CN112998886B - Self-fixing bracket for natural tooth root peripheral alveolar bone increment and manufacturing method thereof - Google Patents

Self-fixing bracket for natural tooth root peripheral alveolar bone increment and manufacturing method thereof Download PDF

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CN112998886B
CN112998886B CN202110182355.7A CN202110182355A CN112998886B CN 112998886 B CN112998886 B CN 112998886B CN 202110182355 A CN202110182355 A CN 202110182355A CN 112998886 B CN112998886 B CN 112998886B
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alveolar bone
tongue
labial
buccal
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CN112998886A (en
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姜雨汐
孙仕晨
王新峦
高永波
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/06—Implements for therapeutic treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0012—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0012—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy
    • A61C8/0016—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy polymeric material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material

Abstract

A self-fixing bracket for increment of alveolar bone around natural tooth root and its making method are disclosed, the external surface of the self-fixing bracket after being in place is similar to the external surface of healthy alveolar bone, its self-fixing fastener structure is set at the root of the adjacent surface contact point of tooth, including separate body on tongue and palate side and separate body on labial and buccal side, the combination part of them is self-fixing fastener, the separate body on tongue and palate side is inserted into the space between tooth roots from tongue and palate side and mutually fastened with the separate body on labial and buccal side inserted into the space between tooth roots from labial and buccal side, so as to form the self-fixing fastener for preventing from being cut and/or changed
Figure DDA0002942477720000011
The inverted concave anti-dislocation structure is shifted upwards, and the shape of the absorbed alveolar bone is restored. The dental implant is used for alveolar bone augmentation around a natural tooth root, is proper in shape and is stable in retention. The tongue palate side components of a whole that can function independently and lip cheek side components of a whole that can function independently that adopt degradable bioactive material preparation to all bone defect regions are filled completely, form the falling concave anticreep and fix a position from the support, are showing and are being solved bone meal and ordinary when filling narrow and small miscellaneous bone repair space that leaves behind the alveolar bone absorption and can't stabilize the problem of taking one's place from the support.

Description

Self-fixing bracket for natural tooth root peripheral alveolar bone increment and manufacturing method thereof
Technical Field
The invention relates to a dental bioactive self-retaining bracket and a manufacturing method thereof, in particular to a self-retaining bracket for increasing alveolar bone around a natural tooth root and a manufacturing method thereof.
Background
The significant decrease in alveolar bone volume and height caused by diseases such as periodontitis may affect the diet, pronunciation, and confidence level of patients for a long time. The main clinical treatment is to remove the infectious agent, but the lost bone tissue cannot recover naturally. The method of combining the titanium nail with the collagen membrane, the titanium mesh, the titanium plate and the like can realize the firm fixation of the alveolar bone implant in the edentulous area, but the operation steps are complicated, the operation times are more, and the cost is overhigh. In addition, the height of the bone is reduced to more than 4mm, the alveolar bone around the tooth root of the existing natural tooth is not obviously loosened, the repairing space left after the alveolar bone is absorbed is small and complicated, and the existing common palliative treatment or extraction treatment in clinic has the defects that the autologous bone block cannot be properly trimmed, and the bone powder is difficult to retain. There is currently no truly effective, long-term stable solution to restore resorbed alveolar bone. There is a need to develop and research a new self-retaining bracket with a proper shape and stable retention for the alveolar bone increment around the natural tooth root.
Disclosure of Invention
The invention aims to solve the technical problem of overcoming the defects of the prior art and provides a self-retaining bracket for natural peridental alveolar bone increment, which is used for natural peridental alveolar bone increment.
The invention aims to solve another technical problem of making up the defects of the prior art and provides a method for manufacturing a self-retaining bracket for increasing alveolar bone around a natural tooth root.
The technical problem of the self-fixing bracket for the increment of the alveolar bone around the natural tooth root is solved by the following technical scheme.
The alveolar bone increment around the natural tooth root is realized by using a self-fixing bracket, the outer surface of the self-fixing bracket after being in place is similar to the outer surface of a healthy alveolar bone, and a self-fixing buckle structure of the self-fixing bracket is arranged at the root of a Contact point (proximate Contact Points) of the adjacent surface of the tooth.
The self-fixing bracket for the increment of the alveolar bone around the natural tooth root is characterized in that:
the self-retaining bracket profile is generated by the difference between the data of the alveolar bone design final profile and the patient alveolar bone profile;
the self-fixing support comprises a tongue-and-palate side split body and a lip-and-cheek side split body, the joint part of the tongue-and-palate side split body and the lip-and-cheek side split body is a self-fixing buckle, the tongue-and-palate side split body is inserted into an inter-tooth root gap from the tongue-and-palate side and is mutually buckled with the lip-and-cheek side split body inserted into the inter-tooth root gap from the lip-and-cheek side, so that the lip-and-cheek side split body and the tongue-and-palate side split body are tightly and stably combined, and after combination, the combined tongue-and-palate side split body tightly surrounds the tooth root surface with the upper part being thick and the lower part being thin, and the cut and ion prevention is formed
Figure BDA0002942477700000021
The anti-dislocation self-retaining bracket with the inverted concave structure is shifted, the shape of the absorbed alveolar bone is recovered, and the problems of bone powder and common self-retaining bracket when a narrow complex bone repair space left after the alveolar bone is absorbed is filled are obviously solvedThe retention bracket cannot be stably positioned.
The palatal side sub-body is made of degradable bioactive materials, and the degradable bioactive materials include but are not limited to three-dimensional printing biological composite materials, biological glass and biological ceramics.
The labial-buccal split body is made of the same material as the lingual-palatal split body.
The invention solves the technical problem of the self-fixing bracket for the increment of alveolar bone around the natural tooth root by the following further technical scheme.
The shape of the split palatine lateral body is the shape of the split palatine lateral body which is positioned on the shape of the split palatine lateral body after the shape of the self-fixing support is split by a buckle.
The shape of the palatine side division is determined by the absorption degree of alveolar bone of the patient and the quantity of the involved tooth positions, and the cross section includes but is not limited to the shape of the palatine side division
Figure BDA0002942477700000022
The tongue and palate side self-retaining buckles are respectively arranged at two ends of the tongue and palate side split body facing to the labial and buccal side split body, and the surface of the tongue and palate side split body comprises a tongue and palate side split tooth root tissue surface which is individually attached to the tooth root surface exposed by a patient, a tongue and palate side split body alveolar bone tissue surface which is individually attached to the outer surface of the absorbed alveolar bone crown side of the patient and a tongue and palate side split body outer surface which is similar to the outer surface of the healthy alveolar bone not absorbed by the patient.
The split shape of the lip and the cheek side is the split shape of the lip and the cheek side which is positioned after the self-fixing support is split by a buckle.
The shape of the labial-buccal side split body is determined by the alveolar bone absorption degree of a patient and the related tooth position quantity, the cross section comprises but is not limited to a shape in a form of a pricinity, two ends which are oppositely butted by the labial-buccal side split body and the two lingual-palatal side self-fixing buckles are respectively provided with the labial-buccal side self-fixing buckles, the surface of the labial-buccal side split body comprises a labial-buccal side split tooth root tissue surface which is personally attached to the tooth root surface exposed by the patient, a labial-buccal side split alveolar bone tissue surface which is personally attached to the outer surface of the coronal side of the alveolar bone absorbed by the patient, and a labial-buccal side split body outer surface which is similar to the outer surface of the healthy alveolar bone not absorbed by the patient, and the structure of the labial-buccal side self-fixing buckle is tightly buckled with the structure of the lingual-palatal side self-fixing buckle. The buckle structure can provide reliable and high-quality fastening configuration, the assembly efficiency is high, the assembly process of the buckle position is quick and convenient, only one inserting action is needed, and the rotation movement or the positioning of a product before assembly is not needed.
The invention solves the technical problem of the self-fixing bracket for the increment of alveolar bone around the natural tooth root by the following further technical scheme.
After the tongue and palate side self-retaining buckle and the lip and cheek side self-retaining buckle are buckled, the shape is similar to the shape of a healthy alveolar space and the self-retaining bracket is kept stable, and the tongue and palate side self-retaining buckle comprises but is not limited to a tongue and palate side wedge-shaped buckle and a tongue and palate side ball cap type buckle;
after the labial-buccal self-fixing buckle and the lingual-palatal self-fixing buckle are buckled, the shape of the labial-buccal self-fixing buckle is similar to the shape of a healthy alveolar space and the self-fixing bracket is kept stable, and the labial-buccal self-fixing buckle comprises, but is not limited to, a labial-buccal wedge-shaped buckle and a labial-buccal ball cap type buckle.
And the corresponding combination density and combination strength of the tongue and palate side split body and the lip and cheek side split body respectively meet the design requirements, and related data are respectively stored as STL format files.
The three-dimensional printing biological composite material comprises traditional Chinese medicine active substances for promoting bone growth, bionic apatite and a degradable biological high polymer material, wherein the traditional Chinese medicine active substances for promoting bone growth are at least one of puerarin, curcumin, a radix puerariae extract and a turmeric extract, the bionic apatite is tricalcium phosphate, and the degradable biological high polymer material is at least one of polylactic acid/glycolic acid copolymer, polylactic acid and chitosan.
The technical problem of the manufacturing method of the self-fixing bracket for the increment of the alveolar bone around the natural tooth root is solved by the following technical scheme.
The manufacturing method of the self-fixing bracket for the increment of the alveolar bone around the natural tooth root is characterized in that:
the method sequentially comprises the following steps:
1) acquiring tomographic image data including the shape of an alveolar bone and the position of a tooth in a range needing to be repaired of a patient, wherein the acquiring method of the tomographic image data comprises acquiring Cone Beam CT (Cone Beam Computer Tomography, a abbreviation CBCT) and acquiring CT;
2) importing the acquired tomographic image data into medical image software with a modular structure: performing three-dimensional reconstruction in a professional interactive medical image control system (material's interactive medical image control system, abbreviation Mimics), setting a threshold value, and selecting an area to generate an STL format file capable of performing data processing and three-dimensional printing;
3) the generated STL format file is imported into the medical and dental field application software PlstyCAD which is modeled in a free form without a boundary, the appearance of the complete self-fixing bracket is designed according to the appearance of the alveolar bone and the tooth position parameters of a healthy person, the height of the crest of the alveolar ridge is 2mm +/-0.5 mm below the cementum of the enamel after the complete self-fixing bracket is in place, a biological width space is reserved, and a morphological support is provided for the growth of gingiva;
4) dividing a designed complete self-fixing support into two parts by taking a connection line of adjacent tooth surface contact points as a boundary in PlstyCAD, setting a self-fixing buckle structure at the boundary, wherein a complete self-fixing support appearance data file comprises an STL format file of data representing corresponding combination density and combination strength for combining a labial-buccal side split body and a lingual-palatal side split body;
5) importing the complete self-fixing support shape data file into a software system of the three-dimensional printer;
6) cutting and layering the complete self-fixing support structure according to the diameter of a strip material extruded by a machine head of a three-dimensional printer and planning a printing path;
7) placing the prepared degradable bioactive material into a three-dimensional printer charging barrel, clicking to start printing, extruding a strip-shaped material by a three-dimensional printing head according to path planning, and automatically moving and printing until the self-fixing support is manufactured;
8) and performing subsequent treatment according to the type of the degradable bioactive material, wherein the subsequent treatment comprises freeze-drying treatment after low-temperature printing of the three-dimensional printing biological composite material, room-temperature curing after high-temperature printing of bioglass and sintering treatment after normal-temperature printing of bioceramic.
The technical problem of the manufacturing method of the self-fixing bracket for the increment of the alveolar bone around the natural tooth root is solved by the following further technical scheme.
The positioning of the self-retaining stent comprises the following sub-steps:
9.1) local infiltration anesthesia;
9.2) incising the gingival mucosa and periosteum, and delaminating and stripping to expose the complete operation area;
9.3) taking out the autogenous bone in a small area of the surface of the alveolar bone in the coverage area of the self-fixing bracket in a circular manner to provide sufficient blood supply and osseointegration sites for a printed body;
9.4) placing the removed autologous bone into the gap inside the self-fixing bracket to provide bone morphogenetic protein for bone reconstruction;
9.5) implanting a self-retaining bracket, after buckling a tongue palate side self-retaining buckle of a tongue palate side split body and a lip cheek side self-retaining buckle of a lip cheek side split body, checking the self-retaining stability condition of the self-retaining bracket, if stable, continuing the subsequent steps, and if unstable, adding a small titanium nail to assist in retaining, and continuing the subsequent steps;
9.6) resetting periosteum, completely covering the bone implantation area as much as possible, providing osteoblasts for the coverage area of the self-retaining bracket through the periosteum, and resetting gingival tissues to cover the complete operation area;
9.7) Tension-reducing Suture (Tension surgery) of gum tissue, and transplantation of gum if necessary, to ensure healing of alveolar bone in a Tension-free state.
The post-operative care and observation of the self-retaining stent includes: taking the antibiotic orally for 7 days after the operation, and removing stitches after 7-10 days if the wound is recovered without obvious symptoms; soft food is fed within 1 month after the operation, and the self-fixing stent is protected to finish primary reconstruction in an interference-free environment; and taking pictures 6 months after the operation to review the bone reconstruction condition.
The technical problem of the manufacturing method of the self-fixing bracket for the increment of the alveolar bone around the natural tooth root is solved by the following further technical scheme.
After the tongue and palate side self-retaining buckle and the lip and cheek side self-retaining buckle are buckled, the shape is similar to the shape of a healthy alveolar space and the self-retaining bracket is kept stable, and the tongue and palate side self-retaining buckle comprises but is not limited to a tongue and palate side wedge-shaped buckle and a tongue and palate side ball cap type buckle;
after the labial-buccal self-retaining buckle and the tongue-palatal self-retaining buckle are buckled, the shape of the buckle is similar to the shape of the interval of the healthy alveolus and keeps the self-retaining bracket stable, and the labial-buccal self-retaining buckle comprises but is not limited to a labial-buccal wedge-shaped buckle and a labial-buccal spherical cap type buckle.
The palatal body is made of degradable bioactive materials, and the degradable bioactive materials include but are not limited to three-dimensional printing biological composite materials, biological glass and biological ceramics.
The labial-buccal split body is made of the same material as the lingual-palatal split body.
The three-dimensional printing biological composite material comprises traditional Chinese medicine active substances for promoting bone growth, bionic apatite and a degradable biological high polymer material, wherein the traditional Chinese medicine active substances for promoting bone growth are at least one of puerarin, curcumin, a radix puerariae extract and a turmeric extract, the bionic apatite is tricalcium phosphate, and the degradable biological high polymer material is at least one of polylactic acid/glycolic acid copolymer, polylactic acid and chitosan.
Compared with the prior art, the invention has the following beneficial effects:
the invention is used for alveolar bone increment around the natural tooth root, has proper shape and stable retention. Degradable bioactive materials are adopted to manufacture the tongue-palate side split body and the lip-cheek side split body with the self-retaining buckle so as to completely fill all bone defect areas and form the function of preventing cutting and/or clamping
Figure BDA0002942477700000051
The inverted concave anti-dislocation self-fixing bracket obviously solves the problem that bone powder and a common self-fixing bracket cannot be stably fixed in place when a narrow complex bone repair space left after alveolar bone absorption is filled.
Drawings
FIG. 1 is a block diagram of an embodiment of the present invention;
FIG. 2 is a diagram of the palatal compartment of FIG. 1;
fig. 3 is a view showing a split structure of a labial and buccal side of fig. 1.
The numerals in the figures are labeled as follows:
1-palate side split body, 2-labial side split body, 3-palate side self-retaining buckle, 4-labial side self-retaining buckle, 11-palate side split tooth root tissue surface, 12-palate side split alveolar bone tissue surface, 13-palate side split body outer surface, 21-labial side split tooth root tissue surface, 22-labial side split alveolar bone tissue surface and 23-labial side split body outer surface.
Detailed Description
The present invention will be described in further detail with reference to the following detailed description and accompanying drawings. It should be emphasized that the embodiments described below are merely exemplary, non-limiting, and non-exclusive.
Examples
A self-fixing bracket for increasing the alveolar bone around a natural tooth root as shown in figures 1 to 3 is characterized in that the outer surface of the self-fixing bracket after being in place is similar to the outer surface of a healthy alveolar bone, a self-fixing buckling structure is arranged in the root of a contact point of adjacent surfaces of teeth, and the appearance of the self-fixing bracket is generated by the difference between the designed final appearance of the alveolar bone and the appearance data of the alveolar bone of a patient.
The self-fixing support comprises a palate side split body 1 and a lip and cheek side split body 2, the joint of the palate side split body 1 and the lip and cheek side split body 2 is a self-fixing buckle, and the number of the self-fixing buckles is determined by the alveolar bone absorption degree of a patient and the number of related tooth positions. The tongue and palate side split body 1 is inserted into the space between the tooth roots from the tongue and palate side and is mutually buckled with the lip and cheek side split body 2 inserted into the space between the tooth roots from the lip and cheek side, so that the lip and cheek side split body 2 and the tongue and palate side split body 1 are tightly and stably combined, and the combined split body is tightly surrounded on the tooth root surface which is thick at the top and thin at the bottom to form a cutting prevention vessel
Figure BDA0002942477700000061
The inverted concave anti-dislocation self-fixing bracket which is shifted towards the direction restores the shape of the absorbed alveolar bone, and obviously solves the problem of the absorption of the filled alveolar boneBone meal and a common self-fixing bracket can not be stably positioned in place when a narrow complex bone repair space is left.
The shape of the palatal side division 1 is the shape of the palatal side division generated by the difference between the tomographic image data including the alveolar bone shape and the tooth position of the range to be repaired of the patient and the data of the reference database including the alveolar bone shape and the tooth position of the selected optimal healthy person.
The cross section of the tongue and palate side split body 1 is
Figure BDA0002942477700000062
And the two end parts facing the labial and buccal side split bodies 2 are respectively provided with a lingual and palatal side self-fixing buckle 3, the surface of the lingual and palatal side split body 1 comprises a lingual and palatal side split tooth root tissue surface 11 which is individually attached to the exposed tooth root surface of the patient, a lingual and palatal side split alveolar bone tissue surface 12 which is individually attached to the outer surface of the coronal side of the alveolar bone of the patient and a lingual and palatal side split outer surface 13 which is similar to the outer surface of the healthy alveolar bone of the patient and does not absorb the lingual and palatal side split body.
The shape of the labial-buccal aspect separate body 2 is the labial-buccal aspect separate body shape generated by the difference between the tomographic image data including the alveolar bone shape and the tooth position of the area to be repaired of the patient and the data of the reference database including the alveolar bone shape and the tooth position of the selected optimal healthy person.
The cross section of the lip-buccal side split body 2 is in a pricingly profile, two opposite butt-jointed end parts facing the tongue-palate side split body 1 and the two tongue-palate side self-fixing buckles 3 are respectively provided with a lip-buccal side self-fixing buckle 4, the surface of the lip-buccal side split body 2 comprises a lip-buccal side split tooth root tissue surface 21 which is individually attached to a tooth root surface exposed by a patient, a lip-buccal side split body alveolar bone tissue surface 22 which is individually attached to the outer surface of an absorbed alveolar bone crown of the patient, and a lip-buccal side split body outer surface 23 which is similar to the outer surface of a healthy alveolar bone which is not absorbed by the patient.
The palatal-side self-retaining clip 3 and the labial-buccal-side self-retaining clip 4 of the self-retaining bracket of the present embodiment are wedge-shaped clips. The structure of the buccal labial self-fixing buckle 4 is tightly buckled with the structure of the lingual palatal self-fixing buckle 3, the shape after buckling is similar to the shape of the interval of the healthy alveolus and the self-fixing bracket is kept stable. The buckle structure can provide reliable and high-quality fastening configuration, the assembly efficiency is high, the assembly process of the buckle position is quick and convenient, only one inserting action is needed, and the rotation movement or the positioning of a product before assembly is not needed.
The tongue and palate side split body 1 is a tongue and palate side split body made of degradable bioactive materials, the degradable bioactive materials are three-dimensional printing biological composite materials, and the three-dimensional printing biological composite materials comprise traditional Chinese medicine active substances puerarin, tricalcium phosphate and degradable biological high molecular materials polylactic acid/glycolic acid copolymer for promoting bone growth.
The labial-buccal part 2 is made of the same material as the lingual-palatal part 1.
The corresponding combination density and combination strength of the tongue and palate side split body 1 and the lip and cheek side split body 2 respectively meet the design requirements, and relevant data are respectively stored as STL format files.
The manufacturing method of the self-retaining bracket of the embodiment sequentially comprises the following steps:
1) acquiring tomographic image data including the shape of the alveolar bone and the position of the tooth in the range needing to be repaired of a patient by CBCT;
2) importing the acquired tomographic image data into medical image software with a modular structure: three-dimensional reconstruction is carried out in a professional interactive medical image control system Mimics, a threshold value is set, and an STL format file capable of carrying out data processing and three-dimensional printing is generated in a selected area;
3) the generated STL format file is imported into medical and dental field application software PlstyCAD which is modeled in a free form without a boundary, the appearance of the complete self-fixing bracket is designed according to the appearance of the alveolar bone and the tooth position parameters of a healthy person, the height of the crest of the alveolar ridge is 2mm below the cementum of the enamel after the complete self-fixing bracket is in place, a biological width space is reserved, and morphological support is provided for the growth of gingiva;
4) dividing a designed complete self-fixing support into two parts by taking a connection line of adjacent tooth contact points as a boundary in the PlstyCAD, arranging a self-fixing buckle structure at the boundary, wherein a complete self-fixing support appearance data file comprises an STL format file of data representing the corresponding combination density and combination strength for combining a labial-buccal side split body and a lingual-palatal side split body;
5) importing the complete self-fixing support shape data file into a software system of the three-dimensional printer;
6) cutting and layering the complete self-fixing support structure according to the diameter of a strip material extruded by a machine head of a three-dimensional printer, and planning a printing path;
7) placing the prepared three-dimensional printing biological composite material into a three-dimensional printer charging barrel, clicking to start printing, extruding a strip-shaped material by a three-dimensional printing head according to path planning, and automatically moving and printing until the self-fixing support is manufactured;
8) and (5) freeze-drying.
The positioning of the self-retaining bracket of this embodiment includes the following sub-steps:
9.1) local infiltration anesthesia;
9.2) incising the gingival mucosa and periosteum, and delaminating and stripping to expose the complete operation area;
9.3) annularly taking out the autogenous bone from the small area of the alveolar bone surface of the coverage area of the self-fixing bracket to provide sufficient blood supply and osseointegration sites for a printed body;
9.4) placing the removed autologous bone into a gap inside the self-fixing bracket to provide bone morphogenetic protein for bone reconstruction;
9.5) implanting a self-fixing bracket, fastening a tongue palate side self-fixing buckle of the tongue palate side split body with a lip cheek side self-fixing buckle of the lip cheek side split body, checking the self-fixing stability condition of the self-fixing bracket, if stable, continuing the subsequent step, and if unstable, adding a small titanium nail to assist in fixing, and continuing the subsequent step;
9.6) resetting periosteum, completely covering the bone implantation area as much as possible, providing osteoblasts for the coverage area of the self-retaining bracket through the periosteum, and resetting gingival tissues to cover the complete operation area;
9, 7) tension-reducing and suturing gum tissue, transplanting gum if necessary, and ensuring the alveolar bone to heal under the tension-free state.
The postoperative care and observation of the self-retaining stent of this embodiment includes: taking the antibiotic orally for 7 days after the operation, and removing stitches after 7-10 days if the wound is recovered without obvious symptoms; soft food is fed within 1 month after the operation, and the self-fixing stent is protected to finish primary reconstruction in an interference-free environment; the bone reconstruction condition was reviewed by taking a photograph 6 months after surgery.
The foregoing is a further detailed description of the invention in connection with specific preferred embodiments and it is not intended to limit the invention to the specific embodiments described. For those skilled in the art to which the invention pertains, several equivalent substitutions or obvious modifications, which are equivalent in performance or use, without departing from the inventive concept, should be considered as falling within the scope of the present invention as defined by the appended claims.

Claims (9)

1. The utility model provides a natural root of tooth is alveolar bone increment around with from position fixing support, the surface after the position fixing support takes one's place is imitative with healthy alveolar bone surface, and its from position fixing buckle structure sets up in tooth adjacent surface contact point root side, its characterized in that:
the self-retaining bracket profile is generated by the difference between the designed final profile of the alveolar bone and the data of the patient alveolar bone profile;
the self-fixing bracket comprises a palate side split body and a lip and cheek side split body, the joint part of the palate side split body and the lip and cheek side split body is a self-fixing buckle, and the number of the self-fixing buckles is determined by the alveolar bone absorption degree of a patient and the number of involved teeth;
the tongue and palate side split body is inserted into the space between the tooth roots from the tongue and palate side and is mutually buckled with the lip and cheek side split body inserted into the space between the tooth roots from the lip and cheek side, so that the lip and cheek side split body and the tongue and palate side split body are tightly and stably combined, the combined split body tightly surrounds the surface of the tooth roots with thick upper parts and thin lower parts, an undercut-preventing position-preventing self-retaining support for preventing the cutting/□ from being displaced is formed, and the shape of the absorbed alveolar bone is recovered;
the palatal side split body is made of degradable bioactive materials, and the degradable bioactive materials include but are not limited to three-dimensional printing biological composite materials, biological glass and biological ceramics;
the labial-buccal split body is made of the same material as the lingual-palatal split body.
2. The natural peri-radicular alveolar bone augmentation self-retaining bracket of claim 1, wherein:
the shape of the tongue and palate side split body is a split shape which is positioned on the tongue and palate side part after being split by the shape of the self-fixing support through buckles;
the shape of the palatine side division is determined by the absorption degree of alveolar bone of the patient and the quantity of the involved tooth positions, and the cross section includes but is not limited to the shape of the palatine side division
Figure FDA0003559869830000011
The tongue and palate side split body is provided with tongue and palate side self-retaining buckles towards two ends of the tongue and palate side split body on the labial and buccal side, and the surface of the tongue and palate side split body comprises a tongue and palate side split tooth root tissue surface which is individually attached to the tooth root surface exposed by a patient, a tongue and palate side split body alveolar bone tissue surface which is individually attached to the outer surface of the absorbed alveolar bone crown side of the patient and a tongue and palate side split body outer surface which is similar to the outer surface of the healthy alveolar bone not absorbed by the patient.
3. The natural peri-radicular alveolar bone augmentation self-retaining bracket of claim 1 or 2, wherein:
the shape of the split part on the labial and buccal sides is the shape of the split part positioned on the labial and buccal sides after the shape of the self-fixing bracket is split by a buckle;
the shape of the buccal and labial split is determined by the alveolar bone absorption degree of a patient and the quantity of related tooth positions, the cross section comprises but is not limited to a profile, the buccal and labial split is provided with buccal and labial self-fixing buckles respectively towards two opposite butt-jointed ends of the lingual and palatal split and the two lingual self-fixing buckles, the surface of the buccal and labial split comprises a buccal and labial split tooth root tissue surface which is personalized and attached to the exposed tooth root surface of the patient, a buccal and labial split alveolar bone tissue surface which is personalized and attached to the external surface of the coronal side of the alveolar bone of the patient, and a buccal and labial split external surface which is similar to the external surface of the unabsorbed healthy alveolar bone of the patient, and the structure of the buccal and labial self-fixing buckles is tightly buckled with the structure of the lingual and palatal self-fixing buckles.
4. The natural peri-radicular alveolar bone augmentation self-retaining bracket of claim 1 or 2, wherein:
after the tongue and palate side self-retaining buckle and the lip and cheek side self-retaining buckle are buckled, the shape is similar to the shape of a healthy alveolar space and the self-retaining bracket is kept stable, and the tongue and palate side self-retaining buckle comprises but is not limited to a tongue and palate side wedge-shaped buckle and a tongue and palate side ball cap type buckle;
after the labial-buccal self-retaining buckle and the tongue-palatal self-retaining buckle are buckled, the shape of the buckle is similar to the shape of the interval of the healthy alveolus and keeps the self-retaining bracket stable, and the labial-buccal self-retaining buckle comprises but is not limited to a labial-buccal wedge-shaped buckle and a labial-buccal spherical cap type buckle.
5. The natural peri-radicular alveolar bone augmentation self-retaining bracket of claim 1 or 2, wherein:
the corresponding combination density and the combination strength of the tongue and palate side split body and the lip and cheek side split body respectively meet the design requirements, and related data are respectively stored as STL format files.
6. The natural peridental alveolar bone augmentation self-retaining bracket of claim 1, wherein:
the three-dimensional printing biological composite material comprises traditional Chinese medicine active substances for promoting bone growth, bionic apatite and a degradable biological high molecular material, wherein the traditional Chinese medicine active substances for promoting bone growth are at least one of puerarin, curcumin, a radix puerariae extract and a turmeric extract, the bionic apatite is tricalcium phosphate, and the degradable biological high molecular material is at least one of polylactic acid/glycolic acid copolymer, polylactic acid and chitosan.
7. The method for manufacturing a self-retaining bracket for natural peridental alveolar bone augmentation according to any one of claims 1 to 6, comprising: the method sequentially comprises the following steps:
1) acquiring tomographic image data including the alveolar bone shape and the tooth position in a range needing to be repaired of a patient, wherein the tomographic image data acquisition method comprises CBCT acquisition and CT acquisition;
2) importing the acquired tomographic image data into medical image software with a modular structure: three-dimensional reconstruction is carried out in a professional interactive medical image control system Mimics, a threshold value is set, and an STL format file capable of carrying out data processing and three-dimensional printing is generated in a selected area;
3) the generated STL format file is imported into a medical and dental field application software PlstyCAD which is modeled in a free form without a boundary, the appearance of a complete self-fixing bracket is designed according to the appearance of the alveolar bone and the tooth position parameters of a healthy person, the height of the crest of the alveolar ridge is 2mm +/-0.5 mm below the enamel cementum boundary after the complete self-fixing bracket is in place, a biological width space is reserved, and a morphological support is provided for the growth of gum;
4) dividing a designed complete self-fixing support into two parts by taking a connection line of adjacent tooth surface contact points as a boundary in PlstyCAD, setting a self-fixing buckle structure at the boundary, wherein a complete self-fixing support appearance data file comprises an STL format file of data representing corresponding combination density and combination strength for combining a labial-buccal side split body and a lingual-palatal side split body;
5) importing the complete self-fixing support shape data file into a software system of the three-dimensional printer;
6) cutting and layering the complete self-fixing support structure according to the diameter of a strip material extruded by a machine head of a three-dimensional printer, and planning a printing path;
7) placing the prepared degradable bioactive material into a three-dimensional printer charging barrel, clicking to start printing, extruding a strip-shaped material by a three-dimensional printing head according to path planning, and automatically moving and printing until the self-fixing support is manufactured;
8) and performing subsequent treatment according to the type of the degradable bioactive material, wherein the subsequent treatment comprises freeze-drying treatment after low-temperature printing of the three-dimensional printing biological composite material, room-temperature curing after high-temperature printing of biological glass and sintering treatment after normal-temperature printing of biological ceramic.
8. The method for manufacturing a self-retaining bracket for natural peridental alveolar bone augmentation of claim 7, wherein:
after the tongue and palate side self-retaining buckle and the lip and cheek side self-retaining buckle are buckled, the shape is similar to the shape of a healthy alveolar space and the self-retaining bracket is kept stable, and the tongue and palate side self-retaining buckle comprises but is not limited to a tongue and palate side wedge-shaped buckle and a tongue and palate side ball cap type buckle;
after the labial-buccal self-retaining buckle and the tongue-palatal self-retaining buckle are buckled, the shape of the buckle is similar to the shape of the interval of the healthy alveolus and keeps the self-retaining bracket stable, and the labial-buccal self-retaining buckle comprises but is not limited to a labial-buccal wedge-shaped buckle and a labial-buccal spherical cap type buckle.
9. The method for manufacturing a self-retaining bracket for natural peridental alveolar bone augmentation of claim 7, wherein:
the palatal side split body is made of degradable bioactive materials, and the degradable bioactive materials include but are not limited to three-dimensional printing biological composite materials, biological glass and biological ceramics;
the labial-buccal split body is made of the same material as the lingual-palatal split body;
the three-dimensional printing biological composite material comprises traditional Chinese medicine active substances for promoting bone growth, bionic apatite and a degradable biological high molecular material, wherein the traditional Chinese medicine active substances for promoting bone growth are at least one of puerarin, curcumin, a radix puerariae extract and a turmeric extract, the bionic apatite is tricalcium phosphate, and the degradable biological high molecular material is at least one of polylactic acid/glycolic acid copolymer, polylactic acid and chitosan.
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