Dental x-ray imaging system

Abstract

A dental X-ray imaging system (1) comprises: a control unit (120) that controls operation of a rotary arm and controls X-ray irradiation; an occlusal force detection means (30) that is installed on a bite plate and is capable of detecting the occlusal force of a patient; a storage unit (140) that associates and stores detected occlusal force information and X-ray image information; a calculation unit (150) that creates treatment information suitable for a patient of interest through a calculation using the X-ray image information and the occlusal force information stored in the storage unit for the patient of interest; and a treatment information output means (160) that outputs the treatment information onto a network (200).

Description

Dental X-ray system

[0001] The present invention relates to a dental x-ray imaging system.

[0002] Conventionally, bite force sensor sheets that are inserted into the oral cavity and detect the bite force of the teeth as an electrical signal have been put to practical use. Measurements using bite force sensor sheets have been performed chairside in dental treatment equipment. In addition, dental X-ray imaging devices (see, for example, Patent Document 1) have been put to practical use, which irradiate and photograph the oral cavity while it is positioned in a predetermined position using a positioning bite plate. Conventionally, dental X-ray CT devices using cone beams and panoramic X-ray imaging devices capable of taking tomographic images of the dentition and the left and right temporomandibular joints have been used.

[0003] JP 2014-124287 A

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

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

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

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

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

[0009] 1A is a schematic diagram of a dental X-ray imaging system according to a first embodiment, showing the periphery of a rotating arm. FIG. 1B is a schematic diagram of the bite plate shown in FIG. 1A. FIG. 1C is a diagram showing an example of a head fixture used together with the bite plate. FIG. 1D is a functional block diagram showing the configuration of a dental X-ray imaging system according to a first embodiment. FIG. 1E is a flowchart showing the processing flow of the dental X-ray imaging system. FIG. 1F is a flowchart showing the processing flow using images stored in states of different occlusal forces. FIG. 1G is a flowchart showing the processing flow using images stored in states of constant occlusal forces but at different imaging times. FIG. 1H is a functional block diagram showing the configuration of a dental X-ray imaging system according to a second embodiment. FIG. 1I is a schematic diagram showing the lingual line of the dentition in an axial section of the mandible before treatment. FIG. 1J is a schematic diagram showing the lingual line of the dentition in an axial section of the mandible after treatment. FIG. 1J is a schematic diagram overlapping FIG. 1A and FIG. 1B. FIG. 1C is a diagram showing major prosthetic materials and their hardness. FIG. 1D is a schematic diagram showing the occlusal force distribution characteristics versus deflection area. FIG. 1E is a diagram showing an example of an image captured by a dental X-ray imaging system. FIG. 1F is a schematic diagram showing the occlusal force distribution characteristics versus gray value. FIG. 1F is a diagram showing an example of an image captured by a dental X-ray imaging system. 1 is a schematic diagram showing bite force distribution characteristics with respect to mandibular lower edge cortical bone thickness. FIG. 1 is a schematic diagram showing the articular disc position during mouth closure in a normal case. FIG. 2 is a schematic diagram showing the articular disc position during mouth closure in a case of temporomandibular joint disorder. FIG. 3 is a schematic diagram showing bite force distribution characteristics with respect to the probability of coincidence of articular disc position. FIG. 4 is a schematic diagram showing the configuration of a dental X-ray imaging system according to a third embodiment. FIG. 5 is a schematic diagram showing an example of a mandibular three-dimensional position data input means. FIG. 6 is a functional block diagram showing the configuration of a dental X-ray imaging system according to the third embodiment. FIG. 7 is a schematic diagram showing the amount of mandibular position movement in the x and y directions. FIG. 8 is a schematic diagram showing the amount of mandibular position movement in the y and z directions. FIG. 9 is a schematic diagram showing bite force distribution characteristics with respect to the amount of mandibular position movement. FIG. 10 is a schematic diagram of a modified bite plate. FIG. 11 is a schematic diagram of bite force detection means provided with impression materials on both sides. FIG. 12 is a schematic diagram of bite force detection means provided with a tooth-imprint shaped portion. FIG. 13 is a schematic diagram showing a modified occlusion detection means in a side view. FIG. 14 is a schematic diagram showing a modified occlusion detection means in a plan view.

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

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

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

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

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

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

[0016] The bite plate 10 is a bite tool for positioning the patient's dentition, and positions the patient's dentition inside the rotation area of ​​the X-ray generator 25 and the X-ray detection unit 26. The bite plate 10 shown in Fig. 1B is formed with a dentition positioning unit 12. Note that the attachment piece unit 11 is not shown in Fig. 1B. The bite plate 10 is provided with an occlusal force detection means 30. The occlusal force detection means 30 is capable of at least detecting the occlusal force of the patient.

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

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

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

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

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

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

[0023] The storage unit 140 stores the detected occlusal force information and the X-ray image information in association with each other. The storage unit 140 includes a read-only memory (ROM), a random access memory (RAM), a hard disk drive (HDD), etc., and stores various programs.

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

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

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

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

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

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

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

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

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

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

[0034] 1-1. The patient measurement information acquisition process (step S30) shown in Fig. 4 may be performed at least twice. In this case, the calculation unit 150 acquires multiple pieces of X-ray image information corresponding to at least two imaging sessions for the target patient and stores the acquired information in the storage unit 140. The calculation unit 150 calculates subtraction image data from the multiple pieces of X-ray image information stored in the storage unit 140 and creates medical information using the subtraction image data.

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

[0036] 1-2. When the patient measurement information acquisition process (step S30) shown in Fig. 4 is performed multiple times on the same day of treatment, the occlusal force setting value set in step S20 may be different. In this case, the calculation unit 150 acquires multiple pieces of X-ray image information with the occlusal force of the target patient set to different values ​​in at least two imaging sessions, and stores the information in the storage unit 140. The calculation unit 150 calculates differential image data from the multiple pieces of X-ray image information with different occlusal forces to create medical information.

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

[0038] Then, on the same day of treatment as the patient measurement information acquisition process 1, the operator sets a second occlusal force (step S20B) and performs the patient measurement information acquisition process 2. At this time, the second occlusal force may be set to, for example, 300 [N], and the patient may bite down hard on the occlusal force detection means 30. Note that the occlusal force detection means 30 ensures that the occlusal position during the patient measurement information acquisition process 1 and the occlusal position during the patient measurement information acquisition process 2 do not deviate. The patient measurement information acquisition process 2 is similar to the process of step S30 shown in FIG. 4 , and therefore its description will be omitted. Note that the calculation unit 150 associates the X-ray image information obtained in the patient measurement information acquisition process 2 with the second occlusal force and stores them in the memory unit 140.

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

[0040] 1-3. When the patient measurement information acquisition process (step S30) shown in Fig. 4 is performed multiple times across several treatment days, the occlusal force setting value set in step S20 may be the same. In this case, the calculation unit 150 acquires multiple X-ray image information with the occlusal force of the target patient set to be the same in at least two imaging sessions, and stores the information in the storage unit 140. The calculation unit 150 calculates differential image data from multiple X-ray image information with the same occlusal force to create medical information.

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

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

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

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

[0045] 1-4. In a modified example of the dental X-ray imaging system 1, the control unit 120 may prevent the operation of the rotating arm 21 and the X-ray irradiation if the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within a predetermined range. In other words, if the occlusal pressure due to proper occlusion cannot be obtained during X-ray imaging, X-ray imaging for that day may be suspended. Alternatively, the control unit 120 may include an alarm unit that displays and / or sounds an alarm when the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within a predetermined range, indicating the abnormality. This alarm unit issues a warning to encourage the patient to reposition. If X-ray irradiation is performed when the occlusal force measured by the occlusal force detection means 30 before X-ray irradiation is not within the predetermined range, the resulting X-ray image will be unreliable and useless. Therefore, X-ray imaging must be performed again with the pre-measured value within the predetermined range. In contrast to this, the above-described modified example has the effect of preventing exposure to radiation due to re-imaging by interrupting imaging or issuing a warning.

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

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

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

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

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

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

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

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

[0054] The characteristic storage unit 141 shown in FIG. 7 stores, for example, the distribution characteristics of the hardness application range shown in FIG. 10 . The distribution characteristics of the hardness application range shown in FIG. 10 are determined in advance according to the type of prosthetic material for the first and second indices, with the bite force measurement value as the first index and the jawbone deflection area in the subtraction image of the X-ray image as the second index. For example, of the measurement areas 301 and 302 when biting hard, measurement area 302 is located in the δ region and has a relatively large deflection area D. If a hard prosthetic material is used for a patient whose measurement area is in the δ region, the impact on the jawbone is significant. A material that is too hard can lead to oral collapse. On the other hand, measurement area 301 is located in the α region and has a relatively small deflection area D. If a hard prosthetic material is used for a patient whose measurement area is in the α region, the impact on the jawbone is minimal. For example, for a patient whose measurement area is in the α region when biting hard, hard zirconia can be used without any problems. For patients whose measurement range when biting down hard is in the δ region, it is desirable to use a hard resin with low hardness. Note that a material that can be processed with a 3D printer may be selected as the prosthetic material.

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

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

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

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

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

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

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

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

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

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

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

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

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

[0068] When using the distribution characteristics of the hardness application range shown in FIG. 14 , a prior determination by the determination unit 153 is required. If the thickness t0 of the mandibular lower edge cortical bone in a patient's X-ray image is smaller than a predetermined threshold, the determination unit 153 determines that the image is a case of osteoporosis. Conventionally, a screening method for osteoporosis has been known in which osteoporosis is indicated when the mandibular lower edge cortical bone becomes thin and is approximately 3 mm or less (see the reference below). Reference: "Japan Society of Dental Radiology, Osteoporosis Screening Materials, June 2021." Therefore, it is preferable that the threshold for the mandibular lower edge cortical bone thickness t0 be 3 mm.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0107] DESCRIPTION OF SYMBOLS 1, 1B, 1C Dental X-ray imaging system 13 Support 14 Slide main body 21 Rotating arm 23 Rotation center axis 25 X-ray generator 26 X-ray detection unit 10, 10D Bite plate 11, 11D Mounting piece 12 Tooth row positioning unit 30, 30B, 30C, 30D Occlusal force detection means 31, 31D Sheet unit 32 Pressure-sensing unit 33, 33D Connection unit 37 Control unit of occlusal force detection means 50 Lower jaw three-dimensional position data input means 51 Chip 120 Control unit 140, 140B, 140C Memory unit 141 Characteristics memory unit 150, 150B, 150C Calculation unit 151 AI calculation unit 152 Prosthetic material selection means 153 Determination unit 160 Clinical information output means 170 Communication unit 180 Display unit 190 Operation input / display unit 200 Network 210 Cloud 220 Facial 3D scanner 230 Intraoral 3D scanner 240 Intraoral observation camera 250 CAD CAM device 260 CT device 270 Swallowing movement analysis device

Claims

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

2. The dental X-ray imaging system according to claim 1, wherein the calculation unit has an AI calculation unit, and the AI ​​calculation unit creates current medical information using a learning model created by performing machine learning using past medical information of the target patient and other patients.

3. The dental X-ray imaging system according to claim 1, characterized in that the control unit issues a warning or does not start the operation of the rotating arm or the irradiation of X-rays if the measured value of the occlusal force measured by the occlusal force detection means before X-ray irradiation is not within a predetermined range.

4. A dental X-ray imaging system as described in any one of claims 1 to 3, characterized in that the calculation unit calculates differential image data from multiple X-ray image information obtained by taking at least two images of the target patient and stored in the memory unit, and creates the medical information using the differential image data.

5. The dental X-ray imaging system described in claim 4, characterized in that the calculation unit calculates differential image data from multiple X-ray image information obtained under different settings of the bite force of the subject patient in at least two exposures and stored in the memory unit, to create the medical information.

6. The dental X-ray imaging system described in claim 4, wherein the calculation unit calculates differential image data from multiple X-ray image information obtained under conditions in which the bite force of the subject patient is set to be the same in at least two imaging sessions and stored in the memory unit, to create the medical information.

7. A dental X-ray imaging system according to claim 4, wherein the calculation unit creates medical information for the target patient, including information on jawbone bending.

8. The dental X-ray imaging system according to claim 7, wherein the calculation unit calculates difference image data in the axial plane from multiple X-ray image information about the target patient stored in the memory unit, estimates the location and amount of bending of the jawbone from the position and area where the difference image is displayed, and creates medical information including the location and amount of bending of the jawbone as information about the bending of the jawbone.

9. A dental X-ray imaging system as described in claim 8, characterized in that it comprises a characteristic memory unit that stores distribution characteristics of hardness application ranges determined in advance according to the type of prosthetic material for the first index and the type of prosthetic material for the second index, with the bite force measurement value being a first index and the jawbone deflection area in the difference image of the X-ray image being a second index, the calculation unit has a prosthetic material selection means that refers to the distribution characteristics and selects a prosthetic material that matches the information on the jawbone deflection area and bite force information measured for the target patient, and the medical information output means outputs medical information for the patient that includes at least information on the selected prosthetic material.

10. A dental X-ray imaging system as claimed in any one of claims 1 to 3, characterized in that it comprises a characteristic memory unit which stores distribution characteristics of hardness application ranges determined in advance according to the type of prosthetic material for a patient's X-ray image, with occlusal force measurement values ​​as a first index and shading values ​​of a predetermined extracted portion of the patient's X-ray image as a second index, the distribution characteristics being determined using the first index and the shading values ​​of a predetermined extracted portion of the patient's X-ray image as a second index, the calculation unit comprising: a determination unit which determines that the image is a case of osteoporosis if the shading values ​​of the extracted portion of the patient's X-ray image are darker than a predetermined threshold; and a prosthetic material selection means which, when determined to be a case of osteoporosis, refers to the distribution characteristics and selects a prosthetic material that matches the shading values ​​of the extracted portion of the X-ray image taken of the patient and information on occlusal force, and the medical information output means outputs medical information of the patient including at least information on the selected prosthetic material.

11. A dental X-ray imaging system as claimed in any one of claims 1 to 3, characterized in that it comprises a characteristic memory unit which stores distribution characteristics of hardness application ranges determined in advance according to the type of prosthetic material for a first index and a second index, the first index being a bite force measurement value and the thickness of the cortical bone at the lower edge of the mandible at a predetermined extracted site on the patient's X-ray image, the calculation unit comprising: a determination unit which determines that the X-ray image of the patient is a case image of osteoporosis if the thickness of the cortical bone at the lower edge of the mandible is smaller than a predetermined threshold; and a prosthetic material selection means which, when determined to be a case image of osteoporosis, refers to the distribution characteristics and selects a prosthetic material that matches the information on the cortical bone thickness at the lower edge of the mandible and bite force on the X-ray image taken of the patient, and the medical information output means outputs medical information of the patient including at least information on the selected prosthetic material.

12. A dental X-ray imaging system as described in any one of claims 1 to 3, wherein the calculation unit creates medical information for the target patient, including information regarding the temporomandibular joint.

13. A dental X-ray imaging system according to claim 12, characterized in that it comprises a characteristic memory unit which stores distribution characteristics of hardness application ranges determined in advance according to the type of prosthetic material for the first index and the second index, the first index being the bite force measurement value and the second index being the match probability calculated by pattern recognition of X-ray images so that the probability when the articular disc is in the correct position is 100% and the probability decreases when the articular disc is not in the correct position, the calculation unit having prosthetic material selection means which calculates the match probability of the articular disc position by pattern recognition of the X-ray image of the target patient and selects a prosthetic material that matches the calculated match probability and bite force information for the patient by referring to the distribution characteristics, and the medical information output means outputs medical information for the patient including at least information on the selected prosthetic material.

14. A dental X-ray imaging system as described in any one of claims 1 to 3, further comprising a mandibular three-dimensional position data input means capable of acquiring three-dimensional position data of the mandible when the patient's upper jaw is placed on the bite plate, wherein the memory unit stores the detected bite force information in association with the three-dimensional position data of the mandible, and the calculation unit creates medical information for the target patient that includes at least one of mandibular position information and bite registration information.

15. A dental X-ray imaging system according to claim 14, characterized in that the mandibular three-dimensional position data input means comprises a chip that can be attached directly or indirectly to the mandibular teeth and that can be detected optically, electromagnetically, by acceleration, or by ultrasonic waves.

16. The dental X-ray imaging system of claim 14, wherein the memory unit stores information including the bite force, the three-dimensional position of the lower jaw, and the X-ray image before opening, obtained by taking at least two images before and after opening in a series of mouth opening movements for the target patient, and the bite force, the three-dimensional position of the lower jaw, and the X-ray image after opening, and the calculation unit calculates the difference information of the bite force, the difference information of the three-dimensional position of the lower jaw, and the difference information of the X-ray image obtained before and after opening from the information stored in the memory unit, thereby creating the medical information including the difference information.

17. A dental X-ray imaging system as described in claim 16, characterized in that the lower jaw three-dimensional position data input means is capable of acquiring three-dimensional position information of the lower jaw during opening, which is the period from before opening to after opening in the series of opening movements, and has output information that can display the trajectory of the lower jaw and / or output information that can analyze the lower jaw movement based on the acquired information.

18. The dental X-ray imaging system according to claim 16, which transmits and receives data to and from at least one of a facial 3D scanner, an intraoral 3D scanner, an intraoral observation camera, a CAD / CAM device, a CT device, and a swallowing movement analysis device, all of which are connected to a network.

19. A dental X-ray imaging system as described in claim 14, characterized in that it comprises a characteristic memory unit that stores distribution characteristics of hardness application ranges determined in advance according to the type of prosthetic material for the first index and the amount of mandibular position movement measured by the mandibular three-dimensional position data input means as a second index, with the bite force measurement value being used as a first index, and the amount of mandibular position movement measured by the mandibular three-dimensional position data input means being used as a second index, the calculation unit has prosthetic material selection means that refers to the distribution characteristics and selects a prosthetic material that matches information on the amount of mandibular position movement measured for a target patient, and the medical information output means outputs medical information for the patient that includes at least information on the selected prosthetic material.

20. A dental X-ray imaging system as claimed in any one of claims 1 to 3, wherein the occlusal force detection means comprises a flexible sheet, and the flexible sheet is provided with a pressure-sensing section in which a pair of electrodes are arranged opposite each other in the thickness direction of the sheet.

21. A dental X-ray imaging system according to claim 20, wherein the occlusal force detection means comprises impression materials arranged on both sides of the flexible sheet so as to cover the surface of the flexible sheet.

22. A dental X-ray imaging system according to claim 20, wherein the occlusal force detection means is detachably attached to the slide main body.

23. A dental X-ray imaging system according to claim 20, wherein the flexible sheet is detachably attached to a control unit of the occlusal force detection means.

24. A dental X-ray imaging system according to any one of claims 1 to 3, characterized in that the occlusal force detection means is capable of detecting the load ratio for each tooth.

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