CN109700532B - Individualized craniomaxillary face navigation registration guide plate and registration method thereof - Google Patents
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- CN109700532B CN109700532B CN201811543849.8A CN201811543849A CN109700532B CN 109700532 B CN109700532 B CN 109700532B CN 201811543849 A CN201811543849 A CN 201811543849A CN 109700532 B CN109700532 B CN 109700532B
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Abstract
The invention belongs to the technical field of craniomaxillofacial surgery, in particular to an individualized craniomaxillofacial navigation registration guide plate and a registration method thereof, wherein the registration guide plate comprises an occlusal plate and registration mark points, and the registration mark points are cones with the diameter of 1mm and the depth of 1 mm; the computer is used for designing, and the main structure of the computer comprises two parts, namely a bite plate part which can be in close contact with the maxillary dentition and registration mark points which are discretely distributed on the side edge and the wing part of the guide plate and used for point registration. The patient only needs to shoot one imaging examination in the initial diagnosis, so that secondary radiation injury can be avoided; simultaneously, a plaster model of maxillary dentition is prepared. The individualized craniomaxillary face navigation registration guide plate is a novel guide plate and combines a computer aided design technology, a three-dimensional printing technology and a navigation technology; the corresponding registration method utilizes the registration mark points of the virtual design to complete the system registration, and is an innovative registration method.
Description
Technical Field
The invention belongs to the technical field of craniomaxillofacial surgery, and particularly relates to an individualized craniomaxillofacial navigation registration guide plate and a registration method thereof.
Background
Registration is an important process for implementing surgical navigation techniques. The registration technology is a key core technology in optical navigation and is directly related to the precision of the whole system and the success or failure of computer-assisted surgery. The registration refers to a virtual coordinate system, i.e., a coordinate system formed in a computer image space after medical image processing of single-mode or multi-mode medical images such as CT, MRI and the like acquired before an operation and a world coordinate system, i.e., a coordinate system constructed by a positioning device of a navigation system in the operation and an actual spatial position of an anatomical structure of an operation area, so that the coordinate system and the world coordinate system establish an accurate corresponding relationship in the navigation system, and the coordinate system can accurately reflect the tracked motion of a probe, an operation instrument and a patient on a computer screen in real time.
Currently, common registration methods can be generalized to point registration and surface registration. Point registration, namely implanting an iconographically developable screw near an operation area of a patient before an operation, or pasting an iconographically developable marker on the surface of soft tissue, then performing CT scanning to obtain original data, and reconstructing a three-dimensional image of an operation area with a registration calibration point of the patient to perform system registration; carrying out system registration by using a special rigid structure of a patient, such as a special site of a tooth, a protruded bone point or a sunken bone point and the like; the trainee also has to embed screws or stuff dental material as positioning markers on the bite plate to perform the system registration. And (3) carrying out plane registration, namely carrying out system registration by using a laser scanning imaging technology or directly sliding and acquiring by using a navigation probe and using the self anatomical structure of the human body, mainly the skin surface around the forehead or the eye socket as a mark plane.
However, in clinical work, the inventor finds that in navigation-assisted craniomaxillofacial surgery (excluding mandible), 4-5 titanium nails are required to be implanted into an alveolar bone of a patient as registration mark points before operation by using point registration, and secondary CT examination is required to be carried out to develop the titanium nails so as to enable the titanium nails to be recognized by a navigation system, the titanium nails are implanted under local anesthesia, but invasive operation on the patient causes discomfort and even strong pain to some patients after the titanium nails are implanted, pain killers are required to be taken, and secondary radiation injury is caused to the patient by the secondary CT examination.
The method is characterized in that a marker which can be visualized by imaging examination is pasted on the craniomaxillary face, point registration is carried out, the risk of falling off before or during operation exists, the registration process of navigation is influenced, an occlusal plate made of self-solidifying plastics is used, screws or dental materials are embedded in the occlusal plate to be used as the marker, point registration is carried out, long preparation time is needed before the operation, and similarly, the two methods can cause secondary radiation damage to a patient in order to visualize the marker through secondary CT examination.
The anatomical landmark points are used for point registration, the cusp, the fossa or the gap of the maxillary tooth is usually selected, however, the CT examination has a certain magnification to the tooth, and the structure cannot be clearly displayed, so that an error is generated between the actual anatomical structure of the patient and the structure of the imaging data, and the target registration error of the navigation system is increased.
Therefore, the invention is a newly designed individual craniomaxillofacial navigation registration guide plate and a registration method thereof, which are individually designed for different patients, and point registration is carried out by using the guide plate, so that the method is a novel noninvasive method capable of avoiding secondary radiation damage, and the accuracy of the method can be popularized and widely applied in craniomaxillofacial cases after further verification.
Disclosure of Invention
To solve the problems set forth in the background art described above. The invention provides an individualized craniomaxillofacial navigation registration guide plate and a registration method thereof, which aim to solve the problems in the background technology.
In order to achieve the purpose, the invention provides the following technical scheme: the individualized craniomaxillary face navigation registration guide plate comprises an occlusal plate and virtual registration mark points which are discretely distributed on the side edge and wing parts of the guide plate, wherein the registration mark points are cones with the diameter of 1mm and the depth of 1 mm;
the registration method of the individualized craniomaxillofacial navigation registration guide plate comprises the following steps:
s1, only two examinations need to be completed during initial diagnosis of the patient: (1) completing the imaging examination, wherein the shooting range is from the top of the skull to the level of the hyoid bone; (2) preparing a plaster model of the maxillary dentition of the patient, designing by a computer, and processing and manufacturing by a three-dimensional printer;
s2, storing the (1) and the imaging data in a DICOM format, importing the data into design software of a computer, and reconstructing the data into a three-dimensional craniomaxillofacial skeleton model; (2) storing the plaster dental model into a three-dimensional virtual dental model in an STL format through a laser scanner; (3) replacing the dentition part of the three-dimensional virtual maxillary dental model with the maxillary dentition part of the three-dimensional craniomaxillofacial skeleton model, and storing the dentition part as a new three-dimensional craniomaxillofacial skeleton model; (4) designing an occlusal splint on the new three-dimensional craniomaxillofacial skeleton model through a reverse back-solving algorithm; (5) designing virtual registration mark points which are distributed discretely on the side edge and the wing part of the guide plate;
s3, (1) storing the new three-dimensional craniomaxillofacial skeleton model, the individualized craniomaxillofacial navigation registration guide plate and the operation simulation scheme into an STL format, and importing navigation system software; (2) the navigation reference frame is arranged on the forehead of the patient; (3) and in the navigation system, the virtual registration mark points of the navigation registration guide plate are utilized, and the navigation probe points are sequentially used for taking corresponding points on the guide plate to complete system registration.
Preferably, the material of the bite plate is the same as that of the registration mark point.
Compared with the prior art, the invention has the beneficial effects that: in order to avoid the injury of the implanted titanium nail to the patient, simplify the preoperative preparation process, shorten the preoperative preparation time and avoid the secondary radiation injury of the patient, the invention designs and manufactures a novel individualized craniomaxillofacial navigation registration guide plate. The individualized craniomaxillary face navigation registration guide plate is designed by a computer, and the major structure of the guide plate comprises two parts, namely an occlusal plate part which can be contacted with the maxillary dentition and a registration mark point for point registration. The occlusal plate part can be closely contacted with the upper jaw teeth; the registration mark points may be designed on the sides and wings of the guide plate in a discrete distribution. The patient only needs to shoot one imaging examination in the initial diagnosis, so that secondary radiation injury can be avoided; simultaneously, a plaster model of maxillary dentition is prepared. The individualized craniomaxillary face navigation registration guide plate is a novel guide plate and combines a computer aided design technology, a three-dimensional printing technology and a navigation technology; the corresponding registration method utilizes the registration mark points of the virtual design to complete the system registration, and is an innovative registration method.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:
FIG. 1 is a front view of the present invention;
FIG. 2 is a schematic top view of the present invention;
FIG. 3 is a three-dimensional craniomaxillofacial bone model;
FIG. 4 is a new three-dimensional craniomaxillofacial bone model with replaced maxillary dentition sections within the circle;
FIG. 5 is a design principle of an individualized craniomaxillofacial navigation registration guide plate;
FIG. 6 is a schematic illustration of intra-operative system registration;
in the figure: 1. a bite plate; 2. and registering the mark points.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example 1
Referring to fig. 1-6, the present invention provides the following technical solutions: the individualized craniomaxillary face navigation registration guide plate comprises an occlusal plate 1 and virtual registration mark points 2 which are discretely distributed on the side edge and wing parts of the guide plate, wherein the registration mark points 2 are cones with the diameter of 1mm and the depth of 1 mm;
the registration method of the individualized craniomaxillofacial navigation registration guide plate comprises the following steps:
s1, only two examinations need to be completed during initial diagnosis of the patient: (1) completing the imaging examination, wherein the shooting range is from the top of the skull to the level of the hyoid bone; (2) preparing a plaster model of the maxillary dentition of the patient, designing by a computer, and processing and manufacturing by a three-dimensional printer;
s2, storing the (1) and the imaging data in a DICOM format, importing the data into design software of a computer, and reconstructing the data into a three-dimensional craniomaxillofacial skeleton model; (2) storing the plaster dental model into a three-dimensional virtual dental model in an STL format through a laser scanner; (3) replacing the dentition part of the three-dimensional virtual maxillary dental model with the maxillary dentition part of the three-dimensional craniomaxillofacial skeleton model, and storing the dentition part as a new three-dimensional craniomaxillofacial skeleton model; (4) designing an occlusal splint on the new three-dimensional craniomaxillofacial skeleton model through a reverse back-solving algorithm; (5) designing virtual registration mark points which are distributed discretely on the side edge and the wing part of the guide plate;
s3, (1) storing the new three-dimensional craniomaxillofacial skeleton model, the individualized craniomaxillofacial navigation registration guide plate and the operation simulation scheme into an STL format, and importing navigation system software; (2) the navigation reference frame is arranged on the forehead of the patient; (3) and in the navigation system, the virtual registration mark points of the navigation registration guide plate are utilized, and the navigation probe points are sequentially used for taking corresponding points on the guide plate to complete system registration.
Specifically, the bite plate 1 and the registration mark point 2 are made of the same material.
After registration is completed, the surgeon may complete the procedure according to the preoperative surgical simulation protocol with navigation assistance. The navigation registration guide does not interfere with the surgeon's surgical procedure.
Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (2)
1. Individualized craniomaxillary face navigation registration baffle, including the bite-block, its characterized in that: virtual registration mark points are designed and distributed on the side edge of the bite plate and the wing part of the guide plate in a discrete mode, and the registration mark points are cones with the diameters of 1mm and the depths of 1 mm;
the registration method of the individualized craniomaxillofacial navigation registration guide plate comprises the following steps:
s1, only two examinations need to be completed during initial diagnosis of the patient: (1) completing the imaging examination, wherein the shooting range is from the top of the skull to the level of the hyoid bone; (2) preparing a plaster model of the maxillary dentition of the patient, designing by a computer, and processing and manufacturing by a three-dimensional printer;
s2, storing the (1) and the imaging data in a DICOM format, importing the data into design software of a computer, and reconstructing the data into a three-dimensional craniomaxillofacial skeleton model; (2) storing the plaster dental model into a three-dimensional virtual dental model in an STL format through a laser scanner; (3) replacing the dentition part of the three-dimensional virtual maxillary dental model with the maxillary dentition part of the three-dimensional craniomaxillofacial skeleton model, and storing the dentition part as a new three-dimensional craniomaxillofacial skeleton model; (4) designing an occlusal splint on the new three-dimensional craniomaxillofacial skeleton model through a reverse back-solving algorithm; (5) designing virtual registration mark points which are distributed discretely on the side edge and the wing part of the guide plate;
s3, (1) storing the new three-dimensional craniomaxillofacial skeleton model, the individualized craniomaxillofacial navigation registration guide plate and the operation simulation scheme into an STL format, and importing navigation system software; (2) the navigation reference frame is arranged on the forehead of the patient; (3) and in the navigation system, the virtual registration mark points of the navigation registration guide plate are utilized, and the navigation probe points are sequentially used for taking corresponding points on the guide plate to complete system registration.
2. The integrated craniomaxillofacial navigation registration guide of claim 1, wherein: the bite plate and the registration mark point are made of the same material.
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| CN113143457A (en) * | 2021-02-09 | 2021-07-23 | 席庆 | Maxillofacial operation auxiliary system and method based on MR head-mounted equipment |
| CN115153838A (en) * | 2022-05-16 | 2022-10-11 | 上海交通大学医学院附属第九人民医院 | Rapid craniomaxillofacial bone tissue operation navigation registration guide plate and registration method thereof |
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Application publication date: 20190503 Assignee: SHANGHAI UEG MEDICAL INSTRUMENT CO.,LTD. Assignor: SHANGHAI NINTH PEOPLE'S HOSPITAL SHANGHAI JIAOTONG University SCHOOL OF MEDICINE Contract record no.: X2022310000031 Denomination of invention: Individualized craniomaxillofacial navigation registration guide and its registration method Granted publication date: 20210730 License type: Common License Record date: 20220705 |
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