular, according to the prior art, the following steps are envisaged:

[0007] - acquisition of the preliminary impressions for producing primary models on which the individual impression trays are built;

[0008] - acquisition of the secondary final impressions, from which it is possible to produce the final models on which resin bases with malleable wax rims are created for the registration of the planes, volumes, positions and relationships of the dental arches;

[0009] - craniomandibular registrations, choice of the teeth and reference to a mechanical or virtual articulator according to the patient's data, which allows mounting the dental arches to try them in; - try-in of the teeth; and

[0010] - delivery of the finished prostheses (for example following processing by polymerisation, moulding or milling) or production of radiological or surgical templates.

[0011] The procedure for obtaining the final product is therefore long and laborious, requiring numerous clinical visits. In the past, some solutions have been proposed with the aim of simplifying the aforesaid procedure, but these solutions have many drawbacks, including the lack of flexibility and difficulty in use, and therefore no truly effective simplification has ever been proposed to date.

[0012] The technical problem of the present invention is to devise a method (and a corresponding system) for assisting the production of dental prostheses having structural and functional features such as to allow to overcome the limitations and the drawbacks of the known solutions, in particular which simplifies the current procedure, reducing the number of required passages and obtaining at the same time an optimal result.

[0013] Summary of the invention

[0014] The solution idea at the basis of the present invention is to streamline and synthesise the operative passages of a prosthetic design and / or of the production of total prosthesis into a single clinical appointment (or, in one embodiment, into only two clinical appointments), acquiring in a simple and precise way all the patient’s data and guaranteeing an excellent quality of the final product. This solution is obtained by means of original devices and through an innovative method (operative protocol) that is extremely simplified in order to achieve a complete oral rehabilitation (total analogue or digital prosthesis or pre-implant prosthetic project) with the possibility of adapting pre-existing total prostheses, the possibility of the treatment of an edentulous oral cavity through a single clinical visit, or the possibility of the treatment of an edentulous oral cavity through two clinical visits. The designed operative protocol thus involves fewer visits than the prior art, thanks to the use of preformed dental arches for obtaining fundamental anatomical information of the patient, as well as thanks to an instrumentation that combines traditional intraoral plates with an innovative adjustment and registration of the occlusal plane based on the specific anatomy of the patient, obtaining indications about the Camper’s plane already during the first appointment; a core element of this operative protocol is the use of an adjustable / tiltable frame for the registration of the correct occlusal plane and of a preformed arch used as a functional and aesthetic reference directly during this operation, with the possibility of arranging at this stage already a set of reference teeth with the correct distances, positions and orientations.

[0015] Still with the aim of reducing the number of clinical passages and simplifying the procedure, the present invention also involves the execution of a dynamic analysis, with acquisition of data intraorally (such as, for example, stomatognathic kinematic data) by means of suitable thermoplastic and / or printed materials that are capable of deforming themselves as a function of the individual masticatory forces (with identification of the direction, intensity and way).

[0016] It is also provided the creation of an electronic computer program that allows to analyse and process, starting from the structural deformation of the aforesaid intraoral deformable material, a prosthetic / restorative structure based on the individual analysis of the force applied by the patient; this program is in particular able to read the direction, intensity and way of the forces applied on the surface of the deformed material, as well as the deformation thereof, after the clinical step, designing an internal structure of the prosthetic body.

[0017] Based on this solution idea, the aforesaid technical problem is solved by a method for producing dental prostheses, comprising the steps of providing a preformed arch which represents a dental arch model of a patient, for example formed starting from a digital model in digital libraries (e.g. printed), applying the preformed arch to a support located in the patient's mouth, for example to a previously formed impression tray (in particular an individual impression tray) or to a pre-existing prosthesis in the patient's mouth, orienting the preformed arch in the patient's mouth (while it is connected to the intraoral support) so as to obtain (i.e. to define / register) the parallelism between the occlusal plane and the Camper’s plane of the patient (thus registering the occlusal plane of the patient, i.e. suitably adjusting this occlusal plane), performing the occlusal registration (and thus the craniomandibular registration) between the preformed arch and an opposing reference in the patient's mouth (and thus performing said occlusal registration using the preformed arch as a reference, for example connected to the impression tray in the patient's mouth), and finally producing the prostheses after the performed registration, in particular based on the performed registration. This allows the production of prostheses in a single clinical visit.

[0018] More in particular, the invention comprises the following additional and optional features, taken individually or in combination if necessary.

[0019] According to one aspect of the present invention, the preformed arch may be hollow (and in particular it may be an upper arch) .

[0020] According to one aspect of the present invention, the preformed arch may be formed by 3D printing based on stored digital arch models.

[0021] According to one aspect of the present invention, the step of producing the prostheses may comprise a step of scanning artifacts obtained after the aforesaid occlusal registration, and a step of sending data of said scanning to a processing unit for forming the prostheses.

[0022] According to one aspect of the present invention, the step of orienting the preformed arch may be performed through the steps of measuring at least the distance between the Camper’s plane and the occlusal plane of the patient, adjusting the relative distance between an intraoral structure (e.g. an intraoral plate) and a frame to which said intraoral structure is connected, said adjusting step being performed based on said measured distance, i.e. the intraoral structure is fastened based on the measured distance, arranging the preformed arch on the intraoral structure, inserting the intraoral structure into the patient's mouth and applying the preformed arch to the support, and adjusting the tilting of the frame so that a plane in which it lies substantially matches with the Camper’s plane.

[0023] According to one aspect of the present invention, the method may comprise the steps of preliminarily forming an upper impression tray (in particular an individual upper impression tray) related to the patient, taking the dental impression of the patient through said individual upper impression tray, once this individual upper impression tray has been formed, it is possible to select the most suitable preformed arch and apply said preformed arch to the individual upper impression tray while taking the impression (i.e. inserted into the patient's mouth), forming a lower impression tray (for example when forming the upper one, or even at a different time, in particular an individual lower impression tray), performing the occlusal registration (craniomandibular registration) between the individual upper impression tray, to which the preformed arch correctly oriented with the Camper’s plane is applied, and the lower impression tray, after which the prostheses are formed.

[0024] According to one aspect of the present invention, the lower impression tray may comprise a rim for the registration of the occlusal parameters through the interaction with the upper preformed arch.

[0025] According to one aspect of the present invention, it can be first performed the step of acquiring impressions of the edentulous patient and forming the impression tray, wherein the shape of the edges is defined following the concepts of the construction of the individual spoons and, based on the formed impression tray, it can be performed the step of selecting the preformed arch measure that is the most suitable for the patient, after which it can be inserted in the intraoral structure, which comprises a dedicated seat. According to one aspect of the present invention, the preformed arch is applied to the impression tray by means of adhesive material or in general hardening material, arranged between them.

[0026] Possibly, much less preferably, upper and lower can be reversed, i.e. the preformed arch can be applied to the lower impression tray, or even both of them can be used (for example one for the adjustment of the occlusal plane and the opposite one for the craniomandibular registrations) .

[0027] According to one aspect of the present invention, the method may comprise the steps of applying the preformed arch to a pre-existing prosthesis (for example after having suitably modelled the prosthesis and chosen the preformed arch suitable for the measures in question), and, after having oriented the preformed arch as described above for the adjustment / correction of the occlusal plane, performing the occlusal registration between the preformed arch, which is oriented with the reference to the Camper’s plane, and the opposite prosthesis in the patient's mouth (with appropriate references).

[0028] According to one aspect of the present invention, the method may further comprise the steps of providing a further preformed arch, which represents a further (e.g. lower) arch model, said further preformed arch comprising a deformable material, deforming the deformable material under the action of the occlusal and masticatory dynamics of the patient, analysing the deformation of said deformable material after the interaction with the patient, and forming the prosthesis based on the analysis of said deformation.

[0029] According to one aspect of the present invention, the deformable material may be a surface layer which represents the occlusal part of the further preformed arch, said deformable material being configured to deform under the action of the occlusal and masticatory individual forces of the patient and to maintain such deformation.

[0030] According to one aspect of the present invention, the deformable material may be a thermoplastic material or a printed material.

[0031] According to one aspect of the present invention, the aforesaid analysing step involves reading the deformation shape, as well as the intensity, direction and way of the forces applied to the deformable material.

[0032] The present invention also refers to a method for producing dental prostheses, comprising the steps of adjusting (registering / defining) the occlusal plane of the patient by using an intraoral structure (for example an intraoral plate) on which impression material is arranged (in particular by adjusting / registering the parallelism between the occlusal plane and the Camper’s plane by tilting the intraoral structure, in particular by means of a suitable frame that at least partially surrounds the patient's face and to which said intraoral structure is connected, said intraoral structure being inserted into the patient's mouth and oriented for the adjustment of said occlusal plane deforming the impression material), forming (also digitally) an upper (or, less preferably lower) individual impression tray that is registered based on the aforesaid adjustment, providing a (also digital) preformed arch which represents a dental arch model of a patient, in particular selected based on the individual upper impression tray formed and / or on the patient's anatomy, applying (also digitally) the preformed arch to the individual upper impression tray, forming an opposing impression tray (in general opposite to the one having the arch, in particular an individual lower impression tray), taking the patient's impressions through said impression trays, performing, through said impression trays in the patient's mouth, the occlusal registration (and thus the craniomandibular registration) between the individual upper impression tray comprising the preformed arch and the lower impression tray, and producing the prostheses after the performed registration (in particular based on the performed registration).

[0033] This allows the production of prostheses in two visits. The registration of the occlusal plane is done with the same instrument described above, and in general the peculiar characteristics described above are applicable, mutatis mutandi, also to this method.

[0034] Possibly, as anticipated above, less preferably, upper and lower can be reversed, i.e. it is possible to apply the preformed arch to the lower impression tray and place the references (e.g. the waxes) on the upper one for the occlusion registration, as well as both arches can be used on the two impression trays.

[0035] According to one aspect of the present invention, the intraoral structure may be an intraoral plate on which the step of applying impression material is performed and which comprises an insert that is abutted on the patient's papilla, controlling the tilting of the frame and thereby adapting the impression material at the anatomical site of interest, and wherein the step of producing the individual impression trays and providing the preformed arch is carried out analogically by the operator, or digitally by selecting the preformed arch from software libraries.

[0036] Furthermore, the present invention also refers to a method for assisting the production of dental prostheses, comprising the steps of:

[0037] - measuring at least one anatomical parameter of a patient, in particular the distance between the occlusal plane and the Camper’s plane, i.e. the distance between the nose wings and the upper lip or between the nose wings and a reference taken with a papillameter;

[0038] - adjusting the relative distance between an intraoral structure (for example an intraoral plate) and a frame to which said intraoral structure is connected, said distance being set based on said measured anatomical parameter;

[0039] - inserting the intraoral structure into the patient's mouth for the adjustment (registration) of the occlusal plane, said intraoral structure being located in particular at the occlusal plane following said step of adjusting; and

[0040] - adjusting the tilting of the frame so that a plane in which it lies substantially matches with the Camper’s plane, suitably adjusting the occlusal plane of the patient.

[0041] According to one aspect of the present invention, the method may comprise the step of connecting a hollow preformed arch to the intraoral structure and of performing the registration of the occlusal plane with said performed arch, which is applied to an individual impression tray in the patient's mouth or to an existing prosthesis.

[0042] According to another aspect of the present invention, the method may comprise the step of arranging impression material on the intraoral structure, inserting the intraoral structure into the patient's mouth and tilting the intraoral structure as indicated above for the registration (adjustment) of the occlusal plane, and of applying the preformed arch to an individual impression tray that is formed subsequently based on said registration (adjustment), which is then inserted into the patient's mouth for the definitive impressions and the occlusal registration.

[0043] The present invention also refers to a system for assisting the production of dental prostheses, comprising a frame lying in a plane and shaped to surround, at least partially, the head of a patient, and an intraoral structure (for example an intraoral plate) configured to be inserted into the patient’s mouth and connectable to the frame by means of connection means (such intraoral structure being parallel to the plane of the frame), wherein the relative distance between the intraoral structure and the frame is adjustable by means of said connection means, wherein the frame is configured to be adjustable (in particular the tilting thereof is adjustable) so that the plane in which it lies substantially matches with the Camper’s plane, when the intraoral structure is in the patient's mouth, and wherein said intraoral structure is configured to accommodate (support / house) means for the adjustment (registration) of the correct occlusal plane (and therefore for determining said occlusal plane and / or obtaining occlusal parameters, with registration of the parallelism between the Camper’s plane and the occlusal plane) of the patient based on the adjustment of the frame, in particular when the intraoral structure is connected to the frame and the aforesaid distance is substantially the distance between the Camper’s plane and the occlusal plane of the patient.

[0044] In other words, the system is configured to switch from a non-adjusted configuration, to an adjusted configuration in which the intraoral structure is inserted into the patient's mouth and is spaced from the frame by a distance set based on the anatomical parameter of interest and said frame is tilted so as to correspond to the Camper’s plane, obtaining the desired registration.

[0045] According to one aspect of the present invention, the frame may be LJ- shaped and may comprise a central portion and two lateral portions which extend from the central portion, said frame being shaped to at least partially surround the patient's face by means of said lateral portions, in particular at the Camper’s plane.

[0046] According to one aspect of the present invention, the system may comprise a support element or vertical insert which is connectable to the frame, and the connection means of the intraoral structure may comprise a body provided with a through recess configured to house said support element and allow sliding therealong.

[0047] According to one aspect of the present invention, the body of the connection means can act as a support for the intraoral structure and be fixable at a determined position on the support element by means of a locking screw.

[0048] According to one aspect of the present invention, the support element may be a vertical element which extends along an axis that is substantially orthogonal to the plane of the frame and may be provided with indicator elements to adjust the relative distance between the frame and the intraoral structure.

[0049] According to one aspect of the present invention, the system may comprise a papillameter configured to determine the distance between the papilla and the upper lip of the patient.

[0050] According to one aspect of the present invention, the papillameter may be at least partially transparent.

[0051] According to one aspect of the present invention, the system may comprise measuring means for measuring at least one anatomical parameter of a patient.

[0052] According to one aspect of the present invention, when the distance between the intraoral structure and the frame is set based on said at least one anatomical parameter and when said intraoral structure is inserted into the patient's mouth, said frame is located at the Camper’s plane (i.e. it crosses the Camper’s plane and therefore its plane and said Camper’s plane are incident).

[0053] According to one aspect of the present invention, the intraoral structure may be tiltable by tilting the frame for the correct registration of the occlusal plane of the patient.

[0054] According to one aspect of the present invention, the anatomical parameter to be measured may be the distance between the Camper’s plane and the occlusal plane of the patient, corresponding to the intraoral structure.

[0055] According to one aspect of the present invention, the aforesaid measuring means may comprise a measuring instrument provided with a gripping portion shaped to be seized, and with a measuring portion shaped to abut on the patient’s nose wings, providing an indicative measure of such distance.

[0056] According to one aspect of the present invention, the gripping portion may have a substantially elongated shape and the measuring portion may have a curved shape, said portions following one after the other seamlessly. According to one aspect of the present invention, the measuring instrument may be at least partially transparent.

[0057] According to one aspect of the present invention, the measuring instrument may be couplable with the papillameter, said measuring instrument and said papillameter being couplable with each other and slidable with respect to each other along a longitudinal axis thereof, allowing a combined measure.

[0058] According to one aspect of the present invention, the intraoral structure may be removably connectable to the frame.

[0059] According to one aspect of the present invention, the intraoral structure may be substantially parallel to the plane of the frame.

[0060] According to one aspect of the present invention, the system may comprise at least one hollow preformed arch which represents a reference dental arch model insertable into the patient's mouth, said preformed arch being comprised in the means for adjusting the occlusal plane of the patient.

[0061] According to one aspect of the present invention, the preformed arch can be configured to be arranged on the intraoral structure, which comprises for example one or more housing seats for the arrangement of said preformed arch, and to be applied by means of said intraoral structure to an impression tray (in particular an individual impression tray) in the patient's mouth or to a pre-existing prosthesis in the patient's mouth, or in general to an intraoral support already in the patient's mouth, for the adjustment of the occlusal plane of the patient and for performing registrations with the correct identification of said occlusal plane.

[0062] According to one aspect of the present invention, the preformed arch can be connected to the intraoral support in the patient's mouth by means of suitable adhesive means, in general through hardening material.

[0063] According to one aspect of the present invention, the preformed arch may be made of moulded or milled resin, for example starting from digital models.

[0064] According to one aspect of the present invention, the preformed arch may be an upper arch model.

[0065] According to one aspect of the present invention, the system may comprise an insert removably connectable to the intraoral structure (e.g. in housing seats thereof) and configured to abut, in use, on the patient's papilla, said insert being comprised in the means for adjusting the occlusal plane of the patient.

[0066] According to one aspect of the present invention, the intraoral structure may be configured to house impression material for the detection of at least part of patient’s edentulous crests, wherein the distance between the intraoral structure and the frame is set based on at least one anatomical parameter and the plane of the frame substantially matches with the Camper’s plane by adjustment of the frame. In particular, in this case two alternatives are possible:

[0067] - the system may comprise at least one moulded hollow preformed arch which represents a dental arch model, which is adapted to be applied to an impression tray (in particular an individual impression tray) that has been previously obtained and registered based on said detection through the intraoral structure; or

[0068] - there may be a processing unit having in memory a plurality of digital models of preformed arches, said processing unit being configured to:

[0069] - create one or more digital models of individual impression trays, in particular at least one individual upper impression tray, based on preliminary impressions taken from the patient and based on said detection;

[0070] - identify the occlusal plane of the patient; - digitally place on the individual impression tray model a preformed arch selected from the plurality of preformed arches, with the reference of the occlusal plane obtained in the previous step; and

[0071] - send data to means for forming individual impression trays, for example a 3D printer.

[0072] According to one aspect of the present invention, the intraoral structure may be in the form of an intraoral plate.

[0073] According to one aspect of the present invention, the system may further comprise:

[0074] - a structure adapted to be applied to the head of a patient; and

[0075] - connecting means between the structure and the frame, said connecting means being configured to allow an adjustment of the relative arrangement between said structure and said frame and keep said frame at a reference position, wherein said structure, when applied to the patient's head, is confingured to make said system self-supporting.

[0076] According to one aspect of the present invention, the structure may be a spectacle mount or a mask configured to be worn by a patient.

[0077] According to one aspect of the present invention, the system may further comprise at least one indicator element which is connected to a respective lateral portion of the frame and is maintained at a determined distance with respect to the structure applicable to the patient's head, said distance being adjustable by means of adjustment means.

[0078] According to one aspect of the present invention, the position of the frame may be set by a spacer connected to the indicator element and to the frame.

[0079] According to one aspect of the present invention, the intraoral structure may be formed by an upper preformed injection arch and a lower injection support which are connected together and configured to be inserted into the patient’s mouth.

[0080] According to one aspect of the present invention, the system may further comprise an injection duct adapted to allow the injection of impression material into the patient’s mouth, said injection duct being in fluid communication with the intraoral structure, which comprises a plurality of holes and is configured to allow dispensing the impression material that flows in said injection duct through said holes towards the anatomical sites of interest of the patient (i.e. towards the edentulous crests) .

[0081] According to one aspect of the present invention, the upper preformed injection arch may represent a reference dental arch model in the patient's mouth, for example orientable as a function of the orientation of the frame, respecting the correct parallelism of the occlusal plane of the patient with the Camper’s plane of the patient.

[0082] According to one aspect of the present invention, the system may comprise a handle connected to the intraoral structure and inside which the injection duct extends towards the intraoral structure.

[0083] According to one aspect of the present invention, the intraoral structure may further comprise a film (e.g. an elastic film) arranged thereon, in particular at the holes (and thus at the surface towards the edentulous crests) and which is configured to house / collect (and keep in place) the impression material exiting from the holes at the anatomical sites of the patient.

[0084] According to one aspect of the present invention, as seen above, the system may comprise measuring means for measuring at least one anatomical parameter of a patient, wherein, when the distance between the intraoral structure and the frame is set based on said at least one anatomical parameter and said intraoral structure is inserted into the patient's mouth, the frame is substantially at the Camper’s plane, said intraoral structure being tiltable by tilting the frame for the correct registration of the occlusal plane and then for performing the correct occlusal registrations.

[0085] According to one aspect of the present invention, as seen above, the system may comprise a structure adapted to be applied to the head of a patient, for example a spectacle mount or a mask, and connecting means between the structure and the frame, said connecting means being configured to allow an adjustment of the relative arrangement between said structure and said frame and to keep said frame in a reference position, wherein said structure, when applied to the head of the patient, is configured to make said system self-supporting.

[0086] In this case, in one embodiment, the handle can be connected to the frame and / or to the structure applied to the patient's head by means of the aforesaid connection means.

[0087] According to one aspect of the present invention, the upper preformed injection arch and the lower injection support may be connected together and integrally formed.

[0088] The features and advantages of the method and of the system according to the invention will become clear from the description, made below, of an embodiment example thereof given by way of non-limiting example with the reference to the attached drawings.

[0089] Brief description of the drawings

[0090] In such drawings:

[0091] - figure 1 schematically shows a view of a system according to the present invention;

[0092] - figures 2A-2D show instruments of the system of the present invention and a way of using them;

[0093] - figures 3A-3C show further instruments of the system of the present invention and a way of using them; - figures 4A-4B schematically show a use of the system of the present invention;

[0094] - figures 5A-5B show examples of preformed arches according to embodiments of the present invention;

[0095] - figure 6 schematically shows the system of the present invention wherein the preformed arch is applied to an intraoral structure;

[0096] - figure 7 schematically shows the system according to an embodiment of the present invention wherein an insert is applied to the intraoral structure;

[0097] - figures 8A-8B schematically show the insert and the application thereof to the intraoral structure of the system according to embodiments of the present invention;

[0098] - figures 9A-9B show examples of preformed arches with a deformable material used in embodiments of the present invention;

[0099] - figure 10 shows the system according to an embodiment of the present invention; and

[0100] - figures 11A and 11B show details of the system according to an embodiment of the present invention for injecting impression material.

[0101] Detailed description

[0102] With reference to these figures, the reference 10 globally and schematically indicates a system for assisting the production of dental prostheses according to the present invention, said system being usable in a corresponding method.

[0103] It should be noted that the figures represent schematic views and are not designed to scale, but are instead designed in such a way as to emphasize the important features of the invention. Furthermore, in the figures, the different elements are schematically represented, and their shape may vary according to the desired application. It should also be noted that in the figures identical reference numbers refer to elements that are identical in form or function. Finally, particular measures described in relation to an embodiment illustrated in a figure can also be used for the other embodiments illustrated in the other figures.

[0104] It is also noted that, unless expressly indicated, the described method steps can also be reversed if needed.

[0105] The system 10 is thus used in order to assist the clinician and the technician in the production of a dental prosthesis, for example starting from an already existing prosthesis or from an edentulous oral cavity, as will be detailed below.

[0106] The following description will start from the instrumentation that can be used in part or in full in the proposed methodology and that makes up the system 10 of the present invention, and then it will detail below various procedures that can be implemented in accordance with the method of the present invention.

[0107] Instrumentation of the invention

[0108] With reference to figure 1, the system 10 comprises first of all a frame (represented with the reference F and hereinafter also referred to as "Camper Plane Instrument"), which is configured to at least partially surround the head of a patient and lying in a plane a, on which frame the main elements of the system are arranged.

[0109] The frame F has for example an open U-shape, and comprises a central portion Fc and two lateral portions Fl which extend from the central portion Fc. Thanks to this shape, the frame F is shaped to surround the patient's face at the Camper’s plane (herein indicated with the reference PC) by means of said lateral portions Fl. A fin (reference Ffin) is also provided, said fin being connected to the frame F for the control of the position thereof. Furthermore, the system 10 comprises a vertical insert (herein also called "support element" and indicated with the reference numeral 11) connectable to the frame F in a proper housing seat with the aim of providing a reference of the median line of the face, as will be detailed later.

[0110] The system 10 also comprises an intraoral structure (herein indicated with the reference numeral 12) configured to be inserted into the patient's mouth and connectable to the frame F by means of connection means (generally indicated with the reference numeral 13). It is noted that, in many embodiments of the present invention, the intraoral structure 12 is in the form of an intraoral plate insertable into the patient's mouth for the registration (or, using a synonym, adjustment) of the occlusal plane and therefore, for convenience of description, the term "plate 12" will be used hereinafter, apart from embodiments that do not comprise the plate but another type of structure. Once it is fixed to the frame F, the plate 12 is parallel to the plane a in which said frame F lies, said plate 12 corresponding to the occlusal plane (herein indicated with the reference PO) of the patient. As will be illustrated below, the relative distance between the plate 12 and the frame F is suitably adjustable by means of the connection means 13.

[0111] More in particular, the connection means 13 for connecting the plate 12 to the frame F comprise a body 13’ provided with a through recess configured to house the vertical insert 11 and allow its sliding along it. The body 13’ thus acts as a support for the plate 12 and is fixable at a determined position on the vertical insert 11, for example by means of a locking screw 13v. In this way, the connection means 13 that support the plate 12 may slide along the vertical insert 11 until the frame F and the plate 12 are at a desired relative distance from each other.

[0112] The plate 12 is therefore removably connectable to the frame F by means of the connection means 13 described above, said plate 12 being provided with a joining portion 12c adapted to be inserted into said connection means 13 and fixed thereto for example by means of a further screw (indicated with the reference 13v’), although obviously other configurations fall within the scope of the present invention, which is not limited to the embodiments shown herein.

[0113] As indicated above, the support element 11 is a vertical element which extends along an axis (indicated with the reference L-L) that is substantially orthogonal to the plane a of the frame F and is provided with indicator elements to adjust the relative distance between the frame F and the plate 12, such as for example a millimetre scale.

[0114] In this regard, in order to find the appropriate relative distance between the frame F and the plate 12, the system 10 comprises suitable measuring means for measuring at least one anatomical parameter of interest of the patient. More in particular, the anatomical parameter of interest is the distance (indicated with the reference D) between the Camper’s plane PC and the occlusal plane PO of the patient. The measuring means therefore comprise a suitable measuring instrument (represented in figures 2A-2D with the reference 14 and also indicated as OBC instrument, acronym for the expression "Occlusal Between Camper"), which is provided with a handle or gripping portion 14a shaped to be seized by the operator, and a measuring portion 14b shaped to abut on the patient's nose wings, providing an indicative measure of the aforesaid distance D.

[0115] The OBC measuring instrument 14 is therefore an instrument for extraoral use with the purpose of measuring the distance D between the Camper’s plane PC (passing through the nasal spine or nose wings and the centre of the ear canals or tragus) and the Occlusal Plane, which are parallel to each other.

[0116] In an embodiment of the present invention, the gripping portion 14a has a substantially elongated shape along a longitudinal axis (indicated with the reference H-H), while the measuring portion 14b has a curved (hemispherical) shape, said contiguous portions following one after the other. More in particular, the measuring portion 14b has a horizontal upper end or edge 14e, for example with a width equal to 5 cm, and which narrows down at the sides until it takes on the dimension of the gripping portion 14a while passing from said upper edge to said gripping portion 14a. The curvature of the upper edge 14e allows the measuring instrument 14 to abut on the nose wings and to surmount the upper lip without touching it.

[0117] The upper edge 14e of the measuring portion 14b has a lowered portion 14r at its centre, for example over a height of 10 mm and width of 20 mm, which allows not to interfere with the nasal columella.

[0118] The measuring instrument 14 is traversed by a central line 141 that extends from the measuring portion 14b up to all handle 14a and has a millimetre scale with the zero at the upper edge 14e.

[0119] Obviously the configuration illustrated above, although advantageous, is only indicative and is in no way limiting the scope of the present invention and other configurations may possibly be adopted based on needs and / or necessities.

[0120] A further instrument is also provided, said instrument being called papillameter and indicated with the reference 15 (herein also called MAR instrument, acronym for the expression "Median Anatomic Reference"), which is configured to determine the length of the patient's upper lip with respect to the lip closure line (see in this regard figures 3A-3C). In particular, the papillameter 15 is configured to measure the distance between the papilla and the upper lip of the patient. In order to facilitate the measurement, the papillameter 15 is at least partially transparent.

[0121] The papillameter 15 is therefore an instrument for intraoral use, of flat and thin shape and also having a handle gripping portion 15a, which extends along a longitudinal axis H’-H’, and a measuring portion 15b. The measuring portion 15b is arc- shaped and sized so as to simulate the arc and the standard dimensions of the upper central and lateral incisors, and has an elongated vertical dimension to allow the desired measurement. The upper edge is shortened from the ends towards the centre so as not to interfere with the labial frenulum.

[0122] In one embodiment, in the inner part of the arc-shaped measuring portion 15b (i.e. in the part facing, in use, the patient), for example at about 4 mm from the upper edge, there is a bracket (indicated with the reference 15p), for example about 10 mm high, 8 mm wide and 2 mm thick, although it should be understood that even in this case the numerical values are only indicative and do not limit the scope of protection of the present invention in any way.

[0123] The papillameter 15 also has a line 151 centred on the longitudinal axis H’-H’ thereof that also traverses the gripping portion 15a, and a millimetre scale with the zero point at the upper horizontal surface of the bracket 15p. The transparency of the material and the central line allow the practitioner to place the bracket 15p on the centre of the papilla, to have it covered by the upper lip in a resting position supported by the instrument itself, to view and photograph the anatomical centre of the palate with respect to the median line of the face and to measure in millimetres the distance from the papilla centre and the occlusal plane in the anterior sector, using the upper lip as a reference. The gripping portion 15a is connected to the measuring portion 15b in outermost position (i.e. it extends in a different plane and is joined thereto) so as not to interfere with the mandible and the lower lip. Furthermore, the shape of the papillameter 15 is such as to allow the gripping portion 14a of the OBC measuring instrument 14 to be surmounted, as described below.

[0124] In particular, in one embodiment, also the measuring instrument 14 is at least partially transparent to facilitate the measurement, and is couplable with the papillameter 15 (figure 2D shows the coupled configuration). More in particular, the measuring instrument 14 and the papillameter 15 are couplable with each other at their gripping portions 14a and 15a and are slidable with respect to each other along the longitudinal axes thereof (which in this case are parallel to each other), allowing a combined measure. In other words, in an embodiment of the present invention, the inner part of the gripping portion 14a of the measuring instrument 14 has a shape that allows it to be coupled to the gripping portion 15a of the papillameter 15, with the possibility of sliding relatively along the longitudinal axis thereof. In this way, the measurement of the measuring instrument 14 is read together with the measurement made with the papillameter 15. Alternatively, in case the instruments 14 and 15 are not coupled, the measurement of the measuring instrument 14 is read with the reference of the upper lip.

[0125] Once the measures have been taken with the instruments 14 and 15 (i.e. with the OBC and the MAR instruments), the measured values are used for the setting of the system 10. As already discussed above, in the lower part of the frame F, the vertical insert 11 is fixed in a proper seat (which is located in an off-centre position), said insert 11 having preferably a square section, with a millimetre scale, and having a length for example of about 6 cm (without, however, limiting itself to a particular value) . The connection means 13 provided with the locking screw 13v slide on the vertical insert 11 so as to fix the plate 12 at a desired height. The intraoral plate 12 is provided with a handle or joining portion 12c so as to be connected to the vertical insert 11 , while keeping at the same time a parallel and centred position in the system 10.

[0126] The plate 12 is flat in its lower part or face, which in some embodiments matches with the occlusal plane PO of the arch of the upper teeth, while in the upper part or face (i.e. at the opposite face) it comprises suitable housing seats (reference 12s), for example in the form of retaining holes for silicone materials - although these housing seats are not limited to a particular shape or configuration - where various components can be inserted depending on the operative protocol implemented, for example with interlocking, among which the following components are listed:

[0127] - anterior insert for horizontal abutment on the papilla, and vestibular abutment fin, made of transparent material, with median line and engraved and calibrated height (height that also takes into account the thickness of the plate, and therefore with an overall height that goes from the lower face of the plate 12 to the surface of said insert abutting on the papilla). In particular, a plurality of inserts with an assortment for various heights (measured in millimetres) can be used, which are individually selectable depending on the measure acquired with the papillameter 15, as discussed below; or

[0128] - preformed dental arches, as specified later.

[0129] Plates with smooth upper face can possibly also be used for the traditional wax rim technique.

[0130] The system 10 therefore comprises an instrument inspired by the traditional Fox plane for the registration of the parallelism between the Camper’s plane PC and the occlusal plane PO, but it has considerable technical advantages, allowing the correct relationship between the said planes to be identified already during the first appointment with the patient. In fact, in the traditional Fox plane there is a single plate with the intraoral part to be placed on the wax rim of the upper arch, while the extraoral part allows the control of the parallelism with the Camper’s plane, which however is not immediate and is often imprecise, a problem that is instead solved thanks to the system of the present invention.

[0131] In particular, advantageously according to the present invention, unlike what occurs in the known solutions, it is possible to adjust the distance between the intraoral plate 12 and the frame F around the patient's face. More in particular, when the distance between the plate 12 and the frame F is set based on the distance D measured by the measuring instrument 14 (i.e., it corresponds to the distance D between the Camper’s plane PC and the occlusal plane PO of the patient that has been measured with the OBC instrument) and when such plate 12 is inserted into the patient’s mouth, the frame F is located substantially already at the Camper’s plane PC, i.e. it crosses the Camper’s plane PC and therefore its plane a and said Camper’s plane PC are incidents.

[0132] In this way, when the plate 12 is inserted into the patient's mouth, the frame F is adjustable (in particular it is possible to adjust the tilting thereof) so that the plane a in which it lies substantially coincides with said Camper’s plane PC, so as to easily establish the parallelism between the Camper’s plane PC and the occlusal plane PO and obtain the correct registration of the occlusal plane PO. See in this regard figures 4A and 4B, which show the system 10 with the plate 12 inserted into the patient's mouth and the frame F aligned with the Camper’s plane PC. As will be detailed below, the plate 12 is thereby configured to accommodate (or more generally support) means for the adjustment (registration) of the correct occlusal plane PO of the patient based on said adjustment of the frame F.

[0133] Thanks to the proposed instrumentation, the invention discloses a key of clinical-technical synthesis of the classic steps of prior art, allowing the production of prostheses in the following situations:

[0134] - management of the patient’s data collection starting from pre-existing prostheses, in a single clinical visit;

[0135] - management of the patient’s data collection starting from an edentulous oral cavity, in a single clinical visit;

[0136] - management of the patient’s data collection starting from an edentulous oral cavity, in two clinical visits.

[0137] These three procedures will be detailed below.

[0138] In any case, what allows the advantageous reduction to a single clinical step (or into two clinical steps) is the use of preformed dental arches (herein identified with the reference 16), which represent the original synthesis key of the present invention. Figures 5A-5B show some examples of preformed arches 16 used in the present invention. In an exemplary embodiment, the dental arches are hollow upper preformed dental arches (made of moulded or milled resin) formed starting from morphologies present in the common software libraries, and thus formed starting from stored digital models, such preformed arches 16 being ideally mounted on a plane according to standard mounting relationships. The preformed arches 16 can also be produced industrially.

[0139] In other words, the system 10 advantageously comprises at least one hollow preformed arch 16 which represents a dental arch model, said preformed arch 16 being configured to be applied to the plate 12 and to be inserted into the patient's mouth for the adjustment / registration of the occlusal plane PO, as it will be illustrated in the following examples (i.e., it is comprised in the aforesaid means for the adjustment of the patient's occlusal plane). The preformed arch 16 may be made of moulded (e.g., 3D printed) or milled resin, although the present invention is not limited by the material and / or production method implemented.

[0140] In the examples shown, the hollow preformed arch 16 is an upper arch model, although the same concepts may possibly be applied to a lower arch model.

[0141] The preformed arches 16 are thus used in the method of the present invention in combination with the original intra- and extra-oral measurement and calibration instrumentation described above, as depicted in figure 6, ensuring the effective simplification of the process which leads to the formation of the final prostheses, providing an immediate reference (for example during the impression step) .

[0142] The setting and using process the aforesaid instrumentation of the system 10 is described below.

[0143] Firstly, in the case of an edentulous patient without pre-existing prostheses, with the aim of a new rehabilitation by forming two total prostheses, during the first visit the distance from the centre of the papilla to the point slightly covered by the upper lip is measured with the papillameter 15, also verifying the anatomical median with respect to the median of the face. Then, with the measuring instrument 14 (i.e., with the OBC instrument) abutted on the wings of the nose, the distance between this abutting point (from which the Camper’s plane PC ideally passes) and the occlusal plane PO is registered, possibly by superimposing it on the papillameter 15 (which in this step supports the upper lip for a correct measurement), thanks to the fact that the two instruments 14 and 15 are couplable with each other as described above. Once the anatomical parameters of interest to the patient have been acquired, the connection means 13 are fixed to the vertical insert 11 at a height selected based on the measure taken with the measuring instrument 14, after which the plate 12 (and more generally the intraoral structure 12) is fixed to these connection means 13, which plate in this way, once in the patient's mouth, is positioned at the occlusal plane PO and can be tilted with the frame F for the correct registration of the occlusal plane PO of the patient.

[0144] This setting process of the system 10 is a general feature of the present invention, theoretically applicable and possibly applicable to all the following described procedures, which represent embodiments of the method of the invention.

[0145] Use of the aforesaid instrumentation in a procedure for the formation of prostheses starting from an edentulous patient in a single clinical visit

[0146] When a procedure that involves a single clinical visit is implemented, the preformed arch 16 is applied to the plate 12, which has the aforesaid housing seats 12s suitably formed for its housing, which seats, as seen above, are not limited to a determined configuration and have the aim of allowing the support of various components (in this case the preformed arches 16).

[0147] As a first step, the operator acquires the impressions of the edentulous patient and forms an impression tray (in particular an individual impression tray), in particular preferably, but not necessarily, an upper impression tray. For example, in this single-step procedure (which involves the acquisition of mono-impressions), when forming the impression trays, the shape of the edges is defined by following the concepts of the construction of the individual spoons and possibly, if necessary, the prostheses can then be relined in a direct manner (i.e. directly in the step of delivery of the prostheses) or indirect manner (with impressions for relining that will be followed by the laboratory) .

[0148] Based on the formed impression tray (and in general based on the patient), the operator evaluates between various arch measures (for example small, medium and large) and then selects the measure of the preformed arch 16 that is the most suitable for the patient, after which he / she inserts it in the plate 12 with the dedicated seat 12s; once the preformed arch 16 has been applied to the plate 12, the operator increases the distance between the frame F and said plate 12, by moving the connection means 13 over the thickness millimetres of the plate 12 with the occlusal part represented by the preformed arch 16 (which has a known measure) .

[0149] With this instrumentation it is possible to register the impressions of the arches synthesizing the first and second traditional visit, to determine volumes, the occlusal plane PO, the positions of the arches and finally craniomandibular relationships in a single clinical appointment, thanks to the use of the aforesaid preformed arches 16 applied to the plates 12, these arches well representing a real arch model and therefore providing a very useful and precise reference.

[0150] Specifically, in this case, as mentioned above, the protocol for the formation of total prostheses first of all involves taking a first impression of the bases with an impression tray for edentulous patients with a puttytype silicone material and a base plate made of photo-polymerizing resin suitably insulated from the oral tissues. The impression tray is then removed from the oral cavity and the support is reduced according to classic analysis; the aforesaid base plate is then photo-polymerized and removed from the putty. Calibrated spacers are then applied and the boxing procedure is carried out. Once the individual impression tray is obtained, the final impression is detected. As soon as the impression has been taken, the preformed arch 16 suitable for the patient is selected and it is applied to the plate 12 of the system 10, which has been suitably calibrated with the aid of the measuring instrument 14 (i.e. the OBC instrument) and possibly the papillameter 15 (i.e. the MAR instrument), after which the preformed arch 16 is applied to the individual upper impression tray present in the patient's mouth (for example by means of appropriate adhesive means, or in general through a hardening material, thus binding it to the impression tray) during the impression step and the adjustment of the system 10 is carried out as described above, i.e. by suitably tilting the frame F so as to align its lateral portions Fl to the Camper’s plane PC. In this way, by obtaining the parallelism between the Camper’s plane PC and the occlusal plane PO and using the preformed arch 16 as reference teeth connected to the intraoral support and said preformed arch being correctly oriented, information is immediately obtained (in particular both functional information, such as the dimensional relationships, the correct registration of the occlusal plane, etc., and aesthetic information) without the need for further clinical visits with the patient. In this case, the preformed arch 16 is comprised in the means for adjusting the occlusal plane PO.

[0151] Once the registration of the occlusal plane PO has been performed as described above, the lower impressions are acquired and the corresponding lower impression tray is produced, so the appropriate craniomandibular registrations can be performed, with the arch connected to the impression tray where the assembly is correctly registered (for example with silicone, possibly also with the acquisition of a lingual impression). Performing a lower lingual piezography can also be envisaged.

[0152] Finally, the obtained product is scanned (for example the product may be the correctly registered impressions, for example the scanning may occur through optical readers) in order to obtain all the data for the formation of the prostheses.

[0153] In fact, there are also provided means for forming prostheses based on the data collected, such as for example 3D printers that operate based on the data acquired in the manner described above, although the present invention is not limited to this specific embodiment and many other modes, including analogue ones, can be implemented.

[0154] It is noted that the aforesaid procedure is part of a more general method that can possibly be implemented without the instrumentation of the system 10 for the adjustment of the preformed arch 16 (which can possibly also be done with traditional instrumentation), although it is preferable to use the system 10 described above.

[0155] Use of the aforesaid instrumentation in a procedure for the formation of prostheses starting from an edentulous patient in two clinical visits

[0156] Heretofore the applicable protocol has been described (for example with the system 10 of the present invention) in the case of an edentulous patient in a single clinical visit.

[0157] According to another embodiment of the present invention, it is also possible to provide a hybrid mode, based on two clinical steps for the production of prostheses starting from an edentulous patient. This procedure may be easier for some operators that are used to operating with the traditional methods.

[0158] As in the previous case, also in this case the system 10 is adjusted in such a way that the plate 12 is spaced from the frame F by the distance D measured by the measuring instrument 14 (i.e. the OBC instrument).

[0159] An insert (indicated with the reference number 18 and illustrated in figure 7 and figures 8A-8B) is then used, which is removably connectable to the plate 12 at the dedicated housing seats 12s of said plate 12 and is configured to abut, in use, on the patient's papilla. The measure of the insert 18 applied to the plate 12 (which is an anterior insert) is established by the measurement previously carried out with the papillameter 15.

[0160] Once the insert 18 is arranged, high-density impression material (for example of the putty type) is then applied on the plate 12 in a horseshoelike manner, with the exception of the anterior insert 18, where in this case the material has the sole purpose of detecting part of the crests, without necessarily producing a complete impression. The plate 12 is then inserted into the oral cavity of the patient by abutting the anterior insert 18 on his / her papilla, controlling the tilting of the frame F as described above, which in this case is lower down posteriorly. The plate 12 is then gently compressed at the posterior part by adapting the impression material until the correct anatomical references (in particular the tragus) on the median line are reached with the frame F (in particular with its lateral portions Fl).

[0161] In this case, the insert 18 and the material arranged on the plate 12 are therefore comprised in the means for adjusting the occlusal plane PO of the patient, helping the operator to correctly perform such adjustment.

[0162] The extended impressions are taken separately with the traditional technique for the production of the individual impression trays, both lower and upper ones (then forming a toothed individual upper impression tray with the upper preformed arch 16, as detailed below).

[0163] In particular, two traditional alginate impressions are taken and two primary gypsum models are produced, on which models the analysis for the production of an individual impression tray base is carried out.

[0164] Once the models (that is, in this procedure, the preliminary impressions) have been developed and the plate registered according to the above procedure has been obtained, it is then possible to proceed with digital or analogue technique.

[0165] In the case of the analogue procedure, the plate 12 with the registration of the occlusal plane PO (i.e. with the impression material modelled based on the tilting of the frame F) is fixed to a proper support near a lower portion of an articulator in the standard occlusal plane, then the upper model is adapted to the imprinted shapes of the crests and is fixed through gypsum to the articulator. On the model thus formed, the profile of the impression tray is then drawn in a conventional way, obtaining an upper individual impression tray model (an analysis is carried out in a similar way to the preparation of a wax rim for the occlusal registration), which is correctly registered thanks to the measure taken previously. The upper preformed arch 16 that is the most suitable for the situation (for example in the measure between small, medium or large) is selected and it is placed with small portions of inert wax on the model, by making it adhere to the standard occlusal support. The shape of the impression tray is then completed, for example by waxing and through the silicone index technique and the resin is made. An upper individual impression tray including the arch is then obtained, which provides an immediate reference for the occlusal registration, with a preliminary set of teeth with correct dimensions and correct relationships.

[0166] A lower impression tray is also made by means of traditional techniques, and instead of the handle it has a resin rim that is smaller in thickness and height than the traditional wax rim for the occlusal registration, which is positioned on the crest centre throughout the arch and extended up to the position of the sixths (lower first molars). On the rim made in this way it is possible to apply the deformable material for the occlusal registration, through the interaction with the aforesaid upper performed arch 16.

[0167] When the final impressions are taken with the aforesaid impression trays (in the second clinical visit) it will therefore already be possible to register the occlusal parameters.

[0168] As regards instead the digital procedure, once the impressions have been developed, scans (for example through optical readers) of the models (where models are understood in this procedure as the preliminary impressions) and of the upper support with the registered plate (i.e. with the impression material suitably registered by means of the aforesaid adjustment of the frame F, in particular also representing a model) are performed and said data are processed by a suitable processing unit (herein indicated with the generic reference C), which executes a software (is configured) to detect the occlusal plane PO of the patient based on the scanned models. In particular, the processing unit C is configured, thanks to said software, to allow to digitally trace the perimeter, the abutting areas, the discharge for the impression material, the thickness and to perform the analysis of the models, so as to design the digital model of the individual upper impression tray. The processing unit C then comprises a digital library comprising a plurality of digital models of preformed dental arches, and from said library it is therefore possible to choose the preformed arch 16 that is the most suitable for the specific situation. Once the appropriate choice has been made (for example between small, medium and large) the selected preformed arch 16 is digitally positioned on the digital upper impression tray modelled with the determined occlusal plane PO. The final step involves the production of the final product by 3D printing, to which the data are sent by the processing unit C. Also the lower impression tray is digitally produced, and is modelled so as to have the characteristics described above with the reference to the analogue procedure. Once the impression trays have been developed, the functionalization is carried out (during the second clinical visit) with acquisition of the final impressions and the various registrations of the craniomandibular relationships, with the individual impression tray already provided with the previously applied arch; finally, the whole is scanned for the production of the final prostheses for example by 3D printing (or they are formed in analogue mode).

[0169] Summarizing the above, in this procedure, the first visit involves the registration by means of the system 10, the detection of the preliminary impressions (by the clinician) and the development of the models, the acquisition of the occlusal plane, the design and production of individual impression trays, with analogue or digital procedures (by the technician) . The second visit instead involves functionalizing with boxings a the individual impression trays and final impressions, wherein the individual impression trays were previously obtained with upper integrated teeth (i.e. by applying the preformed arch 16) and with lower reduced resin rim, and then evaluating aesthetics and function; it is then provided for the registration with facial arch in the analogue procedure, possibly to carry out a lower lingual piezography (resin or silicone), to perform the appropriate craniomandibular registrations (for example with silicone that possibly also allows a lingual impression) and then to scan in order to perform a digital procedure or finalize through analogue procedure (all this by the clinician) . The technician will proceed with the acquisition of the digital files for digital printing, or he / she will acquire the prostheses for the analogue finalization.

[0170] In other words, in this embodiment, the plate 12 is configured to house impression material for the detection of at least part of the edentulous crests of the patient (with the system 10 set and oriented as described above), and the moulded hollow preformed arch 16 (which represents a model of the dental arch) is subsequently used, said preformed arch 16 being adapted to be applied to an individual impression tray obtained and registered based on said detection through the plate. In the digital procedure, there is a processing unit C comprising a plurality of digital models of pre-formed arches 16, said processing unit C being configured to create one or more digital models of impression tray based on the preliminary impressions taken previously and based on said detection, to identify the occlusal plane PO of the patient, to digitally position on the upper impression tray a pre-formed arch selected from among the plurality of pre-formed arches 16 with the reference of the occlusal plane obtained in the previous step, and to send data to means (e.g. a 3D printer) for the formation of the individual impression trays. The functionalization of the impression trays and the finalization is performed in the second step.

[0171] It should be noted that, both in the analogue procedure and in the digital procedure, the operator can manage the individual impression trays in a traditional way but, advantageously, thanks to the preformed arch 16 he / she can immediately check the upper dental arch in relation to the aesthetic / functional aspects, register the position with the facial arch with already a system of teeth, manage several occlusal registration possibilities in the lower impression tray and decide whether a teeth try- in is necessary or whether to proceed with the finalization of the prostheses.

[0172] The present invention therefore has numerous advantages also in this procedure in two clinical visits; in fact, in the conventional procedure, during the third clinical visit, the practitioner must correct the upper wax rim, which is built following standard measurements, adapting it with the help of the Fox Plane to the correct upper occlusal plane, parallel to the Camper’s plane, and to the correct vertical dimension; in the known technique he / she must then create in the occlusal surface of the upper rim notches to obtain the interlocking keys with the wax of the lower rim, and during the fourth clinical visit it will then be possible to evaluate the dental arch in the teeth mounting trial. Advantageously according to the present invention, it is instead possible to provide already during the second clinical visit a prosthetic body that is correct in the vertical dimension and in the occlusal plane PO, with the upper dental arch already included. The occlusal registration with the lower reference may may be made according to different known techniques, with application of temporarily deformable material on the reduced resin rim of the lower impression tray, including the possibility of using the Gothic arch, or of applying a lower hollow arch.

[0173] Use of the aforesaid instrumentation for the modification of existing prostheses in a single clinical visit

[0174] Furthermore, as anticipated above, the system 10 of the present invention is advantageously applicable to a further clinical eventuality, i.e. in the case of pre-existing total prostheses, also allowing in this case the solution of the problem in a single clinical visit. In this case, the objective is to modify and correct the prosthetic support, the occlusal plane and the craniomandibular relationships, with the aim of creating a virtual or analogue articulator in order to produce the new artifacts. Unlike the prior art which proceeds with a duplication of the pre-existing prostheses as a working base, the present invention allows the reversible modification of the prostheses in use up to scanning the modified prostheses in craniomandibular relationship.

[0175] In particular, according to the present invention, first of all the support of the pre-existing prostheses is modified by means of thermoplastic or silicone materials.

[0176] The correction of the occlusal plane and aesthetic correction are then performed by using the upper hollow preformed arch 16 positioned on the upper arch present, this preformed arch 16 being oriented with the aid of the system 10, by suitably orienting the frame F, as illustrated in figure 6 and as described above. The craniomandibular registration with the preformed arch 16 (which is therefore a provisional arch) applied to the pre-existing prosthesis is then performed.

[0177] Finally, the registered model is scanned for the formation of the new prosthesis (with restitution of the original prosthesis) .

[0178] In other words, summarizing the above, advantageously according to the present invention, the preformed arch 16 is configured to be applied to the plate 12, which comprises one or more housing seats 12s, and to be applied through said plate 12 to an upper impression tray in the patient's mouth or to a pre-existing prosthesis in the patient's mouth for the registration of the occlusal parameters thereof.

[0179] Advantages of the invention

[0180] In any case, whatever the clinical eventuality or the protocol applied among those described above, the system of the present invention has numerous advantages. In general, the proposed method makes it possible to simplify the procedure, thanks to the use of the preformed arch 16, which is applicable to impression trays (in particular individual impression trays) developed (both analogically and digitally, both in a single visit with a mono-impression procedure or in a double visit) or to existing prostheses, providing the operator with immediate information (both functional and aesthetic) in a simple and precise way.

[0181] The operator can thus produce individual impression trays for the patient (in particular in the case of an edentulous patient), on which impression trays the performed arch 16 is arranged (in particular, but not necessarily, the upper impression tray) with the occlusal plane PO accurately registered, so that during the step of collection of the definitive impressions it is then possible to proceed immediately with the registration of the occlusal parameters (craniomandibular registrations), completing the whole procedure in one or two clinical visits.

[0182] Additionally, the traditional Fox plane is no longer used, which involves observing the parallelism with the imaginary line that goes from the tragus to the nasal spine (i.e. the Camper’s plane PC), with possible errors of interpretation considering the average distance of about 2.5 cm. Suitably according to the present invention, the system 10, by means of the frame F, is located exactly at the anatomical landmarks, starting from the anterior measure (i.e. the distance between plate and frame) set with the registered measures (i.e. the measure obtained with the measuring instrument 14 and possibly the papillameter 15) and with the posterior parts (i.e. the lateral portions Fl) to surmount the centre of the auditory channels (tragus), this system also having the fin Ffin connected to the frame F with the purpose of helping the practitioner to control the roll of the plane with respect to the median of the face and giving a more precise indication with respect to the relationship with the inter-pupillary line only. In this way, during the first appointment with the patient, in addition to taking impressions, an indication is given on how to correctly build the Camper’s plane PC. General considerations on the operative protocol according to the present invention

[0183] From the above, the present invention defines a working protocol and therefore it also refers to a corresponding method in which the system 10 is used in the manner described above, in one or two clinical visits.

[0184] Furthermore, based on what is illustrated above and in accordance with embodiments of the present invention, a general method for the production of dental prostheses is proposed that provides for a single clinical visit without necessarily using all the instrumentation described above.

[0185] In particular, in the most general form of the method of the present invention, the idea is to apply the preformed arch 16 directly into the patient's mouth during the first appointment. Even more in particular, according to the method of the present invention, there is a first step of providing a preformed arch 16 of the type described above, among various available arches, which represents a model of a patient's dental arch, for example selected and then printed starting from stored digital models. The preformed arch 16 is then applied to a support located in the patient's mouth, for example to a pre-existing prosthesis or to an impression tray (in particular an individual impression tray) arranged in the patient's mouth during the impression step.

[0186] In general, for the application of the preformed arch 16 to the support, a material can be used, which can be for example a thermoplastic or silicone material, which deforms and keeps the whole assembly in place, without however being limited to a specific material.

[0187] The preformed arch 16 is then oriented in the patient's mouth so as to obtain the parallelism between the occlusal plane PO and the Camper’s plane PC of the patient, preferably by means of the system 10 described above, as also specified later, thereby adjusting (registering) the correct occlusal plane PO. The occlusal registration is then performed between the preformed arch 16, which is correctly oriented, and an opposing reference in the patient's mouth (e.g., a deformable material on a lower impression tray or a lower existing prosthesis), and then the occlusal registration is performed using the upper arch as a reference.

[0188] Finally, the prostheses are produced taking into account the information obtained (i.e. at least based on the performed registration).

[0189] As seen above, the preformed arch 16 (which is an upper arch model) is hollow and may be formed by 3D printing based on stored digital arch models.

[0190] The step of producing the prostheses comprises a step of scanning, for example by means of an optical reader, products (such as for example the individual impression trays and the corresponding impressions) obtained following the occlusal registration, and a step of sending data of said scanning to the processing unit C for the formation of the prostheses, by executing an automatic program for producing total prostheses that have preformed arches at average values.

[0191] As indicated above, the orientation of the arch for the correct registration / adjustment of the occlusal plane can be advantageously obtained by means of the system 10, i.e. by measuring at least the distance D between the Camper’s plane PC and the occlusal plane PO of the patient, adjusting the relative distance between the intraoral plate 12 and the frame F to which said plate 12 is connected, fixing the distance based on said measured distance D, arranging the preformed arch 16 on the plate 12, inserting the plate 12 into the patient’s mouth and applying the preformed arch 16 to the support, and finally adjusting the tilting of the frame F so that its plane a substantially matches with the Camper’s plane PC.

[0192] Heretofore, a general method applicable to different situations that involve a single clinical visit has been described. More in particular, in a first application, in the case of an edentulous patient, there is a preliminary step of forming an upper impression tray (in particular an individual impression tray) related to the patient and taking the dental impression of the patient by means of said individual impression tray. Once this individual impression tray has been formed, it is possible to select the most suitable preformed arch (in particular the one most suitable for the dimensions of the formed individual impression tray) and apply said arch to the individual impression tray in the patient's mouth. The preformed arch 16 is then applied to the aforesaid individual upper impression tray (which in this case acts as a support) during the impression step. Once the preformed arch is correctly oriented for the adjustment (registration) of the occlusal plane PO of the patient, the occlusal registration is performed between the upper impression tray to which the preformed arch 16 oriented to the Camper’s plane PC is applied and a lower impression tray (for example, an individual impression tray) that was previously formed (in this case, the formation of the lower impression tray can take place at any time before the aforesaid registration). In this case, the lower impression tray (opposing element) comprises a rim for the registration of the occlusal parameters through the interaction with the upper preformed arch 16, which is already with the correct plane.

[0193] Further, in a second application, the preformed arch 16 is applied to a pre-existing prosthesis (which in this case is the support), and, once the adjustment / correction of the occlusal plane has been performed as described above (for example orienting the preformed arch 16 through the system 10), the occlusal registration between the preformed arch 16 oriented to the Camper’s plane PC and the opposite prosthesis (opposing element) is performed in the patient's mouth, then scanning the obtained product and obtaining the final result in a single clinical visit.

[0194] In any case, different supports may also be used and the procedures shown are non-limiting examples of the present invention.

[0195] Furthermore, based on what is illustrated above and in accordance with embodiments of the present invention, a general method for the production of dental prostheses through a double clinical visit is proposed, thereby satisfying the needs of many operators in this technical field.

[0196] In particular, the method of this embodiment comprises the steps of adjusting (registering) the occlusal plane of the patient by using a plate on which impression material is arranged, producing (also digitally) an individual (preferably upper) impression tray based on said registration, providing a preformed arch (also digital) which represents a model of a patient's dental arch, said preformed arch being chosen based on the formed individual impression tray, applying (also digitally) the preformed arch to the individual upper impression tray, producing an individual lower impression tray, performing the occlusal registration between the individual upper impression tray comprising the preformed arch and the individual lower impression tray, and finally producing the prostheses after the performed registration (in particular at least based on the performed registration) .

[0197] The registration of the occlusal plane can be done with the same system 10 described above, by applying an impression material (for example putty) on the plate 12 on which the insert 18 has been arranged, said insert being selected based on the measurement of the papillameter 15 and being abutted on the patient's papilla, and in general all the characteristics described above are applicable, mutatis mutandis, also to this method.

[0198] This method therefore represents an alternative version to solving the same technical problem of the previous case, i.e. by reducing the number of steps of the prior art, in this case reduction to two clinical visits, with the common feature of using the preformed arches as references (even if said arches are used at different times).

[0199] Further developments of the above operative protocols according to embodiments of the present invention In one embodiment of the present invention, the use of deformable materials for the acquisition of also dynamic data of the patient is provided. It is noted that this embodiment is theoretically independent of the methods described above and could therefore also be made independently.

[0200] In an exemplary embodiment, a further preformed arch is used (indicated in figures 9A and 9B with the reference 16’), which represents a lower arch model, said further preformed arch 16’ comprising a suitable deformable material (reference 19).

[0201] The deformable material 19 will then be deformed under the action of the patient's occlusal and masticatory dynamics, in order to analyse the deformation of said deformable material 19 after the interaction with the patient and form the prosthesis based on the analysis of said deformation.

[0202] This exemplary embodiment therefore provides a printed prototype of the complete arch (shape of a traditional total prosthesis) for the aesthetic trial and for the collection of dynamic data through a material that allows the impression of the dynamics in the occlusal shape, in its three- dimensionality starting from the centric points that determine the vertical occlusion dimension. In other words, a constituent material of a trial prototype of the prosthesis is envisaged, in this case a preformed arch (but also from the inlay to the single tooth) preferably obtained by 3D printing and which has in the occlusal morphology surface component thereof (physics of the internal microstructure or otherwise) the possibility of being modelled under the action of both static and dynamic occlusal dynamics and the masticatory ones while keeping the resulting final shape (as is possible with the thermoplastic materials) . The concept is to individualize the lower occlusal table to the individual dynamics of the patient.

[0203] A system of analysis (reading / scanning) of the final shape obtained is then envisaged, which allows the detection of the forces applied on the occlusal table. More in particular, the processing unit C is configured to read the deformation shape, as well as the intensity, direction and sense of the forces applied on said deformable material 19.

[0204] Using a suitable software, it is then possible to read and develop data to reproduce in a final milled or moulded form the functionalized morphology through chewing movements that are standardized by type of consistency and side (alternated bilateral) of the occlusal table (eliminating the logic of data acquisition for programming a virtual articulator) .

[0205] It is possible to calculate, based on the surface deformation, the applied force by the direction, sense and intensity, so as to automatically design and create (for example with 3D printing technology) a prosthetic body with an internal structure that is the result of the analysis of the forces, and therefore that respects the real force lines of the patient, as well as it is possible to read the shape obtained from the functionalization and to reproduce the occlusal morphology in the final device.

[0206] In other words, in accordance with this embodiment, the deformable material 19 is a surface layer which represents the occlusal part of the further preformed arch 16’, said deformable material 19 being configured to deform under the action of the individual occlusal and masticatory forces of the patient and to maintain said deformation.

[0207] The deformable material 19 is a thermoplastic material or a moulded material, but it should be noted that the present invention is not limited by the material used.

[0208] Summary of the advantages of the invention according to the protocols illustrated above

[0209] Advantageously according to the present invention, the numerous and laborious steps of the prior art are synthesised by using hollow upper preformed arches and suitable measuring and adjustment devices (i.e. the aforesaid MAR, OBC, Camper Plane instruments), these preformed arches being used in such a way as to immediately have, during the step of taking the impressions, an arch with the correct registration and providing the operator with useful information. These preformed arches are applied by the operator to impression trays (in particular individual impression trays) that are suitably formed (for example according to standard technologies, or also digitally) or to existing prostheses directly during the first appointment with the patient, and are therefore they are selected to adapt without problems to the specific cases, without the use of standard impression tray spoons (which are difficult to modify) .

[0210] A single clinical step (or two for the hybrid protocol) is therefore envisaged for the registration of the impression of the upper and lower anatomical base including the boxing procedure, the craniomandibular relationships acquisition with immediate visualization of the patient's situation with regard to the reciprocal 3D position of the two maxillary bases and an aesthetic pre-visualization of the upper arch in the first session.

[0211] In the case of a single clinical visit, an oral mono-impression is made with an upper dental pre-visualization and a better approximation of the craniomandibular relationships without the need for a second visit. Alternatively, it is also possible to provide a second visit for the functionalization of the individual impression trays, but without the subsequent steps of the prior art.

[0212] In both cases it is also possible, once the registration is finished, to use CAD / CAM processors for the finalization of a printed or milled product, or alternatively a traditional analogue production is possible.

[0213] An effective and simple solution is therefore obtained, with great versatility and applicable in different clinical eventualities.

[0214] The preformed arches therefore allow to have a very comfortable reference for the operator, both aesthetic and functional, since they allow to perform all the registrations with the instrumentation and methodology described above with already a model of teeth (with correct heights and relationships) in the patient's mouth, allowing for example the occlusal registrations with already a system of teeth and with the parallelism between the Camper’s plane and the occlusal plane that has been suitably registered.

[0215] It is also provided, optionally, the use of a deformable or thermoplastic moulded material that is indicative of the occlusal portion of a lower preformed arch to be arranged on the lower base for the acquisition of dynamic data, unlike what occurs in the traditional technique, which provides for very complex and expensive instrumentation and further clinical steps. Through the deformable material (having determined structure plasticity characteristics), it is therefore possible to register and obtain a final functionalized shape directly from the patient's kinematics; this finished modelled part is produced by modifying a type- morphological pattern of dental arch preformed at average values per skeletal class. This makes it possible to revolutionise the data acquisition system, towards a cheaper and faster mode that does not require the use of complex systems by the operator. The system allows the finished product to be obtained from a shape point of view directly in the patient's mouth, a product that can be finalized simply through a scanning and reproduced through CAM systems. This aspect is also theoretically applicable to bridges, inlays and single teeth.

[0216] It is also envisaged to develop an advantageous scanning system that allows the functionalized morphology to be reproduced.

[0217] In particular, a computer program is developed, said computer program allowing the preformed pattern to be compared to average values with the same functionalized pattern so as to reproduce the same conformation in the final device.

[0218] This program is also able to read the modelling force applied to the occlusal surface of the prototype according to intensity, direction and way sense, producing structures that are made according to an internal trabeculation according to the force lines. Finally, it is noted that the protocols described above provide for producing an impression tray by the operator, in such a way that he / she can then take all the correct parameters, using the preformed arch as an aesthetic and functional reference, as well as taking a closed mouth impression for the registration of the craniomandibular relationships, with all the advantages indicated above.

[0219] Further new i of the instrumentation of the invention and further new

[0220] Advantageously according to an embodiment of the present invention, as illustrated in figure 10, the system 10 may also comprise a spectacle mount or a mask (reference 20) configured to be worn by a patient. The mount 20 is stably connected to the frame F in order to form a single instrument therewith, in particular to form a stative-cranial body of the system 10 to which said frame F is connected.

[0221] In this way, the system 10 can be stably mounted on the patient's head, thanks to the presence of the mount 20, facilitating the operative process to be performed. In particular, as will be fully illustrated below, once the frame F is fixed to the mount 20 (with the possibility of a fine adjustment of this position), it will remain in a stable position, with the correct and fixed reference of the Camper’s plane of the patient.

[0222] Obviously, the present invention is in no way limited by the shape and / or material of the mount 20, which substantially represents a mask that can be worn by the patient, and will also be indicated with the general term "structure 20". Like the traditional spectacle mounts, it can be provided with a nasal support adapted to engage the user's nose.

[0223] It is also noted that, although the presence of a mount is considered as preferred, this is not strictly necessary and any structure adapted to be applied to the patient's head with the same purpose can be used in the present invention. In any case, for simplicity of illustration, all of the following examples will show the use of the mount (or mask) within the system 10. Thanks to the presence of the mount 20, generally, the reference of the Camper’s plane PC remains suitably fixed by anchoring of the frame F to said mount 20.

[0224] In one embodiment, there is a band (reference 201) for the fixing to the nape in order to keep the mount 20 well fixed.

[0225] As mentioned, there are connecting means between the mount 20 and the frame F, said connecting means being suitably configured to allow the fine adjustment of the relative positioning between said mount 20 and said frame F.

[0226] In one embodiment of the present invention, the aforesaid connecting means comprise a coupling means (reference 25) formed by a body provided with a through recess; this through recess is configured to house a support (reference 30) which is suitably fixed to the mount 20. The support 30 is for example in the form of a rod and is slidable within the through recess of the body of the coupling means 25. The coupling means 25 can be fixed at a determined position with respect to the frame F, for example by tightening an appropriate screw, such position being easily adjustable based on the circumstances and / or determined applications. Referring again to the example of figure 10, the coupling means 25 is connected to the fin Ffin of the frame F, and is therefore adjustable along said fin Ffin.

[0227] In one embodiment of the present invention, the support 30 is fixed to the mount 20 through a further coupling means (reference 35), which is also formed by a body with a through recess in which said support 30 is able to slide, providing a further degree of freedom in the adjustment of the system 10, in particular in the relative adjustment between the frame F and the mount 20.

[0228] In this way, the mount 20 is connected to the frame F in an indirect manner by means of the support 30, which is connected both to the frame F by means of the coupling means 25 and to said mount 20 by means of the further adjustable coupling means 35.

[0229] The support 30 ends, at the end at the patient's face, with an abutting element 30a adapted to abut on the upper part of the nose, for example in the form of a pad (for example made of an elastomeric material without however being limited by a specific material), the position of which is adjustable by means of the further coupling means 35, inside which the support 30 slides.

[0230] The mount 20 thus forms the stative-cranial block of the system 10 with fixation at the median.

[0231] The aforesaid connecting means between the mount 20 and the frame F are configured to allow the adjustment of the relative positioning between said mount 20 and said frame F along at least two directions that are different from each other, for example a vertical direction (orthogonal to the plane a), and a horizontal direction (parallel to said plane a), as well as intermediate directions. The horizontal direction can be adjusted by means of a first screw 25v’ of the coupling means 25 and possibly also a screw 35v of the further coupling means 35 (i.e. the screws that lock the support 30), while the vertical position can be adjusted by means of a second screw 25v” of the coupling means 25 (i.e. the one that locks it to the fin Ffin).

[0232] In one embodiment of the present invention, the system 10 also comprises a pair of indicator elements (reference 40) useful for providing the operator with a visual reference of the auricular tragi. Each of the indicator elements 40 is fixedly connected to a respective lateral portion Fl of the frame F and is kept at a determined distance Dis with respect to the mount 20. In the example of figure 10, each indicator element 40 is kept at a determined distance Dis from the mount 20 by means of a spacer element 45, said distance Dis being adjustable by means of adjustment means (reference 50, for example provided with adjustment screw 50v) and corresponding to a reference position of the frame F. In one embodiment, the spacer element 45 is fixedly connected to the indicator element 40 and not-fixedly connected to the mount 20, for example by means of the aforesaid adjustment means 50. In one embodiment, said spacer element 45 can be considered as part of the indicator element 40.

[0233] The adjustment means 50 are therefore comprised (together with the coupling means 25) in the connecting means between the structure 20 and the frame F and, as seen above, allow the adjustment of the positioning of the indicator elements 40, more in particular of the distance Dis, these indicator elements 40 thus acting as adjustable members with the aim of allowing a stable reference at the auricular tragi (3D calibration), which is thus added to the possibility of adjustment by means of the coupling means 25 at the frontal median (craniocaudal calibration) .

[0234] In order to increase their visibility, the indicator elements 40 protrude with respect to the lateral portions Fl of the frame F, in particular along a different direction from a longitudinal axis along which said lateral portions Fl extend (for example an orthogonal direction) .

[0235] It is further noted that, in one embodiment, there might be only a single indicator element 40 at a lateral portion Fl of the frame F, although it is preferable to use two indicator elements 40 as described above.

[0236] Suitably, the spacer 45 (together with the support 30 fixed with the coupling means 25) then fixes the position of the frame F at the Camper’s plane PC, keeping this reference position stable during use of the system 10, and this position is adjustable through the adjustment means 50 and the coupling means 25.

[0237] In this implementation, the system 10 also comprises a chin support (or support form chin, reference 55), which is configured to be abutted on the patient's chin. The chin support 55 is in the form of a folded plate with two portions angled relative to each other (for example, but not necessarily, by 90 degrees) to ensure a stable abutment for the patient's chin. As illustrated in figure 10, the chin support 55 is supported by and connected to a support means 60 (for example in the form of a rod-like element) whose position with respect to the frame F and also with respect to the patient is suitably adjustable. As will be detailed later, the chin support 55 acts as a reference during the procedure performed by the operator, with the possibility of allowing a vertical and also an anterior / posterior adjustment.

[0238] In one embodiment, the chin support 55 is connected to the frame F by means of the vertical insert 11 , to which it is removably locked by means similar to those discussed above, wherein the vertical insert 11 and the support means 60 are slidably inserted to adjust the positioning both in the vertical direction (by sliding said means along the vertical insert 11) and in the horizontal direction (by sliding the support means 60), as mentioned above.

[0239] In other words, the chin support 55 is an adjustable device for blocking the chin position in the anterior / posterior and craniocaudal direction that allows, after the clinical determination of the relative positionings between the intraoral structure 12 and frame F (as detailed below) performed by the operator, to be able to subsequently reposition the system 10, while maintaining the previously determined craniomandibular relationship, and to support the position during a step of injecting impression material. In this way, the system 10 can be removed and worn again while maintaining all the correct relationships.

[0240] Additionally, in an embodiment of the present invention, the system 10 comprises a frontal element (reference 70) configured to abut on the patient's forehead and connected to the mount 20. The frontal element 70 can be moved with respect to the mount 20 in order to best adjust the system 10. It is therefore a frontal stabilization block that allows greater comfort of use and greater stability of the system 10.

[0241] In one embodiment, the frontal element 70 is connected to the further coupling means 35 so that its movement in the horizontal direction is integral with that of the mount 20, while the relative movement with respect to said mount 20 is allowed by connecting means (reference 75), which block said frontal element 70 in an adjustable way.

[0242] In accordance with the present invention, the system 10 is therefore a kit for the production of prostheses, said kit being therefore intended as a set of instruments, wherein the basic version comprises the frame F and the plate 12 or more generally the intraoral structure 12 connectable thereto, and possibly the accompanying instrumentation described above, including the structure 20 (mask or mount or any other suitable support) to allow the operator to perform the operative steps in the most efficient way possible.

[0243] As described above, the distance between intraoral structure 12 and frame F is possibly adjustable based on one or more anatomical parameters of the patient and the frame F is suitably tiltable; the presence of the mount 20 facilitates all these operations as it makes the system stable and it is such that the operator does not have to keep it in place during use, guaranteeing to the system 10 to support itself, and is particularly useful in the subsequent step of injection of impression material.

[0244] It is also noted that the presence of the structure 20 can be seen as a general feature of the present invention and it therefore can be used regardless of the various expedients implemented in the system 10, such as for example the particular intraoral structure used (both an intraoral plate and even other structures can be provided, for example injection devices with integrated arch, as described later), the particular accompanying instrumentation used, and the particular operative method implemented.

[0245] The present invention therefore also refers to a system (still indicated with 10) for assisting the production of dental prostheses, comprising:

[0246] - a structure 20 adapted to be applied to the head of a patient; - an intraoral structure 12, in particular (but not necessarily) an intraoral plate;

[0247] - a frame F connectable to the intraoral structure 12 and shaped to surround, at least partially, the patient's head, said frame F being configured to allow the registration of the parallelism between the Camper’s plane PC and the occlusal plane PO of said patient; and

[0248] - connecting means between the structure 20 and the frame F, said connecting means being configured to allow an adjustment of the relative positioning between said structure 20 and said frame F and to keep said frame F in a reference position.

[0249] As seen above, in one aspect of the invention, the mount 20 may be a spectacle mount configured to be worn by a patient.

[0250] As mentioned, the stative-cranial block (i.e. the mount) allows a stable and unique anchoring to the patient's head, providing support for anchoring accessories for reference measures, while keeping the identified positional relationships fixed. Thanks to this aspect, all the positional relationships are fixed and the system is also much more stable.

[0251] In this case, the operative protocol is as follows (borrowed from what was seen above), and can be implemented without necessarily using all the instrumentation described above. In the event that a procedure that involves a single clinical visit is implemented, the preformed arch 16 is applied to the intraoral structure 12, which has the aforesaid housing seats 12s suitably formed for its housing, which as seen above are not limited to a determined configuration and have the aim of allowing the support of various components (in this case the arches 16).

[0252] Specifically, as first operative step, the operator acquires the impressions of the edentulous patient, in particular he / she acquires two primary impressions (through primary impression material, such as for example alginate or intraoral scanning) . As with the methodology seen above, in the single visit procedure with mono-impression, when forming the impression trays, the shape of the edges is defined following the concepts of the construction of the individual spoons and possibly, if necessary, the prostheses can be relined in a direct manner (directly in the step of delivery of the prostheses) or indirect manner (with impressions for relining that will be followed by the laboratory) .

[0253] Once this has been done, the operator positions of the stative- cranial block, i.e. of the mount 20, to which the frame F is connected, which, with the mount 20 worn, is suitably adjusted so that the plane in which it lies matches with the Camper’s plane PC; once this adjustment has been performed, the position of the frame is fixed by means of the aforesaid connecting means between the structure 20 and the frame F (i.e. the references 25, 45 / 50).

[0254] The chin support 55 is then mounted and it is adjusted.

[0255] The operator then evaluates between various measures (for example small, medium and large) and chooses the measure of preformed arch 16 that is the most suitable for the patient, then he / she inserts it into the intraoral structure 12 (in the form of a plate) with the dedicated seat 12 s; once the preformed arch 16 has been applied to the intraoral structure 12, the operator then increases the distance between the frame F and this intraoral structure 12, by moving the connection means 13 over the thickness millimetres of the intraoral structure 12 with the occlusal part represented by the preformed arch 16 (which has a known measure). In other words, the preformed arch 16 suitable for the patient is selected and it is applied to the intraoral structure 12 of the system 10, which has possibly - but not necessarily - been suitably calibrated with the aid of the measuring instrument 14 (i.e. the OBC instrument) and possibly of the papillameter 15 (i.e. the MAR instrument), after which said preformed arch 16 is applied, with the correct orientation, in the patient's mouth during the impression step (after having momentarily removed the chin support 55), in particular to the impression tray present in the patient's mouth, as seen above. Once the intraoral structure 12 is inserted, the chin support 55 is also mounted back. As will be described below, this method can also be adapted to an intraoral structure other than the plate, without an impression tray in the patient's mouth.

[0256] Thanks to the presence of the mount 20 that keeps the frame F in the correct position, the preformed arch 16 can be inserted with the frame having the optimal orientation (i.e. the orientation that guarantees the parallelism between the Camper’s plane PC and the occlusal plane PO) and this frame F does not necessarily have to be supported by the operator, and said preformed arch 16 is used as a set of reference teeth, obtaining immediately, and with the correct occlusal plane PO, all the useful information without the need for further clinical visits with the patient.

[0257] The appropriate craniomandibular registrations are then performed, which can take place by injecting impression material into the patient's mouth, possibly also with the acquisition of a lingual impression. This is done by means of a device for intraoral injection of impression material. The presence of the mount to which the whole assembly is fixed greatly simplifies this step, since the operator only provides for the injection of the material while the arch is already at the correct fixed orientation and the whole assembly remains stable: it is therefore not necessary to control the orientation of the arch while acquiring the craniomandibular relationships, greatly simplifying the operator's work.

[0258] Finally, the obtained product is scanned (for example the correctly registered impressions, for example through optical readers) in order to obtain all the data for the formation of the prostheses.

[0259] Obviously, it is possible to develop a protocol with use of the mask 20 also for the production of prostheses in two visits or with existing prostheses, although the greatest advantages can be found for the procedure with a single clinical visit. Summarizing the above, the present invention defines a working protocol and therefore also refers to a corresponding method in which the system 10 is used in the manner described above, in one or two clinical steps.

[0260] In particular, in the most general form of the method of this embodiment, there is the preliminary step of acquisition of at least one impression of the patient, in particular the acquisition of two primary impressions (for example through primary impression material such as for example alginate and / or by intraoral scanning) .

[0261] The structure 20 (e.g. the spectacle mount) is then placed on the patient's head, and the frame F is connected to the structure as described above. As seen above, the frame F is arranged around the patient's head.

[0262] Then, the step of adjusting the relative positioning between the structure 20 and the frame F is performed by moving said frame F so that it substantially matches with the Camper’s plane PC (for example by aligning the lateral portions Fl to the tragus, using the indicator elements 40). This allows the parallelism between the Camper’s plane PC and the occlusal plane PO of the patient to be registered, suitably fixing the frame F in the most appropriate reference position.

[0263] The intraoral structure 12 is connected to the frame F and the relative distance between the intraoral structure 12 and the frame F is adjusted, said distance being set for example based on said measured anatomical parameter, or in an approximately manner. As seen, the adjustment of the intraoral structure 12 can take place before the adjustment of the frame F with respect to the structure 20 (and the latter adjustment takes place with the plate in the patient's mouth which is then removed and put back later for the various registrations), or first the positioning of the frame F with respect to the structure 20 is adjusted and then the intraoral structure 12 is placed and the position of the latter is adjusted.

[0264] The step of intraoral detection of the impression of the craniomandibular relationship (and possibly of the tongue, with incorporation of the preformed arch 16) is obtained by injecting impression material into the patient's mouth by means of a special device.

[0265] This procedure allows, as seen above, to easily obtain all the parameters of a patient in a single clinical visit. It can also possibly be extended to a procedure that involves two clinical visits, and in this case the preformed arch 16 is not applied in the patient's mouth, but putty-type impression material is applied on the plate. The difference in this latter case is that the impressions are taken separately for the production of two individual impression trays, wherein one of them (in particular the individual upper impression tray) comprises the arch which provides an immediate reference for the occlusal registration, which is done during the second visit.

[0266] Heretofore, a system has been described in which the preformed arch 16 is applied to the plate 12, and in which the final impression is taken by injecting impression material through an injection gun. The following paragraph shows an evolution of this system.

[0267] Innovative injection system

[0268] In an advantageous embodiment of the present invention, in order to facilitate the injection of impression material into the patient’s mouth, a modification of the system 10 and of the implemented protocol is envisaged, wherein the system 10 comprises an innovative intraoral device of injection of impression material.

[0269] In this case, as illustrated in figure 11, the intraoral structure 12 is not in the form of a simple plate, but comprises an upper preformed injection arch 90a and a lower injection support 90b, which are preferably connected and formed as one piece with each other, configured to be inserted into the patient's mouth. There is therefore a preformed arch of the upper teeth (i.e. the upper preformed injection arch 90a), which is complete in the vestibular surfaces, with cervical surfaces (i.e. those opposite to the occlusal ones) of concave shape and reduced in height up to half the tooth; the lower injection support 90b is formed in the position of the class I occlusal relationship (slightly backward with respect to the upper preformed injection arch 90a), with reduced shape both in the buccal-lingual direction and in height, and as seen above it forms a single body with the upper injection arch 90a. The lower injection support 90b may also not have the shape of the teeth, since in order to have the correct references it is sufficient that the arch is only the upper one.

[0270] In a less preferred form, it is possible to reverse what has been seen above, and thus have an upper support without teeth and a lower injection arch, or both the upper and lower arches.

[0271] In this embodiment, the system 10 comprises an injection duct (reference 95) adapted to allow the injection of impression material (reference M) into the patient's mouth, said injection duct 95 being in fluid communication with the intraoral structure 12 described above, which comprises a plurality of holes 90h (both at the upper arch 90a and at the lower support 90b) and is configured to allow dispensing the impression material M that flows in said injection duct 95 through said holes 90h towards the anatomical sites of interest of the patient.

[0272] Similar to what was seen for the previous protocols, the upper preformed injection arch 90a represents a reference dental arch model in the patient's mouth that can be oriented, thanks to the frame F, in such a way as to respect the correct parallelism of the occlusal plane PO with the Camper’s plane PC of the patient, with the difference that in this case it is not applied to an impression tray in the patient's mouth, but the intraoral structure 12 is directly inserted into the patient's mouth, which can keep the resting position during the operative steps.

[0273] A handle (reference 90m) is also provided and is connected to the intraoral structure 12 (for example to the lower injection support 90b) and inside which the injection duct 95 develops. The handle 90m may be connected to the frame F and / or to the mount 20 by means of the connection means, although the present invention is not limited to this configuration. Externally, the handle 90m therefore has a shape that allows it to be fixed stably to the mount 20 and / or to the frame F, keeping the arch centred with the median and parallel to the Camper’s plane PC, and is fixed at a determined position and distance.

[0274] The injection duct 95, which extends internally to the handle 90m, continues in the upper preformed injection arch 90a and in the lower injection support 90b (which are in fluid communication with each other), which in turn have conduits of adequate dimensions inside them, and then ends with the aforesaid holes 90h for the outflow of the material towards the edentulous crests.

[0275] As mentioned above, the handle 90m may be connected to the lower injection support 90b and, in one embodiment, it is flat and offset to the left of the patient with the reference to the median of the arches.

[0276] Suitably, the shape of the intraoral structure 12 (and also of the handle) is such as to allow to the lips to close with the arch inserted into the oral cavity.

[0277] A seat (or port) is then provided for the entry of the material M to be injected, in particular by means of an attachment that allows a quick coupling and uncoupling of a dispenser, such seat being arranged at the handle 90m, for example, but not necessarily, in a proximal area opposite to the connection area with the intraoral structure 12.

[0278] In one embodiment, a film may be provided, which is made of an elastic material, arranged on the intraoral structure 12 and configured to collect and house the impression material exiting from the holes 90h at the anatomical sites of the patient. In other words, it can also be provided to apply, on the area of the holes 90h, the aforesaid elastic preformed film at the areas to be registered, wherein with the injection of the material M said film is filled until it is adapted taking on the shape of the crests, thereby balancing the amount of the injectable material on all areas and preventing it from being dispersed in the patient's mouth (and therefore keeping said material in the correct position).

[0279] Obviously, also in this embodiment one or more of the above described expedients can be provided, such as for example the configuration of the frame F and the presence of the mount 20 to which the assembly formed by intraoral structure 12 and handle 90m can be connected, as well as the presence of measuring means for measuring at least one anatomical parameter of the patient, so as to be able to adjust, when said intraoral structure 12 is connected, the distances correctly based on the anatomy of the patient, in particular based on the distance between the Camper’s plane PC and the occlusal plane PO.

[0280] In this case, the operative protocol involves registering with closed mouth the resting position of the patient, with great convenience for both the operator and the patient. In particular, once the intraoral structure 12 has been positioned in a manner similar to that seen in the previous sections, i.e. by connecting it to the frame F by means of the connection means with the correct distances, possibly first arranging the mount 20, the material M is injected into the patient's mouth directly by means of said intraoral structure 12 (already comprising at least one arch from which the material outflows) through the handle 90m, thus avoiding having the patient to open his / her mouth.

[0281] The injected material M does not necessarily have to form a complete impression, but a portion of the crests is sufficient such as to allow a scanning, with a study or laboratory scanner, which allows the alignment with a complete impression of the single arches (which instead can be taken with the traditional techniques at a different time, in any case always in a single clinical visit); in this case, also in the partial impression taken through the system 10, references present in the complete impressions are found, these references being sufficient to perform the alignment of the partial impressions (in which the occlusal plane and the craniomandibular relationships are correctly registered), for example via software, with the complete impressions, thus obtaining the desired complete impressions, which are correctly registered, in a single step. In the analogue procedure this allows the adaptation of the gypsum models.

[0282] In this embodiment, the plate is thus replaced by the intraoral structure with integrated arch and with its handle (which together form the innovative injection system).

[0283] This protocol is very different from the prior art, in which the occlusal registration (also referred to as occlusal relationship registration), i.e. the position of the mandibula in relation to the maxilla, takes place with the aid of stable mucosally-supported plates with wax rims, which plates are manufactured on models obtained from impressions; in particular, in these known solutions, during the third clinical visit, the practitioner corrects the upper wax rim, built following standard measurements, adapting it with the aid of the Fox Plane to the correct upper occlusal plane, parallel to the Camper’s plane, and to the correct vertical dimension. Then, in the occlusal surface of the upper rim, notches are then created to obtain the interlocking keys with the wax of the lower rim. The registration takes place with adaptation of the lower wax, asking the patient to voluntarily perform mouth-closures, immediately after having him / her open the mouth wide to insert the plate with the rim. However, the repetitive closure position is often conditioned by the fact that the voluntary closure is different from the usual one during swallowing and chewing.

[0284] Suitably, this embodiment has the advantage that it is no longer necessary to perform repetitive closures for the occlusal registration, but the whole procedure takes place at rest with the mouth closed; in other words, the registration of the occlusal plane and the registration between the upper part and the lower opposing part takes place directly without having the patient open and close, very easily in a single clinical visit.

[0285] As seen above, also in this embodiment, the upper preformed injection arch 90a represents a reference dental arch model in the patient's mouth that is orientable; in the case of using a mask 20, it is inserted already correctly oriented. Summing up, in this embodiment, a method is therefore implemented which first involves arranging the structure 20 (for example the spectacle mount) on the patient's head, although this step is not strictly necessary, and the frame F is connected to said structure as described above.

[0286] Then the step of adjusting the relative positioning between the structure 20 and the frame F is performed by moving said frame F so that it substantially matches with the Camper’s plane PC (for example by aligning the lateral portions Fl to the tragus, using the indicator elements 40). This allows the parallelism between the Camper’s plane PC and the occlusal plane PO of the patient to be registered, suitably fixing the frame F in the most appropriate reference position.

[0287] As before, the chin support can be arranged after connecting the structure 20 to the frame F, and then possibly momentarily removing it to insert the intraoral structure 12.

[0288] The intraoral structure 12 is then connected to the frame F and the relative distance between the intraoral structure 12 and the frame F is adjusted, said distance being set for example based on said measured anatomical parameter, or in an approximately manner. As seen, the adjustment of the intraoral structure 12 can take place before the adjustment of the frame F with respect to the structure 20, or first the positioning of the frame F with respect to the structure 20 is adjusted and then the intraoral structure 12 is placed and the position of the latter is adjusted.

[0289] Once in the patient's mouth, the intraoral structure 12 is thus suspended between the lower and upper edentulous crests prior to the introduction of the impression material.

[0290] The step of intraoral detection of the impression of the craniomandibular relationship, i.e. the occlusal registration, is obtained by injecting the impression material M into the patient's mouth by means of a special dispenser, which is connected to the injection duct 95, with the impression material M outflowing directly into the patient's mouth through the holes 90h, possibly with the presence of the containment film. As seen above, it is not necessary to take a complete impression by means of said dispenser (also with the aim to reduce the introduction of material into the patient's mouth), and therefore it is possible to have on the same intraoral structure 12 an upper partial impression and a lower partial impression.

[0291] The complete impressions for the alignment with the partial registered ones are instead taken separately.

[0292] Advantageously, this procedure allows to easily obtain all the parameters of a patient in a single clinical visit, all in the patient's resting position. The possible combination with the mask 20 is also advantageous, which allows to maintain the system 10 in the correct position and tilting during the operative steps, and to take the impressions without having to support the frame or other components with the hand, which would be more difficult.

[0293] Finally, it is noted that also this embodiment is a general embodiment of the invention, independent of any further measures, such as the use of the mask (which is in any case advantageous as it keeps the whole assembly in the correct position) or other measuring instruments.

[0294] Conclusion

[0295] In conclusion, the present invention therefore allows to brilliantly overcome the technical problem, providing the above method and system and solving all the drawbacks of the prior art.

[0296] In general, compared to the known solutions, the preformed arches are used for the registration of the occlusal plane, for example positioned directly on the impression tray or in general in the patient's mouth, directly providing anatomical references, in combination with the advantageous instrumentation herein described; after the adjustment, the occlusion impressions can then be taken through closure or by directly injecting material.

[0297] The positioning of the arch, even intraorally, therefore allows to obtain information (also of a quantitative, functional and aesthetic type) and to obtain various precise adjustments that the known solutions are not able to make.

[0298] Obviously, a person skilled in the art, in order to satisfy contingent and specific needs, will be able to make numerous modifications and variations to the method and the system described above, all included in the scope of protection of the invention as defined by the following claims.

Claims

CLAIMS1. A method for producing dental prostheses, comprising the steps of:- providing a preformed arch (16) which represents a dental arch model of a patient;- applying the preformed arch (16) to a support located in the patient's mouth;- orienting said preformed arch ( 16) in the patient's mouth so as to obtain parallelism between the occlusal plane (PO) and the Camper’s plane (PC) of the patient, thereby adjusting the occlusal plane (PC);- performing the occlusal registration using the preformed arch (16) as a reference, in particular performing the occlusal registration between said preformed arch (16) and an opposing reference in the patient's mouth; and- producing the prostheses after the performed registration.

2. The method according to claim 1, wherein the preformed arch (16) is hollow, and / or wherein said preformed arch (16) is formed by 3D printing based on stored digital arch models.

3. The method according to claim 1 or 2, wherein the step of producing the prostheses comprises a step of scanning products obtained following the occlusal registration, and a step of sending data of said scanning to a processing unit (C) for forming the prostheses.

4. The method according to any one of the preceding claims, wherein the step of orienting the preformed arch ( 16) is performed through the following steps:- measuring at least the distance (D) between the Camper’s plane (PC) and the occlusal plane (PO) of the patient;- adjusting the relative distance between an intraoral structure (12) and a frame (F) to which said intraoral structure (12) is connected, said relative distance being set based on said measured distance (D);- arranging the preformed arch (16) on the intraoral structure (12);- inserting the intraoral structure (12) into the patient's mouth and applying the preformed arch (16) to the support; and- adjusting the tilting of the frame (F) so that a plane (a) in which it lies substantially matches with the Camper’s plane (PC) .

5. The method according to any one of the preceding claims, comprising the steps of:- preliminarily forming an upper impression tray related to the patient;- taking the dental impression of the patient through said impression tray;- applying the preformed arch (16) to the upper impression tray while taking the impression;- forming a lower impression tray; and- performing the occlusal registration between the upper impression tray to which the preformed arch (16) is applied, said preformed arch being oriented with the reference to the Camper’s plane (PC), and the lower impression tray.

6. The method according to claim 5, wherein the lower impression tray comprises a rim for the registration of the occlusal parameters through the interaction with the upper preformed arch (16).

7. The method according to any one of claims 1 to 4, comprising the steps of:- applying the preformed arch (16) to a pre-existing prosthesis;- orienting the preformed arch (16) for the adjustment of the occlusal plane (PO); and- performing the occlusal registration between the preformed arch (16), which is oriented to the Camper’s plane (PC), and the opposite prosthesis in the patient's mouth.

8. The method according to any one of the preceding claims, further comprising the following steps of:- providing a further preformed arch (16’), which represents a further arch model, said further preformed arch (16’) comprising a deformable material (19);- deforming said deformable material (19) under the action of the patient's occlusal and masticatory dynamics;- analysing the deformation of said deformable material (19) after the interaction with the patient; and- forming the prosthesis based on the analysis of said deformation.

9. The method according to claim 8, wherein the deformable material (19) is a surface layer which represents the occlusal part of the further preformed arch (16’), said deformable material (19) being configured to deform under the action of the occlusal and masticatory individual forces of the patient and to maintain said deformation, wherein said deformable material (19) is a thermoplastic material or a moulded material, and wherein said analysing step involves reading the deformation shape, as well as the intensity, direction and way of the forces applied on said deformable material (19).

10. A method for producing dental prostheses, comprising the steps of:- adjusting the occlusal plane (PO) of the patient by using an intraoral structure (12) on which impression material is arranged, said intraoral structure (12) being inserted into the patient's mouth and being orientedfor the adjustment of said occlusal plane (PO);- forming an individual impression tray registered based on said adjustment of the occlusal plane (PO);- providing a preformed arch (16) which represents a dental arch model of a patient;- applying the preformed arch (16) to the formed individual impression tray;- forming an impression tray opposing to the impression tray on which the preformed arch (16) is applied;- taking the patient's impressions through said impression trays;- performing the occlusal registration between the individual impression tray comprising the preformed arch (16) and the opposing impression tray; and- producing the prostheses after the performed registration.

11. The method according to claim 10, wherein the intraoral structure (12) is an intraoral plate on which the step of applying impression material is performed and which comprises an insert (18) which is abutted on the patient's papilla controlling the tilting of the frame (F) and thereby adapting the impression material in the anatomical seat of interest, wherein the step of forming the individual impression trays and providing the preformed arch (16) is carried out analogically by the operator, or digitally by selecting the preformed arch (16) from software libraries, and / or wherein the individual impression tray comprising the preformed arch (16) is an individual upper impression tray and the opposing impression tray is a lower impression tray.

12. A system (10) for assisting the production of dental prostheses, comprising:- a frame (F) lying in a plane (a) and shaped to surround, at least partially, the head of a patient; and- an intraoral structure (12) configured to be inserted into the patient's mouth and connectable to the frame (F) by means of connection means (13), wherein the relative distance between the intraoral structure (12) and the frame (F) is adjustable by means of said connection means (13), wherein the frame (F) is configured to be adjustable so that the plane (a) in which it lies substantially matches with the Camper’s plane (PC) when the intraoral structure (12) is in the patient's mouth, and wherein the intraoral structure (12) is configured to house means for the registration of the parallelism between the Camper’s plane (PC) and the occlusal plane (PO) of the patient through adjustment of the frame (F) when the intraoral structure (12) is connected to the frame (F) and said distance (D) is substantially the distance between the Camper’s plane (PC) and the occlusal plane (PO) of the patient.

13. The system (10) according to claim 12, wherein the frame (F) is U- shaped and comprises a central portion (Fc) and two lateral portions (Fl) which extend from the central portion (Fc), said frame (F) being shaped to at least partially surround the patient's face by means of said lateral portions (Fl), in particular at the Camper’s plane (PC).

14. The system (10) according to claim 12 or 13, comprising a support element (11) connectable to the frame (F), wherein the connection means (13) of the intraoral structure (12) comprise a body (13j provided with a through recess configured to house said support element (11) and allow sliding therealong, and wherein said body (13’) acts as a support for the intraoral structure (12) and is fixable in a determined position on the support element (11), for example by means of a locking screw (13v), wherein the support element (11) is an element which extends along an axis (L-L) which is substantially orthogonal to the plane (a) of the frame (F) and is provided with indicator elements to adjust the relative distancebetween the frame (F) and the intraoral structure (12).

15. The system (10) according to any one of claims 12 to 14, comprising a papillameter (15) configured to determine the distance between the papilla and the upper lip of the patient, wherein the papillameter (15) is at least partially transparent.

16. The system according to any one of claims 12 to 15, comprising measuring means for measuring at least one anatomical parameter of a patient, wherein, when the distance between the intraoral structure (12) and the frame (F) is set based on said at least one anatomical parameter and said intraoral structure (12) is inserted into the patient's mouth, said frame (F) is located substantially at the Camper’s plane (PC), said intraoral structure (12) being tiltable by tilting the frame (F) for the correct registration of the occlusal plane (PO) of the patient.

17. The system (10) according to claim 16, wherein said at least one anatomical parameter is the distance (D) between the Camper’s plane (PC) and the occlusal plane (PO) of the patient.

18. The system (10) according to claim 16 or 17, wherein said measuring means comprise a measuring instrument (14) provided with a gripping portion (14a) shaped to be seized, and with a measuring portion (14b) shaped to abut on the patient’s nose wings, providing an indicative measure of said distance (D) .

19. The system (10) according to claims 15 and 18, wherein the measuring instrument (14) is at least partially transparent and couplable with the papillameter (15), said measuring instrument (14) and said papillameter (15) being couplable with each other and slidable with respect to each other along a longitudinal axis (H-H, H’-H’) thereof, allowing a combined measure.

20. The system (10) according to any one of claims 12 to 19, wherein the intraoral structure (12) is removably connectable to the frame (F) and is substantially parallel to the plane (a) of said frame (F) .

21. The system (10) according to any one of claims 12 to 20, comprising at least one preformed arch (16) which represents a reference dental arch model insertable into the patient's mouth, said preformed arch (16) being comprised in the means for adjusting the occlusal plane (PO) of the patient, preferably made of moulded or milled resin and preferably being an upper arch model.

22. The system (10) according to claim 21, wherein the preformed arch (16) is configured to be arranged on the intraoral structure (12) and to be applied by means of said intraoral structure (12) to an impression tray in the patient's mouth or to a pre-existing prosthesis in the patient's mouth or to an intraoral support for the adjustment of the occlusal plane (PO) of the patient and to perform registrations with the correct identification of said occlusal plane (PO) of the patient.

23. The system (10) according to any one of claims 12 to 20, comprising an insert (18) which is removably connectable to the intraoral structure (12) and configured to abut, in use, on the patient's papilla, said insert (18) being comprised in the means for adjusting the occlusal plane (PO) of the patient, wherein the intraoral structure (12) is configured to house impression material for the detection of at least part of patient’s edentulous crests, wherein the distance between the intraoral structure (12) and the frame (F) is set based on at least one anatomical parameter, and wherein said system (10) further comprises:- at least one moulded preformed arch (16) which represents a dental arch model, which is adapted to be applied to an impression tray, said impression tray being obtained and registered based on said detection by means of the intraoral structure (12); or- a processing unit (C) comprising a plurality of digital models of preformed arches (16), said processing unit (C) being configured to:- create one or more digital models of individual impression trays, in particular at least one upper impression tray, based onpreliminary impressions of the patient being taken and based on said detection;- identify the occlusal plane (PO) of the patient;- digitally place, on the individual impression tray model, a preformed arch (16) selected from the plurality of preformed arches, with the reference of the occlusal plane (PO) obtained in the previous step; and- send data to means for forming individual impression trays, for example a 3D printer.

24. The system according to any one of claims 12 to 23, wherein the intraoral structure (12) is in the form of an intraoral plate.

25. The system according to any one of claims 12 to 24, further comprising:- a structure (20) adapted to be applied to the head of a patient; and- connecting means between the structure (20) and the frame (F), said connecting means being configured to allow an adjustment of the relative positioning between said structure (20) and said frame (F) and to keep said frame (F) in a reference position, wherein said structure (20), when applied to the patient's head, is such as to make said system (10) self- supporting.

26. The system (10) according to claim 25, wherein the structure (20) is a spectacle mount or a mask configured to be worn by a patient.

27. The system (10) according to claims 25 and 26, comprising at least one indicator element (40) which is connected to a respective lateral portion (Fl) of the frame (F) and is maintained at a determined distance (Dis) with respect to the structure (20), said distance (Dis) being adjustable by means of adjustment means (50), wherein the position of the frame (F) is set by a spacer (45) connected to the indicator element (40) and to the frame (F).

28. The system (10) according to claim 12, wherein the intraoral structure (12) comprises an upper preformed injection arch (90a) and a lower injection support (90b) which are configured to be inserted into the patient's mouth, said system (10) further comprising an injection duct (95) adapted to allow the injection of impression material (M) into the patient's mouth, said injection duct (95) being in fluid communication with the intraoral structure (12), which comprises a plurality of holes (90h) and is configured to allow dispensing the impression material (M) that flows in said injection duct (95) through said holes (90h) towards the anatomical sites of interest of the patient, and wherein the upper preformed injection arch (90a) represents a reference dental arch model in the patient's mouth.

29. The system (10) according to claim 28, comprising a handle (90m) connected to the intraoral structure (12) and inside which the injection duct (95) extends.

30. The system (10) of claim 28 or 29, wherein the intraoral structure (12) comprises a film arranged thereon and configured to collect the impression material (M) exiting from the holes (90h) at the anatomical sites of the patient.

31. The system according to any one of claims 28 to 30, comprising measuring means for measuring at least one anatomical parameter of a patient, wherein, when the distance between the intraoral structure (12) and the frame (F) is set based on said at least one anatomical parameter and said intraoral structure (12) is inserted into the patient's mouth, said frame (F) is located substantially at the Camper’s plane (PC), said intraoral structure (12) being oriented based on the tilting of the frame (F)-32. The system according to any one of claims 28 to 31, comprising a structure (20) adapted to be applied to the head of a patient, for example a spectacle mount or a mask, and connecting means between the structure (20) and the frame (F), said connecting means being configuredto allow an adjustment of the relative positioning between said structure (20) and said frame (F) and to keep said frame (F) in a reference position, wherein said structure (20), when applied to the head of the patient, is such as to make said system (10) self-supporting.

33. The system (10) according to claims 29 and 32, wherein the handle(90m) is connected to the frame (F) and / or to the structure (20) by means of the connection means (13).

34. The system according to any one of claims 28 to 33, wherein the upper preformed injection arch (90a) and the lower injection support (90b) are connected together and formed as one piece.

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