CN114770949B - Grating front tooth prepared tooth observation plate and digital preparation method thereof - Google Patents

Grating front tooth prepared tooth observation plate and digital preparation method thereof Download PDF

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Publication number
CN114770949B
CN114770949B CN202210397003.8A CN202210397003A CN114770949B CN 114770949 B CN114770949 B CN 114770949B CN 202210397003 A CN202210397003 A CN 202210397003A CN 114770949 B CN114770949 B CN 114770949B
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tooth
grating
preparation
observation
observation plate
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CN114770949A (en
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白石柱
赵瑞峰
钟声
谢瑞
任楠
郑晓娟
叶晓兰
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Air Force Medical University of PLA
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Air Force Medical University of PLA
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    • BPERFORMING OPERATIONS; TRANSPORTING
    • B29WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29CSHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/30Auxiliary operations or equipment
    • B29C64/386Data acquisition or data processing for additive manufacturing
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B33ADDITIVE MANUFACTURING TECHNOLOGY
    • B33YADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y50/00Data acquisition or data processing for additive manufacturing
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B33ADDITIVE MANUFACTURING TECHNOLOGY
    • B33YADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00Products made by additive manufacturing
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B29WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29LINDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
    • B29L2031/00Other particular articles
    • B29L2031/753Medical equipment; Accessories therefor

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  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Materials Engineering (AREA)
  • Manufacturing & Machinery (AREA)
  • Physics & Mathematics (AREA)
  • Mechanical Engineering (AREA)
  • Optics & Photonics (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

The invention discloses a grating front tooth prepared tooth observation plate and a digital preparation method thereof, and belongs to the technical field of digital preparation. The method takes the inner side surface of the tooth preparation indicating plate as a reference surface, the space formed by the tooth preparation indicating plate and the prepared preparation surface is uniformly transited from the gingival margin to the incised margin, the grating facilitates multi-point observation, and the personalized indicating plate thickness can also help doctors to better evaluate the tooth preparation amount, so that the requirements of tooth preparation and restoration manufacturing can be met. The tooth preparation observation plate can improve the problem that the tooth grinding amount is difficult to judge in clinic to a certain extent, and can accurately evaluate the tooth preparation amount under the direct vision condition by carrying out visual observation through the grating with the thickness of 1mm or personalized thickness.

Description

Grating front tooth prepared tooth observation plate and digital preparation method thereof
Technical Field
The invention belongs to the technical field of digital preparation, and particularly relates to a grating-shaped front tooth prepared tooth observation plate and a digital preparation method thereof.
Background
Porcelain veneering is a common way of aesthetic restoration of the anterior teeth. The wax type is used for diagnosis and repair, and after doctors and patients confirm the repair effect, the next step is tooth preparation. In the clinical course, on the basis of meeting the requirements of veneering preparation space, it is desirable to preserve autologous dental tissue as much as possible. How to quantify dental preparation using a digital fashion, preserving healthy dental tissue as much as possible, thereby reducing the incidence of pulp irritation symptoms, is the goal of the restorative practitioner.
The traditional method can observe tooth preparation quantity through the silicone rubber impression, only one observation window can be obtained at the same time, the silicone rubber is required to be continuously cut off to obtain a new observation window, and clinical application is very inconvenient. The existing dental quantitative preparation auxiliary method comprises a TRS system and a First Fit system, and the two systems can solve the problem of dental preparation to a certain extent, but have certain limitations. The TRS system can only perform fixed-point rough measurement, cannot obtain data of all dental sites, and the First Fit system has high use technical requirements, needs specific instruments and increases cost.
In the chinese patent website, a patent (cn201811343388. X) entitled "personalized dental preparation step indication guide for digital design" was retrieved, describing the application of multiple guides using digital design and printing. Although the preparation amount of each preparation surface can be controlled more accurately, the preparation method is complex in use, more in steps and higher in operation requirement. A step or the like may be formed between the respective preliminary faces due to improper operation.
In a patent (CN 202010459049.9) entitled "digital preparation method of triple rigid constraint and guide dental preparation guide plate", a method of preparing dental surfaces using triple constraint is described, which enables accurate dental preparation, but requires trimming of the junction between each preparation surface after application of the guide plate. Therefore, the preparation guide plate can only prepare a cylindrical surface, a spherical surface cannot be prepared, and the preparation surface after the front teeth are prepared is not the cylindrical surface, but a uniformly transitional curved surface.
Therefore, the current digital preparation technology still cannot meet the requirements of dental preparation and prosthesis preparation, and particularly cannot accurately observe and evaluate the preparation quantity of teeth at any time.
Disclosure of Invention
In order to overcome the defects in the prior art, the invention aims to provide the front tooth prepared tooth observation plate and the digital preparation method thereof, which can accurately observe and evaluate the preparation quantity of teeth at any time in the tooth preparation process so as to meet the requirements of tooth preparation and restoration manufacturing.
In order to achieve the above purpose, the invention is realized by adopting the following technical scheme:
the invention discloses a digital preparation method of a grating front tooth prepared tooth observation plate, which comprises the following steps:
1) Acquiring oral scanning data of a patient after the patient tries to wear the diagnostic prosthesis;
2) The final form of the prosthesis is determined after the modification model is adjusted according to the test wearing condition of the diagnostic prosthesis in the dental prosthesis design software;
3) Leading in a final repair model in digital design software, and manufacturing a grid-shaped front tooth standby tooth observation plate;
4) And printing the front teeth preparation observation plate by using a 3D printer, and performing post-treatment to obtain the grid-shaped front teeth preparation observation plate.
Preferably, in step 2), the relevant prosthesis morphology is fine-tuned according to feedback in the repair process, and the final prosthesis morphology is determined; if the tooth shape is irregular, simulating the repair shape in digital software to be used as a final repair model of the prosthesis.
Preferably, in step 2), the dental prosthesis design software is Exocad software, 3Shape software or UPCAD software, etc.; the digitalized Design software in the step 3) adopts software such as Geomagic Wrap, geomagic Design, geomagic studio, IMAGEWARE, COPYCAD or RapidForm.
Preferably, in the step 3), the specific operation of manufacturing the grating-shaped front tooth standby tooth observation plate is as follows:
Drawing edge lines, determining the coverage range of the tooth-prepared observation plate, copying the coverage range into a new object, and uniformly drawing a shell for 1mm towards a compound side to generate a substrate;
three gratings are established on each tooth in the tooth preparation area, and the gratings are stopped at the gingiva beyond the tooth neck;
And (3) carrying out Boolean operation on the grating plate and the base plate to obtain the grating-shaped front tooth standby tooth observation plate.
Further preferably, the coverage area is: the posterior teeth cover one third of the occlusal surface of the dental crowns and do not exceed the outline high-point line; the anterior teeth cover 3-5 mm below the gingival margin and do not enter the soft tissue undercut.
Preferably, in step 4), the printing of the tooth preparation observation plate using the 3D printer is specifically: and printing the tooth-backup observation plate by adopting a dental 3D printer and a guide plate material, wherein the thickness of the printing layer is set to be 50 microns or 100 microns.
It is further preferred to use SPRINTRAY printers and surgical guide materials.
Preferably, the post-treatment in step 4) is a 5 minute wash with 95% alcohol solution, manual removal of support followed by photo-curing at 40 ℃ for 30 minutes).
The invention also discloses a grating-shaped front tooth preparation tooth observation plate manufactured by the digital manufacturing method, the thickness of the grating-shaped front tooth preparation tooth observation plate is 1mm, three gratings are arranged on each tooth surface to be prepared, the interval is 1mm, and the gratings are stopped at gingiva beyond the tooth neck.
Compared with the prior art, the invention has the following beneficial effects:
According to the digital preparation method of the front tooth preparation observation plate, the inner side face of the preparation tooth indication plate is used as a reference face, a space formed by the preparation tooth indication plate and the prepared preparation face is uniformly transited from the gingival margin to the tangential margin, the grating facilitates multi-point observation, and the personalized indication plate thickness can also help doctors to better evaluate the tooth preparation amount, so that the requirements of tooth preparation and restoration manufacturing can be met. The concrete advantages are as follows:
1. The tooth preparation observation plate can improve the problem that the tooth grinding amount is difficult to judge in clinic to a certain extent, has higher application value for doctors, can accurately evaluate the tooth preparation amount under the direct vision condition by carrying out visual observation through the grating with the thickness of 1mm or personalized thickness.
2. In clinical application, the tooth-preparation observation plate can conveniently remove the grids of the observed part one by one, and can provide a better observation view angle for the next observation site; and the auxiliary operation of other instruments is not needed, so that the clinical operation difficulty is reduced.
3. According to the tooth-preparation observation plate, only one observation plate is required to be printed after the design is finished, and a model is not required to be printed, so that the consumable cost of the tooth-preparation observation plate is effectively reduced: only about 4mL of material is needed for printing one piece of observation plate, and the estimated cost is about 6-10 according to the price of various guide plate materials on the market, and the cost is economical compared with a silicon rubber guide plate mode (about 15-20). Compared with a TRS system and a First Fit system, the method has the advantages of lower cost, easy manufacture and simple operation.
Drawings
FIG. 1 is a flow chart of the steps performed in the present invention;
FIG. 2 is a design drawing of a final repair configuration;
FIG. 3 is a schematic diagram of a dental plate in digital software; wherein, (a) is an upper view of the tooth-prepared observation plate after the design is completed; (b) is a front view;
FIG. 4 is a physical diagram of a finished dental caries-prevention observation plate printed by a 3D printer;
FIG. 5 is an application entity diagram of a dental observation plate; wherein (a) is a front view of the dental impression plate applied on the model; (b) is a side view;
FIG. 6 is a measurement of tooth preparation in an example application; wherein, (a) is a way to apply a vertical section to obtain a measurable curve after registering the pre-preparation and post-preparation mouth scan models; (b) measuring sites after obtaining the preliminary tangential plane map.
Detailed Description
In order that those skilled in the art will better understand the present invention, a technical solution in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in which it is apparent that the described embodiments are only some embodiments of the present invention, not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present invention without making any inventive effort, shall fall within the scope of the present invention.
It should be noted that the terms "comprises" and "comprising," along with any variations thereof, in the description and claims of the present invention are intended to cover a non-exclusive inclusion, such as a process, method, system, article, or apparatus that comprises a list of steps or elements is not necessarily limited to those steps or elements expressly listed or inherent to such process, method, article, or apparatus, but may include other steps or elements not expressly listed or inherent to such process, method, article, or apparatus.
The invention is described in further detail below with reference to the attached drawing figures:
as shown in fig. 1, a method for designing and manufacturing an anterior tooth preparation observation plate by using a digitizing technology specifically comprises the following steps:
1) Acquiring oral scan data of a patient after fitting a diagnostic prosthesis: after the diagnosis and repair are finished, determining a general repair form according to adjustment in the patient try-on process, performing intraoral scanning, obtaining intraoral scanning data of the patient after the diagnosis and repair are finished, and exporting and storing the intraoral scanning data into an STL format;
2) The final form of the prosthesis is determined after the modification model is adjusted according to the test wearing condition of the diagnostic prosthesis by using dental prosthesis design software such as Exocad and the like: according to feedback of patients and doctors in the diagnosis and repair process, the related repair body forms are finely adjusted, and the final repair body forms are determined; if the tooth form of the patient is irregular and the diagnosis and repair can not be carried out, the repair form can be simulated in digital software, and the final form of the repair body is obtained after the approval of the patient;
3) Leading in a final repair model in digital design software, and manufacturing a tooth preparation observation plate: and importing the final repair model into digital design software such as Geomagic Wrap, drawing edge lines, and determining the coverage range of the dental implant observation plate. The posterior teeth cover one third of the occlusal surface of the dental crowns and do not exceed the outline high-point line; the anterior teeth cover 3-5mm below the gingival margin and do not enter the soft tissue for recession. And copying the coverage area into a new object, and uniformly pumping the shell to the compound side for 1mm to generate the substrate. Three gratings were built on each tooth in the preparation area and stopped at the gums across the neck. Performing Boolean operation on the grating plate and the substrate to obtain a grating-shaped observation plate;
4) Printing the dental caries observatory plate using a 3D printer: printing the dental backup observation plate using a dental 3D printer with a guide plate material, such as SPRINTRAY printer and surgical guide material, the thickness of the printed layer being set to 50 or 100 microns;
5) Post-printing treatment observation plate: cleaning, removing the support and photo-curing;
6) Clinical application: the dental implant can be worn in the mouth at any time in the dental preparation process, and doctors can observe from different visual angles to estimate the grinding amount of dental tissues at each site. The doctor can remove the guide grids one by one with great convenience to provide a better view.
The grid-shaped structures are placed at 3 positions of each tooth surface to be prepared, and the intervals are 1mm; and the thickness of the observation plate is 1mm, so that a doctor can conveniently obtain visual assessment of the tooth grinding amount by comparing the observation plate with the thickness of 1mm adjacent to the tooth preparation gap in the visual observation process.
In the use process of the tooth-preparation observation plate, the grids of the observed parts are removed one by one, so that a better observation visual angle can be provided for the next observation site.
As shown in fig. 6, a closed curve of removed dental tissue is obtained in Geomangic Wrap software by registering the pre-and post-preparation mouth scan models of the tooth with the back teeth, creating a cross section perpendicular to the prepared tooth face. Each prepared tooth acquires 3 measurement curves of mesial, median and distal by the method described above. The neck, middle, tip and incisor preparation (height, unit mm) were measured manually, and the average of the preparation of 6 front teeth at different sites was calculated to be 0.62.+ -. 0.26mm for the neck, 0.70.+ -. 0.23mm for the middle, 0.70.+ -. 0.29mm for the tip and 1.15.+ -. 0.28mm for the incisor. The preparation quantity accords with clinical standards, the preparation surface is arc-shaped excessively, and the requirements of aesthetic repair and porcelain veneering repair are met. The actual pre-finished oral scan data were 3D compared with the simulated post-preparation morphology in the software to calculate an RMS value of 0.13±0.10mm. The precision is within the clinically acceptable range of 0.2 mm.
In clinical data, young doctors were found to have significantly better accuracy than freehand preparation (0.43±0.25) using the dental plaque preparation (0.15±0.10), had significant statistical significance (P < 0.05), and were not statistically different from the senior physician freehand preparation (0.13±0.09). The senior citizens have no statistical difference between the dental observation plate and the freehand preparation result. This demonstrates that the dental implant plate of the present invention is more suitable for application in inexperienced young doctors, and can quickly shorten the distance to experienced doctors.
The above is only for illustrating the technical idea of the present invention, and the protection scope of the present invention is not limited by this, and any modification made on the basis of the technical scheme according to the technical idea of the present invention falls within the protection scope of the claims of the present invention.

Claims (7)

1. The digital preparation method of the grating-shaped front tooth standby tooth observation plate is characterized by comprising the following steps of:
1) Acquiring oral scanning data of a patient after the patient tries to wear the diagnostic prosthesis;
2) The final form of the prosthesis is determined after the modification model is adjusted according to the test wearing condition of the diagnostic prosthesis in the dental prosthesis design software;
3) Leading in a final repair model in digital design software, and manufacturing a grid-shaped front tooth standby tooth observation plate;
the specific operation of manufacturing the grating-shaped front tooth back tooth observation plate is as follows:
drawing edge lines, determining the coverage range of the tooth-prepared observation plate, copying the coverage range into a new object, and uniformly drawing a shell for 1mm towards a compound side to generate a substrate; the coverage area is as follows: the posterior teeth cover one third of the occlusal surface of the dental crowns and do not exceed the outline high-point line; the front teeth cover 3-5 mm below the gingival margin and do not enter the soft tissue undercut;
three gratings are established on each tooth in the tooth preparation area, and the gratings are stopped at the gingiva beyond the tooth neck;
performing Boolean operation on the grating plate and the base plate to obtain a grating-shaped front tooth standby tooth observation plate;
4) Printing front teeth back teeth observation plates by using a 3D printer, and performing post-treatment to obtain grating front teeth back teeth observation plates, wherein the thickness of each grating front teeth back teeth observation plate is 1mm, three gratings are arranged on each tooth surface to be prepared, the interval is 1mm, and the gratings are stopped at gum after crossing the tooth neck;
The grating-shaped front tooth standby tooth observation plate can remove the grating of the observed part one by one in the use process, and provides a better observation view angle for other observation sites.
2. The method for digitally preparing a grating-like anterior teeth preparation and observation plate according to claim 1, wherein in step 2), the relevant prosthesis morphology is finely tuned according to feedback during the restoration process to determine the final prosthesis morphology; if the tooth shape is irregular, simulating the repair shape in digital software to be used as a final repair model of the prosthesis.
3. The method for digitally producing a grating-like anterior tooth replacement observation plate according to claim 1, wherein in step 2), the dental prosthesis design software is Exocad software, 3Shape software or UPCAD software; the digital Design software in step 3) adopts Geomagic Wrap, geomagic Design, geomagic studio, IMAGEWARE, COPYCAD or RapidForm software.
4. The method for digitally preparing a grating-like front tooth back-up observation plate according to claim 1, wherein in step 4), the back-up observation plate is printed by using a 3D printer specifically comprises: and printing the tooth-backup observation plate by adopting a dental 3D printer and a guide plate material, wherein the thickness of the printing layer is set to be 50 microns or 100 microns.
5. The method for digitally preparing a grating-like anterior tooth monitor plate of claim 4, wherein SPRINTRAY printer and surgical guide material are used.
6. The method for digitally preparing a grating-like anterior teeth preparation and observation plate according to claim 1, wherein the post-treatment in step 4) is a 5-minute wash with 95% alcohol solution, manual removal of the support, and photo-curing at 40 ℃ for 30 minutes.
7. A grating-like front tooth-prepared observation plate manufactured by the digital manufacturing method according to any one of claims 1 to 6, characterized in that the thickness of the grating-like front tooth-prepared observation plate is 1mm, three gratings are arranged on each tooth surface to be prepared, the interval is 1mm, and the gratings are stopped at gingiva beyond the tooth neck.
CN202210397003.8A 2022-04-15 2022-04-15 Grating front tooth prepared tooth observation plate and digital preparation method thereof Active CN114770949B (en)

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CN105147408A (en) * 2015-06-17 2015-12-16 四川大学 Preparation quantity measuring device for prepared teeth and method for applying preparation quantity measuring device
CN108618858A (en) * 2017-07-26 2018-10-09 北京大学口腔医学院 A kind of production method of functional areas tooth preparation guide plate, removable needle limiter of unloading
CN109009511A (en) * 2018-06-21 2018-12-18 四川大学 A kind of three-dimensional analysis standby tooth guide plate production method and application method based on 3D printing
CN109350277A (en) * 2018-10-08 2019-02-19 杭州而然科技有限公司 A method of the accurate production dental prosthesis of digitlization
CN111166507A (en) * 2018-11-09 2020-05-19 北京大学口腔医学院 Personalized tooth preparation step-by-step indication guide plate designed and manufactured in digital mode
CN211381866U (en) * 2019-12-04 2020-09-01 广州市德伦口腔门诊部有限公司 Front tooth facing bonding guide plate
CN111973293A (en) * 2020-07-24 2020-11-24 上海交通大学医学院附属第九人民医院 Method for manufacturing cast porcelain tooth veneers
CN113786262A (en) * 2021-08-16 2021-12-14 合肥市口腔医院 Preparation method of dental crown lengthening operation guide plate

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WO2016153830A1 (en) * 2015-03-20 2016-09-29 3M Innovative Properties Company A method of making a dental restoration
GB2584277B (en) * 2019-05-23 2021-05-26 Smile Fast Ltd Dental stent

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105147408A (en) * 2015-06-17 2015-12-16 四川大学 Preparation quantity measuring device for prepared teeth and method for applying preparation quantity measuring device
CN108618858A (en) * 2017-07-26 2018-10-09 北京大学口腔医学院 A kind of production method of functional areas tooth preparation guide plate, removable needle limiter of unloading
CN109009511A (en) * 2018-06-21 2018-12-18 四川大学 A kind of three-dimensional analysis standby tooth guide plate production method and application method based on 3D printing
CN109350277A (en) * 2018-10-08 2019-02-19 杭州而然科技有限公司 A method of the accurate production dental prosthesis of digitlization
CN111166507A (en) * 2018-11-09 2020-05-19 北京大学口腔医学院 Personalized tooth preparation step-by-step indication guide plate designed and manufactured in digital mode
CN211381866U (en) * 2019-12-04 2020-09-01 广州市德伦口腔门诊部有限公司 Front tooth facing bonding guide plate
CN111973293A (en) * 2020-07-24 2020-11-24 上海交通大学医学院附属第九人民医院 Method for manufacturing cast porcelain tooth veneers
CN113786262A (en) * 2021-08-16 2021-12-14 合肥市口腔医院 Preparation method of dental crown lengthening operation guide plate

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