DE10148389A1 - Control method for use with surgical drills used with medical robots and navigation systems, employed in robot assisted insertion of dental implants, ensures operations follow pre-operation planning - Google Patents

Control method for use with surgical drills used with medical robots and navigation systems, employed in robot assisted insertion of dental implants, ensures operations follow pre-operation planning

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Publication number
DE10148389A1
DE10148389A1 DE10148389A DE10148389A DE10148389A1 DE 10148389 A1 DE10148389 A1 DE 10148389A1 DE 10148389 A DE10148389 A DE 10148389A DE 10148389 A DE10148389 A DE 10148389A DE 10148389 A1 DE10148389 A1 DE 10148389A1
Authority
DE
Germany
Prior art keywords
drill guide
drill
guide according
enable
navigation system
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE10148389A
Other languages
German (de)
Inventor
Robert Boesecke
Jakob Brief
Stefan Hasfeld
Otto Pastyr
Michael Vogele
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
BRIEF, JAKOB, DR., 60435 FRANKFURT, DE
BRIEF, JAKOB, DR., DE
Hassfeld Stefan 69221 Dossenheim De
Hassfeld Stefan De
Pastyr Otto De
PASTYR, OTTO, 69181 LEIMEN, DE
VOGELE, MICHAEL, 86830 SCHWABMUENCHEN, DE
VOGELE, MICHAEL, DE
Precisis AG
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to DE10148389A priority Critical patent/DE10148389A1/en
Publication of DE10148389A1 publication Critical patent/DE10148389A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C2201/00—Material properties
    • A61C2201/005—Material properties using radio-opaque means
    • 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
    • A61C8/0089—Implanting tools or instruments

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • Public Health (AREA)
  • Dentistry (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Epidemiology (AREA)
  • Robotics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Dental Prosthetics (AREA)

Abstract

The drill is directly aligned by hand by the surgeon. Pressing force and forwards movement speed are manually entered by the surgeon. The angle piece with the drill bit can be rotated so that access to the operation field is optimum. Drill control comprises a tool for the surgical robot, a guide rod and a clamping device. Drilling is carried out so that guide rod and drill bit are axially aligned. Thus the surgeon can rotate the angle piece so that access to the operation area is optimized.

Description

Chirurgische Navigationssysteme und Medizinroboter werden als Hilfsmittel zur Positionsfindung für chirurgische Eingriffe seit einiger Zeit verwendet. Ein weiteres Einsatzgebiet ist die teilweise Ausführung von operativen Eingriffen. Hier sind vor allem robotische Systeme im Einsatz, die Knochenfräsarbeiten für Hüftgelenk- und Kniegelenkimplantate ausführen. Surgical navigation systems and medical robots are considered Aid for position finding for surgical interventions for some time used. Another area of application is the partial execution of surgical interventions. Above all, robotic systems are here Use, the bone milling for hip and knee implants To run.

Ein neueres Einsatzgebiet ist die Positionierung und Führung von chirurgischen Bohrern für das Setzen von Dentalimplantaten in optimaler Position. Diese optimale Position wird zusammen mit der Größe des Implantates vor Operationsbeginn oder während der Operation mittels bildgestützter Computerplanung bestimmt. A more recent area of application is the positioning and management of surgical drills for placing dental implants in optimal Position. This optimal position is combined with the size of the Implants before or during the operation image-based computer planning determined.

Beim Setzen von Dentalimplantaten ist es erforderlich, dem Chirurgen eine genaue, mechanische Führung des Bohrers mit einstellbarem Tiefenanschlag zur Verfügung zu stellen, damit die geplante Position, Richtung und die Bohrtiefe für die Implantate eingehalten werden können. Die Bohrerführung wird entweder von einem Roboter oder, bei Verwendung eines Navigationssystems, von einer damit voreingestellten mechanischen Haltevorrichtung gehalten. Der Chirurg führt dann den Bohrer geradlinig bis zum Anschlag. When placing dental implants, it is necessary for the surgeon precise, mechanical guidance of the drill with adjustable To provide a depth stop so that the planned position, Direction and drilling depth for the implants can be maintained. The drill guide is either by a robot or, at Using a navigation system from a preset mechanical holding device held. The surgeon then guides the drill straight to the stop.

Weiterhin ist es notwendig, den Bohrer mit Winkelstück und den Antrieb erst einzusetzen, wenn der Roboter oder die mechanische Haltevorrichtung des Navigationssystems bereits positioniert sind. Damit kann der Zugang des Chirurgen im Mund des Patienten wesentlich erleichtert werden. Furthermore, it is necessary to use the drill with the contra-angle handpiece and the drive only to be used when the robot or the mechanical one Holding device of the navigation system are already positioned. So that the The surgeon's access to the patient's mouth is much easier become.

Ein Ausführungsbeispiel ist für einen assistierenden Medizinroboter für die Dentale Implantologie vorhanden, der in der folgenden Veröffentlichung beschrieben wird (J. Brief, S. Hassfeld, T. Redlich, C. Ziegler, J. Muenchenberg, S. Daueber, A. Pernozzoli, R. Krempien, P. Slacik, M. Opalek, R. Boesecke, J. Mühling: Robot Assisted Insertion of Dental Implants, A clinical evaluation, CARS 2000, Springer Verlag, Hrsg. H. U. Lemke, M. W. Vannier, K. Inamura, A. G. Farman, K. Doi (2000), 932). One embodiment is for an assistant medical robot for the dental implantology available in the following Publication is described (J. Brief, S. Hassfeld, T. Redlich, C. Ziegler, J. Muenchenberg, S. Daueber, A. Pernozzoli, R. Krempien, P. Slacik, M. Opalek, R. Boesecke, J. Mühling: Robot Assisted Insertion of Dental Implants, A clinical evaluation, CARS 2000, Springer Verlag, ed. H. U. Lemke, M.W. Vannier, K. Inamura, A.G. Farman, K. Doi (2000), 932).

Dentale Implantate ersetzen die Zahnwurzel und sind mittlerweile als Zahnersatz etabliert. Die Funktionalität und Lebensdauer des Implantats hängt von der genauen Planung von Größe und Lage der Implantate ab. Die Bohrerführung zusammen mit einem assistierenden Chirurgieroboter oder Navigationssystem dient unter Anwendung der Patentansprüche 1 bis 14 zur Vorgabe von Bohrrichtung und Tiefe nachdem die entsprechende Computerplanung durchgeführt und zum Roboter bzw. Navigationssystem übertragen wurde (Abb. 1). Dental implants replace the tooth root and are now established as dentures. The functionality and lifespan of the implant depends on the precise planning of the size and position of the implants. The drill guide together with an assistive surgical robot or navigation system uses the claims 1 to 14 to specify the drilling direction and depth after the corresponding computer planning has been carried out and transferred to the robot or navigation system ( Fig. 1).

Erläuterungen zur Abb. 2 bis 4Explanations to Fig. 2 to 4

Das Werkzeug 7 wird über Verbindungsteil 1 an der Werkzeugaufnahme des Roboters befestigt. Die Passbohrung 2 ist die für den Führungsstift. Der Bohrer ist über das Winkelstück, das der Chirurg mit der Hand führt, mit den Klemmschrauben 6 am Klemmvorrichtung 8 befestigt. Der Führungsstift 3 ist in die Führungspassbohrung eingesetzt. Führungsstift 3 und Bohrer sind auf einer Achse angeordnet. Der Tiefenanschlag 4 kann über die Einstellschraube 5 eingestellt werden. Der Tiefenanschlag ist verdrehgesichert. Der Bohrer ist somit über das Werkzeug 7 mit dem Chirurgieroboter oder Navigationssystem verbunden. The tool 7 is fastened to the tool holder of the robot via a connecting part 1 . The fitting hole 2 is for the guide pin. The drill is fastened to the clamping device 8 by means of the angle piece which the surgeon guides by hand with the clamping screws 6 . The guide pin 3 is inserted into the guide fitting bore. Guide pin 3 and drill are arranged on one axis. The depth stop 4 can be adjusted using the adjusting screw 5 . The depth stop is secured against rotation. The drill is thus connected to the surgical robot or navigation system via the tool 7 .

Die Vorteile der Bohrerführung ergeben sich aus der genauen, geführten Übertragung der geplanten Bohrposition auf den Patienten und der schnellen Durchführung der Bohrung durch den Tiefenanschlag. Die Druckkraft und die Vorschubgeschwindigkeit bestimmt der Chirurg wie gewohnt von Hand. Richtung und Bohrtiefe sind vorgegeben. The advantages of the drill guide result from the precise, guided Transfer of the planned drilling position to the patient and the rapid drilling through the depth stop. The surgeon determines the pressure force and the feed rate by hand as usual. Direction and drilling depth are specified.

Claims (14)

1. Bohrerführung für chirurgische Bohrer mit Tiefenanschlag für Medizinroboter und Navigationssysteme. Der Bohrer wird vom Chirurgen von Hand am Winkelstück geradlinig bewegt. Andruckkraft und Vorschubgeschwindigkeit werden vom Chirurgen manuell vorgegeben. Das Winkelstück mit Bohrer kann so gedreht werden, dass der Zugang zum Operationsfeld optimal ist. Die Bohrerführung besteht aus einem Werkzeug 7 für Chirurgieroboter oder für mechanische Haltesysteme mit Passbohrung 2, einem Führungsstift 3, der in die Passbohrung 2 eingesetzt wird, einer Klemmvorrichtung 8 zum Klemmen handelsüblicher Winkelstücke (z. B. "Zahnarztbohrer") mit einem einstellbaren Tiefenanschlag 4. Die Bohrerführung ist so ausgeführt, dass Führungsstift 3 und Bohrer auf einer Achse liegen. Dadurch kann der Chirurg das Winkelstück so drehen, dass der Zugang zum Operationsgebiet optimal ist. 1. Drill guide for surgical drills with depth stop for medical robots and navigation systems. The surgeon manually moves the drill straight on the contra-angle handpiece. The surgeon manually sets the contact pressure and feed rate. The contra-angle handpiece with drill can be turned so that access to the operating field is optimal. The drill guide consists of a tool 7 for surgical robots or for mechanical holding systems with a fitting hole 2 , a guide pin 3 which is inserted into the fitting hole 2 , a clamping device 8 for clamping commercially available angle pieces (e.g. "dentist drill") with an adjustable depth stop 4 , The drill guide is designed so that guide pin 3 and drill are on one axis. This allows the surgeon to rotate the contra-angle so that access to the surgical area is optimal. 2. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass der Tiefenanschlag nicht vorhanden ist. 2. drill guide according to claim 1, characterized, that the depth stop is not there. 3. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass die Bohrerführung sterilisierbar ausgeführt ist. 3. drill guide according to claim 1, characterized, that the drill guide can be sterilized. 4. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass röntgendurchsichtiges Material verwendet wird, um Röntgenaufnahmen während des Eingriffs zu ermöglichen. 4. drill guide according to claim 1, characterized, that radiopaque material is used to Allow x-rays during the procedure. 5. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass Referenzmarker für Navigationssysteme daran angebracht sind. Diese Marker können passiv oder aktiv, also unter Aussendung von Strahlung, ausgeführt sein. 5. drill guide according to claim 1, characterized, that reference markers for navigation systems are attached to it. These markers can be passive or active, ie by sending Radiation. 6. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass kernspintomographietaugliches Material verwendet wird, um Kernspintomographieaufnahmen während des Eingriffs zu ermöglichen. 6. drill guide according to claim 1, characterized, that MRI-compatible material is used to Magnetic resonance imaging during the procedure too enable. 7. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass andere chirurgische Instrumente geführt werden können. 7. drill guide according to claim 1, characterized, that other surgical instruments can be used. 8. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass die Bohrerführung mechanisch fest mit einem Zahnabdrucklöffel verbunden wird. Der Zahnabdrucklöffel ist mit dem Gebiss des Patienten über die Zahnabdruckmasse verbunden. Dadurch werden Bewegung des Patienten relativ zum Bohrer verhindert. 8. drill guide according to claim 1, characterized, that the drill guide is mechanically fixed with a dental impression tray is connected. The dental impression tray is with the teeth of the Patients connected via the dental impression compound. This will Prevents patient movement relative to the drill. 9. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese aus Material besteht, das durch den Kernphotoeffekt nicht aktiviert wird, um den Einsatz in der Strahlentherapie zu ermöglichen. 9. drill guide according to claim 1, characterized, that it is made of material that is not due to the core photo effect is activated to use in radiation therapy enable. 10. Bobrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese mit optischen Markierungen versehen ist, die das Erkennen durch ein optisches Navigationssystem ermöglichen. 10. Bobrerführung according to claim 1, characterized, that this is provided with optical markings that facilitate the recognition enable by an optical navigation system. 11. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese Instrumentenhalterung mit infrarotaktiven Markierungen versehen ist, die das Erkennen durch ein optisches Navigationssystem ermöglichen. 11. drill guide according to claim 1, characterized, that this instrument holder with infrared active markings is provided, the recognition by an optical navigation system enable. 12. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese mit ultraschallaktiven Markierungen versehen ist, die das Erkennen durch ein Ultraschallnavigationssystem ermöglichen. 12. drill guide according to claim 1, characterized, that it is provided with ultrasound-active markings that the Enable recognition through an ultrasound navigation system. 13. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese mit magnetischen Markierungen versehen ist, die das Erkennen durch ein Navigationssystem ermöglichen. 13. drill guide according to claim 1, characterized, that this is provided with magnetic markings that the Enable recognition through a navigation system. 14. Bohrerführung nach Patentanspruch 1, dadurch gekennzeichnet, dass diese mit elektromagnetischen Markierungen versehen ist, die das Erkennen durch ein Navigationssystem oder Kernspintomographiesystem ermöglichen. 14. drill guide according to claim 1, characterized, that it is provided with electromagnetic markings that recognition by a navigation system or Enable magnetic resonance imaging system.
DE10148389A 2001-09-29 2001-09-29 Control method for use with surgical drills used with medical robots and navigation systems, employed in robot assisted insertion of dental implants, ensures operations follow pre-operation planning Withdrawn DE10148389A1 (en)

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Application Number Priority Date Filing Date Title
DE10148389A DE10148389A1 (en) 2001-09-29 2001-09-29 Control method for use with surgical drills used with medical robots and navigation systems, employed in robot assisted insertion of dental implants, ensures operations follow pre-operation planning

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Application Number Priority Date Filing Date Title
DE10148389A DE10148389A1 (en) 2001-09-29 2001-09-29 Control method for use with surgical drills used with medical robots and navigation systems, employed in robot assisted insertion of dental implants, ensures operations follow pre-operation planning

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DE10148389A1 true DE10148389A1 (en) 2003-04-24

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008050372A2 (en) * 2006-10-27 2008-05-02 Calabrian High Tech Srl Odonto-navi-robot for precision positioning implants in the oral cavity

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008050372A2 (en) * 2006-10-27 2008-05-02 Calabrian High Tech Srl Odonto-navi-robot for precision positioning implants in the oral cavity
WO2008050372A3 (en) * 2006-10-27 2008-06-19 Calabrian High Tech Srl Odonto-navi-robot for precision positioning implants in the oral cavity

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8141 Disposal/no request for examination
8127 New person/name/address of the applicant

Owner name: VOGELE, MICHAEL, 86830 SCHWABMUENCHEN, DE

Owner name: PRECISIS AG, 69123 HEIDELBERG, DE

Owner name: PASTYR, OTTO, 69181 LEIMEN, DE

Owner name: HASSFELD, STEFAN, 69221 DOSSENHEIM, DE

Owner name: BRIEF, JAKOB, DR., 60435 FRANKFURT, DE

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Inventor name: BOESECKE, ROBERT, DR., 69168 WIESLOCH, DE

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