CN110368109A - One kind arranging tooth method based on personalized bowed precision data - Google Patents
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- A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
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Abstract
The present invention provides a kind of based on personalized bowed precision data row tooth method, when correction digitizes row's tooth, it fully considers individual difference, bends personalized arch wire according to the base Bones morphology of its own, specific torque and inclination data comprising root information is added and carries out row's tooth.Avoid empirical row's tooth because of error caused by the factors such as artificial, ensure to arrange the accuracy of tooth process, and corona and root of the tooth are considered comprehensively during arranging tooth, the 3D control of tooth integral position is realized, to avoid the generation for phenomena such as clinically causing not parallel fenestration, bone cracking, root of the tooth, External apical root resorption because ignoring root of the tooth position to the greatest extent.
Description
Technical field
The present invention is a kind of digitlization row's tooth method applied to orthodontic field, especially a kind of based on personalization
Bowed precision data arrange tooth method.
Background technique
Clinic orthodontic treatment at present mostly uses straight wire appliance theoretical, and in straight wire appliance theory up and down
The arrangement of jaw corona is based on six tooth standardizations of Andrews, and the measurement based on corona does not include root of the tooth, however tooth
Hat arrangement is not meant to that root of the tooth is also arranged in reasonable position when normal.There is scholar to find orientation and the raw silk rings of root of the tooth
The orientation of corona has difference in begg appliance technical know-how.Clinically, whether the arrangement of root of the tooth is well evaluation therapeutic effect
One of standard, incomplete orthodontic treatment may cause that root of the tooth is not parallel, root of the tooth is exposed, bone cracking and fenestration etc. are postoperative
A possibility that bad phenomenon increases periodontal damage risk, increases extraction of tooth space recurrence, influences the effect of correction long-term postoperative holding
Fruit.In addition, clinician seldom considers the difference between dental arch individual, but the form of dental arch, size will fully take into account carrying tooth
The base bone situation of tooth will equally face fenestration and open when orthodontic treatment makes tooth move out the reconstruction range of alveolar bone
It splits, influences periodontal health and correction post surgery stabilization.
Preoperative diagnosis is carried out using various forms of row's tooth methods in clinic at present, as based on traditional plaster cast
Manual teeth arrangement method, computer digital teeth arrangement method.Traditional-handwork row's tooth is time-consuming and laborious, accuracy is poor, and can not consider root of the tooth feelings
Condition；Although existing computer digital teeth arrangement method it can be observed that root of the tooth and alveolar bone relationship, but still be empirical row
Tooth, and the considerations of lack to dental arch individual difference, therefore current row's tooth method can not effectively evade above-mentioned risk.
Summary of the invention
The present invention provides one kind and arranges tooth method based on personalized bowed precision data, when correction digitizes and arranges tooth,
It fully considers individual difference, personalized arch wire is bent according to the base Bones morphology of its own, is added comprising including root information
Row's tooth is carried out after torque and inclination data.
Realization of the invention is based on personalized bowed precision data row tooth, the specific steps are as follows:
1) it is fitted personalized arch:
1. obtaining the CBCT data of research object and carrying out image procossing, lower jaw jawbone and upper mandibular dentition three are obtained
STL formatted file after dimension reconstruction；
2. the determination of each index point and coordinate: corona central point CC point, root of the tooth central point RC point, tooth long axile TLA, cheek
Side basal arch index point BAP point, tongue side basal arch index point LAP point；Base bone index point AP is BAP point, LAP point midpoint；
3. calibrating origin and coordinate system, and carry out three-dimensional coordinate two dimension conversion；
4. obtaining personalized dental arch curve；
2) data arrange tooth:
1. the foundation of one volume data of crown root row's dental cast；
2. arranging the establishment of tooth standard and the selection of normal tooth data；
3. the foundation of each index point and tooth three-dimensional system:
I corona central point CC point；
II root of the tooth central point RC point；
III long axis of tooth TLA；
IV rotation center；
V constructs plane；
VI tooth three-dimensional system；
4. computer arranges tooth:
I determines every sound of baby talk hat central point (CC point) of relative positional relationship and lower jaw of patient's mandibular dental arch and jawbone
Coordinate；
II arranges mandibular dentition；
III arranges maxillary dentition, completes upper and lower dentition matching；
IV fine tuning.
Step 2) data row tooth of the present invention 1. arrange in the foundation of dental cast by one volume data of crown root, for crown root one
It is to be preced with three-dimensional center point and root three-dimensional center point and connect into long axis of tooth TLA that data, which arrange tooth mode,.
3. in the foundation of each index point and tooth three-dimensional system, postoperative tooth closes flat step 2) data row tooth of the present invention
Face is simultaneously indirect according to definition foundation, but establishes indirectly, by measuring CBCT tripleplane, the SN plane OP tooth measured
The range of normal value for closing plane, making individual SN plane in CBCT and rotating normal value angle can be obtained postoperative tooth conjunction
Plane.
The data row tooth of step 2) of the present invention 4. arrange in tooth by computer, the base obtained according to the personalized arch of fitting
Every corona central point is arranged in above as row's arch form curve in the personalized arch of individual base bone.
The data row tooth of step 2) of the present invention 4. arrange in tooth by computer, first that tooth is long in arrangement when mandibular dentition
Axis zero, i.e. torque and axial rake zero, then the angle that the torque of tooth and axial rake rotation is fixed.
The data row tooth of step 2) of the present invention 4. arrange in tooth by computer, after completing torque and the setting of axial rake,
It needs situation of the root of the tooth in jawbone to be finely adjusted, root of the tooth is made to accomplish no fenestration, bone-free cracking.
The invention has the advantages that avoiding empirical row's tooth because of error caused by the factors such as artificial, it is ensured that row's tooth process
Accuracy, and consider corona and root of the tooth comprehensively during arranging tooth, the 3D control of tooth integral position realized, thus most
Big degree avoids clinically causing fenestration, bone cracking, the not parallel, External apical root resorption of root of the tooth etc. existing because ignoring root of the tooth position
The generation of elephant.Crown root one personalized bracket is rectified under the improvement and area of computer aided of the final stealthy row's tooth software of guidance commercialization
Control the design of device system.
Detailed description of the invention
Fig. 1 is the CBCT three-dimensional data schematic diagram of jawbone.
Fig. 2 is the CBCT three-dimensional data schematic diagram of denture.
Fig. 3-1, Fig. 3-2 are the positioning schematic diagram of cheek side basal arch index point BAP.
Fig. 4-1, Fig. 4-2, the positioning schematic diagram that Fig. 4-3 is tongue side basal arch index point LAP.
Fig. 5 is the establishment schematic diagram of coordinate system.
Fig. 6 is personalized dental arch curve schematic diagram.
Fig. 7-1, Fig. 7-2 are the positioning schematic diagram of corona center CC point.
Fig. 8 is the positioning schematic diagram of root of the tooth center RC point.
Fig. 9 is tooth long axile TLA schematic diagram.
Figure 10-1, Figure 10-2 establish schematic diagram for tooth three-dimensional system.
Figure 11-1, Figure 11-2 are that the shaft rake (middle-distant direction gradient) of tooth and cheek-tongue direction tilt schematic diagram.
Figure 12-1, Figure 12-2 are rotation (can be near and far direction, cheek-tongue direction) schematic diagram of long axis of tooth.
Specific embodiment
1-12 with reference to the accompanying drawing, the present invention is described further.
Realization of the invention is based on personalized bowed precision data row tooth, the specific steps are as follows:
One, it is fitted personalized arch:
1. experimental subjects: individual normal occlusion CBCT.
2. shooting CBCT:
Research object shoots conical beam CT, takes seat, and (same radiation technician shooting) CBCT is shot under natural head posture,
Obtain DICOM file.
3. data acquisition and image procossing:
Research object CT image DICOM format is imported into software Mimics17.0, research needed for extracting is adjusted by threshold value
Lower jaw jawbone and upper mandibular dentition data on object generate the 3D rendering of denture, jawbone, carry out the Three-dimensional Gravity of denture, jawbone
It builds.Finally will treated CT data with the output of stl file format, obtain denture STL, jawbone STL and all single tooths
STL。
4. stl file is imported software 3-matic10.0, the positioning of index point is carried out:
1) corona center CC point: corona horizontal plane divides tooth equally and closes (cutting) gum diameter, and sagittal plane divides equally near and far diameter, coronal-plane
It is respectively preced with corona lip (cheek) tongue diameter, three orthogonal plane point of intersection are defined as corona central point.
2) root of the tooth center RC point: the fix-point method at root of the tooth center is consistent with corona center, is located at half positioning in root
Root of the tooth center.
3) cheek side basal arch index point BAP point: for same tooth position lip (cheek) side alveolar process most salient point.
4) tongue side basal arch index point LAP point: crossing tooth long axile for BAP point and do vertical line, in the intersection point of tongue side tooth grain bone.
5) base bone index point AP point: take the midpoint BAP, LAP as base bone index point AP point.
5. calibrating origin and coordinate system, and carry out three-dimensional coordinate two dimension conversion:
Lower jaw AP point coordinate is imported in MATLAB software, generates plane using least square method.Using this plane as X-
Y plane；The vertical line of AP37, AP47 line is done to cross the midpoint AP31, AP41 as Y axis；Intersection point is origin O；Perpendicular to Y-axis, and mistake
O point is X-axis；It is Z axis that origin, which is crossed, perpendicular to X-Y plane, establishes three-dimensional system of coordinate.X-Y plane throwing is carried out to base bone index point
Shadow, the coordinate after obtaining two dimension conversion.
6. the selection of regression equation:
Inventor studies individual normal occlusion crowd, to each tooth position dental arch of lower jaw, basal arch length, width into
Row correlation analysis, analysis and research base bone, dental arch are in the relationship of same tooth position, and obtaining regression equation, (WiCC is corresponding tooth position
Width between bilateral tooth；WiAP width between the bilateral base bone of corresponding tooth position；DiCC is the arch length of corresponding tooth position；DiAP is
The base bone length of corresponding tooth position).
Table 1: bilateral labial teeth area, premolar teeth area, area's dental arch of grinding one's teeth in sleep, basal arch width correlation analysis:
(width correlation between CC ' point, AP ' point)
* P < 0.001
Table 2: bilateral labial teeth area, premolar teeth area, area's dental arch of grinding one's teeth in sleep, basal arch length correlation analysis:
(CC point, AP point length correlation)
* P < 0.001
7. obtaining personalized dental arch curve:
When clinical application base bone predicts lower jaw personalization arch, by the way that individual base bone width, the calculating of length is imported
In aforesaid equation, width, the length of the corresponding tooth position of dental arch are obtained, to obtain each tooth position hat center point prediction coordinate xi=
WiCC/2, yi=D7CC-DiCC.The coordinate of obtained every tooth is imported into OriginPro2017 software, using quadravalence
Polynomial function is fitted the function of prediction dental arch, obtains the personalized bowed function expression Y=a of lower jaw4X4+a3X3
+a2X2+a1X+a0。
Two, data arrange tooth:
1. the foundation of one volume data of crown root row's tooth mode:
The DICOM file that CBCT is obtained will be shot to import in 17.0 software of Mimics, adjusted by threshold value needed for extracting
The object data (denture/jawbone) of research generates the 3D rendering of denture and jawbone, completes the three-dimensional reconstruction of tooth jaw.It finally will place
CT data after reason obtain denture STL, jawbone STL and all single tooth STL with the output of stl file format.
2. the establishment of row's tooth standard and the selection of bioocclusion tooth data:
(1) molar relation: the nearly middle cheek point of maxillary first molars is snapped at the mesiobuccal groove of first permanent mandibular molar
In；The nearly middle the tip of the tongue of maxillary first molars is snapped in the central fovea of Mandibular Second Molar Tooth；The occlusion of upper jaw bicuspid cheek point
In the adjacent gap to jaw tooth；The tip of the tongue of upper jaw bicuspid is snapped in the central fovea of lower jaw bicuspid；Eye tooth is snapped at down
The adjacent gap of jaw canine tooth and first bicuspid, and cusp it is slightly partially close in；Maxillary incior covers mandibular incisors, upperdental arch middle line
Unanimously.
(2) tooth it is close, it is remote in tilt (Guan Jiao, axial rake): represent tooth it is close, remote in inclined degree.Tooth long axis
Gum end to Guan Jiao is positive value when inclination in remote, Guan Jiao is negative value when to mesial inclination.
(3) tooth lip (cheek), Linguoclination (hat inclination, hat torque): lip (cheek) Linguoclination degree of tooth long axis is known as
It is preced with inclination angle or hat torque.
(4) rotate: bioocclusion should be rotated without unsuitable tooth.
(5) gap: bioocclusion dental arch Tooth all remains in contact with one another, and exists without diastema.
(6) tooth jaw curve: the vertical jaw curve of bioocclusion is more straight, or slightly Spee curve, the depth of Spee curve
For 0~2.5mm.
This row tooth method substantially based on above-mentioned six tooth standardizations, but axial rake (2) in six tooth standardizations and
The data such as angle of torsion (3) change the crown root integration data for making that the scholars such as Qinghua LIU include root information.Because of each area ethnic group
Dental cases it is different, it is different so six tooth standardizations are main in actual operation or rely on the subjective judgement of doctor
Doctor has different judgements to this.And the data standard that six teeth close all is only the data measured to tooth mould, this is only capable of
Reflect the corona situation of tooth and can not reflect root of the tooth situation, doctor determines that therapeutic scheme will be led according only to corona situation
The uncertain of orthodontic treatment effect is caused, therefore, in conventional orthodontic treatment, the clinical experience of doctor is most important.Existing skill
Simulation row's tooth and personalized treatment are carried out although also having in art and obtaining three-dimensional dental arch model using scanning, arranges tooth process
Or it is identical as conventional method.In order to fully consider root of the tooth situation, reduction subjective factor as far as possible influences, and this programme uses
The crown root integration data comprising root information for the Chinese that the scholars such as Qinghua LIU are measured with Dolphin software.In row's tooth
When, the corona axial rake and words of every tooth are accurately arranged to gradient according to this, further according to the tooth of arranged tooth
The relationship of root and bone is finely tuned.
Following table is the bioocclusion data comparison of different measurement methods and different regions:
Table 3: each near and far gradient comparison (°) of scholar:
Table 4: each scholar's lip (cheek) tongue is to torque versus (°):
3. the foundation of each index point and tooth three-dimensional system:
1) corona central point: corona horizontal plane divides tooth equally and closes (cutting) gum diameter, and sagittal plane divides equally near and far diameter, and coronal-plane is equal
Divide hat corona lip (cheek) tongue diameter, three orthogonal plane point of intersection are defined as corona center (Crown Center, CC) point.
2) root of the tooth central point: the fix-point method at root of the tooth center is consistent with corona center, is located at half in root and positions tooth
Root center.
3) tooth long axile: the line at corona center and root of the tooth center is as connected.
4) rotation center: corona center.
5) it constructs bite plane: pinpointing bilateral sella turcica (S point), nasion (N as follows in Mimics software
Point).3 points of composition SN planes.It imports in 3-matic software, is obtained according to the obtained CBCT measurement of the scholars such as Wu Mingming
15.84 ± 4.07 ° of the standard value of SN-OP angle obtains postoperative bite plane for 15.84 ° of SN Plane Rotation.
Table 5: the definition of individual normal occlusion cephalometric landmark in CBCT image:
6) foundation of tooth three-dimensional system: adjustment z-axis first is vertical with bite plane and Chong Die with tooth long axile LAT, with
Cross corona be centrally and perpendicular to z-axis the near and far direction of tooth it is Chong Die with x-axis, be centrally and perpendicular to the straight line of x, z-axis to cross corona
For y-axis.
4. computer arranges tooth:
The STL formatted file of every tooth is imported into 3-matic Research 10.0 (x64), according to scholars such as Qinghua LIUs
Obtained crown root integration data standard carries out row's tooth.
1) rule of the denture and jaw relation obtained according to inventor, by step 1 determine patient's mandibular dental arch with
Every sound of baby talk of relative positional relationship and lower jaw of jawbone is preced with center point coordinate.
2) mandibular dentition is arranged:
A. by the corona axial rake and lip (cheek) Linguoclination degree zero of every tooth.[corona axial rake be tooth long axile with
Angle composed by bite plane vertical line, such as Figure 11-1, with projection of the tooth long axile in above-mentioned definition near and far face and z
Angle formed by axis (vertical line that z-axis is bite plane) is its corona axial rake (included angle A)；Lip (cheek) Linguoclination degree is clinic
Angle formed by the tangent line and bite plane vertical line at corona midpoint, as shown in Figure 11-2, with the tooth long axile in above-mentioned definition in lip
Angle formed by projection and z-axis on (cheek) lingual surface is its lip (cheek) Linguoclination degree (included angle B)].
B. using the corona central point of every tooth as origin, by tooth along x, y-axis direction in coordinate system defined above
It rotates a certain angle and (specific rotation numerical can be inputted in 3-matic), which sees Tong data.
C. every tooth position is positioned according to the obtained corona center point coordinate of step 1, and by tooth according to step
One obtained personalized arch is lined up, and so far, mandibular teeth arrangement is completed.
3) maxillary dentition is arranged:
A. with step 2 A, B, C.
B. it according to the mandibular dentition arranged, is arranged referring to occluding relation and the normal overbite covering of bioocclusion
Column maxillary dentition.Maxillary teeth arrangement is completed, and the matching of upper mandibular dental arch is completed.
4) in order to maintain correctly to contact and avoid interference between tooth, in tooth moving step collision detection be must
Must, it is translucent to be adjusted to jawbone model in 3-matic software for the interference portion in detection, observe root of the tooth
With the positional relationship of jawbone, and it is finely adjusted.
The foregoing is merely the preferred embodiment of the present invention, are not intended to restrict the invention, for this field
For technical staff, the invention may be variously modified and varied.All within the spirits and principles of the present invention, made
What modification, equivalent replacement, improvement etc., should all be included in the protection scope of the present invention.
Claims (6)
1. one kind arranges tooth method based on personalized bowed precision data, it is characterized in that: including the following steps:
1) it is fitted personalized arch:
1. obtaining the CBCT data of research object and carrying out the processing of image, lower jaw jawbone and upper mandibular dentition Three-dimensional Gravity are obtained
STL formatted file after building；
2. the determination of each index point and coordinate: corona central point CC point, root of the tooth central point RC point, tooth long axile TLA, cheek side group bone
Bend index point BAP point, tongue side basal arch index point LAP point；Base bone index point AP is BAP point, LAP point midpoint；
3. calibrating origin and coordinate system, and carry out three-dimensional coordinate two dimension conversion；
4. obtaining personalized dental arch curve；
2) data arrange tooth:
1. the foundation of one volume data of crown root row's dental cast；
2. arranging the establishment of tooth standard and the selection of normal tooth data；
3. the foundation of each index point and tooth three-dimensional system:
I corona central point CC point；
II root of the tooth central point RC point；
III long axis of tooth TLA；
IV rotation center；
V constructs plane；
VI tooth three-dimensional system；
4. computer arranges tooth:
I determines every sound of baby talk hat central point CC point coordinate of relative positional relationship and lower jaw of patient's mandibular dental arch and jawbone；
II arranges mandibular dentition；
III arranges maxillary dentition, completes upper and lower dentition matching；
IV fine tuning.
2. a kind of according to claim 1 arrange tooth method based on personalized bowed precision data, it is characterized in that:
Step 2) data arrange tooth 1. one volume data of crown root row dental cast foundation in, for one volume data of crown root row tooth mode be with
Hat three-dimensional center point and root three-dimensional center point connect into long axis of tooth TLA.
3. a kind of according to claim 1 arrange tooth method based on personalized bowed precision data, it is characterized in that: step 2)
3. in the foundation of each index point and tooth three-dimensional system, postoperative bite plane is simultaneously indirect to be established data row tooth according to definition, and
It is to establish indirectly；By measuring CBCT tripleplane, the range of normal value for the SN plane OP bite plane measured, in CBCT
Individual SN plane, which is made, and rotates normal value angle can be obtained postoperative bite plane.
4. a kind of according to claim 1 arrange tooth method based on personalized bowed precision data, it is characterized in that: step 2)
Data row tooth 4. in computer row tooth made according to the personalized arch based on individual base bone for being fitted personalized arch and obtaining
To arrange arch form curve, every corona central point is arranged in above.
5. a kind of according to claim 1 arrange tooth method based on personalized bowed precision data, it is characterized in that:
Step 2) data row tooth 4. computer row tooth in, in arrangement when mandibular dentition, first tooth long axis is zeroed, i.e., torque with
Axial rake zero, then the angle that the torque of tooth and axial rake rotation is fixed.
6. a kind of according to claim 1 arrange tooth method based on personalized bowed precision data, it is characterized in that:
The data row tooth of step 2) 4. in computer row tooth, after completing torque and the setting of axial rake, is needed to root of the tooth in jaw
Situation in bone is finely adjusted, and root of the tooth is made to accomplish no fenestration, bone-free cracking.
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