CN106510865A - Guiding device for tooth coronal cavity preparation and making method thereof - Google Patents

Guiding device for tooth coronal cavity preparation and making method thereof Download PDF

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Publication number
CN106510865A
CN106510865A CN201610992546.9A CN201610992546A CN106510865A CN 106510865 A CN106510865 A CN 106510865A CN 201610992546 A CN201610992546 A CN 201610992546A CN 106510865 A CN106510865 A CN 106510865A
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China
Prior art keywords
tooth
substrate plate
marrow
guide
data
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CN201610992546.9A
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Chinese (zh)
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CN106510865B (en
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陈虎
吕培军
王勇
李虹
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Peking University School of Stomatology
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Peking University School of Stomatology
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C2204/00Features not otherwise provided for

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  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

The invention relates to a guiding device for tooth coronal cavity preparation and a making method thereof. The guiding device comprises a base plate (1) and a guiding structure (2) connected to the base plate, the center of the base plate (1) is provided with a coronal cavity-shaped face boundary positioning hole (5), the shape of the positioning hole (5) is the projection of the shape of a dental pulp chamber (6) and the shape of a root canal orifice (7) to a tooth crown along a guiding direction, the guiding direction (8) of the guiding structure (2) is the optimum direction of entrance into a medullary canal and the guiding direction is determined by an operator or is automatically calculated by a software algorithm. The making method of the guiding device comprises acquiring tooth three-dimensional shape data, then carrying out computer-aided design, and finally making the guiding device through a numerical control cutting or three-dimensional printing device. Through the making method, the personalized guiding device for entrance into a medullary canal is prepared and is used for accurate tooth coronal cavity preparation so that the occurrence of the mistake is reduced.

Description

Tooth opens the guide of marrow hole shape preparation and the method for making the device
Technical field
The present invention relates to a kind of guide that the shape preparation of marrow hole is opened for tooth, belongs to dental care technical field, bag Include substrate plate and guide frame, substrate plate tissue surface and the corona that marrow will be carried out openFace is fitted, and substrate plate central authorities have one Open marrow hole shapeFace boundary alignment hole, guide frame open the approach axis of marrow drill point for guiding.
The invention further relates to a kind of method for making above-mentioned guide, including 3-dimensional image inspection acquisition tooth table Face, pulp chamber and root pipe three-dimensional configuration data, complete the CAD of guide in three-dimensional reverse engineering software, with And the making of guide is completed by numerical control cutting or 3 D-printing equipment.
Background technology
In the root canal of oral cavity, pulp cavity enters into the first step for bizet preparation being whole treatment procedure, good pulp cavity Mouth design and success of the perfect pulp cavity preparation to root canal have very important significance.Pulp cavity is entered and is referred to outside by corona Portion enters pulp chamber, also known as opening marrow, it is desirable to can directly reach, enter root canal orifice;Bizet preparation is referred to by the preliminary of pulp chamber Preparation, reshaping, enable cleaning, the smooth entrance root pipe of apparatus of shaping root pipe.Describe for convenience, hereinafter pulp cavity is entered " opening the shape preparation of marrow hole " is collectively referred to as with bizet preparation.
It is appropriate to open marrow hole shape and be conducive to setting up apparatus into the linear passages of root pipe, retain to greatest extent again Tissue of tooth, to ensure maintenance and drag, this technology to oral cavity doctor has very big dependence.It is not accurate at present clinical Servicing unit guiding oral cavity doctor carries out out the shape preparation of marrow hole, doctor's x-ray tooth piece mainly according to two dimension, with reference to oneself to tooth Anatomical knowledge and clinical experience, conceive and design hole shape and axial direction that pulp cavity is entered, and the root in practical operation in brains Constantly adjust according to vision and touch feedback, ultimately form satisfactory bizet hole shape.If anatomic form of the doctor to tooth It is unfamiliar with, or in clinical manipulation, judges inaccurate, does not such as correctly tell pulp roof and pulp chamber bottom, or to tooth long axile Direction is held and is forbidden, then be readily formed and improperly open marrow hole shape, or even the serious complication such as bottom is worn or side is worn occur.Tooth The individual difference of form also increases out the difficulty of marrow hole shape preparation, and the pulp cavity and root canal morphology of textbook Plays is in clinic Uncommon, the variation of anatomic form and the calcification of pulp chamber often affect searching of the doctor to root canal orifice, easily omit root pipe or Person causes out marrow hole shape excessive.It can be seen that, oral cavity doctor not by servicing unit in the case of prepare it is tubular with pulp cavity and root The marrow hole shape of opening of state accurately mate is extremely difficult.
For this purpose, people are seeking accurately to prepare the method for opening marrow hole shape always, for example, swept using the computerized tomography of tooth Retouch data reconstruction and go out threedimensional model, accurately open marrow position so as to calculate.Chinese invention patent prospectus CN104751516A discloses a kind of tooth for root canal and opens marrow method and device, including from the meter comprising target tooth The image for suffering from Ya Chu centre positions is intercepted in calculation machine tomoscan CT sections, by carrying out separation calculation to the section, Obtain the threedimensional model of the target tooth;The root pipe of the target tooth is partitioned into from the sections of the CT comprising target tooth, And isolate the epimere root pipe of preset length;The center line of split root pipe is extracted, the center and the target tooth is calculated The intersection point of threedimensional model;Intersection point with the center and the target tooth threedimensional model as reference point, according to concrete image point Simultaneously marrow position is opened using what navigation system finally determined the target tooth in analysis adjustment point of penetration position.But, the method is main Refer to the extraction of tooth root pipe three-dimensional data and the algoritic module for opening marrow position is determined on mathematical model, actual determines Position needs the navigation system for giving complexity to complete, the method and device be not directed to position after open marrow hole shape preparation guiding side Case, it is impossible to provide intuitively operation guide for doctor.Also disclose in Chinese invention patent prospectus CN104958118A A kind of intelligent robot that marrow tooth preparation is opened for tooth, including draw-in groove, X-axis motion support plate, angle of drill bit fine setting mouth, Y Axle moving lever, angle of drill bit regulating rod, Z axis moving lever, control drive mechanism, flushing suck-back mechanism, drill bit;Control drive mechanism It is fixedly mounted on described Z axis moving lever, respectively with X-axis motion support plate drive mechanism, Y-axis moving lever drive mechanism, Z axis fortune Lever drive mechanism, angle of drill bit regulating rod drive mechanism, flushing suck-back mechanism, drill bit connection, for receiving outer computer Control information, the described X-axis motion support plate of control, Y-axis moving lever, Z axis moving lever, angle of drill bit regulating rod, rinse resorption Mechanism, bit operation, the robot can be accurate to drive drill bit to mesh based on the analysis to digitizing anatomical dental structured data The tooth body of mark tooth carries out preliminary forming and pulp cavity is opened.However, as oral cavity operating space is very narrow and small, making so high-precision The micro-robot of degree is high to technical requirements, at the same robot system must highly stable reliability with avoid doctor source life injury, R&D cycle is long, involves great expense, it is difficult to rapid to promote in clinic.
The content of the invention
The technical problem to be solved in the present invention is to provide a kind of guide that the shape preparation of marrow hole is opened for tooth, and using should Guide can easy and accurately guide the pulp cavity that doctor completes tooth root canal to enter, and auxiliary oral cavity doctor prepares proper When open marrow hole shape.
It is corresponding to this, another technical problem to be solved of the invention be to provide it is a kind of make tooth and open the shape preparation of marrow hole draw The method for leading device.
For the guide of marrow hole shape preparation is opened for tooth, the present invention guide include substrate plate and with the base The guide frame that base plate is connected, the channeling direction of guide frame be by operator according to the 3-dimensional image of tooth determine it is optimal Pulp cavity approach axis or the optimal pulp cavity approach axis automatically calculated by computer software algorithm, substrate plate tissue surface with The crown surfaces laminating of marrow is carried out out, substrate plate central authorities have one to open marrow hole shapeFace boundary alignment hole, location hole The border in hole be tooth pulp chamber form and root canal orifice form in channeling direction in the reverse direction to coronaThe projection in face.
Using the guide of said structure, as the border for positioning hole is that tooth pulp chamber form and root canal orifice form exist To corona on channeling directionThe projection in face, therefore guide is fixed on after crown surfaces, operator will open marrow car pin control System is in the range of positioning hole, and the channeling direction control car pin according to guide frame pierces direction, you can with accurate Marrow hole shape will be opened to be prepared as being capable of just the size of open pulp cavity and root canal orifice, the shape preparation of marrow hole is simply and easily completed out.
The a kind of of marrow hole shape preparation guide is opened as above-mentioned tooth of the invention to improve:Root canal orifice is designed on substrate plate Position and depth indicating marker, facilitate operator that the position of root canal orifice is found according to this mark, and control car pin and pierce depth Degree, accurately open root canal orifice, prepares the linear passages into root pipe.
The another kind of of marrow hole shape preparation guide is opened as above-mentioned tooth of the invention to improve:Substrate plate is in crown surfaces cheek The coverage of face and lingual surface exceedes 0.5~2mm of below height of contour line, produces mechanical fixing effect, side into undercut region Just guide stable is fixed on into target crown surfaces;Substrate plate has certain elasticity into the part in undercut region, is easy to Wearing in target tooth and take out.
For making the method that tooth opens marrow hole shape preparation guide, technical scheme comprises the steps: 1. pass through three-dimensional optical or Imaging Technology obtains the pulp chamber and root pipe epimere, crown surfaces three-dimensional data of target tooth, by number According to importing reverse engineering software or special designs software;2. determine that optimal pulp cavity enter according to the 3-dimensional image of tooth by operator Enter direction, or optimal pulp cavity approach axis are calculated automatically by computer software algorithm, be set to channeling direction;3. cut out corona Surface data, it is near, remote in coronaFace and buccal surface, lingual surface it is near in, it is remote in edge line be boundary line, cheek, tongue side are with corona cheek 0.5~3.0mm below face, lingual surface height of contour line is boundary, removes above-mentioned 4 boundary lines with the crown surfaces data of exterior domain;④ Crown surfaces data after cutting out form substrate plate tissue surface, substrate plate tissue surface edge along the outside 0~0.2mm of overall offset of normal direction Normal direction is outwards taken out 0.5~3.0mm of shell and forms substrate plate solid data;5. tooth pulp chamber and root canal orifice three-dimensional data are extracted, edge is drawn The opposite direction in direction is led to coronaFace projects, and the border of view field is opens marrow location hole border;6. location hole border edge Channeling direction stretching reaches the thickness of substrate plate and forms positioning hole sidewalls, and substrate plate 3D solid data are subtracted by Boolean calculation Go to position hole sidewalls, generate substrate plate central authorities opens marrow positioning hole;7. shaping-orientation structure, can be axial direction and guiding side To the song that the oriented parallel of parallel cube or cylinder, or a certain shape is formed after channeling direction stretching Face;8. designed guide frame is connected to into ground plane surface, completes the design of guide;9. the guiding for designing is filled Put data and import numerical control cutting equipment or 3 D-printing equipment, complete processing and fabricating.
Using above-mentioned preparation method, by three-dimensional optical or iconography scanning can provide dental surface and internal pulp chamber, The accurate three-dimensional image of root pipe;Optimal pulp cavity approach axis are determined according to 3-D view by operator, or by computer software Automatically the optimal pulp cavity approach axis for calculating are used as channeling direction, it is ensured that set up root canal therapy device into the straight line of root pipe Path, while the tissue of tooth of preservation health as far as possible;Based on accurate pulp chamber, root pipe three-dimensional data along channeling direction negative side To the border that marrow hole shape can be accurately determined out to crown surfaces projection;The three-dimensional data Jing numerical control cutting or three that design is completed Dimension is printed and can be processed for the completely personalized guide of every tooth, and the preparation of marrow hole shape is opened in accurate guiding.
Description of the drawings
With reference to the accompanying drawings and detailed description the present invention is described in further detail:
Fig. 1 is the left view that tooth of the present invention opens marrow hole shape preparation guide and tooth contour
Top views of the Fig. 2 for guide shown in Fig. 1
Longitudinal sections of the Fig. 3 for the I-I lines of guide and tooth shown in Fig. 1 in Fig. 2
Specific embodiment
By shown in Fig. 1, Fig. 2, Fig. 3, by taking maxillary first molar as an example, tooth of the present invention open marrow hole shape preparation guide by Substrate plate (1) and guide frame (2) composition being connected with substrate plate, substrate plate tissue surface (3) and coronaFace (4) phase Laminating, guide frame (2) are axially parallel with channeling direction (8), have positioning hole (5) region, the positioning inside substrate plate (1) The border of hole (5) and tooth pulp chamber (6) and root canal orifice (7) form along channeling direction (8) opposite direction in coronaFace (4) Projected boundary it is consistent.When opening the shape preparation of marrow hole of root canal is being carried out, guide is placed in marrow to be opened by operator Dental surface, the part for entering undercut region below height of contour line (11) by substrate plate itself produce mechanical fixing power and are fixed on Dental surface, or guide is adhered to into dental surface using bonding agent.Holding open marrow car needle shaft to guide frame (2) It is axially consistent, control car pin and abrade tissue of tooth in the border drawn a circle to approve by positioning hole, according on substrate plate (1) to root pipe Mouthful position and deep identification (12) prompting control pierce depth, until smoothly penetrating pulp cavity, will finally open the finishing of marrow hole shape with Location hole border (17) is consistent, completes the operation of pulp cavity entrance.What is so completed opens pulp cavity shape of the marrow hole shape then with tissue of tooth State and root canal orifice position match completely, are taking off net marrow top, are retaining health to greatest extent while setting up root pipe linear passages Tissue of tooth.
The preparation method for realizing guide in the present invention is as follows:Thrown according to computer restructuring tomography shadow by pencil-beam first As CBCT scans the pulp chamber (6) and root pipe epimere (13) three-dimensional data, crown surfaces (14) three-dimensional data that obtain target tooth, will Data import general reverse engineering software, and operator observes tooth and pulp chamber, the three-dimensional configuration of root pipe in software, incorporates experience into really Fixed optimal pulp cavity approach axis, or optimal pulp cavity approach axis are calculated automatically by computer software, and it is set to guiding Direction (8), cuts out crown surfaces data, it is near, remote in coronaThe near middle edge line (15) of face (4) and cheek lingual surface, remote middle side Edge line (16) is boundary line, and 0.5~3.0mm, as boundary, removes above-mentioned 4 below with corona cheek, lingual surface height of contour line (11) for cheek, tongue side With the crown surfaces data of exterior domain, the crown surfaces data after cutting out are along outside 0~0.2mm of the overall offset shapes of normal direction in bar boundary line Into substrate plate tissue surface (3), substrate plate tissue surface (3) outwards takes out 0.5~3.0mm of shell along normal direction and forms substrate plate (1) entity number According to;Tooth pulp chamber (6) and root canal orifice (7) three-dimensional data are extracted, the opposite direction along channeling direction (8) is to coronaFace (4) projects Location hole border (17) is generated, location hole border (17) form positioning along the thickness that channeling direction (8) is stretched beyond substrate plate (1) Hole sidewalls (18), substrate plate (1) 3D solid data deduct location hole side wall by Boolean calculation, so as to generate in substrate plate The positioning hole (5) of centre;Intended diameter 1mm, height 5mm, axially the cylinder parallel with channeling direction (8) is used as guide frame (2), the number of lead column can be designed as needed, typically consistent with the number of root canal, and designed lead column is connected to substrate Plate surface is near the position of root canal orifice;The arrow logo (12) of root canal orifice position is pointed in the design on substrate plate, and marks the position Depth of the dental surface away from root canal orifice is put, the design of guide is completed;Output guide three-dimensional design data, imports three-dimensional Printing device or numerical control cutting equipment, select suitable material to complete processing and fabricating.
The present invention is not limited to above-mentioned specific embodiment, in the ken that those of ordinary skill in the art possess It is interior, can be making a variety of changes on the premise of without departing from present inventive concept.

Claims (4)

1. a kind of guide that the shape preparation of marrow hole is opened for tooth, including substrate plate (1) and with leading that the substrate plate is connected To structure (2), it is characterised in that the channeling direction (8) of described guide frame (2) is according to the three-dimensional shadow of tooth by operator Automatically the optimal pulp cavity approach axis calculated as the optimal pulp cavity approach axis of determination or by computer software algorithm, institute State substrate plate tissue surface (3) and the corona of marrow will be carried out openFace (4) is fitted, and substrate plate (1) central authorities have one to open marrow Hole shapeFace boundary alignment hole (5), the border of positioning hole (5) is tooth pulp chamber (6) form and root canal orifice (7) shape State is in channeling direction (8) in the reverse direction to coronaThe projection in face (4).
2. guide according to claim 1, it is characterised in that have mark root canal orifice to be located on described substrate plate (1) Position and depth sign (12),.
3. guide according to claim 1 and 2, it is characterised in that described substrate plate (1) is in crown surfaces buccal surface (9) and the coverage of lingual surface (10) exceedes height of contour line (11) 0.5~3.0mm below, machinery is produced into undercut region Maintenance is acted on, and the substrate plate (1) has certain elasticity into the part in undercut region, is easy to wearing in target tooth and takes Go out.
4. a kind of method that tooth made described in claim 1 opens marrow hole shape preparation guide, it is characterised in that include with Lower step:1. pass through three-dimensional optical or Imaging Technology obtains the pulp chamber (6) and root pipe epimere (13), crown surfaces of target tooth (14) three-dimensional data;2. reverse engineering software or special designs software are imported data to, by operator according to the three-dimensional of tooth Image determines optimal pulp cavity approach axis, or calculates automatically optimal pulp cavity approach axis by computer software algorithm, is set to Channeling direction (8);3. crown surfaces data are cut out, it is near, remote in coronaFace (4) and buccal surface (9), lingual surface (10) it is near in Edge line (15), it is remote in edge line (16) be boundary line, cheek, tongue side with corona buccal surface (9), lingual surface (10) height of contour line (11) with Lower 0.5~3.0mm is boundary, removes above-mentioned 4 boundary lines with the crown surfaces data of exterior domain;4. the crown surfaces data after cutting out Substrate plate tissue surface (3) is formed along the outside 0~0.2mm of overall offset of normal direction, shell is outwards taken out along normal direction by substrate plate tissue surface (3) 0.5~3.0mm forms substrate plate (1) solid data;5. tooth pulp chamber (6) and root canal orifice (7) three-dimensional data are extracted, along guiding side Opposite direction to (8) is to coronaFace (4) projects, and the border of view field is opens marrow location hole border (17);6. location hole Border (17) forms positioning hole sidewalls (18) along the thickness that channeling direction (8) stretching reaches substrate plate (1), and substrate plate is three-dimensional real Volume data deducts positioning hole sidewalls (18) by Boolean calculation, and generate substrate plate central authorities opens marrow positioning hole (5);7. design Guide frame (2), can be axially parallel with channeling direction (8) cube or cylinder, or a certain shape The curved surface that oriented parallel is formed after channeling direction (8) stretching;8. designed guide frame (2) is connected to into substrate plate (1) Surface, marks position and the depth of root canal orifice, completes the design of guide;9. the guide data for designing are imported into number Control cutting apparatus or 3 D-printing equipment, complete processing and fabricating.
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Cited By (7)

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TWI633875B (en) * 2017-09-15 2018-09-01 霽邦有限公司 Method and system for manufacturing apical resection surgery guide plate and computer-readable recording medium
CN108618859A (en) * 2018-02-06 2018-10-09 北京大学口腔医学院 A kind of production method of high efficiency tooth preparation guide plate
CN108836521A (en) * 2018-05-03 2018-11-20 张艳玲 A kind of tooth opens the guide device of marrow hole shape preparation
CN110384566A (en) * 2018-04-16 2019-10-29 上海交通大学医学院附属第九人民医院 A kind of 3D printing tooth model
CN112603574A (en) * 2020-12-16 2021-04-06 北京大学口腔医学院 Lower jaw impacted wisdom tooth divides tooth guide rail
WO2022017008A1 (en) * 2020-07-20 2022-01-27 中国科学院深圳先进技术研究院 Root canal treatment guide plate and manufacturing method therefor
CN114267218A (en) * 2021-12-08 2022-04-01 泉州医学高等专科学校 Virtual simulation tooth marrow opening method, device and storage medium

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CN104751516A (en) * 2015-04-09 2015-07-01 范兵 Tooth pulp opening method and device for root canal therapy
CN104958118A (en) * 2015-07-20 2015-10-07 武汉大学 Intelligent robot used for tooth preparation during pulp opening of tooth
CN105596091A (en) * 2016-03-14 2016-05-25 四川大学 Navigation device for root canal treatment and making method thereof

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US6390814B1 (en) * 1999-08-18 2002-05-21 Vernon Gardiner Endodontic appliance which stops instruments from extending too far into a root canal during treatment
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Publication number Priority date Publication date Assignee Title
TWI633875B (en) * 2017-09-15 2018-09-01 霽邦有限公司 Method and system for manufacturing apical resection surgery guide plate and computer-readable recording medium
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CN108618859A (en) * 2018-02-06 2018-10-09 北京大学口腔医学院 A kind of production method of high efficiency tooth preparation guide plate
CN110384566A (en) * 2018-04-16 2019-10-29 上海交通大学医学院附属第九人民医院 A kind of 3D printing tooth model
CN108836521A (en) * 2018-05-03 2018-11-20 张艳玲 A kind of tooth opens the guide device of marrow hole shape preparation
WO2022017008A1 (en) * 2020-07-20 2022-01-27 中国科学院深圳先进技术研究院 Root canal treatment guide plate and manufacturing method therefor
CN112603574A (en) * 2020-12-16 2021-04-06 北京大学口腔医学院 Lower jaw impacted wisdom tooth divides tooth guide rail
CN112603574B (en) * 2020-12-16 2022-03-25 北京大学口腔医学院 Lower jaw impacted wisdom tooth divides tooth guide rail
CN114267218A (en) * 2021-12-08 2022-04-01 泉州医学高等专科学校 Virtual simulation tooth marrow opening method, device and storage medium
CN114267218B (en) * 2021-12-08 2023-09-08 泉州医学高等专科学校 Virtual simulated tooth marrow opening method, device and storage medium

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